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SPECIAL INITIATIVE REGARDING HEALTH SERVICES DELIVERY
PRESENTED BY: DR. JANBAZ AFRIDI
DD-EPI
KHYBER PAKHTUKHWA
EXPANDED PROGRAMME ON IMMUNIZATION
SPECIAL INITIATIVE FOR IMPROVING IMMUNIZATION
Government of Khyber Pakhtunkhwa has initiated Special Initiatives in the budget 2013-14 for improving the Mother and Child Health condition of poor and downtrodden of the province to achieve the MDGs 4 & 5.
Rs.200 & 300 Million have been allocated for Special Initiative for enhancing immunization coverage, ante natal care and encourage the skilled deliveries in the far flung and low performing districts.
EXPANDED PROGRAMME ON IMMUNIZATION
EXPANDED PROGRAMME ON IMMUNIZATION
SPECIAL INITIATIVE FOR IMPROVING IMMUNIZATION
To encourage the parents to get vaccinated their children against various childhood vaccine preventable diseases, Government of Khyber Pakhtunkhwa has allocated Rs.200.00 Million in 2013-14 budget.
Rs.1000/child will be paid to parents on completion of the vaccination course of 15 months/ FIC( Fully Immunization Child).
Parents may be encouraged to retain the child Immunization Card
190,000 children will be beneficiaries of this initiative
EXPANDED PROGRAMME ON IMMUNIZATION
OBJECTIVES OF THE INITIATIVE
To Improve the Immunization Coverage and reduce drop out of under 15 months
To reduce the diseases burden, disabilities and deaths in the target districts against EPI targeted diseases
To Control out breaks
To Reduce the neo Natal tetanus by immunizing the pregnant ladies
EXPANDED PROGRAMME ON IMMUNIZATION
OBJECTIVES : CONTI…..
To Encourage ante natal care and to reduce the pregnancy complications which will reduce unwanted deaths in young mothers during her reproductive life/age
To Encourage the skilled deliveries in the public hospital
To Improve the birth registration
EXPANDED PROGRAMME ON IMMUNIZATION
IMPLEMENTING DISTRICTS FOR IMMUNIZATION
1. Battagram 2. Buner
3. Chitral 4. Dir Lower
5. Dir Upper 6. Hangu
7. Kohistan 8. Lakki Marwat
9. Nowshera 10. Shangla
11. Tank 12. Torghar
EXPANDED PROGRAMME ON IMMUNIZATION
CRITERIA FOR SELECTION OF DISTRICTS
Socio Economically backward
Low routine EPI coverage
High disease burden
In- accessible and hard to reach .
EXPANDED PROGRAMME ON IMMUNIZATION
SELECTION CRITERIA FOR DISTRICTS
Twelve Districts of Khyber Pakhtunkhwa are selected on the following
grounds:
Districts having enough resources in terms of cold chain and human
resource to utilize the incentives provided in the budget by the
Provincial government.
Total average Measles II coverage is 46.4 and with this incentives it is
expected to increase to target of 73 %
EXPANDED PROGRAMME ON IMMUNIZATION
IMPLEMENTING DISTRICTS FOR IMMUNIZATIONS No
District No of houses
No of UCs Total Population
<1 year <2 year
Measles IIcoverage
Target coverage
Q Release Financial Implication
1 Battagram
73345 20 456889 16,142 15,534 64 80 3238050 12,427,200
2 Buner 68750 28 752816 16,142 25,596 69 80 5250450 12,960,800
3. Chitral 53733 24 476495 16,835 16,201 64 80 3396450 20,479,900
4. Dir-U 28 860,505 30,402 29,257 42 70 5276225 29,038,400
5. Dir-L 105651 37 1,067,578 37,718 36,298 63 80 7390850 12,596,800
6. Hangue 32937 19 463,125 16,362 15,746 66 80 3280450 14,374,200
7. Kohistan 27206 38 704,611 24,894 23,957 30 60 3724800 14,935,200
