How Learning Networks in Kenya Are Strengthening Health Systems

The IntraHealth International-led Capacity Kenya Project, funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID, was designed to strengthen and transform Human Resources for Heath (HRH) systems of public, private, and faith-based sectors to enhance the quality and equity of health service delivery and, ultimately, to improve health outcomes for the people of Kenya. To support knowledge sharing and learning, the project created Peer Learning Cycles (PLC). Evelyn Wambui, Human Resources Manager at Consolata Mission Hospital Mathari in Kenya’s Nyeri County, participated in the PLCs and shared some of her experiences for this article.

1. What was the primary goal of the PLCs?

In Kenya, faith-based organizations (FBO) have been critical to health systems strengthening and are important partners for the project. In coordination with FBO umbrella groups, the project conducted a baseline survey on 127 FBO facilities to determine the status of implementation of HRH management systems and practices. The baseline findings informed the initiation of a PLC platform for knowledge exchange, learning, and replication of HRH best practices. In 2010, the project supported the secretariats of the faith-based health facilities in the development of a Generic Human Resources Management Policy and Procedures Manual. The HR Manual harmonizes sound human resource management practices across FBO member health units. Additionally, it presents a helpful starting point from which to standardize, motivate, and retain health workers across various categories of employers.

2. What was the biggest value for those involved?

The PLC platform brought health facility and HRH managers together to share experiences, implement strategies and approaches, and initiate virtual task management forums, inter-facility visits, supportive supervision, and quarterly progress-sharing workshops. For the first time ever, 47 health facilities—comprised of 39 hospitals, 6 health centers, and 2 medical training centers, all participated.

One of the participants, Evelyn Wambui,Human Resources Manager at Consolata Mission Hospital Mathari, describes how the teams developed action plans to implement the generic HR Manual.

From the PLC forums training, I have produced information leaflets and distributed them to all departments and followed up with internal sensitization exercises. I am happy that all our staff are now aware of their rights and Human Resources Policy requirements. Another best practice we implemented was establishing a functional disciplinary committee, which we never had in our facility. The PLC sharing platform enabled me to learn the criteria of forming an effective committee. I am glad to report that we now have a committee in place in the hospital and is doing a great job. We have managed two cases based on the approved grievance policy.

3. What are some lessons learned?

The sequence of activities toward increasing learning and improvement in HRH practices may determine the consistency and commitment with which members engage with each other. The figure below shows the continuum of improvement in HRH practices.

4. Are you attempting to measure learning? If so, how?

The PLC platform provided a space where HRH Managers could learn how to track performance improvements in their own staff. Evelyn Wambui discusses the use of the Performance Improvement Plan (PIP), a technique she learned while participating in the PLC.

Prior to our action plan on performance management, it was difficult to efficiently provide a measure of our employee’s performance levels, but out of the sharing in this forum, I identified how best to boost the employee performance.  I’m glad to say that we recently came up with a system known as a “PIP” which stands for the Performance Improvement Plan. In this plan, we identify staff performing below average in the facility and assign them a plan that measures their performance each quarter against specific targets. We currently have two employees with a PIP plan scheduled for an evaluation to determine their performance and identify areas of improvement.

Read more about Learning Networks in the Learning Network Resource Center.

CLA in Action articles are intended to paint a more detailed picture of what collaborating, learning, and adapting (CLA) looks like in practice. Unlike other disciplines, CLA is not a technical "fix;" it looks different in different contexts. This series will showcase examples of intentional collaboration, systematic learning, and resourced adaptation, some of which you may find applicable to your own work. The case studies, blogs, and resources represented in this series document the real-world experiences of development practitioners experimenting with these approaches for the benefit of sharing what's possible.