SOMALI REGIONAL STATE

HEALTH BUREAU

MOBILE HEALTH AND NUTRITION SERVICE

IMPLIMENTATION GUIDELINE

SEPTEMBER, 2011
JIJIGA

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Contents
List of Abbreviations...............................................................................................................................3
Introduction.............................................................................................................................................4
Rationale of the operational manual........................................................................................................4
MHNT Service package..........................................................................................................................5
Service package components..................................................................................................................5
Staffing and Team Management.............................................................................................................6
MHNT Service Delivery Modality.........................................................................................................8
Service Organization...........................................................................................................................8
MH&NT Assignment and Withdrawal Criteria......................................................................................9
Selection of Service Delivery Sites.....................................................................................................9
Working Schedule and Strategy..............................................................................................................9
Logistics................................................................................................................................................10
Supplies.............................................................................................................................................10
Supply Management..........................................................................................................................10
Transportation...................................................................................................................................10
Training Package for the MH&N team members.................................................................................11
OTP Follow up during Suspensions and Withdrawals..........................................................................11
Coordination, Monitoring and Reporting..............................................................................................12
Coordination......................................................................................................................................12
Planning, Monitoring and Supportive Supervision...........................................................................12
Reporting...........................................................................................................................................12
Review meetings...............................................................................................................................12
Documentation and dissemination of good practices........................................................................13

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List of Abbreviations

ARI Acute Respiratory Tract Infection

DPPB Disaster Prevention and Preparedness Bureau
EPI Expanded Programme for Immunization
FP Family Planning
HC Health Centre
HE Health Education
HEP Health Extension Programme
HEW Health Extension Worker
HH Households
HMIS Health management information system
HP Health Post
IDSR Integrated Disease Surveillance and Response
ICCM Integrated community case management
IMNCI integrated management of neonatal and child illnesses
ITN Insecticide treated net
MUAC Mid-Upper Arm Circumference
MH&NT Mobile Health and Nutrition Team
NGO Non-Governmental Organization
OCHA United Nations Office for Coordination of Humanitarian Affairs
OTP Outreach Therapeutic Programme
PHEW Pastoralists Health Extension Worker
RDT Rapid Diagnostic Test
RHB Regional Health Bureau
PHW Primary Health Workers
RHB Regional Health Bureau
SAM Severe Acute Malnutrition
TT Tetanus Toxoid
UNFPA United Nations Population Fund
UNICEF United Nations Children’s Fund
WHO World Health Organization
WoHO Woreda Health Office

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Introduction
Mobile health teams in the Somali region were piloted in 2004 for eight severely drought and measles
epidemic affected areas. During this first period, the teams had neither formal training nor specific
guidelines to follow. There were no clear movement schedules. The teams offered basic health services
with free drugs and health education. There was no attempt to monitor the activities of the teams and
record numbers of patients seen.
In 2006 mobile teams were re-introduced again in 16 woredas during the severe drought which affected
the horn of Africa. During this second period training was organized focussing on key priorities to prevent
child morbidity and mortality. Additional services offered included emergency nutrition and ITNs
distribution. The teams were covering more or less 1 woreda each with at least six service delivery points.
There was increased emphasis on monitoring with regular supervision by the RHB and UNICEF and
regular reporting of outpatient consultations. As a result, achievements made were quite exciting
especially in the 1st phase of the project.
In 2009 mobile health teams were again introduced and expanded to 20 woredas. In this period, including
the existing designated services, immunization and other maternal health services were included.
Over the past seven years, deployment of mobile health teams was needed again and again to save lives of
vulnerable communities because of the repeated emergencies with increasingly weakened resilience to
shocks (Drought, Floods, Disease outbreaks and conflicts) living in poor or limited basic infrastructures
for service delivery that can meet public demand even in normal times. Using the opportunity of the
mobile health and nutrition teams (MHNTs), the regional health bureau and partners have increased
disease surveillance to identify risk factors and monitor malnutrition pattern and alsoimproved access and
utilisation through the provision of free outreach/mobile health and nutrition services with a focus on
women and children, particularly in hard to reach areas and the need for.
With each round of MHNT deployment, the RHB and partners used lessons from previous experience to
improve the service delivery as well as the operational issues related to the team movement. The service
package has evolved from measles epidemic response to including the major child killer diseases (malaria,
pneumonia, diarrhea, malnutrition and measles) and later to including WASH activities and building the
capacity of the local health system.

