Value of management education to enhance health systems
Authors: Guy Pfeffermann, Ann Kurth
Journal: The Lancet Global Health (2014)

Publications from the Consortium of Universities for Global Health (CUGH) conference included a welcome focus on the building of effective global health education programmes. Historically, health-worker education has occurred mainly in schools of medicine, nursing, and public health. Progress has been achieved in increasing the capabilities of such institutions in developing countries. As health systems become increasingly complex, however, the importance of management capabilities has come into sharp focus.1Koplan JP Bond TC Merson MH et al.Towards a common definition of global health.Lancet. 2009; 373: 1993-1995Summary Full Text Full Text PDF PubMed Scopus (820) Google Scholar Health professionals are often promoted to leadership roles, yet specific skillsets needed for the running of these systems are not part of their clinical training.2Sharma K, Zodpey Z. Demand and supply analysis of human resource capacity for hospital management in India. J Health Manag 13: 155–76.Google Scholar Many educational institutions are not equipped to impart the transformative leadership and management capabilities needed to run increasingly complex organisations, particularly in resource-constrained settings facing faculty shortages.3Diallo K Zurn P Gupta N Dal Poz M Monitoring and evaluation of human resources for health: an international perspective.Hum Resour Health. 2003; 1: 3Crossref PubMed Scopus (87) Google Scholar Partnerships between health professional education institutions and specialised management and business schools could be very valuable. Since many of the best management and business schools in developing countries are private (mostly non-profit) institutions, collaboration will entail public–private partnerships.Some health-worker education organisations offer leadership training, but these organisations do not generally use business school faculties or result in degrees for trainees. Much as focus has shifted from in-service to preservice physician, nurse, and midwife capacity building, management training with business schools should now be considered.High quality business schools foster innovation, raising capacity of systems to harness advances in technology and workforce support. These schools help generate effective change and promote strategic planning and operations. The schools emphasise teamwork, critical thinking, and a student-centred focus to learning, similar to the best health professional schools following the 21st century educational framework laid out by Frenk and colleagues.4Frenk J Chen L Bhutta ZA et al.Health professionals for a new century: transforming education to strengthen health systems in an interdependent world.Lancet. 2010; 376: 1923-1958Summary Full Text Full Text PDF PubMed Scopus (2940) Google Scholar Business schools adapt curricula to real-world problems, including use of local teaching cases. The best business schools embrace multidisciplinary approaches, and emphasis is on practice rather than theory. Innovation is taught as a process that entails failure, from which lessons that increase later success can be drawn.5Stanford Graduate School of BusinessGlobal Health Innovation Project.http://www.gsb.stanford.edu/phi/research/project-healthinnovation.htmlGoogle Scholar, 6Harvard Business SchoolThe Business Summit: redefining global health care.http://www.hbs.edu/centennial/businesssummit/healthcare/redefining-global-health-care.htmlGoogle Scholar Effective implementation, a growing area of scientific enquiry7Madon T Hofman KJ Kupfer L Glass RI Public health. Implementation science.Science. 2007; 318: 1728-1729Crossref PubMed Scopus (246) Google Scholar in global health,8National Institutes of Health Fogarty International CenterImplementation science information and resources.http://www.fic.nih.gov/researchtopics/pages/implementation%20science.aspxGoogle Scholar is considered a key outcome.Health outcomes can be improved if advantage is taken of the capabilities of these schools. The Leading High-Performing Healthcare Organizations program of the Strathmore Business School9Steger K New program educates health sector executives in Kenya.http://www.msh.org/blog/2011/09/13/new-program-educates-health-sector-executives-in-kenyaGoogle Scholar (Nairobi, Kenya), launched with the US Agency for International Development support in 2011, provides some examples. As with any education that exchanges students between high-income and low-income country settings, ethical frameworks should be followed.10Crump JA Sugarman J for the Working Group on Ethics Guidelines for Global Health Training (WEIGHT)Ethics and best practice guidelines for training experiences in global health.Am J Trop Med Hyg. 2010; 83: 1178-1182Crossref PubMed Scopus (315) Google Scholar Schools of management and business have much to offer educational teams working to increase availability and quality of health workers to strengthen health systems around the world.We declare no competing interests. Publications from the Consortium of Universities for Global Health (CUGH) conference included a welcome focus on the building of effective global health education programmes. Historically, health-worker education has occurred mainly in schools of medicine, nursing, and public health. Progress has been achieved in increasing the capabilities of such institutions in developing countries. As health systems become increasingly complex, however, the importance of management capabilities has come into sharp focus.1Koplan JP Bond TC Merson MH et al.Towards a common definition of global health.Lancet. 