Health System Strengthening and Effective Management for Jharkhand Family Planning - Manager’s Tool

Publication date: 2014

w This publication was prepared by H. Chokshi, R. Mishra, H. Sethi, and A. Jorgensen of the Health Policy Project. MANAGER’S TOOL February 2014 HEALTH POL ICY P R O J E C T Mentoring and Supportive Supervision for Districts and Subdistricts HEALTH SYSTEM STRENGTHENING AND EFFECTIVE MANAGEMENT FOR JHARKHAND FAMILY PLANNING Suggested citation: Chokshi H., Mishra R., Sethi H., and Jorgensen. A. 2013. Manager’s Tool. Washington, DC: Futures Group, Health Policy Project. The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. It is implemented by Futures Group, in collaboration with CEDPA (part of Plan International USA), Futures Institute, Partners in Population and Development, Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and the White Ribbon Alliance for Safe Motherhood (WRA). Manager’s Tool FEBRUARY 2014 This publication was prepared by H Chokshi, R Mishra, H Sethi, and A Jorgensen of the Health Policy Project. The information provided in this document is not official U.S. Government information and does not necessarily represent the views or positions of the U.S. Agency for International Development. iii What is the Manager’s Tool? The USAID-funded Health Policy Project supported the state to develop the Manager’s Tool as an aid for health managers to check critical aspects of the health system during their field visits to health facilities, to note their observations, and to record the issues discussed and resolved together with health centre staff. The tool also serves as a means to address issues in quality assurance (QA) meetings and family planning–related trainings. This tool is useful for managers at all levels. State-level managers may include members of the family planning (FP) cell and state programme managers. District-level managers may include: district programme managers; civil surgeons; additional chief medical officers (ACMOs); reproductive and child health (RCH) officers; district programme coordinators; district programme officers; information, education, and communication (IEC) officers; and district data officers. Block managers may include programme managers, data managers, and development officers. Managers use this monitoring tool to inform decisionmakers of progress being made in each block or district, and identify the issues that need to be addressed to strengthen the health system and improve health service delivery. Managers use a separate tool for each district. Manager’s Tool Basics For each section in the Manager’s Tool, add the details in the top portion under 1, 2, 3, 4, or 5 rows. Continue using the same row to add other details. Step 1 When the State/District/Block Programme Manager visits a health facility or a meeting, first s/he informs the facility level staff that the visit’s purpose is to understand the functioning of the centre or meeting, which aspects are doing well, and which areas need strengthening. The manager assures the staff that this is neither a test nor a record for punitive action. Rather, the purpose of this visit is to improve the overall health system and health service delivery to the community and to jointly arrive at possible solutions to address existing issues. Invite one person to show you around, and share relevant documents. The manager may ask questions to gather more information for the Manager’s Tool, and should ask the health facility staff to spend 15–20 minutes sharing and discussing things 30–40 minutes, after making observations. Step 2. The manager records the observations as ‘1’ (for present or yes), or ‘2’ (for absent or no). For example, during a sub-centre visit, under the equipment and supplies section, the manager should record information on whether electricity and a telephone are present or absent. Information should also be recorded for water supply, whether an auxiliary nurse midwife (ANM) is staying at the centre, and whether the ANMs are trained as suggested by the Indian Public Health Standards (IPHS). In addition to recording observations, the manager asks the staff to share relevant documents and notes this information. For example, the manager can request the supply register to verify whether all the sections are current and complete. The register is checked against the available stock of supplies to see if it matches. No feedback is given iv at the recording stage—the manager waits to ask questions about why