THE INTERNATIONAL MANAGEMENT DEVELOPMENT PROGRAMME速 (IMDP)
THE HEALTH MANAGER ISSUE 4, 2014
IN THIS ISSUE:
USING STRATEGY TO SOLVE GLOBAL HEALTH PROBLEMS EXECUTIVE PERSPECTIVE: DR KITTY VAN WEEZENBEEK WHY RELATION BUILDING IS AT THE CORE OF STRATEGIC PLANNING
International Union Against Tuberculosis and Lung Disease Health solutions for the poor
union-imdp.org
WELCOME TO
The Health Manager ISSUE 4, 2014 STRATEGIC PLANNING AND INNOVATION Dear Reader, The International Union Against Tuberculosis and Lung Disease (The Union) has a 94 year history of leadership in technical assistance, research and education for public health. Key to this leadership is an understanding that at the core of any successful health programme are the people who make this possible. Strategic planning and innovation can be achieved through a series of developments and interventions, including, but not limited to, training of health professionals. Through a step-by-step approach, it can lead to a significant shift in the quality of services provided to the public. In this issue of Health Manager, we ask important questions: How can health organisations develop strategy that enables them to reach goals and push through in challenging environments? How important are personal relationships for strategic planning and innovation? We hope that the following pages will provide answers to those and other questions.
JosĂŠ Luis Castro Executive Director The Union International Union Against Tuberculosis and Lung Disease Health solutions for the poor
INSIDE THIS ISSUE Executive Perspective: Dr Kitty Van Weezenbeek . . . . . . 4 Using Strategy to Solve Global Health Problems . . . . . . 10 Why Relation Building Is At the Core of Strategic Planning . . . . . . . . . . . . . . . . . . . . . . . . 16
The Health Manager is published by The Union’s International Management Development Programme (IMDP). Director of Publications: José Luis Castro, Marketing and Business Development Manager: Stephan Rabimov. © 2014 The Union. 3
EXECUTIVE PERSPECTIVE: DR KITTY VAN WEEZENBEEK, MD, PHD, MPH
EXECUTIVE DIRECTOR, KNCV TUBERCULOSIS FOUNDATION
As a junior TB officer in India in the 1980s, Dr Kitty van Weezenbeek witnessed and understood the importance of strategic planning in tuberculosis control programmes. KNCV Tuberculosis Foundation is a leading international centre of expertise in TB control. Dr van Weezenbeek was TB chief for WHO’s Western Pacific Regional Office immediately before assuming leadership of KNCV in 2013. On that occasion she said: “The fight against tuberculosis is not just a medical or a technical issue. It is also a management problem.” 4
Photo: Courtesy of Dr. Kitty Van Weezenbeek / KNCV Tuberculosis Foundation
A rural hospital “thought they were doing good,” she recalls, by obtaining a state-of-the-art mobile X-ray lab that significantly increased TB detection in remote villages. Unfortunately, the facility had neither a plan to ramp up treatment for all the newly discovered cases, nor to secure funding for drugs. Worse, many females were among the new cases, at a time when Indian culture stigmatised women with the disease. The newly diagnosed women not only went untreated, but also were banished from their families. For her entire career, Dr van Weezenbeek has fervently advocated for strategic planning. Planning should be comprehensive, integral, ongoing and professionally conducted, she says. It should prioritise and spell out objectives and activities clearly. All this is no longer optional, she notes: funders expect it. Long-term planning becomes a challenge when programmes experience year-to-year uncertainty over funding. The best solution, Dr van Weezenbeek says, is to plan for multiple scenarios, placing the most likely ones in the forefront “while also planning for and remaining open to new opportunities.” Dr van Weezenbeek recalls a time in her WHO tenure when The Philippines crafted an exceptionally well thought out and comprehensive strategic plan after a lengthy and thorough process. As the plan neared completion, a major funding opportunity arose 5
through the Global Fund. Because they were prepared and responded quickly, the Philippines programme met the funding requirements and received a significant grant that is and will be saving many lives. A comprehensive plan is thorough not only in what it covers, but also in whom it covers. “Inclusiveness” is a simple concept, but achieving it in a plan can be complex. It extends vertically within the organisation – good plans are developed with full input at the earliest stages from all levels – and horizontally outside of it. Community groups, private providers, local (or national) governments are all components of a plan who should be engaged in its development. The Philippines National Strategic Plan was developed under the leadership of the National TB Programme and after consultation with many national stakeholders in both the public and private sector. Dr van Weezenbeek stresses that national ownership and leadership are key to success. “Consultants can be of great help in the strategic planning process, but plans written by consultants alone are often not ‘implementable’ as they lack a reality check and political support”. A related component of good, realistic strategic planning is to contextualise the effort. Sound planning will take note of, and incorporate, the social, economic, political, demographic and public health environments in which the programme will operate. It will recognize and adjust for known, emerging and anticipated changes in 6
those environments. “You can’t plan in isolation,” Dr van Weezenbeek says firmly: “Watch the trains, and know when to jump on one. You can always jump off later if you have to.”
