KINGDOM OF CAMBODIA
NATION RELIGION KING
323
Ministry of Health
Kandal Provincial Department of Health-
Lovea Em Health District Lovea Em, 10 August 2008
Project Sponsored by
Harold Grinspoon Charitable foundation Mary L-Mastroiani-Sothea Arun Humanitarian Foundation
In cooperation with Ministry of Health
4444444
I. Introduction:
Initially Mr. Sothea Arun, President of Sovann Komar Organization was founded visional initiative in creating the health station in Phoum Thom commune under the project sponsored by Harold Grinspoon Charitable foundation Mary L-Mastroiani-Sothea Arun Humanitarian with strict concentration with the some representative of commune authority concerned such as Phoum Thom-Prey Rey communes in Lovea Em district, Kandal province and Prek Tasar commune in Peamror district, Prey Veng province together with Lovea Em Health Unit in Kandal province, conducted successfully, particularly within the past 17 months, appeared this program project smoothly and completely supported by the people and all levels of authorities and become more popular for the regional and external, notably this achievement was considered as the model by the Ministry of Health as well as the Royal Government.
This program conducted successfully due to some of the following particulars:
- All parties concerned have the same vision is the common commitment to settle the difficulties of the communities, particularly poor people to obtain good quality health services, good services and humanity in the society.
- In good cooperation with all parties, notably always available common consultation to find the settlement or the proper way before implementation.Available support in kind, in financial, medical equipment properly and regularly from the health station in Phum Thom
commune under the project sponsored by the Harold Grinspoon Charitable foundation Mary
L-Mastroiani-Sothea Arun Humanitarian Foundation
- Available insurance for the monitoring of the common implementation including technical from the representative of the government such as Phoum Thom commune council and Lovea Em District Health Unit.
II. Significant Result achieved by program supported Phum Thom Health Station:
1. Having trained the basic health service management through the national health system (enable chief of personnel and staff group to work in group, particularly how to manage, handle good affairs by the board of Lovea Em District health Unit
2. Having trained the technical MPA (Minimum Package of Activity) to staff (this training enables the staff how to work in health for the communities under the basic health program well, particularly to meet the requirement of the people, and this training provides by the boards of Lovea Em District Health Unit).
3. Having training the Integrated Management of Childhood Illness = IMCI) (through this course enables staff, particularly non-medical staff or doctor could consult and treat the childhood illness and through this course enables them how to monitor the growth and how to find the health issue including the growth of the childhood, enables to educate health about the food of the childhood, appropriate breast feeding, especially also enables to help find the other issues of the mothers either their health issues or attitude correction, this course provides by the boards of Lovea Em District Health Unit and Ministry of Health.
4. Having trained the Birth Spacing program (enabling the staffs to implement this service properly, particularly it can become the consultants to the community based people who wish to know or utilize this service, notably to importantly contribute to the reduction of maternal death and the poverty alleviation, this course provides by the boards of Lovea Em District Health Unit).
5. Having trained the management of medicine, medical equipment and material (enabling the chairman and staff in charge of management of medicine including recording and registering appropriately, this course provides by boards of Lovea Em District Health Unit).
6. Provided EPI = Expanded Program Immunization (enabling the chairman and staff know how to implement well with the national program, particularly can work effectively including the safety for this program to community, this course provides by boards of Lovea Em District Health Unit).
7. Having trained the HIS= Health Information System (enabling the staff how to extract the health data and utilization including health information transmission, this course provides by Lovea Em District Health Unit).
8. Having trained the STD course (enabling to enhance the staff with good research and consultation, this course provides by Lovea Em District Health Unit).
9. Having trained the COPE (Client-Oriented Provider-Efficiency) through this activity enables the staff how to find the issues in their affairs, how to find the main reason, how to give issue priority, how to find the settlement and awareness of the necessary requirement, particularly all affairs was made and settled by them and most of fund expense is less than service quality improvement in time etc, this course provides by the boards of Lovea Em District Health Unit.
10. Significant Services previously provided by health station
III. Experience share from health station conduct:
A- Advantage
1. Health service previously did not provide to the people living in that area completely, presently the people of that area obtained appropriately
2. To be supported with satisfaction by all levels of authority, people in and nearby areas
3. The community health was promoted, particularly the maternal and child death rate were reduced to maximum.
4. Attitude change by the people from their belief or habit of using less quality private health service (such as delivery by ancient midwife etc, turning to utilize the public health service.
