10636.pdf
Media
- extracted text
-
Primary Health Care Management Advancement Programme
ASSESSING
THE QUALITY
OF MANAGEMENT
MODULE 7
FACILITATOR’S GUIDE
AGA KHAN FOUNDATION
Primary Health (are Management Advancement Programme
ASSESSING
THE QUALITY
OF MANAGEMENT
Mary Millar
University Research Corporation
MODULE 7
FACILITATOR S GUIDE
Aga Khan Health Services
University Research Corporation
Center for Human Services
sS
g
iu
in
ill w
M
&
ihj
iU iki iid ihl
a
Dedicated to
Dr. Duane L. Smith (1939-1992),
Dr. William B. Steeler (1948-1992)
and all other health leaders, managers and workers
who follow their example in the effort to bring quality health
care to all in need.
The Primary Health Care Management Advancement
Programme has been funded by the Aga Khan Foundation
Canada, the Commission of the European Communities,
the Aga Khan Foundation U.S.A., the Aga Khan
Foundation’s head office in Geneva, the Rockefeller Foun
dation, the Canadian International Development Agency,
Alberta Aid, and the United States Agency for Interna
tional Development under two matching grants to AKF
USA. The first of these grants was, "Strengthening the
Management, Monitoring and Evaluation of PHC Pro
grams in Selected Countries of Asia and Africa" (cooper
ative agreement no. OTR-0158-A-00-8161-00, 19881991); and the second was "Strengthening the Effective
ness, Management and Sustainability of PHC/Mother and
Child Survival Programs in Asia and Africa" (cooperative
agreement no. PCD-0158-A-00-1102-00, 1991-1994).
The development of Modules 6 and 7 was partially funded
through in-kind contributions from the Primary Health
Care Operations Research project (PRICOR) of the Center
for Human Services under its cooperative agreement with
USAID (DSPE-6920-A-00-1048-00).
This support is gratefully acknowledged. The views
and opinions expressed in the PHC MAP materials are
those of the authors and do not necessarily reflect those
of the donors.
All PHC MAP material (written and computer files) is
in the public domain and may be freely copied and
distributed to others.
Contents
FOREWORD .............................................................................................................
1
SESSION 1: INTRODUCTION AND OVERVIEW ............................... 7
Transparencies
7-1: Workshop objectives........................................................................... 13
7-2: Purposes of Module 7......................................................................... 14
7-3: PHC management functions .......................................................... 15
7-4: Steps in management assessment.................................................. 16
SESSION 2: SPECIFY MANAGEMENT ASSESSMENT
OBJECTIVES (STEP 1)....................................................................................... 17
Transparencies
7-5: Session 2: Objective ........................................................................... 20
7-6: Questions to be answered................................................................ 21
SESSION 3: DESIGN AND CARRY OUT ASSESSMENT
(STEPS 2, 3 AND 4) .............................................................................................. 25
Transparencies
7-7; Session 3: Objectives........................................................................... 29
7-8: Other assessment methods.............................................................. 30
7-9; Selecting information methods ...................................................... 31
7-10: Ground rules......................................................................................... 32
SESSION 4: REVIEW RESULTS (STEPS 5 AND 6).......................... 33
Transparencies
7-11: Session 4: Objectives ......................................................................... 37
7-12: Reviewing results ............................................................................... 38
7-13: Analytic techniques ........................................................................... 39
Module 7: FG; contents
SESSION 5: TAKE ACTION AND CHECK RESULTS
(STEPS 7 AND 8)..................................................................................................... 41
® tg
g $ $
o co m R
T
r
7-14: Session 5: Objectives............................................................................45
7-15: Take action and check ....................................................................... 46
7-16: Other uses of Module 7 ..................................................................... 47
Module 7: FG; contents
Foreword
What is the purpose of the Facilitator’s guide?
The Facilitator’s guide contains a suggested workshop design for use by
individuals who will help PHC managers and staff learn how to use the
Primary Health Care Management Advancement Programme (PHC MAP)
series. There is a Facilitators guide for each module in the PHC MAP series.
What information does it contain?
Each Facilitator’s guide contains instructions for conducting a workshop
on one of the modules in the PHC MAP series using the information
contained in the User’s guide.
The instructions are arranged in one to two hour sessions. The number
of sessions depends on the amount of information and/or the number of
steps contained in the User’s guide. The first page of each session lists
session objectives, major topic headings, time required, and materials and
equipment. The following pages describe the instructional activities in
outline form.
The outline is divided into two columns. The right-hand column
indicates what the facilitator says or does to conduct the session. The
left-hand column lists the handouts, overhead transparencies, or other
materials needed to support the activity. Copies of these materials, suitable
for duplication, appear at the end of the session in which they are first used.
