Bardiya District

31d03d NV3N3Wv BHI WOW awsn. Strengthening Systems for Better Health Activity.

Outcome 1: Availability and Equitable Utilization.

Referral Workshop at Health Office Bardiya.

Outcome 1: Availability and Equitable Utilization.

New Born Corner With Functional Radiant Warmer. New BORN RE.

Family Planning Day Celebration at Neulapur HP. •_w_un.

Outcome 2 : Quality of Care. . Activity Number Activity Status Upcoming plan Remarks 2.1.2 Formation and Orientation of municipal level QI committee. QA functionalization in health facility. Completed in on health facilities Regular meeting is necessary 2.1.2 Technical support to HFs for quality monitoring and improvement by using HP-MSS Remaining (Y6) Support to 1 HFs in each municipality 2.1.2 Conducted joint visit with District/Municipal level to fulfill the MNCH/FP essentials for patient experience of care - 2.1.2 Supply and orientation of clinical guideline and protocol Completed in all HF of 8 municipalities NMS vol-I and III (2020) not available in all HFs of 8 municipality 2.1.5 In Kind support for QI initiatives Supported in 4 HFs.

QA/QI Meeting at Health Facility Level. {t/&lll.

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Outcome 2 : Quality of Care. . Activity Number Activity Status Upcoming plan Remarks 2.2.2 RMNCAH guideline orientation All 8 municipalities, 33 HFs, Health Office and hospital - - 2.2.2 Supply and orientation of clinical guideline and protocol Completed in all HF of 8 municipalities 2.2.2 Distribution/Orientation of BPP flip chart Completed in 11 private health sector Follow-up on its use 2.2.3 MPDSR Committee formation and Orientation Completed - Bardiya hospital - District MPDSR Technical working committee Follow up Activity member MNCH /FP is a member in technical working committee.

Outcome 2 : Quality of Care. . Activity Number Activity Status Upcoming plan Remarks 2.2.4 Clinical Onsite coaching and Mentoring on MNH/CBIMCI/LARC All Birthing Center- MNH, CBIMNCI-33 HFs LARC- 15 HFs (Y5-Y6) Continue follow up is necessary 2.2.4 Training to Staffs for Quality MNCH/FP Services SBA- 14 Implant- 15 IUCD- 5 CoFP- 14 (Y3-Y6) ???? Priority on IUCD 2.2.4 District Level MNH Update training 6 batch (all Nursing staffs from all HF including BHSC and Bardiya Hospital- total143 participants Follow up Cost sharing with health office and 2 batch in Y6 with full SSBH support In Y5 2 batch at municipal level with full SSBH support..

Clinical Onsite Coaching Mentoring on MNH and CBIMNCI.

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Clinical Onsite Coaching Mentoring on LARC.

Outcome 2 : Quality of Care. . Activity Number Activity Status Upcoming plan Remarks 2.2.4 Technical Support on development of Municipal level Coach (CB-IMNCI) 1 Event (16 Participants), CBIMNCI coaching done with mentor of each municipality. - Joint mentoring /coaching Technical support to HO 2.2.4 Development of District level Clinical mentor ???? - 2.3.1 Support develop and institutionalize “patient experience of care. Completed in 1 Health Facility Follow up and support as per action plan.

MNH UPDATE. divSh'S.

PEC at Bhimapur HP. Problem Identification (HFOMC, mothers group and HF Staffs , onsite observation) Problem Analysis and prioritization.

Outcome 3 : Health Systems and Governance. . Activity Number Activity Status Upcoming plan Remarks 3.1.1 Development of Health Act Approved in all Muniicplities 3.1.1 Development of Health Policy Approval stage in 1 municipalities Follow up for approval Bansgadi 3.1.1 Development of EOC fund operation and management Guideline Approval stage in 2 municipalities Follow up for approval On the basis of request, it can be supported in remaining municipalities 3.1.2 Review meeting at Municipal & district level District and all 8 municipalities Regular support to all.

Outcome 3 : Health Systems and Governance. . Activity Number Activity Status Upcoming plan Remarks 3.1.2 District Annual Health Report development Completed - 3.1.2 MES guideline 2 Approved , 3 remaining for approval Follow up for approval On the basis of request, it can be supported in remaining municipalities 3.1.3 Formation & Orientation of HMC/SDC Orientation- 1 reformation and Orientation 3.1.4 Formation & Orientation of HFOMC Completed Support to reformation and Follow up for functionality of HFOMCs.

