MCH/CMAM PROJECT COMPLETION REPORT
15th Nov 2010 to 30th June 2011
Funded By: World Food Program
Under supervision: Salik Development Foundation (SDF)
Head Office: H # 82, St# 02, Sector –C, Shiekhmaltoon Town Mardan Khyber Pakhtoon Khwa (KPK). Phone# 0937-868099, Website: www.salikfoundation.org
CMAM Completion Report District Kohistan, Salik Development Foundation (SDF),
SDF Introduction: Salik Development Foundation (SDF) is a nonprofit organization, established in 1989. Working area of SDF is NWFP and Azad Jamu & Kashmir, while SDF has offices in Takht Bhai, (Mardan), Ghari Habibullah, district Mansehra, Saidu Sharif Mingora Swat,Dassu district Kohistan,Timer gara dist lower dir. The main cause of its establishment is to ensure a peace full, prosperous and developed society. For the purpose, SDF has started the process of community social mobilization and launched several developmental projects i.e Water supply, Sanitation, Environmental Protection, Health, Education, Agriculture development projects, Advocacy, Women in Development projects, Relief Programs, Flood protection, and especially Community Physical Infrastructure Program (CPI) with the financial & technical assistance of PPAF. PPAF and its whole management executive team facilitated Salik Foundation very well, due to which Salik Foundation has found many valuable pearls in the shape of thousands of volunteers from different communities of Khyber Pakhtoon Khwa (KPK), especially District Peshawar, Distt Mardan and Swabi In the whole process of community development and social mobilization.
Registration: 1. Social welfare Department Govt of NWFP (R.No. DSW/845/NWFP) 2. Federal Ministry of Youth Affairs Islamabad.
Affiliation
1. Pakistan Poverty Alleviation Fund (PPAF) 2. Trust For Voluntary Organization (TVO)
Goal Efforts for the Establishment of a Peaceful, Prosperous & Developed.
Objectives:
Provision of educational facilities and awareness raising in back ward communities. Efforts for the provision of basic health facilities, health education, nutrition and awareness raising about prevention and control of diseases. To alleviate poverty and efforts for availability of basic needs of life i.e employment, skill trainings, safe drinking water, sanitation and community physical infrastructure to deprived and backward communities. To improve natural resources for the protection of Environment through awareness raising and capacity building trainings. Capacity building of farmers, information sharing and provision of facilities for agricultural development. Advocacy for peace, equality and human rights (esp. women and children). Coordination and linkage development, Information sharing and capacity building of CSOs / CBOs for participatory development and human resource development. Relief and Rehabilitation efforts in case of natural disasters and accidents.
Development Peace Prosperity
Motive of SDF
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CMAM Completion Report District Kohistan, Salik Development Foundation (SDF),
Background of the project:
Over the course of July and early August 2010, Pakistan experienced the heavy monsoon rains which resulted floods. Heavy rainfall, flash floods and reverie floods have devastated large parts of Pakistan since the beginning of seasonal monsoon rains on 22 July.
In Khyber Pakhtunkhwa (KP) Province, intense rains during the last week of July and in early August were joined by the swelling of major rivers due to rainwater surging down from the highland areas. The Pakistan Meteorological Department reported said that within one week in late July, KP received more than 200 millimeters of rainfall - ten times as much as the province normally receives in the course of an entire year. Baluchistan, Pakistan-Administered Kashmir; kohistan and Gilgit Baltistan, also experienced extreme weather, resulting in widespread losses and damages.
As stated above all the district were severely hit by floods. Kohistan is also one of the flood affected district. Kohistan as because of its unique geographical location faced the floods situation as different from other areas. Kohistan means the land of mountain this feature of kohistan faced a very worse condition during the floods. Inaccessibility to different areas is one of the main hurdles in the relief activities. So many of the NGOs and INGOs are hesitating to visit for relief activities in district kohistan. Due to far flung and spread areas kohistan remain backward both in normal and especially in emergency situation. Due to these reasons district kohistan remain very back ward as compare to other down district. In this catastrophe also district kohistan remain as one of the neglected district as in most of the flood hit districts first phase of emergency response is about to its completion. While district kohistan is still on the first phase of emergency response.
