Building Healthcare Leadership in Africa: A Call to Action

Building Healthcare Leadership in Africa: A Call to Action

Building Health Leadership in AfricaA Call to Action • Individual Leadership • Institutional Leadership • Network Leadership

Individual LeadershipSustained Commitment to Developing Health Leaders in Africa • Health leaders and managers in Africa are facing an ever-growing responsibility to expand their leadership roles • Research shows that health leadership and management skills are desperately neededwithin all levelsof responsibility. • Practices within emerging successful models in Africa and around the globe are provoking more relevant prioritized leadership development programs and processes. • Growing agreement that part of what is needed among leaders is an enhanced sense of professionalism – a deliberate commitment to passing one’s knowledge to the next generation.

Individual LeadershipSustained Commitment to Developing Health Leaders in Africa Inhibitors to Building Leadership Capacity • Lack of adequate preparation for expanded health leadership roles • Workforce deficiencies and competing resource challenges • Existing paradigms do not empower leaders to innovate • Lack of commitment to mentorship and the intentional development of leadership/management skills • Current leadership training is often fragmented and too theoretical • Mistrust of power still exists • Critical skills are rarely taught—i.e. communication, financing, collaboration, persuasion, project management, business development, fundraising, and advocacy • Evidence and success stories are not used nor accessible to influence those with authority to change the status quo. • Inadequate leadership development systems and poorly functioning processes negatively impact human resources • Enabling a pool of talented individuals at all leadership and management levels is often not a priority

Individual LeadershipSustained Commitment to Developing Health Leaders in Africa Core Leadership Attributes Visionary—provides context and alignment Develops their teams—coaches and empowers Authentic and Trustworthy Displays humility, empathy & care Takes leadership personally Appreciates others viewpoints Decisive Results-focused Takes Risks Priority setting masters Delivers on promises Communicates across the organizational ‘ecosystem’ Ability Ability Aspiration Aspiration Engagement

Individual LeadershipSustained Commitment to Developing Health Leaders in Africa Leadership Development Programs--Design Principles • Develop a leadership competency model that aligns leaders with strategy and core values • Integrate with talent management framework • Grow leaders through deployment, targeted learning, and relationship-building • Constructively differentiate your emerging leaders • Engage senior executives and hold them accountable • Create transparency through a formal process • Measure results systematically • Source: The Darden School of Business at the University of Virginia

Individual LeadershipSustained Commitment to Developing Health Leaders in Africa Building the Next Generation Building a leaders developing leaders culture* Developing other leaders is an important part of every leader’s job—they devote at least 20% of their time. Leaders who identify and develop other leaders are rewarded and recognized for it. Managers regularly coach leaders on top 1-2 critical improvement areas. Leaders pool their insights to inform a leader’s development and next move. Most promising leaders often get assignments that are greatly more challenging and outside of their expertise. Talent assessments are precise, balanced and complete—and separated from annual performance appraisals. Leadership development process is as consistent and rigorous as other core business items and processes. Organization ensures leaders at all levels develop other leaders and plan their succession. “Coaching provided by a leader’s direct manager is one of the top drivers of building leader capacity, outpacing even the most heavily used leadership development approaches.” Learning & Development Roundtable 2006 Sr. Leadership Survey • How do leaders/managers do that today? • “Kick off” or “close” programs • Co-teach with outside faculty • Tell personal stories of people and events that have shaped them • Share new business processes and best innovative practices regularly *Adapted from Leaders at all Levels—Ram Charan, 2008

Institutional LeadershipOpportunities for Academic Medical Centers to Lead and Influence in Africa Two Ways in which an Institution can Lead… • Institutions can impact health leadership by creating an enabling environmentfor its development • Academic medical institutions are the factories that produce Africa’s health workforce, and lead in part byincreasing workforce capacityby training medical officers, nurses and others, and by assisting other training institutions to improve the relevance and quality of their training • Academic institutions also lead by: • Conducting health researchin areas of national and regional priority, and developing individuals capable of initiating and executing research in Africa • Strengthening national and regional capacity for public health program innovation, leadership, management, and evaluation • Developing and testing new models of servicethat are suitable for application in resource constrained settings. …By Producing Leaders …By Influencing its environment

Institutional LeadershipOpportunities for Academic Medical Centers to Lead and Influence in Africa “An academic medical institution is built on three pillars of scholarship— discovery of knowledge, teaching and learning, and the integration and application of knowledge.” • From the pillars of academic scholarship stem distinct opportunities to lead: • Making Mentorship a Mandate • Leading African Research for Better Health • Influencing Policy and Practice

Institutional LeadershipOpportunities for Academic Medical Centers to Lead and Influence in Africa • Making Mentorship a Mandate • An institution’s role in leadership development starts with ensuring the personal and professional growth of its individual members • supporting all members of the faculty and staff to become technical and thought leaders within their fields and areas of expertise • insisting that faculty members participate in meaningful and useful ongoing professional development opportunities • striving for constant improvements in the ways that students and trainees are taught and learn • “Above all, a culture must be created in which mentorship is a mandate.” • To be successful, mentorship programs must: • Identify potential leaders early in their training • Include formal components designed to transfer basic knowledge and latest technical content • Incorporate novel components to instill leadership qualities in the best and brightest • Insist that all faculty members participate

