urc-swaziland monthly newsletter · 2018-07-30 · ards 8 training of trainers (tot) ... loosely...
TRANSCRIPT
Improving systems to empower communities
FOREWORD BY THE COUNTRY DIRECTOR
“I wish to congratulate the staff and URC
and MOH counterparts for very produc-
tive months of June and July 2014. We
witnessed major accomplishments.
Starting with the technical support pro-
vided to the Swaziland health Laboratory
Services through CDC HIV and TB, June
started with a bang. Five laboratories that
have been working on strengthening their
quality management systems through the
Stepwise Laboratory improvements to-
wards accreditation (SLIPTA) which were
presented to the African Society for La-
boratory Medicine external laboratory
audits achieved SLIPTA stars on their
journey to accreditation. The hard work
by our staff and the SHLS staff paid off. I
would like to applaud all the laboratories
that attained stars of accreditation. The
National TB lab can be singled out for
additional accolades, attaining 3 stars and
being recommended to work towards full
accreditation assessment within the next
12 months.
The USAID Applying Science to
Strengthen and Improve Systems (ASSIST)
project took the advantage of the FIFA
World cup in Brazil June 13-July 12, 2014,
to launch a campaign of Kick TB out of
Swaziland. Working closely with the Na-
tional TB Control Program and University
Research South Africa, radio, print and
social mobilisation activities were con-
ducted. I wish to congratulate the team on
the successful in-house quarterly review
meeting where facility and regional level
projects continued to critically review and
assess the outputs and outcome of the
year. The Quarterly Review Meeting and
Planning workshops also provided a forum
for staff to reflect on what worked and
what did not, in order to enhance im-
provements in the following year. Other
learning opportunities included the model
clinics collaborative learning & sharing
sessions.
For the new staff who joined us in the last
two months, welcome to URC.”
URC-SWAZILAND MONTHLY NEWSLETTER
June-July 2014 Issue
10 August 2014 Volume 1, Issue 6-7
Inside this issue:
July Staff QRM: Impacting
Health Systems and Health
Outcomes
2
Kick TB Competition:
Health Education that En-
courages Behavioral Change
Towards TB Issues
3
Ngowane Community Dia-
logues on TB, HIV NCDs &
Fitness Games for the Elder-
ly: “Shukuma Gogo”
4
Biosafety Training for Phle-
botomists: Improving Capac-
ities on Evolving Health and
Safety Requirements
5
Five Swaziland Laboratories
Awarded Stars of Accredita-
tion
6
TB/HIV Management &
Guidelines Training: Keeping
Health Care Workers Up to
Speed with Current Stand-
ards
8
Training of Trainers (TOT)
on Quality Assurance/ Quali-
ty Improvement: Improving
Capacity of Healthcare
Workers to Apply Quality
Improvement
9
The New Reigning QRM
Queen
9
New Additions to the URC
Family
10
Learning from a Team’s Own
Experience
12
Other Activities 13
URC Swaziland Country Director, Dr Samson Haumba.
Improving systems to empower communities
practices which could be implemented in
order to carry out successful interventions.
Newly introduced in this quarter’s QRM
was the displaying of storyboards. A total
of 15 Quality Improvement (QI) interven-
tion storyboards illustrating tested interven-
tions and change were displayed from the
different health facilities supported by the
team.
The Project Support Team (PST) was for
the first time present in the July QRM.
Previously, the need for having the PST
team was under rated, however after this
QRM it was realised that they also play a
vital role in carrying out some of these
activities.
Page 2 Volume 1, Issue 6-7
JULY STAFF QUARTERLY REVIEW MEETING: Impacting Health Systems and Health Outcomes
Each quarter the University Research Co.,
LLC (URC-Swaziland) staff Quarterly Re-
view Meeting (QRM) continues to evolve
into new and better practices. In this quar-
ter the QRM fell on the 28th-29th of July
2014, at the Mountain Inn Hotel, which has
since became the main preference for
such workshops. The theme for this work-
shop was, “Impacting Health Systems &
Health Outcomes”.
