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Integrated Family Health Program and other related programs Minutes of Technical Advisory Committee Field trip and visit report Eastern Zone, TIGRAY March 30 – April 01, 2011 MULU HILUF’S TRIP SHIRKA TRIP Integrated Family Health Program and other related program Technical Advisory Committee Quarterly field trip and visit report - Eastern Zone, TIGRAY March 30 – April 1, 2011 MULU HILUF’S TRIP Participants 1. Wz. Genet Mengistu, Population Coordination Core, Ministry of Finance and Economic Development 2. Ato Gemechu Kufa, Ministry of Health 3. Ato Damena Lema, Ministry of Education 4. Ato Tesfa Teferi, Ministry of Women, Children and Youth 5. Ato Alemu Shiferaw, HIV/AIDS Prevention and Control Office 6. Ato Mulugeta G/Hiwot Habte, Charities and Societies Agency 7. Wz. Gezu Berhanu, Consortium of Reproductive Health Associations 8. Ato Birkneh Tewachew Wolde, Board Member- Consortium of Reproductive Health Associations 9. Dr. Samuel Tilahun, Centre for Disease Control 10. Wz. Yalem Tsgeay, Regional Health Bureau 11. Ato Haddish Zewde, Regional Educational Bureau 12. Ato Mulugeta Mesfin, Bureau of Finance and Economic Development 13. Wz. Zenebech Fisseha, Women’s Affairs Staff of IFHP 1. Ato Tilahun Giday, Addis Ababa IFHP Office 2. Ato Girma Kassie, Addis Ababa IFHP Office 3. Wz. Makida Gebre, Addis Ababa IFHP Office 4. Ato Abdusemed Mussa, Addis Ababa IFHP Office 5. Ato Awala Equar, Tigray Regional IFHP Office 6. Ato Girmay Adane, Tigray Regional IFHP Office 7. Ato Kidanmariam Alemseged, Tigray Regional IFHP Office 8. Ato Solomon Kebede, Tigray Regional IFHP Office 9. Ato Samuel Gebre/Egziabher, Tigray Regional IFHP Office 10. Ato Desta Gebre-Egziabher, Tigray Regional IFHP Office 11. Wz. Adey Abebe, Addis Ababa IFHP Office Destination Eastern Tigray Zone Duration of the visit March 30 – April 1, 2011 Sites visited 1. Kilte-Awlaelo Woreda Health Office 2. Negash Health Center 3. Gemad Health Post 4. Adi-Messanu Health Post 5. Adigrat Woreda Health Office 6. Adigrat Health Center 7. Freweyni Health Center 8. Mekelle Hospital 9. REST Office Wednesday, March 30, 2011 Kilte-Awlaelo Woreda Health Office The Technical Advisory Committee (TAC) made its regular visit to Tigray region, Eastern Zone. Its first visit was to Kilte Awlaelo Woreda Health Office. Meeting with the Head of the office Ato Tsegaye and other staff members, Ato Tilahun Giday, Country Representative, Pathfinder International/Ethiopia, briefly informed the Office of the intention of visit. He said composed of government, donor and NGO partners, the TAC makes quarterly field visits to the four program regions of the country (Amhara, Tigray, SNNP, and Oromia). The Committee visits projects of IFHP and provides advice and encouragement on what it has seen. He also explained that a parallel structure - Woreda Advisory Committee (WAC) - was laid at Woreda level and composed of religious leaders, women’s association and representatives of relevant government sectoral offices. Accordingly, this quarter, the TAC arrived in Eastern Tigray Zone to visit and discuss with partners. Head of the Woreda Health Office briefed the TAC on the work they undertook and following his briefing members of the TAC raised certain questions for discussion. In response to various questions, it was explained that IFHP supports the Government’s Health Extension Program by jointly planning its work with Regional and Woreda health structures. During implementation, providing technical, financial and logistic support, IFHP assists in filling gaps within the health plan of the government. Discussing on particular issues, it was explained that community structures such as Women’s Associations, Women’s League and Developmental Army of Women are 1 used in promoting issues of women and children. Prevention of Mother-To-Child- Transmission (PMTCT) service which is 8% was explained to be low because of low awareness of mothers. IFHP however, is helping the Woreda Health Office in improving the situation. IFHP’s support in undertaking Integrated Supportive Supervision (ISS) by providing skills training, helping in developing and jointly implementing follow up tools, was greatly appreciated. It strengthened joint efforts where Zonal and Woreda people visit health facilities to identifying gaps and provide on the spot technical support. Regular review meetings held between IFHP and the various government administrative bodies was also explained to be very effective in ensuring proper implementation of health services. As a result, Kilte-Awlaelo Woreda Health Office has been recognized as one of the best performing Offices in the Zone. The Woreda Health Office stated that IFHP is more than a partner whom they consult on any problem they have. The organization has great commitment not only in assisting but also in following up on assistance provided, e.g. follow-up of capacity building trainings it regularly provides. The Office is now requesting IFHP to provide capacity building training for the newly established Developmental Army