Informing the Capacitation of Clinic Committees in High Prevalence Areas

R Rapiti, N Nkhwashu, R Maithufi, F Cleghorn and M Madibane

in collaboration with the

South African National Department of Health

PHASA 2012

Bloemfontein, South Africa

Background

• USAID Sexual HIV Prevention Programme (SHIPP);

• HIV Combination Prevention;

• Multi- sector approach : health, education and social;

• Capacity building and deliver technical assistance;

• Provision of short-and medium-term technical assistance;

• Strengthen coordination of efforts at the local level.

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Geographic Focus Slide 3

SHIPP’s Objectives

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1. Strengthen leadership capacity of SAG departments

2. Strengthen HIV prevention service delivery

systems 3. Improve the quality, effectiveness and

coverage of HIV prevention programmes

AIM • Series of health capacitation activities at the district

level;

• Using a Baseline Evaluation to Inform the Capacitation of Clinic Committees in High Prevalence Areas of Gauteng, KwaZulu-Natal and Mpumalanga Provinces

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Transfer of skills

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Sustainable Best

Practices

Share/

Apply Evaluate

A Balancing Act

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Method

• 13 Sub districts;

• Randomly selected 10 facilities in each district;

• Technical officer and district health officer;

• Clinic committee representative;

• Questionnaire: Quantitative

Qualitative;

• Timeline: February and July 2012;

• Health promoter, operational manager or chairperson completed the questionnaire.

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Determinants

a. Functionality;

b. Role of clinic committee members;

c. Challenges;

d. Best Practices.

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Results 1 - Members Slide 10

Results 2 – Technical Documents • 22% of the committees did not keep minutes

or any records;

• 39% indicated that they used the DHP as a knowledge management or guidance tool;

• 60% indicated that they were not aware of the IDP;

• In KZN, 100% of the clinic committees interviewed were aware of the IDP and its role and referred to the document during meetings i.e OSS / “war rooms”.

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Results 3 – PHC Re-engineering

• 43% of the respondents indicated that the clinic committees will play a vital role in the PHC re-engineering process

• Only 17% had members who were currently involved in the PHC re-engineering

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43%

17%

play a role

currently involved

Results 4 – Governance & Representation

• Governance framework to assist clinic committees

• 56% indicated that there was a framework in place;

• However only 23% had the framework at the facility;

• Representation of the clinic committee at district or municipal level was only indicated by 3 facilities;

• In KZN, respondents referred issues to the war room or to their ward councilors;

• 65% of respondents indicated that there should be strong links with local government but most could not articulate assistance except to action or resolve issues.

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Results 5 – Challenges • 95% respondents indicated that there were 2

or more challenges experienced

• Challenges:

- Commitment from members;

– Role clarification;

– Providing the community with feedback;

– Which documents to refer to;

– Capacitation on health issues;

– Demotivated members due to unresolved issues;

– Members should be provided with a stipend.

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Recommendations

• Develop a framework of coordination for HIV

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prevention related activities between local political stakeholders, health care workers and the community members.

Community

Municipal

Clinic Committee

Health care workers

Recommendations 1

• Coordinate resources geared towards HIV combination prevention services.

“services are provided on different days which would mean patients have to come in more than once”

• Capacitation of members on clinic committee’s and its role in advocating HIV combination prevention activities within communities.

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Recommendations 2 • Aligning activities to the District Strategic Plan

(DSP) and the needs of the community, using their available resources.

• Capacitating members to monitor implementation of agreed activities as aligned to the DSP.

• Capacitate committee members to develop a framework encapsulating best practices

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Acknowledgments

• SHIPP would like to acknowledge the contributions of:

*District health officers;

*Clinic committee members and

*USAID

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Acknowledgements

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This presentation is made possible by the support of the American people through the United States Agency for International Development (USAID) and do not necessarily reflect the views of USAID or the United States Government.

• For further information on this presentation please contact:

Ravikanthi Rapiti

USAID SHIPP

rrapiti@futuresgroup.com