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. 2020 May 20;19(1):185.
doi: 10.1186/s12936-020-03255-z.

Scaling Up Malaria Elimination Management and Leadership: A Pilot in Three Provinces in Zimbabwe, 2016-2018

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Free PMC article

Scaling Up Malaria Elimination Management and Leadership: A Pilot in Three Provinces in Zimbabwe, 2016-2018

Amanda Marr Chung et al. Malar J. .
Free PMC article

Abstract

Background: Focus for improved malaria programme performance is often placed on the technical challenges, while operational issues are neglected. Many of the operational challenges that inhibit malaria programme effectiveness can be addressed by improving communication and coordination, increasing accountability, maintaining motivation, providing adequate training and supervision, and removing bureaucratic silos.

Methods: A programme of work was piloted in Zimbabwe with one malaria eliminating province, Matabeleland South in 2016-2017, and scaled up to include two other provinces, Matabeleland North and Midlands, in 2017-2018. The intervention included participatory, organization development and quality improvement methods.

Results: Workshop participants in Matabeleland South reported an improvement in data management. In Matabeleland North, motivation among nurses improved as they gained confidence in case management from training, and overall staff morale improved. There was also an improvement in data quality and data sharing. In Midlands, the poorly performing district was motivated to improve, and both participating districts became more goal-oriented. They also became more focused on monitoring their data regularly. Participants from all provinces reported having gained skills in listening, communicating, facilitating discussions, and making presentations. Participation in the intervention changed the mindset of malaria programme staff, increasing ownership and accountability, and empowering them to identify and solve problems, make decisions, and act within their sphere of influence, elevating challenges when appropriate.

Conclusions: This pilot demonstrates that a participatory, organization development and quality improvement approach has broad ranging effects, including improving local delivery of interventions, tailoring strategies to target specific populations, finding efficiencies in the system that could not be found using the traditional top-down approach, and improving motivation and communication between different cadres of health workers. Scale-up of this simple model can be achieved and benefits sustained over time if the process is imbedded into the programme with the training of health staff who can serve as management improvement coaches. Methods to improve operational performance that are scalable at the district level are urgently needed: this approach is a possible tactic that can significantly contribute to the achievement of global malaria eradication goals.

Keywords: Capacity building; Challenges; Leadership; Malaria elimination; Operations; Programme management; Service delivery; Zimbabwe.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Health system building blocks from WHO’s Framework for Action [20]
Fig. 2
Fig. 2
Continuous process improvement cycle

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References

    1. Gosling J, Case P, Tulloch J, Chandramohan D, Wegbreit J, Newby G, et al. Effective program management: a cornerstone of malaria elimination. Am J Trop Med Hyg. 2015;93:135–138. doi: 10.4269/ajtmh.14-0255. - DOI - PMC - PubMed
    1. Muhindo Mavoko H, Ilombe G, da Inocêncio Luz R, Kutekemeni A, van Geertruyden JP, Lutumba P. Malaria policies versus practices, a reality check from Kinshasa, the capital of the Democratic Republic of Congo. BMC Public Health. 2015;15:352. doi: 10.1186/s12889-015-1670-0. - DOI - PMC - PubMed
    1. Feachem RG, Chen I, Akbari O, Bertozzi-Villa A, Bhatt S, Binka F, et al. Malaria eradication within a generation: ambitious, achievable, and necessary. Lancet. 2019;394:1056–1112. doi: 10.1016/S0140-6736(19)31139-0. - DOI - PubMed
    1. Moonen B, Cohen JM, Snow RW, Slutsker L, Drakeley C, Smith D, et al. Operational strategies to achieve and maintain malaria elimination. Lancet. 2010;376:1592–1603. doi: 10.1016/S0140-6736(10)61269-X. - DOI - PMC - PubMed
    1. Muchena G, Dube B, Chikodzore R, Pasipamire J, Murugasampillay S, Mberikunashe J. A review of progress towards sub-national malaria elimination in Matabeleland South province, Zimbabwe (2011–2015): a qualitative study. Malar J. 2018;17:146. doi: 10.1186/s12936-018-2299-0. - DOI - PMC - PubMed

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