This is the official publication of HealthNet TPO in Afghanistan. It is published every three months with updates from HealthNet TPO pro-jects in Afghanistan. This edition covers the 3rd Quarter of 2014 i.e. July, August and Sep-tember. This Newsletter serves to provide in-formation regarding goals, objectives, accom-plishments, , bench marks , technical issues and upcoming activities in HealthNet TPO to the targeted audience (Ministries, Partner Or-ganizations and Community) and is shared with our headquarters in Amsterdam. In addition, it is meant to keep the readers informed about the implementation of projects, its progress, pro-ject staff, donors and other stakeholders. The content of the newsletter is collected through routine HMIS data, project personnel (updated field data from various projects) and internal reports of the organization. The newsletter will be distributed through e-mails, HealthNet TPO website www.hntpo.org.af and hard copies. We will highly appreciate your comments and inputs in further improving our Newsletter.

Health Net TPO is Netherlands based non-government organiza-tion that works on the structural rehabilitation of health care sys-tems in war and disaster stricken areas. Health Net international was originally founded by Doc-tors without borders in 1992 to bridge the gap between emer-gency aid and structural develop-ment. In 2005 Health Net merged with the Trans cultural Psychoso-cial Organization (TPO) and is known as Health Net TPO. Health Net TPO is a leading or-ganization in the fields of disease control including Malaria, Leishmaniasis, AIDS, TB , men-tal health and psychosocial care, , health financing, mother and child care and health systems

development in post conflict settings. HealthNet TPO in Afghanistan In 1994, HealthNet-TPO started its operations. Since that time, HealthNet-TPO has successfully implemented numerous programs in the health care sector in Af-ghanistan. The organization works towards building sustain-able and accessible healthcare systems in remote and unstable areas of Afghanistan . The health services are provided through implementation of fol-lowing main programs and their projects; Health care support project (HCSP) Malaria Control Program Community Resource Mapping

and Mobilization Programs and Projects under Health Directorate Health programs and projects operational under Health Direc-torate are meant to improve health and Nutritional status of the target population through provision of accessible, afford-able, equitable and sustainable primary and secondary health care services to the people of our intervention areas with maximum coverage.

About this Newsletter

I N S I D E T H I S

I S S U E :

Introduction 1

EPHS 2

BPHS & Nutri-

tion 3

CME & EPI 4

MCP & C-RMM 5

HR & Contact

Address 6

Introduction

HealthNet TPO Newsletter A U T U M N 2 0 1 4 I S S U E 1 3

A D D R E S S E

Country Office: House#144, 5th street, Sillo Road, Opp Amar Khel clinic, Kabul Af-ghanistan. Ph: 020 25 10840 Head Quarter: LizzyAnsinghstraat 163, 1072 RG Amsterdam, The Netherland Ph: +31-20-620005 www.hntpo.org Rabo-bankNL47BO0123585163 Donation NL64RABO0104080000 Chamber of Commerce No. 412 11 943

Fig 1– HealthNet TPO Projects 2014 in Afghanistan

P A G E 2

Fig 2: EPHS Indicators and

Achievement –3rd Q 2014, Paktia

EPHS Paktia

EPHS Khost

EPHS (SEHAT) Nangarhar

Table 1 :Accomplishment in Emergency unite of Hospital

HMIS, MNH, Nutrition, IMCI, Reproductive Health, Pharmacy, EPI, CDC/DEWS, LDP, Malaria and Leshmania control, Monthly and Quarterly TB meetings, joint monitoring from HFs and other national and international day’s celebration. During this quarter HNTPO and AADA actively participated in all EPR committee meetings and responded/controlled all types of the emergencies. Two hospital community board and three PDC meetings were attended by the representatives of HNTPO during this quarter

Khost is having only one provin-cial hospital, and all its depart-ments were functional round the clock, and provided comprehen-sive emergency out and indoor services in the field of medicine, peads, surgery, Gynea/Obs, EPI, orthopedic and dentistry. Coordination: HealthNet TPO had close coor-dination and actively participated in all meetings at provincial and central level Kabul. HealthNet/AADA Khost team had active participation in international breast feeding week, NIDs/SNIDs inauguration, PPHCCs,

mobilization by HF staff and satis-faction from providing of health services, finally one of the resi-dence area donated land about (20 mx8m)square for providing of health services, fortunately through community contribution Shura_e_ Sahi of health facility will be constructed four rooms for delivery of health services and on Friday date 19/06/1393 work is starting . Thanks: Health Facility staff for future success

