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1.       Service Delivery

2.       Health Workforce

3.       Health Information Systems

4.       Access to Essential Medicines

5.       Financing

6.       Leadership and Governance

7.       Health Infrastructure

8.Community Ownership and Participation

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Ward-Based Outreach Teams (WBOTs)

Intergrated School health team

District Clinical Specialist Teams (DCSTs)

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Communication

Patient Education (Knowledge and Understanding) & Health Promotion (Influence and Behaviour Modification)

Poor Staff Attitude

Safety

Infrastructure

Governance Structures & Intersectoral Collaboration

Service Integration (Internally and Externally)

Health Efficiency Indicators - ALOS

Clinical Governance/Outcomes

Long Waiting Times

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Access and Overcrowding

Insufficient Allocation of Financial Resources

Poor Quality Services

Absence of Men’s Health

ProgrammeAccess and Overcrowding

Poor Quality Services

Lack of Financial Resources

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Root causes

Gun Shots, Facial Trauma - GBV

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Multiple Data Collection Tools

Too Many Data Elements

Digital Data Management System

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Root causes

Poor Screening & No Linkage to care

Poor Record Management

Treatment Fatigue

Inter-Professional Care (Dietetics, Podiatrists, Oral Health etc.)

Clinical Governance (Guidelines and Protocols)

PHC Reengineering & Continuity of Care

Increase the of Scope of District Specialist Teams

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•Non-Compliance to SOPs

•Poor Integration of Services

•Risk Management

•Poor Data Management

•Monitoring & Evaluation

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Root causes

•Poor Screening & No Linkage to care

•Poor Record Management

•Treatment Fatigue

•Inter-Professional Care (Dietetics, Podiatrists, Oral Health etc.)

•Clinical Governance (Guidelines and Protocols)

•PHC Reengineering & Continuity of Care

•Increase the of Scope of District Specialist Teams

•WBPHCOT ( Leadership, Governance  and Shortage)
NHLS Related Challenges

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Root causes

•Adherence to Rx

•Late Presentation

•Socio Economic Factors

•TB/HIV Collaboration –Non-Adherence to SOPs

•Poor Linkage to Care

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Adult health is a critical component of the Primary Health Care (PHC) service delivery model, yet adults face numerous challenges across different service packages. These challenges hinder the effective management and integration of care for Non-Communicable Diseases (NCDs), HIV/TB, Trauma and Injuries, and Maternal Health. The plenary commission is tasked with examining these issues to develop strategies that improve adult health outcomes within the PHC model.

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Common techniques used in Root Cause Analysis

1. 5 Whys-A simple, iterative interrogative technique where you ask "why" five times (or more) to drill down into the root cause of a problem

2. Barrier analysis- Identify the barriers that failed to prevent the problem and understand why they failed.

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Steps in Root Cause Analysis

1.Define the problem

2.Gather data

3.Identify possible causal factors

4.Identify the root cause

5.Develop and implement solutions

6.Evaluate the effectiveness of the solutions

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5G approach

1. GAP identification (Problem statement )

2. Granulate (root cause analysis, i.e. Theory of 5 Whys; WHO 8 building blocks)

3. Governance (Leadership and Accountability)

4. Growth (Output and Outcome-based)

5. Green (Outline the sustainability strategies)