LHW Systems Review - Oxford Policy Management

More documents

Recommendations

Info

LHWP – Systems ReviewChange/addition tocurriculumIn 2006, the LHWPrevised the whole MISmanual andincorporated thechange into the BasicCurriculum of LHWsand LHSs (2007).Change mechanism:response from the trainingdivision on what stimulatedthe revisionRevision of the MIS wasbased on the changes in theLHS/LHW curriculum.Additional indicators wereadded, based on the LHWmanual (e.g. number ofantenatal visits, registerednumber of pregnant women,children aged 0–35 months,maternal mortality ratio, etc).LHWs were involved in TBDots. The indicator for thisactivity was introduced.Indicators of Initiation of BF,SBA, and the number of ANCvisits were also included.The denominator of tetanustoxoid vaccination, the numberof ANC visits denominator waschanged from all pregnantwomen to all womendelivered.Non-drug items (e.g. weighingmachines, torches, etc.) hadnot previously been recordedin the MIS. They wereintroduced to recordavailability and functionality.Was therepiloting?No pilotingHow and whenwas the changeimplementednationwide?New recruit in theLHWP receivetraining onrevised manual.All workingLHWs receivedthe refreshertraining. NewLHSs receivedtraining on therevised manual.All working LHSshave 12 days’mandatoryrefresher trainingon the new MISmodule for LHSincorporated inthe BasicCurriculum 2007.Four days’training onrevisedcurriculum in2007, and againin 2008 and 09.Is it integratedinto thesupervision/inspectionmechanisms?YesRefresher training was given greater emphasis after the 3rd Evaluation, and included as a requirement inthe PC-1Counselling cardsYesChild Survival andChild Health Modulebased on CommunityIMNCI (initiatives byUNICEF and WHO).Nutrition manualThis initiative was based onthe findings of 3rd Evaluation,where weak counselling skillswere identified.The LHWP felt the need toprovide job support to theLHWs to help them incounselling.The 3rd Evaluation of theLHWP suggested that the useof charts was insufficient, andit was suggested that a tool beintroduced.UNFPA introduced theintervention at LHW level, asthe IMNCI skills were presentat the first-level health facility,but not at LHW level, so it waspiloted at LHW level.The National Nutrition SurveyReport suggested thatnutrition is an important andcross-cutting issue; however,the indicators were not good,which is why this training wasPiloted in2003/04 inSave theChildrendistricts,followed byUNICEF andUNFPAdistricts.Replicated in2005/06throughoutthe country.Piloted byUNFPA andUNICEF in2004/05.Replicated in2005–08.No pilot.Training ofLHWsconducted in2005.YesIt was alreadycovered insupervisorychecklist.80
AnnexesChange/addition tocurriculumInjectablecontraceptivesOBSI moduleUse of InformationCourse, for managersat the district andprovincial levels, andFPOsDistrict supervisionand monitoring formanagers at districtand provincial levels,and FPOs.Source: LHWP, MoH.Change mechanism:response from the trainingdivision on what stimulatedthe revisioninitiated.A theoretical training wasprovided on the micro- andmacronutrients. No practicaltraining was imparted. It wasundertaken by the Nutritionwing of the Ministry of Health.The LHWP was not involved.In the Maternal NeonatalTetanus (MNT) campaign withUNICEF in 2001–02, theLHWs were trained onintramuscular injection (IM).The evaluation of the MNTcampaign showed that anLHW can safely give IMinjections.The LHWP then thought thatLHWs could deliver injectablecontraceptives. This would:increase client choices andincrease the acceptance ofthe LHW, as well ascontraceptives, at communitylevels (according to theliterature review), and ensurethe visit of the client to thehealth facility once a year.New concept introduced byUSAID, and there was changein the definition of familyplanning as the concept ofbirth-spacing of 3 years,instead of contraception, wasintroduced.MIS report from districts werenot