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Facility Based Assessment for Reproductive Health Commodities and Services

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Facility Based Assessment for Reproductive Health Commodities and Services FINAL REPORT United Nations Population Fund (UNFPA) Shanta Bhawan Road, Jhamsikhel Lalitpur, Nepal Submitted By Nepal Development Research Institute Shree Durbar Tole, Pulchowk, Lalitpur, Nepal Submission date: 16th March 2015 i This report is a product of research on "Facility Based Assessment for Reproductive Health Commodities and Services “carried out by Nepal Development Research Institute with the financial support of United Nations Population Fund (UNFPA) from October 2014 to January 2015 Study Team • Dr. Basu Dev Pandey, Team Leader • Prof. Naveen Shrestha, Senior Consultant Expert • Dr. Jaya Kumar Gurung, Project Coordinator • Dr. Rabita Mulmi, Field Survey Coordinator • Ms. Saruna Ghimire, Consultant Expert • Ms. Sona Shakya , Senior Research Associate Report By: Nepal Development Research Institute Shree Durbar Tole, Pulchowk, Lalitpur www.ndri.org.np ii Acknowledgement It is a great pleasure for Nepal Development Research Institute (NDRI) to accomplish this research in collaboration with concern departments of Government of Nepal and UNFPA/Nepal. We thank UNFPA for entrusting NDRI and making congenial environment for this research work. It's immense pleasure to acknowledge the representatives of Nepal Government's agencies particularly Dr. Senendra Raj Upreti, Director General , Department of Health services, Dr. Bhim Singh Tinkari, Director of Logistic Management Division (LMD), Dr. Pushpa Chaudhari, Director, Family Health Division (FHD), Bhogendra Raj Dotel, Senior Public Health Administrator, Mr. Gyan Bahadur BC, Planning Officer (LMD), Krishna Ghimire, Joint Secretary (LMD), Upendra Dhungana (LMD) for their invaluable cooperation into various ways; valuable inputs in the inception phase of project, important contribution in training to field researchers, arranging the district and regional level health facilities for their cooperation, and providing suggestions in the draft report. NDRI highly appreciate UNFPA team particularly, Ms. Guilia Vallese, Country representative of UNFPA; Ms. Latika Maskey Pradhan, Assistant Representative; Dr. Shilu Adhilari, Reproductive Health specialist; Bobby Rawal Basnet, M&E Officer and Chandra Mani Dhungana, RHCS Programme Analyst for their kind cooperation in desigining research tools, their valuable inputs in data analysis, draft report and finally in shaping this report. We also acknowledge the kind cooperation of Mr. Pradeep Paudel, M&E Advisor and Dr. Suresh Mehata, Research Advisor Health Specialists, NHSSP for their valuable inputs in finalizing survey tools and providing important suggestions in the draft report. NDRI offers gratitude to the entire research team: Dr. Basu Dev Pandey, Team Leader; Mr. Naveen Shrestha, Senior Consultant Expert; Ms Saruna Ghimire, Consultant Expert; Ms Sona Shakya, Senior Research Associate and Dr. Rabita Mulmi, GESI Expert for their hard work from the inception period to project accomplishment. With great appreciation, I would particularly like to acknowledge the contribution of all our field supervisors and enumerators; without their contribution this study would not have been accomplished. Active contribution of Ms Roopa Bhandari for entire administrative and financial management incurred to this project is acknowledged as well. We would also like to extent our sincere thanks to all DHO/DPHO in relevant districts for their valuable co- operations. Last but not the least, we would also like to thank all the respondent service recipients for providing the information regarding the service qualities during the exit interview, the in-charge and staffs of relevant health facilities; health posts, sub-health posts, district hospitals, regional and tertiary hospitals, private hospitals, FPAN, Marie stopes, Sangini, SEWA, PSSN, Polyclinics; for providing information and their cooperation during questionnaire survey. Dr. Jaya Kumar Gurung Executive Director Nepal Development Research Institute (NDRI) i Acronyms AHW Auxiliary health workers ANC Antenatal Care ASL Authorized Stock Level CEONC Comprehensive Emergency Obstetric and Neonatal Care CPR Contraceptive Prevalence Rate DRC Development Resource Centre D(P)HOs District Public Health Offices DoHS Department of Health Services DRC Development Resource Centre EC Emergency Contraception EDPs External Development Partners EHCS Essential Health Care Services EOP Emergency Order Point FHCP Free Health Care Policy FHD Family Health Division FP Family Planning FPAN Family Planning Association of Nepal GPRHCS Global Programme to enhance RHCS HDC Hospital Development Committee HFOMC Health Facility Operation and Management Committee HP Health Post ICT Information and Communication Technology IUCD Intrauterine contraceptive device ICPD International Conference on Population and Development LMD Logistics Management Division LMIS Logistics Management Information Systems MDG Millennium Development Goal MoHP Ministry of Health and Population NHSP Nepal Health Sector eProgramme ii NFHP Nepal Family Health Program NHRC Nepal Health Research Council NHTC National Health Training Centre OP Output PHCCs Primary Health Care Centers PNC Post Natal Care PSSN Pariwar Swastha Sewa Network PPA Public Procurement Act RHDs Regional Health Directorates RH Reproductive Health RHCS Reproductive Health Commodity Security RMS Regional Medical Stores SDPs Service Delivery Points SHP Sub Health Post SPSS Statistical Package for Social Scientists STI Sexually Transmitted Infections STS Service Tracking Survey iii Table of Contents Acknowledgement .......................................................................................................................................................................... i Acronyms ......................................................................................................................................................................................... ii List of Tables vii List of Figures ....................................................................................................................................................... ix List of Annex ........................................................................................................................................................ ix Executive summary ......................................................................................................................................................................... i Background ...................................................................................................................................................................................... i Methods ............................................................................................................................................................................................ i Key Findings ..................................................................................................................................................................................... i Findings for exit interview........................................................................................................................................................... iii Conclusion: ...................................................................................................................................................................................... iii Recommendations.......................................................................................................................................................................... iv PART 1: INTRODUCTION ................................................................................................................................ 1 1.1. Background ...................................................................................................................................................................... 1 1.2. Rationale and Objective of the Study........................................................................................................................ 1 1.3. Survey Organization and Management .................................................................................................................... 2 1.4. Methodology and Limitations ....................................................................................................................................... 2 1.4.1. Survey Design and Sampling of Facilities ............................................................................................................ 2 1.4.2. Data Collection ....................................................................................................................................................... 12 Recruit and train field staff enumerators and supervisors and data entry staff .......................................................... 12 Adapt and Pre-test Survey Questionnaires .......................................................................................................................... 12 Finalize the Survey Questionnaires ......................................................................................................................................... 13 Mobilization of the Field Staffs ............................................................................................................................................... 13 1.4.3. Data Analysis and Presentation .........................................................................................................................
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