FPHSM presentation_Christine Tashobya


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Christine Tashobya (PhD student) presents the Fellowship Programme in Health System Management (FPHSM) geared towards providing on the spot specific training in Health District Management for district executive officers. The FPHSM aims to contribute to strengthening of health systems by improving the management capacity and leadership skills of health professionals at middle to senior levels.

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  • Objective of the Presentation: Sharing experiences of the development and early implementation of an innovative programme in capacity building Authors – MoH, MakSPH and ITM Antwerp Some are here – and can respond to questions and comments
  • Although this presentation is focusing on Uganda researchers and policy makers have indicated gaps in health systems management in other L/MICs including in AfricaAdindu A 2013
  • Not discussed today because out of the scope of the presentation.
  • FPHSM presentation_Christine Tashobya

    1. 1. The Fellowship Programme in Health Systems Management (FPHSM) Tashobya CK, VC da Silveira, Orach CG, Nabiwemba E, Mangwi RA, Criel B Ministry of Health & Makerere School of Public Health, Uganda Institute of Tropical Medicine, Antwerp, Belgium Regional Conference on “Health District in Africa: Progress and Prospects 25 years after the Harare Declaration” Dakar, 21-23 October, 2013
    2. 2. FPHSM RATIONALE  Gaps identified in management & leadership skills and competencies (MoH supervisions, annual & mid-term reports; bilateral & multilateral partner reports)  Health systems managers have received Masters training in various institutions with differing emphasis on management  Health systems in low income countries face major challenges that require particular competencies - (Adindu A, 2013) 2
    3. 3. FPHSM RATIONALE  Frequent demand from alumni (Makerere and Institute of Tropical Medicine) for continuing training after Masters in Public Health  Limited appreciation by many stakeholders of health systems management as a specialty within Public Health  Specialization in clinical sciences more recognized  District health managers feel isolated, unrecognized, with unclear career path – yet have a very important contribution for the health system given decentralization 3
    4. 4. FPHSM PHILOSOPHY Introduce an innovative approach to health worker professional development in the work environment, leading to acquisition of advanced health systems management competencies with minimum disruption from their duties, while providing an advanced qualification and professional satisfaction 4
    5. 5. FPHSM GOAL To contribute to strengthening of health systems by improving the management capacity and leadership skills of health professionals at middle to senior levels 5
    6. 6. FPHSM DESIGN _ PROCESS  Needs Assessment Key Informant Interviews  Stakeholders Meetings   Learnt From Makerere School of Public Health HIV/AIDS Fellowship  East & Central Africa Surgeons Fellowship  MoH Uganda health sub-district managers training  Institute of Public Health Bangalore, district mangers training programme  6
    7. 7. FPHSM DESIGN - PARTNER INSTITUTIONS Memorandum of Understanding signed between  Ministry of Health: sector steward, beneficiary, awarding entity  Makerere University School of Public Health: implementer, coordinator  Uganda Public Health Specialists Association: recognition, professional dignity  Institute of Tropical Medicine, Antwerp: technical, financial support 7
    8. 8. FPHSM GUIDING PRINCIPLES  Professional & action-oriented training  In-depth focus on health systems  Commitment to work-based teaching & training  Mentoring & peer-support  Involvement of stakeholders to promote good quality public health training  Empowerment of health managers 8
    10. 10. FPHSM PROGRAMME DESIGN Mix of theory (20%) & work-based capacity building supported by mentoring (80%)  2-year programme  1 week face-to-face session, each quarter  Mentoring at work station by “central” & “local” mentors  Work-based learning including an Individual Field Assignment 10
    11. 11. CORE COURSES      CC1 Concepts in health systems CC2 Strategic leadership and management CC3 Human resources management CC4 Decision making in public health CC5 Health financing and financial management  CC6 Management of health supplies, logistics and infrastructure  CC7 Quality assurance and supportive supervision  CC8 Professionalism, legal and regulatory framework  CC9 Performance assessment, monitoring and evaluation FPHSM COURSES 11
    12. 12. FPHSM ELECTIVE COURSES  EC1 Economic evaluation  EC2 Health systems research methods  EC3 Project planning and management  EC4 Professional and scientific communication 12
    13. 13. FPHSM WORK-BASED COMPONENT  Any activity carried out at the duty station or other work environment, which is structured or intended for learning purposes and/or the acquisition of competencies  An individual field assignment following the steps of experiential learning and action research, introducing a new/adjusted activity in the work place; documentation of whole process; 13
    15. 15. FPHSM ADMISSION REQUIREMENTS  Masters in Public Health or equivalent  At least 3 years post-master working experience in a management position  Currently employed in a management position in the health sector (public, private for profit, private notfor-profit, aid agencies; preference for district-based managers)  Recommendation by current employer with indication of institutional support for training  Commitment and engagement as a public health professional 15
    16. 16. FPHSM FIRST INTAKE PROFILE  8 participants  Education: all with a Master Degree in Public Health from different Schools (Uganda, Israel, Kenya, Finland)  Profession/Gender: 7 medical doctors, male; and 1 social scientist, female  Average age: 42 years (range from 33 to 52 years)  Function: 4 District Health Officers, 1 Municipal Health Officer, 1 MoH Programme Officer, 2 NGO Programme Officers  Length of experience: varying from 6 to 20 years 16
    17. 17. CHOICE OF MENTORS  Role model   Commitment & engagement with Uganda heath sector Known, respected within the public health sector  Health systems management experience  Effort was made to match central / local / fellow (experience, personalities, temperament, …)  From Ministry of Health, Donor Agencies, Public and Non governmental Organisations; Senior District Health Officers 17
    18. 18. FPHSM PROGRESS TO DATE   5 face-to-face sessions organised 4 Discussion Panels:      Attraction and retention of human resources for health in ruaral Uganda health financing for universal health coverage in Uganda Access to essential medicines in Uganda Health system performance assessment - the Uganda District League Table 3 Mentors, Facilitators and Coordination Team Meetings: on mentoring methodology, progress of participants, assessment of their practice, evaluation 18
    19. 19. FPHSM EVALUATION Research Goals To explore whether the FPHSM works, why, for whom, and in which conditions To achieve this goal, we will explore:  what participants learned  if participants are using what they learned  if they are being able to transfer their training  if any institutional performance improvement resulted from the training Theory-driven evaluation methodology 19
    20. 20. OBSERVATIONS/LESSONS LEARNT  Positive, participatory and open atmosphere  100% turn up of participants during the 5 face-to-face sessions  Fellows enthusiastic & happy with training approach used – a few adjustments proposed & made  Seminars and work on Assignment positive challenge for participants encouraging critical thinking and application of taught concepts  The participants are busy people – committing time on on-going basis for reading and documentation not easy 20
    21. 21. OBSERVATIONS/LESSONS LEARNT  Mentors motivated and engaged  Forum to meet and discuss various issues of health systems and mentoring, and receive updates on theoretical concepts = “a club of old friends”;  Major difficulty is time availability for mentoring in the field  Pairing local and central mentors to cope with challenges  Public Seminars – bring together policy makers, system mangers, researchers to discuss topical issues  Resource incentive – human, financial & logistical; about 20,000Euro per Fellow per year 21
    22. 22. CONCLUSIONS/NEXT STEPS  Learning experience  Evaluation to be undertaken after completion of first cohort  Second cohort – expected at beginning of 2014  Experience may be used by other countries to approach capacity building for middle and senior level health systems managers 22