of Women. Negash Health Center The TAC moving on further visited Negash Health Center where it was met by the Center’s head Ato Fitsum Aregawi who gave briefing on this newly established health center. He explained that the Health Center used to be located elsewhere before it moved to this new location six months ago. It serves a population of 26,833, has 4 Health Posts under it and closely works with 4 Kebele peasant associations and 161 Developmental Army of Women. Ato Fitsum took the group around explaining the functions of the different blocks by starting from a small garden where vegetables were planted. This is a demonstration site where they would teach mothers about nutrition and at the same time it generates income for the Health Center. However, water is not sufficiently available and the Center is trying to approach various partners to help resolve this problem. Explaining on the various services provided by the Health Center, institutional delivery was said to be still low because of low awareness by mothers on the benefits of delivery at these facilities. In addition, timely Ambulance service to bring in mothers for delivery is another problem. It was stressed by the Woreda Health Office that the Health Center should work more on improving services of the facility and making the environment more pleasant so that mothers can find it more attractive and beneficial to delivery at Health Centers. 2 Provision of PMTCT was said to be 100% with all women coming for ANC receiving the service. However, problems of partner testing (husbands refusing to test for HIV) and resistance to be linked to follow up services by those tested as positive, are some of the difficulties. It was further explained that Negash Health Center does not provide ART service instead refers to Wukro Hosptial. Because of low case load (low demand for service) it has not been necessary to provide the service at this Health Center. However, several people from Mekelle city and Afar region test for HIV/AIDS at this Center. Capacity building assistance in insertion of Long Acting Family Planning service, provision of PMTCT and FP/HIV integration services, Essential Nutrition Action (ENA), Expanded Program on Immunization (EPI), Integrated Supportive Supervision (ISS), etc. complimented by financial support provided by IFHP was appreciated and said to have helped in improving quality of service provided by the Health Center. As a result of health services provided by Negash Health Center Ato Fitsum says that changes that have been happening are: 1. Decreasing rates of maternal and child mortality, 2. Increasing demand for Long Acting Family Planning methods such as Implanon, and 3. Improving awareness on health issues which is evident from increasing demand for HIV/AIDS testing. Nonetheless, the TAC voiced its concern regarding lack of proper service provision especially in services of delivery. Insignificant problems such as lack of bed sheets and mattress for already available beds (which IFHP said that it could easily have provided had it been notified) was hindering provision of services. Furthermore, unavailability of children’s ward in which case the Center had to convert a men’s ward into a children’s ward was also a concern. Gemad Health Post The visiting group continued its visit to Negash’s primary health care unit – Gemad Health Post and met with Kidan GebreMedhin. She briefed the TAC on the work she carries out with her colleague Tsehay (the other Health Extension Worker (HEW) working here). It was explained that there are 3 Developmental Army of Women which assist the HEWs. They assist in mobilizing communities and raising awareness. They also work hard in ensuring that households practice the 16 health package (of the Health Extension Program) and integrating it with other sector programs (other than health) as well. 3 Moving on, the group visited the home of Gebrehiwot who is a Kebele Chairperson. It is one of the model households within the Kebele. The TAC found the house very impressive in terms of cleanliness and innovative use of materials to build a toilet and kitchen. The group took time to talk to Gebrehiwot. Adi-Mesanu Health Post Atsbi Azmera Gebre who is the HEW at this Health Post welcomed the group upon its arrival. She is one of the first HEWs who received training on Implanon insertion. The Health Post was also said to be one of the exemplary health facilities especially in the provision of PMTCT and nutrition services. It provides health services to a population of 7,583 and 1,723 households. From out of these, 1,628 household have graduated as model households. Thursday, March 31, 2011 Adigrat Woreda Health Office The following day the TAC drove to Adigrat town and started the day’s visit by dropping into IFHP’s Cluster Office which is located in the compound of the Woreda Health Office. Basic information on the work carried out by this Office was given where it was stated that it covers 7 woredas and two administrative towns in Eastern Tigray Zone.
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