JSI Research & Training Institute, Inc.
Nepal Family Health Program II Project Closure
Nepal family Health Program II (NFHP II) is USAID/ Nepal's major Family Planning/Maternal, Neonatal and Child Health (FP/MNCH) 5 year bilateral project and is implemented by JSI Research and Training Institute,Inc. and other 13 National and International Partners during December 2007 to November 14, 2012. NFHP II celebrated the End of Project dissemination event where more than 200 representatives from Government, External Development Partners, NGO/INGOS, Civil Society and Media participated. The Final Project Report highlights the major achievement of NFHP II.
Deputy Director, Bureau of South and Central Asian Affairs, Mr. Todd Sorenson Visits Bhaktapur District
Deputy Director, Bureau of South and Central Asian Affairs, USAID, Washington Mr. Todd Sorenson visited Ward #8 of Sudal VDC in Bhaktapur. Mr. Sorenson spoke with female community health volunteers (FCHV) to understand how they are providing primary health services to their communities. Other participants included Director Shanda Steimer and Team Leader Naramaya Limbu of USAID/Nepal, as well as the FCHV coordinators Mr. Sushil Karki, and Ms. Sabina Pradhan from the Nepal Family Health Program.
Also attending the conversation with FCHVs were Mr. Arjun Kumar Adhikari, and Mr. Prem B. Thapa from the Bhaktapur District Public Health Office, as well as Mr. Babu Ram Subedi and Mr. Bala Ram Timilsina from the Sudal Sub-Health Post.
The group met three FCHVs, Ms. Suntali Timilsina, Ms. Sabitri KC, and Ms. Tara Baniya and discussed the services they are providing, use of the FCHV Fund, and why they wished to be health volunteers. The FCHVs also showed the visitors program materials and commodities contained in the bags used for their community work.
District close-out meetings in 20 Core Program Districts
June 2012 - NFHP II conducted close-out meetings in each of its 20 Core Program Districts (CPDs) in coordination with respective District (Public) Health Offices (DHO/DPHOs). The meetings started on June 3, 2012 and were completed for all CPDs on June 24, 2012.
Those in attendance at each district meeting included the District (Public) Health Officer, District Program Supervisors, medical superintendents of hospitals, IFPSC in-charge, members of reproductive health coordination committees, Chief District Officer (CDO), Local Development Officer (LDO), Women Development Officer (WDO), District Education Officer (DEO) and representatives from Family Planning Association of Nepal, Nepal Red Cross Society, local partner radios, and external development partners working in District. During the meetings NFHP provided folders with district progress reports, lists of NFHP II supported activities (2008-2012) and different technical briefs produced by NFHP II.
The purpose of the close-out meetings was to share the progress made so far by the FP/MNCH programs. During the meetings there were also discussions about the possible continuation of NFHP II-supported activities in the future.. Because many of the NFHP II-supported activities have been included in government health plans and subscribed to by many D(P)Hos, D(P)HO supervisors were confident that most of these activities would survive after the project's closure.
D(P)HOs, District Supervisors and other participants expressed appreciation for the support of NFHP II in improving FP/MNCH activities noted NFHP's role in creating health awareness within communities.
NFHP II Field Office Staff Meetings
The final Field Office Staff Meetings were held in Nepalgunj on June 26 and in Hetauda on June 28, 2012. The participants were district-based staff and Field Office Staff. The Project Director attended the meeting in Nepalgunj and the Deputy Director and Field Coordination Team Leader attended both meetings. The main agenda of each meeting was to 1) share experiences and learning from district-based staff and field office staff, and 2) provide work experience letters to district-based staff and 3) provide an opportunity to meet with each other and say goodbye.
District-based and Field Office staff shared their important experiences, case studies, personal learning, and best memories during the meeting. As an entertaining diversion, an NFHP-themed quiz game was played and enjoyed by all.
During the meeting, selected staff photos were displayed and a prize given for the best photos based on voting from participants. The Project Director and Deputy Director provided comments on NFHP's accomplishments, congratulated the entire staff, and distributed work experience letters to all district-based staff. At the end, participants watched the NFHP II overview video, "Manmali".
EoP meeting with Partners at Kathmandu Office
As NFHP II officially ends on September 30, 2012, JSI R&T, Inc. is proceeding with the process of close out in phases. All sub-agreements with NFHP's 13 partner organizations ended as of June 30, 2012. As part of this close-out process, JSI R&T Inc. held a final meeting on June 22, 2012, with all 13 subs to celebrate this partnership.
