Omorebokhae

Strengthening Health Systems
of Faith Based Organizations:
Implications for Sustainability
CCIH 25th Annual Conference
June 9-12, 2011
INTRODUCTION
• Nigeria Indigenous Capacity Building (NICaB)
project is a 4.5 year, PEPFAR-funded project
through USAID
• Implemented by Christian Health Association
of Nigeria (CHAN) with support from
Management Sciences for Health (MSH)
• NICaB goal: build capacity of local
organizations to respond to HIV and TB in their
communities.
OBJECTIVE
Health systems strengthening tools and
approaches used by the NICaB project not
only improved management practices and
service delivery, but are also showing
potential for sustainability.
ISSUES
• Faith based facilities deliver HIV services
to hard-to-reach communities in Nigeria.
• These facilities are accessible to the
populations they serve. yet face
challenges that cause their management
to struggle to fulfill their mission.
ISSUES (2)
• Challenges cause management to
struggle to fulfill their mission:
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•
•
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Deteriorating health systems
Utilities often not available (water, electricity)
Poor infrastructure
Shortage of qualified human resources
Cultural practices that pose barriers
Interruptions in the supply of medicines and
laboratory commodities
ISSUES (3)
• Using tools developed by MSH, NICaB
supported FBOs to improve their
management and leadership practices.
Approach
NICAB Project Health System Strengthening
entails a continuous process of implementing
changes in policies, management and service
delivery systems and practices, capacity building
structures, capacity building and transfer of skills at
all levels of the health system.
NICAB HSS works fairly, responsively, and
effectively, and offers choice.
METHODS
• NICaB assessed organizational
performance in management and
leadership components of 6 facilities
using the Management and
Organizational Sustainability Tool
(MOST).
• Acton plans were developed to
address prioritized challenges.
Tools - MOST (1)
Management and Organizational
Sustainability Tool (MOST)
• To improve an organization’s management
systems, mission, values, strategy, and structure,
to contribute to improved services.
• A structured, participatory process that enables
organizations to assess their own management
performance, develop a concrete action plan for
improvement, and carry out that plan.
Tools - MOST (2)
• Emphasizes the importance of developing
managers who lead at all levels of a system.
• Incorporates components on organization
values, lines of authority and accountability,
communication, decision-making, and M&E
Tools (3)
The Leadership Development Program (LDP)
• Helps organizations to develop managers
who lead with a vision of a better future
• Three major learning objectives:
• learn the basic practices of leading and
managing
• create a work climate that supports staff
motivation
• create and sustain teams committed to
continuously improving client services
METHODS
• The Leadership Development Program
(LDP) process was applied to
implement activities for improvement.
• MOST workshops and an evaluation
were used to compare organizational
performance. Six sites that did not have
MOST at project commencement
served as control.
RESULTS
In the first three years, the project;
•Strengthened management systems at 12
facilities.
•Tested 65,345 individuals for HIV
•Initiated 3,868 clients on anti-retroviral therapy
(ART)
•Clients and revenue generation at facilities
increased greatly.
•Facilities that had MOST showed better
organizational management performance,
transforming struggling facilities into viable, self
sufficient and sustainable institutions.
CONCLUSION
Strengthening systems of FBO health
facilities led to:
• Improved management and leadership
performance
• Transformed health facilities - enabled to deliver
comprehensive HIV services at the PHC level
• Improved availability and quality of services at the
PHC level
CONCLUSION
• Ensured ownership and empowerment of FBO
networks to serve as agents for change.
• Increased demand for non-HIV and TB services
that are offered on a fee for service basis.
• Revealed a potential for increasing the
sustainability of both HIV/TB services and the
health facility at large.
• Next steps are to replicate the use of approaches
and tools at the denominational network levels
Thank you!