engaging district leaders in health system strengthening · 1 engaging district leaders in health...
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Engaging District Leaders in Health System
Strengthening
4th Global Human Resources for Health Conference, Dublin
November 15, 2017
Mirwais Rahimzai
Regional Director
East Africa
USAID ASSIST
USAID Applying Science to Strengthen and Improve Systems
Kaliro District- Uganda
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Population: 255,047
# of Health Facility: 21
HIV Prevalence: 4.4%
Access to safe water: 68%
Latrine converge: 80%
Staffing: 86%
SBA deliveries: 34%
USAID Applying Science to Strengthen and Improve Systems
Kaliro district health system (21 HFs): HCIV: 1 HCIII: 6 HCII: 14
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USAID Applying Science to Strengthen and Improve Systems
Kaliro district health system: 21 Health Facilities
Patient load and staffing(Doctor, Clinical Medical officer, Anesthetist, Laboratory Technician, Nurse, Midwife)
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OPD IPD
1584 116
OPD IPD
1191 75
OPD IPD
1490 468
OPD IPD
2366 211
OPD IPD
1291 62
OPD IPD
1215 57
OPD IPD
452 363
Doct 3
CMO 4
Ane 1
Lab 2
Nur 14
CMO 4
Lab 2
Nur 7
CMO 3
Lab 3
Nur 7
CMO 2
Lab 2
Nur 8
CMO 2
Lab 2
Nur 7
CMO 2
Lab 2
Nur 5
CMO 2
Lab 2
Nur 6
USAID Applying Science to Strengthen and Improve Systems5
OPD IPD
1584 116
OPD IPD
1191 75
OPD IPD
1490 468
OPD IPD
2366 211
OPD IPD
1291 62
OPD IPD
1215 57
OPD IPD
452 363
Doct 3
CMO 4
Ane 1
Lab 2
Nur 14
CMO 4
Lab 2
Nur 7
CMO 3
Lab 3
Nur 7
CMO 2
Lab 2
Nur 8
CMO 2
Lab 2
Nur 7
249 138 211 471
324 611 403
249 815
561
167
622 728 190
Nu 1
MW 1
HA 1
NA 1
Nu 1
MW 2
HA 1
NA 1
Nu 3
MW 2
HA 1
NA 3
Nu 3
MW 0
HA 1
NA 3
CMO 2
Lab 2
Nur 5
CMO 2
Lab 2
Nur 6
Kaliro district health system: Staffing and Monthly Patient Load
(Doctor, Clinical Medical officer, Anesthetist, Laboratory Technician, Nurse, Midwife)
OPD: Out Patient Department IPD: In-Patient Department
USAID Applying Science to Strengthen and Improve Systems
Meeting with District Leaders: August 2015
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USAID Applying Science to Strengthen and Improve Systems
Achievement!Improving availability of Human resources for Health
18.419.8
5.4
9.8 9.5 8.67.2
0
5
10
15
20
25
Jan Feb Mar April May June July
A graph showing staff absenteeism rate at four high volume HFs in Kaliro
District (Jan-July 2017)
25.5 25.6
14.3
12.3
10.49.3
6.7 6.9
JAN FEB MAR APR MAY JUN JUL AUG
% Health worker absenteeism across five Ugandan Districts of Lira, Lamwo, Kaliro,
Ngora and Mbale; Jan-Aug 2017
USAID Applying Science to Strengthen and Improve Systems
Changes introduced by the district leadership:
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Redistribution:
1 Midwife
1 Nurse
1 Health Assistant
5 Promotions
1 Nurse
2 Health Assistant
1 porter
1 Lab Tech
Job
advertisement
2 Midwife
3 Nurse
4 Porters
Absenteeism
Issued directive
Created file box
Data analysis
Motivation
Rewards
Timely salaries
Timely
confirmation
- SBA deliveries from 34% to 41%
- 6 high level advocacy meetings held
by district leaders.
- Availability of medicine improved-
Stock outs reduced significantly
- Other progresses
