Strengthening the Healthcare and Education Systems of
Resource-Limited Countries through
Training in Leadership and Management:
The Leadership and Management
Initiative (LMI)
of I-TECH
Strategy Paper
Draft – March 3, 2011
Table of Contents
i. Executive Summary ............................................................................................................................................ 3
I.
Background ..................................................................................................................................................... 3
Figure 1. The WHO Health System Framework ........................................................................................ 4
II. Leadership and Management Initiative (LMI)................................................................................................... 7
A. Leadership Development Framework ...................................................................................................... 8
B. Partnership Model and Training Approach.................................................................................................. 9
III. LMI Strategy & Activities ................................................................................................................................ 11
A. Objectives .................................................................................................................................................. 11
Objective 1: External partners .................................................................................................................... 11
Objective 2: Deepen network capacity ....................................................................................................... 12
Objective 3: University-based support....................................................................................................... 12
B. I-TECH LMI Logic Model ............................................................................................................................. 13
C. Menu of Services........................................................................................................................................ 15
D. Current Activities ....................................................................................................................................... 16
IV. Collaboration/Partnership ............................................................................................................................ 19
V. Evaluation Plan .............................................................................................................................................. 19
References .......................................................................................................................................................... 20
Appendix A: Organizational Background ........................................................................................................... 21
Appendix B. MSH Leading and Managing Framework ....................................................................................... 23
Appendix C: MSH Leading and Managing for Results Model ............................................................................. 24
Appendix D: Framework for Training ................................................................................................................. 25
LMI Strategy Paper, 3/3/2011
Page 2
i. Executive Summary
The I-TECH Leadership and Management Initiative (LMI) is an
umbrella initiative that supports the development of strong
public health leaders and managers in the developing world. LMI
furthers I-TECH’s ability to realize its mission, principles, and
strategic planning goals at the organizational level, while
supporting the I-TECH network and external partners to achieve
broader health objectives. LMI addresses a very real need for
increased capacity in these areas.
About I-TECH
The International Training and
Education Center for Health (I-TECH) is
a collaboration between the University
of Washington and the University of
California, San Francisco. It is a center in
the University of Washington's
Department of Global Health and has
offices throughout Africa, Asia, and the
Caribbean.
This initiative is built upon the premise that good leadership and
management can be learned and must be taught alongside
required technical competencies as an essential component of
I-TECH's mission as a global network is
health systems strengthening [8]. I-TECH’s unique approach to
to work with local partners to develop
leadership, management, and supervision is shared through its
skilled health care workers and strong
national health systems in resourcenetwork and to its partners in a variety of ways. In every case,
limited countries. I-TECH promotes local
LMI activities are tailored to the context. Methodologies include
ownership to sustain effective health
distance learning, individual’s skill assessments, workshops,
systems.
curriculum enhancements and personal action plans. LMI
objectives are:
1. Work with external partners to integrate leadership and management capacity strengthening into
existing systems;
2. Deepen leadership and management expert technical capacity within the I-TECH network; and
3. Support the development of a leadership and management approach (institute) at the University of
Washington.
This paper provides the background and rationale that led to the creation of LMI and describes the initiative.
I.
Background
National governments and the nonprofit sector are increasingly acknowledging the need for strengthened
leadership and management capacity in the field of global health. The World Health Organization (WHO)
places leadership & governance as one of the six building blocks of a well-functioning health system in its
Health Systems Strategy Framework for Action [1]. WHO published this framework in 2007 to promote a
common understanding of what constitutes health systems strengthening (See Figure 1).
The building blocks represent the six discrete functions that make up an effective health system:
1. Service Delivery
2. Health Workforce
3. Information
4. Medical Products, Vaccines & Technologies
5. Financing
6. Leadership/Governance
LMI Strategy Paper, 3/3/2011
Page 3
Figure 1. The WHO Health System Framework
These building blocks serve three purposes. They:
1) Define desirable attributes of health systems;
2) Define WHO priorities; and
3) Identify gaps in WHO support [1].
According to WHO, leadership and governance is more than just one of the six building blocks of a wellfunctioning health system. Leadership and governance is the central component of health systems
strengthening around which the five other building blocks revolve (See Figure 2).
The International Training and Education Center for Heath (I-TECH) subscribes to this approach to health
systems strengthening. In accordance with WHO, I-TECH believes that leadership is an essential component
of health systems strengthening. Consequently, activities to build leadership and management capacity are
integrated directly into I-TECH health systems strengthening activities.
Within leadership and governance WHO
defines six priorities:
1. Develop health sector policies and
frameworks
2. Regulatory framework
3. Accountability
4. Generate and interpret intelligence
5. Build coalitions
6. Work with external partners
I-TECH is already engaged in many of these
activities both internally and externally
through our international partners.
The United States President’s Emergency
Plan for AIDS Relief (PEPFAR) has also
identified health systems strengthening and
country ownership as core programmatic
strategies in its latest Five-Year Plan [2]. Along with
LMI Strategy Paper, 3/3/2011
Figure 2. WHO Health System Building Blocks
Page 4
its partners, PEPFAR has helped to build widespread recognition of the critical need for health systems
strengthening as a core component of global health initiatives. This focus has resulted in concrete
improvements in health delivery systems in many PEPFAR countries. Building on this success, PEPFAR is
transitioning its focus to country ownership with an explicit goal of expanding technical assistance and
mentorship of professionals at all levels of national health systems [2].
A recent study conducted by I-TECH’s home institution, the University of Washington Department of Global
Health, echoes the need for increased efforts to build leadership and management capacity. The study
interviewed 25 leaders in the field of global health – including William Foege, Helene Gayle, Peter Piot, Mark
Dybul, and others – about current and future jobs in global health and the competencies and skills required
by professionals to be effective in the field. Analysis of these interviews indicated a substantial need for
stronger management skills, greater leadership/strategic thinking, and more finely tuned policy/political skills
as a complement to competency in specific areas of technical expertise. This emphasis creates an opportunity
for I-TECH to expand its efforts to support capacity strengthening in leadership and management.
I-TECH is a coordinated network of resources dedicated to supporting global health initiatives. At the
University of Washington, I-TECH collaborates with other Department of Global Health centers and projects
to provide education, resources, and training to global health partners. At the University of California - San
Francisco, I-TECH collaborates with numerous centers to support projects throughout the larger I-TECH
network. With access to a wealth of institutional resources and a global network of trained clinical mentors
who regularly interface with leaders in health policy, I-TECH is well placed to advance a strong leadership and
management program both within its 11 country offices and their broader constituencies.
Why Strengthen Capacity in Leadership and Management?
High-performing organizations are those that have, at all levels, individuals who commit to and practice
values-based leadership and management. The results of successful leadership and management are
improved service, performance, and outcomes. Effective leadership and management skills improve
employees’ job performance as well as
“Training is an essential
business/organizational outcomes.
component of high-performance
A wealth of evidence, primarily from the business sector,
work systems because these
exists to support the connection between high-performance
management practices and highly profitable companies or
systems rely on front-line
organizations. Leading this field of study is organizational
employee skill and initiative to
behavior scholar, John Pfeffer. In his book, The Human
identify and resolve problems, to Equation: Building Profits by Putting People First, Pfeffer
references a large base of evidence to document the
initiate changes in work methods, profitability of investing in leadership and management [3].
