Building courses that build health system leaders and managers: steps from a collaborative workshop

Ermin Erasmus, CHEPSAA coordinator
08 May 2018

This blog was written by Ermine Erasmus and originally published on the CHEPSAA website.

At the beginning of April, 28 researchers, educators and health system managers from 12 countries in Africa and Asia attended a workshop in Johannesburg, South Africa with the aim of sharing experience around CHEPSAA’s open access courses and exploring how these courses, as well as other courses that participants teach, can be adapted to better target leaders and strategic managers in the health system. The workshop was a collaboration between the RESYST and CHEPSAA. The full workshop report is available here. In this blog, I report back on key discussions and anticipated next steps.

How do we see leadership and strategic management?
From a teaching perspective, one of the most important issues we discussed was: What is leadership and strategic management? This included the more specific questions of: What knowledge, mind-sets, and skills do health system managers need to be able to lead and manage strategically? Is this the same for managers at all levels of the health system?

The answers to these questions are very important. They will influence what is included in or excluded from new courses, or what is emphasized or de-emphasized. They will determine how courses are taught and assessed. And they will affect how we judge the approach, strengths and weaknesses of existing courses.

In response to these questions, the participants advanced general arguments and insights about the nature of leadership and strategic management, as well as specific ideas about the qualities and values, competencies and skills, and style or behaviours of leaders and strategic managers. I summarise these below, not as the answer, but as points to discuss, supplement and revise as we continue to think about how to develop health policy and systems teaching of relevance to health system leaders and managers.

We used the following, all very interesting, papers as inputs into our thinking about leadership and management:

What support do educators need?
In a meeting like this, it is natural to emphasize topics such as course content (what should students learn about leadership and management?), course delivery (what style should lecturers adopt and how do we make learning relevant to the workplace?), and assessment (how do we assess some of the softer skills that leaders and managers need to possess?).

However, one of the most important discussions during this meeting was about the support needed by educators. This was relevant for two reasons. First, many educators’ teaching has not had a leadership and management focus, and so they are likely to need support to master new content and adapt their courses to new target audiences. Second, health policy and systems is a young and emerging field, which means that people are often asked to teach long before they feel secure in the field and that one cannot assume the existence of teaching resources and supportive institutional cultures. Such issues have also been raised by others.

Indeed, among the many issues raised by participants, some were particularly relevant to teaching courses that develop leadership and management, but many others were about general teaching skills and the teaching environment.

To me, this suggests the need to think more seriously about ways of supporting health policy and systems educators. As one of the workshop participants said: “We are all teaching, but we have never been taught how to teach!”. It also speaks to the important role of networks such as CHEPSAA and Health System Global’s Thematic Working Group on Teaching and Learning in making connections between educators, providing support and encouragement, and spreading knowledge and good practice.

What next?
In addition to educators’ support needs and the nature of leadership and management, we also discussed the origin of CHEPSAA’s open access courses, existing adaptations to these courses for use with leaders and managers, and priority areas for further course and materials development. Beyond the networking, learning and sharing of ideas, what do we hope will come out of this meeting?

  1. We hope to draw on the resources of the participants to begin to create a repository of audio-visual materials - recorded lectures, case study documentaries, animations, webinars and podcasts – on the CHEPSAA website that can be used in teaching that aims to develop leadership and management. 
  2. The participants showed great interest in how to maintain a strong link between the classroom and the workplaces of leaders and managers. The plan is therefore to produce a document that will outline options on how to think about incorporating workplace learning and residential periods in teaching. This will be disseminated with an existing review of workplace-based learning experiences. 
  3. We also had lively discussions about reflective practices and exercises through which leaders and managers can learn to improve their practice. To take this further, we will develop a document that others can use to think about inserting reflective practices into their courses or deepening existing practices. This document will include useful readings, relevant definitions, the soft skills that could be improved through reflective practice, and cases of managers who have benefitted from reflective practices.
  4. We will work in more detail with two case studies that participants offered to share - one on community-based health insurance in Nigeria and another on conflict resolution in Ghana – to see how they address leadership and management, if we can further adapt or improve them, and how they can then be shared widely for open access use. 
  5. We will look at publishing blogs about some of the most interesting and topical issues discussed during the workshop.

In summary, we hope that we can build on this meeting to contribute ideas, experiences and perspectives through media such as blogs, but also other resources such as videos, case studies and how-to documents that can very tangibly support our own and others’ teaching. In keeping with our open access ethos, we will communicate widely as these resources become available for sharing.

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