CHILONGA MISSION HOSPITAL

ANNUAL REPORT
2017

1
 TABLE OF CONTENTS
CONTENT
PAGE

1. Acknowledgement…………………………………………………………………
…..
2. Abbreviations…………………………………………………………………………
.
3. General review of
2015………………………………………………………………..
4. Background/Environment
…………………………………………………………….
5. Organisation Chart…………………………………………………………
6. Organization structure & development
……………………………………………….
7. Human Resource Department
………………………………………………………..
8. Registry Office………………………………………………………………………..
9. Finance
Department………………………………………………………………….
10. Out Patient Department
…………………………………………………………
11. Nursing
care…………………………………………………………………………..
12. Obstetrics
Department………………………………………………………………..
13. Male Medical
ward………………………………………………………………….
14. Paediatrics ward………………………………..
15. Female Medical
ward…………………………………………………………….
16. Surgical and Gynae
ward…………………………………………………..
17. Physiotherapy Department……………………………………………….
18. Operating Theatre
Department…………………………………………………..
19. Sexual Transmitted Infections
Unit………………………………………………
20. Gender Based Violence
Unit…………………………………………………
21. EMTCT Unit………………………………………………………………
22. ART Department………………………………………………………….
23. Pharmacy Department
……………………………………………………………..
24. Dental
Department………………………………………………………………
25. Medical Imaging Department
…………………………………………….
26. Laboratory
Department………………………………………………………
27. Purchasing and Supply
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 Department……………………………………………
28. Transport, Infrastructure and
Maintenance………………………………….
29. Health Management & Information System
Department………………………..
30. Social Services
Department…………………………………………………
31. Training Schools
……………………………………………………………….

1. ACKNOWLEDGEMENT

Chilonga Mission General Hospital would like to acknowledge the work and
effort that went into the production of this annual report. It was through
dedication and commitment of our staff members from various departments
at the hospital and the schools of nursing and midwifery that has made it
possible to provide this report on administration, academics and health
services of our institution.

We appreciate the extensive effort that was put into this report by the Health
Management Information Systems department and core team to compile it.
We also greatly appreciate the following individuals and organizations for
their moral, technical and financial support:

The Archbishop of Kasama and the Apostolic Administrator of Mpika Diocese

– His Grace Ignatius Chama
The Diocese of Mpika
The Sisters of the Child Jesus
The Dominican Sisters
CHAZ
CRS (Catholic Relief Services)
District Medical Office - Mpika
Ministry of Health, Provincial Health Office, Zambia
Mpika District Council
Office of the District Commissioner - Mpika
World Vision, Mpika
ZESCO-Mpika
ZGT Hospital - Netherlands
Dr. Goran, visiting Plastic Surgeon

3
Dr. Michael Breen and the VVF repair crew
All individual donors

Dr. Jean Meji Bertin Kalengayi

Medical Superintendent, Consultant Surgeon

2. ABBREVIATIONS

ADR - Adverse Reaction

ADM - Admission

ANC - Ante Natal Care

ART - Anti Retroviral Therapy

CDC - Centre for Disease Control

CFR - Case Fatality Rate

CHAZ - Churches Health Association of Zambia

CRS - Catholic Relief Services

C&T - Counselling and Testing

DCT - Diagnostic Counselling and Testing

DISC - Discharge

ECG - Echography

eLMIS - electronic Logistic Management Information

System

EMTCT - Elimination of Mother to Child Transmission

EQA - External Quality Assurance

ERPC - Evacuation of Retained Products of Conception

GBV - Gender Based Violence

GNC - General Nursing Council

GRZ - Government of the Republic of Zambia

HAART - High Active Anti-Retroviral Therapy

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HIV - Human Immune deficiency Virus

HMIS - Health Management and Information Systems

LSCS - Lower Segment Caesarean Section

MCH - Mother and Child Health

MOH - Ministry Of Health

MSD - Muscular Skeletal Disorder

MSL - Medical Stores Limited

MTC - Medicines and Therapeutic Committee

MTEF - Medium Term Expenditure Framework

NGO - Non- Governmental Organisation

OBS - Obstetric

OIs - Other Infections

OPD - Out Patient Department

OVC - Orphan and Vulnerable Children

PMO - Provincial Medical Officer

PMTCT - Prevention of Mother to Child Transmission

QIDU - Quality Improvement through Data Use

RHC - Rural Health Centre

RM - Registered Midwife

RTA - Road Traffic Accident

RTI - Respiratory Tract Infection

RPR - Rapid Plasma Reagent

STI - Sexually Transmitted Infection

TB - Tuberculosis

UCI - Universal Child Immunization

VCT - Voluntary Counselling and Testing

VVF - Vesicol Vaginal Fistula

ZAMPHIA - Zambia Population Based HIV Impact Assessment

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ZEM - Zambia Enrolled Midwife

ZEN - Zambia Enrolled Nurse

3. GENERAL REVIEW OF 2017

By Dr. Jean Meji Bertin Kalengayi, Medical Superintendent.

Chilonga Mission Hospital has built for years a reputation for excellence in
healthcare and our achievements in 2017 were exceptional. I am proud to
work with the committed and talented healthcare professionals, staff,
students and volunteers who contributed to successful outcomes and
patient satisfaction during the year 2017. I urge each one of us to continue
promoting the four key values; Collaboration, Openness, Respect and Trust
which made us to work coherently as a team overcoming obstacles and
remaining patient centred as we constantly strived to improve the healthcare
services we provide.

This annual report outlines the activities, successes and challenges from the
departments, wards and schools of Nursing and Midwifery. The Health
Management Information Systems section provides statistics on top ten
hospital conditions or diseases trends comparatively to 2016.

There was a slight improvement on staffing levels due to continuous

recruitment and deployment of staff by the Ministry of Health. However, we
are still far from meeting the ideal staff establishment of a second level
hospital and Schools of Nursing and Midwifery.

The financial reports provide the incomes from the Government of Zambia –
MoH and CHAZ and the expenditures. Prioritization was key to the
implementation of activities as there was need for adjustment due to many
needs.

Regarding infrastructure development, we are still lobbying for the

construction of the administrative block as there is need for office space. The
renovation/rehabilitation of imaging department has also been one of
challenges faced by the institution. The release of K 3, 000.000.00 by the
government for reconstruction of gutted midwifery school infrastructure
brought hope to the management and community as this was a big blow to
the institution.

With the implementation of ART services, it has been an uphill battle for the
institution considering the inverse proportion in programme funding by
partners and escalating demand in ART clinical services by the general
population. However, despite the challenges, the facility recorded an increase
in the enrolment of clients into the programme who received quality clinical,
laboratory and pharmaceutical services. We really want to thank the

6
hospital staff and the cooperating partner CHAZ for the support in ART
services.

On aspects of medical and non-medical supplies, the consistent receipt of

the GRZ grant from MoH managed to sustain the smooth operations of the
pharmaceutical services at the institution. We would like to strengthen
management of logistical supply of commodities, laboratory quality
management systems (LQMS) among other quality enabling and reference
parameters.

