ST LUKES HOSPITAL JULY 2018 - JUNE 2022 (SHHSP I) and its Eight Health Centers' Strategic Plan - St Lukes Hospital ...
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STRATEGIC PLAN JULY 2018 - JUNE 2022
ST LUKES HOSPITAL
and its Eight Health Centers’ Strategic Plan
JULY 2018 – JUNE 2022 (SHHSP I)
Expanding, Sustaining and Mordenising
St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 i
STRATEGIC PLAN JULY 2018 - JUNE 2022 STRATEGIC PLAN JULY 2018 - JUNE 2022
CONTENTS
LIST OF FIGURES.......................................................................................... 2
ACKNOWLEDGEMENTS............................................................................... 3
ABBREVIATIONS/ ACRONYMS....................................................................... 4
FOREWORD................................................................................................ 5
INTRODUCTION........................................................................................... 6
ORGANISATION FRAME WORK..................................................................... 9
GOVERNANCE AND LEADERSHIP................................................................. 9
MISSION, VISION, CORE VALUE STATEMENTS................................................. 10
DOCUMENTS REVIEWED.............................................................................. 11
METHODOLOGY
I. ENVIRONMENTAL ANALYSIS.................................................................. 11
II. POTTERS FIVE FORCES......................................................................... 12
III. STAKEHOLDERS MAPPING AND ANALYSIS.............................................. 13
IV. ORGANISATION ANALYSIS.................................................................... 14
V. RESOURCE AUDIT FOR ST LUKE’S HOSPITAL & HEALTH CENTRES.............. 15
VI. POTTERS VALUE CHAIN......................................................................... 16
KEY DRIVERS FOR CHANGE FOR ST LUKE’S & HEALTH CENTRES...................... 18
STRATEGIC GOAL........................................................................................ 19
GHANTT CHART FOR ST LUKE’S HOSPITAL...................................................... 26
HEALTH FINANCING..................................................................................... 29
REFERENCES............................................................................................... 32
APPENDICES............................................................................................... 33
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ACKNOWLEDGEMENTS
LIST OF FIGURES
1 ST LUKE’S HOSPITAL ANNUAL REPORT 2016/17................................................... 8
2 ORGANIZATION FRAME WORK.......................................................................... 9 mentioned above and those that have not been
mentioned. Since its establishment St Luke’s and
3 GOVERNANCE AND LEADERSHIP....................................................................... 9 its nine health centers has worked together with its
4 SIMPLIFIED VALUE CHAIN FOR ST LUKE’S HOSPITAL.............................................. 17 partners to achieve its mission and vision.
5 SIMPLIFIED VALUE CHAIN FOR HEALTH CENTERS................................................. 17 This process was initiated after the expiry of the
previous strategic plan 2011- 2016, which mainly
focused on structural development. This strategic
plan however is developed from the previous
strategic plan and aims at sustaining, expanding
and modernizing; St Luke’s Hospital and its nine
LIST OF TABLES health centers.
Special thanks goes to CAPRICON Trust for
1 HUMAN RESOURCE STATISTICS........................................................................... 8 financing this project, May God Bless You as we
work together to improve the health of Malawians.
2 SHHC STAKEHOLDER ANALYSIS.......................................................................... 13
May God Bless you all as we begin a new journey
3 SUMMARIZED SWOT ANALYSIS........................................................................... 14
from 2018 to 2022
4 RESOURCES NEEDED........................................................................................ 15
5 GHANTT CHART................................................................................................ 26
The process of developing St Luke’s and its eight
health centers has been challenging and tiresome.
It involved the full participation of management
members of staff, board members, HAC, MOH, Winasi Boma
CHAM, local and international partners and all PRINCIPAL HOSPITAL ADMINISTRATOR
other stakeholders.
It is worth noting that each one participated fully to
this process and therefore wish to thank each one
THIS STRATEGIC PLAN HOWEVER IS DEVELOPED
FROM THE PREVIOUS STRATEGIC PLAN AND AIMS AT
SUSTAINING, EXPANDING AND MODERNIZING; ST LUKE’S
HOSPITAL AND ITS NINE HEALTH CENTERS.
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ABBREVIATIONS / ACCRONAMES FOREWORD
ADUS Anglican Diocese of Upper Shire
AIDS Acquired Immuno-Deficiency
NGO
NND
Non-Governmental Organization
Neonatal Death MESSAGE FROM THE BOARD CHAIRPERSON
Syndrome NRU Nutrition Rehabilitation Unit
ANC Antenatal Care In SHHSP, the main target is to sustain, expand and
OPD Out-Patient Department
ART Anti-retroviral therapy modernize the health services. On sustainability,
PACAM Palliative Care Association of Malawi
we realize the need for continuity of health
ARTI Acute respiratory tract infection PITC Patient Initiative Opt out Testing and
services. So, this paper therefore outlines how
ARV Anti-retroviral Counselling
sustainability issues will be tackled in the next
BBA Born Before Arrival PCU Palliative Care Unit
five years. In Modernizing, we realize the need
CHAM Christian Health Association of Malawi PHA Principal Hospital Administrator
for modern infrastructure equipment technology
CO Clinical Officer PHC Primary Health Care and knowledge for us to survive the dynamics as
CS Caesarean Section PLWHA People Living with HIV and AIDS we continue to provide the health in the next five
DHO District Health Officer PMTCT Prevention of Mother to Child years. Growth is essential therefore the facilities
DDS Drug Distribution Service Transmission (of HIV) intend to expand its services as well as identifying
EID Early Infant Diagnosis PNO Principal Nursing Officer new sites for new health projects.
EPTB Extra Pulmonary Tuberculosis PPH Postpartum hemorrhage
It is imperative to note that the department works
FSB Fresh Stillbirth PTB Pulmonary Tuberculosis
hand in hand with various partners for example;
HC Health Centre RTA Road traffic accident
the MoH through SLA, CHAM, MACS, CAPRICON
HIV Human Immunodeficiency Virus SAO Senior Administrative Officer trust, St Luke’s Foundation, Anglican Aid Abroad,
HMIS Health Management Information SHHCSP St Lukes Hospital and Health Centres Global Partner, Diocese of Birmingham, USPG,
System Strategic Plan Norwegian Church Aid and many others. Hope
HSA Health Surveillance Assistant SLA Service Level Agreement these partnerships to continue in the next five years.
