A report on

Inception meeting with stakeholders

Hotel Avocado, Hetauda, 23rd May, 2016

HEALTH FACILITIES RECONSTRUCTION AND HEALTH SERVICE

STRENGTHENING IN MAKWANPUR DISTRICT, NEPAL

Contents 1. Background ...............................................................................................................................1

2. Objectives of the meeting ...........................................................................................................2

3. Methodology ..............................................................................................................................2

4. Summary of meeting .................................................................................................................3

4.1. Introduction and welcome session ................................................................................................ 3

4.2. Technical session .......................................................................................................................... 4

4.2.1. Post- Earthquake Initiative (BNMT funded project activities): ............................................ 4

4.2.2. Health Facilities Reconstruction and Health Service Strengthening in Makwanpur District,

Nepal (AmeriCares funded project activities): ...................................................................... 4

4.2.3. Rebuilding Communities in Nepal (BLF funded project activities): .................................... 5

4.3. Discussion and Q/A session .......................................................................................................... 5

4.4. Closing session .............................................................................................................................. 5

5. Remarks ....................................................................................................................................6

6. Conclusion .................................................................................................................................7

Annex 1: Schedule of the Meeting .....................................................................................................8

Annex 2: List of Participants ............................................................................................................9

Annex 3: Photo Gallery ................................................................................................................... 10

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1. Background

On April 25, 2015, 11:55 local time, a 7.8-magnitude earthquake struck Nepal, causing widespread

devastation. The devastating earthquake and its subsequent aftershocks have caused damage worth

billions of rupees to physical infrastructure and assets, including the country’s essential

infrastructure i.e. its health infrastructure. According to Ministry of Health and Population

(MoHP), a total of 767 health facilities have been destroyed in the earthquake (342 being

completely destroyed and 281 partially damaged). Makwanpur is also one of the 14 hardest hit

districts of the country that has witnessed interruptions and difficulties in health care service

delivery during and after the disaster thus, showing a strong need to intervene in strengthening the

health service delivery in the district.

While consulting with District Public Office (DPHO) -Makwanpur, Central Regional Health

Directorate (CRHD) and Ministry of Health and Population (MoHP), BNMT and AmeriCares

found that a total of 45 health facilities

have been destroyed by the earthquake

in Makwanpur district among which the

Tistung Health Post (HP), Nibuwatar

HP, Phakhel HP, Makwanpurgadhi HP,

Basamadi HP, Dhiyal HP and

Khairang HP has been completely

destroyed. MoHP has not yet received

any support for reconstruction of these

health facilities hence, they requested

our organization to support for the

same.

On the recommendation of the district

governmental authorities followed by

our preliminary need assessment, the

proposed project aims to strengthen

health service delivery by reconstructing health facilities, promotion of public health and Disaster

Risk Reduction (DRR) interventions and increase resilience and improve community health of

Makwanpur district. The project also aims to re-establish and improve the delivery of health

services through enhancement of knowledge and skills of health workers in the district.

In order to acquaint and develop common understanding on implementation process and standard

guideline of “Health Facilities Reconstruction and Health Service Strengthening in Makwanpur

District” project, a one day meeting was organized at the beginning of the year on 23rd May, 2016

by BNMT at Hetauda with the concerned stakeholders like Chief District Officer (CDO), Local

Development Officer (LDO), Women Development Officer (WDO), Central Regional Health

Directorate (CRHD), District Public Health Officer (DPHO), representatives from District

Administration Office (DAO), District Development Committee (DDC), Health Facility

Operational and Management Committee (HFOMC), I/NGOs.

Figure 1. Working VDCs in Makwanpur

Figure 2. Working VDCs in Makwanpur

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2. Objectives of the meeting

i. To share details of “Health Facilities Reconstruction and Health Service Strengthening in

Makwanpur district” project with concerned stakeholders (CDO, LDO, RHD, DHO/PHO,

HFOMC and I/NGOs).

ii. To develop common understanding on implementation process of the project with the

stakeholders

3. Methodology

Various methods and media were used during the sessions to create an environment for effective

communication and improved understanding of subject matters shared in the meeting, which

included power point presentation on LCD, mini lectures and interaction/discussion sessions

among the attendees. The basic rules of a meeting were followed and a friendly and open

environment was maintained where the participants were encouraged to put forward their ideas,

experiences and queries regarding the project or related issues during the entire meeting.

