Operational Guidelines for the State of Osun Primary Health Care Development Board
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GOVERNMENT OF ABIA STATE OF NIGERIA OPERATIONAL GUIDELINES OF ABIA STATE PRIMARY HEALTH CARE DEVELOPMENT AGENCY (ABSPHCDA) FOR THE IMPLEMENTATION OF PRIMARY HEALTH CARE UNDER ONE ROOF (PHCUOR) March 2019 TABLE OF CONTENTS Table of Contents 2 List of Tables 4 List of Figures 5 Acronyms 6 Foreword 7 Acknowledgements 8 Executive summary 9 Chapter 1: Introduction 10 1.1 Overview 10 1.2 Principles for Bringing PHC under one Roof 10 1.3 The SPHCDA Operation Guidelines 11 Chapter 2: Governance structures and ownership 12 2.1 Overview 12 2.2 Membership of various governance bodies 12 2.2.1 Governance Structure at the State Level: (State PHCDA) 12 2.2.2 Governance Structure at the LG Level: (LGHA) 13 2.2.3 Governance Structure at the Ward Level: (WDC) 13 2.3 Roles and Responsibilities 14 2.3.1 State Primary Health Care Development Agency (SPHCDA) 14 2.3.2 The Executive Secretary 14 2.3.3 Local Government Primary Health Care Authority (LGHA) 14 2.3.4 Ward Development Committee 15 2.4 Organogram of the SPHCDA 15 2.5 Organogram of the LGHA 16 2.6 Linkage of the SPHCDA with other governance structure 17 2.7 Choosing a functional health facility per ward for the BHCPF 17 2.7.1 Criteria for accreditation of a functional health facility per ward 18 Chapter 3: Legislation 19 3.1 Overview 19 3.2. Abia State Primary Health Care Development Agency (Establishment) 19 Law 2015. Chapter 4: Human Resource For Health 21 4.1 Overview 21 4.2 Human Resource Requirement 22 4.3 Staff Mix 28 4.4 Office set-up 29 Chapter 5: Capacity Building and Mentorship 30 5.1 Overview 30 5.2Capacity Building Needs for SPHCB workers 30 5.2.1 Medical Officers of Health 30 5.2.2 Pharmacist/Pharmacy Technician 31 5.2.3 Community Health Officer 31 5.2.4 CHEW and JCHEW 31 24 5.2.5 Nurses and Midwives 31 5.2.6 Nutritionist/Nutrition Officers/Dieticians 31 5.2.7 Medical Laboratory Scientist, Technicians, Science Laboratory 32 Technologist/technicians 5.2.8 Dental Therapist/Technician 32 5.2.9 Environmental Health Officer 32 5.2.10 Medical Record Officer 32 32 5.2.11 Administrative and Account Staff 33 5.2.12 Cross cutting training needs for PHC program 33 Chapter 6: Funds Management System 34 6.1 Overview 34 6.2 Guiding Principles 34 6.3 Budget Processes 35 6.4 Resource Mobilization 36 6.5 Funds Disbursement and tracking 37 6.6 Results-based Financing 38 6.7 Funds Tracking 38 6.8 Accounting 38 6.9 Role of Auditors 39 6.10 Financial Reporting 39 Chapter 7: Materials Management 40 7.1 Overview 40 7.2 Strategic procurement systems 40 7.3 Reporting Channels 41 7.4 Strategic Purchasing System 41 7.5 Store Management 43 7.6 Asset Management 43 Chapter 8: Integrated Supportive Supervision, Monitoring And 44 Evaluation 8.1 Integrated Supportive supervision and mentorship 44 8.2 Transparent independent oversight role 46 8.3 Data management 46 8.4 Transparent reporting 48 8.5 Monitoring and Evaluation 48 Annex 1: Names of Chosen facility for the BHCPF per ward 51 Annex 2: Participant’s list 61 LIST OF TABLES Pag e Tables Table 1: Sections of the Abia State PHCDA Establishment Law 2015 19 24 Table 2: Schedules of the Abia State PHCDA Establishment Law 2015 20 Table 3: Human Resource requirement 22 Table 4: Staff mix for each health center 28 Table 5: Staff mix for each health Clinic 29 Table 6: Staff mix for each health post 29 Table 7: Resource Management 37 Table 8: Minimum Standards for Store Management 43 Table 9: Integrated Supportive Supervisory Schedule 45 Table 10: Work plan for solving problems after supportive supervision 46 Table 11: Work plan for Monitoring and Evaluation Framework 49 Table 12: Template for M&E Framework For SPHCDA 50 LIST OF FIGURES Figure Page Figure 1: Organogram of the SPHCDA 15 24 Figure 2: Organogram of the LGHA 16 Figure 3: Linkage of the SPHCDA with other Governance structure 17 Figure 4: Flow chart showing supply of commodities and reporting 41 channels Figure 5: Strategic purchasing system process 42 Figure 6: Flow of information in HMIS 47 24 ACRONYMS ABSHIS Abia Health Insurance Scheme ABSPHCDA Abia State Primary Health Care Development Agency BOEC Basic Obstetrics Emergency Care BHCPF Basic Health Care Provision Fund CB Capacity Building CHEW Community Health Extension Worker CHIP Community Health Influencer and Promoter CHO Community Health Officer DHIS District Health Information System DPRS Department Planning Research and Statistics DVEA Departmental Vote Allocation Expenditure Book EHO Environmental Health Officer EHT Environmental Health Technician FMF Federal Ministry of Finance FMOH Federal Ministry of Health GoN Government of Nigeria HF Health Facility HFG Health Financing Group HMIS Health Management Information System HR Human Resources HRIS Human Resources Information System ICT Information, Communication Technology IMCI Integrated Management of Child Illness IPC Interpersonal Communication JCHEW Junior Community Health Extension Worker LGA Local Government Authority LGHA Local Government Health Authority LGSC Local Government Service