2. KACHIN SURVEY TEAM
GAVI-HSS assessment at Bhamaw and Shwegu for 2 times
1st time -- May, 2010
2nd time – Nov, 2011

3. Eight System Areas were surveyed
• Health Management and Planning, including
• Mapping hard to reach areas
• Human Resource Management
• Health Finance and Financial Management
• Community Participation
• Essential Drugs & Equipment
• Infrastructure
• Data Quality and Service Quality

4. Identification of Barriers in the Township

5. CTHP Training
• Bhamaw
Total 24 villages – identified as HTR for package of service
• Shwegu
Total 32 villages – identified as HTR for package of service

6. • Evaluation of EPI data for 2011
• Evaluation of HMIS data for 2011
• Detailed plan for package of service for the whole year (2012)
according to CTHP by respective RHC by BHS (bottom up plan)

7. HTR areas by using motorcycle
HTR area by bullock cart
HTR area by using motor boat

9. Immunization
MCH care
Nutrition
Environmental sanitation

10. Health education activities

11. Recording and reporting by uniform reporting formats

14. Drugs distribution lists to RHC (Bhamaw) at 29-6-12
No Items
.
MCH
ManMaLin
Ma-U- Sin
Pin
Khan
Man
Yut
Moe
Total
Phane
1.
Sub centre
Drug Kits
(11/0322)
5
7
7
7
7
5
38
2.
MW SC
Drug Kits
(11/0325)
3
4
4
3
5
3
22
3.
RHC Kit
(11/0377)
-
1
1
1
1
1
5
4.
MW SC
First Aid
Kit
3
4
4
3
5
3
22
5.
Renewabl
e items for
RHC
-
1
1
1
1
1
5

15. GAVI-HSS supply of computer, printer and copier

16. Iodine test
Using IEC materials
•
•
•
•
•
•
•
•
•
Other service activities apart from 4 main activities
PMCT
DHF control
Malaria control
Contact tracing for TB
Reproductive health- birth spacing & male involvement
School health activities
Advocacy with local authorities & religious leaders for more community involvement
Elderly health care
Health education

17. Delivery by SBA during package
followed by immunization in
subsequent package

18. Implementation status of package of services - Bhamaw
57
60
50
37
40
24
30
24
17
20
10
0
Planned
packages for
2012
Packages
conducted till
July
Additional
packages
without GAVI
support
Total HTR
villages
identified
HTR villages
visited up till
July

19. Implementation status of package of services - Shwegu
78
80
70
60
50
43
32
40
32
30
20
10
0
Planned packages
Packages
for 2012
conducted till July
Total HTR villages
identified
HTR villages
visited up till July