The main objective of the mobile teams is to improve access to - and utilization of - basic child and
women friendly health, nutrition and WASH services to prevent avoidable morbidities and mortalities and
alert, prevent and control disease outbreaks.

Rationale of the operational manual

With the use of MHNT modality for longer period in Somali region, the need for clear guidelines became
apparent to enable:
 Standardize and harmonize the MHNT services in the region that are undertaken both by RHB and
NGOs,

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  Document the experience in a guideline and create opportunity for better service provision through
continued revision and improvement,
 Clarify minimum operational standards from MHNT.

MHNT Service package

Table 1: MHNT Service package

Child health services
Health Service Provision Maternal health services
Health education and BCC
Capacity building, e.g. Attachment of HEWs
Support to the woreda health to MHNTs as onjob training.
office Logistics, reporting, referral, functionalizing
and strengthening non-functional HPs

Service package components

The service packages will be clustered under child health, maternal health and other acute and life
threatening illnesses.

Consultation & Treatment

All patients are categorized in to packages; child health package maternal health package and other
acute and life threatening illnesses in to another package. Other major activities in the daily team service
include emergency responses.

Maternal health
Maternal health package is composed on Antenatal and New-born Care (ANC) including Iron
Supplementation, provision of TT, distribution of clean and safe delivery kit, identification of high risk
mothers and facilitation of referral system to the nearest health facility, birth preparedness & complication
readiness, counselling on Family Planning (FP), breast feeding & HIV. Others are promotion of safe
Delivery, Post Natal Care and Vitamin A supplementation to lactating mothers as well as managing other
acute and life threatening illnesses.

Child Health
All sick children are managed under IMNCI protocol. Other services under the child health package are
Immunization, Vitamin A supplementation and De-worming

Nutrition
Screening of all under 5 children (under children health package), pregnant women and lactating women
(under maternal health and other acute & life threatening illnesses package)and essential nutrition actions
(ENAs). Outpatient Therapeutic Program based on priority of public health and health related diseases,
including HIV/AIDS and ANC. The community leaders should be made the agents of behavioural change.

Referral

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All emergency cases beyond the team capacity should be transported to the nearest referral health centre
&/or Hospital, if there is no ambulance in the woreda. However, if there is ambulance in the woreda the
referral case should be transported from the site to the woreda capital and then transported by the
ambulance to nearest referral site.

Support to Woreda Health Office

Selection of six operational sites including one health post will be done in day one for RHB/UNICEF
supported teams. The team will assist in functionalizing and strengthening the health post by visiting one
day per week for three weeks. The support package for health posts includes service delivery, HEWs
capacity development in recording and reporting, active case searching and sensitization, supply and cold
chain management and model household training. Revisit the health post one month after revitalization.
After three weeks, the team will move to another non-functional health post to repeat the same support. As
much as possible, the MHNT will come back for monitoring the progress of the supported health post at
least one month after last visit. If the woreda has no health post, the MHNT will choose another sixth
operational site. NGOs supported teams will adjust according to their operational sites, program extent
and context.

Two HEWs are attached in the team with the health workers so that they have an opportunity to learn
while the team is delivering the service. Assignment of HEWs in a team should be for 3 months (a
minimum of 2 weeks on vaccination, 4 weeks on IMNCI, 2 weeks on safe motherhood, 2 weeks on
WASH, and 2 week on HE is required for one HEW to gain knowledge).

The MHNT will transport supplies to health facilities along the way to its operational site. Moreover, it
will collect reports from health facilities and pass it on to the woreda health office and RHB as
appropriate. In woredas without ambulance, the MHNT may transport sick patients to nearest referral
health facility.