Commission MOLG Ministry of Local Government MOJ Ministry of Justice MCH Mother and Child Health M&E Mother and Child Health MLSS Modified Life Saving Skills MSP Minimum Service Package MTRF Medium Term Revenue Framework MTSS Medium Term Sector Strategy NTD Neglected Tropical Disease NHAct National Health Act NPHCDA National Primary Health Care Development Agency OIC Officer in Charge PFM Public Financial Management PHC Primary Health Care PHCDA Primary Health Care Development AGENCY PHCUOR Primary Health Care Under One Roof PHF Primary Health Facilities SHMB State Health Management AGENCY SMOH State Ministry of Health SPHCDA State PHC Development AGENCY UHC Universal Health Coverage USAID United States UNICEF United Nations Children Fund WDC Ward Development Committee WHO World Health Organization FOREWORD 24 Operational Guideline for the implementation of Primary Health Care Under One Roof is in line with the ongoing revitalization of Primary Health Care. This publication was developed against a background of continuing efforts to reform the Health Sector in Nigeria. Indeed remarkable progress has been made in bringing Primary Health Care Under One Roof in Abia State. It is instructive to state here that in Abia State, the state Primary Health Care Development Agency and Local Government Health Authority Law was innacted in 2015, the Governing Board is equally in place and the complete transfer of Local Government Health Workers and Primary Health staff of the state Ministry of Health has been achieved, there is an urgent need to develop an operational guideline that will help in the full implementation of PHCUOR at the state, Local Government, Ward and Health Facility levels. Consequently, the state Primary Health Care Development Agency, the Local Government Health Authority, Official Development Partners, Civil Society Groups and other relevant MDAs undertook a comprehensive review of relevant manuals, legal frameworks and equally received inputs from stakeholders. The result of the reviews and brainstorming sessions was the development of this scientific document which contains the Roles, and Responsibilities of Primary Health Care Teams at various levels and of course highlighted the measures and activities to achieve PHCUOR and a seamless implementation. It is obvious that Abia is at an advanced state of implementation of PHCUOR, I am confident that this Operational Guidelines will be of immense value to all and serve as a catalyst for the achievement of the deserved health targets and expectations Dr. Chinagozi Adindu Executive Secretary ACKNOWLEDGEMENT The Governing Board of Abia State Primary Health Care Development Agency is very grateful to all those within and outside the state who contributed to the 24 development, review, finalization and production of the Operational Guidelines of Abia State Primary Health Care Development Agency for the implementation of Primary Health Care Under One Roof. We profusely thank all individuals, partners, stakeholders who provided the Technical Assistance and funds neede. We are grateful to Dr. Okezie Ikpeazu, the Executive Governor of Abia State, Dr. John Ahukannah, the Commissioner for Health, History and posterity will not forgive us for wrong doing if we fail to pay glowing tribute to the Health Policy Plus (HP+) for facilitating this activity and in making sure that this publication saw the light of the day. We appreciate the leadership of the National Primary Health Care Development Agency especially the Technical Support Unit (TSU) for coming to our rescue. Finally we are grateful to the Abia State Primary Health Care Development Agency Management Team, the Local Government Health Authority Secretaries for making refreshing lucid contribution which further enriched this document. We thank you all Dr. Madu Awa Board Chairman EXECUTIVE SUMMARY The Operational Guidelines as a comprehensive publication that encompasses the process, procedures and policies that guides the activities of staff, operators and stakeholders in the delivery of primary health care sector and proper implementation 24 of Primary Health Care Under One Roof the Guidelines provides detailed information on how the Abia State Primary Health Care Development Agency and Local Government Health Authority will be administered in accordance with the provision of the Abia SPHCDA and LGHA Law of 2015. The publication took a critical look at the Governance Structure and Ownership of the Agency, Legislation, Human Resource Management, Capacity Building and Mentorship for the Human Resource, Funds Management System, Material Management, Integrated Supportive Supervision as well as Monitoring and Evaluation. Indeed the Operational Guidelines will certainly assist stakeholders, health policy advisors, legislators, governing bodies and managers establish the key elements of the state primary health care institutions, programmes, activities and sustainability arrangement. This work made frantic efforts to explain in details the principles of Primary Health Care Under One Roof, the membership of various governance bodies such as SPHCDA, LGHA, WDC, VDC and FMC.