“If you have capacity built to support quality close-to-community service provision you will encourage the community to maximally access service care and ensure healthy outcomes” Allone Ganizani, Ministry of Health Malawi.
Capacity strengthening is a critical strand throughout REACHOUT and one third of our budget is dedicated to taking forward capacity from a holistic perspective: strengthening the capacity of researchers, institutions, policy makers and practitioners. At the midway point of our REACHOUT journey and at our fifth consortium meeting in beautiful mountainous Cianjur (Indonesia), we thought it was an opportune moment to reflect and share experiences about some of our capacity strengthening strategies.
REACHOUT has a ‘young researchers’ group. The group meets regularly to share experiences, resources and networks and came to Cianjur a week earlier than the rest of the consortium for research skills training led by Vicki Doyle, Malabika Sarker and Miriam Taegtmeyer. The sessions focused on qualitative and quantitative analysis and the ‘how to’ of integrating mixed data sets. Sozinho Ndima, from University Eduardo Mondlane in Mozambique explained: “I enjoyed the focus on mixed methods and how to integrate different qualitative and quantitative data sets.”
Vicki explained: ‘there’s no point being a great researcher unless you can share your findings – this needs both verbal and written skills’. Sessions also included personal development plans (PDP); sharing your passions through a soap box delivery and elevator pitches (what do you say about your research when you only have two minutes with a key and powerful person in a lift). Elias Bunte from REACH Ethiopia said: “it was very nice, we talked without power points, it gave us confidence about how to speak in public” and Sadia Chowdhury from the Bangladeshi James P Grant School of Public Health shared how she “enjoyed the quantitative analysis, as I’m a qualitative researcher I fully understood the motivational questionnaire which was great, I also liked discussing the pitfalls of mixed methods and the PDP was wonderful.”
Young researchers were challenged to practice their elevator pitches on policy makers and key stakeholders the following week.
Enabling joint learning and south-south exchange is a key component of our capacity strengthening strategy. The REACHOUT partnership includes countries taking forward innovative and respected Community Health Worker/close-to-community provider approaches and this provides an excellent opportunity to share experiences across contexts about practices and innovations that could be adapted. James P Grant School of Public Health leads the REACHOUT capacity strengthening strategy and are evaluating south-south learning and exchange. Many examples of south-south learning in the experiences on our first round of quality improvement cycles were shared during our consortium meeting in Cianjur, for example:
The legacy of REACHOUT is sustained as improved close-to-community services, during the second Quality Improvement (QI) cycle, will move from a mainly researcher led process to one that is more embedded and owned by district practitioners and policy players. And each country partner was joined by at least one key policy maker in the Cianjur meeting to jointly go through a Training of Trainers approach for embedded QI cycles. This included training sessions in the morning and ‘teach back’ sessions in the afternoon, where participants were challenged to conduct 20 minute training sessions on the morning’s content (e.g. why quality is important, indicators and methods for quality) to colleagues who pretended to be participants from the various countries e.g. District officials and supervisors from Mozambique. The sessions were interactive and trainers used a lot of engaging adult learning approaches, such as role plays and group exercises. QI processes use a systematic approach and are simple, robust and regularly applied through a cyclical action learning approach. Vicki explained there is little research on the processes of embedding QI cycles in community health services and we will be both pioneers and “NICE guys” who Nurture, Inspire, (provide) Continuity and Embed. In a nutshell we need to inspire others and be creative facilitators and advocates for QI within our countries and programmes.
Charity Tatua, Lilian Otiso and Nelly Muturi role play quality in community health service provision in the teach back session.
This project is funded by the European Union.