Nepal: Kavre Community Outreach Program
Dapcha Health Post Treats 1,612 Patients: Q1 2019
April 01, 2019
Summary of Activities
Since the earthquake of 2015, RMF’s efforts to improve the health and wellbeing of Kavre residents have continued to develop. In 2017, RMF received approval of our 5-year Health Care System Strengthening and Outreach Program from Nepal’s Ministry of Women, Children, and Social Welfare (MoWCSW). As a result, RMF was able to fully implement the Kavre Community Outreach Program. Currently, RMF’s priority in the program has shifted to supporting a health clinic at Dapcha Health Post, which was opened in February 2018, as well as RMF Urban Health Center, which was opened in March 2018.
During this Quarter:
- RMF supports human resources (a medical officer, a nurse, a laboratory technician, and an office assistant) and supplies medical equipment and supplies for Dapcha Health Post.
- At RMF Urban Health Center in Lakainey, RMF supports 3 health workers (a health assistant, an auxiliary health worker, and an office assistant) and supplies medicines which are available to patients at low or no cost.
- RMF Urban Health Center served 777 patients from its OPD, averaging about 259 patients per month. 405 were female and 372 were male.
- RMF Urban Health Center celebrated its first anniversary of establishment on March 6, 2019. A ceremony was held, which was attended by the deputy mayor of Namo Buddha municipality, the ward chairperson, chief executive officer of the municipality, teachers, health post managers, social leaders, and community members. The event was covered in Kavre Post.
TREATING THE YOUNG
The Community Based Integrated Management of Neonatal and Childhood Illness (CB-IMNCI) program is being implemented in Kavre district. This program ensures that sick children under 5 years of age are managed for their health conditions and registered in the CB-IMNCI register.
122 children were treated during this period, 116 of whom were 2 to 59 months of age and 6 of whom were under 2 months old. Respiratory infections, including pneumonia, were found to be the leading health problem among children under 5 years of age with 67 patients.
Dapcha Health Post served 1,612 patients from its OPD from January to March 2019 of whom 938 were female (58.2%) and 674 were male (41.8%). The OPD averaged about 537 patients per month for this quarter.
RMF Urban Health Center celebrated its first anniversary on March 6, 2019. This health center was established on March 6, 2018 based on the agreement between Namo Buddha municipality and RMF Nepal. Deputy Mayor of Namo Buddha municipality Mrs. Ram Devi Tamang was the chief guest at the ceremony. She said that the municipality is committed to serving its people and to developing the area by using available resources and by teaming up with non-government organizations. A large number of community members were involved. Program Manager Mr. Ganesh Shrestha represented RMF.
5 immunization clinics are active in the catchment area of Dapcha Health Post. From January to March 2019, a total of 106 people were vaccinated for tuberculosis (BCG), diphtheria and tetanus (DTP), hepatitis-B (HepB), polio (OPV), pneumococcal disease (PCV), measles and rubella (MR), and Japanese encephalitis (JE), and 16 patients were pregnant women who received vaccinations for tetanus and diphtheria (TD).
RMF is supporting the operation of laboratory services at Dapcha Health Post. In the first quarter of 2019, the lab performed a total of 159 tests.
Caring for Women
During this 3-month period, the health post served 29 pregnant women with antenatal (ANC) services, and 10 mothers received institutional delivery services. There are 287 current users of various family planning methods, including oral contraceptive pills, Depo-Provera, implant, and IUCD, among whom 13 are new users.
- Significantly reduce malnutrition among children under the age of 5
- Cause behavior change related to health, nutrition and hygiene through health education
- Improve the health services and programs
- Help acutely malnourished children graduate from malnourished status to a healthy status
- Improve maternal health, sexual health, family planning
- Reduce neonatal and infant mortalities
Click to enlarge
17 Years Old
Anjana Tamang is just 17 years old and became pregnant 4 months ago. In rural Nepal, especially in the Tamang community, it is acceptable for young girls to elope with a partner of their choice, and the parents of the groom generally support their child’s decision. Due to a lack of education as well as the appeal of the cultural freedom granted by marriage, Nepali girls often marry very young and become pregnant without awareness of the consequences of early pregnancy.
During Anjana’s first antenatal visit to Dapcha Health Post, the gestational age of the fetus was 16 weeks. She was excited but also nervous due to the bodily changes that she was experiencing. Due to her young age, she was thoroughly counseled about her condition, safe pregnancy practices and habits, diet, selfcare, and birth preparedness. She was also vaccinated against tetanus and given iron supplements. Anjana was adequately informed about danger signs so that she could seek immediate medical help in case of an emergency. She was advised to return for regular check-ups, and the date for her next visit was confirmed.
Mangali Maya Tamang
Mangali Maya Tamang hails from a remote area of the Namo Buddha district, and it was difficult for her husband to earn enough to make ends meet. Still, Mangali hoped to send her two children to better schools to secure their bright futures. Thus, her husband decided to go abroad to earn more for their family. He was away for 7 years, and during that period, Mangali had no need to use any contraceptives. However, when her husband returned home, she became pregnant. Although the family’s financial status was still unstable, she could not consider getting rid of the fetus and continued her pregnancy. It has been 32 weeks since then, and she has been visiting the clinic regularly and following the instructions closely. She had not had antenatal check-ups during her previous pregnancies, but now she says that, when quality care is available at one’s doorstep to improve the wellbeing of both mother and child, not utilizing such services is foolish.
25 Years Old
Srijana Tamang is 25-year-old woman who delivered both of her children at Dapcha Health Post. She said that she returned for her second delivery, preceded by a number of antenatal visits, due to the friendly and responsible staff. She delivered a girl weighing 3.2kg via spontaneous vaginal delivery, and both the mother and the baby are doing well. Srijana and her family were counseled about exclusive breastfeeding, maternal nutrition, immunization, and contraception. They were also briefed about warning signs for the mother and the baby and instructed to immediately go to health center in case of such symptoms. Srijana is grateful and elated that she could deliver a healthy baby with the support and guidance of the staff at Dapcha Health Post.
19 Years Old
Ashma Magar hails from Namo Buddha municipality ward no. 9. She just 19 years old but already has 2 children and just delivered a third at Dapcha Health Post. The fact that Ashma already has 3 children at such a young age is a major indicator that the adolescent girls and the community at large are in desperate need of information concerning the consequences of childbearing at a young age. Although this was her third pregnancy, it was the first one for which she sought antenatal care from a health center. She came for antenatal check-ups 4 times as well as for the delivery. She delivered a boy weighing 2.8kg. She was specifically counseled on long-term contraception to prevent the consequences of adolescent pregnancy. She was also advised on other topics such as breastfeeding, immunization, nutrition, continuation of iron supplements, and danger signs.
24 Years Old
Sabina Tamang is 24 years old and has 3 children. She delivered her third one, a boy weighing 2.5kg, at Dapcha Health Post, and the baby was healthy at birth. She visited the clinic twice for antenatal visits despite continuous counseling. After this pregnancy, she had postpartum bleeding due to uterine atony, which was very well managed by the trained clinic staff. She was then counseled that consecutive pregnancies at such a young age may be a risk factor for uterine atony, and the need for contraception was emphasized. She then chose to use an intrauterine contraceptive device (IUD), which was immediately provided. She was happy to no longer have to worry about pregnancy, and she thanked the staff for their prompt response to her condition.