To Improve

Mother & Child Health Center

In

Kandahar-Afghanistan

Looking for Fund!!!

 Goal:

 Objectives:

 Requested Funding:

 Need for Proposed Project

 PROPOSED PROJECT

 Goal

   Objectives

   Activities

    1) Comprehensive Health Care Services

    2) Family Planning

    3) Immunization

    4) Health Education

    5) Capacity Building

  Methodology

  Management and Staff of Maternal and Child Health Center

  ANTICIPATED OUTCOMES

  SUSTAINABILITY

  BUDGET

Goal:

To improve the health of the 30,000 women and children in Kandahar City, Afghanistan.

Objectives:

To establish, staff, and support the first two years of operations of a Maternal and Child Health Center in Kandahar City, Afghanistan.  This Center will:

1. Provide urgently needed and comprehensive health services to over 30,000 impoverished women and their children, with special emphasis on emergency obstetric care; 

2. Provide ongoing family planning information and services to improve the health and well being of individuals and families;

3. Provide improved access to essential immunizations;

4. Work to improve community knowledge, behaviors, and attitudes towards health and nutrition;

5. Build a cadre of locally trained female health workers by providing initial and ongoing preparation for the provision of primary health services and health promotion and education activities.

Requested Funding:  US $236,860 over two years

Contact Persons:       

                                                Aziz R. Qarghah

8603 Westwood Center Drive

Suite 230

Vienna VA, 22182 USA

Phone: (703) 848-9346

Fax: (703) 848-0408

E-mail: arq@ahds.org

Dr. Nabila Osmany, MCH coordinator

                                                Street 4, Next to Uzbek ha Mosque, Karte Seh

Kabul, Afghanistan

                                                Mobile # 079 327265

                                                E-mail: nabila@ahds.org

                                                            info@ahds.org

                                                http://www.ahds.org  

Need for Proposed Project 

Afghanistan is one of the least developed countries in the world (with a Human Development Index score of 167 out of 173 countries It has among of the highest maternal and child mortality rates in the world (1,700 per 100,000 among women, and 257 infant mortalities per 1,000 live births). These high rates are mainly the result of limited access to health care facilities, cultural barriers, low levels of health and nutrition knowledge, and an extreme shortages of skilled female healthcare workers in rural areas,.

There are few places on earth in greater need of quality and comprehensive health care services, and providing these is a fundamental requirement for improving the quality of life in Afghanistan.  This proposal seeks to restore the basic right of access to health care services to the women and children of Kandahar City, who have long totally deprived of this most basic of human rights.

PROPOSED PROJECT

Goal

To improve the health status of over 30,000 women and children in Kandahar City, Afghanistan.

Objectives

To establish, staff, and support the operations (over its first two years) of a Comprehensive Health Center with special focus on mother and child health Kandahar City, Afghanistan.  This Center will:

1. Provide urgently needed and comprehensive health services to over 30,000 impoverished women and their children, with special emphasis on emergency obstetric care;

2. Provide ongoing family planning information and services to improve the health and well being of individuals and families;

3. Provide improved access to essential immunizations;

4. Work to improve community knowledge, behaviors, and attitudes towards health and nutrition;

5. Build a cadre of locally trained female health workers by providing initial and ongoing preparation for the provision of primary health services and health promotion and education activities.

Activities

1) Comprehensive Health Care Services

Provide urgently needed physician-based health services to over 30,000 impoverished women and their children, with special emphasis on emergency obstetric care.

• Provide antenatal and postnatal care;

• Provide basic emergency obstetric care (EOC);

• Provide integrated management of childhood illnesses (IMCI);

• Conduct screening for malnutrition, and provide nutritional information;

• Provide treatment for common diseases;

• Provide routine laboratory services;

• Provide emergency in-patient service;

• Provide essential drugs according to the standardized list;

• Refer complicated cases to Mirwas Provincial Hospital

• Participate in national and regional campaigns (e.g. polio eradication, ARI, control of diarrheal diseases, breast feeding, malaria roll back, etc.);

• Provide adequate required equipment, medical and non-medical supplies;

• Ensure training, oversight, and monitoring of staff, providing incentives to retain skilled health care workers;

• Prepare monthly activity reports

2) Family Planning

Provide ongoing family planning information and services to improve the health and well being of individuals and families.

