2009 Plenary Speech by Health Minister Dr Nelson Martins

8/14/2019 2009 Plenary Speech by Health Minister Dr Nelson Martins

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By Nelson Martins, MD, MHM, PhDBy Nelson Martins, MD, MHM, PhD

Minister of HealthMinister of Health

DiliDili,,JulyJuly 20092009

The Journey of a young nationThe Journey of a young nationfor better healthfor better health


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Historical Background


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NATIONAL HEALTH POLICY


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Government Priority Goals for the Health SectorGovernment Priority Goals for the Health Sector


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5

Dili National HospitalDili National Hospital

Regional Referral HospitalsRegional Referral Hospitals

CHC w/bedsCHC w/beds

(1 each Sub-district)(1 each Sub-district)

CHC without bedsCHC without beds

(1 each Sub-district)(1 each Sub-district)

Health Post villageHealth Post village

level, first point oflevel, first point of

contactcontact

Mobile Clinic Mobile Clinic

outreach fromoutreach from

CHCs (where thereCHCs (where there

is no HP)is no HP)

Radio

CommunicationBetween all levels

CENTRAL SERVICESCENTRAL SERVICES

DISTRICT HEALTH SERVICESDISTRICT HEALTH SERVICES

SUB-DISTRICT HEALTHSUB-DISTRICT HEALTHSERVICESSERVICES

COMMUNITY HEALTHCOMMUNITY HEALTH

SERVICESSERVICES

REFE

RRAL

OF

PATI

ENTS

(AmbulanceServices)

National DiagnosticNational Diagnostic

ServicesServices

(radiology,(radiology,

laboratory)laboratory)

CLINICAL REFERRAL SYSTEMCLINICAL REFERRAL SYSTEM CLINICAL SUPPORT &CLINICAL SUPPORT &TRANSFERTRANSFER

SERVICE SUPPORTSERVICE SUPPORT

Integrated Community Health ServiceIntegrated Community Health Service

(outreach to Suco Posts)(outreach to Suco Posts)

Current National Health Services ConfigurationCurrent National Health Services Configuration


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Health Intervention Progress for Achieving MDGsHealth Intervention Progress for Achieving MDGs

MDG Goal 4 INTERVENTIONS ROUTINE HMIS

Reduce ChildMortality

Accessible, affordable health

careAntenatal CareCare of the newbornImproved nutrition of children:micronutrient supplementationGrowth MonitoringImmunisation of children

Integrated management ofchildhood illnesses

Infant Mortality Rates (target 2015 53/1,000):1998 110/1,0002000 101/1,0002002 98/1,0002008 data not analysed yet but there

is indication of significant improvementto 60/1000 as per national HIS.

U5 Mortality Rates (target 2015 96/1,000):1998 148/1,0002000 194/1,000

2002 129/1,0002008 - data not analysed yet but thereis indication of significant improvementto 83/1000 as per national HIS.

U5 Malnutrition (target 2015 31%)2003 46%2007 32%

2008 21%


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Health Intervention Progress for Achieving MDGHealth Intervention Progress for Achieving MDG


Reduce MaternalMortality

(target 2015 252/100,000)

- Skilled attendance duringpregnancy, delivery and postnatal- Basic Emergency ObstetricCare- Comprehensive emergencyobstetric care

- Family Planning

2003 660/100,000

2005 380/100,000 (Reported by 2008MDG)2008 no data analysis on mortalityrates yet, but there is an increase indelivery assisted by skilled birthattendant from 27% of deliveries in2006 to 36% in 2008, which is a positive

indication of improvement. Estimateson MMR around 450/100,000 in 2008.


