Challenge

Tsholotsho District in Zimbabwe faced severe maternal and child health issues amid a backdrop of economic crisis and demotivated health workers.

From 2014 to 2016, maternal deaths, stillbirths, and neonatal deaths rose significantly.

Approach

To address these issues, the District Health Team (DHT) adopted Spark Health Africa’s Transformative Leadership & Culture Change (TLCC) model.

Key Interventions

1. Creating a Culture of Accountability: 

  • Established a psychologically safe working environment. 

  • Promoted open communication and responsibility across all team members, from cleaners to senior medical staff.
2. Developing a Highly Effective Team: 

  • Conducted Emergency Triage Assessment and Treatment drills to maintain skills and ensure readiness for real-life emergencies.

3. Creating Motivation Through Institutional Justice: 

  • Addressed institutional injustices by promoting equitable information sharing and training opportunities. 

  • Senior leaders demonstrated empathy and support, fostering a committed and motivated team. 

Outcomes

The TLCC initiative led to significant improvements in health outcomes within 12 months: 

  • Maternal deaths decreased from 4 in 2016 to 2 in 2017.

  • Macerated stillbirths dropped from 11 to 5.

  • Fresh stillbirths reduced from 10 to 5.

  • Early neonatal deaths fell from 26 to 10.

This case study highlights the positive impact of leadership and culture change on health outcomes in resource-constrained settings.

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  • Published On: January 13, 2021

    How Work Culture Change Improved Maternal and Infant Mortality Outcomes in Tsholotsho District, Zimbabwe

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