Manual for Urban Health and Family Planning Coordination...

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P(\J- /6'10C[3 Special Publication Manual for Urban Health and Family Planning Coordination Committees Md. Jasim Uddin Mohammed Ali Bhuyian Mohammed Ashraf Uddin Jahanara Khatun CENTRE FOR HEALTH AND POPULATION RESEARCH

Transcript of Manual for Urban Health and Family Planning Coordination...

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P(\J- lA(L.-C{O·~

/6'10C[3

Special Publication

Manual for Urban Healthand Family Planning

Coordination Committees

Md. Jasim UddinMohammed Ali Bhuyian

Mohammed Ashraf UddinJahanara Khatun

CENTREFOR HEALTH AND

POPULATION RESEARCH

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oCENTRE

FOR HEALTH ANDPOPULATION RESEARCH

The Centre

The Centre is a unique global resource dedicated to the highest attainable level ofscientific research concerning the problems of health, population and development froma multi-disciplinary perspective. The Centre is an exceptional position to conductresearch within the socio-geographical environment of Bangladesh, where the problemsof poverty, mortality from readily preventable or treatable causes, and rapid populationgrowth are well-documented and similar to those in many other developing countries ofthe world. The Centre currently has over 200 researchers and medical staff from 10countries participating in research activities. The Centre's staff also provide care at itshospital facilities in Dhaka and Matlab to more than 100,000 patients a year andcommunity-based maternal/child health and family planning services for a population of100,000 in the rural Matlab area of Bangladesh. In addition, the Centre works closelywith the Government of Bangladesh in both urban and rural extension projects, whichaim at improving the planning and implementation of reproductive and child healthservices.

The Centre is an independent, non-profit international organization, funded by donorgovernments, multilateral organizations and international private agencies, all of whichshare a concern for the health problems of developing countries. The Centre has a richtradition of research on topics relating to diarrhoea, nutrition, maternal and child health,family planning and population problems. Recently, the Centre has become involved inthe broader social, economic and environmental dimensions of health and development,

particularly with respect to women's reproductive health, sexually transmitted diseases,and community involvement in rural and urban health care.

The Centre is governed by a distinguished multinational Board of Trustees. The researchactivities of the Centre are undertaken by four scientific divisions: Clinical SciencesDivision, Publ ic Health Sciences Division, Laboratory Science Division, and Health andPopulation Extension Division. Administrative functions are undertaken by Finance,Administration and Personnel offices within the Director's Division.

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Manual for Urban Healthand Family Planning

Coordination Committees

Md. Jasim UddinMohammed Ali Bhuyian

Mohammed Ashraf UddinJahanara Khatun

Itt~~'~()D~"CENTRE

FOR HEALTH ANDPOPULATION RESEARCH

International Centre for Diarrhoeal Disease Research, BangladeshMohakhali, Dhaka-1212, Bangladesh

1998

ICDDR,B Special Publication No. 70

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ISBN: 984-551-140-6

ICDDR,B Special Publication No. 70

Printed by: Sheba Printing Press, Dhaka

M. Shamsul Islam KhanEditing:

Layout Design and Desktop Publishing: Jatindra Nath SarkerSubash Chandra Saha

©1998. International Centre for Diarrhoeal Disease Research, Bangladesh

Published by:

International Centre for Diarrhoeal Disease Research, BangladeshGPO Box 128, Dhaka 1000, BangladeshTelephone: (880-2) 871751-60 (10 lines); Cable: CHOLERA, DhakaFax:: (880-2) 871568, (880-2) 883116 and (880-2) 886050E-mail: [email protected]

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Foreword

SecretaryLocal Government Division

Ministry of Local Government, Rural Development & CooperativesGovernment of the People's Republic of Bangladesh

~ Abdul Hye.

~~

Based on the findings of the intervention in Dhaka, the Local GovernmentDivision of the Ministry of Local Government, Rural Development and Cooperativesissued a nation-wide circular outlining the structure and guidelines to form Healthand Family Planning Coordination Committees in all city corporations andpourashavas of the country. Already more than 50 percent of the pourashavas of thecountry have formed such committees.

The Operations Research Project of ICDDR,B has gathered considerableexperiences to make these committees functional and active during implementationof the interventions over the last two years. These experiences are expected to beuseful to officials of the city corporations and pourashavas and service providers inthe government and non-government sectors and to the local leaders for improvingthe functioning of the committees in their respective areas.

Improving primary health care in cities of Bangladesh requires painstakingefforts and a great deal of coordination among the various providers of health andfamily planning services.

The guidelines outlined in this document are based on the experiences of theOperations Research Project of International Centre for Diarrhoeal DiseaseResearch, Bangladesh (ICDDR,B) and the Health Department of the Dhaka CityCorporation gained while designing and implementing a project intervention toimprove the planning and coordination of urban MCH-FP services at the local level.The document illustrates the process of establishing and maintaining effectivecoordination committees.

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Acknowledgments

The Operations Research Project (ORP) is a collaborative effort of the InternationalCentre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) and the Ministry ofHealth and Family Welfare (MOHFW) of the Government of the People's Republicof Bangladesh, supported by the United States Agency for InternationalDevelopment (USAID). Its purpose is to improve the delivery of essential servicespackage in theJ2lational health and population programme.

