Monthly Progress Report

March 2021
 
 


 A.List of Activities accomplished in the month
SN Activities Status Remarks
          FCHV Training  at Gokarna Primary Hospital  Conducted on 23rd March 2021  
2 Screening camp at AMDA Nepal Office Conducted on 13th March 2021  
3 Screening camp at Jorpati Health Post  Conducted on 20th March 2021  
4 Screening camp at Gokarna Primary Hospital Conducted on 27th March 2021  
5 Coordination with Focal Person of Health Department of Gokarneshwor Nagarpalika Conducted on 3rd, 9th ,15th and 22nd Mar 2021  
6 Procurement of Medical Equipment Technical evaluation was completed and among all the vendor best one will be selected and order will be placed.  
 

B. Narrative Summary of Activities and Key Findings

  1. FCHV Training
In coordination with Health Department of Gokarneswore Nagarpalika, FCHV Training Program was conducted on 23rd March 2021. The program was conducted in the presence of Dev Shobha Shrestha, and Purna Bahadur Basnet, team of Health Department of Municipality, and all the Health Facility Staffs at Gokarna Primary Hospital, Gokarna. The program was commenced by Dr. Ashok Sharma Upadhyay, MO, with a detailed brief on the importance of breast and cervical screening camp that we are planning to conduct in Amda Office and one in Health Post every month.
Before the commencement of training, Program Officer had provided the brief on program, its objective, the Doctors team including other team and schedule of camp. Also, addressed the importance of the program to the community women and its benefits to them.
The training was intended for Female Community Health Volunteers (FCHV).The total number of FCHV participants were 17 and provide participant with:
  • pre-test was done before the commencement of session in order to know the knowledge of the FCHV on breast and cervical cancer.
  • an introduction about cancer and aboutmost common cancer in Nepal
  • briefed about breast and cervical cancer, and the incidence and highly impacted age group
  • causes, risk factors, sign and symptoms, diagnosis method, preventive measures, treatment
  • importance of screening, key notes that need to done before screening and its benefits as well.
  • post-test was done to evaluate the training session whether the FCHV understood the content or not.
During the training session, all the content was explained properly followed by brain-storming, information exchange, and shared opinions and experiences of FCHV. Overall, the program was conducted smoothly and effectively as per the set schedule. With the closing remarks, the program was ended with the valuable keynotes about the program and its positive impact on women's health of the community. Also, disseminated the scheduled camp date on 27th March 2021 at Gokarna Primary Hospital. All the FCHV were delighted to receive the free service to all the community women as this was one of the demanded health service that they were requesting to health desk of Gokarneshwor.
 

2.Details on Screening Camp

The activities undertaken in the camp have been listed in the points below in a sequential manner.
  • Registration of clients was undertaken.
  • Written informed consent was taken from the clients in the consent form.
  • Breast and Cervical Cancer Screening Forms were filled which included personal details, medical history, family history and detail on procedure conducted and findings.
  • Blood pressure and height of the clients were measured and recorded.
  • Cervical cancer screening was performed through visual inspection of the cervix with acetic acid (VIA).
  • After the cervical cancer screening, clinical examination of breast was performed for breast cancer screening.
  • The findings from both the cervical and breast cancer screening was disseminated by the medical team with necessary health information and counseling.
  • Those women who were screened positive (VIA positive and suspected lump in the breast) in the screening tests were referred to the Teaching Hospital for confirmatory diagnosis and prompt treatment.
 I. Composition of the team members
SN Name of the Team Designation Organization AMDA Office Jorpati HP Gokarna Primary Hospital Remarks
1 Dr. YP Singh Consultant  TUTH OD OD OD  
2 Dr. Neebha Ojha  Consultant  TUTH OD OD OD  
3 Dr.Rupam Pandey MO BCH OD   OD  
4 Dr.Prathana Pachhai MS Resident TUTH OD      
5 Dr. Neha Singh  MO   OD      
6 Dr Supriya MS Resident TUTH   OD    
7 Dr Ashma Khanal MS Resident TUTH   OD    
8 Dr Aliza Hamal MS Resident TUTH     OD  
9 Goma Dahal Volunteer   OD OD    
10 Srijana Shrestha PO AMDA OD OD OD  
11 Subash Dulal CF AMDA OD OD OD  
12 Kalpana Khadka Clinic Aid TUTH OD      
13 Niru Thami Clinic Aid     OD OD  
14 Parbati Bhatta  Receptionist AMDA OD   OD  
15 Laxmi Koju Registration AMDA   OD    
16 Bishnu Adhikari CA AMDA OD OD OD  
17 Raju Shrestha Driver Gokarna Nagarpalika OD OD    

a. Screening Camp at AMDA Office
This was a one day event conducted on 13th March 2021(29th Falgun, 2076) at AGWC, Amda Office, Jorpati. The camp was executed from 9.00 am to 3:00 pm. A total of 12 team members comprising of doctors, nursing staffs, clinic aid, volunteers and project staffs (see section I form, complete list of team members) were mobilized for the camp administration and service delivery. The event was targeted to women between 30 to 60 years of age. A total of 40 women attended the camp and 34 clients benefitted from the screening services for cervical cancer and 37 clients benefited from breast cancer screening services.


