Implementation of a health management mentoring
program: year-1 evaluation of its impact on health system
strengthening in Zambézia Province, Mozambique
Background:
Avante Zambézia
is an initiative of a Non-Governmental Organization (NGO), Friends in Global
Health, LLC (FGH) and the Vanderbilt Institute for Global Health (VIGH) to provide technical assistance to
the Mozambican Ministry of Health (MoH) in rural Zambézia Province.
Avante Zambézia
developed a district
level Health Management Mentorship (HMM) program to strengthen health systems in ten of Zambézia’s
17 districts. Our objective was to preliminarily analyze changes in four domains of health system capacity
after the HMM’s first year: accounting, Human Resources (HRs), Monitoring and Evaluation (M&E), and
transportation management.
Methods:
Quantitative metrics were developed in each domain. During district visits for weeklong, on-site
mentoring, the health management mentoring teams documented each indicator as a success ratio percentage.
We analyzed data using linear regressions of each indicator’s mean success ratio across all districts submitting
a report over time.
Results:
Of the four domains, district performance in the accounting domain was the strongest and most
sustained. Linear regressions of mean monthly compliance for HR objectives indicated improvement in three
of six mean success ratios. The M&E capacity domain showed the least overall improvement. The one indicator
analyzed for transportation management suggested progress.
Conclusion:
Our outcome evaluation demonstrates improvement in health system performance during a
HMM initiative. Evaluating which elements of our mentoring program are succeeding in strengthening district
level health systems is vital in preparing to transition fiscal and managerial responsibility to local authorities