Case stories on capacity development and sustainable results

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32 Capacity: ResultsEnhanced performanceThese results are premised on a seriesof capacity development interventions,including: the professional training ofhealth technicians and administrativestaff; the introduction of an integratedpackage of preventive, primary, and specializedhealth care; the sensitization ofthe general population through an educationcampaign and the introduction oftelemedicine.A network of two hospitals, six healthcentres, 28 health posts, and 17 communityhealth units has been strengthenedthrough significant investments in thetechnical capacities of health workers. Theprofessional qualifications of health techniciansand administrative staff at centraland district levels have been enhancedby theoretical and practical training initiatives,held in São Tomé and PríncipeCapacity development investmentsProfessional training of health technicians andadministrative staff.The introduction of an integrated package ofpreventive, primary, and specialized health care.The sensitization of the general populationthrough an education campaign.The introduction of telemedicine.and in Portugal. Investment indeveloping professional managementand planning capacitieshas brought significant improvementsin the quality and deliveryof services.All health units are now providinga decentralized integratedpackage of preventive, primaryand specialized health care services,including family planning,maternal and child care and others.Demand for such servicesis stimulated by education campaignsconducted at the community level.Health Delegates monitor the implementationof the package through inspectionand the application of monitoring tools.The accuracy of data collected at districtlevel and reported to the Ministry ofHealth has also been enhanced. A coordinationunit, which acts in the capacity of aCentral Pharmacy, takes orders from andprovides stocks to health centres, applyingfixed cost recovery prices. A Ministryregulation (Despacho nº 10/GMS/2009)has determined a financial penalty forphysicians, nurses, district officers andtechnicians who do not comply with theguidance provided by the Health Districtcoordination unit.Emerging medical needs made clear thenecessity of an approach that allows swifterand more suitable solutions for morecomplex care provision, the decrease in thenumber of evacuated patients to Portugaland the promotion of local competences.In 2011 the project launched the Telemedicine:health information and communicationtechnology bring together São Toméand Príncipe’s Central Hospital and Portuguesemedical experts of all specialties.Telemedicine breaks the isolation to whichthe country and the medical practice havebeen confined to, and incorporates themin a network of experienced professionalsand state of the art techniques and
São Tomé e Príncipe33technology. Portuguese doctors can nowprovide long distance training and directsupport to São Tomean doctors for themanagement of medical cases. Telemedicinerepresents a strategic and an innovativeinstitutional arrangement for the deliveryof health services.The system has also been provided withadequate equipment, medicines, analysislaboratory, and an improved infrastructure.Support to the capacitydevelopment processNational investmentsLeadership and the big push for changehave come from the Ministry of Healthand Social Services and the district healthcentres.The Ministry of Health and Social Serviceshas retained the major responsibilityfor managing and implementing the programme’sactivities, facilitating communicationsbetween local and central actors,upgrading procedures and monitoringprogress. The Ministry has invested inits district management through training,structured tools, inspection, and informationroutines and equipment to upgradethe Health Delegates capacities.Find out morePlease contact Dr. Ahmed ZakyProject Director at IMVFEmail: azaky@imvf.orgPhone: + 351 96 622 84 49Web: www.imvf.orgDevelopment partners’ supportManagement consultants from IMVFworked with the Ministry of Health andSocial Services to provide technical assistanceto health units’ management. Theyalso arranged staff and health agents’training programmes, mostly using thepublic health system’s own capacity.The Portuguese High Commissioner forHealth has recognized the intervention’s“public interest”. That allows experts fromthe Portuguese Ministry of Health to provideassistance to São Tomé and Príncipefree of charge.IMVF played a supporting role in theproject’s design, in establishing bridgeswith local partners, and in coordinatingbetween health specialists and representativesof the governments of São Toméand Príncipe and Portugal.
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