To be uploaded...
- Key areas raised/discussed under the sub theme
- Concept , implementation status and challenges of the WTA implementation
- Documented best experiences in implementing WT from model woredas
- Experience of Oromia Regional Health Bureau and Legehidha woreda health office in implementing the Woreda Transformation agenda
- Integration of WTA with other HSTP agendas
- Priority area to be considered in the next HSTP development
- Major challenges raised/discussed
- Woreda leadership
- High turnover of leadership and staff at all levels,
- Limited capacity of WoHO leadership and staff,-no motivation mechanisms/incentive , continuous training, inadequate structure and staff number and mix
- Lack of inter sectoral collaboration and fragmented approach even within the sector and no SOP for intersectoral collaboration
- Weak performance management system (indicators, measurement, improvement plan and evaluation)
- Weak accountability framework and commitment
- Limited financial capacity- shortage of budget and inefficient utilization at woreda level
- Lack of contextualized intervention to different settings (Urban, agrarian and pastoral)
- Health service delivery Unit/center
- Inaccessibility of basic amenities (rooms, water, electricity, transport and computer)
- Interruption of essential medicines, supplies and equipment
- Low quality of service delivery ( due to lack of standards for each service packages, HR, infrastructure…)
- Shortage of budget at PHCU level
- Weak referral system and inefficient utilization of Ambulance
- Community
- Reduced momentum of the HEP and WDA (turn-over, motivation, workload, inadequate number per kebele, low male involvement in community health interventions, low attention for Urban HEP)
- Lack of clarity for model household training and graduation
- Lack of comprehensive community engagement approach
- Gaps in partnership and measurement criteria for model school
- Limited culture of documenting local or community level innovations and scaling up
- Consideration for EFY 2012 implementation and beyond to be considered in the next HSTP (in the following four categories)
Intervention/s that need to be dropped:
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- Top -down plan and target setting
- Separate of the Health Insurance Agency/ CBHI scheme from the health sector
Intervention/s that need to be modified:
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- Refine the indicators and performance improvement approach in line with the transformation agenda integration concept.
- Continuous documentation and replication of best practices, local innovations; and implementation in phased approach as a solutions for local problems
- Contextualized Woreda transformation intervention for different settings
- Focus on health system building and household centered interventions.
- Rigorous resource mobilization and efficient utilization of resources as the Woreda transformation initiative requires high budget
- Merit based selection, training and appointment of the woreda leadership
- Review and strengthen the linkage between Woreda health office and Primary Hospital
- Improve ambulance management
- Standardize medical equipment for facilities and strengthen preventive maintenances
- Expand sanitation marketing to progress improved latrine coverage
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Intervention/s that need to be continued as is:
- Mature the concept of transformation agenda Integration into strategy and assign a team or staffs for this role
- Multi-sectoral/holistic community development approach for woreda transformation
- Performance measurement initiative
- Woreda management standard
- Community score card initiative
- Accelerating the EPSA reform implementations
Intervention/s that need to be newly added:
- Reevaluate and redesign the woreda/PHCU level structures (Woreda Health office and health facilities)
- Tailored and comprehensive Human resource development plan/ appropriate competency for woreda/district health system (need based pre/in-service trainings, adequate in number and mix, motivation scheme, Women empowerment…)
- Empower/ encourage women for district health leadership role
- Design, test and scale up accountability framework at all levels
- Reform HEP (rural and urban) based on the available evidence- staffing, volume of work and others perspectives.
- Revise Model Household training and graduation approach and criteria
- Design and test new community engagement platforms
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