Presentation (PDF) Increase-the-uptake-of-RMNCH-Services-in-the-post-EVD-outbreak.pdf

CHIP Plan (PDF)

Details

MoHS - Sierra Leone

• Ministry of Health and Sanitation (MoHS) is primarily responsible for the health needs of the citizens of Sierra Leone. It formulates policies that contribute to promoting and ensuring quality health for the population as well as implementing these policies.
• Options Consultancy Service is a key service provider for DFID funded RCH Programmes in Sierra Leone since 2010. Options is currently the coordinating arm of the IRMNH programme implemented by UNICEF,UNFPA and MSSL
• The MoHS, through the Directorate of Reproductive & Child Health provides oversight role on the IRMNH programme

Mission

The Ministry of Health and Sanitation(MoHS) believe that access to sound health is a human right, and is committed to improve health outcomes of the citizenry through the delivery of quality preventative, promotive and curative health services

External Analysis

• Sierra Leone has the worst maternal and child health indicators in the world
• The health system is weak
• Several strategies/interventions were instituted in recent years (e.g. the Free Health Care Initiative)
• The Ebola viral disease (EVD) outbreak further weakened the health system (poor hygiene practices for example, exacerbated the spread of the virus)
• Mistrust-health workers refused to handle cases; patients considered public health facilities as source of infection
• Overall effect- a decline in the utilization of health care services for non-Ebola related health needs
• 39% drop in children treated for malaria; and 21% drop in children receiving basic immunization (penta3); 90% drop in family planning visits (Source: MoHS/UNICEF, 2014)

The Solution: Your CHIP

The reduced utilization of health facilities was largely as a result of negative rumours of the EVD, mutual fear between patients and health workers and poor facilities for infection prevention and control (IPC).
These have impacted negatively on the health outcomes of, especially the vulnerable women and children (a decline in the uptake of reproductive, maternal, newborn and child health (RMNCH) services).

This CHIP interventions in resolving the problem of low uptake of RMNCH services will include:

• Demand creation for RMNCH services
• Strengthen IPC infrastructure at all service delivery points in the CHIP community
• Enhance the capacity of health staff on IPC management
• Advocacy

Goals and Objectives

Goal:
To promote demand creation for RMNCH services in the post EVD in Sierra Leone

Long term objective:
Achieved pre-EVD status of the targeted RMNCH indicators in the CHIP communities by August 2016

Short term objective 1:
IPC systems in place in 80% of health facilities by August 2016

Short term objective 2:
By end of the project, 90% of the CHIP communities reached and sensitized on EVD containment measures and RMNCH messages.

Measurement

• The success of the project will be measured using various methods: qualitative, quantitative and spot checks
• The indicators for success will include:

1. 1. Number of health staff trained on IPC
   2. % of health facilities with requisite materials for IPC
   3. Attendance rates on RMNCH services
   4. Number of community sensitization meetings held
   5. Number of slots aired in community radio stations on RMNCH and EVD messages
   6. Proportion of communities reached with RMNCH and EVD messages

Lessons Learned

• Differentiating between Inputs, Processes and Outputs has been a key learning point.
• Considering the relevance of communities in health service delivery is critical in promoting ownership of interventions to improve their health
• Governance and ethics lecture will serve as a guiding principle in the implementation of the CHIP in the day-to-day work