Chikando HC Recognition Presentation

CHIPATA DISTRICT COMMUNITY HEALTH OFFICE

CHIKANDO COMMUNITY HEALTH CENTRE

SMGL REVIEW MEETING PRESENTATION

22ND

MAY 2015

Presenter : Kuwani Banda.

Health centre in charge

INTRODUCTION

Chikando Community Zonal Centre is a health center administered by Chipata District Community

Health office.

GOAL

To effectively and efficiently facilitate the provision of quality primary health service care to the

community of Chikando with competence, cleanliness and care, in order to contribute to sustainable

human development.

LOCATION

The centre is located 42 kilometers south of Chipata town. It is accessible by the great east road up to

Mtenguleni and branches off to the left by feeder road with a distance of 15km. It shares its borders

with other 4 Health centers.

FACILITIES WITH SERVICES PROVIDED

OUTPATIENT DEPARTMENT :Consultations are done daily and there is at least one staff on duty

to handle any emergency at all times.

INPATIENT DEPARTMENT: The general ward has a bed space of 5 beds

MATERNAL CHILD HEALTH DEPARTMENT. The centre provides antenatal institutional

deliveries, postnatal services and family planning. Elimination of Mother to Child Transmission

(EMTCT) service is also provided. Under five clinics are held at the centre (static) and outreach

posts. Department has 2 delivery beds and 3 pre/post natal beds

ENVIRONMENTAL HEALTH DEPARTMENT: Service provided that aims at disease

prevention ,prolonging life and reduction of hazards in Chikando community.

ART MOBILE SITE: The centre also has the provision of anti-retro treatment (ART) services

which is done by the Mwami Mission Hospital mobile team once a week.

VOLUNTARY COUNSELLING AND TESTING COUNSELLING: The service is provided on

all working days

POPULATION AND QUARTERLY TARGETS 2015

CATEGORY YEAR % CSO TARGET

POPULATION

CSO QUARTERLY

TARGET

POPULATION

HEAD COUNT

TARGET

POPULATION

HEAD COUNT

QUARTERLY

TARGET

POPULATION

CHILDREN 0 – 11 MONTHS 4% 434 108 387 97 CHILDREN 12 – 59 MONTHS 16% 1737 434 1549 387 5 AND OVER YEARS 80% 8684 7746 WOMEN 15 – 49 YEARS 22% 2388 2130 TOTAL MALE 48.8% 5297 4724 TOTAL FEMALE 51.2 5557 9657 EXPECTED PREGNANCIES 5.4% 586 147 523 131 EXPECTED DELIVERIES 5.2 564 141 503 126 EXPECTED LIVE BIRTHS 4.9% 531 133 474 119 POPULATION GROWTH RATE 2.1% TOTAL POPULATION 100% 10,855 9,682

THE THREE Cs

In order to have successes at health centre, strong emphasis is put on the 3 Cs on delivery of quality health

care to the community .

COMPETENCE: a well leaned staff who have adequate knowledge and skills in their profession.

Knowledge is acquired through trainings, mentorships and even by catching up with new disease trends on

the internet. with their craft so as to give adequate and quality care to the community.

CARE : to have caring heart for the patients .This is done by ensuring tht staff are on time for work, knock

off on time and be sympathetic to the client. Also ensure that clients are seen even at night by allocating staff

to night calls

CLEANLINESS: To ensure that the clients are seen in a clean environment to minimize cross infection and

boost client and staff moral.

INTRAFACILITY RELATIONSHIPS

INTRAFACILITY RELATIONSHIP/LINKAGES

TO ACHIEVE SET GOALS , STRONG INTRA FACILITY RELATIONSHIP AND

UNDERSTANDING IS NEEDED .

Staff meetings are held every month. Staff freely contribute in this forum and all issues are discussed.

Important to allow staff to be open so to move issues out even though they are deemed controversial or

critical of leadership.

Involvement of all staff when revising action plan or having financial meetings. This enables the staff to

have a sense of ownership with the centre. i.e. in 2014 during action plan revision all staff agreed to reduce

funding to their departments and sacrifice so that the centre could be painted internally and externally.

