2014 Half Year Performance review
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2014 Half Year Performance review
Mrs. Beatrice Kunfah (MDHS)
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OUTLINE OF PRESENTATION
Background
Priorities
Key challenges
Key achievements
Performance in Key Service Indicators
Innovations & Best Practices worth Sharing
Key Recommendations and Way forward for Second half of the year
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BACKGROUND INFORMATION/PROFILE
Pop: 115,597
6 Sub-Municipals
33 reporting Health Facilities
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PRIORITIES & CHALLENGES Scale Up Community –based Health
Planning and Services Improve quality of Reproductive and
Child Health Regenerative Health and Nutrition
including medical screening Disease Control and surveillance Regular community dialogue and
sensitization through night Videos and C4D activities
Improve data collection and reporting from private health facilities
Data Management Intersectoral Collaboration
Inadequate Critical Health Staff ( Medical assistants, pharmacist and record and Lab Assistants etc )
Inadequate official and residential accommodation
Medicines and records management(folders)
Delayed Reimbursement for NHIS claims
Staff Indiscipline Weak Continuum of care(Regional
hospital and Health facilities) High communicable disease burden of
Malaria, TB, HIV/AIDS High infant, maternal and neonatal
mortality Collaboration with Private Service
Providers
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KEY ACHIEVEMENTS (1) More than half of the Staff have been Appraised for the year 2013
Newly appointed staff were also oriented before posting to their various facilities
In- service trainings were organized for staff to improve their performances on the job.
No major accident under the period of review.
Active case search for CMAM Cases
Successful sensitization on guinea worm identification and cash reward, & preparation for visit of certification team
Conducted 2 rounds Facilitative supervision to all Sub municipals
Conducted first round of OTSS to all the facilities including private facilities.
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KEY ACHIEVEMENTS (2) Conducted Mass Drug Administration (MDA) against filariasis and Onchocerciasis
Organized refresher training for Community Based Surveillance volunteers
Trained 24 CHNs/CHOs on Implanon and Jadelle insertion
Organized fora for men on family planning and other RCH activities in all sub-municipals
Organized community durbars on maternal/child health activities and importance of family planning
Carried out maternal death audits in two communities on causes and prevention of maternal deaths
Trained fifty five staffs on costumer care
Organized midwives forum on MNH/family planning
Screening of Fire service women for breast cancer
Renovation of MHA Offices
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Commitments TO RMS & NHIS Outstanding claims
FACILITY
RMS COMMITMENTSOUTSTADING CLAIMS FROM
NHISNET BALANCE
NON DRUGS DRUGS
WA SUB. 1,765.61 35,331.02 145,710.42 108,613.79KAMBALI 1,076.95 15,764.16 87,708.33 70,867.22CHARIA 49.5 4,108.23 24,100.32 19,942.59CHARINGU 1,248.49 2,593.94 12,054.60 8,212.17KONTA NORTH 826.21 6,899.25 30,726.65 23,001.19MARKET CLINIC -16.77 31,826.01 78,512.82 46,703.58DOBILE CHPS 215.88 9,692.06 27,674.25 17,766.31BUSA 754.73 6,034.29 28,730.06 21,941.04BAMAHU 503.36 11,263.03 36,750.83 24,984.44WA SHS 360.99 7,828.07 33,212.39 25,023.33KPERISI 340.14 3,797.93 14,511.02 10,372.95ADOLESCENT 277.92 10,313.33 23,565.90 12,974.65TOTAL 7,403.02 145,451.32 543,257.59 390,403.26
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HUMAN RESOURCE - SUMMARYINDICATOR NUMBERTotal number of staff 260
Total number of staff on course 57
