GROUP WORK Key ISSUES AND FACTORS Recommended Changes and Agreements PBF CONFERENCE Jan 19-20, 2006
4 QUESTIONS FOR GROUP WORK 1. How to ensure Quality in implementing PBF 2. What are the minimum inputs to initiate PBF 3. National policies, guidelines for PBF : - what are the clarification needed what are the docs needed 4. Standardization to access technical capacity development to ensure equity of Service
CONTENTS 1. ISSUES 2. WHAT NEEDS TO CHANGE 3. RECOMMENDATION 3
GROUP I How to ensure Quality in implementing PBF 4
DEFINITION DES: Indicateurs de qualité (mesurables) Supervision formatives régulières et encadrement Compétence polyvalentes de l équipe de supervision Definir un paquet, coordination. Unité assurance qualité au niveau des FOSA et des districts Compétences de tout le staff des FOSA (orientation AQ & AC) Travail en équipe. 5
Environnement favorable - Initiative - Outils - Créativité - Intrants - feedback /communication avec la population Formation continue basée sur les compétences Plaidoyer pour étoffer les équipes des superviseurs Alternatives de supervision - Approche collaborative Payement du 13ème Mois Autres motivation : - Formation - Voyage d étude - Meilleures pratiques Aspects communautaires 6
GROUP II What are the minimum inputs to initiate PBF 7
Continue some input financing - renovations, commodities - Replace some input financing with output financing salaries, supervision, formation Proteger les soins primaire - Conditionner les indicateurs d assurer la meme performance de soins primaire. - Penaliser les CS si les autres services diminueaient - Ajouter un prime 5% si les autres services diminueaient - Trouver des autres partenaires pour completer le package. Careful outputs/activities/ indicators developped per PEPFAR/ Public health problems. - Work with districts for integrated SUPERVISION! 8
GROUP III Is there a Need for Reference Documents, National Guidelines on PBF?
Issues A Policy Statement on PBF exists in the National Health Policy but there is an Absence of a Strategy Should this strategy be rough or more prescriptive? Too many guidelines stifle innovation PBF technical WG is not meeting regularly lack of coordination at the technical level? Clear Terms of Reference for the TWG on PBF is lacking 10
Issues B There are three different Models of PBF that have more similarities than dissimilarities and in addition, are seemingly converging towards each other 11
What Needs to Change? All aforementioned issues need to change! Need for a clear Strategy Document on PBF contents: outstanding issue is whether this needs to be a rough but good enough framework or a much more prescriptive one. TWG meetings need to become regular TWG terms of reference need to be better defined CA who would like to introduce PBF for HIV/AIDS would need a fairly elaborate toolkit to be able to do this 12
Recommendations Strategy needs to be developed out of the Policy Statement The PBF TWG needs to have its mandate clearly defined through a clear terms of reference and should meet regularly Leave room for Market Forces to Impact on Quality Improvements Rough Guidelines that are clear versus more Prescriptive Operational Procedures Desirability of one model versus leaving room for various models to develop in parallel 13
GROUP IV Standardization to access technical capacity development to ensure equity of Service 14
Standard are already defined by MoH exept HIV/AIDS (To clearly defined role/interventions) - Implementing partners must intervene per the District needs and not health facility Partner s interventions are not well coordinated - Minimize or eliminate duplication in health intervention for specific sector i.e. VCT + ART 15
Partners contributions not in accordance to needs of specific districts. - Limitations of Implementing. Partners must be clear to help identify appropriate support TECHNICAL WORKING GROUP WILL HARMONIZE + STANDARDIZE THE OPERATIONALIZATION OF THE APPROACH /METHOD Back to notes 16
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