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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

Amanda Marr Chung

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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Copyright Statement
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.




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