Virtual Leadership in Uganda

Michael Musiime Koima, Leadership & Governance Manager, Baylor-Uganda

“By building the leadership skills of Baylor staff who work directly with healthcare workers and district leaders to deliver effective services, we will help them meet their mandate, strengthen the health system and save lives” - Michael Musiime Koima, Leadership and Governance Manager at Baylor-Uganda

The COVID-19 crisis presented the Pepal, Janssen Pharmaceutical Companies of Johnson & Johnson and Baylor-Uganda collaboration with an unprecedented challenge: no face-to-face programmes for the foreseeable future.  While continuing to support the momentum for the leadership and adolescent programme with Baylor-Uganda – we asked ourselves, how can we continue to support our colleagues at Baylor remotely and the Ugandan health system more broadly?

COVID-19 is putting additional strain on the already overburdened health system in Uganda. Measures taken to curb the spread of the virus are affecting access to lifesaving healthcare services. The impact of which is likely to be devastating; UNAIDS warns that a six-month disruption to services could see a 139% rise in the number of new child HIV infections. Baylor staff are on the frontline of the national response – supporting health facilities with capacity building, reporting community alerts, and sitting on the national taskforce. Leadership skills are more critical than ever for Baylor staff who are being asked to respond to the crisis while continuing to maintain existing projects with little additional funding or resources.

Together, we devised an exciting new digital leadership project, which sees a cohort of Janssen volunteers co-create virtual leadership modules that address three critical leadership gaps at Baylor: Leading with Agility, Situational Leadership and Influencing Skills. The exchange of expertise and ideas within these modules will help boost staff performance, develop transformational leadership competencies and leave Baylor staff better able to handle the hectic and uncertain environment they find themselves in. 

Thirteen Janssen alumni volunteered for Phase One of the project and formed three agile innovation teams. Each team will develop one module and a complimentary digital tool to help Baylor leaders apply their learnings at work. Over the next two months, they will design, teach and measure the impact of these modules before bringing them to a broader audience.

As we begin looking to Phase 2 of the project, we are excited about the potential impact of the project and the possibilities that digital platforms provide.  

NJIA Leaders Responding to the COVID-19 Crisis

Pepal is proud to work with transformational leaders in the corporate, government and NGO sectors who are supporting the COVID-19 crisis across the world. Effective leadership and health management are critical to ensure that patients receive the care they need, and the COVID-19 pandemic has pushed this crucial need into focus.

The NJIA programme, a collaboration between Pepal, F. Hoffmann-la Roche AG (Roche), ICAP Tanzania, MoHCDEC Tanzania, and McBride and Lucius, brings leadership development and innovation alive in the context of decreasing the cervical cancer burden in Tanzania, India and Uganda. The Pepal team spoke with leaders from this programme and how their experience as part of NJIA has supported their leadership response to the COVID-19 crisis.

Revocatus Dominic is a District Nursing Officer (DNO) in Tanzania.

District Health Team, Tanzania in June 2020.

“I am very grateful for the NJIA leadership development programme. I have applied many leadership and management skills during the COVID-19 crisis. Some months ago, I was appointed to lead a COVID-19 task force and response team in my district and, to be honest, I was frightened. But remembering my SDI (Strength Deployment Inventory) profile which showed me what kind of a leader I am, as well as the VUCA lessons, changed my perspective on how I react to circumstances. This was the moment I realised leadership is fundamental to crisis management and control. I gathered my team and set goals to save the lives of COVID-19 patients as well as ensuring the safety of the members of my team.”

Markus Ruf has worked for Roche for over 18 years and is the Global Head of Infrastructure Service Integration.

“I attended Cohort 9 of NJIA which took place in Bukoba, Tanzania in November 2019. Since the COVID-19 outbreak began this year, my team has been supporting the transition from roughly 30,000 people working from home to over 100,000 in a very short space of time. 

Markus Ruf

When I reflect upon the NJIA programme and how this has influenced my reaction to the COVID-19 crisis, I realise just how much we take for granted. The leadership and management we are used to seeing in high-middle income countries is often driven by experience and the ability to use past events as reference points. At this current time, there are no precedents, and this reminds me strongly of my experience with NJIA.

There is also a need during this crisis to be creative as a leader; there are many correct solutions, yet what is important is choosing the right solution for the context. The same was true during my time in Tanzania. Additionally, the urgent nature of decisions and the fact that the impact that you are creating is quickly visible are both elements from the NJIA programme that have become far more ‘real’ to me since the outbreak of COVID-19.

I think the way in which we work is changing completely, and it further embeds the demand for agile and flexible leadership. There is so much that we can learn from one another and this is enhanced through using the virtual means available to us as a method of sharing solutions to the challenges we are currently facing.”

Pratima Singh is a staff nurse at the Woman’s District Hospital, Jaunpur, India.

Pratima Singh gave some insight on how NJIA has influenced some of her decisions since the outbreak of the COVID-19 crisis.

“There is a shortage of PPE at my health facility and it reached the point where I was being asked to go without. However, in using some of the learnings from my NJIA experience, I remained calm and analysed the situation at the health facility. Having done this, I discovered a member of staff had an extra PPE kit which I could therefore use, enabling me to help COVID-19 patients.”

Pratima at work in June 2020.

Batu Berkok is Head of Supply Chain Europe for Roche.

“At the end of January 2020 Roche formed a cross-functional taskforce in response to the COVID outbreak in China, and I was a part of this. The taskforce was initially put together to look at risks for getting medicines to patients especially concerning the supply chain in China, however as the crisis grew the scope of the taskforce and the challenges we were facing also grew: it became about broader supply chain issues and ensuring we could get medicines to patients around the world. The issues became more complex still as Roche began to look across all the different medicines we have, and how they could be used to support patients suffering with COVID-19.     

Batu at a focus group session with ASHAs (community health workers) in Varanasi.