This paper is funded by the USAID under the Cooperative Agreement No. 388­A-OO-97-00032-00 with the ICDDR,B. ICDDR,B is supported by the aid agenciesof the governments of Australia, Bangladesh, Belgium, Canada, japan, theNetherlands, Norway, Saudi Arabia, Sri lanka, Sweden, Switzerland, the UnitedKingdom, and the United States; international organizations, including Arab GulfFund, European Union, the United Nations Children's Fund (UNICEF), the UnitedNations Development Programme (UNDP), and the World Health Organization(WHO); private foundations including Aga Khan Foundation, Child HealthFoundation (CHF), Ford Foundation, Population Council, Rockefeller Foundation,Thrasher Research Foundation and the George Mason Foundation; and privateorganizations including, East West Center, Helen Keller International, InternationalAtomic Energy Agency, International Centre for Research on Women, InternationalDevelopment Research Centre, International life Sciences Institute, KarolinskaInstitute, london School of Hygiene and Tropical Medicine, lederle Praxis, NationalInstitute of Health (NIH), New England Medical Centre, Procter & Gamble, RANDCorporation, Social Development Center of the Philippines, Swiss Red Cross, thejohns Hopkins University, the University of Alabama at Birmingham, the Universityof Iowa, University of Goteborg, UCB Osmotics ltd., Wander A.G. and others.

The authors acknowledge the contribution of Dr. Ahmed Al-Kabir, DeputyChief of Party, Family Planning and logistics Management (FPlM) /jSI and Mr AbuSayeed, Program Director, Family Planning Management Development (FPMD) whomade important suggestions for improvement of the manual.

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Contents

Page1. Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1

2. Urban Health and Family Planning Coordination Committees 1

3. Users of the Manual. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .. 2

4. Process of forming the City Corporation/Pourashava/Zone/Ward-IevelHealth and Family Planning Coordination CommitteeS 2

a. Review of the directives, instructions, and manual, regarding the formationof City Corporation/Pourashava/Zone/Ward-Ievel Healthand Family Planning Coordination Committees 2

b. Inventory of health and family planning service providers 3

c. Briefing to major service providers of the City Corporation/Pourashava/Zone/Ward 3

d. Organization of meeting and formation of the City Corporation/Pourashava/Zone/Ward-Ievel Health and Family Planning CoordinationCommittees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4

e. Composition of the City Corporation/Pourashava/Zone/Ward- level Health andFamily Planning Coordination Committees 6

5. Terms of reference (TOR) of the City Corporation/Pourashava/Zone/ Ward-levelHealth and Family Planning Coordination Committees. . . . . . . . . . . . . . . . . . .. 6

6. Regular meetings of the City Corporation/Pourashava/Zone/Ward- level Healthand Family Planning Coordination Committees . . . . . . . . . . . . . . . . . . . . . . . .. 8

7. Generic action plan for the City corporation/Pourashava/Zone/Ward-IevelHealth and Family Planning Coordination Committees. . . . . . . . . . . . . .. 10

a. Process of action plan development " 10

b. Follow-up of action plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 14

8. Process of maintaining linkage with higher/lower-level committees . . .. 14

9. The role of the committee members 15

10. Maintaining the right environment for the committees 15

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Appendices

1. Sample of the invitation letter of the Mayor/Pourashava ChairmanlZonal Executive OfficerlWard Commissioner for City CorporationPourashavalZonelWard-level Health and Family PlanningCoordination Committee 16

2.1. Composition of District-level Pourashava Health and Family PlanningCoordination Committee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 17

2.2. Composition of the Thana-level Poursahava Health and FamilyPlanning Coordination Committee 18

2.3. Composition of Zonal Health and Family PlanningCoordination Committee ! • • . • • • • . • . • • • • • • • • • • • • • • • • • • • • • •. 18

2.4. Composition of the Ward Health and Family PlanningCoordination Committee 19

3.1. Terms of Reference (TOR) for the Zonal Health and FamilyPlanning Coordination Committee 20

3.2. Terms of Reference (TOR) Ward Health and FamilyPlanning Coordination Committee 21

4. Sample of Format for Recording Meeting Minutes 22

5. Memo issued by the Ministry of Local Government, RuralDevelopment and Cooperatives about the Urban EPIIPHC/FPCoordination Committee 23

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1. Background

The city corporations and municipalities of the country are mandated to ens.urehealth and family plan"ning serv-ices for the city dwellers. But the present structure,resources and expertise of most municipalities and their health departments are notpractically organized to support this mandate. On the other hand, it is not realisticto expect any individual service provider in the urban areas, . such as municipalauthorities, Directorate of Family Planning (DFP), Directorate General of HealthServices (DGHS), non- government organizations (NGOs) or the commercial sectoralone, to fulfill the health service requirements of the city dwellers. A coordinatedeffort among the stakeholders is, therefore, essential to meet the challenge of ahealthier city. The municipal authorities are in the best position to facilitatecoordination among the service providers, since they have a city-wideadministrative network of resources. According to the present national policy, thecity corporations and pourashavas are required to form health and family planningcoordination committees at their levels.

2. Urban Health and Family Planning Coordination Committees

The purpose of forming the urban Health and Family Planning CoordinationCommittee is to develop mechanisms of functional coordination among theGovernment of Bangladesh (GoB), non-government organizations (NGOs) andcommercial sector service providers.

More specially the committees seek:

>- To institutionalize a regular mechanism for coordination among the serviceproviders from the city corporations, Directorate General of Health Services,Directorate of Family Planning, NGOs and commercial sector organizations.

>- To identify and minimize gaps and duplications of services at various levelsthrough redistribution of health and family planning service facilities.

>- To maximize the uti! ization of the existing resources through cross referrals andsharing.

