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Home Grown Incentives in Katete District

Home Grown Incentives in Katete District. Harrison Mkandawire District Director of Health Katete District. Katete at a glance. Population: 233,582 (CSO-2000) Health centres: 26 One general hospital:1 Trained staff: 86% Number of CBHCP: 2,462 District grant: K406,341.932 MBB District.

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Home Grown Incentives in Katete District

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  1. Home Grown Incentives in Katete District Harrison Mkandawire District Director of Health Katete District

  2. Katete at a glance • Population: 233,582 (CSO-2000) • Health centres: 26 • One general hospital:1 • Trained staff: 86% • Number of CBHCP: 2,462 • District grant: K406,341.932 • MBB District

  3. Why we Introduced Incentives • Health Care workers paid salaries that are not linked to output or outcome measure • High maternal mortality ratio • High infant mortality rate • More deliveries taking place at home • Focus was on input or processes • High CBHCP turn over

  4. Anchorage • Results based planning • Results based management • Participatory Planning • District Health system strengthening

  5. PPP • CIDRZ • CHAMP • LWF • CARE INTERNATION

  6. The home grown incentive mechanisms: • rewarding institutions for actual not promised performance • linking funding to the quantity of outputs or the quality of outcomes rather than inputs • using performance indicators that reflect public policy objectives rather than institutional needs • designing incentives for institutional improvement, not just maintaining status quo

  7. Why Incentives for Health Workers • Link Incentives to performance • Hold them accountable for the results • Change their mindset • Accelerate the attainment of health related MDGs

  8. Indicators to be attained • Institutional deliveries • Fully immunised children • ITN utilisation • IPT Coverage • Pit latrine coverage • Contraceptive uptake • PMTCT

  9. Incentives for TBAs • K100,000 ( Thirty Dollars ) • Chitenje material • Bicycles

  10. Incentives for clients • Mama kit- those who deliver in the facility • Baby Kit for post-natal- 6 days, 6 wks • Food for Ante-natal clients and Under five clients • Food for clients who attend outreach sessions

  11. Financial incentives for Health workers • Floating Trophy • K1,000,000 for the best performing health centre • K800,000 for the facility for achieving the target

  12. Source of Funds • 10% community allocation from the district grant • 4% replacement of the lost user fees • Child health and Maternal Health allocations • Community Development Funds

  13. Reorientation of CBHCPs • Galvanise efforts towards MNCH • Retrained CBHC • Use of RDTs at Community level • Use of Coartem at Community level • Use of Amoxy at Community level

  14. Other Innovations • Bicycle Ambulances • Community HFRs • Transport for the Dischargees from the hospital and the deceased • Solar panels for staff houses • All centres have motorbikes • All centres have HFRs • Detached delivery rooms • Display of imprest allocation to health centres • 100% disbursement of imprest to health centres

  15. Innovations cont…. • Motor bikes for all health centres • Imprest schedules distributed to Health centres, Health centre chairpersons councillors and Members of parliament • K300,000 local retention allowance • Collection of school children for the members of staff in hard to reach areas

  16. Management benefits • Management latitude • Innovativeness • Development of teams cohesion • Team accountability

  17. Challenge • Increased attendance in health centres

  18. Sustainability • Use of the local resources • PPP- Dunavant Cotton Company • Participatory planning

  19. Conclusion • Need to increase the coverage of selected MNCH services to reach the MDG • Ineffective incentives faced by both providers and households hinder achievements of health outcomes.

  20. THANK YOU FOR YOUR ATTENTION.

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