In October 2019, I had travelled to Varanasi, India to participate in the first cohort of the ‘NJIA programme’ in India which aims to develop leadership skills at Roche, and among colleagues in the Indian health sector, whilst creating social impact around cervical cancer.  My experiences during the NJIA programme supported my approach in my work responding to COVID.  During the NJIA programme there were many challenges we hadn’t anticipated and the context was very volatile, things changed all the time, we had to improvise more and try anything and everything.  This was similar in the work we were doing at the start of the COVID crisis.  Also, at Roche we often want to plan, plan, plan but in my experience during NJIA, and then during the COVID crisis, we thought more about act, act, act, and then adjusting as we learnt.

The other perspective that NJIA bought, which I have considered during COVID, is that although I had travelled a lot in the past, I had never had really been exposed to a government health system in a country like India.  NJIA helped me to appreciate and have more perspective on the scale and depth of the challenge that COVID could create for health systems in countries like India. I understood more about what India healthcare professionals would likely go through and we were receiving messages related to this from our Indian colleagues on WhatsApp. COVID is a crisis for everyone around the world, but it is not an equal playing field.  

As a leader, NJIA taught me to be more comfortable with not knowing, to be better able to trust my team, to realise how much we depend on each other and how important speed is when lives are at stake – I have brought all this to the response to COVID.” 

The NJIA programme is transformational: it intensifies the volatile, uncertain, complex and ambiguous world we are increasingly living and leading in. Leaders on this programme are asked to participate and lead in a pressured co-creation environment, and to make a difference for patients in Tanzania, Uganda and India in a short space of time, using the resources that are already available. This experience has supported Revocatus, Markus, Pratima and Batu to lead effectively through the COVID-19 crisis where serving patients in volatile contexts has become a worldwide priority, demonstrating that leadership development is a sustainable force for change.

Pepal at the Roche Partnering for Innovation Summit

“A needed element to adapting to crisis situations like Covid-19 and enabling organisations to grow in adversity… is leadership. Without strong leadership there can be no change.” Benoit LeGrand, CEO ING Ventures

The Pepal team participated in the Roche Partnering for Innovation Summit organised by F.Hoffman-La Roche (Roche) on the 20th of June 2020. The Summit brought together different actors from the healthcare field to explore the importance of partnerships and innovation in the wider health ecosystem for better patient outcomes.

The NJIA programme, our long-standing leadership development programme with Roche, was featured during the summit’s first panel discussion as an exemplary collaboration between Roche and the health ecosystem. Alain Bindels, Head of Innovation Facilitation and Digitalisation at Roche, showcased a video about NJIA and asked the NJIA Project Manager, Stephanie Mitchell, to share programme impact. This was a proud moment for the team especially when Pepal Project Coordinator, Hezron Festo, appeared on screen!

The NJIA programme was selected to participate and compete in the Summit’s Brain Catalyst hackathon. Tasked with the challenge of adapting the NJIA leadership and innovation programme to digital platforms, we were partnered with our colleagues at Roche and representatives from Idea Foster and Inside Out Solutions. We had just four hours to prepare a 90 second pitch video on how we can create meaningful and engaging online co-creation programmes which support our government and NGO partners in India, Uganda and Tanzania. Chosen from over 800 applications, “NJIA – we go where leadership is needed most” was chosen as one of the top 5 winners of the hackathon!

Other highlights of the day included Pepal’s virtual booth and an important discussion by Andre Hoffman and Katell Le Goulven on the urgent need for sustainable and innovative leadership in the post- COVID-19 world.

Overall the day was a great success. We would like to thank those that organised and facilitated the Summit. We are looking forward to taking part in the Roche and Board of Innovation Entrepreneurship Accelerator this week to develop the Brain Catalyst solution further.

Pepal, Leadership and the COVID-19 Crisis

The COVID-19 pandemic has increased public debate on what it means to be an effective leader.

Are female leaders better at managing the crisis? Do authoritarian leadership styles fare better than more democratic approaches during a public health crisis? Should leaders exhibit flexible, situational styles or rely on their trait leadership tropes?

As this unprecedented crisis forces leaders at all levels to navigate a new normal, it has become clear that there is no shared rulebook for the COVID-19 response; but there are play-books being filled by regional and national leaders worldwide which are coming under scrutiny as the pandemic continues.

Pepal was founded on the belief that effective leaders are critical to sustained social change. What is clear now, more than ever, is that effective, agile, purpose driven leadership is needed to ensure that health and livelihoods are protected above all else.

The challenges we see today are unparalleled. Lockdowns, travel restrictions, business closures and curfews are some of the measures being used in East Africa and India to curb the spread of the virus. These measures have implications beyond the limitation of person-to-person contact: they are affecting the provision of day-to-day healthcare services, the ability of patients to receive routine care and the ability of the average person to make a basic living to cover essential costs such as food and housing. The actual and potential health and economic impact of Covid-19 and the social distancing measures being prescribed across these three countries, while necessary, will likely be devastating for their populations.

Our partners in the NGO, pharmaceutical, health care and government sectors are on the front lines of the response to the COVID-19 crisis. Pepal’s corporate partners are leading the way in the fields of vaccine development and antibody testing; our NGO partners like Baylor-Uganda, ICAP and JHPIEGO are supporting some of the world’s most vulnerable populations through continued health care services and basic livelihood provisions; and the thousands of health care professionals we have worked with over the last 10 years in India, Uganda, Tanzania and Myanmar are continuing to care for patients despite risks to their own health and safety.

Pepal has had to adapt quickly to the challenges that the pandemic has presented. Face-to-face leadership immersion, co-creation and innovation programmes are the heart of what we do - how do we continue to bring this offering to our partners and the communities that we jointly serve when social distancing is of paramount importance? Flattening the curve is on the top of the healthcare agendas of governments, but existing health priorities like cervical cancer prevention and treatment, and adolescent sexual reproductive health still exist. How do we work alongside partners and support them to address the myriad of pressing concerns?

Cervical cancer sensitisation in Uttar Pradesh as part of the NJIA programme, 2019.

Our partners agree that effective leadership is critical during these times of uncertainty.  “With the need to ensure ongoing health programmes continue and healthcare systems are strengthened faster than ever, JHPIEGO and other partners working in India are exploring ways we can build the capacity of our leaders to response despite the barriers faced by the lockdown” - Dr. Nadeem Akhtar, State Programme Officer, Jhpiego, India.  With a continued focus on developing leaders who can drive social change we believe we can support our partners in their efforts to effectively navigate the challenges that they are facing, and support them to be crisis-resilient.

