the international management development programme速 (IMDP)
The health manager ISSUE 1, 2014
In this issue:
A Decade Of Innovation In Management Training For Public Health
EXECUTIVE PERSPECTIVE: DR EHSAN LATIF DIRECTOR, DEPARTMENT OF TOBACCO CONTROL, THE UNION Participant Profile: Gokul Mishra Innovation, Networking & Partnership Creating a Global Roadmap to End Childhood TB
union-imdp.org
weLcome to
The Health Manager Issue 1, 2014 InnoVAtIVe mAnAgement
Health solutions for the poor
The Union's International Management Development Programme (IMDP) has been at the forefront of innovative management trainings for over a decade In that period, the IMDP has trained over 4,000 public health professionals around the world to become champions of innovation and leadership within their organisations and countries In this issue of The Health Manager, we reflect on the IMDP's timeline and legacy, discover the impact of our trainings in Nepal and beyond, speak with an executive about innovative management, and highlight the success story of creating the Roadmap to End Childhood TB.
JosĂŠ Luis castro Interim executive director the union
inside this issue Letter from The IMDP Director . . . . . 4 The IMDP: A Decade of Innovation in Management Training in Public Health . . . . . . . . . 6 Executive Perspective: Dr. Ehsan Latif, Director of Tobacco Control, The Union . . . . . . . 12 Participant Profile: Gokul Mishra, Innovation, Networking & Partnership . . . . . . . . 18 Creating a Global Roadmap to End Childhood TB . . . . . . . . . . .22
The Health Manager is published by The Union’s International Management Development Programme (IMDP). Director of Publications: José Luis Castro, Director of the IMDP: Tom Stuebner, Marketing and Business Development Manager: Stephan Rabimov – © 2014 The Union.
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A message from the IMDP director Dear Colleagues: This year, the IMDP looks forward to welcoming hundreds of new participants from both the TB-sector and non-TB sectors, such as HIV/AIDS, malaria, child and maternal health, population, national planning commissions, INGOs involved in integrated health and all public health professionals seeking to improve their management capacities. The development of two new core courses on “Monitoring & Evaluation” and “Advanced Project Management” is a testament to the IMDP’s continuous focus on delivering programmes that significantly enhance health systems strengthening and human resource development. This year the IMDP will also provide two trainings on “Leading Management Teams” in response to the demand from both experienced and newly assigned programme managers. At the request of individual country programmes, the IMDP provides “Fast Track Courses” based on both our existing core courses and country-specific needs. We will also offer training and technical consultation on “Health Systems Strengthening,” “Impact Evaluation” and “Risk Management.” 4
With support from the Bloomberg Initiative to Reduce Tobacco Use, the IMDP will continue to train tobacco control managers in some of the most high-burden countries around the world. These courses will utilise tobacco control case studies and examples; however the management concepts and methods presented are applicable to all public health programme professionals. Because “management is management”, professionals from non-tobacco fields of public health are welcome to enroll in these courses. Reflecting on 2013, we are proud of our achievements: over 400 professionals attended our international core management courses; management courses related to tobacco control held in Bangladesh, China, India, Indonesia and Mexico; a new road safety-related management course; and international seminars, conference workshops and post-graduate courses. Building on the IMDP’s 10-year history we look forward to ongoing collaboration with our partners, such as the World Health Organization’s TB TEAM, to develop and deliver relevant and timely management training to public health leaders around the world.
Tom Stuebner Director of the IMDP
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THE INTERNATIONAL MANAGEMENT DEVELOPMENT PROGRAMME (IMDP): A Decade of Innovation in Management Training for Public Health
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T
he International Management Development Programme's (IMDP) innovative approach to management education for
public health professionals has helped more than 4,000 managers from over 30 countries become stronger, more effective leaders. The IMDP courses are results-driven and take a practical approach to learning. Global in scope, the programme is designed to strengthen health systems by developing the management skills of professionals working in TB, HIV, malaria, tobacco control, road safety and other public health programmes. In 2013, the IMDP marked its tenth anniversary – a decade of innovation and leadership in management training for the international public health community.