I. Service Details Age Group wise :
SN Age Group of Clients Total Registered Clients Breast Cancer Serviced Clients Cervical Cancer Serviced Clients Remarks
1 30-34 years 4 4 4  
2 35-39 years 9 9 8  
3 40- 44 years 8 8 7  
4 45-49 years 9 8 9  
5 50- 54years 6 3 4  
6 55-59 years 2 2 1  
7 60-64 years 2 2 1  
  Total 40 36 34  

II. Outcomes from the Screening Client
 
SN Cervical Cancer Screened Client Breast Cancer Screened Client Referred To Remarks
1 1 Client’s VIA Test had partially visible Squamocolumnar Junction and was advised for Pap Smear Test
Also, had high BP 170/120
1 Client had Benign Lump
Advised for Mammogram
Teaching Hospital(TUTH)

Immediately referred to NMC emergency
 
2 1 client had history of 16 years use of Depo with amenorrhea followed by heavy Bleeding
Advised for change of Contraceptive Device
30 clients were Suggested for Mammogram Gokarna Primary Hospital  
3 1 client had history of Depo use since 8 years
Advised for change of Contraceptive Device
  Gokarna Primary Hospital  
4 1 client had Multiple Nepothilium Cyst
Advice Pelvis USG
  Nepal Medical College (NMC)  
5 1 client had Vulval Leucoplakia if not treated then advise Vulval Biopsy.   Teaching Hospital(TUTH)  
  
b. Screening Camp at Jorpati Health Post

This was a one day event conducted on 20th March 2021 (7th Chaitra 2077) at Jorpati Health Post, Arubari -9. The camp was executed from 9.00 am to 3:00 pm. A total of 12 team members comprising of doctors, nursing staffs, clinic aid, volunteers and project staffs (see section IV form, complete list of team members) were mobilized for the camp administration and service delivery. The event was targeted to women between 30 to 60 years of age. A total of 45 women attended the camp and 38 clients benefitted from the screening services for cervical cancer and 44 clients benefited from breast cancer screening services.


I. Service Details Age Group wise :

SN Age Group of Clients Total Registered Clients Breast Cancer Serviced Clients Cervical Cancer Serviced Clients Remarks
1 30-34 years 9 9 8  
2 35-39 years 5 5 5  
3 40- 44 years 8 8 6  
4 45-49 years 9 9 9  
5 50- 54years 8 8 8  
6 55-59 years 3 3 1  
7 60-64 years 2 2 1  
8 65+ years 1 0 0  
  Total 45 44 38  

II. Outcomes from the Screening Client
 
SN Cervical Cancer Screened Client Breast Cancer Screened Client Referred To Remarks
1 4 clients were VIA Positive
Advised for HPV DNA test and Cytology
10 Clients were suspected as  Benign Lump
Advised for Mammogram and Breast USG
Teaching Hospital(TUTH)  
2 4 Clients VIA Test had partially visible Squamocolumnar Junction and was advised for Pap Smear Test
2 Clients VIA Test had not fully visible Squamocolumnar Junction and was advised for Cytology Test
3 Clients were suspected as Suspicious Lump
Advised for Mammogram
Teaching Hospital(TUTH)  
3 1 Client had right adenexal cyst
Advised for USG abdomen/Pelvis 
  Teaching Hospital(TUTH)  
4 1 Client had yellowish discharge  and 1 client with Vaginal Trichomonasis
Prescribed Antibiotics 
     
5 1 client had history of prolong bleeding
Advised for USG abdomen/Pelvis
  Teaching Hospital(TUTH)  

 

c. Screening Camp at Gokarna Primary Hospital

This was a one day event conducted on 27th March 2021 (14th Chaitra 2077) at Gokarna Primary Hospital -9. The camp was executed from 9.00 am to 3:00 pm. A total of 8 team members comprising of doctors, nursing staffs, clinic aid, and project staffs (see section I form, complete list of team members) were mobilized for the camp administration and service delivery. The event was targeted to women between 30 to 60 years of age. A total of 64 women attended the camp and 56 clients benefitted from cervical cancer screening services and 60 clients benefited from breast cancer screening services.


