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MOVE Model MC Service Delivery in Swaziland. Litsemba Letfu. Litsemba Letfu. Models for Optimizing Volume & Efficiency. Task Sharing Assigning steps to lower cadres of staff Supported by: -Surgical layout High nurse/doctor ratio High bed/doctor ratio Alcohol hand gel between procedures.
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Models for Optimizing Volume & Efficiency • Task Sharing • Assigning steps to lower cadres of staff • Supported by: • -Surgical layout • High nurse/doctor ratio • High bed/doctor ratio • Alcohol hand gel between procedures Task Shifting -shifting service provision to lower cadres of staff • Technique • Cautery for hemostasis • pre-packaged kits • Theater layout
Stats to date Number of MCs per month • June 2009 – May 2010: 5052 MCs at clinic 2065 MCs on outreach • Clinic HIV Testing rate: 81% • Follow-up rate: • 88% (2-day) • 53% (7-day) • AE rate: 1.7%
Mobile Outreach • Sept 09-May10: 2065 MCs on outreach • Apply MOVE model to mobile outreach
Demand Creation • High volume sites are only as good as the number of clients seen • Demand creation activities essential • Currently 95% of demand creation in Swaziland is interpersonal • Transport primary barrier
Future Directions • Expand mobile outreach • Programmatic support for public sector • Strategies to prevent counseling bottleneck • Expand demand creation efforts