>- To promote the participation of community representatives in the planning andcoordination process to mobilize and generate resources for local healthactivities.

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2

3. Users of the Manual

Ward CommissionerWard SecretaryMajor service providers

Zonal Executive OfficerAssistant Health OfficerMajor service providers

Pourashava ChairmanChief Executive OfficerHealth OfficerPourashava SecretaryMajor service providers

Honourable MayorChief Executive OfficerChief Health OfficerMajor service providers

Staff members of the municipal Health Department at various levels need to befamiliar with the instructions, directives and circulars issued by the Ministry ofLocal Government, Rural Development and Cooperatives and the Ministry ofHealth and Family Welfare regarding the duties of the department and the

a. Review of the directives, instructions, and manual regarding the formationof the City Corporation/PourashavalZone/Ward-level Health and FamilyPlanning Coordination Committees

4. Process of Forming the City Corporation/PourashavalZonel Ward-levelHealth and Family Planning Coordination Committees

The following processes are to be followed to form the City Corporation!Pourashava/Zone/Ward-Ievel Health and Family Planning Coordination Committees:

The programme managers and community leaders will use this document in runningthe coordination committees at different levels. This manual will especially help thefollowing officials in forming the committees and continuing their activities:

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procedures of committee formation. The Appendix section of this manualcontains some materials and references that may be useful while planning theformation of the City Corporation/Pourashava/ ZonelWard-level committees.

b. Inventory of health and family planning service providers

The City Corporation/Pourashava/Zone/Ward offices must have the completeinventory of health and family planning facilities. The inventory should covermapping, staffing pattern and availability of services in those facilities. TheChief Health Officer of the city corporation or the Health Officer of thePourashava, Assistant Health Officer of the zone, Ward Commissioner, or majorservice provider of the Ward (on behalf of the Ward Commissioner) shouldensure that the inventory is done and kept up to date. The list of NGOs maybe collected from the NGO Bureau, the list of government health facilities(Directorate of Health Services and Directorate of Family Planning) can becollected from the concerned Civil Surgeon and Deputy Director, FamilyPlanning (DD-FP) offices. Directories published by different organizations mayalso be consulted to get a complete inventory, in addition to physicalinvestigation. Staff members involved in the urban Expended Programme onImmunization (EPI) could be a potential source to get the inventory done.

c. Briefing to major service providers of the City Corporation! Pourashava/Zone!Ward

Before forming the committees, separate briefing sessions should be organizedat different levels to inform the stakeholders about the objectives and potentialadvantages of forming the committees and to stimulate their interest to take partin the committee activities.

The Civil surgeon, Deputy Director, Family Planning and other major serviceproviders of the city corporation/pourashava should be briefed about thepurpose of forming the committees. The Chief Health Officer of citycorporation or the Health Officer of the pourashava can organize the briefingsessions.

The Zonal Executive Officer and the Assistant Health Officer should brief theWard Commissioners and major service providers of the zones about purposeof forming the committees.

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The briefing sessions may be conducted either individually or in a group. Theagenda for such sessions should include:

I. The purpose and objectives of the committees.

ii. Procedure of committee formation, enrolment of membership, andfunctions of the committees.

iii. Explanation about the benefits that can be obtained from functionalcoordination to ensure maximum utilization of resources throughminimizing gaps and overlaps of services.

A leading NGO of the City Corporation/Pourashava/ZonelWard may beassigned to do this briefing and facilitate the formation of committees, sinceNGOs have considerable successful experiences in assuming this role and toserve as a catalyst in negotiations with different GoB departments and electedrepresentatives.

d. Organization of meeting and formation of City Corporation/Pourashava/Zone/Ward-Ievel Health and Family Planning Coordination­Committees

At the city corporation/pourashava level, the Honourable Mayor or theChairman, respectively, will convene a meeting and invite all serviceproviders and other concerned as per the structure and guidelines provided bythe Local Government Division. At the zonal and ward level, the ZonalExecutive Officer and the Ward Commissioner, respectively, will issue theinvitation letter.

• The invitation letter containing the agenda should be sent to the participantsat least one week before the meeting is convened. Appendix 1 shows asample of an invitation letter for the meeting of the City Corporation/Pourashava/ZonelWard-level Health and Family Planning CoordinationCommittees. The invitation letter should be sent to the participants by handand the receiver's signature should be taken in the peon book.

• The meetings of the committees of City Corporation/Pourashava should beheld under the chairmanship of Mayor or Pourashava Chairman accordingto the guidelines (Box 1 and Appendix 2.1, 2.2, 2.3, and 2.4). The ZonalExecutive Officer and the Ward Commissioner will conduct meetings at thezonal and ward levels respectively. The Chief Health Officer or the Health

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Officer of the city corporation/pourashava and the Assistant Health Officerand the assigned major service provider at the zone and ward-levelrespectively will act as the member-secretary of the committees. Thecommittees may co-opt any member in their regular meetings.

• At the first meeting, the Chairperson will describe the purpose of the Healthand Family Planning Coordination Committee, the appropriate membershipfor that City Corporation/Pourashava/Zone or Ward, and the terms ofreference (TOR) in detail (Box 2 and appendix 3.1, 3.2).

The committees can, however, include any issue in the TOR based on the localneeds.

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Box 1

Note: See appendix 2.1, 2.2, 2.3, and 2.4 for the composition of the Pourashava/ Zone/Ward­level Health and Family Planning Coordination Committees.