Response to Rapid-Onset Emergencies

Response to the acute emergency needs of children and women will be focused during sudden-onset
emergencies. In principle, the service package will be modified to the type of emergency. However,
treatment of children using the IMNCI protocol, measles vaccination, vitamin A supplementation and de-
worming will be prioritized. On nutrition, focus will need to be on screening of all under 5 children,
pregnant and lactating women, essential nutrition actions (ENAs) OTP, Referral for complicated cases.
Depending on the emergency, organizing sanitation campaigns, distribution of water treatment chemicals,
strengthening of surveillance and reporting activities should also be prioritized.
All emergency cases beyond their capacity should be transported to the nearest referral site if there is no
ambulance in the woreda. If there is ambulance in the woreda the referral, case should be transported from
the site to the Woreda and transported by the ambulance to nearest referral site. In extreme situations
where more referrals are made than the ambulance could cope, the team will assist mindful of the full
impact.

In terms of woreda health office support, the team will assist in the mobilization and involvement of
additional HEWs in the Woreda.

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Staffing and Team Management
The staff of a mobile health team will be either attached to or coordinated under the woreda health office.
The team members would be permanent staff of the woreda or temporarily assigned staff specific for the
mobile health team. A mobile health team will consist of:
 2 health workers (clinical and/or a midwife nurses) whose responsibilities will include:
o Medical consultation and nutritional screening
o Safe motherhood (including nutritional screening of PLW), HE and WASH
 2 HEWs
 1 site based social-mobilize for mobilizing the community and crowd control
 1 driver will be responsible in filling the logbook.
A team will have a team leader who will be the most senior team member among the nurses. S/he will
coordinate the work of the team and manage operational matters (e.g. Supplies, Fuel, DSA, Stationery,
etc). S/he will develop the movement plan of the team, compile monthly activity report, monitor supply
utilization and request replenishments (quarterly). S/he will also liaise with local authorities, represent the
team in meetings and be responsible with all communications of the team.

The team members will be rotated/ changed every six months. Rotation of HEWs – 2 months basis.
Measure should be taken in case a MH & NT member is not performing the assigned tasks.
Measures to be taken will be:
1. Change to another woreda,
2. If the performance is still poor, the member should be replaced by another staff,
3. In case of unjustified 5 days absenteeism without permission from the woreda health office or
RHB, the staff should be warned twice and dismissed if no improvement is seen.

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MHNT Service Delivery Modality
Service Organization

Starting the day early is crucial for the smooth operation of mobile health teams including crowd control.
Provide enough space between each of the teams that are providing each component of the service and as
much as possible arrange the services to facilitate one direction of flow of clients with designated entry
and exits. The service delivery should be organized in three main areas: (1) community dialogue/ health
messages at the entrance of the service, (2) Child health package, and (3) maternal health package and
acute/life threatening adult illnesses package.

The health extension workers will be assigned overlapping with health workers so that their stay is used to
build their capacity as much as possible. At the start of the day, the health extension worker will provide
health education while the rest of the team are organizing the service provision order in such a manner that
the movement of people is in one direction and the child health and maternal health service group have the
needed supplies around their point. Each of the child health and maternal health service package will be
provided by one health worker and one HEW as a package. The drugs needed for each of the package will
be arranged by themselves in the morning and they will be responsible to dispense removing the need for

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a separate dispensary. This will allow the HEW to involve both on case management, counselling and
dispensing alongside with the HWs.

MH&NT Assignment and Withdrawal Criteria

A team will be assigned to woreda if it qualifies one or more of the following conditions.
 Disease outbreaks and/or other health related hazards (flood, drought, internal displacement, clan
conflict, etc)
 Woreda with major access problems,
 Woredas with relatively very low service coverage as per the RHB categorization.

A mobile health and nutrition team will be withdrawn from a woreda following:
 Operational limitations for the MH&NT activities in the woreda that extremely limit the services
of the team,
 If the health condition of the woreda improves,
 If the condition of a woreda worsens than a woreda having MH&NT, then the team will be
relocated to the worse off woreda,

NGO mobile teams should have comprehensive package and should be discussed in advance during
planning with the RHB.

CAUTION: No two MH&NTs should co-exist in the same woreda to avoid duplications except during
emergencies that necessitate.

Selection of Service Delivery Sites

A team will normally have 6 service delivery sites, which are accessible, in a woreda. Selection of these
sites will depend on the below criteria and will be determined in consultation with the woreda
coordination committee and community elders.
 Existence of an emergency situation in a kebele(s). These include both disease epidemics and other
disasters.
 High population density area, including catchment area,
 Having no functioning health facility,
 If other conditions necessitate, including hard to reach areas.

