Public Health Action (Jun 2024)

The effect of an intervention to promote isoniazid preventive therapy on leadership and management abilities

  • C. Christian,
  • E. Kakande,
  • V. Nahurira,
  • L.B Balzer,
  • A. Owaraganise,
  • J.R. Nugent,
  • W. DiIeso,
  • D. Rast,
  • J. Kabami,
  • J.J. Peretz,
  • C.S. Camlin,
  • S.B. Shade,
  • M.R. Kamya,
  • D.V. Havlir,
  • G. Chamie

DOI
https://doi.org/10.5588/pha.24.0002
Journal volume & issue
Vol. 14, no. 2
pp. 56 – 60

Abstract

Read online

BACKGROUND: Across sub-Saharan Africa, mid-level healthcare managers oversee implementation of national guidelines. It remains unclear whether leadership and management training can improve population health outcomes. METHODS: We sought to evaluate leadership/management skills among district-level health managers in Uganda participating in the SEARCH-IPT randomised trial to promote isoniazid preventive therapy (IPT) for persons with HIV (PWH). The intervention, which led to higher IPT rates, included annual leadership/management training of managers. We conducted a cross-sectional survey assessing leadership/management skills among managers at trial completion. The survey evaluated self-reported use of leadership/management tools and general leadership/management. We conducted a survey among a sample of providers to understand the intervention’s impact. Targeted minimum loss-based estimation (TMLE) was used to compare responses between trial arms. RESULTS: Of 163 managers participating in the SEARCH-IPT trial, 119 (73%) completed the survey. Intervention managers reported more frequent use of leadership/management tools taught in the intervention curriculum than control managers (+3.64, 95% CI 1.98–5.30, P < 0.001). There were no significant differences in self-reported leadership skills in the intervention as compared to the control group. Among providers, the average reported quality of guidance and supervision was significantly higher in intervention vs control districts (+1.08, 95% CI 0.63–1.53, P = 0.001). CONCLUSIONS: A leadership and management training intervention increased the use of leadership/management tools among mid-level managers and resulted in higher perceived quality of supervision among providers in intervention vs control districts in Uganda. These findings suggest improved leadership/management among managers contributed to increased IPT use among PWH in the intervention districts of the SEARCH-IPT trial.

Keywords