The Kohistan district was completely cut off from the whole country for three weeks. They got shortage of food which badly effected children, women and elders regarding their nutrition requirements.
Similarly health status of the people have become very worst due to unavailability of doctors and medicines especially women have no medical facility i.e gynae, antenatal, postnatal, and EMOC services for safe motherhood.
Salik Development Foundation has signed a Field level agreement (FLA) World Food Program (WFP) for support of Supplementary Feeding (SFP) component in the joint venture program of CMAM with UNICEF and WHO in 6 health facilities of 7 UC of District Kohistan.
Strengthening of MCH (Maternal & Child Health) and establishment of Project Name CMAM (Community Based Management of Acute Malnutrition) Services in seven union councils of District Kohistan, Khyber Pukhtoonkhwa, Pakistan
Project Implementing Agency Salik Development Foundation (SDF)
Reporting Period 15th November to 5th May, 2011 And 6th May to 30th June, 2011(Extension)
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CMAM Completion Report District Kohistan, Salik Development Foundation (SDF),
Target UCs and Health Facilites
1. UC Pattan (RHC Pattan) Basic EmOC 24/7 Services + Nutrition 2. UC Jijal (BHU Jijal). MCH + Nutrition Services 3.UC Segayon (BHU Banil Qila). MCH + Nutrition Services 4. UC Shalkan Abad (BHU Shalkan Abad). MCH + Nutrition Services 5.UC Dassu (RHC Dassu). Nutrition Services 6. UC Komila. Nutrition Services 7. Sazeen (RCH Shatyal) Nutrition Services
Target UCs Population:
S# UCs Detail Target Population
1 Pattan 18000
2 Segayon 7000
3 Shalkan Abad 16000
4 Jejal 11700
5 Dassu 18500
6 Komila 16000
7 Sazeen 15000
Details of Activities planned to be conducted:
Train workers on rapid nutrition assessment using MUAC Conduct a rapid nutrition assessment in the target UCs using MUAC tap to establish baseline information. Establishment of SFP/OTP sites and breastfeeding corners in the target health facilities in coordination with health department Identification of HCPs for CMAM/IYCF trainings Training of HCPs and project staff on CMAM and IYCF Identification and recruitment of project staff Active involvement of HCPs in CMAM services provision Identification, recruitment and training of CRPs on community mobilization and screening services. Recruitment and involvement of local religious leaders as community resource person Identification of religious leaders in the area and formation of supreme ulema council and health facility based councils
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CMAM Completion Report District Kohistan, Salik Development Foundation (SDF),
Orientation of Ulema councils on UNICEF supported MCH and nutrition interventions. Weekly/Monthly meetings of Ulamas for health and nutrition interventions promotion Including/ensuring speeches in Friday Sermons on the importance of health and Nutrition for healthy life. Engage DoH staff in all stages of planning & implementation Train DoH staff on CMAM & IYCF Equip health facilities with anthropometric equipment and necessary supplies for CMAM intervention Advocacy & Lobbying with DoH for integration of CMAM in the public health care Set up a system of monitoring of OTPs and supplies management Data recording and computerization Project documentation and reporting Blanket distribution of Supplies
Coordination activities with health department before project implementation
Meeting with Dr.Gulber Khan, EDO Healtlh Kohistan for project briefing and discussion on implementation. Visit of RHC Dassu and Meeting with MO Dr. Mumtaz RHC Dassu for beginning CMAM activities in RHC Dassu. Visit of RHC Shatyal and Meeting with Incharge Abdurasheed Technician for beginning CMAM activities in RHC Shatyal. Visit of RHC Pattan and Meeting with MO Dr. Muhammad Geer for beginning of MCH/ CMAM activities and establishment of Labour room and basic EmOC 24/7 services in RHC Pattan. Visit of BHU Jajial and Meeting with Incharge Mr.Rustam Khan for beginning of MCH and CMAM activities. Visit of BHU Banil Qila Meeting with staff, project introduction and beginning of MCH and CMAM activities in Banil Qila. Visit of BHU Shalkan Abad Meeting with incharge Dost Muhammad for beginning of MCH and CMAM activities in Shalkan Abad.