Reduce the spreadof HIV/AIDS, STIs,Tuberculosis and

Malaria(halted by 2015 and

begin to reversetrend)

- TB Case detection- TB Treatment with DOTS

- Malaria Treatment- Malaria prevention by

house spraying- Malaria prevention in

Pregnancy- STI treatment- STI Prevention

- Voluntary counsellingand treatment

TB:1999 800/100,000 (prevalence rate)2006 789/100,000 (prevalence rate)2008 - 447/100,000 (prevalence rate)Malaria Morbidity Rates forChildren U5:2005 400/1,0002008 275/1,000HIV Reported cases:

2003 12006 44


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Key Health IndicatorsKey Health IndicatorsIndicators Target by

20152004 2008

IMR 53/1000 90/1000 60/1000


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Maternal & Child Health InterventionsMaternal & Child Health Interventions


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Progress on Human Resources for HealthProgress on Human Resources for Health


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National Health Services FinancingNational Health Services Financing


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SISCa: The Key to achieving healthSISCa: The Key to achieving health

Priority GoalsPriority Goals


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SISCa approach believes inusing real data

to makeplan and propose health needs intervention

SISCa approach believes in local Solution to Localproblem while respecting the international bestpractice and standards

SISCa approach believes in community participationand decision on community health

SISCa approach believes on Trans departmental andinstitutional collaboration in health

SISCa approach believes in the empowerment ofcommunity leaders, village heads, members of SucoCouncil in mobilizing resources available to ensurehealthy life in a healthy environment

The Philosophy Behind SISCaThe Philosophy Behind SISCa


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SISCa

Service DeliveryService Delivery

Utilization of HealthUtilization of HealthFacilityFacility

UP ------------ CHC (Health Staff)UP ------------ CHC (Health Staff)

BottomBottom ----------------(Community)(Community)

Marriege between Access Vs. DemandMarriege between Access Vs. Demand

Quality HealthQuality Health

CareCare


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Table 1 provides basic population data on a monthlyTable 1 provides basic population data on a monthly

basis:basis:

To be able to use the statistic data and to reviseTo be able to use the statistic data and to revise

the denominator and indicator required for HMISthe denominator and indicator required for HMIS

To know the number of household member; To know the number of household member;

number of pregnant women; number of postnumber of pregnant women; number of post

partum; number of TB patients; number ofpartum; number of TB patients; number of

children; number of disable people; number ofchildren; number of disable people; number ofelderly people; etcelderly people; etc

To foresee the number of children to be To foresee the number of children to be

immunized in each village every months; numberimmunized in each village every months; number

of pregnant women need ANC;PNC; number of TBof pregnant women need ANC;PNC; number of TB

patients needs DOT and follow up; number ofpatients needs DOT and follow up; number of

disable and elderly need health assistance.disable and elderly need health assistance. To compare and cross-check data of patients To compare and cross-check data of patients

from CHCs and SISCa ( how many are actually dofrom CHCs and SISCa ( how many are actually do

not go to CHC ?)not go to CHC ?)

To count the drugs, vaccine and other health To count the drugs, vaccine and other health

medication and consumable needed by eachmedication and consumable needed by each

village every monthvillage every month..

What to Expect from SISCa Table 1?:What to Expect from SISCa Table 1?:

Family RegistrationFamily Registration


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Know people with malnourish (child,Know people with malnourish (child,

mothers, elderly), provide immediatemothers, elderly), provide immediate

intervention and referral.intervention and referral.

Know eating habit of the communityKnow eating habit of the community

( how many times and what composition( how many times and what composition

of meal)of meal) Know what are the main source of foodKnow what are the main source of food

available in each sucoavailable in each suco

Predict what the main nutritionalPredict what the main nutritional

deficiencies inside and would be met bydeficiencies inside and would be met by

community in each villagecommunity in each village

Assist community to consume the rightAssist community to consume the right

balance of food.balance of food.

Assist community to access to mainAssist community to access to main

nutrient that are lacking in their suco.nutrient that are lacking in their suco.