Patient satisfaction and student are some of the successful outcomes based
on the acceptance of the fundamental key values which allow us to perform
as a team. In conclusion, we can happily say that despite the highlighted
challenges, the hospital and the schools operated smoothly meeting most of
the set objectives for the year 2017.

1. BACKGROUND / ENVIRONMENT
OUR VISION
Chilonga mission hospital shall provide accessible, sustainable and
cost effective quality health services to the community with special
attention to the underprivileged. We shall uphold Christian, family
and good cultural values and respect each person’s dignity.
OUR MISSION STATEMENT
Chilonga Mission Hospital shall collaborate with other stakeholders
and endeavour to provide the best preventive, curative and restorative
health services as well as spiritual nurture to our patients / clients.

ORGANISATION CHART (TO BE FIXED AS ATTACHED TO THIS EMAIL)

HUMAN RESOURCE DEPARTMENT

Report by Mr. Oliver Chanda, Human Resource Management Officer

The period from January, 2017 to December, 2017, the institution had a
total number of 244 funded positions of which 242 were occupied, two
positions were vacant. The total actual staffing levels were at 232, ten
members of staff were working in other health facilities.

The institution received a total of 13 officers on first appointment as

distributed as follows;

POSITION NUMBER OF OFFICERS

POSTED
REGISTERED NURSE 2
REGISTERED MENTAL HEALTH NURSE 1
ENROLLED NURSE 4
7
MEDICAL LABORATORY 2
TECHNOLOGIST
DENTAL THERAPIST 1
CLINICAL OFFICER GENERAL 3

STATISTICS

Staffing levels of Medical Staff

MEDICAL STAFF PER CATEGORY

80 74
70
60
50
40
30
20 15
10 6 8
1 4 1 1 1 4 3 3 1 2 3
0
s s s t t n ist ist ist ist ist er tist .T ist
rse tor her gis tis cia g c g p g i c H n
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ad ys
R h
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8
STAFFING LEVELS FOR SUPPORT STAFF

3.5
3 3 3
3
2.5
2 2 2
2
1.5
1 1 1 1 1 1 1 1 1 1 1 1
1
0.5
0

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SO M N
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E
V AL I TA LEVELS
R IC SP
D O ESTABLISHMENT
E
M H

STAFFING LEVELS FOR CLASSIFIED DAILY EMPLOYEES

45 4142
40
35
30
25
20
15 1212
99
10 77 STAFFING LEVELS
44
5 11 11 ESTABLISHMENT
0

Comments
9
 - The current establishment is that of level one Hospital.
- A total of 37 positions were created in 2017 and these include four
positions for consultants, fifteen positions for Nurses, six positions for
laboratory technologists, five positions for Clinical officers, four
positions for Environmental Health Technologists and three positions
for Nutritionist Technologists.

STAFF ATRITION

The institutional staff attrition and its causes in 2017 is shown in the
table below:

Staff Retir Resign Deceas Contra Transferr Transferr Tot

Category ed ed ed ct ed ed in al
expire out
d
Pharmacy
Technologi 1 1
st
Driver 3 2 5
Registered
1 1 2
Nurse
Radiograp
hy
2 2
Technologi
st
Radiograp
1 1
her
Laboratory
Technologi 1 1
st
Enrolled
2 2
Nurses
Medical
superinted 1 1 2
ent
Registered
Mental
Health 2 2
Nurse
Enviromen
tal Health
2 2
Technologi
st
Clinical 2 2

10
Officer
General
Total 0 0 1 0 14 7 21

TRAINING AND DEVELOPMENT

During the year 2017, the institution had recommended a total of seven
officers who have since commenced their training as shown in the table
below;

CADRE No of Officers
Paediatric Nursing 2
Certificate in Midwifery 1
Certificate in Theatre
2
Nursing
Diploma in Nursing 1
BSC in Nursing 1

The Summary of the training plan is shown in the table below.

No. of Officer Officers Officers Officers

officers s with without who
on curren approve approved completed
training tly in d study study by
plan trainin leave leave December,
g 2017
29 10 10 0 4

SUCCESSES
- All officers on first appointment were introduced on payroll.
- Four officers successfully completed their long term training in 2016.
- Four officers were promoted.
- Six officers had their appointment normalised and confirmed to
permanent and pensionable establishment.

CHALLENGES AND CONSTRAINTS

- Delay in receiving funds for payment of personnel emolument related
allowances as the year 2016 ended without receiving any funds.
- Inadequate establishment. The institutions runs as a level two (2)
hospital but using the establishment for a level one (1) hospital; thus
posing a challenge in promoting officers who have upgraded in their
career as there are no vacant and funded positions for their
placement.

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 - Delay in normalising staff transfers hence creating artificial shortage.
- Inadequate housing units poses a major challenge as there are limited
housing units (56 housing units) against the 244 staff at the
institution.

REGISTRY

The Registry office is a sub unit within the Human Recourse department. It
operates hand in hand with the Human Resource department.

SUCESSES

 Registers for incoming and outgoing of letters and mails was

introduced.
 Open, Confidential and salary files for officers on first appointment
were opened.
Creation of a new registry office.

CHALLENGES

 Updating of staff files, file inventory as well as submission of new files

for officers on first appointment was done only in the first quarter of
2017.

FINANCE DEPARETMENT
Reported by Sister Mercy Zimba – Assistant Accountant

The Government was the main funder for the hospital during 2017. Monthly grants by the
government were received on a timely basis during the year. The Hospital received 99% funding from
the government for 2017 budget. The Hospital also received funds for Result based Financing (RBF).
This enabled the hospital to carry out most of the planned activities throughout the year.

The institution also received funds from partners such as CHAZ- Global fund, CHAZ-CDC and Catholic
Relief Services (CRS).

In general, the year 2017 was a successful year in terms of funding from both the government and
our partners. We therefore wish to thank the government and partners for the continued financial,
material and technical support to our institution to enable us to carry out our mandate to offer
caring, clean and compassionate health care to the people of Mother Zambia.

The table below highlights different sources of funds received during the year 2017.

SUMMARY OF RECEIPTS FOR 2017

FUNDING SOURCE AMOUNT RECEIVED AMOUNT BUDGETED VARIANCE (F/A)

ZMW ZMW ZMW
GRZ GRANTS 1,752,332.00 1,762,332.00 (10,204.46)
RBF 65,484.00 65,484.00 00.0
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 OTHER FUNDS 62,820.00 0.00 62,820.00
CHAZ-CDC 553,449.94 553,449.94 0.00
CHAZ-GLOBAL FUND 3,365.11 3,365.11 0.00
CRS 115,659.50 115,659.50 0.00

SUMMARY OF INCOME AND EXPENDITURE

FUNDING SOURCE PROGRAM INCOME EXPENDITURE VARIANCE (F/A)

ZMW ZMW ZMW
GRZ GRZ 1,752,332.0 1,732,260.00 20,072.00
0
RBF GRZ 65,484.00 65,484.00 0.00
OTHER BY PASS 62,820.00 49,750.00 13,070.00
CHAZ –GLOBAL FUND NFM 7,502.14 7,211.62 290.52
CHAZ-CDC CART 553,449.94 547,643.19 5,806.75
CRS EPIC-3-90 115,659.50 79,654.75 36,004.75

