Duke Initiative Builds Model for Training Mid-level Nigerian Health Care Managers

Published December 6, 2010, last updated on March 20, 2013 under Education News

A training initiative developed in Nigeria with the assistance of Duke University faculty and staff is filling a gap in leadership and management training in the country’s health sector, which is plagued by high rates of polio, malaria and tuberculosis. With program development and delivery assistance from Will Mitchell, Duke professor of international management and strategy and Duke Global Health Institute affiliate, the program’s collaboration is helping Nigerian partners build a sustainable model for health management training, while improving primary care operations and health outcomes in their country.

This fall, 96 Nigerian mid-level health managers graduated from the Mid-Level Management Training program in Abuja, Nigeria’s capital. The program’s included participants from 36 of Nigeria’s 37 states, who were all affiliated with the National Primary Health Care Development Agency (NPHCDA).  The NPHCDA is made up of more than 700 employees and leads the country’s immunization program and promotes the strengthening of primary health care.  The training targeted doctors, community health officers, midwives, nurses and health administrators – the people serve as a link between direct local primary health care providers and top-level administrators and policy makers.

Consisting of six week-long sessions over 10 months, the discussion and practice-based training program focused on core areas of management, including leadership, financial management, economics, communications, strategic planning, and epidemiology, as well as key aspects of health policy . Rather than replicate a Duke program in an international setting, the training was tailored to local needs and maximized the knowledge and resources of strong faculty and staff already on the ground in Nigeria.

“Our goal was to help our partner identify both content and context experts in Nigeria. By this, we mean the people who are knowledgeable about teaching the principles of management and those who have extensive experience working in the local health-care setting,” said Mitchell, who led efforts to recruit 25 Nigerian course instructors with experience and expertise in business management, economics and public health.  “The training had to be driven and organized by local partners to encourage a model of sustainability. None of us at Duke have the ability to make a lasting difference in Nigeria without local leadership.”

Mitchell and Kevin Schulman, director of Fuqua’s Health Sector Management (HSM) Program and DGHI faculty member, worked with Muhammad Ali Pate, a Fuqua MBA and HSM graduate who is also Executive Director and CEO of the NPHCDA in Nigeria, to build program management skills at the agency, which sets a precedent for the future.

“My hope and the goal of this program and partnership between NPHCDA and Duke is that they will institutionalize and continue to build on this training model,” said Mitchell, on the initiative that’s gaining interest among various health and business programs at Nigerian universities. “And we’re already seeing positive outcomes of this initiative.”

As part of an independent evaluation by the Global Business School Network and faculty at the University of California-Berkeley, preliminary assessments of participant pre- and post-examinations indicate a strong increase in leadership and analytical skills that will allow them to apply what they’ve learned to health projects and programs they are coordinating at the agency.

“There has been a huge boost in confidence in the agency because we’re doing what we said we would do. These positive results will continue to translate to other projects,” said Pate in a recent Fuqua School of Business feature story. “It takes a whole country to make these changes, and Nigeria is now moving ahead. We have an African saying that if you want to go fast, you go alone, but if you want to go far, you go with others.”

The initial round of the health management training was funded by the Nigerian Office of the Millennium Development Goals, which plans to continue support for future offerings of the program. The technical support from Duke received support from the Bill & Melinda Gates Foundation.