Maternal, Newborn, and Child Health
MNCH Health Systems Strengthening Interventions
Maternal, Newborn, and Child Health
MNCH Health Systems Strengthening InterventionsLeadership, Management & Coordination
Strengthening Health System Performance
A well-functioning health system depends on strong leadership, effective coordination, and sound management practices. These elements ensure that health services are efficiently delivered, equitably distributed, and continuously improved to meet community needs. Inspired leadership fosters a shared vision and commitment to high-quality care, while robust management systems provide the structure and processes needed to translate policies into action. Transparent governance ensures that decision-making is inclusive, accountable, and data-driven.
For a health system to perform optimally, equitable and evidence-based policies must be developed and, more importantly, effectively implemented. However, policies alone are not enough. Health workers and managers require well-functioning systems, supportive supervision, and adequate resources to perform their roles effectively. Likewise, service users must be empowered with mechanisms to voice concerns, provide feedback, and hold the health system accountable for its performance.
Effective work planning and resource allocation should be rational, participatory, and transparent, ensuring that financial and human resources are optimally deployed where they are needed most. At every level, health system leaders and managers must cultivate strong leadership and management skills to motivate staff, drive quality improvement, and ensure the consistent and correct implementation of proven interventions.
This intervention provides strategies, tools, and best practices to strengthen leadership, coordination, and management at all levels – ensuring a more responsive, efficient, and resilient health system.
What Are the Benefits of Stronger Leadership, Coordination, and Management?
How to Implement
1. Foster Positive Team Dynamics
- Communicate clearly and effectively.
- Embrace diverse viewpoints and manage conflicts constructively.
- Address challenges promptly and focus on shared results.
2. Use Data to Inform Decisions
- Analyze and interpret data from multiple sources.
- Engage with stakeholders, including clients and colleagues.
- Identify trends, opportunities, and risks.
- Assess organizational strengths and weaknesses.
- Make evidence-based decisions to drive improvements.
3. Align with National MNCH Priorities
4. Develop and Execute a Shared Strategy
- Set clear direction and shared goals.
- Identify performance and development gaps.
- Analyze root causes and select strategic priorities.
- Design action plans to tackle challenges and improve performance.
5. Optimize Resource Allocation
- Forecast and mobilize necessary resources.
- Allocate resources ethically and efficiently.
- Reduce risks, corruption, and waste.
6. Enhance Responsiveness to Clients and Communities
- Establish accountability mechanisms.
- Share information regularly with clients and communities.
- Collect and act on client feedback to improve services.
7. Leverage Team Power for Change
- Create spaces for collaboration and productive exchange.
- Build alliances and engage with decision-makers.
- Shift from individual to collective efforts to drive change.
8. Strengthen Stakeholder Coordination
- Establish steering committees and coordination platforms.
- Align MNCH efforts across health systems and community levels.
9. Promote Multisectoral Action
- Engage multiple sectors to address social determinants of health.
- Foster cross-sector collaboration for sustainable MNCH improvements.
What’s the Evidence?
Conceptual model of Leadership, Management, and Governance Practices.
From: Chepkorir, J., Agata, N., Kiambi, N., & Nangehe, B. (2021). Institutionalizing Leadership Management and Governance for Health System Strengthening in Emerging Economies: Evidence from the Partnership for Health System Strengthening in Africa (PHSSA) Programme. European Journal of Business and Management Research, 6(6), 47-52.
Key Indicators
- Number of steering committee group meetings led by the government who met and used data for decision making to make course corrections.
- Number of governments that have dedicated budget lines for MNCH.
- Number of instances where leaders have met with community members to ensure accountability on commitments.
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Tips
- Steering committees should include participants from the local government, other line ministries from related sectors, community representatives, including youth, and health system stakeholders, and meet quarterly to review program data and make decisions.
- TCI’s Reflection and Action to Improve Self-Reliance and Effectiveness (RAISE) tool can support coordination and decision-making for members of the steering committee.
- At the sub-national level, coaching health district managers to conduct regular supportive supervision and monitoring on MNCH in facilities improves quality of care.
- TCI’s Data Reporting and Utilization Check Up tool tracks capacity on a number of D4D indicators and can help leaders in government, and at all levels, to assess gaps, plan, and monitor progress around D4D.
Challenges
- Leadership positions in the government tend to transition, and programs need to bring new leaders up to speed, which can disturb momentum. Master coaches within the government can ensure that new leadership staff are quickly brought up to speed on program objectives and activities, and continue being engaged and committed to MNCH.
- Government priorities, as well as government resources, can shift away from MNCH (e.g., if there are emerging threats such as pandemics or natural disasters). Advocacy efforts should also focus on ensuring that MNCH is included in 5-year strategic plans and local government action plans.
- Centralized one-size-fits-all health system approach and unclear administrative roles and command structures can also be a challenge. A decentralized approach, especially at the sub-national level, can decide how to allocate and use resources for their communities is a promising approach.
- Leadership and management go hand in hand, however, program management skills may need to be strengthened. This can be strengthened through management coaching throughout the program cycle. This can be done using the How to Design a TCI Program approach.
Key Resources
- Strengthening National Advocacy Coalitions for Improved Women’s and Children’s Health. PMCH 2013
- Strengthening Health Systems to Improve Maternal, Neonatal and Child health Outcomes. MCHIP 2011
- Leadership Development Program Plus. A Guide for Facilitators. MSH 2014 (Updated)
- Improving Leadership, Management, and Governance to Strengthen Health Systems. Technical Highlight 2018