Pfeffer discusses one award-winning study of 968 firms from
and to take responsibility for
all major industries that found that, "a one standard deviation
quality. All of this requires a
increase in use of [high performance management] practices is
skilled and motivated work force associated with a 7% decrease in turnover and an $18,000
increase in stock market value per employee.” Another study
that has the knowledge and
referenced by Pfeffer of 702 firms came to an even stronger
capability to perform the requisite conclusion that “a one standard deviation improvement in the
human resources system was associated with an increase in
tasks.”
shareholder wealth of $41,000 per employee or about a 14
John Pfeffer
LMI Strategy Paper, 3/3/2011
percent market value premium.” A third study of the five-year
survival rate of 136 non-financial companies demonstrated
Page 5
that with other factors such as size, industry, and even
profits held constant, both the value placed on human
resources and the way the organization rewarded
people were significantly related to the probability of
survival [3].
Many of Pfeffer’s ideas were reinforced in a 2003
Forbes’ McKinsey Quarterly report [4]. McKinsey
research shows that companies that regularly earn spots
on the best places to work lists “combine low-powered
tangible incentives with a culture that reflects the
presiding values of customer service, fairness, empathy
for employee concerns and open access to company
information.”
One of the key practices of high-performance
management is leadership and management skills
development through training. In his book, Pfeffer
recommends extensive leadership and management
training as one of the seven essential practices of
successful organizations.
Global Health Case Studies
As part of its effort to develop the leadership
and management skills of health professionals
worldwide, I-TECH is developing a collection of
global health case studies. Each case, written
by an I-TECH staff member, documents a
situation in which a key leadership or
management skill was employed to address an
existing challenge to improving health systems.
The cases, which are drawn from a variety of
settings and written by international staff
members, illustrate how leadership and
management skills can be applied in a variety of
contexts in a culturally appropriate and
effective manner. Case studies not only help
training participants to better understand
leadership and management practices, they
help participants to think creatively about how
they can alter and adjust these practices to be
effective in their particular work environment.
I-TECH has found case studies to be a highly
effective tool for teaching leadership and
management skills.
In 2009 [5], Menasha Packaging trained 300 managers in
order to improve their personal job satisfaction as well
as the performance of their direct reports. The course
focused on effective leadership, supervision and
coaching. Courses were implemented during a 3-month period in 20 two-day classroom training sessions. Inclass work was supplemented with extensive reinforcement from human resources managers. The impact of
training on key job metrics was measured. The detailed participant evaluation data predicted high job impact
and business results, while 91.8 % of employees said they felt the training would have significant impact on
job satisfaction — meaning improved morale and potentially increased engagement.
While this example and Pfeffer’s work refer primarily to the business community, it is easy to see how these
programs and findings apply to complex health systems. The values of training and the need for successful
organizational practices are not limited to for-profit enterprises.
A recently published article in Human Resources for Health describes how a leadership development program
successfully contributed to improved health system outcomes in Egypt [6]. In 2007, WHO representatives
working in Egypt recognized that the broad goal of health systems strengthening depends not only on
resources, but also on how those resources are managed – especially at the local level. WHO worked with
Management Sciences for Health (MSH) to implement the Leadership Development Program (LDP), a skills
development and training program for health care workers, including doctors, nurses, and midwives, at all
levels.
LMI Strategy Paper, 3/3/2011
Page 6
“My supervisor and myself have
different values. I cannot change
her values and I have realized
that. What I can change is myself
and how I interact with her. This
workshop has helped me realize
how I need to be open to
understanding different type(s) of
viewpoints and how I need to first
understand where they are
coming from.”
The program trained existing teams to use the Leading and
Managing Practices Model (See Appendix B) to identify and set
goals. At the end of the first year, 8 of 10 health teams had
achieved 95% or more of their desired results and three
districts increased the number of new family planning visits by
36%, 68% and 20% respectively. The majority of health teams
also selected a new challenge without prompting, illustrating
that the LDP was not only effective but also sustainable. After
the program, participants convened a meeting to discuss how
to continue without outside funding. Health system indicators
continued to improve without outside funding and a
qualitative evaluation showed significant success. One author
notes “The LDP has scaled up with local resources because it
uses a simple process of working with teams over time to
focus on real health results, developing leaders at all levels of
the health system and enabling local health managers to own
the development process” [6]. This is a concrete example of
LIH Namibia Participant Pfeffer’s theories at work in the global health arena.
Another well-documented program related to HIV interventions in the developing world provides evidence
that investing even a limited amount of resources to leadership training can have an impact. An article in
Human Resources for Health [7] describes a program in Zimbabwe aimed at responding more effectively to
the HIV/AIDS epidemic by reinforcing a critical competence-based training institution and producing public
health leaders. The program used HIV/AIDS program-specific funds to support a local education institution to
train public health leaders in leadership and HIV-related content.
The Center for Disease Control (CDC) committed approximately US $400,000/year to this program, or
approximately 5% of its annual budget for Zimbabwe. The results proved that an investment of a modest
proportion of new HIV/AIDS resources in targeted public health leadership training programs can assist in
building capacity to lead and manage national HIV and other public health programs [7].
I-TECH’s leadership and management strengthening efforts are in direct response to the many substantive
studies and articles that point to the need for and effectiveness of leadership and
management training to improve health outcomes in developing countries.
Leadership
II. Leadership and Management Initiative (LMI)
The I-TECH Leadership and Management Initiative (LMI) is an
umbrella initiative that supports excellence in leadership and
management within the I-TECH network and with partners. The goal
of LMI is to strengthen global health systems in order to improve
health outcomes for all. LMI furthers I-TECH’s ability to realize its
mission, principles, and strategic planning goals at the organizational
level, while supporting the I-TECH network and external partners to
achieve broader health objectives. I-TECH has committed to
LMI Strategy Paper, 3/3/2011
Management
Supervision
Figure 3. Essential Skill Sets
Page 7
supporting leadership and management development by instilling a culture that recognizes the importance of
these competencies and by offering multiple opportunities for growth.
LMI is founded upon several core principles:
1. There are three essential skill sets: Leadership, Management, and Supervision (see Figure 3).
2. These skill sets can be learned, taught and nurtured.
3. They are necessary components of effective health system strengthening,
4. Leadership should be encouraged at all levels of an organization.
5. Leadership is founded upon personal practice.
A. Leadership Development Framework
I-TECH’s Leadership Development
Framework empowers healthcare
leaders to design their own path to effective leadership
greater self-awareness and informed by proven leadership
4).
Self-Awareness
Knowing Who You Are
•Assessments i.e., LPI
•Self-Reflection
•Cultivate Wisdom
based on
theories (Figure
The I-TECH Leadership Development Framework
draws
upon a wealth of key resources from a
variety
of disciplines. At its essence, the ISelf-Determination
TECH Framework fosters selfSelf-Development
Roadmap to Desired
awareness. It uses a specific
Exposure to Selected
Behavior
collection of carefully selected
Theories
•Individualized Theory of Action
leadership messages as prompts to
•MSH Framework
•Personal Mission Statement
•Leadership Challenge
help participants craft their own
•Professional Development Plan
•Values-Based Leadership
leadership theory and application
Figure 4. I-TECH Leadership Development Framework
strategies. The I-TECH Framework
encourages participants to begin their leadership development
process by first
looking inward and then focusing on external practices and relationships. The I-TECH Framework requires
participants to focus on self-awareness using specific tools, including the Leadership Practices Inventory, or
LPI, (http://www.lpionline.com/), to identify existing leadership strengths and begin a process of selfreflection.
