HRH FBO Leaders in Action Interview: Joy Mukaire
An interview series with HRH champions in developing countries produced by the HRH Global Resource Center. This part of the series focuses on HRH leaders in faith-based organzations
Joy Mukaire has been the Executive Director for the Christian Health Association of Sudan since 2008. She leads this association of churches in building their capacity to provide equitable, sustainable health care to the Sudanese populations.
Can you briefly describe that path you took to your current position? How does that support you as a leader around human resources?
I decided to take my career back to the basics in terms of working with the communities and working with faith based organizations that are close to the community and can make a significant contribution. During my consultancy in Sudan, I realized there was an opportunity to work with faith based organizations, and I thought I knew what would work in a post conflict environment.
What do you see the role of the FBOs in human resources and the challenges in the FBO sector around human resources?
In terms of human resources, the FBO sector's role first and foremost has been to contribute to training opportunities and the training schools, and to develop the workforce - especially for community level health care. This is true for community midwives as well as community health workers that need to be trained in Sudan where low literacy levels make it difficult to educate skilled health providers. The FBOs have contributed to creating a health workforce that can work at the community level to make a difference.
What do you think others, those in the Ministry of Health, the people that you serve, and the government leaders expect from the Christian Health Association of Sudan?
They expect the association to create an interface between the facility and the community in terms of service delivery by creating community outreach agents who link the community to the facility, and to work on changing practices in the home, such as how caretakers manage illnesses at that level. In Southern Sudan, faith based organizations account for up to 47% of the health care provided, so contributing to the provision of healthcare is also an FBO responsibility. They also expect the faith based to pioneer different models of standardizing the quality of training because of the flexibility within the FBOs and the Christian health providers. FBOs have come up with a lot of curricula which have been adopted for the entire health system.
How can you improve the collaboration on human resources for health with the government and other NGOs?
One way is to work on improving ways to retain the health workforce. Staff retention is very problematic and the Christian Health Association wishes to partner with NGOs and government to standardize the salary scale and to improve staff retention in all sectors. We requested the government to contribute salary payments for service providers who work in the churches, which they agreed to do. We are promoting a partnership with government that would create one system for training, determining salaries, and providing general supervision to make it easier to train and maintain the health workforce.
What is most rewarding aspect of your leadership role?
The most rewarding thing is the change I have seen in the relationship between FBOs and the government. When I joined [the Christian Health Association of Sudan], the churches were isolated, not part of the government strategy or included in decision making. Today, most of the service providers and FBOs are part of government planning, and they receive government resources to provide services. This is important because when churches depended on funds from outside, they did not necessarily have to go by the standards or rules of the government; but today they adhere to those standards and have become a part of the leadership at the secular level. Churches benefit from the training, government funds and resources like medical supplies. This was such a break-through to be recognized and part of the government agenda and be much more visible as a part of the health sector.
What is the biggest human resource challenge that you are facing with Christian Health Associations (CHAs) and the membership, and how are you working through it?
As a local organization, it is important that the technical capacity to undertake tasks should come from within and not rely heavily on consultants, external people or volunteers. To me the biggest challenge has been getting what we need in terms of this technical capacity, while making sure it is sustainable and provided by local people. There are many Sudanese nationals who are qualified, but due to a lack of hands on experience, it is very difficult for them to take up technical tasks. Our challenge is creating training to develop their skills quickly. We are hoping that CHAs will collaborate with others to develop a learn-as-you-work approach. We could place individuals in different associations to learn on the job rather than relying on workshops where you get the skill but not the practice or access to experienced people who can be mentors. We are trying to think of different ways technical staff can gain skills as they work and contribute to the work at the same time. We don't have enough people do the work, so we can't afford to keep staff in workshops.
What is on the road ahead for the Christian Health Association of Sudan?
As an association there are several things ahead of us. There continues to be a struggle to strengthen governance as an organization. We have invested, and continue to invest, in governance to make sure it benefits the stakeholders of the association. We have also planned the gradual technical capacity enhancement program, but we hope to see how we can improve it to better serve staff. Because we have taken three years to set up the association, much more needs to be done for the members to see the benefit. We want to help the members more by expanding their capacity to scale up healthcare, because the bottom line goal is to provide quality health care for the people. The challenge is that every church has a whole list of needs that we have to fulfill as an association, so we have to find a balance between capacity building and their service delivery needs at the facility and community level.