Human Capacity Development for Improved RMNCAH

Addressing human resource challenges through human capacity development (HCD) and related health systems strengthening interventions is essential for long-term health outcomes. The Maternal and Child Survival Program (MCSP) is a global, $560 million, five-year cooperative agreement funded by the United States Agency for International Development (USAID) to introduce and support scale-up of high-impact health interventions among USAID's 25 maternal and child health priority countries, as well as other countries. HCD is a cornerstone of MCSP's support, focusing on the processes used to develop individual and team abilities to set goals and strengthen and maintain the competencies required for individual and team roles in the health system. MCSP's HCD program approaches followed the lifecycle of a health worker, beginning with competency development during pre-service education (PSE) and continuing on to support professional development through in-service training, mentoring, and supportive supervision. The program defined its approach to each phase and summarized evidence from country programs and external literature to identify and synthesize best practices. Pre-service education (PSE) is a critical component of HCD, preparing health providers with the competencies required for entry into a health profession. MCSP guidance on PSE is summarized in the project's PSE brief, which emphasizes the importance of a comprehensive approach to strengthen country PSE systems. The conceptual model used by MCSP to ensure a comprehensive approach is based on an integrative review of the literature, The Health Impacts of Pre-Service Education. In Liberia, MCSP worked closely with the Ministry of Health (MOH) and relevant professional bodies to strengthen PSE systems for midwives and medical laboratory technicians (MLTs). The project used a health systems strengthening approach to assess gaps and then target interventions to improve the education system in each area: clinical practice, students, faculty and preceptors, infrastructure, and management and curriculum. MCSP's comprehensive approach to gender in PSE included supporting schools to implement sexual harassment policies, integrate gender-responsive pedagogy into teaching, implement a communication campaign to improve gender balance for both professions, and remove policies that expel pregnant female students from their education. In Tanzania, MCSP's efforts to improve PSE prioritized using educational standards to implement a continuous quality improvement approach. MCSP used educational standards to identify gaps and tailored interventions to address the gaps and strengthen the overall PSE system. The project engaged the zonal health resource centers (ZHRCs), the local bodies involved in ensuring PSE quality, to support direct implementation. As a result of these efforts, overall percentage of educational standards achieved increased at MCSP-supported health training institutions from 37% in 2015 to 81% in 2017. In Ghana, MCSP set up a fully equipped skills laboratory and introduced eLearning as a blended learning approach for students to achieve competency in clinical areas. MCSP designed the eLearning to be part of a continuum of learning, augmenting classroom learning and skills development. The eLearning approach improved student outcomes, with students from MCSP-supported schools scoring an average of 80% on objective structured clinical exams compared to 68% from schools that MCSP did not support. MCSP's HCD efforts have led to significant improvements in PSE systems, including increased adoption of gender-responsive pedagogy, improved academic leadership and management, and strengthened clinical practice. The project's focus on continuous quality improvement and accreditation processes has also led to improved efficiencies and sustainability of PSE activities.