Ministry of Health REPORT DONOR SUPPORTED POSITIONS IN THE HEALTH SECTOR IN SWAZILAND OCTOBER 2012 1
TABLE OF CONTENTS Background... 3 Introduction... 3 Clinical and Non Clinical (Administrative) Posts... 5 Post Equivalency... 12 Comparisons of Salary Scales... 13 Vacant positions in Government... 14 Post Title... 14 Number of vacancies... 14 Absorption Plan... 15 Short term plan for absorption of posts FY 2012/2013... 16 Medium Term Plan for absorption of posts... 18 General guidance for absorption 18 Issues and Recommendations... 22 2
1. Background The increasing disease burden largely driven by the HIV/AIDS epidemic, has led to increased demand for health services with a resultant need to increase the supply of health workers. However, due to budgetary constraints, government has been unable to employ an adequate health workforce to address the demands of the health sector. Where the government has been unable to quickly expand the establishment in response to newly emerging service delivery needs, several external partner organizations have stepped in to temporarily assist in the rolling out and scaling up of key services such as ART provision to the public, Voluntary Counseling and Testing, Prevention of Mother to Child Transmission of HIV, and diagnostics, among other services. However, this type of support is regarded as a temporary measure to catalyze the delivery of services which ultimately fall within the mandate of the public sector. A number of external partners have been funding the key-service-delivery posts for a limited number of years to enable government to mobilize domestic resources in order to create new posts. Many of the donor funded posts expire after a few years (usually 3-5 years) and there is a need for government to absorb them into public service 2. Introduction In the process of developing and costing Human Resources for Health Strategic Plan (2012-2017) a need was identified to take stock of all human resources flowing into the sector. This is especially in regard to donor funded posts which the MOH is expected to absorb into public service. As such, an assessment was undertaken of all externally funded posts within health facilities and programmes at all levels. The information generated from this exercise is expected to assist the MOH to appreciate the costs of absorbing these posts into public service, planning for the absorption and ensuring that disruption of services are minimized or avoided due to the expiration of donor funding. In view of the current economic challenges facing the country, government issued a circular freezing the hiring of employees in all Ministries and Departments. However, the Ministry of Health together with the Ministry of Education and Training were classified as priority sectors and as such are not affected by the aforementioned new policy on hiring. Partners were formally requested to submit information on whether they were funding any positions in the health sector. Discussions were also held with the HRH TWG and key officials 3
from MOH and MOPS to identify some of the issues that need to be considered in the assessment and absorption of donor funded posts into the civil service. A total of 8 partners are involved in supporting donor funded positions in the health sector. These are Global Fund, EGPAF, Futures Group, URC, ICAP, CHAI, WFP and MSF. Futures Group, EGPAF, URC and ICAP are all funded by PEPFAR who is also financing the MOH Co- Agreement. In total, there are 828 positions being presently funded encompassing clinical and non-clinical posts out of a total of 3,684 positions in the health public sector. This translates to an estimated 22% positions being funded by donors. As reflected in the diagram below, Global fund is funding % of total donor funded posts (351), comprising the largest share. Figure 1: Share of Funded Positions by Donor CHAI, 2.4% WFP, 2.7% MSF, 36.6% Global Fund, 42.7% PEPFAR, 15.6% Feedback received from WHO, UNICEF, UNFPA and EU indicated that they were currently not funding any positions in the health sector. On average, most donors fund positions over a 3-5 year period. There is no evidence of formal agreements between partners and government regarding the absorption of these positions into public service upon expiry of contracts. However, it does appear that most of the positions would need to be sustained beyond the life of projects to ensure serviced delivery. This however requires further evaluation of each post by MOPS before it is absorbed. 4
3. Clinical and Non Clinical (Administrative) Posts The full spectrum of health services delivery requires the existence of both clinical and nonclinical posts. There are a total of 353 clinical posts and 475 non-clinical (administrative posts) constituting 43% and 57% of the total number of posts funded by donors, respectively. The table below reflects clinical and non clinical posts which are currently funded by donors. Table 1: Clinical and Non-clinical posts CLINICAL POSTS Post Title Number Donor Medical Officer 1 GF-HSS Nurse 11 Medical Technologist 1 Phlebotomist 21 Microscopist 7 Pharmacist 4 Pharmacy Technician 2 Lab Coordinator 1 Case Management Coordinator 1 Lab Technologist 6 GF-TB Microscopist 20 Phlebotomist/Drivers 5 Default Tracers/Adherence 25 Pharmacy Technician 2 Pharmacist 1 ACSM Focal Point 1 Regional TB/HIV &MDR 1 5