We are now working closely with our partners to rapidly develop new, contextualised ideas to directly support the leadership response in the countries where we work: Uganda, Tanzania and India. With our partners JHPIEGO in India, we are already piloting online immersive leadership and problem-solving sessions with frontline nurses in Uttar Pradesh who are overwhelmed by the new health burden of COVID-19.  We are also talking with other partners about how leadership offerings could support them.

For insights into the human stories behind the COVID-19 pandemic in East Africa and India, we recommend:

• An important opinion piece by Ugandan journalist Patience Amuku on what life and poverty is like under lockdown in Uganda: click here.

• Al Jazeera describe the impact that the closure of public transport has had on maternal and child health in rural Uganda: click here.

• The World Economic Forum has published a short video outlining the impact of the world’s biggest lockdown on India’s poorest populations: click here.

• This analysis of health data in India shows that routine health services such as child immunisation have dropped dramatically since the beginning of lockdown: click here.

Covid-19 and its associated burden on global health systems will be one of the greatest challenges our leaders and health work forces face, it is also an opportunity for leaders to step up and navigate our new global reality with courage, vision and inspiration. We are dedicated to supporting our global partners remotely to do this not just over the coming months but also as we start to navigate a ‘new normal’.

Generating impact on Adolescent Sexual and Reproductive Health in Uganda

May 2019 was the start of a new impactful collaboration between Janssen Pharmeceutical Companies of Johnson & Johnson employees, government adolescent focal health workers, adolescent peer leaders, and adolescent specialists from our NGO partner, Baylor College of Medicine Children’s Foundation Uganda. Over six months, the participants applied their leadership and innovation skills to reach over 1,100 adolescents with health education and services, using small budgets of just £750 per team. All participants felt they had improved their leadership skills, and several described the programme as life-changing! This will have a lasting impact on the delivery of sexual reproductive health services to some of the 125,000 young people living in Kamwenge and Kitagwenda districts, Uganda.    

“I hope to engage the adolescents more in finding solutions to things that challenge them in their health facilities. I believe they hold the answers” – Baylor Adolescent Officer

Project 1: Team Mahyoro

Team Mahyoro discovered that limited sexual health education is delivered at secondary schools. They found that myths and misconceptions about sexual health and HIV were common amongst teachers and students, and there was a lack of trust between students and their teachers.

The team organized a training of teachers and student leaders on adolescent sexual and reproductive health so they could act as educators and advocates for adolescent health in their schools.

• 300+ students received sexual and reproductive health education delivered by their teachers; 1 in 6 of these student then sought services

• 6 student leaders and 9 teachers are now Adolescent Focal Persons, contributing to a safer and more open environment in three schools for students to discuss sexual health issues.

• 48 students attended the new adolescent only clinic in November 2019 – more than double the number of adolescents that the health facility typically sees in one month!

The team is currently looking at options to scale up this innovation!

“[This programme] helps to build thinking capacity, to change the attitude of health workers, and helps people realise the strength in themselves and believe they can make it”- Ugandan health worker

Project 2: Team Ntara

This team found that Ntara health facility, which serves 80,000 people, provides excellent Adolescent Friendly Health Services to adolescents in HIV care, but that staff are overburdened and have little time to educate the wider community about the adolescent health services they provide. The team agreed that parents should also be educated on the importance of adolescent health and resolved to focus their innovation on increasing community awareness of adolescent sexual and reproductive health issues.

Team Ntara hosted a one-day Family Health Day to increase uptake of adolescent health services at the health centre.

• 450 community members were provided with quality information on adolescent sexual and reproductive health issues.

• 195 adolescents tested for HIV and 3 new HIV positives were identified and linked to care

• 25 people were provided with family planning services

• 68 were screened for STIs, and 25 young people who tested positive were treated.

“My mindset is the greatest weapon that I have to surpass any challenge in life” – Adolescent Peer Leader

Project 3: Team Bigodi

Team Bigodi found that that there are few interventions for HIV- adolescents to learn about Sexual Health and HIV prevention. The team was impressed by the impact HIV+ peer leaders were having in improving care for HIV+ adolescents and wanted to adapt use this model for HIV prevention amongst negative adolescents.

Team Bigodi carried out a two-pronged project for increasing knowledge of and access to SRH services for HIV- adolescents.

• The three new HIV- peer leaders are now supporting fellow young people at Bigodi Health centre

• The team reached 411 clients over a two-day outreach health camp

• 68 young people took up Family Planning services in two days – more than the total number for the Health Facility in 2018 (n=59)!

• 25 young people were screened for HIV and 45 people were tested for STIs

This model has been adopted by Baylor-Uganda as part of their DREAMS pilot.

Leadership Impact

One of the Uganda participants felt that the programme had “changed her life.” She said that it changed the way she perceived the world, improved her motivation at work and encouraged her to pursue further qualifications in nursing. Perhaps most importantly, she changed her opinion on the provision of Family Planning to adolescents. Before the programme, she refused to offer family planning to adolescents unless they were already young mothers. Now, she provides health education on the topic to all adolescents who enter the Health Centre.

Inspired by the field visits, an adolescent peer leader started a savings scheme with 40+ adolescents in HIV care at his facility. He encourages peers to save money from their transport refunds for their future. He believes the programme changed his life, and wants to see every adolescent in Uganda receive leadership training.

Building our programme impact

We hope this project will increase the number of adolescents accessing Family Planning and testing for HIV at the target health facilities, not only because of successful innovations, but also because the improved leadership skills. This programme will continue to change the mindsets of adolescent focal health workers, peer leaders and wider healthcare and NGO staff and they will consider adolescent health a priority. We have already had positive feedback from the new adolescent division of Uganda’s Ministry of Health and are looking forward to multiplying the impact started by Cohort 1!

2019: A Year in Review

From launching new programmes and working in new countries, to welcoming fresh faces to the team, to thinking big and working with experts from ITAD and Dalberg to strategize the Pepal vision for the new decade, 2019 was a year of growth for Pepal.

NEW PROGRAMMES

2019 was an exciting year as we launched two new leadership programmes in two countries.

