program management at District level some lessons for PHC The PHC Improvement Global Stakeholder meeting 68 April Geneva Dr Geoffrey Bisoborwa AFRO FRH RO Dr ID: 815662
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Slide1
Using Data to strengthen disease program management at District level : some lessons for PHC
The PHC Improvement Global Stakeholder
meeting, 6-8 April, Geneva.
-
Dr.
Geoffrey
Bisoborwa,
AFRO
FRH, RO
Dr.
Prosper
Tumusiime, AFRO
HSS, ICT ESA,
Dr
. Tarcisse
Elongo,
AFRO
HSS, RO
Slide2Outline Regional Declarations of Importance to HIUsing Data: Examples from the fieldLessons for PHCConclusion
Bibliography
Slide3Regional Declarations of Importance to HI (1/2)
Lack of policy/strategy or policy/strategy not adapted,Unavailability/ not timely of relevant health information (HI) and poor quality of HI,Low use of results from analyze to inform decision making,Lack or under-funding to support the implementation of Health management information system (HMIS)
What are the problems?
Slide4Regional Declarations of Importance to HI (2/2)
AFR/RC65/5 :
Alger Declaration, 2009
AFR/RC58/R3 :
Ouagadougou Declaration, 2008
AFRO orientations
AFR/DHS/03.06 :
To assess the District Health Systems,
Slide5Using Data: Examples from the Field (1/13)
Integrated community case management
to tackle the childhood
Policy dialogue/
stakeholder
s
at HD level to improve PHC performances
Improving of the EQUITY, reach each District-RED shift to REC (
Community
Planning
tools
to strength the DH approach
Using
TIC for improving data quality
et facilitation of
analyze
5 selected countries
Slide6SENEGAL : Integrated community case management
of childhood disease (2/13)
Slide7TOGO : Policy dialogue to strengthen local health system
(LHS), HD Golfe and Kloto (3/13)
Slide8Year
HD/ Indicators
2012
2013
2014
KLOTO
AGOU
PLAT.Rg
KLOTO
AGOU
PLAT.Rg
KLOTO
AGOU
PLAT.Rg
ANC3+
coverage
35%
28%
33%
47%
29%
36%
54%
30%
42%
Availability
rate of
Ess
.
Medecines
88%
88%
85%
95%
86%
89%
98%
85%
83%
TOGO
: Policy dialogue to strengthen local health system
(LHS), Kloto HD
(4/13)
Performance
indicators
(vaccination and essential
medecines
) in Kloto HD, Togo, 2012-2014
Slide9ZAMBIA : Implementation of RED approach to
reach all unvaccinated children (5/13)
Slide10Immunization charts produced under the RED strategy
in Zambia (2005)HD stratification based on Penta 3 coverage
ZAMBIA
: Implementation of RED approach to
reach all unvaccinated children
(6/13)
Slide11TANZANIA : Tanzania Essential Health Interventions
Project (TEHIP) in Rufiji and Morogoro HD (7/13)
Slide12Reversing the trend in child mortality after district-level health system interventions in Tanzania
TANZANIA : Tanzania Essential Health Interventions Project (TEHIP) in Rufiji and Morogoro HD
(8/13)
Slide13TANZANIA : Funded of Health care function in Zanzibar
(9/13)Prevention
remains underfunded
!!!
Slide14KENYA : Using of electronic data in TB care
(10/13)
Slide15KENYA : Using of electronic data in TB care (11/13)
Slide16KENYA : Distribution of Total Health Expenditure (THE) by major diseases/Conditions, 2013 in Kenya
(12/13)Used of largest share of resources for health - HIV/AIDS
(18.7%),- Reproductive health (12.9%),
-
Malaria
(9.8%),
- Respiratory infections (6.5%),
- Vaccine-preventable diseases (6,3%),
- NCD (6.2 %).
Slide17Health Management Information Systems and DHIS2 (13/13)
Real time update of data
using maps and graphs
Slide18Lessons for PHC (1/3)Involvement of all stakeholders in the operational planning process and monitoring
of the effectiveness of implementation contributes to improved performance indicators of the health system locally,Keeping the community actively involved in use of data in planning and implementation activities, such as defaulter tracing, appears to foster ownershipAs communities share and use information collected locally, they own the information, become confident, motivated and committed to participate in exploring solutions to their challenges
Evidence-based planning, allocation and good tracking of resources utilization result in cost-effective dividends, Under the RED strategy, development and use of micro-plans, maps, review meetings and wall monitoring charts facilitated the use of data for action.
Slide19Lessons for PHC (2/3)Functional network of dynamic CHWs engaged in service delivery (for a specific program) to remote households offers an opportunity to improve the package
offered to improve health coverage of communities,Use of ICT in the management of HMIS at operational level enables a rapid transmission of data to central level should not exclude analyze of these data at operational level to improve the work,Poor
data quality leads to poor decisions and could misguide health programsGood quality and reliable data is not cheap
Slide20Lessons for PHC (3/3)
Slide21Dashboard HMIS at HD level ?
DHMT
HMIS
Operational
manuals,
Available
tools
(Form, registers
...)
Efficient
equipment
(mobile phone, computer,
others logistic..)
Operational
mechanisms of
data reliability
,
Effective
data analysis
to inform decision making,
Data
dissemination
(activity reports) and
documentation
Involvement of all stakeholders,
Dynamic District Health Management Team (DHMT),
Work
plan in line with the
National Health Plan
,
Slide22ConclusionEvidence based planning and programing renders programs cost-effectiveEstablishment and use of community based health information with direct involvement of communities tends to enhance ownership and uptake of health servicesTimely availability of quality data is critical for planning and tracking progress of health program towards achieving universal health coverage that underpins PHCHowever, quality of data is a challenge
in most cases in countries in the African Region (weak HMIS and parallel health information systems)Effective data analysis by the level (community, Health Facility,..) that produced them is a pledge of quality of these data,Use of health data facilitates effective service delivery, decision making, and evaluation of programs
Slide23BibliographiesWHO-AFRO, Tools for assessing the Operationality of District Health Systems, Guidelines, 2003.WHO – AFRO, Ougadougou Declaration on Primary Health Care and Health Systems in Africa : Achieving Better Health For Africa in the new Millennium, 2008WHO-Geneva, The World Health
report 2008: Primary Health Care, now more than ever,AFR/RC59.9.5, June 2009, Alger declaration framework on health research in African Region,WHO-Geneva, The health of people , what works, The African Regional Health Report, 2014,WHO-AFRO, UE-WHO joint program on policy dialogue in selected countries, annual report 2015,WHO database; 2016: National Health accounts : http://apps.who.int/nha/database/DocumentationCentre/Index/en
Slide24Thank YouMerciObrigrada