misp champion workshop national launch of unfpa … · 2016. 3. 21. · dr. khirod kumar rout and...

Report compiled by Dr. Henna Hejazi, Programme Manager, Training & Capacity Building, Sphere India

MISP CHAMPION WORKSHOP &

NATIONAL LAUNCH OF UNFPA STATE OF WORLD POPULATION REPORT 2015

Date: 4th and 5th December 2015 Venue: Vishwa Yuvak Kendra, Chanakyapuri, New Delhi


Background: In India, for the last two and a half years, UNFPA and Sphere India in partnership with State Governments have been rolling out the Minimum Initial Service Package for Reproductive Health in Disasters in the most vulnerable States. Various Regional and State level ToTs have been organized in collaboration with State Health Mission, Disaster Management Authority, Department of Women & Child Development (WCD) and State Inter Agency Groups, with an objective to build the capacity of health/relevant sector professionals including CBOs/NGOs on Minimum Initial Services Package (MISP) for Sexual Reproductive Health (SRH) and protection of women and girls during disasters, so as to achieve the overall goals of decreasing mortality, morbidity and disability in crisis affected population, particularly women and girls. In the process of capacity building many MISP Champions have been making their contributions in effective implementation and Integration of MISP activities in their respective district disaster management plans and health micro-plan, incorporate MISP activities in the State Disaster Management Plan, develop roadmaps for integration into State/District PIP and prepare logistics plan for procurement of RH kits at district levels. MISP Champion Workshop aims to review the previous learnings and work done vis a vis MISP in different States. It will also focus on the way forward actions and recommendations for replicating MISP in other States of India. Objectives:

Demonstrate the Lessons Learnt during MISP roll out in different States of India. Develop a way forward for MISP implementation in India. Developing a Structured Annual 2016 MISP Planning.

Expected Outcomes:

Review of previous learnings and challenges. A structured MISP Action Plan for the year 2016.

Introduction: Session 1: Opening of the workshop and Panel Session Opening speech was given by Mr Vikrant Mahajan, who highlighted the broad objectives of the workshops and sharing of good practices, so that we can strategise the future plans vis a vis MISP. He mentioned that this workshop will also mark the National Launch of the State of World Population Report 2015 and the GBV Guidelines which have been revised recently. Toshihiro Tanaka, highlighted the special needs of women during disasters and development of a strategy whereby we can have minimal casualities before an emergency strikes. He mentioned the security issues in women at displaced camps. He also gave examples of the recent Floods in Chennai and how they can have an impact on the women, adolescent girls and newborn children. Dr. Khirod Kumar Rout and Dr. Shripad Kamat thanked UNFPA and Sphere India for rolling out MISP in the most affected locations and sensitizing the Policy makers on integration of MISP in the Disaster and


Health Plans. They also emphasized on the need of developing SOPs on GBV and provision of Psychosocial services in Disasters. Prof. Vinod Sharma in his introductory speech complimented the efforts of the organizers and appreciated the nomenclature Champion used for the State Representatives who are holding the baton of MISP in their respective States. He stressed upon the ownership from the Ministry regarding this unique cause for effective implementation of MISP. He also admitted that special needs of women and adolescent girls are indeed neglected and sustainable options need to be available at State level tto address them and minimize the impact. Dr. Zoya Ali Rizvi in her opening speech stressed upon the need for addressing issues of Adolescent Health and pre positioning of Rh Kits in the most affected States for preparing the country for impending disasters. She also highlighted the importance of creating a State and District Cadre of Trainers who can train Govt. functionaries on how best to address Maternal and Newborn Health issues and Sexual and Gender based violence. Other MISP Trainers also talked about their experiences in implementing MISP. Dr. Mridul gave the example of Assam Floods where 4 lac population was affected and objectives of MISP were integrated in 50 camps and safe delivery kits were provided to 260 pregnant women. 100% deliveries took place in the camps and 5000 dignity kits were provided to the affected families. Dr. Anurag flagged the issues of Ashas not getting appropriate incentives. Dr. Bali related the J&K Flood experience in which all the maternity hospitals were submerged in water for about a month. Issues related to women and adolescent girls were predominant in the displaced camps. UNFPA provided 5000 dignity kits in J&K post floods. Session 2: Launch of the State of World Population Report, and SWOP presentation : Toshihiro Tanaka, Deputy Representative, UNFPA

