Get to know AMP Health - Uzoamaka Osikhena

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Uzoamaka Osikhena is AMP Health's new Regional Head, Anglophone Africa. Uzo recently sat down to share some information about herself with the AMP Health community. 

Q: What is your hometown?

Uzo: Hackensack, New Jersey; Lagos, Nigeria. Product of both places

Q: Before joining AMP Health, what was the most unusual or interesting job you’ve had?

Uzo: Years before joining AMP Health, I worked for DeWalt power tools as a Brand Representative. The role involved travelling across the US to NASCAR races where I sometimes worked as an event host facilitating car-cutting, tire-changing, and wood-sawing contests all using DeWalt power tools of course. I learned a lot about branding and customer loyalty and met several spirited, die-hard DeWalt fans along the way. It was great to see people relate to a brand with such intense passion.

Q: What made you interested in joining AMP Health?

Uzo: After working with the Ministry of Health (MoH) in Nigeria as part of a partner organization, I came to understand that in an effort to improve health outcomes partners often replace the capacity of the MoH and supporting government agencies at both the national and sub-national levels. While replacing this capacity has resulted in several successful partner-led programs, the issue of sustainability is often left unsolved and programs sometimes stop abruptly leaving a gap in the system. I was drawn to AMP Health because we seek to build the leadership and management capability of the MoH to allow them to be in the driver seat, coordinating partners and donors towards a government-driven strategy which is inherently more sustainable. AMP Health seeks to enhance the MoH’s ability to own and implement their community health programs and I am thrilled to be a part of that mission.

Q: What are 3 words you would use to describe Africa?

Uzo: Vibrant, Dynamic, Promising

Q: What have been the most gratifying and challenging aspects of your work thus far?

Uzo: Being less than two months in, it is a bit early to have gotten to a place of immense gratification. However, I believe that one of the challenges for AMP Health is translating improved leadership and management capability of the MoH to improved health outcomes. Ensuring that with stronger leadership and coordination at the MoH, a culture of stronger implementation, accountability, and focus on results can be developed all the way from the central level to the service delivery level.  Unpacking this challenge and solving for the bottlenecks is something that I’m really looking forward to doing with the team.  

Q: What do you like to do in your spare time?

Uzo: I enjoy cooking, I especially enjoy creating recipes that fuse Nigerian and American cuisine.

Q: People would be surprised if they knew…

Uzo: that I did amateur boxing competitively a few years ago.

Q: What is the best advice you’ve ever received?

Uzo: At a young age, my mom told me to always “think before you speak.” By nature, I have a very direct communication style so this piece of advice helps me pause and consider the impact of how I express myself to others.

What can we learn from Malawi’s first National Community Health Strategy?

This story was originally featured on HuffPost.

By Jeffrey Walker (Vice-Chair, Office of the UN Special Envoy for Health), Matthew Ramirez (Aspen Management Partnership for Health), Nikki Tyler (USAID’s Center for Accelerating Innovation and Impact), Precious Phiri (Malawi Federal Ministry of Health),and Reuben Ligowe (USAID/Malawi)

Strong community health systems can play an integral role in delivering essential healthcare interventions, especially to women and children, in providing linkages to the health system, and in improving the resilience and preparedness of health systems to respond to heath crises, such as Ebola.[1] As the profile of strong community health systems continues to advance, increasing attention has been paid to the important role that leadership and management play in strengthening these systems. Mounting evidence demonstrates that ‘management matters’ and is essential in driving systemic, sustainable change. It is through this lens that a multi-sectoral collaboration, The Aspen Management Partnership for Health (AMP Health), began. AMP Health looks to address the root causes of sub-optimal health services at the community level by providing a menu of support to Ministries of Health to strengthen management and leadership capacity. Working in the Ministry of Health, seasoned mid-career private sector professionals (termed management partners) are seconded to Ministries of Health. These management partners – as well as other offerings provided through the AMP Health platform – provide strategic, focused, and long-term support to address the most pressing community health priorities in a given country. Currently, AMP Health operates in three countries (Kenya, Malawi, and Sierra Leone) and is expanding to new countries in the coming months.