Some transparencies are used in more than one session.
How are the workshops organised?
The first session of each workshop contains activities designed to
introduce the PHC MAP series and explain its importance to PHC
programmes, present an overview of the workshop, explain the purpose of
the module, review specific terms or concepts used in the module, and
Module 7: FG; foreword
2
acquaint the participants with the organisation and content of the Users
guide.
The final session of each workshop contains activities designed to review
key points of the User’s guide, if appropriate, help participants prepare an
action plan, and brings the workshop to a formal conclusion. The sessions
in between present the steps required to accomplish the purpose of the
module and provide an opportunity for participants to apply those steps
to their own programmes.
Each workshop is designed to be given on consecutive days, uninter
rupted except for breaks, meals, and rest, if the workshop is longer than
one day. It is recognised, however, that situations vary and the PHC MAP
modules will be used singly or in combination by individuals and or
ganisations in the field and on university campuses. Therefore, it is
expected that the workshops described in the Facilitator’s guides will be
adapted to fit a range of circumstances. Indeed, those who facilitate PHC
MAP workshops are encouraged to make adaptations to meet the needs
of participants and/or specific PHC programmes.
Who can be a facilitator?
Ideally, the person who serves as facilitator has training and experience
in the fields of public health, management, planning, and evaluation, as well
as sampling and survey design. It is recommended that this person also be
skilful in working with small groups.
The facilitator should be someone from outside the PHC programme,
perhaps from another agency or a university. As a person with no direct
interest in the programme, the facilitator can be neutral in disagreements
that may arise and help the group members resolve an issue objectively.
Having an outside person as facilitator also allows the programme director,
who usually has a leadership role, to contribute his or her knowledge and
experience as a full participant in the work of the group.
It is also recommended that a facilitator have a full set of PHC MAP
User’s guides and Facilitator’s guides. It is sometimes necessary, in the
course of completing one module, to refer to information in another module.
Who should participate in the workshop?
The primary audience for the PHC MAP series is the team that manages
PHC programmes or other population-based health programmes in either
the public or private sector. An example of a PHC management team in
the public sector is the core staff of a district ranging from 100,000 to
300,000 in size of population served.
Module 7: FG; foreword
An example of a PHC management team in the private sector is the
core staff of an NGO that provides PHC services to a specific population
in a given geographic area. The average size of the service population may
range from 40,000 to 60,000, but may be as small as 10,000 or more than
100,000. In either case, the management team should have:
• the knowledge and skills needed to complete the steps in the module
• the time and resources required to collect and analyse the required data
• the authority to plan and implement improvements in management
systems and procedures based on this analysis.
If feasible, teams from several districts or from several PHC programmes
within a given NGO, may work simultaneously with one facilitator to
complete a module. It is recommended that one facilitator work with no
more than four teams or 20 people at one time.
What does the facilitator do?
Understands the needs of participants. If the facilitator is working
with one PHC programme, the most efficient way to gather information
about participants and the programme in which they work is to meet with
the PHC director to determine:
• the nature of the PHC programme (services provided, size and description
of area served, number and type of facilities, number and qualifications
of staff, community involvement, computer capability, strengths, major
problems, etc.)
• if information needs have been clearly identified
• previous staff training in management information systems or related
topics
• resources available for training (time, space, equipment)
• possibility for subsequent technical assistance to workshop participants.
Understands the content of Module 1. Read the User’s guide and
Facilitator’s guide for Module 1 and consider options for workshop delivery.
• The purpose of Module 1 is to help participants select priority information
needs and to review some basic concepts underlying management
information systems. Depending on participant background, the amount
of time available, and the need to establish priorities among management
information needs, Module 1 can be presented in its entirety, limited to
Level 1: Quick start, limited to the PHC MAP systems framework, or in
Module 7: FG; foreword
I
™
ss
ran
ipj
Understands the content of the selected module. Read the User’s
guide and Facilitator’s guide for the selected module and consider options
for workshop delivery.
• Depending upon the length of the module and the availability of staff for
training, the workshop sessions may be presented as described in the
Facilitator’s guide, or workshop sessions may be delivered at intervals (for
example, every morning for a certain number of days, one session per
week, or one day per week for three or four weeks).
ip?
summary form as contained in the first session of the Facilitator’s guides
for Modules 2 through 9.
• If information needs have not been clearly identified and participants
have no background in systems, then Module 1 should be presented in
full. The selection of the next-module will depend upon priorities set by
the participants as they complete the steps in Module 1.