Mayor ofCity •CorporationChief Executive OfficerChief Health OfficerDirector/Superintendent of Medical CollegeHospital/Specialized·Hospitals (whichever isapplicable)Deputy Commissioner or his representativeCivil SurgeonDeputy Director/Family PlanningZonal Executive Qfficers (where applicable)Assistant Health Officer (where applicable)Major NGO representatives (3-5)WASA representativeRepresentative, Public Health EngineeringRepresentative, Bangladesh Medical Association(BMA)Representative,Clinic Owner AssociationRepresentative, Private Medical PractitionersRepresentative, Rotarians/Lions

Composition of the City Corporation-levelHealth and Family Planning Coordination Committee

Chairman'Vice ChairmanMe.mber-SecretaryMembers

The terms of reference (TOR) suggested by the Ministry of Local Government, RuralDevelopment and Cooperatives for the City Corporation/Pourashaval ZonelWard­level Health and Family Planning Coordination Committees are as follows:

5. Terms of Reference of the City Corporation/PourashavalZonelWard­level Health and Family Planning Coordination Committees

e. Composition of the City Corporation/PourashavaiZonelWard-level Health andFamily Planning Coordination Committees

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Box 2

Terms of reference (TOR) for the City Corporation/Pourashava-levelHealth and Family Planning Coordination Committees

a. Review the existing health and family planning activities, facilities,availability and use of services. Identify areas of low coverage,duplication and gaps in terms of types of services offered and geography,including the relocation of areas to NGOs for effective service delivery.A sub-cQmmittee comprising Mayor/ Pourashava Chairman, CivilSurgeon, Deputy Director, Family Planning, and NGO representatives,may be formed for the purpose.

b. Design operational strategy and annual work plan for health and familyplanning, develop combined supervision plan, monitor the progress ofactivities, and review the work plan every after three months.

c. Review the existing resources and assess the need for strengtheninginfrastructure and technical assistance within the CityCorporations/Pourashavas.

d. Develop the local-level capacity to collect, analyze and use health andfamily planning routine service data to improve programme management.

e. Function as the link between the national-level health and familyplanning organizations and local service providers.

f. Foster community participation through establishing the ward-levelHealth and Family Planning Committees.

g. Identify the scope of work for the zone and ward-level committees

h. Submission of performance report to the Interministerial Committee everyafter three months.

I. Maintain liaison with the Directorates of Health and Family Planning toensure required logistic supply for family health services in the urbanareas.

Note: See appendix 3.1 and 3.2 for the terms of reference (TOR) of the Zonal and Ward-levelHealth and Family Planning Coordination Committees

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6. Regular Meetings of the City Corporation/PourashavalZone/ Ward­level Health and Family Planning Coordination Committees

Organization of regular meetings is a pre condition to make the committees activeand effective in performing their jobs. It is suggested that the city corporation andpourashava-Ievel committees should meet quarterly, and the committees at otherlevels may meet every alternate month. The following steps may be taken to makea meeting meaningful and successful:

:> Attendance in meeting must be ensured

Since the attendance of all members in the respective committee meetings isessential to make a committee successful, the Chairperson or Member-Secretaryof the City Corporation/ Pourashava/ZonelWard must make all out effort toensure the attendance of all members in the meetings. The following steps canbe taken to ensure a good attendanc~ in the meeting:

Develop an annual schedule of routine meetings and distribute it to allmembers (Box 3 for a sample of schedule).

Ensure that all members receive the invitation letter to attend the meetingat least one week ahead of the meeting date.

The invitation letter should be hand-delivered, and the receiver's signatureshould be taken in the peon book.

If necessary, the member-secretary may contact the members over telephoneor by fax one or two days before the meeting date.

:> Issues included in the agenda strictly be followed

Agenda are the basic requirement for a formal meeting. It is likely that thechairperson or the member-secretary can not keep in mind each and every issuethat needs to be discussed in the meeting, and it is not possible to maintain thesequence of discussions without any written agenda. To conduct a meetingsmoothly, written agenda should be prepared and circulated well ahead of timeto the members with the invitation letter, so that they are able to attend themeeting with preparation. The agenda should be specific and relevant to theobjectives of the meeting. The member-secretary should prepare the agenda inconsultation with the chairman of the respective committee. While preparingthe agenda it is important to consider the order of items that will be discussed,

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and the chairman should have an idea of the time to be allocated for eachagenda item. During the work with Coordination Committees in Dhaka CityCorporation, the following issues were usually included in the agenda:

o Review and approval of the minutes of the previous meeting.

o Review and follow-up of the implementation of the decisions of theprevious meeti ng.

o Review of activities of the work plan and its implementation status.

o Review of the performance of health and family planning activities of lastmonth.

o Review of other public health activities, such as garbage cleaning, water,sanitation, vector control, environment, and veterinary services.

The members should also be able to suggest additional agenda items based onthe local requirements.

The meeting should be conducted according to the agenda. The chairperson orthe member-secretary will initiate discussion on the different items on theagenda in a sequential order. During the meeting, the chairman should try toend up discussion of an individual item by facilitating a process of decision­making. Once decisions are made, the meeting should agree on the assignmentof responsibilities for their implementation and for monitoring theimplementation of a particular decision. The responsibility should be assignedwith a deadline. While reviewing the performance, necessary feedback shouldbe given to the concerned service-providing organizations. Appreciationand/or a rewarding system for excellent performance may be another way ofmaintaining interest in the meetings.

