Embed Size (px)
Citation preview
FIXED AMOUNT REIMBURSEMENT AGREEMENT
(FARA) V2.0: VERIFICATION REPORT
QUARTER II OF YEAR TWO
(October-December 2017)
Draft: May 8, 2018
This publication was produced for review by the United States Agency for International Development.
It was prepared by Social Impact, Inc.
i
Contents ACRONYMS ........................................................................................................................................... ii
EXECUTIVE SUMMARY ........................................................................................................................ iii
1.0 BACKGROUND ......................................................................................................................... 1
1.1 Objectives ..................................................................................................................................... 1
1.2 Methodology ................................................................................................................................. 1
2.0 FINDINGS AND CONCLUSIONS ............................................................................................ 1
3.0 RECOMMENDATIONS ............................................................................................................. 4
ANNEX 1: DELIVERABLES AND OUTPUTS ........................................................................................ 5
ANNEX 2: FIELD WORK SCHEDULE .................................................................................................. 6
ANNEX 3: TEAM COMPOSITION ...................................................................................................... 7
ANNEX 4: LIST OF DOCUMENTS REVIEWED ................................................................................... 8
ANNEX 5: KEY INFORMANT ............................................................................................................... 9
ANNEX 6: LIST OF HEALTH FACILITIES ........................................................................................... 14
ANNEX 7: LIST OF PERSONS CONSULTED AND INTERVIEWED ................................................ 15
ii
ACRONYMS
CHT County Health Team
DHT District Health Team
EmONC Emergency Obstetric and Newborn Care
EPHS Essential Package of Health Services
FARA Fixed Amount Reimbursement Agreement
FDG Focused Group Discussion
GOL Government of Liberia
HF Health Facility
IP Implementing Partner
IRC International Rescue Committee
JISS Joint Integrated Supportive Supervision
KII Key Informant Interview
LSA Liberia Strategic Analysis
M&E Monitoring & Evaluation
MoH Ministry of Health
NGO Non-Governmental Organization
OIC Officer-in-Charge
PBF Performance Based Financing
PMU Pentecostal Mission Unlimited
RHS Reproductive Health Supervisor
RMNCHA/FP Reproductive Maternal Neonatal Child Health Activities/Family Planning
RMP Risk Mitigation Plan
SOW Statement of Work
USAID United States Agency for International Development
WASH Water Sanitation and Hygiene
iii
EXECUTIVE SUMMARY
In March 2018, USAID/Liberia requested the Liberia Strategic Analysis activity (LSA) to verify five
deliverables under the Fixed Amount Reimbursement Agreement (FARA v2.0). The purpose of the
verification was to provide an independent and thorough examination of target FARA deliverables.
The verification covered Quarter II of Year II (October-December 2017). Field work lasted for 14
days (March 25 - April 7, 2018). LSA visited thirty hard-to-reach health facilities across the three FARA
v2.0 counties (Bong, Lofa and Nimba). This verification report outlines achievements, observations
and recommendations for improvement of the FARA intervention.
The verification exercise validated several achievements reported by the FARA Team as follows:
1) The Ministry of Health conducted an internal audit of the CHTs, and commissioned external
audits of its implementing partners (Africare and IRC). Deliverable #1 (Risk Mitigation Plan)
was achieved.
2) Participants in the three counties confirmed that thirty-three persons attended the EmONC
training, as reported in the iHRIS. Deliverable #9 (iHRIS Report) was achieved.
3) The District and County Health Teams conducted Joint Integrated Supportive Supervision
(JISS) visits across all the facilities visited by the verification team. Nimba and Bong counties
exceeded the JISS targets by 50%, while Lofa fell short by 2.5%. Deliverable #10 was achieved.
4) Seventeen maternal and twenty-six neonatal deaths reported by the health facilities were
reviewed by relevant authorities from the CHTs. The District Contraceptive Events were
conducted in all districts. The $5.00 weekend delivery bonus was paid in all HFs visited. There
were 540 weekends deliveries conducted in the 30 health facilities visited. Deliverable # 15
(RMNCHA/FP outcomes report) was achieved.
