evidence and information for policy service availability mapping presentation to the merg geneva,...
TRANSCRIPT
Evidence and Information for Policy
ServiceService Availability Availability Mapping Mapping
Presentation to the MERG
Geneva, Switzerland
October, 2004
Evidence and Information for Policy
The visionThe vision• SAM as a country owned monitoring tool meeting the needs of
multiple partners.
• At national level, SAM is used to track equity between districts and identify major gaps in service availability.
• At district level, SAM is used for monitoring service availability alongside supervisory visits.
• Disease-specific programmes use SAM, thus avoiding fragmentation and duplication.
• SAM results are widely disseminated and used by health sector and civil society, including other sectors.
• National planners are able to map all facilities and all services on a regular basis.
Evidence and Information for Policy
ApplicationApplication1. Data collected using PDAs by district health teams
2. PDA is synchronized with PC for data transfer
3. Data is analysed and maps produced using HealthMapper
Evidence and Information for Policy
District questionnaireDistrict questionnaire
Questionnaire overview:– Section 1: Availability of services and service
providers, by district– Section 2: Estimated coverage of specific
interventions, by district– Section 3: Availability of services, by facility
Evidence and Information for Policy
Facility questionnaireFacility questionnaire
Questionnaire overview:- Section 1: General characteristics- Section 2: General purpose equipment- Section 3: Injection and sterilization equipment- Section 4: Human resources- Section 5: Trained staff - Section 6: Drugs and commodities - Section 7: Lab tests- Section 8: Information on interventions available in
the facility
Evidence and Information for Policy
SAM implementationSAM implementation
ImplementedUganda Zambia
PlannedBurkina FasoDR CongoCote d`IvoireMozambiqueSenegal South AfricaTanzaniaSri LankaLaosViet Nam
Cost~ USD300 per districts (in- country costs)
Time~ 4-8 weeks
Ongoing
Kenya
Evidence and Information for Policy
Infrastructure topicsInfrastructure topics
• In-patient, maternity, and delivery beds available in all facilities
• Blood transfusion services
• Laboratory services
• Communication and technology resources
• Injection practices
Evidence and Information for Policy
Evidence and Information for Policy
Human resource topicsHuman resource topics
• Number of:– Doctors– Nurses– Clinical officers– Dentists– Laboratory technicians– HMIS personnel– Medical records personnel
Evidence and Information for Policy
Evidence and Information for Policy
Evidence and Information for Policy
Evidence and Information for Policy
Evidence and Information for Policy
Using SAM to look at inequities:Using SAM to look at inequities:Health staff by district: (ass.) doctors, nurses, and midwives per Health staff by district: (ass.) doctors, nurses, and midwives per
10,000 population, excluding Kampala and Jinja districts10,000 population, excluding Kampala and Jinja districts
0
2
4
6
8
0 1 2
Nurse and midwives per 10,000
(assistant) Doctorsper 10,000
Kabarole
Apac
Adjumani
Luwero
More doctors, more nursesFewer doctors, more nurses
Fewer doctors, fewer nurses
Bushenyi
Busia
Kalangala
Kotido
Arua
Yumbe
Masindi
Moroto
Kasese
Hoima
Masaka
Mbale
National average per 10,000 people1.1 (ass.) doctors 2.9 nurses & midwives
Nakapiripirit
Kanungu
Kumi
Nebbi
Kisoro
Moyo
Kaberamaido
Kitgum
Rukungiri
Tororo
Soroti
Bundibugyo
Kiboga
Nakasongola
Kiboga
RakaiMpigiMukono
KyenjojoMubende
KayungaNtungamo
Kapchorwa
KibaaleMbarara
Palissa
Bugiri
Lira
SironkoKatakwi
IgangaMayugeKamwenge
Kamuli
Evidence and Information for Policy
HIV/AIDSHIV/AIDS
• Availability of:– PMTCT– T&C– ART therapy– ART drug supply
Evidence and Information for Policy
Evidence and Information for Policy
Evidence and Information for Policy
Evidence and Information for Policy
Evidence and Information for Policy
Evidence and Information for Policy
Percent of districts with ART, PMTCT or HIV testing & Percent of districts with ART, PMTCT or HIV testing & counselling services, SAM Uganda, 2004counselling services, SAM Uganda, 2004
7254
20
21
24
10
722
70
0%
100%
ART PMTCT Testing &counseling
Pe
rce
nt
of
dis
tric
ts
Two or more
One facility
No facility
Evidence and Information for Policy
Percent of districts that have at least one laboratory Percent of districts that have at least one laboratory that can do specified tests, SAM Uganda 2004that can do specified tests, SAM Uganda 2004
96
83
7
7
0 20 40 60 80 100
Hemoglobin
Blood count
CD4+ cellcount
Liverfunctions
Evidence and Information for Policy
FindingsFindings• The SAM can provide a snapshot of service availability for HIV/AIDS,
health services and other services.
• HealthMapper and palm pilot are a useful way of collecting information that will be relevant for health planning and monitoring.
• A national monitoring system of the scale up of AIDS-related services needs to be put in place. This should depend on district reports, with special visits to the clinics providing the services. The SAM and HealthMapper can be used to track progress on a regular basis and can also monitor system wide effect on service availability.
• Goal is to take the SAM to the district level. The district should be enabled to plan and monitor service availability through mapping of facilities and services on a regular basis related to regular supervision and drug supplies.
Evidence and Information for Policy
THANK YOUTHANK YOU