policy, planning and project management the newsletterhealth.gov.bz/www/attachments/article/878/papu...

April 1, 2016 Volume 2, Issue 1

Policy, Planning and Project Management

The Newsletter

Special points of in-

terest:

JSDF Project Closes

Vector Control—Let’s

Not Lose Focus

Inside this issue:

JSDF Project Closes 1

Let’s Not Lose Focus—

The Targets Remain the

Same

1

“Meet the Staff”

Northern Health Region

3

Development of

Competencies for Nurse

Educators

6

The National TB Program 7

Upcoming Dates and 9

“Childhood stunting

is a condition that is

defined as height for

age below the fifth

percentile on a

reference growth

curve, measuring the

nutritional status of a

child”

JSDF Project Closing By: Dr. Andrew Vernon, Project Coordinator, JSDF Project

On June 15, 2011 the Government of Belize, Ministry of Health received BZD $ 5,505,788 to be used over a five year period to address chronic malnutrition (Stunting) within the district of Tole-do. Childhood stunting, is a condition that is defined as height for age below the fifth percentile on a reference growth curve, measur-ing the nutritional status of a child. It is an important indicator of the prevalence of malnutrition or other nutrition-related disorders among an identified population in a given region or area (UNICEF, 2015).

To accomplish this, MOH developed & implemented a multidisci-plinary approach focusing on, Improving the health and nutrition of children in Toledo, through an early childhood development ap-proach focusing on pre-natal care, nutrition monitoring within the critical window of opportunity (0 - 24 months), and health inter-ventions at the primary school level 5 –13 years. On the 15th of January the Japanese funded initiative came to an end, successfully developing & implementing several health and social change activities district wide. Notable achievements were obtained under the project for the Health and Education Sector.

In October 2014 Belize saw its first imported case of Chikungunya which at the time had swept through the Caribbean and the Americas in less than one year. Since 2015 the same region has been facing an epidemic of Zika, which will eventually make its way across our bor-ders. Since the environmental conditions as it relates to temperature, humidity, rainfall and altitude are within the ideal ranges in all dis-tricts for the proliferation of aedes mosquitoes, the entire country is considered to be at risk for Dengue, Chikungunya, and Zika transmis-sion. The level of risk is primarily determined by life style and socio-economic conditions within communities. Over the past months the ministry has developed a Zika National Preparedness and Response Plan, focusing on strengthening surveillance, diagnosis, and vector control. Cont’d on page 5

Let’s Not Lose Focus—The Targets Remain the Same By: Mr. Kim Bautista, Chief of Operations, Vector Control

Policy, Planning and Project Management The Newsletter

JSDF Project Components

Component 1 Focuses on addressing and preventing malnutrition in chil-dren < 5 years of age by empowering the local community.

Component 2 Focuses on developing healthy lifestyles programs for pri-mary school children in their eight years of primary educa-tion.

Component 3 Focuses on strengthening access and quality of community-based health services in support of Maternal & Child Health (MCH).

Component 4 Focuses on promoting behavior change in communities by understanding the community's attitude and perception to-wards health.

Component 5 Focuses on strengthening monitoring and evaluation of the project

JSDF Project Closing—Cont’d from cover page

Health Achievements

34 parent leaders and 64 Commu-nity Health Workers trained in promotion of antenatal care, coun-seling, health education, nutrition, infant and young child feeding practices, growth monitoring, im-munization and referral

10 Health Posts refurbished and 12 health facilities district-wide energized.

Provision of pharmaceuticals across the Toledo District Health network to improve maternal and child health.

Capacity building and sensitiza-tion training to MOH staff on re-ducing cultural barriers affecting indigenous woman

Education Achievements

15 out of 16 primary school sani-tary facilities were refurbished allowing children access to mod-ern, clean and hygienic facilities. Solar power was installed in all schools and 10 out of 16 have been provided with hand washing stations & self-contained inciner-ating waste disposal units.

6 of the 16 school received water catchment units and all 49 schools within the district received class-room gravity feed water filters.

49 primary schools with feeding programs implemented (12 offer-ing at least one portion of fruits and vegetables).

District wide Parent Teacher As-sociation (PTA) established.

32 primary school educators (principals, teachers, and PTA) trained on nutrition practices, small business management and implementation of school feeding programs.

Set of educational material devel-oped on proper health practices and the effects of stunting on chil-dren adapted to proper cultural setting (language, images, mes-sages).

