Shefa CHS
Overview
Shefa province comprises of islands of, Epi, Lamen, Tongoa, Tongariki, Buninga, Emae, Makira, Mataso, Nguna, Pele, Emau Moso, Lelepa, Efate and Ifira. Shefa has rural a population as well as urban population of Port Vila.
In this reporting period, the priority operation for the province is building up local areas or zone level capability to deliver service to its population. This includes giving support to establishing shared and available resources among all areas and integrated services delivery in a team effort.
As a result, this province noted a well covered service for Zone 2 or North Efate, in zone 4 or Epi there is gradual increase in human resources in Vaemali Health Center and begun formalities to deliver service at Burumba dispensary that was vacant for some years. In Zone 1 or South Efate where Port Vila is there is a significant increase in immunization coverage and low dropout rate. Despite several our breaks in Zone 1, dengue and mumps the team were able to manage to minimise its impact.
The new health structure that builds nursing services of Shefa Community into Vila Central Hospital has seen gradual progress into team effort in the community and hospital. There were nursing supportive supervisions from the hospital to the community services.
The challenge that remains for Shefa to continue to meet up with is the high population for services in Zone 1 and 2 of Efate and Zone 2 on Epi and the small population separated by seas of Zone 2 of Tongoa and Shepherds Islands.
In the provincial health team leaders, there are still key funded vacant positions for Finance, Environmental Health and Health Promotion and Nurse Practitioners, Midwifes and several nurses. Other key demanded unfunded vacant positions include, Public Health Management, Health Information, Non – Communicable Disease, Neglected Tropical Diseases, Immunization and Nutrition.
Summary of Services
Compile a description of the unit including its primary role and what key functions are carried out by the unit under routine conditions. These can be summarised in the following table with links to community and primary models of care in Vanuatu.
- Administration Support providing overall corporate assistant, supply of drugs, supportive supervision and guidance to comply with government systematic processes
- Public Health Program Services for both continued effort for primary care of disease control, surveillance and investigation of disease outbreaks and introduce new programs
- Health Facilities provide primary care services on outpatient consultation, inpatient care, treatment, deliveries and engage community through health committee to manage assets to support health services in local areas.
Distribution of Services
Show the distribution of health services in the province through provision of a provincial map showing all health zones, and location of health facilities
Objectives
Shefa Community Health services objectives include both services and support to the health management and administration support in office an as well services being delivered by health zones as listed below;
Provincial Health Administration Support Services
- All goods and services required to run Provincial Health Office procured within a timely fashion to avoid stock outs of equipment, ensuring procurement using GoV processes on a quarterly basis.
- Utilities used by office paid in full by the 15th of each month through Local Purchase Order (LPO ) system
- 100% of Shefa Health Staff x 2 pairs
- Freight of medical supplies to Health facilities and bottle gases
- Building, Equipment and Vehicle repairs and maintenance
- All CHS staff goals established by February, reviewed in June and staff appraised by November using existing PSSM methods.
- Workforce plan for new recruitment and retirements implemented as approved and funded throughout 2016
- Staff transfers from facilities
- Monthly meetings held at PH offices conducted with CHS staff for operational conduct and review of all activities and administrative issues.
- Monthly meetings held at PH offices and Partners Offices conducted with implementing partners for operational conduct and review of all agreed activities and administrative issues
- 3-year Corporate Plan for CHS operations established including operational, human resources and financial information, developed through consultative process with provincial and national staff members by November 2017
- year annual business plan with associated budget document developed through consultative process with input from national and provincial staff established by June 2017
- Up to 4 National and provincial planning and budgeting workshops / review meetings are supported through participation by Community Health service HQ staff and public health officers, informing national planning and providing linkages to provincial level business plans. Meetings to occur in March, June and October with a further dates to be established to support provincial review.
- Operation Calendar established by January 2017 incorporating all functional areas within CHS for overview of operational support picture within the province, with input form functional PH programs and Zone Supervisors
- Training Calendar established by February 2017 for provision of learning and development opportunities to CHS and Rural health Facility staff, both through on the jobs training support and formalised training provision
- Monthly HIS reports provided to national HIS office inclusive of provincial level data from monthly health facility reporting
- Quarterly HIS reports provided to national HIS office summarising trends in CHS in March, June, October and December 2017
- Annual Report compiled by CHS staff through PHM on CHS activities outputs, outcomes and objectives provided by March 2017
- Training or other learning and development activities are conducted for CHS and rural health facility staff through in house OJT, informal / formal training or outsourced options, in accordance with the approved training plan
- M&E visits are conducted on a quarterly basis as part of supervisory visits on a quarterly basis to selected sites for verification of activities and outputs and
- Provide administration support at the Shefa Health Office
- Establish key office documentation
- Conduct training and supervision
- Health Statistics
Health Facilities Services
- All goods and services required to run Rural facilities procured within a timely fashion to avoid stock outs of equipment, ensuring procurement using GoV processes on a quarterly basis.
