SLA

There is an agreement called Service Level Agreement. It is between the government and the health services (if I understand correctly). This means that Pediatrics under 5 years of age, Maternity cases, and some of the outpatients are paid for by the government. The patients are supposed to get passes from their nearest health center and then they are to get another slip from here…and…and….and. but the first and second slips at least are supposed to be provided to the centers by the government and they haven’t been. This has been both a problem and a blessing. At the beginning we were getting the slips late and then having to back fill and that is a lot of work that needed to be done somewhat urgently so the hospital could get the money from the government. Now the slips don’t come so we don’t have the extra work of filling them out. Now we only have to put them in the computer…name, village, village head, district, patient number, if they do have a pass, what the diagnosis is, and the cost…many of the diagnosis are the same (peds is usually malaria or pneumonia and maternity is delivery and/or malaria).
I finished the January Pediatrics last week for a bumper month…it is malaria season so there are an extraordinary number of patients…1099 (that is only the number that the gov’t pays for—under 5s) (that’s 35 a day) and the costs came to 3,515,030 Kwacha (~$19,530). And then I finished Maternity with 334 patients at 1,001,180 K (~$5,560).
Each month the government gives K5.6 million to the central area. Nkhoma hospital gets half of that and the rest of the centers split the other half. So the 2.8million K ($15,555) won’t cover this month but we will hopefully make it up with some slower months throughout the year…