Methodology for Situation Analysis within the context of RBM

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Methodology for Country Situation Analysis
within Roll Back Malaria

Hans Remme
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RBM at country level

• Objective of Roll Back Malaria
• The malaria burden in participating countries is
  halved through
• interventions adapted to local needs
• reinforcement of the health sector
• Requires understanding of local situation
• malaria epidemiology
• treatment and prevention practices in
  HH/community
• availability and quality of health care
  (public/private)
• health policies, strategies and support systems
• local needs and opportunities

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Situation analysis

• Information on the local situation (evidence)
• adequate, sufficient information available
• incomplete,
• scattered information
• insufficient information
• To help where evidence is insufficient, RBM has
  developed tools for situation analysis at
• national level
• district level
• community level

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National level instruments

• Policy review
• Systematic review of relevant policy documents,
  strategic plans, national guidelines
• In-depth Interviews with senior officials of MOH
• Panel discussion
  using SWOT analysis
  
  with senior officials
  of MOH and other
  
  sectors

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National level instruments
Country X - No national framework for policy
formulation Problem No
documentation No transmission of policy to
lower levels Transfer of officer leads to
transfer of policy Malaria Supposed to be
free treatment for underfives, but policy
poorly developed, unclear, not implemented Countr
y Y - Similar problems

• Policy review

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District level instruments

• Self-assessment of district planning and
  management process as relating to malaria
• Check-list for review of
• policy and implementation issues
• Functioning of DHMT
• Resources
• District Health Plan and Budget
• Malaria Case Management and Prevention

District Health Budget for 1997
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Community level instruments

• Focus Group Discussions
• Case studies
• 40 underfives who were ill during the last 2
  weeks
• 40 women, pregnant during last 6 months

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Community level instruments

• Focus Group Discussions
• Case studies
• 40 underfives who were ill during the last 2
  weeks
• 40 women, pregnant during last 6 months

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Community level instruments (2)

• Interview/observation on bednet use
• Interview with
• Medicine sellers
• Herbalists / drug peddlers
• Community Health Workers
• Indigenous / Spiritual Healers
• CBO leaders

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Instruments for Health Care Facility Level

• Interview with Health Care Provider
• Assessment of Health Care Provider

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Instruments for Health Care Facility Level

• Interview with Health Care Provider
• Assessment of Health Care Provider
• Client exit interview
• Health Care Facility Check List

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Availability of antimalarials

• Clinics
• 3,635 CQ tablets (5/10 clinics without
  CQ)
• no S/P
• Shops in the same villages
• gt 100,000 CQ tablets
• 153 packets of S/P

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Availability of antimalarials

• Clinics
• 3,635 CQ tablets (5/10 clinics without
  CQ)
• no S/P
• Shops in the same villages
• gt 100,000 CQ tablets
• 153 packets of S/P

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Situation analysis yes or no ?

• Arguments against
• Again a situation analysis?
• much already known
• much going on
• dont disrupt ongoing activities
• Huge data collection exercise
• No new discoveries

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Situation analysis yes or no ?

• Arguments in favour
• Evidence-base
• Clear understanding by all partners
• Contributes to common approaches to RBM
• Baseline for evaluation of impact
• Involvement of all stakeholders

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Possible steps in country planning for RBM
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Possible steps in country planning for RBM
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Possible steps in country planning for RBM
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Possible steps in country planning for RBM
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Possible steps in country planning for RBM
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Possible steps in country planning for RBM
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Possible steps in country planning for RBM