Watchman General Cleaning of Maternity and OPD General Cleaning of Maternity and OPD TUESDAY General Cleaning of main building General Cleaning of Maternity and OPD General Cleaning of Maternity and OPD WEDNESDAY General Cleaning of main building General Cleaning of Maternity and OPD General Cleaning of Maternity and OPD THURSDAY General Cleaning of main building General Cleaning of Maternity and OPD General Cleaning of Maternity and OPD FRIDAY General Cleaning of main building

1. CHIPATA DISTRICT COMMUNITY HEALTH OFFICE
CHIKANDO COMMUNITY HEALTH CENTRE
SMGL REVIEW MEETING PRESENTATION
22ND MAY 2015
Presenter : Kuwani Banda.
Health centre in charge

2. INTRODUCTION
Chikando Community Zonal Centre is a health center administered by Chipata District Community
Health office.
GOAL
To effectively and efficiently facilitate the provision of quality primary health service care to the
community of Chikando with competence, cleanliness and care, in order to contribute to sustainable
human development.
LOCATION
The centre is located 42 kilometers south of Chipata town. It is accessible by the great east road up to
Mtenguleni and branches off to the left by feeder road with a distance of 15km. It shares its borders
with other 4 Health centers.

3. FACILITIES WITH SERVICES PROVIDED
OUTPATIENT DEPARTMENT :Consultations are done daily and there is at least one staff on duty
to handle any emergency at all times.
INPATIENT DEPARTMENT: The general ward has a bed space of 5 beds
MATERNAL CHILD HEALTH DEPARTMENT. The centre provides antenatal institutional
deliveries, postnatal services and family planning. Elimination of Mother to Child Transmission
(EMTCT) service is also provided. Under five clinics are held at the centre (static) and outreach
posts. Department has 2 delivery beds and 3 pre/post natal beds
ENVIRONMENTAL HEALTH DEPARTMENT: Service provided that aims at disease
prevention ,prolonging life and reduction of hazards in Chikando community.
ART MOBILE SITE: The centre also has the provision of anti-retro treatment (ART) services
which is done by the Mwami Mission Hospital mobile team once a week.
VOLUNTARY COUNSELLING AND TESTING COUNSELLING: The service is provided on
all working days

4. POPULATION AND QUARTERLY TARGETS 2015
CATEGORY YEAR % CSO TARGET
POPULATION
CSO QUARTERLY
TARGET
POPULATION
HEAD COUNT
TARGET
POPULATION
HEAD COUNT
QUARTERLY
TARGET
POPULATION
CHILDREN 0 – 11 MONTHS
4% 434 108 387 97
CHILDREN 12 – 59 MONTHS
16% 1737 434 1549 387
5 AND OVER YEARS
80% 8684 7746
WOMEN 15 – 49 YEARS
22% 2388 2130
TOTAL MALE
48.8% 5297 4724
TOTAL FEMALE
51.2 5557 9657
EXPECTED PREGNANCIES
5.4% 586 147 523 131
EXPECTED DELIVERIES
5.2 564 141 503 126
EXPECTED LIVE BIRTHS
4.9% 531 133 474 119
POPULATION GROWTH RATE
2.1%
TOTAL POPULATION
100% 10,855 9,682

5. THE THREE Cs
 In order to have successes at health centre, strong emphasis is put on the 3 Cs on delivery of quality health
care to the community .
 COMPETENCE: a well leaned staff who have adequate knowledge and skills in their profession.
Knowledge is acquired through trainings, mentorships and even by catching up with new disease trends on
the internet. with their craft so as to give adequate and quality care to the community.
 CARE : to have caring heart for the patients .This is done by ensuring tht staff are on time for work, knock
off on time and be sympathetic to the client. Also ensure that clients are seen even at night by allocating staff
to night calls
 CLEANLINESS: To ensure that the clients are seen in a clean environment to minimize cross infection and
boost client and staff moral.

6. INTRAFACILITY RELATIONSHIPS

7. INTRAFACILITY RELATIONSHIP/LINKAGES
 TO ACHIEVE SET GOALS , STRONG INTRA FACILITY RELATIONSHIPAND
UNDERSTANDING IS NEEDED .
 Staff meetings are held every month. Staff freely contribute in this forum and all issues are discussed.
Important to allow staff to be open so to move issues out even though they are deemed controversial or
critical of leadership.
 Involvement of all staff when revising action plan or having financial meetings. This enables the staff to
have a sense of ownership with the centre. i.e. in 2014 during action plan revision all staff agreed to reduce
funding to their departments and sacrifice so that the centre could be painted internally and externally.