M.Ibrahim Jan, Project Coordinator Dr.Gulber Khan EDO Health Kohistan M.Ibrahim Jan, Project Coordinator Meeting with Dr.Gulber Khan EDO Health during SDF Dassu Office visit Meeting with Dr.Mumtaz MO RHC Dassu Kohistan Kohistan
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CMAM Completion Report District Kohistan, Salik Development Foundation (SDF),
Orientation & Opening of project
Participants
1. Maulana Abdul Haleem 2. Maulana Dildar ( former MPA) 3. Maulana Lajbar 4. Maulana Dosham Khan 5. Haji Muhammad Anwar ul Haq 6. Qari Rizwan 7. Dr.Geer MO RHC Pattan 8. Abdur Razaq local activist 9. Mr.Khalid Dispenser SDF 10. Muhammad Ibrahim Jan, Project Coordinator, MCH/CMAM Kohistan. 11. Dr.Hafeez ul Wahab, SDF 12. Mr.Shaukat ali, SDF 13. RHC Pattan medical and non medical staff and other community members.
Objective of the ceremony.
To begin the 24/7 basic EmOC services in RHC Pattan with the support of local religious leaders, political and social activists and community leaders.
Meeting with Dr.Geer, MO RHC Pattan
A coordination meeting held with MO RHC Pattan for proper beginning of MNCH, Labour room, MO, WMO offices and proper planning for opening ceremony.
Proceeding of the ceremony Meeting with Dr.M Geer MO RHC Pattan, Kohistan
The ceremony was started with the recitation from the Holy Quran by Qari Rizwan member of local Ulma committee and religious activist.
Mr.Muhammad Ibrahim Jan Project Coordinator welcomed all the guest participants and thanked for their active and short time participation. He thanked Moulana Abdul Haleem, Khateeb Jamia Masjid Pattan, and Moulana Dildar saib (Religious leader and former MPA) for their participation and visit to RHC Pattan. M.Ibrahim Jan PC, Introduce the MCH/CMAM Project
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CMAM Completion Report District Kohistan, Salik Development Foundation (SDF),
He introduced Salik Foundation and World Food Program (WFP). He told that these both organizations has signed an agreement for the project of Mother and Child Health and Community Management of Acute Malnutrition project in 7 union councils of district Kohistan including Tehsil Pattan.
He told to the participants about the main aim of the project is to provide basic EmOC services on 24/7 basis through skilled staff and WMO in RHC Pattan. He also introduced CMAM project and its services and methodology. He highlighted the benefits of this program and positive effects Dr.Hafeez ul Wahab addressing to the participants on the health of children and P/L mothers.
At the end of his speech he requested all the religious and local leaders to support and own this project and make sure the successful implementation of the project.
Dr.Hafeez ul Wahab (SDF) addressed to the participants. He thanked local support of people and leaders. He also thanked Dr.Geer and his staff for support. He ensured that our medical team and MCH/CMAM staff will serve according to their best efforts. Moulana Dildar Religious leader addressing to the participants Qari Rizwan (member of local religious committee and Jirga) appreciated the emergency relief and medical services of Salik Foundation after floods in Tehsil Pattan. He told that we believe that Salik Foundation will successfully implement these projects on the basis of previous experience, local support of community and efficient staff of Salik Foundation.
Maulana Dildar (religious leader and former MPA) addressed. He thanked WFP and Salik Foundation for the consideration of the issue and CMAM problems in Kohistan. He told to the participants that we don’t have qualified and skilled birth attendants in our whole Tehsil Pattan. We have Maulana Abdul Haleem is addressing to carry our women to lady doctors outside Pattan i.e Besham and Abbot Abad for treatment and Deliveries, while majority deliveries are being conducted with the hands of unskilled and traditional birth attendants which cause severe complications to both mother and child and some time deaths occur. At the end of his speech he offered his fullest cooperation and support on behalf of local religious leader and local activist. He also requested local administration for the support and security of staff.