• Ensure training of staff in family planning methods and sensitive approaches to encouraging delay of early pregnancy and the ongoing utilization of spacing methods;

• Make family planning and reproductive health information and contraceptives readily available to all who seek services at the Health Center;

• Encourage all pregnant women to use contraception immediately after delivery;

• Orient eligible couples to utilizing family planning through routine health education sessions twice weekly;

• Orient the community health committees and community leaders to the benefits of family planning;

• Monitor the acceptance rates of family planning, and note (as much as possible) the factors that facilitate or challenge the acceptance of family planning.

3) Immunization

Reduce the incidence of vaccine-preventable diseases through increased immunizations (tuberculosis, poliomyelitis, pertusis, diphtheria, measles, and tetanus).

• Maintain and expand AHDS’ already established program of immunization;

• Provide refresher training for vaccinators, and training for new staff members;

• Orient all staff of health facilities about immunization;

• Supply vaccines to all vaccination teams on regular basis through UNICEF;

• Provide outreach vaccination activities outside the Center according to established work-plan;

• Participate in mass immunization and catch-up immunization campaigns according to the national and regional plans of action, along with other partners;

• Supervise and monitor immunization services on a monthly basis;

• Participate in regional Expanded Program of Immunization (EPI) management team (REMT) activities;

• Launch EPI coverage survey;                  

• Collect and analyze immunization data and reports.                   

4)  Health Education

Improve community knowledge, behaviors, and attitudes towards health and nutrition.

• Provide daily health education sessions to the clients attending the Maternal and Child Health Center;

• Provide bi-weekly health education sessions to the local community and schools;

• Sensitize mothers about re-hydration benefits through providing information on ORT in the MCH Center;

• Demonstrate the provision of nutritious food from locally available foodstuff in educational sessions with mothers, and feed eligible children twice weekly in the MCH Center;

• Disseminate leaflets, posters, and calendars containing prime health messages;

• Report on health education activities on a monthly basis.

5)  Capacity Building

Build a cadre of local female health workers by providing ongoing and need-based health care training to strengthen their capacities to provide quality medical services to improve maternal and child health in the district.

• Frequently assess needs for training among new and experienced staff;

• Create training opportunities utilizing experienced staff from within AHDS and from other organizations;

• Provide on-the-job training for the staff of other health facilities in this Center;

• Train local women as nursing assistants or community health nurses;

• Report on capacity building activities.

Methodology

Primary Health Care (PHC) has been the main component of AHDS’ efforts to promote healthy practices, prevent diseases, and provide curative health services among the needy people of southwest Afghanistan. AHDS works in close collaboration with local communities, assesses the needs of each community, and seeks ways of encouraging individual as well as joint efforts to support the health care system.  AHDS activities are implemented fully in consultation with local authorities. 

AHDS utilizes the most efficient and cost effective essential technologies and programs, taking into account the extremely poor socioeconomic infrastructure of Afghanistan. Through all of its clinics and services, AHDS targets the most deprived and vulnerable communities in southwest Afghanistan – women and children.

AHDS seeks opportunities to collaborate with other health organizations and to integrate available health services by other agencies into its program to increase communities’ access to comprehensive health services.  AHDS participates in the Expanded Program of Immunization supported by the United Nations Children's Fund (UNICEF) and the Afghan Ministry of Health (MoH); the Malaria Control Program of Health Net International (HNI); and the Comprehensive Disabled Afghans’ Program (CDAP) of UNOPS.  Coordination with other agencies in the field is vital for rehabilitation and development, and AHDS collaborates with many other non-governmental organizations and United Nations agencies. 