S.N. Objectives Methods/ Media Responsible

body

Target

group

Venue

1. To share details of

“Health Facilities

Reconstruction and

Health Service

Strengthening in

Makwanpur

district” project

• Presentation

(Power point slides,

use of LCD)

• Mini

lectures

BNMT Nepal

AmeriCares

Concerned

stakeholders

(CDO, LDO,

RHD,

DHO/PHO,

HFOMC,

I/NGOs)

Hetauda,

Makwanpur

2. To develop

common

understanding on

implementation

process of the

project

• Discussions

• Q/A

sessions

All the

participating

stakeholders

3

4. Summary of meeting

The meeting was conducted in Hotel Avocado, Hetauda, Makwanpur on 23rd May 2016 with the

participation of Directors of CRHD, AmeriCares and BNMT along with other representatives from

DAO, DDC, DPHO, WDO,

HFOMC, I/NGOs and BNMT

project staffs. The meeting was

planned for one day where the

representatives from

government stakeholders,

I/NGOs and BNMT discussed

on the objectives of project,

implementation strategies, roles

of government staffs and other

concerned line agencies,

reporting and recording

requirements, intended

outcomes of the project. The

logistics needed for entire

meeting, participants and guests

were managed by the BNMT

Central Office, Kathmandu.

Mr. Raghu Dhital, Program

Coordinator of BNMT Nepal was the moderator of the entire meeting.

4.1. Introduction and welcome session

Formal registration of all the participants marked the commencement of the meeting proceeding

after which they were introduced to each other in a short introduction session. There were total 35

attendees in the meeting including the organizers. Dr. Ramesh Bikram Singh, CHRD was the Chief

Guest and the meeting was chaired by Mr. Suryamani Subedi, Acting DPHO. CDO and LDO were

chaired as special guests in the program. The proceeding was followed by introduction and

speeches from key persons in the meeting.

Dr. Vijaya Shrestha, Treasurer of BNMT Nepal welcomed all the participants and thanked them

for their presence in the meeting despite their busy schedule. She thanked all the stakeholders and

expressed the need for their cooperation and continuous support during implementation of the

projects.

Figure 3. Country Director AmeriCares, Director CRHD, Executive

Director BNMT and other participants in inception meeting, Hetauda

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Mr. Rohit Odari, Country Director of AmeriCares

in Nepal gave introduction of the organization and

current activities done by the organization after

earthquake. He also talked about “Health Facilities

Reconstruction and Health Service Strengthening

in Makwanpur District” project in short providing

the background for the meeting.

4.2. Technical session

The technical session of the meeting was started

by Mr. Suman Chandra Gurung, Executive

Director, BNMT Nepal by thanking all the

participants for their presence in the meeting.

Then, Mr. Gurung presented and shared about

the project objectives, strategies,

implementation process, working districts and

VDCs of the projects by AmeriCares and BLF.

The major contents of his presentation and

sharing during the technical session of the

meeting were as follows:

4.2.1. Post- Earthquake Initiative (BNMT funded project activities):

• Mental Health and Psychosocial Support Program (MHPSS)

– Earthquake affected communities, women including pregnant and lactating women,

children, adolescent, elderly

– Different PSS services, Individual and group counseling

– > 500 individuals benefitted

• Free Health Camps and Free Medicine distribution

• Funding Source: BNMT

4.2.2. Health Facilities Reconstruction and Health Service Strengthening in Makwanpur

District, Nepal (AmeriCares funded project activities):

Project VDCs: Tistung, Nibuwatar, Phakhel, Makwanpurgadi, Basamadi, Dhiyal and

Khairang

Figure 4. Remarks by Rohit Odari -Country

director AmeriCares

Figure 5. Technical Session Presentation by Suman

Chandra Gurung, Executive Director, BNMT Nepal

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Main Activities:

- Construction of seven health facilities

- Community WASH Intervention

- Organize free health camps

- Mental Health and psychosocial support services

- Disaster Risk Reduction Program

Budget: NRs. 4,95,42,084

Funding Source: AmeriCares

4.2.3. Rebuilding Communities in Nepal (BLF funded project activities):

Project VDC: Makwanpur (Manahari, Haadikhola and Padampokhari), Bhaktapur,

Kathmandu,, Nuwakot & Sindhupalchowk

Main Activities:

