Executive Summary

In recent years the need for leadership and management training has moved to the forefront of discussions about Human Resources in Health in Sub-Saharan Africa. While official and private aid programs continue to place the main emphasis on science, technology and supply chain, it has also become clear that health services delivery and outcomes are highly dependent on the quality of health systems leadership and management. These are the issues addressed in this Executive Summary of a report commissioned by the Bill & Melinda Gates Foundation, which was carried out by the Global Business School Network in 2008 and 2009 by national teams in Nigeria, Kenya and Senegal, under the leadership of Jeffrey C. Fine. The report, which is available on request from GBSN, focuses on the management training needs as they are perceived by major stakeholders, and on the contributions which African business schools can make toward meeting these needs.

The views of nearly 800 health professionals and other stakeholders working in the public and private sectors were elicited through surveys, in formal interviews and in focus group discussions. The three countries [1] were selected with a view to encompassing a wide range of constitutional and institutional settings.

The surveys confirm a widespread perceived need for relevant training in basic competencies. Those who had received some form of management training tend to be dissatisfied because it was “not practical” and/or lacked follow-up. Exposure to training is lowest at points of service delivery, notably in primary and secondary level health facilities. Much of this training should be in short-term courses.  Organizational and administrative incentives will need to be strengthened in order to motivate public health employees to be trained.

Local business schools do not have a comparative advantage in providing large-scale, public sector-led, training in basic competencies. Rather, they can play a complementary role which is critical to systemic reform, and which will enhance the effectiveness of basic training.

Quality business schools, such as members of the Association of African Business Schools, offer multi-disciplinary teaching, tailor-made and related to real-life situations. Their focus is on strategy, problem-solving and independent thinking. As such, they may become agents for broad systemic change and reform. Kenya’s Strathmore Business School is running the first high-quality Advanced Health Management Program in tropical Africa, which has strengthened links between Government and the business school. Likewise, Nigeria’s National Health Insurance Scheme is generating demand for advanced and extensive management competencies, not only by HMOs, but private as well as not-for-profit and public providers of health services. In both countries, not-for-profit health services providers, often in partnership with Government, are seeking effective management training.

Strathmore’s post-graduate diploma in health care management offers a “working model” – a possible point of departure for other African business schools considering a longer-term commitment to health care management. Such a program can be extended in the direction of short certificate courses, in which a number of African business schools have experience focused on entrepreneurship. It can also be extended “upward” in MBA programs in health care management.

Missing from the current model is access to an institutional network with a national, regional and international reach, which could significantly backstop current efforts through sharing learning materials, teaching staff and experiential knowledge. It could also serve as a “portal” for international business schools wishing to collaborate in various areas.

Building on this “working model”, the report offers next steps focused on a learning platform, alumni association, and networking framework to the consideration of funders. GBSN is actively engaged in undertaking the next steps.

In order to obtain the full report, please contact Nora Brown, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Download the Executive Summary