8. INTRAFACILITY RELATIONSHIP/LINKAGES
 Strong partnership with clinical and environmental department. Environmental staff
has bi weekly plan which is discussed with the in charge so as to reduce misunderstandings
and misconceptions. Clinical department includes EHO in activities e.g. SMAG
 Debriefing of staff after any training /workshop. This is done after any staff attends a
meeting or workshop. These are in form of clinical meetings or debriefing meetings. All
staff including support staff take turns in presenting. This is vital because all staff get to
have some knowledge on other departments. Also important for linkages i.e follow up
exposed children for testing or refills is done by EHO because debriefed on PMTCT even
though he wasn’t trained. Nurse also oriented on building inspections and water testing. All
staff oriented on helping babies breath by midwife who was trained.

9. STAFFING LEVEL
No Name Cadre
1 Kuwani Banda Registered Nurse
2 Crystal Mkakangoma Registered Nurse
3 Christine Zulu Enrolled Midwife
4 Henry Shankandi Environmental Health Officer
5 Eunice Nyirenda General Indoor Worker
6 Gerard Zulu Driver
7 Thomas Shanzi Watchman

10. NAME CADRE
WORKING DAYS AND TIMES
18
Mon
19
Tue
20
Wed
21
Thu
22
Fri
23
Sat
24
Sun
25
Mon
26
Tue
27
Wed
28
Thu
29
Fri
30
Sat
31
Sun
K.BANDA HCI 8-17
OPD(C)
MAT(C)
8-17
OPD(C)
8-17
OPD(C)
8-17
OPD(C)
8-17
OPD(C)
OFF
OPD(C)
OFF
OPD(C)
mat C
8-17
OPD(C)
8-17
OPD(C)
8-17
OPD(C)
8-17
OPD(C)
8-17
OPD(C)
8-12
OPD(C)
MAT(C)
OFF
(mat C)
C. MKAKANGOMA RN OFF 8-17
MAT(C)
8-13
MAT(C)
8-17
MAT(C)
8-13
MAT(C)
8-12
MAT(C)
OFF 8-17
MAT(C)
8-13
MAT(C)
8-17
MAT(C)
8-17
MAT(C)
8-13
MAT(C)
OFF 8-10
OPD(C)
H.SHANKANDI EHO 8-17 8-17 8-17 8-17 8-17 OFF OFF 8-17 8-17 8-17 8-17 8-17 OFF OFF
C. ZULU M/WIFE
O N L E A V E
E.NYIRENDA GW 8-17 8-17 8-13 8-13 8-17 OFF 8-10 8-17 8-13 8-17 8-17 8-13 8-12 OFF
CHIKANDO COMMUNITY RURAL HEALTH CENTRE.
STAFF TIMETABLE 18 MAY 2015 TO 31 MAY 2015
NOTE:
1. WORKING HOURS AND DAYS SUBJECTED TO CHANGE AT SHORT NOTICE
2. SUBJECTED TO CHANGE DUE TO AVAILABILITY OF STAFF.STAFF WHO WORK ON DAY OFF CAN CLAIM
OFF DAY ON A LATTER DAY
3. ANY CHANGE SHOULD BE COMMUNICATED THROUGH THE IN CHARGE
4. TRIPS OUTSIDE THE CENTRE ON PERSONAL BUSINESS ON NON DCHO DAYS CONSTITUTE A DAY OFF
5. ON CALL BEGIN AT 18 HOURS AND END AT 07 HOURS. IF A STAFF HAS HAD A CALL THE WHOLE NIGHT AND
GOES BETOND THE STIPULATED TIME OF THE CALL, A DAY OFF OR HALF DAY CAN BE CLAIMED
6. IF ONE STAFF IS ABSENT, ANOTHER MEDICAL STAFF TAKES OVER ON THE ABSENT STAFFS CALLS.

11. COMMUNITY PARTNERSHIP

12. COMMUNITY PARTNERSHIP
 Strong community partnership is essential in provision of health care.
 All 6 NHCs are active and meet monthly. This is done after under 5 outreach clinics in their area. This
ensures staff supervision.
 In order to improve maternal and family planning indicators , the centre embarked on program to improve
link between community and health centre.
 In 2nd Quarter 2014 ,health centre embarked on Strengthening SMAG with a 6 month plan to add new
members ,hold regular meetings, regular outreaches action planning and involvement of stakeholders. Even
though SMAG members not formally trained ,orientation was done by clinical staff.