Cough Officer 40 Medical Officers-Regional 8 Nurses-Regional 12 TB GF Grant Coordinator 1 Lab Focal Point 1 ART Doctor 1 EGPAF Medicines Policy Advisor 1 MSH Cough Officer 5 URC-HCI HTC Technical Officer 1 URC-HTC Lab Technologist 1 URC-LAB Phlebotomist 12 URC-LAB Male Circumcision Coordinator 1 Futures Group Male Circumcision QA Officer 1 CoAg Unit Medicines Policy Advisor 1 MSH-SPS Community Health Nurse 1 ICAP-CDC ART Coordinator 3 Clinical Advisor 1 Nurse Advisor 1 Psychosocial Officer 1 Clinical Systems Mentoring Officer 1 Lab Scientists 11 Phlebotomist 5 CHAI Cough Officer 11 MSF 6
Adherence Officer 9 Counsellor 7 Infection Control Officer 2 Lab Assistant 2 Medical Doctor 4 Nurse Supervisor 1 Nurse 13 Nurse Assistant 4 Pharmacist 1 Pharmacy Assistant 2 Psychosocial supervisor 2 Lab technologist 6 Lab technician 8 Clinic/ Zone Supervisor 4 Phlebotomist (includes flying phlebotomist) 11 CTC supervisor 1 Psychosocial officer 1 Infection Control Practitioner 1 Lab technician assistant 7 TB Team Supervisor 1 Pharmacy Supervisor 2 Pharmacy Technician 3 CIO Nurse 18 7
TB Nurse 7 Community Psychosocial Supervisor 3 Therapeutic Education and Counselling Supervisor 1 Psychosocial support supervisor 1 SUB TOTAL 353 NON-CLINICAL POSTS Lecturers 3 GF-HSS Storekeeper 2 Database Programmer 1 IT Officers 4 Systems Manager 1 Data Manager 1 M&E Officer 18 Receptionist 2 Driver 5 Cleaner 1 Assistant Statistician 4 Information Officer 4 Truck Driver 4 Transport Coordinator 1 Hospital Administrator 4 Data Clerk 24 Senior Procurement Officer 2 8
Admin Assistant 1 Data Clerk 3 MSH Systems Manager 1 Data Clerk 2 URC Grant Coordinator 1 GF-Malaria Information Technology 1 Database manager 1 GIS Analyst 1 Surveillance 1 Surveillance Supervisor 2 Surveillance Agent 6 IEC Coordinator 1 Health Promotion Coordinator 1 Data Clerk 1 IRS Operators 12 M&E Research Officer 1 GF-TB Finance Officer-NTP 1 Data Clerks (Health Information Officers) 4 TB Expert Clients 67 Lay Counsellors-HTC 10 Drivers 6 Executive Director-STOP TB Partnership 1 Stop TB Partnership Officer 1 9
Administrative Secretary- STOP TB Partnership Capacity Building Officer-STOP TB Partnership Communications Officer-STOP TB Partnership 1 1 1 Supervision Officer 1 EGPAF Training Officer 1 Public Relations Officer 1 Futures Group Director 1 PEPFAR-CoAg Quality Manager 1 Admin Officer 1 Quality Assurance Officer 1 Activity/Program Officer 1 Finance/Admin Officer 1 Driver/Clerk 1 Driver/Clerk 1 Male Circumcision QA Driver 1 Expert Client 2 URC-HCI Lay Counselor 10 URC-HTC Lab Administrator 1 URC-LAB National Sample Trans. Logistics officer 1 National Sample Trans. Data Clerk 1 Regional Lab Coordinator 4 Expert Client 47 ICAP-CDC 10
Senior Evaluation Analyst 1 Lecturers 2 Strategic Information Analyst 1 CHAI Lay Counselor 12 Data Clerk 2 Food by Prescription Assistant 22 Medical Data Processor 3 MSF Medical Data Supervisor 1 Housekeeper 5 Accountant 1 Cashier 1 Secretary 2 Chief Housekeeper 1 Office Cleaner 1 Human Resources Officer 1 Finance Officer 1 Interpreter 3 Data Clerk 5 Trainee Dispensary Assistant 6 Head Consultant PSEC 1 CTC (Helper) 18 Gardener 1 Logistician 1 Maintenance Agent 2 11
Incinerator Operator 1 Supply Officer 1 Storekeeper 1 T&L Assistant 1 T&L Constr. Assistant 1 Chief Driver 1 Field Driver 16 Clinic Expert Client 36 Community Expert Client 30 TB Expert Client 6 SUB TOTAL 475 TOTAL 828 Even though the support from donors may appear to be heavily skewed towards non-clinical positions, this might have been based on the needs on the ground to ensure that provision of clinical services is fully supported and patients are able to access a full continuum of care. Any attempts therefore at absorbing donor funded posts should consider all critical positions, both clinical and non-clinical, necessary to deliver appropriate healthcare services. 4. Post Equivalency Notably, when comparing the posts titles between donor funded posts with those in the establishment, it is evident that some of these posts are named differently. Below is a list ofsome of the donor funded posts which appear not to have an equivalent post title in the Establishment Register 1. Cough Officer 2. Food By prescription officer 3. Lay Counselor 4. Expert Client 12
