An Interview with Dr. Kouassi Armand Ponou Noel

Alison Collins

Project Officer

Julienne Ahua

Senior Operations Specialist, MSH

From October 2013-September 2015, the USAID-funded Leadership, Management, and Governance (LMG) Project, led by Management Sciences for Health (MSH), implemented a decentralized management pilot project in the health regions of Indénié-Djuablin and N'Zi-Iffou-Moronou, Côte d’Ivoire, with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The two-year goal of the project was to improve health service delivery and health outcomes by building the leadership, management, and governance capacity of regional health directorate and departmental health directorate staff. Decentralizing capacity building motivated leaders at these levels of the health system to take greater ownership, and helped strengthen the health system overall.

After presenting preliminary results from the pilot project to in-country stakeholders in January 2015, the Ministry of Health and Public Hygiene (MSHP) advocated for the expansion of the project to additional health regions. With additional support from USAID and PEPFAR, the LMG Project expanded activities into the regions of Cavally-Guémon, Kabadougou-Bafing-Folon, and Tonkpi; meanwhile, the MSHP advocated extending the LMG Project’s decentralization approach to new health regions across the country by including the approach in several Global Fund grant applications.

Although the LMG Project is scheduled to conclude its activities by September 2017, a recent technical service contract between the MSHP and MSH, under a Global Fund grant, allows for an expansion of the LMG Project’s decentralization approach through MSH technical assistance to the regions of Agnéby-Tiassa-Mé and Bélier, and an additional ten health districts.

Dr. Ponou leads a small breakout session during a workshop. (Photo: MSH Staff)
Dr. Ponou leads a small breakout session during a workshop. (Photo: MSH Staff)

During the first phase of the approximately $3.2 million assistance, MSH will continue to focus its interventions at the regional and departmental levels; however, capacity building activities will shift to referral hospitals and urban health centers during the second phase, and to rural health centers during the third phase. Julienne Ahua, Project Specialist with MSH in Côte d’Ivoire, recently sat down with Dr. Kouassi Armand Ponou Noel, the Research Manager for the General Directorate of Health (DGS) within Côte d’Ivoire’s MSHP, as well as the focal point in the MSHP for the LMG Project, to discuss the impact of the project’s decentralized health systems strengthening approach. Below are excerpts from that conversation (translated from French:

Why did the MSHP/DGS select MSH as its technical partner for the new award between the Global Fund and the National Malaria Control Program (NMCP)? How was the award negotiated?

Dr. Ponou: MSH implemented a two-year decentralized management pilot project focusing on leadership, management, and governance [funded by USAID/PEPFAR, in the health regions of Indénié-Djuablin and N'Zi-Iffou-Moronou] with encouraging results. In order to continue implementation of the “LMG approach” in Côte d’Ivoire, the MSPH/DGS advocated for the expansion of the project to the health regions of Agnéby-Tiassa-Me and Bélier through the Global Fund’s malaria grant. MSH was the natural partner for the DGS as a technical support partner [to implement this approach.]

Can you explain your involvement in securing this funding and tell us what is special about this agreement?

Dr. Ponou: There were two levels of negotiation: first we [the MSHP/DGS] negotiated with the Global Fund to include additional funding in the malaria and tuberculosis grants for the “LMG approach” and second, we conducted negotiations with MSH as the primary technical partner implementing the LMG approach in Côte d’Ivoire. I contributed to these successful negotiations by explaining the “LMG approach” to the Global Fund team members who were familiar with MSH’s work in Côte d’Ivoire, [but unaware of how] this approach would fit into the framework [of the malaria grant.] I also traveled to Geneva during the negotiations in order to obtain the support of the Global Fund team; in short, to "sell the LMG approach”.

What is the purpose / objective of MSH’s technical support provided to the MSHP/DGS in Côte d’Ivoire under this agreement?

Dr. Ponou: The goal is to enable the MSHP to have a skilled pool of technical expertise ...since this agreement empowers us to be the main actors/drivers of this project. What is most important for us is the transfer of skills to us by the end of this project.

What is so unique about the "LMG approach" for health systems strengthening in Côte d'Ivoire?

Dr. Ponou: While the NMCP is the main beneficiary of the malaria grant, the MSHP/DGS is the prime contractor and plays the role of coordinator. This agreement is unique since most of the technical and financial management of the award is entrusted to MSH, who will submit financial and technical reports to the MSHP/DGS (who will then share them with the NMCP).

How (and why) did you become a champion of this approach?

Dr. Ponou: This adventure began in 2013 [when I began serving as the focal point of the LMG Project within the MSHP/DGS]. During a field activity, I listened with great interest as the LMG/Côte d’Ivoire Project Director (and MSH Côte d’Ivoire Country Director), Antoine Ndiaye, talked about his experience developing leadership with street children in Haiti, and I thought this could be an interesting personal experiment, and so that little by little, I developed a passion for [the LMG] approach, and I became one of the defenders. I do not consider myself a champion, because for me there is still much to learn and do ... there are still so many challenges to overcome. One of my biggest challenges is [how to] institutionalize the approach, so that it can be implemented even in the central departments of the MSHP, and of course [at the decentralized level] throughout the country.

What are the next steps?

Dr. Ponou: The next step for the MSHP is to continue to seek funding to ensure that the LMG approach is implemented in all health regions of Côte d’Ivoire.

How can we continue to institutionalize the LMG approach within the MSHP in Côte d'Ivoire?

Dr. Ponou: [We can] convince donors that if they want to maximize funding provided to the MSHP, they need to integrate the LMG approach to strengthen the capacity of beneficiaries.

Learn more about the LMG Project's activities and achievements in Côte d’Ivoire.