FIT scorecard and improving maternal health care services

The FIT scorecard is an eye-opener for advocacy for improved maternal health care services

Amos Ngobeh, a civil society activist working for Partners in Rural Development (PARD-SL) in Kailahun district has said Facility Improvement Team Assessment Scorecard (FIT) “is an eye-opener” to be used by  civil society to advocate for improved maternal and new born health care in the country.

He made this statement on Friday 3rd February, 2017 during the CSO engagement session organized by PMEL- Options- The session was facilitated by Sowo Lebbie, Community Engagement and Accountability Advisor and Daniel Kamara Programme Coordinator.

The engagement in Bonthe attracted the attendance of the District Medical Officer Dr. Samuel Masaquoi, CSO representatives from Health Alert, Health for All Coalition, MAFA, Mothers club, Motor bike Riders, FOCUS 1000, GOAL Sierra Leone, DHMTs, District Council representatives, the media etc. 

The engagement was part of Options “Improving Reproductive, Maternal and Newborn Health (IRMNH) programme” aims to contribute to a reduction in maternal and neonatal mortality in Sierra Leone. 

During the community engagement, participants were made to understand that the Facility Improvement Team (FIT) assessment system tracks the status of designated health facilities in their capability to provide emergency obstetric care for pregnant women and babies.

Daniel Kamara, Programme Coordinator Options during his presentation on FIT to CSOs in Bonthe and Kailahun districts, disclosed that the FIT assessment measures and grades facilities on conditions that provide an enabling environment such as infrastructure and drug supply.He went on to say, FIT looks at seven identified categories, or enablers, which are: water and sanitation, electricity, drugs and supplies, staffing, laboratory, equipment and referrals.

The engagement created an opportunity for CSOs to be informed about the status of designated health facilities in two the districts.The engagement created an opportunity for CSOs to have access and learn about the June, 2016 FIT scorecard. Yoni Community Health Centre (CHCs) in Bonthe district  under performed compared with all the 65th CHCs assessed in the country.

Some of the reasons include:

  • The centre does not have piped born in the labour room
  • No drainage pit
  • No functional laboratory,
  • No access to ambulance services
  • No Community Health Officer and Midwife
  • The centre has incomplete tracer drugs with only one State Registered Nurse and Maternal Child Health Aide nurse.

In Kailahun district, the June FIT 2016 scorecard showed that Pendembu CHC came first meeting greater parts of the FIT enablers except for few challenges in the area of unavailability of laboratory technician.

The scorecards shared with CSOs and DHMTs staff during the community engagement painted a glaring picture that the two districts health systems still have gaps to create an enabling environment for quality health care system delivery for pregnant woman and newborn.

It is important to note that, the meeting on evidence driven advocacy has equipped CSOs with information and evidence about their health needs and health system in the respective districts. They have been empowered to engage communities to participate in a dialogue with health planners at district level by building their capacity to use evidence. It has strengthened the linkages with civil society with existing health accountability mechanism and stimulates them to take active part in planning discussions for health services.

Options- PMEL made provision for the MamaYe Koinadugu District Advocacy group to share their experience on how their organisation has been using FIT to advocate for quality health care for mothers and babies in Koinadugu district. The Coordinator, Steven Gilbrilla, proudly informed colleague CSOs in Bonthe and Kailahun districts that because of CSOs sustained advocacy using FIT in his district, catapulted Koinadugu Kabala Government Hospital fist in the 2016 FIT assessment in the whole country.

At the end of the community engagement, CSOs in Bonthe made the following commitments:

  • To revamp the Bonthe district CSOs health coalition which has not been effective for over a year in advocating for quality health care in the district
  • CSOs in the Island and mainland have agreed to work together in sharing their activity plans to avoid duplication of activities and support each other’s efforts
  • To form media committee within the coalition that will champion advocacy on radio and communities
  • Engage community  radio station owners for the allocation of air time on health advocacy in the district

CSOs in Kailahun district made the following commitments:

  • Hold radio discussion focusing on FIT assessment which was done  on SLBC radio 95.1fm after the community engagement
  • They made commitment to continue engaging the media
  • Discuss FIT during their district CSOs meetings
  • PRO for the Kailahun District CSOs Movement has taken the lead to coordinate CSOs in advocating for improved maternal health in the district
  • Calls on Options to inform stakeholders at national levels to allow district level CSOs to take part in the next FIT assessment
  • Engage communities to support health workers with accommodation.
  • Options to ensure that the drug procurement and distribution agencies are represented in RCH TCC meetings. So that feedback on drug distribution challenges will be discussed

Options community engagements in Bonthe and Kailahun districts have propelled CSOs to take urgent action in raising evidence based advocacy for better health for women and children. It is no secret that mothers and babies are the most vulnerable people in society where health service delivery is weak to meet their health needs.

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