5. HTC technical Officer 6. National Sample Trans. Data Clerk 7. Clinical Systems Mentorship Officer 8. Microscopist 9. Procurement Officer 10. Surveillance Agent 11. Surveillance Supervisor There is a need therefore to assess the roles and responsibilities of each of the abovementioned positions and which existing posts they are equivalent to as well as how they fit into the Establishment Register. The assessment could also look into whether the roles and responsibilities of certain existing positions could be expanded to include those of the aforementioned donor funded posts. For instance, the Food by prescription officer appears to carry out similar functions to a Storekeeper which is a position that exists in the Establishment Register. 5. Comparisons of Salary Scales The table below compares salaries between donor funded posts and posts in government. Salaries in donor funded posts are as high as 22%-35% compared to government funded posts. The absorption of posts needs to also consider this factor so that officers are not disadvantaged. Donors also need to take this into consideration when creating posts so that the gap in salaries is not too wide. Table 2: Salary Comparisons Donor Funded Post Salary (Donor) Equivalent post in Government Salary (Government) ART Doctor 31,460,83 Medical Doctor 24,253.08 (E4) Community Health 14,567.87 Staff Nurse 10,014.25 Nurse Pharmacist 21,635.00 Pharmacist 16,388.57 Pharmacy Technician 10,718.57 Pharmacy Technician 6,904.83 Phlebotomist 3,499.73-5543.46 Phlebotomist I/II 3414.58-4112.08 (A3/ A4) Hospital Administrator 13,450-16,000 Assistant Health Administrator 9,803.25 13
M&E Officer 19 216.66 M&E Analyst 12 416.75 (C6) Assistant Statistician 17003.01 Assistant Statistician 12 416.75 (C6) Data Clerk 4,971.87 Statistical Clerk 3,066.25 (B1) 6. Vacant positions in MOH Despite the pressing and urgent need to create more positions in order to realize adequate staff numbers and even to absorb donor funded positions, advice from MOPS is that MOH needs to fill all vacant positions before requests for creation of new posts is considered. According to a printout on vacant posts obtained from the MOH Human Resources department there were 475 vacant posts as at June 8, 2012 with a value of E8, 200,671.84. If this number is compared to the number of donor funded positions (603), it could be presumed that it may not be potentially possible to absorb all the donor funded positions in the short term. The table below reflects vacancies for selected positions (equivalent to the current donor funded positions) which may be considered for absorption. Table 3: Vacancies in MOH Post Title Number of vacancies Pharmacy Technician 20 Nurse/Counselor 17 Program Officer 6 AIDS Counselling Coordinator 1 Assistant Health Education Officer 4 General Staff Nurse I 39 Program/Logistics Officer 13 Medical Specialist 4 Program Manager 1 Staff Nurse 52 Assistant Statistician* 2 Senior Statistical Assistant 1 14
Senior M&E Officer 1 M&E Analyst 1 Laboratory Technologist* 25 Senior Pharmacy Technician 1 Nursing Assistant 21 Phlebotomist* 12 Medical Officer 8 Pharmacist 3 Research Officer 2 Statistical Clerk 6 Senior Information officer 1 Senior Program officer 1 *Post has 1 or 2 levels but these have been combined Discussions with key officials from MOPS and MOH revealed that there are complex issues regarding the filling of vacant positions in the Ministry. One of the issues is that some of the seemingly vacant positions are not vacant at all. The printout does not reflect positions that are in the process of being filled or already filled. This requires further checks and confirmations of vacant positions. There is a need therefore to determine theactual number of vacant positions at the MOH. 7. Absorption Plan The submission from partners shows that contracts for the positions will expire anytime between 2012 and 2015. Some contracts under PEPFAR funded organizations expired in 2011 and the posts were apparently absorbed into Global Fund Round 11. The proposed absorption plan therefore considers posts that would need to be absorbed in the immediate/ short term (posts expiring 2012) and in the medium term (posts expiring 2014 and 2015). The full list of posts expiring per year is included in the appendix to this document, and it includes detail on each post, its location, the cadre equivalent if it is to be absorbed, funding source, employment dates, funding expiry dates, and comments on action to be taken 15
It should be noted though that the absorption plans presented below are not prioritized in terms of critical posts that need to be absorbed in order to ensure continuity in provision of services deemed crucial. In view of the fiscal challenges, it is therefore important and urgent that the MOH makes the decisions on which posts need to be absorbed into civil service Table 4: Short term plan for absorption of posts FY 2012/2013 Post Title Location Number Date of Expiry CLINICAL POSTS ART Doctor KSII PHU 1 31 Dec 2012 Lab Technologist Phlebotomist National Clinical Lab Service National Clinical Lab Service 1 31 Dec 2012 12 31 Dec 2012 Clinical Advisor Manzini RHMT 1 28 Feb 2012 Nurse Advisor Manzini RHMT 1 28 Feb 2012 Psychosocial Officer Manzini RHMT 1 28 Feb 2012 Clinical Systems Mentoring Officer ART Coordinator 1 April 2012 Phlebotomist Tikhuba 1 16 Feb 2013 Phlebotomist Bhekinkhosi 1 16 Feb 2013 Phlebotomist Shewula 1 16 Feb 2013 Phlebotomist Sinceni 1 16 Feb 2013 Phlebotomist Mliba Nazarene Clinic 1 16 Feb 2013 SUB-TOTAL 23 NON-CLINICAL POSTS Lab Administrator National Clinical Lab 1 Dec 2012 16
