Responding to limited-resource realities in Malawi with a low-cost Modified Re-supply Worksheet Tool

 

Nkhotakota District Pharmacist (Moses Zaola, facing the team) introduces the Modified Product Re-Supply Worksheet to the Facility in-charge, HSA Supervisor, and an HSA at Katimbira Health Centre in Nkhotakota district.

In Nkhotakota, Nsanje, and Kasungu districts in Malawi, District Product Availability Teams (DPATs) meet monthly to assess their performance around improving product availability at community level, thanks to the Ministry of Health and SC4CCM Enhanced Management intervention. The Enhanced Management Intervention is an innovative approach that seeks to catalyze improved product availability at community level for treatment of under 5 illnesses through enhanced team work and improved coordination. DPATs seek to create and increase the sense of urgency around maintaining consistent health product availability at community level to contribute towards reduction in under 5 mortality, and are empowered with data to make better decisions. DPATs comprise of district management, health facility staff, and Health Surveillance Assistants (HSAs), and have a shared vision, agreed coordination mechanism, and performance targets to achieve.

Using printed monthly performance reports for their health facilities from cStock1, DPATs assess their team performance against targets, identify performance bottlenecks, and develop actionable performance improvement plan as a team around product availability.

Faced with budget constraints and competing priorities, districts have not been able to consistently print and distribute monthly cStock performance reports to facilities and that posed a huge risk to effective team performance review and improvement at health facility level. In response, SC4CCM recently introduced a modified product re-supply worksheet as a low-cost alternative report tool maintained at health facility that supports not only re-supply to HSAs, but now incorporates most of the key performance indicators that used to come through the cStock print out reports from districts. Alongside the modified re-supply worksheet tool, SC4CCM also introduced an accompanying Health Facility Performance Indicators Calculation Matrix and a Guide to Documenting DPAT decisions and actions. These tools will help facilities to:

  • Sustain monthly performance improvement meetings using low-cost Modified Re-supply Worksheet
  • Improve quality of documentation of DPAT meetings and
  • Empower DPAT at health facility level with data to manage HSAs’ performance and product availability without relying on print out reports from district level, therefore, make DPAT more sustainable at health facilities.

The roll out of the Modified Re-supply worksheet provides a simple, low-cost yet powerful alternative to the need for districts to keep printing and distributing cStock health facility performance reports on a monthly basis, and better responds to districts’ budget constraints.

Now the HSA supervisor says: “This is a better Product Re-Supply Worksheet and will indeed help us to conduct DPAT meetings consistently even if the cStock print out report from the district is not yet in. Much of the key information needed to evaluate performance for each HSA and the facility is on the worksheet and we will now be able to conduct meetings”.

Learn more about our work in Malawi.

1.  cStock is a web-based SMS system that supports HSAs’ real time product reporting and re-supply