• If information needs have been clearly identified and participants have
no background in systems, then that portion of Module 1 can be added
to the first session of the selected module.
• If information needs have been clearly identified and participants have a
background in systems, then the overview of PHC MAP in the selected
module will be sufficient.
im
4
f^J
• Participants could plan steps in the workshop, complete them on the job,
and bring the results to the next workshop session. This approach is
particularly applicable to Module 2 which requites development of a
questionnaire, selection of a survey sample, training of data collectors,
and data collection. These steps cannot actually be carried out within the
time limits of the workshop as contained in the Module 2 Facilitator’s
guide.
Ep,
• If follow-on technical assistance is available, the content of the module
could be presented in the workshop and the application of the procedure
to the PHC programme could be conducted on the job.
IB
Module 7: FG; foreword
tp.
Determines what programme information, if any, is needed for
completion of the module. For example, census data and lists of households
are required to complete some of the steps in Module 3.
1$.
• Other options are possible depending upon the circumstances of each
situation.
5
Determines the most appropriate people to attend the workshop. For
example, Module 7 is best completed by those responsible for planning,
training, supervision, logistics, and other management services.
Discusses the delivery options and participants with the PHC manager
and make decisions regarding the most appropriate option and participant
selection. Also determines if the needed information is available and if it
is not, the alternatives for obtaining the information.
Notifies participants of the date, time, and purpose of the
workshop and confirms attendance. Initial notice of the meeting may come
from the PHC manager, with follow-up by the facilitator.
Prepares the agenda, using as a model the sample in Session 1 of the
Facilitator’s guide for the selected module.
Inspects the room where the workshop will be held and answers these
questions:
• Is the room large enough to seat all the participants?
• Can chairs and tables be arranged in a variety of ways; all participants
around one table; participants in groups of three or four at smaller tables?
• Is the lighting adequate?
• Can temperature and humidity be controlled?
• Is there an electrical outlet for an overhead projector?
• Is a microphone necessary for everyone to hear and to be heard?
• Are toilets conveniently located?
• Is the site convenient to parking, restaurants and public transportation?
• Are supporting facilities available and convenient: duplication, word
processing, computers?
Prepares notes to conduct the workshop using the session outlines in
the Facilitators guide for the selected module, and makes the necessary
adaptations. Refer to the appropriate User’s guide for content.
Duplicates the worksheets and other handouts as indicated in
the Facilitator’s guide and obtains the necessary equipment.
Conducts the workshop as planned.
Provides follow-on assistance, if appropriate.
Module 7: FG; foreword
7
Session 1: Introduction and overview
Objectives:
Participants will be able to:
• Explain at least one purpose of Module 7
• Describe how checklists and discussion guide
lines are used in management assessment.
Session outline:
1. Introduction (30 minutes)
II. Overview of workshop (10 minutes)
III. Purpose of Module 7 (10 minutes)
IV. Module 7 User’s guide (25 minutes)
Materials:
Module 7 User’s guide
Handout 7-1;
Agenda
Transparency 7-1: Workshop objectives
Transparency 7-2: Purpose of Module 7
Transparency 7-3: PHC management func
tions
Transparency 7-4: Steps in management
assessment
Equipment:
Flipchart, stand, markers, masking tape, over
head projector and screen
Module 7: FG; session 1
8
Session 1: Introduction and overview
I.
Introduction
Note: Omit Section I if you have presented Mod
ule 1, or some other module, immediately prior to
the presentation of Module 7.
A. OPENING REMARKS
• Introduce self and other staff, as necessary.
• Explain your role in the workshop.
• If you do not know the participants, ask each
one to state his or her name, position, title, and
job location.
Name tags
or place cards
Note: If the group is larger than 6 or 8, you may
Flip chart
• Ask each participant to complete this sen
wish to have them wear name tags or place cards
with their names at places where they are sitting.
tence: "As a result of attending this workshop,
I expect.." and write their responses on the
flipchart.
• When all responses have been recorded, say
that you will return to this list after giving an
overview of the workshop.
B. OVERVIEW OF PHC MAP
See Module 1 User’s
guide for this information
• Explain why information is important for
pHC programmes.
• Summarise PHC MAP programme, includ
ing:
Purpose of PHC MAP
Title and purpose of each module and other
materials.
• Make the following points about PHC MAP:
Has been field tested and revised to ensure
usefulness to PHC programme staff.
Module 7: FG; session 1
-3
si
■a
Session 1: Introduction and overview
.. ... . ..................... ... _... .... .. .
__ J 28.. ........ la 2
l ..
Modules can be used in any sequence.
Checklists and other materials can, and
should, be adapted to fit a particular situation.
