Working with FBOs to Strengthen Human Resources for Health in Africa

Faith-based organizations (FBOs) play a key role in providing health care in many parts of the world. FBOs in Africa own and operate an estimated 30% to 70% of health care facilities, mostly serving remote and rural areas where the public sector has difficulty attracting and retaining health workers. FBOs also train a significant portion of health workers, especially nurses and midwives through in-service and pre-service training. Yet FBOs remain under-recognized for their immense contributions, and uncounted in the national health sector. They are often not well integrated into the overall health sector led by the Ministry of Health.

Moreover, FBOs providing health care services in Africa face numerous human resources for health (HRH) challenges including retention, insufficient and inaccurate HRH data, HRH shortages, lack of Human Resource (HR) Training, HR Policy and Human Resource Management (HRM) systems.

About the Project

CapacityPlus is a five-year (2009-2014) global project to strengthen the human resources for health (HRH) needed to help reach the Millennium Development Goals. It received a one year cost extension through 2015. Placing health workers at the center of every effort, the vision of CapacityPlus is to build powerful constituencies to shape the global HRH agenda while achieving demonstrable progress in the health workforce in a set of focus countries. CapacityPlus uses global expertise and evidence to address both the number of health workers needed and the quality and performance of those workers. Working to ensure the right health workers are in the right place at the right time, the project will build capacity in service delivery, thereby increasing access to high quality family planning/reproductive health, HIV/AIDS, malaria, tuberculosis, maternal and child health, and other services.

Through IMA, CapacityPlus has been engaged in an ongoing effort to develop and strengthen partnerships among FBO health care delivery organizations, facilities, and training institutions and national ministries of health in support of integrated HRH systems. Via the African Christian Health Associations Platform (ACHAP) and the project-supported HR Technical Advisor, CapacityPlus has been strengthening the faith-based health care community by sharing information and HR expertise among ACHAP members as well as the larger community, and by promoting improved integration of FBO policies, procedures, and HRM systems with the ministries of health for better HR management, retention and productivity.  ACHAP is an advocacy and networking organization made up 34 Christian/church health associations (CHAs) in 28 sub-Saharan African countries. The ACHAP Secretariat is based in Nairobi, Kenya.



Timeframe: 2009-2015

Funding level: $1,277,351 million (US)

Donor: United States Agency for International Development (USAID)


IMA’s Role: Sub-grantee

CapacityPlus Partnership:

Associate Partners:


Click here for a pdf with more information about the project.

Project Objectives

  • Fostering global leadership and advocacy for HRH
  • Enhancing HRH policy and planning, including HR management and information systems
  • Improving health workforce development, including preservice education, in-service training, and continuing professional development
  • Strengthening support to health workers to improve retention and productivity
  • Generating and disseminating knowledge to promote use of evidence-based HRH approaches.

Key Achievements

Over the past five years, IMA’s achievements within the FBOs include:

  • The establishment and strengthening of an ACHAP HRH technical working group (TWG) that has since grown to a membership of 13 CHAs from 10 African countries.
  • Development and implementation of new HR policies and procedures by the Christian Health Association of Kenya (CHAK) and the Kenya Conference of Catholic Bishops (KCCB) in over 900 FBO health facilities.
  • Replication of generic HRM policy approach in Christian Health Association of Malawi (CHAM), Christian Health Association of Ghana (CHAG) and Christian Health Association of Lesotho (CHALe) through exchange and learning from CHAK and KCCB.
  • Development of an HR data for decision making training course, later translated into an E-learning course and disseminated to support HRIS implementation at country level.
  • Conducted an FBO Assessment to evaluate the effects of FBO work in HRH policies on Family Planning/HIV service delivery in CHAK health facilities.  The study showed positive results that the policies strengthened human resources management (HRM) at FBO health facilities and significantly transformed the organization’s HR culture.
  • Institutionalization of the HRM assessment /score card by CHAG into its organizational assessment approach and application across its network. Findings informed CHAG’s strategies for addressing its members’ HRH challenges, and helped to identify and prioritize areas for HRM system strengthening across CHAG.
  • Development of appropriate strategies to address retention of health workers in rural health facilities, particularly those trained by the Christian Health Association of  Zambia (CHAZ) training institutions that are based in mostly rural Zambia.
  • Strengthened HRH leadership in CHAs: 8 CHAs have invested in full-time staff to support HRH initiatives at member health facility level in addition to provision of day to day HR management services to CHA secretariat staff.
  • Strengthening FBO integration and participation in global, national, and sector-wide HRH interventions incl. Global Health Workforce Alliance (GHWA) and the African Platform on Human Resources for Health
  • Development and dissemination of 90 monthly HRH e-publication (Hotline HRH) to assist in the dissemination of HRH information to a large audience including the FBO community, Ministries of Health and other non FBO organizations.
  • Over 10 FBO health workers participated in the project’s health workers’ advocacy communications initiative; I’m a health worker to highlight how the project places health workers at the center of its efforts to address the global health workforce shortage.
  • Development of the key advocacy messages titled “Because Health Workers Matter” a tool for FBOs and health facility leaders to use to advocate for strengthening HRM at the facility and national levels.
  • Under a Special Assignment through the project, IMA supported activities to strengthen the organizational capacity of the Christian Health Association of Liberia (CHAL). Key achievements include:
    • Appointment of a new Board Chair and full-time Executive Director to strengthen CHAL’s leadership
    • Development of CHAL’s sustainability plan to promote the organization’s sustainability
    • Development of CHAL’s website to improve its visibility and external communications


Tech brief

Partnering with African Faith-Based Organizations for a Strong Health Workforce


Because health workers matter: They need our support


Faith-Based Organizations: Using HR Management to Support Health Workers

Issue Brief

How Can Governments Work with Faith-Based Organizations to Strengthen the Health Workforce?


Achieving HRH Commitments: Lessons Learned and Resources from CapacityPlus

Subject Guide

Subject Guide: Faith-Based Organizations