2-OCT-2020, Dolakha

Following the devastating earthquake of 2015, Nyaya Health Nepal (NHN) entered into a partnership with the Ministry of Health and Population (MoHP) for rebuilding damaged health facilities and strengthening health system in Dolakha district.

Under the MoU signed with the MoHP, Nyaya Health Nepal started rebuilding earthquake damaged health posts from July 2015 itself. After this, under another MoU signed with the MoHP on January 19, 2016, NHN also started managing Charikot Hospital from January 24, 2016.

Since then, NHN has invested $6.7 million in Dolakha during this period, rebuilding 19 healthposts and handed them over to the government. Some 280,000 people have received direct care through Charikot Hospital, and 55,000 through the network of community health workers. The Government of Nepal has also supported the initiative by providing community hospital grants, pharmaceuticals and supplies, human resources (16 people on an average throughout the year), infrastructure development (store expansion, building of High Dependency Unit), provision of training, VTM and PPE support for Covid-19 response. Together, we have been able to make significant achievements in the healthcare system.

Major Achievements:

Integrated Digital system :

using EHR, Open Elis, Digital X-ray,  Open ERP, and CommCare for healthcare management, Asana, Gmail, Google Hangouts, for team communication, and BambooHR, Small Improvement for human resource management.

Infrastructure:

rebuilt earthquake damaged 19 health posts, OPD building and boundary wall construction at Charikot hospital.

Added equipment and services :

Added equipment and services to the community health program, mental health, orthopaedic care, surgery, ultrasound, digital x-ray, IT server, generators, autoclave, biochemistry analyser, dental service

Education and training: regular CME classes, residents placement, trainings and workshops

Covid19 response : screening, PCR testing, management of COVID-19 positive cases.

Improved health status : increased Institutional Birth Rate: 80-95%;neonatal mortality rate 7/1000 (Tamakoshi, Bhimeshor, Baiteshor, Kalinchowk), surgical complication rate: <5%, C-section Rate: 13 % (504/3900) 

Internal System Strengthening

Performance based system–regular and annual performance evaluation; individual, team and organizational objectives and key results; SOPs for processes. 

Employee support daily morning standing meeting, weekly 1:1 meeting, Monthly HIMC meeting, Quarterly HoC meeting, and Interdepartmental meetings.

Learning – Daily CME and Curriculum, Clinical Handbook, Workshops, Internal & external training, MDGP and Nursing placements.

Regular Programs Running Currently at Charikot Hospital and in the Communities:

Regular Services – 24/7 ER, OPD, IPD, Pharmacy, radiology, Laboratory (CBC, Blood group, Serology, LFT, RFT, Calcium, Sugar profile, HbA1c, Coagulation profile, Sputum tests, Stool tests, Urine tests, Body Fluid) , Surgeries (C-section, Appendectomy, Hernia, Hydrocele, Hysterectomy, Orthopedics, Pediatric surgery, Hemorrhoids, Intestinal anastomosis, I&D, Lump excision), Psychosocial counseling, Dental care, One Stop Crisis management Center, Ultrasound, Echocardiography, Transvaginal ultrasound, Immunization, Family planning (Temporary and permanent), Antenatal care and postnatal care, Safe Motherhood (CEONC, Normal vaginal delivery, c-section), Physiotherapy.

Community Health Program – pregnancy surveillance, group antenatal care, postnatal care, under 2 care, chronic disease counseling

Collaborative Care Model for mental health care – managing common psychiatric illnesses with psychosocial counselors, primary care physicians under remote guidance of psychiatrists.

Malnutrition Care – Focusing on Under 5 and pregnancy.

Vertical programs – CEONC and safe motherhood, safe Abortion Service (First and second trimester abortion), MDR-TB, DOTS, HIV/AIDS, Leprosy, Family Planning.

Thank you note:

Nyaya Health Nepal would like to thank the Government of Nepal Ministry of Health and Population, Provincial and Municipal Governments, all the stakeholders who have supported us and guided us, partners, dedicated staff, civil society, for the trust and support in managing the public sector healthcare in Dolakha.

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