COMMUNITY BASED MONITORING SYSTEM HEALTH CARE SYSTEM IN

COMMUNITY BASED MONITORING SYSTEM HEALTH CARE SYSTEM IN ZAMBIA FINDINGS SIN: 160432122 EVANS NJUKA PROGRAM OF STUDY: Bachelor of Business Administration

Overview Research Description � Background � Objective Research Methodology Key Findings � Results Patients � Results Health Workers Conclusion

Research Description Background � Community Based Monitoring System (CBMS) is a tool for improving local governance and is further cofounded on the idea of using data for decision making. � Zambia has 1, 327 healthcare facilities, 85 percent are GRZ facilities, 9 percent are private sector and 6 percent religious affiliated (mission).

Research Objectives Diagnose extent of Service satisfaction by patients Determine the prevalence rate of certain communicable diseases. Provide basis for rational allocation of resources Identify beneficiaries for targeted programmes Monitor and assess impact of various programmes that run in the community

Procedure/Methodology Simple random sampling design is a kind of sampling where each element in the target population has an equal or non-zero chance of being selected into the sample. The study aims at collecting information from the Health workers and patients visiting the Clinic. The questionnaire will be distributed to the Health Workers and collected at a later date.

Target Constituency

Procedure/Methodology Key assumption � The Health Care Services offered in most Health Centres needs improvement � The attitude of Health Workers in general needs a face lift � The efficiency of Health Workers needs improvement

Authorization letter From Ministry of Health

Key Findings/Results 1 Patients Were you (patient) cared for promptly in the Admitting Department? 100% 90% 80% 70% 60% Were you (patient) cared for promptly in the Admitting Department? 50% 40% 30% 20% 10% 0% 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Key Findings/Results 2 Patients Did the Admitting staff courteous and treated you with dignity and respect? 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Key Findings/Results 3 Patients The Nurse (s) treated me with dignity? 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Key Findings/Results 4 Patients Overall, was the patient pleased with the services they received 100% 90% 80% 70% Overall, was the patient pleased with the services they received 60% 50% 40% 30% 20% 10% 0% Excellent Fair Good Poor

Key Findings/Results 5 Patients The Doctor(s) treated me with dignity? 100% 90% 80% 70% 60% The Doctor(s) treated me with dignity? 50% 40% 30% 20% 10% 0% 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Key Findings/Results 6 Patients Overall, was the patient pleased with the services they received 100% 90% 80% 70% Overall, was the patient pleased with the services they received 60% 50% 40% 30% 20% 10% 0% Excellent Fair Good Poor

Key Findings/Results 7 Patients What needs to be done in order to improve the situation at the health facility? 100% 90% 80% 70% 60% What needs to be done in order to improve the situation at the health facility? 50% 40% 30% 20% 10% 0% 0% 25% 50% Clean/Safe improved Sanitation water Cleanliness 75% Improved Sanitation 100% Shortened wait time

Key Findings/Result 1 Health Workers Discription of Job Title of Respodants 35% 30% 25% 20% 15% Discription of Job Title 10% 5% R ev or ct ol le C en ue Ph ar m Te ch se ur st si As N an t T b La ta l. T D en a at D EH st pi he so As O al ic lin C ra ci ffi at ce e r rk le C C as hi er 0%

Key Findings/Result 2 Health Workers

Key Findings/Result 3 Health Workers % Percentage destribution of the Under-Five Mortality rate (per 1, 000 live births) 60% 50% 40% % Percentage destribution of the Under-Five Mortality rate (per 1, 000 live births) 30% 20% 10% 0% 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Key Findings/Result 4 Health Workers % Percentage destribution of the Maternal Mortality Ratio (per 100, 000 live births) 60% 50% 40% % Percentage destribution of the Maternal Mortality Ratio (per 100, 000 live births) 30% 20% 10% % Percentage destribution of the Maternal Mortality Ratio (per 100, 000 live births) 0% Very low 25% Low 50% Moderate 75% High 100% Very high 0%

Key Findings/Result 5 Health Workers % Percentage destribution of the Incidence of Malaria (per 1, 000 population) 60% 50% 40% 30% % Percentage destribution of the Incidence of Malaria (per 1, 000 population) 20% 10% % Percentage destribution of the Incidence of Malaria (per 1, 000 population) 0% Very low 25% Low 50% Moderate 75% High 100% Very high 0%

Key Findings/Result 6 Health Workers 100% 90% 80% 70% % Percentage destribution of deliveries assisted by skilled health personnel 60% 50% 40% 30% 20% 10% 0% 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Key Findings/Result 7 Health Workers 120% 100% 80% % Percentage destribution of Underage pregnancy 60% 40% 20% 0% 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Key Findings/Result 8 Health Workers 100% 90% 80% 70% 60% % Percentage destribution of Gonorrhea Chlamydia rates. 50% 40% 30% 20% 10% 0% 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Key Findings/Result 9 Health Workers % Percentage destribution of fertilty birth rate 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Key Findings/Result 10 Health Workers

Key Findings/Result 11 Health Workers % Percentage destribution of Under weight children 100% 90% 80% 70% 60% % Percentage destribution of Under weight children 50% 40% 30% 20% 10% 0% 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Key Findings/Result 12 Health Workers % Percentage destribution of Provision of malaria prevention and control 100% 90% 80% 70% 60% % Percentage destribution of Provision of malaria prevention and control 50% 40% 30% 20% 10% 0% 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Key Findings/Result 13 Health Workers % Percentage destribution of Management and maintenance of medical equipment 0% Very low 25% Low 50% Moderate 75% High 100% Very high

Findings The research established that (55%) of patients perceived the services they received as good to fair. The patients perceived the dignified treatment rendered to them by nurses to be very low to moderate, that rendered by doctors to moderate to high. The waiting time to see the Nurse or Doctor was perceived to be fairly acceptable by the patients interviewed. The majority of patients interviewed (66%)where of the opinion that in order to improve the situation at the health facility, Sanitation and services offered need to be improved.

Findings Among the 40 health workers interviewed (35%) of these health workers were registered nurses. The research further established that the health facility had quite a number services to offer, some of which included laboratory, counseling, dispensary and screening but however lacked other vital services like ICU, Surgery, x-ray and a maternity ward. The cases of Under-Five Mortality rate, Maternal Mortality Ratio, Incidence of Malaria & Malaria case fatality rate among children were deemed to very low to low while cases of Diabetes prevalence, Obesity prevalence, fertility birth rate & Tuberculosis Prevalence were perceived to be Moderate.

Findings Additionally, Provision services like of outreach services, malaria prevention and control, access to TB control and prevention, access to HIV prevention and treatment, access to environmental health and food safety services, were perceived to be high to very high while provision of other services like, mobile hospital services, strengthening capacity for transport management at all levels of health care, were perceived to be very low. The majority of health workers interviewed were of the opinion that in order to improve the health system at the health centre, an improvement in infrastructure, staffing levels and increased funding was needed.

Conclusion The cost of funding health care is, however, a huge challenge; demand for care is insatiable and difficult decisions have to be taken over the prioritisation of services.