The member-secretary or his delegate will record the minutes, and its copiesshould be circulated to the participants within a week of the meeting, dulysigned by the chairman of the committee. Copy of the minutes must be sentto the higher authority for their support, guidance, and follow-up. Copy of theminutes of the City Corporation/ Pourashava-Ievel committees will be sent tothe Deputy Director (Health) of the Ministry of Local Government, RuralDevelopment and Cooperatives. Copy of the minutes should also be sent to thelower level or any department/persons concerned other than the committeemembers if there is any issue which requires their attention or follow-up bythem.

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The ward committee should send the minutes of its meetings to thezonal/pourashava committee. The zonal committee should send the minutes tothe City Corporation! Pourashava and City Corporation/Pourashava like Ministryof Local Government, Rural Development and Cooperatives. Appendix 4shows the format for recording t~ minutes.

Box 3

Sample of Schedl.llefor routine.meetings of the·City Corporation!Pourashava/Zone!Ward-level Health and Family Planning

Coordination CommitteeJuly 1996"'June1997

MonthMeeting

~Q)..Q bI) - ri > (.) ~ I-<

~ ~ fr ~Q) ~ -£

~ ~ ~ ]tfl 0 0 ..... ~

City Corporation!PourashavalZoneIWard- 12 9 11 12 9 10level Health and FamilyPlanning CoordinationCommittee meeting

7. Generic Action Plan for the City CorporationlPourashavalZone/Ward-level Health and Family Planning Coordination Committees

Perhaps the most effective way of making the committees active is to institute aprocess for the members to develop local action plans and establish self­monitoring mechanism of their activities.

a. Process of action plan development

The committees need to organize a half-day workshop to develop action plansfor one year. The member-secretary, in consultation with the chairman andmembers of the committee, will organize the workshop, which should bestructured into two sessions:

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o Briefing session

:> Opening of the workshop by the chairman of the committee or a dignitary.

:> Either the chairman or the member-secretary should explain theimportance and need of action plan for the committee and the process ofaction plan development.

:> The member-secretary must mention the following:

Methodology of the workshop, e.g. how the groups will be formed.

How long the groups will work, and how they will identify theproblem issues and relevant activities to solve them or improve thesituation.

What logistics and other support will be provided in the workshop(e.g. action plan format or matrix, paper, pen, scale, pencil, etc.).

o Working session

The workshop participants should do the following during the working session:

:> The participants will work in groups.

:> The number of groups will be determined depending on the number of thetotal participants. Normally a group will be comprised of 4-5 participants.

:> The groups will brainstorm and identify the activities for the action plan.

:> The groups will write down the selected issues in format (Box 4 for a sampleof the action plan format)

:> Each group will make presentation of their action plan at the plenarysession, review the feedback, and finalize the action plan.

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Box 4

Sample of an Action. Plan Format for theCity Corporation/Pourashava/Zone/Ward-level

Health and Family Planning Coordination CommitteesPeriod: July - June 199_

City Corporation/Pourashava/Zone/Ward.·Noo__

Activity Month (2) Organization!-(1) person

>. co ..... ;;> ~ ~responsible

fr ..... ()

~ {i I-<

~(3)...... ::s () 0 0 <-~ -< en 0 Z Cl ~ ~ ~ ~

Organization Member-of 2 monthly

"'" "'" "'" "'" "'" "'"Secretary

meetings

Observance of Dhaka CityNational

"'"Corporation!

Immunization ProgatiDay Samajkallan

Protistan

Establ ishment All serviceof

"'" "'" "'" "'" "'" "'" "'" "'" "'" "'" "'" "'"providers

managementinformationsystem at thezone level

Formation of Wardthe Ward

"'"#32,33,34

Committee (FamilyPlanningAssociation ofBangladesh)Ward#35,36,37(Nari Maitree)

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How to complete or fill up the format:

o Column 1: Activity

Different activities may be identified for the committees in the workshop. Theactivities identified by the groups are to be recorded serially in the column. Forexample, the participants of a workshop of Zone 1 of Dhaka City Corporation.identified the activities, like (1) Meeting of Zonal Health and Family PlanningCoordination Committee, (2) Observation of special days, (3) Establishment ofmanagement information system at the zonal level, (4) Formation of the WardCommittee, etc. All these activities will be recorded in this column one by oneas shown in the box 4.

o Column 2: Time frame

Column 2 will be divided into 12 sub-columns wherein months of the actionplan period will be written in short on the top of each sub-column. Tick mark(vi) will be- given in the appropriate box of the month for each activity of theplan. For example, Zone 1 of Dhaka City Corporation is going to develop anaction plan for July 1996-June 1997 period. The participants decided to organizecommittee meeting two monthly, and complete the formation of the wardcommittees in September 1996. Tick mark will be given in the box of everyalternate month for organizing the committee meeting and in the box ofSeptember for ward committee formation. For every activity identified in theworkshop by the groups will be recorded in this column in this way.

o Column 3: Organization/person responsible

The name of the concerned organization or person responsible for each activitywill be recorded in column 3 against the respective activity. For example, themember-secretary is responsible for organizing the zonal committee meetings.So the word "member-secretary"should be written in this column against theactivity. The name of the person or organization responsible for a specificactivity should be recorded against each activity of this column in the waymentioned above.

The City CorporationlPourashavalZonelWard Commissioner's office willcompile and type the action plans developed in the workshop and send it to allthe participants.

Action plan for future period should be developed at least one month beforeconcluding current action plan.

