Shabelle relief and development organization (SHARDO) 1. Health care section: Warshiekh District- Middle Shabelle 2. Report title: Monthly health care report: Report number: 01 3. Project identification: UNICEF Somalia/ csz/yh101&yn102/03/2008/1028 AWP reference: YH101/03/01, 02, 03, 05 YN102/03/01/02/03 4. Introduction/background information : Shardo is non governmental and non profit organization operating in south central Somalia, having offices at Mogadishu, Jawhar and Warsheikh districts. Shardo’s operation is made possible by the assistance of some international and UN agencies. We Have partnering relation ship with many international and UN agency, among these are UNICEF assisting primary health care Warsheikh district, Somali intellectual banadir organization (SIBO) assisting Warshiekh primary education and Gothenburg initiative (GI) assisting vocational trainings in karan , Jawhar and war sheikh districts. Shardo is community owned organization having endorsement and recognition from the communities of middle shabelle and the local authorities in the most of south central Somalia. Shardo had entered an agreement with UNICEF – Somalia on implementing primary health care project in the Warsheikh district of middle shabelle, the project duration is 12 months, the aim of the project was to provide primary health services for more 22,000 people living in and around the district of which 880 are infants (u1) 4400 of the population are children under five years where as 1,100 of the population are pregnant mothers. Similar projects have been implemented on yearly bases with the assistance of UNICEF support during the years of 2006, 2007. So this project is the continuation of the previous project activities of the primary health care in the district. 5. Objectives of the project: 1. Child immunization 2. safe motherhood 3. Malaria control 4. Promotion of improved feeding practice 6. Achievements of the project between June and July: Child immunization • EPI vaccines are available 100% of the times in the vaccination centre • EPI and cold chain adequately managed in the MCH offering immunization services with EPI vaccines available 100% of the time • Increased DPT3 coverage for u1 to at least 30% • increased measles coverage for u1 to at least 30% • decreased DPT1/DPT3 drop-out rate to al most 10& B. safe motherhood • MCH staffed with qualified staff and provide quality child heath care, ATE- natal care (PNC) including TT, micronutrient supplementation delivery and post natal care (PNC) services based on the safe motherhood model. • Increased TT2 and coverage for pregnant women to at least 40% with in the catchment area. C. Malaria control ( see Annex D) • 31 cases of severe complicated malaria have been treated in the district MCH • ACTs and RDTs available 100% time in the MCH • Effective case management ( ACTs +RDTs) in the MCH • Increased IPT2 uptake to 50% of women attending ANC D. Promotion of improved feeding practice . Micronutrient deficiency disorders have been solved through women training on nutritious food making, group of women are trained on food making where the product is given to malnourished pregnant and lactating women and their children.24 malnourished children and their mothers are provided with nutritious food cooked in the demonstration of food making practice, pregnant and lactating women receive this food when they visit the MCH centre. Training of Warsheikh MCH staff Upon the supply of the medicine and the delivery of the cold chain, staff needed technical training and skills building to administrate all medicine and proper use of health facilities, vaccines and cold chain. Shardo had initiated to allocate fund for providing this required professional training for MCH staff to build their professional capacity. The training had been conducted on 21-25/07/08 for 8 MCH staff members. The staff had been given refreshment topics such as:- 1. Test vaccine for BCG and polio 2. DPT and Measles 3. TT , toxeside and registration 4. Cold chain practice 5. Practice final test Training was successful and the participants have achieved the objectives of the training professional and skills building. Training provided for the MCH Date Start Time Type of Facilit funded Day Total hrs Total hrs time end training ator s days 21/7/08 800am 500pm Test C/zak Shardo Day 8 vaccine Basaal 1 for bcg e and polio 22/7/08 800am 500pm DPTand C/rizak Shardo Day 8 Measless 2 23/7/08 800am 5pm TT , C/rizak Shardo Day 8 toxeside 3 and registratio n 24/7/08 800am 5pm Coldchain C/rizak Shardo Day 8 practice 4 25/7/08 800am 5pm Practice C/rizak Shardo