Institutional LeadershipOpportunities for Academic Medical Centers to Lead and Influence in Africa • The most important factor in determining an institution’s ability to lead in health research is the development and retention of African researchers • African academics and researchers are in the best position to identify what is needed to strengthen their own health systems • Innovative models exist, at Makerere University and elsewhere, for effective development of research leadership Leading African Research for Better Health • “The development of attractive career pathways is key to bringing research • in sub-Saharan Africa to international standards of excellence.” • Successful leadership development programs will be guided by these principles: • African academics and researchers are in the best position to identify what is needed to strengthen their own academic institutions • Training should include innovative training components both at home and abroad • Conducive incentive structures must be implemented to encourage partners to send faculty for assignments of varying duration to their counterparts in developing nations • Long-term support is critical: research centers grow organically over time and attractive career paths require years of visibility

Institutional LeadershipOpportunities for Academic Medical Centers to Lead and Influence in Africa • Influencing Policy and Practice • Obstacles to the successful application of knowledge • Funds for trials in clinics or the field • Regulatory hurdles, governance challenges • Long-standing and ingrained clinical behavior • Leading institutions must reinforce relationships with their key stakeholders to increase their influence across disciplines or sectors, other organizations and the public. • Ensure new research is relevant • Accompany implementation with evaluation • “The unfortunate reality is that, often, successful strategies to improve African’s health • never make it out of the classroom or laboratory and into clinical practice.” • Opportunities to strengthen the operational link between academia and policymakers include • Offering short courses for Ministry staff • Seconding faculty to local Ministry of Health agencies • Using the Health Ministry and other health partner institutions as field placements for university undergraduate and graduate students • Integrating senior Ministry personnel into university faculty • Conducting joint research projects

Network LeadershipA Value Proposition for Building Effective Health Networks in Africa • Networks among leading individuals and institutions in global health are generally created in pursuit of one or more of the following objectives: • Enhanced output of the collective system through the pooling of resources and knowledge • Cost or time efficiencies achieved through allocation of shared services and expenses • Expanded geographical reach through organizational collaboration across continents • Improved dissemination of key ideas and technologies among a diverse audience • Examples of existing health networks are plentiful and diverse

Network LeadershipA Value Proposition for Building Effective Health Networks in Africa • Health networks enable and optimize individual and institutional leadership • Successful networks achieve their various aims through one or more of the following value propositions • Reducing redundanciesby creating pooled access to particular services, such as financial services or regulatory approvals • Sharing knowledge and other resourcesbetween individual members, to gain the potential of a more diverse institution • Preserving incentive for innovationby maintaining a solid identity and ownership of research, while pooling resources and information from a variety of sources. • Retaining health leadershipby offering more advanced professional setting with attractive research potential, different working conditions, or greater remuneration • Promoting diversityby facilitating the exchange of students, faculty, and staff among institutions • “Beyond the aggregate size and scale of a collective effort, • a network creates an optimized ability to achieve”

Network LeadershipA Value Proposition for Building Effective Health Networks in Africa • There are several potential pitfalls to “over-networking”: • Diminishing returns on investment of time and resources • National neglect of other local initiatives • System dependency leading to national deficiencies • Power inequity between strong and weaker partners • “When networks prevent partners in the South from acquiring key competencies that they would otherwise be forced to develop, the independence of those institutions is compromised, the benefit to local health systems is limited, and the network suffers in the long run.”

Network LeadershipA Value Proposition for Building Effective Health Networks in Africa • Five of the most commonly cited directives for effective collaboration in a network: • Empower leadership at the most senior level– identify champions who will dedicate their time and energy to move the network from concept to function, agree on goals and strategy, empower decision makers • Choose membership carefully, to optimize capabilities through complementary relative advantages and strengths • Plan for capacity buildingin ways that promote distinct and complementary areas of expertise among partners in the South • Set clear objectivestogether, and monitor and evaluate progress • Build mutual trustby sharing information and responsibility with unwavering transparency and goodwill, and with equitable roles within the network • “A successful network produces greater leadership potential than the sum of its members.”

Conclusion • Three leadership dimensions offer a framework for strengthening health leadership • Compelling argument for focus and investment—public and private sector • Leverage existing examples and determine what works in Africa • Build individual and team skills through other leaders—critical to achieve sustainable results • Leadership/Management Development—a core institutional imperative • Academic Medical Centers are key—mentor, researcher, influencer • Networks optimize and scale individual and institutional leadership • Call to action starts with individual commitment to change the status quo • “A successful network produces greater leadership potential than the sum of its members.”

Building Healthcare Leadership in Africa: A Call to Action