PROJECT BACKGROUND: This project addresses the second objective of the Learning Complex, which is aimed at improving referral and support systems in Area 3. The project is to be done in 3 phases:

Phase 1: To conduct a baseline study to determine the status of referral and support systems in area 3, so as to inform interventions to improve referral and support systems between clinics and district hospitals.

Phase 2: Facilitate development and implementation of interventions to improve referral and support systems

Phase 3: Conduct follow-up evaluation

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ACHIEVEMENTS TO DATE:

Baseline Study: A baseline study has been completed and the results disseminated to the 3 districts. A total of 58 clinics were reviewed, the 22 clinic supervisors responsible for these clinics were interviewed, and a total of 10 focus group discussions were conducted with doctors (4 groups), clinic nurses (3 groups) and community health workers (3 groups).

Interventions: A request has been received from Zululand district for an intervention to improve clinic supervision. The project, to be done in Pongola and Nongoma municipalities, is aimed at building capacity of both facility managers and clinic supervisors in management, using the immunization programme as a vehicle.

Interventions at provincial level: Findings on the role of clinic supervisors were presented at a provincial meeting attended by district deputy managers. Findings on the role of doctors visiting clinics were presented at another provincial meeting convened to develop guidelines for visiting doctors.

A request has been made for CRH to provide input into the development of provincial guidelines for doctors visiting clinics, as well as input into revision of the clinic supervisors’ manual.