Service Supervision officer SRHU 1 Dec 2012 Training Officer SRHU 1 Dec 2012 Public Relations Officer MOH TBD National Sample Trans. Logistics officer National Sample Trans. Data Clerk Regional Lab Coordinator National Clinical Lab Service National Clinical Lab Service National Clinical Lab Service 1 Dec 2012 1 Dec 2012 4 Dec 2012 Expert Client RHMTs 47 31 May 2011 Senior Evaluation Analyst ART Coordinator 1 31 March 2011 Lecturers GSNS 2 Jan 2012 Strategic Information Analyst CMS 1 Dec 2012 Lay Counselor Good Shepherd 3 26 Feb 2012 Lay Counselor Sithobela Health Centre 2 26 Feb 2012 Lay Counselor TB Centre 2 26 Feb 2012 Lay Counselor Matsanjeni Health Centre 1 26 Feb 2012 Lay Counselor RFM Hospital 1 26 Feb 2012 Lay Counselor Mbabane Government Hospital 1 26 Feb 2012 Lay Counselor Hlathikhulu Hospital 1 26 Feb 2012 Lay Counselor Nhlangano Health Centre 1 26 Feb 2012 17
Data Clerk CMS 1 Dec 2012 Food by Prescription Assistant Sithobela Health Centre 2 Dec 2012 Food by Prescription Assistant Food by Prescription Assistant Food by Prescription Assistant Food by Prescription Assistant Good Shepherd 2 Dec 2012 RFM Hospital 2 Dec 2012 Dvokolwako H.C 2 Dec 2012 Mankayane Hospital 2 Dec 2012 Food by Prescription Assistant Mbabane Government Hospital 2 Dec 2012 Food by Prescription Assistant Food by Prescription Assistant Food by Prescription Assistant Food by Prescription Assistant Food by Prescription Assistant Matsanjeni H.C 2 Dec 2012 Mkhuzweni H.C 2 Dec 2012 Nhlangano H.C 2 Dec 2012 Piggs Peak Hospital 2 Dec 2012 Hlathikhulu Hospital 2 Dec 2012 SUB TOTAL 93 TOTAL 116 8. Medium Term Plan for absorption of posts There is a total number of 140 donor funded posts that will require absorption in 2014 and 2015, subject to criteria for absorption and funds availability. 18
The table below captures the donor funded posts that will need to be absorbed. A detailed breakdown of each post is attached to the Appendix. Table 5: Medium Term Plan for absorption of posts Post Title Location Number Expiry Medical Officer Wellness Centre 1 31 March 2015 Nurse Rural Clinics 9 31 March 2015 Nurse Wellness Centre 2 31 March 2015 Medical Technologist NRL 1 31 March 2015 Phlebotomist Rural Clinics 22 31 March 2015 Microscopist NRL 7 31 March 2015 Pharmacist CMS-regional support 4 31 March 2015 Pharmacy Technician CMS 2 31 March 2015 Lab Coordinator NMCP 1 June 2014 Case Management Coordinator NMCP 1 June 2014 NON-CLINICAL POSTS Lecturers SANU 3 31 March 2015 Storekeeper CMS 2 31 March 2015 Database Programmer National SID 1 31 March 2015 M&E Officer National SID 1 31 March 2015 Receptionist National SID 1 31 March 2015 Driver National SID 1 31 March 2015 Cleaner National SID 1 31 March 2015 Assistant Statistician Regional SID 4 31 March 2015 Information Officer Regional SID 4 31 March 2015 19
Truck Driver CMS Drug Distribution 4 31 March 2015 Driver RHA 4 31 March 2015 Transport Coordinator MOH-HQ 1 31 March 2015 Hospital Administrator Matsanjeni H.C 1 31 March 2015 Hospital Administrator Dvokolwako H.C 1 31 March 2015 Hospital Administrator Sithobela H.C 1 31 March 2015 Hospital Administrator Emkhuzweni H.C 1 31 March 2015 Data Clerk Regional SID 24 31 March 2015 Senior Procurement Officer Procurement Unit 2 31 March 2015 Admin Assistant Procurement Unit 1 31 March 2015 Receptionist Procurement Unit 1 31 March 2015 Grant Coordinator NMCP 1 June 2014 Information Technology NMCP 1 June 2014 Database manager NMCP 1 June 2014 GIS Analyst NMCP 1 June 2014 Surveillance NMCP 1 June 2014 Surveillance Supervisor NMCP 2 June 2014 Surveillance Agent NMCP 6 June 2014 IEC Coordinator NMCP 1 June 2014 Health Promotion Coordinator NMCP 1 June 2014 Data Clerk NMCP 1 June 2014 IRS Operators NMCP 12 Director NBTS 1 TBD 20
Quality Manager NBTS 1 TBD Admin Officer NBTS 1 TBD 140 9. General guidance for Absorption The MOPS is presently considering development of a framework to assist the MOH in engaging donors towards funding positions in the health sector. As earlier mentioned, most donors do not have a formal agreement with government. A formal agreement is important to clarify roles and responsibilities of both parties and to understand future implications. Below is a general guidance for developing formal agreements; 1. All positions supported by donors have to be aligned with government positions in terms of functions, title, qualification, salary scales. Donor funded positions need to have an equivalent in government 2. Government conducts its business on specific schedules. Therefore, government has to be made aware on every position that will require absorption 3 years prior to the expiration of the contract 3. MOPS needs to be alerted on the intention to create positions funded by donors in order to enable review of the positions by MSD 4. Only positions related to priority cadres identified by MOH will be considered for absorption subject to relevance, suitability and funds availability. The MOH will always seek to absorb positions that are deemed critical to the continuity and sustainability of services in the health sector. 5. The establishment and subsequent absorption of donor supported positions will be guided by a Memorandum of Agreement between the MOH and donors in collaboration with MOEPD and MOPS. 21
