HRH Leaders in Action: Naomi Kyobutungi
An interview series with HRH champions in developing countries produced by the HRH Global Resource Center. The 2006 HRH Leaders in Action series asks leaders to look at HRH leadership.
Naomi Kyobutungi, MD, is in her third year as Uganda’s Acting Assistant Commissioner for Human Resources Development in the Ministry of Health. With the Ministry’s first human resources for health (HRH) policy in place, she is now leading the development of a fifteen-year HRH strategic plan and HR information system. Two things are at the heart of her success: going office-to-office to bring the right stakeholders together, and memories from her days as a health worker when she envisioned more effective national health leadership.
What does it mean in Uganda to be an HRH leader?
To be an HRH leader in my country at this time, one needs to be very innovative. Human resources for health has not been a priority in Uganda. So to be a leader, you have to market HRH as much as you can. You must bring stakeholders together, talk to them and advocate for HRH. You must be an imaginative leader. You must be someone who is patient, who does not get frustrated. The issue has not been high on the agenda, and there are many people who tend to ignore it. That can be frustrating. It has not been well financed. That can be frustrating. Stamina is important. Be patient and push for what you believe in.
Describe the path you took to your current leadership role. How does your background support you as a leader in HRH?
I am a medical doctor by training and did post-graduate work in public health. I find that my medical background helps me lead in HRH. I understand what health workers are doing—the medical and public health work they are involved in. Having been a health provider, I know what health leaders and managers need to do to enable health workers.
Since coming to this position, I have taken short courses in management, planning, leadership and development. These courses have been extremely helpful. They have exposed me to the principles of good leadership, governance and management. I know how to set goals, objectives and strategies, and how to evaluate them.
I combine both parts of my education whenever I talk about HRH issues. I know both sides of the coin. It puts me in a very good position.
What have you learned from others—who have been your best teachers/mentors in HRH?
My mentors are really the people with whom I work. Within the Ministry of Health, most of my bosses have a medical background similar to mine. But then we have projects in the Ministry of Health that are headed by people with a managerial background. These people are not necessarily my bosses, but they work with us on HRH projects. I find that they help me a lot to analyze myself, to be a leader who identifies problems and knows how to address them. My mentors have helped me to know who I am—my strengths and weaknesses—and how I can improve.
What is your leadership style?
I am research oriented. I always want to see results and outcomes. I also like teamwork. I like to build teams, sit down with my team and set objectives and goals, and work toward achieving those objectives and goals together.
To assemble a team that will work together, you really have to analyze the people you work with to know their capabilities and personalities. I have found that personalities affect the work so much that you need to be flexible when you are dealing with people. Once you understand their strengths and weaknesses, then you can give them jobs that are appropriate. You also need to give people freedom, make them feel important and recognize each one’s contribution. Once they have confidence, they are more likely to work as a team. I encourage each one who works with me to feel very important in meeting our set objectives, feel proud of those objectives and work toward them.
What do you think others—those in the Ministry of Health, the clients you serve and the Government of Uganda—expect from you?
We are going through a difficult time as far as HRH is concerned since it has not been a very high priority in the past. Funding is very low. I am expected to advocate for HRH and bring stakeholders together around HRH issues, and to stress the importance of working together on HRH issues. In my country decision-making in HRH has so many centers-it takes place in many ministries and organizations. If one makes a decision and the others do not embrace it, they may not help it go forward. As a leader I am expected to bring all those stakeholders together so that they can have mutual discussions, come to mutual consensus and come together to push whatever points we want to go forward.
I have been able to bring together ministries, the private sector and associations. They now recognize the importance of meeting frequently to address HRH issues. This was not happening… It takes a lot of energy. I almost have to move from office to office, ministry to ministry, to convince them that they need to come together and to make sure they know that it is the top people who should come. Many times you call a meeting and find very junior staff members are sent. They can’t go back and make an impact. But now it has been turned around so that when I call a meeting, top people come; and they enjoy it. They are interested and willing to come.
The turnaround is due to marketing. If I want a minister to come, I identify the decision-maker, visit him or her and sell my idea. I convince them that if they don’t come how difficult it is going to be for the views of their ministry to be represented and expressed at the meeting. And then I move on to the next decision-maker. You physically have to go there and explain it to them.
