2013 MUNICIPAL HEALTH DIRECTORATE ANNUAL PERFORMANCE REVIEW MEETING

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2013 MUNICIPAL HEALTH DIRECTORATE ANNUAL PERFORMANCE REVIEW MEETING

The Municipal Health Directorate of the Ledzokuku-Krowor Municipal Assembly held an Annual Performance Review Meeting on the 30th January, 2014 at the St. Ann’s Catholic Church Conference Hall inTeshie to access the performance of LEKMA Hospital and other health institutions in the Municipality for the year 2013.

Mr. Daniel Boadu, the Municipal Director of Agriculture represented the Chairperson, MCE of LEKMA, Hon. Seth Badu Tawiahwho could not make it to the programme due to some other engagements.

In her welcome address, the LEKMA Director of Health Service,Mrs. Georgina Amankwa stated that the first phase of the LEKMA Polyclinic project was completed, functional and in the process of increasing geographical access to health care.

Participants at the programme included LEKMA Hospital/RCH, Manna Mission Hospital, Lister Hospital, Family Health Hospital, Inkoom Hospital, Oak Street Hospital, Sharon Clinic, Lekma Polyclinic/RCH, Finger of God, The Births and Deaths Registry, NHIS and MHD. All participants gave Power Point Presentations of all activities undertaken in their health facilities in the year 2013.

ANNUAL CHPS REPORT -2013

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LEDZOKUKU KROWOR

1. INTRODUCTION

The CHPS initiative is a national program for reorienting and relocating primary health care from sub-district health centers to community locations in an attempt to address the challenges in access and quality of care. Community resources are utilised for construction, labour, service delivery, and program oversight. It is a national strategy for community action and leadership in health and

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family planning that requires deploying a Community Health Officerto reside in the community to deliver service.

Communities are engaged in decisionstaking concerning their own health as they are regarded as primary producers of health within households – especially mothers. It is the goal and vision of the Ghana Health Service to see that all households have access to community-based service. Health Centers and Hospitals will then provide referral services and backstopping for this level of service delivery.

Ledzokuku-Krowor municipality commenced the CHPS concept in 2011. It has a population of 249794, 92 demarcated CHPS zones and is divided into three sub-municipals namely Nungua, Teshie North, and Teshie South.

As a matter of priority, the Nungua zone was selected for CHPS implementation based on population density and lack of public health facilities. Currently, the municipality has 2 fully functional zones, Akpeshika and Negba all situated in Nungua sub-district. However plans have been initiated for Marteyman, Senegal, Soopkoti, Odikoman, Yeiakona and Oshekutsoshishi for functional zones. The first two are situated in Teshie North and Teshie South respectively and the others in Nungua. CHO’s have been trained and are working in these zones awaiting steps for inauguration. These include CHC training, logistics provision and deployment and inauguration.

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PERFORMANCE PER ZONES-2013

Zone

Oral Pill

Jadelle

Injectable

IUD

Fp Coun

Condoms

Cycle Beads

Akpeshika

64

8

384

0

781

0

8

Negba

35

6

251

0

367

171

2

Partially-Functional Zones

0

7

14

0

1560

5

22

Municipal

99

21

649

0

2708

176

32

Total number of clients who counseled accepted various commodities after counseling are as per table above. Preference for the injectables and the oral pill remains high. Uptake of jadelle though slow is gradually rising due to training of CHOs in jadelle insertion and removal by FRHP.

Education is directed towards the use of long term methods like the Jadelle and IUD. Performance is quite low and efforts will be stepped up for improvement.

§ ANTENATAL CARE

One hundred and nine (109) pregnant women, out of which 21 were registrants, were counseled and encouraged to seek antenatal care service at health facilities. Second dose of tetanus vaccination was given to nine hundred and forty-one (941) mothers. Additionally these mothers were educated on pregnancy and its related complications, importance of nutritious meals, need for skilled delivery, malaria prevention through use of ITNS and IPT amongst others. .

§ DELIVERY

There was no emergency delivery for the period under review.

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§ CHILD WELFARE

For this activity, 1466 record cards were inspected during the CHO’s visits and 3888 vitamin A (blue 1841, red 2047) capsules administered. No defaulters were identified.

§ SCHOOL HEALTH

The CHO’s examined 3993 school children. There were no referrals made.

§ MALARIA AND DIARRHOEA

266 and 83 suspected cases of malaria/diarrhea cases respectively were identified. They were treated as per IMNCI protocol.

Other conditions seen and referred were:

· 14 skin infections

· 15 CMAM cases,

· 8 Mumps

· 2 Hypertension

· 1 Elephantiasis

· 70 Others

· 63 IMNCI cases

· 2 Ear infection

· 2 Eye infection

· 29 Cholera cases

Education on Malaria and other preventable conditions is still ongoing.

§ HEALTH PROMOTION

The CHO’s in collaboration with the CHC’s held series of health education on current health challenges in the municipality. Key amongst these is

Ø Non-communicable diseases such as hypertension, diabetes, sickle cell disease

Ø Post Partum FP with emphasis on Healthy Timing and Spacing of Pregnancy

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ROTA 2

7468

223

159

881

PNEUMO 3

8349

227

160

1028

MEASLES

10664

111

157

1306

MEASLES 2

5535

200

80

986

YF

10664

111

157

1306

TT 2

4774

81

141

749

H/ VISITS

10568

718

723

4681

Performances of the two functional zones are all improving.

MONITORING

The MHD undertook monitoring visits to the CHPS zones. The objective amongst others was to ascertain progress of work by CHO’s and CHC’s, challenges they are facing and together find workable solutions.

