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

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4) The tendency for politicians to divert efforts away from identified needs in order to achievepolitical imperatives consistently deprived patients and communities of their right to accessible,affordability and acceptable health services.5) The timeframe of the programme did not allow sufficient time for the radical changes that weresupported to become sufficiently embedded.6) By early 2008 the leadership skills and political will to sustain the ongoing health reformsremained fragile.72 PATHS Final Programme Report
Lessons LearntMany lessons have been learnt from all the initiatives. The points below highlight some of the keyprinciples that need to be considered for effective implementation and outcomes.•••••••Before engagement in major health reform initiatives, overt state government commitmentshould be demonstrated and evident (e.g. through MOUs).The building of capacity often starts from a low base, thus is a lengthy and sustained process.Ongoing monitoring, supervision and support are essential if quality standards are to be achievedand sustained in resource poor environments.It is important to acknowledge all the challenges (technical, institutional, political) to effectiveservice delivery, and analyse which of these can be won, and which cannot. In the latter case, itmay still be possible to adopt a management strategy that allows for some gains.Political interests are enormously influential and need to be taken into account when planningprogrammes of work.Bringing donors together in a cohesive and collaborative forum can be highly beneficial and costeffective.The interest of, and engagement from, most stakeholders has a strong pecuniary influence.Concluding CommentsDespite the many challenges faced by the PATHS programme there is little doubt by those whohave come into contact with it, both clients and stakeholders, that it is held in high regard and has areputation for achievement.However none of this could have happened without the very considerable commitment and inputfrom an enormous number of people including government employees, private sectors employees,NGOs, CBOs and communities.Eternal thanks go to them all for making the programme in Enugu what it is today, a well known,popular and highly respected programme.“Togetherness in Health” the Enugu Experience in Health Sector Reform, 2002-2008 73
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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
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Section 1:Setting the Enugu Context
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KEY FACTSHealth Indices: Comparison
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PHC centres and cottage hospitals i
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Section 2:Overview of the PATHSProg
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Stakeholder initiatives supported b
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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
Page 66 and 67: 64 PATHS Final Programme Report
Page 68 and 69: Intermediate Outputs1) The DHS stru
Page 70 and 71: 5) A culture of business planning a
Page 72 and 73: 70 PATHS Final Programme Report
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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