SOUND PLANNING WILL TAKE NOTE OF, AND INCORPORATE, THE SOCIAL, ECONOMIC, POLITICAL, DEMOGRAPHIC AND PUBLIC HEALTH ENVIRONMENTS IN WHICH THE PROGRAMME WILL OPERATE. “Jumping off” implies another planning element that Dr van Weezenbeek considers critical: flexibility. Plans “are not written in stone,” she notes, and need to be adjusted when the situation changes – as it often does. Change can come from many directions, and it is often a challenge for leaders to accept that the plan needs revision. Dr van Weezenbeek recalls the GeneXpert diagnostic tool’s approval by WHO in 2010. This new device reduced the time to diagnose MDR-TB from months to hours and can be rolled out to Photo: Courtesy of KNCV Tuberculosis Foundation MDR TB patient and doctor in TB dispensory, Akmola Oblast, Kazakhstan
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district level. Strategic laboratory plans and diagnostic algorithms everywhere were suddenly obsolete; and, while some agencies were nimbler than others in revising their plans, eventually all had to. Finally, the best strategic planners possess another quality: courage. Dr van Weezenbeek believes strongly in the notion of “Fail fast, fail forward.” If it isn’t working, change it quickly and learn from the experience. “Everyone,” she says, “makes planning and operational mistakes. Address and mitigate them quickly, and don’t repeat them next time.” This is exactly what scientists do, she points out, when new evidence arises and demands that a new approach be considered. “A good plan should be a dynamic document that can be adapted as conditions change,” concludes Dr Kitty van Weezenbeek, a leader who epitomises and preaches the spirit of dynamic response to the tuberculosis challenge.
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Photo: Courtesy of KNCV Tuberculosis Foundation Patient interviews with National TB Program representative, Mekele, Ethiopia
STRATEGIC PLANNING AND INNOVATION 2014 COURSE July 14 – 18, 2014 • Register at union-imdp.org REGISTRATION DEADLINE: MAY 30th, 2014 PROGRAMME AGENDA This five day course focuses on creating learning organizations capable of identifying key issues that may be blocking organisational progress – whether operational, strategic or policy-related. Participants in this course will develop new insights into how to analyse situations, question conventional approaches, encourage new ideas and innovations and design and implement interventions that stimulate programme progress and positive outcomes. Strategic Planning and Innovation emphasises individual and group strategic thinking that leads to innovating applications and results in continuous quality improvement. BENEFITS OF TRAINING 1) Lead participatory approaches to strategic planning 2) Create innovative strategies that provide a framework for future action 3) Prepare a collaborative strategic plan 4) Develop relationships with parties that influence the decision-making process 5) Improve decision-making skills when strategies fail or do not progress 6) Experiment with strategy implementation applications WHO SHOULD ATTEND Middle- to senior- level managers working in public health, as well as managers who oversee personnel across multiple levels, divisions and locations. Strategic organisational leaders, decision makers and thought leaders who are responsible for the formulation of organisational or programme strategy and who lead organisations at regional, national and international levels may also benefit. DATE
LOCATION
FACULTY
LEVEL
FEE
LANGUAGE
July 14 – 18, 2014
Kuala Lumpur, Malaysia
Viswanath Golpalkrishnan and Gayatri Sriram
Middle- to seniorlevel professionals
Euro 1,500 Course fee includes accommodation, breakfast, lunch, tea breaks, and course materials
English
Application deadline is 45 days prior to course. Upon acceptance into course, applicants will be invoiced. Fee payment is due within 30 days of invoicing.
