Thursday, May 16, 2013

Tanzania delegation Study Tour to Church Health Association of Zambia (CHAZ)



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