Currently, we all are dealing with one of the most significant public health challenges in history, the COVID-19 pandemic. Given how the pandemic has confronted the health system, GHD|EMPHNET recognized severe gaps in the management and leadership capacity of health managers, specifically in the areas of planning, implementing, and evaluating public health activities. Such gaps weaken countries’ health system capacities. GHD|EMPHNET has decided to explore an opportunity to strengthen the regional task force in Iraq to face the COVID-19 pandemic and other public health priorities, knowing that Iraq faced unparalleled public health problems in a country following the long war, there was an urgent need for enhancement and leadership of health officials.

Iraqi Health System: Constant Challenges Coupled with the COVID-19 Pandemic

GHD|EMPHNET team is familiar with the Iraqi health system. It has seen that Iraq was overwhelmed, especially when managing the COVID-19 pandemic due to various reasons such as frequent workforce shortage, power outages, lack of funds, less-resourced infrastructure, poor community awareness, and inaccessibility due to security concerns. Furthermore, additional resources to fill current gaps are not expected to be available soon due to the previous gaps. Therefore, logically, one fundamental way forward is to ensure that all public health resources are adequately planned and utilized, requiring more outstanding management and leadership capacity of the existing health staff handling priority health interventions in the country.

Within these challenges, GHD|EMPHNET held practical competency-building training of the 21 residents from the Intermediate Field Epidemiology Training Program in Iraq. This training was purposed to ensure a sustainable change among the residents for managing and leading Iraq’s priority health interventions, including confronting the COVID-19 pandemic. This specific objective was not easy since it demanded agreement with the Iraqi government, identifying management and leadership needs, developing appropriate training contents, and delivering the training through the best possible subject matter experts (SMEs) most efficiently and effectively.

Towards Effective Leadership Skills

In this regard, GHD|EMPHNET collaborated with the Centers for Disease Control and Prevention (CDC)-Atlanta, the Biological Threat Reduction Program (BTRP), and the Ministry of Health (MoH) of Iraq. Subsequently, a team of SMEs from the CDC organized and conducted a three-month mentorship-based Management and Leadership (M&L) training for the Intermediate Iraq Field Epidemiology Training Program (FETP) fellows who perform as middle-level managers within the Iraq health system and are responsible for priority national health programs at the national and sub-national level.

Given travel-related restrictions, the team developed creative ways to deliver the training through online sessions without losing quality. The training was immensely benefited by highly experienced trainers and facilitators who provided need-based training and used real-life examples and case studies from Iraqi public health situations.

During the Symposium and graduation ceremony, the aforementioned initiative by GHD|EMPHNET was well-appreciated by the Iraq MoH and has contributed to sustainable positive changes in the performance of all trainees. Notably, every trainee picked a project/program on priority health concern from his/her respective work environment and utilized management and leadership competencies that they developed from the training to improve plan, implement and evaluate their respective project/program. During their project/program development, they were individually mentored as part of the unique Management and Leadership training.

As part of the training curriculum, the subject matter experts (SMEs) trained the fellows on how to identify a public health problem, how to analyze the situation in the most comprehensive manner, how to identify possible solutions, how to engage with stakeholders, how to strategize, how to develop a log-frame for any health intervention, how to breakdown a complex task, how to schedule activities, how to communicate, how to engage the community and how to handle media. In summary, the training culminated in turning the resident epidemiologist better equipped with M&L competencies that are often necessary to bring desired public health outcomes, especially in an environment with a fragile health system like that in Iraq.

Direct testimony from the trained resident is evidence of the positive outcomes from the M&L training. Before we mentioned some examples of what trainees experienced/expressed, it is notable that the M&L training has successfully brought positive gains. These gains are expressed by the trainees and appreciated by the Iraq MoH, the CDC, and GHD|EMPHNET, during the participant’s presentations of their projects.  As a result of the training, the fellows commonly were more informed about their respective stakeholders, public health problems, and appropriate solutions. Besides, the fellows are now confident in doing strategic planning and implementation of public health interventions.

Dr. Zainab Nasser from Al Rusafa told us how this unique experience has positively impacted her career. She learned a new way of solving problems and thinking outside the box; also, with someone in her position now, she can identify the stakeholders, their concerns, their interests, and how to make the proper situational analysis, choosing suitable strategic analysis. Currently, she is hoping to fill the gap between the private and public sectors using the skills she gained from the Leadership and Management Training and the FETP to improve reporting of suspected measles cases in Baghdad Al-Rusafa.

From his end, Dr. Abbas Jabbar from AlNasseria district Thiqar was also working on the same project in his district, and their focus was on challenges caused by the COVID-19 pandemic. He highlighted how vital teamwork is in their line of work.

Dr. Mahmood Faisal from AlKufa stated that he thinks this training will be a great help in his plans as an epidemiologist. Even today, the training has helped him develop reports and communicate challenges clearly with his community, national and non-governorate organizations, and reach out when needed. The workshop also helped him set his priorities when solving a problem, and he stated that today he is more ready to face future challenges.

Dr. Marha L. Kamoona from Al-Russafa worked on improving preparedness for the COVID-19 pandemic in schools opening; she realized throughout the Leadership and Management Workshop how to do all the need analysis develop the strategies for decision making and tackle all the health problems.

All residents told us how glad they were to take this workshop with a high quality of content and be taught by experts and mentors with international standards. Also, they shared with us how it enriched their career where most of them assumed managerial positions following the knowledge they gained in this workshop. And they wish everyone in their sector could get this kind of experience.

Dr. Mahmood Faisal from AlKufa mentioned a quote that he took from the leadership and Management training that he will never forget “Be the kind of leader that everyone would follow voluntarily even if you had no title or no position.”

Dr. Haitham Bashier, the Workforce Capacity Team Leader, once told us before we started working, I need you to set your priorities right and focus on our given task. We look for three things in our work: “Punctuality, Completeness and Perfection” and we need them in that order.

Current Progress. Continuous Collaboration

Currently, the trained participants are already utilizing M&L competencies in implementing their respective projects/programs in their work environment. As they continue in applying the M&L learnings, GHD|EMPHNET’s Team is maintaining contact with them to know the progress of their work and salient outcomes. GHD|EMPHNET team is also committed to providing every possible technical support to the graduates when requested.

As part of GHD|EMPHNET’s commitment to strengthen health system development, further opportunities would be proactively sought globally where GHD|EMPHNET could again demonstrate collaboration, coordination, and leadership in assisting the public health system development. In this regard, we also hope to continue documentation and share lessons learned from the M&L training experience in Iraq among all stakeholders.