operational plan scale-up mnchn service delivery

Operational Plan

Scale-up MNCHN service delivery

Maternal Health

Goal: Malita would be able to reduce maternal and child mortality by 50%

Maternal Health

Objectives Increase ANC from 5.2% (2013) to - 16% in 2014; 48 % in 2015; 70% in 2016 Increase FBD from 26.3% to 50% and SBA from 28.2% to 50% in 2014; to 70% in 2015; to 80% in 2016

Strategies 1) Masterlisting of pregnant women (monthly) involving purok - sitio leader, BHW, IP leader, CHT, local NGOs, religious groups, hilots

2) Buntis Day (Maternal Health Outreach) in cluster of barangays quarterly

Key Activities 2014 2015 2016

Barangay Captains Forum on Health

May

IP Leaders and Traditional Healers Conference on Health

June


Listing of pregnant women per purok (monthly)

Start April

Review – summarize HUP 2D and include in the list other pregnant women without HUP

Start April

Barangay Council meeting and action planning with hilots, midwife and BHWs, CHT

Note: Tools for action planning

Start: after Barangay Captains Health Forum

Conduct health info/education on safe motherhood i.e. benefits of pre-natal care, skilled birth attended and facility-based delivery, nutrition for pregnant women, risks of unattended pregnancy; PhilHealth MCP benefits

•Develop session guides:, IEC materials : une-July • Model in 6 barangays: 2 upland, 2 lowland, 2 coastal: Aug to Dec • Training of RHMs, BHWs, CHTs, MLs on the session guide: Aug • Monitor – coaching • Review & enhancement of the session guide and IEC materials

Scale-up in other 24 barangays: Jan

Sustain implementation in all barangays


Conduct health info/education on safe motherhood i.e. benefits of pre-natal care, skilled birth attended and facility-based delivery, nutrition for pregnant women, risks of unattended pregnancy; PhilHealth MCP benefits

Need: TA to develop session guide and IEC materials

•Develop session guides:, IEC materials : June-July • Model in 6 barangays: 2 upland, 2 lowland, 2 coastal: Aug to Dec • Training of RHMs, BHWs, CHTs, MLs on the session guide: Aug • Monitor – coaching • Review & enhancement of the session guide and IEC materials

Scale-up in other 24 barangays: Jan

Sustain implementation in all barangays


Organize community support for safe motherhood i.e. family to raise money, community blood collection activity, listing of available transportation in the barangay, support for taking care of family/household members and kept animals

Model in 6 barangays

Need TA in development of project design and action plan; coaching – monitoring

Scale up in 24 barangays

Barangay Council to adapt Provincial or Municipal Policy on FBD (no more hilot assisted delivery)

In 6 barangays (minimum) Scale up in 24 barangays

Formulate a Municipal Policy Incentives for Hilots as part of MCP

Discuss in LHB in May

Policy formulated in June

Policy filed in SB in Aug

Policy Dissemination


Disseminate DOH – Municipal on MNCHN policy during Barangay Council meeting, Barangay Assembly Barangay Council including purok leaders to monitor - follow up pregnant women to motivate her and husband on skilled birth attended delivery (if high risk, deliver in hospital)

During the Barangay Captains Forum on Health

Need: simple advocacy tool kit

Half-way house in the barangay proper (care of Barangay Officials, NGO and community);

To be discussed – proposed during the Barangay Captains Forum on Health

GIDA barangays

Half-way house in the Poblacion already proposed to DOH

Proposed to DOH


Conduct pre-natal consultation through RHU on Wheels (MCH outreach) with doctor, med tech, dentist and midwives •Provide ferrous sulfate and Vit A•Oral care•Laboratory: urine, hemoglobin •Birth plan

2 RHU on Wheels

• clustered GIDA barangays

One per quarter One per quarter

Training of midwives on BEmONC

Oct: Profiling of RHU personnel including training needs assessment

? DOH training program on BEMONC for midwives

10 - 15 midwives first to go to training midwives assigned in GIDA barangays

Supportive supervision

8-10 midwives

Updating of CHT and BHWs on Safe Motherhood and Newborn Care

? Use DOH CMMN training design and module

? Train the PHNs (October)

