Delivering Quality SRH Services through use of SMARTCARE: FHOK’s experience with eCMIS
In 2010, Family Health Options Kenya (FHOK) which is IPPF's Member Association in Kenya shifted from service-oriented data collection to the use of client cards, then to a fully client-based system (CMIS) that involves data capturing and reporting. This electronic data management system is called ‘SMART Care’.
The rationale for the use of the electronic data management system was that, with stakeholders demanding accurate client-related data, and FHOK geared at moving towards performance-based funding, its clinic systems therefore needed to be those that could efficiently support providers in managing client flow whilst providing quality care.
The implementation of the SMART Care system began with a pilot that was initiated in five FHOK clinics distributed across the country. They were:
- Family Care Medical Centre Nairobi West
- Family Care Medical Centre Nakuru
- Family Care Medical Centre Ribeiro
- Family Care Medical Centre Mombasa
- Family Care Medical Centre Meru
- Formation of a CMIS team to spearhead resource mobilization, training and implementation of the system. They included: Director of clinic services, the Monitoring & Evaluation team, GCACI Project Manager, IT Manager, accountant, internal auditor and Procurement Manager
- Selling the benefits of the system and demonstrating incentives for those involved in its implementation to utilize the system. This included showing them the reports generated by the system, analysis of data entered into the system and a user-friendly graphical user interface
- Creating a sense of ownership and addressing the psychological fears of the service providers before implementing the system. Some of the fears included not knowing how to use a software, possible loss of data, investigations and the general ‘fear of the unknown’
- Inclusion of customized reporting tools to assist in reporting to the various partners i.e. FHOK internal reports, IPPF, Ministry of Health and other donors
- Conducting on-the-job training as opposed to offsite training as the trainees were able to practice with real clients and hence gained hands-on skills
- Regular checking of data by the clinic manager and the team at the head office during facilitative supervisory visits which continues to ensure that service providers are keen to capture the correct data which improves quality
- Integration with SMS system for appointment reminders and client follow-up
- Currently, 14 out of 15 FHOK clinics are utilizing the SMART care system to capture financial, programmatic data and stock management (commodities) data. The use of SMART Care has significantly helped FHOK avoid cases of stock-outs
- The SMART Care system has enhanced accurate and timely collection of data from different service delivery points, which has improved data quality
- The data generated is actively used for decision-making at both clinic and Head office level. For example, the clinic can review data client trends and put necessary strategies to improve performance or make changes
- There has been an increase in service statistics in most clinics since the installation of the system
- Minimized loss of data as the service providers can use one data collection system instead of many registers
- It has helped in the management of human resources at clinic level.
- Previously, the clinics would use client cards, daily activity register, prescription pads and lab request forms. But with the paperless SMART Care system, operational costs have now reduced as the clinic manager can monitor and analyze what is happening in the clinic from his/her office
- here has been reduction in the loss regarding follow up on clients as the system automatically sends Short Text Messages (SMS) to clients to remind them of their appointment
- Most of the FHOK clinics extended their operating hours after review of the system which showed some clients preferred to attend the services after working hours
- Reliability and accuracy of the information collected as it is easier to retrieve data and even verify
“SMART Care has significantly reduced the workload of our service providers when it comes to capturing of essential data in real time, and consequent generation of reports. Through SMART Care, consumer specific reports -MoH, FHOK, IPPF and donor reports are readily generated at the end of each month by our health personnel within a very short time. The system has gone a long way in ensuring quality data and enhancing compliance to reporting timelines within FHOK,” says Esther Muketo, Director, Resource Mobilization at FHOK.
‘If I didn’t receive an SMS reminding me of my appointment, I wouldn’t have remembered to come for my family planning resupply” One FP client told a provider
The SMART Care system is one that can be adopted by other Member Associations as it saves immensely on time and money. It has enhanced accurate and timely collection of data from different service delivery points which has in turn improved data quality. Reduced workload is a huge incentive to service providers doing different reports for the different FHOK partners, including the Ministry of Health. Operation costs have reduced and the Clinic Manager can now monitor and analyze what is happening in the clinic from the comfort of his/her seat.
FHOK's social franchising model was identified as one of the Member Association’s Good Practices during the 3rd Cycle of Accreditation. A Good Practice is an activity or practice that has been proven to work and yields positive results. The sharing of Good Practices by IPPF Member Associations offers learning experiences for their counterparts.
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