Key lesson for the planning and implementation of management strengthening interventions (MSI)
| MSI phase | Lesson |
| Planning | 1. An assessment of the perception of externally funded projects and the expectation of additional funding is needed to decide on the suitability and sustainability of the MSI |
| 2. The MSI needs to be planned as a series of ongoing cycles to support continued learning | |
| 3. In some settings, support for the MSI is needed at higher levels than the district, such as the region or province | |
| 4. Stakeholder expectations need to be managed regarding outcomes of the MSI: developing better management skills will be gradual and motivation for key aspects of management (eg, M&E) may take time to develop; the benefits may include change in organisational climate and effectiveness of the District Health Management Teams | |
| Implementation | 5. Care in the selection and training of facilitators is needed to ensure that MSI is faithfully implemented |
| 6. Sufficient time is needed for a thorough problem analysis before developing strategies to address them | |
| 7. The focus should be more on developing complementary strategies, which are appropriate to the task rather than the exact composition of the bundles |