isdp performance review meeting feb 2015_ cip presentation template final_nzara county

South Sudan Integrated Service Delivery Program

ISDP Semi-Annual Performance Review Meeting

July – December 2014

Nzara County Presentation18th-20th/February 2015

By Lodu Moses Wole, PM


OUTLINE OF PRESENTATION:

County specific highlights ISDP/Non-ISDP-supported facilities County activities: July – December 2014 Program implementation challenges Key action points to address challenges Key priorities for next quarter Success story


COUNTY SPECIFIC HIGHLIGHTS: (Very very sketch map of Nzara County)

3

PHCC

PHCU

Hospital


COUNTY POPULATIONTotal & target populations

4

County Payam

Total Population

(2008)

Mid-year population

projection (2013) 0-12 months (4%)6-59 months

(19%)<5 years of age

(21%)

Estimated # of pregnant women

(5.6%)Basukangbi 7160 9432 377 1790 1982 528

Nzara Centre 30754 40514 1621 7698 8509 2268

Ringasi 2214 2917 117 558 614 168

Sakure 14946 19689 788 3740 4136 1106

Sangua 10638 14014 561 2667 2943 786

65712 86566 3464 16453 18184 4856

Target 2013 population is based on 5th Sudan Population and Housing Census 2008, UNHCR, NBS* projections for 2009-2015

Nzara


Unique County Challenge(s)

5

Very high staff turn-over

Low HF staff knowledge despite trainings & technical support during support supervision

Wooing staff to work in very remote health facilities has proved futile


ISDP/None-ISDP-supported facilities:Training title ISDP Non-

ISDPOther Total

PHCCs 3 2 0 5PHCUs 12 3 0 15Other 0 1 0 1Total (proportion) 15 6 0 21


County activities performed in Quarter 1 & 2(July – Sept. and Oct – Dec 2014)

DPT3 Vitamin A >5 Consultations0

500

1000

1500

2000

2500

3000

3500

624

1850

2575

494 591

3151

859634

2508

Target (Quarterly) Achievement (July-Sept) Achievement (Oct-Dec)

FIGURE: CHILD HEALTH INDICATORS


County activities performed in Quarter 1 & 2 (July – Sept and Oct - Dec. 2014)

ANC1 ANC4+ IPT2 SBA Oxytocin FP0

100

200

300

400

500

600

700624

499

250

125 136 161

434

139185

56

144 111

457

248177 144 145 177

Target (Quarterly) Achievement (July - Sep) Achievement (Oct - Dec)

FIGURE: MATERNAL HEALTH INDICATORS


WASH in Health Facilities

Ensured segregation of waste Ensured appropriate waste disposal Cleaning equipment and supplies Health education Hand washing stations installed Waste management plan posted Pit latrine covers distributed Installed 8 water harvest tanks


Technical Trainings

S/no

Training(s) No. of pax trained TotalMale Female

01 HMIS 12 8 2002 SBMR 6 7 1303 EPI

(Pentavalent)14 5 19

04 BeMONC 1 4 5

Total 33 24 57

Non facility based training(s) 01 SSEPs 4 0 402 HHPs 24 25 49


SBMR

2 more health facilities enrolled for SBMR

Training on SBMR Baseline assessment done for the 2

new HFs SBMR team formed in the 2 new HFs Assessment done in 3 HFs already

practicing SBMR to ascertain progress


Supportive supervision using QSC (Oct-Dec 2014)

QSC % SCORE

S/N Health facility Infrastructure Equipment HR & mgt

HMIS Pharmacy Service provision

Demand for service

Average

1 Sangua. II PHCU 60 90 50 80 90 90 80 77%

2 Bureangburu PHCU 30 50 60 40 10 80 20 41%

3 Nangirimo PHCU 30 10 40 60 70 40 0 36%

4 Namaiku PHCU 50 75 70 60 90 100 20 66%

5 Kpasua PHCU 60 75 40 80 80 100 60 71%

6 Dingapai PHCU 50 75 20 60 30 90 40 52%

7 Yabwa PHCU 70 100 90 60 80 90 100 70%

8 Ngbamgbia PHCU 50 70 45 60 90 50 0 52%

9 Napkazigi PHCU 60 85 70 80 100 100 20 74%

10 Sangua. I PHCU 30 50 50 80 30 60 0 43%

11 Yabongo PHCU 50 100 70 60 100 80 40 71%

12 Basukagbi PHCC 60 90 50 80 90 90 60 74%

13 Nzara PHCC 70 95 75 80 75 90 80 81%

14 Ringasi PHCC 55 65 85 100 70 85 100 80%

15 Ndoromo PHCU Joint supportive supervision visit to this health facility was not done due to limited access


Community mobilization activities (CMTs and B/VHCs)

Experience sharing forum (25pax)


CMTs/B/VHC cont’d

Met all the Payam CMTs, B/VHC for coaching on the CM check list

Identified strengths, gaps and constraints in CM process and gave O-J-T

Assessment done to ascertain progress of CM activities


Community mobilization activities-HHPs (Oct-Dec 2014)


WASH cont’d

• One of the many tippy taps constructed in Yabua


Other community activities_ ICCM

Recruited 2 CBD supervisors iCCM introductory meeting done in 2

bomas Identification of potential CBDs• iCCM introductory meeting in

Nangirimo boma


Program Implementation Challenges

Limited staffing & high staff turn over Low HF staff knowledge Dilapidated health facility infrastructure Data quality still a challenge Transport limitation Stock outs of drugs, 2 HFs missed EMF

drugs Over expectation by community

volunteers


Program Implementation Challenges

Limited accessibility Poor community participation Delayed rollout of iCCM


Key Actions to Address Challenges

Continue to source for more staff Continue with on job mentoring and

coaching Minor renovation of health facilities MCHIP to provide additional transport

means Follow up on EMF missed health

facilities


Key Priorities in the Next Quarters

iCCM scale up PPH start up MOU renewal Minor renovation Impant ToT Procure HHP work material Complete BEmONC in Ringasi PHCC DQA Recruitment


Suggestions and ideas to improve implementation

Stake holders should clearly understand ISDP’s mandate(s)

Minimize drug stock outs Harmonize ISDP staff currency/salary Renovations


Success Story

Deliveries increased in Ringasi PHCC Following recruitment of HHPs

Initially, before recruitment of HHPs in Ringasi boma, Ringasi PHCC had been conducting very few deliveries.

With introduction of ISDP’s CAC to Ringasi boma, HHPs were compelled, using the problem tree, to find out why deliveries were very low in the health facility.

Findings pointed to having a male registered midwife carrying out ANC and conducting deliveries. The community said “it was against their norm(s) that another male person saw the nakedness of somebody else’s wife”; therefore many mothers stopped coming to deliver in the health facility.


Success story continued

ISDP having received this feedback as a result of the exploration phase done by HHPs, a second midwife (female) was hired.

Meanwhile HHPs continued sensitizing community members; – about the need to deliver under assistance of skilled

birth attendant(s), – also about the availability of female midwife in the

health facility and – why it does not matter whoever (male or female)

skilled birth attendant does the delivery.

And as a result, deliveries greatly improved in the health facility especially during the reporting period as shown in the graph below.


Success story continued

Janua

ry

Februa

ryMarc

hApri

lMay Jun

e JulyAug

ust

Septe

mber

Octobe

r

Novembe

r

Decembe

r0

5

10

15

20

25

1 1 1 25

75

75

7 8

21

Deliveries before exploration by HHPs Deliveries after exploration by HHPs


Thank you/tambwahe/tinate/shukran

isdp performance review meeting feb 2015_ cip presentation template final_nzara county

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