MOVE Model MC Service Delivery in Swaziland

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Presentation transcript:

MOVE Model MC Service Delivery in Swaziland

Litsemba Letfu First picture: Litsemba Letfu in May 2009 – one big empty space. 2nd and 3rd pictures what it looks like now Designed to use efficiency models to increase the volume of clients seen.

Layout – client flow. Describe what happens in each room. Emphasize unidirectional client flow. Emphasize 8-bed theater (2 private rooms – barely used)

Litsemba Letfu Branding. Explain why men’s clinic. Designed to be an entry point for health services for men

Models for Optimizing Volume & Efficiency Task Sharing Assigning steps to lower cadres of staff Supported by: -Surgical layout High nurse/doctor ratio High bed/doctor ratio Alcohol hand gel between procedures Task Shifting -shifting service provision to lower cadres of staff Technique Cautery for hemostasis pre-packaged kits Theater layout Explain MOVE model. Emphasize: doctors must provide surgical procedure, no clinical officer cadre Sleeve method Explain which components are used by LL and which aren’t. Emphasize that you don’t need a big fancy clinic to use varoius MOVE principles.

Stats to date June 2009 – May 2010: 5052 MCs at clinic Number of MCs per month June 2009 – May 2010: 5052 MCs at clinic 2065 MCs on outreach Clinic HIV Testing rate: 81% Follow-up rate: 88% (2-day) 53% (7-day) AE rate: 1.7% Part of high numbers in april/may attributed to back-to school promotion held during school holidays. Clinic was seeing between 50-70 people a day.

Mobile Outreach Sept 09-May10: 2065 MCs on outreach Apply MOVE model to mobile outreach MOVE model also applied to mobile outreach settings. Identify clinics with space and send clinical teams regularly to perform MCs.

Demand Creation High volume sites are only as good as the number of clients seen Demand creation activities essential Currently 95% of demand creation in Swaziland is interpersonal Transport primary barrier

Future Directions Expand mobile outreach Programmatic support for public sector Strategies to prevent counseling bottleneck Expand demand creation efforts