13. MOTIVATION OF COMMUNITY BASED
VOLUNTEERS
 Motivation of CBVs is done through integration into health centre programs such as
funded SMAG meetings and outreach VCT. This is done through review of action plan to
include activities. When there is no funding ,staff sometimes contribute to ensure programs
continue.
 Integration of trained TBAs to assist in antenatal clinics, post natal clinics, family planning
and follow up of exposed children.
 Centre purchased a total of 7 bicycles for CBVs between 2013/2014 through Imprest.
 All community based volunteers supervised with staff according to program i.e. CLTS
champions closely monitored by EHO.

14. SMAG STAKEHOLDER MEETING
 Stakeholder SMAG meeting with Chief Representative, Community
development officer , Vetenary Officer And Agriculture Camp officer. Done
through guidance of SMGL mentorship.

15. HEALTH CENTRE IN CHARGE
ENVIRONMENTAL HEALTH OFFICER REGISTERED NURSE
COMM. HEALTH
WORKER
GROWTH MONITORS
T. BIRTH ATTENDANTMALARIA
AGENTS
CLTS
CHAMPIONS
CHLORINATORS
SMAG MEMBERS
TB TREATMENT
SUPPORTERS
YOUTHS
NUTRITION PROMOTERS
GENERAL
WORKER
DRIVER WATCHMAN

16. Chikando Community Rural Health Centre
SMAG ACTION PLAN 2014
Schedule 3rd and 4th quarter 2014
Compiled by:
Ruth Banda
SMAG chairperson
NO LOCALITY PRIORITY ACTIVITIES DATE REMARKS
1. LUFU NHC Select new SMAG members, health
education on safe motherhood and
long term family planning
sensitization, Drama play
24/06/2014
2. CHANKHONZI NHC Select new SMAG members, health
education on safe motherhood and
long term family planning
sensitization, Drama play
14/07/14
3. NO. 1 FARMS NHC Select new SMAG members, health
education on safe motherhood and
long term family planning
sensitization, Drama play
21/08/14
4. MGOGO NHC Select new SMAG members, health
education on safe motherhood and
long term family planning
sensitization, Drama play
18/09/14
5. KAZIMOMWE NHC Select new SMAG members, health
education on safe motherhood and
long term family planning
sensitization, Drama play
23/10/14
6. ZAMBEZI NHC Select new SMAG members, health
education on safe motherhood and
long term family planning
sensitization, Drama play
20/11/14

17. DELIVERIES AND POSTNATAL
 All institutional deliveries done by professional staff. One staff on call at maternity at all times. Timetable
made for two weeks in advance and copies are given to all staff.
 No Fresh still born at Chikando to professional staff handling. This greatly due to the fact that professional
staff handle all deliveries.
 Women encouraged to come for post natal @ 6 days because BCG is only given then. Women also
encouraged to come 6 weeks post natal when OPV 1 , DPT 1 Rota 1 and PCV 1 given. These are not given
at outreach stations

18. DELIVERY AND POSTNANTAL INDICATORS 1st QUARTER 2015
Source: Delivery Register. Postnatal Register. HIA 2

19. LONG TERM FAMILY PLANNING
 Staff at clinic mentored by DCMO in inserting Jadelle implant and in 3rd quarter 2014
 Mentorship beneficial in aspects of counselling clients, correcting wrong information/ rumors on long term
family planning ,actual insertions, benefits of LTFP and side effects.
 Through continuous sensitization by staff and SMAG with outreach family planning posts being set up ,the
community has embraced and accepted long term family planning.
 One day in the week is allocated to outreach long term family planning and static family planning is done on
an everyday basis.

20. FAMILY PLANNING INDICATORS 4th quarter 2014 and 1st QUARTER 2015
Source: HIA 2. Family Planning Register
NOTE: MALE CONDOMS ARE A UNIT OF 144 PIECES
0
50
100
150
200
250
300
350
400
450
80
423
1
264
318
450
128
152
NoofClients
INDICATORS
cohrot actuals ACTUALS

22. ELIMINATION OF MOTHER CHILD
TRANSMISSION (EMTCT)
 Centre is currently implementing Option B+ with 14 clients (4 male and 10 females) currently receiving care as
of May 2015.
 We ensure correct and safe filing of client files. Logistical inputs done consistently in the ART DAR register to
know monthly consumption.
 Files are stored under lock and key for client confidentiality
 All exposed children are followed up . This was a weakness during the last performance assessment for 3rd and 4th
Quarter 2015,due to factors such as DBS cared being O/S, lack of properly filled register.
 In the 1st Quarter 2015, all children @ 6 weeks , 6 months , 12 months and 18 months tested have been followed
up and testing done. This was achieved by involving draing up a monthly follow up schedule partnership with
EHO and community based volunteers