10. Issues and Recommendations 1. Expediting the development of a framework/policy to guide the MOH in managing donor supported positions. MOPS is expected to lead development of this framework with input from the MOH and HRH TWG 2. Strengthening the HRIS to create and maintain system for tracking and reporting on donor funded positions. Initially, the HRIS had incorporated information on donor funded positions. There is a need therefore to consider updating the existing information with the data appended to this report and to ensure that the ongoing review and upgrading of the HRIS does capture information on donor funded positions. 3. As part of institutionalizing the reporting of donor funded positions, the core team comprising MOH-SID, HRH and MOPS officials needs to continually review progress on the absorption of donor funded posts and provide the necessary guidance to both government and donors. 22
Appendix I Full details on donor funded positions in the health sector (See excel spreadsheet. NB: information is very confidential and cannot be included as part of this report) 23
Appendix II Donor Funded posts job descriptions No roles/responsibilities Importance of Position 1 Senior M&E Analyst Develop the health sector M&E road Over the years the ministry has not map, Undertakes data audits to verify been able to monitor and evaluate quality of data, Technically supervises its performance. There was no M&E Analyst at all levels. Undertakes M&E framework and plan in place high level analysis on the status of the for the Health Sector to monitor health sector for planning purposes. the implementation of the Health Advise MOH senior management and Sector Strategic Plan. The government to inform policy based on products generated by the officers evidence derived from data mining have guided the Ministry in Participates in the development of developing evidence based policy programme technical guidelines to guide and making informed decisions. It the development of program indicators. is through these officers that the Advise and assist senior managers Ministry is able to inform the throughout the ministry in analysing business processes suitable for their country and the globe of its progress in meeting Millennium programs. Write and design M&E Development Goals, United national reports for the health sector Nations targets to name a few Conduct the assessment and effectiveness of Health Sector interventions through monitoring of the indicators. Conduct capacity building of institutions in the health sector in monitoring and evaluation, Develop and regulates the ministry s M&E framework. Develop a policy agenda to guide the entire M&E process and establish technical standards. Develops the M&E systems in the Health Sector. Conduct evaluation through assessments and surveys, of the health sector to inform program performance. Define MOH performance targets in collaboration with other departments and programs. 24
2 M&E Analyst/Assistant Statistician Develop all health sector data collection and reporting tools. Develop health sector indicators across all programs. Monitor health programs if they meet set targets. Train all health sector staff on the use of the tolls, mentor personnel in health facilities to correctly fill in the tools. Ensure the availability at the clinic of all necessary forms, registers, tally sheets, patient files or booklets (includes ordering of new stationery as required). Manage the strategic information unit in the regions and a member of the regional health management team providing critical information for decision making at that level. Identify appropriate health indicators and benchmarks for HIV/AIDS and other diseases and conditions monitoring. Provide professional and technical advice on research needs in the different diseases and conditions. Produce monitoring and evaluation reports on a quarterly, annual and ad hoc basis. Participate in the process of development of M&E systems. Provide professional and technical advice on research, monitoring and evaluation needs of HIV/AIDS and other diseases and conditions. Performs research, analyzes data and prepares reports as necessary. Facilitate monitoring and evaluation related meetings and prepare field and progress reports regularly. Maintains strict confidentiality in handling all health data. Facilitate the performance appraisal of all staff in the M&E unit at all levelsperforms all human resource functions. 