Annual review of 2022 activities of the Agoè-Nyivé Health District

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Extract from the article: The Agoè-Nyivé Health District has presented a review of the activities carried out during the year 2022 and developed a new operational action plan for 2023. This was done during the annual review initiated by the Prefectural Health Directorate of A

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The Agoè-Nyivé Health District has presented a review of the activities carried out during the year 2022 and developed a new operational action plan for 2023. This was done during the annual review initiated by the Prefectural Health Directorate of Agoè-Nyivé held from January 24 to 26, 2022. This annual review allowed to assess the activities of the health structures of Agoè-Nyivé for the year 2022, to evaluate the level of achievement of objectives, to identify together the bottlenecks in order to propose corrective measures. The work was launched by Mrs. Amivi Ayah, representing the Prefect.

The purpose of this workshop is to contribute to the improvement of the health of the population of the Agoè-Nyivé health district. The participants assessed the level of achievement of the main performance indicators, identified the strengths, areas for improvement, and bottlenecks that hinder the implementation of activities in the Agoè-Nyivé health district. They also proposed solution approaches and made recommendations to address the problems and shortcomings.

Progress made

In terms of performance in relation to maternal health, the evolution of ANC 4 coverage is in continuous growth over the 3 consecutive years (from 44% in 2019; 45% in 2020 and 53% in 2021. 69% in 2022. This performance is linked to the collaboration with private structures, and the intensification of sensitization beginning early in the first CPN1.

Regarding the strengthening of family planning, we note an increase in the number of Couple Year Protection (CAP) from 21972 to 26571.1. This is due to the technical and financial support of Amplify FP; the sensitization activities by the WABA project, and the activities of the Quality Assurance Teams and the formative supervision of the Francophone Task Order (FTO).

We note an increase in the rate of management of severe acute malnutrition (SAM) in several health facilities and at the district level from 36% to 106% from 2021 to 2022. This proves the good involvement of the providers.

Despite the health situation marked by the COVID 19 pandemic, the district has a vaccination coverage of 103%. This performance can be explained by the responsiveness of the mobilization units at all levels (Communal, Health Unit, Ministry of Health, and Partners); the financing of the micro-plan of the Expanded Programme on Immunization (EPI) integrated into the micro-plan of the health units, the support of GAVI for the implementation of the Advanced Strategies over the 3rd quarter, the implementation of 2 Child Health Days (CHD) during which children who had been lost to follow-up were caught up. This coverage leaves disparities of 56% in the Nyivémégble PHU and 147.7% in Légbassito. In general, Vaccine Coverage above 100% is explained by the lack of control of the target population.

The Agoè-Nyivé district has seen a reduction in the dropout rate. 5 health facilities out of 9 have a rate higher than 10%, which can be explained by the low implementation of the advanced strategies, the availability of actors involved in the vaccine acceleration campaigns, the lack of motivation of certain actors because they did not return to their rights after the implementation of the advanced strategies, and the scarcity of resources from partners in the implementation of the advanced strategies.

The percentage of pregnant women who received three doses of IPT during pregnancy, in relation to the number of pregnant women seen in CPN1, has fluctuated. It goes from 62.5% in 2020, 77.347% in 2021 and 67.72% in 2022. This can be explained by the delay in ANC and added to the fact that the indicator is not filled in by certain private health facilities that do not receive SP allocations because they are not accredited by the National Malaria Control Program (PNLP).

The percentage of HIV-positive pregnant women who received antiretroviral drugs during their pregnancy rose from 91% to 100%. The district objectives were achieved in relation to the PNDS, but not in certain public and especially private facilities, where the rate is low, which proves the lack of screening and treatment of HIV in private centers.

The district recorded a performance of less than 0, i.e. -0.71, and a score of 0. This shows that the district has experienced a regression this year compared to 2021. This regression can be explained by the poor performance of public sites such as the Togblékopé and Légbassito CMS.  The district's objective in 2022 was to do everything possible to keep 98.5% of patients on ARV treatment alive and in care during the period from December 26, 2020 to December 25, 2021, but only 91% succeeded. This rate of 91% was achieved thanks to the significant contribution of private facilities (45.46%) to the formative supervision supported by FTO and to the support of the PEPFAR project at certain public and private sites. The objective has been achieved in relation to the PNDS thanks to the involvement of all the facilities, including the private ones, and the training supervisions financed by FTO.

 

For tuberculosis control, the district's performance is equal to 1; the progress achieved is higher than the target value: Community and family follow-up of patients on treatment, the search for pdv and the availability of personnel, drugs and reagents have made it possible to reduce the number of deaths to 3%, the number of people lost to follow-up to 2% and the number of treatment failures to 2%.

In addition, the integrated supervision in 2022 has made it possible to improve the coverage of the Prevention and Control of Infection PCI from 44% to 78%. The Health Facilities (SFs) that do not have an incinerator, such as Agoè Elavagnon and Legbassito, transport their safety boxes to the SFs that have an incinerator.

In terms of the percentage of people living with a disability who receive physical rehabilitation care, the district has five health facilities that have a physiotherapy service: CMS Agoe-nyive, CMS Demakpoe, Cacaveli Hospital, CMS Togblekope, CMS Sanguera. The rate of people living with a disability being cared for this year is the lowest, i.e. 63% since 2020. The Agoè-Nyive and Cacavéli CMS recorded the lowest rates. Nevertheless, the district's performance remains good, at 2.09 with a score of 5.

Bottlenecks recorded

The district has recorded a regression in some indicators over the last 3 years. There has been a slight decrease in the number of new TB cases successfully treated among the new confirmed TB cases recorded over a given period from 93% to 92%. The proportion of PLWHA on ARVs who are known to be alive at 12 months after starting treatment has decreased from 95.6 to 91.

The percentage of people living with a disability in physical rehabilitation went from 91.87% to 63%. In terms of the development of human resources for health, the density of health personnel is below the objectives of the PNDS. The density of health personnel (ratio per 10,000 inhabitants) is from 4.75 to 3.68.

The Agoè-Nyivé health district faces enormous challenges, including: shortages of certain inputs and reagents, low attendance at most health facilities, geographical accessibility difficulties, insufficient advanced strategies for EPI and family planning (FP), insufficient qualified personnel, and one maternal death recorded in the district.

Improving services in 2023

"At the end of this review, the results are satisfactory, but we still have many challenges to face. We need not only qualified human resources but also equipment and financial resources to improve the care of the population. We are going to accelerate the continuous training of providers in private facilities during monthly meetings, conduct unannounced visits to the Peripheral Care Units (PCUs) to monitor the financial management and the management of essential and generic drugs (EGDs) by the committees that have been set up. We also need to strengthen formative supervision and eradicate all kinds of parallel practices. We also plan to install vaccination sites in the markets," emphasized Dr. Tchilalou Tagba-Péleï, Prefectural Director of Health.

Discussions during the review also focused on the reception of patients in health facilities. Poor reception has a negative impact on all services.  To remedy this, Dr. Tagba-Péleï plans to intensify sensitization, training and close follow-up. This is to raise the attendance rate of health facilities, which is falling due to the poor reception of the population.

The implementation of the National Health Development Plan (PNDS 2017 - 2022) requires an annual review at the end of each year at each level in accordance with the monitoring and evaluation framework. This will make it possible to take stock of the implementation of the Operational Action Plan (OAP) based on the analysis of bottlenecks and thus facilitate the reprogramming of activities for the following year.

The Agoè-Nyive health district has a total of 72 health facilities, of which only 09 are public facilities, among which there is no prefectural referral hospital.

William O.