Pursuing Excellence in Hopeful Africa

“Africa rising” was the heading of an article in the Economist Magazine in December 2011. In May 2000, the same magazine had discussed Africa under the title “Hopeless Africa”. I have been in several international meetings during the last two months and in all of them we have been talking about Hopeful Africa. Strong economic growth, improving development indices, peaceful transitions in leadership, discoveries of viable deposits of oil, gas and minerals all support the era of a new hope that some of us have been talking about for some time. There have been a few negatives during this time such as the miners’ deaths in South Africa the festering conflict in the Eastern DRC and the dreaded Ebola virus outbreak in Uganda and the DRC.

The negatives tend catch the news more than the positives. In general Africa is rising. How can the Ashgovnet and the wider health community contribute to transforming the current situation from remaining just a new hope to into an actual reality?

The good news is that we in the health sector are already gearing up to make our contribution. We are creating new institutions to respond to our needs in strengthening health systems performance, we are discussing and have started to educate a new generation of health professionals not just as experts but also as leaders and change agents, we are looking to finance centers of excellence in higher education and research to compete with other Nobel prize winning centers in other parts of the world and we are engaging in strategic partnerships inside our countries and with the very best round the round the world. At another meeting, I heard a strong call from African institutions for the current post MDG discussions to engage with genuine African stakeholders and representatives and in good time. Colleagues please believe me: all this is true and is actually happening right in front of my own eyes.

In order for these initiatives to achieve these lofty aspirations, and gather momentum, we need to cultivate a societal mindset that relentlessly pursues excellence and rejects poor quality. Last week, I was a guest speaker at the launch of the Eastern Africa Paediatric Association in Kampala hosted by the Uganda Paediatric Association with delegations from 9 countries including DRC, Rwanda, South Sudan, Djibouti, Kenya, Tanzania, Uganda, Burundi and Nigeria from the West. The theme of the conference was “Child Health Towards 2015: Improving the Quality of Health Care”. I listened to some of the technical presentations and was very impressed by the high standard of research and analysis from a new generation of youthful pediatricians in this sub-region.

I took the opportunity to discuss ownership and inclusiveness, leadership of individuals and collectively through the professional association, complexity of different country contexts and coping with resource gaps. In order to be consistent with the theme of the conference, I addressed the potential that Continuous Quality Improvement approaches hold for creating the mindset and systems thinking that aspires to do the right thing, the right way, at all times i.e. pursuing excellence. Step wise problem solving that has the courage, humility and honesty to address root causes to quality and performance gaps.

Is this doable in today’s African context? Yes of course. In my earlier life, I was head of the Quality Assurance Program in the Ministry f Health in Uganda and we used Quality Assurance approaches (Total Quality Management) for decentralizing health services management to district leaders in Uganda with good results. With the support from USAID, we also conducted a regional training program in Quality of Health Care for the greater horn of Africa and established the Regional Center for Quality of Health Care at Makerere University in Kampala. Right now there are a number of quality improvement initiatives in several African countries.  Is this an approach that we should popularize? What is the experience of others? There are other performance improvement approaches as well.

I would like to hear from those who have some other experience on how Rising Africa can institutionalize and sustain the relentless pursuit of excellence in the health sector.