Working Schedule and Strategy

1. Regular outreach services

 A team will make site visits 6 days a week on selected service delivery sites, one day to each site.
On the 7th day the team will rest and compile its weekly report.
 Sites on the same direction or route will be clustered together and the team shall have the option of
staying overnight in one of them to reduce travel time.
 The movement plan need to be posted in each of the service delivery sites and the WoHO,

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  During site visit days, the team will need to depart 7.30am to the service delivery sites and be in
their overnight site latest at 5:00pm. The team leader is responsible to ensure timely departure and
arrival of the team.
 Cancellations should be informed to the community mobilizer, wherever that is possible.
2. Emergency investigation and response
 The team will inform public health emergency reports (including rumors) to woreda health
office and RHB immediately where possible.
 For investigation and response the team will intervene based on guidance of the woreda
health office and directives given by the RHB. Existing sites would be revised to respond
to most emergency affected sites.
3. Monthly meetings will be scheduled on their end of month rest day to review performance, analyze
context, and finalize monthly activity report.
4. Only patients medically approved by the MH&NTs will be referred using the MH&NT vehicle, in
woredas where there is no ambulance. From site to woreda capital…

Logistics

Supplies
The basic supplies of MH&NTs will include:
Medical: Basic essential drugs (e.g. emergency drug kits, malaria supplies) and medical supplies and
equipments guidelines, charts, booklets, BP Apparatus, Thermometer. Etc
(See attached annexes.1, 2, 3& 4)
Nutrition: Vitamin A capsules, multi-micronutrient supplements, MUAC tapes, weighing scales, RUTF,
Amoxicillin, folic acid, registers, OTP record card, posters, TFP screening and charts,
WASH: Water treatment chemicals (i.e. PUR, water guard, Aquatab, etc), standard sanitation and hygiene
messages, and AWD messages,
Other supplies: HMIS registration and reporting forms, foldable chairs and tables, gowns, portable water
filters, 20 litres water containers, field materials/survival kit.

Supply Management
Supplies shall be stored in a safe store, agreed by the team leader and the woreda health office head. The
custodian of the store will be the nurse other than the team leader. Issuance of supplies will be authorized
by the team leader and issued by the custodian.
In case of withdrawal and relocations, and during quarterly review meetings, a committee will be formed
to safeguard stocks left behind. Expiry drugs should be managed by the woreda coordination committee
and reported to RHB. The team shall not take more than the supply and fuel required for each trip.

Transportation
A mobile team will have at least one strong 4WD vehicle, fulltime for the purpose. The vehicle will be
used for outreach services and referrals – in woredas where there is no ambulance. Log books will be used
to monitor vehicle movement and will be included into the quarterly reports. Except referred cases with

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only one relative, none other than team members and woreda health office supervisors shall be transported
by the MH&NT vehicle. Vehicle major maintenances will be done once every six months and will be
coordinated with semi-annual review meetings.
Supply replenishment to teams will be made once every 3 months, unless conditions necessitate otherwise.
Training Package for the MH&N team members
The team members will be health professionals (Nurses and HEWs), trainings on the main activities will
be given focusing on the following major areas:
1. Integrated community case management (ICCM) and integrated management of neonatal and
child illnesses (IMNCI);
2. Micronutrient supplementation, screening for malnutrition, management of severe acute
malnutrition using the out-patient therapeutic program approach;
3. Sanitation, hygiene promotion and emergency water treatment;
4. Health education on:
a. Prevention of acute diarrheal diseases, including AWD,
b. Malaria control and utilization of ITN,
c. Family planning, HTPs,
d. Essential nutrition action,
e. HIV and STI,
f. TB,
g. Antenatal care
h. Importance of immunization
5. Immunization and cold chain management,
6. Disease and nutrition surveillance, and use of HMIS reporting tools,
7. Orientation on the health extension package (HEP).

