Practical reflections on combining workshops and mentorships to build capacity in demand and use of evidence in government organisations

Decision makers’ capacity to use evidence is a key component of evidence-informed decision making (EIDM) at a policy level. This paper describes a unique combination of EIDM workshops and mentoring to build decision makers’ capacity to use evidence. It reflects how the deliberate design of sequential workshop and mentoring capacity-building activities enhanced programme effects and reports on the design features that we believe have most contributed to the observed effects. We have found that this combined approach is most effective when it is underpinned by a relationship-building theory of change and remains flexible and responsive to delivering on the needs of participants, and when it is delivered in a timely manner by partners who have been carefully paired with participants based on required expertise

Working relationships between obstetric care staff and their managers: a critical incident analysis

Background Malawi continues to experience critical shortages of key health technical cadres that can adequately respond to Malawi’s disease burden. Difficult working conditions contribute to low morale and frustration among health care workers. We aimed to understand how obstetric care staff perceive their working relationships with managers. Methods A qualitative exploratory study was conducted in health facilities in Malawi between October and December 2008. Critical Incident Analysis interviews were done in government district hospitals, faith-based health facilities, and a sample of health centres’ providing emergency obstetric care. A total of 84 service providers were interviewed. Data were analyzed using NVivo 8 software. Results Poor leadership styles affected working relationships between obstetric care staff and their managers. Main concerns were managers’ lack of support for staff welfare and staff performance, lack of mentorship for new staff and junior colleagues, as well as inadequate supportive supervision. All this led to frustrations, diminished motivation, lack of interest in their job and withdrawal from work, including staff seriously considering leaving their post. Conclusions Positive working relationships between obstetric care staff and their managers are essential for promoting staff motivation and positive work performance. However, this study revealed that staff were demotivated and undermined by transactional leadership styles and behavior, evidenced by management by exception and lack of feedback or recognition. A shift to transformational leadership in nurse-manager relationships is essential to establish good working relationships with staff. Improved providers’ job satisfaction and staff retentionare crucial to the provision of high quality care and will also ensure efficiency in health care delivery in Malawi

Assessment of the Letshabo Cooperative Vegetable Project of the Greater Taung Local Municipality

Abstract: The article aims to provide an assessment of the Letshabo Cooperative Vegetable Project (LCVP), an initiative developed in line with the local economic development (LED) strategy of the Greater Taung Local Municipality (GTLM) in the North West province of South Africa (SA), in order to determine the project’s achievement or lack thereof, of its intended short- to medium-term objectives. These objectives include: creation of jobs for local community members in the vicinity of the project; getting more community members involved in retail vegetable businesses; increasing the availability of fresh, quality produce in the vicinity of the project; and increasing household incomes for project beneficiaries. On that account, an evaluation was conducted of the LCVP, the findings of which are presented in this article. Based on these findings, the article makes recommendations on the possible mitigation of identified problems and challenges

Slow acceptance of universal antiretroviral therapy (ART) among mothers enrolled in IMPAACT PROMISE studies across the globe

CITATION: Stranix‑Chibanda, L., et al. 2019. Slow acceptance of universal antiretroviral therapy (ART) among mothers enrolled in IMPAACT PROMISE studies across the globe. AIDS and Behavior, 23:2522-2531, doi:10.1007/s10461-019-02624-3.The original publication is available at https://link.springer.comThe PROMISE trial enrolled asymptomatic HIV-infected pregnant and postpartum women not eligible for antiretroviral treatment (ART) per local guidelines and randomly assigned proven antiretroviral strategies to assess relative efficacy for perinatal prevention plus maternal/infant safety and maternal health. The START study subsequently demonstrated clear benefit in initiating ART regardless of CD4 count. Active PROMISE participants were informed of results and women not receiving ART were strongly recommended to immediately initiate treatment to optimize their own health. We recorded their decision and the primary reason given for accepting or rejecting the universal ART offer after receiving the START information. One-third of participants did not initiate ART after the initial session, wanting more time to consider. Six sessions were required to attain 95% uptake. The slow uptake of universal ART highlights the need to prepare individuals and sensitize communities regarding the personal and population benefits of the “Treat All” strategy.https://link.springer.com/article/10.1007/s10461-019-02624-3Publisher's versio