Day 8 final 5 examinati on 5 5 8 40 Common diseases treated in the MCH S/N Cases treated/ symptoms Male Female Total 1 Complicated malaria 5 26 31 2 Diarrhea with blood 8 9 17 3 Watery diarrhea 19 26 45 4 Measles 3 0 3 5 Anemia 114 0 131 6 Skin disease 178 77 255 7 Respiratory infections/ pneumonia 166 287 453 8 Intestinal parasites 182 152 334 9 STI infections 51 46 97 10 eye disease infections 23 28 51 11 Suspected TB 6 8 14 12 Urinary tract infections 72 54 126 13 Burns and scalds 13 16 29 14 Others 122 88 310 15 Total 962 948 1910 Below 59 Preg. No. of 1 st Antenatal visits Months Wome Neonatal Tetanus Female Male # Received ITN Female Male n No of cases 0 0 310 455 240 No of deaths 0 0 Nutrition Surveillance Form Month: June/July Year: 2008 Region: Middle Shabelle District: Warsheik Facility Name: MCH Facility Code: 01 Type: Primary Health Care Managing Organization: Shardo Residence IDPs Others Total catchment Population 4500 1100 2635 Estimated < 5yrs Population Estimated 765 459 306 Nutrition Screening (<5 years of Height<110) Weight for Height z-score No of < 5yrs Weight for Height % Median No of < 5yrs Oedema Oedema WFH<-3 Z Score (Severe) WFH<70% -3 Z Score_<WFH <-2 Sc (Moderate) 70%_<WFH<80% WHF Z Score (normal) WFH_>80% Total Number of Children Total Number of Children Screened Screened Number of <5 years Children seen with Vit A Deficiency (night blindness) 12 Number of <5 years Children seen with Iron Deficiency Number of <5 years Children seen with Iodine Deficiency 20 4 Sources of Visits (number of children <5years) Town Residents Surrounding villages IDP’s 209 97 459 Comments on origin and causes of malnutrition:- (Observations of the Health staff at facility level) poverty, poor livelihood sources, , lack of basic primary health principles, lack of purchasing power and in accessibility to food and poor water and sanitation among local people are the main causes of the present nutritional situation in the district. EPI Monthly Report Month: June/July Year: 2008 Region: Middle Shabelle District: Warsheik Facility Name: MCH Facility Code: 01 Type: Primary Health Care Managing Organization: Shardo Annual estimated Nuber of ( in the catchment area ): Under 1 year 209 1 to 5 year 200 Pregnant women 240 Child bearing age women 0 Vaccine Under 1 year Over 1 year Total BCG 30 60 90 OPV-0 4 0 4 OPV-1 24 55 79 OPV-2 1 3 4 OPV-3 1 2 3 DPT-1 24 55 79 DPT-2 1 3 4 DPT-3 1 2 3 Measles 16 30 46 Total 30 60 90 Pregnant Other women Total Vaccine TT-1 20 0 20 TT-2 28 0 28 TT-3 1 0 1 TT-4 4 0 4 TT-5 1 0 1 Vitamin A supplementation 6 months to 1 year 1 to 5 years Pregnant women Postpartum mothers Total 16 30 0 0 46 SAFE MATHERHOOD SURVEILANCE (MCH) Month: June/July Year: 2008 Region: Middle Shabelle District: Warsheik Facility Name: MCH Facility Code: 01 Type: Primary Health Care Managing Organization: Shardo Antenatal Care Number of ANC consultations 918 Number of pregnant women given one course of iron-Folic acid 80 Include number of pregnant women given low dose Vitamin A 92 Number of pregnant women Vaccinated TT1 73 TT2 167 Number of women who receive CDKs 0 Number of women who receive intermittent preventive Treatment 1st 5 (Malaria-SP) dose 2nd 7 dose Number of cases referred to Hospital 4 Delivery Total number of Deliveries in the MCH 12 At Home 3 Number of Live Births (at home, at MCH) 15 Male: 6 Female: 9 Number of Births weighing<2500g 7 Male: 4 Female: 3 Number of Live Births given breast milk w3ithin 1 st hour after 15 delivery Number of Premature Deliveries Male: 0 Female: 0 Number of Still Births Male: 0 Female: 0 Number of Neonatal Deaths (within the first 28 days of life) Male: 0 Female: 0 Number of Miscarriages 0 Number of Maternal Deaths In the MCH 0 At Home 0 Post Natal Consultation Number of lactating mothers given Vit A 72 Number of on exclusive breast-feeding 80 MCH Surveillance Form Control of Iron and Vitamin A Deficiencies Central & South Somalia Partner: Shardo Region: Middle Shabelle MCH Location: Warsheik Report Prepared By: Binti Ali Period From: 01/06/08 To: 31/08/08 4500 Total Estimated Population in Health Area Est. No. of < 5years Children 765 Est. No. of Pregnant Women 240 1. HEMOGLOBIN ASSESSMENT (for new cases only seen at the MCH). A. Women Hemoglobin gm/dl = < 6.0 Severe 6.1- <11.0 11.1 – 16.0 Total Screened Moderate Normal No. % No. % No. % No. Pregnant Women Lactating Women Non-Pregnant Women Total B. Children U5 Years. Hemoglobin gm/dl = < 6.0 Severe 6.1 - <10.0 10.1 -14.0 Total Screened Moderate Normal Total number of Children < 5 Years 2. Iron/Folate and Vitamin A Supplementation. No of < 5 Children No.