2009; 373: 1993-1995Summary Full Text Full Text PDF PubMed Scopus (820) Google Scholar Health professionals are often promoted to leadership roles, yet specific skillsets needed for the running of these systems are not part of their clinical training.2Sharma K, Zodpey Z. Demand and supply analysis of human resource capacity for hospital management in India. J Health Manag 13: 155–76.Google Scholar Many educational institutions are not equipped to impart the transformative leadership and management capabilities needed to run increasingly complex organisations, particularly in resource-constrained settings facing faculty shortages.3Diallo K Zurn P Gupta N Dal Poz M Monitoring and evaluation of human resources for health: an international perspective.Hum Resour Health. 2003; 1: 3Crossref PubMed Scopus (87) Google Scholar Partnerships between health professional education institutions and specialised management and business schools could be very valuable. Since many of the best management and business schools in developing countries are private (mostly non-profit) institutions, collaboration will entail public–private partnerships. Some health-worker education organisations offer leadership training, but these organisations do not generally use business school faculties or result in degrees for trainees. Much as focus has shifted from in-service to preservice physician, nurse, and midwife capacity building, management training with business schools should now be considered. High quality business schools foster innovation, raising capacity of systems to harness advances in technology and workforce support. These schools help generate effective change and promote strategic planning and operations. The schools emphasise teamwork, critical thinking, and a student-centred focus to learning, similar to the best health professional schools following the 21st century educational framework laid out by Frenk and colleagues.4Frenk J Chen L Bhutta ZA et al.Health professionals for a new century: transforming education to strengthen health systems in an interdependent world.Lancet. 2010; 376: 1923-1958Summary Full Text Full Text PDF PubMed Scopus (2940) Google Scholar Business schools adapt curricula to real-world problems, including use of local teaching cases. The best business schools embrace multidisciplinary approaches, and emphasis is on practice rather than theory. Innovation is taught as a process that entails failure, from which lessons that increase later success can be drawn.5Stanford Graduate School of BusinessGlobal Health Innovation Project.http://www.gsb.stanford.edu/phi/research/project-healthinnovation.htmlGoogle Scholar, 6Harvard Business SchoolThe Business Summit: redefining global health care.http://www.hbs.edu/centennial/businesssummit/healthcare/redefining-global-health-care.htmlGoogle Scholar Effective implementation, a growing area of scientific enquiry7Madon T Hofman KJ Kupfer L Glass RI Public health. Implementation science.Science. 2007; 318: 1728-1729Crossref PubMed Scopus (246) Google Scholar in global health,8National Institutes of Health Fogarty International CenterImplementation science information and resources.http://www.fic.nih.gov/researchtopics/pages/implementation%20science.aspxGoogle Scholar is considered a key outcome. Health outcomes can be improved if advantage is taken of the capabilities of these schools. The Leading High-Performing Healthcare Organizations program of the Strathmore Business School9Steger K New program educates health sector executives in Kenya.http://www.msh.org/blog/2011/09/13/new-program-educates-health-sector-executives-in-kenyaGoogle Scholar (Nairobi, Kenya), launched with the US Agency for International Development support in 2011, provides some examples. As with any education that exchanges students between high-income and low-income country settings, ethical frameworks should be followed.10Crump JA Sugarman J for the Working Group on Ethics Guidelines for Global Health Training (WEIGHT)Ethics and best practice guidelines for training experiences in global health.Am J Trop Med Hyg. 2010; 83: 1178-1182Crossref PubMed Scopus (315) Google Scholar Schools of management and business have much to offer educational teams working to increase availability and quality of health workers to strengthen health systems around the world. We declare no competing interests.