5) The service delivery and administrative bonus payments for the quarter under review have
not been made to the beneficiaries. Deliverable # 8 (PBF Score cards for service delivery) was
not achieved.
Based on these findings and observations, LSA recommends the following:
a. Internal and external auditors should hold debrief sessions with the CHTs prior to their
departure from the counties and audit reports should be provided to the CHTs for timely
informed decision making.
b. MoH should ensure that draft audit reports are filed with IPs & CHTs while awaiting final
versions.
c. CHTs and IPs should retroactively pay all outstanding bonuses and improve on timely payment
moving forward.
d. CHTs and IPs need to improve health workers’ knowledge around bonus calculations by
creating awareness about the purpose and calculation method of PBF bonus.
e. The EmONC training should be rolled out by the RHS to the HF staff in Nimba and Bong
counties.
f. Support HR managers need additional training in IT skills so they can effectively manage the
iHRIS.
g. CHTs and IPs should ensure JISS team composition includes the required number of persons
and skills mix.
h. IPs should adopt a standardized payment schedule of weekend delivery bonus.
i. FARA should harmonize weekend bonus payment scheme as per PBF manual so that all IPs
are paying the same amount.
j. The CHTs should ensure that delivery dates in the delivery ledgers match the information
recorded in the partograph.
k. FARA should pay all outstanding bonuses to facility staff.
1
1.0 BACKGROUND
The Fixed Amount Reimbursement Agreement (FARA v2.0) is a $59.1 million agreement signed
between USAID, and the Government of Liberia, acting through Ministry of Health (MoH). This
initiative supports the implementation of Liberia’s 2011-2021 National Health and Social Welfare
Policy and Plan. FARA v2.0 provides critical support to the Liberia health sector to reduce maternal,
neonatal and child mortality through integrated systems and service delivery investments, while
strengthening MoH stewardship and capacity to improve accountability and oversight.
FARA v2.0 financially supports the provision of health services in Bong, Lofa, and Nimba counties,
targeting 115 health facilities. The Government of Liberia (GoL) pre-finances FARA v2.0 through the
national budget, with USAID reimbursing fixed amounts quarterly to the GoL for the achievement of
predetermined outputs. The agreement period of performance is January 1, 2016 to December 31,
2020.
1.1 Objectives
The purpose of this round of verification was to ensure that the selected deliverables comply with
agreed standards and are managed fairly, efficiently and effectively. The emphasis for this round of
verification was placed on hard-to-reach health facilities in the targeted counties because they are
often underserved or left out by the supervision team. The verification was meant to:
▪ Collect evidence of the deliverables through desk review, field visits, interviews and
observation for Quarter II of Year II (October – December 2017).
▪ Validate the quality of outputs reported to the Mission for the period assessed.
1.2 Methodology
The verification exercise covered the three target counties (Bong, Lofa and Nimba). The data
collection method used in this verification involved desk view of reports submitted to USAID, including
review of documents and other materials from MoH and USAID FARA Management Team. In addition,
meetings were held with the FARA team at MoH to finalize the verification plan. The verification
process also used key informant interviews with County Health Teams (CHTs) and Implementing
Partners (IPs). In addition to observing work processes at each health facility visited, a group discussion
was conducted with a cross-section of available staff members. The list of respondents interviewed,
locations and dates can be found in Annexes 6 and 7. Following completion of the data collection
exercise, a county level briefing was held in each county to get a county-level perspective of the
preliminary findings of each deliverable, observations, conclusions and recommendations. Final
presentations were done with the FARA management team at the MoH in Monrovia and with the
Mission team.
