Philippines Toolkit: Self-Reliance
Health Leadership and Governance (HLG)
The Health Leadership & Governance (HLG) approach for City managers is a leadership development program designed to help LGU middle managers & members of the City Leadership Teams (CLTs) develop responsive leadership and governance systems for the immediate reduction of teenage pregnancy rates.
Anchored on the Zuellig Family Foundation’s Bridging Leadership framework, BL Public Health Managers are engaged to develop four essential competencies crucial in building adolescent-friendly cities.
- Develop self-mastery and personal experience as a public health manager
- Achieve health equity outcomes
- Strengthen multisectoral network to attain health equity & better health outcomes
- Engage Community responsively as key stakeholders
The Health Leadership & Governance (HLG) High Impact Intervention (HII) along with the other HIIs in the Philippine Toolkit, will serve as critical inputs to achieve the desired outcome of a reduction in teenage pregnancy by developing the sense of ownership of key decision-makers, as well as enhancing their technical appreciation of the other TCI HIIs.
What are the benefits of this approach?
- Strong leadership and local health governance will create a culture of excellence and improved health system performance.
- Better health systems mean better overall health outcomes from health service delivery.
How to implement
Step 1: Create a City Leadership Team
The City Leadership Team (CLT) is a multi-sectoral team, either newly-created or based on existing counterparts (RPRH Implementation Team, ISDN/KADA Technical Working Group, Local Health Board) created to plan, manage, execute and monitor TCI evidence-based practices.
It is recommended that the CLT be composed of:
- Heads and/or key coordinators of respective city government departments (Health, Social Welfare, SK Federation, Youth Development, Education)
- Counterparts from national agencies, such as the Commission on Population (CPD), the Department of Health (DOH), etc.
- Youth leaders from government (SK, LYDO) & non-governmental organizations (NGOs)
- Representatives from hospitals
- Representatives from civil society organizations (CSO) and the private sector
To strengthen the identity of the CLT and concretize its roles, develop an Executive order or a Memorandum of Understanding mandating the membership, functions and responsibilities of the LGU partners, DOH & CPD.
Step 2: Develop a Program Design
The Program Design is the central document of the TCI program. It contains an analysis of the initial landscape of the LGU in terms of its FP & ASRH program, its gaps & priority problems, and the solutions developed by the team to address these issues using the TCI HIPs/HIIs toolkit.
- Conduct a landscape analysis to identify the scope of the FP & ASRH programs in the city. Landscape analysis is also the prime opportunity to conduct baseline analysis in preparation for targeting.
- Identify the major stakeholders & conduct gap analysis.
- Identify the HIP/HII that best fits the problems & formulate activities that can solve these problems. Implement the intervention and monitor regularly via a set of success indicators that were agreed upon.
- Create a budget plan accounting for the scope of interventions & targets.
- Create a monitoring plan through RAISE and QI assessment to identify the progress of the program.
Step 3: Capacitate the leadership
To capacitate leadership, two types of competencies/knowledge need to be addressed and developed: the explicit, technical knowledge necessary to execute the intervention, and the implicit, adaptive knowledge & soft skills that help the leader navigate strategies, build coalitions and inspire co-creation.
- To build technical knowledge, the TCI University provides toolkits of proven high-impact practices & step-by-step guides to executing proven interventions. At the local level, these are also addressed via the various DOH & CPD issuances & manuals of procedure.
- To build implicit knowledge & adaptive leadership skills, the TCI prescribes its own model of coaching (Lead-Assist-Observe) to serve as a general how-to guide. In addition, ZFF has sessions on instilling Bridging Leadership & Systems thinking to health leaders.
Both types are addressed within the Health Leadership & Governance Workshop
- Check the internal capacities of the leadership team, identify their priorities, their strengths & gaps in terms of technical knowledge (HIP/HIIs), nonverbal skills & leadership.
- Capacitate the leadership through formal training using the Health Leadership & Governance Module (HLG).
HEALTH LEADERSHIP AND GOVERNANCE MODULE |
PRE-REQUISITES
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CONTENTTechnical lectures & activities on:
Workshop skills training on:
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COACHING FOR BRIDGING LEADERS |
PRE-REQUISITES
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CONTENT
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Step 4: Conduct Continuous Coaching
- Deepen the understanding of leadership & improve the confidence of the CLT by providing continuous coaching. The avenues for coaching can vary depending on need, from mentoring on technical knowledge, to coaching conversations, to periodic reviews of performance through the Quality implementation Checklist Assessment on Health Systems Strengthening and Leadership & Ownership. Conduct data review and promote usage of the same to inform programmatic discussions and subsequent decision-making.
Tip: The Reflection and Action to Improve Self-Reliance & Effectiveness (RAISE) tool is used to assess the systemic pillars of the TCI program in the city: Political & Financial Commitment, Capacity Strengthening, HII/HIP Institutionalization and Sustained Demand. The tool identifies the current challenges & gaps in the program opening the way for planning problem solving by the CLT.
- Open communication channels on preferred platforms for regular sharing of information and feedback among leadership team members. Engage a wide range of stakeholders and ensure that they have ready access to technical assistance and the HIIs/HIPs. These can be done through further peer learning among & between CLTs.
- Conduct periodic Pause & Reflect sessions with the entire CLT in order to review the original gaps, track the progress of interventions & decide on subsequent action plans. The P&R sessions are also prime opportunities to deliver enhancement sessions on HIPs & coaching skills to the CLT.
Step 5: Document Learnings and Share Your Story
- Document learnings obtained through coaching & observations in the Program Design / Annual Report document. These should be able to illustrate the progression between the problem to HIP/HII solution to actual short-term & long-terms outputs to large-scale outcomes
- Take note of innovations. These are improvements on the system (practices, procedures, design), that help improve the outcome either by 1) producing results faster or higher than expected, 2) reducing costs or effort, 3) streamlining the process, 4) widening the scope of service provided.
- Once accomplished, these learnings & innovations serve as their own proof of concept that the LGU was able to successfully accomplish its goals. These are valuable lessons that can be shared & broadcast to others through the Community of Practice to serve as a benchmark for others.
Indicators for success
Vertical Indicators
- Inclusion of PHIC into the Program Design
- Inclusion of PHIC in the Work & Financial Plan, Annual Operational Plan, Annual Investment Plan
Horizontal Indicators
- # of facilities accredited with PhilHealth Konsulta Package
- # of facilities accredited with PhilHealth Maternal Care Package
- # of providers accredited with PhilHealth and trained on FP Competency-based Training II for Postpartum IUD & Subdermal Implants
Evidence of Impact
- Constant engagement and proactive leadership in the city of Cagayan de Oro has resulted in rapid gains on their Adolescent Sexual Reproductive Health program. Through successive leadership workshops & dialogue with the City Mayor, the City Health Office was able to build a coalition of other LGU & NGO partners under a City Leadership Team. Prominent among these are the development of the Oro Youth Development Office which, in the span of 2 years, was able to capacitate & man health centers with trained peer educators, generate publicity materials through a song contest & even inspire the SK Federation to sponsor the re-establishment of the Botika ng Barangay (Village pharmacies). The visible success of the CDO CLT has been received by the City Mayor whom in turn has mandated the successive annual increase in the budget allotment for ASRH programs. With the assumption of Mayor Uy in 2023, the city was able to successfully lobby for a separate stand-alone budget item for FP – a first in city history.
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Philippines Program Areas
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Self-Reliance
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