ACTIVITY UNCHANGED FROM FY 2008

SUMMARY:

The overall project goal is to increase access and availability of safe and effective treatment of HIV and

AIDS in the uninsured population of South Africa. The strategy to achieve this goal focuses on Human

Capacity Development (HCD) through activities that are designed to strengthen the AIDS leadership and

human resource (HR) management at the district level to deal with all aspects of improved service delivery.

BACKGROUND:

The South African Institute of Health Care Managers (SAIHCM) is a Not-for-Profit Association representing

qualified health care managers. SAIHCM was founded with a vision to enhance and promote high standards

of professional health care management in both the public and private sectors in South Africa. SAIHCM

supports HCD through a series of interventions designed to strengthen leadership around HIV and AIDS

and HR management. Coordination with provincial Departments of Health (DOH) takes place through

interaction with District Health Managers to identify participants who will enroll in this program. Equal access

to training activities will be ensured for all people. A gender focus will also be built into the work to be

undertaken in the management development forums. In this context, participants will undertake exercises to

assess gender aspects of their treatment project, looking at such issues as ensuring gender parity in uptake

of testing and treatment, including gender in data collection and promoting activities where all counselors

are trained on aspects relating to male norms and behavior..

To date, efforts to develop AIDS management and leadership in South Africa have focused on providing

training, which is an obvious first step to developing managerial competencies. However, not all managers

are able to attend such training, while others often are not aware of the fact that they do not have the

required skills to effectively undertake their managerial tasks. The default health care manager in South

Africa is a health care professional who has migrated into management (95% of AIDS managers surveyed

in the University of Pretoria study referred to earlier met this profile).

This project is designed to supplement existing management training efforts, by various organizations,

including PEPFAR partners, that focus on providing management qualifications, and to create an alternative

management development method that will develop management competencies of managers who cannot

enroll for formal academic qualifications. This project will also establish, at the district level, continued

professional development structures that will serve all managers from the district.

ACTIVITIES AND EXPECTED RESULTS:

ACTIVITY 1: Professional support services to qualified AIDS managers

The project will, on an annual basis, enroll 500 managers at a district level form both the public sector and

civil society who have formal management qualifications, and therefore qualify as SAIHCM members for a

one-year period. This will introduce them to a series of services customized to support the professional

development of health care managers. These include: 1) a monthly health management journal; 2) access

to the SAIHCM mentorship program; 3) an annual management conference and 4) regular newsletters via e

-mail on health management issues and ethical issues 5) the annual top 25 health care leaders award. As

part of this component, SAIHCM will conduct a survey to build a database of qualified health care managers

in the country. It is anticipated that once managers have experienced the benefits of these services, they or

their employer will take over the payment of membership fees in the following years.

ACTIVITY 2: Assessment of the training and development needs of AIDS managers

On an annual basis, 500 managers who have not received formal management training and managers will

be targeted. This is an internally-focused activity where the individual manager takes stock of his or her own

learning styles, preferences, strengths, weaknesses and development needs. These events are a

sophisticated means of identifying and developing competencies which individuals and teams require taking

on new roles effectively. It provides an in-depth picture of an individual by gathering data from many

sources during a three-day event conducted by a skilled facilitator. The end result is that the management

development needs of each participating health care manager are identified and converted into a personal

development strategy that will include enrolling in formal courses, self study, selected reading and

participating in peer learning events called Action Learning Sets (ALS).

ACTIVITY 3: Establishment of district forums for leadership development for AIDS managers.

SAIHCM will establish 50 Action Learning Sets per annum at the level of the health district. These are

facilitated learning events for managers, which will take place every two months. These one-day sessions

entail a continuous process of learning and reflection with the intention of collectively developing solutions

to tangible problems. Learning is centered on the need to find solutions to a real problems faced by the

managers in implementing AIDS projects. Learning is voluntary and learner-driven, while individual

development is as important as finding the solution to the problem. Action Learning is an approach to

management development pioneered by Reg Revans . It is based on his premise that "there can be no

learning without action and no sober and deliberate action without learning. Revans described learning as

having two elements: namely traditional instruction and critical reflection or questioning insight. He

maintained that learning equals programmed learning plus questioning insights. The Action Learning Set

(ALS) is designed to predominantly support the critical reflection component of learning. ALSes are learning

groups comprised of 10-20 members, including a facilitator. The set will meet one day every 6-8 weeks.

