Short Programme Review on Child Health Experience from Sri Lanka

1. Short Programme Reviewon Child HealthExperience from Sri Lanka Family Health Bureau Ministry of Health Sri Lanka Regional Programme Managers Meeting CH Kathmandu

2. Health Master Plan Evaluate health impact and intervention coverage Develop strategic plan (5-10 yearly) Prepare for planning • Manage implementation • (Ongoing) Evaluate program outputs and outcomes; implementation plan (1-2 yearly) Planning and implementation cycle MCH Policy National Maternal and Newborn health SP Child Health SP School and Adolescent Health Medium Term MCH/FP Plan (5yrs) District District Plan Regional Programme Managers Meeting CH Kathmandu WHO Managing program to improve Child health

3. Programme Review Regional Programme Managers Meeting CH Kathmandu

4. Need and the opportunity • Need for organized reviewing of the Programme implementation • Three National Programme Officers (Government &WHO) attended Regional Training Progrmme on SPR on Child Health at Nepal 2007 Regional Programme Managers Meeting CH Kathmandu

5. PROGRAMME ACTIVITIES Advocacy Mobilizing human, material and financial resources Capacity development Programme communication Health system supports Monitoring progress using data PROGRAMME OUTPUTS Increased availability/access of services Increased demand for services Improved quality of services/care Improved information to / knowledge of families INCREASED POPULATION-BASED COVERAGE of key effective Interventions Quality Equity IMPROVED SURVIVAL AND HEALTH Regional Programme Managers Meeting CH Kathmandu

6. Step 1 WS 1 WS 2 Where are we going? Are interventions reaching women and children? Step 2 WS 3 WS4 Step 3 How well are program activities Being implemented? WS 5 Step 4 What are the main problems? WS 6 Step 5 What are solutions and recommendations? WS 7 Step 6 What are next steps for taking action? Regional Programme Managers Meeting CH Kathmandu

7. Human Worksheet 5 sources development Regional Programme Managers Meeting CH Kathmandu

8. Worksheet 6: Identify the main problemsInterventions where more action is needed (from coverage data):__________________________ Regional Programme Managers Meeting CH Kathmandu

9. Worksheet 7: Develop solutions and recommendations Regional Programme Managers Meeting CH Kathmandu

10. Follow up action of the training - Pilot testing at the District of Matale- 2010 Child Health • Adaptation of the worksheets • Limited success - intervention and activities • Opportunities - Familiarizing with the overall process - Identified the short-comings Regional Programme Managers Meeting CH Kathmandu

11. Lessons learnt • Child health alone – not cost effective - time consuming - deviated from overall MCH planning - District /Divisional staff deliver integrated package of Overall MCH Need for combined MCH/FP/Nutrition Regional Programme Managers Meeting CH Kathmandu

12. Pilot testing at the District of Puttlam- 2011 Maternal Newborn and Child Health (MNCH) Identification of interventions - maternal and newborn Implementation level • Evidence based effective interventions – all possible - in place • Four levels – home community, Field clinic, First referral, Tertiary care Regional Programme Managers Meeting CH Kathmandu

13. Groundwork ct. - Identification of data sources Data for WS 1 & 2 – data available But data to address equity gap was not available at district level • Routine – RG, HMIS,IMMR, H 830 • Periodic survey – DHS, Nutrition Surveys Data lacking – WS 3,4 & 5 • Surveys– data extraction H 512 ,CHDR,BHT • LQS - data extraction - Exit interviews • Identify information gaps • Learn to use different data sources • Possibility of them included into the routine system Regional Programme Managers Meeting CH Kathmandu

14. Groundwork ct. – preparation of data collection formats • Data collection formats for each MOH area and summary sheets • Could be used later Regional Programme Managers Meeting CH Kathmandu

15. Advocacy meeting – PD/RD/Hospital administrators, clinicians, Ward sisters , District MCH planning team, other public health Convinced them of the importance – Methodically looking at issues rather than adhoc activities • Future use - • Availability of data • Data collection • methods Data collector training – Public Health Staff Facilitator training Regional Programme Managers Meeting CH Kathmandu

16. Working Groups • Team 1 – Antenatal, Postnatal care and Family planning • Team 2 - Intra partum and Newborn care • Team 3 – Infant and Child care • 20-30 for each group • Facilitator – programme managers Regional Programme Managers Meeting CH Kathmandu

17. Process and learning points Regional Programme Managers Meeting CH Kathmandu

18. Process and learning points Regional Programme Managers Meeting CH Kathmandu

19. Process and learning points Regional Programme Managers Meeting CH Kathmandu

20. Advantages • Convinced the importance of scaling up of intervention to get the universal coverage • Implementation of all categories of activities order to have intervention coverage . • Provided forum to use the available data and review the district MCH Plan • Staff is well aware of the process ,improve the participatory approach in reviewing data • Make baseline data available for review in another programme cycle • Recommendations for both district and national level Regional Programme Managers Meeting CH Kathmandu

21. Way forward • Further amendments to the worksheets – live • Introduce the methodology for other districts - have next in line as observers • Incorporate other life stage interventions e.g. school and adolescent health Regional Programme Managers Meeting CH Kathmandu

22. Thank • WHO SEARO Office – Dr Rajesh Mehtha Dr Aravind Mathur • WHO CO SL – Dr anoma Jayathilake/NPO Regional Programme Managers Meeting CH Kathmandu

23. Regional Programme Managers Meeting CH Kathmandu