Child Health Programme Manager’s Guidelines

Experiences from BangladeshKathmandu, 17 Nov’2011

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Background• In Bangladesh a number of maternal, neonatal and child

health programmes and initiatives in existence– MNHI, a joint Government of Bangladesh-WHO, UNICEF and UNFPA

initiative expanded to 11 districts.

– MNCH supported by DFID through UNICEF and BRAC implemented in 10 districts.

– MNCS supported by AusAid through UNICEF and NGOs is being implemented in 40 upz of 8 districts.

– SMPP supported by JICA through GoB in 3 districts

– MaMoni by Save the Children in 2 districts

– TMNCP supported by KOICA through unicef in 1 district

• These programmes aim to provide a continuum of care by integrating the efforts of these three interconnected areas

• Programme managers, therefore, need to be equipped with programme planning and management skills to deal with this.

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Objectives of Programme Management guidelines

• To equip managers with essential knowledge and it’s execution to improve programme management.

• To develop skills of the managers for advocacy, planning, management, monitoring and resource mobilization for effective implementation of interventions.

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Adaptation of Generic WHO Training Package

• To adapt the generic WHO training package for Bangladesh, two 1-day consultation workshops were organized.

• The technical workshops involved the input and participation of a number of experts and programme managers.

• It was decided to change the title from “Managing programmes to improve child health” to “Managing programmes to improve maternal, newborn and child health”

• Relevant information on maternal health incorporated within the 5-day training course.

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Target Audience

• Programme managers working in maternal, newborn and child Health sector at national/ district/ sub-district levels both from DGHS and DGFP.

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Adaptation process in Bangladesh

Time period ActivitiesNov 27 to Dec 01, 2010 International workshop to adapt

the WHO generic modules for Bangladesh and conduct TOT

Sept 20 to 22 2011 Orientation workshop for the health and family planning managers from district and three Sub-districts in Tangail

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Participants in the International Workshop in 2010From Government side:• Director Primary Health Care and Line Director (Essential Service Delivery)• Programme Manager from

– IMCI– Reproductive Health, DGHS– In- service training, DGHS– (CA & SS), DGFP

• Deputy Programme Manager from – Maternal Health– Neonatal Health– In- service training

• Deputy Chief, MIS• Civil Surgeons from Moulavibazar, Narail and Bandorban districts• UH& FPO from Bandarban, Shirajganj, Rangpur and Dhaka( Dhamrai)

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Participants in the workshop_continued

From Non Government organizations:• Health Specialists and Programme experts and scientists from

WHO, UNICEF, UNFPA and icddr,b

Facilitators:• Programme Manager, IMCI, DGHS• Coordinator, Country Support team Child and Adolescent

Health and Development, WHO, HQ• Medical officer, SEARO, WHO• Medical Officer, Child Health, WHO-Bangladesh

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International Workshop 2010

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Observations from the International Workshop

Duration: 5 days. However, the duration was perceived as too long by GoB managers

Course Content:– Inclusion of maternal section was commended– Reading section perceived as rather large and monotonous – Texts comprising bullets or diagrams were recommended – Inclusion of more ‘role play’ and examples was proposed– Bangladesh specific examples, goals, objectives and targets

was suggested

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Further adaptations following the International Workshop

Duration :Duration reduced to 3 days from 5 days

Course contents:Incorporation of:

– Bangladesh related health System information – Country specific health service provider information – Goals and objectives of ongoing Maternal, Newborn and Child

Health Programmes of Bangladesh– Current status, targets and achievements of ongoing MNCH

programmes – Coverage indicators of these MNCH programmes

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Orientation workshop for 3 sub-district managers in 2011Target audience: • Programme managers, Upazila Health and Family Planning

Officer (UH&FPO) under DGHS and Upazila Family Planning Officers (UFPO)under DGFP from three sub-districts of Tangail District.

• Medical Officers from these sub-Districts

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Orientation workshop in 2011

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Observations from the 2011 orientation Workshop

Duration: – 3 days. Well accepted by the programme managers– However, covering course content was a challenge

Course Content:– Some of the reading sections had to be facilitated instead of

self-reading– All ‘role play’ and examples could not be covered– Some exercises in the “workbook” e.g. resource mobilization,

had to be skipped

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Comparison of the course contentsTopic 5 days package 3 days package

Module 1:Introduction

Duration: 2 and half hoursContent:•Review MNCH Epidemiology•Review Intervention Packages and the continuum of care•Review Planning terms and concepts

•More focus given on understanding the planning cycle

Module 2:Planning implementation

Duration: 2 daysContent:•Preparation for planning•Review programme goals and objectives•Review coverage of interventions and compare it to targets•Review status of indicators

Duration: 1 dayContent: summarized as;•Review preparation for planning

•Review implementation status

•Decide on programme activities

•Plan activities to implement intervention packages and set a priority

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Comparison of the course contentsModule 5 days package 3 days package

Module 2:Implementation Planning(Cont.)

•Review major activities and assess how well they are implemented•Review implementation Status•Review coverage of interventions and compare it to targets•Set a target to improve quality of care•Plan activities to implement intervention packages•List tasks in activities and types of resources needed•Choose priority indicators for monitoring results of activities•Plan monitoring of implementation of activities•Plan for next review of implementation•Decide how to scale up implementation.•Review resources available, work plan and timetable

•List tasks in activities and types of resources needed

•Planning for next review of implementation

•Decide how to scale up implementation

•Review resources available, work plan and timetable

•Write a work plan and budget

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Comparison of the course contentsModule 5 days package 3 days package

Module 3:Managing implementation

Duration: 2 daysContent:•Advocacy for Maternal, Newborn and Child Health•Assessment of potential strategic partnerships and ask for support•Mobilization of funds from donor•How to manage medicines and supplies•How to manage financial supports•How to improve organization of supervision•Analysis of common problems•Feedback and solve problems

Duration: 1 dayContent: summarized as•Advocacy for Maternal, Newborn and Child Health

•Mobilization of funds from donor

•How to manage medicines and supplies

•How to improve organization of supervision

•Feedback and solve problems

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Programme Planning and Management Cycle

Manage implementation (Ongoing)

Advocate Mobilize resources Manage human, material

and financial resources Manage supervision Monitor progress and use

results

Develop implementation plan

(every 1-2 years)

Prepare for planning Review implementation

status Decide on programme

activities Plan monitoring of

implementation of activities

Plan for the next review of implementation status

Write a workplan and budget

Prepare for the review of

implementation status

(every 1–2 years)

Develop strategic plan(every 5-10 years)

Prepare for planning Do situation analysis Prioritize and package

interventions Decide how to deliver interventions Select indicators and set targets

for evaluation Write and disseminate plan Mobilize resources

Evaluate programme

(every 5-10 years)Eg. DHS, MICS

including coverage and health impact (e.g. using

DHS, MICS surveys)

Strategic planning is usually performed at the national level. It is taught in the WHO guidelines: Strategic Planning For Child HealthThis

implementation planning cycle is taught in these guidelines: Managing Programmes to Improve Maternal, Newborn and Child health

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