The procedures outlined in the modules can
be adopted as routine monitoring activities in
a PHC programme.
dsi
•3
• Explain why MAP is being introduced in this
PHC programme.
Note: The remarks here should be tailored to the
specific programme and should provide the an
■3
swers to these questions:
Why are we doing this workshop?
What do we expect to achieve?
It may be appropriate for the PHC manager to
make these remarks.
II. Overview of workshop
Transparency 7-1:
Workshop objectives
Handout 7-1; Agenda
• Review the workshop objectives.
and review the workshop
agenda, describing the activities that will take
place to accomplish the workshop objectives.
• Distribute
• Review the expectations contributed by par
ticipants at the beginning of the session.
Indicate which ones will be met and which
ones will not and why.
Suggest, if possible, alternatives for meeting
the expectations that will not be met in this
workshop.
• Ask for questions or comments.
III. Purposes of module 7
Transparency 7-2:
Purposes of Module 7
'3
Module 7: FG; session 1
• Explain that the purposes of Module 7 are to
help PHC management staff:
10
Session 1: Introduction and overview
Assess the strengths and weaknesses of
PHC management functions in their pro
gramme.
Identify causes of problems and find effec
tive solutions.
Transparency 7-3: PHC
management functions
• Review the eight management functions and
discuss briefly what is involved in each func
tion.
Note: Use the information on pages 9-13 in the
User’s guide. Do not mention the checklists or
guidelines at this time.
IV. Module 7 User’s guide
Module 7 User’s guide
• Distribute a User’s guide to each participant.
• Refer participants to Appendix B and explain
the organization and content of the checklist
for planning, making the points included on
pages 7-8 in the introduction to the User’s
guide.
• Direct participants to glance through the
other checklists in Appendix B.
• Refer participants to Appendix A, page 35,
and explain the purpose and content of the
discussion guidelines, using the points con
tained on page 9.
• Describe the relationship between checklists
and discussion guidelines as management
assessment tools.
• Direct participants to glance through the
other discussion guidelines in Appendix A.
• Ask for questions and comments on checklists
and guidelines.
Module 7: FG; session 1
11
Session 1: Introduction and overview
• Discuss the strengths and limitations of Mod
Transparency 7-4: Steps
in management
assessment
ule 7 as described on page 17 of the User’s
guide.
• Refer participants to page 19 where the man
agement assessment procedure begins.
• Review briefly the steps in management
assessment and explain that Session 2 will be
devoted to Step 1.
3
-3
-*3
Module 7: FG; session 1
12
SAMPLE
AGENDA MODULE 7*
Session 1
(1 hr, 15 mins)
Introduction and
overview
Session 2
(1 hr, 20 mins)
Specify management
assessment objectives
(Step 1)
Session 3
(1 hr, 30 mins)
Design and carry
out assessment
(Steps 2, 3 and 4)
Session 4
(1 hr)
Review results
(Step 5 and 6)
Session 5
(1 hr, 5 mins)
Take action and
check results
(Step 7 and 8)
' For an actual presentation, substitute the appropriate times in the first column
Module 7: FG; session 1; handout 7-1
=3
13
WORKSHOP OBJECTIVES
1. Conduct a management assessment for
one PHC management function using
the steps and materials contained in
Module 7
2. Prepare a list of action steps to assess
other management functions after the
workshop using the same steps and
materials
Module 7: FG; session 1; transparency 7-1
14
SS-
PURPOSES OF MODULE 7
*
®■
To help PHC managers to:
1. assess strengths and weaknesses of
PHC management functions
fib
2. identify causes of problems and find ef- g:
fective solutions
e:
st
6£
ml.
Module 7: FG; session 1; transparency 7-2
15
PHC MANAGEMENT
FUNCTIONS
• Planning
• Personnel management
• Training
• Supervision
• Financial management
• Logistics management
• Information management
• Community organisation
Module 7: FG; session 1; transparency 7-3
16
STEPS IN MANAGEMENT
ASSESSMENT
1. Specify the objectives
2. Determine assessment methods
3. Select and adapt appropriate checklists
or guidelines
4. Carry out the assessment
5. Review preliminary results
6. Analyse the management process
7. Take action to improve management
8. Check results
if
Module 7: FG; session 1; transparency 7-4
17
Session 2: Specify management assess
ment objectives (Step 1)
Objectives:
Participants will be able to follow the directions
in the Module 7 User’s guide to specify the
objectives of a management assessment for their
PHC programme
Session outline:
I. Introduction (5 minutes)
II. Questions to be Addressed (15 minutes)
III. Application (1 hour)
Materials:
Module 7 User’s guide
Transparency 7-5: Session 2: Objectives
Transparency 7-6: Questions to be answered
Handout 7-2:
Worksheet for planning
management assessment
Equipment:
Flipchart, stand, markers, masking tape, over
head projector and screen
Module 7: FG; session 2
18
Session : Specify management assessment objectives
(Step 1)
jg-'
I. Introduction
Transparency 7-5:
Session 2: Objectives
• Review the session objectives.
