HMIS Project-based
Leadership, Management, and Governance
(LMG) workshop
For Performance
Monitoring Team (PMT)
June 01-03,2022
Opening
speech
Self Introduction
Name
Organization
Position
Workshop norms
Expectation
LMG Training
overview
What is the LMG?
The LMG is a structured, participatory process that
enables teams to face challenges and achieve
desired results by applying leading, managing, and
Governance practices
It offers a methodology for success that
participants can take into all parts of their lives
LMG Overview (1)
The science of management, leadership, governance, and
organizational capacity building produces results
In developing countries financial resources are now
available and aid is increasing, especially for Africa
The limiting factor in effectively using the knowledge,
technologies, and resources available is the lack of
sound leadership, management systems, and Governance to
scale up and sustain the delivery of proven practices
LMG Overview (2)
• At the core of developing the capacity of health
care managers is the belief that the proof of good
leadership lies in the achievement of
measurable improvements in health outcomes
• The LMG focuses on improving these health
outcomes through better delivery of health
services
Looking at your mindset and values
“If you look to lead, invest at least 40
percent of your time managing your
ethics, character, principles, purpose,
motivation, and conduct.”
—dee hock
in waldrop, “dee hock on management”
A mindset is a habitual way of
interpreting and responding to
situations.
Leader Shifts
Shift perspective
From… To…
Individual heroics Collaborative
Despair and actions
cynicism Hope and possibility
Blaming others for Taking responsibility
problems for challenges
Scattered, Purposeful,
interconnected
disconnected actions
activities Generosity and
Self-absorption concern for the
common good
Key elements of the LMG
• Guiding principles for developing
managers who lead
• A simple tool—the Challenge Model—
applied in the context of a shared vision
• Focus on challenge, feedback, and
support
• Experiential learning in teams
Training Objectives
General Course objective
• At the end of this training, participants are expected
to demonstrate improved Leadership, Management
and Governance skills and practices required to
sustainably improve the information quality and Use
13
Training Objectives…
Specific Course objectives
At the end of this in-service training, participants
will be able to:
• Describe the health care environment and health
system,
• Improve LMG Skills and Practices,
• Demonstrate how LMG are contributed to HMIS,
• Leverage reliable tools and processes for defining
and addressing HMIS challenges ,
• Produce measurable results through team projects
14
Session-1
Overview and Context
of the Health System in
Ethiopia
Session Objectives
• Discuss emerging national health challenges,
opportunities, and trends
• Analyze the building blocks of a Health care
System and health system strengthening
• Discuss the role of LMG in improving Health
system through information revolution
Introduction
Existing and Emerging Health Issues and
Trends
• Existing issues: can be described as issues that
happened before the last 10 years ( as a cut off) and
persists till now
• Emerging issues: can be described as health issues that
have been emerging over the last ten years.
• Some existing issues have new emerging components
Re-emerging
• Health transition: Epidemiological T, Nutritional T &
Demographic T. 17
Introduction ...
Current health issues in Ethiopia
• High population growth rate
• Malnutrition
• One of the highest rates of maternal and neonatal
mortality
• Communicable diseases such as HIV, malaria and
TB burden
• Increasing number of people affected by Non
Communicable Diseases/NCD/
• Neglected Tropical Diseases /NTDs
• Inadequate immunization coverage
• Low institutional delivery
• Poor quality of health care services
• Epidemics 18
Important global health and health
related
Major issues
pandemics include: Emerging macro health issues:
HIV/AIDS Climate change, environmental
Malaria
Tuberculosis
degradation and deforestation
Malnutrition Changing industrial and
Influenza agricultural practices
Non-communicable (degenerative & Inappropriate or excessive use of
chronic diseases)
antibiotics
Avian influenza
Substance abuse
Acute respiratory syndrome
Ebola Increasing World population
COVID-19 Changing life style
Monkey pox Human Trafficking
Extrinsic factors complicating health Intrinsic factors complicating
issues:
health issues:
Politics
Inadequate/inappropriate Different societal needs of
policies/policy making different health care services
Competition (Market) Culture, societal morals and
Science, Economy
philosophies
Abrupt changes of policies of
international cooperation
Medical technology
Globalization Universal (or socialized) health
Introduction ...
