PARC: Toward More Effective Health Management

Marie-Guirlaine Raymond is a young woman from Haiti. She had just graduated as a general physician, and she found herself practising in the commune of Chambellan (Department de Grand'Anse, Haiti). She quickly realized she would need more than what was in her doctor's bag. "Almost all medical students must begin their careers in outlying areas," she explains. "In Haiti, these are extremely difficult environments where very few resources are available. To do a good job, you have to develop management skills. My country has enormous needs for training in this area."

The health management capacity building project (PARC) was designed to meet these needs. Funded by the Canadian International Development Agency (CIDA), PARC is implemented through cooperation among the international health unit of Université de Montréal, Haiti's Ministry of Health and Population, and the State University of Haiti.

PARC is based on a simple principle. Everyone ultimately benefits from sound and effective health governance.

PARC builds on a variety of approaches. PARC offers continuing education for managers who already form an integral part of the health system. PARC also supports master's degree programs in health services administration. PARC's first 15 graduates will obtain their master's degree in the summer of 2008. Moreover, PARC is broadening its horizons with a new component. Five doctoral fellowships will be offered to the most highly motivated graduates at the master's degree level. Recipients of these special fellowships must agree to do research for two years at the State University of Haiti. It must also be noted that the DESS (graduate degree in health services management) program is now in its fifth cohort and has trained over 125 students.

At the same time, PARC is helping to create a database of human resources in the medical sector. It is well known that Haiti faces a shortage of skilled health care workers. PARC is helping to build the next generation's capacities in this sector, by bringing together key agents of change and promoting dialogue.

Training that produces results

A few years after she began practising in an outlying area, Marie-Guirlaine joined Haiti's Ministry of Health and was able to improve her management expertise, thanks to the CIDA-funded on-the-job training she received there. This extensive training explored a number of areas. Marie-Guirlaine found the human resources module especially useful. "It was very timely," she says. "It really enabled me to improve my management practices." She has moved up higher in the organization since then. She now manages other managers. Eight Haitian professors and ten Canadian professors, specializing in management, are working together to offer high-quality training. Louise Desjardins, a Canadian based in Montreal who acts as a PARC project coordinator, explains: "Training is like a laboratory where participating managers can experiment in a variety of problem areas, dialogue with colleagues and specialists, and come up with useful knowledge and better management practices." Managers themselves must offer possible solutions. Recent efforts have focused on medical waste management and case management of psychiatric patients. Haiti's health system is growing and changing. Dynamic managers are needed to guide this transformation. Marie-Guirlaine is now in her forties and still eager to learn new things. She would like PARC to help her to earn her doctoral degree: "I'd like to teach at the State University of Haiti some day. It will be my turn to share my expertise."