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4.7.4 Quality of health services at the programmatic level ................................... 72 5 HSRP AND FACILITY LEVEL UTILIZATION PATTERNS OF RH-SERVICES.................................................................................................75 5.1 IMPACT OF HSRP ON FP-SERVICES UTILIZATION ................................... 75 5.2 IMPACT OF FHM ON MATERNAL CARE-SERVICES UTILIZATION ........ 80 6 COMMUNITY LEVEL DEMAND FOR RH-SERVICES.....................................................89 6.1 FINDINGS OF THE EXIT INTERVIEW.............................................................. 89 6.2 FINDINGS OF THE COMMUNITY-BASED SURVEY...................................... 93 6.3 FINDING OF THE FGDS AND IN-DEPTH INTERVIEWS.............................. 103 7 SWOC ANALYSIS OF RH-SERVICES PROVISION THROUGH FHM .....113 7.1 IMPACT OF FHM ON SUPPLY, DEMAND AND UTILIZATION OF RH- SERVICES............................................................................................................ 113 7.2 SWOC ANALYSIS OF THE POLITICAL SUPPORT TO FHM-AND RH-RELATED PROGRAMS............................................................................... 118 7.3 SWOC ANALYSIS OF THE ROLE OF FHM IN STRATEGIC PLANNING FOR RH SERVICES ....................................................................... 118 7.4 SWOC ANALYSIS OF THE FHM IN ACHIEVING UNIVERSAL COVERAGE WITH RH-SERVICES................................................................... 119 7.4.1 Availability of RH services through FHM (facilities, services, manpower).................................................................................................. 119 7.4.2 Accessibility of RH services through FHM ............................................... 120 7.5 SWOC ANALYSIS OF THE FHM IN IMPROVING THE ORGANIZATION AND MANAGEMENT OF THE HEALTH SYSTEM FOR RH-SERVICES DELIVERY....................................................... 121 7.5.1 Decentralization through DPO................................................................... 121 7.5.2 Costing, financing and purchasing of RH-services.................................... 122 7.5.3 Human resources development .................................................................. 122 7.5.4 Supervision system..................................................................................... 123 7.5.5 Management information system.............................................................. 124 7.6 SWOC ANALYSIS OF THE ROLE of FHM IN IMPROVING THE HEALTH SERVICES PROVISION FOR REPRODUCTIVE HEALTH SERVICES......... 125 7.6.1 Physical infrastructure of the health facilities ............................................ 125 7.6.2 RH- health commodity system................................................................... 126 7.6.3 FHM facilities’ sta<strong>ff</strong> performance in Rh-services...................................... 126 7.6.4 Integration of services ................................................................................ 127 7.6.5 Referral services......................................................................................... 128 7.6.6 Quality of RH services ............................................................................... 129 7.7 SWOC ANALYSIS FOR THE ROLE OF FHM IN DEMAND CREATION FOR REPRODUCTIVE HEALTH SERVICES................................................... 129 8 KEY FINDINGS AND SUGGESTIONS TO INCREASE UTILIZATION OF RH –SERVICES IN THE FHM CLINICS ...................................................133 8.1 Political and Programmatic Support to RH-services Provision through FHM ..... 133 8.2 Universal Coverage with RH- services through FHM .......................................... 136 8.3 Improve Organization and Management of the Health System ............................ 138 8.4 Improve Health Services Provision....................................................................... 146 8.5 Raising Demands for RH-services in the FHM facilities...................................... 146 Table of contents iii
REFERENCES ..............................................................................................................149 ANNEX ANNEX 1: ANNEX 1 TABLES OF SERVICES............................................................. 155 ANNEX 2: CHECKLIST.................................................................................................. 159 ANNEX 3: EXIT QUESTIONNAIRE ............................................................................. 175 ANNEX 4: FGD FOR HEALTH SERVICE PROVIDER .............................................. 185 ANNEX 5: FGD FOR MARRIED WOMEN IN REPRODUCTIVE AGE ..................... 191 ANNEX 6: FGD FOR NON MARRIED FEMALES....................................................... 199 ANNEX 7: FGD FOR NON MARRIED MALES ........................................................... 205 ANNEX 8: IN-DEPTH INTERVIEW FOR DOCTORS.................................................. 211 ANNEX 9: COMMUNITY QUESTIONNAIRE ............................................................. 215 iv Table of contents
Page 1 and 2: ff STUDY ON REPRODUCTIVE HEALTH IMP
Page 3: 3.3 HSRP OBJECTIVE 2: IMPROVED ORGA
Page 7 and 8: INP IRHSP IUD JICA LPC MCH MD MDGs
Page 9 and 10: I POLITICAL AND PROGRAMMATIC SUPPOR
Page 11 and 12: III IMPROVE ORGANIZATION AND MANAGE
Page 13 and 14: • The heavy involvement of physic
Page 15 and 16: INTRODUCTION AND METHODOLOGY 1 The
Page 17 and 18: • FGDs and in-depth interviews wi
Page 19 and 20: Discussion guide with facility staf
Page 21: • Exit interview with FHM clients
Page 24 and 25: Reliance on vertical-donor-supporte
Page 26 and 27: 2.3.1 Basic benefit package (BBP) T
Page 28 and 29: In the future the contractual oblig
Page 30 and 31: DHAs to carry out this role. Upon a
Page 32 and 33: defined targets at the district or
Page 34 and 35: District hospitals provide in-patie
Page 36 and 37: Annex II shows that there is no spe
Page 38 and 39: 2.5.1 Accreditation of FHM faciliti
Page 40 and 41: 2.5.3 Integration of service delive
Page 42 and 43: 2.8 HSRP FROM PILOT TO NATIONAL ROL
Page 45 and 46: POLICY ON RH-SERVICE PROVISION THRO
Page 47 and 48: Availability of the Service provide
Page 49 and 50: services are also available in the
Page 51 and 52: Mother care Module (Sub-modules: AN
Page 53 and 54: 3.4.3 HSRP/RH-related quality of he
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trying to overcome all common disea
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Quotation (4): The policy of paying
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contraceptive methods, with subsequ
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services are delivered in the famil