- Utilities used by office paid in full by the 15th of each month through Local Purchase Order (LPO ) system and 1 x ambulance for Saupia health centre to be paid 15th of each month through Local Purchase Order (LPO) system
- 1 ambulance with all accessories for emergencies
- Renovation and building staff houses
- All Rural Health staff goals established by February, reviewed in June and staff appraised by November using existing PSSM methods.
- Workforce plan for new recruitment and retirements implemented as approved and funded throughout 2016
- Monthly meetings held at PH offices conducted with CHS staff for operational conduct and review of all activities and administrative issues
- Fees for outpatient and inpatient services are collected and recorded in accordance with Health Committee Act legislation throughout the year
- 2 Health zone visits completed as pat of integrate supervisory visits with Zone Supervisors inclusive all Health Centres and Dispensaries with 2 hours for each Dispensary and 4 hours for each Health centre, non-inclusive travel time
- Supervisory visits conducted down to aid post level in all zones by Zone Supervisors on a 6 monthly basis in May and November 2016
- Monthly HIS reports are submitted by Health Facility Managers to CHS HIS officer in accordance with timelines established by national HIS office
- Patients receive general outpatient consultation inclusive family planning services within 1 hour of arrival at any health facility within the province without previous referral
- Patients requiring admission for inpatient care, are admitted within the facility for provision of secondary level care immediately following consultation identifying requirement for higher level care
- Refer to Role Delineation for maternity services in Remote Dispensary and Health Centre level facilities
- Patients are referred for review at higher level health care facilities with supporting case notes, with follow-up to the higher level health facility for receipt of patient within recommended timeframes, supported (where finance is available) through GoV referral transportation system
- Health promotion awareness activities conducted by Health Facility staff as outreach or static training and awareness campaigns, supported by CHS staff by 2017
- Mobile clinics conducted in zones for conduct of up to consultations with Health Facility staff supported by Zone Supervisor by 2017
Public Health Programs
TB/Leprosy
Increase TB case Detection plus TB/HIV/Diabetics co-infection
Sexual Transmitted Infections/HIV
Increase testing for HIV/STI through expansion of prevention of mother to child transmission (PMTCT), services and voluntary confidential, counselling testing (VCCT) in shefa province
Health Promotion
Conduct Health Promotion Activities
Village Health Worker Program
- Conduct In-service training for VHWs
- Extended supervisory visits (to be conducted in conjunction with other activities, such as regular Integrated Supervisory Visits)
- Community Health Action Grants
Non – Communicable Disease
Identify and reduce NCD risks
Nutrition and Dietetics
Support Nutrition Services
Immunization
Support EPI operations and coverage
Environmental Health
Conduct Environmental health Activities
Neglected Tropical Diseases
- Support Provincial NTD
Malaria and Other Vector-borne Diseases
- Community Awareness & Advocacy
- Vector Control
- Case Management
- Surveillance, Monitoring & Evaluation
Reproductive Health
Increase provincial commitment and strengthen capacity to formulate and update national policies, strategies & programs on sexual & reproductive health, including maternal health, emergency obstetrics, family planning, and availability of reproductive health commodities, adolescent sexual & reproductive health/STI/HIV. 2. Strengthened institutional and NGO capacity to integrate and deliver comprehensive high quality sexual and reproductive health services to the most risk population.
Means of Service Delivery
Provincial Health Administration Support Services
The services provided from the provincial office are basically administrative support services to comply with government system processes, supply of drugs and compilation of health statistics.
Public Health Programs Services
Public Health is the technical sector of service in the province and the service is being provided on program arrangement, supportive supervision, surveillance, investigation and selective appropriate responses.
Health Facilities Services
In health facilities nurse play key role in medical consultation, treatment and health education and awareness. These services are done either on a station arrangement where community people visit the nurses or the nurses visit the people in their respective communities.
Means of Service Delivery
- Improve relationships between national and provincial pharmaceutical sector through continuous regular communication and meetings held.
- Secure sufficient fund to conduct supervisory visits to at least 3 provincial pharmacies in a year.
- Provision of monthly CMS, provincial pharmacies’ reports to cost managers, MoH executives and developing partners.
- Re-establishment of a robust governance structure within the NDTC and PPC to improve the regularity of meetings conducted.
- Continuous updating and analysis of the information input onto the Tupaia dashboard within the Tupaia website.
- Secure budgeted fund for smooth running and maintenance of mSupply software.
- Establish sites that need training to resolve pharmaceutical issues raised and to capacity build the medical officers in their respective health facilities.
