HMG, MoH,
Eastern Regional Health Directorate
Dhankuta, Nepal.
Report on Micro-planning
workshop
For Health
workers in order to strengthening EPI in Udaypur district
From: Nawaraj
Subba (Senior Public Health Officer)
To: Regional Director
Date of Training: 2060.3.17-24 (Duration - 8 days)
Place: City Hall of DDC Udayapur, Gaighat.
Programme: Expanded Programme on Immunization
General objective: To strengthen EPI programme in Udaypur district.
Specific Objective:
· To facilitate in the micro-planning workshop
· To analyze the district situation in terms of access and utilization of services
· To identify problems/ constraints and help to make possible solutions
·
To give feed back and presentations
General Background
One of the target of National Immunization Programme
of Nepal- Universal coverage of 80% for all antigens will be achieved and sustained
at the district level by the year 2002, and 90% by the year 2005, through
strengthened routine immunization services.[1]
Udayapur district is one of the low coverage achieved districts having downward
trend over last three years in eastern region.[2]
With the technical and financial help of UNICEF, DHO Udayapur has organized a 4
days long micro planning workshop for all health workers. Total 144 health
workers comprising of HPI, SHPI, VHW, MCHW and two UNICEF field facilitators
were included in the workshops. 80 participants were present in first batch (2060.3.17-20).
Similarly 64 participants were participated in second batch (2060.3.21-24). Four
facilitators from DHO, two from RHD, two from UNICEF, two from PEN and one from
GAVI total 12 facilitators were involved in these workshops.
Brief Summary
· First day - Mr. Prabhat Bangdel from UNICEF has presented the introduction of micro planning, process, access and utilization of services. Mr. Nawaraj Subba from ERHD gave presentation on the EPI situation of district in the context of region and analysis of coverage and access of services within the district. Dr. K.B.Gharti from GAVI presented on the topic of Adverse Effects Following Injection (AEFI) and Safe injection. Mr. P.B. Bangdel and Mr. Bishnu Paudel from UNICEF had given briefing for a group work and participants were then made aware about what is access and utilization of services. Dr. Binod Shah from PEN presented on the topic of AFP surveillance.
· Day 2 - Dr. Giri from PEN took a session on the topic of monitoring chart. Participants themselves analyzed their Health Institutions' (HIs) coverage and utilization of services on the basis of data of 2057/58, 2058/59 and 2059/60. Number of Immunization posts, catchment households and cluster, distance, road including health facility were drawn and shown on the map of respective VDCs. Participants became known to their situation and problems/ constraints as well.
· Day 3 - Having known the situation, today participants set their target for next fiscal year in their VDC in the group work.
· Day 4 - Presentation by all VDCs or Health Institutions. Full commitment to achieve the target was expressed by each and every health workers with joining hands before audience in the presentation, on the last day of workshop.
Following the completion of each day, facilitators got together to review the day. At the time facilitators also planned for next day.
Workshop showed
commitment by setting the target for next fiscal year
|
Coverage (Access of service) |
Drop Out Rate (Utilization) |
||||
|
District's (aggregate figure) |
BCG |
DPT3 |
Measles |
BCGvMeasles |
DPT1vDPT3 |
|
059/60 (Current year situation) |
76% |
68% |
64% |
12% |
9% |
|
060/61 (Next year's target set) |
93% |
90% |
88% |
7% |
5% |
Physical Arrangement:
Workshop was held at City hall of DDC at Gaighat. Physical facility such as space, furniture, water, electricity, OHP was made available. Management for refreshment was good. Participants took part in the workshop in comfortable physical environment.
Outcome of Workshop
Micro planning as such its objectives and contents were very
urgent and useful for Udayapur district. The desired objectives of workshop
were fulfilled. Existing problems were identified and participants themselves discovered
possible solutions with the help of facilitators. Additional immunization posts
in the VDC are to be managed in order to increase access. Participants have got
new vision and idea for the days on their day to day work of immunization as per
feed back been expressed by participants at the end of workshop.
Problem constraints
identified in the workshops
·
Inadequate
IEC/Inter-personnel communication
·
Mobility
of Population
·
Place
of Immunization Post to be reconsider
·
Inadequate
motivation - Health workers
·
Recording
reporting problem
·
Inadequate
logistics – Vaccine, syringe/needles
·
Inadequate
vaccine supply
·
Irregular
vaccine movement /Cold chain problem / CCA involvement - low
·
TADA
for peon /cost for vaccine transport
·
No supervision
by district / HP/ SHP
·
Register
not properly maintained
·
Reporting
status - to be improved
(Outcome of the group work has been submitted to DHO for the Plan of Action and reference).
Weakness of program:
Group of participants was large. Setting of target for next fiscal year looks like ambitious.
Recommendations:
· Health Education program should be strengthen in VDCs by VHW, MCHW at
Mothers group meetings. NGO partners can take part in this regard.
· Supervision of the EPI posts needed to be done by SHP/HP and DHO. Integrated Supervision by HP and SHP and monitoring should be started.
· Cold chain management should be strengthened in district and sub Centres.
· Some additional immunization posts should be managed. Quality of cold chain should be ensured.
· TADA and cost for vaccine transportation payment need to be managed and closely monitored by district.
Nawaraj Subba
Sr.P.H.O.
E.R.H.D., Dhankuta
2060.3.27