This was followed by the Launch of the Report by Prof Vinod Sharma,iipa, Dr. Zoya Ali Rizvi, MOHFW, Toshihiro Tanaka, UNFPA, Vikrant Mahajan, Sphere India, Nimisha Goswami, IIPF and other MISP Champions from across the country. Mr. Tanaka gave a background of the UNFPA’s State of World Population 2015 which is being launched in New York, globally, on 3rd December, 2015 and o 4th Dec at the MISP Champion Event, New Delhi . The title of this year’s Report is “Shelter from the Storm: A Transformative Agenda for Women and Girls in a Crisis-Prone World.” Women’s health and rights are under siege when natural disasters topple hospitals, when conflicts undermine rule of law and heighten vulnerabilities to rape, when an epidemic makes it unsafe for expectant mothers to find the services of a midwife. Toshihiro Tanaka, UNFPA Deputy Rep. said, “without the uninterrupted sexual and reproductive health services and usual protection of family and community, women and adolescent girls can face increased


risks of maternal mortality and morbidity, and may become victims of sexual violence, unintended pregnancies and sexually transmitted infections”. UNFPA’s report calls on governments, development and humanitarian communities everywhere in to move health and rights of women and girls, and in particular their sexual and reproductive health, from the backseat to the forefront of the transformative agenda.

Day 2 Proceedings: Session1:Strengthening MISP for Sexual and Reproductive Health in Disasters: Sangeeta Singh/Kapil Dev Singh: Learnings/Good Practices Integration of MISP components

1. One day sensitization workshop on Gender Integration for the students of Post gradate diploma in health management

2. Three day “ Intersectoral Convergence Summit” at Uttarakhand involving 175 government officials from four sectors ( Health, Education, WCD and Social Welfare)

3. Panel discussion in “ International conference on Disaster Risk Reduction” organized by Caritas India

Integration of MISP curriculum in International and National Workshops 4. Training for 55 civil surgeons of Madhya Pradesh for five days on “Effective Hospital

Management” 5. Training of 50 Block Medical Officers of Madhya Pradesh for five days on “ Effective Public

Health Leadership” 6. Training of 155 government officials of uttarakhand state on Infection Management and

Environment Plan where the DPMs, BPMs, Medical Officers, Paediatricians , anaesthetist, staff nurse were trained on Management of BMW during disasters.

7. Training of 53 CMOs and civil surgeons of Uttarakhand on “ Public Health Leadership” 8. Training of 20 Civil Surgeons of Chhattisgarh on “ Effective Hospital Management” 9. International Workshop on “Impact Evaluation of Population, Health and Nutrition Programs” at

Pretoria, South Africa 10. Skills building workshop on “ Gender Integration into Nationals Health Programs

Session 2: MISP and Maternal and Neonatal Health-Shripad Kamat Experiences in rolling out the MISP

• MISP has been rolled out across various states in India since 2012 • Have been a part of the team since February 2012 • States covered included Orissa, Maharashtra, Assam, Bihar, Tamil Nadu, Goa, Sikkim, Delhi ,

Jammu and Kashmir. • The personnel who were trained included a cross section of functionaries from the

Government including staff from the Health and Administration , the NGO sector and the Civil society.

MISP and Maternal and Neonatal health • Initial phase involved Sensitisation to the need of requirement of dire need to address the needs

of the pregnant women and the new born in disasters.


• The necessity to build up on the knowledge gained in my working with the Health services in the Rural areas.

• The Design of Kit based delivery system to start the various Signal Functions in the Disaster affected areas at the earliest by starting the BEMONC and CEMONC.

MISP Achievements • The program has created a pool of committed and competent personnel across India. • The MISP Manual for India has been one of the significant milestones for the organisation of

Disaster Management services in India and creation of facilities in the niche areas which were not focussed till now.

• The MISP program has set a precedent for creating an understanding of putting in place of low resource and high output model which can bring about change in the way we manage Disaster.

MISP: Lessons Learnt • Poor Sensitisation among the personnel who would be deputed during Disasters to the need of

focussing on the Maternal and New born need. • reinforcing the need of incorporating the MISP in state disaster plans has been the focus . This

has been a great help in the various states as the states have been the major stake holders in adapting and implementing the plan .

