monitoring and evaluating partnerships between npos and the doh for the delivery of primary health...
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Monitoring and Evaluating Partnerships Between NPOs and the DOH for the Delivery of Primary Health Care in
South Africa.
FP Netshipale, Dr JF Aguilera
PDPHC Programme (EU funded Programme)
Department of Health, South Africa
NPOs PHC delivery in SA
• Often hampered by poor NPO management, coordination and lack of skills
• Poor norms and standards for NPO’s• Lack of
– proper coordination by departments
– M&E, quality assessment and measure of service delivered
– sustainable funding for NPOs
– employment opportunities in certain areas
Partnerships for Delivery of PHC
• Six-year programme, started April 2003
• Developed by the EU in collaboration with the SA Government
• The total grant is 50 million euros
• Operational in 16 districts in 5 provinces
Overall Objective
To provide more accessible and affordable
quality PHC for the poorest communities in SA
Specific Objectives
• To strengthen cooperation between NPO’s & GVT
• To create formalized partnerships for the delivery of PHC
• To train NPOs and DOH staff• To monitor and evaluate PHC services
delivered to the community
Methods
• Selected NPOs delivering PHC are contracted and funded
• National, provincial and district management units support:– Institutional and management strengthening
– Staff and caregivers accredited training
– Implementation of an M&E system integrated into the national District Health Information System
– Operational Research
Methods: M&E Components
• Annual M&E workplan, aligned with programme workplan
• Routine data collection– PHC Data collection tools and guidelines– Programme activities (Gantt’s charts)
• Periodic data collection– NPO organizational information– NPO supervision manual (in preparation)– Baseline studies– Impact study (in preparation)
• Ad hoc research
ResultsNo. of NPOs funded, by Province
Total Funded
Limpopo 88
KZN 52
EC 55
Gauteng 65
WC 79
Total 339
Service Delivery
No. Benef Median No. Median Median
per day daily No. Benef carers* No. carers daily No. benef
per NPO per NPO per carer
EC 55 3,559 40 1,161 14 2.9
Limpopo 84 7,43 44 742 17 2.6
KZN 44 5,848 70 685 20 5.5
Gauteng 66 7,003 29 994 12 2.4
WC 68 6,366 65 364 16 4.1
Overall 317 11,129 49 3,946 15 3.3
*paid + volunteer
No. NPOs
HBC
Monthly Number of Patients, by categories
0
5000
10000
15000
20000
25000
JAN FEB MAR APR MAY JUN JUL AUG SEPT OCT NOV DEC
Cat 1 Cat 2 Cat 3
N
Visits to patients cat 1 75 473 55%
Visits to patients cat 2 41 438 30%
Visits to patients cat 3 21 030 15%
Total Visits 137 941
HBC Distribution of Categories of Visits
HBC Disease Profiles Distribution, National, 2006
Hypertension21%
Diabetes9%
Cancer2%
Cardiac Diseases3%TB
17%
HIV/AIDS21%
Other27%
TB
Monthly No. of TB Patients Supported on DOT
0 0 0 0 33 32250
1074896
2378
1756 1684
0
500
1000
1500
2000
2500
JAN FEB MAR APR MAY JUN JUL AUG SEPT OCT NOV DEC
N
Suspected Cases 5 507
Defaulters 667
Contacts 677
Total 6 851
TB Tracing and Referral
OVC
Monthly No. of OVCs Supported, 2006
0 0 0509
1 150851
1 308
1 964
977
4 808
6 126 6 060
0
1 000
2 000
3 000
4 000
5 000
6 000
7 000
JAN FEB MAR APR MAY JUN JUL AUG SEPT OCT NOV DEC
Monthly No. of household visits to OVCs, 2006
0 0 0
2 3921 898
1 179
4 853
3 822
2 867
5 767 5 9495 459
0
1 000
2 000
3 000
4 000
5 000
6 000
7 000
JAN FEB MAR APR MAY JUN JUL AUG SEPT OCT NOV DEC
Services to OVCs, 2006
N
Child care forums established 167
Counseling Sessions 4 236
Education on memory box 2 702
Link to Food Programme 9 086
Placement in alternative care 667
Referral to relevant institution 2 593
Health Promotion
HP Activities, 2006N
No. persons reached by HP campaigns 66 722
No. of children educated 46 130
No. of Health education sessions 56 014
Condoms Received and Distributed, 2006
785 814
645 619
6 834 10 2500
200 000
400 000
600 000
800 000
1 000 000
Male Condomsreceived
Male Condomsdistributed
Female Condomsreceived
Female Condomsdistributed
No
.
VCT
VCT Activities, 2006
1 348
6 8476 621
22 555
24 694
0
10 000
20 000
30 000
Persons motivatedfor VCT
Clients pre-counseled
Clients testedpositive
Clients + post-counseled
Clients referredfor HIV
management
Conclusions
• Mainly monitoring activities implemented– Service delivery– Organizational NPO data
• Evaluation tools are being developed – Quality assessment– Impact study– Cost-effectiveness of the programme remains to
be demonstrated
Way Forward
• Extension to the whole country
• Strengthen M&E skills in NPOs and DOH staff
• Integration of data into the District Health Information System
• Assess and ensure quality of service provided
Thank You
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