Inclusive, Enabling Communities

Inclusive, Enabling Communities
Learning Brief


Sabona Sonke Foundation

Benefits of public-private sector partnerships for building institutional capacity at state hospitals

Category: Inclusive, Enabling Communities | Older persons | 11 January, 2015 - 06:00

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Introduction

The Sabona Sonke Foundation supports the development of sustainable, comprehensive, and quality eye health services for marginalized communities through the creation of model, fully functional eye health units located within public sector institutions.

We operate in the North West Province working alongside public sector partners, district management teams, and clinicians. Our overall strategic approach is focused on offering sound eye health services at the primary health care level, and strengthening human capacity development.

In the past year (September 2013 – February 2014) the programme has aimed to strengthen comprehensive eye care services in our three partner hospitals:

a)     Potchefstroom hospital located in Dr. Kenneth Kaunda district

b)    Klerksdorp/Tshepong Complex located in Dr. Kenneth Kaunda district

c)     Joe Morolong Memorial hospital located in Dr. Ruth Segomotsi Mompati district 

This learning brief showcases the success of our partnership process, and of our implementation model to build institutional capacity. However, it also points out how the unreliable supply of essential eye-care products can hinder effective service delivery and negate the positive gains achieved throughout the project.

Implementation strategy: Build institutional capacity

In order to develop sound strategies that achieve the set government eye-health targets we believe it is essential to develop the institutional capacity of health care centres. To this end we apply the four distinct steps of the “funnel system”. The Funnel system’s four implementation steps include:

Step 1: Providing screening services at district eye care centres

Step 2: offering pre-operative assessments for all patients needing eye-care interventions.

Step 3: Conducting successful operations for patients in need.

Step 4: Ensuring that patients are treated and receive post-operation follow-up and care.

For each of these steps, we aim to ensure that the facility is adequately staffed and stocked with the required resources needed for the screening, intervention, treatment plan, operation, and long-term care. In addition we provide training and skill development workshops to develop the human capacity in the facilities.

A successful eye care institution needs to have (at all sites) functional eye equipment and instruments, infrastructure to handle the volume of patients, appropriately trained personnel, and an adequate order of consumables made available. In the pursuit of this goal to have a quality, comprehensive eye care service some of our key interventions include:

Increasing human capacity through targeted training

We offered several short training courses to key clinical practitioners and managers. This was one way of facilitating eye care service delivery through acquisition of requisite clinical and management skills. The training was intended to help improve programme-planning capacity for sustainable quality eye care services. The following training took place in the past year:

  • Trained 1 ophthalmologist to perform the phaco emulsification technique.
  • Placed 1 ophthalmic medical officer at the Sabona Eye Centre to acquire further practical skills in cataract surgery, in particular the MSICS technique.
  • Sponsored 4 professional nurses to complete the post-basic “Diploma in Ophthalmic Nursing Science” (course offered through the Chris Hani Bara Nursing College). 
  • Trained 2 equipment technicians to use LAICO eye equipment and perform instrument maintenance.
  • Sponsored 3 members of the eye team from Klerksdorp/Tshepong Complex and a district ophthalmic nurse to attend a learning-training experience at LAICO. There they acquired skills to implement seamless, highly efficient eye health systems capable of structured district-wide community mobilization. 
  • Sent 2 staff members on an “Asset Based Community Development (ABCD)” course, offered by GIBS, in order to help us develop our personnel capacity.

Hiring skilled staff and engaging with district leaders

We have hosted numerous, successful planning meetings and workshops with the leadership and managers in Dr. Kenneth Kaunda and Dr. Ruth Segomotsi Mompati Districts. They have demonstrated commendable commitment to meaningful engagement with us, and to ensuring the provision of essential eye care service to the community members.

We have also worked with our partners to ensure that a full complement of eye care personnel was put in place at the Klerksdorp/Tshepong and Potchefstroom hospitals. The Joe Morolong Memorial Hospital began the search to employ a fulltime ophthalmologist. In the meantime, the other eye care teams committed to conducting the cataract outreach services at this Hospital.

Providing essential services

In one year we were able to deliver substantial eye care services at our three partner institutions. We conducted 381 cataract operations, 609 refraction procedures, and dispensed 64 spectacles to patients. We also ensured that all units obtained the necessary basic equipment to support implementation of the phaco emulsification technique

Implementation challenges

Despite the fact that to date all three hospitals have employed fulltime Optometrists, and have laid out plans to ensure patients receive follow-up screening and examinations, not all deserving patients receive prescription glasses or are adequately treated.

Securing the reliable procurement of spectacles and other visual devices is a cumbersome process that delays the stock supple. Each hospital must source supplies through the tender system, which takes time, and leads to many delays and a shortage of stock.

Suggested solutions: We suggest that tender system for purchasing spectacles be given special attention. It must be reviewed, addressed, and amended immediately.  One solution is to introduce a more effective and user friendly tender system that facilitates a better flow of products from supplier to the hospitals. The second solution would be to shift the purchase of spectacles to the same level as the purchase of medicines (which currently has no major procurement problems in these facilities). 

It is essential that we advocate for a revision of the current system of purchasing consumables, instruments, and equipment for optometry services. The current system negates all the good work that is achieved by the practitioners.

Conclusion

This learning brief offers an important lesson about the need for private and government sector partnerships in building institutional capacity at state hospitals. It also calls on civil society to advocate for better eye-care supply procurement systems in order to improve basic service delivery.

Sabona Sonke Foundation


Postnet 327Private Bag X9063East LondonEast LondonSouth Africa


 0437353646


In Short

This learning brief offers an important lesson about the need for private and government sector partnerships in building institutional capacity at state hospitals. It also calls on civil society to advocate for better eye-care supply procurement systems in order to improve basic service delivery.


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