MP DAN KIMOSHO HOSTS DR DIANA ATWINE PS MINISTRY OF HEALTH OVER LIMITED HEALTH SERVICES IN KAZO DISTRICT

By Goodluck Musinguzi

Kazo District is two years old created and operationalized on 1st July 2019 with very limited health services yet it serves a big population. Three other new sub-counties are without health center IIIs according to area MP Dan Kimosho in a letter requesting a needs assessment tour.

Dr. Diana Atwine, Permanent Secretary Ministry of Health replied Hon Dan Kimosho promising to visit and undertake a familiarization and needs assessment visit of Kazo County, Kazo district.

She has developed a standard template where a needs assessment is done.

1- Leadership and Governance: This module requires the Permanent Secretary and team to interview the in-charge of the health facility, observation of the notice boards, minutes of scheduled meetings, facility work plan and budget,
supervision, HUMC or Hospital Board Guidelines, and support supervision reports/file. The assessment is to establish whether facilities have basic management systems in place include community representation.

2-Human Resources for Health: The standards in this module refer to human resource management and development and shall require an interview with the In-Charge of the facility for HC IV and below and the Personnel Officer for hospital level.

These shall prepare the relevant documents including the current staffing list indicating the staffing levels against the norms, attendance registers, copies of the duty rosters for all work areas, human resource management guidelines, CPD plan, and training database.

Have the service providers, received periodic continuing education on relevant topics, and how recently has training occurred? They shall also provide access to the staff appraisal forms and job descriptions for verification.

The Supervisors shall observe the work environment to verify the provision of resting rooms and teas for staff on duty. Aspects of reward and sanctions shall be verified through the minutes of the rewards and sanctions (disciplinary) committee or facility reports.

3- Health Financing: The standards in this module shall be assessed from the Accounts Department in the case of the hospitals and HC IVs whereas in lower facilities in-charges shall provide the necessary documents and respond to these issues.

The Supervisors shall inspect the notice boards to establish whether facilities have basic financial management systems in place.

4-Health Information: The standards in this module refer to aspects of data management at the health facility. Are routine information systems up-to-date and able to provide basic client and service provision data?

The Health Information Officer or Health Information Assistant shall be interviewed and will be responsible for providing the necessary reports and database for review.

The Supervisors will verify the availability and use of the HMIS tools (manual, registers, and forms), availability, and use of computers for data management at HC IV and above.

They shall also assess data accuracy and reporting, availability of performance indicators with targets and data use at the health facility.

5- Medicines, Health Supplies, Vaccines, and Equipment: The standards in the module refer to the management of medicines, vaccines, and health supplies at the health facility. It also assesses the availability of vaccines, tracer medicines, tracer equipment, and tracer diagnostics.

The Pharmacist, Dispenser, Laboratory staff or Inventory officer at HC IV and Hospital level, and the Health Facility Incharge and Inventory management officers at lower levels (HCII and HCIII) shall be interviewed and shall
be responsible for providing the stock cards, dispensing logs, order forms, copies of the procurement plan, and delivery notes.

The responsible officer will provide access to the store for medicines and diagnostics for inspection and verification of the medicines and health supplies. Inspection of EMHS is for selected tracer items based on the following criteria;

The current tracer list of medicines was defined collectively for the entire sector performance and includes specific and high volume products representing the areas contributing to the heaviest burden of disease
or prevention in the country and they include EPI (immunization program), HIV/AIDS, malaria, Tuberculosis, Reproductive health, general essential medicines diagnostics, and other non-medicinal products including diagnostics and lab commodities.

Address the priority health needs of the population/burden of disease (be most important therapeutically and included in the applicable standard treatment guidelines) Be included in the National Essential Medicines List or formulary Be adequate for the target level of care (mostly specified as outpatient treatment at primary care level).

Be the most widely used amongst alternatives (availability is expected to be 100% and medicines not commonly used should be excluded) Preferably to be part of the 31 tracer commodities. The Cold Chain Technician or Facility EPI Focal Person shall respond to the aspects related to proper cold chain and vaccines supply management. The In-Charge of the facility shall be responsible for providing the comprehensive health facility inventory and the
Supervisors shall visit the respective service delivery areas (OPD, Immunization, FP, Nutrition, Antenatal, Maternity, and Theatre) to verify the availability and functionality of the tracer equipment.

The Supervisors shall interview the Laboratory Technician or Assistant and conduct observations in the Laboratory regarding the availability of all the tracer diagnostics. This module shall also establish the specific equipment
and diagnostics available for meeting various levels of service delivery. Are the equipment and diagnostics required to provide the services meeting the minimum standard, present, functioning, and in the appropriate location for use during service provision? Are there systems for maintaining adequate
availability of medical equipment and diagnostics (inventories; appropriate storage, equipment maintenance, and repair/ replacement systems)?

 

6-Health financing: The standards in this module shall be assessed from the Accounts Department in the case of the hospitals and HC IVs whereas in lower facilities in-charges shall provide the necessary documents and respond to these issues. The Supervisors shall inspect the notice boards to establish
whether facilities have basic financial management systems in place.

