9.experience sharing hsso

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9.experience sharing hsso

  1. 1. KACHIN SURVEY TEAM GAVI-HSS assessment at Bhamaw and Shwegu for 2 times 1st time -- May, 2010 2nd time – Nov, 2011
  2. 2. Eight System Areas were surveyed • Health Management and Planning, including • Mapping hard to reach areas • Human Resource Management • Health Finance and Financial Management • Community Participation • Essential Drugs & Equipment • Infrastructure • Data Quality and Service Quality
  3. 3. Identification of Barriers in the Township
  4. 4. CTHP Training • Bhamaw Total 24 villages – identified as HTR for package of service • Shwegu Total 32 villages – identified as HTR for package of service
  5. 5. • Evaluation of EPI data for 2011 • Evaluation of HMIS data for 2011 • Detailed plan for package of service for the whole year (2012) according to CTHP by respective RHC by BHS (bottom up plan)
  6. 6. HTR areas by using motorcycle HTR area by bullock cart HTR area by using motor boat
  7. 7. Immunization MCH care Nutrition Environmental sanitation
  8. 8. Health education activities
  9. 9. Recording and reporting by uniform reporting formats
  10. 10. Drugs distribution lists to RHC (Bhamaw) at 29-6-12 No Items . MCH ManMaLin Ma-U- Sin Pin Khan Man Yut Moe Total Phane 1. Sub centre Drug Kits (11/0322) 5 7 7 7 7 5 38 2. MW SC Drug Kits (11/0325) 3 4 4 3 5 3 22 3. RHC Kit (11/0377) - 1 1 1 1 1 5 4. MW SC First Aid Kit 3 4 4 3 5 3 22 5. Renewabl e items for RHC - 1 1 1 1 1 5
  11. 11. GAVI-HSS supply of computer, printer and copier
  12. 12. Iodine test Using IEC materials • • • • • • • • • Other service activities apart from 4 main activities PMCT DHF control Malaria control Contact tracing for TB Reproductive health- birth spacing & male involvement School health activities Advocacy with local authorities & religious leaders for more community involvement Elderly health care Health education
  13. 13. Delivery by SBA during package followed by immunization in subsequent package
  14. 14. Implementation status of package of services - Bhamaw 57 60 50 37 40 24 30 24 17 20 10 0 Planned packages for 2012 Packages conducted till July Additional packages without GAVI support Total HTR villages identified HTR villages visited up till July
  15. 15. Implementation status of package of services - Shwegu 78 80 70 60 50 43 32 40 32 30 20 10 0 Planned packages Packages for 2012 conducted till July Total HTR villages identified HTR villages visited up till July
  16. 16. Supportive supervision of sub-RHC
  17. 17. Discussion of BHS in the quarterly meeting
  18. 18. Quarterly Review Meeting (6 months Review) Jan- June (Bhamaw) No. Sub-centre Name of BHS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. MCH1 MCH2 MCH3 MCH4 MCH5 MCH6 Man Yut (main) Kabarni SC Kone Ma Hat SC Kho Kyin SC Si In SC Ma-U-Pin (main) Nant Hlaing Thein Daw SC Kywe Gyo SC Naung Lite SC Moe Phane (main) Naung Kho SC Nant Pha SC Sai Kin SC Man-Ma-Lin (main) Sint Kin SC Mya Sadi SC Kyun Gyi SC Kaung Sint SC Sin Khan (main) Kaung Tone SaWadi SC Yae Ni SC Daw Mar Mar Yin Daw May Thit Daw San San Maw Daw Nilar Aye Daw Ohnmar Nwe Daw Ei Ei Phyu Daw Nyo Mar Zin Daw Mary Soe Daw Hnin Ye Soe Daw Thida Aye Daw Ye Ye Win Daw Nilar Aung Daw Myint Myint Kyu Daw Myint Myint Khine Daw Yone Htan Yin Ze Daw Aye Aye Maw Daw Htu Gya Daw San San Htay Daw Aye Aye Than Daw Nyunt Nyunt Wai Daw Sine Mine Daw Aye Mar Win Daw Nan Ban Daw Oung Hlaing Daw Lei Lei Win Daw Khin Hnin Phyu Daw Htwal Gya Daw Phyu Phyu Win Daw Romi Khine 30. Naung Mo SC Daw Htan Hle Pine AN Coverage 33.67 30.89 27.5 46.1 34.52 33.66 35.6 40.5 42.9 