5. Staff shall change the attitude from being careless, immorality in its practitioner, turning to be friendly with dignity morality.
6. As part of the testing model for the Ministry of Health to review and find out the key point enabling and bettering the public health service activity in the future.
B-Aspect to consider
1. In relying on the assistant almost all under the supporting project by the Harold Grinspoon
Charitable foundation Mary L-Mastroiani-Sothea Arun Humanitarian will not be sustainable
for the future during the end of this project.
2. Will need more assistance requirement due to the utilization of service by the people in other areas increased.
3. Will occur shortage of staff due to scope of work
4. Will be the habit in community without participation to support the public service in their area
C-Experience share for the future
- Should implement the strategy step by step as follows:
1. To construct more building to be consistent with the standard of Ministry of Health to become from Health Station to Health Center upon coverage plan of the national health
2. The project supported by Harold Grinspoon Charitable foundation Mary L-Mastroiani-
Humanitarian Foundation through Mr. Sothea Arun must still renew its supporting activity
and shall be reduced the step by step to what the government section can control.
3. Ministry of Health having Lovea Em District Health Unit, represented by Dr. Yi Sophornnarith who is responsible for preparation and maximum support by Ministry of Health either human resources, or in kind, medical equipment, in financial including the management from the date when the Ministry of Health pronounced to recognize as Health Center (can be after completed construction of new building).
4. To prepare the health funding with the instruction policy of the Ministry of Health to obtain the service charge contribution from the people who are able to make payment and such budget will be included with the state budget to contribute to supplement the expenditure and through this will also reduce the support from Harold Grinspoon Charitable foundation Mary L-Mastroiani-Sothea Arun Humanitarian consecutively (30% for general cost, 1% levied by the government in order that the Ministry of Finance is aware of the budget made, 59% for staff motivation).
5. Harold Grinspoon Charitable foundation Mary L-Mastroiani-Sothea Arun Humanitarian should renew to watch and support what is the necessary affair and the government side is unable to provide, however in the future this health center can be the responsibility of the government, because that here is the difficult and proper start for this area or can be the pure and good heritage from Harold Grinspoon Charitable foundation Mary L-Mastroiani-Sothea Arun Humanitarian.
IV-Development Action Plan for Phoum Thom Health Center
Initiative from the aforesaid experience share and pursuant with agreed discussion from parties concerned the following action plan will help the development from Phoum Thom health station (Sok Sabay Clinic) to Phoum Thom Health Center, particularly the development from assistant process by the Harold Grinspoon Charitable foundation Mary L-Mastroiani-Sothea Arun Humanitarian through Mr. Sothea Arun, most to become the responsibility of the state and most communities.
1: Coverage areas of Phoum Thom Health Center
- Phoum Thom Commune has 2 villages and total population of 2,118 persons equivalent 404 households
- Prek Rey commune has 3 villages and total population of 3,910 persons equivalent 665 households (available people from Prek Tasar commune and some nearby communes utilizing the service at Phoum Thom Health Center).
2: Scope of Work to be responsible and implemented by Health Center
A-Roles and Responsibilities of Health Center
The role of the health center is to provide Minimum Package of Activities service to local people especially to the poor and vulnerable people. These include quality mother-child and reproductive health service; communicable diseases control service, non-communicable diseases and other health problem services, health education and outreach activities services.
Besides, health center has also a role in taking into account quality improvement for its effectiveness according to the national policy on quality improvement in health sector consisting of 6 strategic activity plans as follows:
1-Promotion of client rights
2-Legislation and institutional management
3-Clinical practice
4-Professional development
5-Managerial development
6-Inclusion of quality improvement in institution
Health center should strengthen its health service delivery including preventive and curative services focusing on population need and in accordance with a quality standard.
Health center should focus on human resources development through refresher training or staff motivation.
Health center should well manage health financing/user fee with a transparency, enhance service quality and improve infrastructure as well as participate in community health insurance.