3 Information Officers Receive monthly summary reports from all health facilities. Check for completeness and correctness of the reports. Cleans reports if there are data errors contact facilities to ensure a clean data set. Captures all data into the electronic system so that it is available for mining by the M&E officers. Participate These officers provide the much needed support in developing and defining indicators. The Health Sector has a defined core set of indicators which informs all personnel in Health at all levels on the indicators used to measure performance. These officers are assisting in the development and alignment of M&E systems for all the programs in health. These officers cover all programs and departments in health. Without these officers the M&E analysts and senior M&E analysts will not be able to produce reports as all health sector data is captured by these officers into the electronic system. 25
in data quality assessments. Participate in reporting back on the assessments. Check data entries in the data sever for any errors and liaise with facilities to correct these. Ensures that all data is captured into the computer by end of quarter and it is ready from use. 4 Data clerks Assist nurse to complete, tally sheet and other data collection tools as required.ensure the availability at the clinic of all necessary forms, registers, tally sheets, patient files or booklets (includes ordering of new stationery as required). Registration of all patients in their respective registers as per instruction from nurses.retrieve, file and regular maintenance of the patients files.ensuring confidentiality of all the registers and patients files.maintenance of an appointment system using the available tools of the Ministry of Health. Provide a report of patients who have missed their appointment for more than 7 days.ensuring the safety of clinic property and equipment.collaborate with partners who support the implementation of services at the clinic. Enter patient data into the electronic database (if available at the clinic). Compile monthly statistics and write reports as per need. 5 Cleaner/Receptionist The employee shall be engaged as a cleaner/reception, in this regard her duties shall include:receive and answer visitor inquiries about the office or services. Direct visitors to their destinations. Sort mail. Answer incoming calls on multi-line telephones or a switchboard. Set appointments. Records keeping. Perform a variety of other office tasks, such as faxing. Serve coffee or tea during meetings or as required. Keep the lobby area tidy.clans the office before office operations starts. Empty trash bins, vacuum office floors, window cleaning. If these officers were available in all facilities, nurses would be relieved of a lot of paper to focus on patient care. These officers are in the facilities where the ART electronic system is used. This is the main reason the ART data is of good quality. Without these officers the whole ART data would be lost and vital information on patient management on ART will not be available for good patient management. The support staff is the ones that make the office environment work friendly without this officer the office would not be maintained. The officer starts the day by cleaning the office then at 8am is the receptionist. 26
Does photocopying as assigned. Prepares tea for meetings and cleans after. Set meeting room ready such as set up projector and laptop ready for use. Maintains the office store room keeping record of items borrowed or removed from the storeroom. Ensures a continually clean office environment especially toilet and kitchen thro ought the day. Respect to visitors and all staff 6 Driver Assist in driving health/monitoring and Evaluation officers to various destinations. Serve as messenger for postings. Keep all vehicles clean and serviced ready for use at all times. Support other office activities.utilise all the resources of Government in a responsible manner and in order to achieve maximum impact.at all times faithfully and industriously and to the best of his ability and experience, perform all duties that may be required of him.take all steps necessary to protect the property of Government from damage, loss, and theft in any manner whatsoever.ensure that he/she obeys all lawful orders and directives enshrined in the legal framework of the country and those given by the Employer.Not conduct himself/herself both in his/her private and professional capacity in any manner that may bring Government into disrepute. 7 Systems Manager Implements new systems or modifications by programming database structures, undertaking application coding according to programming standards, and managing testing processes. Proficient in languages such as T-SQL, VB-Script, C#, System development tools: Visual Studio (VB.net), System Testing tools: Moq, Report Design tools: Microsoft Reporting Services, Report Builder, RDBMS include MS Excel, MS Access, MS SQL Server. Develops automated systems that The staff in the strategic information department is continuously in the field without the drivers this would not be possible. They not only drive officers but are also the office messengers. The functionality of all the IT systems in the health sector (hardware and software) is dependent on the existence of the IT officers. Without them all IT support and systems will collapse. The SID has managed to network the regional level to the national level through the IT officers. Without them reporting will be hindered. The unit is able to 27
