Lead, Manage, Govern: Health Leaders in Laos Collaborate for Improved Maternal and Child Health

JSI
3 min readMar 28, 2024
Visavanh Senginthong, technical officer and trained midwife in Bountai District. Photo by JSI staff

When I graduated, my father inquired if I had an interest in working with communities. Without hesitation, I said: yes, of course. And I still enjoy it. I like working with people. But it can be challenging…” Visavanh says.

Visavanh Senginthong works as a primary health care technical officer and trained midwife while raising two children in Bountai District, Phongsaly Province, which sits at the northern tip of Laos and is home to nearly 200,000 people. Visavanh’s workload centers on meeting the maternal and child health care needs of her community, where only 29% of women access modern family planning, 61% complete the recommended four antenatal care visits during pregnancy, and less than 60% deliver children with the help of skilled attendants. Access to services is complicated by the fact that a quarter of Phongsaly’s population is almost unreachable during the rainy season.

In 2023, through the USAID-funded Lao Maternal Child Health and Nutrition Project, JSI began supporting five provinces in Laos, including Phongsaly, to strengthen the capacity of national, provincial, and district health partners to engage communities and achieve better health outcomes among women and children. In Phongsaly, we collaborate across 378 villages in 5 districts, working with health leaders to offer person- and community-centered maternal and child health and nutrition services.

To reach the project’s goals, we adapted the Leadership Management and Governance (LMG) course. Developed by Management Sciences for Health and its partners, the LMG course has been used in more than 90 countries across the world. It teaches skills often learned on the job that are critical for improving health service delivery. These include

- Leading: knowing how to scan, focus, align/mobilize, and inspire;

- Managing: knowing how to plan, organize, implement, monitor, and evaluate; and

- Governing: knowing how to engage stakeholders, set shared direction, and steward resources

We began implementing LMG in 2023 for six- to seven-person teams of mid-career officials from the supported provincial and district health offices. The teams work together for one year through quarterly workshops facilitated by JSI provincial staff. The workshops help participants develop skills in leadership, management, and governance; explore their communities’ greatest needs with each other; and propose solutions. Throughout the year, JSI supports the teams as they implement activities they have identified as having the potential to improve the use of health services in each community. The teams also monitor the results of these “challenge projects.”

This approach encourages local health managers to take ownership of and champion their own solutions. The project strengthens their technical and managerial vision and daily working skills and then invests in the solutions.

Heading maternal, child health, and nutrition activities in Bountai, Visavanh is highly visible among families in her community.

The Bountai District Health Office selected Visavanh to join the LMG workshops. “I have begun to learn essential skills, managing work and private life, solving problems, working effectively in a team, and prioritizing tasks in my daily work.”

She emphasizes how this support has helped alleviate some burdens she placed on herself. “Working with the communities can be challenging because we have different concepts or understanding of issues compared to the people we serve. But one thing I am understanding through the workshops is that we are committed to working with them and adjusting our concepts to the community’s context, working to better understand our clients, while supporting one another.” Visavanh continues, “I can confidently say that the LMG course has helped me to start thinking about how I rely on others in my field and community.”

Visavanh working with colleagues on approaches.

In collaboration with local leaders, JSI has supported 29 LMG teams in 24 districts. Along with participating in LMG skills training, each team is developing its first “challenge project” to deliver solutions that enable families across Laos to better access quality maternal child health services.

To read more about our work on this project and in Laos, click here.

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JSI

JSI is dedicated to improving people’s lives around the world through greater health, education, and socioeconomic equity for individuals and communities.