PATHS Final programme report: "Togetherness in Health" the Enugu ...
PATHS Final programme report: "Togetherness in Health" the Enugu ... PATHS Final programme report: "Togetherness in Health" the Enugu ...
Pro-poor FocusPATHS pro-poor focus was operationalised in Enugu in the following ways:••••Increasing access to servicesReducing the cost of services to clientsImproving the skills of staff in their handling of all clients, including the very poorMobilisation of communities in order to increase demand.Some of the pro-poor initiatives supported by the programme included:••••••Development of the Emergency Obstetric Care Plus (EOC+) scheme managed by EnuguMetropolitan Health Board. This provided subsidised access to EOC services for poor womenState-wide introduction of low cost, quality drugs through introduction of a Drug Revolving Fund(DRF). Although deferral and exemptions (D&E) are an integral part of this, their introduction wasdelayed as it was felt necessary to get the DRF established firstSupport for the development of a free Maternal and Child Health (MCH) policyPromoting safer practice amongst TBAs by orientation and provision of free gloves and soapBuilding capacity among Community Based organisations (CBOs) to undertake communitymobilisation, including in hard to reach areasMonitoring of service charges through LHA reviews• Development of a pro-poor SMoH Health Strategy22 PATHS Final Programme Report
Section 3:ImplementationTheme 1Improved quality and sustainability ofbasic services relating to MDGsTheme 2Sustainable access to quality essentialdrugsTheme 3Prioritised, costed, operationalised,government health policies adequatelyreflected in NEEDS and SEEDSTheme 4Stimulated demand side andaccountability in relation to MDGsAs with all PATHS-supported states, the activitiesundertaken in Enugu were divided into four themes.However, unlike the other PATHS supported states,the request by the State government early in theprogramme to support the implementation of aDistrict Health System across the whole state created aframework within which the different initiatives couldbe situated. This is illustrated in the diagram below.In practice, many of the initiatives were implementedsimultaneously.Examples of initiatives undertakenDeveloping the District Health SystemStrengthening underpinning systemsEnabling service deliveryPromoting improved service deliveryin the facilitiesReorganisation of existing institutionalarrangements &Capacity building of constituent bodiesDevelopment of systems(e.g. HMIS, FMS) &Capacity building of health staffSupplying of drugs and equipment &Rehabilitation of infrastructureDevelopment of facility staff to deliver MinimumService Package &Promoting public private partnerships &Introduction of Integrated Supportive SupervisionIncreasing demand from communitiesCommunity mobilisation and CBO trainingIncreased patient patronageReduced maternal and infant mortalityand increased consumer demand inboth public and private managedprimary and secondary care facilities“Togetherness in Health” the Enugu Experience in Health Sector Reform, 2002-2008 23
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- Page 13 and 14: KEY FACTSHealth Indices: Comparison
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Pro-poor Focus<strong>PATHS</strong> pro-poor focus was operationalised <strong>in</strong> <strong>Enugu</strong> <strong>in</strong> <strong>the</strong> follow<strong>in</strong>g ways:••••Increas<strong>in</strong>g access to servicesReduc<strong>in</strong>g <strong>the</strong> cost of services to clientsImprov<strong>in</strong>g <strong>the</strong> skills of staff <strong>in</strong> <strong>the</strong>ir handl<strong>in</strong>g of all clients, <strong>in</strong>clud<strong>in</strong>g <strong>the</strong> very poorMobilisation of communities <strong>in</strong> order to <strong>in</strong>crease demand.Some of <strong>the</strong> pro-poor <strong>in</strong>itiatives supported by <strong>the</strong> <strong>programme</strong> <strong>in</strong>cluded:••••••Development of <strong>the</strong> Emergency Obstetric Care Plus (EOC+) scheme managed by <strong>Enugu</strong>Metropolitan Health Board. This provided subsidised access to EOC services for poor womenState-wide <strong>in</strong>troduction of low cost, quality drugs through <strong>in</strong>troduction of a Drug Revolv<strong>in</strong>g Fund(DRF). Although deferral and exemptions (D&E) are an <strong>in</strong>tegral part of this, <strong>the</strong>ir <strong>in</strong>troduction wasdelayed as it was felt necessary to get <strong>the</strong> DRF established firstSupport for <strong>the</strong> development of a free Maternal and Child Health (MCH) policyPromot<strong>in</strong>g safer practice amongst TBAs by orientation and provision of free gloves and soapBuild<strong>in</strong>g capacity among Community Based organisations (CBOs) to undertake communitymobilisation, <strong>in</strong>clud<strong>in</strong>g <strong>in</strong> hard to reach areasMonitor<strong>in</strong>g of service charges through LHA reviews• Development of a pro-poor SMoH Health Strategy22 <strong>PATHS</strong> <strong>F<strong>in</strong>al</strong> Programme Report
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