Building upon self-awareness is self-development through I-TECH-supported training and learning
opportunities covering a variety of practical skills. Training topics include project management, human
resources management, supervision, teambuilding, communication, negotiation, time management, financial
management, and advocacy, among others. The I-TECH Framework draws largely on the work of well-known
thinkers such as Stephen Covey and Parker Palmer and pulls from the strong resource materials created by
Management Sciences for Health, including the Leading and Managing Framework (See Appendix B) and
Leading and Managing for Results Model [9] (See Appendix C).
These tools ultimately influence a process of self-determination through which participants apply tools to
their own work environments and develop a personalized approach to continuing leadership development.
The I-TECH Leadership Development Framework is inherently flexible and adjusts to the needs of specific
partners and the realities of cultural contexts. As it is deeply grounded in a reflective, values-based approach
LMI Strategy Paper, 3/3/2011
Page 8
to leadership and management, the I-TECH Framework can be translated across cultures to fit unique cultural
contexts.
By practicing internally the skills we hope to build around us, we are pursuing the development of mutually
reinforcing and collaborative systems that will reduce friction and improve efficiency in an effort to
strengthen health service delivery and ultimately improve overall health outcomes.
B. Partnership Model and Training Approach
In order to integrate leadership and management into health systems strengthening, I-TECH employs its
partnership model (See Figure 5). This model illustrates the process through which I-TECH delivers the
Leadership and Management Initiative.
I-TECH applies its proven partnership approach to the delivery of leadership and management training. The
partnership approach supports I-TECH's commitment to the goals of PEPFAR and the Global Health Initiative.
I-TECH works with host country partners to initiate new programs to build the capacity of the health
workforce and then transfers the ownership and leadership of these programs to the partners. Within ITECH, this requires leaders who implement this process effectively. Leaders must employ a vision of change
and lead staff to
implement the
transition. For our
partners, a
successful handover
requires that we
build the leadership
skills of the host
country institution
receiving the
project. Through
this approach, ITECH builds
sustainability of
projects and has a
lasting impact on
the health
workforce in
countries where we
work.
The Leaders in
Health (LIH) course
offered in Namibia is
an example of this
Figure 5. The I-TECH Partnership Model
partnership approach
in action (See inset box on page 11). I-TECH was approached by various Ministries in Namibia for assistance
building leadership and management capacity. I-TECH conducted a needs assessment, worked to developed
an appropriate partnership structure, identified presenters, delivered the technical services through a threepart series, evaluated the results, and is now preparing participants to lead the second series to be delivered
next year.
LMI Strategy Paper, 3/3/2011
Page 9
This successful project illustrates how I-TECH’s six step partnership model will build leadership and
management capacity through a long-term, sustainable and locally-owned process.
In addition, I-TECH utilizes a training framework that
“The workshop really impacted
consists of six levels. The I-TECH Framework for Training
(See Appendix E) is adapted from the AIDS Education and me on the personal level. It made
Training Centers (AETCs) and outlines multiple stages that
realize that I needed to listen to
result in the transfer of learning from classroom to job
site. The first five levels reflect a progressive degree of
people better and understand
independence, responsibility, and mastery among learners
in
where
they
are
coming
from.
.”
relation to a particular set of skills, knowledge, and
attitudes. Level 1 and 2 trainings typically occur in a
LIH Namibia Participant
classroom setting, and are used to impart large bodies of
knowledge to learners. Level 3 and 4 trainings focus on the application of new skills and knowledge to a
learner's own work setting or one similar to it. Level 5 training involves establishing systems to support
learners who primarily work independently, but may occasionally require assistance with complex situations.
Level 6 refers to systems strengthening, which encompasses efforts to improve or streamline organizational
systems, processes, and routines to ensure transfer of learning in a supportive environment.
I-TECH believes that in order for leadership and management training to effectively strengthen health
systems, capacity strengthening needs to be supported at multiple levels. In-service, or on-the-job, training
provides an opportunity for participants to learn new skills
and immediately apply them to the context in which they
work. Trainings utilize practical real-world examples from
Leadership Initiative for Rural Kenya
the specific context in which they are held and allow
Last year, I-TECH collaborated with UCSF’s
participants to practice in real-time the leadership and
Family AIDS Care and Education Services
management skills they are being asked to integrate into
(FACES) project in the Kisumu and Nyanza
their daily work in the health system. By using examples,
provincial offices of the Ministries of Medial
such as case studies that reflect relevant scenarios and
Services and of Public Health and Sanitation to
practical issues, I-TECH believes there is a higher likelihood
develop and deliver a 5-day leadership and
that new competencies will be put into practice and will
management training to 28 provincial and
result in higher performing health systems that contribute
district health managers working in the
to improved health outcomes.
western region of Kenya. The course is part of
a larger, ongoing initiative that includes regular
workshops, individual and team practical
assignments, and mentoring. Participants
reported high satisfaction with this workshop,
and many gained a greater appreciation for
team building and the contributions of all
members. One participant said, “[This training]
has helped me understand that everyone is
important, and realize that everyone can
contribute to successful performance if we
support each other.”
I-TECH uses this multi-level approach to integrate
leadership and management training into its regular
capacity building programs. In this way, I-TECH delivers
leadership and management training in a manner that is
relevant, appropriate, and applicable to the local context.
I-TECH integrates values-based leadership with evidencebased management practices then enables these
techniques to be adapted to the particular national or local
context. I-TECH utilizes workshops held on-site, within the
local work environment and among regular work teams to
ensure that skills are relevant and applicable to the specific
context. Used together, these approaches aim to increase
leadership and management capacity both within I-TECH and among external partners as a means to improve
overall health outcomes.
LMI Strategy Paper, 3/3/2011
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III. LMI Strategy & Activities
LMI activities are guided by I-TECH’s unique approach to leadership and management and supported through
a library of carefully selected resources and intentionally designed training materials.
A. Objectives
Using this model, I-TECH has prioritized three main objectives for the Leadership and Management Initiative:
1) Work with external partners to integrate leadership and management capacity strengthening into
existing systems;
2) Deepen leadership and management expert technical capacity within the I-TECH network; and
3) Support the development of a leadership and management approach (institute) at the University of
Washington.
Objective 1: External partners
In order to build strong health systems, I-TECH works in direct partnership with external organizations. These
partners may include Ministries of Health, other government Ministries, universities, and non-governmental
organizations (NGOs). I-TECH engages in direct partnerships at the request of the partner organization and
works collaboratively to develop an appropriate and effective plan to incorporate leadership and
management training into existing or new capacity building initiatives. Work with external organizations aims
to integrate leadership and management training into existing health systems strengthening programs
according to the I-TECH partnership model (Figure 4). The ultimate goal is to strengthen public health
leadership in the countries where we work.
Work with external partners begins with a comprehensive
needs assessment. Based on this assessment, I-TECH and
the partner organization decide upon the most appropriate
structure for strengthening leadership and management
capacity. Once this structure is identified, technical experts
and appropriate resources are identified – whenever
possible, experts and resources come from within I-TECH or
from within local partner organizations. These parties then
deliver the agreed upon technical assistance through the
selected program, workshop, or training. The work is
followed up by an evaluation to solicit both participant selfreported satisfaction as well as long-term impacts on health
systems. These evaluations are used to inform the continued
development of leadership and management skills led by
the partner organization either with or without continuing ITECH support.