Taking some time to focus on work done
can count as a beneficial and necessary
practice. The QRM promotes this practice,
allowing staff to track where they started,
whether they are going about it the right
way and whether targets are being met.
The presentations from the different pro-
jects USAID ASSIST and CDC URC-Lab
project were very informative and allowed
for open discussions with participants.
These discussions became beneficial as it
allowed the other projects to understand
on-going activities within the organisation.
The URC staff was also able to share best
The workshop does not only serve the
purpose of assisting staff to identify areas
of collaboration and to share best practic-
es, which could help with project sustaina-
bility. It further helps bring staff members
closer, which helps improve productivity
due to teamwork. The open discussions
have resulted to a number of noticeable
improvements in project results when
compared to the previous quarter.
It is in no doubt that the best practice of
holding QRM workshops is vital in the car-
rying out the URC mission, strengthening
health systems and impacting favourable
health outcomes in Swaziland.
JULY
Let’s move a little… energizer which helped keep participants fo-cused and energetic.
Participants seated in a semi-circle jotting down their comments during the presentation.
Josephine Jonato, Laboratory Technologist, present-ing her storyboard during the QRM.
Improving systems to empower communities
The Kick TB competition started on the
16th of June to the 14th of July 2014. This
competition had targeted the FIFA World
cup as well as Men’s Health month as the
key events to draw the attention of the
public on TB issues. The theme of the
campaign was therefore, “Kick TB: Find
TB. Treat TB. Cure TB.”
The competition involved listening to radio
messages on TB topics, including IPC,
diagnosis, treatment, TB and alternative
medicines traditional healers and TB
symptoms. The audience was expected to
listen to the TB messages then answer
one of three simple questions related to
the radio messages through instant mes-
saging. Radio served as an appropriate
medium to teach about TB issues because
it maintains a high listenership of about
90% of the country’s population.
Response to the competition started off
slow and then improved after promoting
the competition on TV at the breakfast
show, “Kusile”. The visit to the show al-
lowed the USAID ASSIST project team to
go beyond just promoting the competition,
but to also provide health education on
basic TB issues. After the show the public
became responsive and even took the
opportunity to ask personal questions.
The competition entries closed on the 14th
of July and by then a total of 244 people
had entered, double the number of people
that were expected. Towards the last two
Page 3 Volume 1, Issue 6-7
KICK TB COMPETITION: Health Education that Encourages
Behavioural Change towards TB Issues
weeks the answers improved with less
incorrect responses adding up to 228. 71
contestants out of that total answered all
three questions correctly, which gave them
a chance to win one of two android smart
phones. The other 157 contestants stood
to win a shopping voucher worth E500 and
E300.
On the 16th the project team, visited the
Kusile Breakfast TV Show where there
was a live draw. The winners were drawn
from the buckets by the presenter and the
contestants selected were immediately
called, which no doubt the competition
kept interesting. The TB messages
reached the audiences at home, achieving
its intended success.
The official ‘KICK TB’ launch was marked by a soccer match in Nhlangano. The goal keeper URC Swaziland Country Director, Dr Samson Haumba and
striker the Shiselweni Regional Administrator, Themba Masuku.
Shiselweni RA, Themba Masuku exemplary step which moved the public to also screen for TB.
JULY
Improving systems to empower communities
In Swaziland the elderly are normally
considered the wisdom of communities,
which is why a majority of people consult
with them before making decisions. Ac-
cess to health care and imparting
knowledge to them health issues affect-
ing communities is beneficial to them and
their households. On the 12th of June
2014, the Swaziland USAID ASSIST
Project team partnered with Ngowane
Clinic and community leaders, hosted a
one day fitness event, targeting elderly
women, referred to as ‘Bogogo’ in siSwa-
ti. This event was themed, “Shukuma
Gogo”, loosely translated as “Move elder-
ly women”.
This event packed with activities no doubt
left the 60 elderly women aged between
the ages of 55 – 89 years exhausted, but
fit and filled with information pertaining to
TB, HIV and NCDs. The sessions began
with health educational discussions,
which allowed the elderly in attendance to
share their views and ask questions
where needed.
