Kingdom of Cambodia Nation Religion King Ministry of Health Guidelines on Minimum Package of Activities For Health Center Development 2008 ~ 2015 Issued on December 31, 2007 Translated version Forward This “Minimum Package of Activity Guidelines (MPA) for Health Center Development” is resulted from efforts of the Ministry of Health MPA Taskforce for Review and Revision of Guidelines on Minimum Package of Activities. The purposes of this guidelines are to provide a comprehensive guidance on MPA services and some essential activities to be provided by health center including services to be provided at health center and some main services to be provided at community. This guidelines was developed as a detail and stand alone document as well as a companion of the “Guidelines on Complementary Package of Activities for Referral Hospital Development”, which was revised and introduced by the Ministry of Health on December 15, 2006. This guidelines was also developed as a guidance for health center staff for implementation of their work, as well as for provincial and district health officers for their management work in accordance with the development of health sector. It is also a basic and direction for central departments and institutions according to their respective role, especially for formulating training plan and necessary supply for functioning of health center. This guidelines is also useful for all concerned stakeholders including health officers and donors to understand, involve and support activities of health centers in the whole country aiming to achieve the goals of the National Health Strategic Plan 2008-2015. Phnom Penh, December 31, 2008 For Minister Secretary of State Prof. Eng Huot ii Acknowledgement We would like to express our gratitude to H.E. Prof. Eng Huot, Secretary of State, Ministry of Health, for his valuable recommendations for compiling, and thanks to all people and NGOs/IOs concerned for their participation in the process of reviewing and revising the “Guideline on Minimum Package of Activities for Health Center Development 2008- 2015”. We would like also deeply thanks to the members of the MPA Task Force for Review and Revising of the “Guidelines on Minimum Package of Activities for Health Center Development 2008-2015” as listed below, for their huge contribution to the development of the guidelines, through 18 meetings of the taskforce and 2 consultative workshops- participated by staff working at health centers and through consultative meeting with TWGH. Especially, we wish to express great thanks to URC/USAID, UNFPA, JICA, WHO and Health Sector Support Project for their financial and technical support; and to all development partners, both governmental and non-governmental organizations for their technical support to develop of this important document. The members of MPA Task Force for Review and Editing of the “Guidelines on Minimum Package of Activities for Health Center Development 2008-2015” are as follows: 1. Dr. Chi Mean Hea Deputy Director General for Health Chairperson 2. Dr. Mao Tann Eang Director of CNAT Deputy Chair 3. Dr. Ket Ly Sotha Deputy Director of NMCHC Deputy Chair 4. Dr. Sok Srun Deputy Director of HSD Permanent Member 5. Dr. Khuon Eng Mony Deputy Director of DPM Member 6. Dr. Hong Rathmony Deputy Director of CDC Member 7. Dr. Tung Rathavy Deputy Director of NMCHC Member 8. Dr. Oung Thol Deputy Director of Department of Personnel Member 9. Dr. Kheng Sim Deputy Director of NCMC Member 10. Dr. Mam Vichearith Chief of Technical Bureau-Pediatric NH Member 11. Dentist Hak Sithorn Chief of Oral Health Bureau-DPM Member 12. Dr. Chhun Lun Chief of Non-Communicable Control B.-DPM Member 13. Dr. Ou Ketvanna Chief of Nutrition Program-NMCHC Member 14. Dr. Svay Sarath Deputy Manager of NIP Member 15. Dr. Ly Vichearavuth Vice-chief of Planning Bureau-DPHI Secretary 16. Ph. Tep Kila Vice-chief of Essential Drug B.- DDF Member 17. Dr. Cheu Sivuthy Chief of HSB Member 18. Dr. Ouk Sokun Chief of Health Education-NPHP Member 19. Dr. Ka Oeun Chethra Chief of AIDS Care Department-NCHADS Member 20. Dr. Ly Cheata Specialist of General Medicine-Khmer-Soviet H Member 21. Dr. Lim Tang Specialist of Traumatology-Preah Kossamak H Member 22. Dr. Pov Bunthoeun In-charge of Clinic Service Development Member 23. Dr. Pheng Visoth Bureau of Continuing Education –DHRD Member 24. Dr. Ngin Sokhom Bureau of Continuing Education-DRD Member 25. Dr. Ma Soyinda Technical Bureau-PPMHD Member 26. MA. Yem Deth OD Kandal, PPMHD Member 27. Dr. Huong Vuthy URC/USAID Member 28. Ph. Ou Sovandara MEDICAM Member 29. Dr. Hen Sokun Chariya USAID/ OPH Member 30. Dr. Chong Vandara UNFPA Member 31. Dr. Sok Sokun UNFPA Member iii Assistants, Facilitators and Advisors: 1. H.E. Prof. Eng Huot Secretary of State for Health