International Journal of Health Policy and Management

International Journal of Health Policy and Management

Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique

Document Type : Original Article

Authors
Laura J. Edwards 1
Abú Moisés 2
Mathias Nzaramba 2
Aboobacar Cassimo 2
Laura Silva 2
Joaquim Mauricio 2
C. William Wester 3
Sten H. Vermund 4
Troy D. Moon 4
1 Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA
2 Friends in Global Health, Maputo, Mozambique
3 Vanderbilt Institute for Global Health, Department of Medicine, Division of Infectious Diseases, Vanderbilt University, Nashville, TN, USA
4 Vanderbilt Institute for Global Health, Department of Pediatrics, Division of Infectious Diseases, Vanderbilt University, Nashville, TN, USA
10.15171/ijhpm.2015.58
Abstract
Background
Avante Zambéziais an initiative of a Non-Governmental Organization (NGO), Friends in Global Health, LLC (FGH) and the Vanderbilt Institute for Global Health (VIGH) to provide technical assistance to the Mozambican Ministry of Health (MoH) in rural Zambézia Province. Avante Zambézia developed a district level Health Management Mentorship (HMM) program to strengthen health systems in ten of Zambézia’s 17 districts. Our objective was to preliminarily analyze changes in four domains of health system capacity after the HMM’s first year: accounting, Human Resources (HRs), Monitoring and Evaluation (M&E), and transportation management.
 
Methods
Quantitative metrics were developed in each domain. During district visits for weeklong, on-site mentoring, the health management mentoring teams documented each indicator as a success ratio percentage. We analyzed data using linear regressions of each indicator’s mean success ratio across all districts submitting a report over time.
 
Results
Of the four domains, district performance in the accounting domain was the strongest and most sustained. Linear regressions of mean monthly compliance for HR objectives indicated improvement in three of six mean success ratios. The M&E capacity domain showed the least overall improvement. The one indicator analyzed for transportation management suggested progress.
 
Conclusion
Our outcome evaluation demonstrates improvement in health system performance during a HMM initiative. Evaluating which elements of our mentoring program are succeeding in strengthening district level health systems is vital in preparing to transition fiscal and managerial responsibility to local authorities.

Highlights

Commentaries Published on this Paper

  • Seriously Implementing Health Capacity Strengthening Programs in Africa; Comment on “Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique”

            Abstract | PDF

  • 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”

            Abstract | PDF

 

Authors’ Response to the Commentaries

  • Health Management Mentoring for Health Systems Strengthening: A Response to Recent Commentaries

            Abstract | PDF

Keywords
Health Systems Strengthening
Health Management
Mentoring
HIV Care Programs
Mozambique
Monitoring and Evaluation (M&E)
Transportation
Accounting
Human Resources (HRs)
Healthcare Workforce
Subjects
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  • Received Date 15 August 2014
  • Revised Date 12 March 2015
  • Accepted Date 06 March 2015
  • First Published Date 01 June 2015
  • Published Date 01 June 2015