Impact Stories

Improved ANC Attendance Through Challenging Current Practices

Challenge

Dysfunctional Team and Low ANC Attendance

Salima District faced high attrition rates among health professionals, poor communication, and uneven workload distribution, resulting in a highly dysfunctional team. These issues led to late antenatal care (ANC) attendance and inadequate HIV ascertainment, increasing the risk of mother-to-child HIV transmission.

Approach

Transformative Thinking and Team Integration
The Salima District team underwent training in Transformative Leadership, recognizing the importance of human assets within a team. The initiative integrated twelve new managers, promoting frequent meetings to share information and solve challenges collectively. Data-driven discussions were used to evaluate the impact of changes introduced, initially met with resistance but eventually embraced as the benefits became evident.

Interventions

Key actions include:

  • Placing community service pharmacists in Mthatha depot.

  • Reassigning community health workers and re-purposing auxiliary workers as pharmacist assistants.

  • Streamlining ordering processes and requiring weekly stock reports from health facilities.

Outcomes

Within six months, medicine availability at depots increased from 54% to 95%, achieving targets ahead of schedule. This allowed the team to shift focus to maintaining adequate stock levels at health facilities.

Lessons Learned

  • Teamwork across functions and disciplines is crucial for system-wide interventions.

  • Engaging the right stakeholders creates an enabling environment for implementation.

  • Timely data reviewed by appropriate stakeholders drives accountability.

  • A systematic and structured approach aids in problem-solving.

  • Effective inventory management requires addressing both technical and behavioural components.

Eastern Cape Province, South Africa

(2013-2014)

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