SERVICE INTEGRATION

Objectives: at the end of the session, the student should be able to:

Define integration

Enumerate the ad van tapes of integration

Identify factors that will facilitate integration

Explain the reasons for non-integration in primary health care.

DEFINITION:

 Integration is the provision of all health services, that is Primary Health Care components, everyday, all the lime and tinder the same root.

ADVANTAGES

The advantages of integration are:

ü  It prevents wastage and duplication of services and this avoids role conflict.

ü  It enhances good patient flow

ü  It promotes availability and accessibility of health care It promotes service coverage

ü  It reduces the clinic waiting time for patients. It saves the time of the clinic staff

ü  It sustains the interest of the community V/ it makes health care delivery most individualized and
acceptable, for example patients for family planning.

ü   It enhances economics use of human, financial and material resources.

ü  It gives job satisfaction for the health workers

FACTORS THAT WILL FACILITATE INTEGRATION

ü  Orientation: A proper orientation fall that are concerned owith the planning and execution of Primary Health Care to the concepts of integration.

ü  A good and comprehensive health team.

ü  An efficient logistic and support system

ü  An efficient and effective information system An efficient administration

ü  Committed village, facility, district/LGA Development Committees

ü  Sustained drug revolving account

ü  A functional monitoring and evaluation system

ü  Adequate political commitment to integration of service.

 
REASONS FOR NON-INTEGRATION SERVICE PRIMARY HEALTH CARE

i. Lack to team spirit (collective team work).
ii. Ineffective communication system.
iii. Inadequate knowledge on the importance of service integration
iv. Poor governmental organization.
11. Resistance to change particularly among adults.
vi. Lack of political commitment to programmes.
vii. One to selfish gain of worker.

                                                                 JOB DESCRIPTION
Job description is a description of job to the holder. It explains to the job holder his authority, that is, his or right to make decisions and his responsibility, that is the degree to winch he is expected to achieve something.

                                                REASONS FOR USING JOB DESCRIPTION

 To encore that an individual worker r job holder can easily recognize his or her duties and responsibility.

To explicitly set what standards the job hold or worker is expected to reach or maintain.

To show whose work he is to supervise.

                             THE USES OF JOB DESCRIPTION

ü  It serves as a valuable tool for organizing work activities amongst team members.

It makes sharing of activities for team members easy. This is so because every member’s responsibility is usually stated in clear terms.

ü  It helps each health worker to know clearly and without doubt his duties and what he is expected to achieve. Not only does a job description tell the job holder his responsibilities, it also stipulates the expected work standards to reach or to maintain.

ü  Job description helps to prevent arguments between workers as to who should do what.

ü  Job description also helps in the distribution of equipment needed to do the work, because as the jobs are being distributed, equipment needed to execute each job is usually distributed at the same time.

ü  Job description prevents both gaps and overlaps of work and confusion that could arise from non-distribution of work. Gap in work exists where certain jobs areas are not distributed among team members while work overlap refers to a situation whereby a particular responsibility is assigned to several workers simultaneously.

ü  A Job description helps to identify the training needs of job holds. Take for instance, if after a job assigned to a team member and the member was fOund wanting in the performance of the task, then the job holders' inability to perform that task acts as a pointer to the manager that the job holder needs training for the acquisition of the skills needed to perform (lie task. Examples of skills include: administration).

ü  Job description forms the basis for evaluating team members' performance. Job description already explicitly sets the job holders’ responsibility and work standards; these now form the basis for evaluating the job holder.

ü  Finally, job description helps to guide work organization. This means that, it guides the organization that uses it it is pertinent to mention that although there is job description it should be interpreted as being flexible to some extent between the team members.

                                  THE CONTENT OF JOB DESCRIPTION

1.      Job Title: This refers to the title of the job holder, that is, the person to do the job, for V instance, ‘titles like “staff nurse midwife" or “community health office?.

2.         Date is usually stated: The date job is expected to commence and end.

3.         Job Summary: A brief summary of the main responsibilities of the job holder forms an essential part of a job description.

4.       Duties: Job duties should be an identifiable entity, for example duties like dressing’s injections.

5.         Relations: Relations in job description explains the title of t the person the job holder is accountable to and the title of the person whose work lie is to supervise, it clearly shows areas of responsibility and accountability of the job holder.

6.         Qualification: This is a section that explains the basic training experiences of the job holder. Take for instance; the professional qualifications of the community health officer would include a Diploma in community health care.

7.         Training and Development: The training and development section of the job description describes the need for further training and development for the job holder. Every job description should have a programme for further training and development.

8.      Review and Appraisal: This section of the job description, describes the 'process for reviewing and appraisal of performance of job holder, for example the use of annual evaluation report or forms or the confidential report, even the recommendations for change of duty or promotion.

 TOTAL QUALITY MANAGEMENT IN PRIMARY HEALTH CARE INTRODUCTION 

              Total Quality Management (TQM) is a management concept that directs the efforts of all employees and managers of an organization towards customer satisfaction by continuous improvement of customer services.
             “Total" implies that everyone in the organization i.e. Drivers, cleaners” VHW/TBAs. CHEW, CHO must be involved to ensure quality service. “Quality" implies that the services to delivered must meet the minimum acceptance quality standards (or exceed it). The Oxford English Dictionary defines quality as the degree of excellence” and the relative nature or "kind of character.
                  Juran 1964 define it as “Fitness for purpose" Crosby 1979 “conformance to specification." while Goings 1995 defined is doing the right thing right, right the first time.