Agenda [PDF]

Dec 1, 2015 - 15. RMNCH. Expanding (CEmONC services at strategically selected health centers and hospitals to serve as s

7 downloads 45 Views 5MB Size

Recommend Stories


[Pdf] Download Alien Agenda
If you feel beautiful, then you are. Even if you don't, you still are. Terri Guillemets

Download the Agenda (PDF)
Everything in the universe is within you. Ask all from yourself. Rumi

Agenda (Download PDF)
Nothing in nature is unbeautiful. Alfred, Lord Tennyson

Agenda (pdf file)
Life is not meant to be easy, my child; but take courage: it can be delightful. George Bernard Shaw

Download PDF of Agenda
The only limits you see are the ones you impose on yourself. Dr. Wayne Dyer

Board Agenda 1.8.18.pdf
Pretending to not be afraid is as good as actually not being afraid. David Letterman

Agenda cultura en pdf
Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will

Agenda (Download PDF)
Just as there is no loss of basic energy in the universe, so no thought or action is without its effects,

Course Agenda(PDF)
No amount of guilt can solve the past, and no amount of anxiety can change the future. Anonymous

Preliminary Conference Agenda (PDF)
Keep your face always toward the sunshine - and shadows will fall behind you. Walt Whitman

Idea Transcript


Agenda

Health NKRA Focus Area HRH Distribution Health Facilities Health Commodities RMNCH Funding Situation Anticipated Challenges Moving Forward AOB 1

The focus areas of BRN Healthcare NKRA and the initiatives aims to achieve 4 broad outcomes for quick transformation HRH

100% balanced

80% of primary

distribution of skilled health workers at primary level

health facilities to be rated 3 Stars and above

4 initiatives

Health facilities

BRN Healthcare

20% reduction in maternal mortality ratio and neonatal mortality rate in 5 regions

6 initiatives

RMNCH 6 initiatives

Health commodities

6 initiatives

100% stock availability of essential medicines

2

Agenda

Health NKRA Focus Area HRH Distribution Health Facilities Health Commodities RMNCH Funding Situation Anticipated Challenges Moving Forward AOB 3

100% balanced distribution of skilled health workers at primary level Prioritize application of employment permits to regions with critical shortage of skilled HRH 1Analysis of Postings done in FY 2014/15 Total no

%

Original Postings

8345

Posted after remedial plan

9,735

100%

Reported

8,312

85%

Not reported at all

1,423

15%

Reported and available

7,730

78%

582

7%

Reported and left

2 HRH Analysis for 2015/16 and 2016/17 q  Analysis on funded Post received from POSPM for FY 2015/16 •  To conduct assessment and plan for redistribution of staff •  Noted challenge in the suggested posts, communicated to POPSM and are currently working on it q  Approved funded posts – FY 2016/17 o  To determine the needs from LGA’s ( per facility ) and share with POPSM before 1st December 2015 o  Communication made with PMORALG, tool sent to all regions & LGA’s to collect data on gaps per facility

3 PPP ²  Identified unmanned facilities through Star Rating ²  Pre feasibility Study to be conducted in collaboration with PharmAcess on PPP model to be used under HRH Initiative ²  Results will be out by December 2015

4

Density of Clinician and Nurses per 10,000 Population After remedial plan 20 18

• 

16 14 12

9.3

10 8

7.74

6 2015 Nurses

4

2015 Clinicians

2 Kilimanjaro

Njombe

Iringa

Pwani

Mbeya

Dar Es Salaam

Arusha

Morogoro

Lindi

Manyara

Tanga

Ruvuma

Mwanza

Dodoma

Mara

Mtwara

Kagera

Singida

Shinyanga

Rukwa

Kigoma

Geita

Tabora

Katavi

2014 Nurses Simiyu

0

On average, 4 regions improved Katavi, Kagera, Mtwara & Mwanza •  3 regions became worse from above to below 7.74 – Manyara, Lindi & Mbeya

2014 Clinicians

Before

After

Regions critically below 2014’s national average of clinicians and nurses density

9

10

Regions at borderline of 2014’s national average for clinicians and nurses density