The verification field exercise lasted for 14 days from March 25th to April 7th. The verification was
conducted by a team of four LSA M&E Specialists (Annex 3: DQA Team Composition). During the
first week of field work, the DQA Team split into two sub-teams: one team worked in Bong and the
second team worked in Lofa. Both teams merged in Nimba to finalize the verification for the last week.
The thirty health facilities visited were pre-selected by LSA and USAID. Five deliverables were selected
and assessed during this round of verification.
2.0 FINDINGS AND CONCLUSIONS
The findings and conclusions described are derived from the data collection activities conducted by
LSA through the KIIs, FGDs and desk review in the three counties.
1. Deliverable #1: Updated RMP that includes any applicable audit findings and
mitigating measure from the FY16/FY17 FARA EPHS Contracts with Bong, Lofa and
Nimba Counties
2
The objective of deliverable #1 is to ensure that audits are conducted and findings and
recommendations from internal audits/risk mitigation assessments are implemented quarterly to
enhance the financial systems.
Findings
The Ministry of Health conducted an internal audit on the CHTs and commissioned external audits
of its implementing partners (Africare and IRC). The recommendations from the risk mitigation
assessment that calls for internal audit was adhered to by FARA counties. The deliverable outputs
were accomplished as required. The objective of this deliverable calls for the conduct of an audit;
and this was done, as evidenced by all the county accountants through interviews. As a result, LSA
concludes that the above deliverable was achieved.
Observations While the deliverable outputs were achieved, some issues were observed with the deliverable:
a. The audit reports/findings are yet to be received by CHTs.
b. There were no debrief sessions held by the auditors to inform the CHTs of audit findings.
2. Deliverable #8: Generate PBF Scorecard for Service Delivery, including evidence of
timely calculation and payment of Service Delivery incentives to facilities and
healthcare workers, per the PBF Manual
The objective of deliverable #8 is to ensure that health facilities performance is scored, and their
scorecards are used as the basis for calculating bonuses earned at the end of every quarter to make
payments to beneficiaries in the subsequent quarter.
Findings
Service delivery and administrative bonus payments for the quarter under review have not been made
in the project operational counties. The payment for this quarter should have been done in the quarter
of January to March 2018. However, up to the beginning of April, the payments had not been made.
LSA concludes that the above deliverable was not achieved due to lack of accomplishment of the key
output.
Observations
a. Service delivery incentives were paid for the quarter under review in the three counties, but
bonuses have not been paid.
b. Monthly incentive payments are always delayed across the three counties except for the
Bong Hybrid, which is always current with incentive payments.
c. Facility staffers in Nimba & Bong demonstrated poor knowledge of bonus calculations.
3. Deliverable #9: Receipt of iHRIS Reports from MOH containing a list of at least 33
Reproductive Health Supervisors from Bong, Lofa and Nimba, who received two-
week training on EmONC, with a focus on hemorrhage, sepsis, helping babies
breath and asphyxia, and chlorhexidine, countersigned by CHTs and NGOs.
The objective of this deliverable is to ensure that all in-service training conducted during the quarter
under review are entered in iHRIS especially the thirty-three Reproductive Health Supervisors from
Bong, Lofa and Nimba on EmONC.
Findings
The EmONC training’s participants (Reproductive Health Supervisors) information was entered in
iHRIS for the period under review. The iHRIS application shows that there were eleven participants
from each of the counties, and this was confirmed by the respondents from the counties. In addition,
3
other in-services trainings conducted were captured in iHRIS. Therefore, the verification concludes
that this deliverable was achieved.
Observations
Though the deliverable outputs were achieved from the desk review, KII and observations, LSA
observed some issues with this deliverable:
a. In the FARA quarterly report, information from iHRIS highlighted names of thirty-three RH
Supervisors trained on EmONC. However, some HR managers (Lofa & Nimba) could not
readily retrieve data from the system.
b. FARA reported that the training lasted for two consecutive weeks, but participants
interviewed stated that it lasted for a week.
c. The EmONC training was conducted for RH supervisors to be rolled out to facility staff. Lofa
has begun the process, but Bong and Nimba are yet to begin.