The partners spoke on:
JSI R&T, Inc. senior staff gave remarks highlighting the excellent teamwork and productive, friendly relationship among project staff and thanked the partners for their commitment to the collaboration.
The meeting was capped off by a photo session and an all-staff celebration.
March 2012 - An eight-member team of public health professionals from Madagascar visited Nepal on March 13 – 23, 2012 with the objective to observe, on the ground, the totality of the FCHV program, by meeting with health facility staff, FCHVs, community members and leaders who have facilitated local support for this cadre of volunteers.
Nepal was selected as the best possible destination to fulfill the trip objectives because:
The Madagascar team comprised of the following people:
A joint meeting was held between NFHP II senior technical team members and the Madagascar Team on March 14, 2012. During the meeting, the Madagascar Team gave a brief overview of the health situation in Madagascar. Similarly, NFHP II program team leaders gave overviews of the health situation in Nepal and their respective programs and also a gave detailed presentations about the implementation process of community-based programs. The Team also met with NFHP II's Sabina Pradhan, FCHV Program Coordinator, Ram Chandra Silwal and Dr. Jaganath Sharma, Community-based Maternal and Newborn Health (CB-MNH) Program Coordinators and the FCHV Section Chief of the Family Health Division, Mangala Manandhar, along with the Chlorhexidine Program Manager Leela Khanal to receive a more comprehensive understanding of the FCHV, MNH, misoprostol, calcium and chlorhexidine programs.
For the field visits, the Madagascar Team divided into two groups—one went to Salyan, the other to Mahotari—and met with DPHO staff, SHP staff, VHWs/MCHWs, FCHVs, HFOMC members, local leaders and mothers and discussed with them/observed services provided by FCHVs, the recording/reporting system, commodities available with FCHVs, challenges, etc.
The Salyan group was accompanied by NFHP II Deputy Director, Dr. Robin Houston; Deputy Field Manager, Ram B. Shrestha, and Salyan district Field Officer, Santosh Neupane as facilitators from NFHP II. Pamela Poon joined them as the team's French translator.
Dr. Jean Pierre RAKOTOVAO could not join the Salyan team due to his late arrival. However, a separate visit was organized for him in Banke, focusing specifically on the misoprostol and chlorhexidine programs. During this visit, he was able to meet with HF staff, FCHVs and mothers on services provided by FCHVs, observe the recording/reporting process, and commodities available with FCHVs.
After returning from the field, the Madagascar team debriefed NFHP senior technical team members, the Family Health Division Director, Dr. Naresh Pratap KC, OHFP/USAID Director, Shanda Stiemer, and OHFP/USAID Deputy Director, Han Kang, about their visit.
The Madagascar team expressed visible excitement at having been exposed to successful community-based programs in Nepal. Based on these programs' success in Nepal, they are now planning to adopt the following activities/strategies into their national health program:
1) FCHV Fund
USAID Senior Deputy Assistant Administrator – Asia Bureau, Ms. Denise Rollins visited Banke district on March 12, 2012, to observe and learn about USAID/NFHP II's support to in strengthening public sector maternal, newborn, child health and family planning services. Other participants included USAID/Nepal Mission Director, Mr. David C. Atteberry, Program Management Specialist of OHFP/USAID, Ms. Nara Maya Limbu and NFHP II Project Director, Mr. Ashoke Shrestha.
During the Banke visit:
-Ms. Rollins visited a Health Education and Adult and Literacy (HEAL) class in Holia village where she interacted with 10 women HEAL participants and acquired information regarding their reading/writing skills and their newly acquired knowledge on how to keep their families in good health.
- Ms. Rollins had a lunch meeting with the Chief of Banke District Health Office, Mr. Jivan Kumar Malla, Chief of District Health Office and District Program Supervisor, Angad Shahi.
-Ms. Rollins along with other team members visited Puraini Sub Health Post where Ms. Nanda Sen was working as one of the few females working as the in-charge of a government health facility. Ms. Rollins discussed with SHP staff about the catchment population, range of health services provided, service coverage, supervision and staff training.
Ms. Rollins, along with other team members also met 5 FCHVs in Puraini VDC and held discussions with them about the services that they are providing, selection criteria of FCHVs, why they wished to be FCHVs and FCHV training duration, etc. The FCHVs also showed Ms. Rollings program materials and commodities contained in their FCHV bag and demonstrated and explained and their use .