HOSPITAL ACTIVITIES

OUT PATIENT DEPARTMENT

Reported by Ms. Josephine Tupa – OPD In-Charge
The department fared well attending to patients and providing the necessary
health services. The tables below summarise attendance based on the top
conditions or diseases during the year.
Top conditions leading to filter for Under Fives

S/N CONDITION TOTAL

1. Malaria 2290
2. Diarrhea 509
3. Pneumonia 60
4. Skin Diseases 282
5. Respiratory Tract Infection 2207
6. Sickle Cell 223
8. Anaemia 143
9. Digestive System 389

Top conditions leading to filter for Ages above 15 years

S/N CONDITION TOTAL

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 1. Malaria 6770
2. Diarrhea 2261
3. Pneumonia 108
Muscular Skeletal 1828
4. Skin Diseases 651
Epilepsy 125
5. Respiratory Tract Infection 4167
6. Sickle Cell 70
8. Anaemia 53
9. Digestive System 1896

MCH ATTENDANCIES

1 ANC-1ST VISIT 527

2 ANC-REVISIT 1221
3 POSTNATAL 6DAYS 442
4 POSTNATAL 6WEEKS 398
5 GROWTH MONITORING 7696

SUCCESS

1. Spacious and improved treatment room

2. Timely reporting
3. Managed to conduct mobile ANC & UCI throughout the year.
CHALLENGES

1. Late and inadequate funding.

2. Low staffing levels.

NURSING CARE

Reported by Sister Catherine Chisanga AgNO

I take this opportunity to thank our committed nurses and midwives

throughout the year.

NURSES’S MEETINGS

The meetings were conducted both at ward level and as general meetings for
nurses as planned. General meetings were held on a quarterly basis while
ward meetings on a monthly basis.

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 TRAININGS UNDERTAKEN Number Trained
ART /Option B+ 12
ART New Guidelines 05
TB/ART Guidelines 03
Management of STIs 02
FANC 01
Malaria Case Management 04
Successes

 Availability of medical equipment

 Some nurses received watches, pair of scissors and chains from
Ministry of Health.
 One nurse completed her BSc in Nursing.
 Coverage nurse was implemented
 CPD orientation was done to all nurses.

Challenges

 Few workshops / trainings were held in the year.

OBSTETRICAL DEPARTMENT
Reported by Mrs. P. Banda – Ward In -Charge
1Common causes of morbidity
State the conditions or
diseases ADM DISC DEATHS CFR/1000
Malaria in pregnancy 47 47 0 0
Hypertensive disorder 05 05 0 0
Eclampsia 04 04 0 0
Severe pre-eclampsia 05 05 0 0
UTI in Pregnancy 00 00 0 0
Peurperal / Sepsis 08 07 01 125
Anaemia in Pregnancy 10 08 02 200

Analysis of Out- and In-patient attendances

Department Admissions
  2017
OBS 1637
   

Analysis of Discharges , Deaths and CFR /1000

           
Departmen Discharges Deaths Deaths Neonatal
t within Deaths
48
15
 hours
OBS 1589 4 18 21

Analysis of utilisation of hospital services

     
In-Patients
Department Beds and Cots Daily Av/patients
Days
OBS 42 4.5 12293
       

Successes

1. Reviewed all the maternal deaths

2. Reviewed all the still births
3. Availability of medical supplies
4. Staffing levels were good

Challenges

1. Inadequate bed space in the annex and post-natal room

2. Big crack in the annex which is a danger to the expectant mothers.

MALE MEDICAL WARD

Reported by Mrs.C.M. Chanda- Ward In-Charge
1Ten common causes of morbidity
State the conditions or
diseases ADM DISC DEATHS CFR/1000
Tuberculosis 15 10 5 333
Pneumonia 35 30 5 143
Hypertension 23 20 3 130
Malaria 14 10 4 285
Diabetes 15 13 2 133
Congested Cardiac failure 24 19 5 208
Gastro enteritis 19 15 4 210
Aneamia 17 11 6 353
Gastritis 20 16 4 200
Upper respiratory tract
20 19 6 300
infection

16
Analysis of Out- and In-patient attendances

Department Admissions
  2017
MEDICINE 471
   

Analysis of Discharges , Deaths and CFR /1000

           
Deaths
Departmen Deaths within
Discharges
t 48
hours
MEDICINE 387 52 6

Analysis of utilization of hospital services

     
Daily
Department Beds and Cots In-Patients Days
Av/patients
MEDICINE 20 1 2648
       

Successes

1. Routine works of the year were done.

2. Items that were budgeted for were bought.
3. Managed to conduct the annual departmental planning for 2018-
2020.

Challenges

1. The ablution block is not in good condition.

PAEDIATRICS WARD
Reported by Mrs. Mwaka. K. Ndolo Ward In-Charge
1Ten common causes of morbidity

17
Conditions
or diseases ADM DISC DEATHS  CFR
Malaria 210 205 03 14
Pneumonia 141 138 03 21
Trauma
94 94 00 0
(fractures)
Gastro
82 80 02 24
enteritis
Burns 40 32 01 25
Anaemia 51 44 02 39
PCM 63 58 04 63
Snake Bite 17 17 00 0

Analysis of Out- and In-patient attendances

Department Admissions
  Year 2017
PAEDIATRICS 698
   

Analysis of Discharges , Deaths and CFR /1000

           
Deaths
Deaths within
Department Discharges
48
hours
PAEDIATRIC
668 15 02
S

Analysis of utilisation of hospital services

In-Patients
Department Beds and Cots Daily Av/patients
Days
PAEDIATRICS 46 2 5810
       

Successes

1. Availability of drugs and medical supplies

2. All the budgeted for equipment and items were bought
3. PCM cases were managed in collaboration with nutrition
technologists.
4. Availability of food supplements for PCM clients

Challenges
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1. Lack of adherence to treatment guidance by some mothers with PCM
patients.
2. The ablution is not in good condition.

FEMALE MEDICAL WARD

Reported by Ms. Karen Nkandu - Ward In-Charge
1Ten common causes of morbidity
Condition /
Disease ADM DISC DEATHS CFR
Hypertension 89 87 2 22

Anaemia 45 40 5 111

Tuberculosis 22 20 2 90

Pneumonia 43 41 2 47

Malaria 48 47 1 21

Congestive 82
49 45 4
cardiac failure
Gastro enteritis 43 42 1 23

Unitary tract 42
24 24 1
infections
Diabetes 21 21 0 0

Gastritis 18 17 1 56

Analysis of Out- and In-patient attendances

Department Admissions
  Year 2017
MEDICINE 616
   

Analysis of Discharges , Deaths and CFR /1000

           
Deaths
Departmen within
Discharges Deaths
t 48
hours
MEDICINE 533 38 13

Analysis of utilisation of hospital services

     
Department Beds and Cots Daily Av/patients In-Patients
19
 Days
MEDICINE 18 2 2499
       

