HRH Leaders in Action: Kautoo Mutirua


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.

Namibian health facility
Namibian health facility

Ms. Kautoo Mutirua is Namibia’s former director of human resources planning and development and undersecretary for policies in the Ministry of Health (MOH). She currently works as a technical advisor with I-TECH, a consulting firm working with the MOH on human resources for health (HRH) issues. As a frontline HRH leader in the years following Namibia’s independence in 1990, Ms. Mutirua routinely pressed her team to do things for themselves to build their leadership capacity. Today she continues to lead on key issues, including developing HR information systems to strengthen HRH planning.

What does it mean in Namibia to be an HRH leader?

The issue of HR — not only in health care, but mostly so—is a challenging issue for Namibia in general. Namibia, a new country which is not even 20 years old after independence, has been struggling with the issue of shortages and skills in HRH. So the challenge so far has been to try and address that issue, which is much broader than meets the eye. It is broader because it involves many sectors. It is a problem which starts in the educational sector, from the children and the young people. That is what is impacting negatively on the health sector, or rather, that’s why the health sector is struggling to meet HR requirements. So it’s really a big challenge and to be a leader in that area is a very challenging task.

As an HRH leader yourself, describe the path you took to your current leadership position.

I have had a long journey! I originally trained as a district nurse, completing my training in the late ’70s after which I trained as a tutor. So I spent a lot of time in my career, which is now over 50 years long, in the area of HR, first being a nurse’s tutor from the late ’70s up to the late ’80s. Then from the late ’80s I became involved in management issues of HR, where I have grown in the system and reached management positions—of deputy director up until I came to the level of being a director of HR development and planning in the MOH. That took me even further, where I became an undersecretary dealing with policy issues encompassing and addressing HR, until I came to term last year. Now I am currently working with I-TECH as a technical advisor on HR issues, and I am still very much attached to the MOH.

My background has been a very interesting one. Except for training in HR I think the most exciting time of my career was from 1990 when we got our independence. Those were the challenging times, because I got a lot of activity and work addressing HR programs. My involvement was looking at the basis of the organizational structures existing to deal with HR issues. We started with a committee. We didn’t even have a structure, or any division within the Ministry which was dealing with HR issues. So for me it has been really a milestone to start a committee and from the committee to get it into the structure. That is the time when I became the director of HR development and planning. We put up all of the other structures—even the physical structures—like the National Training Center and the regional training centers, and we also put up the teaching programs of training in HR to try and help meet our requirements in the supply of HR. So it has been a very, very eventful journey and career full of challenges. Basically I have been there all along, all the way from nothing to where I can say today that we have touchable things.

How would you describe your leadership style?

Now that you are mentioning leadership, I remember when, in the mid ’90s, we made use of technical assistance from international organizations including the WHO, and there was a time during 1996-97 that I told a group which was working at that time in Namibia, "Look, I think we have had enough of technical assistance." I said, "It’s time now for us to do the things ourselves." And some of them were looking at me with big eyes and said, "Are you serious?" And I said, "Yes, let’s do this, I have put up a plan that we will send some of you to school and you are going to study issues in HR." We sent a few people to England and they came back. One of them is now working in the Ministry. So I think those were key issues and decisions to take. About my leadership style…I am a very dynamic leader. I like to involve everybody, I like participatory management. I always put some trust in the people I am working with; I always say, "You can do it, go and do it." And I am quite happy today when I look back at the programs we started. I believe I have done something right. I hope so. You have to give guidance, but don’t feed the workers too, let them take some initiative. Have trust in them and then you give the leadership and show the way and set the example.

Describe an achievement in HRH that you are most proud of.

Quite a lot, quite a lot. As I mentioned earlier, our problems mostly start from the educational sector and I can tell you that it has been a frustration for us to want to meet our requirements while failing to get an adequate number of schools. So one of my greatest achievements, which I am very proud of today, is that many years ago we could only manage to recruit, let’s say, five school leavers to go into medicine, maybe two, because we couldn’t find anyone who could meet the requirements—especially in maths and sciences. When we realized that there was no way we could meet our objectives, we said let’s start another program in which we will take school leavers who have done reasonably well in maths and sciences and put them in the University of Namibia for three years. They are going to enter a new program for passing all maths and sciences and a few other subjects which we agreed upon with some universities in South Africa, which are teaching these. We did that, and we agreed and negotiated with the universities in South Africa. I was so proud the day we managed to send 20 people. Most importantly, to see the mangers that we have developed become future leaders through specialty practice programs, and I think one can see the future there with them.