• The SRH-Kit Development needs to focus on specific needs of the States and the lessons learnt need to be incorporated at National Level

• The working with the Government has been a great learning process for everyone involved in the MISP program.

• Identification of competent and committed persons with existing systems has been a key to success of the MISP

• The requirements of the different areas of the country needed the assessment of the Vulnerability profile of the areas and this details needed to be incorporated in the State Disaster management plans for better delivery of the resource during the disaster.

MISP : The Future • The MISP concept needs to have a Pan India presence • The success of the program needs to be replicated in various other programs • The MISP concept should be strengthened and should incorporate more focal points. • The coordination addressed in MISP had to be strengthened. • The beneficiaries of the System need to be expanded to include children and elderly.

Session 3: Roll out of MISP in Maharashtra- Dr. Anil Koparkar Achievements

• June 2014 - While preparing for integration of MISP in Odisha, Shared thoughts with Ms. Shachi Grover, UNFPA

• July 2014 - Shared Concept note and need of MISP in Maharashtra with Principal Secretary, Public Health Department, Maharashtra

• June – Sept 2014 – With good learning experience of integration of MISP in Odisha, we geared up for Maharashtra.

• Sept – Dec 2014 – Kept on advocating in various meetings with people from Maharashtra PHD, NHM etc.

• January 2015 - Principal Secretary, Public Health Department approved that MISP should be integrated in state disaster plan.


• 15 to 17 April 2015 - A three day state level MISP workshop on Minimum Initial Service package (MISP) for Sexual and Reproductive Health during disasters was organized at Public Health Institute, Nagpur.

– The key objectives of the workshop was to build capacities of participants and discuss institutional mechanism and coordination for SRH in disasters.

– The participants included DRCHOs from districts across the state and Principals of HFWTCs.

• DRCHOs and Principal HFWTCs were selected as state level trainers as DRCHOs would be nominated as the key RCH coordinator in the district at the time of a disaster and

• Principal HFWTCs in turn, train a group of people from districts falling in the region so that a critical mass of disaster focal points is created in every district.

Support

• Financial support for State training was provided by NHM and UNFPA. • Technical support for State training provided by Department of Public Health, UNFPA and

Sphere India. Recommendations of State TOT

• TOTs to be organized at regional level to build the pool of trainers on MISP. • Regional trainings to have participants from Health, WCD and District disaster units. • Pool of resource persons trained at regional level to form core team for trainings at block and

village level in disaster prone districts. • Drought identified as a specific although slow disaster need of the State. • Eight disaster prone districts identified- Gadchiroli, Nandurbar, Sindudurgh, Yeotmal, Nashik,

Kolhapur, Latur, Satara 09.09.2015 - Integration Workshop

• To review State Disaster Management Plan (SDMP) and integration of MISP into SDMP – Under the chairmanship of Hon’ble Principal Secretary, PHD and H’ble MD NHM, H’ble

Secretary SDMA, H’ble Director Health Services, H’ble Addl Director, SFWB, Principals of training institutes, ADHO from high priority districts, UNFPA coordinator and Sphere India Master Trainer’s Team

• 29-30 October – Group meeting at PHI, Nagpur • Objective was to prepare Draft of MISP Chapter to be included in State Disaster Management

Plan (SDMP) • Draft of MISP Chapter prepared and submitted to Principal Secretary for approval. • Nov 2015 - Draft of MISP Chapter approved by Principal Secretary and accepted by SDMA to

include it in SDMP…! • Training on ‘Health and Disaster’ will be regularly conducted in Maharashtra Learnings • MISP is need of each state, irrespective of past experience in that state. • There is always need of good initiatives (e.g. MISP) in SDMP. • Evidence based key points and continuous advocacy is needed to sensitize key persons. • Ownership by state in early phase gives strength in movements. • Take help of organizations like UNFPA and SPHERE India and network of MISPians. • Tools like Whatsapp and Facebook are of good use. Stay connected. • Take your parent institute into confidence, otherwise can create obstacle in working.


