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Public Health Consultancies

IHS has vast experience in public health consultancies and health related interventions for specific target groups as well as general public. We have an experienced team of consultants including physicians, psychologists, occupational and public health scientists who with the support of resources and manpower at our disposal due to our presence in many other related health fields across the country can undertake health consultancies, research and capacity building projects at any location in Pakistan. Below is a list of some of the recent works done by Public Health Consultancies & Research Division of IHS.

Performance based Agreement under Sindh Public Private Partnership Act 2010 between Integrated Health Services and Government of Sindh, Department of Health (Sindh)

October 2016-Ongoing

IHS has a contract with the department of health, Government of Sindh to operate 110 Health facilities (including 104 RHCs and 06 THQ Hospitals) in 21 districts of Sindh under Public Private Partnership Initiative. The basic goal of the project is to improve the health status of the rural population in these districts by ensuring access to high quality, responsive healthcare delivery system which provides acceptable and affordable services in an equitable manner. In the first phase IHS took management control of 03 THQ hospitals and 21 RHCs in 5 districts of Larkana division in November 2016. All these facilities are now functional with addition of health care providers by filling vacant positions and ensuring 24/7 services. In the next phase Sukkur and Hyderabad division would be added.

MNCH services delivery Project in District Noshehro Feroze and Larkana (Sindh)

Jan 2015 - Ongoing

MNCH Services Delivery project, funded by JHPIEGO/MCHIP, is being implemented in district Larkana & Noshehro Feroze by IHS Pakistan The overall project goal is reducing maternal, newborn, and child mortality by ensuring 24/7 access to MNCH services in both public and private sectors in Noushero Feroz and Larkana districts of the Sindh province The strategic objectives are: - Increase availability and coverage of MNCH services - Enhance quality of MNCH services - Improve behavior and practices of communities The above-mentioned objectives are grouped under 7 Program System Components (PSC) each having its own specific objectives and targets. These include Program Management, Human Resource Management, Costing and Financing, Supplies and Logistics, MNCH Service Delivery, Monitoring and Reporting, and Demand Generation, Communication and Advocacy .

Revitalization & Strengthening the Health Services in District Battagram (KPK)

August 2015-July 2016

A contracting-out project implemented by IHS with funding by Govt of KPK and MDTF, in district Battagram with management of all the health facilities in the districts for revitalization and strengthening the health services under Public Private Partnership contract with GoKPK Healthcare services were provided in all the public health facilities (including 01 type-D THQ hospital, 02 RHCs, 28 BHUs and 09 CDs/01 MCH Centers/01 TBC) with management control, HR management and financial management HUB approach was applied for the implementation of project activities in the district.

Revitalization & Strengthening the Health Services in District Torghar (KPK)

July 2014-July 2016

A contracting-out project implemented by IHS with funding by Govt of KPK and MDTF, in district Torghar with management of all the health facilities in the districts for revitalization and strengthening the health services under Public Private Partnership contract with GoKPK Healthcare services were provided in all the public health facilities (including 09 BHUs- District Torghar is deficient of existence of any DHQ/THQ and RHC in the entire district) with management control, HR management and financial management HUB approach was applied for the implementation of project activities in the district and one BHU, designated as hub, was strengthened with provision of healthcare services on 24/7 basis

Revitalization & Strengthening the Health Services in District Upper & Lower Kohistan (KPK)

April 2014-June 2015

A contracting-out project implemented by IHS with funding by Govt of KPK and MDTF, in district Torghar with management of all the health facilities in the districts for revitalization and strengthening the health services under Public Private Partnership contract with GoKPK Healthcare services were provided in all the public health facilities (including 04 RHCs, 33 BHUs, 02 TBCs, 02 LCs and 01 CD - District Kohistan is deficient of existence of any DHQ/THQ in the entire district) with management control, HR management and financial management HUB approach was applied for the implementation of project activities in the district and three RHCs were designated and strengthened as hubs for the adjacent health facilities .

Technical Skill Refresher and Entrepreneurship Training for Community Midwives in AJK, FATA and Balochistan

October 2014-January 2015

Successfully completed the 10 days refresher training of 630 CMWs (including 187 CMWs from AJK, 97 CMWs from FATA and 346 CMWs from Balochistan) in coordination with the respective MNCH Programs and funded by TRF. In addition to the training of CMWs In addition to the training of CMWs IHS also focused on the capacity building of 14 Nursing and CMW tutors from AJK, FATA, Balochistan and GB as Master Trainers, to create a pool of local resource persons and enhance the capacity of local Health Personnel - After evaluation of the trainees, as per the pre & post-test tools, knowledge & skills of CMWs were improved from 29-46% to 59-86% (as of different training batches in AJK, FATA and Balochistan) .

