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HSMA 1 And 2 > HRM,CHPS,NHIs > Flashcards

HRM,CHPS,NHIs Flashcards

1
Q

‘Employess are the most important asset of the organization’

  • Depends on thr Quality of people that are employed.
  • Skills to achieve strategic goals.
    True or false
    What is human resource management
    What is the goal of HRM
    Name the three stakeholders of HRM
A

According to the British Institute of Personnel management:

“that part of management that is concerned with people at work and their relationship with an organization”

to supply the enterprise with personnel capacities (manpower)

Society

  • Organization/owners
  • Employee
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2
Q

What are the key activities or the scope of HRM

State the four current challenges to HRM

A 
Human resource planning
•Human resource policies
•Salary and benefits administration
•Human rights and labour laws.
•Recruitment, selection and orientation.
•Performance Management
•Training and staff development
•Communications and counselling
Employess conpensation
•Employee motivation
•Employee welfare
•Industrial relation
•Labour relations
•Succession planning
•Quality of working life.
  • Globalization of business
  • Economic and technological changes and managing change
  • Human capital and workforce demographics and diversity.
  • Organizational cost pressures and reconstruction
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3
Q

State the six things that show the evolution of primary health care in Ghana

A

Ghana PHC Policy Doc.(1977) Vs Alma Ata Declaration on PHC(1978)
•Level A (Community)
•Level B (Health Centre)
•Level C (District Hospital)
•Several local initiatives involving training of village volunteers-VHW, CBA, CHW, etc
•National TBAs training programme

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4
Q

What are the components of primary health care

A

Water and sanitation

  1. Food & nutrition
  2. Immunization against 6 major diseases (DPT, measles YF and TB)
  3. MCH/Family Planning
  4. Prevention & control of locally endemic diseases
  5. Treatment for common diseases and injuries
  6. Health education
  7. Provision of essential drugs
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5
Q

As part of the primary health care initiative what did UNICEF introduce

A 
UNICEF GOBIFFF 
As part of the PHC initiative UNICEF introduced GOBIFFF as its response:
1.G- Growth Monitoring
2.O - Oral rehydration
3.B - Breast feeding
4.I - Immunization
5.F - Family planning
6.F - Female literacy
7.F - Food technology
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6
Q

What is CHPS

What services are involved in CHPS

A

CHPS: Community-based Health Planning and Services : There is:-
•Community ownership in the planning and implementing health activities
•Close to client service delivery (through home/household visits) providing
•MCH, Immunization Disease surveillance Nutrition, Community Mobilization

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7
Q

What is the CHPS strategy(they’re 7)

A

Home-grown evidence based approach of mobilizing both the health sector & communities to meet basic health needs:
•Demarcating Sub-districts into CHPS zones
•Mobilization of Community systems – Community Health Committees & volunteer systems
•Preparation & placement of CHOs in zones
•Building DHMT & SDHT support systems for CHPS
•Building Partnerships with government, communities & donor partners/NGOs
•Mainstreaming all Community health programs into CHPS

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8
Q

What is CHPS not?

A

It’s NOT
•Sitting in the CHPS compound to provide care
•The traditional homes by CHNs or PHNs
•Health workers know it all: All stakeholders are important
•Complaining about problems: If there are no problems CHPS will not be needed

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9
Q

What four things are involved in the CHPS process

A

Involves interactive & dynamic steps and milestones, including:
•Community entry & dialogue,
•Partnership building & Resources mobilization
•leading to the placement of a trained health worker (Community Health Officer-CHO) in a zone to work with communities to meet their basic health needs.

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10
Q

What is the CHPS process not?

A

Is NOT
•a linear process
•There is no static point in the process
•Religiously following processes that is important but the positive results of community ownership & empowerment

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11
Q

What are the four objectives of CHPS

A

Improve equity in access to basic health services.

  1. Improve efficiency and responsiveness to client needs.
  2. Develop effective community engagement systems to support service delivery
  3. Develop effective inter-sectoral collaboration.
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12
Q

Define CHPS

What is the aim of the CHPS policy

A

CHPS is a national mechanism to deliver essential community based health services involving planning and service delivery with the communities. Its primary focus is communities in deprived sub-districts and in general bringing health services close to the community.

