MINUTE

On Annual review and planning meeting of GGDK project

Arbaminch

Started date: February 29 -- Ended date: March 1, 2012

Place: Arbaminch GG zone administration council meeting hall

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PARTICIPANTS: There are two zones in project area.

  1. Zonal participants:

 Gamo Goffa and Segene Area People zones health department (heads, Disease Prevention and Health Promotion, MRC and Planning, monitoring and Evaluation work process coordinators )

 Gamo Goffa and Segene Area People zones finance and economic development department ( Heads, government finance administration and planning, monitoring and evaluation work process coordinators )

 Gamo Goffa and Segene Area People zones education department ( Heads and planning and monitoring and Evaluation work process coordinators)

  1. Woreda participants:

 Woreda health offices heads , Medical Cure and Rehabilitation (MCR) coordinators and PEC focal persons

 Woreda finance and economic development offices heads

 Woreda education offices heads

 Health centers heads

 IECWs

  1. Sawla Hospital participants

 Cataract surgeon

 Hospital manager

 Medical director

 IECW

  1. ORBIS participants

 Temesgen Kabeto-GGDK project manager

 Mulat Gebre –GGDK project field coordinator

 Wake Gena –GGDK project accountant

 Meseret –GGDK project assistant

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Agendas:-

  1. To high lighten on the magnitude of global, national, SNNPR and project area
  2. To evaluate 2011 project implementation of plan and its achievements
  3. To discuss challenges and forwards solutions
  4. To develop operational plan with partner for 2012

This regular meeting was organized and facilitated in collaboration with Gamo Goffa Zone Health Department (GGZHD) as majorities of the partner woredas are found in its catchment after many rearrangements to decide the date of meeting. This monitoring and evaluation, developing operational plan forum has great input in creating ownership of partners and sustainability of the project. It is also valuable opportunity for partners to share experience on PEC services and enable them to measure their status from what others best performing woredas did. The meeting was started after participants registration and stationery distribution accomplished around 10:00am. The meeting was opened by Ato Tadele Eshetu’s speech, delegate of Gamo Goffa Zone Health Department and coordinator of Disease Prevention and Health Promotion core process (DPCCP). By the time the opening speech made, almost all of the participants were availed. On his speech, he explained that ORBIS is working closely and in smooth collaboration with the two zones health departments and respective woredas health offices. On his final opening speech, the works of ORBIS is clear and transparent and in line with the Government polices. Finally, he wished and urged all the participants to actively participate in the two days review and planning meeting

As per the attached meeting program, selected 10 woredas were made to present their 2011FY PEC performances, challenges, solutions they attempted on challenges and best experiences they went through. The selection was categorized as best (three woredas), medium (three woredas) and less (four woredas) performed woredas in all aspects of PEC services. Summarized Challenges and solutions forwarded by the presenters (woredas) were stated as follows.

Challenges:-

1. Poor commitment of some IECWs.

2. Lack of support and follow up to IECWs from health centers and woreda health offices

3. Underreporting of WoHOs to Zonal Health Departments (ZHDs) and the project.

4. Shortage of supplies like guaze.

5. Hard to reach topography of kebeles.

6. Decrease of TT cases number from the nearby health facilities catchment area than usual.

7. Lack of transportation means and fuel to keep up the outreach program.

8. Poor participation of Community Health Agents (CHAs), Health Extension Agents (HEWs), and teachers after getting trained on PEC.

9. IECWs turnover and over demanding assignments to them.

10. Less incentives to IECWs (ETB 90 per three cases) and CHAs (ETB 5 per case) as the outreach programme and case finding is tedious.

Solutions taken:-

  1. Integration of PEC services with other routine health services of woredas and HCs in the outreach program.
  2. Sharing of routine activities supplies to PEC activities.
  3. Foot travels as an option taken to outreach despite of its topography and lack of transportation.
  4. Supporting of IECWs by incentives from office budget in absence of TT cases at outreach sites. E.g. Oyda woreda.
  5. Strengthening of outreach service.

After woredas presentation completed and main points of its contents highlighted by Ato Temesgen Kabeto, Project manager of GGDKA, participants’ discussion on presentation continued. Discussion on reasons for poor woredas performances, less cataract service beneficiaries, weak teachers’ contribution on schools eye cares (eye glass distribution), lack of strong ownership by partners and transportation problem for outreach programm was given attention and took longer time. The participants said that under performed and best performed woredas has their own draw back on planning besides all problems stated. These were under planning and over ambitioned planning of 2011. Only activities like trainings and MDA achieved well because of involvement of ORBIS itself. So, the woredas should have been planned on their capacity and regularly follow its implementation with accountability. They commented on importance of sawla hospital SECU report as if it should have been presented to see the systems that needs follow up. Accordingly, participants from the hospital including hospital manager and medical director were given chances to overview the status of the unit based on questions and ideas raised by participants. Cataract service yet remained controversial. The big question was “why less uptake of Cataract Surgery (CS) despite of high cataract backlogs, high cataract screened number per each woreda?” and “why did referred cataract cases not visit hospitals (to where they referred)?” Participants raised different logics and truths so that it will be exhaustibly explored and directions put for coming assignment on CS service as listed below.

