URC-SWAZILAND MONTHLY NEWSLETTER June-July 2014 Issue

Transcription

1 URC-SWAZILAND MONTHLY NEWSLETTER June-July 2014 Issue Volume 1, Issue August 2014 Inside this issue: July Staff QRM: Impacting Health Systems and Health Outcomes Kick TB Competition: Health Education that Encourages Behavioral Change Towards TB Issues Ngowane Community Dialogues on TB, HIV NCDs & Fitness Games for the Elderly: Shukuma Gogo Biosafety Training for Phlebotomists: Improving Capacities on Evolving Health and Safety Requirements Five Swaziland Laboratories Awarded Stars of Accreditation TB/HIV Management & Guidelines Training: Keeping Health Care Workers Up to Speed with Current Standards Training of Trainers (TOT) on Quality Assurance/ Quality Improvement: Improving Capacity of Healthcare Workers to Apply Quality Improvement The New Reigning QRM Queen New Additions to the URC Family Learning from a Team s Own Experience Other Activities 13 FOREWORD BY THE COUNTRY DIRECTOR I wish to congratulate the staff and URC and MOH counterparts for very productive months of June and July We being recommended to work towards full accreditation assessment within the next 12 months. witnessed major accomplishments. The USAID Applying Science to Starting with the technical support provided to the Swaziland health Laboratory Services through CDC HIV and TB, June started with a bang. Five laboratories that have been working on strengthening their quality management systems through the Stepwise Laboratory improvements towards accreditation (SLIPTA) which were presented to the African Society for Laboratory Medicine external laboratory audits achieved SLIPTA stars on their journey to accreditation. The hard work by our staff and the SHLS staff paid off. I would like to applaud all the laboratories that attained stars of accreditation. The National TB lab can be singled out for additional accolades, attaining 3 stars and Strengthen and Improve Systems (ASSIST) project took the advantage of the FIFA World cup in Brazil June 13-July 12, 2014, to launch a campaign of Kick TB out of Swaziland. Working closely with the National TB Control Program and University Research South Africa, radio, print and social mobilisation activities were conducted. I wish to congratulate the team on the successful in-house quarterly review meeting where facility and regional level projects continued to critically review and assess the outputs and outcome of the year. The Quarterly Review Meeting and Planning workshops also provided a forum for staff to reflect on what worked and what did not, in order to enhance improvements in the following year. Other learning opportunities included the model clinics collaborative learning & sharing sessions. For the new staff who joined us in the last two months, welcome to URC. URC Swaziland Country Director, Dr Samson Haumba.

2 JULY Page 2 JULY STAFF QUARTERLY REVIEW MEETING: Impacting Health Systems and Health Outcomes Each quarter the University Research Co., LLC (URC-Swaziland) staff Quarterly Review Meeting (QRM) continues to evolve into new and better practices. In this quarter the QRM fell on the 28 th -29 th of July 2014, at the Mountain Inn Hotel, which has since became the main preference for such workshops. The theme for this workshop was, Impacting Health Systems & Health Outcomes. Taking some time to focus on work done can count as a beneficial and necessary practice. The QRM promotes this practice, allowing staff to track where they started, whether they are going about it the right way and whether targets are being met. The presentations from the different projects USAID ASSIST and CDC URC-Lab project were very informative and allowed for open discussions with participants. These discussions became beneficial as it allowed the other projects to understand on-going activities within the organisation. The URC staff was also able to share best practices which could be implemented in order to carry out successful interventions. Newly introduced in this quarter s QRM was the displaying of storyboards. A total of 15 Quality Improvement (QI) intervention storyboards illustrating tested interventions and change were displayed from the different health facilities supported by the team. The Project Support Team (PST) was for the first time present in the July QRM. Previously, the need for having the PST team was under rated, however after this QRM it was realised that they also play a vital role in carrying out some of these activities. The workshop does not only serve the purpose of assisting staff to identify areas of collaboration and to share best practices, which could help with project sustainability. It further helps bring staff members closer, which helps improve productivity due to teamwork. The open discussions have resulted to a number of noticeable improvements in project results compared to the previous quarter. when It is in no doubt that the best practice of holding QRM workshops is vital in the carrying out the URC mission, strengthening health systems and impacting favourable health outcomes in Swaziland. Let s move a little energizer which helped keep participants focused and energetic. Participants seated in a semi-circle jotting down their comments during the presentation. Josephine Jonato, Laboratory Technologist, presenting her storyboard during the QRM.