Contact IMDP: imdp@theunion.org
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USING STRATEGY TO SOLVE GLOBAL HEALTH PROBLEMS TARA ORNSTEIN, M.A.
PROJECT TECHNICAL OFFICER, TREAT TB
The current global health funding demands advanced strategic planning and management skills from health managers. However, strategic thinking is a skill that requires time and determination to perfect. The three points below can help health managers begin to develop and execute an effective strategy for their organizations. 10
Photo: Courtesy of Tara Ornstein / The Union
Think about Your Environment According to the famous playwright Ethel Watts Mumford, “Knowledge is power, if you know it about the right person�. This humorous comment also has deep relevance for health managers. Several years ago, I worked as a proposal reviewer for a foundation in Eastern Europe. One of the proposals we received was from a local non-governmental organisation (NGO) that was interested in implementing an HIV prevention education programme for teenagers. This NGO had spent a considerable amount of time crafting a persuasive proposal and obtaining support from the local government. But because they did not research the activities of other organisations sufficiently, this NGO did not know that one of their competitors was already implementing a similar programme in the very same city. The foundation would have been interested in funding a partnership project between these two local organisations, but its directors felt that it was up to the applicants to build such networks. Despite having submitted a well-written proposal, the application for funding was denied. The lesson from this example is that it is essential to think about your environment and remember that no organisation operates in isolation. Be aware of what your competitors and partners are doing so you can better plan your 11
organisation’s activities, effectively pursue funding and identify opportunities for collaboration. Plan for Change While designing a study that sought to evaluate the effectiveness of promising new health technology, my colleagues and I were sure we had doneeverything right. We thoroughly researched the countries that expressed interest in participating in the study to
IT IS ESSENTIAL TO THINK ABOUT YOUR ENVIRONMENT AND REMEMBER THAT NO ORGANISATION OPERATES IN ISOLATION 12
Photo: Damien Schumann / The Union
learn about their history, political system and social trends, as well as the type of health system and epidemiological setting. We established equal partnership with local colleagues. We obtained approval from both the government and civil society. Butjust before we were scheduled to begin in the chosen study site, the political landscape changed overnight, and we found ourselves back at square one. Luckily, we knew uncertainty is a common feature in many global health projects and had anticipated change. We made sure to cultivate ties with a wide range of partners, which helped us navigate the new approval process the second time around. We also took steps to inform our donor of what we had accomplished so far, and simultaneously described the challenges we encountered along with the proposed solutions. Because of this, our project moved ahead and ended successfully. Our experience demonstrates the importance of thinking strategically in the early stages of a project and realising that the only certainty in global health is that anything can change at any time. Take the Right Action According to expert Michael Porter, “The essence of strategy is choosing what not to do”. In 2007, “Tim” was the executive director of a medium-sized global health organisation. The mission 13
of his organisation was to help new single mothers obtain health and social services. At this time, the organisation’s portfolio was changing – several of their projects were ending and their largest donor announced that they would only fund projects for vulnerable children. “At that point, we had to make a decision: do we change our focus or do we stick with our mission?” Tim recalled later. In the end, Tim and his colleagues made the difficult decision to scale back, lay off some staff and continue to work towards their goal of supporting mothers in need. Seven years later, Tim’s organisation is thriving. They have provided hundreds of mothers with badly needed services and have diversified their support base, which is a prerequisite for the sustainability of any non-profit during this era of austerity.
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Photo: Damien Schumann / The Union
BUDGETING AND FINANCIAL MANAGEMENT 2014 COURSE August 4 – 8, 2014 • Register at union-imdp.org REGISTRATION DEADLINE: JUNE 20th, 2014 PROGRAMME AGENDA The objective of this course is to provide participants with advanced knowledge of budgeting and financial management processes. Participants will receive training in developing and managing financial reporting systems to apply in their work at national health programmes. The course will cover budget planning, implementation, monitoring, control and reporting. BENEFITS OF TRAINING 1) Explain the uses and functions of budgeting and financial management 2) Design, develop and present programme budgets using Excel 3) Create and use a cash flow budget 4) Perform a workload analysis 5) Identify and practice effective revenue and expenditure estimating techniques 6) Review an operating budget using variance analysis WHO SHOULD ATTEND Middle- to senior- level health managers who are responsible for programme administration in health organisa- tions, as well as doctors, administrators and consultants who manage project budgets.