28.5 38 52 41 37.5 34 37.1 25.49 41.4 40.24 51.78 40.6 35 46.56 51 30.7 52.6 46.3 36.4 48.4 55 PN Coverage 95 97.36 68 98.6 95.23 95.6 81.8 50 93.3 89.6 100 75 96 100 73 85.7 76.9 100 86.05 85.71 77.1 105 100 100 21.6 37 60 87.5 23.5 79.2 SBA rate Delivery by MW (%) 97.6 60.52 80 90.4 100 97.8 72.7 66.7 98.3 89.6 62.7 35 62 63.6 25 42.8 66.6 92.59 88.73 89.65 60 95 29.82 62.16 50 32.6 8 22 26.5 29.2 14 36.8 28 8.2 14.28 13.04 72.7 33.3 45 72.4 47 5 38 50 7 14.28 38.46 42.59 77.46 65.51 60 80 22.8 43.8 52.9 28.2 4 15.6 23.5 25 OPV3 % 36.95 35.65 37.03 41.3 57.69 48.57 41.8 35 48.1 40.6 60 63 47 55 44 28 47.91 45.03 46.05 59.61 34 38.23 47.87 36.89 41.5 47.2 57.8 54.8 50 40.4 Latrine coverage 99.71 87.5 87.03 85.7 135.2 96.05 101 99 106.3 97.1 89.7 97 98 80.5 116 94.8 96 108.52 108.05 107.77 112 99 103.89 96.71 90.8 99 92 0 0 50 Weighing of <5 (%) 35.2 44.04 44.11 49.4 46.32 48.4 40 77.1 46.9 41.7 115 9.7 29.4 5.5 41 72 48.64 64.88 36.14 58.04 52.6 71.88 31.38 30.8 0 14.2 0 49 28 63.8
  19. 19. SWOT analysis of HSS activities STRENGTH  Team work  Quality health care  On job training/supportive supervision  Technical support/ Training  Perception of duties and responsibility by BHS  AN care coverage/ immunization coverage increased  SBA coverage increase to a certain extent  Accessibility to health care services  Utilization of health care services
  20. 20.  More health knowledge can be gained by the community  Improved Data quality  Improved Service quality  Effectiveness of health care services  Efficiency of health care services  HEF –the poor mothers/children being taken care of  Recruitment of new AMW/CHW from HTR villages- health care services covering at HTR areas
  21. 21. WEAKNESSES  Data recording/ Filling in their registers  Inadequate drugs (few items of essential drugs)  Inadequate IEC materials  No advance preparation for packages, No clear job description      among the package group during first package Lack of coordination with other department of health (d/s control)/ NGOs No timely report & feedback from package of service Expectation of community for general medical treatment rather than package of service Vaccine wastage rate increased in Bamaw ---Frequent turn over of BHS (HA, LHV and MW)
  22. 22.  Evidence of actual travel (no camera)  Skillfulness of BHS in remote areas (coming down from mountainous areas)  Utilization of the community for delivery case?  Weight monitoring can be done during package of services but no action for underweight (supplementary feeding, serial monitoring, vitamin supplements, nutritional education)  No specific action on constructing sanitary latrine or providing PVC pan except education of hand washing practices and sanitary latrine inspection  Less active THC/ VHC
  23. 23. OPPORTUNITY  Health personnel become more aware and appreciated by the community  Support by local authorities and religious leaders  Community interest/ involvement  Collaboration with NGOs/project working in the T/S  Incentives & motivation THREAT  Language barrier  Security barrier  Migrant population (head count)-Denominator problem
  24. 24. Meeting with budget committee for hospital equity fund Supply to the poor for emergency from HEF (since 1/6/12-till date) No. Township 1. 2. Bhamaw Shwegu Pregnant mothers 11 12 Children Total 6 7 17 19 Amount (kyats) 1,479,300 1,000,000
  25. 25. Training of new BHS for orientation of GAVI-HSS programme
  26. 26. • Recruitment of new AMW & CHW especially from HTR villages (20 each) • Refresher training of existing and functioning AMW and CHW (50 each)
  27. 27. Thank You

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