Mr M M Zungu is the Deputy Director-General for the National Health Insurance within the Department of Health in Kwa-Zulu Natal. ASELPH recently interviewed him at a policy workshop presented by the University of Fort Hare in East London.
Question: As a DDG how would you describe the ASELPH programme?
Answer: The ASELPH programme is a critical milestone in public-sector health training in South Africa. For us, as KZN, I believe it is one of the best things to have happened to the department. The programme provides training, support and mentorship for managers to allow them to confidently implement the health-sector reforms that are envisaged by the National Development Plan.
ASELPH responds to the needs of the Department. Although there are many tertiary offerings in Health, these are producing generic skills. ASELPH is tailor made to the needs of the country taking into account international experiences in terms of the health reforms.
As such our department has a lot of confidence in the programme because it trains leaders relevant to the service needs of the department.
Question: What impact have you seen from your ASELPH Fellows?
Answer: Recently the Office of Health Standard Compliance concluded a study to measure the overall performance of health services throughout the country. Kwa-Zulu Natal performed above standard in the assessments in health quality improvement. I can say that this achievement was, in part, as a result of ASELPH Fellows, their training and their exposure.
Secondly we are benefiting in terms of the confidence of managers in the department which has a further impact in terms of retention. Managers feel they are valued and appreciated. The ASELPH training and support they receive builds capacity and allows them to have confidence in making the health system work.
The direct impact of this is that if you have managers and leaders who appreciate change and who can manage change, you have a team that then provides clear direction and leadership. This then makes the management of the health reforms an easy exercise.
The third impact we have seen is in terms of governance outcomes within the health system. There has been a marked improvement in this area which, once again, can be directly and indirectly attributed to managers who have undergone ASELPH.
All of these impacts are underpinned by the fact that we have promoted no fewer than six managers into acting or permanent posts in the past year. This includes Dr Sandile Tshabalala who was promoted to a Hospital CEO, two managers promoted to be district managers, an acting District Manager, Mr Vilikhazi, promoted to be CEO of the central hospital, Dr Moyaketsi promoted to CEO of Ladysmith Hospital and Dr Mdaweni promoted to DDG. All of these ASELPH Fellows are now strategically positioned to take up more responsibility and improve health service delivery in the province.
Question: Why did KZN select the ASELPH programme for the training of its leaders?
Answer: ASELPH is designed around our own health needs and specifics. It responds to our health sector needs and is designed around the South African model with an international input. This is what we need as a department.
Question: Can you quantify the return on investment you have received from ASELPH?
Answer: We have seen improvements in productivity, service delivery, good governance and overall management and leadership within the department. We spend approximately R122 000 on each ASELPH Fellow. This pays for flights, accommodation, tuition, etc.
If we were to train our managers elsewhere, this cost would be significantly higher and we would not be getting the health-sector specific training we get through ASELPH.
It is difficult to quantify the financial return but, in terms of the quality, we can confidently say that we have capacitated and confident managers and leaders and we have retained our institutional memory. This has allowed us to “promote from within” and ensured institutional stability for the department. Although we cannot quantify this in rand terms, the overall impact has been extremely positive for the department.
Question: Based on your understanding of the ASELPH programme, what would be the most important component/module of the programme?
Answer: Managing change and strategic leadership are two of the most important aspects currently facing the department. Through their exposure to ASELPH, managers can now lead top/down and sideways.
In addition to this, the introduction to research and research methodology has allowed our managers to use evidence and facts for decision-making as opposed to “gut feel”. This too is an important skill for leaders and managers in the public sector.
Question: What would you see as the long-term contribution of ASELPH to public-sector healthcare?
I think the introduction of work-based training with good mentors will need to be expanded. There is no substitute for on-the-job training. However the identification and selection of talent within the department goes hand-in-hand with this work-based training and mentorship.
The second contribution would be allowing ASELPH Fellows the space to apply knowledge and theory within the workspace to improve the overall outcomes of the Department of Health.
Question: If you were to recommend ASELPH as a training programme to your peers i.e. other provincial DDG’s, firstly would you recommend the programme, and secondly, why would you recommend the programme?
Answer: Yes, I would definitely recommend ASELPH. The fact that it is structured towards the SA Health systems needs and responds to the governance requirements is enough to promote the programme.
My colleagues at national and provincial level have seen the commitment from the leadership in KZN in terms of ASELPH. The political and administrative support to place leaders and managers in ASELPH has played a large role in our success. We, as a department see it as a good investment in managers and leaders. Investing in your people is never a mistake.
In addition to this, ASELPH also has a broader social investment in terms of the short seminars, workhops and policy programmes it runs. This provides for a better understanding between programme participants and policy makers because ASELPH creates an inclusive environment around course content, policy directives, relationship management and international best-practice. In addition to this it also builds long-term relationships between the facilitators and participants creating a network of professionals who can then address policy issues. The seminars and workshops allow for a foundation of relationship buildings between the troika – the university, the department, and students.
ASELPH Fellows are also impacting on the performance of their peers and colleagues. Getting things right is dependent on good leaders. In Kwa-Zulu Natal we have seen significant improvement in terms of the Operation Phakisa clinics. Once again, a testimony to ASELPH.