being fed back properly,hindering planning andcorrective action planning.Initiated in 1999. It wasdesigned as a middlemanagement-levelcourse,and included job descriptionsand use of checklists. Thepurpose was to provide newmanagers with the skills tosupervise and inspect theProgramme in the field.Was therepiloting?The pilotstudy wasfunded byUNFPA in2005/06 anddesigned totest LHWskills indelivering IM.Piloted in 10districts ofCatalystconsortium in2004/05.Implementedinitially inUNFPAdistricts,followed byUNICEFdistricts. (1)How and whenwas the changeimplementednationwide?Replicatedthroughout thecountry in2006/07. AllLHWs are trainedbut, as yet, noinjectablecontraceptiveshave beenprovided.UNFPA provided3 month’ initialsupply. 87Replicated in2007/2008.Is it integratedinto thesupervision/inspectionmechanisms?Included inLogistics listOnly CPR isseen in theLHS/FPO report.Part of thechecks on familyplanningservices.2004/05 Replicatedthroughout thecountry. Someparts of Sindhstill to becovered.Implementedfrom 1999.Updated in 2007.Not monitored orevaluated.Note: (1) UNICEF districts and UNFPA districts refer to the districts where these development partners sponsorprogrammes.87There is no approval given for the purchasing of injectable contraceptives in the PC-1. The Planning Commission gaveassurance that funds would be available from November 2008. However, they have yet to be released.81
Page 3 and 4:
Lady Health Worker ProgrammeExterna
Page 5:
AcknowledgementsThis evaluation of
Page 8 and 9:
LHWP - Systems ReviewThe Management
Page 10 and 11:
LHWP - Systems Review• Contributi
Page 12 and 13:
LHWP - Systems Review• External c
Page 14 and 15:
LHWP - Systems Review• Over-relia
Page 16 and 17:
LHWP - Systems Review8 Performance
Page 18:
LHWP - Systems ReviewTable C.2 Stra
Page 21:
RPIURs.SCF-UKSCF-USSNIDsSoEsTAMATB-
Page 24 and 25:
LHWP - Systems ReviewTo do this she
Page 26 and 27:
LHWP - Systems Review• LHW appoin
Page 28 and 29:
LHWP - Systems Review2.2 System per
Page 30 and 31:
LHWP - Systems Review3.1 Systems an
Page 32 and 33:
LHWP - Systems ReviewTable 4.1YearP
Page 34 and 35:
LHWP - Systems Reviewto remain unch
Page 36 and 37:
LHWP - Systems ReviewTable 4.7Numbe
Page 39 and 40:
Training system5 Training system5.1
Page 41 and 42:
Training systemTraining delivery is
Page 43 and 44:
Training systemTrainer’s database
Page 45 and 46:
Training systemTable 5.2Percentage
Page 47 and 48:
Training systemTransfers of trainer
Page 49:
Training system8. Quality of traini
Page 52 and 53: LHWP - Systems ReviewThe forecast f
Page 54 and 55: LHWP - Systems ReviewFigure 6.2Outl
Page 56 and 57: LHWP - Systems Review6.4 System per
Page 58 and 59: LHWP - Systems Reviewo The minutes
Page 60 and 61: LHWP - Systems ReviewTable 6.4Perce
Page 62 and 63: LHWP - Systems Review• Lack of lo
Page 65 and 66: Salaries and payments system7 Salar
Page 67 and 68: Salaries and payments systemThe POL
Page 69 and 70: Salaries and payments system7.5.2 S
Page 71 and 72: Performance monitoring of LHWs8 Per
Page 73 and 74: Performance monitoring of LHWseduca
Page 75 and 76: Performance monitoring of LHWsTable
Page 77 and 78: Performance monitoring of LHWsNon-p
Page 79 and 80: Transportation9 Transportation‘We
Page 81 and 82: Transportationvehicle access from e
Page 83 and 84: TransportationThe database shows th
Page 85: Transportationdelays. These problem
Page 89 and 90: Management information system• DP
Page 91 and 92: Management information systemand th
Page 93 and 94: Management information systemFigure
Page 95: Conclusion11 ConclusionThe performa
Page 99: Annexes77
Page 105 and 106: AnnexesAnnex B Personnel positions
Page 107 and 108: AnnexesAnnex C MIS and the measurem
Page 109 and 110: AnnexesTable C.4Strategic Plan KPIs
Page 111: AnnexesTable C.6Specific objectives
show all

LHW Systems Review - Oxford Policy Management

Create successful ePaper yourself

Delete template?

Save as template?