Scaling up malaria elimination management and leadership: a pilot in three provinces in Zimbabwe, 2016–2018

• Published in: Malaria Journal
• Main Authors: Amanda Marr Chung, Peter Case, Jonathan Gosling, Roland Gosling, Munashe Madinga, Rudo Chikodzore, Macdonald Hove, Greyling Viljoen, Precious Chitapi, Matsiliso Gumbi, Peliwe Mnguni, Joseph Murungu, Busisani Dube, Patience Dhliwayo, Joseph Mberikunashe
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2020
• Subjects: Programme management; Challenges; Leadership; Malaria elimination; Capacity building; Zimbabwe; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-020-03255-z; https://doaj.org/article/bc03464959164a728baeb38eb1f29852

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 ...