4. Deliverable #10: Bi-annual EPHS Joint Integrated Supportive Supervision (JISS)
Report for Bong, Lofa and Nimba – in coordination with the CHTs and NGOs—to
include:
a. Monitoring and supportive supervision visits to 25% of health facilities in each county, with
an emphasis on RMNCHA/FP, WASH and Malaria.
b. Documentation and resolution of major challenges of a particular county or cross cutting
issues affecting multiple counties in the implementation of the EPHS.
The objective of this deliverable is to ensure that DHT, CHT, and central MoH conduct JISS 100%
monthly, 75% quarterly and 25% semi-annually of the 115 FARA health facilities respectively to mentor
health facility staff in areas where they face challenges.
Findings
Nimba and Bong exceed targets by 50% while Lofa fell short by 2.5%. The District and County Health
Teams conducted JISS across all the facilities visited by LSA during the verification exercise, as
evidenced by signed visitors’ log available at each facility. Therefore, the verification concludes that the
deliverable was achieved.
Observations
Nevertheless, the team made the following observations:
a. DHTs conducted 100% of JISS at all HFs visited.
b. Challenges identified were documented in action points by JISS teams.
c. JISS action points are not followed-up to detect whether the previous recommendations were
implemented.
d. JISS team composition was not always consistent (# of staff in some instances range from 2 to
3 persons; technical skills were sometimes missing in the team composition).
e. In some instances, # of JISS team members reported did not match visitors’ log at HFs.
5. Deliverable #15: Quarter 1 Report outlining progress to accelerate focused
RMNCHA/FP outcomes in Bong, Grand Bassa, Lofa, Margibi, Montserrado and
Nimba
a. Analysis of all Maternal and Newborn Death Reports and Reviews, conducted as per
Ministry policy and protocols, and evidence of follow up.
b. Report on district contraceptive outreach days conducted in each district for that quarter,
indicating the number of beneficiaries reached per district population
c. $5 weekend bonus for midwives or healthcare worker that keep at least 190 facilities open
and operational over the weekend to assist with facility-based delivery.
4
The objective of deliverable #15 is to ensure that a quarterly report on analysis of maternal and
newborn deaths are completed. In addition, the contraceptive outreach days and weekend delivery
bonus payment for healthcare workers, who keep their facilities operational over the weekends, are
done.
Findings
There were seventeen maternal and twenty-six neonatal deaths reported from the three counties.
These reports were reviewed. Copies of the reports are filed with the CHT. District Contraceptive
Events were conducted in all districts during the period verified. LSA verified the reports with the
reproductive health supervisor and IPs.
The $5.00 weekend delivery bonus was paid in all HFs visited for the quarter. This was verified through
interviews of recipients of the payment. There were 540 weekend deliveries conducted in the 30
health facilities visited. Health facilities visited were always opened during weekends, as evidenced by
attendance and weekend deliveries records at the HFs. Considering the above accomplishments, the
team concludes that this deliverable was achieved.
Observations
The team observed some issues with the deliverable:
a. In some HFs, there were no partographs for some deliveries conducted.
b. The dates recorded in some of the delivery ledgers were not sequential.
c. There is variation in weekend $5 payment scheme:
i. IRC pays each staff $5 per month
ii. PMU pays $50 per HF per quarter
iii. Africare pays each staff $20 per month (includes ambulance driver)
iv. Africare double pays ambulance drivers (separate payment for each HF served).
