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Empowering Health Workers_Alison Annette Foster_10.17.13
1. USAID Applying Science to Strengthen and Improve Systems Project
Improving Performance
District Management Level
Allison Annette Foster, URC
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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
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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.
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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
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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
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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.
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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
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USAID Applying Science to Strengthen and Improve Systems
Hinweis der Redaktion
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)
Notice that we have the ordering because they are not able to effect the outcome.
Job Fairs and Stage support
Welcome Package
Using the time they go to
Job Fairs and Stage support
Welcome Package
Using the time they go to