HSSP II Health Sector Strategic Plan II SMO Senior Medical Officer
HTC HIV Testing and Counselling STI Sexually Transmitted Infection
IGA Income Generating Activities SVD Spontaneous vaginal delivery
KS Kaposi Sarcoma TB Tuberculosis The Anglican Diocese of Upper Shire has three
UMCA University Mission to Central Africa fold ministries namely; preaching the gospel,
LBW Low birth weight
USPG United Society for the Proclamination education and health, of recent cross cutting
MA Medical Assistant
of the Gospel issues have been included in the ministry to
MACS Malawi Association for Christian +Brighton Upper Shire
VCT Voluntary Counselling and testing tackle emerging issues. It is in the pursuit of this
Support (United Kingdom)
ministry that the health department was born for
MCH Mother and Child Health VE Vacuum Extraction
over fifty years the health department continues
MK Malawian kwacha YFHS Youth Friendly Health Services The Right Reverend Brighton Vita Malasa,
to offer quality health services to the population
MO Medical Officer WHO World Health Organization OSF
of Malawi specifically for St Luke’s Hospital and its
MoH Ministry of Health eight health centres namely Nkasala and Chilipa BISHOP OF UPPER SHIRE & CHAIRMAN
MoU Memorandum of Understanding which are in Zomba District, Mposa and Gawanani
OF THE BOARD
MSB Macerated Stillbirth in Machinga district, Matope in Mneno district and
NCA Norwegian Church Aid finally Mpondasi, Nkope and Lulanga in Mangochi
District.
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INTRODUCTION INTRODUCTION
St Luke’s mission hospital and its eight health include basic OPD, maternal and neonatal 53 villages and 1189 expected pregnancies. The consumers for these services are those under
centres which are both primary and secondary health services, currently the facility is under SLA facility offers primary care health services which private insurance, employers insurance and
level institutions is a member of the CHAM facilities with government in only maternal and neonatal include basic OPD, maternal and neonatal health very few on cash basis.
owned by the Anglican Diocese of Upper Shire and health. Minimal User fees are charged for the services which are offered free due to the SLA
d) Partnerships
serves as a District Hospital for Zomba. It has 156 other services. signed with government.
beds, an out- patient and inpatient department, The hospital has partnerships specifically NGO’s
Lulanga HC is the furthest health centre found Nkasala HC is found in Zomba district at Chinsewu
theatre, paediatrics, maternity unit, radiology unit, that pays for specific interest groups. These
in Mangochi district 132km from Mangochi ship trading centre. It has a total catchment population
laboratory, pharmacy, numerous clinics, HIV/AIDS allows customer to receive free service at the
under tradition authority Makanjira, sub TA Lulanga. 20582, serves 62 villages and has 1029 expected
and primary health care services. point of delivery.
It has a total population of 39889, 40 villages, and pregnancies. The facility offers primary care health
The primary catchment population is 50,000 expected pregnancies 1994. The facility offers services which include basic OPD, maternal and e) Donations
persons with a referral population of more than primary care health services which include basic neonatal health services which are offered free
140,000. The names and location of the eight OPD, maternal and neonatal health services. The due to the SLA signed with government. These are made as direct budgetary support
health centres are Mposa, Gawanani in Machinga facility currently is under SLA with government in to cover operational expenses in form of
district, Nkasala and Chilipa in Zomba district, only maternal and neonatal health. cash. Furthermore, donations in kind in which
other partners donate drugs and supplies,
Matope in Neno district and Lulanga, Nkope, and
Chilipa HC is found in Zomba district with a total
FINANCING ST LUKES HOSPITAL AND
equipment, and related supplies.
Mpondasi in Mangochi district. The maternity unit
catchment population of 17112, 18 villages and
HEALTH CENTRES
comprises of the antenatal, delivery rooms, post f) Infrastructure
expected pregnancies of 826.The facility offers 1. Income
natal and theatre.
primary care health services which include basic The organisation receives support from various
Matope HC is one of the oldest facilities which was OPD, maternal and neonatal health services a) User Fees
partners in terms of construction of buildings
opened in 1933 by UMCA missionaries. It is found which are offered free due to the SLA signed with The hospital charges minimal user fees which and maintenances and procurement of large
in Neno district along Zalewa road close to Shire government. are not cost recovery. The charges are made hospital equipment and resources.
river. It serves a catchment population of 11,625 of consultations, drugs, diagnostic services
Mponda’s HC is located in Mangochi district about g) Salaries and Allowances
with an under five population of 3,135 under one and related services. So payments are made
7km from Mangochi . The facility has a catchment
year population of 938, women of child bearing through cash at the point of service or through
The facility receives salary grants from
population of 13000 with 14 villages and 920
age 4,292 and 11 health post at the moment. private medical schemes and insurances. government through CHAM via a memorandum
expected pregnancies. The health centre offers
The facility provides free services at the point of of understanding that has been made by
basic care health services which include OPD, b) Service Level Agreement
delivery curtsey of partners in Health and Neno government and CHAM institutions. Other staffs
maternal and neonatal health services.
DHO. It is a localised universal model approach
The government pays for maternal and are paid by the hospital itself. The hospital also
designed by St Luke’s Hospital, PiH and Neno DHO. Nkope HC; the facility is located in Mangochi neonatal services that are offered to the covers allowances for staff.
Through this approach St Luke’s Hospital maintains District at Nkope mission just along the Lake community. So beneficially receive free care
administrative support of the facility, PiH provides Malawi. It has a total catchment population29979 2. Financial Sustainability
at the point of service from which invoices are
funding for operations and Neno DHO handles with 38 villages and 1499 expected pregnancies. sent to the government for payments. Health service delivery is a cost and the need to
drugs. It as well provides basic out patient services as sustain the services is paramount and essential.
