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Managing Programmes to Improve MNCH_Bangladesh

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					Child Health Programme Manager’s
             Guidelines
     Experiences from Bangladesh
        Kathmandu, 17 Nov’2011



                                   1
                          Background
• In Bangladesh a number of maternal, neonatal and child
  health programmes and initiatives in existence
   – MNHI, a joint Government of Bangladesh-WHO, UNICEF and UNFPA
     initiative expanded to 11 districts.
   – MNCH supported by DFID through UNICEF and BRAC implemented in
     10 districts.
   – MNCS supported by AusAid through UNICEF and NGOs is being
     implemented in 40 upz of 8 districts.
   – SMPP supported by JICA through GoB in 3 districts
   – MaMoni by Save the Children in 2 districts
   – TMNCP supported by KOICA through unicef in 1 district
• These programmes aim to provide a continuum of care by
  integrating the efforts of these three interconnected areas
• Programme managers, therefore, need to be equipped with
  programme planning and management skills to deal with this.2
  Objectives of Programme Management
                 guidelines

• To equip managers with essential knowledge and it’s
  execution to improve programme management.

• To develop skills of the managers for advocacy, planning,
  management, monitoring and resource mobilization for
  effective implementation of interventions.




                                                              3
    Adaptation of Generic WHO Training
                  Package
• To adapt the generic WHO training package for Bangladesh,
  two 1-day consultation workshops were organized.
• The technical workshops involved the input and participation
  of a number of experts and programme managers.
• It was decided to change the title from “Managing
  programmes to improve child health” to “Managing
  programmes to improve maternal, newborn and child health”
• Relevant information on maternal health incorporated within
  the 5-day training course.



                                                                 4
                Target Audience


• Programme managers working in maternal, newborn
  and child Health sector at national/ district/ sub-
  district levels both from DGHS and DGFP.




                                                    5
       Adaptation process in Bangladesh

Time period            Activities
Nov 27 to Dec 01, 2010 International workshop to adapt
                       the WHO generic modules for
                       Bangladesh and conduct TOT


Sept 20 to 22 2011     Orientation workshop for the
                       health and family planning
                       managers from district and three
                       Sub-districts in Tangail



                                                          6
Participants in the International Workshop in 2010
From Government side:
•   Director Primary Health Care and Line Director (Essential Service Delivery)
•   Programme Manager from
     – IMCI
     – Reproductive Health, DGHS
     – In- service training, DGHS
     – (CA & SS), DGFP
•   Deputy Programme Manager from
     – Maternal Health
     – Neonatal Health
     – In- service training
•   Deputy Chief, MIS
•   Civil Surgeons from Moulavibazar, Narail and Bandorban districts
•   UH& FPO from Bandarban, Shirajganj, Rangpur and Dhaka( Dhamrai)
                                                                                  7
     Participants in the workshop_continued
From Non Government organizations:
• Health Specialists and Programme experts and scientists
   from WHO, UNICEF, UNFPA and icddr,b

Facilitators:
• Programme Manager, IMCI, DGHS
• Coordinator, Country Support team Child and Adolescent
  Health and Development, WHO, HQ
• Medical officer, SEARO, WHO
• Medical Officer, Child Health, WHO-Bangladesh


                                                            8
International Workshop 2010




                              9
10
11
Observations from the International Workshop

 Duration:
   5 days. However, the duration was perceived as too long by
   GoB managers
 Course Content:
  – Inclusion of maternal section was commended
  – Reading section perceived as rather large and monotonous
  – Texts comprising bullets or diagrams were recommended
  – Inclusion of more ‘role play’ and examples was proposed
  – Bangladesh specific examples, goals, objectives and targets
    was suggested

                                                                  12
Further adaptations following the
International Workshop
 Duration :
   Duration reduced to 3 days from 5 days
 Course contents:
   Incorporation of:
  – Bangladesh related health System information
  – Country specific health service provider information
  – Goals and objectives of ongoing Maternal, Newborn and Child
     Health Programmes of Bangladesh
  – Current status, targets and achievements of ongoing MNCH
     programmes
  – Coverage indicators of these MNCH programmes
                                                             13
Orientation workshop for 3 sub-district
managers in 2011
Target audience:
• Programme managers, Upazila Health and Family Planning
   Officer (UH&FPO) under DGHS and Upazila Family Planning
   Officers (UFPO)under DGFP from three sub-districts of Tangail
   District.
 • Medical Officers from these sub-Districts




