1. Leadership Training for quality management: How the Client Service Charter could be an effective communication tool if properly understood and accepted by healthcare managers. Contribution of Quality Improvement in attainment Of Health and Social Welfare MDGs in 2015 NQIF - August 2015, Hyatt Regency Hotel Dar-es-Salaam Presented by Wema Moyo

2. Key Messages Leadership training a forum for quality management can best be used to educate the health managers on the importance of the Client Service Charter (CSC) for effective communication between service providers and service users and thus improve service delivery In Quality improvement leaders are crucial to enforcing good communication in-house and between clients and service providers

3. Leadership Training : What is it? For Who? A training to strengthen communication structures and communication skills across the different levels of the health system and communities served pushes to identify avenues within the health system that could be used to encourage communication with the clients Analyze case studies (maternal deaths, perinatal deaths and complaints and draw steps to solve the problems and avoid reoccurrence. Seeks effective support of managers in Quality Management within their respective health facilities. Including to encourage support and recognize efforts by WITS & QIT Conducted regionally participants from different levels within the health system including DED,RAS,RMO,RHMT,RQIFP,DMO,CHMT,CHSB,MO/ic, hospital complaints officer, regional coaches/mentors (adapted from the coaching concept to improve QI)

4. Enforcing Communication Good communication practices with clients, health workers and other stakeholders Including listening, understanding, asking questions, showing empathy. Good body language, facial expressions, eye contact, arms gestures Reflecting back to the speaker Suitable environment to allow privacy and effective listening

5. Managing Internal communication through Critical Incidents Reporting System (CIRS) What are critical incidents How to establish the CIRS system How to analyze critical incidences and steps to avoid reoccurrences How can critical incident reporting system improve health services How to encourage staff to report critical incidents

6. Managing Critical Incidences Reporting System (CIRS)

7. Effectively Managing Complaints

8. Template for Action Plan for QI activities Problem Priority: System Strengthening Intervention / Solution Activities Date Start: Finish: Resources needed Responsible Person/s/assisted Output / ResultsMeans of verifications

9. Client Service Charter (CSC) National charter was developed in 2005 never fully implemented and was not adapted to district level Korogwe being one of the first districts to adapt the charter to reflect local needs and concerns, this is followed by others including Geita, Nyan’hwale, Msalala, Ushetu, Kondoa, Chemba, Mbozi, Kalambo and Sumbawanga

10. Frequent Comments on Charter Draft More transparency of fees and services Services should be provided in a timely manner Make providers’ rights more specific Facilities should be a corruption-free environment Use respectful language when speaking to patients

11. Voices from the process “By having this Charter it will make the District Council accountable because they know that they have a contract with the community who are aware of what should be done for them.” Chair, Social Welfare Committee, District Council,Korogwe

12. Key messages of the CSC Mutual respect between service providers and service seekers Patients rights and responsibilities Provider rights and responsibilities Standards of services Standards of ethical conduct Accountability,feedback and complaint mechanism Ongoing maintenance of the charter

13. Steps in local charter adaptation At district & facility levels: Select charter committee Review MoHSW/existing charter Develop new draft of charter Solicit feedback from multiple stakeholders through comment forms & community meetings Integrate comments in charter Seek approval by District Council Disseminate, implement & monitor Make revisions as needed

14. Conclusion Charter will push for change and reinforce accountability if well understood and supported/implemented by health care leaders The community awareness of what is expected from their service providers will have confounding effects on demand and supply Health workers awareness of their rights and obligations will bring comfortable working conditions and understanding boundaries in service provision Transparency of community and providers relations, standards of service will push for improved services and quality management A well disseminated CSC with shared experiences of its implementations can be used in forums such as Leadership Training to allow upscale and wider understanding of managers on the benefits, challenges and importance of having a CSC within their health facilities.

15. THANK YOU FOR LISTENING!