We often talk about how countries grapple with the challenge of building and maintaining a health workforce that can deliver high-quality health services. In part, it’s a problem of too few health workers or a poor mix of the right skill sets or geographic distribution. We talk less about what countries are actually doing to respond to these human resources for health (HRH) challenges and to reach the optimum level of staffing, improve the work climate, and create strong leadership and management in the health sector. I wanted to share some recent successes from Uganda, and work being supported by the Uganda Capacity Program.
In an effort to staff the health sector with managers who possess the knowledge, skills, and professional attitudes required to assume leadership roles in Uganda’s public and private health systems, the Uganda Capacity Program, together with CapacityPlus, recently launched a collaborative training program with the Uganda Ministry of Health and Makerere University School of Public Health.
The six-month leadership and management course aims to produce health managers who are equipped to lead with practical skills. Like many other developing countries, Uganda has existing standards, policies, strategic and operational plans for the health sector, but often they are not widely or purposefully implemented. Staff outside of headquarters may not be sufficiently informed to use these tools to guide their work, and, instead use a trial-and-error approach rather than a systematic one.
In preparing for the launch of the six-month course, facilitators from Uganda Capacity Program and CapacityPlus organized a two-week intensive course for 16 leaders and practitioners in the health workforce field who will be the trainers for future courses. This training of trainers sets up the partnering organizations—the Ministry of Health, Makerere University School of Public Health, Belgian Technical Cooperation, Strengthening Decentralization for Sustainability, Securing Uganda’s Rights to Essential Medicines, and the Uganda Capacity Program—to jointly implement leadership and management programs that use a standard course curriculum and materials. The success of this program will depend on the commitment of top-level Ministry of Health leadership to:
- Reinforce among senior ministry staff the importance of the leadership and management program as an important way of building stronger health systems
- Carefully select input to the program
- Apply lessons learned through the training to improve systems
- Sustain an ongoing stakeholder leadership group after the conclusion of the program.
“In the past, the HRH Action Framework has been used to help the Ministry of Health obtain a loan of $130 million—$7 million dollars of that would be allocated to the HRH component of the health sector in order to address productivity of civil servants. Bad things have become normal in the Ugandan civil service!” said Dr. Francis Runumi, the commissioner of health services in charge of planning at the Ministry of Health. “We have decided that every project coming to the Ministry of Health must have a component of leadership and management. You are few, but you will multiply. We need to have this collaboration strengthened.”
Dr. Vincent Oketcho, chief of party of Uganda Capacity Program, emphasized the need for this training program: “In Uganda, it has been observed that health workers report to duty late and leave early. They lack a good working environment and supervision. The difference between the public and private sector organizations lies in the area of leadership and management; we need to put things right.”
Building on this innovative training approach, the Uganda Capacity Program will identify other effective human resources for health managers who can also serve as mentors. At the district level, the training program will also include health workers and managers from the public and private sectors. The core team of trainers together with facilitators from Makerere University School of Public Health and the Ministry of Health will take the lead in coaching and supporting trainees through work site visits. This program will be financially and technically supported by Uganda Capacity Program.