Bobby Jefferson Senior HMIS Advisor

Futures Group

The Site Capacity Assessment (SCA) Tool and other Mechanisms to Monitor Transition Status

Track 1 Implementers MeetingMaputo, Mozambique

August 2010

Olivier Byicaza SI Advisor Rwanda

Futures Group

Transition

“Begin with the end in mind.” Steven Covey

Emerging Program Environment

1. Flat-line budgets

2. Increasing number of patients

3. Period of Transition Aligning with MOH

4. Sustainability capacity and strengthening local organizations

NOT BUSINESS AS USUAL

Environment led toward

development

SCA enables targeted technical

assistance (TA)

Cost Efficiencies

When to provide targeted TA

Site Capacity Assessment (SCA)

Program Monitoring tool

Monitor Site Progress Toward Sustainability

Targeting 12 Component toward Sustainability

12 Components Adult HIV Care Nursing Community

Based Treatment Services

Quality Improvement Program

Adolescent Care Maternal and

Child Health (PMTCT)

Finance and Compliance

Health Care Management

Pharmacy Laboratory Strategic

Information Advocacy,

Fundraising Public Relations

7 Functional Areas

Physical Infrastructure and Equipment

Human Resources

Planning and Budgeting

Practice/Activities

Management, Supervision, and Communication

Commodities and Supplies

Record Keeping and Reporting

Scoring

1.0-1.9 2.0-2.9 3.0-4.5 4.6-5.0

Red Flag

Significant support needed

Yellow Flag

Targeted Assistance Needed

Approaching Sustainability

Green Flag

Sustainable

Blue Flag

Exceeds Expectations

Consider for training purposes

Components and Functional Areas Matrix

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Score

Physical Infrastructure & Equipment

Human Resources

Planning & Budgeting

Record Keeping & Reporting

Practices (Activities)

Mangement, Supervision & Communication

Commodities & Supplies

Score

Provides clear guidelines to sites

Identify areas fortargeted technical assistance to support transition process/ site self

sustain

Allows us to provide tangible data anddescriptive goals to sites

Provide information for decision on Workplan and Action Plans

A key area for successful transition use of cost efficient tools that builds ownership

Identifying and sharing best practices

SI Action Plan Progress

Action Plan Items vs. Completed

Facility A.

Total Action Plans

Total Action Plans Completed

Action Plan

Follow-up and Action Planning

1. Schedule follow-up meeting with the health facility and appropriate component experts.

2. Work with health facility and relevant component experts to develop action plans.

3. Identify and schedule component expert technical assistance needed to implement action plans.

4. Coordinate and monitor capacity strengthening.

Use SCA Dashboard to monitor health facility status relative to sustainability benchmark

Monitoring

SI Scope Of Work

M&E

HMIS

DDIU

Supportive Supervision

Transition SI Activities

SCA Rwanda

Carried out assessments 10 sites

Provided feedback to facility

Collaboratively develop specific work plan

Targeted Technical assistance

Example: RwandaKey performance program Indicators for DDIU

have been used as measurement for site readiness for transition

Olivier BYICAZA, Strategic Information Advisor

AR/Futures Group International

Site Activities

ARV Missed Pickup Reports

Numbers of Patients Missing Clinics Visits

Number of Patients Missing CD4

Use of Integrated Clinical Data Management

system (IQChart software)

0.0%

0.2%

0.4%

0.6%

0.8%

1.0%

1.2%

1.4%

0.4%

0.3%

1.2%

0.4%

0.3%0.3%

0.2%

0.3%0.4%

0.2%

% OF Missed ART pickup in 10 days, Feb-ruary 28, 2010; N= 4017

% OF Missed ART pickup in 10 days

Data clerks and nurses were in solidarity camp

0

500

1,000

1,500

2,0001972

1301

1209

13741297

1032

870885

614618

502 471

508477

648

# OF ACTIVE PATIENTS WITH NO CD4 CONTROL > 6 MONTH_ALL SITES As of

February 28, 2010# OF ACTIVE PATIENTS WITH NO ...

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

19.8%

14.1%

12.8%13.5%

12.5%

8.1%8.0%

7.9%

5.4%5.4%

4.1%3.8% 4.0%

3.1%3.0%

% patients who missed their clinical follow up as of February 28, 2010; N= 6500

% patients who missed their clin-ical follow up

Conclusion Collaboration between data managers,

community support team and clinical team has resulted to a consultative informed decision making for program improvement.

Key performance program Indicators for DDIU have been used as measurement for site readiness for transition

We will continue support MOH and Districts

HMIS, M&E, DDIU

Thank You