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SPECIAL INITIATIVE REGARDING HEALTH SERVICES DELIVERY

SPECIAL INITIATIVE REGARDING HEALTH SERVICES DELIVERY. PRESENTED BY: DR. JANBAZ AFRIDI DD-EPI KHYBER PAKHTUKHWA. Special Initiative for improving immunization.

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SPECIAL INITIATIVE REGARDING HEALTH SERVICES DELIVERY

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  1. SPECIAL INITIATIVE REGARDING HEALTH SERVICES DELIVERY PRESENTED BY: DR. JANBAZ AFRIDI DD-EPI KHYBER PAKHTUKHWA EXPANDED PROGRAMME ON IMMUNIZATION

  2. Special Initiative for improving immunization • Government of Khyber Pakhtunkhwa has initiated Special Initiatives in the budget 2013-14 for improving the Mother and Child Health condition of poor and downtrodden of the province to achieve the MDGs 4 & 5. • Rs.200 & 300 Million have been allocated for Special Initiative for enhancing immunization coverage, ante natal care and encourage the skilled deliveries in the far flung and low performing districts. EXPANDED PROGRAMME ON IMMUNIZATION

  3. Special Initiative for improving immunization • To encourage the parents to get vaccinated their children against various childhood vaccine preventable diseases, Government of Khyber Pakhtunkhwa has allocated Rs.200.00 Million in 2013-14 budget. • Rs.1000/child will be paid to parents on completion of the vaccination course of 15 months/ FIC( Fully Immunization Child). • Parents may be encouraged to retain the child Immunization Card • 190,000 children will be beneficiaries of this initiative EXPANDED PROGRAMME ON IMMUNIZATION

  4. Objectives of The Initiative • To Improve the Immunization Coverage and reduce drop out of under 15 months • To reduce the diseases burden, disabilities and deaths in the target districts against EPI targeted diseases • To Control out breaks • To Reduce the neo Natal tetanus by immunizing the pregnant ladies EXPANDED PROGRAMME ON IMMUNIZATION

  5. OBJECTIVES : Conti….. • To Encourage ante natal care and to reduce the pregnancy complications which will reduce unwanted deaths in young mothers during her reproductive life/age • To Encourage the skilled deliveries in the public hospital • To Improve the birth registration EXPANDED PROGRAMME ON IMMUNIZATION

  6. Implementing Districts FOR IMMUNIZATION Battagram 2. Buner Chitral 4. Dir Lower 5. Dir Upper 6. Hangu 7. Kohistan 8. Lakki Marwat 9. Nowshera 10. Shangla 11. Tank 12. Torghar EXPANDED PROGRAMME ON IMMUNIZATION

  7. CRITERIA FOR SELECTION OF DISTRICTS • Socio Economically backward • Low routine EPI coverage • High disease burden • In- accessible and hard to reach . EXPANDED PROGRAMME ON IMMUNIZATION

  8. Selection Criteria FOR DISTRICTS Twelve Districts of Khyber Pakhtunkhwa are selected on the following grounds: • Districts having enough resources in terms of cold chain and human resource to utilize the incentives provided in the budget by the Provincial government. • Total average Measles II coverage is 46.4 and with this incentives it is expected to increase to target of 73 % EXPANDED PROGRAMME ON IMMUNIZATION

  9. Implementing Districts FOR IMMUNIZATION EXPANDED PROGRAMME ON IMMUNIZATION

  10. Penta -3 & Measles 2, District wise coverage, 2013 EXPANDED PROGRAMME ON IMMUNIZATION

  11. District wise drop Out, 2013 EXPANDED PROGRAMME ON IMMUNIZATION

  12. Distribution formula • Total Allocated budget of the special initiative on EPI is 200 million and further distribution or allocation • Payment to parents 190.0 Million • SM activities 6.0 Million • Monitoring 3.0 Million • Bank Charges 1.0 Million EXPANDED PROGRAMME ON IMMUNIZATION

  13. Mechanism to ensure transparency To Ensure the transparency and simplify the procedure for the money among the selected beneficiaries the following criteria is suggested . Card/ Vouchers may be printed to facilitate the process after the completion of the successful course parents may be issued the vouchers by the respective vaccination center, and parents may receive the amounts on the same day in future after transfer of the money to the districts The bank will release the payment on provision of Immunization card/voucher/Parents ID card. Eligibility of the children completion of immunization of the children after 31st December 2013 EXPANDED PROGRAMME ON IMMUNIZATION

  14. Means of Disbursement • Province released the check Rs.50191400 to the districts and districts will release to the banks • The following means for disbursement can be utilized to the beneficiaries: • Bank s • Pakistan Post office • Easy Paisa • UBL Omni • Cash Payments Through Notified committee • Quarter release of the amount to the districts in advance EXPANDED PROGRAMME ON IMMUNIZATION

