In its final year of implementing the USAID-funded Human Resources for Health in 2030 (HRH2030) Capacity Building for Malaria (CBM) activity, the question of sustainability is looming. Since 2016, the CBM project has embedded long-term technical advisors into National Malaria Control Programs (NMCPs) to strengthen leadership, management, and governance capacity. However, with the program wrapping up this year, what will happen once the activity comes to a close? How will the CBM project and its partners ensure the transfer of technical skills, knowledge, and leadership abilities to the next generation? Do current NMCP staff feel confident to carry the work into the future? When CBM sought to answer these questions, they turned to coaching.
Coaching is the process of partnering with others in an interactive and meaningful way that inspires individuals to maximize their personal and professional potential. Coaches assist trainees to recognize the source of a performance challenge, clarify objectives, and generate a viable solution. While coaching is often used interchangeably with mentoring and advising, each is a distinct approach with a different objective. An advisor or mentor is typically a subject matter expert that provides recommendations on how to address specific technical problems and a coach is a behavior change specialist whose goal is to facilitate learning, focus, and results.
To ensure program sustainability, the HRH2030-CBM Activity shifted its strategy to train its advisors on coaching skills, who, in turn, would coach NMCP staff in five embedded countries across in Africa. This initiative became known as the Leader as Coach Accelerator Program (LCAP). Developed in collaboration with Bean Group Global, this eight-month comprehensive pilot coaching and training program was designed to build the capacity of seven advisors embedded within NMCPs in Central African Republic, Chad, Côte d’Ivoire, Guinea, and Togo.
The LCAP consisted of coaching and blended learning approaches including learning modules on coaching strategies, on-the-job training techniques, and virtual peer knowledge sharing through a community of practice (COP) online platform (see graphic). The LCAP trained advisors on how to shift their focus to coaching to build NMCP leaders’ confidence in decision making and problem solving and less on telling or showing them what to do.
This pilot program revealed that coaching is a potential key to breaking the endless cycle of training; it cultivates intangibles that are most valuable to organizational health and resilience: critical thinking skills and leadership through action.
Coaches Build Critical Thinkers
The coaching method builds critical problem-solving skills through open-ended questions and active listening. Advisors led NMCP staff in pinpointing the source of specific problems, identifying possible solutions, and specifying workplace opportunities to test the new approach. For example, in Chad, to address a persistent problem of inconsistent attendance of field staff in training sessions, the advisor sought guidance from the NMCP Coordinator on how to encourage greater participation. The solution was to involve all relevant NMCP Unit Managers in the planning, development, and implementation of these trainings to ensure accountability and attendance of their colleagues.
The coaching program taught advisors how to guide others in the process of problem identification, brainstorming, pinpointing a solution, and applying a new behavior. This approach was utilized in Cote d’Ivoire to address data quality challenges in the Monitoring and Evaluation (M&E) department. The advisor led M&E department staff through discussions and brainstorming activities guided by open-ended questions to identify clear goals and activities that would help them meet the data quality standards of NMCP management. The solution that the staff generated was to reorganize the department into separate units, each with a strategic function.
A simple reframing of “ask,” rather than “tell,” stimulated critical thinking skills, which led to solutions that were specific to the local context and problem. This approach leads to empowering decision-making and is distinct from previous models of advising and mentoring where answers are provided to a problem by an outsider. As one advisor remarked, “this training not only helps us in the professional context, but also in the wider personal and social context. Instead of giving directions and orders, you start to encourage and inspire.”
Coaches Empower Doers
Coaching can lead to organizational sustainability and resilience because it focuses on putting skills into action. Throughout the LCAP program, advisors met with their NMCP staff counterpart to develop a plan which specified the outcomes, approaches, and actions necessary to address problems and create solutions to ensure continued implementation of high-quality malaria services after the CBM activity ended. These intentional conversations focused on three questions: 1) what will you do?; 2) how will you do it?; and 3) when will you put the solution into action? Where there were gaps in knowledge and skills to carry out the plan, there was a support system to facilitate learning.
Through these conversations and trainings, NMCP staff strengthened essential skills and were motivated to follow through on managerial, technical, and leadership responsibilities. In the Central African Republic, through the advisor’s coaching and support, the NMCP M&E Officer was able to plan, prepare, and facilitate their 2021-2023 National Strategic Plan review workshop without a consultant. This example demonstrates how coaching can help build NMCP staff confidence to become “doers” and strengthen technical knowledge to build a more sustainable and resilient workforce.
To measure the effectiveness of the LCAP approach, behavior change data was tracked to allow for real-time course correction. The dual feedback loops of one-on-one coaching coupled with group coaching encouraged accountability and reflection. Coaching conversations allowed advisors to develop their own roadmap and the COP online sharing platform gave the advisors an opportunity to share experiences, troubleshoot problems, and brainstorm solutions with their peers. At pivotal program junctures, advisors and their NMCP counterparts noted improvements in active listening, asking powerful questions, providing feedback, motivating others to action, and a shift in dynamics from simply receiving instructions to a focus on co-creating solutions.
The Road Ahead
Coaching’s ability to transform organizational resilience is not unique to malaria programs. This approach can and should be used across all sectors in programs that rely on skilled leaders to produce meaningful change within communities. With the international development community’s continual focus on developing local capacity, there has been a resurgence in mentoring and coaching, and the LCAP experience demonstrates that these powerful tools develop critical thinking skills and motivate leaders to act. Programs seeking to cultivate stronger organizational performance and leadership skills among local partners should consider the LCAP model as a component of their capacity building strategy for sustainable local capacity development.
Banner photo caption: Anitta Kamara and Brenda Stafford train pharmacists on the Test, Treat, and Track directive for diagnosing malaria. Credit: Mohamed Marcel Tucker, ZOOM Media Inc. for HRH2030.
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