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Scaling up Malaria Elimination Management and Leadership: A pilot in three provinces in Zimbabwe, 2016 -2018
Amanda Marr Chung
University of California San Francisco
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4443-9616
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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 communication between different cadres of health workers. Scale-up of this simple model can be achieved and benefits sustained over time if the process is imbedded into the programme with the training of health staff who can serve as management improvement coaches. Methods to improve operational performance that are scalable at the district level are urgently needed: this approach is a possible tactic that can significantly contribute to the achievement of global malaria eradication goals.
Keywords
Programme management, challenges, leadership, malaria elimination, capacity building, Zimbabwe, service delivery, operations
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Posted 18 May, 2020
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Editor assigned
On 05 May, 2020
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On 04 May, 2020
Editor invited
On 04 May, 2020
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Editorial decision: Minor Revision
On 14 Apr, 2020
Editor assigned
On 06 Apr, 2020
Submission checks complete
On 05 Apr, 2020
Editor invited
On 05 Apr, 2020
No comments provided
Review #1 received
Received 10 Feb, 2020
Editorial decision: Minor Revision
On 10 Feb, 2020
Reviewer #3 agreed
On 09 Feb, 2020
Review #2 received
Received 09 Feb, 2020
Reviewer #2 agreed
On 03 Feb, 2020
Reviewer #1 agreed
On 20 Jan, 2020
Reviewers invited
Invitations sent on 19 Jan, 2020
Editor assigned
On 17 Jan, 2020
First submitted
On 16 Jan, 2020
Submission checks complete
On 16 Jan, 2020
Editor invited
On 16 Jan, 2020
Metrics
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Subject Areas
Infectious Diseases
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This preprint is under consideration at Malaria Journal. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Scaling up Malaria Elimination Management and Leadership: A pilot in three provinces in Zimbabwe, 2016 -2018
Amanda Marr Chung
University of California San Francisco
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4443-9616
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 18 May, 2020
No community comments so far
Editor assigned
On 05 May, 2020
Submission checks complete
On 04 May, 2020
Editor invited
On 04 May, 2020
No comments provided
Editorial decision: Minor Revision
On 14 Apr, 2020
Editor assigned
On 06 Apr, 2020
Submission checks complete
On 05 Apr, 2020
Editor invited
On 05 Apr, 2020
No comments provided
Review #1 received
Received 10 Feb, 2020
Editorial decision: Minor Revision
On 10 Feb, 2020
Reviewer #3 agreed
On 09 Feb, 2020
Review #2 received
Received 09 Feb, 2020
Reviewer #2 agreed
On 03 Feb, 2020
Reviewer #1 agreed
On 20 Jan, 2020
Reviewers invited
Invitations sent on 19 Jan, 2020
Editor assigned
On 17 Jan, 2020
First submitted
On 16 Jan, 2020
Submission checks complete
On 16 Jan, 2020
Editor invited
On 16 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 communication between different cadres of health workers. Scale-up of this simple model can be achieved and benefits sustained over time if the process is imbedded into the programme with the training of health staff who can serve as management improvement coaches. Methods to improve operational performance that are scalable at the district level are urgently needed: this approach is a possible tactic that can significantly contribute to the achievement of global malaria eradication goals.
Figure 1
Figure 2