Ms. Rollin' visit to Banke District was fruitful. The visit provided her with an opportunity to learn about health programs that are being implemented by the Government of Nepal – from the community to district levels – and observe how well they are being institutionalized, which she believes will continue. She also admired USAID/NFHP II's role, contribution and work in strengthening these Government programs and expressed thorough satisfaction and enjoyment vis-a-vis the trip.
Review Meeting with the Department of Health Services
NFHP II holds regular program review meetings with the Director General of the Department of Health Services, MoHP, and Directors of Family Health Division (FHD), Child Health Division (CHD), Logistics Management Division (LMD), National Health Training Center (NHTC), and National Health Education Information Communications Center (NHEICC). Such a meeting was held on February 29, 2012, at the FHD meeting room, with two agenda points:
2. Major activities supported by NFHP II in FY 2011/12 including plans for final end of project documentation/reports – presented by Dr. Robin Houston, Deputy Director, NFHP II.
The meeting was attended by : Dr. Yashovardhan Pradhan, Director General of DoHS, and Directors of FHD, CHD,LMD, NHTC and NHEICC, Dr. Naresh Pratap KC, Dr. Shyam R. Uprety, Dr. Mingmar G. Sherpa, Mr Lakshmi N. Deo and Mr Badri B. Khadka respectively. Participants from USAID included, Ms. Shanda Steimer, Director, Health and Family Planning, Narmaya Limbu , Team Leader, FP/MNCH/Nutrition, Marie Ahmed, Pradeep Neupane and From NFHP II, Ashoke Shrestha, Project Director, Robin Houston, Deputy Director, Dr Janardan Lamichhane, Senior Specialist, System & Policy, Geeta Lama, Finance & Administration Manager, Bharat Ban, Specialist, M&E, Sushil Karki, Team Leader, Field Coordination, Dilip Poudel, Team Leader, Child Health, and Heem Shakya, Team Leader, Logistics, Shyam Shrestha, Team Leader, Literacy and Life Skill participated in this meeting.
The Director General and Directors listened keenly to the findings of the NFHP II Evaluation presentation and at the end congratulated NFHP II on receiving such positive conclusions from the evaluation team. Ms. Naramaya Limbu did a good job of capturing the major highlights of the report in a clear and concise manner.
NFHP II also shared the following materials with the MoHP officials who participated in this meeting;
NFHP II Supports Transportation of Fortified Flour to 2 Districts
This fiscal year, the Logistics Management Division/Ministry of Health and Population procured and transported a total of 121,074 kilograms of fortified flour to the District Health Offices in Dolpa, Humla, Jumla, Kalikot and Mugu, for children between the ages of 6-24 months. However, the District Health Offices lacked a separate budget to transport the flour to their respective health facilities for distribution to children. The Logistics Management Division requested for support from NFHP II/USAID to transport 79,560 kilograms of flour - more than half of the total flour procured – from the district center to health facilities in Jumla and Kalikot. The flour will be distributed to approximately 9,000 children in the two districts.
Support to National Level Bi-Annual Review of Consensus Forecast and Quantification of Health Commodities
USAID/Nepal is providing financial and technical support through JSI (FPLM/DELIVER, NFHP, NFHP-II and DELIVER-II) to strengthen and improve the supply chain management system and health commodities security in the country since 1994. The exercise of consensus forecasting and quantification started for Family Planning commodities started under the leadership of Logistics Management Division, Department of Health Services/MoHP in 1999/2000. After few years, maternal and child health commodities like ORS, Vitamin A, Cotrim/pediatric, Iron Tablets, Zinc Tablets and Essential Drugs were added in the consensus forecast exercise. Government of Nepal (GoN) started to put funds to procure FP commodities in 2001/02 and the share was less than 5% of total need. The scenario has changed and at present majority of funds to procure FP commodities comes from GoN’s budget.
This exercise is crucial in identifying the long term need and funding requirements of health commodities. It gives an excellent platform to discuss the funding required and shortfall among the MoHP and EDPs and meet the shortfall in time. This gives an opportunity to interact among different stakeholder (Public, EDPs, NGOs, and Social Marketing) to improve the supply chain management and achieve the health commodity security in the country. For Program Divisions of Department of Health Services, it serves a starting point to make budgets for their concerned health commodities in their annual work plan and for Logistics Management Division a basis for making a procurement plan and delivery schedules of the commodities. As the decision is based on consensus, the process has improved the procurement system in the public sector and Government’s commitment of delivery of health commodities to the people of the country to strengthen the essential health care services. The entire process can be an example to the other line Ministries in Nepal.