13

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b. Follow-up of action plan

The action plan developed by the committees should be followed-up in theroutine meetings of the committees.' The agenda of the meetings will includethe review of activities of the action plan/work plan. The chairman/member­secretary should have a copy of the action plan for reviewing the activitiesduring the meeting; he/she will review the implementation status of the activitiesin the meeting. The concerned persons/ organizations responsible forperforming activities will be enquired regarding their implementation status. Ifany responsible person or organisation fails to implement any activity of theaction plan within the time schedule, rescheduling of the time frame will bedone for these particular activities in the meeting, and it will be recorded in themeeting minutes for follow-up in the next meeting.

8. Process of Maintaining Linkage with Higher/Lower-level Committees

Committees at each level, i.e. City Corporation/Pourashava/ZonelWard-level, shouldmaintain linkage with their higher and lower-level committees. Committees canmaintain linkage in the following ways:

:> Inform the higher committee about the formation of the committee as soon asit is formed.

:> Send the meeting minutes regularly to the higher-level committee/authority.

:> Send public health and family planning performance reports regularly to thehigher-level committee.

:> Implement decisions of the higher authority/committee.

:> Seek suggestions from the higher-level committee for solving the unresolvedproblems.

:> Inform the meeting schedule to the higher-level authority/committee on time,and the lower-level committees should invite the higher authority/committeein meetings.

:> The higher-level committees should provide feedback to the lower-leveJcommittees on the decisions of the meeting.

14

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»- The higher-level committees should extend cooperation to the lower-levelcommittees as and when required, and help the lower-level committees toidentify the local problems and develop local-level planning for solutions.

»- The lower-level committees should also extend their cooperation to the higher­level committee activities as and when required.

9. The Role of the Committee Members

Since Health and Family Planning Coordination Committee is a new concept for theurban health sector service providers, it is necessary to orient the committeemembers about their role in the committees. The chairman and the member­secretary of the concerned committee will orient the committee members abouttheir role as the committee members. The following issues may be considered as theimportant role of the committee members:

• Attend regularly and participate actively in the meetings.

• Identify resources and expertise of individual organizations and share witheach other. .

• Identify the local health-related problems and solve them through thecommittees.

• Submit copy of the activity report of individual organizations to the concernedcommittee (by the first week of a month).

• Each and every member organization should be treated equally. There shouldnot be any differential treatment for big or small organizations.

• Give importance/appreciation to others' works and opinions.

10. Maintaining the Right Environment for the Committees

Experiences of Operations Research Project of ICDDR,B working in DCC areasshow that the issue of coordination is an issue of mutual interest of all stakeholders.DCC is being benefitted out of the services provided by DFP, DGHS and NGOs tothe city dwellers. Similarly, DFP, DGHS and NGOs are being benefited using citywide infrastructural facilities of DCC.

As members of the committee, the representatives of the Government of Bangladesh(GoB), NGO and commercial sector health service providers, all have equal rights.

15

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cc: ;••..•••.•.•.

Dear sir,

16

Date .Ref: .

To

Mayor/ChairmanlZEOlWard Commissioner............... City Corporation/Pourashava/ZonelWard

You or your representative are requested to attend the meetinp'

Sincerely yours,

You have been providing health and family planning services in this CityCorporation/Pourashava/ZonelWard area since long time. I appreciate your sincere efforts and congratulateyou/your organization on behalf of City Corporation IPourashavalZonelWard. I would liketo let you know that the City Corporation IPourashavalZonelWard has taken an initiative to providecontinued support to the health and family planning activities in ••....CityCorporation/Pourashava/ZonelWard.

As a first step toward this initiative a coordination and review meeting on health and family planningactivities in this City Corporation/PourashavalZonelWard will be held on day at. .•..........•. in the office of the undersigned.

Office of the Mayor/Pourashava Chairman/Zonal Executive Officer/WardCommissioner of ~ity Corporation/PourashavaiZone/Ward

Sub: Health and Family Planning Coordination Committee meeting

( )

The committee members should maintain a congenial atmosphere. The membersget together in the meetings in response to the invitation by the City Corporation/Pourashava/ZonallWard-level committees. The City Corporation/Pourashava/ZonelWard commissioner offices are the lead agents and hosts. The Chief of the CityCorporation/Pourashava/ ZonelWard-level offices should brief their concerned staffmembers about this.

Appendix 1

Sample of the invitation letter of the Mayor/Pourashava Chairman/Zonal Executive Officer/Ward Commissioner for the City Corporation/

PourashavaiZone/Ward-level Health andFamily Planning Coordination Committee formation meeting

Page 25: Manual for Urban Health and Family Planning Coordination Committeespdf.usaid.gov/pdf_docs/PNACL902.pdf · Manual for Urban Health and Family Planning Coordination Committees Md. Jasim

Composition ofthe District-level Pourashava Health and Family PlanningCoordination Committee

ChairmanVice Chairman • I

Member-Secretary :

Members

Appendix 2.1

Pourashava ChairmanChief Executive Officer

Health Officer/Pourashava Secretary (if HealthOfficer is not posted) /major NGO working in thePourashava

Director/Superintendent of Medical CollegeHospital/Specialized Hospitals (whichever isapplicable)

Additional Deputy Commissioner (General)Civil SurgeonDeputy Director, Family PlanningRepresentative, WASA

Representative, Public Health EngineeringPourashava Secretary (if he is not assigned asmember- secretary )Ward Commissioners (all)Female Ward Commissioners ( all )NGO Managers

Thana Health and Family Planning Officer (SadarThana)

