Behavior Profile: District Health Management Teams apply funds
Health Goal: Catalyze transformation of a holistic health system to sustain equitable improvements in health for all
District Health Management Teams efficiently apply funds received to identified priority community needs
Percentage of District Health Management Teams that disburse funds to community level authorities, on a quarterly basis

Behavior Analysis

Strategy

BEHAVIOR AND STEPS

What steps are needed to practice this behavior?

District Health Management Teams (DHMTs) efficiently apply funds received to identified priority community needs

  1. Create budget implementation and M& E plans for funds/resources received (both on budget and off budget)
  2. Review budget at least quarterly to make adjustments as activities are carried out and monies spent
  3. Initiate regular quarterly forum to share information on the use of funds/resources with the community
  4. Share findings of these checks and balances and adjustments regularly with the community
  5. Share feedback with Regional Health Management Teams to ensure their continuous engagement

FACTORS

What factors may prevent or support practice of this behavior?
Structural
Accessibility: DHMTS do not apply funds efficiently because they have inadequate qualified staff to effectively plan and apply received funds for health activities.
Accessibility: DHMTs do not apply funds efficiently because they do not receive supervision from RHMTS on the use of the disbursed funds.
Accessibility: DHMTs do not have sufficient funding which prevents district health managers from visiting health zones.
Accessibility: DHMTs do not apply funds efficiently because they do not receive their funding when needed, funds delayed, for planned activities.
Service Experience: DHMTs do not apply funds efficiently because they do not have financial planning tools from national level tailored to their implementation needs.
Internal
Knowledge: DHMTs apply funds efficiently because they receive needed information from pilot implementation of clinic financing in specific zones.
Skills: DHMTs do not apply funds efficiently because they do not have the skills and competencies required for efficiently apply disbursed resources.
Skills: DHMTs do not apply funds efficiently because they have insufficient training to implement plans and protocols.

SUPPORTING ACTORS AND ACTIONS

Who must support the practice of this behavior, and what actions must they take?
Institutional
Policymakers: Advocate for innovative funding of lower levels of health service delivery as part of the universal health coverage goals.
Policymakers: Review and update staffing and structuring policies and post qualified staff to DHMT.
Managers: Adopt financial planning and implementation tools tailored to the RHMTs to enable them administer clinics effectively.
Managers: , at the regional level, provide regular supportive supervision visits.
Managers: Train DHMT staff tasked duties.
Regional and District Officers : Identify training needs of staff and draw up training plans that addresses the knowledge and skills gaps of individuals.

POSSIBLE PROGRAM STRATEGIES

What strategies will best focus our efforts based on this analysis?

Strategy requires Communication Support

Enabling Environment
Financing: Utilize innovative funding mechanisms through the National Health Insurance Scheme for health services at clinics.
Institutional Capacity Building: Create capacity building program on the use of financial planning tools as part of DHMTs orientation.
Institutional Capacity Building: Create training programs on effective financial management of the health zones.
Policies and Governance: Prioritize human resource allocation of well trained and qualified staff to insufficiently staffed DHMTs.
Systems, Products and Services
Quality Improvement: Roll out the implementation of the clinics in all health zones.
Demand and Use
Skills Building: Conduct periodic hands on training for DHMT leadership.