Extract from PHASE Nepal Annual Progress Report 2014-2015:
In the last fiscal year 2014-2015, community health programmes were supported by Hrothgar & Lindsey (Bajura: Kolti, Gorkha: Chhekampar, Chumchet, Kashigaon, Keraunja, Manbu, Sirdibas, Kavre: Rayale), DFID through PHASE Worldwide (Bajura: Wai, Humla: Jair), and PHASE Worldwide (Humla: Maila, Melchham, Bajura: Baddhu, Sindhupalchowk: Fulpingkot, Hagam).
Community Health Programme (CHP)
PHASE Nepal has been working on health programmes since 2006 in close coordination with district health offices and other district level government stakeholders. It has been providing basic essential health care services, prioritising especially maternal and child health. PHASE is working in very remote areas where the nearest road access is often very far. In spite of very difficult geographical and cultural barriers, PHASE staff have been regularly providing services to the communities in the project areas. This year programmes have been extended in 3 VDCs in Humla and Bajura, to reach a total of 17 VDCs in five districts.
A total of 1,229 pregnant mothers received first antenatal care service during this reporting period which is more than the target. All VDCs crossed the target for 1st ANC, which is very positive but in comparison with 1st ANC, 4th ANC is not satisfactory. This is partly due to women presenting late in pregnancy for their first ANC. This is one of the hardest targets to improve, but will be a priority in the coming year.
PHASE staff helped deliver 531 babies safely during the period. Among the 17 VDCs, Kolti Primary Health Centre (PHC) of Bajura has the highest delivery record. 633 mothers and babies got at least one postnatal (PNC) service during the period. All pregnant women were sent to the nearest government institution for TT vaccine. Despite all these preventive measures, there were 11 cases of neonatal death in Kolti, Rugin, Maila and Kashigaun and one still birth in Kolti. There was one maternal death in Hagam.
Children are very vulnerable due to their lower immunity power and higher risk from infectious diseases. Child health is still a big problem in the project areas. PHASE Nepal’s community health activities include child health care, with emphasis on CB-IMCI (Community Based Integrated Management of Neonatal and Childhood Illness), a standard set of guidance by the government of Nepal. PHASE health services include support to immunization services, distribution of de-worming tablets in schools, CB-IMCI and nutrition training to FCHV and Mothers’ Groups, child monitoring for nutrition status. PHASE Nepal also organizes school health education in each school of the project areas once a month.
Albendazole (de-worming) was administered to 1,251 children and a total of 12,187 children under 5 years age were provided with clinical care services for different health problems.
PHASE staff supported various immunization events at government institutions throughout the year where numerous children were immunized in 17 field posts of the project areas. 765 children were vaccinated with BCG (against TB), 889 were given DPT1st, OPV (oral polio vaccine), PCV (pneumococcal vaccine), Hep B, HiB. Similarly, 800 children were vaccinated for DPT2, OPV, PCV2 and 750 children were administered DPT3, OPV and 818 children were given vaccine against measles and rubella.
Family planning service is a part of PHASE community health activities; increasing availability and access to quality family planning services is a key priority of PHASE. PHASE Nepal staff provide family planning counselling to the clients who visit for postnatal care service as well. Besides the services offered in the health facilities, PHASE staff also organize community health education sessions in each ward of the village and provide counselling services.
Within this reporting period, PHASE health staff injected 5,969 vials of Depo-Provera. 2,351 women received contraceptive pills at least once from the PHASE health posts. 5,820 condoms were distributed from the PHASE supported health posts.
Health Awareness Raising Activities
Apart from health services, public health is also a part of PHASE Nepal’s work. It is essential to increase awareness everywhere in the community – amongst opinion leaders, decision makers, community leaders, parents, teachers, children and health professionals. PHASE Nepal runs various community-based participatory activities to increase awareness, knowledge and skill amongst primary health care and other health workers in this field. The activities are focused on the situation and needs of the community. PHASE health staff teach about safety, first aid, personal hygiene and cleanliness and about adolescent health to the schoolchildren of 13-16 years of age. With the purpose of improving children’s nutritious status, workshops to teach preparation of “super flour” weaning food were conducted and over 1,200 parents participated.
Local Capacity Building
PHASE conducted nutrition workshops in 4 VDCs of north Gorkha. The training was targeted particularly on FCHVs and Mothers Group leaders. After the training, participants are able to make home-based nutritious diet for children, monitor nutrition status of children and treat mild malnutrition.
Traditional healers training was conducted 19 times, all traditional healers of related VDCs were participants. The main purpose of the training was to empower traditional healers with a better understanding of diseases for which community people usually visit them and to ensure a referral mechanism to the health centres. 258 traditional healers were trained for referral of patients.
FCHVs meetings are conducted once a month in each VDC. Health facility management committee meetings were conducted 127 times and Mothers group meetings were conducted 184 times.
The optimum use of local resources depends on capacity of the local stakeholders; therefore, PHASE health staff encourage local functioning bodies such as HFMC, FCHV, MGs and VCCs to organize meetings every month. In these meetings PHASE health staff help these local CBOs to find the local resources, identify problems in the community regarding health related issues; find the solutions of these problems and assist them in decision making. PHASE staff also organize orientation to facilitate discussions about basic health rights, duties, roles and responsibilities of members of CBOs and community members.
Number of patients visiting health facilities
PHASE Nepal is expanding its services, providing regular basic essential primary health services in the government health facilities, and the number of beneficiaries is increasing every year. Patients from adjacent VDCs also come to access health services in the PHASE project areas.