NutritionNutrition


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Number of Pregnant Mother receiveNumber of Pregnant Mother receiveroutine ANCroutine ANC Number of Post Partum MotherNumber of Post Partum Mother

receive PNCreceive PNC Number of Child have LISIO andNumber of Child have LISIO and

receive routine immunizationreceive routine immunization Number of Child receive VitaminNumber of Child receive Vitamin

and other nutrient supplementationand other nutrient supplementation Early referral of high risk PregnantEarly referral of high risk Pregnant

MotherMother

Routine access to information andRoutine access to information andintervention on Family planningintervention on Family planning

Place for plan a delivery togetherPlace for plan a delivery together

with pregnant motherwith pregnant mother Other Gynecology consultationOther Gynecology consultation

What to Expect from SISCa Table 3?: MCHWhat to Expect from SISCa Table 3?: MCH

h f T bl


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Will treat and demonstrate personnel hygieneWill treat and demonstrate personnel hygiene Know how people manage their personnelKnow how people manage their personnel

hygienehygiene

Know number and type of toilet in each SucoKnow number and type of toilet in each Suco

Know number of water source in each SucoKnow number of water source in each Suco

How community breed their cattle , and othersHow community breed their cattle , and others

How community organize their plan that riskierHow community organize their plan that riskierfor Malaria and Denguefor Malaria and Dengue

Know number of healthy housesKnow number of healthy houses

Know the water and sewage drainage in eachKnow the water and sewage drainage in each

SucoSuco

Know number of place and how people manageKnow number of place and how people manage

their household wastetheir household waste

Work with member and leader of Suco to planWork with member and leader of Suco to plan

and propose interventionand propose intervention


Hygiene & SanitationHygiene & Sanitation

h f blWh E f SISC T bl 5?


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At SISCa Posts, the community will have access to someAt SISCa Posts, the community will have access to somemedical treatment if required and the medical team maymedical treatment if required and the medical team mayidentify the need for referrals to a health facilityidentify the need for referrals to a health facility


Curative ServicesCurative Services

h f S SC T bl 6?Wh t t E t f SISC T bl 6?


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Develop local health promotion materialDevelop local health promotion material

identified in each Suco from table 1-5.identified in each Suco from table 1-5.

Then, conduct Health promotion andThen, conduct Health promotion and

education every month through differenteducation every month through differentcommunication tools such as films, groupcommunication tools such as films, group

discussion; sport activities; distributediscussion; sport activities; distribute

brochure or banners; Band music andbrochure or banners; Band music and

theatre; etc.theatre; etc.

Promote participation of LocalPromote participation of Local

Community RadioCommunity Radio


Health Promotion & EducationHealth Promotion & Education


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It expressed the need forIt expressed the need for urgent actionurgent action by all governments, allby all governments, allhealth and development workers, and the world community to protect andhealth and development workers, and the world community to protect andpromote the health of all the people of the world.promote the health of all the people of the world.

It was the first international declaration underlining the importance ofIt was the first international declaration underlining the importance ofprimary health careprimary health care.. The primary health care approach has since then The primary health care approach has since then

been accepted by member countries ofbeen accepted by member countries of WHOWHO asas the key tothe key toachieving the goal of "Health for All".achieving the goal of "Health for All".

The Conference called for urgent and effective national and internationalThe Conference called for urgent and effective national and internationalaction to develop and implement primary health care throughout theaction to develop and implement primary health care throughout theworld and particularly in developing countries in a spirit of technicalworld and particularly in developing countries in a spirit of technicalcooperation and in keeping with a New International Economic Order.cooperation and in keeping with a New International Economic Order.

It urged governments, WHO andIt urged governments, WHO and UNICEFUNICEF, and other international, and other international

organizations, aorganizations, ato channel increased technical andto channel increased technical and

financial support to it, particularly in developingfinancial support to it, particularly in developingcountries.countries.

ili-kekereLautem
http://en.wikipedia.org/wiki/Primary_health_carehttp://en.wikipedia.org/wiki/Primary_health_carehttp://en.wikipedia.org/wiki/WHOhttp://en.wikipedia.org/wiki/WHOhttp://en.wikipedia.org/wiki/UNICEFhttp://en.wikipedia.org/wiki/UNICEFhttp://en.wikipedia.org/wiki/UNICEFhttp://en.wikipedia.org/wiki/WHOhttp://en.wikipedia.org/wiki/Primary_health_care


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Health Timorese in a Healthy Timor-Health Timorese in a Healthy Timor-

LesteLeste

2009 Plenary Speech by Health Minister Dr Nelson Martins

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Transcript of 2009 Plenary Speech by Health Minister Dr Nelson Martins