Catholic coalition to develop training institute in Zambia

October 15, 2013

Program to offer practical skill-building for administrators, boards of faith-based hospitals


A coalition of Catholic organizations in the U.S. and Zambia are forming an institute to bolster the leadership skills of administrators and managers at Christian hospitals across Zambia. The institute's creation is part of a larger initiative to strengthen faith-based health care in the southern African country.

The Leadership and Governance Academy training program will equip hospital administrators in Zambia "with management and leadership skills necessary to enable them to steer their organization using modern management theories and practices," said Josephat Kakoma, of the Churches Health Association of Zambia, or CHAZ, in Lusaka, Zambia. Kakoma is managing the project for CHAZ.

"In the long term," he said, "the training will enhance the delivery of health services and potentially improve relations with communities, improve health outcomes and reduce disease burdens and morbidity in the catchment areas."

Nurses at Chikuni Mission Hospital.

CHAZ, Catholic Relief Services, the University of Notre Dame, Saint Louis University College of Public Health and Social Justice, CHA, St. Louis-based Ascension Global Mission and the Global Health Partnership Initiative are collaborating on the academy's creation.

Students in the executive training program will sharpen their management and governance skills. They will learn to develop governance systems that are transparent and accountable, make strategic plans and work plans, manage performance, hone advocacy skills, improve human resource practices, mobilize workers and engage communities in decision-making, Kakoma said.

"Ultimately, the training will equip administrators with skills to meet the often unpredictable and challenging environmental, socioeconomic stimuli that often have adverse impacts on their institutions," Kakoma said. The Leadership and Governance Academy plans to offer diploma programs in health management and health administration.

The institute will launch early next year and be based at the Lusaka headquarters of CHAZ, a membership organization representing 151 Christian facilities, including 36 hospitals, 81 rural health clinics, 10 training schools and other health care sites. Most of CHAZ' member facilities are owned by a church or faith-based mission; just over 50 percent of CHAZ' members are Catholic facilities owned by churches within the Zambia Episcopal Conference.

Robin Contino, program manager for the global health system strengthening initiative for Baltimore-based CRS, said the courses will be delivered using a combination of online and on-site lectures as well as in-person training at CHAZ' headquarters. Saint Louis University is leading the development of curriculum and will train CHAZ staff to teach much of the formal course work. Executive mentors drawn from throughout Ascension will be in regular conversations with the students to reinforce the course work and give students a sounding board for questions and discussion.

Opportunity for growth

The academy's inaugural class of students will be made up of teams of working hospital administrators and their managers. CHAZ said several of its member facilities have expressed interest in participating. CHAZ representatives expect several dozen students in the inaugural session.

CHAZ plans to train the students in groups of about seven to 11 people per site. Each group will include an executive administrator and his or her management team. Initially, the center will offer a yearlong program for management groups at up to six yet-to-be-identified hospitals.

Kakoma said in time "the training can be extended to the entire faith-based Christian health service delivery (network) countrywide."

Raising the bar

Bruce Compton, CHA senior director of international outreach, said that with CHAZ members serving an estimated 50 percent of the rural population of Zambia, the academy could have widespread impact by improving health care management.

For years, the Zambian government's Ministry of Health has raised concerns about the qualifications of some hospital administrators at health facilities sponsored by churches, in part because many hospital administrators do not have the relevant management qualifications required by the government, Kakoma said. He explained there are no existing health administration or management degree programs in Zambia; many hospital administrators have a bachelor's of arts degree in public administration or a diploma in management studies or the like.

After years of pressing the issue of administrators' qualifications, the government began an effort to replace the administrative heads of some private nonprofit hospitals with its own civil service employees. The Zambian churches that own hospitals — and the Zambia Episcopal Conference that oversees many of the hospitals — were concerned that when it came to Christian hospitals in the country, "they need to appoint individuals who shared Christian (values)," said Kakoma, adding that Christian hospitals uphold "moral standards" of sobriety and marital fidelity.

CHAZ requested the government give the association an opportunity to train administrators at its member facilities and bring their credentials in line with government requirements.

Through a series of negotiations, the Zambian government agreed in 2010 that church hospitals may continue to employ their own administrators, as long as those individuals have academic credentials deemed appropriate by the government.

Familiar partners

CHAZ turned to CRS for help with the training program.

The two organizations had built a strong relationship working on projects to provide antiretroviral therapy and reduce AIDS in Zambia, initiatives funded by the U.S. President's Emergency Plan for AIDS Relief.

CRS in turn involved CHA, Saint Louis University College of Public Health and Social Justice and the University of Notre Dame Eck Institute for Global Health. CRS, CHA and the University of Notre Dame collaborate through the Global Health System Strengthening Initiative which aims in part to strengthen faith-based health systems.

Compton said that CHA's role in the Zambia project is limited to facilitating introductions with its members. Currently, Ascension Global Mission and Saint Louis University College of Public Health and Social Justice are the only CHA members involved.

Locally owned

Importantly, CHAZ has taken "ownership" of the training initiative and will work directly with CRS Zambia, which will provide in-country oversight, Compton said. "As U.S. partners, the Catholic health care providers and Catholic universities will provide resources to help them solve their problem," Compton said.

Notre Dame is leading the operations research component of the project by using research methodologies and applications to understand the project's impact. It also is helping develop the methods of monitoring and evaluating the executive training program. Saint Louis University's College of Public Health and Social Justice is developing the curriculum in close cooperation with CHAZ.

Ascension Global Mission will engage managers with strong hospital leadership and governance experience from throughout Ascension to mentor the institute's students.

The Global Health Partnership Initiative is providing financial support. CRS and Notre Dame also have contributed money. Contino estimates the institute will require an annual investment of about $250,000 to $300,000 from the U.S. partners for its first three years of operations. CHA is not contributing financially to the initiative.

The Global Health Partnership Initiative

One of the collaborators in the Zambia academy is the Global Health Partnership Initiative.

The initiative is an independent, nonprofit corporation formed by a collaboration of Ascension Global Mission and Ascension's "historic founding sponsors." Those sponsors are the Congregation of St. Joseph; the Daughters of Charity, Province of St. Louise; and the Sisters of St. Joseph of Carondelet. The Global Health Partnership Initiative's mission is to improve the health of the world's most neglected people.

The initiative's partners welcome additional partners, according to Susan Nestor Levy, president and chief executive of Ascension Global Mission.


Copyright © 2013 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2013 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.