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Uhc july 14


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Ceren Ozer of the World Bank and Brigitta Villaronga of GIZ have been working together for about 18 months to support development of universal health coverage in several countries. This raises not only issues of how to transform health systems, but how to work within organizations that are not adept at addressing complex challenges.

Published in: Leadership & Management
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Uhc july 14

  1. 1. JNk0fEY&feature=em-share_video_user
  2. 2. Leadership for Universal Health Coverage World Bank, Washington DC, May 6 2015 Partners in: Ceren Ozer, World Bank Economist, Leadership Learning and Innovation Brigitta Villaronga, GIZ Head of Leadership Development
  3. 3. Origins
  4. 4. Levers • Leadership skills for improved communication, dialogue and trust building • Establishing effective collaboration mechanisms across sectors • High-level thinking partnership and support from subject-matter and leadership experts • Learning by doing and demonstration of successful implementation via Collective Action Initiatives in- country • Peer learning and knowledge exchange
  5. 5. Why the “how” matters?
  6. 6. A program approach to leadership and advancing reform agenda A 9 month intensive engagement with 3 face-to-face workshops, in- country team work and coalition building, and coaching support
  7. 7. Leadership for UHC Edition 1.0 Nigeria Ethiopia Kenya Uganda Zambia South Africa Sierra Leone Ebola Tanzania Change of staff
  8. 8. Nigeria: A country team example Nigeria Kafayat Bukola Health Insurance Officer Lagos State Abubakar Koko CEO PHC Dev Agency Kebbi State Jonathon Eke Deputy CEO National Health Insurance Scheme (NHIS) Peter Damza Planning Officer Fed. Ministry of Health Olalekan Olubajo Chief Health Economist Fed. PHCDA Francis Ukwuije Head Health Financing Fed. Ministry of Health Idriss Alhaji Zonal Executive Officer NHIS
  9. 9. Quotes from participants Our problem was our shared understanding of what UHC is – what it will take to domesticate a global agenda for [our country] and run with it; and also the fact that we have unfocused policy dialogue on UHC. Once we had those two, we were able to strategize “ ” It actually helps me to listen to them instead of me preaching at them or giving them the solution [Now I ask the] person who is delivering the service for our clients, how is it for you? […] How can I give you support, so that you can deliver that service better. “ ”Yes, when we did the stakeholder mapping, it truly changed my view about them. […] we do use a lot of the stakeholders mapping to know within the group we intend to engage. “ ”
  10. 10. Reactions from DPs in country Change was pronounced in the participant: more humble approach to colleagues, listens more; [he] is a person who likes to learn and who likes to apply learnings – quite possible that changes have been triggered by program “ ”Change [to more inclusive behavior] not necessarily observed in the participant, but difficult in [the country’s] context, which is very hierarchical, but delegation to others was good. “ ” The Collective Action Initiative was perfectly aligned with national work-plan, assured through participation of the right people in the team  100% positive responses “ ” from what observed, it seemed great, could not have been much better.  100% positive responses “ ” On individuals‘ learning results… On the initiatives‘ alignment… On info from organizers…
  11. 11. Participant feedback: Overall usefulness of the Program
  12. 12. Our Learnings and Insights
  13. 13. What are your thoughts? • How can we deepen this work (we have the next edition coming up)? • How is this relevant or useful for our book project? • What lessons are emerging for institutional cooperation that may be relevant for system change work?
  14. 14. Thank you for your attention
  15. 15. Additional slides
  16. 16. Developing competencies of leaders Deepen understanding of value-base of UHC reform • Fair choices in UHC reform • Drill-down on values Gain competency in analysis of political-economy of UHC • Adaptive Challenges • Constraints to collective action Improve coalition building & consensus brokering skills • Stakeholder analysis • Communicating results • Working across sectors Improve learning from success & failure • Results Action Learning • Structured project review Strengthen willingness to seek & ability to give peer advice • Training of different methods of peer advice Help leaders to strengthen their resolve & commitment • Establish personal connection • Reflection exercises