Success story : Sahak Comprehensive Health Cen-ter (CHC) which is located in Zur-mat District Paktia province, this health facility infrastructure was made for Basic Health Center (BHC) level health facility the existence rooms were not enough for health service delivery, no on duty room for male and female health workers, no stock for medi-cine no specific room for EPI ser-vices and any others, due to regular conduct of coordination meeting with Shur-e-Sahi and community

Fig 3: EPHS Indicators and Achievement –

3rd Q 2014 , Khost

H E A L T H N E T T P O N E W S L E T T E R

Staff Recruitment: Based on the proposal it was planned to recruit 59 technical and 36 support staff. There was a long debate on recruiting the technical staff. During the quarter 39 vacancies are filed and 67 tech-nical and support staff have been hired. Bed re-distribution: As a part of the pro-posal the number of beds in NRH is planned to be extended to 498 IPD and 35 emergency beds. During the quarter total number of IPD beds are increased to 482 plus 35 emergency beds. Rehabilitation: A room and canal in Obs/Gyn ward, doctor campus, new walk way and 5 bath rooms in surgery ward, new office for hospital administration, parts of kitchen, barrier for main gate of the hospi-tal are rehabilitated

Nutrition

P A G E 3 I S S U E 1 3

Khost Province is located in the South east of the country, and is having volatile security situation. Its total Population according to CSO-1392 is 556,000 and having 13 districts. Total 31 HFs of PCH including (1 PH, 12 CHCs, 8 BHCs, 9SHCs and One Prison Health).

Trainings: According to the CSKT plan HNTPO-Khost office has conducted fol-lowing trainings for the BPHS staff. To-tal plan trainings according to CSKT planning were planed 4 and we achieved 2

2 surgeon from male in 16 days. IPSO training for 2 Nurses from Male for 6 days

M&E report Writing training for 1 MD from male for 5 days.

BNBC training for 1 MW from female for 9 days.

Male involve in FP training for 6 MD, 1 CDO, 1 M&E officer form male in 3 days.

PPIUD training for 3MW from female in 3 days.

IMNCI training for 9 MD, 1 Nurse from Male in 8 days.

Trainings During last Quarter some trainings were conducted by HNTPO: HMIS Training for 3 MD, 12 Nurses from male and 12 Mid-wives from female in 3 days. IP Training for 5 MD, 24 Nurses, from Male and 1 MW from Fe-male in 5 days. MH & Disability Training for 3 MD, 4 Nurses from male and 11 MW, 1 CBHC officer and 1 CSO officer from female in 6 days. Trauma Training for 2 MD and

BPHS Paktia

BPHS Khost

Fig 5: Key indicators and achievements of

BPHS –3rd Q, 2014, Khost

Fig 4: Key indicators and achievements

of BPHS –3rd Q 2014, Paktya

Pic 1: Group working in Training ‐

Khost

TSFP In the last 3 months in SFP pro-gram we have had distribution in 21 TSFP sites. Our planned patients were58671 out of these 28864were children 6-59months the actual patients who got RUSF were 10434and our planned PLW were 29807the ac-tual PLWs who got food com-modities were 12411 . During this quarter we distributed 437.671MT food commodities.

Trainings in CHF We have conducted Two days C-MAM training for 82 male and 60 female CHWs during this quarter. We have conducted Five days IMAM (CMAM) training for (56) clinic in charges and nurses out of these 11 were female nurses and 45 were male. We have conducted Two days C-MAM training for 21 CHS .

OTP (CHF) We have established 22 new OTP centers, totally now we have 29 OTP centers, 2 stabilization cen-ters and one TFU in Khost provin-cial hospital. During this quarter we have hired 34 nutrition nurses

P A G E 4

Training of 141 Vaccinator

CME

of 141 trainees has received ini-tial EPI training.

Total of 18 female vaccina-tors has been trained out of 141 vaccinators.

All the trained vaccinators has been deployed back with 99 percent deployment rate. The project has been ended by 30th September 2014.

