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Short Program Review India Experience and way forward

Short Program Review India Experience and way forward. Subodh S Gupta WHO India. India experience Short Program Review – Child Health:. Rajasthan Bihar Karnataka. 1 st Short Program Review Rajasthan. 5-days workshop Facilitated by experts from WHO HQ, SEARO & WHO Bangladesh

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Short Program Review India Experience and way forward

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  1. Short Program ReviewIndia Experience and way forward Subodh S Gupta WHO India

  2. India experience Short Program Review – Child Health: • Rajasthan • Bihar • Karnataka

  3. 1st Short Program ReviewRajasthan 5-days workshop Facilitated by experts from WHO HQ, SEARO & WHO Bangladesh Followed the Global Package on SPR CH

  4. Adaptation of SPR PackageKarnataka 3-days workshop Adaptation of worksheets and small changes in group work

  5. Recommendations Example: SPR Karnataka Appointment of contractual staff to fill in gaps in current vacancies  Rejuvenate Divisional Joint Directorate covering seven ‘C’ districts Prepare a dedicated HR policy for these districts (Seven ‘C’ category districts & Bellary) Problem • Lack of Human Resource Management in ‘C’ category districts (and Bellary)

  6. Recommendations Example: SPR Karnataka SIHFW and SHSRC to develop comprehensive supervisory checklist Activation of district coordination committee for Child Health (to address gap between training and implementation ) Designate Medical colleges / other public health institutions as nodal agencies for supervision and handholding for district trainings Problem • Supervision, monitoring and feedback of trainings is inadequate

  7. Rajasthan: SPR Recommendations incorporated in PIP • Strengthening of VHSC • Expedite training of VHSC members • Develop system of monthly meeting of VHSC • Develop five model VHSC at block level • Community mobilization • Mainstreaming of AYUSH practitioners • Utilize them for monitoring MNCHN services • Efforts for convergence with ICDS • Monthly meeting of State Steering committee to discuss issues related to MCHN jointly by Health and ICDS • Training of Jan Mangal Couples for Interpersonal communication • Strengthening of quality of trainings of frontline workers • Rapid evaluation of IMNCI

  8. Strengths • Participation of all important stakeholders • Uses data for recommendations • Group work ensures experience of people from the field is discussed • Focus on interventions • Adequate scope to address availability, access, quality and inequity • Causal analysis to identify health system issues

  9. Challenges • Bringing all stakeholders together • Ownership by State/ District health team • Follow-up and action for implementing the recommendations of the review team • Focus on improving implementation planning

  10. Way forward • Comprehensive package for RCH • Package both for state and district level • Shorter duration of review workshop

  11. Development/ Adaptation of an Integrated Package for RCH

  12. Scope • Review all the activities under current RCH programmes • Maternal Health • Child Health • Adolescent Health • Family Planning • Nutrition • Levels • State • District

  13. SPR Process Preparatory activity by core team Step 1 Where are we? SPR Workshop Are interventions reaching target population? Step 2 Step 3 How well are program activities being implemented? Step 4 What are the main problems? What are solutions and recommendations? Step 5 Follow-up of recommendations at appropriate level

  14. Formation of groups • Step 1 – Plenary Session • Step 2 – Life-cycle approach • Gp 1: Maternal Health • Gp 2: Newborn and Child Health • Gp 3: A) Adolescent Health, and B) Family Planning

  15. Formation of groups • Step 3 onwards - Thematic groups • Group 1 : Monitoring & Evaluation • Service Coverage • Quality assurance • Group 2 : Strengthening Health Systems • Human Resources • Supplies • Group 3 : Community Empowerment • Communication • Community Mobilization

  16. Infant Mortality Rate Step 1: Where are we going?

  17. Focus on Equity Full Antenatal Check-up (DLHS 3) Institutional Delivery (DLHS 3) Full Immunization Coverage (DLHS 3)

  18. Identifying best practices • At present, Worksheet 4 : Best Practices & major problems • Derived from Strengths/Gaps/ weaknesses identified in Worksheet 1A & 1B & 3.

  19. Data sources • Vital Statistics Registration System: • Civil Registration System Sample Registration System • Survey: • National Family Health Survey • District Level Health Survey • Annual Health Survey

  20. Challenges: Adaptation • Identifying the indicators • Data availability for the period under review • Data quality of ‘Health MIS’ • Converge separate packages into one • Converge with the existing tools for Program Implementation Plan

  21. Challenges: District-level SPR • Data sources to be used • Data related to equity • Data quality of Health MIS • How to use the experiences of program managers and local experts

  22. Thank You

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