Table 3 Steps and components of the local health systems analysis and results (capacity-building needs)
Steps of the analysis | Essential components to be evaluated | Results: Defined capacity-building needs within the two districts |
|---|---|---|
1. Description of the local health system | Context (geographic, sociodemographic, socioeconomic) Coverage of health facilities HRH Stakeholder analysis and mapping | Definition of an adequate coverage plan of health services within a district (difference between urban and rural district) Coordination capacity with a multitude of actors in Dar Naim Capacity to assess HRH needs |
2. Analysis of interactions between the demand, need and supply dimension of healthcare services | Evaluation of the offered package of activities, compared to the demand from the population and the needs defined by health actors | Definition of a comprehensive integrated package Capacity in terms of mental health, basic obstetric care, etc. |
3. Analysis of accessibility and quality of care | Analysis of accessibility by evaluating the existing data (e.g. data provided by the Health Information System) and framework [24] Analysis of quality of care in four dimensions: cost-efficiency, continuity of care, integrated care and patient-centred care [25] | Capacity in data analysis and monitoring and evaluation Knowledge of and experience in patient-centred care General capacity to enhance quality of care (among all health actors) |
4. Pharmacy management | Analysis of the process: from supply to management to prescription | General knowledge on pharmacy management Provision of tools |
5. Evaluation of local healthcare financing arrangements | Â | Provision of tools Awareness on transparency Knowledge on health insurance and social protection schemes |
6. Analysis of the stewardship function of the local health system | Evaluation of the various functions of a DHT [26]; evaluation of the team’s interactions with local, regional and central actors | Leadership skills General public health knowledge according to defined functions of a DHT [26]: Response to local needs in terms of healthcare, coordination of actors, management of health services, activities and health staff, supervision and training, adaptation of national strategies to local context Capacity to analyse health information data |
7. Analysis of community participation | Analysis of formal and informal health committees; evaluation of the level of community participation [27, 28] | Awareness on advantages of a genuine partnership and a non-utilitarian vision of community participation Capacity to define a strategy adapted to an urban context (Dar Naim) |
8. Synthesis and lessons learned | Â | Capacity to prioritise A systems vision |