Last month,the Christian
Social Services Commission (CSSC) organized four days study Tour for six
Tanzanian officials to Sister Organization in Zambia namely Church Health Association of
Zambia (CHAZ) from 7th to 11th April 2013 to learn
how they successfully implemented PBF Pilot Project through selecting specific
role and challenges they faced. The tour
was congruent with the project over-all objective which is to improve the
functioning of the health sector through exchange of experiences of PBF
approach from seven countries in the Network. It is worth expressing that Zambia
and Tanzania are only Anglophone Countries in the Network, and thus have more
or less similar health sector set up.
On 8th April
2013 the CHAZ Executive Director Ms. Carin Sichinga briefed the Tanzania delegation
about her organization. Of much interest was the strong collaboration with the
Government which was reflected by: Government seconding health workers to
church health facilities, Supply All Essential Drugs to Faith Based
Organization Health Facilities, and finally the Government Covers 75% of the running
cost of the Faith Based Organization Health Facilities. It was also realized
that CHAZ is the second principal recipient of the Global Fund.
There after the delegation
spent two days visiting four health facilities which are implementing PBF Pilot
Project on the Northern part of Zambia in Mpika namely Chilonga Hospital (owned
by Catholic Church) and Mpika District Hospital. Other facilities visited are
two Health Centres- Chibansa and Chalabesa.
Moreover, the delegation
also had an opportunity to visit to Local Purchasing Agency - Development Aid
from People to People in Zambia (DAPP) in the project area, and Result Based
Financing project (RBF) under Ministry of Health (MoH) of Zambia.
The following were the
main issues observed, which were of interest to the delegation from Tanzania:
There is strong Public
Private Partnership between Government of Zambia and CHAZ in health Care Provision
which make Church health facilities to provide health services to the population
according to Government regulation.
On the project set-up, it
is well incorporated in the organizational set-up and linked to the National
Level whereby one can exactly see separation of functions vital in the
governance of the project.
Being Pure PBF, it was
realized that all the health facilities have Business plans, and LPA monthly counter
verify the quantitative data and Quality review is done accordingly by the
District Medical Office team. At the end, the health facilities receive
performance payment, out of which 50% is for staff motivation, 40% for
investment and 10% for promoting community participation.
From the quick
observations and the health facilities management site reports, it was noted
that the staff were quite motivated due to bonus payment and improved
infrastructures in the facilities. However, the issue of sustaining the spirit
of the staff was further discussed with CHAZ and expressed that they are
working on ways to sustain that.
For the case of RBF
project, they have similar incentivized indicators and have wider coverage.
Above that, the delegation appreciated the way they monitor Health Management
Information System, of which they have a data base which is entered once at
health facility and accessed by the HQT. That means, no one can temper with
data easily. Of much interest was an experience sharing with PBF pilot Project under
CHAZ. However, it was also realized that RBF has no strict separation of
function as in PBF Pilot Project implemented by CHAZ. However, they explained
that they will have project review soon to consider some improvement.
The following were the results of the four days Study Tour to
CHAZ in Zambia:
First and foremost, the members of the delegation gained
knowledge of implementing pure PBF project whereby the players have
separate functions which promote accountability, transparency and efficiency.
Second they understood how to align the organization when collaborating with
other stakeholders in implementing PBF and lastly, they have captured the
challenges in separation of functions in PBF projects.
The delegation was
composed of the following:
-
Rt.Rev.Bishop Dr. Israel-Peter Mwakyolile- Chairman of the Zonal
Policy Forum of CSSC- Southern Zone- Head of the delegation
-
Mr. Josibert J Rubona – Director of Planning and Policy MoHSW.
-
Mr. I. Lyimo- CSSC Zonal
Manager-Northern Zone
-
Dr.Sungwa Ndagabwene-
District Medical Officer- Rungwe District
-
Dr.Bernard Njau-Lecturer Kilimanjaro Christian Medical Centre
(KCMC)
-
Mr.Sule,T.Michael- Zonal PBF Coordinator
See the Photo: the delegation from Tanzania, staff from CHAZ and Mpika District Hospital Management