well as maternal and neonatal health services. c) Private Services
Gawanani HC is located in Machinga district, Quality health services only comes from
Liwundi village, TA Mkula with a total catchment Mposa HC; it is found in Machinga district, along The hospital offers private services which are sustainable health services, while maintaining
population of 11,600. It covers 16 villages. . The the lake Chirwa basin, and serves a catchment optional to those that are willing and chooses financial prudence as we go into the future,
facility offers primary care health services which population 23785 who are mostly farmers. It has to be treated as private patients. Most the organisation has to explore other forms of
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INTRODUCTION ORGANISATION FRAMEWORK
income generating mechanisms to reduce challenges of understaffing as illustrated in
donor dependence. This will ensure continued the table underneath. Most vacant positions ST LUKES HOSPITAL
delivery of services to the community, the are technical staff. St Luke’s Hospital and
hospital while it is non profit making need to its health centres have a total number of
adopt business mindset and marketing so as to 414 filled positions against 529 posts on the
offer quality services. This can be achieved by establishment. Most of these are Patient LULANGA NKOPE MPONDASI GAWANANI MPOSA CHILIPA NKASALA MATOPE
the introduction of IGA’s like private clinics but Attendants who are doing task shifting with HC HC HC HC HC HC HC HC
also diversify to other businesses that respond an average of a medical assistant at each Figure 1
GOVERNANCE AND LEADERSHIP
differently to external economic pressures. As health centre and two nurses. There are 3
stated in health sector strategic plan II (HSSP clinical officers, 13 medical assistants, 2
II, 2017) that health financing in Malawi is foreign doctors and 51 nurses, 2 Pharmacy, 4
not sustainable. The proposed strategies are Laboratory, 2 Radiology and 2 dental. Below is
innovative ways to tackle this ticking bomb. a table of the current status at the facilities.
ORGANOGRAM OF ST LUKES HEALTH DEPARTMENT
Below is a sample of annual income for the Facility Total Allocation Total ANGLICAN DIOCESE OF UPPER SHIRE (June 2018)
HospitaL of Staff as Per Number
ADUS
Staff of Staff as HEALTH COORDINATOR
Establishment Present at
St Luke’s College of Lakeshore Health Lakeshore Health
the Nursing Department Department
Facility
St Luke’s 225 193 St Luke’s College of Nursing ST LUKE’S HEALTH DEPARTMENT
Hospital PRINCIPAL TUTOR PRINCIPAL HOSPITAL ADMINISTRATOR (PHA)
Chilipa HC 38 21
Clinical/Medical Services Nursing Services
Gawanani HC 38 21 SENIOR MEDICAL OFFICER (SMO) PRINCIPAL NURSING OFFICER (PNO)
Preventive Health Finance & Administration
Services SENIOR ADMIN OFFICER
Lulanga HC 38 35 PHC COORDINATOR (SAO)
Matope HC 38 25 Clinical Services
CLINICAL Financial Human
Mpondasi HC 38 34 SUPERINTENDENT Pharmacy
Management Resources
Maintenance
Graph 1: St Luke’s Hospital annual report 2016/2017. Services Services
Mposa HC 38 20 PHARMACIST
Services Management
MAINTENANCE
ACCOUNTANT HRMO
3. Human Resources for Health Nkasala HC 38 21 Laboratory Radiology Dental
Services Services Services Nursing Office
Nkope HC 38 44 LABORATORY RADIOLOGY DENTAL Services Services
The hospital realises that human resources
529 414
are essential for the delivery of quality health
services. The facility is facing the same Table 1: Human resource statistics The organization is managed by a board of which act as a link with the facilities.
governors appointed by the diocese, which serves
The hospital realizes the need for good governance
its two year terms. Below the board of governors is
and leadership as it has been stated to be a core
management which is responsible for day to day element in the WHO health systems frame work
running of the hospital. (2007).
In addition to the fore mentioned, the hospital Therefore it will continue to work on its leadership
realize the need for the contribution of the and governance structures to strengthen health
community, therefore all the facilities have HAC delivery.
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THE HOSPITAL MISSION, VISION AND CORE VALUE DOCUMMENTS REVIEWED
VISION I. Heath Sector Strategic Plan II • Externally funding for salaries for all
institutions
II. Anglican Diocese of Upper Shire Strategic
To create communities of healthy people where no one dies from Plan (2016-2020) • Major source of income for Lulanga
community is farming and some find
preventable and curable diseases. III.
ADUS Health Department Strategic Plan small scale jobs in the republic of South
(2011-2016) Africa.
IV. Sustainable Development Goals (2030) • Long distances to banking institutions
MISSION The process utilized a highly participatory approach • The community for Mposa HC mostly
(Appendix 1) and the following: relies on rice farming.
We exist to promote the physical and spiritual well being of all c. Social
people in our catchment area and beyond through preventive and • Early marriages
METHODOLOGY
curative health services that are accessible and of high quality. • Teenage pregnancies
1. ENVIRONMENTAL ANALYSIS PESTEL
• Strong cultural beliefs
a. Political
CORE VALUE • Service Level Agreement
• High illiteracy levels along surrounded
villages of Gawanani HC, Nkasala HC
and Lulanga HC, as most of the people
In line with the healing ministry of our Lord Jesus we exist to show • MoU between government and CHAM
end up in primary schools (STD 8).
love by: • Programs like Malaria and HIV • Sexually active community at risk of STI’s
• In adequate incentives in rural institution due to fishing business at Nkope HC.
• Team work (Lulanga) • Most people believe traditional
• Shortage of technical staff in villages medicine and they delay in seeking
• Good governance and stewardship
health care medicine at Nkope.
b. Economic
• Customer care • Drunkenness and delinquency for
• It’s a mixture of working class, small Matope communitY
• Effective communication scale business people and farmers for
d. Technological
St Luke’s Hospital.
• Strategic management of human resource • Inflation • Change in technology and coming up
of digital medical equipment.
• Source of income for the community at
• Order and discipline Gawanani HC, Nkasala HC and Chilipa • Unavailability of wireless message in
HC is mostly farming. Lulanga.
• Self sustainability • Lack of electricity in Lulanga.
• Matope catchment area, source of
income is mostly small scale farming • Insufficient of mobile networks in
and small scale businesses Lulanga, Nkasala and Chilipa.
