Strengthening and Activating district Health System (SAHaS) Fifth Bi- Monthly Report May / June, 2017 (Baishak / Jestha) District: Dhading Submitted by: Ganga Thapa Project Officer Nepal Public Health Foundation Kathmandu, Nepal List of Acronyms AG Advocacy Group ANC Antenatal Check Up C4D Communication for Development D(P)HO District (Public) Health Office FCHVs Female Community Health Volunteers FHD Family Health Division MToT Master of Training for Trainer VDC Village Development Committe HFoMC Health Facility operational Management Committee H-MG Health Mother Group HP Health Post MEAL Monitoring and Evaluation LearningOfficer NGO Non-Governmental Organization NPHF Nepal Public Health Foundation PHCC Primary Health Care Center PO Project Officer SAHaS Strengthening and Activating District Health System SHP School Health Program SM Social Mobilizer WASH Water Sanitation and Hygiene i Table of Contents Content List of Acronyms ............................................................................................................................ i Table of Contents .......................................................................................................................... ii List of Tables ................................................................................................................................ iii List of Figures ............................................................................................................................... iii CHAPTER I - Introduction ......................................................................................................... 1 1.1 Glimpse of the district ........................................................................................................... 1 1.2 General information of VDC................................................................................................. 2 1.3 Relevance of the Project ........................................................................................................ 4 1.4.1Objectives of SAHaS Project ....................................................................................... 4 1.4.2Activities of the SAHaS Project ................................................................................... 4 CHAPTER II - RESULTS ........................................................................................................... 7 2.1 FCHVs and HealthMothersGroup ......................................................................................... 7 2.2 Mother Group Meeting.......................................................................................................... 8 2.3 Participants in Mothers Group Meeting ................................................................................ 9 2.4 Ethnicity of the participants in H-MG Meeting .................................................................. 10 2.5 Participation of Lactating Mothers in H-MG Meeting ........................................................ 11 2.6 Participation of Pregnant women in H-MG ........................................................................ 11 2.7 Participation of Social mobilizers and Health workers in H-MG meeting ......................... 12 2.8 Health Facility Operation Management Committee ........................................................... 13 2.9 Sex of the participants in HFOMC Meeting ....................................................................... 13 2.10 Ethnicity of the participants in HFOMC Meeting ............................................................. 13 2.11 Participation of Social Mobilizers in HFOMC Meeting ................................................... 13 2.12 Advocacy Group Meeting ................................................................................................. 14 CHAPTER III - CONCLUSION ............................................................................................... 15 CHAPTER IV – CHALLENGES AND WAY FORWARD ................................................... 16 4.1 Key challenges: ................................................................................................................... 16 4.2 Way Forward ....................................................................................................................... 16 CHAPTER V - LESSON LEARNED ....................................................................................... 17 ii List of Tables Table 1: Total number of FCHVs andH-MG .................................................................................. 7 Table 2: Number of H-MG conducted ............................................................................................ 