Supporting Better Health Through Enhanced Coaching and Communication Skills

Betsie Cialino

Senior Project Officer

What is coaching, and how can it support health service delivery? These two questions were addressed by 18 representatives of organizations offering services in reproductive health, integrated health, and support for people with physical disabilities. As a group, they examined how improved coaching and communication practices could help them better handle some of their greatest workplace challenges. The workshop was hosted in Kampala, Uganda by the USAID-funded Leadership, Management, and Governance (LMG) project from June 16-20, 2015. Its main objective was to introduce conversational and coaching skills in order to improve participants’ interpersonal communication, coordination, and performance as a team, with the ultimate goal of improving health service delivery.

The LMG Project has recognized that gaps in these skills can limit the sustainability of leadership, management, and governance programs. To address this challenge and improve the sustainability of other LMG activities, the LMG Project updated its Communication and Coaching Skills Program, a six-module program focusing on exercises and practical sessions, and invited participants from its partners to attend.

LMG Project consultant Andrew Kigozi (left) and Peter Muganga from LMG Project partner Reproductive Health Uganda.
(Photo: Emmanuel Were)
LMG Project consultant Andrew Kigozi and Peter Muganga from LMG Project partner Reproductive Health Uganda. (Photo: Emmanuel Were)

The LMG facilitators asked participants to reflect upon the top five challenges they faced at work prior to arriving at the workshop. Once in Kampala, participants focused on these real-life challenges as they worked in teams to practice key coaching skills and processes. This involved facilitating productive conversations, crafting powerful questions, and giving and receiving feedback. Participants also worked in teams to better understand the intentions and process of coaching and know the difference between inquiring and advocating. Working together, participants practiced focused listening, tolerating silence, and deconstructing and then re-scripting conversations that failed to produce intended results. The facilitators further guided participants to reflect on their own motives and intentions, and how these might interfere with the application of their new skills.

Participants’ initial feedback after the workshop was extremely positive; the post-workshop evaluation forms were filled with participants’ optimism and desire to apply what they learned once back at their jobs. However, the LMG workshop organizers were aware that energy generated at workshops may not be sufficient to sustain lasting change. Sustained application of new concepts and skills often does not happen once participants return to their “real-life” workplace challenges. Therefore, instead of relying on the feedback given on the last day of the workshop—including participants’ expressed good intentions to implement the skills learned—to measure the workshop’s success, LMG followed up with participants after four months to see if they reported any changes in their behavior and ability to overcome workplace communication challenges, as well as whether or not they had practiced their new coaching and communication skills. The workshop facilitators spoke with 14 participants to determine what they had retained, and whether or not the challenges identified ahead of the workshop had changed. They found that all of the participants had been able to use some of the skills practiced at the workshop to resolve communication challenges in their workplaces, to guide interactions with coworkers and beneficiaries, and even to inform new coaching training modules that their organizations will offer.  

“In the past, my approach has been to just give people the answers - ‘This is what we want you to do.’ With what I took from this workshop - asking better questions and listening - I can help teams to own their challenges and also to think through solutions themselves,” maintained Peter Muganga, of Reproductive Health Uganda (RHU), an affiliate of the International Planned Parenthood Federation (IPPF). “I thought it was going to be the ‘normal’ training, where you get many materials and then the facilitators lead you through them. But really, the training was more focused on working through different coaching processes, using my real challenges,” he explained.

Peter reported that he was able to use his initial enthusiasm for the workshop to specifically address the challenge of motivating teams to see their roles in solving problems. “To a great extent, especially with a team that was trying to offer immunizations at their facility, when we drilled down to see why they were not able to offer vaccines before, this was exactly the challenge. The administrator would say ‘I'm not a medical person’, the medical people would say, ‘I'm just here to offer services, not to organize.’ But when we really delved in and asked good questions such as ‘What is your role in service delivery?’ and ‘What is your role in this organization?,’ we were able to help the team members to move past blame to find solutions. Asking good questions allowed them to see their role in solving this challenge.”

Several participants from RHU worked together to develop a coaching curriculum for their field trainers, borrowing key concepts from the workshop. Raymond Ruyoka of RHU shared, “We held a training in September with participants from different branches from RHU. The training of trainers was on peer coaching for young people, and asked the question: ‘communications for what?’ We trained the peer coaches on methods of communication, listening, focused conversation methods, the ‘ladder of inference’, the challenge model and how to use it for a personal challenge, personal development plans for young people (new tool from IPPF), how to give feedback, and coaches’ roles and responsibilities.”

Participants continue to use skills practiced during the workshop to coach teams. Emmanuel Were of RHU reported, “During the training, I realized that I was not very good at listening. There is always the temptation to add something, to finish people's sentences, or to try to interrupt when I had something burning to say. I tend to do that, and after this workshop, I'm more aware of that. I have been using the listening and inquiry practices from the workshop to coach the teams that I facilitate in the field. Asking the kinds of good questions that we practiced at the workshop allows me to elicit more information and helps guide me to dig deeper. I find this enables the teams I work with to identify their own solutions, and I feel the conversations are more productive.”

Susanne Balera, a Strategic Advisor for Rwanda's National Commission for Children. (Photo: Emmanuel Were)
Susanne Balera, a Strategic Advisor for Rwanda's National Commission for Children. (Photo: Emmanuel Were)

In fact, participants most frequently cited improved listening and personal reflection as the biggest changes they experienced after attending the workshop. Susanne Balera, a Strategic Advisor for Rwanda's National Commission for Children, found that the workshop prompted her to question her own role in solving challenges. “The learning really happened as we did a lot of practical exercises, which reflected our real experiences and everyday lives. From this workshop, I know that before I put the blame or responsibility on someone else, I need to check myself. How much have I done? What have I done to contribute to a challenge? What more do I need to inquire about?”

Michael Kabugo, from the Joint Clinical Research Centre in Kampala, Uganda told workshop facilitators, “What has been most impactful for me is the art of listening—giving people time to express themselves and really listening to them. Using the focused conversation method allows me to help people figure out what they need to do on their own, instead of just telling them what to do. This can be difficult in a deadline-driven environment, but it is something that works and requires practice. I would add that this training is very important for people and should be offered to others. We are really grateful for all the printed and online materials, because they allow us to share with a greater audience.”

In response to a request from participants from the International Committee of the Red Cross, LMG is looking to offer the workshop again in 2016 to a broader group of participants. This will allow LMG to both expand the number of partner organizations who benefit from in-depth training on coaching and communication, as well as to contribute to a body of knowledge regarding the workshop training methods that can have the most lasting impact. Interested in building these skills within your organization? The updated Communication and Coaching Skills Program is now available on the resources section of LeaderNet.org, and will soon be available in French.