*************

Project Indicators

The JSDF initiative comprised of two key project develop-ment indicators, which measures the over all success of the project and eight intermediate indicators which were uti-lized to measure the projects implementation over the five year period. These are:

1. Percentage decrease in rates of worm infestation in pri-mary school-aged children in Toledo rural community 2. Percentage decrease in rates of anemia in primary schooled-aged children in Toledo’s rural community

There are also eight intermediate indicators. For further information, please contact the Project Management Unit (PMU)

“Meet the Staff” - Northern Health Region Management Team

Volume 2, Issue 1


“Meet the Staff” - Cont’d from page 3

Ms. Guadalupe Longsworth Ag. Regional Health Manager

Northern Health Region

Ms. Vioney Sheppard Ag. Senior Public Health Nurse Corozal Community Hospital

Dr. Jorge Sajia Chief of Staff

Corozal Community Hospital

St. Iveth Balan Departmental Sister


Dr. Jair Osorio Chief of Staff

Northern Regional Hospital

Ms. Trecia Mortiz Ag. Administrative Assistant Northern Regional Hospital

St. Lourdes Heredia Infection Control Nurse


Ms. Rossana Herstig Ag. Nursing Administrator Northern Regional Hospital

The Northern Health Region is comprised of two health districts, Corozal District and Orange Walk District with a popu-lation estimate of 93,357. Corozal District has a population estimate of 44,613 (33,186 rural, 74%). This is equivalent to 12% of the country’s population. Orange Walk District with a population estimate of 48,744 (35,052 rural, 72%). This is equivalent to 14% of the country’s population. The five leading causes of mortality are Diabetes—55 (45 in 2013), Cancer—49 (48 in 2013), Heart Disease—47, Pneumonia—22 (20 in 2013), Cirrhosis of Liver—10 (21 in 2013) The Northern Health Region is composed of two (2) public Health Institutions (Northern Regional Hospital and Corozal Community Hospital), eleven (11) Health Centers and sixteen (16) Health Posts. The Regional Hospital has 57 beds and Corozal Community Hospital (CCH) has 30 beds. Source: Northern Health Region Annual Report 2014 & www.health.gov.bz


Let’s Not Lose Focus - Cont’d from cover page

Even before the emergence of these two viral diseases, the entire re-gion has been facing an epidemic of Dengue and as a result, within the span of a year we now have 3 viral diseases all transmitted by the same mosquitoes! The main dengue vector in Belize is the Aedes aegypti. In 2009 a secondary vector Aedes albopictus was first detected in the West of the country and in 2010 in both Northern districts. Further monitor-ing in other areas of the country is being planned in order to fully understand the distribution of Aedes albopictus. The first reported outbreak of dengue in Be-lize was in 1978; since then there have been mild outbreaks every two to three years. The outbreaks have become more frequent and we now experience out-breaks in most areas of the country on a yearly basis, with the peak transmission period coinciding with the rainy season from May to November.

Belizeans are now con-cerned about Zika, particularly due to its possible association with con-genital malformations and neurolog-ical disorders. While we continue to refer samples to CARPHA for test-ing, to date we remain Zika free. But Belizeans must not be distracted by possible medical associations which have a very low probability of contraction. We must remain focused on prevention, which can only come as a result of a concert-ed effort to prevent these aedes mosquitoes from breeding right in our own yards – this is what we have 100% control over. We must be even more concerned about the increasing trend of deadly Severe Dengue cas-es also known as Dengue Hemor-rhagic Fever. In years past dengue was associated in only urban areas

but it is now common in many rural commu-nities which over time have developed “urban like” settings. Issues with drainage, garbage disposal, storage of water and used tires are all contributing factors in rural communities. With the emergence of Zika bring-ing to the forefront the urgent need for aedes mosquito control, the Ministry of Health is seizing this opportunity to build relation-ships with stakeholders such as other gov-ernment ministries/departments and the pri-vate sector. The ministry if re-emphasizing its message of the importance of fighting this vector collectively if we are to be suc-cessful. A good fight against these aedes mosquitoes is a good fight against the afore-mentioned diseases. The ministry will con-tinue to support the various health regions in their educational efforts and clean up efforts with stakeholders. Individually, we must continue to share the message of prevention.


Subregional Workshop on the Development of Competencies for Nurse Educators in the Region 2-4 December 2015 By: Mrs. Shanna Tun Broomfield, Health Planner (HRH Focal Point)

In the past years of the (RENR) Regional Examination for Nurse Registration monitored by the Caribbean Examinations Council, the results have shown that less than 60% of students are successful. This poses a serious problem with the availability of Nurses in the workforce. In some coun-tries in the region, Nurse Educators are not being updated with the skill de-mand and competencies needed in the population, and they may not be tradi-tionally trained with Educational peda-gogical skills to train or teach Nursing or midwifery. The Pan American Organiza-tion and World Health Organization have initiated support to strengthen the education and training programs for Nurses and Nurse Educators. Repre-sentatives from the Ministry of Health, Belize: Deputy Director of Health Ser-

vices, Nursing Health planners, along with University of Belize Dean of Allied Health and Nursing, Chair and Lecturers represented and worked on the plans for Belize’s Nursing Educators. This event was held in Belize in December 2015 at the Radisson Hotel. Nurse Educators, Chairs of Nursing schools across the Caribbean participated. The objectives of the work-shop sessions were: 1. Review and update existing nurs-ing and midwifery competences for faculty/adjunct teaching staff.

2. Review and discuss current status of evidence on benchmarks for nurs-ing services.

3. Develop a plan of action for the process of strengthening competen-cies with a time line.

4. How nursing education can contribute to strengthening UA/UHC as part of Car-ibbean Cooperation in Health (CCHIV) Most of these objectives were met and the groups from each Nursing school and Island were charged to contin-ue the work of updating the core compe-tencies based on the gaps identified within the Country’s setting. The Ministry of Health continues to work

closely with the University of Belize in improving the competencies of Nurse

Educators that will ultimately impact the quality and caliber of Nurses assimilated within the workforce.