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DOCUMMENTS REVIEWED DOCUMMENTS REVIEWED
• Lack of computerized systems in all Luke’s Hospital) • The threat of substitute is high at f. Donors
health centres Mpondas’ due to a large number of g. Partners
• Switching cost is low (St Luke’s)
private clinics, government district h. Hospital Advisory Committee
• Lack of solar backup systems in
b. Bargaining power of Suppliers hospital and private drug stores. i. Anglican Diocese of Uppers Shire
Mpondasi, Nkope, Chilipa and Matope
health centers. • Suppliers determine the price of their • low for lulanga due to distance from j. Suppliers
products. town. k. Employees
e. Environmental
• Switching cost is higher for all facilities. • High in Matope due to private clinics. l. Non Governmental Organizations
• Deforestation along Malosa Mountain. m. The Church
c. Threat of new entrance e. Competitive rivalry n. Training Institutions
• Decrease in water levels at likwenu
• Only small clinics at St Luke’s Hospital. o. District Council
dam, shire river (Matope HC), and • No because St Luke hospital is big
Chilipa. • Threat is minimal due to high capital of compared to small clinics. p. Political leaders
starting a hospital. q. Trade Unions
• Mposa community is at risk of diarrheria • Competition is low because
• There is limited restriction in the opening r. Regulatory bodies
diseases as they are located at the government facilities normally run out
lake Chirwa basin. of private clinics and drug store in all off drugs (Mposa HC). STAKEHOLDER ANALYSIS (POWER AND
facilities except for Lulanga HC due to
• Environmental degradation • Competition is low due to long distances INTEREST GRID)
distance from Mangochi township.
from other facilities. (Nkasala H C)
• High malaria cases due to bases and • Threat of new entrance is high • Partners • Anglican
Mashes. • Competition is high due to community • Donors Diocese of Uppe
at Gawanani as other churches
outreach clinics (Gawanani HC). • Church Shire
f. Legal and government institutions have • Government
• Competition is high for Mpondas’ as • Chiefs
constructed clinics nearby. • Other Donors
• Regulatory institution act as watch dogs • Community
it is located in the heart of mangochi
and do not carry supervisory visits. d. Threat of Substitutes • Health Advisory • Employees
town which has many drug stores and HIGH
Committees • Patients
• Regulatory bodies restrict some services • Customers may buy medicine in shops private clinics.
• Non • Christian Health
in rural areas i.e. dental services (St Luke’s Hospital).
• Competition is low for lulanga HC due Governmental Association of
• Offices of regulatory bodies are far • Customers may opt for herbal to location (132 km) from Mangochi organisation Malawi
away. treatment (Zomba malosa road). town (Boma).
Interest Keep informed Key players
• High cost of registration fee at CHAM. • Vendors selling drugs at the market in • Competition is high at Nkope. • Suppliers • Trade Unions
Mposa.
• Delayed payments of SLA’s 3. STAKEHOLDER MAPPING AND ANALYSIS • Training • Regulatory bod-
• Government clinics offering free institutions ies
2. POTTERS FIVE FORCES List of stakeholders for St Luke’s Hospital and • Political leaders
services (Mposa)
a. Bargaining power of Customers Health centers • District councils
• Customers may opt for drug store and LOW Minimal effort Keep satisfied
• Customers are represented by HAC, a. Government of Malawi/ Ministry of Health
witch doctors (Nkasala).
Zone, regulatory bodies, DHO and b. Christian Health Organization
• Vendors selling drugs at the market, LOW HIGH
Ministry of Health in all the facilities. c. Patients Power
government facilities and private
• They can easily switch to other hospitals clinics for Gawanani HC, Nkope HC d. Community Table 2: Adapted from Eden ans Ackermann
due to a number of private clinics. (St and NKasala HC. e. Chiefs 1998, 122. As cited in Bryson (2003)
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DOCUMMENTS REVIEWED DOCUMMENTS REVIEWED
4. ORGANISATION ANALYSIS 5. RESOURCE AUDIT FOR ST LUKES HOSPITAL AND HEALTH CENTERS
SUMMARISED SWOT ANALYSIS FOR ST LUKE’S HOSPITAL AND HEATLH CENTERS This process was basically done to identify what we have and what shall be needed for the facilities in
STRENGTH WEAKNESS the next five years. This process was further implemented using a standard check list provided by MOH
• B asic infrastructure available (St Luke’s Hospital) • O ld ambulances through JICA. A separate list was used for the health centers and the hospital (2009).
• S teady drug availability and supplies for all • H igh donor dependency The summary is that the facility has most basic equipment. However, most of them are insufficient and
facilities. • O ld infrastructure and equipment
old.
• S taff motivation eg loan and fertiliser. • O ld and non refrigerated mortuary.
• V arious outreach programs like palliative care • Inadequate knowledge in customer care Amongst the equipment, the priority list is described below:
• S pecifics clinics available like high risk amongst staff.
antenatal. • S hortage of staff NO EQUIPMENT QUANTITIES REMARKS LOCATION
• S taff trainings • Inadequate infection prevention materials. NEEDED
• U niversal SLA at Matope HC • N o backup system Matope, Mpondasi, Nkope 1 Desktop steriliser 5 For health centres that Health centres
• S trong ART at Matope HC and Nkasala health centers use charcoal to sterilise
• G ood mobile clinics at Matope HC • L ack of laboratory machines in health centres equipment
• S killed human resource • O ld maternity building at Mpondasi and 2 Gas cylinders 5 For health centres that Health centres
• G ood laboratory Lulanga HC use charcoal to sterilise
• Income generating activities like PVT ward • S mall NRU for Nkope HC. equipment
• Good
relationship with donors and partners • N o guardian shelter for Gawanani HC and 3 Hemacues 4 To improve HB checks Hospital and health centres
• S LA Nkasala HC. 4 Nebulisers 5 Hospital and health centres
• G ood OPD infrastructure at Mpondasi HC • Insufficient portable water supply and un
5 15 To replace and insufficient Hospital and health centres
• M ale involvement in martenal issues for reliable water supply for Gawanani HC
concentrators especially at
Gawanani HC. • S mall martenity wing at Mposa HC
the hospital
• T eam work • U nreliable water source for Mposa HC
• R eliable power source for Mposa, Chilipa and • Inadequate of staff houses 6 1 To replace the old and worn Hospital
out steriliser.