The project has started from 1st Dec 2013 and will last for 10 months. Total of 141 students from 16 prov-inces of East, South-east and South zones will receive 3 months initial EPI training. The project is contracted by HSS department of MoPH Through financial support of GAVI/WHO

The second batch of EPI ini-tial training has been also com-pleted in all three regions and toal

Pic 3: View of newly enrolled trainees

to EPI initial training in Nangarhar

H E A L T H N E T T P O N E W S L E T T E R

Table 2: Total of 26 Management staff have received different kind of trainings

Community Midwifery Edu-cation Program Funded by Cordaid (AF211CO): Currently studnets are busy with the third phase of thier training which mostly the focus is in clin-cial pracitse in relevant health facilites.

All students have succesfully pas-sed all module exam with an ave-rage of 89% score and the term exam with an average of 84% of the score.

The third phase of the CME trai-ning will be ended by 15th Februa-

ry 2015 and the deployment phase will start from start of March 2015.

Providing Emergency Health Care in prioritizing access to critical services through Nangarhar Re-gional Hospital and provincial hospitals of Khost and Paktya: The rehabiliation activititeis of emergency ward in Nangarhar regional hospital and Gardiz PH is 90% completed. Total of 23 items of medical equipments icluding suction machines, patient beds, patient trolyes, dressing trolyes,

suction machine, oxygen con-centrattor machine, OT re-quired equipments and instru-ments are supplied to all three hospitals. Aside to that, non meidcal equipments and furnu-ture has been also procured and supplied to the hospitals based on privious need assesments results. Total of 14352 trauma patients has received trauma surgical serives during the quarter in three hopsitals of Nangahar khosta and Paktya.

MHT

Fig6: Key indicators and achievements of MHT–3rd Q 2014 Table 3: Training during 3rd Quarter 2014

Pic2 :View of under rehabilitation emergency departement in Nan‐

garhar regional hospital

Malaria Control Program (MCP) P A G E 5 I S S U E 1 3

HealthNet TPO is a Principle Recipient (PR) for Global Fund Round 8-Malaria Grant in Afghanistan. Since May 2010, HealthNet TPO has been implementing Malaria Control Program (MCP) in Afghanistan. Under this grant, Malaria Control Program of HealthNet TPO has been carrying out some core activities in highly endemic area of the country. These core activities are: House to House Free Distribution of LLINs: 3nd quarter of 2014 was a very busy quarter for MCP concerning house to house free distribution of LLINs. HealthNet TPO and its SRs distributed 1,748,853 LLINs, which effectively covered 4,654,579 population, in Nan-garhar, Kabul, Khost, Paktia, Parwan, Kapisa, Panjsher, Baghlan, Samangan, Jawzjan, Balkh, Herat, Urozgan, Faryab, Sur-i-pul, Takhar, Badakhshan, Logar, Badghis, Ghazni, Helmand, Ghor, Za-bul, Nooristan, Paktika, Wardak and Daikundi provinces. Community Based Management of Malaria (CBMM):

Implementation of Community Based Management of Malaria is amongst the core activities of the Global Fund ma-laria grant in all stratum 1 and stratum 2 districts of the country, in this regard from July-September 2014 Malaria Control Program with the collaboration of BPHS implementers has successfully implemented the Community Based Management of Malaria (CBMM) in Ghazni province via signing the MoUs with SDO organization. It is worth mentioning that currently CBMM is being implemented in 27 province out of 30 targeted provinces for this activity. Furthermore, following the completion of MoUs, MCP has been distributed RDTs, ACT and its relevant accessories to the mentioned BPHS implementers in the mentioned province. Research: 1. Evaluating insecticide resistance status in wild-caught anopheles mos-quitoes in Afghanistan: the implemen-tation has been stared. Nangarhar, Kunar, Badakhshan and Ghazni prov-inces have been covered. Study is on progress in Laghman province and it will be completed soon. Struggle of

finding a lab for Kdr polite study is continue and it will be founded soon. 2. Durability and Efficacy of LLINs distributed three years back: This study is in its third stage of implementa-tion. Cone bioassay part of the study is in progress and up to date four prov-inces (Nangarhar, Khost, Kunduz and Hirat) have been complete at the rate of 40LNs * 4Pieces * 2 Cones * 5 Repli-cate per province. Arrangements for wire ball bioassay are ready and con-secutively after finishing the cone bioas-say it will be started. The whole wire ball procedure will take about two months for completion. HPLC study is in progress and the LLINs pieces have been sent to the India Lab for HPLC analysis. 3. Efficacy and safety of Artemether-Lumefantrine (Coartem) for treat-ment of uncomplicated Pf and Pv malaria: This study was started in 28th of September 2014. Up to date 50 pa-tients have been enrolled, out of which 15 are falciparum and 35 are vivax patients. Slides and filter papers are taken according the protocol and stored in descent pouches.