Ultimately, the development of leadership and management
skills among external partners contributes both directly to
health systems strengthening as well as indirectly to the
continuing development of leadership and management
skills in the health sector. The Leaders in Health Educational
LMI Strategy Paper, 3/3/2011
Leaders in Health Educational Series in
Namibia
In March 2010, I-TECH held the first of the
three part Leaders in Health educational
series. The series, designed to further
strengthen health care systems in Namibia
through effective mentoring of health leaders,
managers, and teachers, brought together
leaders from collaborative Namibian
institutions, including the Ministry of Health
and Social Services, the Ministry of Defense,
the University of Namibia, and I-TECH. In
workshops participants studied and discussed
the nuances of leadership and management
and practiced team building and
communications skills. The series is
complemented by a new distance-based
course called "Global Program Management
and Evaluation," which is being offered
through the UW (see inset box on page 13).
The series concluded with a final face-to-face
workshop in June 2010. The series is being
repeated in 2011.
Page 11
Series in Namibia described in the inset box on page 11 presents an example of highly effective leadership
and management capacity strengthening with external partners. Several other countries are considering
replicating this successful model.
Objective 2: Deepen network capacity
While simultaneously building the capacity of external
partners, I-TECH aims to build its own internal leadership
and management skills. The I-TECH network consists of all
I-TECH offices located in Seattle and San Francisco and
throughout the 16 I-TECH country offices. The leadership
and management capacity of the I-TECH network will be
deepened through a variety of activities described below
in the Menu of Services on page 15.
Similar to work with external partners, the process of
developing leadership and management activities is
driven by country offices, according to their identified
needs and using the delivery method most appropriate for
the cultural and work climate. The first LMI Workshop
described in the inset box on this page describes an
example of efforts to deepen network capacity. The
synchronous distance learning Global Program
Management and Evaluation course described in the inset
box on page 13 is another example of I-TECH’s work to
deepen the capacity of its network. The Current Activities
Table (included below in section III. D.) illustrates the
variety of ways LMI activities are currently being
implemented in our country offices.
Principles into Practices:
LMI Workshop I
In March 2010, the first official workshop of
I-TECH’s LMI took place in Seattle, WA.
Deputy Directors, Unit Directors, Country
Program Managers and other managers
from I-TECH Country Offices and
headquarters came together to share
experiences, learn skills and contribute to
the development of the next phase of the
Initiative. Participants were asked to
envision future benefits of the LMI and
work backwards to identify key actions
taken. This valuable feedback is being used
to develop the strategy and inform the
direction of the LMI. As such the LMI is
growing directly from the identified needs
and suggestions of participants.
Furthermore, this workshop serves as the
nucleus of leadership and management
change practices, which are then integrated
into the health systems strengthening
programs at the country level.
Objective 3: University-based support
As a member of the University of Washington community, I-TECH benefits from strong university initiatives
and is invested in the success of other university efforts. Thus, I-TECH contributes to the University of
Washington’s overall leadership and management efforts. Recognizing the tremendous need for leadership
and management strengthening in the field of global health and possessing a rich collection of resources
dedicated to global health work, the University of Washington is well placed to take a leadership role in
designing and implementing leadership and management development as an essential component of health
systems strengthening.
I-TECH plays an integral role in this effort and will help to ensure the success of the University of Washington
on this front. For example, I-TECH supports and contributes to the University-wide Leadership, Policy, and
Management Technical Working Group. I-TECH also relies on and connects the larger University community
to its work both internally and externally to further leadership and management development. Shared vision
is one of our operating principles and I-TECH aims to support a shared vision of leadership and management
development within the Department of Global Health and the larger University of Washington community.
I-TECH staff were involved in the development of a new track within the University of Washington School of
Public Health’s Department of Global Health (DGH), known as the Leadership, Policy, and Management (LPM)
track. The LPM track is designed to build the capacity of mid-career professionals to incorporate leadership
LMI Strategy Paper, 3/3/2011
Page 12
and management development into their public health
education. Students in the track gain concrete skills,
which they can later apply in practice in their
respective countries and organizations. I-TECH
Executive Director, Dr. Ann Downer, teaches one of the
required courses for the LPM track, Global Program
Management and Evaluation (see inset box on this
page).
Through the Leaders in Health program, I-TECH taps
into university expertise in areas such as health policy,
communication, and adult learning and metacognition.
UW professors developed the curricula and lead the
training activities, sharing current trends and applying
them to developing world realities. This program is
offered to I-TECH partners and universities in a variety
of countries.
Global Classroom in Leadership &
Management
In March 2010, I-TECH launched its first tenweek distance-learning course, Global Program
Management and Evaluation. Taught by ITECH’s Executive Director, Ann Downer, this
course delivers weekly synchronous lessons to
over 100 students located in 8 classrooms
throughout the world. The unique delivery of
this important training material allows country
program teams to work collaboratively on class
discussions and assignments. The course
curriculum was designed in response to a
global needs assessment and weekly feedback
is integrated to continuously improve delivery
and content. The result of this course is a new
class of I-TECH staff members who now speak
and understand a common language around
leadership and management tools. This course
is being repeated in 2011 – with 11 global
classrooms.
In addition to playing an integral role in the
development of leadership and management
competencies for global health professionals, I-TECH is
also at the center of efforts to strengthen distancelearning opportunities offered by the UW DGH. The
Global Program Management and Evaluation course
referred to above was piloted this year as a distance-learning course offered to I-TECH staff located in offices
around the world. Delivered synchronously to 8 classrooms around the globe, this course has inspired a high
volume of interest in distance learning opportunities. The course has since been repeated to I-TECH staff in
Uganda and an extension of the course delivered through monthly distance learning sessions is currently in
development.
Both the LPM track and the distance learning initiatives fall within the scope of the target priorities set by the
University of Washington’s outgoing President, Dr. Mark Emmert. Dr. Emmert has long supported the
strengthening of global health programs and was behind the creation of the Department of Global Health.
While participating in the Consortium of Universities for Global Health’s inaugural annual meeting in 2009 Dr.
Emmert stated, “[Global Health] is a field that has incited more student interest and engagement in a
relatively short period of time than virtually anything I’ve ever seen…Similarly, it fits our faculty’s strengths in
many fields.” [10]
B. I-TECH LMI Logic Model
Goal: Strengthen global health systems to improve health outcomes for all
Objectives:
1. Work with external partners to integrate leadership and management capacity strengthening into
existing systems
2. Deepen leadership and management expert technical capacity within the I-TECH network
3. Support the development of a leadership and management approach (institute) within the University of
Washington
LMI Strategy Paper, 3/3/2011
Page 13





Inputs
DGH Faculty
I-TECH
Executive Team
I-TECH Country
Directors/
Country
Program
Managers
Content (I-TECH
Curricula, MSH,
FACES, other)
Case Studies






Activities
GH 521 Course
LMI Workshops
L/M Distance
Learning Series
Integration into
Existing Programs
Standardized
Curriculum and
Multimedia
Support
Materials
Evaluation of
training/activities
LMI Strategy Paper, 3/3/2011




Output
Staff/
Partners
trained
Trainings
completed
Staff/Partners
receiving
mentoring
Country-level
initiatives
established






Outcome
Improved patient care
Improved management
practices
Program standards achieved
consistently
Improved workplace
satisfaction
Systems strengthened
Ethical management
Impact
 Sustainable
programs
 Improved
health
outcomes
for
patients
Page 14
C. Menu of Services
LMI-related activities include:
ACTIVITY
Leadership and
Management Needs
Assessment
Self-Assessment, i.e.,
LPI 360° Assessment
LPI Refresher Training
Skills-Building
Workshops
Leaders in Health
Education Series
GH 521 – Global
Program
Management and
Evaluation
521 Alumni Support
Global Program
Management and
Evaluation (based on
521 content)
L/M Distance Learning
Series
L/M Topics Integrated
into Existing InService/Meetings
(Professional Dev’t)
Curriculum
Enhancement
Technical Assistance/
Site Visits
Case Studies
Professional
Development
Planning
Mentoring
Practicum
DESCRIPTION
The L/M Needs Assessment is a detailed survey to determine which leadership and
management skills are most relevant to a unit, office, or program. Needs assessments
form the basis for the integration of leadership and management skills development into
ongoing program work. Data is used to design an approach as well as to develop specific
workshop topics or training activities.
