meeting of south east asia regional programme managers on child health kathmandu 15 18 nov 2011 n.
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Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, 15 – 18 Nov 2011. Progress in Implementation of Child Health Programme. Country: Sri Lanka Dr. Neil Thalagala ( MBBS,MSc,MD ) Programme Manager Early Child Developement & Special Needs

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meeting of south east asia regional programme managers on child health kathmandu 15 18 nov 2011
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, 15 – 18 Nov 2011

Progress in Implementation of Child Health Programme

Country: Sri Lanka

Dr. Neil Thalagala(MBBS,MSc,MD)

Programme Manager

Early Child Developement & Special Needs

Family Health Bureau, Ministry of Health

Regional CH Meeting, Kathmandu

sri lankan child health program
Sri Lankan Child Health Program

National Child Health program (Design, M&E @ Central )

Tertiary Care Hospitals (curative)

LRH (1)

DISTRICT COORDINATORS

Secondary care hospitals

(curative)

TH(16),

PH (12),

BH (44)

Total 72

PHC

MOMCH (25)

329 divisions

MOH teams

(329)

Preventive

Primary care hospitals

(Curative)

DH (161)

PU (95)

RH(182)

CD&MH(59)

CD(441)

Total 938

Community based care (Implementation)

Regional CH Meeting, Kathmandu

sri lankan child health system
Sri Lankan Child Health System

25 Administrative

District

329 Health Districts

(MOH AREAS )

FURTHER DIVIDED IN TO 6690 PHM AREAS

slide4

6690 PHM AREAS IN THE COUNTRY

EACH MOH AREA IS DIVIDED IN TO SEVERAL PHM AREAS

MOH (1-2)

PHNS (2) SPHI (1)

SPHM (2)

PHMS(15-25)

PHIS (10-15)

PHM AREA

FOR 3000 PEOPLE

1000-3000 births year

5000 to 15000 Under 5 children

slide5

6690 PHM AREAS IN THE COUNTRY

EACH MOH AREA IS DIVIDED IN TO SEVERAL PHM AREAS

PHM AREA

FOR 3000 PEOPLE

secondary tertiary care hospitals
Secondary//Tertiary care Hospitals

Regional CH Meeting, Kathmandu

slide7

ESTATE SECTOR POPULATION

806128 18,797,252

Nuwara Eliya,

Hatton 376878 Badulla 161269

Rathnapura 102384

Kandy 92869

Galle 17257

Total 806128

4.29%

Under estate health program

PHDT

Regional CH Meeting, Kathmandu

slide8

SPR

Regional CH Meeting, Kathmandu

epidemiology burden of childhood diseases1
Epidemiology / burden of childhood diseases:

Under 5 mortality =10.4

Regional CH Meeting, Kathmandu

epidemiology burden of childhood diseases2
Epidemiology / burden of childhood diseases:

Regional CH Meeting, Kathmandu

slide12
LBW

Regional CH Meeting, Kathmandu

epidemiology burden of childhood diseases3
Epidemiology / burden of childhood diseases:

Regional CH Meeting, Kathmandu

imci implementation
IMCI Implementation
  • IMCI WAS NOT ADAPTED AS A GENERIC PACKAGE
  • LIMITED APPLICATION
  • DEVELOPMENTOF STANDARD GUIDELINES FOR MANAGING COMON ILLNESSES
  • TRAINNED ONLY Estate Medical Assistants
newborn health
Newborn health
  • ENCC Course adapted: Year 2007
  • Other training courses:
    • Neonatal Advanced Life Support Course (One day)
    • Breastfeeding Promotion and Support in a Baby Friendly Hospital A 20 hour course for maternity staff
    • WHO/UNICEF 40 hour Breastfeeding Counseling

Course

in patient hospital care of sick newborns and children
In-Patient (Hospital) care of sick newborns and children
  • NOT ADAPTED

Regional CH Meeting, Kathmandu

special need program
Special need program
  • National Strategic plan for special need children developed
  • Community based parent mediated model for children with special needs being piloted
  • PHC training program was developed
  • PHC workers in Colombo and Puttlum district trained
  • A model EDC is being established

Regional CH Meeting, Kathmandu

slide20

Non Specific Early Interventions

by parents

supervised by

PHC workers

CFD interventions for all by parents

Special need interventions by parents / PHC workers / therapists jointly

< 18 months

Developmental screening

By parents using ECDS

By PHC workers using a developmental scaledesigned for Sri Lanka

Birth cohort 375000

Delays & Deviations

> 18 months

Special need screening for ASD/

CP etc…

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24……………60 Age in months

slide21

Assessment &

Follow up

Parent education

Parent counseling

Training of parents care givers

on intervention

Function as a day care center

Staff training

Early intervention center

Pre school

MOH

Screening by mothers/PHC

Parent mediated intervention

Home

Clinic

Case management model

child health indicators
Child Health Indicators
  • Neonatal Mortality Rate
  • Infant Mortality Rate
  • Perinatal Mortality Rate
  • Under five Mortality Rate
  • % Infant registered
  • % infants visited at home by area PHM
  • % infants attending CWC
  • Low birth weight index
  • % weighing
  • % moderate underweight
  • % severe underweight
  • % overweight
  • Immunization coverage

Infant

Preschoolar

1-2 yrs & 3-5 yrs

future plans
Future Plans

Strengthening and scale-up plans for Next 2 years

  • IMCI: Capacity development OPD staff/N&E
  • Develop national strategic plan on Child Health
  • Develop NSP on IYCF
  • Completion of adapting & systematizing of SPR on MCH & FP
  • Healthy Child (ECD) package: Being scaled up to N&E
  • Capacity development of health care workers on ENCC and BFHI and LM
  • Evaluation of impact of ENCC training
  • Quality assurance system for newborn care introduced

Regional CH Meeting, Kathmandu

future plans1
Future Plans

Strengthening and scale-up plans for Next 2 years

  • Scaling up of NSP on special needs
  • Develop and implement a Surveillance system on child mortality and establishment of a child death review system

Regional CH Meeting, Kathmandu