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Jan – Apr 2020 Activity Report

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Jan – Apr 2020 Activity Report Rural Health Care Initiative Activity Report, January 2020 RHCI in Sierra Leone operates programs out of its office in Tikonko to support efforts in maternal and child health. The programs in this report include: ñ Mbao-mi Birth Waiting Home, Tikonko ñ Community Health Clinic birth waiting facility support, Kassama and Sembehun Tabema ñ Motorbike Outreach – Tikonko; serving Lembema, Dodo, Gbalehun and Sunga ñ Motorbike Outreach – Gondama; serving Gelehun, Sembehun Kokofele, Magbema and Gandorhun ñ Family Planning Services, Tikonko and surrounding villages Birth Waiting Homes The Mbao-mi accommodates 24 women and is staffed with a Senior Midwife, State Registered Nurse, Community Health Workers, security and administration personnel with two drivers for the RHCI vehicles. Women admitted are referred by the Tikonko Community Health Clinic (CHC) and receive lodging, food, health care, education, vocational training and transportation to the site of delivery and to their home village. Most women return to Mbao-mi after delivery for post-natal care, education and support. Mbao- mi provides staff and supplies to accompany the woman to the CHC for delivery. The Gondama Birth Waiting Home will accommodate 10 women and will provide similar services as Mbao-mi. The Kassama and Sembehun Tabema Peripheral Health Units (PHU’s) receive support from RHCI. The support includes medical supplies, medications and a stipend for food for women who stay at their facilities prior to labor and delivery. This arrangement was made between RHCI and these PHU’s due to their desire to keep deliveries at their CHC. Table 1. Number of Birth Waiting Home admissions in January, 2020. Location Admissions Tikonko 14 Kassama 5 Sembehun Tabema 3 Gondama Not Open Total 22 Motorbike Outreach Clinics The motorbike outreach program is a partnership with the Tikonko CHC and Gondama CHC. It provides staff stipends, medications, supplies and education to eight villages in the Tikonko Chiefdom. Each village in the outreach program hosts a motorbike clinic one day per month. Services provided include: immuniZations (provided by UNICEF), triage and treatment for children under 5, malnutrition evaluation and referral, prenatal visits with monitoring, treatment and education. Table 2. Number of children and pregnant women evaluated and treated by clinic location and date. January, 2020. Under 5’s Antenatal Care Location Date Number Treatments* Number Treatments* Tikonko Outreach Lembema January 3 21 59 5 11 Dodo January 10 67 116 5 13 Gbalehun January 17 46 81 7 16 Sunga January 24 24 70 5 16 Tikonko Total 158 326 22 56 Gondama Outreach Gelehun January 2 59 93 16 45 Gandorhun January 9 72 137 9 24 Magbema January 16 20 37 13 35 Sembehun Kokofele January 23 18 48 20 60 Gondama Total 169 315 58 164 Total 327 641 80 214 *Treatments are the number of doses of medications that were dispensed, some individuals received multiple treatments. During January, children were most frequently treated for acute respiratory infections/pneumonia and malaria. Malnutrition was not documented specifically as a diagnosis on the patient ledger, but will be tracked in future reports and evaluated based on MUAC and Z-scores. A diagnosis was not reported on every child treated. Table 3. Diagnoses reported in Children’s Under 5’s Clinic, ordered by most frequent; January, 2020. More than one diagnosis can be reported for each child. Under 5’s Diagnosis Tikonko (number) Gondama (number) Acute respiratory Infection or pneumonia 39 52 Malaria 36 46 Diarrhea 2 11 Skin infection 10 1 Anemia 0 1 Eye infection 0 0 Other reported diagnoses* 6 0 *other diagnoses reported included: malnutrition, sepsis, intestinal parasites Family Planning Activities Table 4. Number of women evaluated and treated by clinic location, date and method of family planning. January, 2020 Method of Family Planning Condom Pills* Depo Implant Location Date Number Number Number Cycles Number Number Tikonko January 7 15 0 7 14 6 2 Dodo January 17 35 2 7 14 23 3 Tikonko January 21 28 0 20 40 8 0 FAWE School January 25 34 0 32 44 2 0 Surgbehun January 28 32 0 18 25 14 0 Total January, 2020 144 2 84 137 53 5 *Birth control pills are documented as the number of women prescribed this method of family planning. A cycle is 21 active pills, 7 days no active pill Under 5's Motorike Outreach Medications and Treatments, January 2020 January Tikonko Gondama Medication Albendazole 400 mg, Tab 5 9 Amoxycillin 125 mg/5ml, bottle 1 7 Amoxycillin 250 mg, tab 72 10 Ampicillin 500 mg, pow for inj, Vial 0 2 Benzyl Benzoate 25%, Emulsion 100 ml Bottle 10 0 Chlorhexidine 7.1% Tube 0 0 Clotrimazole 1%, Tabs250 