CHF Best Practices MAKING FBO PARTICIPATE IN CHF OPERATIONS

1
CHF Best PracticesMAKING FBO PARTICIPATE IN
CHF OPERATIONS

• ROMBO DISTRICT COUNCIL
• Presenter Dr. C.E. Nkya - DMO
• And Secretary CHSB -

ROMBO DISTRICT COUNCIL Presenter Dr. C.E. Nkya -
DMO And Secretary CHSB -
2
ENROLLMENT

• Currently there are 8,415 households enrolled OUT
  OF 60,000 WHICH IS ABOUT 14
• Rombo district Council started CHF on 1st March
  2005
• Enrollment steadily increased for the first six
  month (march september2005)
• After that we observed a decline

3
Factors contributing to declining membership

• Misleading information about CHF to the community
  during campaigns in general election.
• Lack of enough sensitization
• The premium level of 10,000/ was too much for
  most of the households
• Shortage of drugs at the District Hospital

4
PROVISION ISSUES

• CHF scheme covers one DDH, 4 public health
  centers, 18 public dispensaries
• CHF covers both outpatient and inpatient services

5
CHF contract with DDH

• Rombo DDH is owned by the Roman Catholic Church,
  subsidized by the government.
• It provides health services to CHF members under
  the contract between the District Executive
  Director and the DDH
• Under the contract, the CHF patient should have a
  referral letter from the primary health facility
  except seriously ill patients or involved in
  accident.
• The patients should have CHF membership cards
  with the photographs of six beneficiaries.

6
CHF contract with DDH

• The District council introduced the CHF claim
  forms to DDH which have to be filled for each CHF
  patient service (fee per service reimbursement)
  rendered and sent to DMO monthly
• A sub committee which comprises 2 people from
  the hospital (DDH) and 2 out of CHMT members
  crosscheck the claim forms
• Payments have to be authorized by DMO, DED, and
  the Board chairman
• Since the introduction of this claim forms there
  are less complains from DDH

7
ACHIEVEMENTS

• The CHF members are appreciating health services
  provided
• Availability of Drugs all the time
• Sense of ownership to health facility around them
• Patient referred from primary health facilities
  to DDH
• Rational prescription has started picking up
• Demand for VAs and private dispensaries to give
  services to CHF members

8
Challenges

• Council does not have direct authority to a DDH
• Drop out of qualified staff at DDH
• Difficulties in agreement on claims and
  reimbursements

9
RECOMMEDATIONS FOR MAKING FBOS PARTCIPATE IN CHF
OPERATIONS

• Claim forms for payments
• Government management control
• Special services room for CHF members
• Grant for exempted groups
• Staff recruitment.

10

• ASANTENI SANA KUTOKA ROMBO.