Meeting with health facility staff in Kamwenge district, Uganda.

Global Health Leadership Challenge: This programme brings together adolescent peer leaders, healthcare workers, Baylor Children’s Foundation, Uganda staff, and leaders from the Janssen Pharmaceutical Companies of Johnson & Johnson to develop their leadership skills, and learn from each other to strengthen existing efforts to improve adolescent health outcomes in Western Uganda. By leveraging leaders on the ground to creatively engage communities and improve adolescent friendly health services across two districts, the programme aims to improve HIV and sexual and reproductive health outcomes for young people through the small scale piloting of youth-led innovation projects.  So far, 48 leaders have received leadership training from the faculty Aesara Partners, and 4 innovations have been piloted reaching over 1100 adolescents with improved knowledge of and access to sexual and reproductive health services, at just £1.62 spent per young person reached.

Presenting to stakeholders in Varanasi during Cohort 1 of NJIA India.

NJIA India: Inspired by the success of our collaboration in Tanzania, Pepal has again partnered with F. Hoffman-La Roche on a programme to strengthen leadership and governance to improve cervical cancer prevention in Uttar Pradesh state, India. This programme brings together Roche leaders, Indian healthcare leaders, and NGO partners to build agile leadership and innovation skills, and generate innovative, resource-efficient approaches to cervical cancer prevention in three districts of Varanasi division. More than 4000 community members and health workers have been sensitised on cervical cancer prevention as part of the first cohort’s innovation pilots.

SOCIAL IMPACT

In 2019, Pepal reached over 13,000 individuals through 21 innovations piloted through our leadership workshops. These projects ranged from teacher training on adolescent sexual and reproductive health, community education projects, and outreach campaigns to provide family planning, HIV and STI testing, and cervical cancer screenings in underserved communities in Tanzania, Uganda, and India. £7,700 was invested in these innovations, translating to an estimated £0.59 spent per beneficiary reached.

This year Pepal also worked on sharpening our organisational tools for monitoring and evaluation, in order to better and capture and communicate the impact of the Pepal approach.

Raising awareness of cervical cancer with community health workers in Varanasi division, India.

LEADERSHIP GROWTH

Pepal delivered 5 highly ranked leadership development workshops in 3 countries in 2019, hosting a total of 141 participants from 17 countries. The workshops focused on developing agile leadership skills, greater cultural inclusivity, and strengthening growth mindsets in leaders from across the public, private, and NGO sector. In their own words, participants shared:

“I’ve learnt that when I truly stay close to myself, I should and can be confident of my own skills and make a difference” – Janssen leader, Global Health Leadership Challenge, Cohort 2

“Fall in love with the process, not the idea” – Roche leader, NJIA Tanzania, Cohort 9

Participants in the Global Health Leadership Challenge visiting a facility in Rwenzori region, Uganda.

“This programme truly is transformative and feeds directly into Roche’s mission”- Roche leader, NJIA Tanzania, Cohort 7

“Incredible agility experience. Speed of shaping teams. Getting very good results under continuous time pressure. Highlight: Exposure to very different culture and working effectively in a VUCA environment = Absolutely mind-changing.” – Roche leader, NJIA India, Cohort 1

“[As a result of participating in NJIA] I will open more space to my subordinates so they feel more engaged and empowered” – National leader, NJIA India Cohort 1

“[As a result of participating in NJIA] I will be a role model wherever I go” – National leader, NJIA Tanzania Cohort 7

“[This programme] helps to build thinking capacity, to change the attitude of health workers, and helps people realise the strength in themselves and believe they can make it” – National leader, Global Health Leadership Challenge, Cohort 1

“My mindset is the greatest weapon that I have to surpass any challenge in life” – National leader, Global Health Leadership Challenge, Cohort 1

An NJIA team taking a break during their field visits in Kagera, Tanzania.

A Second Cohort of Leaders Working Together to Improve Adolescent Health in Uganda

“My mindset is the greatest weapon that I have to surpass any challenge in life”

- Dennis Odetta, OVC Officer, Baylor-Uganda

The second group of leaders in the Pepal Global Health Leadership Challenge came together in November to improve their leadership skills and to co-create innovative ideas to improve adolescent sexual reproductive health in Kamwenge and Kitagwenda Districts in Western Uganda.

Diverse teams made up of staff from Janssen Pharmaceutical Companies of Johnson & Johnson, Baylor College of Medicine Children’s Foundation, government health facilities, as well as adolescent peer leaders, worked together for a week across classroom and field visit settings. Their task was two-fold: to improve their own leadership capacity as well as finding low-cost solutions to some of the biggest challenges to adolescent sexual reproductive health uptake and access across two districts.

For context, the teams visited a variety of stakeholders who are critical in the lives of adolescents in Western Uganda: health workers, church leaders, community members, CBO leaders and of course, adolescents themselves. The cohort also hosted a community football match which brought young people from Kamwenge town together to keep fit and learn more about adolescent sexual health and services available to them.

Teams presented three exciting innovation action plans to local political leadership for their feedback, approval and buy-in. The projects, ranging from building private spaces for adolescents in HIV care, to a church-facility referral framework, to an economic-skills building piggery for adolescents, all place adolescents at the centre, and were inspired by the young peer leaders on each of the three teams and what they believe to be most beneficial to their peers.

The Pepal in-country team are looking forward to supporting the implementation of these projects over the next six months!

NJIA Launches in India!

It has been almost one month since Pepal concluded the first leadership training as part of the NJIA programme in Uttar Pradesh, India. Bringing together frontline Indian health workers, international leaders from F. Hoffman la Roche AG and Progressive Foundation India, the teams developed their leadership skills whilst co-creating six-month pilot ideas to improve cervical cancer prevention and treatment in Varanasi. This video below captures the excitement of the final day of the programme where teams presented their project ideas to key donor, NGO and local government stakeholders.

We have been so impressed with the dedication and motivation of the national leaders who have begun mass education and mobilisation for screening campaigns since they began the programme. We cannot wait to share their progress to improve women’s health with you over the coming weeks.

Pepal is growing!

New beginnings: sunrise over Bukoba, Tanzania in June 2019.