St Luke’s Hospital. • N eed for dispensary services
• G ood relationship with the community. • D elayed referrals for Nkasala, Chilipa and 7 1 To support the over Hospital
Lulanga HC burdened existing one
OPPORTUNITY THREAT 8 Brocken and damaged Hospital and Health centres
furniture
• NGO’s active in our programms like NRU. • NGO’s recruiting our staff
• D
emand for specialist services like eye and 9 1 Opening of the new eye Hospital
• Decrease in water levels
clinic by the clinician
skin. • Opening of big clinics in Zomba trained equipment like snails
• Many dental patients in all health centres • Village health clinics and private health clinics. charts, ophthalmoscope,
• Many NGO’s working with health sectors • Free mobile clinics pen torch, slit lump,
• M
pondasi HC is close to which is ideals for • Poor road, infrastructure and long distance gonioscope are needed
private services
• High donor dependency 10 MVA sets 7 Improve post arbotal care Health centres
• High catchment population for Lulanga HC
• Delayed referrals for Matope HC 11 Assorted theatre assorted To promote surgical care Hospital
• Mpondas’ is close to the main district hospital. instruments and introduction of new
• Fence for all health centres procedures
• Erosion of the lake for Nkope HC. 12 Angle pole light 10 To be used in Hospital and Health centres
• Government and private clinics. gynaecologicalcare
Table 3: Summarised SWOT ANALYSIS
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DOCUMMENTS REVIEWED SIMPLIFIED VALUE CHAIN FOR ST LUKES HOSPITAL
NO EQUIPMENT QUANTITIES REMARKS LOCATION
NEEDED Orthopedics
13 Heavy duty waste bins 20 To promote waste Hospital and health
management centres
14 Trolleys 15 Patient transport Hospital and health Private OPD
Cashier & consultation
centres
15 Wheel chairs 15 Patient transport Hospital and health
Laboratory
centres
16 Delivery beds 10 Ordinary beds are used as Hospital and health
deliveries in most facilities centres General OPD HMIS Phamarcy
Cashier & consultation
which is not ideal
17 Examination couches 10 For consultation rooms in Hospital and health
Admissions
both maternity and OPD centres
18 Delivery sets 90 To improve maternal health Hospital and health Maternity
centres Dental
19 Heavy duty X- ray 1 The current one not working Hospital and health
machine and un repairable. centres HOME
KEY
20 Laboratory fridge 1 Hospital Patients movement
21 Pressing machine 1 Not in condition Hospital Figure 4 patients going back after
Table 4: Resources needed
SIMPLIFIED VALUE CHAIN FOR HEALTH CENTERS
6. POTTERS VALUE CHAIN
The hospital provides essential health package as prescribed by government of Malawi as well as private
services, which are preventive, curative, rehabilitative and curative.
OPD Laboratory HMIS Pharmacy
Health centers only provide essential health package at primary level without private services. Cashier & Consultation
Maternity Home
KEY
Patients movement from OPD
patients going back for prescription & payment
Figure 5
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KEY DRIVER FOR CHANGE FOR ST LUKE’S
STRATEGIC GOALS
HOSPIAL AND HEALTH CENTRES
After utilizing the above methodologies, the below • Timely salaries FIVE STRATEGIC GOALS 1.2. Strengthening, monitoring and evaluating
listed five items were categorized as priorities for • Staffing of clinical performance
each facility; 1.
Strengthening accessible and quality health
VI. Gawanani HC care CPDs
I. St Luke’s Hospital 2. Sustaining Hospital Buildings and infrastructure Standard and supportive supervision
• Water Supply
• Timely Salaries 3. Developing financially viable institution In house training
• Reliable Electricity
• Customer care 4.
Contribute to the reduction of environmental Research
• Staffing
• Theatre degradation, pollution and water conservation Data analysis
• Timely Salaries
• Mortuary 5. Promoting Good Governance And Stewardship Sustain timely health centre supervision
• Hospital equipment
• Staff houses
VII. Nkasala HC SPECIFIC OBJECTIVES Targets
II. Lulanga HC Maintain quarterly standard and
• Ambulance 1.
STRENGTHENING ACCESSIBLE AND QUALITY
• Ambulance supportive supervision in health centre.
• Timely salaries HEALTH CARE
• Maternity wing Utilize health statistical reports monthly.
• Dental outreach clinic 1.1. Improving Human resource performance
• Outreach and private clinic 100% data complete and timely going
• Guardian shelter
Training (short i.e In house, to the DHO 2018 by June 2018.
• Timely Salaries
• Staffing
upgrading Perform scheduled death audit on
• Communication
VIII. Chilipa HC weekly basis.
III. Nkope HC Targets
• Ambulance Achieve zero percent maternal mortality
• Ambulance One ophthalmologist to be trained by rate by 2020
• New OPD
• Timely salaries 2019. Improve Neonatal death rate Below
• Timely salaries
• Fence One surgeon to be trained by 2020. national in comparison with CHAM
• Fence
• Dental Outreach clinic One clinician to be trained in pediatrics hospital average by 2020
• Staff houses
• Customer care by 2022. Improve CPD uptake by 100% of clinical
IX. Matope HC 90% nurses to be trained in CPAP by staff
IV. Mpondasi HC
• Water Supply 2019. 1.3.
Enhancing Regulation And Good
• Maternity
• Ambulance 90%of nurses and clinicians to be
Governance
• Fence trained in ETAT and CEMOC.
• Solar backup system
• Hospital Equipment HAC
• Timely salaries 75% of health care workers in customer
• Timely Salaries DHO
• equipment care 2022.
• Staff houses Board of Governors
Retaining
/maintaining staff
establishment by 2020. Ombudspersons
V. Mposa HC
95% of health workers to be trained in Target
• Become Rural hospital
infection prevention by 2020
• Maternity and postnatal Rooms Ensure the organization pay registration
Employing qualified personnel
• New observation room fees and all necessary required
18 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 19STRATEGIC PLAN JULY 2018 - JUNE 2022 STRATEGIC PLAN JULY 2018 - JUNE 2022
STRATEGIC GOALS STRATEGIC GOALS
payments to all regulatory bodies Targets Procure a sterilizer and five desktop
Targets
annually. sterilizers by 2022.
To procure three (Lulanga, Chilipa and Commencing school health beginning
Training healthy advisory committee
Signing contract with relevant engineers 2019
Nkasala) new ambulances by 2022.
members on their roles and concerning repair of equipment.
Create a buffer of drugs and supplies Introduction of Performance quality
responsibilities by 2020. Investigating insurance options
for
for at least a month by July 2018 improvement by july 2018
Maintaining
managerial meeting hospital equipment by 2021
Lobbying for the revision of staff
Initiate monthly departmental meetings
and financial performance reviews
establishment to meet current needs 1.7.
