Improving Health Services with the Leadership Development Program Plus (LDP+)

By Sasha Grenier

The Leadership Development Program Plus (LDP+) is an updated program that expands and refines the widely successful Leadership Development Program (LDP), which empowers teams to overcome local health service delivery challenges by utilizing hands-on leadership, management, and governance practices. With increased focus on country ownership, gender, governance, and monitoring & evaluation, the LDP+ works to systematically scale-up innovative health service results.

During the LDP+, participants learn to lead and manage by implementing improvement projects with a team over a period of five to eight months. Participants use leadership and management practices to develop shared visions, analyze what stands in the way of progress, think collaboratively and creatively, and develop innovative solutions to overcome identified obstacles. Coupled with a greater confidence and sense of power that this process instills, participants are sharing impressive health service delivery improvement results.

In Gwagwalada, Nigeria, mother-to-child transmission of HIV was identified as a particularly formidable health challenge. In 2013, the Gwagwalada Health Council and the LMG Project piloted the new LDP+ in ten health facility teams to increase the uptake of Prevention of Mother to Child Transmission of HIV (PMTCT) services.  A Governing Body composed of critical stakeholders set the direction by selecting five critical PMTCT indicators and proven interventions that local teams then adapted and implemented. The teams worked to create a vision of improved results around PMTCT, aligned stakeholders around this challenge, implemented their action plans, and shared what they learned with other teams for continuous improvement. After six months of extremely promising results, including 100 babies born HIV-free to HIV-positive mothers, the Governing Body made a plan to scale up the improvement process throughout the country.

Similarly, the LMG project is partnering with International Planned Parenthood Federation Learning Centers in sub-Saharan Africa to deliver and scale-up the LDP+ in Uganda, Ghana, and Cameroon. Six teams from Reproductive Health Uganda (RHU) and four teams from Planned Parenthood Association of Ghana (PPAG) implemented action plans during 2014 that were directed at improving the quality of and access to family planning, reproductive health and rights, and STI-related services. All teams have utilized the LDP+ process to achieve remarkable results in relation to improving and increasing access to sexual and reproductive health services.

All local teams have shown a remarkable enthusiasm for the LDP+ process, and have surpassed or met their original program objectives for service delivery improvement. For example, the team from RHU’s Mbarara branch identified the unmet needs of young people’s sexual and reproductive health needs in their community and worked together to develop and implement actions to improve health education, outreach, and collaboration between the youth center and clinic. These activities, in combination with improved communication, team work, stakeholder engagement, and joint work planning, resulted in the clinic’s improved monthly access to sexual and reproductive health services by 175%. Similarly, the Bwaise clinic, located in an underserved suburb of Kampala, successfully carried out innovative strategies to reach marginalized groups, including sex workers — doubling their provision of STI services to the community within six months.

The LDP+ continues to show tangible health improvements because of its highly effective experiential learning approaches, proven benefits from its emphasis on local ownership and adaptability, its embedded elements of coaching and support, and its technical guidance for governing bodies and multi-stakeholder support. As one Kenyan nurse shared, “The LDP+ gave me the conviction that I did not need to wait until the day everything was in place—money, support, etc. Leadership and management skills were enough!”