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China pakistan ghc

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  • Six control and Six Interventions counties Six control counties chosen from where 2007 baseline survey was conducted A total 24 counties staff included ( 62 for baseline and 47 for endline) from CDC, Health Bureau, MCH were interviewed A total of facility staff in 141 facilities (273 for baseline and 288 for end-line) – facility director or other facility staff
  • Use of directive for use and sharing stories of success stories of use of information are important mechanisms to promote use of information. However, there is limited change in that direction.
  • Transcript

    • 1. Strengthening Routine Health Information System for Better Health Systems Outputs: China and Pakistan Experiences Anwer Aqil , MD, MCPS, MPH, DrPH Senior HIS Advisor, MEASURE/JSI June 17, 2010
    • 2. Objectives
      • Describe PRISM Framework and Tools
      • List interventions in China and Pakistan
      • Illustrate significant changes after interventions
      • Lessons learned
    • 3.
      • Technical Factors
      • Complexity of the reporting form, procedures
      • RHIS design
      • Computer software
      • IT Complexity
      • Behavioral Factors
      • Level of knowledge of content of RHIS forms
      • Data quality checking skill
      • Problem-solving for RHIS tasks
      • Competence in HIS tasks
      • Confidence levels for RHIS tasks
      • Motivation
      RHIS Determinants PRISM Framework
      • RHIS Processes
      • Data collection
      • Data trans- mission
      • Data Processing
      • Data Analysis
      • Data presentation
      • Data check
      • Feedback
      Improved Health System Performance Improved health status
      • Improved RHIS Performance
      • Data Quality
      • Information Use
      PROCESSES OUPUTS OUTCOMES INPUTS IMPACT Diagnostic Tool OBAT MAT Facility/Office Checklist
      • Promotion of a culture of information
      • Organizational Factors
      • Critical management functions & information needs
      • Governance
      • Planning
      • Training
      • Supervision
      • Finances
      • Availability of resources
    • 4. Cycle of RHIS Performance Improvement Develop Interventions Monitor Progress Base line and Final Assessment
    • 5. List of interventions
      • Training in
      • Data interpretation,
      • Information use,
      • Better management of HIV/AIDS services by use of performance tools
      • Develop and Institute
      • Supervisory Monitoring Tool
      • Feedback report
    • 6. Monitoring Tool 1                     1 Observe that county has a newsletter or other means to share success stories of use of information? C5                       1 Did feedback report make comparison by facilities? C4                       1 Observe that County has a feedback mechanism in place based on training C3                       1 Observe that county has denominator for each facility catchment area? C2                       1 Observe that county office has the HIV/AIDS targets broken down by months for facilities C1 18 24 20 16 19 23 22 23 22 22 24 22     1 1 0 0 0 1 1 0 0 0 1 1 Observe Newsletter or other means of communicating describing success stories of use of information available 24 1 1 1 0 0   1 1 0 0 1 1 Observe county feedback report from last months available 23 1 1 1 0 0 1 1 1 1 1 1 1 Record showed that data was used for community education 22 0 1 1 0 0 1 1 1 1 1 1 1 Observe record showing that identified problem referred to county for solutions 21 1 1 1 0 0 1 1 1 1 1 1 1 Observe records showing follow-up actions on previous decisions reviewed 20 1 1 1 0 1 1 1 1 1 1 1 1 Observe records showing that decisions were taken to correct gap in the performance indicator(s) 19 1 1 1 0 1 1 1 1 1 1 1 1 Observe records showing that HIV/AIDS performance indicators which were below target performance were noted 18 1 1 1 0 1 1 1 1 1 1 1 1 Observe monthly meeting records showing discussion on the HIV/AIDS data 17 1 1 1 1 1 1 1 1 1 1 1 1 Observe display of control chart of any service performance indicator (HIV/AIDS, Immunization, ANC etc) by target and time 16 1 1 1 1 1 1 1 1 1 1 1 1 Observe display of control chart of data quality over time 15 1 1 0 1 1 1 1 1 1 1 1 1 Observe that HIV/AIDS services filled monthly report for last month is available 14 1 1 0 1 1 1 1 1 1 1 1 1 Observe display of catchment area population chart with calculation of target population 13 1 1 0 1 1 1 1 1 1 1 1 1 Can you show me you story board/book? 12 0 1 1 1 1 1 1 1 1 1 1 1 Describe at least four things included in story board or book 11 0 1 1 1 1 1 0 1 1 1 1 1 Show me your advocacy chartl 10 0 1 1 1 1 1 0 1 1 1 1 1 Describe at least two benefits of advocacy 9 0 1 1 1 1 1 1 1 1 1 1 1 Can you show me priority matrix for causes 8 0 1 1 1 1 1 1 1 1 1 1 1 Describe at least two benefits of prioritizing causes 7 1 1 1 1 1 1 1 1 1 1 1 1 Can you show me cause and effect diagram of your identified problem? 