Better health system management helps HIV patients in Côte d’Ivoire stay on ART

By Alison Collins, Project Specialist, MSH and Julienne Ahua, Project Specialist, MSH

Awa coulibaly, Pharmacist for the Daoukro Health District, explains how LDP+ practices have contributed to better health outcomes in her district. Photo: Management Sciences for Health

When the USAID-funded Leadership, Management, & Governance Côte d’Ivoire Decentralization Pilot Project (LMG/CIDMP) launched in October 2013 in the regions of Indénié-Djuablin and N'zi -Iffou-Moronou, Côte d’Ivoire, the ART retention rates for people living with HIV in the past 12 months was 59% and 58%, respectively, and local health authorities had long struggled to increase this rate.

The LMG/CIDMP Project supports Côte d’Ivoire’s Ministry of Health to improve the leadership, management, and governance skills of health workers in order to improve the health status of people living with HIV and AIDS. As part of this effort, the project completed a Leadership Development Program Plus (LDP+) in Indénié-Djuablin and N'zi-Iffou-Moronou between April 2014 and January 2015.

Developed by Management Sciences for Health (MSH), the LDP+ empowers health management teams to achieve health results by strengthening team members’ leadership, management, and governance skills. Participants develop their leadership capacities by identifying service delivery challenges, aligning their team around a common vision to address those challenges, increasing their capacity to mobilize local resources, and developing an action plan to achieve measurable health service delivery results. After each LDP+ workshop, teams return to their respective regional and district offices, sharing what they have learned with their colleagues.

All the regional and district improvement teams used the LDP+ to reduce the number of persons on ART who stop treatment. By the end of the LDP+, every team had increased ART retention rates. In fact, seven of the eleven teams exceeded the original target of 80 percent retention.

Impressed by these results, donors, including the World Bank, have expressed interest in supporting similar leadership, management, and governance interventions in other regions of Côte d’Ivoire. In addition, the National Malaria Control Program has included the LDP+ approach in its malaria concept note submitted to the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Health leaders in Côte d’Ivoire are now using the LDP+ methodology to address other priority health issues. The LMG/CIDMP Project will soon launch a second LDP+ cycle at health facilities in each project district. As Dr. Andre Tia, Bettié Departmental Health Director and LDP+ participant, stated, "The LDP+ has allowed us to change the way we work and commit to achieve good results on all health indicators, despite the difficulties and obstacles."

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N’Zi-Iffou-Moronou                                                                                              Indénié-Djuablin