 

7- Health information: The standards in this module refer to aspects of data management at the health facility. Are routine information systems up-to-date and able to provide basic client and service provision data? The Health Information Officer or Health Information Assistant shall be interviewed and will be responsible for providing the necessary reports and database for review. The Supervisors will verify the availability and use of the HMIS tools (manual, registers, and forms), availability, and use of computers for
data management at HC IV and above. They shall also assess data accuracy and reporting, availability of performance indicators with targets and data use at the health facility.

8-Medicines, health supplies, vaccines, and Equipment: The standards in the module refer to the management of medicines, vaccines, and health supplies at the health facility. It also assesses the availability of vaccines, tracer medicines, tracer equipment, and tracer diagnostics.

The Pharmacist, Dispenser, Laboratory staff or Inventory officer at HC IV and Hospital level, and the Health Facility Incharge and Inventory management officers at lower levels (HCII and HCIII) shall be interviewed and shall be responsible for providing the stock cards, dispensing logs, order forms, copies of the procurement plan, and delivery notes.

The responsible officer will provide access to the store for medicines and diagnostics for inspection and verification of the medicines and health supplies. Inspection of EMHS is for selected tracer items based on the following criteria;

The current tracer list of medicines was defined collectively for the entire sector performance and includes specific and high volume products representing the areas contributing to the heaviest burden of disease
or prevention in the country and they include EPI (immunization program), HIV/AIDS, malaria, Tuberculosis, Reproductive health, general essential medicines diagnostics, and other non-medicinal products including diagnostics and lab commodities Address the priority health needs of the population/burden of disease (be most important therapeutically and included in the applicable standard treatment guidelines) Be included in the National Essential Medicines List or formulary Be adequate for the target level of care (mostly specified as outpatient treatment at primary care level).
Be the most widely used amongst alternatives (availability is expected to be 100% and medicines not commonly used should be excluded) Preferably to be part of the 31 tracer commodities. The Cold Chain Technician or Facility EPI Focal Person shall respond to the aspects related to proper cold chain and vaccines supply management.

The In-Charge of the facility shall be responsible for providing the comprehensive health facility inventory and the Supervisors shall visit the respective service delivery areas (OPD, Immunization, FP, Nutrition, Antenatal, Maternity, and Theatre) to verify availability and functionality of the tracer equipment. The Supervisors shall interview the Laboratory Technician or Assistant and conduct observations in the Laboratory
regarding the availability of all the tracer diagnostics. This module shall also establish the specific equipment and diagnostics available for meeting various levels of service delivery. Are the equipment and diagnostics required to provide the services meeting the minimum standard, present, functioning, and in the appropriate location for use during service provision? Are there systems for maintaining adequate availability of medical equipment and diagnostics (inventories; appropriate storage, equipment maintenance, and repair/ replacement systems)?

Health Infrastructure: The Supervisors shall inspect all the external and internal environment of the health
facility; specifically, the compound, OPD, RMNCAH, Wards, Latrines/Toilets/Bathrooms. They shall
interview the In-charge of the facility about the availability of a clean water source, reliable power supply
and functionality of the referral system and emergency services. The objective is to establish availability
of the basic systems and infrastructure that may impact utilization and capacity to provide standard level
services?
Reproductive, Maternal, Neonatal, Child and Adolescent Health: The Supervisors shall assess the
RMNCAH services. This module involves actual observation of client consultations with health workers to
assess technical competence. Do protocols and standards of practice for each service meet generally
accepted quality standards for basic as well as advanced level services at referral facilities? Do providers
adhere to the standards of practice for service delivery?
Clinical Care, Surgical Care, Referral, and Emergency Services: The processes assessed through
observation in this module include functionality of the health education program, availability of trained
personnel and current guidelines. The supervisors also assess the technical competences through
observation of procedures using checklists. If a health facility has more than one in-patient ward, the
Supervision team will randomly choose one in which to conduct the assessment. There are opportunities
when a Supervisor can assess several standards during one clinical observation. If Supervisors are not
able to observe the required number of cases for clinical observations during their time at the health
facility, then they will make all possible efforts to complete the assessment on the next day or the closest
possible date. The scoring section for Clinical Observations will not be completed until the required client
consultations are evaluated. Thus, it is vitally important that the Supervisors arrive early to have an
opportunity to observe all clients who attend the facility if it is a slow day.
Diagnostic Services: The Supervisors shall assess the availability of trained staff and guidelines in the
laboratory and radiology departments. This will be through observations of the training database and
interview with the laboratory personnel. They will also assess the functionality of the referral system and
a Laboratory Quality Management System (LQMS).
Client Centered Care and Safety: The standards in this module refer to the aspects of client centeredness
and safety. The Supervisors shall observe the facility for signage, client flow and provider practices in
terms of client provider interactions, infections prevention and control practices, occupational health and
safety in the OPD and RMNCAH clinics. The Supervisors shall interview 2 to 5 clients and 2 to 3 health
workers per facility about the clients’ rights and responsibilities. The Supervisors shall also verify use of
client feedback mechanisms at the health facility.

 

 

About Musinguzi Goodluck

Check Also

OPINION:THE RETURN OF THE PRIMITIVE: THE CASE OF SSEWANYANA, SSEGIRINYA

The return of the primitive: the case of Sewanyana, Segirinya, and company By Jonah Ruhima …

Leave a Reply

Your email address will not be published. Required fields are marked *