6 1 1 1 1 1 1 1 1 1 1 1 0 Describe at least two benefits of cause and effect diagram 5 1 1 1 1 1 1 1 1 1 1 1 1 Describe at least three criteria for interpreting information? 4 1 1 1 1 1 1 1 1 1 1 1 1 Describe at least three components of cycle of use of information? 3 1 1 1 1 1 1 1 1 1 1 1 0 Describe at least three methods of checking data accuracy? 2 1 1 1 1 1 1 1 1 1 1 1 1 Did you share methods of use of information learned during training with your facility team members, especially facility incharges? 1 12 11 10 9 8 7 6 5 4 3 2 1 Observe   MONTH 2                       1 Observe that county has a newsletter or other means to share success stories of use of information? C5                       1 Did feedback report make comparison by facilities? C4                       1 Observe that County has a feedback mechanism in place based on training C3                       1 Observe that county has denominator for each facility catchment area? C2                       1 Observe that county office has the HIV/AIDS targets broken down by months for facilities C1 9 9 10 14 15 14 15 15 13 16 24 14     1 1 1 1 1 1 1 0 0 0 1 1 Observe Newsletter or other means of communicating describing success stories of use of information available 24 0 0 0 1 1 1 0 0 0 1 1 0 Observe county feedback report from last months available 23 0 1 0 0 0 1 1 0 0 1 1 1 Record showed that data was used for community education 22 1 0 0 1 1 1 0 0 0 1 1 1 Observe record showing that identified problem referred to county for solutions 21 0 0 1 1 1 1 0 1 1 0 1 0 Observe records showing follow-up actions on previous decisions reviewed 20 0 0 1 1 0 0 0 1 1 1 1 1 Observe records showing that decisions were taken to correct gap in the performance indicator(s) 19 1 0 1 0 1 0 1 0 1 1 1 0 Observe records showing that HIV/AIDS performance indicators which were below target performance were noted 18 0 1 0 1 0 1 1 1 0 0 1 1 Observe monthly meeting records showing discussion on the HIV/AIDS data 17 1 1 1 1 1 1 1 1 1 1 1 1 Observe that HIV/AIDS services filled monthly report for last month is available 16 0 0 0 0 0 0 1 0 1 0 1 0 Observe display of control chart of any service performance indicator (HIV/AIDS, Immunization, ANC etc) by target and time 15 1 0 1 0 1 0 1 0 1 0 1 1 Observe display of control chart of data quality over time 14 1 1 1 1 1 1 1 1 1 1 1 1 Observe display of catchment area population chart with calculation of target population 13 0 1 1 0 0 1 0 1 0 1 1 0 Can you show me you story board/book? 12 0 0 0 1 1 1 0 0 0 1 1 1 Describe at least five things included in story board or book 11 1 0 0 0 0 0 1 1 0 0 1 0 Show me your advocacy chart 10 0 0 0 0 1 1 1 1 1 1 1 1 Describe at least four steps of advocacy process 9 0 0 0 0 0 1 1 1 1 0 1 0 Can you show me priority matrix for causes 8 1 0 0 1 1 0 0 1 1 0 1 1 Describe at least four benefits of prioritizing causes 7 1 1 1 0 0 0 0 1 0 1 1 0 Can you show me cause and effect diagram of your identified problem? 6 0 0 0 1 1 1 1 1 1 1 1 1 Describe at least three benefits of cause and effect diagram 5 0 0 0 1 1 0 1 1 0 1 1 0 Describe at least three criteria for interpreting information? 4 0 0 0 0 0 0 1 1 1 1 1 1 Describe at least five components of cycle of use of information? 3 0 1 1 1 1 1 1 1 1 1 1 0 Describe at least four methods of checking data accuracy? 2 0 1 0 1 1 0 0 0 0 1 1 1 Did you share methods of use of information learned during training with your facility team members, especially facility incharges? 1 12 11 10 9 8 7 6 5 4 3 2 1 Observe   MONTH 1
    • 7. Summary of Activities with Timeline
      Baseline May-June07 Control (14counties) Random selection of 6 control counties Baseline August 07 Intervention ( 6 counties ) Training Master trainers November 07 County officials & facility staff March/April 08 Monitoring June- July 08 Endline October- November 08
    • 8. Significant Improvements
    • 9.  
    • 10.  
    • 11.  
    • 12.  
    • 13.  
    • 14.  
    • 15.  
    • 16. Improved Health Service Coverage
      • In Yunnan, the follow-up rate HIV/AIDS cases increased from 56.7% in Year 2008 to 80.7% in Year 2009. CD4 test rate increased from 27.6% in Year 2008 to 60.4% in Year 2009.
      • Guangxi Province, in Lu Zhai MMT clinic the follow-up treatment rate was 56.1% in August 09 and improved to 70.8% in February 2010.
    • 17.  
    • 18.  
    • 19. Conclusions -
      • Improvement not possible without :
      • Team work
      • Systems perspective
      • Ownership
      • Taking responsibility and willing to learn from mistakes
      • Accountability
      • Self-regulation
      • Continuous improvement
    • 20.
      • THANK YOU

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