THE
PROJECT
I Introduction
The Association of the medical coverage COMENAH has been adopting
since 1996 all possible strategies to offer services of quality in the sphere of
health for impoverished people of the country. So, through rural areas, the
institution has opened mobile clinics. Transport of health personnel and
medicines has done on back of animals toward far-flung zones of difficult access
of the country.
Since some time, COMENAH in a larger context in the sphere of
medical coverage would like to enlarge setting of its services from which
necessity to raise the association in the rank of NGO, non governmental
organization. Moreover, in its continual concern to reach the greatest number,
the association had directed its activities to curative and preventive cares.
Education of health workers and matrons, information of 500 voodooists feminine
associations and community leaders are elements not to be neglected.
II
Justification of the project
Haïti is a country composed of 565 communal
sections whose a very small part is covered by community medical cares. Rational
distribution of medical cares in slums remains a challenge to take up by
department of Health and Population. It is a sad notice that in a general way
the community medicine and even specialized medicine has not yet reached
countrymen’s door, while “Push button” world invaded us through well, definite
concepts materialized in the process of globalization and integration. Peasants
do not know mode of transmission of tuberculosis and sexually infectious
diseases. Notions of body dental hygiene do not enter their daily life
activities. Pathologies, even the most curable ones, stay and remain for
peasants’ bad luck thrown by “loas spirits” and impure spirits. Natural deaths
sometimes coming form their ignorance and negligence are caused by sending devil
on other people considered as enemies or envious of their economic welfare
situation. Medicine in all scientific discoveries remains for them empiric and
doubtful science whose some positive and concrete realizations are clearly
hazardous. This project will enable to reach a large number of people or
countrymen constituting living and productive strength of the country through
organizational, hierarchical and disciplined structure. Educated and informed
workers in the sphere of pathologies principally communicable and family
planning will represent a back of skilled human resources to solicit and use for
all form of integrated projects in their affectation zones. Not convicted
refusing to invest in the sphere of health constitutes a lack in disfavor of the
population. In a more specific extent, community leaders, pastors, voodooists
and health workers will enable to become potential, through rural communities
relevant to their residence zones, information services for larger number.
III
Objective of the project or
principal objective
The project is intended to contribute improving the state of
health of Haitian population in genera by healing persons suffering curable
pathologies and preventing expansion of communicable diseases particularly
tuberculosis and AIDS
Specific objectives
a)
Sensitize, educate, from and inform.
b)
Decrease the rate morbidity and mortality trough rural areas
and impoverished class of country.
c)
Increase the contraceptive prevalence at the level of
population living in our intervention areas.
d)
Decrease the risk of population of sexually communicable
diseases specially ADIS.
e)
Improve nutritional state of infants from 0 to 6 years of
age.
V
Intervention zones
This project will cover the whole country, namely: dropped out
rural and urban zones. Three Zones of reference will be used for execution of
the project whose quantitative and quantitative evaluation from sensitive
parameters will enable adoption of a more efficient politics in the stage of
expansion.
a)
9th section in Bainet where a health a center
capable of covering 19.000 persons.
b)
Mr. Guilloux Street where already working a health center for
10.000 inhabitants.
c)
St. Martin Street where evaluation of beneficiaries will do
from specialized polyclinics in ORL and ophthalmology.
The number of
program beneficiaries in all forms of activities may be already evaluated at
more than 40.000 people about.
VI
Planning of Execution
The association will have to execute short middle and long-term
project.
a)
Short term project
Curative and preventive cares in phase of execution in the
association
b) Make
functional after physical restructure, if there is need, health centers built by
non-governmental organization
on request of community organizations that have taking
charge.
c) Middle term project
Establishing nutrition centers and school canteens.
d)
Long term project
Building health centers through rural areas and provide them in
human, material and financial resources for their full functioning.
VII
Strategies
They are of two orders: institutional and
community.
A.-
Institutional
1)
Creating a system to welcome clients
2)
Educational session of institutional and community group,
either a minimum of 6 sessions for the year by promoter with groups of 15
people.
3)
Session of counseling for acceptant of MPI/FP and for people
suffering immunodeficiency syndrome or HIV or positive Elisa Test.
4)
Preparing medical records for all patients needed medical and
surgical cares for FP clients and pregnant women.