Refresher and Entrepreneurship Training for Community Midwives in Gilgit Baltistan

September 2014-October 2014

Successfully completed the 10 days refresher training of 92 CMWs in Gilgit Baltistan, in coordination with the respective MNCH Program and funded by TRF. In addition to the training of CMWs IHS also focused on the capacity building of 08 Nursing and CMW tutors from Gilgit Baltistan as Master Trainers, to create a pool of local resource persons and enhance the capacity of local Health Personnel - After evaluation of the trainees, as per the pre & post-test tools, knowledge & skills of CMWs were improved from 29-46% to 59-86% (as of different training batches in AJK, FATA and Balochistan)

Training of Medical Technicians in Gilgit Baltistan; to improve their skills and competency thereby improving health service delivery

March 2014-August 2014

Successfully completed the 10 days refresher training of 822 Medical Technicians working at public health facilities with department of health- Gilgit Baltistan, in coordination with the DoH gilgit Baltistan and funded by TRF. In addition to the training of MTs, IHS also focused on the capacity building of 10 Nursing tutors from Gilgit Baltistan as Master Trainers, to create a pool of local resource persons and enhance the capacity of local Health Personnel - After evaluation of the trainees, as per the pre & post-test tools, knowledge & skills of MTs were improved from 21-46% to 63-85% (as of different training batches in Gilgit Baltistan)

Health Service Delivery Contracting Out for MNCH Services in District Larkana and District Shaheer Benazirabad (Sindh)

November 2011-June 2014

A project funded by the Norwegian government under the Norway Pakistan Partnership Initiative (NPPI) IHS implemented health services delivery contracting out in coordination with UNICEF & UNFPA in the districts of Larkana and Shaheed Benazirabad (SBA) in the Sindh province. This program entailed delivery of free MNCH services to a population of 2.78 million in both the districts through the public sector health facilities. It was a 30 month intervention undertaken for the first time in Pakistan under contracting out. HSDC/IHSAS provided an integrated obstetric care model by linking of public facility obstetric and newborn care with the existing health system and support system for care at community level. HSDC/IHSAS accomplished this by working with a broad range of partners such as the public and private health care sectors, Non-Governmental Organizations and local communities. Multi-pronged strategy of HSDC/IHSAS project counted on various interventions for enhancing access and utilization to subsequently achieve the following targets as outputs: i. Strengthened and operationalized public health facilities for quality MNCH Services. ii. Improved coverage of MNCH services to under-served areas through collaboration with both private and civil society organizations & by operating a 24 hour MNCH Helpline. iii. Strengthened and improved community based public MNCH/FP services. iv. Established and strengthened performance & management system for improved efficiency & results

PHC & MNCH Service Delivery through RHC & BHUs in Taluka Garhi Yasin, District Shikarpur (Sindh)

February 2013-June 2013

District Shikarpur was hit by flood in the year 2012, affecting its all four talukas. Humanitarian organization started their interventions to help out the flood affected population in different talukas/areas of the district. Integrated Health Services implemented its ERF funded project Taluka Garhi Yasin, District Shikarpur. - IHS Support the Operations at three Public Health facilities including one RHC and Two BHUs to provide following free healthcare services: - Out patient management of the acute & chronic health problems - MNCH services: Antenatal, Postnatal and management of common childhood diseases like diarrhea, ARI etc. - Support TT vaccination for Pregnant Ladies & EPI vaccination for children under 2 years - Health education sessions were conducted at health facility level, at community level and also conducted along with the medical camps. Distribution of IEC material among the participants - Distribution of Health & Hygiene kits among communities - Refurbishment/repair work of the damaged Health facilities - Project beneficiaries included 46,040 (13,874 women; 9,226 men; 11,378 boys<15 yrs.; 11,562 girls <15 yrs.)

Primary healthcare and MNCH services for flood affected district of Nawabshah through Mobile Health Units (Sindh)

November 2011-May 2012

Flooding for the second consecutive year (2010 & 2011) due to monsoon rains in Sindh, had a major impact on health infrastructure. A number of existing hospitals and health facilities were severely damaged with disruption of an already limited health system, resulting in very limited health services facility at their doorsteps. Mostly these women and children that were affected most. In this scenario, the best mean to reach the affected population was through mobile health units to provide treatment at site as accessibility to BHUs and RHCs was limited due to multiple factors. IHS adopted this approach for its health services delivery project, funded by ERF, for the flood affected population of District Nawabshah. MNCH & Primary Healthcare Services were provided through four mobile Medical Camps in the District, benefiting a maximum population of the district. Health Education was imparted along with distribution of Clean Delivery Kits, Newborn Kits and Health & Hygiene Kits. - Project beneficiaries included 46,040 (13,874 women; 9,226 men; 11,378 boys<15 yrs.; 11,562 girls <15 yrs.) .

