The Community Health Department (CHD) of the UMN Hospital, Tansen
For over 40 years the former Community Health and Development Project (CHDP) of the UMN used its skill and experience in integrated development work to serve the people of Palpa. Upon its closure in 2002 the UMHT leadership saw the importance of partnering with local communities to enable them to meet their health needs as well as continuing to assist in the provision of high quality primary health services. They also saw the need to assist the staff of the Government Health Services to improve their overall ability to provide quality health services to people in rural Palpa. Therefore, the Community Health Department of the UMHT was born. Mission:
The Mission of the CHD is to improve the quality of life of the people of Palpa District by providing high quality primary health care and to provide training in primary health care.
To improve the quality of life of the people of Palpa District through the provision of high quality primary health care and to provide training for medical, nursing and paramedical students and other personnel.
To improve the linkage of health care from the community level to the hospital level.
To create partnerships with the local community to enable them to address their health needs.
Overall the CHD is concerned with helping people to transform their lives in order to enable them to have better control of their health and therefore their future. We believe that this change can come about through community awareness, empowerment, and strengthening those within the community who are currently involved in the provision of health care.
The CHD runs a collection of several programs that are aimed at improving access to quality health care to those who are beyond the reach of the dispensary, and empowering communities to address their own wider health needs. Removing the social, cultural, geographical and economic barriers to care are essential.
Brief Program Descriptions:
Mother and Child Health Centre (MCHC)
The MCHC (commonly called Town Clinic) is situated on the District Hospital premises in Tansen. It is a busy clinic providing antenatal care, post-natal care, family planning counselling and services, health education, under-five care, and immunizations. It logged over 10000 patient encounters in the last year. It also serves as a training site for RN students, midwifery students, UMHT medical residents and other district health personnel.
Satellite Maternal Child Health Clinics (SMCHC)
The SMCHC program is an attempt to reproduce the services and quality of care provided at Town Clinic in several rural locations within the District. We are currently partnering with one village and have identified two other rural areas where women have not had access to good MCH care. In the process we also hope to raise the quality of services provided at the local health facilities. As with the Health Post Strengthening Program (HSPS) this program has been temporarily suspended in two of the three sites due to security issues.
Health Post Strengthening Program (HSPS)
Within Palpa District there are nine Health Posts (HP) and three Primary Health Centres (PHC). The CHD has a working relationship with nine of these Government facilities. The main emphasis of the HPSP is to build the capacity of the HP/PHC staff to enable them to correctly diagnose and treat the many patients who visit their facilities. This is done through periodically scheduled visits to these rural facilities by UMHT medical and nursing staff. Unfortunately, this program is temporarily suspended due to the political unrest in the country.
UMHT Referral System
All Government health facilities within Palpa District now have the ability to refer all medical, obstetric and dental patients to the UMHT for advanced evaluation and treatment without having to pay the doctors evaluation fee. Our referral system not only enables rural people the benefit of access to proper diagnosis and treatment but also enables the CHD to give constructive feedback to the rural health facilities when they come to Tansen for periodic District meetings.
Child Nutrition Rehabilitation/Community Health Centre (CNR/CHC)
For many years the problem of poor nutrition has been identified as a causative factor in the increased morbidity and mortality of the people of Palpa. This is always most pronounced in children. The CNR/CHC will be a multi-purpose residential facility that can house up to four families at a time to aggresively teach and demonstrate good nutrititional practices as well as help the families (specifically mothers) to become more aware of preventative health measures. The CNC/CHC will not only help reduce malnutrition but also educate the people of Palpa regarding multiple aspects of Community Health and Development. This will be in cooperation with other INGO and NGOs in Palpa. We are currently in the building process and hope to begin operations within the next fiscal year.
Tansen Naggar Pallika (TNP) Postpartum Program (PPP)
Many women in Palpa give birth to their children in the home and often have no skilled care for the first few weeks after birth. This can lead to the death of the mother or child. The maternal and infant mortality rates in Nepal are high and show us the extent of this problem. The TNP/PPP visits, examines, counsels and cares for all postpartum women and their children in the home during the first two weeks after birth. This is done by CHD staff and local FCHVs or volunteers in cooperation with the local Tole Lane Organizations of the TNP.
Healthy Schools Programs
The children of today are the future of Nepal. We feel that teaching children to live healthier lives is a good step in health promotion and disease reduction. This program is geared to help Nepali children to have a better understanding of health issues and health promotion. We feel that this can occur if we assist the teachers to better teach health in the curriculum as well as providing an environment of healthy living for the children. The program will focus on health screening examinations, health education, oral health, sanitation and community involvement. Four initial schools were identified and the program began in May 2005, at the beginning of the Nepali school year.
Female Community Health Volunteer Refresher Training
In each Ward of all Village Development Committees of our district a local repesentative is chosen by the community to act as the Female Community Health Volunteer (FCHV). She is a voice for women and children. She is given basic education about how to prevent and teach about the common illnesses and birth-associated problems seen in Nepal. These women need to have current and relevant encouragement to do their work in an appropriate way. The CHD with the help of the District Public Health Service will begin a concerted effort to encourage and enable these volunteers to do their scheduled tasks in preventing and identifying health related issues in their communities. We hope that all 615 FCHVs in Palpa District will attend our five-day refresher training program within the next five years.