PHASE provides the highest possible quality of primary care in remote areas that have no well functioning services, by supporting existing governmental health centres with improved buildings, essential equipment and medicines, and most importantly, staff.
PHASE Nepal offers employment to dedicated qualified Nepali staff in governmental health posts in liaison with District Health Offices (DHOs). Usually these health workers are female “Auxiliary Nurse Midwives” (ANMs), who have 18 months training and experience in antenatal and delivery care and can supplement the skills of the governmental community health workers. PHASE also employs staff nurses or Health Assistants, and sometimes Public Health Graduates, as health supervisors. Their role is to visit all health centres in turn, support the staff in their work and ensure good communication with local communities, District Health Offices and the central office in Kathmandu.
We also assist governmental staff to stay in their post by giving them extra training, financial incentives and supervision. Many of these health workers are frustrated by the difficulties of providing a good service under challenging conditions and far from easy logistical circumstances. If they are well supported, many government employees are quite happy to return to and remain in their posts.
The responsibilities of PHASE health workers include health education and awareness campaigns, family planning and maternal and child health activities, treatment of most common health problems, and are the first point of call in any health-related emergency. To all intents and purposes they perform the role of rural GPs, treating problems from typhoid fever to broken bones to dental care and tooth extractions, and they help to deliver babies safely, either in the health facility or at the woman’s home. PHASE staff undertake preventative health programmes like childhood vaccinations, antenatal care and family planning. Health awareness is also important and guidance is given on nutrition, worm-infestation, the problems associated with smoke from indoor open fires, safe water and sanitation. The staff are active leaders in the community and encourage participation and advocacy for health rights.
We ensure the delivery and utilisation of government-supplied medicines and top this up with other essential medication and equipment. PHASE provide in-post clinical supervision, coaching and training to our staff and to the governmental health workers, which is supported by a group of experienced British GP volunteers. PHASE developed Nepalese language clinical guidelines for primary health care in rural areas, which are now widely used, not only by are our staff, but have been adopted by district governments and other NGOs.
We estimate that each member of staff is saving at least one child’s life every month. One health worker costs PHASE about £200 per month and we invest around the same amount again in programme support costs (drug supplies, transport and travel etc) for each health centre. As most areas did not have any kind of functioning health system prior to PHASE’s interventions, the modest amount of money invested compared to the impact is remarkable and illustrative of how essential this work is.
In 2018 we support health posts in 21 communities with 40 health workers. Between 2006 and 2018 PHASE saw over 550,000 patients, assisted around 2,000 child births. For more details see the Annual Reports.
Extract from PHASE Nepal Annual Progress Report 2017-2018:
In the fiscal year 2016-2017, community health programmes are supported by Hrothgar & Lindsey (Humla: Jair, Bajura: Bichhaya, Wai), PHASE Worldwide (Bajura: Kolti, Bichhaya ;Humla: Maila; Gorkha: Kashigaun, Keraunja, Manbu; Sindhupalchok: Hagam) Big Lottery Fund (Gorkha: Kashigaun, Keraunja), PHASE Austria: Bichhaya), Himalayan Development Foundation Australia (Sindhupalchok: Baruwa, Bhotang); Médecins du Monde (Kathmandu), Australian Development Agency (Mugu: Ruga, Kotdanda, Dhainakot, Hyanglu, Natharpu, Photu; Bajura: Rugin)