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Monitoring Transition of Harvard Support to Management and Development for Health (MDH), Tanzania. Mary Mwanyika-Sando, MD 8 th Annual CDC/HRSA Track 1.0 HIV Care and Treatment Program Meeting August 12, 2010, Maputo, Mozambique. Outline. Monitoring of organizational transition

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monitoring transition of harvard support to management and development for health mdh tanzania

Monitoring Transition of Harvard Support to Management and Development for Health (MDH), Tanzania

Mary Mwanyika-Sando, MD

8th Annual CDC/HRSA Track 1.0 HIV Care and Treatment Program Meeting

August 12, 2010, Maputo, Mozambique

outline
Outline
  • Monitoring of organizational transition
  • Monitoring of service delivery
the transition
The Transition

Harvard University transitioning technical and financial support to the new local organization (MDH Ltd.)

Transition: gradual, smooth and seamless

organizational transition
Organizational Transition
  • Detailed transition plans
  • Set up of MDH
    • Organizational concept paper
    • Registration
    • TIN Number
    • Organizational structure
    • Staffing: Management and operational staff
    • Name, logos, etc.
  • Governance
    • Board of governors: composition and change over time
  • Bank accounts
  • Host government concurrence and buy in
  • USG consultations
  • Harvard headquarters support
staffing
Staffing

The required recruitment – senior management and operational staff

Transfer of staff – to the government payroll

Capacity building: technical, administrative and finance (GoT and USG regulations)

the process
The Process!
  • Overall Transition Coordinator in Boston
  • Transition team – Boston and Dar
  • Activities (to assess progress of implementation of the Transition Plan):
    • Weekly conference calls of the Transition Team
    • Regular in-person meetings
    • Joint retreats
    • Site visits and TA from Boston
    • Regular consultations with CDC-Tz
what do we monitor
What do We Monitor?
  • Before, during and after transition
    • Patient enrollment
    • Delivery of care, treatment and patient retention
    • Continuous assessment and improvement of quality of care
patient enrollment
Patient Enrollment

Utilize existing reporting systems

Monthly

Quarterly

Semi-annual

Annual reports

Assess trends

By district, by sites

care treatment and retention
Care, Treatment and Retention
  • District Coordinators
    • Liaise with municipal health management teams: Administrative, Logistics and supplies
  • District Clinical Monitors
    • continue providing technical support to Care and Treatment Clinics
  • Counsellor-patient pairs
  • Active patient tracking integrated with community based health care system
quality assessment and improvement
Quality Assessment and Improvement

Initiated in 2006

Strategies

Core clinical quality care indicators

Patient satisfaction surveys

Time flow assessments

Patient chart reviews

Health care worker surveys

Build capacity of the district and site staff on integrating quality improvement as routine function

quality assessment and improvement continued
Quality Assessment and Improvement (Continued)
  • District/sites QI teams established and involved in:
    • development of indicators
    • performance measurement tools
    • quality improvement plan
  • Regular data collection, processing and dissemination plan
acknowledgements
Acknowledgements
  • USG – HRSA, CDC
  • Tanzania MOH & SW
  • Harvard School of Public Health
  • Dar City Regional Medical Office
  • Municipal Medical Offices of Health
  • Muhimbili University of Health and Allied Sciences
  • MDH management and staff
  • Management and staff of all supported sites