Technical Advisor 2. Mr. Takeshi MATSUO JICA ME Expert ME Advisor 3. MA. Krang Sun Lorn ADB/HSSP Facilitator 4. Dr. Hun Rattana URC/USAID Compiling Assistant Editor and Computer Operators 1. Dr. Chi Mean Hea 2. Dr. Sok Srun 3. Dr. Hong Rath Mony 4. Dr. Cheu Sivuthy 5. Dr. So Nakry 6. Dr. Sim Sansam 7. Pha. Ouk Romanea 8. Pha. Sam Sopheap iv Abbreviation and Definition of Terminology AD : Auto-Disable Syringe ANC : Antenatal Care BCG : BCG vaccine BMI : Body Mass Index BPOC : Basic Package of Oral Care CBHI : Community Based Health Insurance DTC : Diphtery Tetanus and Coqueluche Vaccine DTP, : Diphtery Tetanus and Polio Vaccine FEFO : First Expired, First Out GMP : Good Manufacturing Practice HBC : Home Based Care HC : Health Center HCMC : Health Center Management Committee HepB : Hepatitis B Vaccine HIS : Health Information System HIV : Human Immune Deficiency Virus IEC : Information, Education and Communication IMCI : Integrated Management of Childhood Illness ISO : International Standard Organization IOs : International Organization MDTs : Multi Drug Treatment MPA : Minimum Package of Activity NGOs, : Non Governmental Organization OD : Operational District OI/ART : Opportunistic Infection/Anti Retroviral Treatment PMTCT : Prevention Mother To Child Transmission RH : Referral Hospital STD : Sexually Transmissible Disease TB : Tuberculosis TB-DOTS : Tuberculosis-Direct Observed Treatment Service TBAs : Traditional Birth Attendant TT : Tetanus Toxoid Vaccine UV : Ultra-Violet UNICEF : United Nation Children Fund VCCT : Voluntary Counseling Confidential Testing VHSG : Village Health Support Group VMW : Village Malaria Worker VVM : Vaccine Vials Monitor WHO : World Health Organization v Minimum Package Activities of Health Center Services Delivery Management and Support Services Outpatient Consultation Services Patient Referral System Mother, Newborn, Child and Reproductive Planning, Budgeting, Monitoring, and Health Services Evaluation 1- Antenatal care 1- Working schedule 2- Normal delivery and delivery with 2- Ensuring 24 hour services intervention 3- Developing the annual operational plan 3- Postpartum care 4- Budget management for health center 4- Provision of immunizations to children and 5- Monitoring the implementation of quarterly mothers/women plan 5- Nutrition 6- Hold regular staff meeting 6- Prevention of Mother to Child 7- Attending the meeting at Operational District Transmission of HIH/AIDS 8- Organizing and attending the meeting of Health 7- Neonatal and young child care Center Management Committee 8- Integrated Management of Childhood 9- Organizing meeting of Village Health Support Illness (IMCI) Committee 9- Birth Spacing 10- Conducting demographic census in the HC 10- Adolescent Reproductive Health catchments area 11- Breast-uterine cancer consultation 11- Hygiene, health care wastes management and 12- Safe abortion and post abortion care safe water 12- Daily record, making activity report, and inventory Communicable Diseases Service Human Resources Management & 1- Sexually transmitted diseases Development 2- HIV/AIDS 1- Staff training and continuous education 3- Tuberculosis; 4-Leprosy 2- Promotion on performance of staff 5- Malaria/ dengue fever; 6- Bird Flu 3- Provision of continuing education to community through members of Village Health Support Group Non-communicable Diseases Service and Drug and Medical Equipment Management Other Health Problems: 1- Drug Store 1- Hypertension 2- Medical Equipment Management and 2- Diabetes Maintenance 3- Breast cancer/ uterine cancer 4- Mental health 5- Oral health 6- Eye care 7- Minor surgery and wound dressing Health Education and Health Promotion Health Financing 1- Health education 1- National Budget 2- Health promotion 2- User Fee 3- Equity Fund 4- Community-base Health Insurance Outreach Services Services provision at health post 1- Guide for Outreach Services Some of services are same to services 2- Implementation of Outreach Services provided at health center including 3- Community Participation management vi Content Page Chapter 1: Introduction 1. Background of health center and its coverage services ..........................................1 2. Purpose of the Guidelines .......................................................................................1 Chapter 2: Roles and Responsibilities 1. Roles and Responsibilities of a health center .........................................................2 2. Organization Chart ..................................................................................................3 3. Personnel Standard..................................................................................................3 4. Roles and Duties of Health Center Staff .................................................................4