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MBBS 3: Community Health > DIP Preparation Implementation > Flashcards

DIP Preparation Implementation Flashcards

1
Q

Name the components of the DIP cycle?

A
  1. planning
  2. implementation
  3. monitoring and evaluation
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2
Q

What are the components under planning?

A
  1. Stakeholder Analysis
  2. Situation Analysis
  3. Priority & Objective Setting
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3
Q

What are the components under implementation?

A

Work Breakdowns
Scheduling
Task Allocations
Budget and Accounts
Management
Procurement
Supervision
Co-ordination
Monitor Progress and Review Plans

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4
Q

What are the components of monitoring and evaluation?

A
  1. monitor progress
  2. evaluate outcomes
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5
Q

What are the steps in DIP?

A
  1. stakeholder analysis
  2. invite stakeholders to activities and meetings
  3. conduct a situational analysis
  4. create district specific objectives
  5. analyze and prioritize strategies to achieve objectives
  6. build concensus with stakeholders around objectives and prioritized strategies
  7. develop implementation plan
  8. develop budget for implementation plan
  9. reprogram the implementation plan according to ministry of finance ceilings
  10. conduct peer review of draft DIP within zone
  11. review draft DIP with stakeholders
  12. present final DIP to zonal health support office
  13. obtain official approval from zonal health support office for DIP
  14. submit approved DIP to district assembly
  15. distribute copies of the draft DIP to stakeholders
  16. revise DIP based on approved budget from parliament
  17. distribute copies of final
  18. quarterly reviews of the implementation of DIP
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6
Q

What is the importance of stakeholder analysis?

A
  1. Reminds the DHMT of significant players in health delivery
  2. Promotes coordination to efficiently use resources (financial and other)
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7
Q

How to conduct situational analysis?
What questions to ask?

A
  1. Which stakeholders were involved last year?
  2. How were they involved? How could they be involved?
  3. Are there any new groups working in the District?
  4. At what level/stage should they be involved?
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8
Q

How do districts invite stakeholders?

A
  1. Set up work plan for DIP development
  2. Create a stakeholder contact database – phone numbers, emails, etc.
    - Identify key person (s) to involve
  3. Let stakeholders know about important dates within work plan in advance.
  4. Share information even if they can’t attend
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9
Q

What is situational analysis?

A

The goal is to identify priority health problems for the district.

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10
Q

How to conduct situational analysis?
What questions do you ask?

A
  1. who gets sick
    – extent or magnitude
  2. what conditions or diseases are prevalent in the area
  3. when do people get sick
    – patterns and trends of diseases/conditions
  4. Where do the clients/patients come from
    – location of where the various conditions
  5. Why do they get sick
    – underlying social or economic factors that we can directly or indirectly influence to improve the situation such as water, sanitation, diet etc.
  6. How do we overcome the problems – coming up with solutions to address priority problems
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11
Q

What is SWOT analysis?

A
  1. strengths
  2. weaknesses
    - internal origin
  3. opportunities
  4. threats
    - external origin
    > for companies, organizations etc.
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12
Q

What are the factors under PESTEL analysis?

A

Political
Economic
Social
Technological
Environmental
Legislative

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13
Q

What is PEARL analysis?

A

PEARL is a tool which will help us to assess whether the problems that have been selected are feasible to address.

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14
Q

What does PEARL stand for?

A

P – Propriety: Is it your responsibility?
E – Economics: Does it make economic sense?
A – Acceptability: Will the community accept it?
R – Resources: Is funding available?
L – Legality: Is the program legal?

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15
Q

How do you come up with good district specific objectives?

A

objectives must be SMART
Specific
Measurable
Achievable
Realistic
Time bound

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16
Q

Describe what SMART objectives are?

A
  1. SPECIFIC - An objective describes the details of the tasks.
  2. MEASURABLE - provides a baseline or standard for before-and-after comparison e.g. use numbers to specify the amount of change
  3. ACHIEVABLE - describes the tasks to be accomplished with considerations of resource constrains (human resources, money and time).
  4. REALISTIC - objectives make sense and are practical.
  5. TIME BOUND - An objective with a deadline helps organize what should happen, when it should happen, and who is responsible for the task
17
Q

What is the essential health package?

A

A set of interventions that targets the leading causes of morbidity and mortality that mainly affect the poor and vulnerable sections of the society

18
Q

How are the interventions of the EHP selected on the basis of?

A
  1. Country’s epidemiological and disease profile
  2. Cost-effectiveness of the interventions
19
Q

What is decentralization?

A
20
Q

What is community participation?