it is or is not updated. Comments are made during the follow-up discussion. Step 3 When all the sections are filled out, the manager meets with the key staff to, discuss what is going well, what needs strengthening, and gather more information on the health facility and its functioning. The discussion should begin with a focus on the positive aspects observed during the visit. S/he can then look at all the areas marked ‘2’ and address all these issues with the relevant staff in a group discussion. This is a good opportunity for the entire staff to consider the positives and negatives; assess the resources they have and those that they can maximise; recognise and accept the issues or problem areas; and think together about options to address the issues at hand and find innovative solutions. Step 4 The next step is to develop specific actions with both a timeframe and assigned responsibility to address particular issues. Be realistic with timelines and responsibilities to assure that problems are addressed in a timely fashion and that the relevant people are informed about the needs, requirements, and changes. The manager may also assign some responsibility to himself/herself. Some issues do not have an obvious solution, and may require a human resource or policy decision from the district or state. In this case the manager adopts the appropriate chain of command, communicates with the responsible person, and keeps the relevant staff informed of communication and follow-up for all policy actions. For example, a manager may learn that the supply of emergency contraceptive pills (ECPs) has been depleted for the last three months. Since ECPs are procured at the centre and contracted out to a manufacturer, if the manufacturer has delayed supply to the state or the district, the sub-centre staff cannot be held responsible. In such a case, the district programme manager should inform the state programme manager, the state FP cell, or the procurement officer to remedy the problem—or short-term solutions can be explored. One option is to check whether unused or excess ECP stocks exist in other districts, facilities, or in the state repository, and can be shared with the sub-centre. Simultaneously, take steps to ensure that clients are advised to use ECPs available in the private sector. The Manager's Tool contains the following sections: Section Head Number Basic Information 1 Plan for the Month 2 Sub-centre Visit 5 Primary Health Centre (PHC) Visit 9 Community Health Centre (CHC) Visit 16 Family Planning (FP) Camps 24 Quality Assurance (QA) Meetings 28 Village Health and Nutrition Days (VHNDs) 30 Community Monitoring Meetings 31 Private Hospital Accreditation 32 Empanelment of Doctors 32 Trainings 33 State Meetings 34 District Meetings 34 1 Basic Information Name of manager: Mobile number: District: Email: List of Blocks and Contact Details No. Block Name of medical officer in charge (MOIC) Contact number Email 1 2 3 4 5 6 7 8 List of Blocks and Contact Details No. Block Name of block MOIC Contact number Email 11 12 13 14 15 16 17 18 2 Plan for the Month Write the names of the blocks or villages and the number of visits you plan to make in each section. Consider the number of working days, holidays, and seasonal variations that may affect your visits. TASK Month: ______________________ Week 1 Week 2 Week 3 Week 4 Sub-centre visit CHC visit PHC visit District hospital (DH) visit Rogi kalyan samiti (RKS) meeting QA meetings 3 TASK Month: ______________________ Week 1 Week 2 Week 3 Week 4 Village health and sanitation committee (VHSC) meetings Village health and nutrition day (VHND) with FP services District headquarters Health management information systems (HMIS) data quality at district headquarters Adolescent reproductive and sexual health (ARSH) clinics providing counselling on delaying 4 TASK Month: ______________________ Week 1 Week 2 Week 3 Week 4 VHSC meeting including FP agenda FP camps and fixed-day services FP-related trainings Other 5 Sub-centre Visit Add the details of the sub-centre visit. # Date Sub-centre name Block Village Person in charge Mobile/landline number 1. 2. 3. 4. 5. 6. 7. 8. 6 Sub-centre Visit: Basic Infrastructure In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Sub-centre visit: Basic facilities Labour room hygienic Electricity available with backup, telephone functional Toilet facility available and functional Clean drinking water supply ANM staying at sub-centre ANM trained in SBS and postpartum intrauterine contraceptive device (PPIUCD) Male health worker appointed and working Contractual Safai Karmachari to assist ANM Labour room well equipped 1. 