Thana Family Planning Officer (Sadar Thana)RMO, Sadar HospitalMedical Officer, Civil Surgeon OfficeMedical Officer, MCWCMedical Officer, EPIMedical Officer, CDDMedical Officer, MCHRepresentatives of professional associationslocally reputed and interested social workers

17

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Composition of Zonal Health and Family Planning Coordination Committee

Composition of the thana-level Pourashava Health and FamilyPlanning Coordination Committee

ChairmanMember-Secretary:

Members

ChairmanAdvisorsMember-Secretary :Members

Appendix 2.2

Pourashava ChairmanHealth Officer/Pourashava Secretary/major NGOworking in the wardThana Nirbahi OfficerThana Health and Family Planning OfficerThana Family Planning OfficerRepresentative, WASARepresentative, Public Health EngineeringNGO ManagersWard Commissioners (all)Female Ward Commissioners (all)Medical Officer, EPIMedical Officer, MCHInterested social workers

Appendix 2.3

Zonal Executive Officer (ZEO)Local Ward Commissioner (all-both male and female)

Assistant Health Officer (AHO)Thana Family Planning OfficerRepresentative from the Civil Surgeon officeRepresentative from local NGOsHead, Government dispensariesPrivate sector representativeLocal social activistsRepresentatives from municipal health facilities

18

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Composition of the Ward Health and Family PlanningCoordination Committee

ChairmanMember-Secretary :

Members

Appendix 2.4

Ward CommissionerMajor services provider (GOB/NGO) of the ward(FPI/FWV/AHI/EPI supervisor/representative from

.NGO) or ward secretary.

Concerned Female Ward CommissionerNGO representativesLocally reputed and interested social workersPrivate sector representativeSanitary InspectorEPI SupervisorNaccinatorConservancy SupervisorRepresentatives, Ministry of Health and FamilyWelfare

19

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Appendix 3.1

Terms of Reference (TOR) for theZonal Health and Family Planning Coordination Committee

a. Establish coordination among the government, NGOs and commercialsector providers of health and family planning services within the zone.

b. Review regularly the current distribution and utilization of existingprimary health care services to determine areas of low coverage, gapsand overlapping wards, and take appropriate steps to solve theproblems.

c. Review the existing zonal primary health-care resources to assesstechnical assistance needs.

d. Prepare a zonal work plan and review the progress twice a year.

e. Promote the establishment of Ward-level coordination committees tofoster community participation and local health promotion activities.

f. Establish information exchange systems on local primary health-careservices and needs.

g. Increase health education activities and institute mechanisms to addressconsumer queries on MCH-FP services.

h. The committee can co-opt members and include issues in the TORbased on the local requirements.

20

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Appendix 3.2

Terms of Reference (TOR) for theWard Health and Family Planning Coordination Committee

a. Establish coordination among the government, NGOs, and commercialsector providers of health and family planning services within theWard.

b. Plan and implement health and family planning activities at the Wardlevel. Develop monthly and yearly work plan on the basis of availableinformation and review the progress of implementation of the workplan in quarterly, half-yearly and yearly on a regular basis.

c. Review the performance of the field workers. Initiate steps to improvethe quality of their work. Extend appreciation and reward for goodwork.

d. Strengthen the health education programme at the Ward level forcommunity participation. Provide health education at schools, clinicsand satellite clinics as part of the health education programme.

e. Initiate necessary steps for the clients who have side-effects. Providenecessary treatment by accumulation of funds locally or send to anearer hospital.

f. Maintain record on births and deaths in the Ward by the field workersand ensure the surveillance system.

g. Organize monthly meetings on a regular basis.

21

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Signature of ChairmanCity Corporation/Pourashava/Zone/Ward .

22

Office of the .

Appendix 4

DesignationName

___ ended at: _

Copy forwarded to :1.

2. Agenda 2

Issue:

Decision:

3. Agenda 3

Issue:

Decision:

City Corporation/PourashavalZone/Ward..•.......••.•

.ww •••• w ••••••••••• ww ••••• w ••••• w ••• w •••••••• ww •••••••••••• w •••••• w •••••• w ••••• w •••••••••••• w ••••••••••• w ••••• w ..· .· .· .L. ~~.~~~~.~~ ..~~~.~~ ..~~~ ..~~~.~~~.~.~ ..~.~~~~~.~~~.~.~~ .J

Memo no. : _Chaired by: --------Minutes by: __'-- _VenueMeeting started at:

Agenda

1. Review and confirmation of the last meeting minutes2.3.4.

Any other business

1. Review and confirmation of the last meeting minutes:Issue 1

Issue 2

Issue 3

Participants:51. No.Organization1.2.3.

Page 31: Manual for Urban Health and Family Planning Coordination Committeespdf.usaid.gov/pdf_docs/PNACL902.pdf · Manual for Urban Health and Family Planning Coordination Committees Md. Jasim

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23.24.25.26.27.28.29.30.31.32.

34.35.36.37.38.39.40.