3.0 RECOMMENDATIONS
Based on these findings, the following recommendations are offered:
a. Internal and external auditors should hold debrief sessions with the CHTs prior to their
departure from the counties and audit reports should be provided to the CHTs for timely,
informed decision making.
b. MoH should ensure that draft audit reports are filed with IPs & CHTs while awaiting final
versions.
c. CHTs and IPs should retroactively pay all outstanding bonuses and improve on timely
payment moving forward.
d. CHTs and IPs need to improve health workers’ knowledge around bonus calculations by
creating awareness about the purpose and calculation method of PBF bonus
e. The EmONC training should be rolled out by the RHS to the HF staff in Nimba and Bong
counties.
f. Support HR managers need additional training in IT skills so they can effectively manage
the iHRIS.
g. CHTs and IPs should ensure JISS team composition includes the required number of
persons and skills mix.
h. IPs should adopt a standardized payment schedule of weekend delivery bonus.
i. FARA should harmonize weekend bonus payment scheme as per PBF manual so that all
IPs are paying the same amount.
j. The CHTs should ensure that delivery dates in the delivery ledgers match the information
recorded in the partograph.
k. FARA should pay all outstanding bonuses to facility staff.
5
ANNEX 1: DELIVERABLES AND OUTPUTS
1. Deliverable # 1: Updated RMP that include:
a) Updated RMP that includes any applicable audit findings and mitigating measure from the
FY16/FY17 FARA EPHS Contracts with Bong, Lofa and Nimba Counties
2. Deliverable #8: PBF Scorecard for Service Delivery:
a) Generate PBF Scorecard for Service Delivery, including evidence of timely calculation
and payment of Service Delivery incentives to facilities and healthcare workers, per the
PBF Manual
b) Provide evidence of timely payment of NGO and CHT PBF Administrative incentives (for
the previous two quarters), in compliance with PBF manual
3. Deliverable #9: iHRIS Reports
a) Receipt of iHRIS Reports from MOH containing a list of at least 33 Reproductive Health
Supervisors from Bong, Lofa and Nimba, who received two-week training on EmONC,
with a focus on hemorrhage, sepsis, helping baby’s breath and asphyxia, and chlorhexidine,
countersigned by CHTs and NGOs.
4. Deliverable #10: Bi-annual EPHS Joint Integrated Supportive Supervision
(JISS):
Bi-annual EPHS Joint Integrated Supportive Supervision (JISS) Report for Bong, Lofa and
Nimba – in coordination with the CHTs and NGOs—to include:
(a) Monitoring and supportive supervision visits to 25% of health facilities in each county, with
an emphasis on RMNCHA/FP, WASH and Malaria
(b) Documentation and resolution of major challenges of a county or cross cutting issues
affecting multiple counties in the implementation of the EPHS
5. Deliverable #15: Quarter 2 Report outlining progress to accelerate focused
RMNCHA/FP
Quarter 2 Report outlining progress to accelerate focused RMNCHA/FP outcomes in Bong,
Grand Bassa, Lofa, Margibi, Montserrado and Nimba, against the achievement of the following:
(c) Analysis of all Maternal and Newborn Death Reports and Reviews, conducted as per
Ministry policy and protocols, and evidence of follow up
(d) Report on district contraceptive outreach days conducted in each district for that quarter,
indicating the number of beneficiaries reached per district population
(e) $5 weekend bonus for midwives or healthcare worker that keep at least 190 facilities open
and operational over the weekend to assist with facility-based delivery
6
ANNEX 2: FIELD WORK SCHEDULE
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
March 2018
4 5 6 7 8
Development
of SOW
9
Development
of SOW
10
11 12
Submission of
scope of work
to Mission
13
Review of
background
document
and
preparatory
work
14
Review of
background
document and
preparatory
work
15
Review of
background
document and
preparatory
work
16
Planning
meeting LSA &
Mission FARA