2. 3. 4. 5. 6. 7. 8. 7 Sub-centre Visit: Health Management Information System (HMIS) In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Management information system (MIS) data updated MIS data checked by lady health visitor (LHV)/block programme management unit (BPMU) MIS data checked by MOIC MIS data complete Sterilisations done/failure cases ANM-reported intrauterine contraceptive device (IUCD)/HSC cases JSY/ postpartum IUCD/ sterilisation Newly married/oral contraceptive pill (OCP) Motivated for sterilisation 1. 2. 3. 4. 5. 6. 7. 8. 8 Sub-centre Visit: Discussion with Staff In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no'). Write down the reason or details for the same. # Issues discussed With Solutions offered Next steps Action Responsible person Due date for action 1. 2. 3. 4. 5. 6. 7. 8. 9 Primary Health Centre (PHC) Visit Add the details of the PHC here. # Date PHC Block Name of medical officer in charge Mobile/landline number and Email 1. 2. 3. 4. 5. Primary Health Centre: Basic Facilities In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Computer functional Labour room hygienic and well equipped Water supply regular and clean Normal- delivery kits Deep freezer Neonatal warmer Operation theatre + Boyles Apparatus Operation theatre + anaesthetic medicine 1. 2. 3. 4. 5. 10 Primary Health Centre: Supplies In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Auto dispensable syringes IFA tablets Vitamin A ORS packets Received untied fund and utilising it Haemoglobin tests Supply register updated Blood smear for malaria Condoms Pills ECPs IUCD 1. 2. 3. 4. 5. 11 Primary Health Centre: Human Resources In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Medical officer (MO) staying Laboratory technician present MO received training in IUCD insertion MO received training in PPIUCD insertion Nurse/LHV/ANM trained in IUCD Nurse trained in PPIUCD FP Counsellor present 1. 2. 3. 4. 5. 12 Primary Health Centre: Information, Education, and Communication (IEC)/Behaviour Change Communication (BCC) In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # IEC BCC posters/banners displayed Handouts for clients Clients’ Rights displayed Dates for next community BCC event Audio visual material on display Counselling using a flip chart or facilitation tool Staff trained in effective communication 1. 2. 3. 4. 5. 13 Primary Health Centre: Health Management Information System (HMIS) In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. HMIS Data Consistency Data Linkages # MIS data updated MIS data checked by BPM MIS data checked by MOIC/medical officer (MO) MIS data complete MIS software package used to enter service data Sterilisations done/failure cases or deaths ANM- reported IUCD/PHC Cases JSY/ PPIUCD Newly married/OCP Motivated for sterilisation 1. 2. 3. 4. 5. 14 Primary Health Centre: Transport and Referral In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Transport vehicle available Vehicle in running condition Average number of trips/month Types of cases for which the transport was used Pregnancy and childbirth cases Accidents FP camp-related issues Other maternal and child health (MCH) issues Non-MCH issues 1. 2. 3. 4. 5. 15 Primary Health Centre: Discussion with Staff # Issues discussed With Solutions offered Next steps Action Responsible person Due date for action 1. 2. 3. 4. 5. 16 Community Health Centre (CHC) Visit Add the details of the CHC here. # Date CHC Block Names of key staff Mobile/landline number and email 1. 2. 3. 4. 5. Community Health Centre: Basic Facilities In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Outpatient department Waiting rooms OT Labour room X-ray room Blood storage Pharmacy Water supply Electricity Garden Transport 1. 2. 3. 4. 5. 17 Community Health Centre: Supplies In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Patients’ rights RKS Supplies Contraceptives RKS meets monthly and minutes are sent to the state in the RKS format Received untied fund and used for FP Equipment register updated Supply register updated Blood smear for malaria Condoms Pills ECPs IUCD Non-scalpel vasectomy (NSV) kits 1. 2. 3. 4. 5. 