Amanda Marr Chung
Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016-2018
Chung, Amanda Marr; Case, Peter; Gosling, Jonathan; Gosling, Roland; Madinga, Munashe; Chikodzore, Rudo; Hove, Macdonald; Viljoen, Greyling; Chitapi, Precious; Gumbi, Matsiliso; Mnguni, Peliwe; Murungu, Joseph; Dube, Busisani; Dhliwayo, Patience; Mberikunashe, Joseph
Authors
Professor Peter Case Peter.Case@uwe.ac.uk
Professor of Organization Studies
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
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.
Citation
Chung, A. M., Case, P., Gosling, J., Gosling, R., Madinga, M., Chikodzore, R., …Mberikunashe, J. (2020). Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016-2018. Malaria Journal, 19, Article 185. https://doi.org/10.1186/s12936-020-03255-z
Journal Article Type | Article |
---|---|
Acceptance Date | May 8, 2020 |
Online Publication Date | May 20, 2020 |
Publication Date | May 20, 2020 |
Deposit Date | May 27, 2020 |
Publicly Available Date | Mar 28, 2024 |
Journal | Malaria journal |
Electronic ISSN | 1475-2875 |
Publisher | BioMed Central |
Peer Reviewed | Peer Reviewed |
Volume | 19 |
Article Number | 185 |
DOI | https://doi.org/10.1186/s12936-020-03255-z |
Keywords | Programme management, challenges, leadership, malaria elimination, capacity building, Zimbabwe, service delivery, operations |
Public URL | https://uwe-repository.worktribe.com/output/5973158 |
Publisher URL | https://malariajournal.biomedcentral.com/articles/10.1186/s12936-020-03255-z |
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