5)
Compulsory medical exam for each new acceptant of hormonal
methods.
6)
Organizing prenatal and clinics
7)
Compulsory weighing and vaccinating of pregnant women and
infants from 0 to 3 years of age
8)
Realizing club of satisfactory clients of the year.
9)
Examining detection of cervix and breast
10)
Extraction of dental prophylaxis.
11)
ORL and ophthalmology.
12)
Monthly planning of FP activities at the level of each sector
used.
(Drop out to reactivate, determination of number of
acceptants’users)
13) Monthly preparation and in case of need of medical
staff for evaluation, correction of deviations in
relation to that is planned or study of
changes in the planning.
14)
Planning of supervision by taking account of performance of
the sector.
15)
Preparing at the beginning of each month planning of
institutional and community activities.
16)
Specialized exams by voluntary foreign physicians, Haitian
physicians used or active voluntary members.
17)
Systematic and orientated detection of tuberculosis from
defined priority criteria.
B.-
Community
1)
Distributing contraceptives for FP clients.
2)
Distributing condoms within AIDS prevention or other sexually
communicable diseases.
3)
Realizing session of sanitation education and information
each year by promoter.
4)
Identifying and reactivating cases of dropout and family
planning and for tuberculosis.
5)
Using check-lest pills by promoters.
6)
Referring pregnant women to clinics, potential acceptant of
FP and users under hormonal methods.
7)
Censing matron’s formation and integration of educational
motivation system in FP and in AIDS prevention.
8)
Preparing monthly activities reports and stock administration
of medicines and contraceptive material or others.
9)
Creating clubs of mothers (1 club by sector or promoter).
10)
Participating of promoters in debates or on evolution of
programs.
11)
Programming activities to accomplish by personnel depending
on performance of sector and determination monthly objectives of each promoter.
12)
Organizing mobile clinics in churches, schools, squares such
as markets, gaguere or under a big, large and shady tree.
VIII
Human Resources
a)
General Director
b)
Technical Director
c)
Administrative Director
d)
Specialized physicians
e)
General practitioner
f)
Dentists
g)
Accountants
h)
Lab Technicians
i)
Pharmacists
j)
Auxiliaries
k)
Heath workers
l)
Drivers
m)
Mechanics
n)
Maids
o)
Washerwomen
p)
Office boys
q)
Security officers
r)
Licensed nurses
s)
Engineers
Description of tasks
A.- General Director
1.- Supervise evolution
of the project.
2.- plan
institututional and community politics.
3.- Serve transmission
belt between organization and funds donors.
4.- Take part in the
staff meeting
B.- Technical Director
Properly speaking, Technical Director is the Medical Director,
the 3rd technical and administrative authority of the
non-governmental organization COMENAH.
1.- Organizing monthly
staff meeting to discuss performance and constraints and constraints and
definite activities of the
sector
2.- Supervising FP
activities not only at institutional level also at community level.
3.- Elaborating at the
beginning of each month a planning of institutional and community activities.
4.- Inventorying
education needs.
5.- Participating at
periodical progress of programs.
6.- Elaborating monthly
with the supervisor of promoters planning taking account realizations of the
sector.
7.-Transporting monthly
statistic reports.
C.- Administrative Director
1.- Plan work of people
who are under his responsibility.
2.- Organize personnel’s
works by providing necessary tools in order that objectives settled by manager’s
office are reached.
3.- That care of
institution’s progress by taking account of respect of hierarchy and
administrative norms.
4.- Answer positively to
invitation of meeting organized periodically by General Director.
D.- FP/OBGN physicians
1-Supervise and guide
auxiliary’s and nurse’s work.
2.-Supervise promoter’s
work on quantity and quality point of view.
3.-General consultation and gynecological consultation of clients
of family planning and prenatal clinics
4.-provide services of
family planning.
5.-Realizing sterilizer ; insertion of Norphant/VCC
E.- NURSES
1.-Take care of
repartition auxiliaries’ work.
2.-Help doctors in
planning activities.
3.-Watch execution
programmed activities.
4.-Collect complaints of
ground personnel.
5.-Assist the doctor in
realization of FPM/FP program.
F.-Medical Auxiliary IEC
1.-Execute counseling of
family planning clients.
2.-Supervise with FP
responsible promoters’ work.
