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Family Health Division Presentation

Family Health Division Presentation. Dr. Kiran Regmi Director, Family Health Division Feb 2011 regmikiran@gmail.com. Lesson Learnt from the Key Interventions to Achieve MDGs 4 & 5: Direction Beyond MDG for Nepal. Outline. Millennium Development Goals (MDG) 4 & 5

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Family Health Division Presentation

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  1. Family Health Division Presentation

  2. Dr. Kiran Regmi Director, Family Health Division Feb 2011 regmikiran@gmail.com Lesson Learnt from the Key Interventions to Achieve MDGs 4 & 5: Direction Beyond MDG for Nepal

  3. Outline • Millennium Development Goals (MDG) 4 & 5 • Targets set by Nepal and achievements • Key interventions to achieve MDG 4 and 5 • Direction beyond MDG for Nepal

  4. MDG 4 & 5 • Goal 4.A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate • Goal 5.A. Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio • Goal 5.B. Achieve, by 2015, universal access to reproductive health

  5. Target Set by Nepal and AchievementsGoal 4A

  6. Target Set by Nepal and Achievements Goal 5A Millennium Development targets and achievements of Nepal

  7. Target Set by Nepal and Achievements Goal 5B

  8. Target Set by Nepal and Achievements Goal 5B

  9. KeyInterventions > Ama Surachha Program Key interventions 1. Ama Surachha program 2. Family Planning

  10. Key Intervention I: Ama Surachha Program • ANC • Promotion of SBA conducted childbirth • Promotion of institutional childbirth and initiation of delivery incentives • PNC

  11. Ama Surachha Program <ANC • As Ama Surachha program ANC component focused on targeted ANC there is increase in 1st and 4th visits • ANC motivational incentive package • Transportation allowance and free childbirth • This shows that Ama program is heading towards in right direction • This is a good indication towards meeting MDG 5A • There is marked increase in ANC 1st and 4th in 2066 because of initiation of free childbirth policy

  12. ANC 1st Visits by Region FY 2062/63 to 2066/67(As % of Expected Pregnancies) Source: HMIS/MD, DOHS

  13. Four Time Antenatal Visits by Region FY 2062/63 to 2066/67 (As % of Expected Pregnancies) Source: HMIS/MD, DOHS

  14. Delivery Conducted by SBA • There is increase in SBA conducted delivery indicating achievement of MDG 5B

  15. Delivery Conducted by SBA by Region FY 2065/66 to 2066/67 (As % of Expected Pregnancy)

  16. Institutional deliveries have risen substantially – much of the increase can be attributed to Aama 44% (Aamaaverage)

  17. Ama Surachha Program > PNC • After the initiation of free childbirth policy there is a marked increase in PNC

  18. Postnatal Service Coverage by Region FY 2062/63 to 2066/67 (as a% of Expected Pregnancies) Source: HMIS/MD, DOHS

  19. Postnatal Service Coverage by Region FY 2062/63 to 2066/67 (as a% of Expected Pregnancies) Source: HMIS/MD, DOHS

  20. Key Intervention II: Family Planning

  21. Target Set by Nepal and Achievements Gap 57

  22. Family Planning Programs • New satellite concept introduced to increase access of LTFP • IUCD training integrated into SBA training • Sr. AHW training in implant insertion

  23. IUCD Trend (No. in 000) Current Users New Acceptors

  24. Implants Users in 000 New Acceptors Current Users

  25. Direction Beyond MDG for Nepal

  26. Thoughts for “Beyond MDG” • Continue reduction of MNMR • Sustainability of Ama program • Quality of care

  27. Continue Reduction of MNMR • Coverage of unreached and underserved population • Bringing childbirth institution at home

  28. Sustainability • Develop a concept of tertiary referral centers and satellite birthing centers • Finding alternate ways to replace the adhoc human resources and interventions adopted to achieve MDG • Train and involve under used midlevel health worker (HA) in various reproductive health programs • Selective verses universal free childbirth services • Think of the interventions beyond aid

  29. Quality of care • Develop a strong Reporting, Monitoring and Evaluation mechanism

  30. Thank You

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