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Health Facility Graduation from Donor-Supported Intensive Technical Assistance and Associated Factors in Zambia.

Koni P, Chishinga N, Nyirenda L, Kasonde P, Nsakanya R, Welsh M - PLoS ONE (2015)

Bottom Line: Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate.The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29-7.86) and in both rural and urban settings.Human resources management domain was found to be an important factor associated with district graduation.

View Article: PubMed Central - PubMed

Affiliation: FHI 360, PO Box 320303, Lusaka, Zambia.

ABSTRACT

Introduction: The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation.

Methods: Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata.

Results: 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.20-1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24-1.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29-7.86) and in both rural and urban settings.

Conclusions: QA/QI tools can be used to assess performance at health facilities and determine readiness for district graduation. Human resources management domain was found to be an important factor associated with district graduation.

No MeSH data available.


Related in: MedlinePlus

District Graduation performance.
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pone.0131084.g002: District Graduation performance.

Mentions: Of the 39 districts (with 275 health facilities) assessed for graduation, 24 districts (62%) graduated from intensive donor supported technical assistance and 15 districts (38%) did not. The 24 districts that graduated had 145 health facilities while the 15 districts that did not graduated had 130 health facilities. In the districts that graduated, 77 (53%) out of 145 health facilities were rural based while the remaining 68 (47%) were urban. In districts that did not graduate, 88 (68%) out of the 130 health facilities were rural while the remaining 42 (32%) were urban. The proportion of rural facilities was less in districts that graduated than those that did not graduate; 53% versus 68%, respectively (Fig 2).


Health Facility Graduation from Donor-Supported Intensive Technical Assistance and Associated Factors in Zambia.

Koni P, Chishinga N, Nyirenda L, Kasonde P, Nsakanya R, Welsh M - PLoS ONE (2015)

District Graduation performance.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4476711&req=5

pone.0131084.g002: District Graduation performance.
Mentions: Of the 39 districts (with 275 health facilities) assessed for graduation, 24 districts (62%) graduated from intensive donor supported technical assistance and 15 districts (38%) did not. The 24 districts that graduated had 145 health facilities while the 15 districts that did not graduated had 130 health facilities. In the districts that graduated, 77 (53%) out of 145 health facilities were rural based while the remaining 68 (47%) were urban. In districts that did not graduate, 88 (68%) out of the 130 health facilities were rural while the remaining 42 (32%) were urban. The proportion of rural facilities was less in districts that graduated than those that did not graduate; 53% versus 68%, respectively (Fig 2).

Bottom Line: Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate.The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29-7.86) and in both rural and urban settings.Human resources management domain was found to be an important factor associated with district graduation.

View Article: PubMed Central - PubMed

Affiliation: FHI 360, PO Box 320303, Lusaka, Zambia.

ABSTRACT

Introduction: The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation.

Methods: Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata.

Results: 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.20-1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24-1.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29-7.86) and in both rural and urban settings.

Conclusions: QA/QI tools can be used to assess performance at health facilities and determine readiness for district graduation. Human resources management domain was found to be an important factor associated with district graduation.

No MeSH data available.


Related in: MedlinePlus