SPECIFIC OBJECTIVE

PLANNED ACTIVITY

ACTUAL ACTIVITY

FACILITATING / CONSTRAINING FACTORS

PLANS TO OVERCOME CHALLENGES/ FUTURE PLANS

To finalize National Maternity Care Guide lines

• To obtain  relevant input from all stake holders

• To obtain formal approval for the National Maternity Care Guidelines

• To Print the National Maternity Care Guidelines

• To launch the National Maternity Care Guidelines

• To provide training in the provinces for implementation of National Maternity Care Guidelines

• Inputs and comments obtained from all provinces, medical and nursing universities and colleges

• National Maternity Care Guidelines taken through formal process of approval by the relevant structures of the Department of Health

• National Maternity Care Guidelines officially launched by the Minister during December 2000

• National Maternity Care Guidelines printed and distributed to all provinces for further distribution to all institutions.

• Provincial commitment, cooperation and collaboration with provinces, medical and nursing universities and colleges

• Delay in printing the guidelines led to delay in planning and conducting the training workshops for implementing of the guidelines.

• Training workshops for implementation of the guidelines to be held in the next financial year

• To hold four meetings with the members of NCCEMD to discuss the technical issues of maternal deaths notification

• To conduct provincial feedback on the 1998 Saving Mothers Report

• To facilitate formulation of Reproductive Health Committees at Provincial and District level

• To embark on communities awareness campaigns on importance of safe pregnancy and maternal deaths notification

• To hold one National Workshop with provincial assessors and the NCCEMD to update the assessors, orientate new assessors and to discuss and plan the constraining factors in the implementation of maternal deaths

• To provide report on maternal deaths notification

• One meeting held during each quarter of the financial year.

• Provincial feedback on the 1998 Saving Mothers Report held in all provinces

• National workshop to finalize Policy and Management Guidelines for common causes of maternal deaths held during April 2000

• Policy and Management Guidelines for common causes of maternal deaths finalized - to be printed

• Second interim report on maternal deaths notification compiled during June to July 2000, printed, officially launched by the Minister and distributed to all provinces for further distribution and dissemination of information to all health care providers, NGO’s, CBO’s and the public

• Provinces committed to the implementation of the recommendations made by the NCCEMD to improve the quality of maternal health care services

• A national workshop for NCCEMD members, Provincial Assessors and Provincial MCWH coordinators held in February to update assessors, orientate new assessors, discuss and plan to overcome constraining factors in the implementation of maternal deaths notification.

• Annual Midwifery Congress held during December 2000 as one of the continuing professional development for midwives in the country

• Media launch on pregnancy education and expansion of Hands On Programme (Pregnancy Education Programme to enhance and strengthen pregnancy education) to one facility per province held during February 2001

• Training of one trainer per province to facilitate implementation of Hands On Programme held during February 2001

• Community campaigns and other activities held in provinces to raise awareness on the importance of promoting safe pregnancy, child birth and child rearing

• Cooperation and collaboration with provinces on notification of maternal deaths

• Active involvement and participation of provincial assessors in assessing the notified maternal deaths

• Commitment, active involvement and participation of NCCEMD members

• Delay in getting the notified cases from provinces

• Delay in getting feedback from provinces on progress with implementation of the ten recommendations from 1998 Saving Mothers Report

• Insufficient funds to print adequate materials for expansion of the Hands On Programme in the provinces

• To identify some institutions in the provinces for ongoing monitoring of implementation of the recommendations by the NCCEMD to improve the quality of maternal health services

• Provincial visits to strengthen Reproductive Health Committees

• Continuing collaboration with private sector to facilitate roll out of Hands On Programme

• To develop a draft National Maternity Case Sheet

• To obtain inputs and comments on National Maternity Case Sheet from all relevant stake holders

• To obtain formal approval for the National Maternity Case Sheet

• To develop a guide on utilization of National Maternity Case Sheet· To print the finalized National Maternity Case Sheet

• To launch the National Maternity Case Sheet

• To distribute the printed National Maternity Case Sheet

• Draft National Maternity Case Sheet developed from samples of maternity case sheet from all provinces

• Draft National Maternity Case Sheet sent to all provinces, medical and nursing universities and colleges for comments and inputs

• National Maternity Case sheet taken through the process of formal approval by relevant structures of the Department of Health

• National Maternity Case Sheet formally launched by the Minister on the 27^th November 2000

• Availability of samples of maternity case sheet from all provinces

• Cooperation/ collaboration with all stake holders for comments and inputs on National Maternity Case Sheet

• Participation of Northern Province in piloting the National Maternity Case Sheet

• Delay in printing the National Maternity Case Sheet due to financial constrain

• Printing of National Maternity Case Sheet for all public sectors providing delivery services to be done in collaboration with HIV/AIDS unit during the first six months of the next financial year while provinces are preparing to take over printing for their institutions

• Training of midwives and doctors on utilization of National Maternity Case Sheet to be held during the next financial year.

To promote implementation of the Decentralized Education Programme in Advanced Midwifery and Neonatal Nursing Science

• To hold meetings with provinces to discuss implementation of DEPAM

• Discussions around implementation of DEPAM held with provinces at the MCWH quarterly meetings

• Letters directed to Provincial Heads of Health were sent to all provinces requesting for their progress report on DEPAM

• Meeting held with National Human Resource Development to discuss problems around implementation of DEPAM in the provinces

• National and Provincial Human Resource Directorate to take over the primary responsibility of facilitating training of advanced midwives through the Decentralized Education Programme

To reduce perinatal mortality ratio

• To identify sentinel sites for monitoring perinatal mortality ratio

• Meetings to discuss monitoring of perinatal mortality held with MRC that is utilizing the Perinatal Problem Identification Programme (PPIP) to monitor the perinatal mortality ratio in eight of the provinces

• National workshop held with Provincial MCWH coordinators, Health Information Systems and representatives from MRC and institutions utilizing the PPIP during November 2000 to discuss monitoring of perinatal mortality ratio in the country· Training of trainers to implement The PPIP conducted by the MRC

• Meetings held with NHISSA to further discuss data collection and implementation of PPIP for monitoring of perinatal mortality ratio in the country

• Common causes of perinatal deaths in the country identified.

• Perinatal mortality ratio for the country estimated

• Saving Babies report with recommendations to improve the perinatal care for the country compiled to be printed

• Lack of information and / or programmes at National and Provincial level to capture perinatal mortality ratio for the country

• Delay in provincial response to commitment

• Representative from MRC to further present the PPIP in the NHISSA meeting

• Provincial visit to discuss and facilitate implementation of the recommendations

To develop IEC materials

• To develop pamphlets; posters and booklet around causes of maternal deaths

• Five posters developed for pregnancy education were translated into the other ten official languages of the country

• Lack of money for printing translated materials

• Printing for IEC materials to be budgeted for in the next financial year

To promulgate the National Maternal Child and Women's Health Policy document that is utilized as a draft since 1995

• To print the National Maternal Child and Women's Health Policy document

• To launch the National Maternal Child and Women's Health Policy document
• To distribute the National Maternal Child and Women's Health Policy document

• Submission sent to all Sub-directorates within the cluster requesting them to update their particular section in the policy document

• Submission was sent to office of Cluster Manager requesting financial assistance for this specific objective.

• Lack of money for printing of the National Maternal Child and Women's Health Policy document

• Lack of cooperation and support from other sub directorates within the cluster

• The specific objective to be referred to office of Cluster Manager for the coming financial year