PATHS Final programme report: "Togetherness in Health" the Enugu ...

More documents

Recommendations

Info

Enugu State Total Deliveries in Public Facilities, 2003 - 2007No. Live Births5,0004,5004,0003,5003,0002,5002,0001,5001,00050002003 2004 2005 2006 2007YEARS“I am recommending to friends to come herenow. Last year, I would not say the same. Butnow the conditions are not the same.”A patient awaiting care at Ozalla PHC facility2007 Data provisional (Oct - Dec being collated)Staff using the new EOC equipment52 PATHS Final Programme Report
“Before now I had nightmares as thedelivery period approached. For me it alwayshappened in the quiet hours of the night.Nurses were rarely at the centre and werenever there during those late nights. OnlyGod, grandmother, and mother came tomy rescue. We looked like an abandonedgeneration. Now that PATHS has trained ournurses and re-equipped our health centrewe come here daily for care. At the worstwe receive an initial attention before beingreferred to the big hospital.”Enugu now has six functioning CEOC centresand 56 functioning BEOC centres in the publicsector, while enhanced care is being provided ina number of faith-based hospitals.Mary Ani, a patient at a primaryhealth care facilityPublic Private Partnership -Contracting Emergency Obstetric Care ServicesPerhaps the most innovative of all the EOC work was the provison of public emergency obstetric careservices through three faith-based hospitals at public sector prices. This public-private partnershipaimed to make EOC services more accessible to those who would otherwise be forced to incur verysubstantial costs in the private sector. The rationale for the pilot scheme was the absence of a DistrictHospital in Enugu Metropolitan District. This led to an exploration of ways to use private sectorfacilities to provide the equivalent secondary care services. The Enugu Metropolitan DHB decided toconcentrate on the provision of emergency obstetric care for poorer women living in the rural partsof the metropolitan district. PATHS agreed to support the pilot by providing technical assistance andfunding the provision of services during the life of the pilot.The initial concept was that woman using the scheme would be charged the same official user feeas those attending district hospitals in other parts of the State. If, however, the cost was greater, thedifference would be made up by the DHB.The key steps for developing and managing the pilot were:• Securing the support and political backing of the Hon. Commissioner of Health;• Information gathering by the DHB through visits and meetings with key opinion formers in bothpublic and private facilities and with key SMOH and State Health Board officials;• Selection of providers for the pilot scheme following an open, transparent and objective processthat assessed potential providers against an agreed set of criteria;• Selection of referring clinics;• Setting up the mechanisms to deliver the service;• Training staff of the primary care referring centres;• Mobilising communities in order to promote the scheme;• Tracking utilisation of the scheme.“Togetherness in Health” the Enugu Experience in Health Sector Reform, 2002-2008 53
Page 3 and 4: "Togetherness in Health"the Enugu E
Page 5 and 6: FORWARDI am very pleased on behalf
Page 8 and 9: 6 PATHS Final Programme Report
Page 11 and 12: Section 1:Setting the Enugu Context
Page 13 and 14: KEY FACTSHealth Indices: Comparison
Page 15 and 16: PHC centres and cottage hospitals i
Page 17 and 18: Section 2:Overview of the PATHSProg
Page 19: Stakeholder initiatives supported b
Page 22 and 23: PATHS ApproachEngagement Process wi
Page 24 and 25: Pro-poor FocusPATHS pro-poor focus
Page 26 and 27: “PATHS has indeed impacted very p
Page 28 and 29: the 56 Executive Secretaries of Loc
Page 30 and 31: Health Board and the Districts. The
Page 32 and 33: it was agreed that the original ide
Page 34 and 35: •••Working to an agreed timef
Page 36 and 37: PATHS provided much of the infrastr
Page 38 and 39: to access for the Ministry of Healt
Page 40 and 41: and the core DRF models used in oth
Page 42 and 43: Enabling Service DeliveryDeveloping
Page 44 and 45: Procurement of Drugs and EquipmentT
Page 46 and 47: equired in order to ensure that mor
Page 48 and 49: Training in the laboratory of Annun
Page 50 and 51: The services to be delivered were a
Page 52 and 53: Where care is givenEnugu’s health
Page 56 and 57: The selection process resulted in t
Page 58 and 59: Reduced maternal andinfant mortalit
Page 60 and 61: By the conclusion of the second ser
Page 62 and 63: With the advent of the DHS it was a
Page 64 and 65: Inter-Personal Communication and Co
Page 68 and 69: Intermediate Outputs1) The DHS stru
Page 70 and 71: 5) A culture of business planning a
Page 74 and 75: 4) The tendency for politicians to
Page 76 and 77: Abbreviations and AcronymsANCBCCBEO
Page 78 and 79: AcknowledgementsThe PATHS programme
Page 80 and 81: Master trainersSMoH/faith based sec
Page 82: 80 PATHS Final Programme Report

PATHS Final programme report: "Togetherness in Health" the Enugu ...

Create successful ePaper yourself

Delete template?

Save as template?