Key Archievements
Provincial Administration Office:
Shefa has established and developed a team management and a shared mechanism to meet regularly and drive its services in an integrated manner as a provincial program services and moved away from the vertical program. There has been an integrated services from nursing for Shefa community and Vila Central hospital
Health Facilities:
- All goods and services for the facilities to function are procured and supply in timely manner
- No stock out of supplies
- Good team work
- Good referral
- Good reporting
Public Health
- Integrated outreach services
Sanma CHS
Overview
Jivi Mele, Sanma Provincial Health Manager
In this summary report there have been a number of issues the SANMA has tackled during the period under review. For the last three years the SANMA community health has utilised annual business plans to identify priorities and provide focus. The plan covering the period of this report is attached as section or public health arm. 2017 is a challenging year for SANMA province. In the mid-year leader ship was change and no proper handing over despite this challenge we make some key achievement. Section in public health and clinical service have given us their successful story then from there we move on. The concern here is not sure whether it is in the business plan or not because no document that will in justify such as end of year report. What give us light is we ask staff of its key achievement area. In this report we have some overall achievement like
- All public health programme reported less than 70 % achieve results
- The clinical service has successful up to 90 % reporting but not documented in this report
- SANMA have send to nurse to attend the 20118 midwifery course in Portville. And one self-sponsor by sama.
- 2 falbalas glass seven-meter boat pulse 40 horse power engine paid by UNDP and will send to west coast to facilitate and speed up the process of stagnant referral system and will also facilitate the day to day operation smoothing
- Increase of staff salary.
- Jaralan aid post in South Santo zone 4 A have turns from aid post clinic have a nurse
- Panaviti aid post in Malo zone 2 turn to clinic is place with a nurse
- Prepared All retires nurse have taken on boat to sign a new contract.
Challenge face and encounter in 2017
- Change of leadership in mid-year
- GRT - MATTERS
- Continue saturated of opening new aid post to clinic without nursTanovusvus clinic
- Ipayato clinic
- Kole clinic
- Tutuba clinic
- Wunavae clinic
- BIG BAY clinic
- Puama clinic
Vaccant and not operating clinic
- Wusi clinic/joseph mape
- Sele clinic
- Kole clinic
- Bene clinic
Human resource
Work force is not enough SANMA community need 20 – 30 nurse to fill in the cap if we are seriously want to address the decentralisation and want to see it happen.
SANMA analysis of progress against any longer ranging targets for the organisation. Our aim is provide comment on any issues that were found and need to overcome, or are yet to be resolved but remain as a priority focus for this 2018, is the continuing increase of human resource.
Summary of Services
- Provide pharmaceutical advice to the Ministry of Health or to individuals when required.
- Respond to pharmaceutical queries via email or by phone or face to face and provide relevant information.
- Liaise with relevant personnel to ensure efficient and effective provision of pharmaceutical services to all public health facilities and private sectors within Vanuatu and ensure services provided abide to country’s legislation and regulations.
- Organizing and making preparations for National Drugs and Therapeutic Committee (NDTC) and Pharmacists Practitioners’ Commission (PPC) meetings.
- Review and collate monthly provincial pharmacies and Central Medical Stores, CMS mSupply reports on current pharmaceutical stock and its usage and distributions plus other pharmacy/CMS issues and refer to the senior relevant managers to act upon as required.
- Provide one to one or group training or education on pharmaceuticals and rational use of medicines to relevant health staff.
- Provision of mSupply training to pharmacy staff upon request.
- Oversee Medicines Safety Unit’s (MSU) operation and ensure it is efficient and effective.
- Prepare and submit reports on country’s narcotics and psychotropic substances’ consumption and estimates to Narcotics Board Vienna.
- Prepare and provide pharmaceutical reports and NDTC newsletters.
- Attend to relevant meetings and trainings/workshops.
Objectives
- Strengthen the integration of national and provincial pharmaceutical sector services through maintenance of a regular meeting schedules, including supervisory visits and dissemination of key planning, financial and clinical information to provincial pharmacies and encourage information push to national level.
- Provide ongoing secretarial support and management of the NDTC, which oversees the National Essential Drugs List (NEDL) and the rational use of medicines (RUM), and PPC to ensure all requirements of this commission are met.
- Promote and implement the National Medicines Policy, NMP through yearly monitoring and evaluation of the NMP key indicators which include percentage availability of 30 essential medicines in health facilities, number of days out of stock of these 30 essential medicines, number/value of expired drugs in health facilities and percentage of medicines prescribed from NEDL.
- Provide ongoing trainings on pharmaceutical issues such as RUM, clinical pharmacy and supply chain management, SCM to relevant pharmacy staff, students and medical officers.
