Leadership Development Program Northern/Tygerberg Sub-Structure September 2012–May 2013: Final Report June 2015 Leadership Development Program, Northern/Tygerberg Sub-Structure, September 2012–May 2013: Final Report Gail Mkele Sue Putter Tiwonge Mkandawire June 2015 Leadership Development Program, Northern/Tygerberg Sub-Structure, September 2012–May 2013: Final Report This report is made possible by the generous support of the American people through the US Agency for International Development (USAID), under the terms of cooperative agreement number AID-OAA-A-11-00021. The contents are the responsibility of Management Sciences for Health and do not necessarily reflect the views of USAID or the United States Government. About SIAPS The goal of the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program is to assure the availability of quality pharmaceutical products and effective pharmaceutical services to achieve desired health outcomes. Toward this end, the SIAPS result areas include improving governance, building capacity for pharmaceutical management and services, addressing information needed for decision-making in the pharmaceutical sector, strengthening financing strategies and mechanisms to improve access to medicines, and increasing quality pharmaceutical services. Recommended Citation This report may be reproduced if credit is given to SIAPS. Please use the following citation: Mkele G., S. Putter, and T. Mkandawire T. 2015. Leadership Development Program Northern/Tygerberg Sub-Structure, September 2012–May 2013: Final Report. Submitted to the US Agency for International Development by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Arlington, VA: Management Sciences for Health. Key Words Leadership Development Program, capacity building, Western Cape Systems for Improved Access to Pharmaceuticals and Services Pharmaceutical and Health Technologies Group Management Sciences for Health Ditsela Place, 1204 Park Street (Cnr Jan Shoba Street) P.O. Box 11471, Hatfield, 0028, Gauteng Telephone: +27 12 364-0400 Fax: +27 12 364 0416-0462 E-mail: [email protected] www.siapsprogram.org ii CONTENTS Acronyms ................................................................................................................................... v Acknowledgments..................................................................................................................... vi Executive Summary ................................................................................................................. vii Introduction and Background .................................................................................................... 1 Vision and Values of the Western Cape Province ................................................................. 1 Metro District Health Services ............................................................................................... 1 Overview of Northern/Tygerberg Sub-Structure ................................................................... 2 Building Leadership and Management Capacity in the Western Cape ................................. 2 Leadership Development Program ........................................................................................ 3 LDP Training for Northern/Tygerberg Sub-Structure ............................................................... 7 Participants in the Program .................................................................................................... 7 LDP Workshop Schedule ....................................................................................................... 7 LDP Process in Northern/Tygerberg Sub-Structure ............................................................ 11 Coaching Visits .................................................................................................................... 11 Results Achieved ..................................................................................................................... 14 Compliance with National Core Standards Related to Pharmacy: Bellville CDC .............. 14 Introduction of a New Bin/Stock Card System to Improve Stock Control and Availability: Bishop Lavis CHC ............................................................................................................... 14 Minimizing Prescriptions Rejected by the CDU: Delft CHC .............................................. 15 Increase the Off-Site Service Delivery of Medication in the Catchment Area: Durbanville CDC ..................................................................................................................................... 17 Supplying CDU Medicines Off-Site: Elsies River CHC ..................................................... 17 Improving Patient Compliance with Chronic Medication Appointment Dates: Goodwood CHC ..................................................................................................................................... 18 Reducing the Waiting Time of CDU Patients: Kraaifontein CHC ...................................... 19 Pharmacy Services Monitoring of Expired Medicine: Metro District Health Services ....... 21 Reduce the Waiting Time from 20 to 10 Minutes: Parow CDC .......................................... 21 Reducing Out-of-Stock Items: Ravensmead CDC .............................................................. 22 Increasing Patient Knowledge on Chronic Medication: Reed Street Clinic ........................ 23 Reduce CDU Patient Waiting Times at the Pharmacy: Ruytewacht CDC and Belhar CDC .............................................................................................................................................. 24 Sharing the Results .............................................................................................................. 27 Feedback from Program Participants ................................................................................... 27 References ................................................................................................................................ 29 Annex A. LDP Workshop Schedules....................................................................................... 30 Annex B: Coaching Visit Schedules ........................................................................................ 32 Annex C. Final Presentation Schedule ..................................................................................... 40 Annex D. Final Team Presentations ........................................................................................ 41 Annex E. Workshop Evaluation Reports ................................................................................. 44 iii Leadership Development Program, Northern/Tygerberg Sub-Structure, September 2012–May 2013: Final Report List of Tables Table 1. HIV Prevalence in Women Aged 15–24 in the Cape Metro District (%) ................... 2 Table 2. District TB Profile: All New Pulmonary Cases—Case Finding Cohort ..................... 2 Table 3. Program Participants Disaggregated by Gender .......................................................... 7 Table 4. LDP Workshop Schedule for the Northern/Tygerberg Sub-Structure ......................... 8 Table 5. First LDP Coaching/Support Visit Groups, January 22–25, 2013* .......................... 12 Table 6. Second LDP Coaching/Support Visit Representatives by Facility, March 12–15, 2013*........................................................................................................................................ 13 Table 7. Rejected Prescriptions, November 2012–March 2013 .............................................. 16 Table 8. Percentage of Off-Site Deliveries* ............................................................................ 17 Table 9. Measurable Results by Facility Team ........................................................................ 25 List of Figures Figure 1. Leading and Managing Framework............................................................................ 4 Figure 2. Leading and Managing for Results Model ................................................................. 5 Figure 3. Challenge Model ........................................................................................................ 6 Figure 4. Number of out-of-stock items, Bishop Lavis Pharmacy Department, September 2012–April 2013 ...................................................................................................................... 15 Figure 5. Number of prescriptions rejected by the Delft CDC (supplier) ............................... 16 Figure 6. Percentage of CDU prescriptions collected off-site, December 2012–April 2013, Elsies River CHC ..................................................................................................................... 18 Figure 7. Average waiting time per hour for CDU patients, October 2012–February 2013, Kraaifontein CHC .................................................................................................................... 20 Figure 8. Prescription waiting times, Parow CDC, at baseline and endline ............................ 21 Figure 9. Average prescription waiting time across weekdays, Parow CDC .......................... 22 Figure 10. Out-of-stock items during LDP, Ravensmead CDC .............................................. 23 Figure 11. Change in patient medicines knowledge, diabetic chronic club, Reed Street Clinic .................................................................................................................................................