20. Supportive supervision of sub-RHC

21. Discussion of BHS in the quarterly meeting

22. Quarterly Review Meeting (6 months Review) Jan- June (Bhamaw)
No.
Sub-centre
Name of BHS
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
MCH1
MCH2
MCH3
MCH4
MCH5
MCH6
Man Yut (main)
Kabarni SC
Kone Ma Hat SC
Kho Kyin SC
Si In SC
Ma-U-Pin (main)
Nant Hlaing
Thein Daw SC
Kywe Gyo SC
Naung Lite SC
Moe Phane (main)
Naung Kho SC
Nant Pha SC
Sai Kin SC
Man-Ma-Lin (main)
Sint Kin SC
Mya Sadi SC
Kyun Gyi SC
Kaung Sint SC
Sin Khan (main)
Kaung Tone
SaWadi SC
Yae Ni SC
Daw Mar Mar Yin
Daw May Thit
Daw San San Maw
Daw Nilar Aye
Daw Ohnmar Nwe
Daw Ei Ei Phyu
Daw Nyo Mar Zin
Daw Mary Soe
Daw Hnin Ye Soe
Daw Thida Aye
Daw Ye Ye Win
Daw Nilar Aung
Daw Myint Myint Kyu
Daw Myint Myint Khine
Daw Yone Htan Yin Ze
Daw Aye Aye Maw
Daw Htu Gya
Daw San San Htay
Daw Aye Aye Than
Daw Nyunt Nyunt Wai
Daw Sine Mine
Daw Aye Mar Win
Daw Nan Ban
Daw Oung Hlaing
Daw Lei Lei Win
Daw Khin Hnin Phyu
Daw Htwal Gya
Daw Phyu Phyu Win
Daw Romi Khine
30.
Naung Mo SC
Daw Htan Hle Pine
AN
Coverage
33.67
30.89
27.5
46.1
34.52
33.66
35.6
40.5
42.9
28.5
38
52
41
37.5
34
37.1
25.49
41.4
40.24
51.78
40.6
35
46.56
51
30.7
52.6
46.3
36.4
48.4
55
PN
Coverage
95
97.36
68
98.6
95.23
95.6
81.8
50
93.3
89.6
100
75
96
100
73
85.7
76.9
100
86.05
85.71
77.1
105
100
100
21.6
37
60
87.5
23.5
79.2
SBA rate Delivery by MW
(%)
97.6
60.52
80
90.4
100
97.8
72.7
66.7
98.3
89.6
62.7
35
62
63.6
25
42.8
66.6
92.59
88.73
89.65
60
95
29.82
62.16
50
32.6
8
22
26.5
29.2
14
36.8
28
8.2
14.28
13.04
72.7
33.3
45
72.4
47
5
38
50
7
14.28
38.46
42.59
77.46
65.51
60
80
22.8
43.8
52.9
28.2
4
15.6
23.5
25
OPV3 %
36.95
35.65
37.03
41.3
57.69
48.57
41.8
35
48.1
40.6
60
63
47
55
44
28
47.91
45.03
46.05
59.61
34
38.23
47.87
36.89
41.5
47.2
57.8
54.8
50
40.4
Latrine
coverage
99.71
87.5
87.03
85.7
135.2
96.05
101
99
106.3
97.1
89.7
97
98
80.5
116
94.8
96
108.52
108.05
107.77
112
99
103.89
96.71
90.8
99
92
0
0
50
Weighing
of <5 (%)
35.2
44.04
44.11
49.4
46.32
48.4
40
77.1
46.9
41.7
115
9.7
29.4
5.5
41
72
48.64
64.88
36.14
58.04
52.6
71.88
31.38
30.8
0
14.2
0
49
28
63.8

23. SWOT analysis of HSS activities
STRENGTH
 Team work
 Quality health care
 On job training/supportive supervision
 Technical support/ Training
 Perception of duties and responsibility by BHS
 AN care coverage/ immunization coverage increased
 SBA coverage increase to a certain extent
 Accessibility to health care services
 Utilization of health care services

24.  More health knowledge can be gained by the community
 Improved Data quality
 Improved Service quality
 Effectiveness of health care services
 Efficiency of health care services
 HEF –the poor mothers/children being taken care of
 Recruitment of new AMW/CHW from HTR villages- health
care services covering at HTR areas

25. WEAKNESSES
 Data recording/ Filling in their registers
 Inadequate drugs (few items of essential drugs)
 Inadequate IEC materials
 No advance preparation for packages, No clear job description





among the package group during first package
Lack of coordination with other department of health (d/s
control)/ NGOs
No timely report & feedback from package of service
Expectation of community for general medical treatment
rather than package of service
Vaccine wastage rate increased in Bamaw ---Frequent turn over of BHS (HA, LHV and MW)

26.  Evidence of actual travel (no camera)
 Skillfulness of BHS in remote areas (coming down from mountainous
areas)
 Utilization of the community for delivery case?
 Weight monitoring can be done during package of services but no
action for underweight (supplementary feeding, serial
monitoring, vitamin supplements, nutritional education)
 No specific action on constructing sanitary latrine or providing PVC
pan except education of hand washing practices and sanitary latrine
inspection
 Less active THC/ VHC

27. OPPORTUNITY
 Health personnel become more aware and appreciated by
the community
 Support by local authorities and religious leaders
 Community interest/ involvement
 Collaboration with NGOs/project working in the T/S
 Incentives & motivation
THREAT
 Language barrier
 Security barrier
 Migrant population (head count)-Denominator problem

28. Meeting with budget committee for hospital equity fund
Supply to the poor for emergency from HEF (since 1/6/12-till date)
No.
Township
1.
2.
Bhamaw
Shwegu
Pregnant
mothers
11
12
Children
Total
6
7
17
19
Amount
(kyats)
1,479,300
1,000,000

29. Training of new BHS for orientation of GAVI-HSS programme

30. • Recruitment of new AMW & CHW especially from HTR villages (20 each)
• Refresher training of existing and functioning AMW and CHW (50 each)

31. Thank You