• MISP/ RH Coordinator – – The Department of Public Health will designate any officer of the rank of Joint Director

and above to be the MISP/ RH coordinator at the State level – will be the focal point for RH services and provide technical advice and assistance on RH

• He/she be responsible for collection of basic health information and will ensure delegation of powers both administrative and financial (at the district and divisional Level) at the time of disaster. The State MISP coordinators will also ensure that the following is undertaken:

– Geographic mapping of health institutions – Institute wise availability of recourses – Availability of skilled Manpower – Availability of machinery/machines/equipments – Availability of beds – Other infrastructure : e.g. OTs, Wards etc

Challenges for roll out of MISP • A key challenge for roll out of MISP in the State would be inter and intra departmental

coordination. Delegation of financial and administrative powers should be undertaken for effective for implementation of MISP. Deputation of staff for joint training could also pose a challenge.

• Messages to fellow MISP champions.. • You can explore past disasters in your state or disaster your state is prone for, do the need

assessment and advocate for inclusion of MISP in your state. • Evidence based and continuous advocacy is needed to sensitize key persons in higher authority. • Ownership by state in early phase gives strength in movements.

Session 4: Roll out of MISP in Odisha-Dr. Kamlakanta Das Activities undertaken in Odisha:

• STATE LEVEL: State Sensitization meeting 02 State TOT’s State Planning Meeting 12 District Training MISP budget provision made in NHM PIP Integration MISP SRH Plan in State Disaster Plan

• DISTRICT LEVEL: • Calculation of logistics for MISP in the State • MISP action plan for 12 districts • Kitting planning for the state • Micro plan for 12 disticts • Pool of Resource persons

-National Trainers -State Trainers -District Trainers

• Data on rapid analysis for MISP in disaster • Participated in National Disaster day.

The following details were discussed during the session

Data on Rapid Analysis for MISP in Disasters.


Calculation of Logistics for MISP in Disasters MISP YeaRLY Activity Plan Action Planning for integrating diff. components of MISP into Disaster Preparedness and

Contingency Plan of State/District Budget allocations for Trainings on MISP at District Level. RH Kit budget estimations Break up of NHM Funds for 2015-16 Kit Planning Plan Ahead for MISP Integration.

Session 5: MISP in Assam- Dr. Mridul Deka Background

• Doctors For You (DFY) has been responding to different crisis situations in Assam since 2012. • Reproductive and Sexual Health needs of the community are a integral part of any response by

DFY. Achievements

• Pregnant women: A total of 1066 pregnant was registered and received medical care and awareness on safe delivery practice from camp and affected villages.

• Deliveries enhanced: There was enhanced deliveries in camps and institutions. A total of 241 safe deliveries were conducted during the project period. And a total of 500 women were given delivery kits to facilitate safe delivery and avoid complication which could result to mortality and morbidity.

Good Practices

• Contextualising the objectives of MISP according to the local needs of the community. • Assembling kits with materials available locally. • Integrating MISP with other needs of the community • Learning’s • Pre-positioning of cost effective MISP kit in PHC, CHC and district hospital can facilitate

immediate response to address sexual and reproductive health need of women. • Liaising in preparedness period. • Sensitizing the community about the imperative need of catering to sexual and reproductive

health needs of women and adolescent girls of reproductive age. • Training of community frontline health workers.

Session 6: MISP Integration and Emergency Preparedness Plan in Hud Hud- Dr. Khirod Kumar Rout List of information which was collected during the Hud Hud

• MAP SHOWING AREAS PRONE TO BE CUT-OFF AFTER HEAVY RAIN

• MAP SHOWING DESIGNETED DELIVERY POINTS • MAP SHOWING “HUDHUD” SHELTER POINTS • INTRODUCTION • NODAL PERSONS • HUMAN RESOURCE • ESTABLISHMENT OF CONTROL ROOM


• RAPID RESPONSE TEAM • DELIVERY POINT • CYCLONE SHELTER • LINE LISTING OF HIGH RISK PREGNANT WOMEN • NGO’S • PREPARATORY ACTIVITIES • TRANSPORTATION SERVICE • ESSENTIAL DRUGS • LIST OF ILR POINTS • ALTERNATIVE POWER BACKUP SYSTEM • DISTRICT MONITORING & SUPERVISION TEAM • REVENUE VILLAGE LIST • DAILY REPORTING FORMAT • LETTERS OF CORRESPONDENCE