4

1

12

14

Regions above 2014’s national average for clinicians and nurses density

5

Situation in the first 9 Regions Density of HRH before and after remedial plan in 9 Regions 9.00 8.00

Baseline Nat. Aver 2014- 7.74

7.00

6.4

6.00

Density of HRH BF

5.00

Density of HRHAF

4.00

4.4

3.00 2.00 1.00 0.00 Katavi

Simiyu

Tabora

Geita

Kigoma

Rukwa

Shinyanga

Kagera

Singida

6

Human Resource for Health Distribution 4

Redistribution of health workers •  Developed 40 National WSIN •  Develop National Standard to be used during assessments •  1st Training for Dodoma and Ruvuma Region – 8th November 2015

6 Enforcing retention & incentive policy at LGA

•  •  • 

Met POPSM to discuss implementation of Pay and Incentive policy (2010) Requested officially the Implementation Guideline for the 29 LGA’s To be used as basis to advice the LGA’s on the implementation

•  •  • 

5 Ring Fencing of Subsistence allowances Met MOF directives given Letter sent to PMORALG to request them for follow up of permit for Fy 2015/16 PMORALG to develop a budget and submit official request for Ring fencing of subsistence allowances to MOF 7

Reinforce Orientations and induction for newly hired staff

Letter was sent to PMORALG to remind LGA’s to plan and budget for orientation and induction of new staff

7

Agenda

Health NKRA Focus Area HRH Distribution Health Facilities Health Commodities RMNCH Funding Situation Anticipated Challenges Moving Forward AOB 8

Health Facilities 1 •  •  • 

• 

Star Rating Assessment Star Rating Completed in Mwanza, Shinyanga and Geita Regions Plan in place to develop reporting template for the districts Start assessment's for Mara, Kagera and Kigoma Regions as from 8th November 2013, DSM in Dec 2015 To complete BRN Region in Feb 2016

3 Opening of Accounts in lower Health Facilities •  Until May 2015 only 3652 (64%) out of 5699 had opened bank Accounts •  During Star Rating assessment – 96% have opened bank accounts •  PMORALG to conduct visits as from next week

2 Social accountability at the facility and community level Work plan for 2015/16 completed Completion of guideline, Piloting and TOT training Rolling out to 77 LGA’s will be done

4 National Health Facilities User Satisfaction Level Scoring System •  Developing a concept Note and plan is to have stakeholders meeting in December •  Plan to have it place by March 2015

9

All Star Rating Assessment Findings 2

Mwan za

Simiyu

Shinyanga

Total

%

151

70

40

261  

36.8%  

161

71

147

379  

53.5%  

37

12

17

66  

9.3%  

3 Star

1

0

2

3  

0.4%  

4 Star

0

0

0

0  

0.0%  

5 Star

0

0

0

0  

0.0%  

350

153

206

709  

280  

122  

165  

709  

Star Rating 0 Star 1 Star 2 Star

Total Facilities Target

0- 2

99.4% of alll facilities

10

Agenda

Health NKRA Focus Area HRH Distribution Health Facilities Health Commodities RMNCH Funding Situation Anticipated Challenges Moving Forward AOB 11

Health Commodities 1

2

Improving governance, accountability, and sense of ownership of Health Commodities supply chain

Strengthen  management  of    MSD  working   capital  work •   Prime  vendor  on  MSD  zonal  basis  is  on  

•  Toolkit  for  best  prac0ces  of  health   commodi0es    implemented  in  Serenge0,   Busega,  Chato,  Kwimba,  Kigoma  and  Muleba   districts.     •  Concept  note  for  resources  mobiliza0on   under  development   •  Revised  dona0on  guideline  approved  &  to  be   disseminated  

going  well   •  Government  strategic  review  of  MSD  is  in   progress  under  independent  reviewer   DeloiFe  to  see  how  best  MSD  can  be   strengthened   •   The  dialogue  for  signing  of  MOU  among   MOHSW(ver0cal  program  actors),  MSD   and  MOF  is  on  progress 3

To  complement  MSD  in  the  procurement  &  distribuBon  of  medicines  by  engaging  private   sector   ²  Tender evaluation and Board Adjudication is completed . The offering will be announced any time from now ²  MSD is in a procurement process to engage a consultant for conducting feasibility study on local manufacturing Plant under PPP . ²  MOF have sources funding for the study 12

Health Commodities 4

5

Introduction of ICT mobile applications platform at lower level facilities for improved communication and data management in supply chain

Use of SMS to report stock outs and quality of health services by service users and civil society

Assessment of health facilities readiness to implement e-LMIS done in 6 districts (Serengeti, Busega, Chato, Kwimba, Kigoma and Muleba districts). ICT unit is working on analysis.