Attendance and commitment creates a culture of mutual support and challenge. Groups normally have a

facilitator whose main responsibility is helping the group create a culture that is supportive and challenging.

SAIHCM will further provide ALS members with access to a mentor, who will be an AIDS manager that has

a formal management qualification and who has received a complimentary SAIHCM membership on the

Activity Narrative: basis of their willingness to fulfill this role. The supervision by a SAIHCM facilitator will only be required for

the first six-month period. Learning is centered on the need to find solutions to real problems faced by the

managers in implementing AIDS projects. Once the ALS structures have been established they continue

under an elected group leader as forums for continuous professional development, peer support,

mechanism to improve morale and forums where collaboration between managers from both the public and

the private sector can be promoted. SAIHCM will continuously monitor that the ALS remain active and

actively support group leaders to ensure continuation. SAIHCM will, on a two monthly basis, interact with

group leaders via a dedicated web-based discussion forum and newsletter. The purpose of this interaction

is to provide group leaders with subject matter for the bi-monthly meetings and share the hot topics for

discussion identified by other districts. Annually, group leaders will convene at the SAIHCM Conference.

Articles produced by or relevant to the ALSes will be published in the SAIHCM Journal to further share

lessons learned with the broader health management community.

ACTIVITY 4: Workplace visits

Depending on need and funding SAIHCM will attempt to arrange a supervisory visit to the workplace of all

the managers enrolled on this program during the first year of participation. The purpose of these visits will

be to review that application of managerial competencies in the workplace with the participating manager, to

help identify opportunities to improve service delivery as well as potential challenges and obstacles that

these managers face that can be addressed in the monthly training sessions.

The anticipated outcomes of the project will be that every year:

400 AIDS managers who had never previously been trained in management will have participated in a

formal assessment of the managerial competencies and other skills needed to function as AIDS Managers.

They will have developed personal development plans and been channeled to formal training opportunities

offered by PEPFAR training partners or enrolled in the district-based management development forums.

20 district-based development forums will have been established where AIDS managers from all sectors

meet on a regular basis to participate in problem-solving brainstorming events and other Continuing

Professional Development (CPD) events.

Implementation of this project will rely on developing partnerships with various role players at the district

level involved in AIDS service delivery and capacity development.

Training institutions: SAIHCM already has a close working relationship with the Foundation for Professional

Development (FPD), a private institution of higher education, and also a PEPFAR training partner. In this

context SAIHCM provides alumni of FPD management training programs access to SAIHCM membership

benefits. This relationship will be leveraged to create a conduit to channel managers into sponsored formal

clinical and managerial training courses offered by FPD. SAIHCM will also actively engage other PEPFAR

partners who offer training, using the PEPFAR training catalogue with the same objective. Any AIDS

manager who is a graduate from a formal training program such as those offered by FPD, will also be

invited to attend the ALSes as a way for them to engage in life-long learning.

PEPFAR Partners and Civil Society AIDS Service organizations: SAIHCM will also engage PEPFAR

partners and other AIDS service organizations form civil society to invite their managers to participate in the

project. An added benefit of involving civil society leaders and managers is that it will create a forum where

the district-level leaders from both the public and the private sector will interact, leading to increased public-

private partnerships.

Provincial Government: SAIHCM will work in partnership with the Human Resources Departments of the

provincial Departments of Health in the all provinces to develop the capacity of AIDS managers at the

district level based on the outcomes of the ALSes. The District Health Services competency framework is

one that was introduced in the pilot phase with full support of provincial and National Health Department

management. The Health Systems Framework will guide the project. All interventions will be aligned

developing the competencies to implement this framework.

New/Continuing Activity: Continuing Activity

Continuing Activity: 21170

Continued Associated Activity Information

Activity Activity ID USG Agency Prime Partner Mechanism Mechanism ID Mechanism Planned Funds

System ID System ID

21170 21170.08 U.S. Agency for South African 9228 9228.08 $640,316

International Institute of Health

Development Care Managers

Emphasis Areas

Gender

* Increasing gender equity in HIV/AIDS programs

Human Capacity Development

Estimated amount of funding that is planned for Human Capacity Development $640,316

Public Health Evaluation

Food and Nutrition: Policy, Tools, and Service Delivery

Food and Nutrition: Commodities

Economic Strengthening

Education

Water

Table 3.3.09: