HEALTH POST- TANKISUNWARI,MORANG,NEPAL

MANAGEMENT SKILLS FOR HEALTH SERVICES

PRESENTED BY- PRADEEP PARAJULI(MBBS)

INTRODUCTION
Total (health post in nepal):- 677
Each 5-6 village development committee (25,000-29,000 Population), there should be one health post.
On the VDC where health post is present, there is no SHP(sub health post).
OUR VISIT
LOCATION: TANKISUNWARI VDC-MORANG
It SUPERVISES -3 SHP
COVERS-4 VDCs
OFFICE TIME= 10-5 pm
INFRASTRUCTURE
It has a building with three rooms.
-OPD
-Drug distribution
-ANC/PNC check up
STAFFING PATTERN
1.In charge- HA(health assistant)-1
2.AHW(auxiliary health worker)-3
3.ANM(auxiliary nurse midwife)-1
4.KHARDAR-1
5.KARYALAYA SAHAYOGI-1
6.EXTRA BY HEALTH POST DEVELOPMENT COMMITTEE- 3 trained ANM
HEALTH POST DEVELOPMENT COMMITTEE
 chairman- executive head of VDC
 Member secretary-HP in charge
 Members-
WARD CHAIRMAN
DALIT
FCHV(FEMALE AND CHILD HEALTH VOLUNTEER)
Teacher
Social worker-2
VDC nominated

FUNCTIONS
`OPD(OUTPATIENT DEPARTMENT)
 10-2 PM
 Ticket free
 30-35 patient per day
 Most common disease-diarrhea , ARI , skin diseases
FAMILY PLANING
>through ANM staff
1.Depo
2.pills
3.IUD
4.Copper-T
5. Norplant
6.Condom
ANC/PNC(antenatal/postnatal checkup)
EPI(expanded programme on immunization)
Every month vaccination for infants- on6,7,8,9,10th day of month in Immunization centers.
Vaccines-BCG, DPT, OPV, Hep. B, JE, Measles & TT, from DPHO (district public health office)
Storage of vaccine- permanent vaccine carrier.
DISEASE CONTROL PROGRAM
 DIARRHEA
 ARI
NUTRITIONAL PROGRAM
 VHW and FCHV conduct nutritional programs
 Monitoring height & weight- std. growth chart(Road to health chart)
 Poor growth rate, severe malnutrition- referred to koshi zonal hospital
 >6 months – vit.A capsule
 Awareness about sarbottam pitho
 Pitho distributed from ‘posan shakha’ in Biratnagar.
TUBERCULOSIS AND LEPROSY CONTROL PROGRAM
 HP act as DOTS sub center and provides ATT drugs
 All suspected TB cases referred to NATA
 ATT Regimens-8 month regime replaced by 6 month (since Chaitra 2065)
 2 months-intensive
 4 months – continuation phase
Leprosy:
 No facility for diagnosis
 Referred to Netherlands Leprosy Relief(NLR) in Biratnagar for diagnosis
 Anti leprosy drugs provided as under MDT regimen for both PB & MB free of cost.
MALARIA AND KALA-AZAR CONTROL PROGRAM
 MALARIA:
 free drugs available
 Blood smear of suspected cases are sent to higher center for diagnosis
 Kala-azar :
 diagnosis not done. suspected cases sent to Koshi zonal hospital.
Free drugs(SAG) given
HEALTH EDUCATION
 Given by ANM, AHW, HA 4 times/yr according to directives of DPHO on HIV- AIDS, seasonal diseases, viral, malaria, Kala-azar
 School health program on LEPROSY,TB,HIV
OUT REACH CLINIC
 Health services to community people who reside away from these facilities
 21,22 and 23rd of every month
 Involved health workers-AHW, VHW, ANM
 Services provided-ANC, PNC, family planning, counseling, health education ,
Vitamin A, iron, Albendazole distribution
FCHV PROGRAMME
 Backbone of health delivery system
 Volunteers from Aama Samuha- who can read & write
 Initial training for 18 days (9 +9)
 Then refresher trainings as new programs launched
 Rs.200/training
 Ideally 1 FCHV/600 population, but here 1 FCHV/ward
 FCHV kit :
• drugs- cotrimoxazol, gentamycin, ORS, tetracycline as eye ointment
• Timer, thermometer
• Weighing machine
• Condoms, pills, iron tablets
• Manuals, flip charts, IEC material, record books
 FCHV kit :
• drugs- cotrimoxazol, gentamycin, ORS, tetracycline as eye ointment
• Timer, thermometer
• Weighing machine
• Condoms, pills, iron tablets
• Manuals, flip charts, IEC material, record books

FINANCIAL RESOURCES
 Rs. 5 per OPD patient given by Nepal govt
 Government provides salary via DPHO
Report and reporting
Through HMIS-32(health management information system). They get reporting from 3 sub- health post by 4th of the next month and they send the report of every month by 7TH of the next month to the DPHO
WASTE MANAGEMENT
 sharp waste in safety box given by DPHO
 No color coding for wastes
 No Incinerator provided
LIMITATIONS
 No laboratory facilities available
 No proper waste disposal
 Under free drug program- Patients come even for minor ailments
 Limited drugs, not available for STIs
 Infrequent meetings of Development Committee
 Shortage of manpower
RECOMMENDATIONS
 Improvement in laboratory facilities
 Autoclave should be present
 Improvement in methods of waste disposal
 Awareness about free drug program
 Proper co-ordination between VDC & HP

THANK YOU