• Explain that you will introduce and discuss
the questions to be answered in specifying
assessment objectives, after which participants
will answer those questions to plan their own
management assessment.
II.
IT
F
JjKsw-xi
Questions to be answered
Transparency 7-6:
Questions to be answered
‘Explain that assessment objectives are
• Show one question at a time and discuss the
.ST
purpose of each and possible responses, using
the points contained on pages 19-21.
s
• Encourage participants to ask questions and
give examples from their programmes as you
present each question.
III.
Application
Handout 7-2. Worksheet
for planning
• Distribute the worksheet and direct partic-
ipants to complete Step 1 for their PHC pro
gramme.
Note: If it will not be possible to actually collect
data during the workshop, direct participants to
choose a management function for assessment,
such as planning, that they are most familiar with
and that requires more qualitative than quantita
tive data.
if
JL
specified by answering a series of questions.
Module 7: FG; session 2
& &
Session 2: Specify management assessment objectives
(Step 1)
&
(£i
19
• When participants have completed the work
sheet for Step 1, ask one participant to pre
sent the responses developed by the group and
explain the rationale for each response.
Note: As you listen to the presentation, consider
whether the responses are consistent with the pur
pose of each question and consistent with each
other and the needs of the programme. For ex
ample:
Are the units to be studied consistent with the
purpose of the assessment?
Does the scope of the assessment exceed the
resources available?
• Ask for questions and comments about the
a
&
worksheet and the process of specifying the
assessment objectives.
Module 7: FG; session 2
20
SESSION 2: OBJECTIVE
F
Specify the objectives of management ~
assessment for your PHC programme
iP
S-
£
&
iF
£
if
Module 7: FG; session 2; transparency 7-5
21
QUESTIONS TO BE
ANSWERED
• What is purpose?
• What activities included?
• Who will use information?
• How will information be used?
• What is the unit of study?
• Length of time?
• Do we have the resources?
Module 7: FG; session 2; transparency 7-6
22
WORKSHEET FOR PLANNING
MANAGEMENT ASSESSMENT
STEP 1:
Specify the objectives of the
assessment
A. What is the purpose of the assessment?:
B. What is the scope of the assessment?
Management activity(ies):
Sub-tasks:
C. Who will use the information gathered?
D. How will the information be used?
E. What programmes or facilities (units) will be covered?
F. Over what period of time will the activities take place?
G. Are resources adequate?
Module 7: FG; session 2; handout 7-2
23
WORKSHEET FOR PLANNING
MANAGEMENT ASSESSMENT
STEP 2: Determine assessment methods
Unit of observation
Data sources
Sampling methods
STEP 3: Choose relevant checklists:
Modification required:
Module 7: FG
25
Session 3: Design and carry out assess
ment (Steps 2, 3 and 4)
Objectives:
Participants will be able to follow the directions
in the Module 7 User’s guide to:
• Determine assessment methods.
• Select and adapt checklists or guidelines.
• Carry out the assessment.
Session outline:
I. Introduction (5 minutes)
11. Determine assessment methods (10 minutes)
III. Select and adapt checklists or guidelines (30
minutes)
IV. Carry out the assessment (45 minutes)
Materials:
Module 7 User’s guide
Transparency 7-7: Session 3 objectives
Transparency 7-8; Other assessment methods
Transparency 7-9: Selecting information
methods
Transparency 7-10: Ground rules
Equipment
Flipchart, stand, markers, masking tape, over
head projector and screen
Module 7: FG; session 3
&
Session 3: Design and carry out assessment (Steps 2, 3
and 4)
I. Introduction
Transparency 7-7:
Session 3: Objectives
• Review session objectives.
• Explain that details regarding each of the
three steps will be discussed and that the major
portion of the time will be spent in a group
discussion focused on the management func
tion chosen in Step 1.
tty'
liu-
Sr
II. Determine assessment methods
APPROACHES TO MANAGEMENT ASSESS
MENT:
(tlr
(EC
• Remind participants that this module pre
sents quantitative and qualitative approaches
to management assessment.
I®-
• Say that the quantitative approach empha
sizes the use of the checklists contained in
Appendix B; the qualitative approach empha
sizes use of the discussion guidelines contained
in Appendix A.