23. EXPOSED INFANTS INDICATORS 1st QUARTER 2015

24. DATA MANAGEMENT
 Data management follows the 3Cs of quality data which are
A) Correct Data - raw data should be accurate e.g. number of ANC tally sheet and also be validated by use of
register by in charge.
B) Completeness. Daily Checks in registers (data audit) done to ensure completeness and correctness in MCH
department. This is done because CBVs assist in MCH department and so Staff is required to do data audit.
C) Consistent data. Data should always remain within normal ranges if out of
range then cleaning up of data required. Example of -3Z score was very high in one month. After data audit, it
was found that incorrect tallying by new staff.
 Patients records are produced and stored in an organised manner. Tally sheets ,files and registers organised
and stored in an orderly manner. This is essential for easy reference .

26. SMART CARE
 The health centre is a Smart care model site. There are 5 computers, each in a different
departments at the centre. Staff was not formally trained but oriented in smart care
program.
 Program installed in December 2014 and fully operational in January 2015. As of May
2015, 4000 patient records , 160 new ANC, 130 follow up , 91 delivery discharges and 152
new Family planning clients recorded in system.
 Continuality of care present as client records are backed up ,in case of card loss by client or
computer crash.

27. SMART CARE PROVIDERS

28. CLEANLINESS
 The HC prioritises the cleanliness as it is an essential component health care delivery to ensure clients seen
in a clean environment
 With revision of action plan in 2013/2014, the health centre managed to renovate and paint the whole
centre, internally and externally.
 Indoor general worker has work schedule which was formulated with other staff so as to ensure equitable use
of her time. The watchman is responsible for outdoor cleaning/slashing. He also has a work schedule.
 Every Imprest allocation has adequate funds allocated to essentials such as floor polish(Sun Beam) brooms
mops and so on.
 Grounds slashed and maintained by the community, as this gives then a sense of ownership. This was a
resolution of a Headman meeting in 2014.

29. DAILY ACTIVITY PLAN
STAFF NAME: EUNICE NYIENDA CADRE: GENERAL WORKER
DAYS TIME
07:00 HRS TO 08:00 HRS
TIME
10 HRS TO 12 HRS
TIME
14hrs to 16 HRS
MONDAY General Cleaning of main
building
 General cleaning of
admission ward
 Bed making
Application of Floor
polish in Admission ward
TUESDAY General Cleaning of main
building
 General Cleaning of
Pharmacy
 Updating of stock
control cards
 Checking of soon to
expire drugs
Application of Floor
polish in Main Building
WEDNESDAY General Cleaning of main
building
Dump dusting all rooms
in main building
Dump dusting MCH
building
THURSDAY General Cleaning of main
building
General Cleaning of
MCH building
Supervision of Cleaning of
mothers Shelter
FRIDAY General Cleaning of main
building
Updating Registers Application of Floor
polish in MCH building
SATURDAY General Cleaning of main
building
OFF OFF
SUNDAY General Cleaning of main
building
OFF OFF

31. INFECTION PREVENTION
 To minimize the risk of cross infections, the centre has set standards in infection
prevention.
 Standards met with regard to infection prevention include PPE, sharp boxes in all rooms.
Colour coded bins with liners, hand washing facilities with hand wash, gloves, Fenced
refuse pit placenta pit and functioning incinerator. Infection prevention corner is essential
in treatment room and delivery room.
 Infection prevention Meetings held twice yearly with Environmental Health Staff as IP
focal person to discuss all issues relating to infection prevention.

33. QUALITY CONTROL
 In order to give only quality and true results to our clients, the centre exercises internal quality control on all
rapid tests whenever a new box is opened.
 This is done on HIV determine tests, HIV unigold , malaria rapid diagnostic tests and syphilis RDT.
 External quality control is done by reference lab, which is Mwami Adventist Hospital every quarter. Random
samples collected and tested at the centre and then sent to Mwami lab for verification of test results.
 Control samples are collected every month so as to keep them fresh and stored in refrigerator.

34. INTERNAL QUALITY CONTROL

35. TEAM WORK
TEAM WORK, if you do not work
as a team then programs will fail.
Together as one , all things are
POSSIBLE!!!

36. THE END
Thank You