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.
|District||VDCs||Target vs. Achievement||ANC 1st||ANC 4th||Delivery||PNC|
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.
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.
|OPD service <= 5 yrs||8,924||8,122||17,046|
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 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.
|Family planning counseling||1356||2274||3630|
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
|Calendar for health promotion||21 VDCs||21 VDCs|
|Street drama event||16||26||938||1,533||2,471|
|Day celebration event||16||44||-||-||-|
|School health education||190||284||4,036||4,708||8,744|
|Community health education||305||426||1,938||5,101||7,039|
|Door to door health education||744||1,489||4,316||8,103||12,419|
|Clinic health education||408||623||2,433||4,317||6,157|
|Super flour making demonstration||82||34||157||680||837|
|Participatory village cleaning||176||252||697||3,382||4,079|
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 Activities||Event||Male||Female||Total|
|FCHV & Mother group orientation||194||364||7742||8106|
|Traditional Healers Training||28||590||267||857|
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 Activities||Event||Male||Female||Total|
|FCHV meeting facilitation||170||388||1899||2131|
|HFMC meeting facilitation||101||966||542||2219|
|Mothers group meeting||367||362||7322||5072|
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.