Quality problems in the health care
(Ethiopia)
– Under-use of services
– Shortage and inefficient use of resources
– Poor generation and utilization of health information
– Non-functional referral system
– Poor record keeping
– Poor service delivery systems
– Lack of caring, respectful and compassionate health
professionals
Introduction ...
Health system strengthening
• System: is a set of interacting or interdependent
components forming an integrated whole.
• Health system: The sum of the organizations, institutions,
and resources whose shared primary purpose is to improve
health (WHO).
• Health system strengthening: is any array of initiatives
and strategies that improves one or more of the functions
of the health system and that leads to better health through
improvements in access, coverage, quality, or efficiency.
Introduction ...
Approaches for health system strengthening:
• Systems thinking: is an approach to problem solving that
views "problem" as part of the wider, dynamic system (WHO,
2009).
• It is a discipline for seeing wholes, recognizing patterns and
interrelationships, and learning how to structure those
interrelationships in more effective, efficient ways.
• Program focused: is a process of identifying national priority
and developing programs to address these priorities (UNDP,
1998)
System thinking…
System thinking…
Introduction ...
Health system strengthening…. (WHO)
•A point at which the various management systems and
subsystems are connected and integrated so as to provide the
best possible health services to all the intended beneficiaries
of those services.
•It involves six key components
•When all the six components function effectively and deliver
their intended results, the entire health will become
strong.
Introduction ...
Health system components:
Health System Building blocks as defined by the WHO
include (WHO, 2007);
1. Service delivery
2. Health workforce
3. Information
4. Medical products, vaccines & technologies
5. Financing
6. Leadership, Management and governance
(LMG) 27
Session II
Basic concepts of Leadership,
Management, and Governance
Activity1:
Duration: 10 minutes
Brainstorming:
Take a few moments and brainstorm on the
generic concepts of Leadership, Management,
and governance.
Definitions of concepts
Management
• The process of accomplishing predetermined
objectives through the effective use of human,
financial, and technical resources (Longest
Jr.,Rakich, & Darr, 2000).
• The practice of consciously and continually
shaping organizations
• Efficient utilization of resources for effective
achievement of organizational objectives
09/18/2025 By Behailu H 32
09/18/2025 By Behailu H 33
The cycle of managerial functions
and skills
LEADERSHIP
Definition
• Leadership is a set of practices, behaviors and values that
enable work groups and organizations to face challenges and
achieve results.
• Management sciences for health (2006) defines:
Leadership is enabling groups to make progress in
complex conditions.
– It is helping groups of people to identify their critical
challenges, and mobilizing them to learn and take effective
action.
– Leadership is an activity that takes place at all levels, not a
Who is a leader?
• As Bass stated “ leaders are agents of change,
persons whose acts affect other people more
than other people's acts affect them.”
• View leadership as a process of one individual
influencing another individual or group to
achieve particular objectives.
Exercise To To achieve
leadership
influence objectives
leaders
followers
behavior
’
behavior
Fig:1 The process of leadership (Longest,etal,2000)
09/18/2025 37
Defining Characteristics in Transactional
and Transformational Leadership
Characteristics of transformational leader
Agents of
Ignite fire change
within their Trust
follower
Challenges
Value
the status Transfor driven
quo mational
leader
Empa Life long
thy learner
Deal with
Vision
complexit
ary
y
Characteristic differences between a Manager & a leader
• A Manager is a formally appointed and
authorized individual in an
organization/system.
- Direct and support others to do their work
effectively
- Oversee resource utilization and
- Is accountable for work results.
• A Leader is an individual in a team capable
of influencing group activities towards goal
formulation and achievement.
Which do we want for the current health
care organization?
Leader or manager?
‘MANAGER WHO
LEAD’
Overview of Governance (1)
Governance:
The process of decision-making in which a
community or group organizes itself and exercises
authority to achieve particular ends
Good governance:
Good or “smart” governance is a policy context that
celebrates, enables, and empowers good working
conditions for men and women leaders/managers to
perform their work wisely and well
Overview of Governance (2)
Good health governance
• Competent stewardship of health system
resources, engagement of stakeholders, and
alignment toward a shared vision in pursuit of
improved health and health equity; achieved
through processes that are transparent,
equitable and accountable to the governed.
Any question?
Thank you
