HRH FBO Leaders in Action Interview: Doris Mwarey
An interview series with HRH champions in developing countries produced by the HRH Global Resource Center.
Doris Mwarey is the Regional HR Specialist with the Africa Christian Health Associations (ACHA) Platform. In this role, she supports the Christian Health Associations in Africa to resolve human resources for health challenges, works to build the capacity of HR point persons in the secretariat, and coordinates the technical working group for human resources for health (HRH) among the Christian Health Associations network.
Could you please briefly describe the path you took to your current position?
I began working with an NGO based in Northern Kenya more than 10 years ago as the administrator of the project, but I found myself involved in a lot of human resources management issues. I developed a passion for working for people, particularly because this was a very remote area and I could see the challenges of working in such harsh conditions. I became driven to improve the conditions under which people work, so I formalized my career with training in human resources management (HRM) and continued on until I gained a master's degree in HRM. A couple of years ago I joined the IntraHealth project in Kenya under the Capacity Project to support the faith based subsector in Kenya. I was seconded to work for the Christian Health Association of Kenya and the Kenya Episcopal Conference - Catholic Health Commission to resolve human resources for health challenges. Now, I'm with the CapacityPlus Project, again working with the faith-based fraternity within the Africa Region.
What do you see as the role of FBOs in HRH in your country or your region?
I think that the FBOs have a big role to play given the high level of service delivery that they provide in Africa. They provide 30 to 70% of health care in many countries, so they contribute quite a bit to the health workforce. Most of their institutions are in very remote environments, so they complement government support in providing coverage in Africa. Also, FBOs offer a lot of experience in providing health services as many of these organizations were working in healthcare delivery even before some of the current governments came into place, so FBOs make good partners for any government.
What do you think others (those in the ministry of health, the clients you service, government leaders) expect from FBOs?
I think they expect a lot of collaboration. Some governments and partners have signed memorandums of understanding (MOU) with FBOs to ensure that they have a working agreement on how their efforts will help service delivery. It is important to ensure that there is commitment from the faith based organizations to participate in sector wide initiatives and approaches that are being driven at a country level. I think the participation and contributions of the faith based organizations were not well recognized for a long time in some countries, but FBOs are now expected to put forth their efforts and pull together with the other health sector providers to impact health care delivery in each country.
What is the most rewarding aspect of your HRH leadership role?
For me, it has been the opportunity to impact and support health workers, particularly in how they are managed, and seeing that my efforts can contribute to improved health worker productivity, motivation, and eventually to better healthcare service delivery.
For someone who isn’t familiar with human resources management can you define it?
Human resources management (HRM) is all the practices and procedures that you put in place to attract, to maintain, and develop an employee. It includes all the activities surrounding hiring an employee, how you're going to keep them there through pay and motivation, and how you develop them in terms of training and building their skills. In simple terms, it is looking at that whole cycle of an employee working for an institution.
What is the biggest HRH challenge you are facing right now and how are you approaching it?
There's a huge diversity in the needs of various Christian Health Association Networks. The biggest challenge has been to identify human resources for health initiatives for the different contexts. Some initiatives might work in one country but not work in another, but we must still recognize that there might be a lot that one country can learn from what has worked in a different country. The HRH crises and challenges are quite huge, but I take them one day at a time and don’t give up. It is the small things that make a difference in terms of human resource management. I think if we talked to health workers and asked what we could do that would motivate them, some of the things that they would rate as important would appear to be very minor, but have a bigger impact, i.e. how somebody is managed, whether the supervisor cares about what they are doing, basic provisions at the workplace, how safe they feel at work. I feel that every effort counts in human resources for health, and the more opportunities we have to involve health workers, the better.
How are you helping the Christian Health Association Community to learn from each other in terms of HRH?
One of the key roles I'm playing is to create linkages between the different Christian Health Associations. I help them to learn from each other, and I support them through various collaborations, especially the human resources for health technical working group that exists within the ACHA Platform. We are organizing forums within the Africa Christian Health Associations Platform where human resources for health topics are discussed and different countries have opportunities to share on the strides they're making and the challenges they're facing and to encourage peer learning within the network.
I would like to play a big role in the documentation of what is going on in individual countries to help scale up the application of good practices for replication by Christian Health Associations in other countries. For example, Malawi is learning from Kenya's human resource management policy development process. The Christian Health Association of Malawi wants to develop human resource management policies for their affiliate health facilities. They realized that the Christian Health Association of Kenya and the Kenya Episcopal Conference – Catholic Health have gone through a similar process, and they would like to learn from what Kenya has done. Through the support of the CapacityPlus project, I assisted in setting up an exchange meeting where a team from Malawi visited the Christian Health Association of Kenya to talk about their HR policy development and implementation process. They were able to learn and talk to different facilities on implementation and what progress has been made. That's just one example of the linkages and how I’m trying to make sure that they learn from each other.
Would you please describe the importance of HR management for FBOs?
One of the challenges that FBOs have been facing is how to attract, motivate and retain health workers. Through effective HR management systems, FBOs stand to improve the productivity and retention of health workers in the FBO sector. Also, through sound HR management, they will strengthen their collaborations and partnerships. Human resources for health issues are very complex, but by forming partnerships with governments and other organizations, FBOs will get the needed support to address some of their health worker challenges such as health worker shortages, unrealistic workloads and poor work conditions - particularly in very remote areas where most of the mission hospitals and faith based facilities are based. I think effective HR management is therefore critical to ensure that FBO facilities have adequate numbers of motivated and skilled health workers in each location.
How will you help improve FBO collaboration on HRH and HRM with the government and NGOs?
One of the entry points we have is to strengthen the implementation of the existing memorandums of understanding (MOUs) and to ensure that human resources for health issues are being addressed either through an MOU or through health sector wide initiatives in each country. The important thing is to make sure that the human resources for health issues are highlighted in discussions at the country and regional levels. I was in Zambia in June, and I learned that the MOU between the government and the Churches Health Association of Zambia (CHAZ) is due for review. As they revise it, the CHAZ office would like to include human resources for health issues which were lacking or missing in the previous MOU. I think this is a good starting point because this is an opportunity for the FBOs to emphasize the need for sound human resource management of the health workers posted to their facilities, whether these workers were hired by the ministries of health or hired by the FBOs themselves. I also want to encourage the participation of the FBOs in various forums at the national, regional and global level. They need to be recognized and included in key policy making forums so that their HRH issues can be considered, particularly when there are unique issues that affect human resources for health in FBOs.
What do you see on the road ahead for future FBO HRH leaders?
I see a strong network of human resources of health advocates that is reputable and has a voice that influences health policy and planning at all levels. I think that in the future, faith-based HRH leaders will have great impact and influence, and that the FBO HRH leaders will be part of global, regional and national HRH reference and resource groups.