These were:-

  1. Topography and socioeconomic factors. Some clients with cases of cataract are living in very remote kebeles where they could not travel on foot to where they can get service or where they can catch transportation as most are very old. The rest are too needy even to cover transportation and food costs e.g. as stated from Deramalo.
  2. Gap on convincing clients and follow up from CHAs and IECWs so that clients will get service.
  3. Loose network between referred cases hospitals woredas including HPs & HCs.
  4. Interruption of sawla hospital SECU service due to maternity and annual leave of cataract surgeon.
  5. Health Development Expansion task force, which was developed by 2011 FY by government, is best tool to implement every activity successfully. However, missing of this opportunity deteriorated routine health services and our PEC performance as well.

It was summarized by saying identification and notification of needy cataract cases feasible for CS by woredas and reporting to ORBIS project, ZHD and hospitals to solve the problem must be there. Added, the issue of ownership will be the cornerstones to decrease cataract backlog.

It was also noted that teachers trained on PEC and RE to establish schools eye care club were not given attention from all sides. The ground set was woreda education office should own schools eye care and made follow up of its implementation as routine activities. The participants were agreed that Partners and the project contribution must be there to solve the problems of shortage of motor bicycle and fuel in collaboration. Finally, the project plan Vs achievement report of 2011 was presented. The content of the report include highlight on magnitude of blindness& low vision and its causes, trachoma, budget expenditure, challenges, solutions taken, lessons learnt and recommendations. General discussion was made on overall 2011 FY activities report presented by the partners and the project in detail on early morning session of second date of the meeting.

A/Minch Zuriya woreda PEC focal person presenting 2011 FY annual report of PEC activities to participants Feb.29, 2012

Ato Temesgen Kabeto Presenting 2011 ORBIS GGDKA project annual activity report of PEC including budget and plan of 2012 FY to participants March 1, 2012.

Afterwards, presentation of 2012 FY ORBIS GGDKA project plan was presented by Ato Temesgen. Different questions and suggestions were raised by participants for discussion on the plans. The participants said “what we have to plan should address our community problems and take in to account our resources and capacity. We don’t have to talk on planning, poor performance, commitment and ownership problems on coming meeting.” Some questions asked on planning were as follows.

  1. Can ORBIS or others concerned body facilitate transportation to collect cataract cases to and from Sawla hospital by vehicle or arrange outreach program to increase service utilization?
  2. Could the project expand its horizon and embrace two woredas of Segen Area People Zone (SAPZ) -Burji and Amaro woreda) in to the project?
  3. When shall the shortage of ‘Trail Set’ could be solved?
  4. Is there any possibility of improving CHAs and IECWs incentive for TT outreach?

For these questions, Ato Tadele and Ato Temesgen gave responses on those which needs decision right there and took an assignment on those which need further discussion and decisions. Sawla hospital, ZHD and ORBIS can deal with facilitation of cataract clients’ mobilization if requests come on appropriate time with tangible demands. Ato Tamesgen also said ORBIS is always in continuous changes to amend and modify its strategy towards achieving the set objectives. So, the project is ready to flexibly handle things by analyzing the existing situation. In these processes, incentives improvements can be taken in to consideration for all PEC implementing partners accordingly. The supply of trail set to all woredas; at least one trail set per woredas will be processed and it will be delivered very soon. Regarding inclusion of two SAPZ’s woreda in to the project, Ato Temesgen said “the issue needs attention of OI, Donors and OE country seniors decision. Thus, it will be forwarded to the next level and the feedback will be informed to the SAPZ in the future.”

Finally, partner woredas were made to develop and submit their PEC plan for 2012 FY.

Ato Tadele Eshetu from GGZHD making summary discussion on the meeting March1, 2012.

Recommendations:-

 Most MDA plan was during rainy and farming season which make the distribution very difficult. So, It would rather be scheduled on dry and comfortable season in this fiscal year.

 Plan of PEC must be included in routine plan of health sectors and must also be included in Supportive Supervision checklist of at all levels.

 Frequency of ORBIS supportive supervision to partner sectors was not sufficient and it would be better if integrated with governmental regular (quarter base) supervision plan also.

 SAPZ woredas activities report should pass through SAPZ department like that of GGZ departments.

After addressing issues raised during the final discussion, Ato Tadele Eshetu , stressed that let have a stand not hear low commitments of health workers and avoid calling ORBIS works from this time on words. Eye health care is one of the Primary Health Care program. ORBIS is here to help us fill the gap in the effort to fight against blindness. Let us have a firm stand on this issue and properly utilize the budget transferred from ORBIS and settle on time

The meeting was wind up by making closing speech by Ato Tadele and he said the meeting was very fruitful and urges very participants to act according to plan