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i5fT~~ qs(4~, ~ UfiilSt M CRt"1IC~"01 (~)Director, OPR, USAID, DhakaResident Representative, World BaIJkCountry Representative, lJN1CEFChief of Mission. WHOResident Representative, ADBCountry Representative, BASICS, Urban EPI ProgramJ;7oject Director, Urban MCH-FP E,'{1:ension Project, ICDDRBExecutive Director. Concerned Women for Family Planing (CWFP)Director, Voluntary Health Services Society (VHSS)

Country Representative. Pathfinder Fund International (PFI)

E.xecutive Director. Family Planning Services :md Training Centre (FPSTC)Population Program Manager, The Asia Foundation (TAF)

Country Representative, Association for Voluntary Surgical Contraception (AVSC)Director General, Family Planning :md Association of Bangladesh (FPAB)Director, Radda Bamen

Project Director, Dhaka Urban Integrated Child Survival Project (DUICSP)Director, Dhaka Urban Child Health Progrnm (DUCHP)PS to Secretary, MOHFW I for kind information of the SecretaryPS to Secretary, LGD I

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AHO

CC

CS

CHO

DCC

DD-FP

DGHS

DFP

GOB

ICDDR,B

LGD

MOHFW

MOLGRDC

MCH-FP

MIS

NGO

NID

ORP

PHC

TOR

UEP

ZEO

Glossary

Assistant Health Officer

City Corporation

Civil Surgeon

Chief Health Officer

Dhaka City Corporation

Deputy Director, Family Planning

Directorate General of Health Services

Directorate of Family Planning

Government of Bangladesh

International Centre for Diarrhoeal Disease Research, Bangladesh

Local Government Division

Ministry of Health and Family Welfare

Ministry of Local Government, Rural Development andCooperatives

Maternal Child Health and Family Planning

Management Information System

Non-Government Organization

National Immunization Day

Operations Research Project

Primary Health Care

Terms of Reference

Urban MCH-FP Extension Project

Zonal Executive Officer

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MCH-FP Extension Work at the Centre

An important lesson learned from the Matlab MCH-FP project is that a high CPRis attainable in a poor socioeconomic setting. In 1982, the MCH-FP Extension Project(Rural) with funding from USAID began to examine in rural areas how elements of theMatlab programme could be transferred to Bangladesh's national family planningprogramme. In its first year, the Extension Project set out to replicate workplans, andrecord-keeping and supervision systems, within the resource constraints of thegovernment programme.

During 1986-89, the Centre helped the national programme to plan andimplement recruitment and training, and ensure the integrity of the hiring process for aneffective expansion of the work force of governmental Family Welfare Assistants. Othersuccessful programme strategies scaled up or in the process of being scaled up to thenational programme include doorstep delivery of injectable contraceptives, managementaction to improve quality of care, management information systems, and strategies todeal with problems encountered in collaborative work with local area family planningofficials. In 1994, this project started family planning initiatives in Chittagong, thelowest performing division in the country.

The Centre and USAID, in consultation with the government through the Project'sNational Steering Committees, concluded an agreement for new rural and urbanExtension Projects for the period 1993-97. Salient features include: improvingmanagement, quality of care and sustainability of the MCH-FP programmes, andproviding technical assistance to GoB and NGO partners. In 1994, the Centre began anMCH-FP Extension Project (Urban) in Dhaka (based on its decade long experience inurban health) to provide a coordinated, cost-effective and replicable system of deliveringMCH-FP services for Dhaka urban population. This important event marked anexpansion of the Centre's capacity to test interventions in both urban and rural settings.The urban and rural extension projects have both generated a wealth of research dataand published papers in international scientific journals.

In August 1997 the Centre established the Operations Research Project (ORP) bymerging the two former MCH-FP Extension Projects. The ORP research agenda isfocussed on increasing the availability and use of the high impact services included inthe national Essential Services Package (ESP). In this context, ORP has begun to workwith partners in government and NGOs on interventions seeking to increase coveragein low performing areas and among underserved groups, improve quality, strengthensupport systems, enhance financial sustainability and involve t he commercial sector.

ORP has also established appropriate linkages with service delivery partners toensure that research findings are promptly used to assist policy formulation and improveprogramme performance.

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The Division

The Health and Population Extension Division (HPED) has the primary mandateto conduct operations research, to disseminate research findings to program managersand policy makers and to provide technical assistance to GoB and NGOs in the processof scaling-up research findings to strengthen the national health and family planningprogrammes.

The Division has a long history of solid accomplishments in applied researchwhich focuses on the application of simple, effective, appropriate and accessible healthand family planning technologies to improve the health and well-being of underservedand population-in-need. There are various projects in the Division which specialize inoperations research in health, family planning, environmental health and epidemiccontrol measures. These cut across several Divisions and disciplines in the Centre. TheOperation Research Project (ORP) is the result of merging the former MCH-FP ExtensionProject (Rural) and MCH-FP Extension Project (Urban). These projects built up aconsiderable body of research and constituted the established operations researchelement for child and reproductive health in the Centre. Together with theEnvironmental Health and Epidemic Control Programmes, the ORP provides theDivision with a strong group of diverse expertise and disciplines to significantlyconsolidate and expand its operations research activities. There are several distinctivecharacteristics of these endeavors in relation to health services and policy research. Forone, the public health research activities of these Projects are focused on improvingprogramme performance which has policy implications at the national level and lessonsfor the international audience also. Secondly, these Projects incorporate the full cycleof conducting applied programmatic and policy relevant research in actual GoB andNGO service delivery infrastructure, dissemination of research findings to the highestlevels of policy makers as well as recipients of the services at the community level;application of research findings to improve program performance through systematicprovision of technical assistance; and scaling-up of applicable findings from pilot phaseto the national program at Thana, Ward, District and Zonal levels both in the urban andrural settings.

Health and Population Extension Division (HPED)International Centre for Diarrhoeal Disease Research, BangladeshGPO Box 128, Dhaka 1000, BangladeshTelephone: 871751-871760 (10 lines)Fax: 880-2-871568 and 880-2-883116