• Make these additional points regarding ap
Transparency 7-8: Other
assessment methods
Transparency 7-9:
Selecting information
methods
proaches to management assessment:
Both checklists and guidelines can be used
by the management team.
Both also can be adapted for use in the field.
Briefly review other assessment methods
that can be used in the field.
Briefly review factors to consider in select
ing assessment methods.
gP
gL
• Refer participants to their responses to ques
tions on Step 1 of the Worksheet for planning
management assessment for the management
activities or subtasks (functions) they selected
for assessment.
Module 7: FG; session 3
ST
27
Session 3: Design and carry out assessment (Steps 2, 3
and 4)
III. Select and adapt appropriate checklist or guidelines
User’s guide
• Refer participants to Appendix A to find the
guidelines appropriate to the management ac
tivity they chose to assess.
• Direct participants to review the questions
under the section headed "Discussion guide
lines" and "Key questions."
• Point out that the "Key questions" have been
extracted from the corresponding checklist for
this activity and are phrased to be answered
yes or no.
• Direct participants to find the corresponding
checklist in Appendix B and, if they wish,
select other key questions they would like to
address in the group discussion.
• Next, ask participants to rephrase the key
questions so that they cannot be answered yes
or no. Record the rephrased questions on a
flipchart.
Note: The questions under "Discussion guide
lines" can serve as a model for rephrasing the key
questions.
Questions that begin with "how" or "how well,"
"when," "why," and "what" are called open-ended
questions and require more than a "yes" or "no"
response.
Open-ended questions stimulate discussion and
promote exploring questions rather than making
judgements.
Module 7: FG; session 3
28
Session 3: Design and carry out assessment (Steps 2, 3
and 4)
IV. Carry out the assessment
Transparency 7-10:
Ground rules
• Review the ground rules for a group discus
sion and explain their value in making the
discussion as productive as possible.
• Explain the procedure for the group discus
sion:
You will take the role of facilitator, reminding
the group of the ground rules when they are
broken, pointing out when the discussion is off
the subject, and announcing the time at
various points so participants can adjust the
process as needed.
The group will select a leader and a recorder.
The leader will chair the discussion using the
guidelines as provided or modified. The re
corder will write down the group conclusions
to each question including minority opinions
where applicable.
• Facilitate the discussion for no longer than
30 minutes.
• At the end of the discussion, direct the re
corder to read aloud the conclusions of the
group to each question and make agreed upon
modifications.
• Summarise the group performance on the
ground rules, including things they did well
and areas where they need to improve.
Module 7. FG; session 3
29
«■ u
40
=3
40
SESSION 3: OBJECTIVES
• Determine assessment methods
• Select and adapt checklists or guide
lines
• Carry out assessment
3
Module 7: FG; session 3; transparency 7-7
30
OTHER ASSESSMENT
METHODS
• Observation of job performance
• Health facility inspection
• Record review
• Interview/ survey
Module 7: FG; session 3; transparency 7-8
SELECTING
INFORMATION METHODS
Consider:
33
•31
• Reliability of information
• Time required
38
38
• Cost
39
38
38
CPHE
39
38
36
Module 7: FG; session 3; transparency 7-9
32
GROUND RULES
• Everyone’s ideas are important
• No "right" or "wrong" answers
• Positive and negative comments
• Disagreement is expected/encouraged
• Don’t wait to be called on
• Only one person speaks at a time
Module 7: FG; session 3; transparency 7-10
33
Session 4: Review results (Steps 5 and 6)
Objectives:
Participants will be able to follow the directions
in the Module 7 User’s guide to:
• Present and review preliminary results with
the assessment team.
• Use at least one analytical technique to deter
mine the cause of a problem identified in the
management assessment.
Session outline:
I. Introduction (5 minutes)
II. Reviewing results (10 minutes)
III. Problem analysis (45 minutes)
Materials:
Module 7 User’s guide
Transparency 7-11: Session 4: Objectives
Transparency 7-12: Reviewing results
Transparency 7-13: Analytic techniques
Equipment:
Flipchart, stand, markers, masking tape, over
head projector and screen
Module 7: FG; session 4
34
Session 4: Review results (Steps 5 and 6)
I. Introduction
Transparency 7-11:
Session 4: Objectives
• Review session objectives.
• Explain that in this session, participants will
review assessment results to determine prob
lem areas and then analyse one problem to
identify the root cause of the problem.
II. Reviewing results
• Refer participants to the Notes from their
group discussion in the previous session.
Transparency 7-12:
Reviewing results
• Explain the review questions and direct
Flip chart
• As participants classify the problems into
categories, record them on three separate
flipchart pages headed "easy," "difficult," and
"priority."
participants to review their discussion Notes
with these questions in mind and to list the
easy problems, the priority problems, and the
difficult problems.