3.-Promote continuing
education of ground personnel.
4.-Watch holding of
education sessions; the quality of messages transmitted by promoters during
home visits and
education and motivation sessions.
G. - Medical Auxiliary FP
1.-Help the doctoc in
prevision of pre and post natal FP
services.
2.-Responsible of monthly
bill of calendars super vision and institutional and community activities.
3.-Administration and
supervision of contraceptive material stockage.
4.-Picking up to date
card-index file
5.-Preparing requisition
in contraceptives.
6. -Realizing monthly
inventory of contraceptives warehouse
H. -Supervisor-promoter
1. -Verifying and regular
and correct utilization of contraceptives.
2, -Verifying reliability
of data.
3. -Controlling quality
of messages transmitted by promoters.
4. -Collecting intermediary reports.
I.-FP and health promoter
1.-Promote planning
methods.
2.-Recruit new acceptant
of family planning.
3.-Refer to center
clients under hormonal method.
4.-Visit people at home.
5.-Realize sanitation
education sessions and grouping education in FP;SCD;AIDS.
6.-Creating mother’s
clubs or other clients satisfied of medical cares+.
7.-Census of matrons at the level of work zone.
J.- Accountant
1.-Check entering and
coming out money.
2.-Make payment and
financial report.
3.-Give an account of
expenses at the end of the end.
4.-Hold the account book in better conditions of financiary
administration.
K.-Secretary
1.-Receive telephone
call.
2.-Transmit messages.
3.-Type documents.
4.-Responsibility of
mailing.
5.-Classifying documents.
6.-Convoke meeting on authorized instructions; assist; and take
notes and minutes.
L.- Archivist- Statistician
1.-Collect statistics
reports; treat and keep them.
2.-Responsible of
classifying and holding records.
3.-Organizing archives following alphanumeric classification.
M.- Lab Technician
Responsible of biological
and paraclinic exams.
N.- pharmacist
1.-Responsible of stock.
2.-Control and have executer prescriptions.
O.- Responsible of stock
1.-Responsible of entry
and coming out of medicine consumable products and materials.
2.-Submit each week a report to the accountant.
P.- constructing engineer or architect
1.-Being responsible of restructure and maintenance of health
centers.
2.-Making relevant plans and estimate before implantation new
health centers.
3.-Preparation of calendars of work and costs of construction for
information and discussions for
general assembly.
4.- Be responsible directly of personnel or operators working
under his supervision
Needs of information
A.-Doctors
1.- Medical and
surgical spcialties in post graduation
2.- Sanitation;
hospital and community administration
3.- Education in
Norplant
B.- Nurses
1.- Contraception
technology
2.- Education of
educators
3.- Education in
pre and postnatal cares and SCD - AIDS
4.- Education in
hospital administration of nurses cares.
5.- Formation in education of community
C.- Auxiliaries
1.-Contraception
technology
2.- Formation in pre and postnatal caress
D.- Promoters
1.- FP contraceptive
technology
2.- Nutrition and
pregnancy hygiene
3.- Formation in SCD/AIDS
E.- Responsible of stock
Education in
stock administration
F.- Supervisor
Formation in
technics of supervision
G.- Engineer
e) Convince authorities of
concerned instances at different levels necessity to moral support and offer a
legal basis to medical and paramedical members of COMENAH working in
intervention zones.
f) Look at possibility of free
distribution of medical cares and medicine at 80% of peasants and slums
inhabitants of very weak economic resources.
g) Recruit after well done
sensitization campaign of active members and observers of COMENAH, medical and
paramedical personnel of public HEALTH Department working in difficult
conditions in hospital and dispensaries of some commune towns.
h) Make expansion of distribution
of medical cares of needed people an act of civism and professional conscience
of high level, thanks to the use of sensitization sessions through media of the
capital and provinces.
i) Inform and convince the
countryman of specialized consultations for some pathologies of fearful
complications.
j) Conceive and execute latrine
programs
XVII
Impact of project
COMENAH, from opinion
of founders’ members is a positive answer to economic and social bad results in
the development of country. Reduction of morbidity and mortality rate through
rural areas by putting in place mobile clinics will be an unprecedented gain for
Department of public Health and population whose contribution is strongly
desirable. Countrymen for healing from pathologies as curable as malaria,
typhoid, parasitosis and others don’t need to walk several kilometers either,
either on animals back or by trucks before reaching health centers where they
would enable to spend the day before to be a physician or a nurse or in default
by an auxiliary.