Leadership assessment for individuals that includes self-assessment and input from
colleagues, supervisees, supervisor, and partners; group feedback workshop to apply
results. Recommend to be done with a work team or group of participants (pre-skillbuilding workshop). Can be done online or using paper.
Refresher training to encourage ongoing application of leadership growth after taking LPI
360°. New members of team take the LPI, group brought back together to review results
and chart course for next year. Suggested frequency: quarterly or annually.
Skills-based workshops focusing on needs identified through needs assessment.
Examples of topics include: leadership, management, supervision, workplace culture,
influence without authority, top-middle-bottom, communication and team building
An educational series covering leadership competencies, management skills,
communication & storytelling abilities, and policy skills. The blended-learning format
uses two on-site skills-based workshops separated by distance learning sessions and
assignments.
Skills-building, graduate-level distance learning course that connects a classroom at the
UW to classrooms around the world using Adobe Acrobat Connect Pro. Engages
students in discussion and learning about leadership and management in complex global
health environments. Utilizes lecture, discussion, case studies and other interactive
exercises.
Sessions designed to bring group of participants back together to drill down into the
topics more deeply and support ongoing leadership growth. Suggested frequency:
Quarterly.
Skills-building course about leadership and management in complex global health
environments. Utilizes taped lectures from DGH 521, group discussion, case studies and
other interactive exercises.
Monthly series of L/M topics; e.g., project management and conflict resolution.
L/M topics needed by a team or group are determined based on needs assessment and
training on particular topics is integrated into existing meetings/trainings, e.g., clinical
mentoring in-service, staff meetings, etc. Use case studies and existing lesson plans.
L/M topics are integrated into existing pre-service and in-service curricula.
TA as needed; can identify UW and I-TECH resources to meet identified needs.
Developing cases from L/M experiences. Training/support for use of I-TECH template to
develop and for integrating use of case studies in ongoing capacity development efforts.
Support for developing the leadership and management capacity of staff. Includes
library of resources, training on and materials for personal action plans.
Supporting leaders and managers over time. Suggested timeframe: 2 years.
Providing opportunities for L/M skill development by sending learners to work with
competent leaders/managers.
LMI Strategy Paper, 3/3/2011
Page 15
D. Current Activities
The following table summarizes global and country-level leadership and management activities currently being planned
or implemented throughout the I-TECH network:
Name
Location
or Focus
Project Type
Audience
Delivery
Method
Date
Leadership
& Mgmt
Initiative
(LMI)
Workshop
I-TECH
Global
Network
Skills-based workshops
focusing on needs identified
through needs assessment
I-TECH
Staff
On-site
“Principles
into
Practice”
March 2010
GH 521 –
Global
Program
Management
and
Evaluation
DGH
MPH
Students
and ITECH
Global
Network
Skills-building, graduate-level
distance learning course that
connects a classroom at the
UW to classrooms around the
world. Focuses on leadership &
mgmt in complex global health
environments. Utilizes lecture,
discussion, case studies &
other interactive exercises.
DGH MPH
Students
and ITECH
Global
Network
Synchronous
distance
learning
technology,
small group
discussion,
individual
assignments
LPI 360degree
Assessment
COs and
Units
Leadership assessment for
individuals; input from
colleagues and partners; group
feedback available
L/M
Distance
Learning
Series
I-TECH
Global
Network
Monthly series of L/M topics;
e.g., project management and
conflict resolution.
Video –
Interviews
with GH
Leaders
Case
Studies
Technical
Assistance
L/M Training
Materials
Database
Country
Director
Mentoring
Project
Frequency of
Activity
Funding
Status
As needed
PiP = core
and country
funds
A= Raleigh;
R=Elaine; C=Ann;
I=LMI Listserv, ET
Spring
2010;
spring 2011
Annually
UW / fully
funded
A/R=Ann
Downer; H= Anita
Verna Crofts,
Alison Ensminger
I-TECH
staff
Online or
paper
assessments
; feedback
workshops
ongoing
tbd
Country/Unit
budgets
A/R=Elaine
I-TECH
staff &
partners
synchronous
distance
learning
Summer
2010
Annually
tbd
A=Ann Downer;
R=tbd; H= Anita,
Elaine
Production
summer-fall
2010
After
production,
ongoing
Core /
Funded
A=Ann; R=Tom
Furtwangler
Under
developme
nt; ongoing
Ongoing
Core/country
budgets
A=Ann; R=Elaine;
H=Jenny
Schechter, Anita
tbd
A/R=Elaine; H=
Jenny
Video –
posted on ITECH
Website,
used in
classroom
settings
Used within
and outside
of workshops
n/a
Taped interviews with GH
leaders; answering the question
“What 2 things have you
learned about leadership?”
I-TECH
Network,
general
audience
I-TECH
Scenarios and in-depth case
studies covering leadership and
management issues
I-TECH
Staff and
Partners
TA as needed; can identify UW
and I-TECH resources to meet
identified needs.
I-TECH
Staff and
Partners
On-site
support
ongoing
As needed
Country
budgets /
funded
according to
need
Gathering of materials from all
activities
I-TECH
Staff and
Partners
multiple
ongoing
Ongoing
Core
I-TECH
Country
Directors
Email/phone
communicati
on, in-person
meetings
Ongoing
Monthly
phone calls,
two inperson visits
during first
year
Core/Country
Budgets
I-TECH
Global
Network
(includes
HQ, COs
&
Partners)
I-TECH
Global
Network
(includes
HQ, COs
&
Partners)
I-TECH
Global
Network
New Country Directors
matched with experienced
Country Directors to provide a
second source of consultation,
coaching and support.
LMI Strategy Paper, 3/3/2011
ARCHI
A=Raleigh
Page 16
Name
Location
or Focus
Project Type
Audience
Delivery
Method
Date
Frequency of
Activity
Funding
Status
ARCHI
COUNTRY PROGRAM ACTIVITIES
Professional
Development
Work-Life
Balance
Support
Professional
Development –
7 Habits of
Highly
Effective
People
Botswana
Botswana
Formalizing a professional
development program.
Includes individualized needs
assessment and action plan.
Committee focused on
supporting a more healthy
balance. Examples include:
Motswana & French lessons,
photography lessons, etc.