3 JULY Page 3 KICK TB COMPETITION: Health Education that Encourages Behavioural Change towards TB Issues The official KICK TB launch was marked by a soccer match in Nhlangano. The goal keeper URC Swaziland Country Director, Dr Samson Haumba and striker the Shiselweni Regional Administrator, Themba Masuku. Shiselweni RA, Themba Masuku exemplary step which moved the public to also screen for TB. The Kick TB competition started on the 16 th of June to the 14 th of July This competition had targeted the FIFA World cup as well as Men s Health month as the key events to draw the attention of the public on TB issues. The theme of the campaign was therefore, Kick TB: Find TB. Treat TB. Cure TB. The competition involved listening to radio messages on TB topics, including IPC, diagnosis, treatment, TB and alternative medicines traditional healers and TB symptoms. The audience was expected to listen to the TB messages then answer one of three simple questions related to the radio messages through instant messaging. Radio served as an appropriate medium to teach about TB issues because it maintains a high listenership of about 90% of the country s population. Response to the competition started off slow and then improved after promoting the competition on TV at the breakfast show, Kusile. The visit to the show allowed the USAID ASSIST project team to go beyond just promoting the competition, but to also provide health education on basic TB issues. After the show the public became responsive and even took the opportunity to ask personal questions. The competition entries closed on the 14 th of July and by then a total of 244 people had entered, double the number of people that were expected. Towards the last two weeks the answers improved with less incorrect responses adding up to contestants out of that total answered all three questions correctly, which gave them a chance to win one of two android smart phones. The other 157 contestants stood to win a shopping voucher worth E500 and E300. On the 16 th the project team, visited the Kusile Breakfast TV Show where there was a live draw. The winners were drawn from the buckets by the presenter and the contestants selected were immediately called, which no doubt the competition kept interesting. The TB messages reached the audiences at home, achieving its intended success.

4 JUNE Page 4 NGOWANE COMMUNITY DIALOGUES ON TB, HIV NCDs & FITNESS GAMES FOR THE ELDERLY WOMEN: Shukuma Gogo In Swaziland the elderly are normally considered the wisdom of communities, which is why a majority of people consult with them before making decisions. Access to health care and imparting knowledge to them health issues affecting communities is beneficial to them and their households. On the 12 th of June 2014, the Swaziland USAID ASSIST Project team partnered with Ngowane Clinic and community leaders, hosted a one day fitness event, targeting elderly women, referred to as Bogogo in siswati. This event was themed, Shukuma Gogo, loosely translated as Move elderly women. This event packed with activities no doubt left the 60 elderly women aged between the ages of years exhausted, but fit and filled with information pertaining to TB, HIV and NCDs. The sessions began with health educational discussions, which allowed the elderly in attendance to share their views and ask questions where needed. Even though as elderly people the women were quite receptive to what they were being taught even though it meant changing some of their custom practices. For example, as per the Swazi custom, a dead family member is normally bathed and dressed by the elderly, even if they are from the morgue, before their funeral. By the end of the dialogues a majority of the participants were now against the practice aware of all the risks of infection. URC TB /HIV Coordinator, facilitating dialogues with the elderly community members. Gogos versus Ngowane Senior Nurse, Nokwakhe Mkhumane racing to the finish line. The second session in the day s programme involved engaging participants In some of the games and exercises included the egg race, running, coordination games and games that encouraged healthy eating. By the end of the day all the Gogos were screened and 16 tested positive. Seven produced spot sputum and only one out of that group was diagnosed with TB and initiated on treatment. Among the 16 suspects, 4 were MDR-TB contacts thus GeneXpert and culture was ordered for them. 300 TB/HIV and Infection Prevention and Control (IPC) Behavioural Change Communication (BCC) were distributed by the end of the day. The elderly women holding up their BCC materials after an educational day. The Gogos showed how fit they are during the egg race. Having events that focus on specifically on key population and risk groups helps them understand the information imparted to them better. This is particularly true because they become comfortable with asking questions freely, especially those that touch directly on their lives. One old women said Maye nente kona ke kusibita sodvwa ngoba bese siyesaba lokukhuluma embikwe bantfu labakakhulu ikakhulukati bobabe Meaning You did well by calling us as a separate group because we tend to be shy in the presence of other groups of people especially men