Successes

1. Improvement in the capturing of data in registers

2. Ward affairs meetings were held

Challenges

1. There was low staffing levels

SURGICAL WARD

Reported by Sr. Belinda Chisanga - Ward In-Charge

1Ten common causes of morbidity

conditions
or diseases ADM DISC DEATHS CFR
Trauma RTA 42 38 04 95
Hernias 78 72 00 0
Fractures 111 109 02 18
Wounds 48 40 08 167
Abscess 32 29 00 0
Snake bite 17 17 00 0
BPH 22 20 00 0
Burns 29 24 05 172

Analysis of Out- and In-patient attendances

Department Admissions
  Year 2017
SURGERY 932
GYNAE 250
TOTAL 1182
   

Analysis of Discharges , Deaths and CFR /1000

 
       
 
Departmen Discharges Deaths Deaths
t within
48
20
 hours
SURGERY 895 37 06
GYNAE 247 03 00
TOTAL 1142 40 06

Analysis of utilisation of hospital services

In-Patients
Department Beds and Cots Daily Av/patients
Days
 
SURGERY 28 3 14963
GYNAE 4 1 2181
TOTAL 32 4 17144
       

Successes

1. There was team work

2. Surgical and medical supplies were always available
3. Major surgeries were performed such as Thyroidectomy
4. Had a VVF camp which benefitted patients from Muchinga and
Northern Province.

Challenges

1. Staffing levels were low.

2. Inadequate bed capacity to cater for many surgical patients that we
received.

INTENSIVE CARE UNIT

Reported by Ms. Grace Chibuli - ICU In-Charge

The unit facilitates the recovery of patients from recoverable life threatening
conditions. The patients benefit from more detailed observation and invasive
treatment that cannot be safely provided on the general ward.

Services offered are mechanical ventilation, defibrillation, cardiac

monitoring, ECG among others. During the year, the unit attended to a total
number of 37 patients, recorded 5 deaths and referred 11 patients to higher
health institutions by the advanced life support ambulance.

Successes

1. The unit was operational throughout.

2. Medical and surgical supplies were well stocked.
3. Installation of the solar system.
21
Challenges

1. Low staffing levels.

2. Inadequate equipment.

PHYSIOTHERAPY DEPARTMENT

By Andrew Kangwa - Physiotherapy Technologist

The department is a branch of medicine that is primarily concerned with the

remediation of improvements and disabilities. The department attended to a
total of 331 patients, out patients were 260 and in patients were 71 of which
children below 15 years were 87, above 15 years were 244. In addition,
orthopaedic cases were 236 and neurological cases were 95.

Successes

1. Most of the planned activities were implemented

Challenges

3. Inconsistent attendance of clients due to long distances making it difficult

for the department to carry out patient monitoring and evaluation.

OPERATING THEATRE

By Njekwa Mufaweli – Registered Operating Theatre Nurse

The department managed to conduct various activities and all planned

activities were implemented. The total number of patients received were 859
of which 263 were for minor cases, 386 were for major cases and male
circumcisions were 114 at local and outreach sites.

Successes

1. Staffing levels improved.

2. Hosted the gynaecological surgeon and a plastic surgeon.
3. Item and materials were readily available.

Challenges

4. The department does not have a porter.

5. The department experienced shortage of orthopaedic materials.

ANAESTHESIA UNIT

Reported by Mr. Benjamin Banda – Principal Clinical Officer Anaesthesia

22
The operating theatre team is composed of the surgical team (Surgeon),
Operating theatre nurses and the Anaesthesia team. The unit only had one
member of staff. This meant that the officer was on duty throughout. There
was an increase of cases as the hospital received a surgeon.

Type Minor Major Total

General 206 386 592
Anaesthesia
Regional 144 210 354
Anaesthesia
Cooperation 27 0 27
Total 263 596 973

Successes

1. The unit received a newly trained Anaesthetic officer who went for
training at Chainama College.

Challenges

1. Low staffing levels.

GENDER BASED VIOLENCE UNIT

Reported by Ms. Mwansa C.S - GBV Focal Person

The GBV unit is located under the ART Department, and came into being
after training staff in GBV by CHAZ in June, 2015. During the year 2017,
the following cases were recorded; 25 wife/husband battering, 4 family
neglect, 2 attempted defilement, 12 defilement, 4 early marriage, 1
attempted rape, 60 teenage pregnancies, 2 economical abuse, 2 rape, 6
child neglect, 5 psychological /emotional abuse, and 3 child abuse giving
a total of 102 cases.

Successes

1. Sensitisation went on very well as planned.

2. The rate of reporting GBV cases increased in as compared to the
previous year.

Challenges

1. There is no permanent office for GBV activities

2. Victims of GBV were failing to go to the one stop centre in Mpika boma
when referred due to lack of transport money.

ART DEPARTMENT

23
Reported by Mr. Fewdays Chibuye – ART Coordinator

INTRODUCTION

It is now ten years since the ART department was initiated at Chilonga
Mission General Hospital. From the humble statistical background of 205
patients on Care Cumulative, 122 cumulative patients on ART and 116
patients active (current) on ART respectively by the end December, 2006.

The programme has seen a lot of expansions in a number of facets resulting

in a high retention rate of 4,118 patients cumulative on Care, 3,099 patients
cumulative on ART and 1,929 patients active (current) on ART respectively
by December, 2017.

The following were activities undertaken in the course of 2017:

1. VCT/DCT

2. Client enrolment on the programme (on care and ART initiation)

3. Client monitoring, follow – up and tracing.

4. Community mobilization and sensitization.

5. Capacity building.

6. Laboratory and pharmaceutical supplies.

7. Monthly and quarterly reporting to the partners.

8. Department and general meetings.

STATISTICS FOR VCT/DCT

24
 1400
GENERAL HIV TESTS FOR DCT/VCT AT CHILONGA IN THE YR 2016 VS 2017
1200 1226
1000 1021 965 979
922 925 895
800 818
600
400
200
0

 Total tested were 3,657 of which our target was 3,500 which was
giving us 104%.

(ii) POSITIVE RESULTS FOR DCT/VCT HIV TESTS FOR 2016 VS 2017

POSITIVE RESULTS FOR GENERAL DCT/VCT HIV TESTS FOR 2016 VS 2017
80
74
70 69
60 60 61
54
50 47
40 39
30 32
20
10
0

 We had a low number of proportion of clients taking an HIV test and

tested Positive of 5% as compared to 2016 positive rate at 6%.

(ii) STATISTICS FOR VCT/DCT IN 2017 FOR CHILDREN FROM 1 – 14

YRS

25
 CHILDREN FROM 1-14YRS 2016 VS 2017
160
152
140
120 116
100 101 95
80 84
67 67 68
60
40
20
0

 A total number of 382 children in 2017 from the target of 323 in 2017
were tested representing (118%). In 2016 (368) had been tested for
HIV.

(iii) POSITIVE RESULTS FOR DCT/VCT FOR CHILDREN 2016 VS 2017

POSITIVE RESULTS FOR DCT/VCT FOR CHILDREN FROM 1-14YRS 2016 VS 2017
4.5 4 4
4
3.5
3
2.52 2 2 2
2
1.5 1 1
1
0.5
0

 We had so many children tested for HIV we had also high number of
children who were found HIV positive as compared to 2016.
 The rate of positivity for 2016 was 2.1% and 2017 was 3%.

