Developing an Evaluation of a Plan for Primary Health Care - Term Paper Example

Report on developing of an evaluation plan Name Course Tutor Date Introduction Primary health care (PHC) is an essential health care program that refers to the health care services that are provided outside the hospital setting. This health care program is tailored to reach families and the society; it encourages full participation of individuals in the society in raising the healthy standards at an affordable cost. On the other words, primary health care (PHC) is a health strategy that goes beyond traditional health care that emphasizes health equity resulting to tangible social policies (Downie & Tannahill, 1996:23). It is a program that has been in existence for over three decades when it was adopted by the World health organization (WHO)) in 1978. The main goal of this program in its initiation was “health for all”. The purpose of this program was to eliminate the political, economic and social health care inequalities seen around the world. WHO identified the key elements that would aid in achieving the goal of “health for all’. These elements are; first, we have the element of reduction of social disparities, this element aims at establishing universal coverage reforms for every individual (Downie & Tannahill, 1996:23). Secondly, we have the element of service delivery where the clients are given the services according to their needs. Thirdly, we have the element of public policy reform, meaning health matters have to be blended in all public sectors in ensuring health for all goals. The lastly, we have leadership reforms, where all the stakeholders are actively involved in matters to do with health care. In implementation of the primary health care services, one has many approaches to choose. Some of the programs that are found in primary health care include; PHC on population aging, PHC on mental health, PHC on maternal and child health care, PHC on overweight and Obesity etc. This report is all about developing an evaluation plan on implementation of PHC on maternal and child health care in the sub-Saharan Africa. This implies that it will show the strategies that can be adopted to boost maternal and child health care as part of PHC. It will be an important report that can be adopted by countries with low income hence burdened with high infant and child mortality. Description of the program Maternal and child health is an issue that has become of big concern in the health sector all over the world. Poor maternal and child health care has caused loss of many lives around the globe; thus, it is a health issue ought to be taken by every government with a lot of seriousness. Reports from the health records reveal that this problem of poor maternal and child health has been prevalent in the developing countries. For example, statistics reveals that in every year, about 4.4 million children and 265,000 mothers die in sub Saharan Africa (Kinney. 2010:1). This means that every day, 13,000 deaths occur resulting from poor maternal and child health in Sub-Saharan Africa. This means that most countries in this region have not adopted the scientifically proven health interventions for the maternal and child health. Some of the scientific proven methods to address this problem are; immunizations, using treated nets, use of emergency equipments for obstetric care etc. However, many African countries are not using these methods to save women and children (Kinney. 2010:1). Some of the challenges for maternal and child health in Africa include; pregnancy and child birth complications, newborn ailments, malnutrition, Obesity, childhood infections and HIV and Aids. Therefore, it is the responsibility of the health sectors in Sub-Saharan countries to develop and implement a primary health care plan to curb this problem (Valean, Tatar &Ichim, 2009:1). This is because it is one of the health problems that is claiming the lives of many individuals globally. Evaluation goal The goal of this evaluation is to determine effectiveness of primary health support program in improving the maternal and child health among the sub-Saharan countries. The evaluation would examine the components of the maternal and child health programs that are performing well and how they can be expanded in future. Moreover, the evaluation will aid in determining the funding needs maternal and child health care program for the proceeding years. Evaluation team The team is composed of maternal and child health support staff from the maternal clinics who work in the healthy sector thus, they can access the program data easily. Members from ministry of health from different countries were engaged to participate in the team in reviewing the plan. Country representatives who had background information on the social sciences were also included in the team to ensure that the evaluation is culturally relevant to the targeted societies. The table below shows the roles and responsibilities of the members. Team members Role Responsibility 10 Maternal &pediatric nurses Lead evaluator -overseeing of the evaluation process -Coordinating the team meetings Program Manager Data analysis -Does the analysis of the quantitative data -Supervise the implementation findings -Does the coordination of the analysis of qualitative data Ministry health commissioners Stakeholders and advisors -They provide the necessary support for the team -They guide the dissemination of the results -They advise their home ministry on the results found Social workers representatives Data collection -They aid in data collection from their various countries -They review data for the team to make it more useful Stakeholders’ assessment During the annual stakeholders meeting in one of the cities, the evaluation of maternal and childcare program was discussed. In the course of the meeting, stakeholders were identified with their interests and how they ought to be engaged in the process. The table shows s the plan for stakeholders involvement. Stakeholders’ engagement and assessment plan Stakeholders Interests Role How to involve them Staff members -Take the evaluation to be personal judgment -Fear that the program may be affected -They define the context of the program -they identify the sources of the data -They collect data -They interpret the findings -Play direct roles in carrying out the evaluation process -Meetings Clients (mothers& children) -May fear or even reject health system -They may want better and accessible services -Interpreting the results -Giving clients perspectives -Survey Foreign communities in the region -May be suspicious of the program -Giving community context Other service programs in the region -May or may not be encountering similar challenges in the region -They disseminate results to community members Program manager -Showing effectiveness of the program -Using the results to enhance the program -Responsible in defining information required for the evaluation -He develops and implements the recommendation of the evaluation -Has a direct role in evaluation process Clinical staff -They provide acceptable and effective care intervention for maternal and child health -They interpret the findings -They also modify the evaluation practice -Meeting Ministry commissioners -Ascertain if the program is effective -Assess if the program utilize the country’s funds well -They provide administrative funding -They also interpret the results -Meetings -Direct roles 2. Description of the program and program approaches The need of the program A culturally competent maternal and childcare program is needed to counter the incidences among the Su-Saharan Africa countries. The incidences have been on the rise in the last two decades where the problems of hunger and HIV and Aids emerged (Valean, Tatar &Ichim, 2009:1). The victims who are affected are mostly found in rural areas where the health facilities are few. In addition, the affected individuals have low income per capita in that they cannot cater for their basic needs and their health. The treatment of the childhood infections and maternal care has proved to be costly to the few health facilities and even the human resources available. If this problem is left unattended to, lead to loss of many lives in few years to come. Objectives of the program -To reduce the incidences of death caused by maternal and child health care problems -Establish good health policies that cater for mothers and children health -Create awareness among the rural dwellers on the ways to improve their health -Introduce the prevention methods that can be used to reduce the problems of maternal and child health care - Establish enough health facilities in the regions affected most Resources or inputs -Government registered nurses -Program evaluation staff -community based organizations -community health centers -Government funding Program activities or approaches -Growth monitoring -Oral rehydration therapy -Breastfeeding -Immunization -Family planning -Female education -Food supplementation Program activities or approaches One of the approaches the program proposes to adopt in improving maternal and child health is through growth monitoring. This is an activity done to prevent most child malnutrition before it begins (Weiss, 1998; 1). This can be done through seminars by teaching the mothers on how to monitor their children growth rate. They should take their children to health centers to take their weight regularly. When a drop in the weight is observed, the health workers would investigate and advise them on what is supposed to be done. The mothers would be advised on how to feed their children on balanced diet and on how to get enough food to feed their children to avoid the problem of malnutrition. Therefore, growth monitoring would be one of the approaches the program will use to raise the standards of maternal and child health care. The second approach is the adoption of oral rehydration therapy. Dehydration is the rapid loss of water in the human body; it is a situation that can easily lead to death if it is not attended to on timely manner (Weiss, 1998; 1). Therefore, administering oral rehydration therapy can be adapted to combat dehydration that is associated with diarrhea. Diarrhea is a problem mostly experienced by young children especially when they stay in poor hygienic environment. In most cases, families with low-income stay in poor houses, eat substandard foods, and even drink contaminated water (Weiss, 1998; 1). These conditions affect young children and lead to frequent diarrhea. Therefore, administering oral rehydration therapy in such population would help to reduce diarrhea problem hence improving child health care. The third activity or approach the program would have to adopt is the advocating and encouraging breastfeeding among the mothers who are breastfeeding (Patton, Michael& Quinn, 2002:1). Through seminars, home visits, literary materials and media, the staff would emphasize the issue of breastfeeding. Mothers’ milk is very much important during the initial stages of child development. The milk contains minerals such as calcium and iron, which are very essential for growth of the bones and development of body muscles. Most mothers who come from poor families are ignorant of these facts and they deny their young child their breast milk at the tender ages. Thus, this program aims to create awareness among such mothers the importance of breastfeeding their children. The next approach is conducting of the immunization program. This is one of the primary health care administered to young children to prevent some common diseases such as Measles, Tuberculosis, Whooping cough, Tetanus, polio etc. When immunization is carried out well on every child, then rate of death caused by these diseases would automatically go down. The program would recommend the immunization program to be taking place regularly for example on annual basis. Another approach in administering primary health care among the affected regions in sub Saharan Africa is introduction of the family planning program. From the records, we find that Sub-Saharan Africa a densely populated. Many couples deliver many children as compared to developed nations. Therefore, every family has many members and the dependence ratio is high since children often depend on their parents. Due to inadequate resources, the children face malnourishment hence being exposed to dangers of contracting diseases. Thus, advocating for family planning is one way of improving the child health care. The last activity in implementing the primary health care in this region would be establishment of food supplementation program. The government and the stakeholders would be responsible for buying food and supplying it to affected areas so that children would not be malnourished. Those food supplements would be made in a manner that they contain all the dietary values to improve the health of the children. Even pregnant women would be supplied with dietary food, which contain iron and folic acid supplementation to prevent deficiencies in pregnant women. As a result of the efforts done in supporting maternal and child care, the following steps were done. Output -Registered nurses were hired -Counseling activity was conducted -Maternal and child care education was conducted -Tests were conducted -Referrals were made -Treatment plans were established Outcomes -Patience awareness increased -Trust was developed -Patience accepted to be treated on various diseases that affected them -The clients identified the possible causes of their problems -There was reduced hospital admission for maternal and child