Sunita Subedi and Lila Paudel, Fulbari

HP Chitwan

Introduction

• Fullbari VDC located in Chitwan District

of Narayani Zone

• Total Population: 4800

• Mixed population (Brahamin /Chhetri, Janjati,

Dalit and Terai ethinc group)

• Average Family size : 5.3

• None of the I/NGOs, CBOs working

with in VDC currently

• known as VDC of “Full Literate” ( 100% literacy)

• Schools: 4

HP’s catchment Area •Fulbari VDC all

• Mangalpur VDC ward 1,2

•Bharatpur municipality ward 13, 14,

•Shivnagar VDC ward 2, 5,6, 7

•Gitanagar VDC- Indrapuri

• More than 8000 people (est.popn)

• Serving Mixed population

• More Brahamin/ chhetri and Dalit

Beneficiaries

• Own building : 7 rooms • OPD room • Dispensary, • Laboratory, • Surgery ( minor boils and

abscess), • Administration • Store • Meeting hall

• Toilet facility

Infrastructure

Total staffs- 8

• Health Assistant-1

• Senior AHW- 2

• Sr. ANM-1

• AHW-1 ( Padnam-VHW)

• ANM-1 ( Padnam- MCHW)

• Lab Assistant- 1 ( from HFoMC)

• Office Assistant-1

Staffing

Available Free Health Services • Immunization

• Nutrition- Growth monitoring, Vit-A, Iron and albendazole Distribution

• Diarrhea- ORS and Zinc distribution

• ARI

• Safe motherhood- ANC, PNC

• Family Planning- Counseling, condom, pills and Depo

• Disease control- Malaria slide collection, treatment,

• TB- sputum collection and testing and treatment

• Leprosy- treatment

• HIV/AIDS and STDs- Health Education and STDs treatment

• OPD services

• Community level services: PHCORC and EPI clinic

Milestones

Milestones Date

Established SHP 2054/06/09

Upgraded to HP from SHP- 2069/02/23

Re- formation of HFOMC 2069/04/24

Started to Prepare a yearly work plan and approved by DPHO 2069/04/24

Started public Audit as well as routine audit ( establish a audit

committee)

2069/04/24

Household survey 2069/05/19

Extension of lab service 0269/06/07

Recording and updating household vital data through survey

separately

2069/07/11

Why Fullbari HP Different?? • Household survey each year

Why Fullbari HP Different??

• Good Recording keeping and updating health profile of every households

Why Fullbari HP Different?? • Proper Mobilization of FCHVs

for HHS

Why Fullbari HP Different??

• Functional Lab Services

Strength of Lab •Free TB services

•Free Malaria Services

•Measles sentinel site

•Screening of diabetic patients and

continuous follow up

•Stop misuse of antibiotics

•Free service to HFOMC member and FCHVs

• 50% subsidy to students

•Full/partial subsidy to poor

Why Fullbari HP Different?? • Monthly routine health check up- camp- mentally

retarded pupils (Sustha Manasthiti kalyan Vidhaylaya)

• Creation of Communicable disease management Fund

• Declare Model HP based on population related services

• Yearly Annual Review meeting

• Annual presentation of health service statics to stakeholders and public

• Social Audit

• Open Defecation free VDC

SERVICE STATISTICS

OPD Service Utilization

3443 3992

4461

8121

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

066/067 067/068 068/069 069/070

Number of OPD cases

Fiscal Year

Re-formation of HFOMC Household Survey Started Lab Services

Monthly Distribution of OPD cases

567

415 399

333

271 256 275 284

390 389 385

497

706

805

704

528 525

465

666 651

720 690

790

871

0

100

200

300

400

500

600

700

800

900

1000

Shra

wan

Bh

adra

Ash

win

Kar

thik

Man

gsir

Po

ush

Mag

h

Falg

un

Ch

aitr

a

Bai

sakh

Jest

ha

Ash

ar

Shra

wan

Bh

adra

Ash

win

Kar

thik

Man

gsir

Po

ush

Mag

h

Falg

un

Ch

aitr

a

Bai

sakh

Jest

ha

Ash

ar

068/069 069/70

Number of OPD cases

FY/Months

Household survey

Reformation of HFOMC Prepare yearly work plan

Immunization Coverage

49%

66%

79%

105%

38%

73%

81%

102%

65%

52%

78%

105%

0% 20% 40% 60% 80% 100% 120%

066/067

067/068

068/069

069/070

Measlse DPT 3rd BCG

Re-formation of HFOMC Household Survey

% of New Growth Monitoring

78%

72% 72%

105%

0%

20%

40%

60%

80%

100%

120%

066/067 067/068 068/069 069/070

Percents

Fiscal Years

Re-formation of HFOMC Household Survey

ANC and PNC coverage

39%

33%

28%

47%

43%

23%

16%

45%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

066/067 067/068 068/069 069/070

Percents

Fiscal Years

ANC ( 4th Visit) PNC (1st, 2nd, 3rd)

Re-formation of HFOMC Household Survey

HFOMC Meetings

9

4

7

17

0

2

4

6

8

10

12

14

16

18

066/067 067/068 068/069 069/070

Number of meetings

Fiscal year

Re- formation of HFOMC

Contraceptive Prevalence Rate ( CPR)

46%

59%

64%

0%

10%

20%

30%

40%

50%

60%

70%

067/068 068/069 069/070

Percents

Fiscal Years

Re-formation of HFOMC Household Survey

Findings from Household survey

Population Pyramid

Age group

Educational Status (N=3273)

87%

12% 1% 0%

Hindu Buddhist Others

99.29%

0.70% 0 0

literate illiterate

Religion of household (N=961)

Occupation of Household (n= 961)

0%

5%

10%

15%

20%

25%

30%

35%

40%

agriculture services foreign

employment

business labor

38%

29%

20%

8% 5%

Type of fuel use for cooking ( n=961)

0%

10%

20%

30%

40%

50%

60%

70%

80%

cylinder gas bio- gas wood electricity

70%

17% 12%

1%

Type of Toilet (n=961)

Source of Drinking water (n=961)

98%

1% 1%

tub-well well tap

12%

88%

kachhi pakki

Published Excellent work of Fulbari HP

Upcoming -plans

• Establish Birthing center

• Extend 24 hours service

• Declare Full Immunization VDC

• Declare Uterus prolapsed free VDC

• Start Safe Abortion service

• Extend Family planning service (Copper-T and Implant)

• Extend lab services

• Well managed recording and reporting system

• HP building construction

• Declare organic free VDC in collaboration with Agriculture

Take Home Message

Local Innovation

Updated household information though

HHS

Multi-sectoral collaboration

Increase service utilization Increase quality of care

Functional Lab

DPHO

Agriculture HFOMC

VDC

Schools

Proper and

updated Record Keeping