Management Training: An Investment Necessary to Advance Public Health

The world is at a crucial turning point in medical progress, with dropping infection rates and expanded efforts to prevent and treat the three pandemics: AIDS, Tuberculosis and Malaria. Recognizing this pivotal junction, The Global Fund Against AIDS, Tuberculosis and Malaria (GFATM) has developed a New Funding Model that will allow it to invest more strategically, engage implementers and partners more effectively, and achieve greater global impact. The new model includes two types of funding: formula based funding, which is adjusted for qualitative factors, such as major sources of external financing, absorptive capacity, and risk; and, incentive funding, which rewards well-performing programs.

Experience and research, has taught us that the performance of public health programs, is directly linked to the performance of its leaders, managers, and systems. As pressure to deliver results rises, partially driven by incentive funding, the demand to support human resources development (HRD) and, with it, health systems strengthening (HSS), becomes more pertinent than ever before. "Efficiency is a management issue, not a medical issue," advocates GFATM, in its recent documentation on the New Funding Model. It underlines that: "Effectiveness is what gives value, and efficiency is to achieve that value for the least amount of money. Together, effectiveness with efficiency give value for money." As GFATM grant-recipient countries begin developing new and strengthening existing national strategic plans to eliminate the three diseases for the 2014-2016 funding period, national bodies are faced with an important question:

How can countries achieve better efficiency and effectiveness of their programs?

The International Union Against Tuberculosis and Lung Disease (The Union), with more than nine decades of experience developing health solutions for the poor, designed an innovative and accredited training on programmatic and management issues. The International Management Development Programme (IMDP) aims to increase capacity to efficiently deliver interventions, retain a responsive and knowledgeable workforce, and offer effective leadership and governance across programs and beyond - all in limited-resource settings.
Over the past decade, the IMDP has trained more than 4,000 public health professionals from leading international development institutions, including the Global Fund, the United States Centers for Disease Control and Prevention, the World Health Organization, the United National Development Programme, as well as National TB and HIV Controllers (NTPs and NAPs). The qualitative information collected over the history of the IMDP program yields key conclusions pertaining to human resources development and health systems strengthening, including:

1. Management is management. Many of the effective management concepts addressed within the private sector professional development -- project management, budget and financial management, human resources management, leadership, and communication skills -- are essential for the success of public health programs worldwide;

2. Organizational culture for training has a positive impact on the program effectiveness. Programs that support management training and knowledge transfer, and reward trained employees, produce a well-educated network with a greater capacity;

3. Global professional networking complements local management development. Through cross-cutting HSS and HRD trainings, students establish direct contact with regional and international professionals addressing similar public health issues, which greatly enriches the experience pool and results in a shared learning environment, and a wider global knowledge disbursement.

Recognizing the wide-reaching potential of management training on program efficiency and effectiveness, Vietnam has continuously trained its national public health staff through various management training programs, including dozens of national staff trained by The Union's IMDP. Vietnam's long-term investments into strengthening of its health systems, improvements in reduction of bottlenecks in the delivery, and scaling up of interventions, were reflected in the highest possible grant assessment score (A-1) of existing GFATM HSS programs.

The previous experience, prior knowledge, training, and education all facilitate HRD and HSS, as they are cumulative in nature. The more training and education public health program managers receive the greater use of the new knowledge and skills application will be, leading to better performing programs. Management training remains one of the most under-utilized program improvement tools and the need for HRD was further reinforced in a recent letter to the GFATM Board Members by the Chair, Nafsiah Mboi, and Vice Chair, Mireille Guigaz: "The Global Fund relies on its workforce. This is why continuous improvement of the management of human resources is crucial and is an area that we need to cultivate."

As countries prepare for the next round of GFATM funding by developing and strengthening their national strategic plans, the inclusion of management development training in the countries' Global Fund proposals remains an important human resources component and a strategic health systems investment. This will surely benefit all stakeholders in support of the global fight against AIDS, Tuberculosis and Malaria.