Total number of Staff at Post 203
Postings In 63
Promotions 11
Appointments 9
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HIGHLIGHTS OF PERFORMANCE
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Sensitization on guinea worm Identification & Cash reward
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VISIT OF GUINEA WORM INT. CERTIFICATION TEAM
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HIV & AIDS - PMTCTINDICATORS 2012 2013 2014
ANC registrants 1,854 1,998 2,249
Number Counseled 1,692 1,915 2,187
percentage counseled 91.3% 95.8 97.2
No. Tested 1,662 1,909 2,195
Percentage Tested 89.6% 95.5 97.5
Number positive 17 19 20
percentage positive 0.05% 1.0 0.9
Number tested for syphilis 1,909 1,446
Number positive for syphilis 3 9
Number treated for syphilis 3 9
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TUBERCULOSIS –NEW CASES @ Half Year INDICATOR 2012 2013 2014
New Smear Positive PTB 26 5 5
New Smear Negative PTB
10 0 0
Extra Pulmonary ETB
11 0 0
Smear Not Done 5 0 0
Total 52 0 5
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MATERNAL & NEW BORN CARE – ANC, DELIVERY & PNC
2012 2013 2014 2012 2013 2014
ANC 66.4 66.6 71.4
SKILLED DEL. 51.6730294183696 57.6685764654033 66.6089965397924
PNC 56.1 56.7 67.5
TARGET 45 45 45
5
15
25
35
45
55
65
75
% Cl
ients
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MATERNAL HEALTH – FIRST TRIMESTER REGISTRATION
Jan
'10
Fe
b'1
0
Ma
r'10
Ap
r'10
Ma
y'1
0
Jun
'10
Jul'1
0
Au
g'1
0
Se
pt'1
0
Oct
'10
No
v'1
0
De
c'1
0
Jan
'11
Fe
b'1
1
Ma
r'11
Ap
r'11
Ma
y'1
1
Jun
'11
Jul'1
1
Au
g'1
1
Se
pt'1
1
Oct
'11
No
v'1
1
De
c'1
1
Jan
'12
Fe
b'1
2
Ma
r'12
Ap
r'12
Ma
y'1
2
Jun
'12
Jul'1
2
Au
g'1
2
Se
pt'1
2
Oct
'12
No
v'1
2
De
c'1
2
Jan
'13
Fe
b'1
3
Ma
r'13
Ap
r'13
Ma
y'1
3
Jun
'13
Jul'1
3
Au
g'1
3
Se
pt'1
3
Oct
'13
No
v'1
3
De
c'1
3
0
10
20
30
40
50
60
70
80
MedianGoal
Months
Pe
rce
nta
ge
(%)
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MATERNAL HEALTH – AVERAGE VISIT PER CLIENT
Sub Municipal 2012 2013 2014
Bamahu 2.9 4 4
Busa 3.1 3.4 4
Charia 3.3 5 5.3
Charingu 3.3 4.3 4.3
Kambali 5.1 3.3 4
Upper West Regional Hospital 2.7 3.1 3.7
Wa Central 3.2 3.9 3.6
Wa Municipal 3.2 3.7 3.9
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MIDWIVES FORUM
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CUSTOMER CARE TRAINING
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TEENAGE PREGNANCIES – INCREASING TRENDS
Bamahu Busa Charia Charingu Kambali Reg. Hospital
Wa Cen-tral
Wa
2012 6.4 11 10.7 13.5 6.7 5.6 8.3 7.8
2013 7.4 19.1 17 20.2 10.1 7.4 9.4 10.3
2014 12.7 14 16.8 16.4 11.9 4.7 9.3 9.8
2.5
7.5
12.5
17.5
22.5
% of Adolescent 10-19yrs attending ANC
Pe
rce
nta
ge
(%
) 0
f A
do
lesce
nts
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MATERNAL & NEW BORN CARE – MATERNAL MORTALITY – Half year Trend (2008-2014)
2008 2009 2010 2011 2012 2013 2014
Maternal Deaths 4 7 3 4 3 6 3
MMR 278 429 190 218 132 224 98
Target 185 185 185 185 185 185 185
25
75
125
175
225
275
325
375
425
475
278
429
190218
132
224
98
MM
R/1
00,0
00 L
iveb
irth
s
MDG Target (185/100,00 live births
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CAUSES OF MATERNAL DEATHS
CAUSES OF MATERNAL DEATHS -2012-2014 1/2 YEAR
CAUSE OF DEATH 2012 2013 2014
HAEMORRHAGE 0 1 0
ECLAMPSIA 1 0 0CEREBRAL MALARIA 1 0 0HEPATITIS 1 0 0
DRUG REACTION ( community death) 1 0 0
MYOCARDIAL INFARCTION 0 1 0MENIGITIS 0 1 0SICKLE CELL DISEASE 0 1 0UNSAFE ABORTION 0 1 2SEPSIS 0 1 1TOTAL 3 6 3
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SCREENING FOR BREAST CANCER
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MATERNAL & NEW BORN CARE – STILL BIRTH RATE
2008 2009 2010 2011 2012 2013 2014
Still Births 83 97 76 87 95 103 104
still Birth Rate 58 59 48 47 42 38 34
10
50
90 8397
7687 95 103 104
58 5948 47 42 38 34
No.
