Family Health Team (FHT) in UNRWA

Akihiro Seita Director of Health, UNRWA: a.seita@unrwa.org

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When Fatima, Mohamed & their children go to the health center

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Pharmacy

Clerk room

LaboratoryPre & Post natal care

General clinic (Dr’s office)

Growth monitoring & Immunization

NCD clinic(DM+HTN)

Oral health (dental)

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Family planning

Dres

sing

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Pharmacy

Clerk room

Laboratory

When Fatima, Mohamed & their children go to the FHT health center

Oral health (dental)`

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Family planningFamily Health Team

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UNRWA’s Family Health Team (FHT) Rapid expansion

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Oct-11 Jan-12 Apr-120

100,000

200,000

300,000

400,000

500,000Registered refugee populations with FHT

SyriaJordanWest BankLebanonGaza

(6)

(2)(2)(1)

(3)

(2)(1)

(1)(1)

Note: No. in brackets = No. of health centers with FHT approach

(1)

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Changes that UNRWA’s FHT brought Excitement & innovations in all Fields

5Proud teams!

Lebanon

Gaza

West Bank

Jordan

Syria

All chiefs for Field Health Programs

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Changes that UNRWA’s FHT brought Excitement & innovations in all Fields

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Paint each FHT differently!

And even files!

E-health with appointment system!

Health messages WITH communities!

Painted by community

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Changes that UNRWA’s FHT broughtPatients and Staff are satisfied

PATIENT: Satisfaction with FHT?

PATIENT: More confident in FHT?

STAFF: difference in role after FHT?

STAFF: FHT is better care?

72%

84%

64%

27%

28%

14%

27%

63%

Patients & staff satisfaction survey (B/Hanoun HC, Gaza)

Satisfaction level

(big difference) (difference)

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Dr A Dr B Dr C0

20

40

60

80

100

120

No. of patients per doctor a day before FHT (Beirut

PC)

Changes that UNRWA’s FHT broughtImproved efficiency in services

Dr A Dr B Dr C0

20

40

60

80

100

120

No. of patients per doctor a day after FHT (Beirut PC)

(July 2011) (January 2012)

General clinic

NCD clinic

MCH

Team 1

Team 2

Team 3

Estimated expenditures for Family Health Team expansion to date (USD in 1,000)

Additional donor funds

Relevant existing funds

Total

For overall facilitationHeadquarters 375 50 425sub-total 375 50 425

For health center supportWest Bank (3) 67 15 82Gaza (6) 100 100Lebanon (2) 50 50Jordan (1) 6 9 15Syria (1) 20 20sub-total 73 194 267

Total 448 244 692

Note: Average expenditure per HC was USD 21K (USD 267K for 13 HC), of which USD 15K were from the existing funds (GF, project, etc).

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What we learned / produced with Family Health Team

• FHT is doable– From 2 HC to 13 HC in 6 months, and now in all five fields

• FHT shows potential efficiency gain– Improve performance (e.g. efficient use of staff time)– Minimum additional expenditure (e.g. USD 21K / HC),

and – Strengthen evidence based intervention (e.g. e-health)

• FHT is well appreciated by refugees & staff

• VISON: FHT All Over by 2015– All Palestine refugee families will have their own family health team

by 2015

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What we need to do next with Family Health Team

• FHT full costing exercise– Complete by Ad Com (ongoing)– Define major expenditures: e-health infra & training

• FHT quality and efficiency target– Conduct diabetes e-health analysis & clinical audit– Explore efficiency gain in medicine procurement

• Systems development for FHT sustainability– Empower health centers as cost centers– Develop continuous education for family medicine