Work was getting on well but for funding challenges. Lack of adequate office accommodation still remains a challenge for the partially functional zones a challenge which is still being sorted by CHCS and the assembly.

§ CHALLENGES

· Inadequate office accommodation

· Inadequate financial support

· Community healths committees yet to be trained for partially functional zones as a result of financial constraints

· Lack of commitment from most CHCs

· Limited staff to man CHPS zones yet to be created

WAY FORWARD

ž Form 6 extra functional zones by 2014 with assistance from Municipal Assembly.

ž Advocate for staff

ž Selection and training of 96 community health committee members

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1.1 OBJECTIVES

· To relocate primary health care from sub-district health centers, to convenient community locations.

· To offer consistent, curative and preventative health care in areas that formerly had limited access to the public health system.

· To step up community participation in health decision making

· To make 6 zones fully functional (Marteyman, Senegal, Soopkoti, Odikoman, Yeiakona and Oshekutsoshishi)

2.0 ACTIVITIES

In view of the above objectives a number of health service activities were carried out within the year to enhance the skills and knowledge of the CHO’s.

2.1 TRAININGS:

Ø The CHO’S were refreshed on IMNCI, trained in postpartum family planning and jadelle insertions and removal.

3.0 CHO ACTIVITIES

§ HOME VISITS

This forms the main activity of the CHO’s. A total of 6122 visits were conducted in all zones, non-functional inclusive. There was a tremendous improvement over the previous years as depicted by the table.

§ FAMILY PLANNING

A total of 764 clients received, one form or the other, contraceptives from the zones, whilst 2708 clients were counseled for family planning.

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§ POST NATAL CARE

Zone

No Seen

Vitamin A Supplementation

6-11mth

12-59mths

Post partum

Akpeshika

31

188

235

76

Negba

141

224

346

207

P/Functioning Zones

161

470

557

240

Municipal

333

882

1138

523

A total of 333 postnatal mothers were seen for the period as per table above with majority coming from Negba. Vitamin A supplementation was given to 523 mothers. The graph below shows performance per age groups.

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Ø Introduction of the new 2 vaccines and 2nd dose Measles.(Rotavirus and Pneumo)

Ø Prevention of diarrhoeal diseases eg. Cholera

Ø Maintaining good personal and environmental hygiene

TAB 1. CHPS CONTRIBUTION TO COVERAGES; 2011-2013

INDICATOR

2013

2012

2011

DIST TOTAL

CONTR FROM CHPS

% CONTR

DIST TOTAL

CONTR FROM CHPS

% CONTR

DIST TOTAL

CONT FROM CHPS

%

CONTR

ANC

32111

109

0.34

6529

89

1.4

6229

112

1.8

SUPERVISED DELIVERY

4434

0

0

3876

0

0

3675

0

0

PNC

4389

333

7.6

4289

30

0.7

4036

99

2.45

IMMUNIZATION

BCG

7534

749

9.9

8888

107

1.2

11155

0

0

OPV-3

8347

1425

17

9278

198

2.1

9467

28

0.25

PENTA-3

8347

1425

17

9278

198

2.1

9467

28

0.25

sMEASLES

10664

1696

15.9

13147

265

2

14971

29

0.19

Y/F

10664

1696

15.9

11598

265

2.3

14971

29

0.19

ROTARIX 2

7468

1273

17

4212

122

2.9

-

-

-

PNEUMO 3

8349

1395

16.7

3467

132

3.8

-

-

-

FP COUNSELLING

27753

2708

0

23801

153

0.6

448

CWC-Regs & Atten

0-11mths

12-24mths

76902

-

1466

-

-

1.9

-

1110

1089

381

-

34.3

0

381

HOME VISITS

10568

6122

58

4233

1220

28.8

1220

Minor ailments-Malaria Diarrhoea in children > 5

10714

6869

266

83

2.48

1.2

40341

-

288

-

0.7

-

-

-

-

sTAB 2: PERFORMANCE OF INDIVIDUAL ZONES; 2013.

INDICATORS

TOTAL DIST OUTPUT

INDIVIDUAL ZONES CONTRIBUTION

AKPESHIKA

NEGBA

PARTIALY FUNCTIONING ZONES

ANC

32111

104

3

0

SUP DEL

4434

0

0

0

PNC

4389

31

40

161

IMMUNIZATION

BCG

7534

56

96

597

OPV 3

8447

226

164

1046

PENTA 3

8447

226

164

1046

Normal
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false

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ž Provision of basic logistics to enhance work at initiated zones

ž Training of 13 CHO’s to man the extra priority zones selected.

ž Training of 54 CHC’s for the newly initiated zones

ž Selection and Training of VHC’s

ž Deploy CHO’S to their zones

ž Monitor and report on programme quarterly

§ CONCLUSION

Generally, performance of the CHO’s continues to improve. Basic logistics such as home

visiting bags, BP apparatus & weighing scales needs to be provided for implementation of fully functional new zones. The issue of for basic needs and repairs of the offices remains unsolved, nevertheless the period is an improvement compared to same period last year.

You can be working on this quarterly monitoring tool for now.

Data Element

Number

Demarcated CHPS Zones

92

Functional CHPS Zones

2

Zones planned to be made functional for the quarter

3

New Functional CHPS Zones for the quarter

0

Functional CHPS zones with constructed CHPS compounds

0

Functional CHPS zones with newly constructed CHPS compounds

0

Functional CHPS zones with basic equipment

2

Population covered by Functional CHPS zones

7820

Trained CHOs

16

Home visits done by CHOs

6122

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