ICT Planning is on going

6 Scale up 5S-KAIZEN-Total quality Management (TQM) initiatives to improve inventory management from district level to lower health facilities level 5S -KAIZEN-TQM for health commodities manual and facilitators guide developed. Pending availability of funds, editing, pilot testing of the documents and translation into Kiswahili will be done prior to implementation 13

Agenda

Health NKRA Focus Area HRH Distribution Health Facilities Health Commodities RMNCH Funding Situation Anticipated Challenges Moving Forward AOB 14

RMNCH 1

2

Expanding (CEmONC services at strategically selected health centers and hospitals to serve as satellite sites Strategically selected dispensaries and health centers to provide full fledge BEmONC •  • 

Assessment for BEmOC, CEmOC was undertaken Identification of gasp per facility – Quality Improvement plans done Plans is to upgraded and constructed in one year and CHW will be undertaken in 5 regions between April-June 2015 Identification of needs per districts ongoing

•  •  • 

3 Develop integrated 360 Degree mass media campaign that can be multi sponsored through PPP • 

Conduct Rapid Assessment of Mass Media needs at the 5 regions

Mobilise Community Health Workers (CHW) to improve RMNCH services •  Assessment of CHW conducted •  Review of training materials (3 Wks Training) will be conducted on 9th to 21st Nov ember 2015 •  Work plan and Budget in place •  Training to follow up in December 2015 •  Appreciate the response to GOT request on commitment •  Request Support in Training CHW 4 Regional Satellite Blood bank facilities supporting CEmOC •  Reviewed Work plan •  To operationalize Kigoma na Mara •  Regional BB. •  To construct Simiyu 15

Initial Findings (2/3) 2

EmONC  assessment  completed  in  5  RMNCH  regions.  Final  results:  

Region

Number of CEmOC Facilities Number of BEmOC Facilities

Baseline Geita 2 Kigoma 4 Mara 3 Mwanza 7 Simiyu 1 Total 17

Target 12 23 22 34 14 105

Gap 10 19 19 27 13 88

Baseline 13 9 25 13 4 64

Target 56 100 113 123 61 453

Gap 43 91 88 110 57 389

16

IniBal  Findings  (3/3)   3 Community Health Workers (CHWs) •  Mapping was completed in Simiyu and Kigoma regions in July 2015, while the mapping for the other 3 regions of Mwanza, Mara and Geita was completed in Aug. Full Results :  

Target for CHW  

Baseline of CHWs  

# of New CHW to be trained  

Geita  

5,386  

1,598  

3,788  

Kigoma  

4,358  

1,424  

2,934  

Mara  

3,973  

2,074  

1,899  

Mwanza  

5,543  

4,318  

1,225  

Simiyu  

3,924  

3,390  

534  

23,184  

12,804  

10,475  

Region  

Total  

17

Agenda

Health NKRA Focus Area HRH Distribution Health Facilities Health Commodities RMNCH Funding Situation Anticipated Challenges Moving Forward AOB 18

Funding Situation

Funding source

Budget Estimated

Funds Disbursed

%

Expenditure

%

DANIDA

1,196,745,000

613,530,318

51%

613,530,318

100%

World Bank

1,194,364,440

1,194,364,440

100%

-

0%

Basket Funds

6,919,123,000

9%

632,575,000

100%

632,575,000 (funds from fy 2014/15)

UNICEF

432,567,900

432,567,900

100%

432,567,900

100%

Irish Aid

356,293,000

356,293,000

100%

356,293,000

100%

1,578,673,048

35,028,925

2%

35,028,925

100%

11,677,766,388

3,264,359,583

28%

2,069,995,143

63%

GovernmentOthers Charges

19

CCHP Preparation

•  Coordinator District Health Services and System Strengthening, •  Participated in the development of CCHP Plan guideline •  Activities for Fy 2016/17 included in the guide