Community– Resource Mapping and Mobilization (C-RMM)

Table 4: Malaria morbidity in the 3rd quarter of the year 2014.

Pic 5: EPI services through GAVI PPP Project in Uruzgan province

Fig 7: Quarter target compare to achievement during the 3rd Quarter 2014 in Paktia Province

Pic4:LLINs distribution to Chemtal District of Balkh Province

GAVI-Public Private Partnership (PPP) Project in Paktya and Uruzgan Provinces Public Private Partnership is an innovative approach by HealthNet TPO for the access of the commu-nity to health services in areas highly volatile and insecure. The model was introduced by HNTPO for the first time, which has proved to be successful in accessing the population for health services. HealthNet TPO started this program since 2008 in Uruzgan province which is now replicated by MoPH and implemented in many prov-inces of Afghanistan. HealthNet TPO started the program in partnership with private sector. The private health facility staff are trained and supported to provide quality Health services especial Reporductive health services and Immunization services to the popu-lation in remote and insecure areas of Uruzgan and Paktya provinces. 30 clinics in Uruzgan and 40 clinics

in Paktia now provide immuniza-tion, Reproductive Health, before and after delivery care free of cost to the populations. During this quarter the following activities achieved for both Paktya and Uruzgan Provinces; In order to improve quality of pro-ject activities, regular supportive supervision was done by project staff. During this quarter, monthly base supportive supervision of the Private Health Facilities was done by Provincial Project staff; Supportive supervision visit done by Kabul relevant focal point to Uruzgan and Paktya provinces As per regular training plan, Paktya GAVI PPP staff conducted Drug Management Training for duration of 3 days. The training was for Private Health Practitioners and collectively there were 35 partici-pants. The evaluation result in this

training has shown 67% improve-ment. Uruzgan GAVI PPP staff conducted Nutrition Training for duration of 4 days. The training was for contract-edPrivate Health Practitioners and collectively there were 22 partici-pants. The evaluation result in this training has shown 32.5% improve-ment. During the project period the fol-lowing Immunization, RH and Ba-sic Health services provided by 30 Private Health Services Providers in Uruzgan Province and 40 Private Health Services providers in Paktya Province Private Medical Association gather-ing conducted in Paktya Provinces, objective of this PMA is to strength link between Private Health Sector and Public Health sector for im-proving the quality of health ser-vices in Paktya province

Contact Address Contact address

Country office:

House # 144,street # 5, District #

3, Sello Road, Dehnaw Dehburi,

Kabul Afghanistan

Tel: (020) 2510840

P.O Box : 768, Kabul Afghanistan

@: Kbul.office@healthnettpoaf.org

Web: www.healthnettpo.org

@: h.shams@healthnettpoaf.org

HeatlhNet TPO Financial Supporters Editorial Board

Chief editor:

Dr Abdul Majeed Siddiqi

Head of Mission Health Net TPO

Afghanistan

Editor:

Mr. Hasibullah Shams

Best Staff

Table 5: Summery of HealthNet TPO staff in the country ‐ Q3 2014

Human Resource HealthNet TPO has employed 1574 qualified staff during this quarter Challenges Lack of qualified female staff is major challenge especially in Khost province.

Dr. M. Farooq, who is the pro-gram Manager for MCP has joined HNTPO at the time when there was almost a back lock of the year 2012 and 2013 with the targets for 2014 which needed to be completed in one year. There were many challenges, like security, political unrest, hard to reach areas and so on. He was able to manage the two year back lock and the 2014 implementation in one year by almost 95% and by the end of 2014 the MCP will achieve all the targets of 3 years.

HNTPO management and leader-ship , appreciates his efforts, com-mitment , hardworking, tireless ef-forts , responsiveness and leading the team and recognize him for all of his services as the best employ of the 3rd Quarter of 2014. HNTPO is proud of having such talented and skilled employee who can be example for others.

Pic 6: Dr. M. Farooq during supervision of re‐search site in kunar province.