Even though as elderly people the wom-
en were quite receptive to what they were
being taught even though it meant chang-
ing some of their custom practices. For
example, as per the Swazi custom, a
dead family member is normally bathed
and dressed by the elderly, even if they
are from the morgue, before their funeral.
By the end of the dialogues a majority of
the participants were now against the
practice aware of all the risks of infection.
The second session in the day’s pro-
gramme involved engaging participants
In some of the games and exercises
included the egg race, running, coordina-
tion games and games that encouraged
healthy eating. By the end of the day all
the ‘Gogos’ were screened and 16 tested
positive. Seven produced spot sputum
and only one out of that group was diag-
nosed with TB and initiated on treatment.
Among the 16 suspects, 4 were MDR-TB
contacts thus GeneXpert and culture was
ordered for them. 300 TB/HIV and Infec-
tion Prevention and Control (IPC) Behav-
ioural Change Communication (BCC)
were distributed by the end of the day.
NGOWANE COMMUNITY DIALOGUES ON TB, HIV NCDs & FITNESS GAMES
FOR THE ELDERLY WOMEN: “Shukuma Gogo”
Page 4 Volume 1, Issue 6-7
Having events that focus on specifically
on key population and risk groups helps
them understand the information impart-
ed to them better. This is particularly true
because they become comfortable with
asking questions freely, especially those
that touch directly on their lives. One old
women said “Maye nente kona ke
kusibita sodvwa ngoba bese siyesaba
lokukhuluma embikwe bantfu laba-
kakhulu ikakhulukati bobabe” Meaning
“ You did well by calling us as a sepa-
rate group because we tend to be shy
in the presence of other groups of
people especially men “
The elderly women holding up their BCC materials after an educational
day.
URC TB /HIV Coordinator, facilitating dialogues with the elderly community members.
Gogos versus Ngowane Senior Nurse, Nokwakhe Mkhumane racing to the finish
line.
The Gogos showed how fit they are during the egg race.
JUNE
Improving systems to empower communities
A number of mini laboratories had phlebotomists that
had inadequate knowledge to enable them implement
biosafety requirements based on the World Health Or-
ganisation (WHO) Biosafety Manual and the ISO 15189,
15190 and 22870. To help improve their capacity, on the
27th-29th of June 2014, at Sibane Hotel, training was held
specifically for 23 phlebotomists from different health
laboratories around the country
The main goal of the training was to improve health and
safety in the mini laboratories considering the number of
hazards they are exposed to while carrying out their du-
ties. The biosafety training covered comprehensive as-
pects of Biosafety, fire safety, Infection Prevention Con-
trol (IPC) and waste management in efforts to keep up
with the evolving health and safety requirements.
For a training that was first of its kind, the pre and post
test results revealed that there was some knowledge
gained from the training. The lowest score for the pre-
test was 25% and the highest mark was 75%. After a
number of presentations that also included practical
sessions the lowest score recorded from the post test
was 56% and the highest was 100% showing a remark-
able gain in knowledge
At the end of the training the Swaziland Health Labora-
tories Services (SHLS) Chief Technologist Representa-
tive expressed thanks to the CDC Lab project for mak-
ing this training possible, which would help improve the
skills and practices of the phlebotomists in the labs.
Page 5 Volume 1, Issue 6-7
BIOSAFETY TRAINING FOR PHLEBOTOMISTS: Improving Capacities on Evolving Health and Safety
Requirements
Group of URC staff and phlebotomists from different facilities posing after the workshop .
JUNE
Improving systems to empower communities
Volume 1, Issue 6-7 Page 6
FIVE SWAZILAND LABORATORIES AWARDED STARTS OF ACCREDITATION
After countless months of hard towards laboratory
accreditation, on the13thth June 2014, five of the
country’s laboratories were awarded stars of ac-
creditation by the African Society for Laboratory
Medicine (ASLM).
