“THE CHALLENGES IN UNDER · MCPS, FCPS, MRCOG Society of ob/gyn Pakistan. 2 Scheme of...
Transcript of “THE CHALLENGES IN UNDER · MCPS, FCPS, MRCOG Society of ob/gyn Pakistan. 2 Scheme of...
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“THE CHALLENGES IN UNDER
DEVELOPED THIRDWORLD
COUNTRY”
“HCPA IN QUALITY IMPPROVEMENT !”
Dr. Nighat ShahMCPS, FCPS, MRCOG
Society of ob/gyn Pakistan
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Scheme of Presentation:
• Introduction : Pakistan
Health Care Association
• Different Vertical Programmes / Projects
• Bridging the gap HCPA, NGOs, Govt.
• FIGO Project / Fistula Project
• Barriers, Gaps, Shortages
• Overcoming barriers / hurdles
• What have the projects achieved
• How can the progress be measured
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HEAVY POPULATION BURDEN
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Pakistan home to 160 million mostly poor people (60%
below poverty level).
Socio – cultural, economic, norms are anti women.
Women are mostly poor, pregnant and powerless.
Less than 50% women & men are educated.
Health infrastructure is inadequate and more concentrated
in urban areas.
Health care professional association include
- PMA, Pakistan Medical Association
- SOGP, Society of Ob/Gyn Pakistan
• PNFWH
- NCMNH, National committee on Maternal, Neonatal
Health Cont…
Introduction:
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- Mainly CME (for medical professionals, for paramedical,
students & general public)
- Conferences (Academic and scientific session and
workshops)
- Community work:
Training ambulance drivers, Sensitizing
Politicians, Sensitizing Religious Scholars.
Fistula camps, Gynae operations, Medical
camps, public awareness.
- Ethical practice / standardization of medical education and
practice
Different Vertical Programmes / Projects
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COLLABORATION WITH PAKISTAN
NATIONAL FORUM ON WOMEN’S HEALTH
•Midwifery Pictorial
•Simple Midwifery
•Where Women have no Doctor
•Textbook of Midwifery
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COLLABORATION WITH PAKISTAN
NATIONAL FORUM ON WOMEN’S HEALTH
•Emergency Labour Management
•Infection Prevention
•Managing Complications in Pregnancy
•Manual of Teaching Nursing and Midwifery
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SOGP/ FIGO did capacity building in RHC, the hospital was
non functional which was built, renovated, equipped and
professional doctors / nurses were hired.
Community started availing services, trust was built and the
number of out patient and inpatient services.
Problems:
- Cost, Sustainability
- Corruption
- Govt. not involved
- Hiring Professional
SOGP PROJECT / FISTULA PROJECT:
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November 1, 2006 to Oct 31st, 2010
(4 Years)
FIGO – SOGP Project
Saving Mothers & Newborns
COMMUNITY BASED
INTERVENTIONS TO REDUCE
MATERNAL AND PERINATAL
MORTALITY AND MORBIDITY IN
RURAL SINDH, PAKISTAN
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Project initiation
Health facility needs assessments
Non functional Female ward. RHC Gharo TBA in BHU Ghari Wah.
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OT / Labour Room, SZMC, Mirpursakro
Project initiationHealth facility needs assessments
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Facility Readiness
SZMC Renovated Labour Room
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Facility Readiness
SZMC OT- ready
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Facility Readiness
SZMC OT is functional
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In collaboration with UNFPA, PNFWH, Fistula Project was
taken up, whereby,
FISTULA PROJECT:
Training was given to health professional in all four province
for fistula repair.
A hospital specially for this problem now stands in Karachi
where by surgeries are done without cost.
Community camps are regularly organized for repair of
fistula in far fetched rural areas.
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QUALITY IMPROVEMENT
• Any process or tool aimed at reducing the quality gap in the systemic and organisational functions according to the dimensions of quality
• The basic principles are common sense, customer focus, strong leadership, involvement of people, process approach, systemic approach to management, continual improvement, factual approach to decision making and mutually beneficial supplier relationship
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An army of dedicated / committed people is required.
Government has to be seriously engaged.
HCPA have to dedicate more time, energy & resources
Most of the Projects are in the initial period and may faze
out because of funding.
There is a wide gap of leadership, time, commitment.
QUALITY IMPROVEMENT:
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Bridging the gap, bringing politicians, NGOs, and HCPA on
one table to rationalize scarce resources.
Training, sensitizing, midwifes, nurses and doctors
Seriously engaging government, community leaders,
media, taking all stake holders along
Building up sensitivity in the youth so that next generation
wakes up to reality.
HOW CAN THE BARRIERS BE ERADICATED:
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Overall it has in creased sensitivity, awareness.
Decrease in Maternal Morbidity / Mortality.
WHAT HAS THE PROJECT ACHIEVED SO FAR:
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Quality improvement stands on good information as well
as expertise in problem detection and solution, therefore
has to be proper data & documentation.
Protocols and regular trainings on infection control, mva,
Labour ward management
Accountability and audits specially confidential inquiries in
maternal mortality
MEASURING, REPORTING OF HCPA
CONTRIBUTIONS:
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IN CONCLUSION:
HCPAs have to support networks and collaborate to foster
sharing of data, resources, and disseminate findings
Develop, validate new methods for the measurement of
quality in maternal health care, to include optimal health
outcomes
Create mechanisms and tools for providers that promote
adherence to and use of standards.HCPAs have to
continue for constant quality improvement so that goals
and outcomes are met
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