OTP Follow up during Suspensions and Withdrawals

1. Temporary suspension and relocation (e.g. for review meeting, for sudden emergency response in
another woreda and other external factors etc.) – OTP enrolled children should receive 1 month
Plumpy Nut supply given to:
a. The HEWs in area with functioning health post, trained HEWs and better access.
b. The care taker (e.g. mother) in areas where there is no functional health post and access to
functioning health facilities is difficult.
c. Upon return the team will pay visit to the sites to monitor improvements and register the
outcome.
2. Team Transfer to a new woreda or site – OTP enrolled children should receive on average 6
weeks’Plumpy Nut supply given to:
a. The HEWs in area with functioning health post, trained HEWs and better access. The
HEWs will need to report the outcomes to the WoHO.
b. The care taker (e.g. mother) in areas where there is no functional health post and access to
functioning health facilities is difficult.

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Coordination, Monitoring and Reporting

Coordination
The overall coordination of the mobile teams operation will fall under the regional health and nutrition
task force and assist on more specific issues and will closely oversee the MH&NT operation. Members
will include RHB (chairperson), DPPB/ENCU, UNICEF (secretary), WHO, 2 rotating representatives of
NGOs implementing MH&NTs.
The coordination committee will also serve as information sharing platform. RHB will also produce semi-
annual bulletin of MH&NT performance and best practices.
At woreda level, a more operational coordination committee will be formed to coordinate and support the
activities of the mobile health team. Members will include Woreda administrator (chairperson), Woreda
health office head, major health facility director, WAO, NGO implementing health and nutrition activities/
MH&N team leader (secretary).

Planning, Monitoring and Supportive Supervision

The MH&NT support should be factored into the woreda health plan and coordinated by the WoHO. Once
deployed, the team should work with the WoHO in defining targets and determining service delivery sites
following the criteria set out in this operational guideline.
The woreda health office and the RHB supported by their respective coordination committees will
continuously monitor the operation of the MH&NTs. Based on the service reports, coordination
committee discussions, supervision findings, and identified problems, the committees will take
appropriate actions in line with this guideline. Woreda monitoring reports, actions taken and
recommendations should be shared with the RHB on monthly basis along with the monthly performance
report of the team
Each team will be supervised at least once per quarter. This will be jointly planned through the regional
coordination committee. The supervisors will spend minimum two days with each team, excluding travel
days. The supervisory team will use the supervision checklist. Action points of previous supervisions will
also be tracked by the supervisory team. Feedback will be given to the team members on the spot.
Team reports should be evaluated by supervisors on their completeness, timeliness, and accuracy. Written
feedback will be given to the team, and briefings and debriefings should be provided to the woreda
coordination committee.
Based on its monitoring, supervision findings, and woreda and partners reports the regional coordination
committee will advise the RHB to take appropriate actions to prioritize and optimize the performance of
the teams.

Reporting
Teams will use adopted reporting format and report to WoHO and RHB on monthly basis. The copy sent
to the RHB should be woreda health office stamped. Surveillance reports will be communicated to woreda
health office and PHEM/RHB on weekly basis.

Review meetings
Review meetings will be conducted on quarterly basis. Performance of the teams, findings of supportive
supervisions, recommendations of the regional coordination committee and reports from the woredas will

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be discussed and reviewed. Participants will include MH&NT members (team leader for all, and the other
nurse for every other quarter meeting), WoHO representatives, NGOs implementing MH&N teams,
representatives from UNICEF, WHO and other relevant UN agencies, and community representatives –
possibly once a year.
The review meeting will also serve as a venue to take strategic decisions, and review and update the
operational guideline and disseminate best practices.

Documentation and dissemination of good practices

Documentation
 Integrating the monthly reporting format with major challenges, solutions and recommendations.
 Adoption and development of standard checklist
 Adoption of criteria for setting of best practice
 Establishing Woreda committee comprising major stakeholders for review and recommendations
 Organizing coordination committee for selection & approval best practices at Regional Level
Dissemination
 Review meeting
 Workshops
 Publish in electronic and paper format and Store it.
 Distribution among mobile teams and any concerned bodies