DATE
LOCATION
FACULTY
LEVEL
August 4 – 8, 2014
Kuala Lumpur, Malaysia
Frank Colella and Salil Kumar
Middle- to Seniorlevel professionals
FEE
LANGUAGE
Euro 1,500 English Course fee includes accommodation, breakfast, lunch, tea breaks, and course materials Application deadline is 45 days prior to course. Upon acceptance into course, applicants will be invoiced. Fee payment is due within 30 days of invoicing.
Contact IMDP: imdp@theunion.org
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WHY RELATION BUILDING IS AT THE CORE OF STRATEGIC PLANNING VISWANATH GOPALAKRISHNAN IMDP FACULTY
The Myth Organisations - through their people - create myths of all kinds. A short anecdote illustrates this. When I worked with a large multinational company based in India, we had many employees who were hired on a “contractual” basis. They performed regular tasks (like their colleagues) but were “contract” employees and, therefore, not eligible for some of the benefits employees enjoyed. One such benefit was the Annual Day celebration. The debate here was whether 16
Photo: Courtesy of Viswanath Gopalakrishnan / The Union
“contract” employees qualified or not? The Human Resources manager’s position was that, since they worked for the company, they were equally eligible to be a part of the celebrations and, therefore, must be included. However, some members of the senior management didn’t think so. Another example of this is that “contract” employees are, at times, not nominated for training and development initiatives although their performance is crucial to the company. The myth here seems to be that “we don’t need to invest in all the people we work with”. We can pay lip service to “some”, while we pay greater attention to the ones who “really” matter. This is the infamous “divide and rule” pattern where one doesn’t have to take the trouble to relate to some as it means some extra hard work. And why work harder if one can avoid it? Where human relationships are concerned investing in people pays off more often than not. Unfortunately, managers and managements are, often, myopic and don’t see this as building a significant base for influencing at work. Investing in relationships is a “win-win” strategy. On the one hand, you win yourself a friend and on the other the task also gets addressed. Repeatedly, we have heard in post-workshop evaluations that participants had gotten to know their colleagues from other departments better, and therefore they were now much more confident about handling larger and more complex projects or situations. They felt 17
they would receive better support from these people who were until now ‘strangers’ to them - simply because there was no organisational process that helped them get to know the others better. So, what is the connection between investing in relationships and strategic planning? Let’s consider just one of the elements of strategy. Anyone engaged in a strategic initiative is dealing with “uncertainty”. This is a given because a strategy is developed to solve a particular problem in a situation which has not been dealt with before or to apply a preexisting solution in a new area. In either case, success is not guaranteed and the solution has to be put to test. Such "uncertainty” about the end result (success) causes managers to become highly anxious and uneasy about going ahead with the strategy developed. Naturally, managers want to seek reassurance that they will be successful – either from those who have some competence in the same field and/or from someone whom the manager can trust to listen and respond. It, therefore, follows that building relationships is essential for strategic initiatives to succeed. In my very first year as an independent consultant, another consultant approached me and wanted to join me in my consulting business. Since I knew him quite well I agreed and soon we were working together. He initiated the concept of ‘Outward Bound team building’ and within six months we conducted a programme
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for a very large company. Despite the fact that I was new to the concept, I trusted him and went along. In subsequent years, this methodology of using the wilderness for team building (and many other kinds of learning) became a successful ‘strategic advantage’ for my work. So, had I not trusted him with this methodology I may not have had access to a very powerful process for creating learning environments. Finally, comes the question of “how” do we form such strong relationships? As with our friends, the basis of our relationships is trust and trust-worthiness. Hence, managers need to keep building trust with their counterparts and do this consistently. Trust is built brick by brick, and each of these bricks represents the commitments we actually deliver on.
TRUST IS BUILT BRICK BY BRICK, AND EACH OF THESE BRICKS REPRESENTS THE COMMITMENTS WE ACTUALLY DELIVER ON. A very famous world spiritual leader is said never to break a promise he makes. Flip it around and consider this: Maybe he never makes a promise he can’t keep! In the increasingly complex and diverse world we live in, the potential of people to help us with our goals at work and outside can never be under estimated, and, to leverage this to the maximum, building relationships is essential – not just desirable.