Strengthening preventable, curable and by march 2018
monthlyy
starting December by 2018. rehabilitative health services. Procurement of PA system by 2020
1.4 Developing good customer and supplier Increase number of partnerships from Introduction of occupation
health
Strengthening information education
relation two to at least four by 2020. services by December 2019.
and communication in schools and
Flow of patients Lobby for sustainable service level
surrounding community Improving ophthalmology by 2019
agreement partnerships through Introduction of dermatology services by
Reduce waiting time Water inspection
payments once in three months. 2020
Target Commencing school health activities
Opening three outreach clinics and
To investigate options of visiting a
strengthening the already existing ones Procuring of Public Address system
Conduct annual patient satisfactory
specialist by 2021
by 2020. Doctors visit
survey. Have presentations on proposal and
Strengthening already existing outreach Training of health care workers on new
Improve patient feedback system researched paper by at least once
clinics guidelines.
Improve patient curing system annually.
Adding new services to the system
Improve patient waiting time 1.6. Ensuring quality and sufficient equipment Collaborate locally and internationally
Reinforce critical evaluation of patient with researchers annually.
Patient should not stay more than one Awards care and Incorporating data in patient
hour in the hospital Dissemination
of information
Property insurance care decision
of communicable and non
Adopt a philosophy of
customer
Dryers Promoting research communicable through awareness
orientation by July 2018
Sterilizer Initiate monthly departmental
and campaigns by annually.
1.5.
Improving access, affordability and Enhancing preventive maintenance section meetings Liaising with ADUS water committee to
effective use of health services Strengthen supervision feedback and
enhance water inspection.
Assess and reclaim missing and
Procurement of Ambulances damaged equipment from users. actions.
1.8. Attain an award in infection prevention
Increasing drug supplies and related
To start problem solving Approach
Targets Trainings for every cadre
services Introduce a problem solving approach
Assess and reclaim missing and
Placenta pits and Toilets
Availability of resources during standard and supportive
damaged equipment from users. supervisions. Increase IP equipment
Partnerships i.e. SLA, PIH
Reinforce awards to be giving health Improve efficiency of doctor’s visit by Maintain and sustain high standards of
Strengthening
and opening of infection prevention
care workers beginning 2018 and at planning a head at least a day before
Outreach clinics
least once annually. and follow up on requests and leaving Construction of fence
Procure one dryer by 2021. on time.
20 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 21STRATEGIC PLAN JULY 2018 - JUNE 2022 STRATEGIC PLAN JULY 2018 - JUNE 2022
STRATEGIC GOALS STRATEGIC GOALS
Targets Construct a New theatre by 2019 Construction of a dispensary at St Lukes Start chicken production by 2018
Train all health workers in infection
Maintain the postnatal ward for St Luke’s Target Become a Kaizen facility by 2019.
prevention IP by 2019 by 2020. Construct building for rent in Zomba by
Utilize the housing policy fully to Rehabilitate St Lukes Hospital OPD by
Construction of wall fence at Nkope
2022.
December 2018
and Mpondasi by 2022 effectively maintain houses by 2018. Introduce visiting surgeon specialist by
Extend private facilities including private
Score above 80% in both internal
Assessing the need for maintenance
2022
kitchen by 2021
and external infection prevention of staff houses and come up with a
Extend postnatal ward by 2020 3.2. Strengthen internal controls
assessment. list of priority buildings and annual
maintenance plan. Rehabilitate dispensaries of Mposa,
Stock taking
Construction
of placenta
Construct at least two toilets per facility Nkasala, Gawanani and Chilipa
pitandincinerator forgawanani health Internal and external audit
by the 2021 dispensary by 2022.
centre by 2022. Reports
Construct
new incinerators for Extend the radiology department by
2.
SUSTAINING HOSPITAL BUILDINGS 2022. GPS tracking of vehicles
Gawanani, Mpondasi and Mposa by
AND INFRASTRUCTURE 2021. Construction of a dispensary at St Luke’s Inventory management
by 2020. Targets
2.1. Constructing new building in area where Build guardian shelter at St Luke’s by
the current systems are old and congested 2019 3. DEVELOPING FINANCIALLY VIABLE Conduct stock taking quarterly.
Construct new private admission
HEALTH SYSTEM
New Mortuary To conduct external audits annually by
building at Mpondasi health center by
New Maternity Wings 3.1. Investments 2018
2022
Fence Opening of Clinics and three drug
Strengthen reporting systems by 2018
Liaise with the Anglican Diocese of
New OPD Upper Shire on leasing land in Lilongwe stores. Installation of GPS tracking system by
Theatre by 2021. (Ntcheu, Mneno and Balaka) 2022
Postnatal Construct dental clinic in Ntcheu by
Rearing of Chickens Strengthen inventory management by
Staff houses 2021. Filling Station December 2018
Incinerators and toilets Building to rent out in Zomba 3.3.
Ensure salary funding independent from
2.2.
Maintenance and face lifting of
Guardian Shelter infrastructures Explore for visit Surgeons the partner
Having activity based budgets Opening of Clinics and three drug
Targets OPD
To become a Kaizen institution stores.
Construction of new mortuary for St
Health centerdispensary
Staff houses Target (Ntcheu, Mneno and Balaka)
Luke’s by 2020
Corridors Rearing of Chickens
Build new maternity wing for Lulanga, Opening of three pharmacy/drug store
Mposa, Mpondasi and Matope by Postnatal Building in Ntcheu, Mneno and Balaka by 2021 Filling Station
2022 Extension of the private wing Opening of outreach clinic in Lulanga Building to rent out in Zomba
Construct a fence for Nkope by 2021 Extension of postnatal ward by 2021 Explore for visit Surgeons
Build a new OPD for Chillipa by 2021 Extension of radiology department Opening of filling station by 2022 Having activity based budgets
22 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 23STRATEGIC PLAN JULY 2018 - JUNE 2022 STRATEGIC PLAN JULY 2018 - JUNE 2022
STRATEGIC GOALS STRATEGIC GOALS
To become a Kaizen institution Targets Promote activities of HAC, customers,
Communicate job descriptions bi-
DHO, staff,etc… annually during performance appraisals
Target Formulate water committees in all
facilities by 2019 Production of annual financial reports Ongoing sensitization to the community
Opening of three pharmacy/drug store and employees on their rights and
Ensure proper disposal of waste in all Involving stakeholders’ in activities such
in Ntcheu, Mneno and Balaka by 2021 responsibilities.
facilities by digging rubbish pit and as open days
Opening of outreach clinic in Lulanga
procure heavy duty bins by 2020 Targets 5.4.
