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District Health Management. What is a district?. Geographic area Population: 100 000 to 300 000 people HQ: in main town; all ministries A natural setting and meeting point for “bottom up” planning and organization of community and
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What is a district? • Geographic area • Population: 100 000 to 300 000 people • HQ: in main town; all ministries • A natural setting and meeting point for “bottom up” planning and organization of community and • For “top down” planning by central government planning and development.
Key level for management of PHC • Coordinate all health activities • Hosp.; H/centre, clinics • CHWs, traditional and private practitioners; NGOs
District health management (DHMT) • A team managing a district health office in a district • Health services extend from CHWs to hospital • Hospital main centre for curative health care services • Namibia district hospital is a 3rd level of referral • PHC strategy: CHWs to clinic to HC to District/Regional hospital and then National referral hospital
Responsibility of DHMT • District health planning • District health administration • Training and supervision of all health staff • Hospital work and outpatient services. • To work effectively the DHMT need to understand the EPIDEMIOLOGY • To enable them to use health information in planning, management and evaluation
Source of health information • District population and people at risk • How many? • What % of each population? • What proportion is affected?
NB. DHMT need epidemiological information on • District population e.g. age, sex-structure, income etc. • Vital statistics • Causes of morbidity and mortality • Organization of district health services e.g. access, coverage, effectiveness
Sources of data • Existing data in various agencies • Census surveys • Vital statistics • Morbidity data • Answers to questionnaires • Domestic surveys • Laboratory data • Growth and monitoring charts • Environmental reports • Information and surveillance surveys • Scientific studies
DHMT should know • General information • History e.g. physical and climatic characters, community organization, economic devel. Etc. • Geographical distribution e.g. villages, towns, roads, any NB features as rivers etc. • Populations: Under 5, elderly • Health status, morbidity, and mortality patterns
Health services: public, private, church/NGOs, HRH, programmes • District health programmes e.g. • Preg. ANC, Deliveries, postnatal care • Nutrition: growth monitoring • EPI – coverage, incomplete, up-to-date • Environmental health – water suppl, refuse etc. • Communicable diseases control
Keep in mind: records not always complete or not well recorded!
Community diagnosis • Define population groups • Assess health and disease problems • Collect health data • Produce health information • Assess district health status • Decide on priority health problems • Choose alternative interventions • Implement programmes • Evaluate effectiveness of programmes – e.g. Increase/improve in health status