Annual Report 2016 – 2017 (Health)

Extract from PHASE Nepal Annual Progress Report 2016-2017:

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, Melcham; 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)

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. 

Maternal Health

DistrictVDCsTarget vs. AchievementANC 1stANC 4thDeliveryPNC
Sindhupalchok2Target141486095
Achievement130308686
Humla3Target275119106108
Achievement28079176146
Gorkha6Target1081024040
Achievement110804242
Bajura4Target300200193364
Achievement310180403498
Kavre1Target25161120
Achievement23142222
Mugu6Target2101635050
(2months)
Achievement305140187187
Total24Total Target1059648460677
Achievement1158523916981

A total of 1,158 pregnant mothers received first antenatal care services during this reporting period, more than the target set at the beginning of the year. The target for the  1st ANC visit was achieved in all the VDCs but there is still room for improvement for 4th ANC visits: 523 women received 4 visits, 45% of all antenatal patients. This is 80% of the target (target 648). Nevertheless, this is a significant improvement on last year, when only 76% of the target was achieved – in 2015/16 38% of women who had ANC achieved 4 visits. 916 safe deliveries were carried out by skilled attendants, mostly PHASE Nepal staff. The highest number of deliveries was recorded in Kolti Primary Health Centre (120). 981 mothers and babies got at least one postnatal (PNC) service during the period and all the pregnant women were sent to nearest government institution for TT vaccine.

Child Health

Children are very vulnerable due to their lower immunity power and because they cannot access health services by themselves without support. Child health is still a big problem in the project area. PHASE Nepal’s community health activities include child health care, emphasised on CB-IMNCI (Community Based Integrated Management of Neonatal and Childhood Illness); a standard set by government health policy of Nepal. PHASE health service includes support to immunization services, distribution of deworming tablets in schools, CB-IMCI and nutrition training to FCHV and Mothers’ Group, child monitoring for nutrition status and counselling to parents of undernourished children. PHASE Nepal also organizes school health education in each school of the project area once a month in different topics according to need of area.

Output IndicatorsBeneficiaries  
MaleFemaleTotal
Albendazole distribution2,1612,1834,344
OPD service <= 5 yrs8,9248,12217,046

Albendazole (deworming tablets) was administered to 4,344 children and total 17,046 children under the age of 5 years were seen and treated at health posts and ORCs.

PHASE staff supported various immunization events to government institutions throughout the year where children were immunized in 22 health posts of the project area. The immunization follows the Nepal EPI programme including BCG, DPT Hib Hep B, OPV,PCV, Measles & Rubella, IPV and Japanese Encephalitis.

   

Family Planning

Family planning service is an important part of PHASE community health activities; thus 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 as general temporary family planning services. In addition PHASE staff also organize community health education sessions in each ward of the village and provide counselling for temporary family planning services.

    
ContraceptivesBeneficiaries
MaleFemaleTotal
Family planning counseling135622743630
Depo-provera43904390
Pills20692069
Implant192192
Condom (piece)21792179

Within this reporting period, PHASE health staff injected 4,390 vials of Depo-Provera (a  three monthly contraceptive injection for women). Similarly, 2,069 women took contraceptive pills at least once from PHASE health post and 192 women had a contraceptive implant (effective for 5 years) inserted. 2,179 individuals received condoms from the health posts and 3630 people were given counselling for temporary family planning services, around 2/3 of them women.

Health Awareness Raising Activities

ActivitiesTargetAchievementBeneficiaries  
MaleFemaleTotal
Calendar for health promotion21 VDCs21 VDCs
Street drama event16269381,5332,471
Day celebration event1644---
School health education1902844,0364,7088,744
Community health education3054261,9385,1017,039
Door to door health education7441,4894,3168,10312,419
Clinic health education4086232,4334,3176,157
Super flour making demonstration8234157680837
Participatory village cleaning1762526973,3824,079

Apart from clinic services, public health is also a priority programme 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 planned several community-based participatory activities to increase health related awareness, knowledge and skills. The activities were 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 objectiveof improving children’s nutrition status, super flour (weaning food) making orientation events were run in which 837 parents took part.

Local Capacity Building

     
Capacity Building ActivitiesEventMaleFemaleTotal
FCHV & Mother group orientation19436477428106
Orientation
Traditional Healers Training28590267857
Public Audit35104210282070
Total257507235858657

194 events related to health and hygiene for FCHVs and mothers group were conducted. A total of 8106 people participated in these events. Similarly, with the objective of empowering traditional healers and setting up referral mechanisms, 28 traditional healers’ trainings were organized where 857 traditional healers participated. Maintaining good governance, following accountability and for maintaining transparency PHASE Nepal organised biannual public audit program in every working VDC.

      
Capacity Building ActivitiesEventMaleFemaleTotal
FCHV meeting facilitation17038818992131
HFMC meeting facilitation1019665422219
Mothers group meeting36736273225072
Total6381716976312117

FCHVs meeting are conducted once a month in each VDC. Health facility management committee meeting was conducted 101times and Mothers group meeting was conducted 367 times.

The optimum use of local resources depends on capacity of the local stakeholders; therefore, PHASE health staff encouraged local functioning bodies such as HFMC (health facility management committee), FCHV (Female Community Health Volunteers), MGs (Mothers Groups) and VCCs (Village Cleaning Committees) to organize meetings every month. In these meetings PHASE health staff help 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 organise orientation on basic health rights, duties, roles and responsibilities of being a member of such CBOs and community member.

Number of patients visiting health facilities

PHASE Nepal is a growing organization and as a result the reach to beneficiaries is also increasing every year. Patients from adjacent VDCs also come to access PHASE Nepal’s services in the project areas. A basic essential primary health service has been provided regularly from Health posts and outreach clinics, supporting and supplementing the government services, and the number of people benefitting is increasing every year.