South Sudan Integrated Service Delivery Program ISDP Semi-Annual Performance Review Meeting July – December 2014 Nzara County Presentation 18 th -20 th /February 2015 By Lodu Moses Wole, PM
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
COUNTY SPECIFIC HIGHLIGHTS: (Very very sketch map of Nzara County)
3
PHCC
PHCU
Hospital
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
Community mobilization activities (CMTs and B/VHCs)
Experience sharing forum (25pax)
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
Community mobilization activities-HHPs (Oct-Dec 2014)
South Sudan Integrated Service Delivery Program
WASH cont’d
• One of the many tippy taps constructed in Yabua
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
Program Implementation Challenges
Limited accessibility Poor community participation Delayed rollout of iCCM
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
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.
South Sudan Integrated Service Delivery Program
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.
South Sudan Integrated Service Delivery Program
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
South Sudan Integrated Service Delivery Program
Thank you/tambwahe/tinate/shukran