(Published - 8 April 2020)
Health systems in sub-Saharan Africa face multifaceted capacity challenges to fulfil their mandates of service provision and governance of their resources. And while wide-ranging capacity development interventions exist to address these limitations, failure to take into account complexity in planning and implementation in the practice and research of these capacity development interventions can result in poor implementation or lack of sustainability of the capacity gains.
“The COVID-19 pandemic has proved our interdependence globally and locally, and the importance of alignment and coherence in the public health actions we are taking,” says Dr Woldekidan Amde of the University of the Western Cape’s School of Public Health (SOPH-UWC). “It’s drawn attention to the paramount importance of strengthening health systems, addressing all forms of inequities within and across countries, and implementing a public health strategy to ensure sustained wellbeing of society and avert catastrophes.”
Dr Amde is intimately familiar with these capacity challenges - both as a coordinator of the SOPH’s international PhD programme and as a member of the SOPH team engaged in inter-university collaborative initiatives to develop capacity in the field of health policy and systems analysis in Africa.
This informs his recently-completed PhD thesis, Unpacking capacity development: A systemic exploration of a partnership of African universities to develop capacity on health workforce development, on the complexity of a multi-country capacity development initiative in the area of health workforce development.
Here’s what Dr Amde had to say about his work, his virtual graduation, and his hopes for the future.
If you had to do an elevator pitch description of your research, what would you say?
My research interrogates meaning and practice of capacity development in the context of a collaboration of four higher education institutions (based in Ethiopia, Rwanda, Mozambique and South Africa) towards addressing capacity challenges in the area of health workforce development. The work sought to determine the mechanisms that mediate the process and outcomes of such collaborative interventions across different contexts.
What were some of your main findings?
What was evident in my research is the dual capacity challenges facing public health training higher education institutions in sub-Saharan countries: expectation for the institutions to produce the next generation of health workforce while facing capacity challenges of their own. The study further demonstrates the relational and contextual nature of capacity development; the importance of sustained engagement of and ownership by key actors; and significance of coordination to ensure alignment and coherence across the interests and actions of multiple actors.
What general public health lessons can be drawn from your work?
My results resonate with some of the debates in public health around health systems strengthening and the concern for and recognition of leadership capacity development - and highlight the need to explore innovative ways of sustaining such partnerships. I see some parallels as well with current developments related to COVID-19. As the disease spreads, many nations have adopted similar sets of prevention strategies to different degrees and effects, and shown the importance of alignment and coherence in the public health actions we are taking, and the significance of supporting WHO and health ministries to execute their mandate of harnessing efforts and providing strategic guidance.
How did it feel to be graduating virtually?
I am so relieved that I graduated - the virtual graduation afforded me (and others) a sense of closure, headspace and of course the certificate to plan ahead and move on with our lives. It’s a good start; virtual learning in higher education institutions is bound to become the norm and not the exception post COVID-19. Virtual graduation parties aren’t there yet, though.
Why did you choose to study at UWC?
UWC has been my intellectual and professional home for several years now. And the idea of exploring the intricacies of planning and implementing a multi-country capacity development intervention, working under the guidance of two of UWC’s distinguished scholars, Prof Uta Lehmann and Emeritus Professor David Sanders - it made for the perfect PhD journey. Sadly, David passed away last year, but he was a giant in public health, and an example to us all. May his legacy live on!
How do you spend your spare time, when you’re not studying or working?
I spend most of my spare time with my family - their love and inspiration keeps me going. If it’s not catching movies with my wife or reading, then it is doing all sorts of playful activities with my daughter. She’s at the age where she thinks I’m still “cool”, so I try to make the most of that!
So what’s next for you?
In my time at SOPH-UWC, I have had the privilege of working with students across several countries in Africa, and been part of international teaching and research partnerships. I enjoy being in this space, contributing to the development of public health research and capacity. A career in academia is definitely in the cards for me - and I hope to do a lot of good that way.