(iv) TOTAL HIV POSITIVE CLIENTS REFERRED FOR ENROLLMENT

FOR 2017

26
 HIV POSITIVE CLIENTS REFERRED FOR ENROLLMENTN FOR 2017
80 74
HIV POSITIVES NEWLY ON CARE
70
62
60 54
50 48 47
42
39
40
32
30

20

10

(v) ENROLLMENT OF CLIENTS ON CARE VS TREATMENT NEWLY IN

2017

ENROLLMENT OF CLIENTS ON CARE AND TREATMENT NEWLY IN 2017

NEWLY ON CARE NEWLY ON TREATMENT
80 69 70
70 62
60
48 47 47
50 42 46
40
30
20
10
0

 Total newly enrolled on Care in 2017 were = 199

 Total newly initiated on treatment in 2017 were = 232

(VI) NEWLY CHILDREN ENROLLED ON CARE VS TREATMENT FOR

2017

27
 NEWLY CHILDREN ENROLLED ON CARE AND TREATMENT FOR 2017
NEWLY ON CARE NEWLY ON TREATMENT
6
5 5
5
4
3
3
2 2 2 2 2
2
1
0

 Total newly children enrolled on care were = 11

 Total newly children initiated on treatment were = 12 (109%).

STATISTICS FOR TERMINATION CLIENTS ON THE PROGRAMME FOR

YR 2017

Defaulters on ART
40
35 35
30 29
25
20 20
18 18
15 16 16
13
10
5
0

 We had a low number of defaulters on ART in the fourth quarter of

2017 because of the out reach activities which were carried out. Most
of the clients were tracked and refills were done.

(vii) CUMULATIVE STATISTICS OF CLIENTS FOR LOST TO FOLLOW-UP

ON TREATMENT 2016 VS 2017

28
 CLIENTS LOST TO FOLLOWUP ON ART
600

500 490
456 458
433
400
373 374

300 313

216
200

100

 Clean up or updating of data was done for those who were not coming
for the drug pickups.

(viii) CUMULATIVE STATISTICS OF CLIENTS TRANSFERRED OUT ON

TREATMENT

2016 VS 2017

Clients transferred out on ART

700
553
652
600 504 520 527 539
476 491
500
400
300
200
100
0

 The fourth quarter of 2017 had a high number of clients transferred

out on ART as a result of lost to follow up and defaulters. We had
found out that most of the defaulters and lost to follow up clients had
were already getting treatment from other facilities.

CUMULATIVE STATISTICS FOR PATIENTS ON CARE AND ART FORM

2006 TO 2017

29
 CUMULATIVE STATISTICS: ON CARE, ON ART &
CURRENT ON ART
Cum On Care Cum On ART Current On ART
4500

4000 4118
3932
3721
3500 3460
3000 3121 3099
2789 2867
No. of patients

2500 2588
2406 2283
2000 1989 2054
1670 1922 1867 1929
1543 1382 1662
1500 1403
1056 1281
1000 1033 808 1110
634 573 854
390
344 660
500122
205 457
0 109
2006 2007 2008 2009 2010 2011
Years 2012 2013 2014 2015 2016 2017

 By the end of 2017, we had to drop down in the numbers of current

on ART because of the transferred out clients.

TREATMENT & OUTCOME ON MANAGEMENT OF HIV/AIDS

GENERAL TESTED FOR HIV AT CHILONGA M.G. H QUARTERLY IN 2017

Q1 Q2 Q3 Q4
INDICATOR
# of patients counselled and tested for HIV 965 895 818 979
Positive 74 54 39 32
% 8% 6% 5% 3%
HIV positive referred to ART 62 48 47 42

TREATMENT OUTCOME &MANAGEMENT ON HIV/AIDS

INDICATORS Q1 Q2 Q3 Q4
ART cohort at 12months ago 75 62 73 78

Still on original 1st line drug at 12 months 52 51 55 61

% 69 82% 75% 78%
%
Substituted to alternative 1st line drug by 12 2 3 3 2
months
% 4% 6% 5% 3%
Switched to 2nd line drug by 12 months # 1 2 1 2
% 2% 5% 2% 3%
Total alive and on ART at 12 months # 54 44 56 63
% 72 71% 77% 80%
%

30
Post exposure prophylaxis to workers 3 0 0 3
SUCCESSES:

1. Managed to conduct out–reach programmes in quarter three and four

in satellite clinics of Mpumba, Lukulu, Lubunga, Chiundaponde and
Muwele.
2. Received funding for ART activities from CHAZ
3. Monthly and quarterly reports were submitted on time to partners and
the Ministry of Health.
4. The 2017 ART revised protocols were adhered to.
5. Technical support was offered by government and the cooperating
partners and members of staff were trained in various programmes.
6. Opening of the ARVs dispensary in the ART clinic.

CHALLENGES

1. Increment in the number of defaulters due to none availability of

funds for mobile ART activities.
2. Late receipt of virological test results.
3. Limited space for clients files.

SUPPORTIVE MEDICAL SERVICES

PHARMACY DEPARTMENT

By Mr. Kaluba Amon, Pharmacist

The department managed to implement all planned for activities during the
period under review. Medical Stores Limited fulfilled their delivery schedule
100%. However, Essential Medicines and Medical Supplies which were not
supplied by Medical Stores Limited, the institution supplemented from the
GRZ grant using the 4% allocation.

31
Essential Medicines and Medical Supplies

The delivery of supplies from MSL was excellent, the department experienced
smooth operation due to good logistic management and prioritization.

ARVs and Medicines for OIs

The electronically generated report and requisition (R&R) was submitted to

MSL on a monthly basis according to the MSL schedule and the products
were received by the facility bi-monthly.

Pharmacovigilance

The concept of pharmacovigilance stepped up awareness and appropriate

reporting of any adverse drug reactions to the provincial Heath Office.

Successes

1. Improved staffing levels.

2. The department installed a new air conditioner.
Challenges

1. Late delivery and low fill-rates of Essential medicines and Medical

Supplies by MSL.

2. Inadequate trained manpower in the department in view of the 24/7

work shifts.

3. Inadequate storage space in the pharmacy.

DENTAL DEPARTMENT

By Br. Vincent Chapatuka - Dental Therapist

The department, attended to a total number of 3,323 clients and patients.

Recorded a lot of lot of successes in the implementation of activities that
were planned for as compared to 2016. The following procedures and
conditions were attended to; Trans alveolar extraction, Periodontal disease,
gross caries with complete crown damage or with periapical infection,
attrition, hyperplasia, or pulp lesions such as (pulpits, pulp hyperplasia),
trauma to the teeth or jaws leading to dislocation of a tooth from its socket
and tooth lying in the fracture line.

SUCCESSES

32
1. There was an improvement on data capturing.
2. Availability of drugs all year around.
3. The department conducted outreach programmes at six different schools
and attended to 1,330 pupils.
4. Improved staffing levels.
5. Most of the things budgeted and planned for were bought.

In the picture above, pupils receiving oral health education from Dental staff at
Kaombe Primary School.

