CHF Best Practices MAKING FBO PARTICIPATE IN CHF OPERATIONS ROMBO DISTRICT COUNCIL Presenter: Dr. C.E. Nkya - DMO And Secretary CHSB - ROMBO DISTRICT COUNCIL Presenter: Dr. C.E. Nkya - DMO And Secretary CHSB -

ENROLLMENT Currently there are 8,415 households enrolled OUT OF 60,000 WHICH IS ABOUT 14% Rombo district Council started CHF on 1st March 2005 Enrollment steadily increased for the first six month (march – september’2005) After that we observed a decline

Factors contributing to declining membership: Misleading information about CHF to the community during campaigns in general election. Lack of enough sensitization The premium level of 10,000/= was too much for most of the households Shortage of drugs at the District Hospital

PROVISION ISSUES CHF scheme covers one DDH, 4 public health centers, 18 public dispensaries CHF covers both outpatient and inpatient services

CHF contract with DDH Rombo DDH is owned by the Roman Catholic Church, subsidized by the government. It provides health services to CHF members under the contract between the District Executive Director and the DDH Under the contract, the CHF patient should have a referral letter from the primary health facility except seriously ill patients or involved in accident. The patients should have CHF membership cards with the photographs of six beneficiaries.

CHF contract with DDH The District council introduced the CHF claim forms to DDH which have to be filled for each CHF patient service (fee per service reimbursement) rendered and sent to DMO monthly A sub committee which comprises 2 people from the hospital (DDH) and 2 out of CHMT members crosscheck the claim forms Payments have to be authorized by DMO, DED, and the Board chairman Since the introduction of this claim forms there are less complains from DDH

ACHIEVEMENTS The CHF members are appreciating health services provided Availability of Drugs all the time Sense of ownership to health facility around them Patient referred from primary health facilities to DDH Rational prescription has started picking up Demand for VAs and private dispensaries to give services to CHF members

Challenges Council does not have direct authority to a DDH Drop out of qualified staff at DDH Difficulties in agreement on claims and reimbursements

RECOMMEDATIONS FOR MAKING FBOS PARTCIPATE IN CHF OPERATIONS Claim forms for payments Government management control Special services room for CHF members Grant for exempted groups Staff recruitment.

ASANTENI SANA KUTOKA ROMBO.