Outcome 3 : Health Systems and Governance. . Activity Number Activity Status Upcoming plan Remarks 3.1.6 Client exit interview Completed in 3 HFs of 2 Municipalities conduct remaining HFs of Core+ and HQ municipality 3.1.6 Citizen Charter 33 HFs Core+ Municipalities 3.1.6 Social Audit Completed in Barbardiya Mun Advocate to allocate budget 3.2.1 Municipal level program implementation guideline orientation Completed in district level for all 8 Mun -.

Outcome 3 : Health Systems and Governance. . Activity Number Activity Status Upcoming plan Remarks 3.2.1 Support to develop Annual work plan and budgeting Completed in 8 Municipalities for FY 078/79 In all 8 municipalities for next FY 079/80 3.3.1 Basic Health Logistic Training 4 batch completed 1 day program conducted Jointly with HMIS training 3.3.3 Modular Managerial and leadership training - ???.

Cross Cutting. . Activity Number Activity Status Upcoming plan Remarks 4.1.2 Development of private health sector regulatory Guidelines Submitted draft for approval in Thakurbaba Mun Support to Develop in Madhuwan Mun and Finalize in both Mun 4.1.3 CBIMNCI training to public/private HFs 3 batch completed (1 public and private mix) 1 batch to public participants priority to nursing staffs Public and private participation with cost sharing. 4.3.1 Develop mentor/coach (DHIS2/HMIS) 2 core+ municipalities and 1 health office Support to regular follow up and mobilize 4.3.1 HMIS training No events in y6 Support to conduct Training on new guideline.

CBIMNCI Training. Rö aqoe : nap:eÄ.

Cross Cutting. . Activity Number Activity Status Upcoming plan Remarks 4.3.1 DHIS2 training 2 Batch (45 person ) Requested from palika at BHSC Level 4.3.1 DHIS2 onsite mentoring and coaching (Municipal/HF) 5 HFs Core+ & cluster HQ Selected poor performing health facilities Group coaching during monthly meeting in all municipalities 4.3.1 Data Quality Analysis and Verification 0 Ongoing 4.3.1 DHIS2 and eLMIS Review - 1 time.

Cross Cutting. . Activity Number Activity Status Upcoming plan Remarks 4.3.1 HMIS onsite mentoring and coaching 4 HFs Core+ & cluster HQ (Municipal/HF) Selected poor performing health facilities Group coaching during monthly meeting in all municipalities 4.3.2 eLMIS /LMIS onsite mentoring and coaching 2 municipalities/ 4 HFs Core+ & cluster HQ (Municipal/HF) Selected poor performing health facilities 4.3.2 eLMIS training Coordination and collaboration for remaining 9 HFs of Thakurbaba mun 4.3.2 HMIS Vs LMIS report cross-verification (FP commodities expenditure) 1 time during review meeting 1 time during review meeting.

Cross Cutting. . Activity Number Activity Status Upcoming plan Remarks 4.3.3 Data flex All 25 Regular Follow up and support to update 4.3.4 Web-based health profile update All 8 municipalities Dissemination, sharing and advocacy to use for evidence-based planning with newly representative 4.3.4 RDQA orientation 16 HWs of all 8 municipalities Previous Year 4.3.4 Conduct RDQA 3 HF Beluwa , Padhanaha , Motipur All 15 HFs (Core+ Municipalities) and hospital Selected poor performing HFs.

Result/Output of Program till date. .

Result/Output of Program till date.

Result/Output of Program till date. . 2. Decrease in data variation.

Lessons Learned. . Functionalization of HFOMC/MHC enhances the Health Governance & Quality Health Services EOC fund is a crucial solution to support the management of delays as well as timely referral. Conduction of monthly meeting after accomplishment of data entry and verification during meeting modality is effective to minimize the data error and linking issues to municipal executive committee meeting Activities performed through cost sharing basis enhanced ownership and the shared responsibility of result ​​ Onsite coaching is effective and sustainable if the involvement of health office and municipal health section representative. LARC and CBIMNCI onsite coaching is effective for quality services.

Sustainability Approach. . Data quality team formed at district level and assigned responsibility DHIS2/HMIS focal person assigned in each palika Onsite coaching conducted jointly with district and palika Advocay to implement act, policy and guideline SBA and CBIMNCI mentors in each Municipality can successfully conduct clinical onsite coaching/mentoring..

Thank You!. 32.