Preparation of a Medium-Term Health Sector Strategy and Plan of Action (1996 - 1998)
MCDI completed an AfDB-funded health sector study in Swaziland. The study reviewed the whole health care system to identify major problems and design appropriate interventions in terms of project packages for AfDB and other donor funding.
MCDI, with the guidance of the Government of Swaziland (GoS) prepared an appropriate and effective medium-term health sector strategy and plan of action, and ensured that activities in the health sector were consistent with overall development objectives and that they adequately addressed key problem areas including new epidemics such as HIV/AIDS.
The study also identified project packages for possible funding by donors. This enabled the GoS to direct external assistance to priority health needs as opposed to those determined by available donor funding; indeed, in March 1999, the GoS conducted a two-day donors' conference, which MCDI's chief of party and human resources development specialist attended in order to present the main findings of the Phase II Report, as well as the project packages for discussion by donors.
MCDI also developed a strategic health facility plan using a computerized Health Facility Requirements Model© it has developed, which projects future facility requirements taking into account the impact of the following demand and supply side factors on inpatient and outpatient service utilization:
- demographic changes including internal migration, emigration, expected changes in fertility, and changes in mortality associated with AIDS or other factors,
- major epidemiological shifts such as the AIDS/TB/STDs epidemic,
- policy changes affecting the pricing of care and the quality of care provided,
- improvements in clinical case management and referral practice between the primary care level and the hospital level,
- improvements in preventive and public health service delivery that reduce the demand for curative care, and
- developments in mental health service capacity.
The software also generates a series of comparative efficiency and effectiveness analyses of health facility performance, which serve as the basis for some of the recommendations for restructuring and/or strengthening clinical service capacity.