The Aim:
•Is to attain the goal of reaching every community with a basic package of essential health services towards attaining Universal Health Coverage and bridging the access inequity gap by 2020

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13
Q

What are the four components of CHPS implementation

A

A CHPS Zone refers to a demarcated geographical area of up to 5,000 persons or 750 households in densely populated areas and may be conterminous with electoral areas where feasible.
•A CHPS Compound refers to an approved structure consisting of a service delivery point and accommodation complex both of which must be present
•A Community Health Officer (CHO) is a trained and oriented Community Health Nurse working in a CHPS zone and may be assigned to a Community within the zone
•Community Health Volunteers (CHVs) are non-salaried community members identified and trained persons supporting CHOs in a Community within the CHPS zone

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14
Q

What are the general principles of the CHPS policy

A

General Principle:
The general principles guiding the development and implementation of CHPS are
•Community participation, empowerment, ownership, gender considerations and volunteerism
•Focus on community health needs to determine the package of CHPS services
•Task shifting to achieve universal access
•Communities as social and human capital for health system development and delivery
•Health services delivered using systems approach
•CHO is a leader and community mobilizer.

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15
Q

State the five policy directives in CHPS

A

Policy directive 1: Duty of care and minimum package of services

Policy directive 2: Human resources for CHPS

Policy directive 3: Infrastructure and equipment for CHPS

Policy directive 4: Financing

Policy directive 5: Supervision, monitoring and evaluation

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16
Q

Explain Duty of care and minimum package of services and Human Resources for CHPS

A

Policy directive 1: Duty of care and minimum package of services
•Maternal and reproductive services
•Child Health including neonatal
•Management of minor illnesses
•Follow up on defaulters and discharged patients
•Information and disease surveillance
•Deliveries if trained
•Private Maternity homes can be referral point for CHPS zones
•Not all CHPS zones shall require CHPS compounds

Policy directive 2: Human resources for CHPS
•Staffing of CHPS zones:- up to three staff of right mix.
•Trained CHNs who are assigned CHPS zones are CHOs. CHO is not a grade but a title
•Community health volunteers (CHVs) and community health management committees (CHMCs) shall be selected by communities and oriented by the sub-districts
•Appropriate incentive packages shall be developed for CHOs and CHNs
•Appropriate Career progression for CHNs shall be developed by the MoH

17
Q

Explain infrastructure and equipment for CHPS,Financing and supervision,monitoring and evaluation

A

Policy directive 3: Infrastructure and equipment for CHPS
•More than one CHPS compound design options shall be available
•All CHPs compounds shall be equipped and furnished according to a standard list approved by the Minister of Health
•Location of CHPS zones and siting of CHPS compounds shall be determined by the District Assembly on the advice of the DDHS and consistent with District Strategic Health Plan
•Lands for construction for CHPS compounds shall be donated by the community and land title registry done in the name of the GHS

Policy directive 4: Financing
•Services at the CHPS compound shall be free. CHOs and CHVs and CHMCs are to ensure all clients are registered under the NHIS
•Government shall be main financier of CHPS implementation. Others financiers are
•NHIS fund allocation to the MoH
•Donor Partners contributions
•Benefactors and philanthropists

Policy directive 5: Supervision, monitoring and evaluation
•The technical lead of CHPS implementation in the district is the DDHHS and reports to the DCE/MCE
•Sub-district heads are to supervise CHOs
•Medical Officers in District Hospitals are to be assigned to sub-districts and shall visit CHPS compounds at least once in a quarter
•DCE with the support of the DDHS shall organize annual CHPS review meetings, discuss report with District Assembly and submit final report to the Director General and Minister of Health through RDHS.

18
Q

State five ways healthcare is financed and explain free (taxes) as one way

A

Free???? (Taxes) :-
•Individuals contribute to the provision of health services through taxes on income, purchases, property and a variety of other items and activities.
•These are typically pooled across the whole population, unless local governments raise and retain tax revenues.
•Health services are purchased by government, usually from a mix of public and private providers.

