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BSF-IAe

BSF-IAe. Results of the analysis of data collected in 2012. Note on presentation. Data analysis and interpretation still in process Need for nuances in interpretation of data Underlying determinants of different achievements need attention – follow up by NGO health forum?

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BSF-IAe

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  1. BSF-IAe Results of the analysis of data collected in 2012 BSF-IAe data analysis

  2. Note on presentation • Data analysis and interpretation still in process • Need for nuances in interpretation of data • Underlying determinants of different achievements need attention – follow up by NGO health forum? • Data analysis will be made available to all through BSF website BSF-IAe data analysis

  3. Specific objective of BSF-IAe • Improved access to effective primary health services and primary education, particularly for vulnerable groups and in priority host communities for returnees • Contribute to a reduction in Maternal mortality and Child mortality (<5) BSF-IAe data analysis

  4. Proxy impact indicators • Births attended by skilled health worker • Facility based attended births • Access to treatment of 3 killer-diseases <5 BSF-IAe data analysis

  5. How monitored? • QPR by grantees processed into database • Field visits by monitors, accompanied by • NGO • CHD • MoH • Round tables with several grantees • Peer monitoring • Ongoing communication by mail, phone, meetings at Juba level BSF-IAe data analysis

  6. What has been funded? • Human resources at all levels (46%) • Travel, transport, project & base running costs (11%) • Infrastructure, essential drugs and medical equipment (19%) • Training and capacity building (4%) • WASH (3%) • Direct costs transport, per diem (9%) • M&E incl audits (8%) BSF-IAe data analysis

  7. Health System Strengthening • Steering Committees • DHIS capacity building • CHD infrastructure incl laptop, solar, furnit. • Joint supervision • Joint monitoring visits incl. visits to private sector e.g. local drug shops • Coordination meetings • Debriefing at SMoH BSF-IAe data analysis

  8. Database information • Health service attendance • Morbidity for 3 killer diseases <5 • Death in the facility • Access to water • Staffing pattern • HMIS • Supervision by CHD and grantee • Essential drugs supply BSF-IAe data analysis

  9. How well did we do? • Target setting by NGOs and BSF: based on what? • Absolute figures versus percentages • Catchment and target populations BSF-IAe data analysis

  10. Target population estimates • Catchment population payam based • Impact of returnees on population figures • Pregnant women: 4.2 % based on CBR • CBR 3.59 / 1000 people (live births) acc to Statistical Yearbook 2011 • Miscarriages/spontaneous abortion: approx 10% • Still births: approx 1%-2% of all births • Expected births/deliveries: 4% rounded • Under 1 year: 4% • 12-23 months: 3.5% BSF-IAe data analysis

  11. Demographic figures/denominators • HMIS report • Pregnant 5.6% • Live births 10% less (miscarriage/abortion) • Under ones: live births – IMR (approx 10%) • No clear guidance on proportions • Need for alignment / harmonization BSF-IAe data analysis

  12. HPF and ISDP • Pregnant women 5.2% • Under ones 3.5% - 4% • Under ones 4% • Births ? • 12-23 months (EPI) ? BSF-IAe data analysis

  13. BSF-IAe population figures • Catchment population: payam based (NBS) and corrected for population growth • CBR (live births) 35.9/1000 (NBS-Statistical Yearbook 2011) • % pregnant women: 4.2% • % births/deliveries : 4% (rounded) • Under 1 year: 4% • 12-23 months: 3.5% BSF-IAe data analysis

  14. Coverages achieved in BSF-IAe • OPD attendance rate: 0.53 • ANC 1 coverage 54% • ANC 4+ coverage 26% • Skilled attended births 1.5% • DPT3 46% BSF-IAe data analysis

  15. Returnees (acc to IOM) BSF-IAe data analysis

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  19. What do the figures tell us? • Daily attendance differs from place to place and between NGOs • Some facilities have very low attendance. Why? • To assess achieved change the figures need to be compared to baseline data BSF-IAe data analysis

  20. ANC • ANC coverage: % of pregnant women (4.2%) who attended ANC services • HMIS indicators: ANC 1st and ANC 4+ • ANC care rate: % of ANC-1 users who attended 4 or more times • Quality of ANC not monitored BSF-IAe data analysis

  21. BSF-IAe data analysis

  22. ANC 1st visit • Some NGOs report coverage > 100% • Concern, Tearfund, IRC • Some report coverage < 25% • ARC, IMA (Duk), OVCI • Why? • Population estimates too low? Returnees not included in catchment population estimates • Unreliable figures? • Users from other payams because of quality? • Other?? BSF-IAe data analysis

  23. BSF-IAe data analysis

  24. ANC • 54% of pregnant women attended ANC-1 • 26% of pregnant women attended ANC 4+ • Almost 50% of women who start ANC completed ANC 4 (care rate) • ANC 4+ >> ANC 1 (Tearfund) is very unlikely • Huge differences between grantees • Underestimated pregnant population • Accessibility of ANC (routine/daily, distance..) • Health seeking behaviour / culture • … BSF-IAe data analysis

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  27. Skilled birth attendant • MoH RH working group: excluding CMW • BPHS: including Community Midwife • HSDP: including Community Midwife • HMIS: excluding Community Midwife • MoH RH policy & strategic plan: not well defined • confusion and inconsistencies in reporting BSF-IAe data analysis

  28. Trends BSF-IAe • % of health facility deliveries increasing over time • % of facility based births of all births in catchment population: 11% (2012) • % of facility based births attended by skilled staff: 14% (2012) • % of all births attended by skilled HW: 1.5% • < 15% of facilities (BSF) have skilled midwife • NGO often include CMW in report on skilled attended births. • BPHS 2011 also considers CMW as skilled! BSF-IAe data analysis

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  30. DPT3 completed • Coverage ranges from < 5% to > 120%.... • Access to service: • Static and outreach services • Daily – weekly – monthly • NID by MoH • Availability of vaccines • Involvement of SMoH/CHD in EPI services • Quality of figures • Different baseline data • Coverage > 100% impossible; caused by underestimated catchment population BSF-IAe data analysis

  31. Why different achievements of grantees? • Geographical differences • Access to the facility (geo, security,season, …) • Tribal differences (culture, nomads,..) • Population density varies a lot • Urban versus rural area • Quality of support by NGO / strategies used • Quality of monitoring, supervision and reporting • Effect of returnees/IDPs population • Difference at baseline level • Degree of past support / history in the area BSF-IAe data analysis

  32. Essential drugs • MoH push system- not covering needs • Additional drugs procured for an average of approx 1 USD/consultation (ranging from 0.2 USD to 5 USD per consultation) • MoH supply differs • Prescription behaviour differs • Management of stock and consumption • Rational use and leakage of essential drugs BSF-IAe data analysis

  33. DHIS BSF-IAe data analysis

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