care problems -There was reduced transmission of communicable diseases -Healthier community 3. Focus of the evaluation Stakeholders’ needs From the start, groups were identified as the core users of the evaluation findings. These groups would be using the findings in different ways and for the different purposes. This is summarized in the table below Users Need Uses Program managers How to enhance and modify the program -Implement the change to ensure effectiveness of the program -Ensuring coordination of the whole process Clinical staff Clinical outcomes -Adjust clinical practices where necessary -Concentrate in areas that seem to cause more problems Social workers representatives Social health outcomes -Advocacy to the community -Advice the government on the priorities Ministry or government officers -Ascertain whether the program is working or not -Determine if the program ought to be funded -Determine whether the program should be expanded to other areas Evaluation questions However, the evaluation team came up with evaluation question, but they considered the following to be priority since they represents the most important aspects of the program to be examined. -Has the appropriate staff for evaluation recruited? -Has the recruited staff been trained properly? -Has more affected children and women tested and treated? -Are the targeted population adhering to treatment? 4. Data collection He evaluation team utilized several methods of data collection. They used Methods of data collection -Interviews -Surveys -Observation -Record review -Staff reviews -Questionnaires Interviews would be conducted to ascertain the knowledge and skills of the hired nurses. Surveys would be administered to the women and children sampled out. Observation would be conducted to gauge the behaviors of the staff and the language they used in creating awareness of maternal and child health care problems. Finally, there will be a review of the charts, records and other training materials. Data collection plan Indicators Data source Data collection method Number of qualified staff members -Personnel records -Evaluation staff records -Observing the presence of staff -Reviewing staff records The Nurses received training on interviewing women and children -Training attendance records -Reviewing records of training sessions -Reviewing material presented Sub Saharan Africa children treated by the staff -interviewing the staff -Clinical records -Reviewing records for every country -Staff identifying from the client list Clinical treatment standards -Clinical charts -Reviewing the charts Patient developing trust to the staff -Perception of the patience -Staff -Observation Clinic visits -Records of program visits -Reviewing the records Plan timeline 2012-month July August September October Evaluation of activities + Evaluation planning + Data collection + Analysis and interpretation + Report/dissemination 5 Analysis and interpretation Analysis In analyzing the data, both qualitative and quantitative methods would be employed. Counts of frequency would be used for quantitative analysis, whereas methods include content analysis such as reviewing training curriculum, charts, records etc. Data analysis method Person responsible Qualitative –Content analysis Nurses &staff Quantitative –Frequency counts Program manager Interpretation All stakeholders i.e. ministry officers, nurses, program managers, social worker representatives would be involved in interpreting the findings. A meeting would be called and the data from the evaluation would be compared to establish program benchmarks. All the stakeholders would be given an opportunity to justify the results and make the appropriate recommendations accordingly. 6. Report dissemination All the evaluation findings would be disseminated through various channels. A short simple to understand report would be drafted and presented to ministry representatives to take it to their governments so that the recommendations can be acted upon. There will be an article, which would accompany the newsletter. Some of the dissemination medium include; presentation at staff meeting, presentation to health care providers, report and briefing to the countries involved, article and newsletter and briefing of the community groups. Summary of the evaluation plan This health evaluation program is aimed at reducing the prevalence of problems related to maternal and childcare. The plan starts by looking at the overview of the situation of maternal and childcare in Sub Saharan Africa. Findings show that many deaths occur due to poor maternal and childcare in this region. The goal of the evaluation process is stated which says, the evaluation is aimed to determine the effectiveness of primary health supportive program in this region. The evaluation team is identified; this team is the one that carries the whole process; their roles and responsibilities are identified. Moreover, the stakeholders in this evaluation process are identified and their roles defined. The need of this evaluation program is stated and the objectives are drawn. Program activities are explained also the focus and the outcomes of the evaluation process are shown. The stakeholders needs and uses are identified, evaluation question are designed. Data collection is conducted analyzed and interpreted by the stakeholders. Conclusion Maternal and child health care is a problem that has become prevalent mostly in the developing countries. This problem has been propelled by rapid population growth that has put pressure on the available resources. Therefore, it is taken to be a world health problem that ought to be addressed with seriousness. Many developing countries especially from Africa and Asia may not attain the millennium development goals of 2015 because of poor policy structures. It is advisable that the affected regions adopt the scientifically proven methods in countering health problems to reduce the many deaths that results. This evaluation plan acts as a guideline to those countries that need to improve the maternal and child health care. Bibliographic references Baum, F. (2008). The new public health: Chapter 10; Planning and evaluation of health promotion. Melbourne: Oxford University press. UK. Cahiim.org. Program goals and evaluation plan. Accessed 21st Nov 2012. Retrieved from http://www.cahiim.org/files/Program%20Plan%20definitions%20and%20sample.pdf Cdc.gov. Developing an effective evaluation plan. Accessed 21st Nov 2012. Retrieved from http://www.cdc.gov/obesity/downloads/CDC-Evaluation-Workbook-508.pdf Downie, R and Tannahill, C. (1996). Health promotion models and values. 2nd ed. Oxford. Oxford University press. UK. Hawe, P. Degeling, D. Hall, J. (1990). Chapter2: Needs assessment: What issue should your program address? 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