Key Messages from the July FORCE Community Webinar: Coaching Approach for Country Engagement in Burkina Faso

Background

The July FORCE community webinar explored the coaching approach through the lens of the Burkina Faso country engagement process. The coach from our engagement in Burkina Faso, Dr Jean-Paul Dossou and a Burkina Faso policymaker who was a major stakeholder, Dr Lamine Traore, were invited to discuss the skills used to ensure a successful process. The discussion was between a giver and a receiver of the coaching approach using the country engagement framework and highlighted key steps in the country engagement process including problem identification and solution development. The panellists were invited to answer several questions and provide real-life examples of critical steps from the engagement.

The objectives of the session include to:

1. Describe the coaching approach using the country engagement process in Burkina Faso.
2. Highlight key skills used to achieve a successful country engagement.
3. To explore the coaching approach and country engagement process from a stakeholder’s perspective

SHP challenges in Burkina Faso

The Burkina Faso 10-year national health plan includes a national strategy for health financing which is currently being implemented. This plan is in effect from 2018 – 2030 and implementing Strategic Health Purchasing (SHP) is a critical part to effectively achieve the goals outlined in the plan. However, this process required both technical and institutional support to be effective.

Supported by the World Bank (WB), Thinkwell and SPARC, the Burkina Faso health financing stakeholders developed a strategy that outlined the way forward for implementing SHP in the country. The SPARC coach provided in-person technical support to Burkina Faso between December 2020 and January 2021 and virtual convenings. The technical support method used by SPARC enabled the health system stakeholders to take ownership of the strategy development and implementation process for strategic purchasing of health services in the country.

Summary of technical and non-technical skills

Through early engagements with in-country stakeholders, the coach identified two streams of stakeholder expectations for the country engagement – an urgent stream and a long-term agenda. The urgent stream focused on restructuring an existing WB project on SHP that should have started in 2018 but was struggling to spend the existing resources effectively due to conflicting definitions of SHP and how the funds would be conceptualized and channelled to relevant activities to achieve SHP.

The coach advanced a common definition of Strategic Health Purchasing that was developed and agreed upon by various country stakeholders. To do this, he reviewed the literature on SHP to identify a definition for SHP that contained all its key functions but was also structured in a way that was easily understood and agreed upon by the country stakeholders. The definition was integrated into the current version of the restructured project which is being validated by the WB in preparation for the implementation of this project.

Several key skills were utilized by the coach to achieve a successful country engagement. These skills include:

Technical Skills

• Technical knowledge of the project area (health financing, health system strengthening and universal health coverage).
• Good understanding of qualitative research to gather relevant information from stakeholders and synthesize effective recommendations to achieve the project goals.
• Good understanding of the complexity of health systems in practice, political economy analysis to understand the root causes to resistance and difficulty of stakeholders
• Process facilitation to assist stakeholders in different factions to align on SHP and its importance to achieving the goal of universal health coverage.

These skills helped build the confidence and trust of stakeholders in the coach’s ability to provide valuable and effective insight into the unique challenges in SHP in the country.

Non-technical skills

• The coach exhibited a good attitude, neutrality, and openness to create and maintain the confidence of stakeholders during the engagement.
• The coach understood the unique national, political, and cultural context of the country which helped his approach to stakeholders.
• Good listening skills were required to understand stakeholders’ priorities and enable the coach to factor these in the definition and planning for the implementation of SHP in Burkina Faso,
• Building trust and rapport among stakeholders, including funders, was a major part of the success during the country engagement. For example, the coach capitalized on a common membership to a professional body to build a sense of connection which helped form a foundation of mutual understanding with a key stakeholder.

Key takeaways for technical support consultants

• The integrity and credibility of the consultant organization is important to ensure stakeholders of the quality of assistance being provided. The institutional relationship between the different parties (the technical support provider and receiver) can influence the way a coach or consultant is received by the country.
• Making the coach the focus person for country engagement builds the confidence of stakeholders in the coach and empowers the coach to make important decisions to deliver on the objectives of the engagement.  
• Coaches should ensure the country stays in the driver seat of their own change processes by engaging stakeholders at every stage of the process.
• Coaches must be flexible and willing to adapt to changing situations, schedules, and programs as this will help build rapport with stakeholders.
• Coaches should ensure stakeholder views are identified, acknowledged, and respected during the engagement.
• Coaches should ensure that they are emotionally and mentally prepared for the country engagement to ensure stakeholder relationships are not imperilled due to non-official matters.
• Coaches should construct relationships that will lay a foundation for achieving the objectives of the engagement
• Coaches should build their interpersonal communication skills to ensure stakeholders have a clear understanding of the information they share and to ensure they understand stakeholders as well.
• Coaches should ground all their recommendations on sound evidence and maintain a healthy respect for the goals country partners and stakeholders hope to achieve from the engagement process.

Conclusion

The country engagement in Burkina Faso was successful due to several technical and non-technical factors from all parties involved (country stakeholders and partners, funders, the coach, and the technical support organization). The coach built the confidence and trust of the stakeholders by having good technical knowledge of the subject area he supported and explaining the complicated context of health financing and SHP in simple terms that all stakeholders understood.

Apart from technical knowledge and skills, the coach also used several non-technical skills such as active listening and interpersonal communication, patience, neutrality, adaptability, and flexibility to build rapport and effective communication among stakeholders to achieve the objectives of the engagement.

It is important for coaches to have a firm grasp of coaching and mentoring technical and non-technical skills. While some of these skills need to be built over time, the coaching and mentoring courses provide a background to these skills. The courses can be accessed here.