- Community WASH Intervention (Construction of community toilets)

- Organize Tuberculosis Microscopic Camps

- Mental Health and Psychosocial support services

Budget: NRS 3,09,98,250.00 (For five districts)

Funding Source: Big Lottery Fund (BLF)

4.3. Discussion and Q/A session

Questions were raised related to the various topics regarding the project and discussions were

carried on those topics among the participants. Some of the topics under queries and discussions

were regarding:

Design of the health posts

Approval for reconstruction from the concerned authority

Future challenges during the implementation phase of the project

Approval from Social Welfare Council for the entire project

Addressing Gender and Social Inclusion issue in the project’s implementation

Satisfactory clarifications were given to the raised topics by Executive Director of BNMT Nepal

during the session.

4.4. Closing session

The meeting was formally closed by Mr. Suryamani Subedi, Acting DPHO. Mr. Subedi thanked

all the participants for their patience during the meeting. He also appreciated the co-ordination

and cooperation between the government and I/NGOs and committed to maintain sound co-

ordination in the future.

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5. Remarks

During this session, some of the representatives from government line agencies shared their

experiences, learning and expectations regarding the project in following manner:

Public Health Inspector, Mr. Bhola Chaulagain gave his remarks on behalf of the DPHO

in Makwanpur. He stated that BNMT was in constant contact with the DPHO Makwanpur

following the earthquake. He also mentioned that BNMT was previously working in the

tuberculosis program in Makwanpur district and has continued working in the district after

the earthquake. All the health posts were selected and suggested by the DPHO and BNMT

was conducting its psychosocial counseling program, community sanitation program and

health camps in the district. He expressed his appreciation to BNMT and hoped for such

continuous enthusiasm and productivity for future projects in collaboration with BNMT in

Makwanpur district.

Local Development Officer, Mr. Laxman Birkam Thapa shared his thoughts on behalf

of the District Development Committee. He noted that BNMT should contact

reconstruction authorities in order to confirm the legal procedure for the construction of

health posts. He was aware of this project as his fellow worker had informed him about it.

He thus, thanked BNMT and expressed his hope for all projects to be transparent and gave

his best wishes for the project. He stated that the DDC would support the organization

whenever needed.

Assistant Chief District Officer, Mr. Hari Prasad Panta gave his remarks on behalf of

District Administration Office, Makwanpur. He expressed his satisfaction for being able to

coordinate with the health sector in order to improve the health of earthquake-affected

people. He also expressed his gratitude for AmeriCares and BNMT’s partnership for

improving health care delivery in the district and hoped for successful implementation of

the project. He thanked for selecting Makwanpur as a project district and for sharing

information regarding the project. He also expressed his hope that BNMT will implement

its program in highly needy areas. He gave his best wishes for the successful

implementation of the project and promised support from DAO whenever needed.

“I hope that transparency and accountability of the organizations will be maintained

and that BNMT will supervise whether target population, the needy ones, are getting

the services through the projects.”

- Assistant CDO, Makwanpur

“I am glad that BNMT has been doing many important works after the earthquake in

our district and has been reporting regularly to the DPHO. I hope for the same with

this project too.”

- PHI, Makwanpur

“We are very thankful that this project is helping to construct these health posts in

critically needed areas of the district.”

- LDO, Makwanpur

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Central Regional Health Directorate, Dr. Ramesh Bikram Singh expressed his

gratitude for being invited to the meeting, which he described as a good platform for

communication with all the stakeholders working for the betterment of society. He

appreciated that BNMT have worked well

in different districts in Nepal in past. He

also mentioned that the organization had

felt need after the earthquake and came for

the coordination to work in this district. He

expressed his hope to extend the

reconstruction and construction activities

with other health facilities besides the

proposed ones in the future. He finally

stated that the CRHD will support BNMT

in all of its project activities and anytime

when required. He gave his best wishes for

the successful implementation of the

program like other attendees.