team
17
18 19
Planning
meeting LSA &
MOH
20
21
22
23
Planning
meeting LSA &
MOH
24
25
Travel field
Lofa Team 1 &
Bong Team II
26
Field work
Lofa Team 1I &
Bong Team I
27
Field work
Lofa Team 1
& Bong Team
I
28
Field work
Lofa Team 1 &
Bong Team I
29
Field work
Lofa Team 1 &
Bong Team I
30
Field work
Lofa Team 1 &
Bong Team I
31
April 2018
1
Travel field
2
Field work
Lofa & Bong
Teams Travel
to Nimba
3
Field work
Nimba
4
Field work
Nimba
5
Field work
Nimba
6
Field work
Nimba
7
Teams travel
Back to
Monrovia
8
9
Preparing
presentation
10
Preparing
presentation
11
Preparing
presentation
12
Dry Run with
Mission and
MoH FARA
Teams
13
Debrief with
Mission
14
15 16
Report writing
17
Report
writing
18
Report writing
19
Report
writing
20
Submit Final
Report to
Mission
7
ANNEX 3: TEAM COMPOSITION
1. Julius N. Lekpeh, M&E specialist
2. Mark T. Bassie, M&E Specialist
3. Ishmael Flomo, M&E Specialist
4. Jeff Juaquellie, Senior Monitoring Advisor
Team I (Travel to Bong and Nimba)
1. Julius N. Lekpeh, M&E specialist
2. Jeff Juaquellie, Senior Monitoring Advisor
Team 2 (Travel to Lofa and Nimba)
3. Mark T. Bassie, M&E Specialist
4. Ishmael Flomo, M&E Specialist
8
ANNEX 4: LIST OF DOCUMENTS REVIEWED
MoH/CHTs and IPs (Africare, IRC) documents
▪ FARA Quarterly Progress Report
▪ RMNCH Report
▪ Counter Verification Report
▪ Final Bong Hybrid County Validation Report
▪ Nimba Africare EPHS Year 2, Quarter I1 Report
▪ BCHT JISS Final Report
▪ LCHT JISS Report
▪ Facilities Scorecards Report
▪ Health Facilities Weekend Delivery Report
▪ FARA Field Monitoring Report
▪ LCHT Field Monitoring Report
9
ANNEX 5: KEY INFORMANT
Means of Verification Persons to interview Questions and documents to
ask and collect at central
level
Questions at County and Facility Level
Verification # 1:
Updated RMP that
includes any applicable
audit findings and
mitigating measure from
the FY16/FY17 FARA
EPHS Contracts with
Bong, Lofa and Nimba
Counties
Central Level
a) FARA Compliance
Officer
b) FARA Accountant
County Level
a) County Accountant
b) CHSA
Was there any audit (internal or
external) conducted during year
one (FY2016/2017) of the
project?
What were some of the key
findings and recommendations
from the RMP review report?
What are the risk detection
mitigation procedure in place to
control project assets?
The mitigation procedure been
enforced.
Has there been a follow-up visit
to the counties to verify or do
spot check?
Does MOH/FARA conduct a
regular Fixed Asset review at the
central and county levels?
How useful are mitigation
measures to your system?
Was there any audit (internal or external) conducted
during year one (FY2016/2017) of the project?
What were some of the key findings of the RMP
review?
What were some of the measures put in place to
resolve those review findings?
How useful are those measures to your County?
What is missing that needs to be included in the future
review of this document?
10
Means of Verification Persons to interview Questions and documents to
ask and collect at central
level
Questions at County and Facility Level
Verification #8:
Generate PBF
Scorecard for Service
Delivery, including
evidence of timely
calculation and payment
of Service Delivery
incentives to facilities and
healthcare workers, per
the PBF Manual
Provide evidence of
timely payment of NGO
and CHT PBF
Administrative incentives
(for the previous two
quarters), in compliance
with PBF manual
Central Level
a) Performance Based
Financing Unit
b) FARA Accountant
c) IRC & Africare
County Level
d) PBF/FARA Focal
person
e) M&E
f) IRC & Africare
Health Facility Level
a) OIC
Were bonuses given for the
period under review?
Who benefit from the bonus
payment?
How are they calculated? What
does the manual say about
timely payment of bonus
(schedule)?
May we see the documents for
the quarter? (NGOs and the
administrative bonus)
When were the calculation of
those bonuses was made and
what were the precise dates of
payment for the period under
review?
