- The DHMTs have been formed in the SOHIP demonstration districts within the remit of a notification of the Punjab Government’s Department of Local Government and Rural Development (now Local Government and Community Development). The DHMTs in both districts provide support and advice to the Health Department and are notified within these districts as statutory bodies of the respective district governments.
- Formal notification of the District Health Management Team in Mianwali district on 10th October 2007.
- Formal notification of the District Health Management Team in Pakpattan district on 3 June 2008.
- The development of DHMTs was preceded by an extensive process of developing capacity of the members of DHMTs in planning and understanding of district health management functions.
- Detailed DHMT Bylaws have been finalized and adopted by the DHMTs in both Mianwali and Pakpattan. The District Assembly of Minawali has formally approved the DHMT Bylaws and the same have been put on the agenda of the Pakpattan District Assembly.
- The DHMTs are now being assisted by SOHIP to actuively monitor the implementation of the District Annual Health Plans in both districts.
3. Implementation and use of District Health Information System (DHIS)
- Evidence-based planning is a pre-requisite to ensuring that services respond to real needs, and that scarce human and financial resources are utilized effectively to produce health results. It was in pursuit of this goal that SOHIP with the agreement of Punjab Health Department made it one of its priorities to implement District Health Information System (DHIS) in Mianwali and Pakpattan. The Government of Pakistan had approved the National Action Plan for the implementation of DHIS in 2007 following phasing out of the existing Health Management Information System (HMIS). In the context of devolution and considering the variety of information that DHIS can handle and analyze, its implementation is a landmark step in Pakistan’s health sector.
- In addition to strengthening the provincial DHIS cell, SOHIP assisted the Punjab Health Department to orient 13 districts planned for the current phase of DHIS implementation to the principles of evidence-based planning and the role of the new DHIS. A DHIS implementation plan for Punjab and our two demonstration districts was also developed by the Provincial MIS Coordinator and District Health Management Teams (DHMTs) of Mianwali and Pakpattan with SOHIP’s assistance.
- SOHIP has also invested in :
- strengthening DHIS training course materials by adding gender and health promotion sections
- training DHIS master trainers for Mianwali and Pakpattan with additional responsibility of assuring quality of health-related information, mentoring and hand-holding of other colleagues
- cascading DHIS training to approximately 900 health facility-based staff in Mianwali and Pakpattan
- provision of DHIS tools and instruments to both Mianwali and Pakpattan
- provision of computers (servers & clients), laser printers, furniture and air-conditioning facilities for DHIS operation at Mianwali and Pakpattan.
- The DHIS is now operational in both SOHIP demonstration districts and it is anticipated that the district planners will have an effective decision support mechanism in the form of credible information, in addition to other sources of qualitative and substantive information, to ensure evidence–based planning and stronger district
4. District Head Quarter Hospitals Standardization
Development of Operations Manual for District Headquarters Hospitals, approved by the DHMTs. Training of all hospital staff now underway for adoption of standardized protocols for hospital functions.
5. Building capacity of district health managers and service providers
Building capacity of systems and services for improved performance, effectiveness and efficiency is at the core of all activities of SOHIP. Whereas the development of capacity of systems takes the form of establishing mechanisms, rules of business, standard operating procedures, bye-laws, terms of reference at the same time Health Department officials in Pakpattan and Mianwali are also undergoing many capacity building programs via SOHIP especially focusing at management, planning, monitoring, Health Promotion and Gender.
SOHIP endeavours to ensure that recipients of training must use their capacity in addressing priority issues in the district health system. SOHIP has also assisted in formation of networks to enable more a deep-rooted and formative process of learning.
Following are the main areas in which SOHIP builds capacity of the district health staff:
- Health Promotion and Advocacy
- Gender & Equity
- Gender Mainstreaming
- Community Mobilization
- “Shape Up” Training of Dispensers Trainers program
- Community Accountability training for staff from the district departments of health, community development, and social welfare
- Leadership & Management
- Systems Strengthening
- IT Training
- DoH Punjab’s DHIS Downstream & Trainers Training (assisted/sponsored by SOHIP in 15 Districts of Punjab).
- Training on Demand: SOHIP also takes pride in providing technical support for training if demanded by any other program/department/ organization working towards health systems strengthening (e.g. orientation & induction training of Social Organizers of MNCH program).
6. Enhancing Learning and Networking
A brief list of some significant Learning and Networking activities is given hereunder with links to relevant documents and details:
2007
- Health Promotion Indaba
- Participation in International Union on Health Promotion
- DHMTs Study Tour Jehlum
- Health Promoters Network activities
2008
- Nepal study tour: learning from best practices on Gender
- District Health Management Forum
- Participation in Canadian Conference on International Health
- Health Promotion Indaba
- Health Promoters Network activities
- Dissemination of Findings of Gender Audit of DoH and DoPW
- Health Promotion Case Studies
- Gender Docudrama
- Study visit to Shaukat Khanum Memorial Hospital and Research Center
- ‘The Jhang Model’ – a case study
7. Research
To strengthen evidence-based planning and improve program implementation, SOHIP has done many studies. The information generated is being utilised to gain a deeper understanding of the underlying causes of problems and to set up benchmarks for performance and monitoring. These benefits are used both internally as well as are being extended to SOHIP counterparts in government health and population welfare departments at the SOHIP demonstration districts. Some notable formal and informal researches are:
- SOHIP Baseline Study
- District readiness on Public-Private Partnership on Health Promotion
- Dispenser’s situation Analysis in Punjab
- Gender Audit of DoH and DoPW
- Management needs analysis of Nursing System in Punjab
Building capacity for undertaking and using action research is another key area that SOHIP is working on. Presently training of a group of both government and non-government personnel identified from both Mianwali and Pakpattan is in the pipeline and will be completed by March 2009. We hope that such capacity will help implementers and managers of district health services to ask the right questions and gather information to gain a better understanding for improving their systems and services and also to make more informed decisions.
8. Supporting and facilitating Community Mobilization
- Community Mobilization and Accountability process initiated in pilot sites in both districts. Comprehensive training manual prepared and training of both government and non-government actors completed. Next steps will be to initiate public private partnerships on Health Promotion. Lessons to be learnt and applied district-wide.
- Launching of the SOHIP Community Mobilization Training Manual, and holding training based on the manual for social mobilizers from the Maternal, Neonatal and Child Health (MNCH) Program in Pakpattan district has been accomplished in mid 2008.
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