2019 is a year of expansion and growth for Pepal as an organisation. This year, we have welcomed two non-executive directors and two board members to the team, hired a new staff member to join us in Uganda, and are busy expanding our programming to India.

New Non-Executive Directors and Board Members

At the beginning of the year, we were thrilled to welcome two new members and two non-executive directors to the boards of Pepal Foundation and Pepal Limited: Ed Marsh, CJ Green, David Savage and Natalie Nicholles. The unique insights and expertise that each of these individuals has brought to Pepal since they joined the team have been invaluable and we are excited to have them with us as Pepal grows from strength to strength!

Ed Marsh, Trustee, Pepal Foundation

Ed has thirty years’ international Human Resources leadership experience in global consumer goods and technology companies. At Nestlé Ed was Global Head of Talent and Organisation Development responsible for a complete approach to hiring, developing and empowering leadership talent for Nestlé’s 350,000 employees. Subsequently, he spent 5 years as Global Head of Human Resources.

CJ Green, Trustee, Pepal Foundation

CJ served on the Board of a global facilities management business in the UK as Chief People Officer for a 26,000 strong UK workforce. Subsequently C-J took the helm as Chief Executive and led the UK business through a period of organic and acquisitive growth from £300million turnover to £600million and was instrumental in creating a forward thinking and progressive approach to Human Resource leadership.

David Savage, Non-Executive Director, Pepal Limited

David is an independent management consultant and development economist. David has thirty years of experience across the developed and developing world, working with commercial, public sector and not-for-profit clients. David has recently worked for not-for profits in Cambodia, India, Uganda, Tanzania and Myanmar.

Natalie Nicholles, Non-Executive Director, Pepal Limited

Natalie is the Global Director at RSA (Royal Society for the Encouragement of Arts, Manufactures and Commerce) responsible for developing global strategy. Natalie has published, chaired and spoken publicly on a range of topics. She launched an enterprise project for leprosy and tuberculosis charity in Bangladesh, and built a successful socio-economic impact consultancy within think tank the New Economics Foundation (NEF).

Pictured left to right: Ed March, CJ Green, David Savage, Natalie Nicholles.

Strategy Day and Theory of Change Workshop

In July and August, the Pepal team had the opportunity to work with Board members and corporate partners to strategise on Pepal’s growth plan for the next decade, as well as collaborate with ITAD (https://itad.com/) to streamline Pepal’s Theory of Change.

Both workshops were critical to defining what makes Pepal’s mission and vision just so unique in the context of international development and public-private partnerships. We look forward to sharing developments from these workshops with you all over the coming months!

New Staff Member in Uganda

We are very excited to have a new Project Officer join the Uganda team in early October! Kim Sorenson has a degree from the University of Cambridge, and has been working in the NGO sector since graduation. He was worked with United World Schools, a UK NGO dedicated to bringing education to children living in remote communities in South East Asia. He also has experience working abroad in Cambodia and Nepal. Kim will be supporting the Uganda programmes, mainly the adolescent health programme with Janssen Pharmaceutical Companies of Johnson & Johnson and the Cross Sector Leadership Exchange (CSLE).

Roche and East African healthcare leaders contribute to the fight against cervical cancer in East Africa

“It is so inspiring and mind blowing to expand leadership ability in real life and make a difference to patients and society.” - Roche Participant

In June 2019, the eighth group of NJIA leaders came together in Bukoba, Tanzania to develop their leadership skills and co-create ideas to tackle the cervical cancer burden. “NJIA” means “path” in Kiswahili and is the name of the leadership development collaboration between Pepal, F. Hoffmann la-Roche, ICAP Tanzania and MoHCDGEC Tanzania to combat cervical cancer in Kagera Region, Tanzania.

This cohort was the first of its kind, inviting a delegation from Baylor College of Medicine Children’s Foundation Uganda, Ministry of Health Uganda and Uganda Cancer Institute to participate in the programme and pilot innovation ideas for improving cervical cancer prevention and treatment across five districts in Uganda’s Rwenzori region.

“As Ministry of Health, we have seen NJIA’s work improving leadership skills of our leaders for better cervical cancer prevention management. We think it would be good to scale up this program to other parts of Tanzania using cervical cancer prevention as an entry point to improve the leadership skills of district and regional health leaders to improve their day to day performance.” -  Dr. Safina Yuma, Head of Reproductive Cancer Unit, MoHGCDEC, Tanzania

Pilot innovation projects will be implemented across seven districts in Tanzania and five in Uganda ranging from strengthening treatment referral systems to coordinated HPV vaccine awareness campaigns. Make sure to check back to the blog over the next few months to follow project progress.

Leadership Development and Improved Adolescent Sexual Reproductive Health in Uganda

Pepal, together with Baylor-Uganda, Janssen Pharmaceutical Companies of Johnson & Johnson and Aesara Partners, launched a new leadership programme focused on improving adolescent health in Kamwenge District, Uganda last week.

Bringing together adolescent peer leaders, adolescent focal health workers and Baylor-Uganda adolescent health specialists, this new programme is one-of-a-kind in the context of existing adolescent health interventions in the country.

Adolescent peer leaders work as volunteers at their local health facilities. Chosen because of their exemplary leadership potential, their adherence to HIV care and treatment and their passion to help their peers achieve better health, they support the adolescent focal health workers at facilities to deliver top rate service delivery to young people in their communities. It has been proven in multiple studies that peers prefer to confide in and receive care from their fellow peers and Baylor-Uganda have been engaging peer leaders in health care delivery for over two years, particularly under the incredibly successful ELMA-funded ‘Unfinished Business’ project. This new programme aims to develop the leadership skills of these volunteers - an as of yet unexplored part of their training.

Peer leaders receive their training separately from their link adolescent focal health workers but in this programme, we bring together both parties as teams. Building strong relationships of mutual respect, and creating a platform where peer leaders and health workers can share their experiences, opinions and frustrations with adolescent health services, should improve service delivery at the health facilities where the new Pepal intervention will be piloted.

Made up of three teams stationed at Ntara HCIV, Bigodi HCIII and Mahyoro HCIII respectively, the three teams have been engaged twice thus far by the programme. At both their Orientation and Immersion trainings, teams learned new leadership skills like thinking partnerships, self-awareness, conflict resolution and performance equations alongside sexual health education and counselling skills.

