Review of integrated health camp for Southern Humla district

Background:

The project "Mobile health camp in Humla district" was carried out by CVICT in the period August to November 2008. The project was designed as an integrated health camp to be implemented by CVICT in partnership with local institutions mobilising local volunteers and resource persons. CVICT has organised several mobile health camps in various locations around Nepal since 2004 with support from HAMU, but this is the first health camp that the partners have conducted in Humla district.  

Purpose/objective:

The primary purpose was to assess to what extent the project had met its stated objectives and whether project design and organisation had been appropriate for local needs.  The objectives were to assess program effectiveness, impact, organisation management, partnership relationship, project process monitoring and documentation, identifying the best practises and future roles in the changing context

Methodology:

Review of relevant documents, meetings with implementing partner, field visit, interviews, analysis and assessment.

Key findings:

The review team found that the project wass well organised and designed, and that it was appropriate for local needs in view of the acute situation in Humla district. While the project made a significant contribution towards addressing he needs of the target population, several areas with room for improvement were also uncovered.

Initially the project was planned for the southern part of Humla district. Later the project was re-designed and the location for the clinic was moved to Simkot, the district headquarters. The health camp was implemented by working in close collaboration with the District Health Office and the local Red Cross Society. It was hoped that the active involvement of the two organisations would help ensure long-term benefits in that the patients would receive follow-up. However, the DHO and the local Red Cross Society with their current resources feel that they are not able to provide the health services as indicated by the government policies and regulation. The evaluation team found that none of the respondents they talked to had been to the local hospital in the weeks following the health camp. Community members and local leaders claim they are aware of the need to seek health services if a family member falls sick, but due to financial constraints and lack of health service providers in the local health facilities they do not go.  Most wait for the health camps to be organised. 

During the health camp 600 individuals were provided check-ups and medicines over a period of three days, instead of 500 over five days, as originally planned. While this meant that the camp was conducted efficiently, it also meant that consultation time with each patient was severely reduced. Many did not receive adequate information on the nature of the drugs they were given or how they were to be used. The review team found that 50 % of the respondents still had medicines left hat they had not taken two months after the camp had taken place. The main reason given for this were that they were saving the medicines for when they were really sick or that did not know what he medicines were for.

The majority of the service seekers were from low-income groups such as students or farmers and many were illiterate. The review team did not have the data to comment on the participation of various ethnic groups, but it is felt that more proactive effort needs to be made to encourage the participation of ethnic minorities and disadvantaged groups.

Recommendations:

• Better planning and coordination with local stakeholders.
• Camps should be a series of coordinated events rather than just one event, with a strong element of monitoring and follow-up at different levels through the mobilisation of local health institutions with a focus on developing the capacityof the local service delivery mechanism.
• Conduct screening camps prior to the main camps using local health professionals.

• Bring more specialised teams of health workers along with more eqipment for better diagnostic services.

Comments from the organisation, if any:

The health camp was originally planned to take place in the more remote location of Southern Humla, and to be of 2-3 week's duration with a more diverse medical team. However, due to financial constraints the original plans had to be scaled down, which lead to a reduced service being offered. HAMU will take the recommendations into consideration when planning similar interventions in the future.