Incorporate the Rule of Law in the
by 2021
Plant 200 trees each year at each management of the organization
Opening of filling station by 2022 Conduct quarterly engagement HAC,
health centers through HAC DHO, staff and customer meetings. Ensure the organization is registered with
Start chicken production by 2018
Continue producing financial reports
necessary regulatory bodies
Become a Kaizen facility by 2019. 5.
PROMOTING GOOD GOVERNANCE
and sharing it to both local and Recruiting qualified and registered
Construct building for rent in Zomba by AND STEWARDSHIP
international stakeholders annually. employees with their registered bodies
2022.
5.1. Enhance transparency and Organise St Luke Hospital open day on Ensure the organization is registered as
Introduce visiting surgeon specialist by accountability annual basis. a legal entity
2022
Timely submission of reports Targets
4. CONTRIBUTE TO THE REDUCTION OF 5.3.
Ensure delegation and segregation of
Updating and communicating clear
duties among bodies of institution. Renew annual registrations with
ENVIRONMENTAL DEGRADATION,
governing procedures necessary relevant bodies.
POLLUTION AND WATER Participate in quarterly board meetings
CONSERVATION Reinforcing adherence to rules and
Reinforce the recruitment of qualified
Ensure monthly management
and
regulations and registered employees annually.
4.1. Reduce Environmental Degradation financial meetings
Initiate annual external audits
Encourage
monthly departmental 5.5. Introduce risk management activities
Planting trees Targets meetings Initiate property and life insurance
Sensitization campaigns
100% of the reports have to be
Reinforce
quarterly general staff Initiate formulation of risk management
Targets submitted timely i.e monthly, quarterly meetings policy
and annually. Communicate job descriptions Maintain active emergency response
Plant 500 trees each year at Malosa
Updating and communicating clear
Sensitize the community and employees committee
Mountain.
governing procedures quarterly by on their rights and responsibilities Ensure occupation safety and health
Carry out on going sensitization
December 2019. guidelines
campaign on importance of tree Targets
through the water committee. To reinforce adherence to rules and
Participate in board
of governors Targets
regulation on quarterly basis starting meetings quarterly. To initiate property and life insurance by
4.2. Preserve water resources July 2018
Conduct monthly management and
2022.
Formulate water committees Engage an auditor for the next three financial meetings To formulate risk management policy
Procure and use ozone layer friendly
years by June 2018. by 2021.
Conduct
departmental meeting
equipment 5.2.
Encourage stakeholders’ participation monthly. Ongoing active emergency committee.
Ensure proper disposal of waste in decision making and running of the Organize
quarterly general staff Develop occupation, safety and health
Plant trees organization meetings. guidelines by 2021.
24 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 25STRATEGIC PLAN JULY 2018 - JUNE 2022 STRATEGIC PLAN JULY 2018 - JUNE 2022
GHANTT CHART FOR ST LUKE’S HOSPITAL AND GHANTT CHART FOR ST LUKE’S HOSPITAL AND
HEALTH CENTERS HEALTH CENTERS
NO Activities Responsible 2018 2019 2020 2021 2022 NO Activities Responsible 2018 2019 2020 2021 2022
person person
1 3 Ambulances PHA 33 Enhance housing policy HRMO
2 Create a buffer of drugs and supplies SMO/SAO 34 Preventive housing maintenance plan Maintenance
3 Lobbying staff establishment HRMO supervisor
4 Partnerships PHA 35 Two toilets each facility SAO/ EHO
5 Service Level Agreement PHA 36 Incinerator and placenta pit for EHO/SAO
mpondasi HC
6 Out reach clinics EHO
37 Incinerator and placenta pit for mposa EHO/SAO
7 Health care awards Management
HC
8 Washing machine and dryer PHA
38 St Luke’s guardian shelter PHA/MO
9 Steriliser and Desktop steriliser PHA/SAO
39 St Luke theatre PHA
10 Insurance options Accountant
40 Rehabilitation of St Lukes OPD PHA &
11 School health EHO Maintenance
12 Initiate performance quality Management supervisor
improvement 41 Extend private facilities at St Luke’s PNO& SAO
13 Initiate monthly departmental meetings Management 42 Rehabilitate despensaries Mposa HC SMO & SAO
14 Public Address system EHO/SAO 43 Rehabilitate despensaries Nkasala HC SMO & SAO
15 Occupation health EHO 44 Rehabilitate despensaries Chilipa HC SMO & SAO
16 Ophthalmology SMO 45 Rehabilitate despensaries Gawanani SMO & SAO
17 Dermatology SMO 46 Extend radiology department PHA, SMO &
18 Specialist services SMO Radiology in
19 Research presentations Management charge
20 Disease awareness campaigns EHO 47 Construction of dispensary at St Luke’s PHA & SMO
21 Infection prevention training PNO 48 Private pharmacies Ntcheu Accountant
22 Wall fence for Nkope HC PHA/EHO 49 Private pharmaciesBalaka Accountant
23 Wall fence Mpondasi HC PHA/EHO 50 Private pharmaciesMneno Accountant
24 Attain IP award Management 51 Out reach clinic Lulanga HC EHO, Incharge,
& SMO
25 Placenta pit and incinerator Gawanani EHO/SAO
HC 52 Filling station Board Chair-
person & PHA
26 Mortuary st Luke’s PHA
53 Chicken production EHO
27 Martenity wing Lulanga HC PHA
54 Become Kaizen facility Management
28 Marteninty wing Mposa HC PHA
& Staff
29 Martenity wing Mpondasi HC PHA
55 Construction of building for rent in Zomba Board Chair-
30 Martenity wing Matope HC PHA city person & PHA
31 OPD Chilipa HC PHA 56 Stock taking Accountant
32 Maintenance St Luke’s postnatal SAO 57 External audit Accountant
26 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 27STRATEGIC PLAN JULY 2018 - JUNE 2022 STRATEGIC PLAN JULY 2018 - JUNE 2022
GHANTT CHART FOR ST LUKE’S HOSPITAL AND
HEALTH FINANCING
HEALTH CENTERS
NO Activities Responsible person 2018 2019 2020 2021 2022 2018-22 ACCOUNTING CALENDARS FINANCING DECISIONS
58 Reports HMIS Coordinator
59 GPS tracking systems SAO Projected Income
60 Inventory Management Accountant & Asset
