Table 5.

Example of integrated bundle of HRM and health systems strategies from Kwahu West district, Ghana

Problem identified	HR/HS strategies to address the problem	Activities
Poor implementation of new vaccine schedule leading to high dropout rate of pneumococcal (46.9%) and rotatix (19.1%) vaccination in the municipality	Improve data management at all levels Improve supportive supervision to subdistrict Reward (certificate and material) best performing facilities (drop rate of PCV and ROTA 10% and below)	Train and retrain all staff on new vaccine
		Conduct monthly data validation per facility by comparing tally books
		Enforce use of separate log books for drop-in and drop-out
		Train all staff in logistics management
		Obtain standard EPI supportive supervision checklist from DDPH/RHA
		Input from subdistrict staff effected and final checklists circulated to all facilities
		On-site supportive supervision in general but EPI in particular (two visits per facility per year)
		Hold quarterly meetings to review performance and share best practices Award prize to best performing health facilities

DDPH, Deputy Director of Public Health; EPI, Expanded Programme for Immunisation; PCV, pneumococcal conjugate vaccine; RHA, Regional Health Administration.