Significant milestones of the first 10 years: 2003
Recognising the importance and urgency of strengthening management capacity among government programmes, NGOs and other providers at both the national and local level, The Union launches the International Management Development Programme. Its first offering: “The Basics of Budgeting� is presented to a small group of physicians in Uganda. 7
2004
With financial support from TBTCA (USAID) and the US Centers for Disease Control and Prevention (CDC), the IMDP’s first international management course “Management, Finance and Logistics” takes place in Jaipur, India. It is hailed as “groundbreaking” due to its peer-to-peer, sharing of management challenges as well as innovative solutions. 35 participants from 13 countries successfully complete the training. During the fall of the same year, a high-level, NTP-managers-only course, “Management of Managers” is held in Bangkok, Thailand; solidifying the IMDP's international role in health systems strengthening and human resource development.
2005
In collaboration with the Tropical Disease Foundation (TDF), the IMDP presents a new “Racing Ahead” course on creating change agents for organisational effectiveness in Manila. For the first time the IMDP offers a stand-alone course on the subject of innovation and positive change.
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Photo: Jens Jeske / The Union
2005 2006
Recognising the need to address budgeting and project planning challenges in public health as building blocks for successful programme implementation, the IMDP expands its course offerings, with 112 participants in China attending courses in “Budget Planning and Project Management”.
2007
With support from the Bloomberg Initiative to Reduce Tobacco Use, since 2007 the IMDP annually offers management training courses for tobacco control managers in countries with a high burden of tobacco use: China, India, Mexico, Russia, Bangladesh, Indonesia and many others. These courses cover the same content as IMDP core courses, but focus on examples of the challenges faced by managers working in tobacco control.
2008
Due to high demand for the IMDP's training, additional programmes on the subjects of change agents and mentoring take place in Manila in collaboration with TDF. In partnership with the World Health Organization, the IMDP offers “I Make the Difference”, a new 10-day course on building managerial competencies, in Geneva – a center for innovative international public health policy-making. 9
2010
In Johannesburg, 44 health workers take part in backto-back courses on “Management and Finance” for tuberculosis control. Worldwide a total of 331 participants attend 17 IMDP courses.
2011
378 participants attend 20 IMDP courses.
2012
291 participants attend 15 IMDP courses.
2013
A week-long training in “Management and Finance” takes place in South Africa for 25 mid- to senior-level government programme managers from that country. Participants from 14 African countries attend other IMDP international courses. Professionals from non-TB fields, such as child and maternal health, HIV/AIDS, malaria and road safety, increasingly choose the IMDP for their management training needs.
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The future As new programme priorities and needs develop in the public health community, the IMDP is developing new courses, such as “Monitoring and Evaluation” and “Advanced Project Management”, and preparing to introduce them in several countries.
The IMDP is making an impact. In a survey of IMDP alumni: • 88% of IMDP participants report receiving more responsibility in their current job • 73% report they have been encouraged to obtain additional qualifications • 58% have been given an opportunity to present papers at conferences • 42% have been promoted • 31% have been transferred to another job with greater responsibilities Photos: Jens Jeske / The Union
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EXECUTIVE PERSPECTIVE:
Dr. Ehsan Latif, Director of Tobacco Control The Union
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Photo: Courtesy of Dr. Ehsan Latif / The Union
I
nnovation, by definition, is the application of solutions that meet new requirements, unarticulated needs, or existing mar-
ket needs. The International Union Against Tuberculosis and Lung Disease (The Union) has thrived for nearly a century in part because of its ability to innovate in the face of changing times. Innovative management, in turn, is a way to instill better solutions at the human level. As Director of Tobacco Control for The Union, Dr. Ehsan Latif knows about innovative management, and he puts it to good use in his work overseeing 63 staff members in more than 15 countries. In a recent interview, Dr. Latif commented on his approach to management: “My staff are brought on board because they are strong advocates of tobacco control and lung health. My first management principle is that we want to nurture their passion while following the basic management rules. We always need to keep a balance between a well-managed department and an overly-managed one, where outputs are compromised and nothing comes out of it. We don’t want to drown the passion of these people for the cause they’re working for.” Of course, what Dr. Latif is really referring to is his dislike of micro-management. He is also not a big fan of hierarchies. While he emphasises the need to manage the basics of any working organisation—budgets, rules, deadlines, and so on—he is emphatic that 13