mg 22 19 Cotrimoxazole 240 mg mg/ 5ml, Susp Bottle 1 1 Dexamethazone 4mg/ml. Inj 0 0 Dextrose 5%, Soln Bag 0 0 Diazapam, 5mg/ml, Inj 0 0 Erythromycin 125mg/5ml, powder, bottle 0 0 Erythromycin 250, tab 0 0 Ferrous Sulphate 125 mg.ml, oral drop bottle 0 3 Ferrous sulphate 200mg tab 31 29 Folic acid 5mg tab 0 0 Gentamycin 0.5%, eye drop, bottle 0 0 Gentamycin 400 mg/ml, Inj 0 3 Lidocaine HCl 2%, vial 0 0 Metronidazole 200 mg/5ml, Powder100, bottle 1 2 Metronidazole 250 mg tab 10 6 Normal saline 0.9% soln, bag 0 0 (ORS) oral rehydration salt 7 1 Paracetamol 100 mg Tab 6 3 Paracetamol 125 mg/5ml, syrup or bottle 5 15 Paracetamol 250 mg tab 119 63 Ringers Lactate soln, bag 0 0 Tetracycline 1% eye ointment, Tube 0 0 (RUFT) Ready to Use Therapeutic Food, Sachet 0 0 Zinc Sulphate 20 mg, Tab 1 0 AL-6 Tab Blister or ASAQ-3 tab (2-11 mos) 35 39 AL-12 Tab Blister or ASAQ-3 Tab (1-5 yrs) 0 7 Artesunate 60 mg.ml Inj, 1 ml vial 0 0 LLIN (Long Lasting Insecticide-Treated Net) 0 0 Vitamin A red 30 mg RE (6-11 mos) 0 31 Vitamin A blue 60 mg RE (12-59 mos) 0 6 Vitamin A (not defined) 0 10 MLS 0 5 MSD 0 13 Nystatin syrup 0 3 Cystain injection 0 2 Cough syrup 0 1 Penta 2 Vaccine 0 2 Penta 3 Vaccine 0 4 Yellow Fever Vaccine 0 8 TOTAL 326 304 Rural Health Care Initiative Activity Report, February 2020 RHCI in Sierra Leone operates programs out of its office in Tikonko to support efforts in maternal and child health. The programs in this report include: ñ Mbao-mi Birth Waiting Home, Tikonko ñ Community Health Clinic birth waiting facility support, Kassama and Sembehun Tabema ñ Motorbike Outreach – Tikonko; serving Lembema, Dodo, Gbalehun and Sunga ñ Motorbike Outreach – Gondama; serving Gelehun, Sembehun Kokofele, Magbema and Gandorhun ñ Family Planning Services, Tikonko and surrounding villages ñ Patient Transports – RHCI vehicles Birth Waiting Homes The Mbao-mi accommodates 24 women and is staffed with a Senior Midwife, State Registered Nurse, Community Health Workers, security and administration personnel with two drivers for the RHCI vehicles. Women admitted are referred by the Tikonko Community Health Clinic (CHC) and receive lodging, food, health care, education, vocational training and transportation to the site of delivery and to their home village. Most women return to Mbao-mi after delivery for post-natal care, education and support. Mbao- mi provides staff and supplies to accompany the woman to the CHC for delivery. The Gondama Birth Waiting Home will accommodate 10 women and will provide similar services as Mbao-mi. The opening of the Gondama birth waiting home is being delayed due to the global COVID-19 pandemic. The Kassama and Sembehun Tabema Peripheral Health Units (PHU’s) receive support from RHCI. The support includes medical supplies, medications and a stipend for food for women who stay at their facilities prior to labor and delivery. This arrangement was made between RHCI and these PHU’s due to their desire to keep deliveries at their CHC. Table 1. Number of Birth Waiting Home admissions in February, 2020. Location Admissions Tikonko 20 Kassama 4 Sembehun Tabema 4 Gondama Not Open Total 28 Motorbike Outreach Clinics The motorbike outreach program is a partnership with the Tikonko CHC and Gondama CHC. It provides staff stipends, medications, supplies and education to eight villages in the Tikonko Chiefdom. Each village in the outreach program hosts a motorbike clinic one day per month. Services provided include: immuniZations (provided by UNICEF), triage and treatment for children under 5, malnutrition evaluation and referral, prenatal visits with monitoring, treatment and education. Beginning in mid-April, 2020 Pikinmix will be provided as a treatment for malnutrition at all under 5’s motorbike outreach clinics. A nutritionist will accompany motorbike outreach and provide assessment for this treatment and nutrition education. Table 2. Number of children and pregnant women evaluated and treated by clinic location and date. February, 2020. Under 5’s Antenatal Care Location Date Number Treatments* Number Treatments* Tikonko Outreach Lembema February 7 NR NR NR NR Dodo February 14 36 73 3 9 Gbalehun February 21 25 44 4 8 Sunga February 28 35 58 6 16 Tikonko Total 96 175 13 33 Gondama Outreach Gelehun February 6 25 78 17 46 Gandorhun February 13 36 103 12 40 Magbema February 20 19 55 12 28 Sembehun Kokofele February 27 24 69 19 53 Gondama Total 104 306 60 167 Total 200 481 73 200 *Treatments are the number of doses of medications that were dispensed, some individuals received multiple treatments. NR=No Report for Tikonko Outreach on February 7, 2020 due to training for nursing staff. During February, children were most frequently treated for acute respiratory infections/pneumonia and malaria.
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