What is the biggest HRH challenge you are facing right now? How are you approaching it?

Currently, the difficult problem, which many other countries are struggling with, is the challenges brought about by the prevalence of HIV/AIDS. The Ministry of [Health in] Namibia for the first time in 1998 realized that HIV/AIDS was the major impacting issue. And we started feeling the pressure. And it took us a long time because we realized our staffing norms were not up to it. On top of that we also came up with new initiatives to introduce ARV drugs which actually increased the workload, so the challenge now is to try and accommodate the number of health personnel you have, and I can tell you at the end of the day we were forced to try and get the personnel from outside our borders. Currently we are working very hard to ensure that our management-trained health personnel eventually have these skills and capacity.

There are other issues which are very worrying, the issue of health education for one. Now in Namibia you hear that most personnel are leaving the country or sector, which is true. Or they jump from public sector to private sector and then back again. It really destabilizes our approach and we still haven’t come to terms with these movements, to develop a proper strategy as to how to best deal with that. That is why we have decided to look into the area of HRIS [human resources information systems], so that we can really capture good data which we can use to assess and to do proper planning. The other big challenge is getting women nurses to rural settings. The reality is that in most African countries, rural development is not up to snuff. You’ll find that many HR and staff members, especially young people, do not want to go to rural settings. They want good schools for their children and all these things, which in most cases, you won’t find in the rural setting. So you would be lucky to get some young people to stay. But normally, there will come a time when they say, look, my children are ready to go to school and I am going to Windhoek, or wherever. So the staffing of rural health facilities is challenging on many levels.

Where do you look for your own inspiration?

I have been a part-time farmer for a few years now. More than ten years actually, and that is probably what is giving me inspiration, just being out there, enjoying nature, being among the animals. You know, when I’m out there, I forget everything. I actually go down and do some work nursing and giving injections to animals, giving the treatment for them but also for me. I think one’s mind is active, and you need a bit of relaxation and time to reflect on some things. Then you are rejuvenated. Stress levels, everything, my blood pressure, is zero when I’m there. Just getting away.

How do you cultivate leadership in others?

I like giving people responsibility and I sort of play the role of a mentor. I will give you an example. If I was in a Directorate to coordinate the overall development and policies that relate to women and HRH, I wouldn’t be sitting there working on it alone. I would call in women and normally we would sit together and work on it for two or three hours. I would leave it up to that person to say OK, these are the broad issues we will discuss and maybe you can go and work on it. Then we meet and work on it again and again until we have got it. So I have been always a leader who liked to delegate a lot. I believe that when you manage, you have got to get people out to do things themselves—you don’t just do things yourself. So, I have been really keeping to that and I have cultivated quite a few leaders—technical advisors with international organizations that have been working under particular health groups. It’s so satisfying to see the trained people leading the way. I think my approach has been to groom people so that when I leave, the work does not leave. I shouldn’t be the only person who knows what is happening.

What do you see on the road ahead for future HRH leaders in Namibia?

There is always a challenge. There is a cycle—the problems never end. There are a few things that are generally happening in this country. We are seeing a growing private sector. That’s number one. The private sector is growing at a very fast rate and interestingly, it is growing in the northern part of the country, where most of the population is, so it is going to be a big industry. There is the issue of planning to meet the country’s requirements, and in the case of the private sector, if proper planning is not done to provide for people’s needs, then I think the issue of retention in the sector is going to become a very serious one. I think that is a big challenge. I think HIV prevalence, number two. They are not taking the impact of this into consideration. I am not talking about many years—maybe five to ten years that we are going to run into problems.

HRIS should have been done before anything else happened, but unfortunately that’s the way of things in our country—we try and plan to do many things without actually having proper information. I am glad that we have started that challenge and that we are moving forward. Currently I am working on an assignment to do some competency analysis. That took me to look at our current syllabuses which are provided at the district levels and to look at and ensure HIV care and treatment, especially at lower levels like the clinic level and the role nurses especially are going to play to provide that service.

Past HRH Leaders in Action Interviews