INTRAFACILITY RELATIONSHIP/LINKAGES

Strong partnership with clinical and environmental department. Environmental staff

has bi weekly plan which is discussed with the in charge so as to reduce misunderstandings

and misconceptions. Clinical department includes EHO in activities e.g. SMAG

Debriefing of staff after any training /workshop. This is done after any staff attends a

meeting or workshop. These are in form of clinical meetings or debriefing meetings. All

staff including support staff take turns in presenting. This is vital because all staff get to

have some knowledge on other departments. Also important for linkages i.e follow up

exposed children for testing or refills is done by EHO because debriefed on PMTCT even

though he wasn’t trained. Nurse also oriented on building inspections and water testing. All

staff oriented on helping babies breath by midwife who was trained.

STAFFING LEVEL

No Name Cadre

1 Kuwani Banda Registered Nurse

2 Crystal Mkakangoma Registered Nurse

3 Christine Zulu Enrolled Midwife

4 Henry Shankandi Environmental Health Officer

5 Eunice Nyirenda General Indoor Worker

6 Gerard Zulu Driver

7 Thomas Shanzi Watchman

NAME CADRE WORKING DAYS AND TIMES

18

Mon

19

Tue

20

Wed

21

Thu

22

Fri

23

Sat

24

Sun

25

Mon

26

Tue

27

Wed

28

Thu

29

Fri

30

Sat

31

Sun

K.BANDA HCI 8-17 OPD(C)

MAT(C)

8-17 OPD(C)

8-17 OPD(C)

8-17 OPD(C)

8-17 OPD(C)

OFF OPD(C)

OFF OPD(C)

mat C

8-17 OPD(C)

8-17 OPD(C)

8-17 OPD(C)

8-17 OPD(C)

8-17 OPD(C)

8-12 OPD(C)

MAT(C)

OFF (mat C)

C. MKAKANGOMA RN OFF

8-17 MAT(C)

8-13 MAT(C)

8-17 MAT(C)

8-13 MAT(C)

8-12 MAT(C)

OFF

8-17 MAT(C)

8-13 MAT(C)

8-17 MAT(C)

8-17

MAT(C)

8-13 MAT(C)

OFF

8-10 OPD(C)

H.SHANKANDI EHO 8-17 8-17 8-17 8-17 8-17 OFF OFF 8-17 8-17 8-17

8-17 8-17 OFF OFF

C. ZULU M/WIFE O N L E A V E

E.NYIRENDA GW 8-17 8-17 8-13 8-13 8-17 OFF 8-10 8-17 8-13 8-17 8-17 8-13 8-12 OFF

CHIKANDO COMMUNITY RURAL HEALTH CENTRE.

STAFF TIMETABLE 18 MAY 2015 TO 31 MAY 2015

NOTE:

1. WORKING HOURS AND DAYS SUBJECTED TO CHANGE AT SHORT NOTICE

2. SUBJECTED TO CHANGE DUE TO AVAILABILITY OF STAFF.STAFF WHO WORK ON DAY OFF CAN CLAIM

OFF DAY ON A LATTER DAY

3. ANY CHANGE SHOULD BE COMMUNICATED THROUGH THE IN CHARGE

4. TRIPS OUTSIDE THE CENTRE ON PERSONAL BUSINESS ON NON DCHO DAYS CONSTITUTE A DAY OFF

5. ON CALL BEGIN AT 18 HOURS AND END AT 07 HOURS. IF A STAFF HAS HAD A CALL THE WHOLE NIGHT AND

GOES BETOND THE STIPULATED TIME OF THE CALL, A DAY OFF OR HALF DAY CAN BE CLAIMED

6. IF ONE STAFF IS ABSENT, ANOTHER MEDICAL STAFF TAKES OVER ON THE ABSENT STAFFS CALLS.

COMMUNITY PARTNERSHIP

COMMUNITY PARTNERSHIP

Strong community partnership is essential in provision of health care.

All 6 NHCs are active and meet monthly. This is done after under 5 outreach clinics in their area. This

ensures staff supervision.

In order to improve maternal and family planning indicators , the centre embarked on program to improve

link between community and health centre.

In 2nd Quarter 2014 ,health centre embarked on Strengthening SMAG with a 6 month plan to add new

members ,hold regular meetings, regular outreaches action planning and involvement of stakeholders. Even

though SMAG members not formally trained ,orientation was done by clinical staff.

