Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016–2018
Abstract Background Focus for improved malaria programme performance is often placed on the technical challenges, while operational issues are neglected. Many of the operational challenges that inhibit malaria programme effectiveness can be addressed by improving communication and coordination, incr...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12936-020-03255-z |
| _version_ | 1818257284775542784 |
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| author | Amanda Marr Chung Peter Case Jonathan Gosling Roland Gosling Munashe Madinga Rudo Chikodzore Macdonald Hove Greyling Viljoen Precious Chitapi Matsiliso Gumbi Peliwe Mnguni Joseph Murungu Busisani Dube Patience Dhliwayo Joseph Mberikunashe |
| author_facet | Amanda Marr Chung Peter Case Jonathan Gosling Roland Gosling Munashe Madinga Rudo Chikodzore Macdonald Hove Greyling Viljoen Precious Chitapi Matsiliso Gumbi Peliwe Mnguni Joseph Murungu Busisani Dube Patience Dhliwayo Joseph Mberikunashe |
| author_sort | Amanda Marr Chung |
| collection | DOAJ |
| description | Abstract Background Focus for improved malaria programme performance is often placed on the technical challenges, while operational issues are neglected. Many of the operational challenges that inhibit malaria programme effectiveness can be addressed by improving communication and coordination, increasing accountability, maintaining motivation, providing adequate training and supervision, and removing bureaucratic silos. Methods A programme of work was piloted in Zimbabwe with one malaria eliminating province, Matabeleland South in 2016–2017, and scaled up to include two other provinces, Matabeleland North and Midlands, in 2017–2018. The intervention included participatory, organization development and quality improvement methods. Results Workshop participants in Matabeleland South reported an improvement in data management. In Matabeleland North, motivation among nurses improved as they gained confidence in case management from training, and overall staff morale improved. There was also an improvement in data quality and data sharing. In Midlands, the poorly performing district was motivated to improve, and both participating districts became more goal-oriented. They also became more focused on monitoring their data regularly. Participants from all provinces reported having gained skills in listening, communicating, facilitating discussions, and making presentations. Participation in the intervention changed the mindset of malaria programme staff, increasing ownership and accountability, and empowering them to identify and solve problems, make decisions, and act within their sphere of influence, elevating challenges when appropriate. Conclusions This pilot demonstrates that a participatory, organization development and quality improvement approach has broad ranging effects, including improving local delivery of interventions, tailoring strategies to target specific populations, finding efficiencies in the system that could not be found using the traditional top-down approach, and improving motivation and communication between different cadres of health workers. Scale-up of this simple model can be achieved and benefits sustained over time if the process is imbedded into the programme with the training of health staff who can serve as management improvement coaches. Methods to improve operational performance that are scalable at the district level are urgently needed: this approach is a possible tactic that can significantly contribute to the achievement of global malaria eradication goals. |
| first_indexed | 2024-12-12T17:41:13Z |
| format | Article |
| id | doaj.art-bc03464959164a728baeb38eb1f29852 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-12T17:41:13Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-bc03464959164a728baeb38eb1f298522022-12-22T00:17:05ZengBMCMalaria Journal1475-28752020-05-0119111410.1186/s12936-020-03255-zScaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016–2018Amanda Marr Chung0Peter Case1Jonathan Gosling2Roland Gosling3Munashe Madinga4Rudo Chikodzore5Macdonald Hove6Greyling Viljoen7Precious Chitapi8Matsiliso Gumbi9Peliwe Mnguni10Joseph Murungu11Busisani Dube12Patience Dhliwayo13Joseph Mberikunashe14Malaria Elimination Initiative, Global Health Group, Institute of Global Health Sciences, University of CaliforniaBristol Business School, University of West of EnglandBusiness School, University of ExeterMalaria Elimination Initiative, Global Health Group, Institute of Global Health Sciences, University of CaliforniaClinton Health Access InitiativeMinistry of Health and Child CareMinistry of Health and Child CareIndependent ConsultantIndependent ConsultantIndependent ConsultantUniversity of South AfricaHEALTHQUAL, University of CaliforniaMinistry of Health and Child CareMinistry of Health and Child CareMinistry of Health and Child CareAbstract Background Focus for improved malaria programme performance is often placed on the technical challenges, while operational issues are neglected. Many of the operational challenges that inhibit malaria programme effectiveness can be addressed by improving communication and coordination, increasing accountability, maintaining motivation, providing adequate training and supervision, and removing bureaucratic silos. Methods A programme of work was piloted in Zimbabwe with one malaria eliminating province, Matabeleland South in 2016–2017, and scaled up to include two other provinces, Matabeleland North and Midlands, in 2017–2018. The intervention included participatory, organization development and quality improvement methods. Results Workshop participants in Matabeleland South reported an improvement in data management. In Matabeleland North, motivation among nurses improved as they gained confidence in case management from training, and overall staff morale improved. There was also an improvement in data quality and data sharing. In Midlands, the poorly performing district was motivated to improve, and both participating districts became more goal-oriented. They also became more focused on monitoring their data regularly. Participants from all provinces reported having gained skills in listening, communicating, facilitating discussions, and making presentations. Participation in the intervention changed the mindset of malaria programme staff, increasing ownership and accountability, and empowering them to identify and solve problems, make decisions, and act within their sphere of influence, elevating challenges when appropriate. Conclusions This pilot demonstrates that a participatory, organization development and quality improvement approach has broad ranging effects, including improving local delivery of interventions, tailoring strategies to target specific populations, finding efficiencies in the system that could not be found using the traditional top-down approach, and improving motivation and communication between different cadres of health workers. Scale-up of this simple model can be achieved and benefits sustained over time if the process is imbedded into the programme with the training of health staff who can serve as management improvement coaches. Methods to improve operational performance that are scalable at the district level are urgently needed: this approach is a possible tactic that can significantly contribute to the achievement of global malaria eradication goals.http://link.springer.com/article/10.1186/s12936-020-03255-zProgramme managementChallengesLeadershipMalaria eliminationCapacity buildingZimbabwe |
| spellingShingle | Amanda Marr Chung Peter Case Jonathan Gosling Roland Gosling Munashe Madinga Rudo Chikodzore Macdonald Hove Greyling Viljoen Precious Chitapi Matsiliso Gumbi Peliwe Mnguni Joseph Murungu Busisani Dube Patience Dhliwayo Joseph Mberikunashe Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016–2018 Malaria Journal Programme management Challenges Leadership Malaria elimination Capacity building Zimbabwe |
| title | Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016–2018 |
| title_full | Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016–2018 |
| title_fullStr | Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016–2018 |
| title_full_unstemmed | Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016–2018 |
| title_short | Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016–2018 |
| title_sort | scaling up malaria elimination management and leadership a pilot in three provinces in zimbabwe 2016 2018 |
| topic | Programme management Challenges Leadership Malaria elimination Capacity building Zimbabwe |
| url | http://link.springer.com/article/10.1186/s12936-020-03255-z |
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