Success of the
whole activities of COMENAH will contribute to improve medical and
sanitary conditions of countrymen and make them productive in the agriculture
domain.
Project made
written by Dr. Denis Cyrille
Read and
approved by other members.
Board of Directors
General Direction
General Secretariat Advisory Members
Technical Direction
Administrative Direction
Community Health Centers
Formation in
technics of supervision
G.- Engineer
Education in hospital building
IX
Organization and proceeding
Execution of this project will
depend on contrivance used in relation with organizational structure for
responsibility of powers according to command and authority lines. Macro and
micro administration manuals previewing other functions will be written to this
end. However, conjugation of intrinsic and extrinsic motive will improve to
positive working conditions and increase quality and quality of medical cares.
COMENAH as non-governmental institution and no profit organization will adopt in
a long term the same technical, administrative and sanitary structure as the
public Health Department. These structures will be only for supervision of
development that reinforcement structures.
X
PHYSICAL RESOURCES
Community health centers on
Monseigneur Guilloux street on 9th section of
Bainet, places such as gaguere and markets, community Schools given to COMENAH
by casecs members or quarter leaders, shadow spaces arranged by branches of
strong and thick trees are many as physical resources offering space of general
consultation to poor peasants asking not better than to ease them from their
morbid suffering. Several other small dispensaries or centers are already giving
to us by community groupings to make them functional Health centers, according
to already convened plans and studies will be built in long terms through rural
areas.
XI
MATERIAL RESOURCES
Supplying in medicine,
lab materials, X-RAY and different consumable products will assure by supply
section of COMENAH from subscription of founder members and especially from
donations of overseas and national benevolence organizations .Pre project
requisition will be studied to this end, will be of all utility.
a)Rolling stocks
b)Animals such as horses and mules
for transport of medical, paramedical personnel and materials from tows to rural
areas through paths. Due to the of mountainous nature of the Republic of Haiti,
helicopter-borne mobile clinics would enable to become true.
XII
FINANCIAL RESOURCES
Donations from some NGO, working on the spot at the first time
then subscription from founder members on the second time have made possible
several mobile clinics through rural areas. National and foreign slipping
partners will solicit in short time solicitude for the expansion stage of
association. Checking account named COMENAH account will be opened at any bank
of the Republic of Haiti. Budget will be an annual budget at renewable zero
basis. Time and experience will allow necessary adjustments to integration of
resources. Availability on the budget question, economic situation of the
country and collective aspiration are as many factors to consider.
XIII
COORDINATION AND SUPREVISION
Multidisciplinary committee formed by direction central committee
will assure project coordination and supervision of he project. That
multidisciplinary committee can be provisional and permanent, according needs
and profit.
XIV
EVALUATION
Project will be evaluated from results obtained to aimed
objectives during evolution of action programs. Specific evaluations with
submission of activities reports will be done for all foresaid programs
executing in COMENAH. An annual general balance sheet of project will be made
and submitted to concerned authorities.
XV
ACTIVITIES
Activities to build up
enabling to reach its objectives are:
a) Elaborating
a work plan and a calendar of activities
b) Realizing
sensitizing and information sessions
c) Equitation
sessions
d) Realizing
education sessions on SCD/AIDS and family planning for medical members of
Medical and
paramedical personnel of COMENAH.
e)Regular
providing in medicines, contraceptive and condoms in health centers
f)Imprinting
and distributing education material (bills, booklets, etc. )
h)Collecting
statistic data.
I) preparing
reports of quarterly and annual activities.
XVI
RESPONSIBILITIES OF COMENAH
a) COMENAH will
undertake some steps near slipping partners to find necessary support for
functioning the activities of the project.,
b) Executing
the project in the inaugural stage will be held on December 1st
c)
Sensitize community leaders and
responsible of places of mobile clinics in order the that the transport of
personnel medical has done as usual through all rural areas on animal back.
d) Dates of
rendezvous in mobile clinics must be respected
Centre de
Santé Communautaire
Rue Mgr Guilloux # 556
B.P. 1382, Port-au-Prince, Haïti (W.I)