I-TECH Bots
staff (incl.
seconded
staff)
Individual
s with
supervisor
s
Summer
2010
Ongoing
Funded –
Country
budget
A=Baz
I-TECH Bots
staff (incl.
seconded
staff)
various
Spring
2010
launch
Ongoing
Funded –
Country
budget
A=Baz
I-TECH
Botswana
staff
(including
seconded
staff)
Facilitated
sessions
SpringFall 2010
once
Funded –
Country
budget
A=Baz; R=Ditsa &
Jenny
Spring
2010
Ongoing
Funded –
Country
budget
A=Baz
FebMarch
2011
Once
FundedCountry
Budget
A=Marrianne;
R=Baz, Danielle,
Jenny
On-line
assessme
nt; On-site
feedback
workshop
Summer
’10
=ass’mt;
December
2010
Feedback
workshop
once
Funded –
Country
budget
A/R=Elaine
Survey
Summer
2010
annually
Funded –
Country
budget
A=Elaine;
R=Jenny & Elaine,
H=Matt, Wesen,
Nega
Facilitated
session
November
15-19,
2010
once
Funded –
Country
budget
A=Bill; R=??
On-site
workshop
December
15-16,
2010
Once
Funded –
Country
Budget
A=Elaine; R=Bill,
Nega, Matt; H=
Jenny
On-site
session
Spring
2011
(tentative)
once
Funded –
Country
budget
A=Bill; R=Elaine
On-site
session
Spring
2011
(tentative)
Quarterly or
by-annually
Funded –
Country
budget
A=Bill; R=Elaine
Botswana
Monthly lunch and learn
sessions for 7 months (one
habit covered each month).
Facilitated by Ditsa and Jenny
(LMI March ’10 participants).
Botswana
Developed several case studies
to share lessons learned in
management and leadership.
I-TECH
Network
Botswana
On-line Leadership assessment
instrument providing a chance
to self- assess and get input
from those you work with.
I-TECH
Botswana
senior
management
Ethiopia
On-line Leadership assessment
instrument providing a chance
to self- assess and get input
from those you work with.
I-TECH
Senior
Management
, including 3
Regional
Managers
L/M Needs
Assessment
Ethiopia
Survey to determine most
relevant leadership and
management skills for future
workshop or training activity.
Strategic
Planning
Session
Ethiopia
4-day Strategic Planning
Meeting to facilitate process for
rolling out strategic objectives
LMI Workshop
Ethiopia
2-day workshop, linked to LPI
Feedback Workshop, focusing
on teambuilding and
communication skills.
521 Alumni
Session
Ethiopia
Special session to bring 521
students together to drill down
on topics and support ongoing
development.
LPI Review
Ethiopia
Review of leadership
development process
Case Studies
LPI 360-degree
Online
Assessment
LPI 360-degree
LMI Strategy Paper, 3/3/2011
I-TECHEthiopia
Senior and
Mid-level
Managers
I-TECHEthiopia Sr
Managers,
Raleigh, Ann,
Tech Leads,
Elaine,
CPMs
I-TECH
Senior Mgmt,
including 3
Regional
Managers
I-TECH Staff
who
participated
in DGH 521
I-TECH
Senior Mgmt,
including 3
Reg’l
Managers
Workshop
s,
meetings,
sessions,
etc.
On-line
assessme
nt, on-site
feedback
workshop
given by
Ann
Downer
Page 17
Name
HIV
Fellowship
Programme
Leaders in
Health
University of
Namibia
(LIH)
LMI
Workshop
Leadership
Training for
Clinical
Mentors
Location
or Focus
LPI 360degree
Leadership
and
Management
Pilot Course
Date
Frequency
Funding
of Activity
Status
ARCHI
On-site
and
distance
learning
January June
2010;
MarchJune 2011
Annually (at
least for 2
years)
UNAM grant /
fully funded
I-TECH
Namibia
supervisors
On-site
workshop
October
25-29
2010
once
Funded Country
Budget
6 I-TECHsupported
Clinical
Mentors
During
regular
CM
Meetings
July 2010
(1st),
November
2010, etc.
Ongoing –
every 4
months
FundedCountry
Budget
A=Laura Brandt;
R=Sean & Laura;
H=Elaine
On-site
workshop
25-26
February
2011
Once
Fogarty
Grant –
Externally
Funded
A=Patty Garcia &
Ann Marie
Kimball;
R=Elaine, Liz and
Matt
During
staff
meeting
Spring
2010
Once
n/a
A=Brian
On-line
assessme
nt, On-site
feedback
workshop
Assessme
nt Sept –
Oct 2010,
Workshop
possibly
Dec 2010
Once
FundedCountry
Budget
A=Elaine;
R=Harnik
All I-TECH
Tanzania
Staff
Facilitated
discussion
COP 2010
Regular
n/a
A=Tumaini;
R=Tumaini & Mary
I-TECH
Tanzania
managers &
supervisors
Facilitated
discussion
COP 2010
Regular
n/a
A=Tumaini;
R=Tumaini & Mary
All I-TECH
Tanzania
Staff
On-site
workshop
LateSeptembe
r 2010
Once
FundedCountry
Budget
A=Alyson
Shumays;
R=Richard &
Elaine
Tanzania
On-line Leadership Assessment
instrument providing a chance
to self-assess and get input
from those you work with
I-TECH
Senior
Manager (3 –
new, 4 –
review)
On-line
assessme
nt, On-site
feedback
workshop
Fall 2010
Once
FundedCountry
Budget
A=Elaine;
R=Alyson
Tanzania
3-day content orientation for
Tanzanian facilitators followed
by comprehensive 5-day pilot
course on leadership and
management.
ZHRC
Coordinators
and HTI
Principals
On-site
workshop
February
2-11,
2011
Once
FundedCountry
Budget
A=Lauren
Dunnington;
R=Alyson, Hilda,
Elaine
Namibia
Namibia
Namibia
South
Africa
LMI
Workshop
Method
MOH,
Ministry of
Defense,
University of
Namibia and
I-TECH
India
Leadership
Presentation
Professional
Development
II
Delivery
Yearly
beginning
in October
for 1 year
Peru
Professional
Development I
Audience
Didactic
and
experienc
e-based
curriculum
and
mentorshi
p activities
Leadership
and
Management
Workshop
LPI 360degree
Project Type
South
Africa
Tanzania
Tanzania
Tanzania
1-year residential clinical and
leadership program. Contains
topics directly related to
leadership and management
An educational series covering
leadership competencies,
management skills,
communication & storytelling
abilities and policy skills.
Skill-based workshop focusing
on leadership, management,
supervision, communication
and team building
In-Service training for CMs – 1st
session included Understanding
Leadership, LPI Results, Habit
5-Empathetic Communication
2-day workshop for Fogarty
Scholars in Peru focusing on
leadership, teambuilding,
communication and managing
change.
Presentation on Leadership and
summary of March LMI
Workshop
On-line Leadership Assessment
instrument providing a chance
to self-assess and get input
from those you work with
Skill-building sessions on L/M
Topics: teambuilding,
professional development, &
possibilities of organization
(bottom, middle, top concepts).
Skill-building sessions on L/M
Topics: workplace culture,
leadership concepts; and
supervision.
Skill-based workshop focusing
on Supervision,
Communication/ Negotiation
and Professional Development
LMI Strategy Paper, 3/3/2011
Sr. Medical
Officers and
other
physicians
from
throughout
India
10-17
Peruvian
Fogarty
Scholars
I-TECH
South Africa
staff
I-TECH
Senior and
Mid-level
Managers (510
participants)
Year-long
residential
Funded –
Country
budget
A=Jacob
A/R=Ann
Downer; C- Erin
Seiler & Ruth
Levine; H=Aaron
Katz, Anita Verna
Crofts, Alison
Ensminger
A=Sean Oslin;
R=Richard &
Elaine; H=Erin;
I=Raleigh & Deqa
Page 18
GH 521
Uganda
– Global
Program
Management
and
Evaluation
Uganda
Skills-building course about
leadership and management in
complex global health
environments. Utilizes taped
lectures, discussion, case
studies and other interactive
exercises.