of
Sti
ll B
irth
s &
Sti
ll
Bir
th R
ate
/1,0
00live-
bir
ths
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Neonatal Deaths, 2008-2014: Half Year
2008 2009 2010 2011 2012 2013 20140
5
10
15
20
25
30
35
40
45
50
156
114 4
9 8
7
7
20 28 3134 30
Post neonatal deaths Neonatal deaths (<1 m)
NO
. o
f N
eon
ata
l D
eath
s
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CHILD HEALTH – EXPANDED PROGRAM ON IMMUNIZATION
BCG PENTA3 MEASLES RUBELLA YF BCG PENTA3 MEASLES RUBELLA YF
2012 61 49 49 46
2013 102 48 40 40
2014 70 54 52 52
Target 45 45 45 45
10
30
50
70
90
110
% of C
hn. V
accina
ted
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EPI COVERAGE & DROP OUT RATES - 2014SUB MUNICIPAL
BCG MEASLES PENTA 3 BCG/MEASLES DROP OUT
PENTA 1 & 3 DROP
OUT
BAMAHU 10% 49% 38% -378.0 -0.7
BUSA 27% 59% 63% -116.5 -18.5
CHARIA 11% 61% 61% -462.5 -17.6
CHARINGU 19% 29% 39% -53.1 1.7
KAMBALI 1% 67% 70% -6733.3 -24.6
WA CENTRAL 14% 44% 41% -208.0 -62.1
REG. HOSPITAL 108% 7% 11% 93.9 65.9
MUNICIPAL 70% 52% 54% 26.1 0.2
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FAMILY PLANNING ACCEPTORS
Bamahu Busa Charia Charingu Kambali Wa Cen-tral
Reg. Hos-pital
Municipal Bamahu Busa Charia Charingu Kambali Wa Cen-tral
Reg. Hos-pital
Municipal
2012
32 30.6 34.6 15.1 36.5 9.8 4.7 32.4
2013
41.4 29.7 42.8 8.4 25.9 31.2 3.3 31.8
2014
34.7 28.6 52.4 17.9 50.6 40.9 5.4 42.3
Target
40 40 40 40 40 40 40 40
5
15
25
35
45
55
% F
P A
ccepto
rs
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NUTRITION – HOUSEHOLD SALT SURVEY
Neutral <15ppm >15ppm
May, 2011 27.3 34 38.3
May, 2012 30 37 33
June, 2013 26 25 49
June, 2014 10.3 31.8 57.9
5
15
25
35
45
55
65
PERC
ENTA
GES
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Proportion of suspected Malaria OPD Cases tested
TOTAL TESTED (MICROSCOPY OR RDT)% TOTAL POSITIVE (CONFIRMED MALARIA CASES ONLY) %
2013 0.396000000000001 0.498
2014 0.843000000000001 0.634000000000001
5.00%
15.00%
25.00%
35.00%
45.00%
55.00%
65.00%
75.00%
85.00%
20132014
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INTERMITENT PREVENTIVE TREATMENT
Sub Municipal2012 2013 2014
IPT1 IPT3 IPT1 IPT3 IPT1 IPT3
Bamahu 203 117 194 164 62 2
Busa 58 61 76 40 30 2
Charia 119 91 141 127 83 0
Charingu 149 71 92 35 18 5
Kambali 229 89 224 88 45 27
Reg. Hospital 566 298 620 359 294 151
Wa Central 836 349 1047 694 284 116
Wa Municipal 2160 1076 2394 1507 816 303
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Home based care by CBAs – Jan-Jun, 2014
Sub Municipal
Children Checked
Children with
danger sign
Conditions Treatments with Recommended
Medicines
Referrals
Fast breathing Diarrhoea Fever AA Amoxicillin ORS Zinc
Bamahu 79 9 0 27 43 43 0 27 0 0
Busa 57 0 14 18 25 25 14 18 2 8
Charia 0 0 0 0 0 0 0 0 0 0
Charingu 53 0 22 12 19 19 22 10 2 25
Kambali 0 0 0 0 0 0 0 0 0 0
Wa Central
475 6 81 173 215 145 81 173 0 120
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Community Based Services – CHPS Implementation
2005 2006 2007 2008 2009 2010 2011 2012 2013 20140
5
10
15
20
25
30
24 24
2 2 3
710 10
12 12 13 13
2 24
811
1315
