Q&A with Sindi Gede, District Health Manager for the Department of Health in the Eastern Cape

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Sindi Gede, District Health Manager for the Department of Health in the Eastern Cape, is one of the key South African professionals getting management training through the Albertina Sisulu Executive Leadership Program in Health. Here, she talks about how she's putting her training into action.

How do you balance your time on the job with your time in the ASELPH program? 

I have been given this opportunity by the Eastern Cape Provincial Department of Health to pursue a post graduate qualification named after Mrs. Albertina Sisulu.  Dedication, commitment, self-discipline and time management are required to meet the social life, work and school demands. Beyond the working hours I make use of the weekend afternoons, dedicating  five hours to school work. After hours I work on my projects, and during the work week I’m doing my job. What I like about this program is that it’s not taking you from your job. For instance, we have a study group for East London, and we meet at five o’clock after working hours during the week. People really are committed — we make time for our studies and we work on various projects as a group.  


Are your projects real-world focused? Are you looking for solutions that you’ll actually implement?

Yes. One of the projects I’m working on is to lower the infant mortality rate. What I found is that one of my hospitals is contributing a lot — that is, it has a high rate of neonatal mortality. And what I found is that there are more babies born before their time there, born underweight, and that the neonatal unit is not up to standards. Those babies are managed by people who are not well-skilled.

So my project is to improve the quality of the neonatal unit at that hospital, looking at staffing, infrastructure, essential medical equipment and morns and standards to improve the overall quality of service. ASELPH is providing a sound understanding of the evolving South Africa health care system and is equipping me with skills and competencies necessary to make decisions based on sound evidence and that respond to health service needs.


So you’re putting your studies directly into use in your healthcare programs.

Yes, exactly. All my hospitals will be improving their neonatal care. On the academic side, on the administration side, I’m working on how to retain the doctors in my hospitals. Because I’ve found that I've got a brain drain in my institutions. So I've got a partnership with Africa Health Placement, whereby they hire and recruit doctors for me, and we work together to retain them. 

The programme has helped me to plan differently and to facilitate strategic implementation of those plans, remaining in line with the vision of Department of Health and benefiting the people of South Africa.  Research is helping me to gain skills to critically analyze the knowledge, attitudes and practices of clinical staff towards attaining the set goals to improve health outcomes. One area of research is on the implementation of Reproductive Health, Maternal Health and Child Health programs, and how to make best use of the scarce recourses to design and manage effectively.


How have your interests in these areas been enhanced by your ASELPH studies?

ASELPH has provided me skills and competencies necessary to make sound decisions.

In our program, we are doing an HR focus, with budgeting, managing, planning, quality, finance. With my research topic, on the factors that are leading to severe malnutrition in the poorest district in my area, I’m looking at how to manage the solutions, how to market them, and how to budget for them.

We are being trained to be the decision makers. To be able to budget effectively manage financial resources and human capital.  Some of the modules in the program are basically enforcing leadership skills. I have attended leadership courses before, but the difference is the approach and the follow up. With ASELPH, the way they teach is so simple and it comes from people who are so experienced. They make me understand my role, and they provide examples to be able to apply in a work situation. The other area that has been enhanced is the use of data from District Health Information (DHIS) to make reports, planning and decision making. I now use of data to mobilize resources for health outcomes improvement. Today I can connect the values expressed at Alma-Ata to strategy and systems analysis. Alma-Ata was focusing on access to effective, efficient primary health care that the communities can afford and fully participate in the implementation of primary health care services. Today we talk of Re-engineering of Primary Health Care.


How did you choose to get involved with health care?

You know what? I had a dream of giving and helping needy people. I am coming from a rural community, and I saw a lot of people suffering from illnesses and struggling to access primary health care services. Getting to a hospital would take them about 200 kilometers. I thought, if I could train to be a professional nurse I would be able to help those down trodden communities. I can help a lot of people through health education and diseases prevention programs, rather than just treating the disease. Even when I was a young person, I would help out at school because I was a Girl Guide, with the motto “Be Prepared.” At a young age I could imagine people living a healthy life style, we could have a healthy nation.  I have a caring attitude that makes me feel good whenever I give help to the needy.


Did you have the kind of encouragement to go into health care management as a young woman that you would have as a young man?

Women of South Africa — we are so shy that we under estimate our potential. There used to be the mentality that men are the only people who can lead and be leaders. But in my mind, I told myself, “Women can be leaders, women can hold higher positions in administrations.” And we can prove that by hard work and having knowledge of the principles of management and leadership.  When I took nursing as a career I could see that women are dominating and are managing effectively. That encouraged me to further my studies by enrolling with UNISA for a Bachelor of Nursing Administrationdegree majoring with Health Services Management and Health Science Education. The Diploma in Community Nursing Science made me to understand more the community needs and the social determinants of health.

I like to motivate and empower women and am invited to be a motivational speaker at women’s gatherings. Supporting each other as women in leadership can make a positive change.  This country needs educated women who will serve as role models for achieving positive health outcomes. Young women need mentors so that they can be leaders of tomorrow. We need to develop young women so that they can lead this country for future generation.


What do you hope for?

My personal goal is to make a difference in the health sector, through adopting a transformational leadership style. My vision is to see health services being accessible to my communities and for health to serve these communities with dignity, professionalism and a caring attitude. I look forward to seeing the Department of Health in the Eastern Cape transforming and being successful in rolling out the National Health Insurance. This requires effective implementation of change management and consequence management in all levels of care, and the effective implementation of Re-engineering of Primary health care in my district.  It also means a reduction of maternal and infant mortality and a reduction of TB, HIV and AIDS. Finally, it means health system strengthening and increased life expectancy of the people of South Africa.

I look forward to the whole group of ASELPH Fellows graduating next year. I also hope to visit Harvard School of Public Health one day and get exposure to mentoring and facilitation skills.