AMP Health’s model is already working – as evidenced through its support to the Malawi Federal Ministry of Health (FMoH) in creating the country’s first ever National Community Health Strategy (NCHS). To guide the myriad community health activities necessary in the face of decentralization, resource constraints, increased focus on community-level prevention and promotion, and quality of community health services, the FMoH recognized the need to develop a costed, actionable National Community Health Strategy – a strategy akin to those developed in the private sector. The FMoH, through the Community Health Services section, led the development of the strategy with support from key partners, including AMP Health, Dalberg Global Development Advisors, Save the Children, UNICEF, the World Bank, the United States Agency for International Development’s Center for Accelerating Innovation and Impact (USAID CII), and USAID/Malawi. Throughout this process, the important role of leadership and management became evident – not only in terms of developing a costed, actionable strategy but also in terms of ensuring a collaborative, practical, and outcomes-focused approach.

The NCHS – launched in July 2017 – outlines how the community health system will function and details interventions to achieve this across six thematic areas: (1) health services delivery; (2) human resources; (3) information, communication, technology; (4) supply chain and infrastructure; (5) community engagement; and, (6) leadership and coordination. The NCHS also contains a costed implementation plan and a return on investment analysis to guide activities and aid in resource mobilization. Over its five-year implementation from 2017 - 2022, the NCHS seeks to improve health outcomes, community ownership, and integration of health services and will contribute to reducing under-5 mortality by 25% and maternal mortality by 20%, deliver a 5:1 long-term economic return on investment, and strengthen the community health system for a generation.

Throughout the development of the NCHS, the FMoH and partners catalogued lessons learned to help other countries in the process of developing their own national community health strategies.

Key insights and lessons learned are outlined below.

· Developing a strategy requires a strong focus and detailed planning up front: The NCHS, including all consultations, was developed in six months. Before beginning the development of the strategy, the FMoH created a roadmap for its development, which included a timeline, and secured all resources needed for its development. The FMoH credits this roadmap with ensuring a streamlined, efficient process that did not need to stop/start multiple times.

· Include people across all levels during strategic development: The NCHS was developed with the input of over 500 stakeholders through an in-depth situation assessment, five zonal workshops, two national workshops, and various interviews. Contributors and participants included FMoH officials, implementing partners, community members, community health workers, and representatives from every district. These extensive consultations secured buy-in from other programs, built teamwork across organizations, allowed people to provide multiple levels of input throughout the process, and also served as an advocacy activity. This process ensured the strategy was owned by all stakeholders, including communities themselves, partners, the FMoH, and local governments. In the face of increasing decentralization, highly consultative processes are increasingly important.

· Have a diverse core working team: The Community Health Services Section was supported by a working team with diverse perspectives and expertise that included other FMoH programs, implementing partners, and consultants. Work was shared across the team, creating an environment with commitment, teamwork, and various skill sets, such as technical expertise of the FMoH and partners paired with leadership and management expertise from AMP Health and USAID’s CII. This dynamic ensured sufficient preparation for each activity –contributing to a well-run process, quality output, and building the team’s credibility.

· Align – and co-create – with other national policies: In Malawi, the NCHS was developed in parallel with the Health Sector Strategic Plan II (HSSP II). This integration led to alignment between national policies, strengthened relationships between FMoH departments, and was well received by partners. It also ensured that key elements of the NCHS are advocated for, and planned at, multiple levels.

· Prioritize: During NCHS development, workshop participants were frequently required to prioritize issues and activities in groups by thematic area using stickers and flipcharts. This visually showed how many issues and activities were under consideration, and the importance of prioritizing to have a greater chance of successful implementation.

· Ensure there are early, achievable wins in the strategy: Incorporate early, achievable targets to build momentum for implementation and to reinforce the strategy across the system.

· Clearly define community health and how it fits within the overall health sector: It is important to clearly define community health and establish how it integrates with broader health and community systems. This includes outlining how community health takes places, at what levels it is delivered and managed, and defining the roles of various contributors. For Malawi, this included considerations for the roles and relationships of multiple cadres of community health workers (CHWs), management positions at the district and national level, and community groups and committees.