6. Conclusion All the participating stakeholders were acquainted with the project and its activities during the

meeting. The meeting ended with appreciation and commitments by the concerned stakeholders

for the effective implementation of the project and to achieve the proposed outcome.

However, more similar meetings and sharing sessions are required to be conducted on timely basis

in order to implement the project effectively and coordination from concerned authorities and the

community itself is essential to ensure the proper delivery of health services in the district.

Figure 6. Remarks from Central Regional

Health Directorate

“This project is primarily the responsibility of the government but BNMT and

AmeriCares have supported by constructing these health facilities in our community, for

which I am very thankful to both the organizations.”

- CRHD, Makwanpur

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Annex 1: Schedule of the Meeting

Venue: Hotel Avocado, Hetauda

Date: 23rd May, 2016

S.N Program Time Responsible body

1 Registration 2:00 – 2:15 pm BNMT Team

2

Chairing of Distinguished Guests: 2:15 – 2:20 pm

Chair DHO Makwanpur

Chief Guest RHD- Hetauda

Special Guest

CDO, Makwanpur

LDO- Makwanpur

Executive officer- Hetauda

Municipality

3 Welcome/Objectives 2:20 – 2:30 pm BNMT Treasurer

4 Program Presentation 2:30 – 3:00 pm BNMT Director

5 Remarks 3:00 – 3:25 pm CDO,LDO, CRHD, AmeriCares

6 Closing Remarks 3:25 – 3:30 pm DHO Makwanpur

7 Refreshment 3:30 onwards All participants

Moderator: Mr. Raghu Dhital, Program Coordinator, BNMT

Note taker of the proceedings: Shikha Khatiwada, Psychosocial Counselor

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Annex 2: List of Participants

S.N. Name of Participants Designation Organization

1 Mr. Suryamani Subedi Acting DHO DHO- Makwanpur

2 Dr. Ramesh Bikram Singh Director CRHD, Hetauda

3 Mr. Hari Panta CDO DAO, Makwanpur

4 Mr. Laxman Bikram Thapa LDO DAO, Makwanpur

5 Ms. Shova Shah WDO WDO, Makwanpur

6 Mr. Pratap Bist Reporter-Kantipur Makwanpur

7 Mr. Rohit Odari Country Director Americares

8 Ms. Roji Shrestha Project Engineeer Americares

9 Ms. Bijaya Shrestha Treasurer BNMT Nepal

10 Mr. Suman Chandra Gurung Executive Director BNMT Nepal

11 Mr. Bhola Chaulagai PHI DPHO- Makwanpur

12 Mr. Dilip Rokka Magar Health Assistant Tistung- HP

13 Mr. Surendra Mandal S.AHW Khairang- HP

14 Mr. Dhurba Prasad

Lamichhane

S.AHW Officer Nibuwatar- HP

15 Mr. Pramod Roniyar H.A Makwanpurgadhi- HP

16 Ms. Sarita Dhakal H.A Basamadi- HP

17 Mr. Jyoti Raj Luitel AHW Madikhola- HP

18 Mr. Bipin Karki Engineer BNMT Nepal

19 Mr. Tej Lopchan Site Engineer BNMT Nepal

20 Mr. Topendra Shahi Program Officer BIJAM

21 Mr. Thakuram Thapa Lab Assistant BIJAM

22 Mr. Krishna Prasad Sapkota S.AHW Manahari PHCC

23 Mr. Dhaneshwor Shaha S.AHW PadamPokhari-HP

24 Mr. Ramchandra Dahal AHW Manahari PHC

25 Mr. Mihir Kumar Jha Health Program Coordinator Plan International

26 Mr. Shirish Singh Program Officer ACF

27 Mr. Bhim Prasad Timalsina Manager Sub-

Metropolitan,Hetauda

28 Mr. Shivaraj Sunar HA Dhiyal-HP

29 Mr. Chiniya Lama S.AHW PHC, Palung

30 Mr. Balam Pokharel DSP Makwanpur

31 Ms. Anita Budha HA Fakhel HP

32 Mr. Raghu Dhital PC BNMT

33 Ms. Shikha U. Khatiwada Psychosocial Counsellor BNMT

34 Mr. Dharma Bhandari DCM BNMT

35 Mr. Sudin Shrestha Construction manager BNMT

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Annex 3: Photo Gallery

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