CMMN training for BHWs and CHTs in 30 barangays


Furbish selected BHS with delivery table, OB (delivery kit), drugs medicines and other supplies, newborn care package, water supply, emergency light, stove and utensils needed for sterilizing, refrigerator in barangays with electricity

Logistics: OB and newborn kits

Ultrasound machine for use of the trained physician (requested from Mindanao Cluster)

Fishing Village LagumitTiculon (former WHSMP)

Construction of BHS (birthing facility) in GIDA

Demoloc approved for implementation

Sangay, Lagumit proposed to DOH

Datu Danwata, Manuel Peralta, Little Baguio (2015);

Tical, Tubalan (2016)

MCP accreditation RHU birthing facility (2014)

Fishing Village BHS (2015)


Furbish BHS birthing facilities with equipment and supplies

Datu Danwata, Manuel Peralta, Little Baguio (2015);

Tical, Tubalan (2016)

Referral mechanism for normal delivery in private hospital (NBB)

Note: TA need design, facilitator, resource persons from CHD, PhilHealth, kit and meals for meeting

Consultative meeting with RHU-MDH and private hospitals (July) to agree on referral mechanism

Present to LHB then disseminate to ABC – MLs, midwives (Aug)

Start implementation

Implementation - - Monitor (feedback) - - implement loop


Referral mechanism for emergency from barangay to MDH to DSPH

Note: TA need design, facilitator, resource persons from CHD, PhilHealth, kit and meals for meeting

Consultative meeting with RHU staff , MDH and DSPH (July)

Present to LHB the Present – discuss ABC meeting (Aug)

Start implementation


Transport support (ambulance) plus procedure and policy

Aug - SeptTA need: organizing the transportation support from barangay to referral facility


Communication (text and call) to RHU and MDH and DSPH; from barangay to RHU;

Aug – Sept TA need: organizing the communication (text and call) network from barangay to RHU to MDH to DHSP



Updating for BHWs, CHTS on maternal health topics

Need: design, materials, resource persons, meals

2nd quarter 2015 2nd quarter 2016

• Strengthen supportive supervision of PHN to midwives; and midwives to BHWs, CHT

• Strengthen cooperation between midwives and hilots

Training on Supportive Supervision for MHO and PHNs (DOH & MH)

Coaching: implementation – feedback

Health HR Planning Propose to LGU hiring of additional health work force – integrated in ELA

HR Plan towards organization of a City Health Office

Presentation of HR Plan to LHB


HIS: Data Quality Check, RAMOS , re-training of midwives, PHNs, Sanitary Inspectors, MHOs on FHSIS

FP-MNCHN Data quality Check (DOH & MH)

Re-training of MHO, PHNs, midwives, 2 Sanitary Inspectors on FHSIS

Training on Verbal Autopsy

Conduct RAMOS and maternal death review for 2013 data on reproductive age and maternal deaths

Coach – monitor involving PHO FHSIS in-charge

Coach implementation of verbal autopsy

Coach selected RHU staff in conduct of RAMOS and maternal death review for 2014 data on reproductive age and maternal deaths

Coach selected RHU staff in conduct of RAMOS and maternal death review for 2014 data on reproductive age and maternal deaths

Logistics Management: Stocks Inventory Management

Training of selected RHU staff on stocks inventory management (DOH & MH)

Coaching monitor implementation of the inventory system

Family Planning as part of Maternal Health continuum


Family Planning as Part of Maternal Health continuum

Objectives Increase CPR from 55% to 60% by providing FP counseling and services to at least 80% of women identified to have unmet need in FP (reference HUP 2F)

Strategies 1) Intensify dissemination of information on family planning focused on benefits, evidence-based information on FP methods to ally fear of side effects and correct misinformation, myths, FP methods available in health center2) Provision of FP service in every purok/sitio (monthly)


