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

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With the advent of the DHS it was agreed that one NGO would be attached to each District andwould work consistently with that District. On the whole, this arrangement worked well and a strongrelationship was established between the NGOs and the DHAs, and between the NGOs and the CBOsthey supported.The most extensive training provided to NGOs and CBOs focused on the Better Health Kit and CBOmanual. The Better Health Kit dealt with specific common conditions, offering information and simpleremedies that facility staff could use, all targeted at contributing to the achievement of the MillenniumDevelopment Goals 4 and 5. The CBO manual outlined effective community mobilization strategies,skills and techniques.In preparation for the roll-out of these trainings, six representatives from six NGOs were selectedand trained as master trainers in Abuja. The NGO trainers came back to Enugu and trained 21 NGOrepresentatives from seven Enugu-based NGOs. These individuals became master trainers who wereresponsible for cascading the training down to CBOs and facility staff. More than 600 CBOs weretrained in the use of the CBO manual, while 372 CBOs and 124 facility staff were trained in the use ofboth the CBO manual and the Better Health Kit.Even though PATHS Enugu worked primarily with seven NGOs, another five NGOs benefited fromextensive capacity building support in the following areas: communication skills, mobilization andengagement strategies, report writing, TB/DOTS campaign strategies and IPCC. One of the maindifficulties, however, was the rapid turnover of NGO staff.Q. Have you ever heard of communitymobilizers who talk on health issues?How did you know about them?A. Yes. I got to know about them whenthey demonstrated how to preparesalt sugar solution to the villagers. Itried using it and it worked.Q. Did they teach you about Malaria?A. They did. They taught us to clear thebushes around us and to throw awayempty cans that can trap water.Igweze Ikoma Umuueze, Okoma communityEunice Ani, Umoalor communityCommunity Mobilisationefforts60 PATHS Final Programme Report
Mass Mobilization in Nsukka District Health Board (DHB)Due to the very low client turnout at Nsukka District Hospital, a major stakeholder mobilizationexercise was undertaken in August 2007. The purpose of the exercise was to pilot in Nsukka DHB thepromotion of greater cohesion in the working relationship between trained CBOs and communitieswithin the Local Health Authority. The ultimate aim was to increase patronage of the hospital. Twoworkshops were held, focused on Nsukka District Hospital. Traditional rulers, NGOs, CBOs, Officers inCharge of health facilities, DHB and LHA officials and other community representatives were invited toattend.At the end of the training, the following key decisions were made:• To uplift the status of the Nsukka District Hospital;• To increase linkages between the communities and the hospital;• To form Facility Health Committees;• To reconstitute the drug revolving fund committee; and• To renew commitment by both health workers and community members to improve the quality ofservices and patronage of the hospital.Nsukka District Hospital experienced an increase in clients from 2,065 in 2006 to 4,886 in 2007. Morethan 80% of the 2007 increase occurred after the August exercise. The challenge, however, will be tofind ways to sustain the improved relationship between communities and providers.Nsukka District Hospital Utilization,3 Months Pre & 3 Months Post Community Mobilization600No. Clients/Patients5004003002001000Apr 07 May 07 Jun 07 Sep 07 Oct 07 Nov 07MonthsAug07 was month of mobilization and therefore, not reflected“Togetherness in Health” the Enugu Experience in Health Sector Reform, 2002-2008 61
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"Togetherness in Health"the Enugu E
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FORWARDI am very pleased on behalf
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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 54 and 55: Enugu State Total Deliveries in Pub
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 64 and 65: Inter-Personal Communication and Co
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Page 68 and 69: Intermediate Outputs1) The DHS stru
Page 70 and 71: 5) A culture of business planning a
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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
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