  15. Responsibilities Provincial Budgeting Coordination and facilitation Policy guidelines Supervision, Monitoring and Evaluation Provincial level Advocacy and Social Mobilization EXPANDED PROGRAMME ON IMMUNIZATION

  16. Action taken by provincial epi Three meetings conducted with DHOs of the concerned districts Presentation to DGHS Approval accorded by the honorable Secretary Health Implementations will be started in the first week of February Checks has been handover to the districts for the first quarter in this Final Planning meeting(29/02/2014) Social Mobilization printed and dispatched to the districts Provincial Inauguration request has been sent to the HCM EXPANDED PROGRAMME ON IMMUNIZATION

  17. Responsibilities Districts Preparation of FIC( Fully Immunized Children) list , facility based and district based List of banks and its catchment Areas Amounts disbursement in case of any other facility is not available Preparation of districts Monitoring Plan Preparation of Districts SM Plan Notification of disbursement committees Nomination of Focal person EXPANDED PROGRAMME ON IMMUNIZATION

  18. Budget ALLOCATION FOR SM/MONITORING EXPANDED PROGRAMME ON IMMUNIZATION

  19. SOCIAL MOBILIZATION Provincial inauguration Press briefing at Provincial level. Awareness/Orientation sessions with DHOs and EPI Coordinators and other stake Holders Preparation of Banners , flyers and other IEC material Involvement of other stake holders like PPHI & Education department etc UNICEF has agreed to provide support in IEC Material later on UNICEF has agreed to support the inaugurations at provincial level EXPANDED PROGRAMME ON IMMUNIZATION

  20. SOCIAL MOBILIZATION District inauguration followed by UCs inaugurations. Press briefing at District level. Awareness sessions in Schools and Madrassas , To sensitize all health care providers (Medics & Paramedics of health facility) All EPI technicians LHWs & LHSs should be trained and sensitized to create awareness in the community through mothers counseling & compound dialogue Involvement of PPHI at districts( Chitral, Dir Upper, Shangla, Nowshehra & Lakki Marwat) level EXPANDED PROGRAMME ON IMMUNIZATION

  21. Budget for SOCIAL MOBILIZATION first Q EXPANDED PROGRAMME ON IMMUNIZATION

  22. EXPANDED PROGRAMME ON IMMUNIZATION

  23. Banner EXPANDED PROGRAMME ON IMMUNIZATION

  24. Flayer EXPANDED PROGRAMME ON IMMUNIZATION

  25. Poster EXPANDED PROGRAMME ON IMMUNIZATION

  26. calendar poster EXPANDED PROGRAMME ON IMMUNIZATION

  27. EXPANDED PROGRAMME ON IMMUNIZATION

  28. Monitoring Overall activities swill be supervised by HSH/DGHS Khyber Pakhtunkhwa and will be thoroughly monitored through special monitoring check list by Provincial committees split in 2 tiers 1, District Level : DHO,DDHO,EPI Coordinator,LHWs Coordinator, PH Coordinator, DHCSO, DSM PPHI and Partners staff Provincial Level HSH,DGHS,DHS KP ,DDs /ADs of DGHS office, NP,PPHIand Partners. First Monitoring visit has been done on 21th Feb 2014, by EPI Team(Dr. Farid, Dr. Rahim, Dr. Ishaq and Mr. Hanif) to Nowshehra EXPANDED PROGRAMME ON IMMUNIZATION

  29. Special Initiatives for Improving ImmunizationGovernment Khyber Pakhtunkhwa monitoring check list District ______________ Tehsil: ________________ Union council ______________ Name of Health facility _____________ Name of In-charge Health facility _______________ Designation of HF In-charge: __________________ Name of EPI technician________________________ Total Population of UC: __________­­­___ Target Under 1 Year: _____________ Total Number of Children Completed Measles 2 Vaccination: _____________ Total Number of Children received Incentives: _________________ Name of Bank/ BHU/ Easy Paisa/ other: ___________________________________________ Information of Clients Who Received Incentives EXPANDED PROGRAMME ON IMMUNIZATION

  30. Budget for Monitoring EXPANDED PROGRAMME ON IMMUNIZATION

  31. Challenges/way forward Poor compliance from the districts Timely getting plans Successful implementation of Special Initiative Achievements of desiring targets Transparent and timely disbursement of money to the beneficiaries Reduce drop out at district level Achieving highest possible coverage Reduce diseases burden, disabilities and deaths EXPANDED PROGRAMME ON IMMUNIZATION

  32. THANKS EXPANDED PROGRAMME ON IMMUNIZATION

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