Professor Brendan Bain

THE LEADERSHIP CHALLENGE

Up to recently in the Caribbean, middle and senior managers in the health sector have often been promoted to their positions just on the basis of seniority. Few have had formal preparation for their leadership roles. In addition, very few have received on-the-job reinforcement of the principles and practice of leadership. For more than ten years, CARICOM Chief Medical Officers, officials at the Pan-American Health Organisation (PAHO) and University of the West Indies (UWI) staff have shared their concerns about these gaps, which hinder effective work. PAHO has taken steps to remedy the problem by offering opportunities for leadership training to a small number of Public Health practitioners from Caribbean countries. In addition, a doctorate in Public Health (DrPH) degree programme has been started recently at UWI. However, according to some observers, the need for leadership training exists across the entire health sector, not just in Public Health.

The Caribbean Health Leadership Institute
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BIRTH OF THE CARIBBEAN HEALTH LEADERSHIP INSTITUTE (CHLI)

In 2007, UWI’s HIV/AIDS Response Programme (UWI HARP) grasped the opportunity to join in addressing the leadership gap. Support for the move came through the Global AIDS Program of the Centers for Disease Control and Prevention (CDC) with start-up funds from the US President’s Emergency Fund for AIDS Relief (PEPFAR). Staff at the Caribbean Regional Office of the CDC Global AIDS Program identified the need for managers of HIV programmes in the region to be exposed to leadership training. They made representation to their Head Office in the USA. CDC Headquarters then prepared and released a request for proposals, inviting “an academic institution” to develop and deliver a suitable training programme. UWI HARP applied on behalf of UWI. And, in September 2007, the news broke that we had received a US$2.1 million, five-year grant to establish the Caribbean Health Leadership Institute (CHLI). This is the first agreement of this kind between CDC and a Caribbean university. The Institute was launched in April 2008.

LEADERSHIP OF CHLI

CHLI team leader, Professor Brendan Bain is a former Head of the Department of Community Health & Psychiatry at Mona. His interest in health leadership was stimulated in 2005 when he attended a summer course in “Strategic Leadership and Management for Population and Reproductive Health” organized by the Bill and Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health in Maryland, U.S.A. According to Professor Bain, the definition of “Health” used by CHLI encompasses the physical, mental, social and spiritual wellbeing of individuals and entire communities. Leadership is regarded as a combination of knowledge, wisdom, skills, attitudes and actions that must be mastered progressively throughout personal and professional life.

OPERATION OF CHLI

CHLI was started in the Faculty of Medical Sciences on the Mona Campus and has now been transferred to operate under the Office of the Vice-chancellor. Courses have been developed and are being run in partnership with staff of the US National Public Health Leadership Institute at the North Carolina Institute for Public Health (NCIPH), University of North Carolina, Chapel Hill. Ideas for the CHLI curriculum were taken from the NCIPH approach and the programme is being adapted to the Caribbean context. To date, 49 scholars from 14 Caribbean countries have been admitted to CHLI in two groups. Participating countries range from Belize and the Bahamas in the west and north to Guyana and Suriname in the south. The programme brings together public health specialists, health administrators, doctors, nurses, pharmacists and laboratory staff, with preference given to persons with direct or indirect responsibility for HIV/AIDS programmes. The future aim is to open the opportunity to the entire health sector.

The programme brings together professionals in the health sector
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THE CHLI APPROACH

Retreats

Two three-day residential retreats, one early and the other later in the course, are a central feature of the CHLI programme. These occasions allow networking between scholars, faculty and mentors, time for new learning, personal reflection and collaboration in small groups. Guest speakers share their accumulated experience in leadership with the participants.

Distance Learning

Other important facets of the course include: reading of recommended books and articles, listening to taped interviews with outstanding health leaders, optional writing of personal journals, on-going communication with faculty and mentors at a distance, an action learning project done in small groups with group members working from their respective countries, and monthly Internet-based seminars. Scholars are expected to grow through reading and reflection, assessing their own skills and styles, listening and receiving feedback, applying leadership concepts, and continuing to accumulate experience through practice.

A lifelong leadership network

At the end of each year a new group of scholars graduates as members of the CHLI alumni. The long-term aim is to create a “lifelong learning network” across the Caribbean, with leaders who commit to passing on knowledge, skills and wholesome attitudes to each succeeding generation of leaders in health.

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THE RESEARCH COMPONENT OF CHLI

Evaluation research is built into the CHLI programme. The hypothesis is that the programme will ultimately have a measurable impact on Caribbean HIV systems as well as on national and regional health systems in general. Early feedback from the participants indicates that they have welcomed this innovative approach to learning about leadership. Several persons report that they have greater insight into themselves and a clearer approach to relationships at the workplace. Some have said that others are noting the positive change in their behaviour. Some participants report that they have started to use some of the materials at their workplaces and others have already implemented organizational changes. As the graduates continue to lead and manage health promotion, prevention, curative and social services, they will be interviewed at intervals by researchers to find out if CHLI is helping them to do better jobs individually and in teams. Their supervisors, peers and subordinates will also be interviewed for supporting evidence of personal and organizational change.

WHO WILL BENEFIT ULTIMATELY FROM CHLI?

The results of the CHLI programme will be shared with Ministries of Health, other persons and agencies involved in similar teaching/learning programmes and financial partners. In the final analysis, the goal of CHLI is to improve health systems to the benefit of the general public.