The Zambia Management Leadership Academy

Across Zambia, BRITE’s innovative approach and highly skilled graduates are making a difference in the lives of patients at medical facilities urban and rural, large and small.

BRITE’s flagship MLA initiative in Zambia (ZMLA) has provided training for more than 700 healthcare administrators, managers and other ministry officials in district health regions and provincial health offices throughout Zambia.

Through this program, BRITE has significantly increased the number of healthcare workers who feel prepared to meet the management and leadership challenges they encounter each day. Nearly 100 percent of ZMLA graduates report an improvement in their management and leadership skills, and would recommend the program to a colleague.

ZMLA’s impact, by the numbers:

  • 700+ healthcare workers trained
  • 90% of ZMLA students report an improvement in their management and leadership skills
  • 99% of ZMLA students would recommend the course to a colleague

“…the ZMLA has had a major
effect on health systems
improvements. The facilities we
monitor were really chaotic before
staff were trained by the ZMLA. Now,
the offices are more organized and
running efficiently.”

– Ministry of Health
District Team Leader

Empowering Local Teams to Reduce Maternal Mortality

In Zambia’s Copperbelt province, the maternal mortality rate was alarmingly high. While dwindling global aid dollars were being filtered to respond to epidemics, the local community health team was empowered to improve local health outcomes by recognizing and addressing their own challenges.

The Luanshya district community health team was trained through the Management and Leadership Academy (MLA). The MLA empowered the team to address high maternal mortality rates in their district. Through MLA tools, the team recognized that its community had a crippled emergency care referral network, as well as a shortage of skilled health care workers. This recognition sparked the team to take a series of steps that led to the provision of four ambulances procured from the local government constituency development funds. In addition, two midwives were allocated to support the district’s most problematic health site – the Fisenga rural health center.

Investing in local problem solving – training community health teams to recognize and address unique issues in their community – results in empowered health care workers, stronger local health systems and improved health outcomes.

MLA trainings in other sites around Zambia have worked to improve maternal mortality:

At Libonda Health Centre in Kalabo District, an overhaul of management procedures has led to zero reported instances of maternal death at the hospital.

The Mpunde Rural Health Clinic improved service delivery and quality of care for improved maternal health outcomes. Activities included training staff on Emergency Obstetric and Neonatal Care; procuring essential maternal health equipment; adding a registered nurse at the facility; repairing the facility vehicle to assist in emergency situations; and conducting community outreach on safe maternal and reproductive health practices.

Improving Information Management for Better Patient Outcomes

“I would like to
commend BRITE for
such an insightful
training that’s helped
me and my colleagues.”

– Molly Kashumba,
Senior Nursing Officer

Mishandling of patient files was causing problems at Maamba hospital in Sinazongwe District, Zambia. After patient visits, files were being lost or misplaced. A poor filing system resulted in delayed attention to patients, lengthy patient wait times, and significant staff time wasted on locating files.

Through the Management Leadership Academy, the hospital management team identified and defined shortfalls that affected daily operations of the hospital. File management and patient wait time rose to the top as issues that could be addressed without additional funding.

While the hospital did not have the ability to computerize patient files, they applied a new strategy to improve the existing filing system in the registry. Patient files are now labeled for easy access when needed. Drugs are now grouped and filed alphabetically. All files are placed in a box after a drug is dispensed for easy collection and organization.

Management meetings are held three times a month to strategize and share tasks and responsibilities for weekly and monthly operations. New committees meet monthly to address other hospital functions and improve communication among departmental heads.

As a result, the hospital has improved average patient wait times from 40 minutes to only 10 minutes. Files can be located easily now, even by non-registry staff. The pharmacy is organized and drugs are monitored for inventory, expiration dates and usage. Staff members are motivated because they have a role to play in the management of the hospital affairs through records management. Committee meetings have enhanced communication and improved information management at the hospital. Nine out of 10 patients who were interviewed after the reorganization acknowledged that the quick accessibility of their files is a significant improvement.

Improving Teamwork and Health Service Delivery in the District Pharmacy

“MLA has indeed changed
the way I work for the better,
and the skills and tools are
enabling me to be better
manager and as I put them
into practice a better leader.”

– Rachel Msimuko

Rachel Msimuko was appointed as district pharmacist after a one-year pharmacy internship in Mkushi District in the Central Province of Zambia. Without any formal orientation in managerial and leadership skills, she was placed in a managerial position and tasked with overseeing the provision of pharmaceutical services and products for an entire district. The quality health service delivery in the district depended, in part, on the success of her management skills.

Rachel went through her first two years in day-to-day mode — attending to all problems as they came her way. This was stressful for her and her team.

The next year, Rachel participated in the Management Leadership Academy (MLA). She learned that most problems can be solved by identifying the root cause and dealing with them – allowing her to tackle multiple problems at once.

The ZMLA team at Musofu Rural Health Centre reviewing PMTCT data for the case study with health centre staff

Not everyone is a born leader, but after the MLA, Rachel is confident that leadership skills can be acquired. She now understands the importance of communicating her vision and getting buy-in from her colleagues, so the entire pharmacy department can work as a team.

Teamwork is, in fact, the most important lesson Rachel learned in MLA. She and the other group members from her cohort have shared the knowledge acquired in the MLA with their colleagues who didn’t attend the training. As a result, they have reported more effective meetings and active adherence to action plans.

Unifying Staff for Improved Systems and Services

“I would like to 
thank BRITE…for this
opportunity to have a
clear insight in
leadership and

– MLA Participant

Staff members at Chongwe District Hospital were frustrated. There was a disconnect between leadership and staff, with issues ranging from human resources to financial and equipment management to linen supply.

Then the Chongwe Medical Officer in Charge, Hospital Administrator and the Assistant Human Resource Management Officer participated in the Management Leadership Academy, and it changed the course for the hospital staff.

The MLA program participants set a vision for the hospital – “to provide equal access of quality health care to our community in a clean environment by competent, motivated staff” – and then communicated that vision to all staff members. From there, staff members committed to working toward a central vision, and many even formulated individual work plans tied to that vision.

The MLA participants also learned how to utilize the little available resources effectively and efficiently by setting priorities for the hospital. Working in collaboration with newly-formed staff committees, the team identified the root causes of problems as well as solutions. They prioritized privacy for female patients and storage area organization as two problems that could immediately improve hospital services and the patient experience without significant financial investment.

Privacy screens were installed in the female ward. And, despite a lack of shelves, the storage area was organized according to expiration date, using stock control cards and physical inventory. A storage officer was appointed to maintain regular inventory, giving the hospital a clear understanding monthly consumptions. Resources are now being utilized according to an action plan, and staff members have a clear focus on their role – all improving hospital services for better patient outcomes.