· Set ambitious, but achievable, targets to support resource mobilization: The NCHS lists ten outcome and output targets that are intentionally ambitious but still meant to be achievable. This supports advocacy for resources based on targets in the strategy, but also recognizes the limitations of implementation. For example, Malawi policy recommends a 1:1,000 health surveillance assistant (HSA) to population ratio, though by 2022, the NCHS targets a 1:1,345 HSA to population ratio.[2]

· Community health systems can be costed in many ways: Be clear in communicating the scope of costing; for example, costing community health workers versus costing a community health system that includes community health workers, supplies, supervision, training, community health infrastructure (e.g., housing for community health workers, health posts), and interventions. The scope of costing greatly influences total costs. Organizing costs by categories, as well as start-up versus recurrent costs, makes it easier to understand the biggest cost drivers, as well as ‘steady-state’ cost of implementation separate from start-up activities/costs. This supports cross-country costing comparisons and understanding factors for varying per capita implementation. And remember that different partners – be it Ministries of Finance, public sector donors, or private sector investors – will be able to fund different activities, so tailoring advocacy materials or discussions appropriately can potentially lead to greater success.

· Importance of flexible, quickly accessible funding: Any process can face unexpected challenges or setbacks. Having flexible, quickly accessible funding can ensure minor challenges don’t lead to major setbacks. In this regard, the NCHS benefitted from the AMP Health country fund, a small fund accessed through the management partner, which filled gaps to ensure that unexpected issues and delays with funding from the FMoH and other partners did not delay activities or the process overall.

As a result of this process, the Malawi FMoH developed an actionable, costed community health strategy with a clear path to guide stakeholders throughout its implementation. It also gave the Malawi FMoH the opportunity to lead by setting targets and prioritizing costed activities to reach these targets, which has already aided conversations around resource mobilization within other Ministries, development partners, and the private sector.

As the Malawi FMoH states, “NCHS was developed by all to be implemented by all for the benefit of all for the next generation. There are no beneficiaries and implementers, we are all in this together.”

To learn more about the Malawi work and see how you can help, please visit http://www.ampforhealth.org/malawi/.

AMP Health is a partnership of The Aspen Institute, GlaxoSmithKline, Horace W. Goldsmith Foundation, Margaret A. Cargill Foundation, Merck, Global Health Alliance/UNSEO, Sall Family Foundation, USAID, GAVI.

[1] Strengthening Primary Health Care through Community Health Workers: Investment Case and Financing Recommendations.

[2] In Malawi, CHWs are commonly known as HSAs.

Expediting Access to Healthcare in Rural Africa

This story was originally featured on #WalkTogether

MALAWI / SPARKS OF HOPE / 30 OCT 2017

One billion people across the globe have no access to adequate health services. These individuals lack the basic care needed to prevent premature deaths from preventable diseases such as malaria, pneumonia, or complications from childbirth. Local community health workers have proven to play an integral role in delivering essential health services to the hardest to reach communities in the world. They have helped reduce child mortality by almost one-third, and help health systems prepare to respond to health crises like Ebola.

Today, a growing number of governments have recognised the health, social and economic returns of investing in community health workers and are ambitiously trying to scale their own community health worker systems. Yet, many lack the managerial, financial and strategic proficiency needed to mobilise large work forces. That’s where Aspen Management Partnership for Health (AMP Health) comes in. AMP Health is committed to making resilient community health systems the norm in Sub-Saharan Africa. AMP Health places experienced professionals in a country’s Ministry of Health to help them accelerate their community health programs. With public and private-sector partners, AMP Health offers ongoing training, consulting, and cross-country collaborations.

In July 2017, support from AMP Health led to the publication of the first-ever National Community Health Strategy in Malawi. Over the next 5 years, the implementation of this country-wide strategywill improve health outcomes, community ownership, and integration of health services throughout Malawi. Throughout the process, the Malawi Federal Ministry of Health engaged over 500 community members and other stakeholders for their feedback and recommendations. The strategy ambitiously plans to reduce under-5 mortality by 25%, reducing maternal mortality by 20%, and strengthening the community health system for the next generation. Along the way, the Ministry learned key lessons to help other countries develop their own national community health strategies.