Review of monitoring logbook of CHT, TCL By midwives, BHW, CHT

Start: April, all barangays


Midwives with BHWs, CHT to prepare a masterlist of WRA who want to space pregnancy, do not want to have another pregnancy, drop outs per barangay (sitio/purok)

Start: April, all barangays

Ensure availability of FP commodities in BHS (LGU to procure, request FP commodity from CHD or PHO, POPSHOP or consignment by midwife)

FP commodity forecast from June to Dec

Request for FP commodities for poor WRA (NHTS-CCT) from DOH and other sources

TA need: prepare inventory of FP commodities plus FP commodity forecast based on WRA with FP unmet need

FP commodity forecast per quarter

Request for FP commodities for poor WRA (NHTS-CCT) from DOH and other sources


Midwives Integrate FP counseling and service during immunization day in purok/sitio

Start: May

Midwives to schedule a regular FP counseling and service day in the BHS

Disseminate information on schedule of FP day in BHS to Barangay Council

Start: May

Track FP acceptors needing re-supply and the drop outs by BHWs, CHTs, midwife

Start: May


Agree with MHO regular schedule of BTL/NSV and other LAPM (quarterly in RHU or MDH)

Disseminate information on BTL/NSV schedule to Barangay Council

Include in RHU team meeting for April

BTL service in MDH in May

BTL service in MDH in Nov

BTL service in MDH quarterly

Training doctor and nurse from RHU , midwife in Fishing Village and MHD on PPIUD

Start providing other LAPM services in MDH and RHU Birthing facility

BTL service in MDH quarterly

Training of midwives on FP CBT 1; train midwives in GIDA on FP CBT 2

FP CBT 1 training for midwives

FP CBT 2 training for selected midwives

Prompt recording and reporting

PHN to review completeness and accuracy of records and reports

Start May


Agree with MHO regular schedule of BTL/NSV and other LAPM (quarterly in RHU or MDH)

Disseminate information on BTL/NSV schedule to Barangay Council

Include in RHU team meeting for April

Training of midwives on FP CBT 1; train midwives in GIDA on FP CBT 2

FP CBT 1 training for midwives

FP CBT 2 training for selected midwives

Prompt recording and reporting

PHN to review completeness and accuracy of records and reports

Start May


Conduct usapang FP among WRA or couple who wanted to space pregnancy (spacers); do not want to have another pregnancy (limiters) in puroks/sitios

Note: PHN trained

Start in April

Train RHMs on usapang FP in July (DOH – MH)

Roll out in all barangays

Training of midwives and BHWs and CHTs on Interpersonal communication skills (usapang FP)

Note: dependent on support of DOH and dev’t partnerIntegrate provision of FP message during house visits by BHWs and CHTs

(TA need: session guide and job aid – dependent on support of DOH and devt partner)


Put in place supportive supervision: (PHN/MHO to RHMs; RHMs to BHWs)

Start: July

Child Heath


Child Health

Objectives Breakthrough result: 100% of newborn delivered by skilled birth attendants or in health facilities (BHS, RHU or MDH) provided newborn package

Strategies 1) Intensify social awareness on package of services for the newborn 2) Provision of newborn care services by skilled birth attendants in BHS, RHU birthing facility, 2 private hospitals, MDH


Include dissemination on newborn care package in bench conference or meeting in sitio/purok of pregnant women

Start: June

(TA need: session guide and job aid)


Disseminate information on newborn care /services in churches, in barangay council meetings, purok/sitio pulong-pulong

Start: June

Disseminate information on newborn care /services in FDS

Note: Orient the MLs on NBS using session guide (need – session guide and IEC tools)

Start: July

Orientation of MLS in June


Radio plugs, Public Service Announcements

Start in Jan

Note: TA preparation of the PSAs

Conduct watchers class or one-on-one info dissemination in the hospitals and RHU birthing facility