School TB Clubs Program (Round 6) titled as Moving towards Comprehensive Dots (Pakistan) Phase 2

October 2007- December 2012

Supported by the Global Fund and in association with Mercy Corps and the National TB Program (NTP) IHS launched a novel intervention to create awareness about tuberculosis through establishing ‘Health Clubs’ at school level in ten districts of Pakistan (Sialkot, Narowal, Mandi Bahauddin, Gujrat, Khushab, Tando Muhammad Khan, Tando Allahyar Khan, Bagh, Muzafarabad and Quetta). During this 5 year program students of middle and high schools were trained to become ‘Ambassadors of Health’ and they imparted education among their class fellows, families and the community at large on health issues specially the spread, treatment and prevention of TB. Every year 1500 students were trained as ‘TB Ambassadors’ in 50 schools of the above mentioned districts. This program increased the case detection and treatment completion rates of the disease in the selected areas. Achievements of School TB Clubs Project are listed below: - Successful completion of 5 years project with sensitizing 133183 school students about TB, it prevention, detection and treatment - Training of 263 School TB Clubs including 7437 school TB club members and 500 school TB club in-charges (Teachers). - 4466 TB suspects were identified by school TB clubs in 10 districts and - 378 patients of TB completed the treatment under supervision of school students as TB DOTS facilitators.

Monitoring & Evaluation Surveys

IHS has been conducting monitoring & evaluation surveys of projects & interventions conducted by Micro Nutrient International, Concern Worldwide, Plan International (Pakistan), Save the Children (UK) and a host of other organizations during the last 5-6 years. We have worked in all provinces of Pakistan and conducted project evaluation studies in over 40 districts. We have a pool of human resource including trained field workers, HMIS experts and public health consultants to conduct such surveys that enables us to complete our assignments in short period of time with reliable results and accurate assessments.

School Health Clubs Project District Layyah

Behavior Change Communication in Communities through School Health Clubs with School Children as Ambassadors of Health & Hygiene and Messengers of Change in district Layyah, funded by WHO & implemented by Integrated Health Services (IHS Pakistan). The efforts and interventions by various organizations and development partners had targeted curative measures but for a long term solution and early recovery it is required that health and hygiene awareness be created among the affected communities to prevent diseases and reduce the cost and effort associated with curative measures. School children were chosen for this intervention as the target audience because they are the future generations and if educated at this stage of life they can become lifelong ambassadors of health. They have immense energy which if not rightly channelized can cause frustration and lead them towards disarray. While if intelligently used they can become the most vocal proponents of health awareness not just in their schools, families but the community as well .

HIV – Reducing Stigma & Discrimination – A World Bank Project

The World Bank’s South Asian Regional Development Marketplace (SARDM) awarded IHS with a one year project on reducing stigma associated with HIV through creation of ‘Youth HIV Forums’ at colleges. IHS was one of the 25 organizations from the 8 SAARC countries selected out of a total of over 1100 applicants after a long & thorough process of selection held at Mumbai. This project is a BCC intervention targeting the youth & channelizing their energies to create awareness about HIV with special reference to the socio-cultural aspects of the Pakistani society. Focus will also be on IDUs & MSMs to educate them on preventive measures to reduce HIV transmission. This is the first of its type initiative being taken in the world where energies of the youth is being channelized through organized forums and if found successful has the potential to be replicated at other places.

Mother’s Health Education - Balakot

After the 2005 earthquake, in league with the UAE Red Crescent Society & the Embassy of United Arab Emirates in Pakistan, IHS operating a 24 hr. curative & preventive health facility in Baissian (7 km. short of Balakot) since February 2006. Around 150 Patients visited the facility daily and are provided free treatment. Till the end of 2008, over 150,000 patients have received treatment from this facility free of cost. Besides treatment the facility specific health education was provided to the ‘mothers’ on how to manage the health and development of their children starting from birth to the teens.

Geographical Survey for World Bank

IHS conducted a GIS survey in the four provinces and FATA/FANA for the World Bank to map the primary healthcare facilities. It involved digital mapping of the locations and setting up of communication systems. The survey took 11 months to complete and was the first of its kind in Pakistan. In the 2nd phase of the project secondary & tertiary care facilities are also planned to be added in the data base and made available through a web based server for ready access of information and coordination between the users & partners.

Health Capacity Building of Local Health Councils – Kotli Satiian/Murree

Implementing on behalf of Concern Worldwide, IHS conducted health awareness trainings and capacity building sessions on general health issues ranging from hygiene to communicable diseases, MCH, and First Aid for ‘Village Health Councils’. Separate trainings were conducted for men and women through multimedia aids and practical demonstrations. Trainings were tailor-made to meet the needs of the local population in accordance with the socioeconomic and cultural practices.

AJK School Health Program - Save the Children, UK

As the implementing consultant of Save the Children (UK), IHS executed a comprehensive school health initiative in Bagh and Muzafarabad districts of AJK. This project was a pilot intervention in two union councils (Bagh & Langarpura) only. IHS after developing a viable school health system transferred it to the public sector health facilities of the area. The project is planned to be replicated in other districts of AJK and Pakistan. The IHS school health program for these areas had three basic components: • School health capacity building of teachers and health professionals in the public sector institutions (a 140 page capacity building manual for teachers in Urdu was prepared by IHS during the process). • Health screening of all school going children (Primary, middle & high schools) • Networking of health facilities for referral and follow up of school health services on long term and self sustainable basis .

Development of National Guidelines for Viral Hepatitis Case Management & Counseling

IHS has the unique honor of having developed the National Hepatitis Case Management and Counseling Guidelines for the Prime Minister’s Program for Hepatitis Control & Prevention. IHS consultants in liaison with 32 leading Hepatologists & Gastroenterologists of the country developed these guidelines which after field testing are now in the process of being adopted across Pakistan in all public sector health facilities. Hepatitis has remained a focal point of our activities. We were the first organization in Pakistan to launch mass awareness and vaccination programs from 1996-8. During the process 73,000 B and C screenings were conducted along with over 2 million vaccinations. Marked variation in prevalence of Hepatitis B & C was noted among various socioeconomic groups and geographical areas.

General Health Awareness

Since 1996 IHS has developed and printed over 2 million pieces of health awareness material including handouts, leaflets and newsletters for a diverse range of population including school children, house wives, mothers, village elders/councils, office and industrial workers & executives. Some of these were sponsored while most were undertaken by IHS through its own resources as a contribution towards creating a health conscious and healthy society. Such trainings and workshops have been held in many cities, towns and villages including Rawalpindi, Mansehra, Balakot, Azad Kashmir, interior Sindh, etc.

Research on Worm Infestation in Rural School Children:

In 1998 IHS conducted a study on the incidence of worm infestation among school going children in the Attock district. 53% children tested positive for worms on stool R/E. De-worming of 93% children of the area was later carried out by IHS.

School Health Research & Trainings

During the last 10 years 0.8 million school children have remained enrolled with IHS School Health. The data obtained through periodic examinations and sick reports is being evaluated in order to develop effective interventions to prevent and correct diseases at an early stage. This data and the feedback that we have been receiving has also helped us in making and tailoring the health education material for students and teachers in a most effective manner besides developing interventions that can be more cost effective and sustainable. IHS has developed manuals for capacity building in school health of various stakeholders including teachers and medical professionals and our staff has been conducting these trainings in many schools both in the public and private sector. Manuals are available both in Urdu and English.

Rescue 15, Islamabad Police – Establishment of Emergency Medical Operations

IHS was the pioneer with Islamabad Police in setting up medical services at Rescue 15, Islamabad. IHS doctors operated this medical system from Jan 2000 to November 2005. It was not funded by any one particular group. Without putting any burden on the government exchequer IHS arranged the finances for operations and salaries through charging Rs. 50/- as medical examination fee of new applicants of driving license (IHS for the first time in the history of Traffic Police in Pakistan organized the medical aspects of license issuing on modern lines and established proper clinical examination rooms at traffic police offices in Islamabad).

Free Medical Camps & Health Awareness ‘Melas’

IHS organizes free medical camps periodically through its own resources in the slums around and in Islamabad, Azad Kashmir, Balakot and many other areas. Some of the camps have been sponsored by organizations like CIDA, Dar-ul-Hikmat International, etc. others have been held through our own resources. IHS provides doctors, medics, nurses and medicines for such activities. We organize the whole activity starting from creating awareness to managing logistics, procuring drugs, deputing staff and actually running the camp followed by preparation of reports.