Training for Better Management: Avante Zambézia, PEPFAR and Improving the Quality of Administrative Services; Comment on “Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique”

Document Type: Commentary

Authors

1 Global Health Sciences and Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

2 The San Francisco Department of Public Health, San Francisco, CA, USA

Abstract

The United States President’s Emergency Plan for AIDS Relief (PEPFAR) emphasizes health systems strengthening as a cornerstone of programmatic success. Health systems strengthening, among other things, includes effective capacity building for clinical care, administrative management and public health practice. Avante Zambéziais a district-level in-service training program for administrative staff. It is associated with improved accounting practices and human resources and transportation management but not monitoring and evaluation. We discuss other examples of successful administrative training programs that vary in the proportion of time that is spent learning on the job and the proportion of time spent in classrooms. We suggest that these programs be more rigorously evaluated so that lessons learned can be generalized to other countries and regions.

Keywords

Main Subjects


  1. The Office of the U.S. Global AIDS Coordinator US Department of State. PEPFAR 3.0: Controlling the Epidemic: Delivering on the Promise of an AIDS-free Generation, 2014. Available at: http://www.pepfar.gov/documents/organization/234744.pdf.
  2. Edwards LJ, Moises A, Nzaramba M, et al. Implementation of a health management mentoring program: year-1 evaluation of its impact on health system strengthening in Zambézia province, Mozambique. Int J Health Policy Manag. 2015;4(6):353-361. doi:10.15171/ijhpm.2015.58
  3. IJsselmuiden CB, Nchinda TC, Tumwesigye NM, Serwadda D. Mapping Africa’s advanced public health education capacity: the AfriHealth project. Bull World Health Organ. 2007;85(12):914-922. doi:10.2471/blt.07.045526
  4. Ncayiyana D. Doctor migration is a universal phenomenon. S Afr Med J. 1999; 89:1107.
  5. Bradley E, hartwig KA, Rowe LA, et al. Hospital quality improvement in Ethiopia: a partnership-mentoring model. Int J Qual Health Care. 2008;20:392-399. doi:10.1093/intqhc/mzn042
  6. Matovu JK, Wanyenze RK, Mawemuko S, et al. Building capacity for HIV/AIDS program leadership and management in Uganda through mentored Fellowships. Glob Health Action. 2011;4:5815. doi:10.3402/gha.v4i0.5815
  7. Matovu JK, Wwanyenze RK, Mawemuko S, Okui O, Bazeyo W, Serwadda D. Strengthening health workforce capacity through work-based training. BMC Int Health Hum Rights. 2013;13:8. doi:10.1186/1472-698x-13-8
  8. US Centers for Disease Control and Prevention (CDC). Field Epidemiology Training Program (FETP). Centers for Disease Control and Prevention—Global Health. http://www.cdc.gov/globalhealth/fetp.
  9. US Centers for Disease Control and Prevention (CDC). Field Epidemiology Training Program Standard Core Curriculum.  http://www.cdc.gov/globalhealth/fetp/pdf/FETP_standard_core_curriculum_508.pdf
  10. US Centers for Disease Control and Prevention and Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET). Multisite Evaluation of Field Epidemiology Training Programs Findings and Recommendations. http://www.cdc.gov/globalhealth/fetp/pdf/fetp_evaluation_report_may_2014.pdf. Published May 2014. 
  11. Kebede S, Abebe Y, Wolde M, Bekele B, Mantopoulos J, Bradley E. Educating leaders in hospital management: a new model in sub-Saharan Africa. Int J Qual Health Care. 2010;22:39-43. doi:10.1093/intqhc/mzp051
  12. Mpofu M, Semo BW, Grignon J, et al. Strengthening monitoring and evaluation (M&E) and building sustainable health information systems in resource limited countries: lessons learned from and M&E task-shifting initiative in Botswana. BMC Public Health. 2014;14:1032. doi:10.1093/intqhc/mzp051