Session 8: Way Forward Actions and Recommendations for forward actions for strengthening MISP at the State level- Vikrant Mahajan Recommendations/Way Forward

Toshihiro Tanaka, UNFPA: Investing in preparedness Engage all development partners. How can they be prepared for Emergency Preparedness Kits Commitment required from Policy Makers and Service Providers. In Maharashtra there is

commitment. How to engage womenfolk/youth and community level worker in the existing programmes. MISP is all about how community can be a part of the solution. How can we provide technical resources and do regular evaluations. How preparednewss can be better focussed for eg in the recent Chennai experience.

Vikrant Mahajan:

Focus of 2016 to be on North East and South India. Continuity of support in MISP Intervention States. Handholding of MISP Focal Points in J&K,

Odisha, Bihar, Sikkim. Best way to leverage the stregthy of Champions. Publish a Disaster Alert every quarterly with propwer illustrations and pictures. Healthy competition between States where MISP capacity building has happened. Focus on private sector. Create awareness. CMI Certification. Sensitise CDPOs and DDOs since they have huge funds and are responsible for planning at

district level. For National and Quality Assurance Standards, we can have a mandatory checklist of MISP

activities which can be part of QCI-Hospital Kits. Shorter versions of Module. For eg how to use an MVA Canula. Training of endline and NDRF and Relief Workers in MISP. Simulations are very important after every training. IPPF can share the simulation module with

Sphere India. MISP during Disasters. At the end of the year build credible evidence and come up with Evidence based Evaluation.


Inter-sectoral convergence is important. How private sector can work with NHM. Motivation and sustainability of the MISP Focal Points.

MISP Trainers Recommendations:

Need for revising few contents of MISP Manual especially the sessions on Data, Monitoring and Evaluation

Need to review the MISP Manual to rectify the errors if any This manual only focuses on MNH where we need to include RMNCH+A strategy as most states

follow the same Few sessions are too technical and hence it is difficult for the heterogeneous profile of

participants Need for separate curriculum for such types of trainings Too much to cover in three days (either day should be increased or curriculum needs to be

reduced) Statistics needs to be updated, data is too old. Recommendations/Way Forward Need to expand the scope of MISP capacity building in other states as well

1.Uttarakhand Uttarakhand highly disaster prone state needs such trainings. As per our TNA

study on Medical officers and District Program Managers there is need for such trainings

Health Secretary and Mission Director NHM are keen to strengthen the disaster preparedness plan in the state

2.Madhya Pradesh Based on the feedback received from the civil surgeons in the training, there is a

need to build the capacity in the state on Disaster Management and Preparedness

3.Uttar Pradesh There is need to build capacity as some part of the state are prone for disaster

4.Gujarat Since this state has witnessed many disasters in the past and very proactive in

the implementation of innovations and sustainable strategies, we can consider building the capacity of this state for MISP

• As a MISP advocate, we will see to it that whatever has been planned will come true in recent future.

• We will also plan training and re-training for maintaining and improving quality of services • We will also emphasize to formulate MISP manual for Block level and lower level workers in

local language • We will also try to modify process and Kits according to local needs. • Coordinating with the state and district administration for pre-positioning of MISP. • Coordinating with IAG Assam to make MISP an integral part of disaster response. • Training and capacity building of state and district level policy makers on MISP

Annexures: PROGRAMME SCHEDULE

PROGRAMME SCHEDULE


Time Session Facilitators

Day 1

01:00 PM to 02:00 PM Lunch

02:00 PM to 03:00 PM

National Launch of the “State Of World Population Report 2015” by UNFPA

Toshi Tanaka, Deputy Representative, UNFPA, Prof. Vinod, IIPA/Sikkim State Disaster Management Authority, Zoya Ali Rizvi, Asst. Commisioner RCH,MoHFW, Vikrant Mahajan, Chief Executive Officer, Sphere India

02:30 PM to 03:00 PM Presentation on State of World Population Report 2015 by UNFPA

Toshi Tanaka, Deputy Representative, UNFPA,

03:00 PM to 04:00 PM Panel Discussion(UNFPA, MISP Champions, Media)