5 JUNE Page 5 BIOSAFETY TRAINING FOR PHLEBOTOMISTS: Improving Capacities on Evolving Health and Safety Requirements A number of mini laboratories had phlebotomists that had inadequate knowledge to enable them implement biosafety requirements based on the World Health Organisation (WHO) Biosafety Manual and the ISO 15189, and To help improve their capacity, on the 27 th -29 th of June 2014, at Sibane Hotel, training was held specifically for 23 phlebotomists from different health laboratories around the country The main goal of the training was to improve health and safety in the mini laboratories considering the number of hazards they are exposed to while carrying out their duties. The biosafety training covered comprehensive aspects of Biosafety, fire safety, Infection Prevention Control (IPC) and waste management in efforts to keep up with the evolving health and safety requirements. For a training that was first of its kind, the pre and post test results revealed that there was some knowledge gained from the training. The lowest score for the pretest was 25% and the highest mark was 75%. After a number of presentations that also included practical sessions the lowest score recorded from the post test was 56% and the highest was 100% showing a remarkable gain in knowledge At the end of the training the Swaziland Health Laboratories Services (SHLS) Chief Technologist Representative expressed thanks to the CDC Lab project for making this training possible, which would help improve the skills and practices of the phlebotomists in the labs. Group of URC staff and phlebotomists from different facilities posing after the workshop.

6 JUNE Page 6 FIVE SWAZILAND LABORATORIES AWARDED STARTS OF ACCREDITATION URC, MOH, IDI and ASLM team posing after the debriefing session at the Mbabane Government Laboratory. After countless months of hard towards laboratory accreditation, on the13th th June 2014, five of the country s laboratories were awarded stars of accreditation by the African Society for Laboratory Medicine (ASLM). This counted as an important landmark for Swaziland, as it is 50% close to accreditation. These results placed the country at a recognisable average than other African countries though hosting audits for the first time. This was announced during a debriefing meeting at the Mbabane Government Laboratory complex following the conducted external laboratory audits. The audits were conducted in collaboration with the WHO AFRO office and the African Society for Laboratory Medicine. The auditing process focused on 12 criteria, totalling to an overall score of 250. The five laboratories included: Central Laboratory Scored 156 (2 Stars) Pigg s Peak Hospital Laboratory 169 (2 Stars) National Molecular Reference Laboratory 169 (2 Stars) Mbabane Government Laboratory 171 (2 Stars) National TB Referral Laboratory 198 (3 Stars) This approach was embraced in an effort to strengthen national laboratory services in stepwise manner by providing graduated levels of performance recognition towards a long term fulfilment of the ISO standard. This was done through CDC lab project with technical support by the University Research CO., LLC (URC) in collaboration with the Infectious Disease Institute (IDI). Also announced during the meeting were the 6 newly certified ASLM internal audits who are now qualified to conduct laboratory audits. These are namely Rogers Kisame, Cinisile Ndlangamandla, Philton Ndzinisa, Anafi Mataka, Gcina Dlamini, Nokuthula Magongo who are all affiliated with the countries laboratories.

7 Page 7 Score s and stars that were given to the five laboratories by the ASLM auditors Words by URC Country Director, Dr Samson Haumba The CD applauded the awarded stars acknowledging that it has indeed been an effective process which started in 2011 as well as the newly recruited internal audits. He further thanked the Swaziland Ministry of Health for providing the opportunity to work with them in building the capacity and quality of the country s laboratories. Words by Director of Health Services, Dr, Vusi Magagula When I was first appointed as Director of Health Services, laboratories in the country t needed the most attention. Therefore without a doubt I am proud that they have since improved to the point that all the audited labs achieved stars of accreditation. He added that, internal audits are important, because it will help keep everyone on their toes, pushing them to work hard.

