Friday, 3 June 2016

Zambia: training health workers to make a difference

Sophie Pinder, Evaluation and Learning Officer at THET in London, shares her impressions following a recent monitoring visit to health partnership projects in Zambia which are funded through the DFID/THET Health Partnership Scheme (HPS).

In May 2016, my colleagues Pippa, Viki and I visited five health partnership projects in Zambia working on different health themes in major hospitals across the country. The week-long monitoring visit involved meeting local leads and stakeholders at the sites where these projects are being implemented.

Beyond the monitoring purpose of the trip, this was an excellent opportunity for me to gain a deeper understanding of the local context these partnerships are working in, of the perspectives of local stakeholders and which direction they want to take their projects – aspects that can often be difficult to grasp just by reading project reports when sitting at my desk in London.

One of these projects is being implemented by the Zambian Union of Nurses Organisation (ZUNO) and the Royal College of Nursing in the UK. They established their partnership in 2012. Their project aims to build ZUNO’s capacity to influence nursing policy and improve nursing practice in Zambia. 
At the ZUNO offices in Lusaka, Jennifer Munsaka, Director of Programmes and Professional Affairs and lead for this project along with Rita Mutale, Programmes Officer, explained to us how the partnership has trained twelve staff members at the University Teaching Hospital (UTH) in Lusaka in advocacy skills and supported them to become champions for the implementation of the WHO safe surgery checklist, enabling them to build their advocacy skills in practice. Not only did the champions go on to train 164 members of theatre staff to implement the checklist, they now form a strong collective voice to bring issues and needs, backed by evidence, to the attention of hospital management and advocate for improvements. Their work has also improved interdisciplinary team work and raised the profile of ZUNO at the University Teaching Hospital, the largest hospital in the country. 
The partnership now plans to train the regional directors of ZUNO in advocacy so that they can influence national policy. This expansion has the full support of ZUNO’s new General Secretary, Michelo Fray, who stressed how this project is in line with ZUNO’s strategy of empowering nurses and midwives and protecting and promoting their interests.

In the Eastern Province, Chipata General Hospital has been working in partnership with NHS Highlands since early 2014. The objective of their current HPS project is to empower communities to address mental issues through an improved understanding of mental ill health and how to provide a safe and supportive environment. Communications lead, Pearson Moyo and professional lead, Marron Mugala, introduced us to the hospital staff who are volunteering to deliver messages on mental health in 20 communities around Chipata. We participated in one of the mental health education sessions organised by the volunteers and I found that the community members were very active in the discussion and their answers reflected their awareness of how to deal with mental health issues. At the end of the session, they even told us that they hope this project would be extended to other communities in the region so that volunteers could continue to raise awareness on mental health. The volunteers come from different specialities and wards across the hospital and some of them live nearby or in the communities themselves. As such, I had the feeling that the entire hospital was mobilizing itself for this project and that this could raise the profile of psychiatry and mental health as a speciality with the hospital.

After every project we visited, I felt a real sense of commitment of those engaged, from the UK volunteers delivering training to hospital staff to health workers volunteering their time to drive the projects forward. All have the ambition to expand their work at regional or national level, despite the challenging environment and obstacles they face along the way. On a number of occasions, projects mentioned the lack of resources and workload, hospital budget cuts that are putting a clear strain on already over-stretched services and health workforce.

On a personal level, this visit has broadened my understanding of health partnership work on the ground. It has also inspired me and my colleagues to think more deeply about how THET can support health partnerships working in the same geographical area to collaborate with each other and how this can enable them to become stronger catalysts for change at national level. In light of this visit and others to come, my team and I are discussing how we can support partnerships to connect with each other and deepen their influence and impact.