Transcript Service availability mapping

Service
Availability
Mapping
Presentation to the MERG
Geneva, Switzerland
October, 2004
Evidence and Information for Policy
The vision
• SAM as a country owned monitoring tool meeting the needs of
multiple partners.
• At national level, SAM is used to track equity between districts and
identify major gaps in service availability.
• At district level, SAM is used for monitoring service availability
alongside supervisory visits.
• Disease-specific programmes use SAM, thus avoiding fragmentation
and duplication.
• SAM results are widely disseminated and used by health sector and
civil society, including other sectors.
• National planners are able to map all facilities and all services on a
regular basis.
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Application
1. Data collected using PDAs by
district health teams
2. PDA is synchronized with
PC for data transfer
3. Data is analysed
and maps produced
using HealthMapper
Evidence and Information for Policy
District questionnaire
Questionnaire overview:
– Section 1: Availability of services and service
providers, by district
– Section 2: Estimated coverage of specific
interventions, by district
– Section 3: Availability of services, by facility
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Facility questionnaire
Questionnaire overview:
-
Section 1: General characteristics
Section 2: General purpose equipment
Section 3: Injection and sterilization equipment
Section 4: Human resources
Section 5: Trained staff
Section 6: Drugs and commodities
Section 7: Lab tests
Section 8: Information on interventions available in
the facility
Evidence and Information for Policy
SAM implementation
Implemented
Uganda
Zambia
Ongoing
Kenya
Cost
~ USD300 per districts (in- country
costs)
Time
~ 4-8 weeks
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Planned
Burkina Faso
DR Congo
Cote d`Ivoire
Mozambique
Senegal
South Africa
Tanzania
Sri Lanka
Laos
Viet Nam
Infrastructure topics
• In-patient, maternity, and delivery beds
available in all facilities
• Blood transfusion services
• Laboratory services
• Communication and technology resources
• Injection practices
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Human resource topics
• Number of:
– Doctors
– Nurses
– Clinical officers
– Dentists
– Laboratory technicians
– HMIS personnel
– Medical records personnel
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Using SAM to look at inequities:
Health staff by district: (ass.) doctors, nurses, and midwives per
10,000 population, excluding Kampala and Jinja districts
Kaberamaido
8
Fewer doctors, more nurses
More doctors, more nurses
Kalangala
Adjumani
Kabarole
Yumbe
6
Masindi
Moroto
Kumi
Kotido
Nakapiripirit
Arua
Moyo
4
Kanungu
0
Bushenyi
Luwero
Kasese
Kitgum
Masaka
Hoima
Bundibugyo
Rukungiri
Nebbi
Kayunga
Sironko
Kisoro
Ntungamo
Katakwi
Kyenjojo
Tororo
Kapchorwa
Kiboga
Mubende
Mayuge Iganga Palissa
Kiboga
Kamwenge
Kibaale
Soroti
Bugiri
Kamuli
Nakasongola
Mbarara
Lira
Rakai
Busia
Apac
Mpigi
Mukono
Fewer doctors, fewer nurses
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1
2
0
Nurse and midwives
per 10,000
Mbale
2
(assistant) Doctors
per 10,000
National average per 10,000 people
1.1 (ass.) doctors
2.9 nurses & midwives
HIV/AIDS
• Availability of:
– PMTCT
– T&C
– ART therapy
– ART drug supply
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Percent of districts with ART, PMTCT or HIV testing &
counselling services, SAM Uganda, 2004
100%
7
Percent of districts
21
22
24
70
Two or more
One facility
No facility
72
54
10
20
0%
ART
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PMTCT
Testing &
counseling
Percent of districts that have at least one laboratory
that can do specified tests, SAM Uganda 2004
Liver
functions
7
CD4+ cell
count
7
83
Blood count
96
Hemoglobin
0
Evidence and Information for Policy
20
40
60
80
100
Findings
• The SAM can provide a snapshot of service availability for HIV/AIDS,
health services and other services.
• HealthMapper and palm pilot are a useful way of collecting information
that will be relevant for health planning and monitoring.
• A national monitoring system of the scale up of AIDS-related services
needs to be put in place. This should depend on district reports, with
special visits to the clinics providing the services. The SAM and
HealthMapper can be used to track progress on a regular basis and can
also monitor system wide effect on service availability.
• Goal is to take the SAM to the district level. The district should be
enabled to plan and monitor service availability through mapping of
facilities and services on a regular basis related to regular supervision
and drug supplies.
Evidence and Information for Policy
THANK YOU
Evidence and Information for Policy