The 2-day National Level workshop (August 22-23, 2010) on Bi-Annual Review of Consensus Forecast and Quantification of RH/FP, MCH commodities, Essential Drugs and Vaccines for coming 5 years was organized by Logistics Management Division, Department of Health Services with the technical support from NFHP-II/DELIVER-II and financial support from USAID/Nepal. Read detail Workshop Report.
The Ministry of Health and Population (MoHP) is committed to achieve the Millennium Development Goals (MDGs) through strengthening of local health governance, decentralization, public-private partnership and other reform initiatives.
An Memorandum of Understanding (MoU) was signed on March 17, 2010 among key implementing partners of the Local Health Governance Strengthening Program (LHGSP), namely, Ministry of Health and Population (MoHP), Ministry of Local Development (MoLD) and technical assistance agencies, namely, HSSP/GTZ and NFHP II/USAID. Signatories also included district level partners such as , District Development Committees (DDCs) and District Health Offices of Dang, Surkhet, Kailali and Doti districts. The purpose of this MOU is to strengthen their cooperation through joint planning, implementation and monitoring of public health services thereby making health service more effective, efficient, and equitable through decentralization.
Nepal Family Health Program (NFHP) II is a key partner under this program.
NFHP II at Global Maternal Health Conference 2010
Members of NFHP II team will be taking part in the Global Maternal Health Conference 2010, which is being held in New Delhi, India from August 30 to September 01. Around 500 maternal experts from worldwide are expected to attend this conference. It is our pleasure to announce that two abstracts for oral presentation have been accepted.
Newborn Vitamin A Dosing - Generating Evidence for Scale in NepalLarge trials in India and Bangladesh have established that dosing newborns with 50,000 IU of vitamin A within the first few days of life can reduce mortality. Based on this evidence, the Ministry of Health and Population (MoHP) has decided to proceed with piloting Vitamin A projects in 4 districts — Banke and Nawalparasi in the southern plain area and Sindhuli and Tanahu in the hill/ mountain area. The objective of the pilot is to identify the most effective delivery mechanism for maximum coverage. A technical working group, created under the leadership of the Nutrition Section in the Child Health Division, has approved two methods of distribution — one through early postnatal visits at home by FCHVs (to be piloted in Banke and Nawalparasi), and another by antenatal dispensing and self-dosing by mother/family members (to be piloted in Tanahun and Sindhuli). NFHP II will spearhead program implementation in Banke and Sindhuli, while providing technical support to Nawalparasi and Tanahun. Led by the Director General of Health, the Technical Advisory Group has approved training materials and monitoring and evaluation methods for scale up of these programs. Training is to be initiated the last week of April 2009. Results of the pilot, expected to be available towards the end of 2010, will provide information for national scale up of the intervention.
NFHP II Partnership Celebration
During the ceremony, the honorable Minister of Health, Mr. Giri Raj Mani Pokharel, emphasized the importance of the US Government's support and partnership in the development of health sector in Nepal. He also thanked the American government for its valuable long-term support and for the decision to continue to support the improvement of health system of Nepal through the second phase of the Nepal Family Health Program (NFHP II).
Her Excellency Ms. Nancy J. Powell, US Ambassador to Nepal, articulated her happiness as well, as she expressed her appreciation to the Nepal Family Health Program II. She also noted that NFHP II reflects the United State government's commitment to support government of Nepal's health goals and objectives.
Dr. Sudha Sharma, Secretary, Ministry of Health and Population, Dr. Mahesh Maskey, Chief of High Level Health Advisory Committee, and Dr. Govinda Pd. Ojha, Director General, Department of Health Services also expressed their satisfaction with NFHP's effort in strengthening public health system in Nepal and expect this fruitful relationship to continue with NFHP II, long into the future.
The ceremony culminated in the signing of a document reflecting the partnership between Ministry of Health and Population of Nepal and the United States government.
NFHP II was funded by the United States Agency for International Development (USAID) and implemented by JSI Research & Training Institute, Inc., with EngenderHealth, Jhpiego, Save the Children, World Education, Inc., Nepali Technical Assistance Group, Nepal Fertility Care Center, Management Support Services Private Ltd., and Nepal Red Cross Society. Copyright 2012 John Snow, Inc. All Rights Reserved.