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The problem
While Kenya does have a strong HMIS, indicators collected on MNH at the facility level are limited data is often incomplete, inaccurate, reporting is poor- Some indicators not captured data is rarely available for use in planning lack of data limits MNH service availability and quality Improvement of MNH data management and utilisation is the top priority of the Kenya MNH Road Map (August 2010)
Testing a solution
USAID MCHIP is partnering with DRH/MOPHS to pilot an MNH surveillance system in Kenya
GOK/DRH
M-CHIP
MNH Surveillance
BEmONC equipment sets were incomplete or missing; supplies were lacking or not available at point of use
Data was rarely utilised at facility level for for decision making
Site Visits
Participants identified site specific problems Participants identified areas that did not require project help Procurement of basic supplies; reorganisation of services; maternal and perinatal death audits, communication etc;
Onsite Interventions
Training: Data management and use Service skill updates in key MNH interventions e.g., Pre-eclampsia, neo-natal resuscitation, etc.
Tools Job aids, guidelines, policies Data collection tools (sup. Register, data use wkbk,
Results:
Outputs:
At least 60 health workers have been updated in EmONC skills and in data management Procured basic equipment and supplied Reorganized work flow
Outcomes:
More complete and accurate reporting of MNH indicators including the partograph use Data is being used at the facilities for decision making- MDR; timely referrals, partograph
Box with emergency supplies for management of ecclampsia ready for use in the labour ward
Impact
? Reduced Maternal and Perinatal Morbidity and Mortality
The updates have really helped us . some of us are retiring and had never been updated. You are removing us from mud.
(Matron at Gilgil Hospital)
Key Insights
Numbers alone are not useful they have to be good numbers What makes a GOOD number?
Common definition of what the indicator is
attempting to capture Everybody is counting the same thing in the same way
E.g. Asphyxia and resuscitation
Conclusion
For an effective MNH surveillance system, data management skills building MUST BE accompanied by: 1. Clinical skills standardization & 2. Systems strengthening
Acknowledgements
DRH/MOPHS- Kenya Administration and Staff of Naivasha, Makindu, Gilgil and Kangundo Hospitals USAID MCHIP- WashingtonBarbara and Maya USAID MCHIP Kenya team Jhpiego Kenya
THANK YOU!
www.mchipnet
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