MOTIVATION OF COMMUNITY BASED

VOLUNTEERS

Motivation of CBVs is done through integration into health centre programs such as

funded SMAG meetings and outreach VCT. This is done through review of action plan to

include activities. When there is no funding ,staff sometimes contribute to ensure programs

continue.

Integration of trained TBAs to assist in antenatal clinics, post natal clinics, family planning

and follow up of exposed children.

Centre purchased a total of 7 bicycles for CBVs between 2013/2014 through Imprest.

All community based volunteers supervised with staff according to program i.e. CLTS

champions closely monitored by EHO.

SMAG STAKEHOLDER MEETING Stakeholder SMAG meeting with Chief Representative, Community

development officer , Vetenary Officer And Agriculture Camp officer. Done through guidance of SMGL mentorship.

HEALTH CENTRE IN CHARGE

ENVIRONMENTAL HEALTH OFFICER REGISTERED NURSE

COMM. HEALTH

WORKER

GROWTH MONITORS

T. BIRTH ATTENDANT MALARIA

AGENTS

CLTS

CHAMPIONS CHLORINATORS

SMAG MEMBERS

TB TREATMENT

SUPPORTERS YOUTHS

NUTRITION PROMOTERS

GENERAL

WORKER DRIVER WATCHMAN

Chikando Community Rural Health Centre

SMAG ACTION PLAN 2014

Schedule 3rd and 4th quarter 2014

Compiled by:

Ruth Banda

SMAG chairperson

NO LOCALITY PRIORITY ACTIVITIES DATE REMARKS 1. LUFU NHC Select new SMAG members, health

education on safe motherhood and

long term family planning

sensitization, Drama play

24/06/2014

2. CHANKHONZI NHC Select new SMAG members, health




14/07/14

3. NO. 1 FARMS NHC Select new SMAG members, health




21/08/14

4. MGOGO NHC Select new SMAG members, health




18/09/14

5. KAZIMOMWE NHC Select new SMAG members, health




23/10/14

6. ZAMBEZI NHC Select new SMAG members, health




20/11/14

DELIVERIES AND POSTNATAL

All institutional deliveries done by professional staff. One staff on call at maternity at all times. Timetable

made for two weeks in advance and copies are given to all staff.

No Fresh still born at Chikando to professional staff handling. This greatly due to the fact that professional

staff handle all deliveries.

Women encouraged to come for post natal @ 6 days because BCG is only given then. Women also

encouraged to come 6 weeks post natal when OPV 1 , DPT 1 Rota 1 and PCV 1 given. These are not given

at outreach stations

DELIVERY AND POSTNANTAL INDICATORS 1st QUARTER 2015

Source: Delivery Register. Postnatal Register. HIA 2

LONG TERM FAMILY PLANNING Staff at clinic mentored by DCMO in inserting Jadelle implant and in 3rd quarter 2014

Mentorship beneficial in aspects of counselling clients, correcting wrong information/ rumors on long term

family planning ,actual insertions, benefits of LTFP and side effects.

Through continuous sensitization by staff and SMAG with outreach family planning posts being set up ,the

community has embraced and accepted long term family planning.

One day in the week is allocated to outreach long term family planning and static family planning is done on

an everyday basis.

FAMILY PLANNING INDICATORS 4th quarter 2014 and 1st QUARTER 2015

Source: HIA 2. Family Planning Register

NOTE: MALE CONDOMS ARE A UNIT OF 144 PIECES

0

50

100

150

200

250

300

350

400

450

80

423

1

264

318

450

128152

No o

f Cl

ient

s

INDICATORS

cohrot actuals ACTUALS

ELIMINATION OF MOTHER CHILD

TRANSMISSION (EMTCT)

Centre is currently implementing Option B+ with 14 clients (4 male and 10 females) currently receiving care as

of May 2015.

We ensure correct and safe filing of client files. Logistical inputs done consistently in the ART DAR register to

know monthly consumption.

Files are stored under lock and key for client confidentiality

All exposed children are followed up . This was a weakness during the last performance assessment for 3rd and 4th

Quarter 2015,due to factors such as DBS cared being O/S, lack of properly filled register.

