Improving health systems at district level
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Improving health systems at district level
- 1. USAID Applying Science to Strengthen and Improve Systems Project Improving Performance District Management Level Allison Annette Foster, URC 1
- 2. BACKGROUND • Quality Improvement: A Science • Applying Science to Strengthen and Improve Systems • Health Workforce Performance: Key to all Quality Improvement Efforts • Engagement: Leads to Sustainability, Retention and Increased Improvement in Care Delivery – Tanzania • Performance Factors impact Engagement USAID Applying Science to Strengthen and Improve Systems
- 3. HEALTH WORKFORCE DEVELOPMENT INDICATOR % of HIV-Positive patients assessed for active TB BEGINNING LEVEL MOST RECENT LEVEL July 2010: 35% Dec 2011: 99% July 2010: 13% Dec 2011: 94% % of exposed children under 18 months receiving daily cotrimoxazole prophylaxis USAID Applying Science to Strengthen and Improve Systems
- 5. SIX DOMAINS OF DISTRICT LEVEL • • • • • • 5 Management Roles Supply Chains Information Streams District Planning Quality Improvement Human Resources Management USAID Applying Science to Strengthen and Improve Systems
- 6. FLOW OF SUPPLIES - IMPROVEMENTS The % of facilities that submitted supply orders on time increased from 76% in March 2011 to 94% in June 2013. 6 USAID Applying Science to Strengthen and Improve Systems
- 7. HUMAN RESOURCES FOR HEALTH • Recruitment • Retention of new Staff • Performance Support in Improving HIV indicators • Supervision 7 USAID Applying Science to Strengthen and Improve Systems
- 8. IMPROVEMENTS IN RETENTION INDICATOR % of newly recruited staff that received a technical orientation package within two weeks of reporting BEGINNING LEVEL MOST RECENT LEVEL March 2011: 53% March 2013: 89% March 2011: 69% March 2013: 89% % of newly recruited staff that are retained at 6 months 8 USAID Applying Science to Strengthen and Improve Systems
- 9. LESSONS LEARNED • Empowerment aligns with leadership and governance efforts and yet is different. • District Management is where Health Workforce Development Really intersects with Health Systems Strengthening. • There is always a solution. 9 USAID Applying Science to Strengthen and Improve Systems
- 10. NEXT STEPS • CONTINUE TO MONTOR HIV INDICATORS • STRENGTHEN TEAMS IN QUALITY IMPROVEMENT AT FACILITY LEVEL • EXPLORE ROLE AS CHANGE AGENTS 10 USAID Applying Science to Strengthen and Improve Systems
Notas do Editor
- In 2011, HCI/ ASSIST began a District Health Management Performance improvement intervention with the aim of building the capacities of Regional and Council (District) Health Management Teams in district management - meaning to effectively manage and coordinate health human resources, monitoring and evaluation through better management of district health information systems, and supply chains (supplies and logistics), and Council health planning, which will ultimately improve care services and health outcomes for HIV/AIDS patients. In the Lindi region are six districts, including 192 facilities (district hospitals, health centers, and dispensaries). Those districts are: Kilwa (41facilities), Lindi DC (41 facilities), Lindi Municipal (15 facilities), Nachingwea (36 facilities), and Ruangwa (29 facilities), and Liwale (30 facilities)
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