BID Zambia Presentation BLN Meeting. Fwasa Singogo & Mandy Dube 9 th December, 2015 Mt. Meru Hotel; Arusha, TANZANIA

Transcription

1 BID Zambia Presentation BLN Meeting Fwasa Singogo & Mandy Dube 9 th December, 2015 Mt. Meru Hotel; Arusha, TANZANIA

2 Presentation layout Presentation objectives The BID approach and interventions Challenges in the process Next steps Our ears are open 9 Dec

3 Presentation Objectives Highlight the context for BID s work in Zambia Share BID Initiative interventions, plans and challenges and seek advice on how we might do better 9 Dec

4 IMMUNISATION SITUATION IN ZAMBIA

5 Some Facts About Zambia Surrounded by 8 countries Zambia is experiencing massive infrastructure development in Health, Education and Roads The Victoria Falls rocks on Zambia side for tourism T/ Population: 14.6million NMR: 24 IMR: 45 U5M: 75 MMR: 398 TT protected: 82% 5

6 ZDHS 2013/14

7 Immunisation Challenges in Zambia Zambia faces common challenges in immunization as other countries Data accuracy (issues with calculating target estimates, poor record keeping, lack of data verifications), Completeness and timeliness of data (this includes access to the data), Limited utilization of data at local level for decision making,

8 Immunisation Challenges in Zambia Inadequate supervision Inadequate data management staff, Multiple vertical data collection systems and Inability to monitor vaccine supply chain.

9 THE BID APPROACH AND INTERVENTIONS

10 The Better Immunization Data (BID) Initiative The Vision Empower Zambia esp. MOH to enhance immunization and overall health service delivery through improved data collection, quality, and use. The Approach Partner with MOH in Zambia to: Identify the most pressing routine immunization service delivery problems. Develop, perfect, and scale solutions with the users on the ground throughout the health system. Facilitate peer learning with other sub-saharan African countries in design, testing, and applying interventions.

11 Priority Solutions to Address Challenges Denominator Issue Immunization registries, redefining immunization targets for areas with inconsistent populations Local Data Use Data use guides and campaigns, peer to peer networking, video-based training, targeted supportive supervision Supply Chain Use of facility stock management tools to improve vaccine visibility and availability at service delivery points

12 BID s Guiding Principles Coordinated approach Country ownership Interoperability Innovation Sustainability Openness Strategic re-use Research, monitoring, evaluation Coordinate with other key initiatives and organizations Stakeholder analysis, CDC, UNICEF, DNRPC, Focus on countries primary ownership and responsibility MOU, BID TWG, EPI TWG Interoperate with existing information systems.unicef lead Leverage the latest learning and technology DHIS2 Consider need for long-term sustainability MOH leadership in decision making, barcodes, cross site visits, costing, local hosting Remain committed to openness DHIS2 Extract reusable components from and build new as required.dhis2, HIA1/2, SMT Contribute to the body of knowledge M&E, BLN, Google Groups, Observation

13 Interventions Tested & Validated Barcodes and cross site visits use & acceptability but sustainability won the fight Formation of peer networks WhatsApp group Validation of indicators for dashboards for use at various levels Adoption of electronic immunization registry (use of tablets vs paper)

14 Interventions Tested & Validated Stock management/reporting workflows Data Use Guide.docx Data Use Campaigns Change Management\Micro training videos\videos\micro Training Videos.mp4 District and Facility Touch StrategyZambia_Provinci al_district_touch_strate gy.pptx

15 Martha s experience with BID MY EXPERIENCE WITH BID INITIATIVE.pptm

16 Opportunities Development of expandable/interoperable immunization registry in collaboration with key stakeholders like CDC/SmartCare, DNRPC and MGDi Integration of the BID solution into core DHIS2 functionality provides an organic opportunity for scale Continued testing different change management approaches to identify what works and is scalable and gets us the results we need

17 How Tanzania and Zambia Compare / Arusha / Livingstone 17

18 How Zambia and Tanzania Compare Both countries tested the same core interventions Same RFP process Immunization registries will be hosted locally Some common and some different interventions to roll out e.g paper and electronic vs. all electronic, data use guide for Zambia Different vendors and platforms Engagement with the ministries was different Tanzania s lessons learnt are shaping Zambia s thinking around issues like back entry of data, support for high volume facilities

19 CHALLENGES IN THE PROCESS 12 June 2014

20 Some Challenges to the process Getting alignment from the two ministries towards the BID Initiative goals Frequent staff/leadership changes in the CHU Existing practices within the health sector which made it difficult to align certain interventions e.g roles and responsibilities The iterative nature of the Initiative approach created uncertainty among stakeholders

21 Some Challenges to the process Staffing levels at health facilities Frequent rotations (Permanent or Routine) of staff at facilities Existing data quality affecting key decisions on implementation Aligning different partner requirements and donor mandates e.g Smartcare Partners placing conflicting demands and benefits on health workers thereby affecting attention to BID

22 NEXT STEPS

23 Next steps 1 Drawing up of the development plan with University of Oslo identifying stakeholders to play a key role in the system design(prime source of the information required to understand the information flow, data needs & interoperability) An expert committee of stakeholders created to oversee progress of the project, and make decisions 23

24 Next steps 2 Development of the beta version of the immunisation registry through an iterative process & training/user manuals by May 2016 will be built on the DHIS 2 platform and utilize the Tracker Capture app and related Tracker services 24

25 Next steps 3 Field Testing and feedback; software and related documentation/materials will be introduced to a selected number of health facilities and go through intensive testing in a real user environment with support from the local technical teams including GRZ Deployment of the Beta version of the system (Going Live in pilot sites) in Livingstone by April/May

26 Next steps 4 Finalising CM, PV & M&E training manuals, teaching aids and baseline survey tools Procurement of devices & equipment for use in facilities Conducting of the M&E Baseline survey Conducting of sensitization meetings in districts 26

27 Next steps 5 Recruitment of additional staff at field level Training of BID staff for implementation Conducting touches and Roll out to health facilities starting in Livingstone then to other districts Development of sustainability and handover plan 27

28 OUR EARS ARE OPEN 12 June 2014

29 GROUP WORK Your advice on best practices in the following areas of the BID implementation approach. 1: Stakeholder engagement. What are best practices in ensuring that the government is fully engaged especially when dealing with 2 or more ministries? 2: Sustainability. What are best practices in ensuring sustainability? Who else would be interested in funding activities to go to scale? 3: Promoting Data use. What are the best practices in promoting data use? Who else has done work in this area that we should be talking with? 4: Training approaches. What are best practices in onsite training?

30 Questions? 12 June