Implementation of Merged HEP Services and H
Unit at Primary care Level
Table of Content
✓Implementation of Merged HEP Services
✓HEP unit at Primary level of care
Session Objectives
Session objective:- by the end of this session participants will be able to:
✓ Explain the implementation processes of merging HEP
services/health posts
✓ Describe the implementation processes to establish the HEP unit
✓ Discuss the structure and functions of a HEP unit at Primary level of
care
Brainstorming
✓ Be in pair and brainstorm the following questions;
✓ Do you have experience merging health posts in any of the health
centers/Primary Hospitals in the woreda?
• If yes, please share your experience (the implementation steps you applied,
the challenges).
• If no, what are the anticipated challenges of merging health posts with the
supervising health centers? What do you propose to overcome the
challenges?
✓ Time : 10’ for discussion and reflection
Implementation of merged HEP services
✓ As indicated on the HEP optimization roadmap, HPs located within the same
vicinity with HC or PH is merged with either of them.
✓ To facilitate smooth implementation, it is advisable to engage all stakeholders
through the processes
✓ The steps to implement the health post merging are as follows:
• Provide orientation to and agree on the rationale with HEWs
• Provide orientation to the HC/PH management members and staff
• Engage Kebele cabinets
• Engage community
• Prepare HEP unit at the HC/PH
Implementation of merged…
✓ Service delivery approach: - All the HEP services must be delivered to the catchment population
through
• The HC,
• Household visits, and outreach schedules,
• HEWs are mainly required to deal with outreach health activities, and health promotion
activities at household and community levels and facilitate referrals to HC.
• Other HEP services such as ICCM/CBNC, family planning, DOTs, etc will be integrated with the
HC services.
✓ HEWs will provide services under their scopes such as IMNCI/ICCM, FP, and EPI…. at the health
center in collaboration with the health center staff.
✓ But, the time they spend at the health center will be limited-1-2 days a week.
✓ HEWs need to spend remaining time providing outreach, house-to-house services, data
management, and review and experience-sharing meetings.
✓ A team-based service delivery approach will be applied for a facility, outreach, community-based,
and household health service.
Implementation of merged…
✓ Administrative and technical support from the health center: -
• The HEWs are directly accountable to the HEP unit head and
• The HEP unit head at the health center is responsible for coordinating and
supervising the day-to-day activities of the HEWs including administrative
issues.
✓ The HC will prepare a dedicated office for HEWs which they use to organize data
and reports.
✓ The HEWs must be managed as HC staff on HR management issues.
✓ The HC staff will continue providing regular SS, coaching, and mentorship support
to the HEWs during community & home-based outreach HEP services.
Implementation of merged…
✓ Direct involvement of the HC staff is needed;
• In capacity building for the community-based structures,
• Pregnant women conferences,
• Multi-sectoral engagement,
• Different campaigns,
• School health services, and
• Model kebele creation activities.
✓ During the monthly review meeting at the PHCUs, the HEP performance of the
kebele should be reviewed along with other HPs focusing on community-based
services.
✓ The HEWs are expected to develop and submit their respective weekly, monthly,
and quarterly plan and reports to their supervisors.
Group Discussion
✓ Be in 4 group and discuss the following questions & write your response on flip
chart
✓ What is HEP unit?
✓ What would be the roles of the HEP unit?
✓ What are the challenges of establishing and implementing a HEP unit?
✓ Time allotted: 15’ for discussion & 15’ for reflection
HEP Unit at the Primary care Level
✓ The HEPO Roadmap indicated every HC and PH should establish a HEP Unit.
✓ The main purpose of the unit is to provide the required technical, managerial,
financial, and logistical support to the Health Posts
✓ The unit shall be headed by the deputy director of the health Center (HC) or HEP
focal point.
✓ Quality focal can lead the unit at PH; referral focal, planning and pharmacy head
of the PH will be member of the unit.
✓ In addition, two technical staff from the health center will be assigned to provide
technical assistance to the unit in addition to their routine tasks.
✓ HEP focal and HEWs will be part of such units where the HPs is merged with the
nearby referral HC or PH.
HEP Unit …
Woreda health office & Governing
board
PHCU Director
Disease prevention & Outpatient Finance, procurement & Human resource
MCH HMIS
HEP service logistics management management
ART and TB Medical Laboratory
HEW/HEP
clinic record
Pharmacy Facility Finance & General
management casher service
OPD
Emergency
Procedure
Triage & liaison Medical Equipment
&Facility Management
ANC,PNC
Delivery EPI <5 Clinic
& FP
Key functions of HEP Unit at HC
✓ Developing a joint planning
✓ Facilitate performance-based incentive systems
✓ Prepare a budget plan for HPs and follow up on
✓ Coordinate need-based training for HEWs
its implementation.
✓ Coordinate community engagement in PHC
✓ Coordinating technical support to the catchment
health posts ✓ Coordinate experience-sharing visits within and
✓ Coordinating regular review meetings at the HC
out of the PHCU for catchment HEWs
✓ Prepare basic data of all health posts
✓ Strengthening the network of care between
hospitals, health centers, and health posts ✓ Ensure e/CHIS is established in all health posts
✓ Improving referral systems ✓ Collect, organize, and analyze routine service
✓ Improving supply chain systems & ensure the
data of the health posts
availability of adequate medicine, supply, and ✓ Follow up on the performance of health post-
medical equipment reform implementation guidelines.
✓ Establishing linkage with the woreda health ✓ Ensure CSC is implemented in all kebeles
office to get the required support
Key functions of HEP unit at HC
✓Leadership and Governance: planning, SS, Review meeting, linkage, standards, etc
✓Human Resource: PBI, HR requirement, training needs, HRM functions, cross-
learning
✓Finance: budget allocation & utilization, user fee mgt, resource mobilization
✓Drugs, medical equipment's and other supplies: SCM, recording and reporting tool
✓Infrastructure: physical infrastructure, basic amenities, preventive maintenance
✓Service Delivery: functional Referral system, Quality, service utilization
✓CHIS: tools, baseline profile, information use, feedback
✓Community Engagement: Services, CE structures functionality, client satisfaction
Key functions of HEP Unit at PH
✓ Plan, implement, and monitor implementation of mentorship and coaching of key prioritized
health interventions for HC staff
✓ Asses and identify technical capacity gaps of HCs and HPs and organize various capacity
building training at the hospital
✓ Organize technical supervision to the HCs and HPs under its catchment areas.
✓ Organize an out-reach curative and rehabilitative service at the community level
✓ Organize a learning tour at the PH for HP staff
✓ Serve as a referral facility for the HCs and implement an effective referral system using
referral protocols, tools
✓ In areas where there is no HC; lead, coordinate, plan, support, implement & monitor the
implementation of HEP including linkage between the primary hospital, HPs, and communities
✓ Provide appropriate supplies, drugs, and equipment for HCs and HPs as deemed necessary
Thank you!