  1. Social health insurance
  2. private health insurance
  3. medical savings account
  4. other possibilities
19
Q

Explain social health insurance and private health insurance

A

Social health insurance
•In social health insurance, contributions from workers, the self-employed, enterprises and government are pooled into a single or multiple funds on a compulsory basis.
•These funds typically contract with a mix of public and private providers for the provision of a specified benefit package.
•Preventive and public health care may be provided by these funds or responsibility may be kept solely by the Ministry of Health.

Private health insurance
•Premiums are paid directly from employers, associations, individuals and families to insurance companies, which pool risks across their membership base.
•Private insurance includes policies sold by commercial for profit firms, non-profit companies, and community health insurers.
•Generally private insurance is voluntary in contrast to social insurance programs that tend to be compulsory.

20
Q

Explain medical savings account and other possibilities

A

.

Medical savings accounts
•Medical Savings Accounts are individual savings accounts that are restricted to spending on health or medical care.
•They have been generally introduced to: (1) encourage savings for the expected high costs of medical care; (2) enlist health care consumers in controlling costs; and (3) mobilize additional funds for health systems.

Other possibilities
•Full fee paying
•Hypotheticated taxes, e.g. ‘sin taxes’ for tobacco and alcohol
•national and state lotteries dedicated to health
•public-private partnerships between governments and the private sector to co-fund health care.

21
Q

State and explain six sources of funding for health activities

A

Government:
•Training of health workers, Payment of salaries and emoluments, provision of equipment, buildings as well as supporting public health interventions
•Source of funds is usually through export of resources, tariffs and taxes.

  1. International organizations
    Global fund, UN organizations (WHO, UNICEF(United Nations childrens fund), UNFPA(United nation’s population fund) ,UNAIDS(Joint United Nations Programme on HIV/AIDS. ) ,USAID (United States agency for international development)?(through its agencies), JICA(Japan International Cooperation Agency ),DANIDA(Danish International Development Agency ),DFID(Department for International Development) etc.
    •With the exception of USAID, Funds from international organizations are pooled and made part of the Government fund.
    •Funding are usually tied to specific programs
    •Funds are usually in the form of grants
  2. International Non-Governmental organizations
    World Vision, Plan Ghana, Adventist Relief Agency (ADRA), CARE etc
    •They source funds from outside partners and support the MOH in s specific activities across the country. Funds are usually grants.

Local Non-Governmental organizations
•Most are district based and usually receives funds from international organizations and occasionally government to support the GHS implement specific district based activities.
•Funds are usually in the form of grants

  1. Bilateral partners
    The World bank, African development bank, Saudi fund etc.
    •They support specific activities of the MOH/GHS
    •Funding is usually in the form of small loans and grants
  2. Private sector
    •Private companies in Mining, oil, beverages, textiles, building, healthcare etc support specific health activities of MOH/GHS through grants. Eg Anglogold Ashanti support for Malaria
22
Q

What is the budget
Give an example using the national budget
Give an importance of a budget
The MOH develops what kind of plan an what did his plan incorporate
How is it prepared?

A

The budget is the plan to raise funds and how to spend it. The national budget, for example, outlines how income generated by the national government will be divided between national, regional, and district.
•The budget can also be an important tool for advocacy
•The health needs of a country do not remain static. We see changes in the population, both in terms of absolute numbers and in terms of the distribution of people. There could be significant changes in mortality (sickness) and morbidity (dying)
•The MOH develops a 5-Year Strategic Plan (2007-2011) which incorporates all intervention areas to achieve its health development goals.
•Each year’s annual Program of Work (POW) is prepared through a planning and budgeting process which captures all essential services from the districts to the regions and the national level.