In the 1st Quarter 2015, all children @ 6 weeks , 6 months , 12 months and 18 months tested have been followed

up and testing done. This was achieved by involving draing up a monthly follow up schedule partnership with

EHO and community based volunteers

EXPOSED INFANTS INDICATORS 1st QUARTER 2015

DATA MANAGEMENT Data management follows the 3Cs of quality data which are

A) Correct Data - raw data should be accurate e.g. number of ANC tally sheet and also be validated by use of

register by in charge.

B) Completeness. Daily Checks in registers (data audit) done to ensure completeness and correctness in MCH

department. This is done because CBVs assist in MCH department and so Staff is required to do data audit.

C) Consistent data. Data should always remain within normal ranges if out of

range then cleaning up of data required. Example of -3Z score was very high in one month. After data audit, it

was found that incorrect tallying by new staff.

Patients records are produced and stored in an organised manner. Tally sheets ,files and registers organised

and stored in an orderly manner. This is essential for easy reference .

SMART CARE

The health centre is a Smart care model site. There are 5 computers, each in a different

departments at the centre. Staff was not formally trained but oriented in smart care

program.

Program installed in December 2014 and fully operational in January 2015. As of May

2015, 4000 patient records , 160 new ANC, 130 follow up , 91 delivery discharges and 152

new Family planning clients recorded in system.

Continuality of care present as client records are backed up ,in case of card loss by client or

computer crash.

SMART CARE PROVIDERS

CLEANLINESS The HC prioritises the cleanliness as it is an essential component health care delivery to ensure clients seen

in a clean environment

With revision of action plan in 2013/2014, the health centre managed to renovate and paint the whole

centre, internally and externally.

Indoor general worker has work schedule which was formulated with other staff so as to ensure equitable use

of her time. The watchman is responsible for outdoor cleaning/slashing. He also has a work schedule.

Every Imprest allocation has adequate funds allocated to essentials such as floor polish(Sun Beam) brooms

mops and so on.

Grounds slashed and maintained by the community, as this gives then a sense of ownership. This was a

resolution of a Headman meeting in 2014.

DAILY ACTIVITY PLAN

STAFF NAME: EUNICE NYIENDA CADRE: GENERAL WORKER

DAYS TIME

07:00 HRS TO 08:00 HRS

TIME

10 HRS TO 12 HRS

TIME

14hrs to 16 HRS

MONDAY General Cleaning of main

building

General cleaning of

admission ward

Bed making

Application of Floor

polish in Admission ward

TUESDAY General Cleaning of main

building

General Cleaning of

Pharmacy

Updating of stock

control cards

Checking of soon to

expire drugs

Application of Floor

polish in Main Building

WEDNESDAY General Cleaning of main

building

Dump dusting all rooms

in main building

Dump dusting MCH

building

THURSDAY General Cleaning of main

building

General Cleaning of

MCH building

Supervision of Cleaning of

mothers Shelter

FRIDAY General Cleaning of main

building

Updating Registers Application of Floor

polish in MCH building

SATURDAY General Cleaning of main

building

OFF OFF

SUNDAY General Cleaning of main

building

OFF OFF

INFECTION PREVENTION

To minimize the risk of cross infections, the centre has set standards in infection

prevention.

Standards met with regard to infection prevention include PPE, sharp boxes in all rooms.

Colour coded bins with liners, hand washing facilities with hand wash, gloves, Fenced

refuse pit placenta pit and functioning incinerator. Infection prevention corner is essential

in treatment room and delivery room.

Infection prevention Meetings held twice yearly with Environmental Health Staff as IP

focal person to discuss all issues relating to infection prevention.

QUALITY CONTROL In order to give only quality and true results to our clients, the centre exercises internal quality control on all

rapid tests whenever a new box is opened.

This is done on HIV determine tests, HIV unigold , malaria rapid diagnostic tests and syphilis RDT.

External quality control is done by reference lab, which is Mwami Adventist Hospital every quarter. Random

samples collected and tested at the centre and then sent to Mwami lab for verification of test results.

Control samples are collected every month so as to keep them fresh and stored in refrigerator.

INTERNAL QUALITY CONTROL

TEAM WORK

TEAM WORK, if you do not work

as a team then programs will fail.

Together as one , all things are

POSSIBLE!!!

THE END

Thank You

Documents

Chikando HC Recognition Presentation