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Annex 1

Terms of References (TOR) of the Coordination Committees

Regional Coordination Committee
1. Coordinate and oversee the mobile health and nutrition services in the region,
2. Organize regular coordination meeting and participate other relevant managerial meetings (e.g.
H&N task force meeting, humanitarian coordination meeting, WASH-ETF, etc). Assist its
organization and participate in review meetings,
3. Based on its situational analysis, monitoring, supervision findings, and woreda and partners reports
provide advice on assignment and withdrawal of mobile health and nutrition teams. Also
contribute in solving other important issues,
4. Assist on resource mobilization for mobile health and nutrition services,
5. Assist and coordinate information and experience sharing, and dissemination of best practices,
6. Provide guidance and assistance to evaluation of MH&NT projects and situational monitoring, and
7. Support review and updating of the MH&NT concept and operational guideline.
Woreda Coordination Committee
1. Coordinate and oversee the mobile health and nutrition services in the Woreda,
2. Organize monthly MH&NT meetings and performance evaluations and in solving important
issues,
3. Ensure that the team operates in accordance with the operational guideline and prevent
unnecessary service disruptions,
4. Support in supply management and safety and
5. Assist and coordinate information sharing between the team, woreda health office &woreda
administration.

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 Annex – 2
Mobile Health & Nutrition program
MT Supervision check list

1. Identification, operational sites information and trips outside of the district

Zone ________________ District _____________ Site: _____________Date ______________

Name of the Team Leader__________________________________________

Relocated Team? Yes/No__________________ Reason for relocation__________________________

1. Operational sites information

S. Name of the site Est Pop. Pop. of Pop. Distance Working No of Availability of
N. at site pregnant children in km days/per missed movement
women under-5 main site in a days plan Y/N
town month (verify)
1

2. Site time management, service organization and environmental health of the site at the day of
the visit

a. Site time management

Departure time in the Travel time to the Arrival time at Working hours in Time of departure from the
morning from the site/km site the site site to base/km
base

b. Service organization at the site

Observe how the site is arrange and organized
Good Average – Poor Remark
need
improvement
Crowd control
Is health education provided
Set up of maternal services
Set up of child services
Set up of EPI

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Dispensary system is well organized
c. Environmental health of operational site
Observe if water supply is available at the site or if the MHT are bringing it
Yes No Remark
Water permanently available?
Water source? (Borehole, well, rainwater,
brining water in a jerry can etc.)
Hand washing facility available?
Latrine available? If, in Health Post
Is the latrine clean?
Proper waste disposal available? And what
type (pit, incinerator, etc.), if in Health Post

a. Child Health Care Services – IMNCI

Observe management of min two sick children. If the child is not correctly managed,
Please give feedback right away to correct the mistakes.
Criteria Correctly classify and treat Correctly classify and treat
child 1 (Yes/No/ NA) child 2 (Yes/No/ NA)
Checked RDT in case of Fever
Checked fast breathing in case cough
Checked for DHN in case Diarrhoea
Checked for immunization status
Is the IMNCI protocol and chart booklet used
during consultation?
Does the mother/care taker understand how
to take medication before leaving the MHT?

b. Child Health Care Services – Nutrition

Observe how active case finding and management is provided
Active Case finding Poor Average need Good
improvement
Screening MUAC measurement
Oedema detection
Adherence on Admission criteria
Treatment RUTF
Routine medications
Follow up and Filling of cards /register
OTP cards Weight measurement
Adherence on discharge criteria

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 2. Feedback from mothers using the services
Ask a pregnant woman and a woman with a sick child under-5 what they think about the services
provided
Questions Pregnant woman Woman with sick child
(Under-5 years)
For how long (in time) did you walk to
reach the MHNT?
Did you get the services that you came for?

Are you content with the services

provided?
What suggestions do you have to make the
services better in the future?