some of his most important roles include listening to, encouraging and collaborating with staff at every level. “Public health demands an innovative management style,” Dr. Latif says, “because what works in one place at one time might not work in another.” It is also a field in which goals can be difficult to measure, at least in the short-term: “In other organisations you have clear targets. In a business you need to meet your sales targets, for example. We have public health targets which are related to human behaviour: the consumption of tobacco products, number of deaths averted, degrees of disability reduced. At times you can’t see those effects immediately.” “Sometimes, for example when working on a piece of legislation, you don’t accomplish what you intended or reach your target goal. It may feel as if you have nothing to show for all your hard work,” Dr. Latif explains. “This means managers have to concentrate not on monitoring employees’ abilities to meet fixed goals, but on motivating them to keep working even in the face of sometimes discouraging results and challenging environments and also remember to celebrate successes.” Dr. Latif didn’t always have this innovative approach to leadership. When he took on his current role in January 2011, he brought to 14
the position his expertise in medicine and public health, not management: “When you are a doctor in a clinical setting you are very prescriptive. You know what works, which medicine to give. But when you move into public health, one size doesn’t fit all. You need to listen to the people, who are based in the country; seek their advice on what works; and what is the best approach to achieving the goals we set for ourselves.” With the help of José Luis Castro, Interim Executive Director of The Union and formerly Director of the International Management Development Programme, Dr. Latif began to adopt a more open, collaborative style. He credits this management style, in part, with creating the atmosphere of creative problem-solving that has recently led to some promising results in Indonesia. When attempts to promote national tobacco control measures there failed, The Union worked together with its partners under the Bloomberg Initiative to seek change at local government levels. It was a strategy that worked; many cities and provincial governments passed smoke-free and other tobacco-control-related legislation. This opened the door and created momentum for the country’s Minister of Health to move towards a national legislative amendment to the current law and recommend that Indonesia accede to the Framework Convention on Tobacco Control, a decision that would pave the way for more com15
prehensive country-wide tobacco control legislation. (The accession is currently awaiting Presidential approval.) “If we had just given up and said, ‘We didn’t achieve our targets for national legislation, let’s move on to another country,’ a lot of people would have missed out on a public health benefit,” comments Dr. Latif. “It was giving [our staff] the space to innovate, to find a Plan B solution that made it work.” And, thanks to the sub-national approach, 20 cities and local jurisdictions have passed tobacco control laws and 35 million people in Indonesia now enjoy smoke-free environments. An important tenet of The Union’s International Management Development Programme, is that in order to sustain success, good leaders must pass their knowledge and techniques on to their staff. Dr. Latif is committed to passing on his unorthodox and innovative management methods and works with his staff to develop their own management skills through training, coaching and example. Once they have mastered the techniques of innovative management, he trusts their own knowledge and passion for the cause will do the rest.
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“It was giving [our staff] the space to innovate, to find a Plan B solution, that made it work.� Dr. Ehsan Latif Director of Tobacco Control, The Union
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PARTICIPANT PROFILE:
GOKUL MISHRA Innovation, Networking & Partnership
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n 2010, when Gokul Mishra became the Focal Person to Nepal for Norway’s LHL International Tuberculosis Foundation
(LHLI), one thing was immediately clear: he would need to build a strong network of partners to succeed in his new job. Mishra’s role is to provide policy and planning expertise, as well as monitor the activities of Nepal’s National TB Programme (NTP), one of seven NTPs in high-burden countries supported by LHLI.