                                                               14
Orientation workshop in 2011




                               15
16
Observations from the 2011 orientation
Workshop
Duration:
 – 3 days. Well accepted by the programme managers
 – However, covering course content was a challenge
Course Content:
 – Some of the reading sections had to be facilitated instead of
   self-reading
 – All ‘role play’ and examples could not be covered
 – Some exercises in the “workbook” e.g. resource mobilization,
   had to be skipped



                                                               17
        Comparison of the course contents
Topic          5 days package                 3 days package

Module 1:      Duration: 2 and half hours    •More focus given on understanding the
Introduction   Content:                      planning cycle
               •Review MNCH Epidemiology
               •Review Intervention Packages
               and the continuum of care
               •Review Planning terms and
               concepts
Module 2:      Duration: 2 days               Duration: 1 day
Planning       Content:                       Content: summarized as;
implementat    •Preparation for planning      •Review preparation for planning
ion            •Review programme goals
                                              •Review implementation status
               and objectives
               •Review coverage of            •Decide on programme activities
               interventions and compare it
               to targets                     •Plan activities to implement
               •Review status of indicators   intervention packages and set a priority
                                                                                     18
            Comparison of the course contents
Module           5 days package                                     3 days package

Module 2:        •Review major activities and assess how well       •List tasks in activities and
Implementation   they are implemented
Planning                                                            types of resources needed
                 •Review implementation Status
(Cont.)          •Review coverage of interventions and
                 compare it to targets                              •Planning for next review
                 •Set a target to improve quality of care           of implementation
                 •Plan activities to implement intervention
                 packages
                 •List tasks in activities and types of resources   •Decide how to scale up
                 needed                                             implementation
                 •Choose priority indicators for monitoring
                 results of activities
                                                                    •Review resources
                 •Plan monitoring of implementation of
                 activities                                         available, work plan and
                 •Plan for next review of implementation            timetable
                 •Decide how to scale up implementation.
                 •Review resources available, work plan and
                                                                    •Write a work plan and
                 timetable
                                                                    budget
                                                                                             19
    Comparison of the course contents
Module           5 days package                       3 days package


Module 3:        Duration: 2 days                     Duration: 1 day
Managing         Content:                             Content:
implementation   •Advocacy for Maternal, Newborn      summarized as
                 and Child Health                     •Advocacy for Maternal, Newborn
                 •Assessment of potential strategic
                                                      and Child Health
                 partnerships and ask for support
                 •Mobilization of funds from donor
                 •How to manage medicines and         •Mobilization of funds from donor
                 supplies
                 •How to manage financial supports    •How to manage medicines and
                 •How to improve organization of      supplies
                 supervision
                 •Analysis of common problems         •How to improve organization of
                 •Feedback and solve problems
                                                      supervision

                                                      •Feedback and solve problems      20
          Programme Planning and Management Cycle
                                                          Evaluate
                                                         programme
                                                       (every 5-10 years)
                                                        Eg. DHS, MICS
                                                                                                                          Strategic
                                                                                                                          planning is
                                                    including coverage and
                                                    health impact (e.g. using                                             usually
                               Manage                DHS, MICS surveys)                                                  performed at the
                             implementation                                                                               national level.
                                (Ongoing)
                                                                                     Develop strategic plan               It is taught in the
                    ü Advocate                                                            (every 5-10 years)              WHO guidelines:
                    ü Mobilize resources                                        ü Prepare for planning                    Strategic
                    ü Manage human, material
                      and financial resources
                                                                                ü Do situation analysis                   Planning
This                ü Manage supervision
                                                                                ü Prioritize and package                  For Child Health
                                                    Prepare for the               interventions
implementation      ü Monitor progress and use
                      results                          review of                ü Decide how to deliver interventions
planning cycle is
                                                    implementation              ü Select indicators and set targets for
taught in these                                          status                   evaluation
guidelines:                                         (every 1–2 years)           ü Write and disseminate plan
Managing                                                                        ü Mobilize resources
Programmes
to Improve                   Develop
Maternal,               implementation plan
Newborn and                  (every 1-2 years)
Child health           ü Prepare for planning
                       ü Review implementation
                         status
                       ü Decide on programme
                         activities
                       ü Plan monitoring of
                         implementation of
                         activities
                       ü Plan for the next review
                         of implementation status
                       ü Write a workplan and
                         budget
                                                                                                                                       21

				
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