IDCAP Staff
Uganda
Taped
lectures,
small
group
discussion
,
individual
assignme
nts
Summer
2010
Annually
UW / fully
funded
A=Ann Downer;
R=Ann Micelli
IV. Collaboration/Partnership
Collaboration is currently built into LMI in the following ways:
 The LMI Working Group – a HQ-based working group composed of representatives of all three divisions.
Focused on supporting the LMI.
 LPM Technical Working Group – a group dedicated to supporting the UW’s DGH leadership, policy &
management activities and ensuring collaboration and coordination across units, organizations and other
entities.
 Global Program Management Division – LMI is a division priority and division staff support strengthening of
leadership and management skills and programs across the Network.
 Regular meetings between Ann Downer, Raleigh Watts, and Elaine Douglas to coordinate activities.
 LMI Listserv – a list of I-TECH staff across divisions interested in leadership and management activities within ITECH.
 GPM Division Buzz – providing updates to Country Directors, Unit Directors and the Executive Team.
 Within Country Offices, I-TECH HQ staff work with government and other partners to implement effective
leadership and management capacity strengthening projects/programs.
V. Evaluation Plan
LMI is working with I-TECH’s Quality Improvement (QI) to develop a monitoring and evaluation plan and to support
country efforts. An LMI TrainSmart Website is being developed to track leadership and management training efforts.
LMI Strategy Paper, 3/3/2011
Page 19
References
1. World Health Organization (WHO). 2007. Everybody’s Business, Strengthening Health Systems to Improve Health
Outcomes: WHO’s Framework for Action.
http://www.who.int/healthsystems/strategy/everybodys_business.pdf.
2. President’s Emergency Plan for AIDS Relief (PEPFAR). 2009. The U.S. President’s Emergency Plan for AIDS Relief:
Five Year Strategy, December 2009. http://www.pepfar.gov/documents/organization/133035.pdf.
3. Pfeffer J and Veiga J, May 1999. Putting People First for Organizational Success, The Academy of Management
Executive (1993-2005), Vol. 13, No. 2, Themes: Technology, Rewards, and Commitment (May, 1999), pp. 37-48,
http://www.jstor.org/stable/4165538.
4. Lattal D, 2003. The Science of Success: Creating Great Places to Work. The Performance Management
Magazine, February 28, 2033. http://www.pmezine.com/?q=node/8.
5. Daniels, Sharon. November 2009. Hard numbers: Measuring Leadership Development.
http://www.clomedia.com/features/2009/November/2784/index.php
6. Mansour et al. 2010. Scaling up proven public health interventions through a locally owned and sustained
leadership development programme in rural Upper Egypt, Human Resources for Health 2010, 8:1,
http://www.human-resources-health.com/content/8/1/1.
7. Jones DS et al. August 2009. Increasing Leadership Capacity for HIV/AIDS Programs by Strengthening Public
Health Epidemiology and Management Training in Zimbabwe. http://www.hrhresourcecenter.org/node/2741
8. O’Neil, Mary L. 2008. Human Resource Leadership: the Key to Improved Results in Health, Human Resources for
Health 2008, 6:10. http://www.human-resources-health.com/content/6/1/10.
9. Management Sciences for Health. 2005. Managers Who Lead: A Handbook for Improving Health Services.
Management Science for Health, Cambridge, MA.
10. Epstein J, 2009. Presidents Push for Global Health, Inside Higher Ed.
http://www.insidehighered.com/news/2009/09/15/health.
LMI Strategy Paper, 3/3/2011
Page 20
Appendix A: Organizational Background
The International Training and Education Center for Health (I-TECH) is a collaboration between the University of
Washington and the University of California, San Francisco. It is a center in the University of Washington's Department
of Global Health and has offices throughout Africa, Asia, and the Caribbean. I-TECH has 600 worldwide staff who work in
partnership with local ministries of health, universities, non-governmental organizations (NGOs), medical facilities, and
other organizations to support the development of a skilled health work force and well-organized national health
delivery systems. I-TECH activities occur primarily in the following technical areas:
•
•
•
•
Health system strengthening
Health workforce development
Operations research and evaluation
Prevention, care, and treatment of infectious diseases
I-TECH receives funding from the Health Resources and Services Administration (HRSA), the United States Agency for
International Development (USAID), the US Centers for Disease Control and Prevention (CDC), the US Department of
Defense (DOD), and others. Most of I-TECH's project work is part of the President’s Emergency Plan for AIDS Relief
(PEPFAR).
Vision
I-TECH envisions a world in which all people have access to high quality, compassionate, and equitable health care.
Mission
I-TECH is a global network that works with local partners to develop skilled health care workers and strong national
health systems in resource-limited countries. I-TECH promotes local ownership to sustain effective health systems.
Operating Principles
Honoring a shared vision. We believe in the benefits of a network. We recognize the unique contribution of individual ITECH offices while benefiting from our collective strengths.
 Our vision and mission are future-oriented, while the operating principles guide us day-to-day.
 Our vision, mission, and principles are posted in each office.
 We use our long-term vision and mission to prevent us from becoming discouraged by short-term challenges.
 Each office strives to operate in accordance with the I-TECH standards.
Offering a rewarding work environment. We strive for high satisfaction and low turnover among staff.
 We offer regular opportunities for personal and professional growth and renewal.
 As a result of our trust and respect for one another, we take concerns or complaints directly to the source for
resolution.
 We value and promote the skill of good listening.
 We believe that each person's accomplishments benefit the entire group, and we take time to acknowledge and
celebrate them.
 We recognize the positive impact of personal time on productivity.
Acting with integrity. We recognize that our operating principles are ideals, and we strive to honor and achieve them.
 We encourage and model civility in our personal and professional interactions.
 We deal fairly and honorably with employees, donors, and partners.
 Conflicts are resolved in private.
 We believe trust is essential to a productive work environment.
 We seek to understand a problem from the other's perspective before making a judgment.
Producing high-quality work. We strive to deliver high quality work, on time and under budget.
 We employ people with technical ability and communication skills.
 We collaborate with universities and other organizational partners to improve our methods and outcomes.
 We recognize and reward innovative thinking.
LMI Strategy Paper, 3/3/2011
Page 21


We believe that multidisciplinary approaches to complex challenges are the most sustainable.
We employ team-based management, and all members of a team are respected for the expertise and work they
contribute.
Flexibility. Our mission is complex. We recognize that there are many ways to approach it.
 We make a genuine effort to learn from mistakes.
 We believe in working collaboratively with other organizational partners in order to achieve the best outcomes
for a community.
 We value and encourage the ability to respond to changing conditions and priorities in the workplace.
 We listen to our stakeholders and constituents.
An attitude of hope. We come to work with a belief that our job is to overcome challenges.
 We support staff renewal periods and personal growth plans because we recognize that hope is essential for
productivity and creativity.
 We expect employees to demonstrate a sense of personal responsibility toward the organization and the people
in it.
 We support one another personally and professionally.
 We accept that change takes time.
I-TECH’s strengths include:
MULTIDISCIPLINARY I-TECH combines the intellectual talents of leading clinicians, educators,
APPROACH
researchers, and instructional designers to form multidisciplinary project teams.
This results in innovative, comprehensive, and targeted capacity development
activities that are tailored to the needs of individual countries.
