Partnering with African Faith-Based Organisations for a Strong Health Workforce

This 6-page technical brief from CapacityPLus looks at efforts that African faith-based organisations (FBOs) are making to strengthen their health workforce and integrate into national health systems, with the goal of improving health outcomes. The brief presents examples from the Africa Christian Health Associations Platform (ACHAP) and its members to strengthen human resources for health (HRH) and integrate FBOs into national health systems. It highlights achievements, provides lessons learned, and offers key recommendations for furthering FBOs' efforts. This includes the need for more advocacy, documentation, and relationship building.

According to the brief, FBOs play an important role in health care work, both as operators of health facilities and as trainers of health care workers. "Yet FBOs remain under recognised for their immense contributions to the health sector. In many contexts, national human resources (HR) information systems fail to count FBO health workers, and FBOs are often not integrated into planning and resource allocations for national health systems, leading to service and system redundancies and gaps."

CapacityPlus worked in partnership with Africa Christian Health Associations Platform (ACHAP) to strengthen the HRH capacities of Christian/church health associations (CHAs) in Ghana, Kenya, Liberia, Malawi, and Zambia. This included creating working groups and facilitating training. In 2012, members of ACHAP's HRH technical working group identified the need for advocacy to increase support for the health workforce in Africa. Members developed advocacy messages to guide FBO leaders, proprietors, partners, and stakeholders. Through support from Novo Nordisk and CapacityPlus, ACHAP also published Because Health Workers Matter: They Need Our Support and disseminated it at the sixth biennial ACHAP conference in Zambia in 2013.

The brief outlines notable achievements from the collaboration between CapacityPlus and ACHAP in strengthening and integrating the HRH expertise of FBOs. These include improved HRH leadership of ACHAP itself; knowledge advancement through an eLearning course; effective HR management policies and practices within the CHAs of Kenya and Malawi; strengthened HR management within the Christian Health Association of Ghana; targeted retention mechanisms within the Churches Health Association of Zambia; and strengthened institutional capacity of the Christian Health Association of Liberia and the ACHAP secretariat.

The brief outlines a number of key lessons learned through these initiatives. In terms of communication, it was found that involvement and advocacy with church leadership and structures can be challenging because of competing priorities. Lack of information also hinders a true understanding of the importance of FBO health workers. "It is critical to integrate FBO health worker statistics into national databases. Integration will make it possible to obtain a true picture of health workers in a country. More resources are required to fully support efforts to ensure participation and inclusion of FBOs in national HR information systems."

The brief states that as a regional network ACHAP was better able to foster shared learning and exchange, support scale-up of interventions, and carry out joint advocacy efforts. "The HRH technical working group offered a particularly effective forum for intercountry exchanges and learning. CapacityPlus was able to tailor and pilot a variety of studies and products, including a wage study, the HR management assessment approach, application of Global Health Workforce Alliance recommendations, and testing of eLearning courses."

A number of recommendations are offered, including the following communication related suggestions:

• "Explore ways to build the ACHAP HRH technical working group as an interactive knowledge gateway for all HRH field practitioners extending beyond the FBO networks."
• "Work to increase FBOs' application and institutionalisation of evidence-based tools to strengthen the health workforce and improve service delivery."
• "Advocate for strengthened Ministry of Health and FBO partnerships through harmonisation of systems such as HR information systems, national HRH plans and retention strategies, and other health worker support systems."
• "Increase HRH research and studies among FBOs to provide the necessary evidence base for FBO advocacy efforts and strengthen documentation and participation of FBO training institutions in regional, national, and global initiatives."
• "Increase FBO visibility through appropriate representation on relevant global-level steering committees, councils, and task forces where policies and resource allocation decisions are made."
• "Increase documentation and publication of FBO accomplishments in peer-reviewed journals and other strategic media to further advocate for FBO inclusion in national HRH initiatives and to strengthen partnerships with governments, development partners, and among FBOs."