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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

Short Program ReviewIndia Experience and way forward

Subodh S Gupta

WHO India


India experience short program review child health
India experience Short Program Review – Child Health:

  • Rajasthan

  • Bihar

  • Karnataka


1 st short program review rajasthan
1st Short Program ReviewRajasthan

5-days workshop

Facilitated by experts from WHO HQ, SEARO & WHO Bangladesh

Followed the Global Package on SPR CH


Adaptation of spr package karnataka
Adaptation of SPR PackageKarnataka

3-days workshop

Adaptation of worksheets and small changes in group work


Recommendations
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)


Recommendations1
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


Rajasthan spr recommendations incorporated in pip
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


Strengths
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


Challenges
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


Way forward
Way forward

  • Comprehensive package for RCH

  • Package both for state and district level

  • Shorter duration of review workshop



Scope
Scope

  • Review all the activities under current RCH programmes

    • Maternal Health

    • Child Health

    • Adolescent Health

    • Family Planning

    • Nutrition

  • Levels

    • State

    • District


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


Formation of groups
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


Formation of groups1
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


  • Infant mortality rate
    Infant Mortality Rate

    Step 1: Where are we going?


    Focus on equity
    Focus on Equity

    Full Antenatal Check-up (DLHS 3)

    Institutional Delivery (DLHS 3)

    Full Immunization Coverage (DLHS 3)


    Identifying best practices

    • At present, Worksheet 4 : Best Practices & major problems

    • Derived from Strengths/Gaps/ weaknesses identified in Worksheet 1A & 1B & 3.


    Data sources
    Data sources

    • Vital Statistics Registration System:

      • Civil Registration System Sample Registration System

    • Survey:

      • National Family Health Survey

      • District Level Health Survey

      • Annual Health Survey


    Challenges adaptation
    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


    Challenges district level spr
    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



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