This counted as an important landmark for Swazi-
land, as it is 50% close to accreditation. These
results placed the country at a recognisable aver-
age than other African countries though hosting
audits for the first time. This was announced dur-
ing a debriefing meeting at the Mbabane Govern-
ment Laboratory complex following the conducted
external laboratory audits.
The audits were conducted in collaboration with
the WHO AFRO office and the African Society for
Laboratory Medicine. The auditing process fo-
cused on 12 criteria, totalling to an overall score of
250. The five laboratories included:
Central Laboratory – Scored 156 (2 Stars)
Pigg’s Peak Hospital Laboratory – 169 (2
Stars)
National Molecular Reference Laboratory –
169 (2 Stars)
Mbabane Government Laboratory – 171 (2
Stars)
National TB Referral Laboratory – 198 (3
Stars)
This approach was embraced in an effort to
strengthen national laboratory services in stepwise
manner by providing graduated levels of perfor-
mance recognition towards a long term fulfilment
of the ISO 15189 standard. This was done through
CDC lab project with technical support by the Uni-
versity Research CO., LLC (URC) in collaboration
with the Infectious Disease Institute (IDI).
Also announced during the meeting were the 6
newly certified ASLM internal audits who are now
qualified to conduct laboratory audits. These are
namely Rogers Kisame, Cinisile Ndlangamandla,
Philton Ndzinisa, Anafi Mataka, Gcina Dlamini,
Nokuthula Magongo who are all affiliated with the
countries laboratories.
URC, MOH, IDI and ASLM team posing after the debriefing session at the Mbabane Government Laboratory.
JUNE
Improving systems to empower communities
Page 7 Volume 1, Issue 6-7
Words by URC Country Director, Dr Samson
Haumba
The CD applauded the awarded stars acknowledging
that it has indeed been an effective process which
started in 2011 as well as the newly recruited internal
audits. He further thanked the Swaziland Ministry of
Health for providing the opportunity to work with them
in building the capacity and quality of the country’s
laboratories.
Words by Director of Health Services, Dr, Vusi
Magagula
When I was first appointed as Director of Health Ser-
vices, laboratories in the country t needed the most
attention. Therefore without a doubt I am proud that
they have since improved to the point that all the
audited labs achieved stars of accreditation. He add-
ed that, internal audits are important, because it will
help keep everyone on their toes, pushing them to
work hard.
Score s and stars that were given to the five laboratories by the ASLM auditors
Improving systems to empower communities
On the 23rd to 27th of June 2014, the
USAID ASSIST project held training at
Lugogo Sun Hotel targeting health care
workers from TB diagnostic sites and non
-diagnostic sites. The training was on TB/
HIV management and guidelines. This
training key focus was to introduce the 26
participants to the TB manual with current
national and international guidance in the
diagnosis, management and control of TB
and TB/HIV co-infection. This training is a
5 days training covering seven modules.
Each day was filled with knowledge
packed presentations by different facilita-
tors who are expert TB/HIV trainers well
equipped in their field of work. The first
day focused on three modules the epide-
miology of TB, transmission and Patho-
geneses as well as clinical diagnosis of
TB. The second day was especially de-
signed to equip participants with laborato-
ry TB diagnosis knowledge. On this day
the participants had various discussions
of improvement points about the transpor-
tation of samples and results.
TB/HIV MANAGEMENT & GUIDELINES TRAINING: Keeping Health Care Workers Up To Speed with Current Standards
Page 8 Volume 1, Issue 6-7
The third day’s presentations comprised
of TB case definitions, TB treatment and
monitoring, 3ls of TB control, patient
support and DOT. Some of these ses-
sions included visual presentations which
were quite helpful to the participants. The
fourth day covered the basics of drug
resistant tuberculosis (DR-TB) and TB
supply chain management. Finally, on
the last day the Monitoring and Evalua-
tion (M&E) module was covered.