• Explain that they will return to the lists after
hearing about some techniques for analyzing
problems to identify root causes.
III. Analytic techniques
• State the value of these and similar analytic
techniques:
Provide a framework for examining prob
lems that have multiple causes or have a cause
that is not immediately obvious.
Draw on the experience and insight of all
staff involved in the process.
Module 7: FG; session 4
35
Session 4: Review results (Steps 5 and 6)
Lead to the root cause so that the action
taken will solve the problem, rather than treat
the symptoms.
Transparency 7-13:
Analytic techniques
• Explain each technique and answer partic
ipant questions.
Note: Include the information contained in pages
30-31 in the User’s guide in your explanation.
The 5 whys
The fishbone diagram
Note: Refer participants to page 31 (Exhibit 6) for
an example of a completed fishbone diagram.
Process flow chart
Note: Refer participants to page 33 (Exhibit 7)
for an example of completed process flow chart.
Flip chart
• Direct participants to select one problem
from their flipchart list of hard-to-correct
problems on the flipchart that they would like
to analyse further.
• Ask them to analyse it using one of the
techniques just presented.
Assist them in selecting a technique by
suggesting that the process flow chart is most
suitable for a process problem, such as one
related to logistics.
The fishbone diagram works best for prob
lems that may have multiple causes that can
be classified under larger headings as shown
in the example.
The 5 whys can be used alone and is often
helpful after the fishbone diagram has re
vealed a number of possible causes and the
group, based on its experience, has selected
the most likely cause or causes.
Facilitate the application of the selected
technique by recording the results of the
Module 7: FG; session 4
Session 4: Review results (Steps 5 and 6)
H
36
analysis on a flipchart as the group works, or
invite a participant to serve that role for the
group.
Note: The analysis will be successful if the group
uncovers a cause for the problem that was not
immediately apparent or gains insights that guide
them to further analysis or additional data collec
tion.
&
• If time permits, direct the group to choose a
second problem for analysis.
• Ask for questions and comments about analy
sis techniques, particularly the one they used.
£
Module 7: FG; session 4
37
SESSION 4: OBJECTIVES
• Present and review results
© Use an analytical technique to
determine cause of a problem
Module 7: FG; session 4; transparency 7-11
38
fiE'
REVIEWING RESULTS
• What activities are going well
• What activities need improvement
|
E^—
s
© Of the problem activities, which are:
• Easy to correct
gz
• A priority
B-
,
• Hard to correct
&
■5
E£
gh
if
Module 7: FG; session 4; transparency 7-12
39
ANALYTIC TECHNIQUES
• The 5 whys
o Fishbone diagram
• Process flow chart
Module 7: FG; session 4; transparency 7-13
41
Session 5: Take action and check results
(Steps 7 and 8)
Objectives:
Participants will be able to follow the directions
in the Module 7 User’s guide to:
• Describe how to take action necessary to
implement an appropriate, effective, and ac
ceptable solution.
• Check the results of that action.
Session outline:
I. Introduction (5 minutes)
II. Taking action and checking results (15
minutes)
111. Next Steps (30 minutes)
IV. Conclusion (15 minutes)
Materials:
Module 7 User’s guide
Transparency 7-14: Session 5: Objectives
Transparency 7-15: Take action and check
Transparency 7-16: Other uses of Module 7
Equipment:
Flipchart, stand, markers, masking tape, over
head projector and screen
Module 7: FG; session 5
42
Session 5: Take action and check results (Steps 7 and 8)
I. Introduction
Transparency 7-14:
Session 5; Objectives
• Review session objectives.
• Say that the final activity of the session will
give participants an opportunity to think
about and list the actions they will need to take
after the workshop to continue the work they
have begun on assessing and improving the
management functions of their PHC pro
gramme.
II. Take action and check results
Transparency 7-15: Take
action and check
• Explain the process involved in the last two
steps of the process of assessing PHC man
agement functions.
• Refer participants to the PHC MAP Prob
lem-solving guide and the PRICOR Opera
tions Research manuals for additional ideas
and guidelines for completing these last two
steps.
• Ask for questions and comments on the man
agement assessment process.
Transparency 7-16: Other
uses of Module 7
• Discuss other ways that PHC managers
could use these steps and materials in Module
7 to improve their management functions.
Note: Include the information contained on
pages 4 and 5 in the User’s guide in the discussion.