Together with their Baylor-Uganda and Janssen teammates, the three teams were tasked with a mission to create action plans in their communities to improve adolescent HIV and sexual reproductive health. During their Immersion training, teams visited health facilities, Community Based Organisations and local secondary schools to '“step into the shoes” of adolescents living in Kamwenge District, one of the country’s most under-served districts.

Teams presented their innovation ideas to District representatives including Central Administrative Officer, District Health Officer, Secretary for Health, District Education Officer and District Community Development Officer Kamwenge. With their full support and buy in, our teams are going to bring sexual health education to secondary schools, set up sexual reproductive health focused camps and organise family days at their health facilities to increase knowledge of and access to adolescent friendly health services over the next six months.

The Pepal Team in Uganda are excited to support the implementation of these ideas and to track their impact on adolescent health in the district.

NJIA Leadership Testimonials: "NJIA helped my dreams come true"

Rachel Yangwa is a Nursing Officer at Rwamishenye Health Centre in Bukoba MC, and the Public Private Partnership Coordinator at District level.

When Rachel first joined our fourth cohort of leaders in 2017, she had quiet ambitions to further her career within the health care system in Tanzania but lacked the confidence to pursue them. Her leadership goal for the program was to improve her communication and presentation skills so that she could articulate the ideas she had to improve health care at her facility to her colleagues and her superiors. During the week-long leadership training, which focuses on leadership development in the context of piloting innovation ideas to improve cervical cancer outcomes, Rachel’s confidence exponentially grew.

On the final day of the week, Rachel was tasked with presenting her team’s innovation idea to District Health Officers, NGO staff, Regional Health Team officials and representatives from the Ministry of Health - a daunting challenge! Rachel’s idea of integrating cervical cancer screening into existing HIV testing services, combined with her confidence as the team’s Presentation Lead, encouraged her District Health Officer to approach her after the program and offer her an important position within his team as the District Public Private Partnership Coordinator.

As Rachel says in the below video, “NJIA helped my dreams come true”. Following her participation in the latest NJIA cohort in November 2018, we cannot wait to see what is next for Rachel!

The NJIA Program Makes Headline News for International Women's Day!

The NJIA program, which Pepal has been running together with F. Hoffmann-la Roche Pharmaceutica, ICAP Tanzania and MoHCDGEC Tanzania since 2016 has been featured on ICAP Columbia University’s website!

Make sure to check out this great article to mark International Women’s Day 2019!

The NJIA Program in Tanzania: Perspectives from Community Outreach Volunteers

Cervical Cancer is a 90% preventable disease but in Tanzania is the leading cause of cancer and cancer-related deaths among Tanzanian women. Each year more than 9,772 women are diagnosed with cervical cancer and over 69% of these women die as they are diagnosed at a late stage of the disease.

Pepal partners with ICAP Tanzania on a program called ‘NJIA’ which develops the leadership capacities of health care professionals to tackle this disease burden in the Kagera Region. This partnership, together with Roche Pharmaceutica and MoHCDGEC Tanzania has been running since 2016, and has evolved from strength to strength.

Over the years, NJIA has engaged with individuals working in the health system structure at all levels - from Ministry of Health officials to community health workers. The focus of this blog is to feature the perspectives of two outstanding participants from our fifth cohort of leaders in 2017: Community Outreach Volunteers (COVs).

COVs are enrolled by ICAP to engage with key and vulnerable population groups in the community and link them to vital HIV and primary health care. Their work is crucial to achieving healthy, empowered communities across Tanzania. COVs are representatives of key and vulnerable populations (e.g. adolescent girls and young women, sex workers, HIV+ patients) and are often the first point of contact for many communities to learn about essential healthcare. They act as role models, are relatable and approachable to other community members, and complete all of their work on a voluntary basis.

Pepal and ICAP are working together to integrate cervical cancer education into the rigorous training that COVs undergo before they begin volunteering with ICAP. Valentina Vicent and Anisia Kamugisha, through their participation in the fifth cohort of the program, demonstrated how powerful this idea is - not only in helping to save lives of women in their communities, but for their own personal development.

Valentina Vicent (left), ICAP COV Muleba District and Inviolata Antony (right), Registered Nurse Muleba District

“When I joined the NJIA program I was excited by the exposure of working with different people and professions who I never imaged I would have had the chance to work with. The first day it was hard for me to engage with them but they were so interactive with me and I slowly gained the confidence to engage. Today I have no fear standing and talking to new people in my day to-day work. I have learned a lot about cervical cancer, which enabled me to integrate CCS sensitization during my HIV testing, community mobilization, and I have gotten women to go for screening. This make me feel so empowered and motivated to approach the community because of the confidence I gained on the NJIA program.” ~ Valentina Vicent

Anicia Kamugisha, ICAP COV Bukoba MC and JJ Palombo, Roche Pharmaceutica

“Being in a NJIA program as a COV has helped me to strengthen my capacity to interact with my community and I have gained confidence to stand and speak to people. I am grateful to have an opportunity to learn and increase my knowledge on leadership and cervical cancer, which I use now to sensitize community” ~ Anicia Kamugisha

Cervical Cancer Awareness Month 2019: A Recap

Pepal’s mission is to bring together NGOs and global corporations to develop leaders and find practical solutions to challenging social issues in emerging economies.

In Tanzania, Pepal collaborates with Roche Pharmaceutica (a global pharmaceutical company based in Switzerland), ICAP Tanzania (NGO under Columbia University Mailman School of Public Health) and MoHCDGEC Tanzania to develop leaders in the context of tackling the cervical cancer burden in Kagera Region, Northwest Tanzania. We call this program ‘NJIA’.

January 2019 was Cervical Cancer Awareness Month, and the Pepal Team were busy spreading awareness across our online platforms about this 90% preventable disease. This post features some of our favourite graphics!

Don’t forget to follow us on Facebook, Twitter, and Instagram (@PepalFoundation) and watch this space for an exciting new feature on the NJIA Program for International Women’s Day in the ICAP HQ newsletter!