8 Table 3: Participants in H-MG Meeting ......................................................................................... 9 Table 4: Participation of Health workers and Social mobilizers in H-MG meeting ..................... 12 Table 5: HFOMC Meeting conduction ......................................................................................... 13 List of Figures Figure 4: Ethnicity of the participants in H-MGmeeting .............................................................. 10 Figure 5: Participation of Lactating Mothers in H-MG ............................................................... 11 Figure 6: Participation of Pregnant women in H-MG .................................................................. 11 iii CHAPTER I - Introduction 1.1 Glimpse of the district Dhading is one of the eight districts of Bagmati Zone with Dhadingbesi as its district headquarters. The district covers an area of 1,926 square kilometers (744 sq. mi)1.It is the only district of Nepal extending from the northern Himalaya to the southern Mahabharata and is considered as the longest district of Nepal. The district spreads from 27'40" E to 28'17" E and 80'17"N to 84'35"N1. The mountain range Ganesh Himal is the predominant mountain located in Dhading and some of its peaks are over 7,000 meters (23,000 ft).The district is bounded by Kathmandu, Rasuwa and Nuwakot in the East, Gorkha in the West, Rasuwa and Tibet in the North and Makwanpur and Chitwan in the South. The population of Dhading comprises Hindu religion (72.6%) followed by Buddhism (20.3%). Some of the other minor religions in Dhading district are Prakriti and Jain. Very small proportion of population follows Christian and Muslim religion (6.27% and 0.3% respectively. Dhading district has 2 Municipality and 11 Rural Municipality after the election held on Baisakh 31, 2074. Below are the list of our working VDCs and Municipality and Rural Municipality S.N Working VDCs Municipality/Rural Municipality Ward no. 1 Nalang Siddhalekh Municipality 1, 2 2 Khari Jwalamukhi Rural Municipality 5 3 Chainpur Jwalamukhi Rural Municipality 6,7 4 Agnichok Tripurasundari Rural Municipality 5,6 5 Tripureswor Tripurasundari Rural Municipality 7 6 Salyantar Tripurasundari Rural Municipality 1,2 7 Jaymrung Nilkanta Municipality 10, 11 http://ddcdhading.gov.np 1 1.2 General information of VDC General Salyantar Chainpur Jaymrun Agnichok Tripuresh Nalang Khari District information g wor Total No. of FCHV 10 10 10 9 9 9 9 66 No. of HMG 10 10 10 8 9 10 10 68 No. of HFoMC 1 1 1 1 1 1 1 7 Total Population 8141 6505 7122 3667 3465 8246 4440 347755 Under 1 year 172 155 178 102 91 201 107 8005 neo-nates (0-28 203 158 171 92 84 191 103 8021 days) 2 to 59 months 776 660 718 382 318 917 479 35600 6 to 59 months 695 588 635 334 275 823 429 31861 0 to 6 months 86 78 89 51 45 100 53 4002 6 to 9 months 86 78 89 51 45 100 53 4002 6 to 23 months 247 218 244 137 119 292 154 11470 0 to 23 months 333 296 333 188 164 392 207 15472 0 to 35 months 487 426 473 262 224 575 302 22530 1 to 2 yrs (12 to 161 155 86 73 191 100 7468 23 months) 141 12 to 59 months 609 511 547 283 230 722 376 27859 0 to 59 months 781 665 724 385 321 923 482 35864 Adolescent 1824 1384 1635 818 837 1777 996 76419 population(10 to 19 years) 2 0 to 14 yrs 2375 1909 2147 1022 958 2597 1391 105187 (Child Population) 29 days to 1 year 166 150 172 99 88 195 104 7741 1 to 4 years 609 511 547 283 230 722 376 27859 05 to 14 years 1592 1243 1424 636 637 1674 908 69323 Married Female 2027 1628 1718 928 860 1914 1061 78251 pop 15 to 49 years Female Pop 15- 2674 2148 2267 1224 1134 2525 1399 103233 49 years 15 to 24 years 1764 1325 1538 814 758 1625 891 76873 Expected 239 187 202 109 99 225 122 9459 Pregnancies Expected live 203 158 171 92 84 191 103 8021 birth 20 to 59 years 4113 3261 3401 1797 1731 3949 2079 173276 above 60 years 680 614 733 393 330 773 447 29444 Source: DHO, VDCwise shifted population FY 2072/73 (2015/16) 3 1.3 Relevance of the Project Conduction of health mothers group meeting on monthly basis comes under the primary responsibility of FCHVs. Although the health management information system (HMIS) shows that 80 percent of mother group meeting are being conducted as planned but the survey shows otherwise. The recent FCHV survey shows that only 46 percent of FCHVs reported conducting the health mother’s group meeting. Moreover, it is still not revealed how often and actually the health education takes place as the meeting conducted only for saving and credit purpose also is called as mother’s group meeting. Some of the reported problems for irregularities of health mothers groups meeting such as lack of allowance for tea-snacks, lack of appropriate place to conduct meeting, lack of innovative methods for providing health education materials such as audio-visual aid. Experts are of view