  17. 17. Leadership for UHC Edition 1.0 • World Bank GHNDR • GIZ Health & SP Units Country • Country Staff / TTLs • P4H in- country Networks Reform Area • Organizations • Level • Diversity Team
  18. 18. Target group • Key issue: Variety across organizations, sectors, age, gender… enough to create constructive friction but not to bring deadlock Institution Level Ministries of Health, Labor, Finance. Planning, Prime Minister’s Office, AIDS Commissions, etc. Director Level or above, those responsible for Policy, Planning and Implementation Health Insurance / Social Security Funds Directors General / Chief Executive Officers, & Deputies Civil Society / Medical Associations / Trade Unions / Employer Associations Directors General / Chief Executive Officers, Managing / Executive Directors Parliament: Committee responsible for Health / Social Protection Members of Parliament Health Service Providers (Associations, Tertiary / Teaching Hospitals) Directors General / Chief Executive Officers, Managing / Executive Directors
  19. 19. Leadership in Health Programs Program Harvard Ministerial Leadership in Health Aspen Institute Ministerial Leadership for Global Health WB / GIZ Leadership for UHC Target Group Health and Finance Ministers Health Ministers and Senior Ministry Officials (federal level only) Senior officals from central and local Government Ministries and Agencies (esp. Insurance); Civil Society leaders; provider & professional associations Format 3 Forum Meetings per year between Ministers, combined planning and implementation, a small number of countries receives In-Country Follow-Up (Ministers and senior level ministry officials) Accompanied through „country leads“ for 5 years (recruitment through applications): 3 stages • Identification of Objectives • Communication Strategy • Technical Assistance 3 meetings and on-demand technical support for 1 Collective Action Initiative in 1 year Content Leadership effectivneess but mostly Techical Focus: Priority Setting, Ressources Mobilization, M&E, Planning; for a project focused on efficiency in procurement, supply Focus: Health Financing (in general), Donor Harmonization, Reproductive Health Social Change & Collective Action; leadership competencies & commitment for UHC: cross-sectoral coalition-building, stakeholder analysis, inclusiveness, team leadership
  20. 20. Approach to Evaluation Participant in-depth interviews Results To be completed by end June
  21. 21. What Changes swaddell@networkingaction. net 21 Steve Waddell © Natural Environment Memes, values, beliefs Social-Political-Economic Structures Technology Individual
  22. 22. Change Strategies Name Supporting Change Forcing Change Co-creating Change Paternalistic Change Components Generative power Degenerative power Generative love Degenerative love Dynamic Empowering Raising up Confronting Violence Collaborating Co-evolving Minor change Maintaining status quo Requirement Willingness to share power Willingness to ignore harm Willingness of everyone to change Willingness of disempowered to settle for minor improvement Popular terms Noblesse oblige Upliftment Forcing Co-production Paternalism Being bought off Archetypal strategies Community organizing Rights legislation Legal cases Education State force Strikes (capital, labor) Demonstrations Multi-stakeholder fora Public engagement Social labs Reinforcing legal cases Financial pay-offs Consultation
  23. 23. Opportunity Identification Quiet Convening Systems Awareness Self Convening Prototype Projects Systemic Change Outcomes Systems Leadership Network Capacity Building Program Peer Coaching Action Learning Design Systems Funding Action Research Communication Outreach Potential Backbone Organization Systems Mapping Change Process Design Stakeholder Dialogue & Facilitation Investment & Funding Backbone Organization Hybrid Organization Design Shared Measurement Revenue Generation Shared Vision Reinforcing Activities R1 Self-convening R2 Capacity Building R4 Systems Funding Isolated Successes Relationship Building Collaborative Potentials Stakeholder Map & Interview Champions Identification Personal Mastery U Process Co-presencing Sensing the field Scaling Collaborative Network R3 Scaling Tipping Point Learning Journey Rapid Results Method After Action Review Wicked Problem Critical System Systems Aspiration & Stuckness Leverage Point Identification Shared Strategy Collective Systems Mapping Process CoachingLearning Infrastructure R0 Quiet Convening Developmental Evaluation Prototyping Systemic Change Process Map Version 2013.8.25 © Dr. Joe Hsueh, Academy for Systemic Change