3. Feedback from each activity

After completing the report, give overall feedback for each topic area based on the performance of the
team
SN Area Good Average Poor Remark
1 Available information about all the sites and movement
plan
2 Division of task among team members well organized
and fair
3 Service organization at the site are well organized
4 Drugs and supplies are properly organized and recorded.
If out of stock correct actions have been taken
5 Health education is given correctly
6 Child health EPI is available
7 Child health IMNCI Children are correctly assessed,
classified and treated
8 Child health Nutrition children are correctly screened
and managed
9 Referral and linkage arranged
10 Reporting system timely, accurate and correctly filled in

4. Action taken
S Problem identified Recommendations Action taken When? Responsible Person
N
1
2
3
4

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Annex 3

SOMALI REGIONAL STATE

RHB/UNICEF MOBILE HEALTH TEAM REFERRAL SHEET

Zone __________ Woreda ____________ Date ___________

PATEINT NAME _____________________________________________

AGE _________ SEX________ NAME OF INSTITUTION ____________________

HISTROY____________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

PHYSICAL FINDINGS ________________________________________________________________

_____________________________________________________________________________________
____________________________________________________________________________________

DIAGNOSIS__________________________________________________________________________
____________________________________________________________________________________

REASON FOR REFERRAL ________________________________________________

________________________________________________________________________

NAME OF IN CHARGE
PERSON________________________________________________________________

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Annex 4
MHNT Quarterly Review Meeting Presentation Template
Date/Month/Year
Operating Zone/Woreda back ground with Brief Highlight on the General Humanitarian Situation: (in
terms, Health & Nutrition (including Food Security) & WASH – Max 3 slides).
 Population (Including population per sites, Site selection procedure and if any change to previous
sites)
 Operational woreda Health Infrastructure- (Health Facilities status, number HFs re-opened by the
MHTs and other NGOs activities on H&N)
 Operational Site Selection criteria & Team composition
 Average number of working days in a month _________, If necessary Justify
Major achievements During the Quarter:
A. Health
 Total Consultations and treatment made quarter per month
 Proportion of under 5 year of age & Women; compare to the total consultations to last quarter
 At least 5 -10 top diseases encountered compare to previous quarter & Justify
 Health Education (No of sessions, Topics, number Audience by Sex disaggregation)
 Expanded Program Immunization (EPI) Achievement and
 Any Disease outbreak within the woreda by Age & Sex during this quarter, If any
B. Nutrition
 Total of number of under five children screened and managed at OTP level (Normal, MAM &
SAM)
 Management outcome (Total admissions and discharges including number of children discharged
cured, defaulter, death or transfer out to SC /SFP).
 Total Number of Pregnant &Lactating Women screened and their outcome; any support given to
them
 Total PL Women Received iron Supplementation in the maternal health package
C. WASH
 Types of water purification chemicals distributed and total beneficiaries
 Sanitation campaign organized, if any in the main towns esp. during outbreaks
D. Reproductive Health service achievements
 Number of Pregnant Women attended for Antenatal Care (ANC) and Postnatal Care supported.
 Number of clean and safe delivery kits distributed to women > second trimester or to local TBAs
and number of normal deliveries assisted by the teams using clean and safe delivery kit.

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E. Referrals
 Type & total number of severely classified cases medical and Nutrition with med. Complication
cases (ex. 3 severe pneumonia, 1 SAM with medical complication etc.)
 Outcome of the referred cases (If possible)

F. Response to Rapid-Onset Emergencies/Outside the duty woreda

 All services provided must be recorded and added to the monthly reporting format, but in
demarcated manner& present in separate slides to evaluate the magnitude of the outbreak against
the responses provided.

G. Any support given to WoHO to strengthen existing health facilities support

 Trainings/orientations co-facilitated or given to HEWs/WoHO
 Total number of health facilities re-functionalized, support given in the quarter & current status
H. Supply management throughout quarter
 Essential Drug Kits, Plumpy Nuts, Clean and safe Delivery Kits and water guards
I. Major Challenges and solutions given during the quarter
 List of possible challenges & solutions given

J. Major recommendations for the next quarter

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ANNEX 5 Basic Essential Drugs and Supplies list for Standard MHNT

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 Packed in Remarks
SN Items Description Qty Unit Part No
1. Coartem Pk/Bilster
2. Rapid Diagnostic Test (RDT) EA This are
3. Dextrose 40% of 20ml (ampule 20), pack Pk additional items,
4. Vitamin A 200,000IU or 100,000 IU of 500 /tin Tin that are not
5. CAF Inj (only 25 Vials as pre-referral Rx/IMNCI) Box 25 Vials included in the
6. Drug dispense envelop Pcs 1000 kit and requires
7. Clean and safe delivery Kit (CDK) Pcs 200 separate stock

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