To assess knowledge gain and transfer
participants were given a pre-test to as-
sess their level of knowledge at the be-
ginning of the training and a post-test to
evaluate how much they learnt at the end
of the training. According to results from
both the pre-test and post-test the aver-
age knowledge gained was 36%. Despite
emphasis on how indicators are devel-
oped and exposure to indicators, partici-
pants still performed poorly on the indica-
tors questions. This showed that partici-
pants still need to be trained on M&E.
JUNE
Nompumelelo Ndwandwe, TB/HIV Regional Coordinator facilitating during the workshop.
Participants sitting-in during the proceedings of the workshop.
OTHER FACILITATORS
Dr Arnold Mafukidze, TB/HIV Clinical Advisor
Julius Manjengwa, TB Lab Advisor
Improving systems to empower communities
USAID ASSIST project and the CDC-
URC lab project in collaboration with the
National Quality Management Programme
seeks to improve the capacity of
healthcare workers to apply Quality Im-
provement (QI) approaches to make es-
sential services better meet the needs of
patients, improve efficiency, reduce the
cost of poor quality, and improve the ca-
pacity of HCWs on QA/QI methodologies.
On the 30 June-04 July 2014 at Esibayeni
Lodge a TOT training was conducted to
establish a group of Quality Assurance
(QA) trainers to support rollout of quality
improvement and develop competencies
and capacities of imparting training to other
health care workers. The training benefit-
ted 13 participants drawn from hospitals,
health centres and the region.
The participants were trained over a 5-day
workshop. The workshop was designed to
have technical presentations, group delib-
erations and plenary sessions. This al-
lowed participants an opportunity to share
experiences, learn new approaches for
knowledge and skill transfer and develop-
ing lesson plans. By the end of the train-
ing the participants were expected to be:
Trained as trainers for field level
training activities.
To develop necessary skills in
organising and conducting QA/QI
training
TRAINING OF TRAINERS (TOT) ON QUALITY ASSURANCE/ QUALITY IMPROVEMENT: Improving Capacity of Healthcare Workers to Apply Quality Improvement
Page 9 Volume 1, Issue 6-7
To provide an understanding of the
principles and practices of the
training process.
The National Quality Management Pro-
gramme Manager, Thuli Thomo-Dlamini,
remarked that QI should be central for all
health delivery services within available
resources and against set standards to
improve regional outcomes. She further
emphasized that QA and QI is everybody’s
business and needs to be an integrated
part of all activities in all programs and
services.
JULY
THE NEW REIGNING QRM QUEEN
The first URC-
Swaziland QRM star
has officially handed
over to another qualify-
ing individual.
Congratulations to our
QRM star…
Yvonne Makwabara
SOCIAL Extra...
Improving systems to empower communities
NEW ADDITIONS TO THE URC FAMILY
Page 10 Volume 1, Issue 6-7
SOCIAL CORNER
NAME: Bongile Nzima
DESIGNATION: Finance Manager
EXPERTISE:
NAME: Ntombikayise Nkambule ’Kayise’
DESIGNATION: Human Resource Manager
EXPERTISE:
NAME: Dr Arnold Mafukidze
DESIGNATION: National TB/HIV Clinical Advisor
EXPERTISE:
NAME: Victoria Masuku ‘Vicky’
DESIGNATION: University Research South Africa
(URSA) National URSA Project Coordinator
EXPERTISE:
Human Resource Management, Recruit-
ment, Performance Management, Bene-
fits Administration
Financial Accounting, Financial manage-
ment & Reporting ,Auditing
Public Health specialist, Organizational
Development and Project Management
Clinical management of TB (including MDR-
TB) and HIV in resource-constrained set-
tings
Improving systems to empower communities
Page 11 Volume 1, Issue 6-7
SOCIAL CORNER
… For Laughs
NAME: Tumelo Mampa
DESIGNATION: Lab Quality Advisor
EXPERTISE: Laboratory technologist, Quality Assurance
and microbiology TB
NAME: Sarah Darteh
DESIGNATION: HIV Lab Mentor
EXPERTISE: Masters in Business Admin, Laboratory Technologist, HIV lab Mentor, Malaria Lab Diagnosis Coordinator
NAME: Bathabile Simelane
DESIGNATION: Human Resource Assistant (Volunteer)
EXPERTISE: Development studies; development econom-
ics and policies; research. Data management, Report
writing and Welfare analysis
NAME: Njabuliso Maphanga ’Njabu’
DESIGNATION: Intern (project DGF TB in the mines)
EXPERTISE: Clinical management; psychosocial support;
community care and midwifery
Improving systems to empower communities
Experience can be defined in a number of ways. The best definitions being it is an observation of facts or events which leave impressions
on one; and knowledge and skill acquired over time and finally. In short we can refer to ‘Experience’ as the best teacher! Taking advantage
of experience to analyse workshops can be beneficial. This process of analysing is known as After Action Review (AAR), this is a brief
meeting that focuses on a single activity. Its purpose is to analyse the difference between planned and actual experience, identify the les-
sons and create an action plan to improve the next time.
