District Level

Orienting and engaging district health management teams

Once the leaders of the district have been informed and their approval for the initiative to proceed has been obtained, the district health management team needs to be fully briefed on what contribution they would be required to make.

This step is about orienting health facility staff on the rationale for the quality improvement initiative, and to build their capacity to implement and monitor it.

The focus is on the functions they will need to carry out:

  • act as a bridge between the national level and health facilities, thus helping to ensure that health facilities have the resources they need to deliver health services to adolescents, including: adequate staff; guidelines and standard operating procedures; educational materials; equipment, medicines and other supplies;
  • facilitate stronger working relationships among managers of health facilities, between officials in the health and other sectors, and between health facilities and community-based organizations;
  • support health facility managers to carry out assessments of the quality of health service provision, and to use these findings to address gaps and areas of weakness;
  • support health facility managers to carry out the essential actions in their health facilities and in the community.

Depending on the country, this could be done by national health officials or by state/provincial/regional level health officials.

It is important that district health management teams are provided tools that guide the work they will need to carry out. In Bangladesh an  implementation and monitoring guide was developed with the active involvement of district level managers. 

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WHO/CAH publication
WHO/CAH publication on the 4-S framework and systematic process


WHO/CAH case study
WHO/CAH case studies

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