18 Community Health Centre: Human Resources In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # CHC has general surgeon CHC has obstetrician/ gynaecologist Medical officer (MO) received non-scalpel vasectomy (NSV) training in last 5 years MO received PPIUCD training in last 5 years MO received IUCD insertion (380A and 375) training MO received minilap training in last 5 years MO received tubectomy training in last 5 years 1. 2. 3. 4. 5. 19 Community Health Centre: Information, Education, and Communication (IEC)/Behaviour Change Communication (BCC) In each section, add ‘1’ (for ‘present’ or ‘yes’), and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # IEC/BCC posters/banners displayed Handouts for clients Citizens’ Charter displayed Dates for next community- level BCC event Audio-visual material on display Counselling using a flip chart or facilitation tool Staff trained in effective communication 1. 2. 3. 4. 5. 20 Community Health Centre: Health Management Information System (HMIS) In each section, add ‘1’ (for ‘present’ or ‘yes’) and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. HMIS Data Consistency Data Linkages # MIS data updated MIS data checked by block programme management (BPM) MIS data checked by MOIC/MO MIS data complete MIS software used regularly for data entry Sterilisation done/failure cases and/or deaths ANM- reported IUCD/PHC cases JSY/ PPIUCD Newly married/OCP Motivated for sterilisation 1. 2. 3. 4. 5. 21 Community Health Centre (CHC): Adolescent Reproductive and Sexual Health Centre In each section, add ‘1’ (for ‘present’ or ‘yes’) and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Adolescent counselling services provided Adolescent -friendly health services provided Register with services provided updated Provision and setting leads to privacy Materials for adolescen t reading/ playing Display of adolescen t- friendly services IEC/BCC display Facilitation tools (flip charts) for counselling available Special sessions organised Other 1. 2. 3. 4. 5. 22 Community Health Centre: Transport and Referral In each section, add ‘1’ (for ‘present’ or ‘yes’) and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Transport vehicle available Vehicle in running condition Average number of trips/month Types of cases for which the transport was used Pregnancy and childbirth cases Accidents FP camp- related issues Other maternal and child health (MCH) issues Non-MCH issues 1. 2. 3. 4. 5. 23 Community Health Centre: Discussion with Staff # Issues discussed With Solutions offered Next Steps Action Responsible person Due date for action 1. 2. 3. 4. 5. 24 Family Planning Camps and Fixed-Day Service Provide details about the FP camps or fixed-day services you visit and the number of products/services offered that day, until your visit (they may offer more products and services after you leave). # Date Distric t Bloc k Facilit y type In field— village/landmark/locatio n Timin g of the visit Number of services/products offered NS V Tubectom y Minila p IUC D Condom s Pill s ECP s 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 25 Family Planning Camps and Fixed-Day Service: Tubectomy/Minilap Write your observations about tubectomy/minilap services. Also, add client opinions in the same row. # Diagnostics done Infection prevention procedures followed Equipment and supplies present Postoperative food and water provided for clients Postoperative transport provided for clients Surgical team transport provided Preoperative counselling provided Postoperative counselling provided IEC material given to clients as handouts 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 26 Family Planning Camps and Fixed-Day Service: IUCD Write your observations regarding the IUCD services. Also gather some client opinions and add them in the same row. In each section, add ‘1’ (for ‘present’ or ‘yes’) and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Check for reproductive tract infection (RTI)/sexually transmitted infection (STI) Referral for RTI/STI Treatment for RTI/STI IUCD inserted Pre-treatment counselling provided Post treatment counselling provided IEC material given to clients as take away 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 27 Family Planning Camps and Fixed-Day Service: Discussion with Staff # Issues discussed With Solutions offered Next Steps Action Responsible person Due date for action 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 28 Quality Assurance Committee (QAC) Meetings In each section, add ‘1’ (for ‘present’ or ‘yes’) and ‘2’ (for ‘absent’ or ‘no’). Please write the number of visits in the last column. Write down the reason or details for the same. # Block QAC or district QAC Meeting date District Block All members present Functional (meet every quarter for the last one year) Trained in GOI format Use GOI reporting format Send QA quarterly reports to state Make visits to FP camps to ensure QA # of QA visits in the previous month 1. 