Bookmark and Share

You are here

72 Hour Clinic Makeover

Introduction

Over the years, the Nigerian health system especially the public hospitals have become weakened as a result of several factors ranging from poor funding poor planning, lack of will and commitment on part of Government and health care workers to effect change. This has led to dilapidation and reduction in capacity to provide quality care and services to patients, especially as regard Family Planning.   NURHI discovered at the beginning of the project that there were lots of incorrect assumptions and information about status of health facility and utilization in relation to Family Planning.   

The Government did not have an accurate list of private health facilities.  Most hospitals did not have National Health Management Information System records or an efficient and adequate recording keeping methods or materials. This situation revealed the need to strengthen the health systems capacity to provide quality FP services. The HSS activities comprised of training and re training HCWs  on FP and HMIS, providing materials for HMIS and strengthening commodity logistic systems, supporting HCWs to provide quality services through ISS and improving the physical environment where FP services were provided ; the 72-Hour Clinic Makeover.

 

72-Hour Clinic Makeover

The concept means family planning clinics, Primary Health Care centres and sometimes other integration sites that promote family planning information, counseling and services – i.e. antenatal care (ANC), delivery, post-natal care (PNC), immunization clinics, post abortion care (PAC), HIV counseling and testing (HCT), and Antiretroviral Therapy services are set up (renovated, refurbished and equipped) for optimal family planning service provision using the National Standards of Performance for Family Planning Services.  Clients attending these integration points would be referred to the family planning clinic especially in NURHI High Volume Sites (HVS). The NURHI Integration Strategy was revised accordingly.

 

The entire implementation of this concept is carried out within a time frame of 72 hours from after work on a Friday to before work the following Monday. The 72-Hour Clinic makeover is mostly carried out in facilities where NURHI has trained health care workers and ensured good record keeping, provided materials for referrals, job aids SOPs, IEC etc., it supports the facility and community members to “make-over” the facility. A process of assessment prioritization and cost effectiveness is ensured through direct labor, which brings about community involvement. The “72-Hour Clinic Make-over” exercise begins with a planning session with community members and service providers agreeing on what will be done in a chosen facility.   By the close of business on a chosen Friday, repairs, renovations and installing of equipment are carried out through the weekend, and by Monday morning the clinic reopens in a renewed state, ready to provide optimal family planning services.  The intent is to make family planning services more inviting for clients, thereby increasing utilization.  

 

This concept was undertaken starting with the first five high volume sites in each NURHI initial cities (Ibadan; Kaduna; Ilorin and FCT).

In Nigeria top government functionaries (either the first lady, commissioner for health or LGA chairman commissions or launches the facility after renovation.

 

Preparatory Activities for a 72-Hour Clinic Makeover in a facility

  1. Notify the State Ministry of Health; Local Government Area (LGA), Medical Directors of High Volume Sites; State and LGA Family Planning Coordinators and Family Planning providers and providers in integration points (Labor ward, ANC, Post natal clinic, PAC Units, Immunization units, HIV units and GOPD units) through joint meetings and discuss details of the activity.
  2. Target LGA chairmen and Commissioners for health specifically for diffusion opportunities. The message is NURHI can support them to makeover any number of health facilities in the state and such can be commissioned on same day with the NURHI facilities. (EVIDENCE FOR DIFFUSION)
  3. Visit health facilities and make plans for its renovation, refurbishing and equipping.
  4. Assemble all materials required (danglers, nurses aprons, badges, notice boards, referral boxes etc).
  5. Assemble a task team for each facility and develop plan of action

 

In the fourth year of the project, NURHI modified its 72-Hour Clinic Make-cover concept to Clean, Repair, Use and make Functional (CRUF) existing equipment just as a Fairy would wave its wand (FY).  This was necessitated by the PIP findings, which identified that some equipment in some facilities just needed minimal repairs, cleaning and refurbishing.

 

Activities at a 72-Hour Clinic Make-over site

  • Paint FP clinic, Sew curtains, land scape. Partitions where necessary
  • Assemble all equipment, brand them and test run where necessary
  • Commodities and consumables
  • CLMS tools (service registers, FP clinic cards, Referral boxes, CLMS forms,  service statistics forms, referral forms SD template etc)
  • Assemble all IEC materials ( models, hand bills, flip charts, GATHER, FP methods posters etc), service protocols and Job aids. MEC wheel, Performance standards
  • Print out list of all FPPN contacts with telephone numbers
  • Assemble notice boards on the wall
  • Draw out charts of service utilization and paste on the board
  • Paste outreach calendar, OJT timetable, list of providers
  • Ensure source of running water either tap or plastic bucket with tap
  • Ensure infection prevention measures are in place
  • Outreach plans and maps. List of social mobilizers and their contacts
  • If HF is a proposed resource centre, order a cupboard and load with materials and a computer and designate the corner as resource centre. Appoint a manger from the providers
  • Address toilets within FP clinic
  • Hang Danglers along FP clinic corridors and Directions to FP clinic in all integration sites
  • Arrange for radio talks , TV program and TV coverage of event.
  • Appoint a lead person in each HF( Doctor or Nurse)
  • Ensure video coverage of the processes
  • RIBBONS (NURHI COLOURS) TO CUT FOR COMMISSIONING
  • PAC/MVA ROOM