LEARNING FROM A TEAM’S OWN EXPERIENCE
Page 12 URC-SWAZILAND MONTHLY NEWSLETTER June-July 2014
KNOWLEDGE NUGGETS
What did we set out to do?
What did we actually do?
Why did it happen? (good or bad)
What can we do next time?
Who are we going to tell?
AAR STRUCTURE
For an AAR to be useful the team must have a clearly stated objective it is trying to achieve. The objective can be an outcome objective or a process objective.
Conducted by a facility team on a regular basis
or after an important event
During a coaching visit
Among the organizing team at the end of a
learning session
Among the trainers at the end of a training ses-
sion
WHEN TO USE AAR?
Openness, not hiding
Leaders and team members on equal footing
Learning, not blame or evaluation – nothing
said at an AAR goes into personnel records
Don’t rush to solutions
Everyone involved takes part
No outsiders should be present
Deal with the significant issues, not trivia
Facilitated – outsider or trained insider
Held consistently, not just when things go
wrong
AFTER ACTION REVIEW GUIDELINES
Improving systems to empower communities
UPCOMING ACTIVITIES IN AUGUST:
National TB QRM
TB NSP plan
Leadership and Management Training
NCD policy strategy
URC Planning Workshop
MOH Cultural Day
Lab mentoring
URC Orientation
Regional Semi Annual Review Meeting (RESAR) - Hhohho region
University Research CO., LLC (URC) 3rd Floor, North Wing, Building 1
Mbabane Office Park
Sozisa Road
P. O. Box 1404 Mbabane H100, Swaziland
Tel: (+268) 2404 7154/56/69
Fax: (+268) 2404 7199
Website: www.urc-chs.com
OTHER ACTIVITIES IN JUNE - JULY:
EDITORIAL TEAM
Jilly B. Motsa
Janet Ongole
Dr Marianne Calnan
Dr Samson Haumba
URC– SWAZILAND
Who Are We…
University Research CO., LLC (URC) is dedicated to improving the quality of
healthcare, social services and health education worldwide.
Mission
URC’s mission is to provide innovative, evidence– based solutions to
health and social challenges worldwide.
Expertise
In Swaziland, URC expands access to and improves the quality of services
addressing infectious diseases including HIV/AIDS, TB, and improving laborato-
ry quality management system
Approaches
URC focuses on finding ways to deliver proven approaches to health care prob-
lems, applying quality improvement (QI) methods and conducting research and
evaluation to tailor those approaches to various settings. Recognizing imple-
mentation barriers unique to each setting, we train local managers and service
providers to apply QI methods to strengthen health systems, integrate system
elements, and bring improvements to scale. URC also specializes in designing
health messages and materials to educate target audiences about improving
health behaviors.
Men’s Health month
RHMT Training
PSI Cough Officer training on TB management
Wellness Centre Healthcare Screening Report Sharing With Focal Persons
MDR-TB training
IST Quality Improvement
Model Clinics Collaborative Learning & Sharing Sessions
Intensive Case finding PHU Training
SWAMIWA Volunteers train-ing
Pre-service Training for Grad-
uating SANU Nurses
RSSC Feedback Session &
On-site QA/QI Training