Health Systems

The Project’s Purpose

The purpose of the World Economic Forum’s Health Systems Management Strengthening
(HSMS) initiative is to:
• Increase international recognition of the need to help strengthen the management of
health systems in Africa
• Innovatively partner corporate businesses with ministries of health in an effort to adapt leading corporate and academic practical management practices and tools to support public health system needs
• Provide support to in-country leaders from both the private and public sectors to reinforce their focus on management and leadership strengthening
• Disseminate lessons learned to bring a robust approach to scale via various health system implementers

The Public – Private Partnership Model and Background

Model
The vision of the Forum’s HSMS initiative is to catalyze an innovative PPP to:
• Work in support of ongoing national health reforms
• Build on existing, in-country leading practices for health system management
• Leverage untapped international and national private sector business management competencies and resources to support in-country public health system needs
• Create a replicable approach which emphasizes ownership and sustainability, and can be brought to scale throughout Sub-Saharan Africa

Background
In recent years, much has been said about the shortcomings of focusing solely on vertical disease programmes at the expense of not addressing “root cause” health system issues such as weak governance, information systems, poor infrastructure or human resource challenges.

Since September 2005, the Global Health Initiative (GHI) of the World Economic Forum has endeavoured to address the issue of health systems strengthening through piloting a PPP which could serve as a model to be brought to scale and implemented in Sub-Saharan Africa and potentially other regions of the world. After several rounds of consultation and based on a white paper analysis, the GHI and its partners identified management strengthening as a key area of need in public health systems that the Forum could positively impact by leveraging the business experience, expertise and tools of its private sector members.

In November 2007, the GHI and the Ghana Ministry of Health launched a pilot PPP focused on strengthening the communication, collaboration and overall management and leadership capacity within the Ghana Ministry of Health and its 16 regulatory, service, insurance and research agencies. Through this implementation effort, the GHI also intends to make a broader contribution to African health systems strengthening by sharing lessons learned and building a practical toolkit that would allow the approach to be replicated and scaled up in other Sub-Saharan countries.

Strengthening the Management of Health Systems In Practice

The Ghana Ministry of Health in conjunction with the GHI agreed that the most effective way to strengthen Ghana’s health system, would be by leveraging the former Heads of Agency  Committee. Under the PPP the Committee was revitalized into the Inter Agency Leadership Committee (IALC). IALC meetings provided the Ministry with a familiar platform where it could focus on building leadership and management capacities among the Heads of the 16 agencies involved. Regular quarterly IALC meetings were instituted, at which corporate sector partners shared management practices common to complex organizations.

Leveraging Private Sector Skill Offerings
In 2008, BD took the lead in sharing its “Portfolio Management Approach” to prioritization and planning. BD run two “Management Spotlights” during IALC meetings, which included case studies and a demonstration of the potential for the tools and processes to be used, including expected outcomes in Ghana. The members of the Inter-Agency Leadership Committee decided to adopt this approach to prioritizing the committee’s work, and potentially utilize the approach within their own respective agencies. BD followed up by offering facilitation and change management training to four Ghanaian health leaders at the company’s headquarters in New Jersey, and then supported the facilitators to lead a day-and-a-half Portfolio Management workshop for the committee, that allowed the processes and tools to be practically implemented and integrated at the leadership committee level.

Results after the First Year of Implementation
The M&E Framework developed together by the GHI and the Ghana Ministry of Health included four performance indicator targets that addressed participation, action-oriented processes and overall improved effectiveness and efficiency of inter-agency communication and
collaboration. All four of the indicators successfully met or exceeded their targets, demonstrating real improvement within the public health leadership team in Ghana. Several lessons learned were captured that will be shared during relevant Forum and international events, in addition to
feeding into future strategic plans. A survey administered at baseline and repeated at the end of year one with the health leadership in Ghana demonstrated the following results:
• 91% agreement of improvement of communication and collaboration between the heads of agency
• 82% agreement in improvement of health sector prioritization
• 73% agreement in improvement of management and/or leadership skills
• 100% agreement in understanding the benefit of the Inter- Agency Leadership Committee

The PPP results demonstrate:
• The value of innovatively partnering corporate businesses with ministries of health in an effort to
adapt leading corporate and academic practical management practices and tools to support public health system needs
• The potential of this HSMS model to be further tested, replicated and brought to scale in Sub-Saharan Africa