23
Q

The types of audit depend on two things name them and state the types under them

A

Depends on the Nature:

 - Statutory Audit
 - Private Audit
 - Internal Audit
 - External audit
•Depends on the Purpose:
     - Financial Audit
     - Control and Compliance Audit
     - Performance/Operational/Management
       Audit
24
Q

When did the govern pass the Financial Administration /Internal Audit Act and why?
What is held to review and plan for the following years POW?
When is an aide memoire developed and ehy?
All funds received by MDAs are subject to periodic audits true or false

A

The government of Ghana passed the Financial Administration /Internal Audit Act(Act 658 in 2003), to guide all MDAs in financial, audit and procurement management of goods and services.
•The MOH and its partners organize joint annual performance (programmatic and financial) reviews.
•Twice yearly ‘Partners Forums’ are held to review and plan for the following year’s POW.
• An aide memoire is developed after each forum which specifies critical ‘must dos’ by the GOG/MOH and the partners to serve as memorandum of understanding for all stakeholders as a way of monitoring progress with implementation of the POW.
•All funds received by MDAs are subject to periodic audits

25
Q

What is the purpose of audit procedures?
Who develops the audit procedures and who approves it?
What happens if a decision is made not to perform one or more of the procedures?

A

The purpose of audit procedures is to provide detailed audit steps to be performed to achieve the specific audit objectives. The audit procedures are developed by the auditor and approved by the MDA management prior to performance of the audit procedures.
•If prior to the approval by MDA management, a decision is made not to perform one or more of the procedures, a note documenting the reasons for the decision is included in the audit procedures.

26
Q

The specific objectives of any audit will address one or more of the general management objectives. Name them

A

The specific objectives of any audit will address one or more of the following general management objectives:
•Risks are appropriately identified and managed.
•Interaction with the various governance groups occurs as needed
•Financial, managerial, and operating information is accurate, reliable, and timely
•Resources are acquired economically, used efficiently, and adequately protected.
•During the course of the audit, conditions may arise which warrant revising the audit procedures, scope, or budgeted hours. The auditor should evaluate the situation, make timely recommendations to audit management, and obtain approval before incorporating any changes.

27
Q

What are common pitfalls when the auditor comes

A 
Common pitfalls and their implications
•Misappropriation/embezzlement of funds.
•Misapplication of funds.
•Non-acquittal of P.Vs.
•Un-presented /missing P.Vs.
•Un-retired Programme/Project funds.
•Mis-procurements.
•Deficiencies in Store Records.
•Undue retention of W/holding Tax.
•Personnel/Payroll irregularities.
•Refusal/failure to pay-back Staff Advances.
28
Q

What is the procurement law in Ghana and state the acts.

What are the main processes common to all procurements ?

A

Procurement policies and procedures follow a logical pattern and are designed to ensure that the procurement process adheres to the financial regulations and procurement law. (Procurement Act 2003, Act 663) for Ghana
•The main processes common to all procurements include supplier selection, requesting information, tender submission, tender evaluation, contract award and inspection.

29
Q

Explain supplier selection and requesting information

A

Supplier Selection
•Most companies will keep a list of preferred suppliers that the procurement department manages and updates. Suppliers on a preferred list will have undergone some form of selection process to evaluate them against criteria such as cost, quality and compliance

Requesting Information
•This is a core function of the procurement department. When there is a need to purchase something, the procurement department finds wholesalers or retailers that can effectively deliver the requirement.
•Once suppliers have been identified, the team will develop a specification, which details the description of the requirement and sends it to the suppliers who will be asked to return quotes on prices for needed goods and services.

30
Q

Explain tender returns and tender evaluations and contract award

A

Tender Returns
•Tenders usually have to be returned to the procurement on a specific day and time. The returned tenders will include the description and price for the service/ product required, financial information detailing the suppliers accounts, etc.

Tender evaluation
•Returned tenders are distributed to internal specialists who evaluate the different parts of the tender. The Procurement department will usually assess the pricing schedules and collate and prepare a recommendations report within a time line.
5. Contract Award
•The procurement department will inform all suppliers of their decision. It is best practice to offer all unsuccessful suppliers a debrief to help them understand where their bid failed. Successful suppliers are notified in writing of their success

31
Q

What is contract conclusion

A

Contract Conclusion
•A post-contract meeting offers both supplier and buyer improvement opportunities.
•At the end of the contract, when the service or product has been delivered, the procurement team will check that all of the terms of the contract have been met and they are happy with the performance of the suppliers.
•After this has been satisfactorily completed, the buying organization will typically authorize payment to be made.

