Knowledge Exchange among African Faith-Based Organizations Strengthens Health Workforce Management in Ghana

Samuel Nugblega is committed to supporting the people who provide health care to his fellow Ghanaians. “I have a passion for personnel development,” he says. “My key passion is to support people to grow.” As technical advisor of leadership, governance, and human resources for the Christian Health Association of Ghana (CHAG), Nugblega is in a position to do just that.

Samuel NugblegaSupporting health workers to do their jobs well is vital to his country’s efforts to improve health outcomes. As Ghana seeks to provide universal health coverage to more than 25 million people from multiple ethnic and linguistic groups, the government relies on people like Nugblega and faith-based organizations like CHAG to help move closer to this goal. Coordinating the many different pieces of the puzzle, however, is no easy feat.

Bringing health services to people in need

CHAG is responsible for over 40% of health services delivered in Ghana. It coordinates the activities of 184 health facilities with over 13,500 health workers, as well as training institutions owned by 21 different Christian denominations. As many of these facilities are in the country’s most remote areas, where qualified health workers are often reluctant to serve, CHAG’s role in providing health care is especially important.

Ensuring that all of these facilities and institutions are providing high-quality services requires a systematic approach that includes both frequent communication and large amounts of collaboration. This is something Nugblega understands well: “If we begin to look at health from a systems perspective, where we integrate all the factors and actors, such that we are able to have a holistic view of what we do and solve health issues from that proper perspective, then we can save more lives.”

Christian Health Associations across Africa come together to focus on health workers

In order to achieve that holistic view and see how their work fits into a bigger picture, staff of CHAG and sister associations in Africa helped to establish the Africa Christian Health Associations Platform. Designed to strengthen coordination among member associations in 21 countries, the platform holds regular meetings to facilitate knowledge exchange and ensure that members are actively involved in local, regional, and global initiatives focused on the health workforce.

Doris Mwarey and Samuel NugblegaRecognizing a shared need to focus on one especially key area—the health workforce—and strengthen their HR management practices, members formed a Human Resources for Health (HRH) Technical Working Group. HR management focuses on health workers—how they fit within a health system, as well as how they are hired, trained, paid, and supported to be most productive. Nugblega is the chair of the working group, and CapacityPlus’s Doris Mwarey is the coordinator. Mwarey also serves as regional HR technical advisor for the Africa Christian Health Associations Platform—a position supported by CapacityPlus and IMA World Health. “One of the key roles I’m playing is to create linkages between the different Christian Health Associations,” she explains. “I help them to learn from each other, and I support them through various collaborations.” Today the HRH Technical Working Group includes representatives from 13 Christian Health Associations in 10 countries.

Knowledge-sharing strengthens the health workforce

In Ghana, CHAG’s development of an HR management policy for all of its facilities is just one example of the benefits of this knowledge-sharing.
Many of CHAG’s facilities were using different HR manuals, creating a fragmented system of guidelines and policies. Without a uniform manual, everything from employee benefits and workplace safety procedures to salary schemes and vacation allowances varied from facility to facility, creating confusion and inequality. Then, at a meeting of the HRH Technical Working Group, Nugblega learned about a standardized HR manual being used by the Christian Health Association of Kenya. He was inspired to bring the idea back to Ghana.

Given the numerous denominations and institutions represented by CHAG, creating such a manual was a big challenge. Nevertheless, Nugblega and his colleagues worked diligently to include them in the development of the manual. “When it came to giving inputs, reviewing the document, and all that,” says Nugblega, “we wanted all [facilities] to give input so that it is seen as their document.”

Staff at Agogo Presbyterian HospitalThanks to this participatory process, CHAG-supported facilities are now eager for the document to be finalized so they can put it to use. Nugblega estimates it will be completed by the end of the summer. “This is the first time we have had a harmonized manual that the entire network can use,” he reports with evident pride in this accomplishment.

CHAG also adapted CapacityPlus’s HR Management Assessment Approach and incorporated some elements such as the scorecard into a new, customized tool called the Organizational Performance Assessment Tool. “It is still at the pilot stage,” says Nugblega. “We are increasing the number this year, so that we can scale it up to all our facilities in 2015.”

Soon, 13,500 health workers at 184 facilities will be working in a more coordinated manner than ever before, strengthening health services for millions of people in Ghana. “Health is fundamental to everything,” says Nugblega. “We say health creates wealth. And for that matter I want to help my nation create more wealth.”

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Emily Nicholson, UNC-IntraHealth summer fellow, contributed this feature article. Photos 1 and 2 by Gracey Vaughn (Samuel Nugblega; Doris Mwarey and Nugblega); photo 3 by Carol Bales (staff at Agogo Presbyterian Hospital, a CHAG-supported facility)