ACADEMIC
Supported by the University of Washington (UW) in Seattle and the University of
AFFILIATION
California, San Francisco (UCSF), I-TECH offers its network of offices and partners
access to technical specialists and new research in all areas of global health. I-TECH
also links to the 11 university-affiliated AIDS Education and Training Centers in the
United States.
LEADERSHIP
The Principal Investigator for I-TECH is Dr. King K. Holmes, MD, PhD, Chair of the
UW Department of Global Health. Dr. Holmes is one of the most influential
infectious disease researchers and mentors of other scientists in the world.
GLOBAL PRESENCE
I-TECH is a network of NGOs in 10 countries in southern and eastern Africa, Asia,
South America, and the Caribbean region. Additionally, I-TECH implements projects
in several countries where it does not maintain a formal presence, with support
from its network. More than 85% of I-TECH employees are hired locally.
OVERSEAS PROJECT I-TECH has extensive experience in overseas human resource management, risk
ADMINISTRATION
mitigation, contract monitoring, NGO registration, auditing, and quality assurance.
I-TECH builds the capacity of its overseas offices so they can independently
manage funds and operate strong in-country programs. Among the skills
transferred to local staff are strategic planning, funds development, management
systems, report writing, and managing for results.
EMPHASIS ON
I-TECH applies the principles of quality improvement to all of its work. Throughout
QUALITY
a project cycle, I-TECH leads staff and partners through facilitated reflection on
IMPROVEMENT
areas for improvement, and helps to address these areas by finding appropriate,
relevant solutions.
EXPERIENCE WITH
I-TECH has extensive experience working with United States government partners,
DIVERSE
including the Health Resources and Services Administration (HRSA), the Centers for
DONORS AND
Disease Control and Prevention (CDC), the Department of Defense, and the United
PARTNERS
States Agency for International Development (USAID). The goal of all these
partnerships is the development of better human resources for health, and
achievement of the President’s Emergency Plan for AIDS Relief (PEPFAR).
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Appendix B. MSH Leading and Managing Framework
Practices that enable work groups and organizations to face challenges and achieve results
Leading
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
scanning
identify client and stakeholder needs and priorities
recognize trends, opportunities, and risks that affect
the organization
look for best practices
identify staff capacities and constraints
know yourself, your staff, and your organization –
values, strengths, and weaknesses
ORGANIZATIONAL OUTCOME
Managers have up-to-date, valid knowledge of their
clients, the organization, and its context; they know how
their behavior affects others

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
focusing
articulate the organization’s mission and strategy
identify critical challenges
link goals with the overall organizational strategy
determine key priorities for action
create a common picture of desired results
Managing
planning
 set short-term organizational goals and performance
objectives
 develop multi-year and annual plans
 allocate adequate resources (money, people, and
materials)
 anticipate and reduce risks
ORGANIZATIONAL OUTCOME
Organization has defined results, assigned resources, and
an operational plan
organizing
 ensure a structure that provides accountability and
delineates authority
 ensure that systems for human resource management,
finance, logistics, quality assurance, operations,
information, and marketing effectively support the plan
 strengthen work processes to implement the plan
 align staff capacities with planned activities
ORGANIZATIONAL OUTCOME
ORGANIZATIONAL OUTCOME
Organization’s work is directed by well-defined mission,
strategy, and priorities
Organization has functional structures, systems, and
processes for efficient operations; staff are organized and
aware of job responsibilities and expectations
aligning / mobilizing
 ensure congruence of values, mission, strategy,
structure, systems, and daily actions
 facilitate teamwork
 unite key stakeholders around an inspiring vision
 link goals with rewards and recognition
 enlist stakeholders to commit resources
ORGANIZATIONAL OUTCOME
Internal and external stakeholders understand and
support the organization’s goals and have mobilized
resources to reach these goals
inspiring
 match deeds to words
 demonstrate honesty in interactions
 show trust and confidence in staff, acknowledge the
contributions of others
 provide staff with challenges, feedback, and support
 be a model of creativity, innovation, and learning and
staff show commitment, even when setbacks occur
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
implementing
integrate systems and coordinate work flow
balance competing demands
routinely use data for decision-making
coordinate activities with other programs and sectors
adjust plans and resources as circumstances change
ORGANIZATIONAL OUTCOME
Activities are carried out efficiently, effectively , and
responsively

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
monitoring and evaluating
monitor and reflect on progress against plans
provide feedback
identify needed changes
improve work processes, procedures, and tools
ORGANIZATIONAL OUTCOME
Organization continuously updates information about the
status of achievements and results, and applies ongoing
learning knowledge.
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Appendix C: MSH Leading and Managing for Results Model
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Appendix D: Framework for Training
LEVEL 1: Didactic Training
 Role of Learner: Learners in passive role.
 Location: Classroom setting in any location (training facility, health care facility, etc.).
 Methods: One-way communication from trainer to learner, though might include Q&A from participants;
includes specific learning objectives.
 Examples: Lectures, presentations.
LEVEL 2: Skills-building Workshops
 Location: Classroom setting in any location (training facility, health care facility, etc.).
 Methods: Participatory training methods (must include a method other than lecture plus Q&A); includes specific
learning objectives.
 Role of Learner: Trainer leads sessions, but learners are actively involved; two-way knowledge exchanges
between trainers and learners.
 Examples: Case presentations, role-playing, small group work, simulated patients.
LEVEL 3: Practicum
 Location: Work setting similar to that in which the learner will apply new skills and knowledge (but not learner's
work site); trainer and learner are in same location (i.e., not communicating via phone or email).
 Methods: May include discussion, case presentations, demonstrations, grand rounds; patients may be present;
includes real-life resources, constraints, challenges; training can be one-on-one or in small groups (eight people
or under); must include exchange of information and knowledge from trainer to learner that is related to topic
of training (i.e., learner is not just observing at the site); includes specific learning objectives.
 Role of Learner: Trainer leads sessions, but learners are actively involved; two-way knowledge exchanges
between trainers and learners.
 Examples: Preceptorship, clinical practicum, mini-residencies.
LEVEL 4: Onsite Mentoring
 Location: Learner's work site; trainer and learner are in same location (i.e., not communicating via phone or
email).
 Methods: May include discussion, case presentations, demonstrations, grand rounds, clinical vignettes; patients
may be present; includes real-life resources, constraints, and challenges; training can be one-on-one or in small
groups (eight people or under); must include exchange of information and knowledge between trainer and
learner; includes learning objectives.
 Role of Learner: Learner is an active participant (not just recipient of information); learner is actively engaged in
the work with the trainer present and/or observing; learning may be initiated by learner or by trainer.
 Examples: Clinical mentoring, supportive supervision, onsite training in using new EMR system.
LEVEL 5: Distance Consultation
 Location: Trainer and learner are not in same location.
 Methods: Consultation with expert via telephone, email, instant messaging, video conferencing, etc.
 Role of Learner: Interaction is typically initiated by learner and is usually related to a specific patient, situation,
or challenge faced by the learner.
 Examples: Warmline, telephone, or email consultations, video-conferencing case discussion.
LEVEL 6: Systems Strengthening
 Location: Usually at the facility, organization, or site receiving assistance.
 Methods: In contrast to the previous levels, assistance is provided to address organizational and/or system
issues versus helping an individual master new skills and knowledge.
 Examples: Strengthening national training networks; curricula enhancement in pre-service training institutions;
strengthening health care facility record-keeping systems; addressing patient flow issues; developing systems to
track medication defaulters; introducing systems to avoid pharmacy stock-outs.
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