2022 22
Demarcated Zones Zones with compounds Functional Zones
No.
of
Zon
es Target
CHPS ZONEHOUSEHOLD VISITS
DURBARS SOCIAL GROUP MEETINGS
CHC MEETINGS
TOTAL 15667 44 45 71
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DISTRIBUTION OF CHPS ZONES
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Intersectoral CollaborationPartner/Collaborator
Contribution
Municipal Assembly
• Health Infrastructure• Child Health
AGAMAL Ltd. • Indoor Residual Spraying for malaria control
PLAN GHANA • Disease control and child Health
World FOOD PROGRAMME
• Child Health
GES • School Health Services• Deworming and Immunization of school children
NCCE • Social MobilizationNational Ambulance • Referrals
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Media collaboration
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radio discussion on male involvement at w fm.
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HMIS, RESEARCH & ICT
Networking of the Municipal Health DirectorateCreation of a Data bank and installing a server Using file sharing system (e.g, dropbox) to make key information available to desktop computers in the network
Preparation for an Integrated EPI Cluster survey are complete and will be conducted in the third quarter to assess immunization coverage for all sub municipal.
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Innovations & Best Practices worth Sharing Development and hosting a website for the Wa Municipal Health Service (www.wamunicipalhealthservice.com )
Internal study tour among CHPS Zones in the municipal Formation of CHOs Association Using occasions in communities such as naming ceremonies to pass Health messages to community members
Compilation of social groups and their meeting dates within CHPS catchment areas in the Municipality
Printing of Identity Cards for Community Volunteers
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RENOVATION - MDHS OFFICE
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Conference Room
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Way forward for Second part of the year Intensify community education and dialogue on reproductive health
services. Quarterly orientation on data management Organize a staff durbar in the 3rd qtr Functionalize demarcated CHPS Zones• Conduct EPI Cluster Survey• Conduct quarterly data validation at health facilities • Posting/redistribution of midwives, CHNs and CHOs Organize health screening for health staff in the third Qtr. Begin to audit all neonatal deaths from the municipality Conduct Stakeholders forum in all sub municipals Meeting with all private health providers Staff Awards
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ACKNOWLEDGEMENT RHD
MUNICIPAL ASSEMBLY
DECENTRALISED DEPARTMENTS
PATH MALARIA CARE
COMMUNITY BASED VOLUNTEERS
COMMUNITY MEMBERS & TRADITIONAL LEADERS
NCCE
WFP
UNICEF
WHO
JICA
Local NGOs
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THANK YOUvisit www.wamunicipalhealthservice.com for more
details
“Some is not a number, soon is not a time, hope is not a plan”
- Anonymous