2. 3. 4. 5. 29 Quality Assurance Meetings: Discussion with Staff # Issues discussed With Solutions offered Next Steps Action Responsible person Due date for action 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 30 Village Health and Nutrition Days (VHND) Write down your observations regarding the VHND services. Include client opinions in the same row. In each section, add ‘1’ (for ‘present’ or ‘yes’) and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Anganwadi worker name/contact number/address District Block Village Date Sahiya and ANM present FP products available, displayed and given to clients FP counselling for pregnant women Delay age of marriage/first child discussed with adolescents/newlyweds FP messages displayed 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 31 Community Monitoring: Rogi Kalyan Samiti Meetings, Village Health and Sanitation Committee Meetings, and Other Meetings with Community Providers/Mobilisers In addition to the details asked for in the columns below, include client opinions in the same row. In each section, add ‘1’ (for ‘present’ or ‘yes’) and ‘2’ (for ‘absent’ or ‘no’). Write down the reason or details for the same. # Meeting type (VHSC/RKS/ ANMs/ASHAs) District Block Village Date Key person’s name/contact number/address Objective Achievements Next steps Next meeting date 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 32 Accreditation of Private Facilities and Empanelled Doctors/Providers Provide details of the private facilities accredited this month. In each section, add ‘1’ (for ‘present’ or ‘yes’) and ‘2’ (for ‘absent’ or ‘no’). # Private facility name Address Doctor’s name Contact no. No. of beds Accreditation guidelines followed 24-hour facilities 1. 2. 3. 4. 5. # Name of empanelled doctor Degree Specialisation Name/address of practice Contact No. Empanelled for which service Other details 1. 2. 3. 4. 5. 33 Trainings, Workshops, and Orientation Please include all details. # Date Training or workshop topic Objectives For District Block Duration Venue Number of participants M F Total 1. 2. 3. 4. 5. 34 Meetings Please include all details. # State meetings attended Date/s (from ___ to ___) Purpose 1. 2. 3. 4. 5. # District meetings attended Date/s (from___ to___) Purpose 6. 7. 8. 9. 10. For more information, contact: Health Policy Project Futures Group One Thomas Circle NW, Suite 200 Washington, DC 20005 Tel: (202) 775-9680 Fax: (202) 775-9694 Email: policyinfo@futuresgroup.com www.healthpolicyproject.com What is the Manager’s Tool? Step 1 Step 2. Step 3 Step 4 The Manager's Tool contains the following sections: Number Section Head Basic Information Plan for the Month Sub-centre Visit Sub-centre Visit: Basic Infrastructure Primary Health Centre (PHC) Visit Primary Health Centre: Basic Facilities Primary Health Centre: Supplies Primary Health Centre: Human Resources Primary Health Centre: Information, Education, and Communication (IEC)/Behaviour Change Communication (BCC) Primary Health Centre: Health Management Information System (HMIS) Primary Health Centre: Transport and Referral Primary Health Centre: Discussion with Staff Community Health Centre (CHC) Visit Community Health Centre: Basic Facilities Community Health Centre: Supplies Community Health Centre: Human Resources Community Health Centre: Information, Education, and Communication (IEC)/Behaviour Change Communication (BCC) Community Health Centre: Health Management Information System (HMIS) Community Health Centre: Transport and Referral Community Health Centre: Discussion with Staff Family Planning Camps and Fixed-Day Service Family Planning Camps and Fixed-Day Service: Tubectomy/Minilap Family Planning Camps and Fixed-Day Service: IUCD Family Planning Camps and Fixed-Day Service: Discussion with Staff Quality Assurance Committee (QAC) Meetings Quality Assurance Meetings: Discussion with Staff Village Health and Nutrition Days (VHND) Community Monitoring: Rogi Kalyan Samiti Meetings, Village Health and Sanitation Committee Meetings, and Other Meetings with Community Providers/Mobilisers Accreditation of Private Facilities and Empanelled Doctors/Providers Trainings, Workshops, and Orientation Meetings

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