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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: Sri Lanka Dr. Neil Thalagala ( MBBS,MSc,MD ) Programme Manager Early Child Developement & Special Needs

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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: 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

  2. 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

  3. Sri Lankan Child Health System 25 Administrative District 329 Health Districts (MOH AREAS ) FURTHER DIVIDED IN TO 6690 PHM AREAS

  4. 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

  5. 6690 PHM AREAS IN THE COUNTRY EACH MOH AREA IS DIVIDED IN TO SEVERAL PHM AREAS PHM AREA FOR 3000 PEOPLE

  6. Secondary//Tertiary care Hospitals Regional CH Meeting, Kathmandu

  7. 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

  8. SPR Regional CH Meeting, Kathmandu

  9. Under 5 mortality 1992-2007 Epidemiology / burden of childhood diseases: Regional CH Meeting, Kathmandu

  10. Epidemiology / burden of childhood diseases: Under 5 mortality =10.4 Regional CH Meeting, Kathmandu

  11. Epidemiology / burden of childhood diseases: Regional CH Meeting, Kathmandu

  12. LBW Regional CH Meeting, Kathmandu

  13. Epidemiology / burden of childhood diseases: Regional CH Meeting, Kathmandu

  14. IMCI Implementation • IMCI WAS NOT ADAPTED AS A GENERIC PACKAGE • LIMITED APPLICATION • DEVELOPMENTOF STANDARD GUIDELINES FOR MANAGING COMON ILLNESSES • TRAINNED ONLY Estate Medical Assistants

  15. 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

  16. Newborn Health

  17. In-Patient (Hospital) care of sick newborns and children • NOT ADAPTED Regional CH Meeting, Kathmandu

  18. 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

  19. 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

  20. 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

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

  22. 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

  23. 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

  24. 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

  25. Regional CH Meeting, Kathmandu

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