Transcript MAKING FBO PARTICIPATE IN CHF OPERATIONS

CHF Best Practices
MAKING FBO PARTICIPATE IN CHF
OPERATIONS
ROMBO DISTRICT COUNCIL
Presenter: Dr. C.E. Nkya - DMO
And Secretary CHSB -
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 – september’2005)
• After that we observed a decline
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
PROVISION ISSUES
• CHF scheme covers one DDH, 4 public
health centers, 18 public dispensaries
• CHF covers both outpatient and inpatient
services
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.
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
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
Challenges
• Council does not have direct authority to a DDH
• Drop out of qualified staff at DDH
• Difficulties in agreement on claims and
reimbursements
RECOMMEDATIONS FOR MAKING
FBOS PARTCIPATE IN CHF
OPERATIONS
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Claim forms for payments
Government management control
Special services room for CHF members
Grant for exempted groups
Staff recruitment.
• ASANTENI SANA KUTOKA ROMBO.