8 JUNE Page 8 TB/HIV MANAGEMENT & GUIDELINES TRAINING: Keeping Health Care Workers Up To Speed with Current Standards Nompumelelo Ndwandwe, TB/HIV Regional Coordinator facilitating during the workshop. OTHER FACILITATORS Dr Arnold Mafukidze, TB/HIV Clinical Advisor Julius Manjengwa, TB Lab Advisor On the 23 rd to 27 th of June 2014, the USAID ASSIST project held training at Lugogo Sun Hotel targeting health care workers from TB diagnostic sites and non -diagnostic sites. The training was on TB/ HIV management and guidelines. This training key focus was to introduce the 26 participants to the TB manual with current national and international guidance in the diagnosis, management and control of TB and TB/HIV co-infection. This training is a 5 days training covering seven modules. Each day was filled with knowledge packed presentations by different facilitators who are expert TB/HIV trainers well equipped in their field of work. The first day focused on three modules the epidemiology of TB, transmission and Pathogeneses as well as clinical diagnosis of TB. The second day was especially designed to equip participants with laboratory TB diagnosis knowledge. On this day the participants had various discussions of improvement points about the transportation of samples and results. The third day s presentations comprised of TB case definitions, TB treatment and monitoring, 3ls of TB control, patient support and DOT. Some of these sessions included visual presentations which were quite helpful to the participants. The fourth day covered the basics of drug resistant tuberculosis (DR-TB) and TB supply chain management. Finally, on the last day the Monitoring and Evaluation (M&E) module was covered. To assess knowledge gain and transfer participants were given a pre-test to assess their level of knowledge at the beginning of the training and a post-test to evaluate how much they learnt at the end of the training. According to results from both the pre-test and post-test the average knowledge gained was 36%. Despite emphasis on how indicators are developed and exposure to indicators, participants still performed poorly on the indicators questions. This showed that participants still need to be trained on M&E. Participants sitting-in during the proceedings of the workshop.

9 JULY Page 9 TRAINING OF TRAINERS (TOT) ON QUALITY ASSURANCE/ QUALITY IMPROVEMENT: Improving Capacity of Healthcare Workers to Apply Quality Improvement USAID ASSIST project and the CDC- URC lab project in collaboration with the National Quality Management Programme seeks to improve the capacity of healthcare workers to apply Quality Improvement (QI) approaches to make essential services better meet the needs of patients, improve efficiency, reduce the cost of poor quality, and improve the capacity of HCWs on QA/QI methodologies. On the 30 June-04 July 2014 at Esibayeni Lodge a TOT training was conducted to establish a group of Quality Assurance (QA) trainers to support rollout of quality improvement and develop competencies and capacities of imparting training to other health care workers. The training benefitted 13 participants drawn from hospitals, health centres and the region. The participants were trained over a 5-day workshop. The workshop was designed to have technical presentations, group deliberations and plenary sessions. This allowed participants an opportunity to share experiences, learn new approaches for knowledge and skill transfer and developing lesson plans. By the end of the training the participants were expected to be: Trained as trainers for field level training activities. To develop necessary skills in organising and conducting QA/QI training To provide an understanding of the principles and practices of the training process. The National Quality Management Programme Manager, Thuli Thomo-Dlamini, remarked that QI should be central for all health delivery services within available resources and against set standards to improve regional outcomes. She further emphasized that QA and QI is everybody s business and needs to be an integrated part of all activities in all programs and services. SOCIAL Extra... THE NEW REIGNING QRM QUEEN The first URC- Swaziland QRM star has officially handed over to another qualifying individual. Congratulations to our QRM star Yvonne Makwabara

10 SOCIAL CORNER Page 10 NEW ADDITIONS TO THE URC FAMILY NAME: Ntombikayise Nkambule Kayise DESIGNATION: Human Resource Manager EXPERTISE: Human Resource Management, Recruitment, Performance Management, Benefits Administration NAME: Bongile Nzima DESIGNATION: Finance Manager EXPERTISE: Financial Accounting, Financial management & Reporting,Auditing NAME: Victoria Masuku Vicky DESIGNATION: University Research South Africa (URSA) National URSA Project Coordinator EXPERTISE: Public Health specialist, Organizational Development and Project Management NAME: Dr Arnold Mafukidze DESIGNATION: National TB/HIV Clinical Advisor EXPERTISE: Clinical management of TB (including MDR- TB) and HIV in resource-constrained settings