Pepal 2019: The Year Ahead

2019 is Pepal’s ten year anniversary and is set to be one of the most exciting years yet for the organisation.

We are establishing new programs in new countries across East Africa and South Asia and expanding our social impact to some of the world’s most vulnerable communities.

The video below captures Pepal’s vision and the new paths the organisation will be breaking in 2019.

Caring Together: 10 Months On

It has been almost ten months since 150 guests from over 40 health-focused organizations travelled from ten different countries to learn about both the final Caring Together project results and other initiatives impacting healthcare in Uganda at the International Summit on Leadership in Healthcare in Kampala.  

The Caring Together project and the Baylor-Uganda Leadership Academy received resounding endorsements from many different stakeholders, including the Prime Minister, Dr. Ruhakana Rugunda, the Ministry of Health, and Centers for Disease Control (CDC).

The Baylor-Uganda team have worked hard to ensure that the legacy of Caring Together continues and that the Leadership Academy becomes reality.

Caring Together is Helping Baylor-Uganda Reach 90:90:90

There has been nationwide progress in Uganda towards meeting the UNAID’s 90:90:90 targets – a vision that by 2020, 90% of people who are HIV infected will be diagnosed, 90% of people who are diagnosed will be on antiretroviral treatment and 90% of those who receive antiretrovirals will be virally suppressed.

While there have been increased efforts to scale up treatment initiatives in Uganda there are still many people living with HIV who are unaware of their status and do not have access to medicines. As of September 2018, Uganda stands at 81:89:78.*

The Ministry of Health, with support from PEPFAR, introduced a SURGE strategy to all implementing partners to encourage progress. Health facilities are now required to find a specific number of new HIV+ cases per week, this ranges from as low as 5 to as high as 30 cases per week depending on the size of the health facility. SURGE requires weekly reporting and using facility level data. Each facility needs to be aware of their goals and able to visualize their progress towards them.

During the Caring Together project, Janssen worked with healthcare practitioners to create tools to like the TPMT (Team Performance Monitoring Tool) to help monitor team performance and increase staff motivation to reach targets.

Adapted by Baylor-Uganda to monitor weekly (rather than monthly) performance, the TPMT is now being used by facilities across the Rwenzori region to track reporting on SURGE performance. Key indicators tracked on the TPMT are number of clients tested, number of positives identified, and percentage of those positive linked into care, which is expected to be 100%.  It has empowered facilities to use data, to visualize their results, and to plan well.  

During support supervision visits, healthcare practitioners have been reoriented on how to use both monthly staff meeting books and the TPMT, and in facilities which are not regularly using these tools, Baylor staff have noticed that staff are unaware of targets.

The Baylor-Uganda Leadership Academy

Ministry of Health

The Baylor-Uganda Leadership and Governance Team have been working with the Ministry of Health to realize the dream of the Leadership Academy.

In particular, the Commissioner for Human Resources has shown interest in the concept and has recommended a number of future paths for the Academy. During a follow-up meeting, it was agreed that the best path would be to partner with the Health ManPower Development Center (HMDC) that has been restructured to be under Ministry of Health. This would be a sustainable way to extend leadership training to health workers. A revised concept note will be discussed in 2019.

Health Development Partners

Baylor-Uganda were invited to present at the Health Development Partners (HDP) meeting. Dr. Adeodata Kekitiinwa (Executive Director of Baylor-Uganda) presented on the Leadership and Governance agenda at Baylor and was thanked by leading stakeholders at the meeting including WHO, PEPFAR, UNICEF, UNAIDS, World Bank, DFID and CDC for Caring Together’s contribution to health systems strengthening in the country. The meeting was a platform to disseminate learnings from the Summit to those partners who could not attend. The Baylor-Uganda team are in discussions with partners present at the meeting about future collaboration.

11th Joint Annual AIDS Review Conference

Baylor-Uganda were invited to present at the 11th Joint Annual AIDS Review Conference in Kampala on “Innovative Leadership in Community Based HIV programming.” Michael Musiime Koima presented on the Caring Together approaches being used successfully to help Baylor-Uganda reach SURGE targets at facility level.

“Magic in Patient Flow”

The Caring Together patient waiting cards were recognized as an important tool for ensuring efficiency at health facility level by the Programmes Outcomes and Evaluations Coordinator at Baylor-Uganda in early December. Dubbed as “creating magic in patient flow” at Rukunyu Health Centre IV, the patient waiting cards were used as an example of a simple tool creating huge impact in HIV care and treatment at facility level.

Research Published in the Journal of Healthcare Leadership

Research conducted by Musinguzi Conrad, funded by Janssen, has been published in the Journal of Healthcare Leadership.

This cross-sectional study was conducted in three different geographical regions in Uganda - Eastern and Rwenzori regions (where the Caring Together leadership project was implemented), and West Nile region (where the project was not implemented). The study found that transformational leadership styles had a positive impact on stimulating motivation, assuring job satisfaction, and consolidating teamwork among health workers compared with those who demonstrated transactional skills or laissez-faire styles.

As the graph below demonstrates, the paper has proved to be very popular with nearly 2,000 views thus far!

Pepal is seeking new Board Members

Pepal is a unique organisation which brings together global corporations, NGOs and the government to develop leaders and find practical solutions to challenging social issues. We are now entering a new and exciting period of growth; new clients, new programmes, new countries. We have ambitions to achieve greater impact and long term change. Key to this expansion is growing our board.

We are seeking two committed and dynamic people to join our highly experienced team.

The NJIA program in Tanzania: Creating Shared Value

“We came together as strangers with little in common and faced a serious challenge. We supported each other, shared our personal stories and celebrated each other’s successes. We created a unique community in that week, bonded to a common purpose, helping patients.”

NJIA is a collaboration between Pepal, F. Hoffman-La Roche Ltd, Mc Bride & Lucius, ICAP Tanzania and the Government of Tanzania to tackle the cervical cancer burden in the Kagera Region through leadership development. NJIA brings together Roche employees from across the world with Tanzanian healthcare workers and NGO staff to take part in an immersive leadership development program in Bukoba, the urban center of the Kagera Region. Participants apply their leadership learning to an important cause: the co-creation of innovative ideas to increase access to and awareness of cervical cancer prevention services.