8. Lakki -M 60135 33 732,128 25,866 24,892 24 60 3890050 30,052,800
9. Nowshehra
147551 53 1149863
4024536025 68 80 7669450 15,360,800
10 Shangla 54137 28 645,421 22,803 21,944 48 70 3996450 5,909,500
11. Tank 27849 16 1,518,259 12,281 11,819 18 50 1608625 5,353,200
12. T Ghar 18985 15 1,877,106 9,271 8,922 36 60 1469660 193,965,600
EPI-District-Wise Target population and quarterly (Jan-Mar 2014) required budget for the financial year 2013-14 under Special Initiative Regarding Health Services Delivery
S. No DistrictTotal
Population<1 Year <2 Year
Measles-II coverage
Total allocation for 2013-14
Proposed Quarterly release
for Social Mobilization (Jan-
Mar 2014)
Proposed Quarterly release for Monitoring
(Jan-Mar 2014)
Proposed Quarterly
release to PPHI (Jan-Mar 2014)
Proposed Quarterly release for Payment to
parents (Jan-Mar 2014)
Total Proposed release for
quarter (Jan-Mar 2014)
Current Expected
% %
1 Battagram 456889 16142 15,534 64 80 12,427,200 93750 37500 3,106,800 3,238,050
2 Buner 752816 16142 25,596 69 80 20,476,800 93750 37500 5,119,200 5,250,450
3 Chitral 476495 16835 16,201 64 80 12,960,800 93750 37500 25000 3,240,200 3,396,450
4 Nowshera 1149863 40245 37,566 68 80 30,052,800 93750 37500 25000 7,513,200 7,669,450
5 Dir Lower 1067578 37718 36,298 63 80 29,038,400 93750 37500 7,259,600 7,390,850
6 Dir Upper 860505 30402 29,257 42 70 20,479,900 93750 37500 25000 5,119,975 5,276,225
7 Hangu 463125 16362 15,746 66 80 12,596,800 93750 37500 3,149,200 3,280,450
8 Kohistan 704611 24894 23,957 30 60 14,374,200 93750 37500 3,593,550 3,724,800
9 Lakki Marwat 732128 25866 24,892 24 60 14,935,200 93750 37500 25000 3,733,800 3,890,050
10 Shangla 645421 22803 21,944 48 70 15,360,800 93750 37500 25000 3,840,200 3,996,450
11 Tank 1518259 12281 11,819 18 50 5,909,500 93750 37500 1,477,375 1,608,625
12 Tor Ghar 1877106 9271 8,922 36 60 5,353,200 93750 37500 1,338,300 1,469,550
Total: 268961 267,732 193965600 1125000 450000 125000 48491400 50,191,400
EXPANDED PROGRAMME ON IMMUNIZATION
Penta -3 & Measles 2, District wise coverage, 2013
Batag
ram
Bannu
Chitra
l
Dir up
per
Dir Lo
wer
Hangu
Kohistan
Lakk
i Mar
wat
Nowsh
era
Shan
gla
tank
Tor G
har
0102030405060708090
100
Penta 3Measles 2
EXPANDED PROGRAMME ON IMMUNIZATION
DISTRICT WISE DROP OUT, 2013
Batag
ram
Bannu
Chitra
l
Dir up
per
Dir Lo
wer
Hangu
Kohistan
Lakk
i Mar
wat
Nowsh
era
Shan
gla
tank
Tor G
har
0
5
10
15
20
25
30
35
40
45
BCG- MeaslesPenta 1- Penta 3TT1-TT2
EXPANDED PROGRAMME ON IMMUNIZATION
DISTRIBUTION FORMULA
Total Allocated budget of the special initiative on EPI is 200 million and further distribution or allocation
Payment to parents 190.0 MillionSM activities 6.0 MillionMonitoring 3.0 MillionBank Charges 1.0 Million
EXPANDED PROGRAMME ON IMMUNIZATION
MECHANISM TO ENSURE TRANSPARENCY
To Ensure the transparency and simplify the procedure for the money among the selected beneficiaries the following criteria is suggested .
Card/ Vouchers may be printed to facilitate the process after the completion of the successful course parents may be issued the vouchers by the respective vaccination center, and parents may receive the amounts on the same day in future after transfer of the money to the districts
The bank will release the payment on provision of Immunization card/voucher/Parents ID card.
