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8. experience sharing of cthp nilar tin


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8. experience sharing of cthp nilar tin

  1. 1. Coordinated Township Health Plan in (20) townships GAVI HSS
  2. 2. Contents of CTHP 1. Conducting a health system assessment 2. Establishing a Monitoring and Evaluation Framework 3. Developing RHC plans with sub RHC participation 4. Township Level Activity setting 5. Analyzing Costs and Sources of Finance at Township level 6. Incorporating all of the above into a Coordinated Township Health Plan
  3. 3. Scope of the Coordinated Health Plan (Package of Services) • the focus will be on “system planning” for maternal and child health, immunization, nutrition and environmental health. • the planning is therefore for the coordinated management and delivery of a “package of services,” and is not simply a collection of projects and programs. • Once the system has been designed, tested and evaluated, consideration should be given to expanding the package of services to include communicable disease control, NCDs and hospital service
  4. 4. Results of Package Service Delivery from Jan-June 2012 in (20) townships
  5. 5. Package of service from Jan-Jun 2012 in (20) Tsps s/n Township Planned package Package service from Jan-Jun Percent 1 Bamaw 57 43 75.4 2 Shwegu 78 45 57.7 3 Demawsoe 88 46 52.3 4 Hlaingbwe 100 74 74 5 Hakkha 85 78 91.8 6 Ye Oo 159 81 50.9 7 Myeik 79 43 54.4 8 Mudon 132 64 48.5 9 Thaton 102 62 60.8 10 Lewe 137 82 59.9 11 Pyinmana 96 61 63.5 12 Htilin 142 77 54.2 13 Yedarshay 129 84 65.1 14 Thayarwaddy 163 93 57.1
  6. 6. Package of service from Jan-Jun 2012 in (20) Tsps s/ Township n Planned package Package service from Jan-Jun 180 % 15 Maungdaw 253 16 Kyaington 210 198 94.3 17 Nyaungshwe 180 75 41.7 18 Ngaputaw 92 38 41.3 19 Kawthmu 118 66 55.9 20 Hsipaw 101 95 94.1 2501 1585 63.4 Total 71.1
  7. 7. s/n Problem/Gaps Response Strengths Weaknesses 1 Lack of coordinated plan CTHP Guideline Costed Less coordination 2 Lack of access to health in HTR area • Mapping HTR • Planned for Package of service tour together with BHS for the whole year • Provision of TA/DA for midwives + Supervisors + AMW/CHW to move to additional villages more frequently with package service (MCH+EPI Nutrition + ES) •Increase in service delivery • Team work culture created • Good rapport with community Specific•ANC -increased • improper arrangement for health posts • EPI- can give to missed case •Nutrition assessment • Env Sanitation • HE- a lot can be done -Delivery by SBA ??? -High vaccine wastage -Corrective measures still needed -Need P&P infrastructure -IEC materials -Time -NCD?
  8. 8. s/n Problem/Gaps Response Advantage Disadvantage 3 Lack of coordination with local authorities/others Quarterly and annual review meetings at RHC levels/Township level • Successive packagesbecome smooth More positive collaboration CHW thou' motivated 4 Infrequent supervision and Financing supervision monitoring Regular supervision at all levels Motivated midwives 5 -Low midwife: population ratio -Incorrect skill mix HR research Evidence based policy making tools -Poor retention of staff in HTR Training of AMW/CHW Refresher training 6 Lack of operational finance MCH Voucher Scheme for providers and (pilot in Yedarshay) economic barriers in the community HEF for all hospitals Increase access to MCH service Save lives of poor mothers and children Heavy workload for hospital staff
  9. 9. s/ n Problem/Gaps 7 Response Advantage Disadvantage Limitations in supplies of ED Essential Drugs to and equipment (no TH/SH/ RHC/ sub center replenishment for 10 years) level Equipment (RHC kit/HA kit/MW kit/CDK) Incremental for 4 years ED provided and used Did not meet the needs- s/a Antibiotics, Multivitamins, Antacid , Anti hypertensive 8 Lack of training on management & research HSR training HSR grant S/R level , TMO are equipped with training and funds – motivated Still cannot give full time for research 9 Bicycles- old and inoperable Motorbikes provided 10 117 midwives are without sub centers To build new SC/ refurbish old RHC- this year –program changed Cannot give to all those in need MOH is building new RHC/SC
  10. 10. Way forward • With a national scale up of the HSS Strategy to (40,60,60 to a total of 180 townships) there is need for – a strong middle level of management in the health system – Provision of resources to S/R – A clear budget allocation for HSS to ensure adequate governance mechanisms at the State/Regional levels • More collaborative actions at the central level to become comprehensive CTHP in future • More collaborative efforts with UN Agencies & Donors • Many space for improvement in HSS townships that can be filled by different agencies at township operational levels • Lessons learned can be inputs for sustainability issue of package of service delivery by group of BHS • Policy guidance from evidence based research ----
  11. 11. Thank You