- Strengthen in-country capacity building through remote and/or in-country support from technical advisory support services.
Means of Service Delivery
- Improve relationships between national and provincial pharmaceutical sector through continuous regular communication and meetings held.
- Secure sufficient fund to conduct supervisory visits to at least 3 provincial pharmacies in a year.
- Provision of monthly CMS, provincial pharmacies’ reports to cost managers, MoH executives and developing partners.
- Re-establishment of a robust governance structure within the NDTC and PPC to improve the regularity of meetings conducted.
- Continuous updating and analysis of the information input onto the Tupaia dashboard within the Tupaia website.
- Secure budgeted fund for smooth running and maintenance of mSupply software.
- Establish sites that need training to resolve pharmaceutical issues raised and to capacity build the medical officers in their respective health facilities.
Tafea CHS
Overview
Tafea Provincial Health Manager
TAFEA Provincial Health Services this year is on the blink of getting on track with the health services after the devastated effect on health infrastructure by cyclone Pam 3 years ago. Clinics have been in the rehabilitation processes, staffs have settled in and people have focused on moving forward in terms of health services.
TAFEA Provincial Health office continue to press on for speeding up the rehabilitation processes on health infrastructures and at the same time continue to make sure health care services continue to reach the communities. As far as health care services is concern, TAFEA Province has achieved one of its target to eliminate Malaria and is targeting other diseases e.g. yaws. With the establishment of a Gen X-pert machine we look forward to more improvements in diagnostics and detection rate for TB and HIV
While focusing on these communicable diseases Non communicable diseases such as Diabetes or High blood pressure is still a burden and on the rise. NCD will be a priority agenda for TAFEA Provincial Health in the future and as such we acknowledge the ministry of health for the restructuring so that we can be able to accommodate to address the issue, but again continuous support in terms of Finance will be the key to achievements of these goals.
Summary of Services
- Provide pharmaceutical advice to the Ministry of Health or to individuals when required.
- Respond to pharmaceutical queries via email or by phone or face to face and provide relevant information.
- Liaise with relevant personnel to ensure efficient and effective provision of pharmaceutical services to all public health facilities and private sectors within Vanuatu and ensure services provided abide to country’s legislation and regulations.
- Organizing and making preparations for National Drugs and Therapeutic Committee (NDTC) and Pharmacists Practitioners’ Commission (PPC) meetings.
- Review and collate monthly provincial pharmacies and Central Medical Stores, CMS mSupply reports on current pharmaceutical stock and its usage and distributions plus other pharmacy/CMS issues and refer to the senior relevant managers to act upon as required.
- Provide one to one or group training or education on pharmaceuticals and rational use of medicines to relevant health staff.
- Provision of mSupply training to pharmacy staff upon request.
- Oversee Medicines Safety Unit’s (MSU) operation and ensure it is efficient and effective.
- Prepare and submit reports on country’s narcotics and psychotropic substances’ consumption and estimates to Narcotics Board Vienna.
- Prepare and provide pharmaceutical reports and NDTC newsletters.
- Attend to relevant meetings and trainings/workshops.
Objectives
- Strengthen the integration of national and provincial pharmaceutical sector services through maintenance of a regular meeting schedules, including supervisory visits and dissemination of key planning, financial and clinical information to provincial pharmacies and encourage information push to national level.
- Provide ongoing secretarial support and management of the NDTC, which oversees the National Essential Drugs List (NEDL) and the rational use of medicines (RUM), and PPC to ensure all requirements of this commission are met.
- Promote and implement the National Medicines Policy, NMP through yearly monitoring and evaluation of the NMP key indicators which include percentage availability of 30 essential medicines in health facilities, number of days out of stock of these 30 essential medicines, number/value of expired drugs in health facilities and percentage of medicines prescribed from NEDL.
- Provide ongoing trainings on pharmaceutical issues such as RUM, clinical pharmacy and supply chain management, SCM to relevant pharmacy staff, students and medical officers.
- Strengthen in-country capacity building through remote and/or in-country support from technical advisory support services.
Means of Service Delivery
- Improve relationships between national and provincial pharmaceutical sector through continuous regular communication and meetings held.
- Secure sufficient fund to conduct supervisory visits to at least 3 provincial pharmacies in a year.
- Provision of monthly CMS, provincial pharmacies’ reports to cost managers, MoH executives and developing partners.
- Re-establishment of a robust governance structure within the NDTC and PPC to improve the regularity of meetings conducted.
- Continuous updating and analysis of the information input onto the Tupaia dashboard within the Tupaia website.
- Secure budgeted fund for smooth running and maintenance of mSupply software.
- Establish sites that need training to resolve pharmaceutical issues raised and to capacity build the medical officers in their respective health facilities.