• Ask participants which of the other uses for
the checklists they think would be most useful
in their programme.
if
Module 7: FG; session 5
43
Session 5: Take action and check results (Steps 7 and 8)
HI. Next steps
Transparency 7-4:
Steps in management
assessment
Flipchart of problems
from Session 4
• Review the steps in management assessment,
highlighting the outcome of each step.
• Direct participants to review their completed
worksheet, the notes from the group discus
sion, and the lists of problems on the flipcharts
and indicate where they need to take action
to:
Assess other management functions;
Take action on easy-to-correct and priority
problems;
Conduct analyses of hard-to-correct prob
lems; and
Implement and check solutions that have
been identified.
• Direct participants to list what they need to
do to implement those actions and then
develop an action plan which includes:
Tasks in order of accomplishment.
When each task must be completed.
Who is responsible for each task.
• Ask participants to review their action plan,
anticipate any problems that might occur, and
suggest a way to deal with each problem.
• Ask for questions and comments on the ac
tion plan.
IV. Conclusion
Flipchart of expectations
from Session 1
Module 7: FG; session 5
• Review the expectations participants ex
pressed at the beginning of the workshop and
ask them to assess how well they think those
expectations have been met. If any were not
met, ask how the workshop could be im
proved to make that happen.
Session 5: Take action and check results (Steps 7 and 8)
• Thank participants for their time and atten
tion, congratulate them on the results of
their work, and wish them good luck in im
plementing their action plans.
Note: Indicate what follow-on assistance will be
available, if appropriate.
Module 7: FG; session 5
45
SESSION 5: OBJECTIVES
• Take the action necessary to implement
a solution
• Check the results
Module 7: FG; session 5; transparency 7-14
46
TAKE ACTION AND
CHECK
EtModule 7: FG; session 5; transparency 7-15
-.jT
47
OTHER USES OF MODULE 7
2^ 1. Management evaluation
2. Management team self-assessment
3. Planning new management procedures
p
4. Monitoring management improvement
3
efforts
...n 5. Job aids
•Ul
6. Management training
h
XJ
Id
Module 7: FG; session 5; transparency 7-16
PHC MAP MANAGEMENT COMMITTEE
Dr. Ronald Wilson • Aga Khan Foundation, Switzerland (Co-Chair)
Dr. Jack Bryant • Aga Khan University, Pakistan (Co-Chair)
Dr. William Steeler • Secretariat of His Highness the Aga Khan, France (Co-Chair)
Dr. Jack Reynolds • Center for Human Services, USA (PHC MAP Director)
Dr. David Nicholas • Center for Human Services, USA
Dr. Duane Smith • Aga Khan Foundation, Switzerland
Dr. Pierre Claquin • Aga Khan Foundation, Switzerland
Mr. Aziz Currimbhoy • Aga Khan Health Service, Pakistan
Mr. Kabir Mitha • Aga Khan Health Service, India
Dr. Nizar Verjee • Aga Khan Health Service, Kenya
Ms. Khatidja Husein • Aga Khan University, Pakistan
Dr. Sadia Chowdhury • Aga Khan Community Health Programme, Bangladesh
Dr. Mizan Siddiqi • Aga Khan Community Health Programme, Bangladesh
Dr. Krasae Chanawongse • ASEAN Institute for Health Development, Thailand
Dr. Yawarat Porapakkham • ASEAN Institute for Health Development, Thailand
Dr. Jumroon Mikhanorn • Somboon Vacharotai Foundation, Thailand
Dr. Nirmala Murthy • Foundation for Research in Health Systems, India
PHC MAP TECHNICAL ADVISORY COMMITTEE
-- -------------
Dr. Nirmala Murthy • Foundation for Research in Health Systems, India (Chair)
Dr. Krasae Chanawongse • ASEAN Institute for Health Development, Thailand
Dr. Al Henn • African Medical and Research Foundation (AMREF), formerly of
the Harvard Institute for International Development
Dr. Siraj-ul Haque Mahmud • Ministry of Planning, Pakistan
Dr. Peter Tugwell • Faculty of Medicine, University of Ottawa, Canada
Dr. Dan Kaseje • Christian Medical Commission, Switzerland, formerly of the
University of Nairobi, Kenya
KEY PHC MAP STAFF AT THE CENTER FOR HUMAN SERVICES
Dr. Jack Reynolds (PHC MAP Director)
Dr. Paul Richardson
Dr. David Nicholas
Dr. Wayne Stinson
Ms. Maria Francisco
&
Dr. Neeraj Kak
Ms. Lori DiPrete Brown
Ms. Pam Homan
Dr. Lynne Miller-Franco
Ms. Mary Millar
MODULE 7
FACILITATOR’S GUIDE
Primary Health Care Management Advancement Programme
Position: 1027 (5 views)