You have to focus on what you want to see happen in the near future. Then you have to talk to the people who matter. Sometimes you find that your idea is not correct—they convince you that your idea is not the best. It is good if they sell me their idea. I do not have a monopoly on ideas. But still I will have succeeded in getting something good for my sector. If I am convinced, I tell others we must come together, look at it and come to consensus. It is marketing, mobilization, advocacy—all those combined.
Describe an achievement in HRH that you are most proud of?
Bringing stakeholders together—I am very, very proud of that.
Another achievement is our HRH policy and strategic plan. When I came, we had a health sector policy, but we did not have an HRH policy. And that was a big set back because the health sector policy is broad. It touches a little bit on HRH, and it is not exhaustive. So we have managed to put an HRH policy in place and develop the vision for a strategic plan. Right now, we are developing a strategic plan for fifteen years, building on the health sector policy and strategic plan and HRH policies. It will help us know how many people we should be producing, how many people we should be employing and specifically how much money we really need.
And soon we will have an established human resource information system. We did not have an information system for human resources in our ministry. We had a health management information system, which has a small amount of information on human resources but is not very helpful. I initiated this in my first year, and it has sparked a lot of interest. A donor suggested we start a small HRIS and then help fund a bigger one and establish a comprehensive information system. The European Union and the Capacity Project (USAID) are funding it. This will be a great achievement.
What are the most rewarding aspects of your HRH leadership role?
I receive great satisfaction in seeing human resources for health recognized. It is getting recognition from important ministries like the Ministry of Public Service, the Ministry of Finance and even our president. During World Health Week, two ministers attended and vowed to give all their support. The Minister of Finance’s top official attended. That was a big achievement. The Minister of Public Service attended. This was the first time the Ministries of Finance, Public Service and Health all attended a workshop together. They were able to exchange ideas and say to one another, "Yes, I am in agreement." That recognition is rewarding.
What is the biggest HRH challenge you are facing right now? How are you approaching it?
Leadership and management represent big challenges for me. Dealing with human resource issues in the face of limited funding is a very big challenge. There are so many things to do that we would like to see done, but there is limited funding. There may be funding somewhere else—donors and the government may be pushing a lot of money, but without human resources, however much money you are pushing, change is limited. It is difficult to make them see the sense of what you are talking about. So the way donors and the government see things is very different from how I see them. It is a big challenge. I feel that there are so many things we can solve by having in place the right teams who are motivated—they can do much, much more with the resources we have.
You can solve a lot by hiring people who can counsel and educate clients—it would change so much. Instead we are investing in stocking our hospitals with drugs, buying equipment.
What do you do to help keep your staff members focused and their morale up while facing increasingly complex and changing conditions?
The key to keeping my team focused is really developing good teamwork. We have quarterly meetings where we sit together for two or three days outside of the ministry and develop our workplan. We examine how we performed in the previous quarter and plan for the next quarter. Each of my staff proposes what he or she wants to do and see done. We plan together. I provide access to the resources available in that division according to the plan. We develop a monitoring and evaluation plan, and this helps us to stay focused and motivated. Team members are free to contribute ideas, they are free to develop activities and they are free to set their own objectives. We remain focused by coming together, evaluating together and supporting one another.
Where do you look for inspiration?
I have been a health worker—I am still a health worker. I’ve been out there in the health clinic. I know what I wanted my leaders to do. I have not forgotten that. I aim to do for them what I wanted my leaders to do for me. I have sympathy for the health workers who are out there working in disadvantaged conditions because I have worked there.
I am also drawn to the plight of the poor. Most of our clients and patients are poor and disadvantaged. When I think about them I know I must do my best to improve their situation.
And then I think I love this job! It is very interesting and challenging. You want to tackle the challenges and succeed. Finally, I love God so much. I am drawn to his people who are the health workers and their clients.
How do you cultivate leadership in others?
I give my colleagues the freedom to lead. In my division we have sections and each staff member leads a section. I don’t interfere much. I let them lead the way they feel they should lead or guide their sections. I am available if they need assistance. If they want assistance, I give them support. But I don’t dictate how they should lead their sections. In the end, they are leading as much as I am leading. We meet frequently and compare notes.
What do you see on the road ahead for future HRH leaders in Uganda?
The road ahead is an exciting one. There are many challenges, but they are challenges that will be overcome with determination and focus. The country is waking up to the importance of HRH. The goodwill is there. All one has to do is stay focused and bring people together. The future looks good.