The Muhimbili National Hospital team faced the challenge of reversing revenue loss from the National Health Insurance. The team discovered the root cause for this revenue loss was due to incorrect completion of the clinical investigation, prescription, and National Health Insurance claim forms. The LDP team met with directors, department heads, and staff to discuss the implications for the hospital. A number of actions were taken to improve the situation, such as revising the specimen collection forms with increased font size and writing space, training staff to complete the request forms correctly, and meeting regularly with the hospital Quality Improvement unit to follow up on these activities.
After six months of implementation, the team was able to track and report a change in trends. The forms are now more user-friendly and the majority of staff complete them correctly. Laboratory personnel can read the request forms easily and provide clinicians with the correct results enabling them to accurately diagnose patients. Fewer claim forms are rejected resulting in improved financial returns for the hospital.
The Directorates of Human Resources and Administration team at the MOHSW faced the challenge of monitoring new employees to ensure that they are consistently reporting to their work stations. To address this challenge, the team developed a system for obtaining updated, accurate, and reliable information on human resources. With assistance from the Capacity Project the team used the “Human Resource for Health Tracking Tool” that has an interface with software that allows it to monitor new employees, human resource information, employee files and their movements through the system. With this new system the LDP team plans to train Officers and Registry staff at the MOHSW to collect the information they need to monitor new employees. The team also held a workshop in September 2008 to synchronize the Human Resource Information System and the Human Information Management System.
The Directorates of Preventive Services and Policy and Planning team, also from the MOHSW, faced the challenge of improving and overseeing the Council Health Service Board (CHSB) for Kisarawe district. The main purpose of CHSB is to empower communities to address their health care development issues. The LDP team consulted national officials responsible for the CHSB at the MOHSW, the District Medical Officer, and CHSB members in July 2008, discovering that members had received insufficient orientation to their roles and responsibilities. In order to resolve this, the team sensitized the district authority on the importance of a well functioning CHSB. The team is currently mobilizing resources to train CHSB members on their roles and responsibilities and support the administrative function of the Board as sufficient funding was lacking in this area.
The Christian Social Services Commission (CSSC) team faced the challenge of having an incomplete and outdated human resource database for Church Health Institutions (CHIs) making it difficult to coordinate and develop strategies for capacity building and sustainability. The LDP team designed a plan to complete the database for CHIs and successfully mobilized resources to carry this out. The team compiled available information from the Information Technology (IT) Department and trained Zonal Secretaries on data management and the collection of missing information from other available sources. The LDP team is currently organizing two workshops on human resource data management for Zonal Secretaries and other stakeholders, including MOHSW officials. The CSSC also acquired human resource management software developed by the Capacity Project.
Conclusion
The LDP focused on developing the necessary skills of the teams to undertake and overcome the human resource challenges they face. The success of the Program to date is evidenced by the teams’ ability to apply the leadership and management skills acquired and begin to address their challenges.