CHALLENGES

1. Lack of a dental Laboratory.

2. Lack of proper dental clinic.
3. Lack of resources to conduct oral health education outreach.

33
 SUMMARY OF PROCEDURES DONE - 2017
3323
3500

3000

2500

2000
1330
1500
1069
1000
542
500 214
38 90 4 36
0

IMAGING DEPARTMENT

Reported by Mr. Chewe Chilindi - Radiography Technologist

Analysis of Medical Imagery

  2017
X-ray
Number Other Number
(Radiology)
1. X-Ray Lung 785 6. Gastroscopy 0
7. Ultrasound
2. X-Ray Bones 901 2925
(Echography)
3. X-Ray
Abdomen without 325 8. ECG 0
preparation
4. X-Ray
9 Other medical
Abdomen with 4 0
imagery
dye

Successes

1. Improved staffing levels.

2. Most consumables were available.
3. Radiation monitoring programs were carried out.

34
Challenges

1. Disruption of x-ray services due to the breakdown of the x-ray

machine.
2. Limited work space in the department.

LABORATORY

Reported By: Mr. Siame Amon, BioMedical Scientist (Dip. & BSc.
in Biomedical Sciences)

Continuous Professional Development/Capacity Building

Different laboratory staff attended a number of
trainings/workshops/meetings outside the institution as follows:
1. Malaria Microscopy training by National malaria Elimination
center.
2. Laboratory Biosafety training by CDC.
3. Diagnosis of opportunistic infections by CHAZ/MGIC.
4. Zambia National Biomedical Society annual general meeting in
Chipata.
5. Drug Resistant TB training by ZNTP.
6. Genexpert comprehensive training by Eradicate TB.
7. Viral Load and DBS training by CRS.
8. Equipment inventory template design by MOH.
9. Continuous improvement (CQI) training by CRS.

HAEMATOLOGY UNIT
J F M A M JU JU A SE O N D TOT
A E AR P AY NE LY U PT C O E AL
N B R G T V C
TOTAL
62 68 62 58 90 86 76 62 71 86 84 88 8,98
FBC
9 7 6 0 6 0 7 8 3 6 2 2 6
DONE
ESR
and 11 21 28 13 23 13 18 12 20 6 10 5 180
others

Sickling
Tests 7 15 3 18 9 12 8 5 9 4 5 2 97
done
Positive 2 6 2 0 3 4 5 1 3 0 0 0 26
Positivi
27%
ty Rate
Total 9,26
Haemat 3
ology
35
Tests
Done

BLOOD TRANSFUSION UNIT

TESTS N
JA FE M AP M JU JU AU SE O D TOT
O
N B AR R AY NE LY G PT CT EC AL
V
X-
match
es
done/
Used
Blood
Type A 9 7 10 14 9 9 13 21 14 22 20 4 152
Type B 5 6 10 10 8 13 8 10 12 6 26 13 127
Type
1 0 2 1 0 4 0 1 3 2 4 2 20
AB
Type O 5 13 9 24 30 30 16 20 31 49 29 16 273
ABO
and RH
Typing
Receiv
ed
Blood
units
Type A 4 13 4 8 6 4 5 9 0 9 10 11 82
Type B 4 5 0 7 3 5 10 5 0 8 12 10 69
Type
1 2 0 0 3 1 0 0 0 2 1 3 13
AB
Type O 5 10 0 10 15 15 21 16 0 19 14 13 138
Expirie
s
Type A 6 2 3 0 3 0 1 0 0 2 0 0 17
Type B 5 0 0 0 0 0 2 0 0 2 0 0 9
Type
0 0 0 0 0 1 0 0 0 1 0 0 2
AB
Type O 8 0 3 0 1 0 3 0 0 5 0 0 20

36
PARASITOLOGY UNIT
J S TO
JA FE M AP M JU AU NO DE
U E OCT TA
N B AR R AY NE G V C
LY PT L
STOO
L
Total 14 81
48 52 51 72 50 84 53 69 94 46 55
Done 1 5
Hook
worm 4 3 5 4 1 2 2 3 2 2 1 3 32
s
S.
mans 0 1 1 0 0 0 0 2 1 3 0 2 10
onii
Ascar
is
lumbr 1 0 0 0 0 0 0 0 0 0 0 0 1
icoide
s
E.
histol 1 0 1 1 3 3 3 1 1 2 1 1 18
ytica
S.
sterco 0 0 0 1 0 0 0 1 0 3 0 1 6
laris
C.par
0 0 0 0 0 0 0 0 0 0 0 0 0
vum
G.
lambr 0 0 1 0 0 0 1 2 0 0 0 2 6
ia
Other
Paras 0 0 0 0 0 0 1 0 0 1 0 0 2
ites
URIN
E
Total 17 14 11 18 21 18 17 25 24 18 14 22
224
Done 4 5 8 1 6 1 8 8 4 6 4 49
T.
vagin 3 1 2 2 0 2 0 0 0 0 0 1 11
alis
S.
hema
1 0 0 1 1 0 0 1 0 0 0 1 5
tobiu
m

MALA
RIA
TEST
S

37
Total 97 70 76 11 11 89 14 16 46 63 24 73
12
Blood 3 9 0 6 7
99
Slides
Positi 35 24 35 57 53 18 12 27 10 13 76 22 38
ves 2
Positi
36 34 46 50 44 20 8. 16 20 30 30
vity 21.7 29.
.1 .3 .1 .4 .5 .2 6 .3 .6 .8 .1
rate % 4%
% % % % % % % % % % %
(%)

MOLECULAR UNIT

J F M A M JU JU A SE O N D TOT
A E AR P AY NE LY U PT C O E AL
N B R G T V C
Total CD4 73 34 23 10 15 11 11 12 10 90 12 13 1,4
Done 8 9 0 5 9 0 6 5 4 13

D Total - 11 26 0 9 32 8 14 15 8 8 6 136
B Posit - 0 0 0 0 0 0 0 1 0 0 0 1
S ives
No - 0 15 0 5 1 5 2 3 6 0 3 40
Results
Positivity 1%
Rate (%)

SEROLOGY UNIT
U
ri
n
Prosta
Rapid Hepati e
te Helico Crypto Rheum Other
Plasma tis B H
Specifi bacter coccal atoid Serolo
Reagin Virus C
c pylori Antige Factor gical
Syphili Antige G
Antige Test n Test Test Tests
s Test n Test T
n Test
e
st
s
T To T To T To T To T To T To T To
ot tal ot tal ot tal ot tal ot tal ot tal ot tal
al Po al Po al Po al Po al Po al Po al Po

38
 Te Te sit Te Te sit Te Te sit Te
sit sit sit sit
st st iv st st iv st st iv st
ive ive ive ive
ed ed e ed ed e ed ed e ed
JAN
UAR 13 4
23 0 0 15 14 4 0 24 3 8 0 1 1
Y 7 7

