Ncasc fhi fhd unicef site visit 042111
-
Upload
nyayahealth -
Category
Health & Medicine
-
view
334 -
download
1
Transcript of Ncasc fhi fhd unicef site visit 042111
BAYALPATA HOSPITAL बयलपा�टा� अस्पता�लNCASC, FHD, FHI, UNICEF PresentationAchham, 8 Chaitra 2068
Bayalpata Hospital RepresentativesDan Schwarz, Executive DirectorDr. Amir Bista, HIV Program DirectorMs. Megha Giri Bista, Nurse In Charge Ms. Ranju Sharma, Community Health Director
Outline of Presentation
1. Nyaya Health – Bayalpata Hospital, Overview (Dan Schwarz)
2. Maternal Health Programs Review (Ms. Megha Giri Bista)
3. HIV Services Review (Dr. Amir Bista)
4. Community Health Services Review (Ms. Ranju Sharma)
5. Questions & Discussion, Facilities tour
Nyaya Health Nepal: Who We Are
3
Social justice-oriented mission:
1. To provide free community-based healthcare in rural Nepal with a focus on the most marginalized populations
2. To work in a public private partnership with the Ministry to strengthen the public sector for long-term health systems development
Founded in 2063 in Nepal along with partner organization Nyaya Health International (NHI) in the USA
Opened Sanfe Bagar Medical Clinic in 2065 Public-private partnership with Nepali
Ministry of Health & Population in 2066 Opened the Bayalpata Hospital in Jestha
2066 Managed by a volunteer Board of Directors
and 27 full-time employed Nepali staff
Current Services: Bayalpata Hospital All health care services free of charge:
Inpatient & Outpatient services 24-hour emergency room Safe Motherhood program, CAC
services Laboratory & Pharmacy Radiology: X-Ray & Ultrasound HIV, TB treatment programs Malnutrition treatment (CMAM) Ambulance services Community Health Worker (CHWs)
services
7
Next Steps for 2068: Continue Renovations
Next Steps
8
Next Steps for 2068: Scale-up of Surgical Services
Next Steps
9
Next Steps for 2068: Building Solar Power Capacity
Next Steps
10
Next Steps: Expanding Community Health
Nyaya Health Nepal Financing – Income & Expenditures
All line-item financial statements available at http://wiki.nyayahealth.org for full organizational
transparency and accountability
Projected Budget FY 2066-67 vs. FY 2067-68
*Over 99% of all NHN funds used in Nepal
Outline of Presentation
1. Nyaya Health – Bayalpata Hospital, Overview (Dan Schwarz)
2. Maternal Health Programs Review (Ms. Megha Giri Bista)
3. HIV Services Review (Dr. Amir Bista)
4. Community Health Services Review (Ms. Ranju Sharma)
5. Questions & Discussion, Facilities tour
Maternal Health Programs
• Antenatal Clinic – – Six days/week with range of client flow being 5 to 15/day– One separate staff– Lab services and USG services– Needs: USG training
• PMTCT – – One trained staff – Testing all clients on first visit and during deliveries when indicated– Needs: PMTCT training to more staffs
• Delivery Service – – 24 hour service – Separate well equipped labour room ,vacuum and forcep delivery, – One SBA trained nurse and one New Born Care trained nurse– Ambulance with preference to deliveries – In-service training to the clinical staffs – Needs: SBA training to nurses and doctors, radiant warmer
Maternal Health Programs
Preventing Unwanted Pregnancies
Family Planning – Services (condom, depo, pills, IUCD) Counselling Locally developed patient information video
(shown in patient waiting area) Needs: training for implants and permanent
sterilization, better supply of IUCDs
Safe Abortion Services – CAC (MVA & MA) PAC Free of cost Needs: provision of free supply of
medabon for MA
Antenatal Visit and PMTCT Program
Shraw
an
Bhadra
Asoj
karti
