Experience sharing by midwives
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Implementation of package tour Experience sharing by Midwife
Daw Khin Myo WinMidwife
Bawgahta SubcenterBoe Ma RHC
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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 .
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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.
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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
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Package of Services
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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
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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
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• 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
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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
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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
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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
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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.
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Thank You