Eligibility of the children completion of immunization of the children after 31st December 2013
EXPANDED PROGRAMME ON IMMUNIZATION
MEANS OF DISBURSEMENT
Province released the check Rs.50191400 to the districts and districts will release to the banks
The following means for disbursement can be utilized to the beneficiaries: Bank s Pakistan Post office Easy Paisa UBL Omni Cash Payments Through Notified committee Quarter release of the amount to the districts in advance
EXPANDED PROGRAMME ON IMMUNIZATION
RESPONSIBILITIES
Provincial Budgeting Coordination and facilitationPolicy guidelines Supervision, Monitoring and EvaluationProvincial level Advocacy and Social Mobilization
EXPANDED PROGRAMME ON IMMUNIZATION
ACTION TAKEN BY PROVINCIAL EPI
Three meetings conducted with DHOs of the concerned districts
Presentation to DGHS
Approval accorded by the honorable Secretary Health
Implementations will be started in the first week of February
Checks has been handover to the districts for the first quarter in this Final Planning meeting(29/02/2014)
Social Mobilization printed and dispatched to the districts
Provincial Inauguration request has been sent to the HCM
EXPANDED PROGRAMME ON IMMUNIZATION
RESPONSIBILITIES
Districts Preparation of FIC( Fully Immunized Children) list , facility based and district based
List of banks and its catchment Areas Amounts disbursement in case of any other facility is not available Preparation of districts Monitoring Plan Preparation of Districts SM Plan Notification of disbursement committees Nomination of Focal person
EXPANDED PROGRAMME ON IMMUNIZATION
BUDGET ALLOCATION FOR SM/MONITORING
S NO SM Monitoring Provincial 1.5 million 1.2 millionDistricts 4.5 million 1.8 million
EXPANDED PROGRAMME ON IMMUNIZATION
SOCIAL MOBILIZATION
Provincial inaugurationPress briefing at Provincial level.Awareness/Orientation sessions with DHOs and EPI Coordinators and other stake Holders
Preparation of Banners , flyers and other IEC material Involvement of other stake holders like PPHI & Education department etc
UNICEF has agreed to provide support in IEC Material later on UNICEF has agreed to support the inaugurations at provincial level
EXPANDED PROGRAMME ON IMMUNIZATION
SOCIAL MOBILIZATION
District inauguration followed by UCs inaugurations. Press briefing at District level.Awareness sessions in Schools and Madrassas , To sensitize all health care providers (Medics & Paramedics of health facility)
All EPI technicians LHWs & LHSs should be trained and sensitized to create awareness in the community through mothers counseling & compound dialogue
Involvement of PPHI at districts( Chitral, Dir Upper, Shangla, Nowshehra & Lakki Marwat) level
EXPANDED PROGRAMME ON IMMUNIZATION
BUDGET FOR SOCIAL MOBILIZATION FIRST Q
S.No Activity Cost allocation Total for 3 Months/ District
Total for 6 months for 12 districts
1 District inauguration ( 12 ) 1.8million 4.52 UC inauguration ( 315 )/No of
Health Facilities
3 Provincial Press Briefing
4 District Press Briefing
5 Awareness sessions in Schools
6 Awareness session for LHS/LHWs Paramedics
7 Banners / Boards/ Flyers
8 IEC Material
9 PPHI for 5 districts 125,000
EXPANDED PROGRAMME ON IMMUNIZATION
EXPANDED PROGRAMME ON IMMUNIZATION
BANNER
EXPANDED PROGRAMME ON IMMUNIZATION
FLAYER
EXPANDED PROGRAMME ON IMMUNIZATION
POSTER
EXPANDED PROGRAMME ON IMMUNIZATION
CALENDAR POSTER
EXPANDED PROGRAMME ON IMMUNIZATION
EXPANDED PROGRAMME ON IMMUNIZATION
MONITORING
Overall activities swill be supervised by HSH/DGHS Khyber Pakhtunkhwa and will be thoroughly monitored through special monitoring check list by Provincial committees split in 2 tiers
1, District Level : DHO,DDHO,EPI Coordinator,LHWs Coordinator, PH Coordinator, DHCSO, DSM PPHI and Partners staff
Provincial Level HSH,DGHS,DHS KP ,DDs /ADs of DGHS office, NP,PPHI and Partners.
First Monitoring visit has been done on 21th Feb 2014, by EPI Team(Dr. Farid, Dr. Rahim, Dr. Ishaq and Mr. Hanif) to Nowshehra
EXPANDED PROGRAMME ON IMMUNIZATION
SPECIAL INITIATIVES FOR IMPROVING IMMUNIZATIONGOVERNMENT KHYBER PAKHTUNKHWA MONITORING CHECK LIST
District ______________ Tehsil: ________________ Union council ______________
Name of Health facility _____________ Name of In-charge Health facility _______________ Designation of HF In-charge: __________________
Name of EPI technician________________________
Total Population of UC: __________ ___ Target Under 1 Year: _____________
Total Number of Children Completed Measles 2 Vaccination: _____________
Total Number of Children received Incentives: _________________
Name of Bank/ BHU/ Easy Paisa/ other: ___________________________________________
Information of Clients Who Received Incentives
S No Name of Child Father Name
NIC No. of Father
Date of Vaccination Completed
Date of Incentives Received
Verified
Yes No
EXPANDED PROGRAMME ON IMMUNIZATION
BUDGET FOR MONITORING
S.No
Monitors Honorarium per Month
No of visits Total for 6 Months/ District
Remarks
1 DHO, DDHO, EPI Coordinator, DCNP, DSV
5000/per monitor
2/ per month by each monitor
1.8million
2 Provincial Monitors. DGHS, DHS, DDs, ADs
10,000/month
1-2 visits per month
1.2million
3 Quarter review Presentation will be made by the districts on special initiative
.3million UNICEF agreed to support this activity
EXPANDED PROGRAMME ON IMMUNIZATION
CHALLENGES/WAY FORWARD
Poor compliance from the districts Timely getting plans Successful implementation of Special Initiative Achievements of desiring targets Transparent and timely disbursement of money to the beneficiaries Reduce drop out at district level
Achieving highest possible coverage Reduce diseases burden, disabilities and deaths
EXPANDED PROGRAMME ON IMMUNIZATION
THANKS