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CMAM Completion Report District Kohistan, Salik Development Foundation (SDF),
Moulana Abdul Haleem Saib Khateeb Jamia Masjid Pattan appreciated the said services and ensured his cooperation and support. He also advised present Ulma e Kiram to help and support Salik Foundation for the MCH and CMAM project activities.
At the end of the ceremony Maulana Abdul Haleem saib called all participants to raise their hands for pray for the success of the project.
The CMAM program started with the pray of all participants.
1. Facility Based and Outreach Activities CMAM
1.1 Target Union Councils: ……………..07 (Dassu, Sazeen, Pattan, Shalkan Abad, Jajial, Segayon and Komila)
1.2 Total Target Health Facilities: ….06 (RHC Dassu, RHC Shatyal, RHC Pattan, BHU Shalkan Abad, BHU Jajial and BHU Banil Qila)
Project Targets
Activities Target
Screening of Children 15754
Total SFP Children 1575
OTP Children 374
Screening of PLWs 1003
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CMAM Completion Report District Kohistan, Salik Development Foundation (SDF),
Project Achievements:
Screening of Children OTP 558 SFP 1973
Total: 18036
Total SFP Children 2048
Total SFP Children Cured 983
Total SFP Default 36
Current in Program 1065
OTP Children 564
Cured 225
Default 78 (including seasonal migrations)
Current in Program 261
Screening of PLWs total 10928 SFP PLWs 1447 Cured 589
Current PLWs in program 858
Capacity Building
02 Trainings conducted for DoH and Project staff (04days planned vs Actual)
10 HCPs of DoH trained VS 15 Planned
15 HCPs of DoH involved in project VS 15 Planned
16 Outreach workers trained on screening and referrals of Acute Malnutrition cases (same training for DoH & Project Staff)
02 MIS Assistant trained on NIS
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CMAM Completion Report District Kohistan, Salik Development Foundation (SDF),
Details of establishing services at facilities
Total 06 health facilities adopted for CMAM interventions 02 HCPs of the MoH involved and they supported in term of social mobilization, finding defaulters, health education to parents. At the beginning space problem faced in RHC Dassu & Pattan for CMAM services but the problem resolved after few days. Accessibility of beneficiaries to the centre was easy for plan area population while it was difficult for population from hilly areas. The composition of nutrition staff at each facility level was 1 NA, 1 H & N Educator, 2 COWs for BHU while 3 COWs for RHC while 3 CRPs at each RHC level supported CMAM / WFP services in term of social mobilization/health awareness sessions etc. Health & Nutrition awareness sessions conducted by female H&N Educators at facility level on daily basis when 3, 4 , 5 mothers/PLs got together.
Supplies Details
Total Food Received / Issued Detail in MT District Level Total 7 UCs
Commodity Received Issued Balance
S/ Plumpy 4.36 4.36 0
Veg. OIL 3.8115 3.8115 0
HEBs 0.88425 0.88425 0
WSB 2.92008 2.92008 0
Damages / Losses:
Total 0.04 MT Oil received in damaged cartons & the oil was lost.
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CMAM Completion Report District Kohistan, Salik Development Foundation (SDF),
Constraints and Issues:
Insufficient space for CMAM services at RHC Dassu and RHC Pattan at the beginning of the project
Lack of cooperation from government health staff at beginning.
Delayed supplies for SFP from WFP.
Community resistance in some outreach areas.
Start of activities in damaged health facilities especially in RHC Pattan, BHU Jajial and BHU Shalkan Abad was not able to start work.
Lack of accommodation for project staff especially in RHC Pattan, RHC Dassu,BHU Jajial.
Long Distance between health facilities.
Communication problems of internet/phone etc especially for daily reporting to WFP.
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