(need: key message on newborn care, exclusive breastfeeding, and immunization among mothers, fathers c/o DOH)

Orient nurses/midwife in OB on NBS by DOH rep

Start: July

June

Mount IEC board in MDH and RHU birthing facility starting Jan (with MCH topics and messages)


Provision of essential drugs like Vit K, eye prophylaxis, immunization, NBS in BHS, RHU birthing facility, 2 private hospitals, MDH)

Note: currently RHU dependent on logistics from DOH

LGU will start procuring using income from MCP and NBS

Start: Jan in RHU birthing facility

Start: Jan in MDH

Start: 1st quarter

Technical update on newborn care for RHMs, nurses/midwives in hospital

Start: 1st quarter


Provision of Update on newborn care for BHWs, CHTs

Start: second quarter

Ensure complete records and reports (including reporting on newborn deaths)

Start: Jan


Child Health

Objectives Breakthrough result: Increase FIC from 69.4% to 80%

Strategies 1) Reaching every purok/sitio (monthly)

2) Intensify social awareness on immunization (what are the different vaccines, benefits, schedule – day and time of libreng immunization service in sitio/purok)


Review of monitoring logbook of CHT, TCL by midwives and BHW

Start: April

Masterlisting of 0-11 months per sitio/purok by midwives and BHWs, CHT

Start: March


Attendance of midwife to Barangay Council session to inform Barangay officials on the number of children for immunization

Include child immunization in Barangay Captains Forum on Health

Start: April

Barangay Kagawad with purok/sitio leaders to follow up households in respective area of responsibility

Start: April


Formulate Barangay Ordinance on Child Immunization

Disseminate barangay policy on child immunization to purok leaders

All barangays by Sept

Start Oct

Ensure availability of vaccines and other supplies

Request vaccines from DOH - PHO

Start: April

ASAP

Ensure cold chain management of vaccines in the RHU

Replacement of old vaccine carriers

Start: April (management of vaccines during brownouts)


Regularly schedule of immunization by sitio by midwives, BHW, CHT and barangay officials (monthly)

Start: April

Tracking of defaulters by midwife and BHWs, CHT, Barangay Officials

Start: May

Prompt recording and reporting (include immunization in private hospitals)

MHO/PHN with DOH rep to hold meeting with private hospitals and MDH on EPI

Start: May

May


Hold monitoring and evaluation quarterly

Start: June

Technical updates on Immunization including cold chain management for RHMs

Start: 1st quarter

Updates on immunization for BHWs and CHTs

Start: Feb


Conduct bench conference or meeting in sitio/purok including schedule of immunization day by midwives and BHWs

Start: April

Disseminate information on immunization including schedule of immunization day in churches in barangaysby BHWs, barangay officials

Start: April

Disseminate information on immunization including schedule of immunization in FDS by MLs

Start: April



Start in Jan

Note: need TA in making the PSA

Watchers class in the hospitals and RHU birthing facility

(need: key message on newborn care, exclusive breastfeeding, and immunization among mothers, fathers c/o DOH)

Orient nurses/midwife in OB on immunization by DOH rep and PHN

Start: July

June


Child Health

Objectives Breakthrough result: Provide child survival package of service in all barangays for sick children (AGE, pneumonia, URTI etc)

Strategies 1) Bring the sick child to health provider consultation and management 2) Provision of child health service in all barangays thru RHU on Wheels (outreach) or through the midwife


Make available adequate stock of drugs and medicines for children, ORS in all BHS

Midwives to from RHU

Start: April


Organize and conduct RHU on Wheels (outreach services especially in GIDA communities) quarterly

Note: integrate sick child consulation with maternal health outreach

Start: 3rd quarter

Provide support to BnB (source of quality and affordable generic medicines)