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the needs of all health facilities
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• Being a pre-service training, i
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outpatient clinic and emergency car
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Organizational structure: HSRP stra
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(3) Improper selection of approache
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the family medicine program. The st
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HSRP-supportive projects (UNFPA-Sup
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handicapped child, improving RH (So
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Creating Demand for RH-service in t
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the FP clinic. But, acceptors of ot
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The simple indicators and compound
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services (82%) and immunization ser
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FHM AND FACILITY LEVEL UTILIZATION
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services. In 2007, the FHM reported
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Impact of FHM on FP-services utiliz
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according to the traditional PHC ha
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Table (5.8) Trend in Utilization Pa
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Impact of FHM on utilization patter
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coverage, especially in Urban Gover
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Table (6.2) Frequency distribution
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Table (6.5) Percent distribution of
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2- Community general knowledge and
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were MOHP facilities outside the vi
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Table (6.11) Percent distribution o
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The current study is looking also t
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The views of women towards the reas
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Quotation (1): Now there is more ca
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affirmed that nurses become more ef
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• Marketing for FHM-services: All
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unawareness of parents (clinical ex
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4- Perception of male youth to FHM
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coverage of the population within t
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• Motivation of the staff The FHM
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7.2 SWOC ANALYSIS OF THE POLITICAL
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Opportunities: • There are many f
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7.5.2 Costing, financing and purcha
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Strengths: Opportunities: • The s
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7.6.2 RH- health commodity system S
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Opportunities: • According to the
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Strengths: Knowledge about RH-servi
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Opportunities: Attitude of the FHM
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Figure 3: Acceptability versus util
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Figure 6: The variability in the or
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5- Revised and Updated Performance-
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* Suggested DPO Organogram The DPO
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• The community workers play an a
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4- The FHM supervision system is in
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8.4 IMPROVE HEALTH SERVICES PROVISI
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to accept the idea of family folder
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19. MOHP/Population Sector (2008) S
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Annex
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156 Annex 1 tables of services ARAB
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ARAB REPUBLIC OF EGYPT MINISTRY OF
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Checklist of the Quality PHC Servic
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No Observation Items Findings (Obse
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# Service Item Findings Guide for t
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Item Service Item No B10-10 Enough
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C4: Well-baby Care Services No Serv
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No Service Item Findings Item Cooli
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D3: Meetings of the Clinic Board Me
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EXIT QUESTIONNAIRE IDENTIFICATION G
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NO. QUESTIONS & FILTERS CODING CATE
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NO. QUESTIONS & FILTERS CODING CATE
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No. QUESTIONS & FILTERS CODING CLAS
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Arab Republic of Egypt Ministry of
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ARAB REPUBLIC OF EGYPT MINISTRY OF
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HOUSEHOLD SCHEDULE Now we would lik
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LINE ELIGIBILE FOR EDUCATION NO. WO
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NO. QUESTIONS AND FILTERS CODING CA
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OBSERVATIONS TO BE FILLED IN AFTER
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WOMAN QUESTIONNAIRE IDENTIFICATION
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No. QUESTIONS AND FILTERS CODING CA
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No. QUESTIONS AND FILTERS CODING CA
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302 305 306 307 307a SECTION 3. ANT
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SECTION 4: FAMILY PLANNING METHODS
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CHECK Q110 HOUSEHOLD QUESTIONNAIRE:
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SECTION 7: SOCIETY KNOWLEDGE OF FAM
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