FEB
41 4
RUA 8 0 0 2 0 3 0 8 2 3 0
5 0
RY
MAR 4
82 15 0 0 0 0 0 0 23 7 4 3
CH 5
APR 5
72 11 2 2 0 0 0 0 27 5 4 2
IL 0
15 7
MAY 5 0 0 25 17 0 0 45 3 3 0
8 1
JUN 5
73 8 3 2 0 0 1 0 14 0 0 0
E 6
JUL 10 8
10 3 2 0 0 0 0 76 6 3 0
Y 7 8
AUG 14 6
11 3 1 0 0 2 0 37 7 6 3
UST 2 0
SEP
6
TEM 96 9 1 1 0 0 1 1 25 2 6 1
8
BER
OCT 1
OBE 60 2 0 0 0 0 2 1 19 4 5 0 0 1 0
R 1
NOV
7
EMB 72 5 0 0 0 0 2 0 21 2 0 0
4
ER
DEC
10 4
EMB 7 0 0 0 0 1 0 23 5 2 0
6 8
ER
1,
3 7
TOT 5 11 1 4 1 4
8 31 2 4 46 9 4
AL 2 4 2 2 6 4
2 8
0
Posi
tivit
y 7.5% 66.7% 73.8% 12.5% 13.5% 20.5%
rate
(%)

MICROBIOLOGY UNIT

J F A O N D
M AP M JU JU SE TOT
TESTS A E U C O E
AR R AY NE LY PT AL
N B G T V C

39
HVS 27 24 23 9 19 13 14 10 15 7 9 11 181
Urine 13 6 6 9 17 13 10 14 12 11 16 10 137
19
Stool 1 4 1 2 40 3 6 5 8 5 13 282
4
Urethral
Dischar 8 3 3 2 2 3 6 2 1 2 6 3 41
ge
Spermio
1 0 1 0 0 2 1 1 1 0 0 1 8
gram
Pus
2 3 1 5 2 12 6 9 15 9 8 13 85
Swabs
Effusion
0 1 0 0 2 1 0 1 0 1 2 1 9
s
Others 0 2 0 2 0 1 3 6 6 3 0 2 25
Total
23
Tests 52 43 35 29 85 43 49 55 41 46 54 768
6
Done

TB/LEPROSY UNIT

F M A O N D
JA MA JU JU AU SE TO
TESTS E A P C O E
N Y NE LY G PT TAL
B R R T V C
Total
41 58 25 38 42 30 56 49 45 41 22 16 463
Smears
Positive
4 3 12 3 7 4 6 6 2 2 2 0 41
Smears
Negative
37 55 23 35 35 26 50 43 43 39 20 16 422
Smears
Positivit
9. 5. 8. 7. 16. 13. 10. 12. 4. 4. 9. 8.8
y Rate 0
76 17 00 89 67 33 71 24 44 88 09 6
(%)
GENEXPERT TESTS STATISTICS
MTB
Not
0 6 5 4 4 5 5 5 3 10 6 11 64
Detecte
d
MTB
Detecte
d + Rif
0 1 0 1 1 2 2 0 0 0 2 3 12
Not
Detecte
d
MTB 0 0 0 0 0 0 0 0 0 0 0 0 0
Detecte

40
d + Rif
Detecte
d
MTB
Detecte
d + Rif 0 0 0 0 0 0 0 0 0 0 0 0 0
Indeter
minate
Error
0 0 0 0 0 0 0 0 0 0 0 0 0
Results
Invalid
0 0 0 0 0 0 0 0 0 0 0 3 3
Results
No
0 0 0 0 0 0 0 0 0 0 0 0 0
results
RR
Referred
for
0 0 0 0 0 0 0 0 0 0 0 0 0
Culture
DST/LP
A
Culture
DST/LP
A 0 0 0 0 0 0 0 0 0 0 0 0 0
Receive
d
TOTAL 0 7 5 5 5 7 7 5 3 10 8 17 79

CLINICAL CHEMISTRY

A A O N D
JA FE MA M JU JU SE TOT
TESTS P U C O E
N B R AY NE LY PT AL
R G T V C
14 17 27 14 20 17 20 13 15 18 19 19 221
AST
7 9 7 9 5 8 8 6 6 7 9 2 3
14 17 27 15 20 17 21 16 18 18 18 216
ALT 93
7 9 7 0 8 9 0 2 9 2 8 4
Creatini 15 18 19 12 20 18 21 17 14 19 21 17 215
ne 1 1 3 8 6 1 3 5 2 4 1 8 3
14 17 22 12 17 12 19 14 18 15 17 19 203
Urea
9 7 9 5 4 9 3 9 8 3 7 4 7
Albumi
39 45 15 4 9 9 20 0 15 26 30 22 234
n
Total
42 57 48 76 8 15 0 0 51 14 1 1 313
Protein
Total
12 15 20
Bilirubi 37 88 17 44 51 73 63 22 59 932
1 1 6
n
41
Direct
11 15 21
Bilirubi 58 86 42 45 49 73 63 73 10 985
9 1 6
n
Triglyce
38 16 27 7 0 11 12 0 1 0 27 17 156
rides
Cholest
20 16 19 6 3 8 0 1 5 12 10 0 100
erol
Glucose 90 29 39 5 5 12 5 3 0 1 5 0 194
ALP 44 69 0 0 0 23 41 1 1 1 0 2 182
Uric
9 16 0 0 4 7 0 9 0 0 0 0 45
acid
Total
11 12 15 74 99 81 99 73 79 90 93 86 117
Tests
16 66 46 5 6 1 1 6 8 3 7 3 08
Done

SUCCESSES

1. The installation of the solar energy power backup.

2. Mentorship in quality management system (QMS) and bacteriology.
3. Implementation of QMS and appointment of a quality officer, safety
officer, Heads of sections and stores officer.
4. The laboratory maintained a 100% score in EQA (i.e. HIV, TB smears and
CD4).
5. Improved staffing levels.
6. Received a four channel Genexpert machine and its accessories from
MoH.
7. Received a new computer from CHAZ.

Challenges

1. Continuous breakdown of equipment and delay in servicing dysfunctional

equipment.
2. Stock outs of some essential/indicator laboratory products.
3. Late/non delivery of some ordered commodities by MSL.
4. No proper laboratory autoclave making it difficult to do full
bacteriology/mycology investigations.
5. Intermittent functionality challenges on the eLMIS facility edition.

SUPPORT SERVICES

PURCHASING AND SUPPLY

Reported by Sr. Monica Nanyangwe – Ag Procurement Officer

All the planned activities were implemented accordingly during the period
under review.
42
SUCCESSES

1. Annual contracts were signed with food suppliers.

2. The procurement plan was developed and implemented.
3. The 2008 ZPPA Act and the standard operating procedures were
adhere to.
4. The unit managed to run effectively throughout the year.

CHALLENGES

1. Difficulties in soliciting for quotations at local level as most of the

venders do not accept cheques.
2. Currency fluctuations which affected prices of commodities.

TRANSPORT, INFRASTRUCTURE AND MAINTENANCE

Reported by Sr. Mutamba Elizabeth, Hospital Administrator / Transport

Officer

(a) TRANSPORT

The institution functioned with a fleet of four vehicles, three land cruisers (1
for CHAZ programs and 2 for the hospital) and one advanced life support
ambulance.