query, analyze and check the quality of HMIS and M&E data, and that provide both printed and on-screen reports to users. Proficient in Talend Data Quality (Enterprise) for: The design and deployment of Data Warehousing and Business Intelligence ETL jobs: Conduct Data quality profiling and building of data quality improvement evolutionary reports. Provides technical advice and support for the day-to-day management of all servers, databases and software applications that form part of the MOH s health management information systems, servers include Web servers (IIS 6-7), Database server (Microsoft SQL Server 2000-2008), Windows Server 2003-2008 (Active Directory). Provides technical advice and support for day-to-day IT support services for the MOH s computer networks and PC hardware, including domain administrator duties where required (e.g. registration of new computer on the domain): Active directory administration, End user support, End user training, Software installation and upgrades 8 Database Programmer Responsible indeveloping and maintaining, implementing and testing of databases using technical knowledge and understanding of database management systems as well as organizing, planning, coordinating, and applying security measures in order to ensure safe computer databases.in charge of coordinating changes to computer databases and standard automated reports. Also perform other duties as may be assigned by supervisors. 9 Data Manager The data manager is responsible for liaising with the SID (Strategic and Information Department) in ensuring data resource communication, proper implementation of the Ministry of Health s policies and adherence to make maintain the systems internally because of their existence, fully functional and reliable Operational Database systems. Availability of real time, telephonic and or onsite user software & technical support as well as hands-on in-house developed systems applications support and maintenance of data security (back-ups, recovery & restoration) and integrity. 28
sure that Health data are secure, accessible, accurate and reliable for national statistics and patient care uses especially in guiding interventions. The manager is also responsible for ensuring that health data is captured accurately and regular backups of the data are carried out.he also manages the functions and staff of the Data Resource Department, assesses training needs among data users and coordinates training activities 10 Regional IT Officers Develop & manage MoH Databases, ICT policies and procedures, provide support & analysis of data workflow processes, planning & gathering of system requirements; development, deployment & support of software applications created for/by the Ministry as well as train personnel on the use of developed systems, documentation of in house developed systems applications, prepare IT work plans for the regions and maintenance of good performance standards, troubleshoot networks, maintain hardware & related components, provide feedback about technical problems &/or needs of the regional health facilities, supervise & monitor data entry, provide backup and restoration of data as well as link MoH with other ministries to support data collection. 11 Strategic Information Analyst Analyse monthly reports from healthcare facilities to understand site-level consumption of drugs and identify patterns and trends; Develop dashboards and tools to better monitor monthly data and easily report information to stakeholders; Prepare data inputs for quarterly forecasts for pharmaceutical products, monitor trends for these assumptions over time, and participate in 29
all regular forecasting meetings; Liaise with relevant stakeholders to incorporate programme changes and updates that will impact pharmaceutical consumption in quantification efforts; Ensure accuracy of reported data by performing regular audits of registers, summary sheets, and other completed data collection tools and highlight discrepancies; Liaise with the Strategic Information Department (SID) of the MOH to reconcile pharmaceutical reporting with other reports from facilities, including patient numbers, disease patterns, patients on ARVs by regimen, and other relevant statistics; Support CMS in validation and rationalization of orders placed by facilities through the development and implementation of standard validation tools; Monitor compliance with national policies and procedures related to information management for pharmaceuticals; In