Empowering Health Workers_Alison Annette Foster_10.17.13
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The document summarizes efforts to improve health workforce performance and systems at the district management level in Tanzania. Key health indicators related to HIV/AIDS treatment improved dramatically from 2010 to 2011. The role of district management was strengthened across six domains including management, supply chains, planning, and human resources. Initiatives like improved orientation for new staff led to substantially higher retention rates. Lessons highlighted the importance of empowerment and how district management intersects with health systems strengthening. Next steps focused on continuing quality improvement and exploring their role as change agents.
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 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
Editor's Notes
- #6: 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)
- #7: Notice that we have the ordering because they are not able to effect the outcome.
- #8: Job Fairs and Stage support Welcome Package Using the time they go to
- #9: Job Fairs and Stage support Welcome Package Using the time they go to