A few weeks after participating in a training workshop, a group of nutritionists went to the Chief of Staff at the Oromia Region president’s office. This was an unusual action – but perfectly in line with the training, which focused on leadership.
“Improving nutrition outcomes involves people acting across multiple sectors, ensuring action at multiple levels,” explained Tadele Yitaferu, deputy director of the Alive & Thrive program in Ethiopia. “The visit to the regional president’s office – advocacy to highest government authority, which led to meaningful changes in incorporating nutrition activities in sectoral plans and in the budget – is a good example of the type of leadership capacity we need to develop at all levels and in multiple sectors of the government.”
The group who went to the regional president’s office that day were among a group of emerging leaders in nutrition who had participated in regional workshops to develop their leadership skills. To date, more than 120 have participated in the trainings from five regions – Afar, Amhara, Oromia, SNNPR, and Somali. The training effort reflects a shared commitment to building leadership capacity among multiple stakeholders – the government, academia, NGOs, and others.
“The training is very impressive,” said Taye Wondimu, a nutrition expert in the Office of the Regional Health Bureau, for the Oromia Region. Wondimu participated in the training of trainers for the program, and will facilitate trainings as they are cascaded to regions in coming months.
“Since I'm a nutritionist, the introduction parts of the training were routine for me – facts and focus of nutrition at the global, national, and regional levels,” he said. “The most impressive parts focused on understanding leadership and managerial roles – the difference between leaders and managers. I didn't have any idea of this before the training.”
The training uses a series of games, he said, that help participants understand the qualities of a leader – such as effective communication, motivating others, and presenting a vision.
“All of the games were very important – you learn about communication among the group, team spirit, understanding each other,” he said. “And when you do these games, you have to prepare a plan –planning” is not commonly a focus of coursework for nutritionists at university.
The importance of effective leadership within health systems has been an issue of concern to nutrition stakeholders for a number of years. Research has identified a leadership skills gap while noting the need for multisectoral collaboration.
In 2016, the African Development Bank launched the African Leaders for Nutrition Initiative, a platform for high-level political engagement to advance nutrition in Africa. The initiative has brought together heads of state and ministers to ensure nutrition is meaningfully on their governments’ agendas.
Similarly, the African Nutrition Leadership Program connects nutrition leaders across the continent “committed to the development of both individual and organizational leadership capabilities in the broader area of nutrition on the African continent.” Its workshops have trained over 300 nutrition leaders in more than 30 countries on the continent.
“We have a good nutrition landscape in Ethiopia,” said Birara Yalew, senior MIYCN advisor in the Maternal, Child Health and Nutrition Directorate of the Federal Ministry of Health and an Alive & Thrive staff member. “But the leadership component is challenging.”
Ethiopian stakeholders recognized the problem and, after attending an African Nutrition Leadership Program training in South Africa in 2018, three of the participants, including one Alive & Thrive staff member, returned and developed a similar training tailored to the Ethiopian context.
“That was the starting point,” said Yalew, who is also now a facilitator of the trainings. “At that time, we were discussing the importance of a national leadership program and then we developed the training manuals, an effort which Alive & Thrive led.”
“To strengthen the multisectoral nutrition system, we realize that we need to support efforts to build leadership capacity across multiple sectors of the government,” Yitaferu said. “Leadership is a core pillar – relevant to all functions of a system.”
In Ethiopia, government commitments to improving nutrition implicate numerous signatory sectors. But they have not been equally active on reducing malnutrition.
“Within the signatory sectors, their engagement to meaningfully contribute to reduce malnutrition varies – only a few of them, like the Ministry of Health, Ministry of Agriculture and Ministry of Education are most active in their nutrition tasks linked to their leadership’s commitment,” Yitaferu explained. “To make the less active sectors as proactive as their counterparts in the ministries of health and agriculture, and reinforcing the leadership in the active sectors, the nutrition leaders have to be reoriented – they have to become transformational leaders to lead from where they are.”
The regional training workshops help participants develop a comprehensive understanding of the qualities of a leader and, at the same time, the skills necessary for effective communication and leadership.
Upon request of the Ministry of Health, Alive & Thrive led the development of training manuals for both facilitators and participants, tailored to the Ethiopia health system context. The manuals are currently working drafts, revised and improved after each training experience.
In the workshops, the emerging leaders, selected from the top and mid-levels of the various ministries, learn fundamentals of leadership, management and governance, and self-assessment, team building and advocacy skills.
Prior to the trainings, “there was no skill or knowledge about leading programs at different levels – this is what we bring attention to,” Yalew said. “It has dramatically improved knowledge of leadership.
“The critical concept is leadership at different levels – how to manage and lead the different sectors, clarify roles and responsibilities, and coordinate and link across sectors,” he said. “Most of us are managers, but leadership is a very different modality involving inspiring people and creating a common vision for people. If you are a leader, your vision will be shared among sectoral actors.”
After the training, participants develop detailed personal development plans for the following three months. Each region’s leaders then join a virtual networking group, which is housed on Telegram, a communications platform. The network now includes over 330 members.
The impacts so far are promising, Yitaferu said.
“They are revitalizing things, transforming nutrition within and across the sectors,” he said. “They have initiated grassroots-level nutrition activities and collaborated at the networking level. Some are starting to revitalize the fish value chain system, advocating nutrition-sensitive approaches.”
“The training has influenced every expert in each sector who has taken it,” Wondimu said. “I believe this will bring change in nutrition interventions and not just for nutrition but for other sectors as well.”