Were bonuses given for the period under review?
Are bonuses given to deserving staff as required in
your County/Facility?
Do you have a copy of the PBFM?
Are the staff of this County/Facility aware of how their
bonuses are calculated?
Did you receive your bonuses for the period under
review as required in the manual?
Were the calculations properly done as you expected?
What are your doubts and how would you like to see
it done during the next quarter?
Verification #9: Receipt
of iHRIS Reports from
MOH containing a list of
at least 33 Reproductive
Health Supervisors from
Bong, Lofa and Nimba,
who received two-week
training on EmONC, with
a focus on hemorrhage,
sepsis, helping baby’s
breath and asphyxia, and
chlorhexidine,
Central Level
a) iHRIS
Manager/Personnel
unit
b) Training Director
c) Family Health
Director
d) IR & Africare
County Level
a) HR Manager
b) IRC & Africare
c) RH Supervisors
Were in-service trainings
conducted for the period under
review on EmONC?
Is there a training report that
entails a list of trainings
conducted, persons that
attended the trainings and dates
of trainings?
What is the total number of staff
you have trained in EmONC this
quarter?
How many in-service trainings were conducted for the
period under review?
Were in-service trainings conducted for the period
under review on EmONC?
Did any of the staff from the county/Facility participate
in the EONC trainings?
How long was the conducted for?
Were handouts/training manuals given?
How useful was the trainings to those that
participated?
What were some other benefits gained from the
trainings?
Have those skills acquired been fully utilized?
11
Means of Verification Persons to interview Questions and documents to
ask and collect at central
level
Questions at County and Facility Level
countersigned by CHTs
and NGOs.
.
May we have both hard and
electronic copies of the trainings
reports?
How were training participants selected?
How would you like the selection process to be done
next time?
Is there any other contribution on the way forward
regarding future trainings?
Verification #10: Bi-
annual EPHS Joint
Integrated Supportive
Supervision (JISS)
Report for Bong, Lofa
and Nimba – in
coordination with the
CHTs and NGOs—to
include:
a. Monitoring and
supportive supervision
visits to 25% of health
facilities in each county,
with an emphasis on
RMNCHA/FP, WASH
and Malaria
b. Documentation and
resolution of major
challenges of a County or
cross cutting issues
affecting multiple
Counties in the
implementation of the
EPHS
County Level
a) County M&E Officers
b) IPs M&E Officers
c) Clinical Supervisors
d) Reproductive Health
Supervisors
Facility Level
a. OIC
Did the CHT conduct 25% of
HFs quarterly JISS during
quarter? … request for the report Check for achievements,
successes and challenges
identified in those reports.
Has there been a joint integrated
Supportive Supervision done for
the quarter under review by the
CHT?
What were the challenges/issues
that the JISS addressed regarding
the implementation of EPHS for
the quarter under review? ......
request for the completed tool/report What have been some of the
challenges identified?
Has there been a joint integrated Supportive
Supervision done for the quarter under review by the
CHT?
What were the challenges/issues that the JISS
addressed regarding the implementation of EPHS for
the quarter under review? ...... request for the completed tool/report Check for achievements, successes, and challenges identified in those reports What have been some of the challenges identified?
Verification #15: Quarter 2 Report outlining
progress to accelerate focused RMNCHA/FP outcomes in
Central Level Is FARA quarter two
(October to December)
Is FARA quarter one
(October to December)
12
Means of Verification Persons to interview Questions and documents to
ask and collect at central
level
Questions at County and Facility Level
Bong, Grand Bassa, Lofa, Margibi, Montserrado and
Nimba, against the achievement of the following:
a) Analysis of all Maternal and Newborn Death
Reports and Reviews, conducted as per Ministry
policy and protocols, and evidence of follow up
b) Report on district contraceptive outreach days
conducted in each district for that quarter,
indicating the number of beneficiaries reached per
district population
c) $5 weekend bonus for midwives or healthcare
worker that keep at least 190 facilities open and
operational over the weekend to assist with
facility-based delivery
d) Adolescent health services protocols developed,
and standards finalized
a) Family Health Division
Director
b) PBF Manager
c) M&E Officer
County Level
a) Reproductive Health
Supervisor
b) IP County Managers
c) M&E Officers
d) Clinical
Supervisors/Surveillance
Officers
Facility Level
a) OIC
report available outlining
progress to accelerate
focused RMNCHA/FP
outcomes at county
levels? … request for the report
• Check for the
analysis of all
maternal and
newborn
deaths?
