Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to page options Skip directly to site content

Our Global Voices Posts

IMPACT Program in Kenya: A Fellow’s Experience

Posted on by Dr. Oren Nyambane Ombiro
Oren (right) with some of his colleagues Dr. Vincent Yator (center) and Athanasio Omondi (left) engage with a International Union Against Tuberculosis and Lung Disease facilitator, Dr. Gihan El-Nehas (standing) during a group session.
Oren (right) with some of his colleagues Dr. Vincent Yator (center) and Athanasio Omondi (left) engage with a International Union Against Tuberculosis and Lung Disease facilitator, Dr. Gihan El-Nehas (standing) during a group session.

Many doctors and other health workers in my country have limited background or training in leadership and management, yet they often find themselves in leadership positions. This was my case when I was appointed Sub-County Medical Officer in February 2014. Starting out was no easy task, considering I was more used to clinical work. Here, I was expected to oversee the operations of close to 70 health facilities, ensure food and water safety, manage human resources, procurement and finance, resolve conflicts every now and again, deal with commodity shortages and supply chain issues, as well as work with other departments, ministries, donors, NGOs, politicians, the media and other stakeholders. It was overwhelming. I even lost weight!

Seeking help – and finding it

In a bid to improve my management skills, I enrolled in a senior management certificate course at the Kenya School of Government, which equipped me with some basic general skills for management. I later joined the Young African Leaders Initiative (YALI) program in the Public Management track, which provided me with competency-based leadership and management training. It was during my YALI training that I came across CDC’s Improving Public Health Management for Action (IMPACT) program advertisement.

I immediately knew this was what I wanted: a leadership and management training that emphasizes skills-building and practical application, but with a broader focus on my passion for public health and health systems strengthening. The selection process was extremely intense, which included both a written test and oral interviews. I feel privileged to have been selected alongside seven others to pursue this great venture.

Two ways to learn

The IMPACT program has been exciting and eye opening. It requires a serious commitment of time and effort, factors that have helped me to learn to better manage my time and effectively prioritize. It places emphasis on service, providing real results to the health sector as I “learn by doing” in the field.

IMPACT is organized into two main components: in-class courses and field placement. The in-class component includes short, targeted lectures followed by group discussions, case studies, demonstrations, and class projects to enhance understanding and elaborate on how to put the training into action. This component is delivered by highly knowledgeable, interesting, passionate, and accomplished experts in the field that including CDC IMPACT staff, the International Union Against Tuberculosis and Lung Disease, senior lecturers from Kenyatta University, staff of CDC Kenya and the Ministry of Health, and invited guest lecturers from other institutions.

The field placement component is the core of the program. We are expected to apply what we learn in class to a real workplace in a way that adds value to the placement site and the Ministry of Health in general, while building our own skills through on-the-job training. Here we are expected to participate in community needs assessments, program evaluation, program management and planning, and emergency response. We are also expected to use communication skills, including oral presentations, and to participate in budgeting and financial planning.

‘Kiherehere’ is a good thing

I was posted to the Division of Noncommunicable Diseases, where I was assigned a mentor and supervisor. My mentor is the head of the division, and my supervisor is the head of the Violence and Injury Prevention Unit. Both have undergone the IMPACT Distinguished Fellows Program (another version of IMPACT for senior managers) and are highly accomplished leaders in the public health sphere in the country. Having gone through the program, together with their vast knowledge and experience, they have been extremely helpful in providing guidance, keeping me engaged, assigning me tasks and providing opportunities for me to practice my new skills.

In my first meeting with my mentor, he encouraged me to be aggressive, to actively participate in meetings and activities, and to network. He told me, “In our culture, ‘kiherehere’ (being too outspoken or assertive) has always been discouraged, but kiherehere is actually a good thing. Go out there, explore opportunities and network. What is the worst that could happen? Maybe someone will say no, but they might say yes. And that ‘yes’ could make a difference to the people we serve, to the division, or to your own professional growth.”

“Learning by doing” in the community

Oren with Bright Oywaya, Executive Director ASIRT-Kenya and students of St. Dominics primary school sensitizing motorists in commemoration of the UN Road Safety Week
Oren with Bright Oywaya, Executive Director ASIRT-Kenya and students of St. Dominics primary school sensitizing motorists in commemoration of the UN Road Safety Week

Being posted to a field placement has been one of the most exciting aspects of the program. One of the highlights of my placement has been a community health needs assessment. It allowed me to apply many of the management skills learned in class, including stakeholder identification and engagement, budgeting and financial planning, supervision and effective delegation, and community entry, among others.

I liked the focus group discussions most of all, where I got to hear the community’s perspectives, fears, and concerns about noncommunicable diseases. Some of the participants’ views and beliefs provided opportunities for public health intervention. For instance, many people in the community don’t believe diseases like epilepsy are illnesses that can be controlled with conventional medicine. The same applies to conditions that take time to respond to treatment (e.g., diabetic foot ulcer in a person who is not well-controlled). Some in the community thought their medical conditions were a result of witchcraft. The consequence of some of these beliefs is that the residents will not seek medical services in time to prevent further complications or because they believe witchcraft can only be healed by witchcraft. A number of hypertensive and diabetic clients I talked to admitted to defaulting on their medications. On further probing for reasons for defaulting, one of them said, “Those medicines are not food to be taken daily.” These are just a few of the feelings and perceptions I gathered that would help us as we design effective interventions to improve the community’s health outcomes. This exercise also made me realize that many programs often fail because there is no input and participation by host/benefiting communities.

