USING EQUIST FOR BOTTLENECK ANALYSIS
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1) Cameroon conducted bottleneck analyses in 2013-2014 and 2015-2016 using the EQUIST tool to identify barriers to health coverage and prioritize interventions. 2) The EQUIST tool assesses coverage determinants for deprived populations and prioritizes bottlenecks to address. 3) The 2015-2016 analysis involved multiple stakeholders and provided a more quantitative analysis of severity of bottlenecks compared to previous analyses.
USING EQUIST FOR BOTTLENECK ANALYSIS
- 1. USING EQUIST FOR BOTTLENECK ANALYSIS Cameroon’s experience. Dr. AMANI Adidja MD MPH ENAP FORUM Dakar, 31Oct-‐5th Nov 2016
- 2. PROCESS • 2013-2014 Bottleneck analysis based on the 6 pillars of the health system and the key interventions • More of a shopping list – Severity of bottleneck not quantified • 2015- GFF initiative: Investment case • 2016-Capacity building on Equist for the situational analysis=è>> Sharpened analysis • Review and update the newborn operational
- 3. About EQUIST • EQUIST : The EQUitable Impact Sensitive Tool Medium-term analysis and strategic planning tool to improve child and maternal health as well as nutrition equity in developing and middle-income countries • Assessing coverage determinants for deprived populations • Prioritizing bottlenecks to be addressed
- 4. PARTICIPANTS • The process was highly consulative and participative • MoH: Different Departments, EPI, HIV • Consultants • National Institute of Statistics • Partners: WHO, UNICEF, UNFPA, UNAIDS, WB Bilateral: GIZ • Professional associations • Civil Society
- 5. Coverage Bottleneck Framework Social Norms Availability of essenFal commodiFes Geographic access Financial affordability Social Acceptability Enabling Environment Policies/ legislaFon Budget/ expenditures Governance Ini9al U9lisa9on dis-‐con9nui9on Poor Quality Effec9ve coverage Adequate coverage Non-‐U9lisa9on In-‐accessibility Un-‐affordability Un-‐availability Un-‐acceptability Coverage Determinant Absolute BoDleneck Quality of care Con9nuity & 9ming poor quality/adequate coverage discon9nui9on/u9liza9on Contribu9ng BoDleneck Rela9ve BoDleneck
- 6. BoRle Neck analysis e service
- 7. ADDED VALUE OF THE EQUIST 1. Définir les populaFons prioriFaires 2. Prioriser les sujets de santé 3. Prioriser les intervenFons 4. Prioriser les goulots 5. Analyser les causes des goulots 6. SélecFonner les stratégies 7. EsFmer l’impact et le coût-‐efficacité
- 8. CHALLENGES • Availability of updated validated data for the tool to generate information needed ( Source: DHS, MICs, Child Mortality estimates, coverage surveys,…) • Ability to select the relevant the information generated by EQUIST for the investment plan • Proper use of the tool at the regional and district levels • High speed internet connection needed to use the tool easily • Adolescents: data needed • CRVS : Comprehensive evaluation ongoing
- 9. Lessons learned • Garbage in , garbage out= the quality of data used to populate the tool is very important • Availability of updated validated data for the tool to generate information needed ( Source: DHS, MICs, Child Mortality estimates, coverage surveys,…) • Need to associate districts and stakeholders in the field • enough time for bottleneck analysis and development of scenarios • The technical support should continue countries need to be accompanied all along the process
- 10. Lessons learned • Adolescents health- bottleneck analys was done aside • Improving data quality and completeness upfront should be at the center of the GFF preparation in countries • Search and gather all existing required data well in advance to optimize the time. • Need to collect disaggregated data to have an impact