The National Community Health Strategy was “developed by all to be implemented by all for the benefit of all for the next generation. There are no beneficiaries and implementers, we are all in this together.” AMP Health’s work and commitment is key to continue to support community health activities, which not only are essential to improve Malawi’s health outcomes, but also to support the country to achieve its commitment to the Sustainable Development Goals (SDG); in particular, SDG 3 on universal health coverage. Therefore, building a strong community health system is core to Malawi’s development agenda.

AMP Health & Gavi partner to strengthen health management capacity in developing countries

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Gavi, the Vaccine Alliance and the Aspen Institute have joined forces to strengthen national leadership, management and coordination of Malawi’s immunisation programme through the Aspen Management Partnership for Health (AMP Health). The partnership will improve managerial capacity to support Gavi’s mission to ensure that every child in Malawi is protected with life-saving vaccines.

In 2016-2020, Gavi, the Vaccine Alliance aims to immunise 300 million children worldwide, saving 5-6 million lives. Achieving this goal requires effective planning, implementation and monitoring of immunisation programmes. At the same time, immunisation teams in Ministries of Health are often inadequately resourced presenting an opportunity for improvement in management practices.

The partnership between Gavi and the Aspen Institute seeks to address these challenges by embedding a management partner into Malawi’s immunisation team, who will coach staff and build capacity to improve the performance of the immunisation programme.  

“At Gavi we know that effective management of immunisation programmes is key to building strong health systems and extending those systems to reach all children who desperately need them”, said Dr Seth Berkley, CEO of Gavi. “Our partnership with the Aspen Institute is one of many innovative investments in effective management that Gavi is rolling out. Aspen’s leadership and management expertise will be an important boost to our mission to ensure no child goes without lifesaving vaccines”, he added.

The partnership between Gavi and the Aspen Institute will build on the experience of AMP Health. AMP Health is a program of the Aspen Global Innovators Group working with ministries of health to build stronger leadership and management practices through real-time skills transfer, relevant training, and a platform for cross-country sharing of best practices. AMP Health currently works in Kenya, Malawi and Sierra Leone.

"The Aspen Institute's mission is to develop values-based leadership, which is critical to health systems facing grave challenges like Ebola and other diseases which can be prevented through immunisation," said Aspen Institute Vice President of Policy Programs, Peggy Clark. "AMP Health's innovative partnership will improve the health and well-being of many living in the hardest to reach parts of the world."

Original press release from Gavi, the Vaccine Alliance

AMP Health participates in meeting on integrating disease surveillance into community health worker networks

On October 3, 2017, AMP Health Director Mike Park and Aspen Global Innovators Group Managing Director Katie Drasser joined the Skoll Global Threats Fund and representatives from Medic Mobile, Living Goods, Last Mile Health, the Rockefeller Foundation, and more to discuss disease surveillance in community health worker networks. Participants discussed strategies and challenges to integrate community health workers into the detection, response, and verification stages of pandemic prevention. Through collaborative partnerships, stakeholder and community engagement, there is a huge opportunity to integrate disease surveillance into community health worker training programs across the globe. 

AMP Health attends Gates Foundation Goalkeepers Event

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On the 20th September 2017, the first ever Goalkeepers event took place in New York and was streamed live across the world. The event, hosted by the Bill and Melinda Gates Foundation, brought together a generation of determined thinkers, doers and givers, sharing their work and their ideas to help hit the ambitious Global Goals targets by 2030. Director Mike Park represented AMP Health as a Goalkeeper at the #GlobalGoals Event.

AMP Health featured at Institutionalizing Community Health Conference

Over 400 delegates from more than 15 countries, including all three AMP Health countries, gathered in Johannesburg in late March for the Institutionalizing Community Health Conference (ICHC) hosted by USAID and UNICEF in partnership with the Bill & Melinda Gates Foundation. Focused on promoting collective dialogue and advancing action on community health, ICHC brought together individuals from across sectors to share experiences and expertise.

Read about the session AMP Health led on public-private partnerships for strategy, leadership, and management in community health.