Toshi Tanaka, Deputy Representative, UNFPA, Prof. Vinod, IIPA/Sikkim State Disaster Management Authority, Zoya Ali Rizvi, Asst. Commisioner RCH,MoHFW, Vikrant Mahajan, Chief Executive Officer, Sphere India,Dr. Shripad Kamat, Goa, Dr. Khirod Kumar Rout, Odisha

04:00 to 04:30 PM Inter face with the MISP Champions

Day 2

09:30 am to 09:45 am Strengthening MISP for Sexual and Reproductive Health in Disasters Sangeeta Tikyani/Kapildev Singh

09:45 am to 10:00 am MISP and Maternal and Neonatal Health Dr. Shripad Kamat

10:00 am to 10: 15 am Roll out of MISP in Maharashtra Dr. Anil Koparkar

10:15 am to 10: 30 am Roll out of MISP in Odisha Dr. Kamla Kanta Das

10: 30 am to 10: 45 am MISP in Assam Dr. Mridul Deka

10:45 am to 11:00 am Tea Break

11:00 am to 11:30 am MISP Integration and Emergency Preparedness Plan in Hud Hud Dr. Khirod Kumar Rout

11:30 am to 11: 45 am Key Recommendations and Way Forward-SPRINT Initiative Nimisha Goswami

11:45 am to 12: 00 pm J&K MISP Implementation Dr. Itinderpal Singh Bali

12:00 pm to 1:30 pm

Way Forward Actions and Recommendations for forward actions for strengthening MISP at the UNFPA/Sphere India


State level.

1:30 pm to 2:00 pm Lunch

LIST OF PARTICIPANTS

List of Participants

State Name Designation Govt/NGO/DM/Private Institute

MISP Work in

Odisha

1 Dr. Khirod Kumar Rout Health Consultant Private Consultant Odisha

J&K

2 Dr. Kamla Kanta Das Asst. Director Govt. Health Services Odisha

Maharashtra

Uttarakhand 3 Dr. Bhola Nath Professor Medical College Govt. Health Services Uttarakhand

Maharashtra 4 Dr. Anil Koparkar Medical Officer Govt. Health Services Bihar

Odisha

Maharashtra

Uttarakhand

Goa 5 Dr. Shripad Kamat Gynaecologist Govt. Health Services Faridabad

Kolkatta

Odisha

Maharashtra

Goa

Sikkim

Assam 6 Dr. Mridul Deka State Manager Doctors for you(NGO) Uttarakhand

Assam

J&K 7 Dr. Itinderpal Singh Bali Health Consultant Private J&K

West Bengal

Odisha

Faridabad

J&K 8 Dr. Masarat Iqbal Chief Medical Officer Govt. Health Services J&K

New Delhi 9 Anurag Mishra Asst. Prof. MAMC Govt. Health Services Odisha

J&K


New Delhi 10 Sangeeta Tikyani Professor Public Health Foundation of India Odisha

Tamil Nadu

Sikkim

New Delhi 11 Kapil dev Singh Professor Public Health Foundation of Inda Tamil Nadu

J&K

South Asia

Nimisha Goswami

Project Specialist The SPRINT Initiative IPPF South Asia

West Bengal 12 Shikha Mitra Director All India Womens Conference West Bengal

Sikkim

Prof. Vinod Sharma

IIPA/Sikkim State Disaster Management Authority Sikkim

New Delhi

Zoya Ali Rizvi Assistant Commisioner RCH MOHFW-GOI New Delhi

New Delhi 13 Toshihiro Tanaka Deputy Representative UNFPA

New Delhi

New Delhi 14 Ram Haridass Programme Officer UNFPA New Delhi

New Delhi 15 Ena Singh UNFPA New Delhi

New Delhi 16 Vikrant Mahajan Chief Executive Officer Sphere India

New Delhi

New Delhi 17 Manoj Dash Senior Programme Manager Sphere India

New Delhi

New deLHI 18 Elia Jafar Head Disaster Management Unit Care India

New DElhi

New Delhi 18 Dr. Henna Hejazi Programme Manager Sphere India

New Delhi

misp champion workshop national launch of unfpa … · 2016. 3. 21. · dr. khirod kumar rout and...

Documents