Considering the relief work experience & learning, and the above constraints and gaps, the proposed project “UPAKAR” has the following description in terms of its objectives, beneficiaries, coverage, activities, expected outcomes and management modality.
Supporting the District Health office for the resumption of health services in the selected Quake affected VDCs of Sindhupalchok district by strengthening health service delivery, and by promoting health seeking behavior among affected community, in particular women, children and disabled people.
Objectives 1: To enable the identified 12 VDCs of Sidhupalchowk to deliver basic health care services to the communities through strengthening physical and technical capacity of the health facilities/health workers including the HMIS system (back to function), surveillance system & replenishment of damaged equipment based on the need assessment of the health facilities.
Objective 2: To provide awareness and counseling to the affected families and communities (especially pregnant and lactating women) for healthy pregnancy outcomes and care of new born and children< five years, injured and disabled by reverting their need and priority.
Objective 3: To promote inclusive health care services, ensuring access to health care or rehabilitation to the people with disabilities.
Objective 4: To establish referral systems and networks for affected communities and families with other supporting organizations (government as well as non-government sectors) with service provision in reproductive health, psychosocial support, mental health, livelihoods and rehabilitation services
Objective 5: Knowledge management through efficient implementation and monitoring, learning and sharing, documentation and dissemination of achievements, and results at various forums for show casing our contribution and achievements (best practice examples).
On 25 April 2015, Nepal experienced a sudden strike of 7.8 Richter scale earthquake and frequent powerful aftershocks, which left an unprecedented trail of damage and devastation, with compounding fear among the population. More than 8699 lives were lost in the earthquakes and over 21,000 people were injured, leading to increased health care needs (Ministry of Home Affairs, 2015) while health facilities in 61 districts were directly affected of which 14 districts severely.
Ministry of Health and Population (MoHP) has a network of 4,118 health facilities ranging from the central level specialized hospitals to Health Posts and Urban Health Centers at the Village Development Committee (VDC) and Municipality levels respectively. Out of the total public health facilities of the country, 19% and 23% of total health facilities are located respectively in highly and moderately affected districts.
Population profile shows that highly and moderately affected districts respectively consist of 20% and 17% of the total population in the country. These districts also consist of 19and 16 percent of expected pregnancies in the year 2014/15. Clearly, large numbers of pregnant women have been at risk due to the disruption in health service delivery and family priorities and behaviors.
A total of 18 health workers and community health volunteers among the total in country also lost their lives and 75 health workers and volunteers got injured due to the earthquake adding further challenges in health service delivery. It has been estimated that a total of 29,332 deliveries and corresponding new born children have been directly affected in the 3 months following the earthquake.
In order to lend a helping hand during the critical time post-quake disaster, FAIRMED quickly decided to support and develop a proposal for fund raising for immediate response. Through the active support of FAIRMED Head office, FAIRMED Nepal was able to engage in the relief work together with the government of Nepal (MoHP) and other stakeholders, particularly WHO. FAIRMED, through its small scale efforts, was able to provide immediate relief support to a total of 4,000 households of 2 VDCs of Sindhupalchok, one VDC each of Gorkha and Dolkha and, Sankhu of Kathmandu.
The relief work of FAIRMED was a combination of relief material distribution, training, social mobilization, and information dissemination by mobilizing 25 field mobilisers. The community based activities were as listed below:
Given FAIRMED’s recent relief work in the affected VDCs of various districts, it has been encouraged by the government as well as the affected communities to continue its support during the recovery phase as well. Our experience and learning has been that resumption of health services is possible through community mobilization, promotion of preventive care, capacity development of community health workers and Health Facility Operation Management Committee for systems strengthening and quality of care. We also strongly believe that the affected communities can be helped for comprehensive support through establishing effective linkages of the affected families/communities with other organizations with expertise and resources in livelihoods and infrastructure, and working in the same areas. FAIRMED, through its expertise in disabled inclusive primary health care approach, will demonstrate an example of comprehensive recovery model in the affected rural communities.
1: In 12 focused VDCs, the quality of health care delivery system improved in the health institution and positive health seeking behavior increased in the community
2: The health practices among pregnant mother improve that enhance health condition of women and children
3: Disable people got equal opportunity and access of health services from health institution
4: The affected communities and families utilized the health services provided from government and non-government organization that improves mental and psychosocial well-being, healthy life style and reintegration in the society
5: The institutional knowledge management enhances the capacity and capability of the organization.