**************

Volume 2, Issue 1

The National Tuberculosis Program By: Dr. Francis Morey, National Tuberculosis Coordinator

Press Release (World TB Day 2016) “World TB Day is observed every year on March 24th as a means of creating public awareness around TB. This year’s theme is “Unite to end TB”. TB remains a public health concern and is still responsi-ble for 1.5 million global deaths every year. Tuberculosis is a curable and pre-ventable disease caused by Mycobacterium tuberculosis (which generally affects the lungs). When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. TB is transmitted from the infected person to another weak person through the droplets formed in the throat or lungs. In 2014, 9.6 million people fell ill with TB and 1.5 million died from the dis-ease. Over 95% of TB deaths occur in low- and middle-income countries, and it is among the top 5 causes of death for women aged 15 to 44. TB is a leading entity in terms of mortality of HIV-positive people: in 2015, 1 in 3 HIV deaths was related to TB. In Belize in 2015 there were 78 new cases of Tuberculosis, of these 7 were Extra-pulmonary tuberculosis, 14 were co –

infections with TB/HIV. The age groups most affected were between the ages of 20-59 years of age fol-lowing the same trend as seen in pre-vious years. There were 9 deaths for 2015 which represents a 11.5% mor-tality rate The National TB program of the Ministry of Health continues to engage in the following activities as part of a TB reduction strategy: High-quality DOTS (directly ob-served treatment strategy) expansion and enhancement by: -securing political commitment, with adequate and sustained financing improve methods for early case de-tection, and diagnosis through quali-ty-assured bacteriology in the dis-tricts provide standardized treatment with supervision -ensure effective drug supply and management at all levels. monitor and evaluate performance and impact in the peripheral sites -Contribute to health system strengthening based on primary health care;

-Engage all care providers; with con-tinuous training and re-training. -Consistent Monitoring and evaluation of activities to improve case finding and adherence to treatment. -Educational activities and health fairs which are held in each district to com-memorate this day The above mentioned strate-gies will be supported by a grant pro-posal that was successful for a period of 3 years enabling the program to improve its national goals and suc-cess.”

Stop TB Disease Belize NSP-TB Objective

Pursue quality DOTS 1. Improve diagnosis of TB

2. Improve treatment success

Address TB/HIV and MDR-TB

3. Improve detection and management of MDR-TB

4. Reduce burden of HIV in patients with presumptive and diagnosed TB

5. Reduce burden of TB in people living with HIV and initiate early ART (three I’s)

Engage all Partners 6. Develop public-private partnerships

Involve TB patients and Communities

7. Involve communities and community volunteers

Pursue quality DOTS 8. Improve supervision and monitoring system for TB control

Promote Operational Research

9. Do operational research

VISION: A Belize in which TB is no longer a public health problem. MISSION: To promptly find and completely cure all cases of TB disease (including MDR -TB), while as-

suring that patients benefit from broader preventive care (especially PLWHA).

OBJECTIVES:

******

“Unite to end TB”

******

Volume 1, Issue 1

0

20

40

60

80

100

120

140

160

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

years

Total Number of TB all forms 2010-2015

Number of cases

The National TB Program - Cont’d from page 7

0

50

100

150

200

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Number of TB and HIV Co-infections 2001-2015

HIV/TB cases TB all forms

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

To Subscribe, please contact:

Policy Analysis & Planning Unit and

Project Management Unit

6-8 Trinity Boulevard

City of Belmopan, Cayo

Telephone: (501) 822-0992

Fax: (501) 822-0994

[email protected]

[email protected]

MISSION

The Policy Analysis and Planning Unit, in coordination with Technical Ad-

visors and Regional Management teams, continuously work in partner-

ship with other stakeholders in identifying the social determinants of health

that greatly impact the development of our country, Belize. The unit,

through evidence-based health policy development and planning,

will guide the Ministry of Health in addressing health care disparities with

society wide measures that improve social welfare. h

VISION

A Policy Analysis & Planning Unit effectively working with the Ministry of

Health & its regions to assist them in making evidence based decisions

OBJECTIVE

To promote and generate evidence-based policy development and planning

in health care issues and serve as advisory body to the Ministry of Health.

April 7—World Health Day 25—International Malaria Day 28—World Day for Safety and Health at Work 23-30—Vaccination Week in the Americas (World Immunization Week)

May 12—International Nurses Day 15—International Day of Families 17—World Hypertension Day 22—International Day for Biological Diversity 23-28—World Health Assembly, WHO 28—International Day of Action for Women’s Health 31—World No Tobacco Day

June 5—World Environment Day 14—World Blood Donor Day 26—International Day against Drug Abuse and Illicit Trafficking

July 11—World Population Day 28—World Hepatitis Day

Upcoming Dates and Events

Ministry of Health East Block Building Independence Plaza

Belmopan Belize, C.A

www.health.gov.bz

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Next Issue ~July 1, 2016~

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