Kagera is now ranked third in the country for meeting national cervical cancer targets on number of women screened. After 3 years, the NJIA program is evidently having a lasting impact on health outcomes.

In this blog post, we dig a little deeper into the corporate participant experience to understand why this shared value program is effective not only for cervical cancer prevention, but also for professional leadership development. We are delighted to share the personal insights of Francesca Paolone Lamb, PDR Business Analysis and Insights at Genentech Inc, San Francisco, who travelled to Bukoba in November 2018 to take part in the NJIA program.

A Stranger with a Challenge

I travelled thousands of miles, over vast landscapes of oceans and mountains, from a predictable environment and a trusted support network to land in a world completely foreign to me:  Bukoba, Tanzania.  I was joined by 18 fellow Roche colleagues, only a few I had worked with before, and 20 Tanzanian health care professionals I had never met. I felt out-of-place and awkward. 

Our challenge was clear: we were to form teams, visit 7 districts in the Kagera region, learn the hurdles to effective cervical cancer prevention, treatment, and comprehensive HPV vaccination, and come up with 6 proposals which aimed to reduce barriers to care using only the resources available. We had just 1 week to accomplish this.

Fortunately, we had NJIA to guide us. “Njia” is the Kiswahili word for “the way”, and we literally had to find a way to quickly unite across cultures and language barriers to design innovative, and sustainable proposals.  Together, we formed Cohort 8 of the NJIA program. 

Prior to landing in Bukoba, a town in the Kagera region and the home base of the program, I had completed an assessment of my leadership skills.  This assessment collated extensive peer feedback, and was debriefed by an HR coach, to highlight my leadership challenge:  Taking action in the presence of little information or data.  In Bukoba, I had immediate opportunity to practice.

I was thrilled to be a part of NJIA as I am personally passionate about increasing access to health care, and I desperately wanted to make a difference for the women in Kagera.  True to my nature I absorbed as much data as I could, I asked many questions of my Tanzanian teammates, and of their peers.  By the end of the 4th day, with only 2 days left, I was frustrated and disappointed. The data didn’t make sense, and in some places it was even conflicting. Insights from the field visits also highlighted fundamental cultural hurdles, hurdles that could not be removed with a simple proposal. I could see no way to make a difference.   

A Team with a Purpose

The program included Leadership Circles, where small groups gathered to discuss our leadership challenges and how we were addressing them throughout the week.  Listening to my colleagues share their insights, and sharing my challenges with them, helped me to uncover a deeper purpose to the week. 

Our facilitator stated it so clearly, “In the corporate world, we often speak about creating culture or changing culture by launching big, cross-organization initiatives.  Sometimes the most effective approach is to focus on a few people.”  I realized right then, the best way I could help the women of Tanzania was to focus on supporting my Tanzanian teammates.  By working with my team and supporting each other become better leaders, we would create a sustainable path to better health outcomes.

Once I oriented to this purpose, everything became much clearer.  We prepared a bilingual, 10-minute presentation of our proposal to the Kagera Regional Medical Officer, the District Medical Officers, leaders of our NGO partner, ICAP and the Ministry of Health.  With their endorsement and the support of Pepal, our team will work virtually over the next 6 months to implement our proposal.  

The Impact of a Shared Value

This program had a profound impact on me.  Yes, I learned how to get comfortable taking action with little information.  And yet, above and beyond, I experienced something greater: the power of ‘we’, the powerful impact of a Shared Purpose and Community.  We came together as strangers with little in common and faced a serious challenge.  We supported each other, shared our personal stories and celebrated each other’s successes.  We created a unique community in that week, bonded to a common purpose, helping patients.  What’s more, we are part of a legacy which builds on the successes of prior cohorts adding this to our own and continuing the path to a healthier life. 

Francesca Paolone Lamb

Francesca is passionate about public health and increasing patient access to care.  To that end, Francesca has dedicated her career to simplifying drug development and volunteering in global health efforts. 

With over 15 years of experience in academic and industry settings, Francesca has expertise in finance, program management and in clinical research.  She has led global teams to develop innovative solutions to complex problems always with an eye toward productivity and fostering an engaged work environment.  She is recognized for cultivating high-performing teams and enjoys mentoring young professionals.  

Francesca is currently the lead for PDR Business Analysis and Insights at Genentech, and a board member for Global Healing, a non-profit organization.  She has a BA in Spanish Language and studied Neuroscience at the University of California, Los Angeles.  She has a Masters in Public Health in Epidemiology from the UCLA School of Public Health.

How Coffee is Tackling the Cervical Cancer Burden in Tanzania

Over 2.25 billion cups of coffee are consumed in the world everyday. Have you ever stopped to think how your morning brew could make a difference in the lives of others?

Three alumni from our leadership program in Tanzania, Davide Ravazzoni, Carol Zoner and Angie Namenuk, considered this question as a result of their participation in their “Immersion Week” in Kagera Region in 2016. Pepal, in collaboration with Roche Pharmaceutica, ICAP Tanzania and Ministry of Health Tanzania (MohCDGEC) runs the NJIA program in Kagera to improve the leadership skills of international pharmaceutical employees and local healthcare workers over a six month period. Participants are brought together for one week in Kagera to learn new leadership competencies and to put them into practice by co-creating innovative solutions to tackle the high cervical cancer burden in the region (known as the “Immersion Week”). The ideas generated from this week are then implemented over the following 5-6 months and results shared at a Handover meeting in Basel, Switzerland, and Bukoba, Tanzania.

Davide, Carol, and Angie decided to extend their six month commitment to improving health outcomes for women in Tanzania by setting up the Kahawa Foundation. “Kahawa” means coffee in Kiswahili, and during their time in Tanzania as part of the NJIA program, the three founders wondered if the abundant coffee produced in Kagera Region could be sold at their workplace in San Francisco to generate funds to implement projects to save women’s lives in Tanzania.

One such project which is underway is the building of a reproductive child health unit at Nyaishozi Dispensary in Karagwe District in Kagera Region. This building will provide women with the privacy they need to be screened for cervical cancer, and for other reproductive health-related matters.

For more information about the work they do, please make sure to visit their website by clicking this link.