Health center should well strengthen information system and referral system, and should have good governance, harmonization with development partners and community
B-Minimum Package Activities of Health Center:
- Services Delivery
-Antenatal care
-Normal delivery and delivery with intervention
-Postpartum care
-Provision of immunizations to children and mothers/women
-Nutrition
-Prevention of Mother to Child Transmission of HIH/AIDS
-Neonatal and young child care
-Integrated Management of Childhood Illness (IMCI)
-Birth Spacing
-Adolescent Reproductive Health
-Breast-uterine cancer consultation
-Safe abortion and post abortion care
- Drug and Medical Equipment Management
-Drug Store
-Medical Equipment Management and Maintenance
- Health Education and Health Promotion
-Health education
-Health promotion
- Health Financing
-National Budget
-User Fee
-Equity Fund
-Community-base Health Insurance
- Services provision at health post
-Some of services are same to services provided at health center including
management
- Communicable Diseases Service
-Sexually transmitted diseases
-HIV/AIDS
-Tuberculosis; 4-Leprosy
-Malaria/ dengue fever; 6- Bird Flu
- Non-communicable Diseases Service and Other Health Problems:
-Hypertension
-Diabetes
-Breast cancer/ uterine cancer
-Mental health
-Oral health
-Eye care
-Minor surgery and wound dressing
- Outreach Services
-Guide for Outreach Services
-Implementation of Outreach Services
-Community Participation
- Planning, Budgeting, Monitoring, and Evaluation
-Working schedule
-Ensuring 24 hour services
-Developing the annual operational plan
-Budget management for health center
-Monitoring the implementation of quarterly plan
-Hold regular staff meeting
-Attending the meeting at Operational District
-Organizing and attending the meeting of Health Center Management Committee
-Organizing meeting of Village Health Support Committee
-Conducting demographic census in the HC catchments area
-Hygiene, health care wastes management and safe water
-Daily record, making activity report, and inventory
- Human Resources Management & Development
-Staff training and continuous education
-Promotion on performance of staff
-Provision of continuing education to community through members of Village
Health Support Group
3: Responsibility of all level of authority and regional communities
- The Health Center Management Committee (HCMC) and Village Health Support Group (VHSGs) shall be founded by Lovea Em authority, having authority of Prek Rey commune and authority of Phoum Thom commune, village chief, volunteers together with staff of Health Center and very important persons in some other communities as the members of the committee to be formed (this committee detailed in the instruction of Ministry of Health where is the target to help support the general conduct of Health Center and assist the Health Center to fulfill role to meet the certain requirement of the community).
- After the aforesaid two groups of committee were formed, the startup for health funding (service charge determined by proper community for the ones who are able to pay and except the service charge for poor people, ensuring the equity in obtaining the service, with public quotation board and shall be abode ... etc as well defined in the law of Ministry of Health).
4- Responsibility of Public Health Section
- However in present situation, as well after Phoum Thom Health Center formed to be responsible for steering the activities over there to follow the policy of the royal government through the management, plan construction, implementation monitoring, assessment and support to be considered here is the unit for serving the public service to the community in that area like other ones, but what is different from other health units that the more complete activity, better than because it is the heritage formed and supported by Harold Grinspoon Charitable foundation Mary L-Mastroiani-Sothea Arun Humanitarian
5-Responsibility by Harold Grinspoon Charitable foundation Mary L-Mastroiani-Sothea Arun Humanitarian :
To keep the sustainability of this unit and anyway presently was noticed by the royal government that can be the model for other ones with similar situation and possibility to follow because this model is very appropriate to the situation of Cambodia presently is in shortage of human resource (human, budget ...), therefore the responsibility of the donor shall renew supporting what the government side is unable to provide, particularly the budget support for staff in previous number, budget support for general conduct and support the medicine, material and equipment retaining in the same support status and in the meantime, Dr. Yi Sophornnarith, Health Director of Lovea Em District, the representative will use his effort to find the support sources form the government or other regional organizations, communities etc., enabling to meet the requirement to ensure to abide by the ministry’s standard.
Yi Sophornnarith
Dr. Yi Sophornnarith
Director of Lovea Em Health District.
Phone: (855)012 877 857
e-mail: yisophornnarith@yahoo.com
Director of Lovea Em Health District.
Phone: (855)012 877 857
e-mail: yisophornnarith@yahoo.com
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