CSSC team on Study Visit to HDP Rwanda

The team from CSSC (PBF Coordinator- Ms. Madina Mukulu and Mr. Sule, T.Michael- Zonal PBF Coordinator) paid a study visit to HDP Rwanda for one week – from 27^th November to 3^rd December 2010. The aim of the study visit was basically to learn on Community participation.  So that we replicate the best practice to the Rungwe Pilot Project in Tanzania; as PBF Rungwe Pilot Project has just recently established facility governing Committees who represent the community in health Care management.

The study tour was preceded by one day discussion on the subject matter with Mr. Christian Habineza in HDP office.  The discussion laid a strong base for the conceptual framework and the real art of doing it including the challenges experienced.  The second day i.e. 30^th November 2010, we visited Gikomero Health centre, and met the acting In charge, Mr. Samwel, who took us around the health centre; which so to say according to our standard is very clean, well kept environment and really PBF Model.  It was a double coincidence of good luck as our Visit coincided with the national campaign on vaccination and malaria control program. That means, It was easy to meet responsible community representatives.  In Gikomero, we managed to have brief meeting with members of the Cooperative.  Really, they are working hand in hand with the health facilities as upon our arrival; they were assisting the health staff in counter checking the names of the people for bed nets distribution, while some were doing cleanliness around the health facility.  Moreover, we went to the outreach, under Gikomero Health centre, and found that the three health staff working diligently with the community members after the Health committee done their mobilization job.

Our Last field day was on the North- Gisenye District border of DRC.  There we managed to visit one health centre, by the name of Nyundo, and as usual, the staff were involved in the campaign and they explained to us the same experience of working closely with health committee and cooperative.

On Thursday, we had some discussion with Mr. Christian on Community Based Organization as part of Community participation.   Here, he shared with us how they involved the CBO in various counter checking.  Furthermore, he noted that HDP has initiated the move for CBOs to have a federation; which carry out validation on professionally level. 

Again, we discussed indicators developed by PBF Rungwe Pilot Project for performance assessment- participatory Monitoring and evaluation.  Also, Mr. Christian shared with us experience of bonus payment on pure PBF in Rwanda context.

Lastly, our study tour was culminated by paying a visit to Kigali Memorial centre.  Here we were accompanied by Mr. Alexis.  As usual, we had brief introduction at the reception and later we had a tour to three major units: the main part showing events that took place,the  second part documented children unit and the last one was the general world genocide- which included the Holocaust, Darfur and some from Balkans.The big lesson learnt was that Peace has a high Price.

Lesson learnt from our study tour:

First, there is strong collaboration between the health facility and community through health workers cooperatives

Second, the facility team is well organized, and probably is due to information sharing amongst the staff.  Again, the facility environment is quite neat and clean. 

Third, the data is well arranged at the facility to the extent that it is easier for counter checking purposes.

Fourth, the feedback meeting between the facility staff and cooperative members promotes customer care.

Fifth, the involvement of the community in provision of some services e.g. distribution of mosquito nets reduced the workload of the facility technical team who are focused more on technical matters.

However, the cooperatives members are faced by these Challenges: They are lacking adequate working tools such as:  boots, torch and even transport facility.

Lastly, it is worth noting that we had wonderful reception by HDP team.  They provided us all the assistance we needed from the first day till the last day of our visit.  We thank them All. Long live HDP Rwanda!!See the photo below.

               

CSSC team in a  group photo with some of

HDP staff.  From right to left: Mr. Theo, Mr. Sule,

Ms. Madina, Mr. Gaspar and Mr. Alexis.

Supportive Supervision to Health Facilities

During this quarter, the project made a supportive supervision to health six facilities in PBF Rungwe pilot area.  The team involved CSSC PBF Coordinator- Ms. Madina Mukulu and Mr. Sule, T.Michael Zonal PBF Coordinator for Rungwe PBF Pilot Project.  In the the supervision, the team used for the first time the jointly developed Participatory Monitoring and Evaluation indicators; which were developed for performance assessment.  The visit took two days i.e. from 1^st November to 2^nd November 2010.  The facilities visited included the following:  Ntaba Dispensary, Kasyabone Dispensary and Itete Hospital.  Others were Tukuyu Health Centre, Rungwe Mission Dispensary and Igogwe Hospital.  From the questionnaire, it was found that the Health facilities are doing well with exception of the (Health Management Information System, famously called MTUHA Books.  There is a mix of stories.  First, the facilities are lacking one important book: Book 10, where they summarize the data for the quarter and send the original document to DMO.  Second, the majority of staff in the visited health facilities were not trained on filling MTUHA. Again, there was a problem on the ledger for the medicines and medical supplies- they are not updated regularly.  In addition to that, the issue of HRH was seen as quite overwhelming in most of the dispensaries visited.  Definitely, it was due to the fact that the staff personal files either remains at the employer office- in this case the General Secretary or at the hospital level to Doctor.  At least that was easy to rectify as we agreed upon facilities having the copies.

From the general assessment made, the management of the facilities visited understood the need to improve these jointly developed for participatory Monitoring and Evaluation indicators.  Most of these were in their capacities.  However, each part understood the need for improvement.