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CHF Best Practices MAKING FBO PARTICIPATE IN CHF OPERATIONS

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.

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CHF Best Practices MAKING FBO PARTICIPATE IN CHF OPERATIONS

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  1. CHF Best PracticesMAKING 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 -

  2. 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

  3. 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

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

  5. 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.

  6. 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

  7. 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

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

  9. 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.

  10. ASANTENI SANA KUTOKA ROMBO.

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