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UPCOMING 2014 IMDP COURSES
•
Register at union-imdp.org
APPLICATION DEADLINE IS 45 DAYS PRIOR TO COURSE / UPON ACCEPTANCE INTO COURSE, APPLICANTS WILL BE INVOICED / FEE PAYMENT IS DUE WITHIN 30 DAYS OF INVOICING COURSE
DATE
LOCATION
FACULTY
LEVEL
Strategic Planning and Innovation
July 14 – 18, 2014
Kuala Lumpur, Malaysia
Viswanath Golpalkrishnan and Gayatri Sriram
Middle- to senior-level professionals
(registration deadline: May 30)
FEE
LANGUAGE
Euro 1,500
English
Course fee includes accommodation, breakfast, lunch, tea breaks and course materials.
This five-day course focuses on creating learning organisations capable of identifying key issues that may be blocking organisational progress – whether operational, strategic or policy-related. Management and Leadership
July 28 – August 1, 2014
(registration deadline: June 15)
Kunming, Yunnan Province China
Rajesh Kapoor and Swati Devgon
Middle- to senior-level professionals
Euro 1,500
Course fee includes accommodation, breakfast, lunch, tea breaks and course materials.
English, (translated to Mandarin)
(Modified for tobacco control, but appropriate for all public health providers.) This course explores leadership and strategy execution in high performing teams. Changing the performance and behavior of others requires that leaders first identify the changes that must occur within themselves. Budget and Financial Management
August 4 – 8, 2014
(registration deadline: June 24)
Kuala Lumpur, Malaysia
Frank Colella and Salil Kumar
Middle- to senior-level professionals
Euro 1,500
Course fee includes accommodation, breakfast, lunch, tea breaks and course materials.
English
The objective of this course is to provide participants with advanced knowledge of budgeting and financial management processes. Training of Trainers
August 4 – 8, 2014
(registration deadline: June 24)
Kunming, Yunnan Province China
Rajesh Kapoor and Tom Stuebner
Middle- to senior-level professionals
Euro 1,500
Course fee includes accommodation, breakfast, lunch, tea breaks and course materials.
English, (translated to Mandarin)
Modified for tobacco control, but appropriate for all public health providers) Training of Trainers (ToT) prepares participants to be more effective trainers and facilitators. This five-day course addresses core competencies required for training preparation, planning, delivery and evaluation. Project Management
August 24 – 28, 2014
(registration deadline: July 10)
Sylhet, Bangladesh
Rajesh Kapoor and Swati Devgon
Middle- to senior-level professionals
Euro 1,500
Course fee includes accommodation, breakfast, lunch, tea breaks and course materials.
English
(Modified for tobacco control, but appropriate for all public health providers) Project management is a fundamental component of successful programmes. This five-day course equips participants with an integrated, logical framework approach to project planning, implementation and review. Mass Media and Communications
September 15 – 19, 2014
(registration deadline: August 1)
Istanbul, Turkey
Sandra Mullin and Stephen Hamill
Middle- to senior-level professionals
Euro 2,000
Course fee includes accommodation, breakfast, lunch, tea breaks and course materials.
English
Gain a greater understanding of effective communications strategies for promoting health programmes and disseminating important health messages to the public. Influencing, Networking, and Partnership
September 29 – October 19, 2014
(registration deadline: August 14)
Chicago, Illinois, USA
Dennis Jennings and Judy Weddle
Middle- to senior-level professionals
Euro 2,000
Course fee includes accommodation, breakfast, lunch, tea breaks and course materials.
20This course teaches participants various negotiating and collaborating techniques to build relationships with diverse stakeholders.
English
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THE INTERNATIONAL MANAGEMENT DEVELOPMENT PROGRAMME庐 (IMDP)
THE HEALTH MANAGER ISSUE 4, 2014
The Union, North America 61 Broadway, Suite 1720 路 10006 New York, NY, USA Tel: (+1) 212 500 5736 路 Fax: (+1) 347 772 3033 email: imdp@theunion.org 路 www.union-imdp.org
International Union Against Tuberculosis and Lung Disease Health solutions for the poor
union-imdp.org