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Progress in Implementation of Child Health Programme

Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, 15 – 18 Nov 2011. Progress in Implementation of Child Health Programme. Country:BHUTAN. Road to MDG 4. Infant Mortality Rate: reduced from 90 in 1990 to 40 per 1000 live births. ROAD TO MDG 4.

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Progress in Implementation of Child Health Programme

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  1. Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, 15 – 18 Nov 2011 Progress in Implementation of Child Health Programme Country:BHUTAN Regional CH Meeting, Kathmandu

  2. Road to MDG 4 Infant Mortality Rate: reduced from 90 in 1990 to 40 per 1000 live births.

  3. ROAD TO MDG 4

  4. Epidemiology / burden of childhood diseases: • Main causes of Neonatal Mortality: 1) Prematurity 2) Birth Asphyxia 3)Sepsis 4) Congenital malformation 5) IUGR Regional CH Meeting, Kathmandu

  5. Child mortality causes • Pneumonia • Diarrhoea Regional CH Meeting, Kathmandu

  6. IMCI Implementation

  7. IMCI implementation

  8. IMCI Implementation Key factors that helped scaling up 1. Program Officer with longer duration of posting. 2.Core team of IMNCI trainers 3.Recording Forms made available in all the health centres. 4.Implementation of supportive supervision. 5.Formation of Child Health Advisory Group (CHAG). Key challenges to scaling up: 1.Continuity of supportive supervision( follow up). 2.Time constraints of the supervisors. 3. Rapid turnover of trained health workers.

  9. Newborn Health • ENC Course adapted: Year 2006 • Other training courses: • Healthcare providers trained: Regional CH Meeting, Kathmandu

  10. In-Patient (Hospital) care of sick newborns and children • WHO Pocket Book introduced: Year 2006 • Training courses for Hospital care done: Yes / No; Details, If yes: • Number and proportion of Healthcare providers trained: • MOs:nil • Nurses:nil • Proportion of hospitals providing pediatric care having oxygen:31 hospitals and 14 BHU I • Hospital assessment using WHO tools carried out: • Year/s: • How many hospitals covered: Regional CH Meeting, Kathmandu

  11. CHW approach for care of sick newborns and children Regional CH Meeting, Kathmandu

  12. Programme Review and Management • CH Short Programme Review introduced, if yes : • Year:2010 • National level. • Programme Management Course introduced, if yes: • Year:Not implemented • National or sub-national: Regional CH Meeting, Kathmandu

  13. Health Management Information Systems (HMIS) and DHS/MICS • List the key indicators for newborn and child health included in HMIS and DHS/MICS? 1.Number of diarrhoea cases 2.Number of pneumonia cases 3. Immunisation status. • How and at what level are the data for these key programme indicators analysed and used by the programmes? -analysed for Mid term review and whenever required. -to carry out thematic analysis( WHO,UNICEF,MoH) Regional CH Meeting, Kathmandu

  14. Future Plans Strengthening and scale-up plans for Next 2 years • IMCI: expand the F-IMNCI to all the hospitals. • ICATT use:No • CHW Packages: • Home Based NB Care package: • Sick child package:through C-IMNCI • Healthy Child (ECD)--No • Referral (Hospital) Care:F-IMNCI • Programme Review and Management: • CH Short Programme Review:2013 • Programme Managers Course: Regional CH Meeting, Kathmandu

  15. Future Plans • Nutrition program. • Anemia—survey result-(6 to 36 months)age –81% . Intervention:Fortification of complimentary food.( sprinkles) Target :same age group Method:at 6,9,24 and 36 months contact and whenever children come for weighing.Start from 2013.

  16. Future plans continued Malnutrition: stunting 33%. Intervention: strengthen nutrition rehabilitation units in the hospitals.Currently only at JDWNR hospital,Thimphu Start from:2012-2013 Regional CH Meeting, Kathmandu

  17. Future plans Neonates 1.Set up neonatal Care units at Regional hospitals. 2.Continue the advance training on neonatal care for nurses 3.Continue nurses attachment in the regional hospitals in NICU. Regional CH Meeting, Kathmandu

  18. Future plans for IMNCI Expand F-IMNCI to all hospitals. Regional CH Meeting, Kathmandu

  19. THANK YOU TRASHI DELEK Regional CH Meeting, Kathmandu

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