11 Page 11 SOCIAL CORNER NAME: Tumelo Mampa DESIGNATION: Lab Quality Advisor EXPERTISE: Laboratory technologist, Quality Assurance and microbiology TB NAME: Sarah Darteh DESIGNATION: HIV Lab Mentor EXPERTISE: Masters in Business Admin, Laboratory Technologist, HIV lab Mentor, Malaria Lab Diagnosis Coordinator NAME: Bathabile Simelane DESIGNATION: Human Resource Assistant (Volunteer) EXPERTISE: Development studies; development economics and policies; research. Data management, Report writing and Welfare analysis NAME: Njabuliso Maphanga Njabu DESIGNATION: Intern (project DGF TB in the mines) EXPERTISE: Clinical management; psychosocial support; community care and midwifery For Laughs

12 Page 12 URC-SWAZILAND MONTHLY NEWSLETTER June-July 2014 KNOWLEDGE NUGGETS LEARNING FROM A TEAM S OWN EXPERIENCE Experience can be defined in a number of ways. The best definitions being it is an observation of facts or events which leave impressions on one; and knowledge and skill acquired over time and finally. In short we can refer to Experience as the best teacher! Taking advantage of experience to analyse workshops can be beneficial. This process of analysing is known as After Action Review (AAR), this is a brief meeting that focuses on a single activity. Its purpose is to analyse the difference between planned and actual experience, identify the lessons and create an action plan to improve the next time. AAR STRUCTURE What did we set out to do? What did we actually do? Why did it happen? (good or bad) What can we do next time? Who are we going to tell? For an AAR to be useful the team must have a clearly stated objective it is trying to achieve. The objective can be an outcome objective or a process objective. AFTER ACTION REVIEW GUIDELINES WHEN TO USE AAR? Conducted by a facility team on a regular basis or after an important event During a coaching visit Among the organizing team at the end of a learning session Among the trainers at the end of a training session Openness, not hiding Leaders and team members on equal footing Learning, not blame or evaluation nothing said at an AAR goes into personnel records Don t rush to solutions Everyone involved takes part No outsiders should be present Deal with the significant issues, not trivia Facilitated outsider or trained insider Held consistently, not just when things go wrong

13 URC SWAZILAND Who Are We University Research CO., LLC (URC) is dedicated to improving the quality of healthcare, social services and health education worldwide. Mission URC s mission is to provide innovative, evidence based solutions to health and social challenges worldwide. Expertise In Swaziland, URC expands access to and improves the quality of services addressing infectious diseases including HIV/AIDS, TB, and improving laboratory quality management system Approaches URC focuses on finding ways to deliver proven approaches to health care problems, applying quality improvement (QI) methods and conducting research and evaluation to tailor those approaches to various settings. Recognizing implementation barriers unique to each setting, we train local managers and service providers to apply QI methods to strengthen health systems, integrate system elements, and bring improvements to scale. URC also specializes in designing health messages and materials to educate target audiences about improving health behaviors. OTHER ACTIVITIES IN JUNE - JULY: Men s Health month RHMT Training PSI Cough Officer training on TB management Wellness Centre Healthcare Screening Report Sharing With Focal Persons MDR-TB training IST Quality Improvement Model Clinics Collaborative Learning & Sharing Sessions Intensive Case finding PHU Training SWAMIWA Volunteers training Pre-service Training for Graduating SANU Nurses RSSC Feedback Session & On-site QA/QI Training UPCOMING ACTIVITIES IN AUGUST: National TB QRM TB NSP plan Leadership and Management Training NCD policy strategy URC Planning Workshop MOH Cultural Day Lab mentoring URC Orientation Regional Semi Annual Review Meeting (RESAR) - Hhohho region EDITORIAL TEAM Jilly B. Motsa Janet Ongole Dr Marianne Calnan Dr Samson Haumba University Research CO., LLC (URC) 3rd Floor, North Wing, Building 1 Mbabane Office Park Sozisa Road P. O. Box 1404 Mbabane H100, Swaziland Tel: (+268) /56/69 Fax: (+268) Website: