District Health System
Upazila Health System
- Streamlining Upazila health system
- Initiatives will be taken for the formation of a committee comprising MOHFW, DGHS, DGFP, BMA etc. for reviewing domiciliary visits and satellite clinic conduction in light of changed context.
- Follow-up actions for the implementation of the decisions made by the MOHFW for domiciliary visit and satellite clinic.
- Initiatives will be taken for the formation of a committee comprising MOHFW, DGHS, DGFP, BMA etc. for reviewing current existence of multiple facilities at union and Upazila level and recommend policy direction about those in light of fully functional facility at each level for the Upazila health system to the MOHFW for final decision.
- Follow-up actions for the implementation of the decisions made by the MOHFW for fully functioning facility at union and Upazila level.
- Functional Referral
- Referral manual will be developed narrating roles of responsibilities at each tier of facilities (CC, union and Upazila) for referral in both ways
- Orientation of staffs of all levels for the establishment and functional of referral system
- Quarterly monitoring of the functionality of referral system and decide for remedial measures
- Establishment functional referral with the district/general/medical college hospital, as the case may be.
- Establishment of a CC within the premise of Upazila health complex (other facilities like trauma center etc.) to serve the immediate surrounding catchment as after establishment of the functional referral system Upazila health complex to entertain only referred and emergency cases
- Functioning of Upazila Health System
- Initiatives will be taken for transformation of hospitals operation fully by revenue by creating adequate posts, sanctioning bed strengths for supplying diet and MSR etc.
- Till the transformation to the revenue, support continues from this OP for proper functioning of Upazila health complexes
- Need based supplies including medicines, reagents, equipments will be supplied to the facilities of Upazila health system
- Efforts will be undertaken for local level resources mobilization (cash, kind, human resource etc. from Upazila/union parishad, municipalities, philanthropists, business community, college etc.) for making the Upazila health system functioning better.
- Staffing pattern at different Upazila health complexes (31 and 50 beds) will be reviewed to reflect adequate skill-mix required to deliver the services assigned in the ESP and emergency services.
- Initiatives will be undertaken to revise the existing organogram in light of the review recommendations and government decision
- Staffing pattern at the Union Sub Centre/Rural Dispensaries will be reviewed to reflect adequate human resources required with skill-mix to deliver services assigned in the ESP and initiatives will be undertaken for the compliance of the decision made by the government in light of the review recommendations.
- Initiative will be taken for deciding about the posts of assistant surgeons and medical assistants at union level from DGHS having no facilities
- Initiative will be taken to review the work-load of UH&FPO and recommend appropriate level and number of supporting HWF and other support like transport requirement for proper discharging the responsibilities vested on him/her.
Medical Waste management
A feasible and sustainable system for safe medical waste management is to be developed.
- MWM related Logistics (bin, needle cutter, waste trolley) to be properly mobilized.
- The safety of health care provider and waste handlers is to be ensured by providing personal protective gear.
- Polythene bags for segregation of waste, especially for infectious waste to be incorporated.
- Proper use of different color-coded bins to be ensured at different level facilities
- An EMP (Environmental Management Plan) for different level facilities is to be developed.
- General waste is to be disposed by Municipality/Union Parishad from UHC.
- Final disposal pit (new design according to EMP,4 chambered) to be built at 100 UHCs.
- 1 waste carrying trolley van is to be procured for out-house management for each 100 UHCs.
- Activation of different committee is formed for facilitating MWM.
- Local training of the health service providers on in-house Medical Waste Management.
- The mass people is to be oriented through Bill board, Neon sign, video film, TV clip.
- IEC (information, education & communication) & BCC materials are to be developed & disseminate.
- Record keeping system and reporting through prescribed format are to be implemented.
- Regular Supervision and Monitoring to be ensured.