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 ...
5) A culture of business planning and planned preventive maintenance now exists across all thedistricts.6) A series of district-based networks and teams were established for:•••••PPPTBAsPPRHAAISSPPM“We have an offshoot of the District HealthSystem which we call PPP, that is PublicPrivate Partnership and it runs across all theareas of interest in the healthcare delivery,from laboratory test to X-Ray and the rest ofthem.”“PATHS trained a group of men who wereintroduced to us and asked that wheneveranything goes wrong with the equipment,we should report to them.”CEO, DHBHealth provider talking about thenewly instigated PPM service7) Seven NGOs and approximately 600 CBOs underwent extensive training in communitymobilisation and creating demand for health services.“The make up of the [CBOs] are membersof the community. They go back, sensitizethe people, tell them about the changesand encourage them to start attending theHealth Centre….. when [the health facility]has a problem that could be solved by thecommunity, they go back and tell themwhat the problem of the health centre is.”Officer In-charge, PHC Facility“There is abundant improvement in theservices provided here. Before when youcame here, there were no drugs and nolaboratory for testing. But from a few yearsago, they said some people make drugsavailable here and now you can obtainprescribed drugs and at cheap rates and thenurses sent here are OK for their profession.Also, attendance here has improved….because of their services. There is no delayand the midwives are doing fine.”A patient attending a clinic8) By early 2008 there were many stakeholders, especially at mid-management level, who coulddrive the health needs of the state.“Having been trained by PATHS in the Drug Revolving Fund, financial management systems,budgeting processes and PPRHAA I am now very thrilled that I have lead responsibility on behalfof the State Health Board for the training of other staff across the State in all areas of financialmanagement. I would very much like to see myself continuing in this role after PATHS completes.”Mrs Amoge Ani, Principal Accountant to the Enugu State Health Board68 PATHS Final Programme Report
Trends in Utilisation and CoverageThere was a steady increase in routine immunisation rates (apart from BCG, due to supply deficits inboth 2006 and 2007 3 ).Enugu State Sentinel Sites Utilization, 2003 - 2007Enugu State Sentinel Sites Utilization, 2003 - 200760,000PHCs SHCs60,000PHCs SHCs50,00050,00040,00040,00030,00030,00020,00020,00010,00010,00002003 2004 2005 2006 200702003 2004 Years2005 2006 2007YearsAll of the above resulted in a dramatic increase in patient attendance.Enugu State District Hospitals Utilization, 2003 - 2007Enugu State District Hospitals Utilization, 2003 - 2007No. Clients/PatientsNo. Clients / Patients12,00012,00010,00010,0008,0008,0006,0006,0004,0004,000No. Clients/PatientsNo. Clients / Patients2,0002,0000Agbani DH Awgu DH Enugu Ezike DH Nsukka DH Isi Uzo DH Udi DH0Agbani DH Awgu DH Enugu District Ezike DH Hospitals Nsukka DH Isi Uzo DH Udi DHDistrict HospitalsThe graph above shows that all four hospitalsfully supported by PATHS (Agbani, Enugu Ezike,Nsukka, Udi) showed an increase in attendance.Awgu Hospital showed a decline in patientattendance between 2005-2007. Althoughthis facility was originally among those to besupported by PATHS, for various reasons thisdid not happen. PATHS did not support Isi UzoDistrict Hospital. The rise in patient attendanceat this facility was due to the fact that a youthcorper doctor was posted to this facility, thusattracting patients.2003200420032005200420062005200720062007“Before they started, patient attendance ina month was about 30 persons, but we didour roll-out last year in April and since thenwe’ve been having about 200-300 patientsin a month. Presently, we have about 380patients in attendance every month.”Facility Officer In-charge3 This was a nationwide problem“Togetherness in Health” the Enugu Experience in Health Sector Reform, 2002-2008 69
- 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 62 and 63: With the advent of the DHS it was a
- Page 64 and 65: Inter-Personal Communication and Co
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- Page 68 and 69: Intermediate Outputs1) The DHS stru
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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
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Trends <strong>in</strong> Utilisation and CoverageThere was a steady <strong>in</strong>crease <strong>in</strong> rout<strong>in</strong>e immunisation rates (apart from BCG, due to supply deficits <strong>in</strong>both 2006 and 2007 3 ).<strong>Enugu</strong> State Sent<strong>in</strong>el Sites Utilization, 2003 - 2007<strong>Enugu</strong> State Sent<strong>in</strong>el Sites Utilization, 2003 - 200760,000PHCs SHCs60,000PHCs SHCs50,00050,00040,00040,00030,00030,00020,00020,00010,00010,00002003 2004 2005 2006 200702003 2004 Years2005 2006 2007YearsAll of <strong>the</strong> above resulted <strong>in</strong> a dramatic <strong>in</strong>crease <strong>in</strong> patient attendance.<strong>Enugu</strong> State District Hospitals Utilization, 2003 - 2007<strong>Enugu</strong> State District Hospitals Utilization, 2003 - 2007No. Clients/PatientsNo. Clients / Patients12,00012,00010,00010,0008,0008,0006,0006,0004,0004,000No. Clients/PatientsNo. Clients / Patients2,0002,0000Agbani DH Awgu DH <strong>Enugu</strong> Ezike DH Nsukka DH Isi Uzo DH Udi DH0Agbani DH Awgu DH <strong>Enugu</strong> District Ezike DH Hospitals Nsukka DH Isi Uzo DH Udi DHDistrict HospitalsThe graph above shows that all four hospitalsfully supported by <strong>PATHS</strong> (Agbani, <strong>Enugu</strong> Ezike,Nsukka, Udi) showed an <strong>in</strong>crease <strong>in</strong> attendance.Awgu Hospital showed a decl<strong>in</strong>e <strong>in</strong> patientattendance between 2005-2007. Althoughthis facility was orig<strong>in</strong>ally among those to besupported by <strong>PATHS</strong>, for various reasons thisdid not happen. <strong>PATHS</strong> did not support Isi UzoDistrict Hospital. The rise <strong>in</strong> patient attendanceat this facility was due to <strong>the</strong> fact that a youthcorper doctor was posted to this facility, thusattract<strong>in</strong>g patients.2003200420032005200420062005200720062007“Before <strong>the</strong>y started, patient attendance <strong>in</strong>a month was about 30 persons, but we didour roll-out last year <strong>in</strong> April and s<strong>in</strong>ce <strong>the</strong>nwe’ve been hav<strong>in</strong>g about 200-300 patients<strong>in</strong> a month. Presently, we have about 380patients <strong>in</strong> attendance every month.”Facility Officer In-charge3 This was a nationwide problem“<strong>Toge<strong>the</strong>rness</strong> <strong>in</strong> Health” <strong>the</strong> <strong>Enugu</strong> Experience <strong>in</strong> Health Sector Reform, 2002-2008 69
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