He is also in charge of implementing related LHLI projects, including a country-wide health communication project. The ability to collaborate innovatively with both local and international partners working in Nepal is thus an integral part of his job. 18
Photo: Stephan Rabimov / The Union
Mishra has advanced degrees in sociology and health care management, as well as more than 20 years of experience working as an evaluator, trainer, manager and policy-developer in national and international health and development. Nonetheless, the type of network-building required by his LHLI position presented him with a new challenge. For example, one of his assignments was to help develop and expand an LHLI-supported job skill development programme for TB patients run by the Nepal Anti-Tuberculosis Association (NATA). He hoped to involve other organisations in the project, but he wasn’t sure how to bring them on board, so he thought of The Union’s International Management Development Programme. The course he chose – “Influencing, Networking and Partnership” – covered a variety of techniques for collaborating and negotiating with diverse stakeholders, just what he was looking for. Mishra found the mix of lectures and practical exercises, such as role-playing, gave him a chance to increase his knowledge and also test his skills before he had to use them on the job. His newly acquired experience has expanded his understanding of consensus-building and helped him support the Nepal NTP’s efforts to launch a community-based directly observed treatment (CBDOT) programme to expand TB services across the country. To pass on his new skills, Mishra developed a workshop on consensus 19
development, which the NTP plans to incorporate into local, regional and national stakeholder meetings, enabling partners fighting TB throughout the country to more successfully implement and sustain CBDOT in their communities. And, as for the NATA job training project, Mishra has begun expanding the programme through a new partnership with another TB treatment centre in Nepal; and he is taking steps to find other partners as well. Indeed, the programme is becoming such a success that he recently gave a presentation on it at the 44th Union World Conference on Lung Health in Paris.
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INFLUENCING, NETWORKING AND PARTNERSHIP 2014 COURSE September 29 – October 3, 2014 • Register at union-imdp.org This course teaches participants various negotiating and collaborating techniques to build relationships with diverse stakeholders. In this five-day course, participants will engage in rigorous practice sessions to demonstrate how to build partnerships and networks. They will receive training on how to reach both consensus and common understanding to ensure smooth execution of project plans. Focus is given to developing the interpersonal communication skills to facilitate an enhanced sense of community and cooperation as well as to establish strong partnerships for promoting public health initiatives.
Programme Agenda DAY
1
DAY
› Welcome and introduction › Leadership tasks and relationships › Psychometric self-tests › Building on key themes of the day
2
DAY
› Importance of networking › Tasks and relationships › Giving and receiving feedback
3
DAY
› Expanding partnerships › Assessing personal influencing skills › Overview of leadership styles › Focused conversation method
4
DAY
5
› Consensus workshop › Method demonstration › Practice workshop
› Top action planning method › Preparation for personal action plan › Action plan presentations
Date
location
faculty
LEVEL
FEE
language
September 29 – October 3, 2014
Chicago, USA
Dennis Jennings and Judy Weddle
Middle- to seniorlevel professionals
Euro 2,000
English
“With the knowledge from this course I now know how to set up networking groups from provinces to the county level and also how to collaborate better with different kinds of organisations and staff in my division.” Dr. Feiying Liu Chief of TB Division, Guangxi Center for Disease Control and Prevention
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Creating a Global Roadmap to End Childhood TB
T
uberculosis is not a disease of the past, since more than 5,000 people – including at least 200 children – die of TB
every day. Young children under 5 years of age are particularly susceptible if they are exposed to TB, due to their age and other risks factors, such as the immunodeficiency caused by HIV infection or severe malnutrition. 22
Photo: Hnin Su Mon / The Union