20

Agenda

Health NKRA Focus Area HRH Distribution Health Facilities Health Commodities RMNCH Funding Situation Anticipated Challenges Moving Forward AOB 21

Anticipated challenges in implementation & mitigation measures Anticipated challenges Shortage of funds to implement all the initiatives Delayed disbursement to the Ministry, implementing agencies and to the LGAs Buy-in from all stakeholders for smooth implementation Have an interim MDU members, Very very helpful - However, they have also to attend other issues Election year – Competing priorities

Suggested mitigation measures Integrate budget into MTEF through government funding; identified funding gaps to be negotiated from the partners for respective LGAs To streamline the disbursement of funds at central level to LGA Continuous communication and syndication with all levels of stakeholders to galvanize support for BRN, Advocacy at national level Continuous communication with PDB to fill the posts In some cases have to wait work on issues that do not require implementation 22

Agenda

Health NKRA Focus Area HRH Distribution Health Facilities Health Commodities RMNCH Funding Situation Anticipated Challenges Moving Forward AOB 23

Moving forward

1

Complete baselining exercise and finalize the KPI and targets for BRN for the 3-year timeframe

2

Onboarding PMORALG staff – MDU & health department – 10 – 12 December

3

Finalization of KPI’s & Start Tracking the results

4

Source for additional funding required to fund the gap for unfunded & underfunded initiatives

5

Frequent communication between MDU-PMORALG, PDB and Project Implementers on implementation details, updates and issues.

What we would like from you

A

Full support and commitment from in realizing the implementation & to inform and escalate to MDU & PDB on any issues, roadblocks and risks

24

Healthcare NKRA contact details

MDU

Interim MDU

PDB Team

Dr. Adeline Saguti-Nyamhiwura Ministerial Delivery Unit [email protected] 0753545166

Dr. Rosina S M Lipyoga Ministerial Delivery Unit [email protected] 0754294554

Dr. Joseph Hakororo MDU Liaison [email protected] 0767314190

Mr. Andrew Makoi MDU Liaison [email protected] 0754260883

Mr. William Reuben MDU Liaison [email protected] 0784254572 Dr. Linda Ezekiel Director, Social Sector [email protected] 0754290499

Azlin Niza Ismail Social Sector [email protected] 0785447843

Abdul Muiz Abdul Aziz Healthcare NKRA [email protected] 0687966998

Nasrul Yusuf Healthcare NKRA [email protected] 0785447381 25

BEMOC & CEMOC Assessments Results

26

26

InsBtuBonal  Delivery   107  

120  

85.9  

81.9  

71.6  

51   25.2  

46.4  

%  Delivery  in  HF   %  Delivery  in  fully  funcBonal   EMONC  HF  

14  

22.6  

27.6   10.7  

11.6  

20  

28.4  

40  

58.8  

50.6  

60  

62.7  

80  

60.9  

100  

0  

27  

27

Causes  of  Maternal  Deaths  in  Study  Zones  

Other  indirect   causes   4%   Abor0on   19%   Anemia   12%  

Malaria   8%  

Hemorrhage   29%  

Sepsis   7%  

Obstructed   labour   13%  

Hypertensive   disorders   8%   28  

28

In which HF level were maternal deaths occurring (Figures in %)? 28  

Tabora  

37   35   92.4  

Simiyu  

7.6   72.7  

6.1  

Shinyanga  

21.2   22.4  

8.7  

Mwanza  

Health  Centre  

18.0  

Mara  

75.3  

6.7  

Kigoma  

48.6  

13.5  

Geita  

37.8   46.0  

0   0  

10  

20  

Hospital  

39.3   39.3  

21.4  

Kagera  

Dispensary  

68.8  

30  

40  

50  

54.0  

60  

70  

80  

90  

29  

100   29

Asante Sana

30

Smile Life

When life gives you a hundred reasons to cry, show life that you have a thousand reasons to smile

Get in touch

© Copyright 2015 - 2024 PDFFOX.COM - All rights reserved.