Successes

1. Routine vehicle servicing was done after every 5000 km of mileage, and
maintenance was done at Vehicle Service Centre and Mpika Diocesan
garage.
2. All the vehicles were insured with VERITAS General Insurance.
3. Routine inspection, general cleaning of vehicles and mileage update
was done weekly, and reports were generated.
4. There were no major vehicle breakdowns.

Challenges

1. One land cruiser for CHAZ programme was lost in a road traffic
accident which claimed the life of the Medical superintendent.
2. Two land cruisers are very old.
3. The institution has no light truck for transportation of bulky supplies.
4. The institution does not have a staff bus.

(b) INFRASTRUCTURE AND MAINTENANCE

Routine maintenance of buildings and surrounding was done throughout

the year.
43
Successes

1. The hospital managed to do routine maintenance and major

maintenance works for both grounds and buildings by hospital
maintenance department.
2. Replacement of a new burner for a micro-bun incinerator.
3. Quarterly and bi-annual preventive maintenance of equipment was
done by the medical equipment technicians from MOH and
Netherlands.
4. All departments adhered to reporting faulty equipment and furniture
using the designed maintenance request form.
5. Firefighting equipment was serviced quarterly by Consolidate fire
Services.

Challenges

 Limited infrastructure (office space and wards).

 Old and dilapidated buildings.
 Limited housing units for members of staff.

HEALTH MANAGEMENT AND INFORMATION SYSTEMS DEPARTMENT

Reported by Patrick K. Kaleng’a – HMIS Focal Person

The department coordinates issues of data and information; by orienting

data handlers, analysing disease trends and updating the hospital
management on health indicators to aid discussion and provide
interventions. In addition, the department generates reports and submits
them to the Ministry of Health to facilitate planning and decision making.

In the period under review, it conducted one orientation meeting for data
handlers on quality data management and reporting standards, presented
on selected health indicators and trends at institutional and provincial
meetings. In addition, submitted 12 HIA3 reports to the MOH.

44
 Top Ten Conditions / Diseases 2016
395
400
300
200 163
110 108
100 49 37 26 25 24 24
0
ia ia ia iti
s se re n ia ns ite
ar on m r ea u tio er
n
ur B
al e e is ct r i
um
a nt a t H B ke
M e An E lD Fr nu a
Pn ro el al S n
t C M
as le
G ick
S

Top Ten Conditions / Diseases 2017

319
300
219
200 123 114 117
100 73 78
36 42 37
0
ia ia ia s es n e s is
ar iti t io r ia TA os
on m r be s lu n R l
al ae e n ai r u
um nt ia te f e a c
M e An E D er c H m er
Pn ro yp
ia au b
t rd Tr Tu
as H ca
G e
iv
e st
g
on
C

The most cause of admission all ages in the previous year was malaria at
395 cases, followed by Pneumonia 163, Anaemia at 101 cases and Gastro
enteritis cases at 108. The least was burns and snake bites both at 24 cases.
In the year 2017, the picture was similar with malaria topping at 319 cases
though it shows a minor decline from the 2016 cases. However, there was a
rise in 2017 on the second, third and fourth of the top ten diseases as
compared to the 2016 cases. The second was Pneumonia with 219, Anaemia
with 123 cases, Hypertension at 117 cases and in the fifth position was
45
Gastro Enteritis at 114. This shows us that the top three conditions
remained the same in both years with hypertension taking up fourth
position at 117 in 2017.

Successes

1. All data handlers were oriented in quality data handling and reporting
requirements.
2. Submitted all the 12 HIA3 reports to the MOH.

Challenges

1. Running out of registers at times for selected wards or departments

making it difficult for the wards to capture data effectively and
consistently.
2. Poor and intermittent access to internet making it difficult to upload
reports into the DHIS2 web platform.

TRAINING SCHOOLS

CHILONGA SCHOOLS OF NURSING AND MIDWIFERY

Reported by Sr. Rosemary Kabonga, Principal Tutor, BSc Nursing, MPH

BACKGROUND INFORMATION

The training institution is now running a three year Registered Nursing and
a one year Registered Midwifery programmes. The training institution
planned to undertake a number of activities which depended on monthly
financial grants from the government and student fees. The monthly
funding was constant, though not adequate. This resulted in the institution
failing to undertake some of the planned activities. The government released
K 3, 000.000.00 towards the reconstruction of gutted midwifery school
infrastructure.

STUDENT BODY

The student population was fourty five (45) third year Registered students
nurses as other students were distributed to other schools after the
guttering of the school; a tragedy which fell the school on 1st October 2016.

46
The school is supposed to increase the enrolment up to maximum capacity,
but it cannot because of limited boarding facilities.

ENROLLMENT : In July 2017, 80 Student Nurses were enrolled into

training.

GNC FINAL EXAMINATIONS

JUNE 2017

 41 student nurses sat for this examination and all passed which gave
the school 100% pass rate. The overall performance was very good
compared to other schools.

DECEMBER 2017

Four (4) student nurses who were deferred due to poor performance and
disciplinary measures sat for this exam. They all cleared the examinations.

STAFFING

Teaching staff
The training started the year with four Nurse Tutors (4), one (1) principal
tutor coordinating the two programmes and three clinical instructors. Three
(3) tutors accompanied students to the training institutions where they were
sent. Out of this, only one (1) tutor came and re-joined the school in
December 2017. The staffing level is below the acceptable level resulting in
work overload. It also becomes inevitable for officers to go on leave at certain
times. To try and meet the needs of the students, the members of staff teach
and supervise students in both programmes. This strains tutors as at times
they teach 1-2 courses at a time. There is still great need for a Librarian,
stores officer and purchasing and supply officer.

PRIORITIES FOR 2017

The training institution had the following priorities
Training of health workers
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 1. Purchase of current textbooks
2. Taking students for psychiatry at Chainama-Lusaka or Ndola
3. Taking students for Rural Experience
4. Taking students for Community experience
5. Taking students for Clinical experience at Mpika district hospital
6. DSTV subscription
7. Taking students for Sports
8. Construction of student hostels, library and skills laboratory

B. Maintenance and procurement of equipment

1. Purchase of shining machine
2. Purchase of requisites
3. Routine maintenance
4. Purchase of lawn mower
5. Purchase of event tents
6. Vehicle servicing and paying insurance

C. STAFF SUPPORT
1. Staff training
2. International/National day’s celebrations
3. Graduation celebration
4. Administrative trips

Infrastructural projects going on

1. Construction of 2 student hostel blocks funded by Government

GRADUATION CEREMONY

The training institution had no graduation ceremony due to limited funds.

FINANCIAL MANAGEMENT

The training institution received funding consistently from GRZ though

inadequate as it was reduced. It also received extra funds for infrastructure
to rebuild the school. The expected user fee from students was also erratic
as some students paid in instalments or failed to pay. Generally, the
training institution fared well on a day to day basis.

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FUTURE PLANS/CAPITAL PROJECTS
1. Construction of skills laboratory and library
2. Construction of administration block
3. Construction of 3 more hostels
4. Construction of staff houses

5. Construction of a second classroom and a lecture theatre

6. Construction of a chapel
CONCLUSION

Despite the staffing and financial problems, the training institution

functioned well and had to meet most of the set objectives for the year.

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