Implementation of package tour Experience sharing by Midwife

Daw Khin Myo WinMidwife

Bawgahta SubcenterBoe Ma RHC

Background

• Boema RHC is 60 miles away from Pyinmanar Township.

• There are 4 sub-centers and 25 villages under Boema RHC.

• All the villages are hard to reach and situated on the hills.

• Population residing are mostly Kayan and Kayin races.

• Social barrier and financial barrier are also present .

Bawgahta sub-center is 20 miles away from Boema RHC

To reach Bawgahta sub-center from Pyinmanar---•First travel by public bus to Yeni from Yedarshe township,• from there by cycle taxi to Yepu subcenter of Boema RHC for night stop •and then walk for 7 hours in the next morning to reach Bawgahta SC.

Package of Services

• Started in January to April 2012 according to CTHP .

• Service package cannot be conducted in rainy season.

• Two groups of BHS - (4) in each group HA + 1 MW +1 PHSII + 1 AMW in one group LHV + 2 PHSII + 1 AMW in other group

• Also plan to deliver package of service in November and December, 2012

Package of Services

Preparation of Package Tour

• Prepare for HE session (IEC materials)

• Prepare for reports/returns (register book)

• Prepare some drugs/equipment (bathroom scale, salter scale, BP cuff, Stethoscope, MAC tape, Test strips)

• Prepare to carry vaccines in vaccine carrier

• Information about package tour is sent to village authorities one week before actual implementation

Implementation of Service Packages

• First, HE session is given using IEC materials as soon as community is organized.

• Health talks and focus group talks are conducted according to planned topics. (4 cleans, nutrition, danger signs of pregnancy)

• Hand washing - practical exercise by community.

• Then group of health staff conduct each activity separately - one performing quality ANC, - another performing immunization, - another performing weighing of under five

• General examination of people for their illnesses and treatment are given accordingly for ARI, hypertension and minor ailments.

• After that inspection of latrines in the village is done by group of health staff.

• VHWs (AMW & CHW) assist the activities by- calling and gathering pregnant mothers for ANC

- weighing under five children - assist in recording activities- translate to the community

Strengths• Many services (EPI, MCH, Nutrition, EH & HE) can be given

during one visit.

• The unreached villages can be reached and provide services.

• Quality ANC and PNC can be done due to group activity . PMCT also conducted.

• Under five children can be weighed and screening can be done for malnutrition and referral.

• Iodized salt contents can be examined randomly in some households

Strengths

• Focus group talks to target population used to be conducted as follows:

– Pregnant mothers for ANC, danger signs of pregnancy– Adolescents in separate groups for RH– Elderly for nutrition– Mothers of under 5 children on EPI and ARI, breast feeding– Men group on risks of HIV/AIDS and STDs

• Hand-washing demonstration is being appreciated by the people

Constraints

• Time consuming for collecting the community if the villagers are working in the fields.

• Village authority are not cooperative sometimes .

• More difficult to travel during rainy season.

• When hired/owned cycles are broken down during package tour, it is difficult to compensate or could not repair for high cost .

• Slip and fall due to thick mud and dust while climbing up the hills

Constraints

• Inadequate medicines for giving general treatment to people who come for illnesses.

• No bathroom scale for weighing AN mother.

• Missed delivery cases while travelling for group tour to other villages.

• Sometimes health posts -not convenient for conducting activities.

• Difficult to construct sanitary latrine and repair after

latrine inspection in the village.

Thank You