Health systems management

SESPAS will implement the project with help from five resident advisors. The project includes a small component to strengthen control of schistosomiasis, dengue, and yellow fever, in which the Centers for Disease Control will assist. Seven management systems will be improved: finance, logistics, information, supervision, personnel, maintenance, and planning. A management information system (MIS), the centerpiece of this effort, will support the individual systems, facilitate improved planning and policymaking, and provide regular information on SESPAS performance. Case studies, surveys, and operations research will be conducted for specific management problems. Operations and procedures handbooks will be developed for each management system and will include modules for each health system level (e.g., rural clinics, subcenters). A variety of related documentation (including baseline and follow-up survey reports, at least 24 case studies, policy papers, and a report on household health expenditures) will be produced, as will routine management reports. To accompany these management improvements, the project will develop SESPAS" capacity to provide continuing education and management training to all personnel (up to mid-level managers) in need of it. The training will be based on project-developed handbooks, modules, and case studies (including 2-hour mini-modules for 5,200 promoters and 350 rural auxiliary nurses in urgent need of continuing education). Curricula for specific personnel categories will also be developed. Senior SESPAS staff will receive on-the-job training and will attend workshops on team building, health policy, and technical issues. Some specialized M.S. training may be provided. Schistosomiasis control activities will include: an epidemiologic survey; chemotherapy of confirmed cases; chemical and environmental control of snails; and physician/technician training. For dengue and yellow fever, training and equipment will be provided to upgrade laboratory surveillance. PAHO will provide complementary management TA. Amendment of 7/13/85 decreases funding to $1.5 million (deobligating all loan funds), hastens the PACD (to 4/88), and limits management improvements to the areas of finance, personnel, and information. SESPAS" training capacity will not be upgraded. (PD-KAE-319) Amendment of 8/16/88 extends PACD to 10/90 and expands the project to include purchasing, transportation, and maintenance systems and to train 400 mid-level managers and supervisors. (PD-AAY-121)