Meeting a complex challenge

I believe improving public health management through innovative programs like IMPACT is a step in the right direction for the country. Delivery of health services is becoming increasingly complicated, with the rising burden of noncommunicable diseases and injuries on top of communicable diseases, frequent disease outbreaks, numerous industrial actions, devolution of health services, shortage of health workers and supplies, emergence of new technologies, and persistence of cultural barriers among other complexities.

Navigating these challenges calls for stronger leadership and management ability at all levels of the health system, and I am glad IMPACT is coming in to strengthen public health systems towards achievement of the highest attainable standard of health as envisioned in our country’s Constitution.

Related Links

 

Posted on by Dr. Oren Nyambane OmbiroLeave a commentTags , , ,

Creating Strength in Numbers to End Violence Against Women & Girls

Dr. Daniela Ligiero

The 16 Days of Activism Against Gender-Based Violence campaign falls every year between the International Day for the Elimination of Violence against Women on November 25th, and Human Rights Day on December 10th. It is a time to raise awareness and galvanize global support and action to end violence against women and girls around the Read More >

Posted on by Dr. Daniela Ligiero, Executive Director and CEO, Together for GirlsLeave a commentTags ,

Rubella and CRS Elimination: A Race Worth Winning

AEFI management kit

AEFI Management Kit. Photo credit: Rania Tohme/CDC More than 100,000 children worldwide are born with congenital rubella syndrome (CRS) every year to mothers infected with the rubella virus. Sadly, these children will suffer a lifetime because of birth defects such as blindness, deafness, and heart disease, even though a cost-effective vaccine is widely available to Read More >

Posted on by Susan Reef, MD, MPH, Medical Epidemiologist and Rubella Team Lead, Global Immunization Division & Gavin Grant, MD, MPH, Medical Epidemiologist, Global Immunization DivisionLeave a commentTags , , ,

Everyone Needs Somewhere to Go: World Toilet Day

Charcoal briquettes manufactured from human waste in East Africa

Charcoal briquettes manufactured from human waste in East Africa (Photo courtesy of Eric Mintz, CDC) We use toilets every day – at home, school, and work – yet 40% of the world’s population does not have this luxury.  Clean and safe toilets are more than just a place to use the restroom.  They are essential Read More >

Posted on by Madison Walter, MPH, CHESLeave a commentTags ,

Overcoming obstacles to polio eradication in Pakistan

Picture of worker distributing polio advocacy items to children.

Originally published on October 5, 2017 on Rotary Voices “Coming together is a beginning. Keeping together is progress. Working together is success.” Henry Ford When I first joined Pakistan’s PolioPlus Committee (PNPPC) as a manager close to eight years ago, polio eradication seemed within our reach. I used the opportunity to study poliomyelitis beyond just Read More >

Posted on by Alina A. Visram, manager, Pakistan National PolioPlus CommitteeLeave a commentTags ,

Precision Public Health: Using Malawi Population-Based Impact Assessment (MPHIA) Data to Reach HIV Epidemic Control in Malawi

The Malawi Population-Based HIV Impact Assessment (MPHIA) is Malawi’s first nationally representative HIV survey that measures national HIV incidence, pediatric HIV prevalence, and viral load suppression. MPHIA has provided detailed information on the current status of the HIV epidemic and the uptake of HIV prevention, care, and treatment services in Malawi. In his remarks during Read More >

Posted on by Nellie Wadonda-Kabondo and Danielle PayneLeave a commentTags , , , ,

Looking Ahead to a Measles and Rubella Free World

Robert Linkins, MPH, PhD

Vaccines fight diseases and save lives. Think of achievements like smallpox eradication, a polio-free world close at hand, and 2-3 million deaths prevented each year through routine immunizations. Yet despite a safe and effective vaccine against measles and rubella, these deadly viruses continue to steal the health and lives of children all over the world. Read More >

Posted on by Robert Linkins, MPH, PhDLeave a comment

Optimistic in the Face of Ongoing Tragedy: Progress toward a World Free of Human Rabies

During her presentation at 2017 PARACON meeting on how to plan and budget for a mass dog vaccination campaign, Emily Pieracci asked who was committed to ending rabies.

Rabies is a fatal disease that kills an estimated 59,000 people each year, almost half of whom are children. The majority of deaths occur in Africa and Asia. All of these deaths are vaccine-preventable with timely administration of post-exposure prophylaxis (PEP), the shots needed to prevent rabies from developing in bite victims. So why is Read More >

Posted on by Emily PieracciLeave a comment

CDC Global Rapid Response Team Pilots Workshop for Senegal and Burkina Faso

Global Rapid Response Team

Participants to the Rapid Response Team Management workshop, Dakar, Senegal, August 7-11 The 2014-2016 Ebola epidemic clearly demonstrated the need for trained scientists who can deploy quickly to confront health threats and ensure global health security. While we often think about the emergency response itself, we typically don’t think about the work that happens behind Read More >

Posted on by Global Rapid Response TeamLeave a comment

Making some noise about noncommunicable diseases in Rwanda

We weren’t sure what to expect when the Rwanda Biomedical Center requested a training for their noncommunicable disease (NCD) program managers. We had never delivered this particular curriculum before, but after three months of preparation, our journey from Atlanta began. After landing in the capital Kigali, we faced a bumpy three-hour drive into the mountains Read More >

Posted on by Kristy Joseph, MA, CDC Global NCD BranchLeave a comment
TOP