coordination with pharmacists and operations manager at CMS, develop work plans and execute projects requiring pharmaceutical data analysis; Supervise data clerks at CMS, taking joint responsibility for data quality assurance; Present analyses of pharmaceutical data to CMS staff and SID on a regular basis; Prepare data for regular, structured, feedback sessions for regional stakeholders to inform improvements based on identified trends. Maintain strict confidentiality in handling all health data. 12. Data Clerk Data entry, with rigorous data checks for completeness and quality, Assistance with analysis, as required, Ensuring the confidentiality of records and data, Support the implementation of commodity tracking system, Additional tasks as designated by the Strategic Information Analyst or CMS management. 30
12. Lay Counselor Provide pre-test, post-test and on-going counselling to patients seen at health care facility according to National HTC Guidelines, in support of Nurses and Doctors also providing this service; Provide routine health education and information on HIV to patients and their partners in individual and group education sessions; Create demand for HTC and HIV treatment and care through liaising with other health professionals, disciplines, NGOs on activities aimed at promotion and advocacy for HTC and HIV treatment and care ;Perform HIV rapid testing, adhering to the nationally recommended rapid testing algorithm; Refer clients tested for HIV for follow-up services i.e. for HIV prevention services or HIV care and treatment services.; Participate in updating HTC clinic registers on HIV testing and counselling conducted and facilitate timely submission of reports; Promote HIV prevention by providing prevention messages and methods, including group education sessions, demonstrations and providing one-on-one information; Perform other HTC related duties as per arising need. 13 Food by Prescription Officers Disbursing food to Food by Prescription beneficiaries, according to the procedures outlined in the Food by Prescription Implementation Protocol; Applying security procedures, as outlined in the Food by Prescription Implementation Protocol, to reduce losses from inappropriate and/or unlawful behaviour (Control of food movements within the facility, Controlling access to areas where food is stored &Verification of client vouchers) ; Distribution of nutritionrelated IEC materials as required; Managing and monitoring food stocks at the facility, including: Monitoring of 31
available food stocks in the facility, reporting monthly to Hospital Administrator and SNNC; Ensuring that food quality is maintained by rigorously applying proper storage, handling and stock rotation procedures; Promptly reporting any losses and damages to food stocks to Hospital Administrator and SNNC and assisting with verification of said losses and damages. Failures to correctly and completely account for losses and damages will constitute grounds for summary dismissal; Compiling and forwarding monthly, quarterly and annual reports on nutrition related programs within the facility to the SNNC as well as the Hospital management; Promptly reporting any persistent client concerns or programmerelated issues to Hospital Administrator and SNNC; Attending re-training and continuing education sessions as assigned by agreement of Hospital Administrator and SNNC 13 Phlebotomist Perform and monitor venepunctures to obtain blood donations and patient samples in accordance with approved procedures; Observe and assess donors and patients throughout the procedure and take action in the event of an adverse reaction under the direction and support of medically qualified staff; Assist in maintaining day to day stock levels and ensuring adequate supplies and in the identification of future supplies needed and placing orders; Provide the patients and blood donors with accurate information and refer to medically qualified staff for further explanation; Perform the relevant Point of Care tests, where training has been obtained; Responsible for ensuring accurate 32
documentation at sessions and in the wards. This includes providing feedback of necessary information vital to the monitoring and quality systems relating to all aspects of sample collection; Refer all relevant queries to medically qualified staff; Perform computerized linking of requests and samples, ensuring that the information is linked to correct samples, ensuring that all relevant information is accurately recorded and input to the computer; Care of patients and blood donors during the bleeding process including labeling of sample tubes, documentation and ensuring correct labels; Maintenance of skills and knowledge by participation in personal development, performance review, and undertaking appropriate training to meet the requirements of the post; Undertake any other reasonable relevant duties that may be assigned by supervisor. 33
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