I. Service Details Age Group wise :

SN Age Group of Clients Total Registered Clients Breast Cancer Serviced Clients Cervical Cancer Serviced Clients Remarks
1 30-34 years 11 11 11  
2 35-39 years 14 14 12  
3 40- 44 years 13 13 13  
4 45-49 years 9 8 8  
5 50- 54years 7 7 7  
6 55-59 years 5 5 4  
7 60-64 years 2 2 2  
8 65+ years 3 0 0  
  Total 64 60 57  

III. Outcomes from the Screening Client
 
SN Cervical Cancer Screened Client Breast Cancer Screened Client Referred To Remarks
1 4 clients - VIA Positive
Advised for HPV DNA test and Cytology
6 Clients were suspected as  Benign Lump
Advised for Mammogram and Breast USG
Teaching Hospital(TUTH)  
2 1 Client had uterine bleeding due to which VIA could not be done.
Advise for USG to rule out fibroid Uterus, cervical cytology and may need endometrial biopsy.
  Teaching Hospital(TUTH)  

 
3.Coordination with Focal Person of Health Department of Gokarneswore Nagarpalika

On 3rd March 2021, coordination was done with Hari Psd Upadhaya Sir regarding program planning of March i.e. FCHV meeting and Screening Camp. Likewise, on 9th and 15th March coordinated with health desk team for the screening camp and dissemination of camp date to the respective health facility staff. On 22nd March, submitted the camp report that was conducted previously and planned for screening camp at Gokarna Primary Hospital.


4. Procurement of Medical Equipment
Technical Evaluation of the supplies was completed. Among all the vendor best one will be selected by the procurement team and purchase order will be placed. After the order is placed, probably within a month Mammogram and USG machine will be received.

 

5. Lesson Learned

  • FCHV training have been instrumental in increasing of Breast and Cervical Cancer Screening service numbers. The content and quality of FCHV training plays an important role in educating FCHVs on the importance of breast and cervical cancer screening services for their community. Due to which, the client flow at Gokarna Primary Hospital was optimum and all the client including FCHV were satisfied with the service they received. Also, requesting for another camp to organize soon as the need is very high in the area.
  • In some areas, Mothers Group (Aama Samuha) were engaged in various community activities. This helped establish greater trust of community people toward health service. So, meeting with this group had become the pivotal reason in increasing the awareness of people on screening services. As the meeting was scheduled at Jorpati Health Post and this aided to self-interest of women toward screening service.
  • Regular coordination and meeting with Health Desk Team, proper planning with implementation of activities and good team work always lead the program to success.

D. Plan for Next Month (April 2021)

SN Planned Activities Planned Date Remarks
1 FCHV Training  at Baluwa Health Post On 6th April 2021  
2 Screening Camp at Baluwa Health Post On 13th April 2021  
3 Screening Camp at AMDA Office On 17th April 2021  
4 Purchase order placement of Medical Equipment’s namely Mammogram, USG machine and Colposcopy By 2nd week of May 2021  
 

7.Success Stories:

Tara Khadka, 50 years old lady visited to Jorpati Health Post on 20th Mar 2021 with her daughter. For a while, she looked around the crowd and listened the conversation at registration area that was ongoing with other women. She was feeling awkward to receive the service. Her daughter was requesting her to sit in chair and register her name but looks like she was not ready for it. Meanwhile, I started the gentle conversation with her whether she is here for service or not. She replied, actually I was here just because my daughter insisted and also it is near to my home. I am not ready for the service as till date with god blessing I am fit and fine and I don’t think this service is meant for me.

Furthermore, I explained her the importance of screening regarding breast and cervical cancer. However, she was not convinced with my words. So, I requested her to sit in the waiting area for a while and drink water. After a while, I requested one of the satisfied client of her age to interact with her and explain how she felt about service and how doctor provided the service. They both started the conversation, gradually few minutes later, she felt comfortable and started to query her few hesitation. Finally, she got ready to receive the service.

So, she went to the screening service after registration and received the service. After that, I asked with her weather she has anything to say or anything she is dissatisfied with or any queries. Well, she showed her prescription card and said Doctor has told me to go the teaching hospital for further test. Breast screening result was query suspicious lump and advised for Mammogram and FNAC. Also, she had VIA positive report during cervical screening and advised for HPV DNA test. I explained her and her daughter regarding further test at hospital and to visit AMDA Office with report for the follow up on 17th April 2021. Though she was quite worried with the result, she was so satisfied and happy that timely the problem had been detected and thanked her daughter for bringing her for checkup and the team for the service.

 
 
AMDA Nepal

Contact Details

AMDA Nepal
Gokarneshwar Municipality - 6, Jorpati
P.O. Box 8909, Kathmandu
Phone: +977 (1) 4910235, 4911140
Fax: +977 (1) 4911141
E-mail: amda@amda.org.np

AMDA Hospital
Damak Municipality-2, Kharkhare, Jhapa
Phone: +977 (23) 580046, 580667
Fax: +977 (23) 580186
E-mail: ah.damak@amda.org.np

Siddharth Children & Women Hospital
Butwal Sub-Metrpolitan -7, Rupendehi
Phone: +977 (71) 502097
Fax: +977 (71) 502085
E-mail: scwh.butwal@amda.org.np

AMDA Mechi Hospital
Mechinagar Municipality-10, Dhulabari, Jhapa
Phone: +977 (23) 560550
E-mail: amh.dhulabari@amda.org.np

AMDA Institute of Health Science
Damak Municipality-2, Kharkhare, Jhapa
Phone: +977 (23) 580186, 582186
E-mail: aihs.damak@amda.org.np