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Binjwala Shrestha , Assistant Professor Institute of Medicine,

Binjwala Shrestha , Assistant Professor Institute of Medicine, Department of Community Medicine and Public Health Kabiraj Khanal , Under Secretary Ministry of Health and Population GoN.

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Binjwala Shrestha , Assistant Professor Institute of Medicine,

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  1. BinjwalaShrestha,Assistant Professor Institute of Medicine, Department of Community Medicine and Public Health KabirajKhanal, Under Secretary Ministry of Health and Population GoN COMMUNITY HEALTH PROMOTION PROJECTS IN NEPALAPPROACHES AND ISSUESFIRSTNational Health promotion Conference, Nepal31 March 2013

  2. Community Based Health Promotion (CBHP) projects are mainly aimed to develop • sense of ownership and responsibility of communities for their health, • improve health care seeking behaviour in communities and to increase service coverage, • access to, and utilization of preventive, promotive and curative health services. Introduction

  3. right based approach, participation, coordination and collaboration, build on existing programmes and activities, Ref: WHO/SWC, Nepal Principles and values for effectiveness and sustainability of projects • maintain equity and social justice, • use of a variety of approaches and methods, • evidence of effectiveness, • transparent and accountable and • information dissemination

  4. Rationale In Nepal, various national and international organisations are contributing to community health development by implementing CBHP projects. Social Welfare Council and Ministry of Health and Population jointly evaluate those projects as per the agreement. The report are shared with all concerned ministry, however we don’t know how those reports are using by them.

  5. Some project evaluation reports are available in SWC website UN supported projects will not come under SWC monitoring In this context Review of project evaluation reports with insights of evaluators would be useful feedback to all concerned stakeholders

  6. to highlight the success and gaps observed while evaluating some projects supported by • international donor agencies on behalf of social welfare council and • UN agencies under MoHP. Objective

  7. Data collection Review of project reports (Mid term and final) and HMIS reports on specific project indicators Key informant interview with concerned stakeholders in district, community and chief of the projects Interaction with specific project beneficiaries Interaction with local partners and collaborators Methodology

  8. Data analysis Framework analysis using the criteria developed by Social welfare council and WHO Data interpretation Gaps and success in effectiveness and sustainability (SWC/WHO)

  9. Results

  10. Total eight projects evaluated • Major areas of projects • Maternal and newborn care • Child health, • HIV/AIDS, • Leprosy • Malaria • Safe abortion care • Uterine prolapse, and • Reproductive Health Project description

  11. Projects launched in various districts of Nepal • Some of the projects were supported by INGOs and some by UN agencies. • Most of the projects were launched with local community mobilisation.

  12. Major community activities were targeted to specific population as per the project indicators with both VDC based or district based. Main strategy of community health promotion was empowerment of communities through participatory processes.

  13. Success and Gap Analysis on effectiveness and sustainability

  14. Most of the projects were effective because they used the principle of • right based approach, • participation, • equity and social justice, and • continuous follow-ups , • however the accountability and transparency was questionable in most of the projects. Summary

  15. Summary contd.. • Similarly most of the projects might not be sustained because • not properly coordinated and collaborated with local health system and • not build on existing programmes.

  16. Some projects were working with parallel to • mothers group • FCHV and • Primary Health Care Outreach Clinic (PHC/ORC) • This has negatively affected on existing community based health promotion program. • Out of 8 projects only 2 projects can be sustained because this has been incorporated with existing health service delivery system. Summary contd..

  17. Health promotion projects were implemented under the policy of PPP model of MoHP. Most of the projects were effective although not much efficient to maintain sustainability. Some projects may pose challenges to existing health system providing incentives and additional service without coordinatingthe system Conclusions

  18. The concerned development sectors and council should be vigilant and make coordination with local District Health Office and District Development Committee to ensure the sustainability. The development partners should be sensitive to supplement and compliment the existing system or work with the principle of DO NO HARM Recommendations

  19. Thank You

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