officer All figures are to the
nearest MK’000million
61 Training of an ophthalmologist HRMO
62 Training of a Surgeon HRMO Income Projected 2018 2019 2020 2021 2022
63 Paediatrics specialist HRMO
Medical User Fees 227,771,584 415,704,673 452,044,879 487,168,766 514,791,235
64 Nurses CPAP training HRMO & PNO
65 Nurses and clinicians ETA training Coordinator of Service Level Agreement 75,932,517 85,095,611 94,516,348 105,090,892 115,580,016
Coordinators Private Services 39,074,718 48,843,398 61,054,247 76,317,809 95,397,261
66 Customer care training Management Donations 97,620,900 248,600,143 159,761,276 49,179,628 45,579,628
67 Staff retention HRMO Salaries 632,702,616 727,608,008 836,749,209 962,261,591 1,106,600,829
68 Infection Prevention training EHO & PNO
69 CPD uptake HRMO, PNO & SMO Grand Total 1,073,102,335 1,525,851,833 1,604,125,959 1,680,018,686 1,877,948,969
70 Improved neonatal death rate PNO & SMO
71 Decrease in Maternal health Management Estimated Cash Outflow
72 Weekly death audits PNO & SMO All figures are to the
73 Health statistics utilisation Management nearest MK’000million
74 HAC Training EHO
Cash Outflow 2018 2019 2020 2021 2022
75 Monthly management and financial PHA
meetings Salaries 632,702,616 727,608,008 836,749,209 962,261,591 1,156,600,829
76 Fridge Laboratory SAO & Laboratory In Investments 113,300,000 330,200,000 441,500,000 644,700,000 732,900,000
charge
Human Capital Investments 7,400,000 9,170,000 12,710,000 12,710,000 10,940,000
77 Hospital equipment SMO, SAO, PNO &
Non-Current Assets 9,248,620 284,693,517 284,222,620 109,243,620 19,093,620
Accountant
78 Customer care orientation Management Grand Total 762,651,236 1,351,671,525 1,575,181,829 1,728,915,211 1,919,534,449
79 Planting of tree at St Luke’s Hospital EHO &
Management
80 Planting trees in health centres EHO & HAC
81 Staff Houses PHA & SMO
82 Construction of private admission PHA
building at Mpondasi HC
83 Leasing land in Lilongwe PHA & Board
Chaiperson
84 Construction of dental clinic in Ntcheu PHA & SMO
28 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 29STRATEGIC PLAN JULY 2018 - JUNE 2022 STRATEGIC PLAN JULY 2018 - JUNE 2022
HEALTH FINANCING HEALTH FINANCING
BUDGET NOTES b). Motor Vehicles: 2018-22 FINANCING VS INVESTING DECISIONS
In the next five accounting calendars,
Financing Decisions:- 0.2 billion has been allocated for the
i. Salary Grants: acquisition of three hospital ambulances. Financing vs Investing Decisions
In the next five accounting calendars or c). Hospital Equipment:
financial years, salary grants from the Ministry The hospital has allocated Mwk 0.04 billion Cashflow
of Health through CHAM secretariat have for the procurement of various hospital
7,100,000,000 7,200,000,000 7,300,000,000 7,400,000,000 7,500,000,000 7,600,000,000 7,700,000,000 7,800,000,000
been pegged at Mwk 4.3 billion. equipments in the next five financial years.
Investing Decisions Financing Decisions
ii. Hospital Fees: v. Investments:
a). Medical User Fees: a). Income Generating Activities: CONCLUSION
User Fees for 2018-22 financial years have In the next five years, the hospital has
A STRATEGIC PLAN is an intangible asset of an organization, This strategic plan will ensure the accomplishment
been estimated at Mwk 2.1 billion. planned to spend Mwk 0.1 billion on
of the organization Mission and Vision over the whole five year period, therefore its expense cannot be
income generating activities.
b). Service Level Agreement: attributed to a single year only but rather to the whole five year period. Its participatory approach that
The Hospital is anticipating to generate Mwk b). Insurances: stakeholder’s demands are met.
0.4 billion from its Service Level Agreement The hospital has allocated Mwk 2 billion on
with the Malawian Government through various insurance options for its assets in
MoH in the next five years. the next five accounting calendars.
c). Private Services: vi. Human Capital:
Private Service sales from Bishop Malasa a). Salaries:
private wing has been budgeted at
The hospital is anticipating to spend Mwk
Mwk 0.3 billion for the period of 2018-22
4.3 billion on salaries in the next five years.
accounting calendars.
b). Trainings and Seminars:
iii. Donations:
In the next five financial years, the
In the next five years, the Hospital is anticipating hospital has allocated Mwk 0.05 billion on
to receive donations worthy Mwk 0.6 billion intellectual assets.
from its partners for various projects and
activities.
Investing Decisions:
iv. Non-Current Assets:
a). Real Estate:
The Hospital is anticipating to spend Mwk
0.4 billion on real estate in the next five
years.
30 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 31STRATEGIC PLAN JULY 2018 - JUNE 2022 STRATEGIC PLAN JULY 2018 - JUNE 2022
REFERENCES APPENDICES
Government of the republic of Malawi (2017), Health Sector Strategic Plan II, 2017-2022. Towards universal
Health coverage
St Lukes Hospital (2018) annual report for the financial year July 2016 – June 2017. Sustaining, expanding
and modernizing highland and lakeshore health services. APPENDIX I
WHO (2007) everybodies business, strengthening health systems to improve health outcomes…. WHO’s
Frame work for Action.
Bryson, J.M., (2003) What To Do When Stakeholders Matter: A Guide To Stakeholder Identification And
Analysis Techniques’ A Paper Presented At The London School Of Economics And Political Science PROPOSAL FOR THE DEVELOPMENT OF A STRATEGIC PLAN
Jica (2009) Standard Equipment List For Typical District And Health Centre With Generic Specifications For FOR
Some Common And General Equipment, Government Of Malawi; Ministry Of Health
ST LUKE’SHOSPITAL AND ITS EIGHT HEALTH CENTRES
(2017-2021)
SUBMITTTED
BY
WINASI BOMA
PRINCIPAL HOSPITAL ADMINISTARTOR
“EXPANDING, SUSTAINING AND MODERNISING ST LUKES”
32 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 St Luke Hospital and Its Eight Health Centres | July 2018 - June 2022 33You can also read
