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Leadership and HR Systems Strengthening: The Nicaragua experience Elena Décima, LMS Program, MSH April 2004 World Health

Leadership and HR Systems Strengthening: The Nicaragua experience Elena Décima, LMS Program, MSH April 2004 World Health Conference. INTRODUCTION.

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Leadership and HR Systems Strengthening: The Nicaragua experience Elena Décima, LMS Program, MSH April 2004 World Health

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  1. Leadership and HR Systems Strengthening:The Nicaragua experienceElena Décima, LMS Program, MSHApril 2004World Health Conference

  2. INTRODUCTION This presentation will focus on the work MSH is and has been doing in Nicaragua, where leadership has been used as the key to address many of the challenges faced by the health sector, using a systems approach.

  3. Three elements of HR strengthening • The HRH Framework • The Systems Approach • The Leadership Model

  4. Systemsapproach .

  5. HRH Technical Framework

  6. Leading and Managing Results model

  7. Methodology Dialogue Challenge Competencies Leadership dialogue. Participants (Minister and high level Directors) identify a challenge and leadership competencies To arrive to a Health Care Model which would integrate well with the Strategic Plan. The competencies selected were Change Management, Systemic Thought, Communication and Negotiation THE CHALLENGE MODEL: stage I

  8. Dialogue Challenge Competencies Participants (representatives of all the areas of the ministry) identified a second challenge and leadership competencies To produce a proposal for restructuring/ modernizing the Ministry of Health. The competencies selected were systemic thought, negotiation, change management and some technical competencies (results-based budgeting, critical path design, etc.) THE CHALLENGE MODEL: stage II

  9. RESTRUCTURING of the MOH • Mission and vision reviewed • Systems identified • Processes of each system (with their procedures, activities, norms) defined • Human resources identified (staff needed, job descriptions and profiles, work loads) • Manuals produced for each system • Critical paths identified • Implementation plan drawn

  10. NICARAGUAN PROGRAM RESULTS 1. Human resources management • A redesigned Human Resource System at central level • Staff concerns and issues heard: staff surveys of personnel conducted • Needed human resources identified, new jobs created, job descriptions and profile defined, union negotiations conducted. 2. Policy • New Health Care Model approved - New health policies • Chapter 9 of Law 290 revised to approve the restructuring of the MOH

  11. NICARAGUAN PROGRAM RESULTS 3. Finance - Results-based budgets and planning, which are expected to promote a more fair evaluation of staff performance - Beginning to work with Ministry of Finance on results-based budgeting and planning, which if approved would become a national policy 4. Education - Entrust the HR Division with human capacity development in coordination with the training institutions - Insure that this HR development responds in quantity and quality to the needs of the health sector

  12. NICARAGUAN PROGRAM RESULTS 5. Leadership - Leadership competencies have been developed - Three Leadership programs have been conducted with MOH personnel, one at the municipal level and the other two associated with the challenges here described.

  13. LESSONS LEARNED • Systemic changes are “non-linear”, slow processes and at times results are scarcely visible. • Communication at all levels and at every step is very important • Labor unions and labor conflicts are a hurdle and have an impact • Technical assistance must be present at both the operational and policy levels • The participatory nature of the process is a key to the success of the program; counterpart ownership is indispensable • Donor collaboration benefits the program

  14. Closing the gap between what is known about public health problems and what is done to solve them

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