• Check on
timeliness of
reviews
conducted for
maternal and
newborn deaths
• Request for
updated version
of the protocol
Is there a contraceptive
outreach report
available for the quarter
under review? …request for the report
• Check for the
number of
outreach
report available outlining
progress to accelerate
focused RMNCHA/FP
outcomes at county levels?
… request for the report
• Check for the
analysis of all
maternal and
newborn deaths?
• Check on timeliness
of reviews
conducted for
maternal and
newborn deaths
• Request for
updated version of
the protocol
Is there a contraceptive
outreach report available
for the quarter under
review? …request for the report
• Check for the
number of outreach
conducted and the
number district
reached?
13
Means of Verification Persons to interview Questions and documents to
ask and collect at central
level
Questions at County and Facility Level
conducted and
the number
district reached?
Have facility staff
members (midwives)
been paid for weekend
deliveries for the
quarter under review?
How many districts
benefited from the
weekend delivery
payment for the quarter
under review per
county? [request for the report]
Has the Adolescent
health services protocol
been developed and
finalized?
Request for updated version of the protocol
Have facility staff members
(midwives) been paid for
weekend deliveries for the
quarter under review?
a) Is the payment
made per delivery
or number of staff
that attend the
delivery?
How many facilities
benefited from the
weekend delivery payment
for the quarter under
review? …. request for the report
14
ANNEX 6: LIST OF HEALTH FACILITIES
No. FACILITY NAME HF TYPE DISTRICT
Bong County
1 Zebay Clinic Clinic Penta-Kpaai
2 Yolota Clinic Clinic Kokoya
3 Gbartala Clinic Clinic Suakoko
4 Haindi Clinic Clinic Fuamah
5 Kpaai Clinic Clinic Penta-Kpaai
6 Jorwah Clinic Clinic Penta-Kpaai
7 Bah-ta Clinic Clinic Kokoyah
8 Zowieta Clinic Clinic Penta-Kpaai
9 Tokpaipolu Clinic Clinic Salala
10 Kelebei Clinic Clinic Sanoyea
Lofa County
1. Gorlu Clinic Clinic Salayea
2. Zolowo Clinic Clinic Zorzor
3. Leingbamba Clinic Clinic Foyah
4. Sorlumba Clinic Clinic Foyah
5. Worsonga Clinic Clinic Foyah
6. Zenalormai Clinic Clinic Voinjama
7. Barkedu Clinic Clinic Voinjama
8. Sacromu Clinic Clinic Salayea
9. Yarpuah Clinic Clinic Salayea
10. Borkeza Clinic Clinic Zorzor
Nimba County
1. Bonlay Clinic Clinic Tappita
2. Diallah Clinic Clinic Tappita
3. Toweh Town Clinic Clinic Tappita
4. Buutuo Clinic Clinic Zoe-Geh
5. Lepula Clinic Clinic Zoe-Geh
6. Gbloulay Clinic Clinic Zoe-Geh
7. Lugbehyee Clinic Clinic Sanniquellie-mah
8. Youhnlay Clinic Clinic Gbehlay-geh
9. Garplay Clinic Clinic Gbehlay-geh
10. Gbeivonwea Clinic Health Center Gbehlay-geh
15
ANNEX 7: LIST OF PERSONS CONSULTED AND INTERVIEWED
16
17
18
19
20
21
22
23