TA from DOH & other partners : link up with HealthPlus

Assessment of BnB operations: 3rd quarter

Start: 1st quarter


Nutrition: Re-start feeding program for low birth weight and stunted children

Note: consider tapping private corporation or NGO

Start: 1st quarter 2015

Training of all midwives on CMMNC

Schedule in 3rd quarter

Midwives to provide service (consultation ) for sick child in BHS

Start: Jan


Masterlisting of low birth weight infants and under five children by BHW and midwife and disseminate to barangay officials

Start: Jan Start: Jan Start: Jan

Masterlisting of HH without access to potable water and sanitary toilet by BHW and midwife and disseminate to barangay officials


Scale-up OPT by BHWs and midwives: house to house purok/sitio level



Disseminate information on available health service for children to barangay officials and IP leaders

Integrate in Barangay Leaders Forum on Health

Integrate in IP leaders Forum on Health

Start: June - midwives to sit down in barangay council meeting

Conduct bench conference or health class on topics related to child illness and remedies; food and nutrition for UFC

Note: can also be integrated in FBS


Note: need TA on session guide and IEC tools for midwives


Child Health

Objectives Breakthrough result: Increase exclusive breastfeeding from 61% to 80%

Strategies 1) Intensify social awareness on exclusive breastfeeding and food/nutrition for infant and young children2) Organize community support groups for exclusive breastfeeding and IYCF


Train – mobilize breastfeeding advocates and champions

Start in 2015

Organize breastfeeding support group

Start in 2015


Organize breastfeeding room in work places

Start in 2015

Orient Day Care Center Workers on IYCF (food and nutrition including food preparation - “plant to plate”)

Start in 2015


Conduct bench conference or meeting in sitio/purok on EBF and food/nutrition for infant and children

Start: May

Disseminate information on EBF and food/nutrition for infant and children in FDS, barangay officials, IP leaders

Start: July

Disseminate information on food/nutrition for children in Day Care Centers

Start: June


Disseminate Milk Code during ABC meeting

Need: Advocacy material on EBF and milk code

Start: 3rd quarter


Start in 2015

Promotion of exclusive breastfeeding in birthing facility (need IEC tools on EBF)

and Revitalize Mother-Baby Friendly Initiative in birthing facility

Start: July


Update on exclusive breastfeeding and IYCF for BHWs and CHTs

Implement in 2015

Technical update on exclusive breastfeeding for midwives, nurses and doctors

Implement in 2015


Child Health

Objectives Breakthrough result: Sustain VAC and Deworming service coverage at no less than 90% of children

Strategies 1) Continue social awareness on Garantisadong Pambata services particularly Vit A supplementation and deworming2) Continue GP in April and October each year


Masterlisting 6 mos to 59 mos children per sitio/purok by midwives and BHWs


Disseminate information to barangay officials, day care centers, FDS on GP service and schedule

Start: Mar Start: Mar Start: Mar


Radio plug and Public service announcement

Note: use existing materials of DOH on GP

March – April

Aug - Sept

March – April

Aug - Sept

March – April

Aug - Sept

Provision of Vit A and deworming in all puroks/sitio

Note: ensure logistics are available Vit A and deworming from DOH

April and May

Sept and Oct

April and May

Sept and Oct

April and May

Sept and Oct

Promptly record and submit report by midwives

May-June

Oct- Nov

May-June

Oct- Nov

May-June

Oct- Nov


HIS: Data Quality Check, Training of MHO, PHN and midwives on newborn and infant mortality review (tools)

Training on Verbal Autopsy tools for newborn, infant and child deaths

Coach implementation of verbal autopsy

Coaching: newborn, infant and child mortality review

Coaching: newborn, infant and child mortality review

Logistics Management: Stocks Inventory Management

Training of selected RHU staff on stocks inventory management (DOH & MH)

Coaching monitor implementation of the inventory system

Re-application: PhilHealth accreditation on Newborn Screening

1st quarter 1st quarter 1st quarter

THANK YOU Daghang Salamat

operational plan scale-up mnchn service delivery

Documents

barangays barangay council

health need

iec materials scale

session guides

cluster of barangays

barangays minimum scale

mnchn policy

municipal policy incentives