As per international guidelines, young or HIV-infected children in contact with an adult with TB should be offered preventive treatment that can reduce the risk of their developing TB disease. However, in many limited-resource settings, this protocol is not followed and, unfortunately, children who do not receive proper diagnosis and preventive therapy often develop TB disease within one or two years – or at any later stage – after exposure. This is precisely why the burden of TB in children must be addressed. To build public awareness and offer a plan of action, in 2013 a group of seven partner organisations worked together to produce a new Roadmap for Childhood Tuberculosis with leadership from the Stop TB Partnership’s Childhood TB Subgroup, the global umbrella that advocates for all TB-related topics. Although there are well-developed systems for managing TB in adults, children most frequently receive health care from clinics providing maternal and child services, so their awareness and understanding of TB, as well as their participation, are critical to success. The partners were therefore very pleased that The United Nations Children’s Fund (UNICEF) joined their campaign, which, in addition to the Stop TB Partnership, also involved the World Health Organization (WHO), the International Union Against Tuberculosis and Lung Disease (The Union), Treatment Action Group (TAG), the US Centers for Disease Control and Prevention (CDC) and the US Agency for International Development (USAID). 23
“We managed to go beyond the TB community by including maternal and child health organisations, and this will facilitate the scale-up of better coordinated services for children,” said Dr. Anne Detjen, a technical consultant based at The Union North America Office, who served on the Roadmap writing team. The next challenge will be to see that the 10 steps for addressing childhood TB outlined in the Roadmap are implemented. “The Roadmap is more like an advocacy document than a policy statement,” said Detjen. “There are lots of policies. We want to see this happening on the ground, so our goal was to set out very clear steps.” Among the steps are very practical suggestions, including the need to: • Adapt the Roadmap to country needs • Develop child-friendly TB diagnostic tools, especially at peripheral levels of the health care systems • Train the human resources involved at each level, from the laboratory worker to senior management • Scale up services for efficiency and effectiveness. 24
TB-FREE FUTURE FOR CHILDREN 530 000
new cases of childhood TB
occur every year
Only US$ 120 million per year is required to address TB in children
This includes US$40 million for ART
Greater awareness and understanding of childhood TB must be promoted
Collaboration and joint action are essential to tackling childhood TB
TB
is a preventable and treatable disease
Focused investments are critical to ending TB deaths among children
Crucial research is urgently required to help END Childhood TB
74 000 children die from TB annually
*this number only includes HIV uninfected children
Design by Inís Communication – www.iniscommunication.com
infographic: Who / d Schumann, eCdC / t. hofsäss and Who / hm dias
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“Any child who dies from TB is one child too many,” said Dr Mario Raviglione, Director, Global Tuberculosis Programme at WHO in commenting on the importance of this campaign. “TB is preventable and treatable, and WHO is working towards translating this roadmap to action in countries to stop children dying.” Like other public health problems, a successful roll-out of the Roadmap is also linked to addressing other broad challenges, including the need to improve coordination among the many local, regional and international players involved in TB control; and avoid the duplication of efforts and wasted resources. Coordinating the development of the Roadmap took skilful project management and careful consensus building, especially since childhood TB can only be effectively addressed with greater collaboration of partners and players beyond the standard TB network, including the maternal and child health community. One of the key concepts of project management is that project plans should focus on prediction and prevention, not reaction and recognition. The partners who developed the Roadmap have successfully demonstrated this principle with their proactive plan to move the world toward a future with zero childhood deaths from TB. Although there are many challenges ahead, remaining stuck in ‘reaction and recognition’ will inevitably lead to the unacceptable outcome that thousands of children continue to die from TB. 26
upcoming 2014 IMDP Core 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 fee includes accommodation, breakfast, lunch, tea breaks and course materials. Course
Date
location
faculty
LEVEL
FEE
language
Leading Management Teams
April 7 – 11, 2014
Kuala Lumpur, Malaysia
Rajesh Kapoor and Gihan El Nahas
Middle- to senior-level professionals
Euro 1,500
English
Monitoring and Evaluation
May 12 – 16, 2014
Kuala Lumpur, Malaysia
Rajesh Kapoor and Gihan El Nahas
Middle- to senior-level professionals
Euro 1,500
English
Project Management
June 16 – 20, 2014
Entebbe, Uganda
Rajesh Kapoor and Gihan El Nahas
Junior- to middle-level professionals
Euro 2,000
English
Strategic Planning and Innovation
July 14 – 18, 2014
Kuala Lumpur, Malaysia
Viswanath Golpalkrishnan and Gayatri Sriram
Middle- to senior-level professionals
Euro 1,500
English
Budgeting and Financial Management
August 4 – 8, 2014
Kuala Lumpur, Malaysia
Frank Colella and Salil Kumar
Middle- to senior-level professionals
Euro 1,500
English
Photos credit: Jens Jeske / The Union
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the international management development programme庐 (imdp)
The healTh manager Issue 1, 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
union-imdp.org
Health solutions for the poor