AHDS is seeking for volunteers to provide consultancy for the training of community nurse and its follow up within international nursing universities. At least one professor has shown interest about. It will be the first intentions to train community midwife in Afghanistan that is extremely needed. Unfortunately, number of nurses in general and especially female nurse is very low. There are some untrained females with some knowledge and skill who can be advanced to assistant nurse and then later on to standard nurse level through in-service trainings. 

Management and Staff of Maternal and Child Health Center

AHDS’ Kandahar Office is responsible for overall management of the proposed Maternal and Child Health Center, playing the key role in donor and inter-agency coordination, planning, procurement of medicines and supplies, overall financial management, data processing and analysis, staff supervision, and evaluation and reporting (both technical and financial). AHDS’ medical coordinator, MCH coordinator, and monitoring officers will regularly oversee the Center’s activities. Furthermore, relevant technical staff from the Ministry of Health (MoH) will often visit the project.

The MCH Center’s staff will consist of the following:

Trainer/Supervisor, MD (1)

Physician with obstetrics experience, MD (1)

General Practitioner, MD (1)

Nurse (1)

Midwives (2)

Health educator (1)

Laboratory technician (1)

Pharmacist (1)

Vaccinators (2)

Administrator (1)

Driver (1 male)

Cook (1)

Cleaners (2)

Guard (1 male)

ANTICIPATED OUTCOMES

It is anticipated that the proposed Maternal and Child Health Center will result in the following:

• Increased access to primary health care in the Kandahar City, through healthcare services;

• More than 20,000 patients being served per year;

• A sound health information system, with outreach into the community;

• Increase by 50% of the number of eligible couples becoming aware of family planning services, and provision of family planning information and contraceptives;

• Provision of safe motherhood assistance to women in delivery;

• Increase by 50% in pregnant women attending at least two prenatal care visits;

• At least 80% of children less than one-year-old will have received immunizations;

• 50% of women of childbearing age will be vaccinated against tetanus;

• Prime health and nutrition messages are widely disseminated to prompt changes in attitudes and behavior;

• 6 assistant nurses are trained as a pilot project.

• An increase in the number of females working outside the home, and strengthening of their knowledge and skills.

Above all, women in the targeted district (particularly women of reproductive age) will have greatly enhanced accessibility to health services, leading to a substantial improvement in the health of them and their children. The health education component of the program will encourage families to delay early childbirth and practice safe child spacing methods as essential facets of the healthy life.  Because birth-related complications will be able to be prevented, the maternal and infant mortality and morbidity rates in the district will be decreased.

In addition, through fully involving the community in its efforts to establish and operate the Maternal and Child Health Center, AHDS will contribute greatly to raising health-related awareness and utilization of medical services, as well as a feeling of ownership for the Center within the community.

Finally, through hiring and training female health workers, AHDS will provide valuable job opportunities to vulnerable but trained (or trainable) women in the district. Training of health care providers will result in increasing their skills and their medical, managerial, and technical capacities, as well as empowering them to play critical roles in improving the lives and well being of women and children in the district. 

SUSTAINABILITY 

In a post-conflict country like Afghanistan, because of the extremely low purchasing power of the population (Afghanistan is one of the lowest income countries), the financial sustainability of the proposed Maternal and Child Center is dependent for the time being on external donors. While patients will be asked to pay nominal fees for consultations and laboratory work, these are by no means sufficient to cover actual expenses, now or in the near future. AHDS will work with its management staff and the community to build community ownership in the Center and seek means to promote community involvement in helping to sustain the project. However, in the near future, it is anticipated that AHDS and the Ministry of Health will need to seek and secure funding support from external donors to sustain operations of the Center.

BUDGET

Total required budget for two years is US$ 236,860. In addition, UNICEF will provide the vaccines in kind.