k
Mangsi
rPoush
Magh
Falgu
n
Chaitra
Baisak
hJes
thaAsh
ad
Shraw
an
Bhadra
Asoj
karti
k
Mangsi
rPoush
Magh
Falgu
n
Chaitra
0
20
40
60
80
100
120
ANC VisitsPMTCT TestingPMTCT Positive"+ve deliveries"
Bayalpata Hospital: Monthly Deliveries
Family Planning Service – Video education in OPD
Safe Abortion Service
Ashad
Shraw
an
Bhadra
Asoj
karti
k
Mangsi
rPoush
Magh
Falgu
n
Chaitra
Baisak
hJes
thaAsh
ad
Shraw
an
Bhadra
Asoj
karti
k
Mangsi
rPoush
Magh
Falgu
n
Chaitra
0
10
20
30
40
50
60
70 T-645
Outline of Presentation
1. Nyaya Health – Bayalpata Hospital, Overview (Dan Schwarz)
2. Maternal Health Programs Review (Ms. Megha Giri Bista)
3. HIV Services Review (Dr. Amir Bista)
4. Community Health Services Review (Ms. Ranju Sharma)
5. Questions & Discussion, Facilities tour
HIV in Nepal & in the Far West
• HIV in Nepal– National prevalence only 0.49%, but heavily focused in high-risk groups 1, 2
> CSWs> IDUs> Migrants / Wives of migrants – 3.3% in WoM’s in Doti/Achham 3
– Only ~16,000 out of an estimated 70,000 HIV+ have been diagnosed 2
– Only ~15% of those known to be eligible currently on treatment 4
> 24 ART sites in the country, 20 of which are MOH-run sites 5
• HIV in the Far Western Hills– Over 80% of the men are migrants; over 7% return from India HIV+ 6
– Resource-poor primary health infrastructure– Until 2008, no ART at all; now 4 MOH sites plus Bayalpata Hospital 4
MOH; 2009 UNGASS; 2010
Nyaya’s HIV Program—History to date
• Petition to NCASC beginning in 2008• Service pre-requisites: • Inpatient / outpatient• Radiology• Dedicated buildings for ART consultations• Dedicated pharmacy space
• Delays in program initiation while Bayalpata developed facilities
• Sub-center facility initiation: July 2010• Great progress for Achham• Improved access to care for many remote populations
who previously had to go to Mangalsen
• Currently: April 2011• Nine months of enrollment• 130 patients enrolled in treatment; 103 on ART
Bayalpata Hospital HIV/AIDS Treatment Program
Nyaya’s ART Program – Demographics
Nyaya’s HIV Program—Challenges
•Barriers to patient enrollment and follow-up:– Awareness– Inconsistent presence in the district
> Migrants> Agricultural demands
– Transportation to Bayalpata> Seasonal work demands> Seasonal access to roads
– Increased risk of LTFUs, drug-resistance
•Service constraints:– Cannot initiate HAART or change regimens– Lack of CD4 counter (must go to District Hospital)– Lack of PVL in all of the Far West– Lack of pediatric formulations
Outline of Presentation
1. Nyaya Health – Bayalpata Hospital, Overview (Dan Schwarz)
2. Maternal Health Programs Review (Ms. Megha Giri Bista)
3. HIV Services Review (Dr. Amir Bista)
4. Community Health Services Review (Ms. Ranju Sharma)
5. Questions & Discussion, Facilities tour
Bayalpata Hospital Community Health
• Innovative program to strengthen the MOHP FCHV program
• Partnership between Bayalpata Hospital and local FCHVs
> Surveillance of VDC> Clinical follow-up from Hospital visits> Enhanced FCHV training> Financial incentives weekly
• Currently in six VDCs, 70 FCHVs• Ridikot• Mastamandu• Sidheshwor
– Scale-up to six additional VDCs in 2068
• Bagheshwor• Chandika• Hatikot
Bayalpata Hospital Community Health
Constant Communication with the FCHVs to ensure that we, Never forget the
patients!Never forget the
FCHVs and their needs!
Questions, comments, discussion…
29
[email protected] http://www.nyayahealth.org http://wiki.nyayahealth.org
http://blog.nyayahealth.org
Bayalpata Hospital, Ridikot VDCAchham, Nepal
Phone: 977-94-690-404 (Achham)Phone: 977-9845-236-035(KTM)