Launching Leadership for Better Health in Cote d’Ivoire

Sylvia Vriesendorp

Principal Technical Advisor for Leadership

Dr Tia Andre : Directeur départemental de Bettie, Dr Kouakou Elisabeth Directeur départemental d’Abengourou et m. kouakou Lucien, charge de surveillance épidémiologique a la région sanitaire d’Abengourou.  Photo: MSH Staff

From left to right: Dr. Tia Andre, District Medical Director of Bettie district, Dr. Kouakou Elisabeth, District Medical Director of Abengourou district and Mr. Kouakou Lucien, Director of Epidemiology and Sanitation for Abengourou district. Photo: MSH Staff

“I wasn’t always sure how to get my staff to engage fully and contribute to our activities. I sometimes wondered how to mobilize my team and those in charge of health centers as well as our partners so that we could produce the results people expected of us.”  It is with this dilemma in mind that Dr. Jean-Baptiste Brindou, Regional Health Director of N’zi-Moronou-Iffou in Cote d’Ivoire, joined a small team of future facilitators of the new and improved version of MSH’s flagship Leadership Development Program Plus, known as the LDP+, on April 28, 2014 in Grand-Bassam, Cote d’Ivoire for a three-day training of LDP+ facilitators. The new elements of the program are governance, gender, and the improvements include a greater emphasis on evidence-based monitoring & evaluation and coaching activities. What remains, is improved leadership, management and governance and not the goal itself but rather a means to produce results that are reflected in key health indicators.

The LMG project in Cote d’Ivoire focuses, among other things on helping the government in its efforts to decentralize its health services down to the regions and districts. This effort requires investments in leadership, management and governance skill development of officials who, in the past, were use to follow rather than lead. The LDP+ was selected at a good approach to helping the government in this transition.

During the three day training, the central Ministry of Health, regional, and district level facilitators, and staff from the local MSH office mastered enough of the basics of the LDP+ (the process, structure and approach) to accept the challenge of leading the transformation rather than being led by outsiders. At the end of the week, they experienced the power of the Challenge Model, a central tool of the LDP+, as they designed a four-hour senior alignment meeting that took place on May 5th. Three staff from the central ministry facilitated the meeting with a dedication and enthusiasm that only full ownership can produce.  Not only did the message that the practices of good leadership, management and governance will manifest themselves in improved services and, ultimately, health outcomes, they are resonated deeply with the government’s decentralization push. Cote d’Ivoire’s national strategic plan for health (Plan National de Developpement Sanitaire 2012-2015) explicitly states that these practices are critical to get back on track and improve on the current model.

A week later the local team facilitated the first workshop of the LDP+ in Cote d’Ivoire. Nine district teams from two regions, and two teams from the regional level were invited to participate. Now, all eyes are on them. "We cannot fail." emphasized Dr. Assi Bernard, Technical Advisor at the General Directorate of Health and one of several LDP+ champions in the country, in his opening remarks to the workshop. Dr. Assi is also the West African Health Organization (WAHO) Liaison Officer for Cote d’Ivoire, where, incidentally, a small group of professional and administrative staff have just embarked on a leadership program as part of LMG's assistance to WAHO.

With great enthusiasm, studying long into the night to master concepts and practices new to themselves, the newly minted facilitators led the district teams to explore a different way of planning for success. Facilitators and participants have shown they are motivated by a sincere wish to make a difference and challenging themselves and each other on habits that get in the way.

Most of the teams will seek improvement on the retention rate of those under antiretroviral vaccines treatment. In their initial analysis, many of the participants realized that they didn’t know enough about why people do not come back, or simply don’t have the data to determine who has dropped out. This will be the initial focus of their work before the next workshop. In this they will be supported by the facilitator/coaching team and two dedicated regional directors.

There was no doubt in the mind of anyone that they will be successful. Dr. Assi Bernard expressed his confidence, not just in the participants and the facilitators but also in himself with these words:  “In one word, this methodology can help us ‘move mountains.’  It will also help me to change my professional future and, why not, the future of our country.”