32
Q

What is the history of individual health care
Funding of the NHIs are from two main sources name them
What Act led to the establishment of the NHIS?
What year was NHIS established?

A

From the late 1950s up to 1966, when the Convention Peoples’ Party government was overthrown, healthcare financing in Ghana was virtually free.
•Ghanaians were asked to pay for their healthcare during subsequent regimes. Drugs and consumables were highly subsidized.
•In the 1980’s the poor economic situation of the country led to low staff morale and poor hospital attendance.

Cash and Carry’ the system of healthcare financing introduced by the PNDC survived until 2004 when the present health insurance system came into being.
•Under Cash and Carry’, patients were required to pay for drugs and some medical consumables while the state bore all other costs including consultation, salaries and emoluments of health workers in state hospitals.
•Experimentation of various insurance schemes-CHAG (Nkoranza, Techiman schemes) and private schemes like nationwide mutual, Medex etc acted as precursors

The New Patriotic Party (NPP) enacted, the National Health Insurance Act 650 in 2003, which led to the establishment of a National Health Insurance Scheme(NHIS) in 2004 under a National Health Insurance Authority(NHIA).

•Funding for the NHIS are from two main sources:- the NHI Levy, a 2.5% top up of the Value Added Tax (VAT), and a 2.5% transfer from the existing Social Security and National Insurance Trust. For those not on SSNIT, paying an annual premium

33
Q

What is insurance

Give two functions of insurance and give examples

A

arrangement with a company or an institution in which regular amounts of money are paid so that the company/institution pays the cost of some service as and when needed.
•It is a security
•It serves as a guarantor for bank loans
Examples of Insurance coverage:
•Death,
•Ilness,
•Loss of a material (car, building, ship, shop, factory etc) through accident, theft or fire.

34
Q

Define premium,solidarity,morale hazard,benefit package

A

Premium:
•The regular contributions paid by the clients towards the scheme.

Solidarity:
•The strength of a scheme is based on the number of contributors. The larger the number of contributors the stronger the scheme. “Consider the Broom”.
•There is risk sharing and risk equalization

Morale Hazard:
• Providers continue to prescribe more drugs and expensive diagnostics. And clients also abuse the system by accessing health care even when they could avoid visits to health facilities.

Benefit Package:
•Minimum services that members can receive.

35
Q

What are the pillars of a basic health insurance scheme

A 
DESIGN OF A BASIC HEALTH 
INSURANCE SCHEME:
Also referred to as the pillars are:-
•Scheme administration
•Clients of the Scheme
•Providers of health services to the Scheme
36
Q

What are the modes of payment for NHIS
Explain the fee for service and what does it ensure?
What is the disadvantage of this mode of payment?

A

Fee for service:
• payment to a provider is based on each service rendered.

  • Ensures high quality service to clients since providers will undertake all services required by the patient without worry
  • It is subject to abuse by providers through request of sometimes unnecessary tests. This could raise the cost of insurance payment if a proper costing system and monitoring is not adopted due to the excessive drug prescriptions and diagnostics.
  1. Co payment
  2. capitation
  3. diagnostic related grouping
37
Q

Explain Co payment,capitation and diagnostic related grouping

A

Co-payment

  • The client is made to pay a certain amount of money any time he/she receives a service. The amount he/she pays is a proportion of the actual cost of services.
  • It helps checks abuse of services as the client always has to pay some part of the medical bill
  • It can affect access to health care by the insured because of the payment demanded.

Capitation
•an agreement on the payment of a fixed amount of money to providers irrespective of whether services have been rendered or not

  • May be cheaper for the management unit since providers do not charge per service.
  • Quality of service may be compromised when funds approved by scheme do not meet the cost of services rendered by providers.

Diagnostic related grouping (DRG)
•an agreement on the payment of a fixed amount of money to providers based on diagnosis related groupings. Eg. OPD, PAED 36C, MED 128A, ZOOM, OBGY06A
•May be cheaper for the management unit since providers do not charge per service but based on diagnosis.
•Quality of service may be compromised when funds approved by scheme do not meet the cost of services rendered by providers.

HSMA 1 And 2 (11 decks)

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