1. The Need for Management Capacity Building in African Systems Presented at the XVII International AIDS Conference 3 rd to 8 th August 2008, Mexico City, MEXICO By Dr. Peter M. Ngatia Directorate of Learning Systems AMREF, Nairobi

2. 2 Africa’s disease burden ●Africa which bears more illness (25% of the disease burden) and fewer health workers (only 2% resources) needs good leadership to maximise on the meagre resources.

3. 3 More Illness and Fewer Health Workers in Africa Africa’s share of world’s health workers

4. 4 Increased Resource Envelope for Health Interventions ●Health care in Africa has become a multi-billion dollar endeavour. Those charged with leading and managing health systems have little or no formal preparation in management.

5. 5 Why Leadership and Management ●The quality of leaders and managers is a vital element for the effective delivery of Basic Health Care Packages and attainment of the Millennium Development Goals (MDGs) in Africa. Poor management of health systems and services are a major obstacle to scaling up service delivery.

6. 6 Purpose of Management Capacity Building ●The overall purpose of management capacity building is to increase the ability of the African Health Systems to meet their obligations (provide services – preventive, promotive, curative, etc) to the African people.

7. 7 Leadership & Management Framework But skills alone are not sufficient. African health systems need to urgently address the following issues, not singly but in combination: –sufficient managers, with the necessary competencies and well functioning management and support systems; –appropriate rules and regulations and policy guidelines; incentive and rewards; drugs and medical supplies, logistics and communication; –an enabling environment – those internal and external factors (constraints/opportunities) that promote or hinder or enable the manager to function effectively.

8. 8 Leadership and Management Framework (contd)

9. 9 What Skill Sets and Competencies? Leadership and management training is needed for: - planning, implementation of health services; - managing resources, human resources for health, budgets, drugs and supplies, equipment, information, buildings, etc. - management of external relations and partners, including service consumers. -policy formulation and implementation -Resource mobilisation * This list was confirmed in an unpublished assessment done by AMREF, and WHO in Liberia in May 2008.

10. 10 Leadership & Management for Who? ●Skills in leadership and management are required at all levels of the health systems in Africa; National, Regional, district and county, and community levels. Hospitals, clinics, dispensaries, programmes e.g. HIV/AIDS, malaria, family planning, etc.

11. 11 What is happening? The need for management has been recognised and several initiatives are happening across the continent. e.g. -The UCLA/AMREF/Johnson & Johnson Management Development Institute Programme for programme leaders of HIV/AIDS -The AMREF Strategic Leadership Training for Health Managers -The Clinton Foundation has funded management development in Liberia - Incorporation of management training in basic training curricula.

12. 12 What is happening? (contd) ●Management NETWORK for strengthening Health Sector Management and Leadership in Africa is in its formative stage. Its overall objective is to improve coverage and quality of health services in Africa by strengthening management and leadership.

13. 13 The AMREF International Training Centre ●AIM “To develop practical training of highest quality in leadership and management The courses offered include: -Strategic Management & Leadership -Health Services Management -Management Development for HIV/AIDS Service Providers -Health Systems Research -Monitoring & Evaluation AMREF’s Interventions

14. 14 Proposed Framework for Leadership & Management Training Pool of Eligibles Universities Community Health Worker Training Quality Health Care BETTER HEALTH Selection Licensing Emigration Attrition Mid Level Health Training Certification CPD Health Workforce At work

15. 15 Conclusion ●“ The ability of health systems to deliver the Basic Health Care Packages (BHCP) for the respective African populations will depend on knowledge, attitudes and skills (competencies) of the health workers in Management and Leadership” Dr. Peter Ngatia, Director for Capacity Building, AMREF.

16. 16 Gracias! Asante Sana!