A

Encourages communities to be active participants in their health and well-being

21
Q

What are the existing structures that are utilized under community participation?

A
  1. Village Health Committees (VHCs)
  2. Village Development Committees (VDC)
  3. HSAs
  4. Health Centres
  5. Area Executive Committee
22
Q

What are examples of national policies?

A
  1. Malawi Growth and Development Strategy (MGDS)
  2. National Health Policy (NHP)
  3. Malawi Vision 2020
  4. Health Sector Strategic Plan (HSSP)
    - Outlines the Essential Health Package (EHP)
  5. Decentralization of the Public Health Sector
23
Q

What is prioritization?

A

is key to dealing strategically with resource constraints such as:
1. Time
2. People
3. Money

24
Q

Prioritization ensures that the DIP facilitates what?

A
  1. Quality - appropriate care at the right time and place
  2. Equity - access for all, equal care for equal need
  3. Efficiency - maximizing care for given funds
25
Q

Describe the process of prioritization?

A
  1. Identify issues (or health problems)
  2. Identify possible interventions to address the issues
  3. Discuss criteria with which to evaluate the possible interventions
  4. Discuss and determine weightings for each intervention
26
Q

How do you build a consensus with stakeholders?

A
  • DHMT needs to call for a meeting with major stakeholders to discuss objectives, strategies and activities
  • Such a meeting will help ensure that stakeholder activities are aligned with district priorities
27
Q

How do you develop the implementation plan?

A

The Objectives and Activities developed in the previous stages of the planning process now need to be entered into the DIP Implementation Plan Work

28
Q

What is the DIP costing workbook?

A

The costing sheet provide a methodical way to cost aspects of the DIP budget.
- The costing workbook should be filled out once the prioritized objectives and activities have been set
e.g.
Equipment Maintenance (CS3) easier to use.
Training Needs Sheet (CS5 a) more detailed

29
Q

Describe the peer review of the DIP?

A

From last year, Districts are being asked to peer review each others’ DIP within the Zone: Zones will review all DIP.
- This provides and learning opportunity for all Districts.
- It is hoped that this step will improve the overall quality of the DIP.

30
Q

How do you review draft DIP with stakeholders?

A

Involving the Stakeholders, who were identified in the original Stakeholder Identification Matrix, is critical to ensuring the DIP reflects the needs and priorities of the District.

31
Q

What do you include in the final DIP submission?

A

Introduction
· Table of Contents
· Executive Summary
· Mission, vision, values
· Overview of District Services, Demographic, socio-economic situation
· Summary of Annual Report of District (previous year review)
Description of the DIP development process followed and sources of data
· Summary of District Health Profile/Situation Analysis
· Key Objectives, Strategies to address them and prioritized activities.
· Highlights of Implementation Plan and Budget
· DIP Submission Forms – Central Equipment Purchases, Training Plan, and Procurement Plan.

32
Q

What are the goals of the review process?

A
  1. To have a thorough review of the DIP – assess activity implementation, its impact and its limitations
  2. To link this review to evidence based decision-making
  3. To ensure participation of NGO’s and other Development Partners
  4. To adjust the DIP where appropriate
33
Q

What is the purpose of monitoring and evaluation?

A

Creating the DIP is only the START of the process.
Implementation of the DIP is the most important step.
To measure the progress of implementation, the DHMT must actively MONITOR & EVALUATE activities against the DIP.
Joint quarterly HMIS and DIP review meetings are key!

34
Q

For Quarterly Reviews, the DHMT can facilitate by?

A

Ensuring that preparatory meetings take place i.e. that Health Programme level DIP review occurs;
Ensuring that appropriate and responsible persons participate in meeting CHAM, NGO’s and others; and,
Ensuring that funding is set aside in the DIP for the quarterly review meetings.

35
Q

Important EHP indicators for review

A

EHP Coverage
OPD Service Utilization
% fully immunized under one children
TB cure rate
% of pregnant women starting antenatal care during the first trimester
Family Planning coverage
Proportion of births attended by skilled health personnel;
# of people ever started on HAART
# of ITNs sold/distributed
% Surveyed population satisfied with services
% health centres with minimum staff norms
% of functional utilities (water, electricity, and communication)

36
Q

At Quarterly Reviews, DHMT should

A

Review of HMIS indicators relevant to DIP as well as key coverage data. Review HMIS data on programme
Review of DIP activities to monitor progress (each programme area)
Financial review – to provide financial report on ORT for last quarter
Feedback from supervisory activities at HC level and hospital level – in order to inform future DIP activity implementation

MBBS 3: Community Health (28 decks)

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