PROJECT ON MATERNAL HEALTH CARE

By FAITH CHEBET CHEREN

LAP14/30097/12
AGHE 332
APPROPRIET TECHNOLOGY II
SUBMITTED IN PARTIAL FULFILLMENT OF
THE REQUIREMENT FOR THE DEGREE IN
COMMUNITY DEELOPMNT!
"ISII UNIERSITY
"ITALE CAMPUS
i
ABSTRACT
The project will assist the government in improving the health and nutrition status of poor
mothers and children and promoting comprehensive care and development of preschoolers in
participating municipalities in six provinces. The project will also support government efforts
to decentralize social service management and financing from the provinces to the
municipalities. The project will be targeted to promote efficiency and service quality
improvements in existing maternal, child health, nutrition and early childhood The principal
objective of the Comprehensive Maternal and Child ealth !MC" project is to reduce
maternal and child morbidity and mortality in the poorest areas of Trans #zoia County. This
will be achieved by$ %" improving the quality and effectiveness of MC care at the primary
and county levels& '" increasing equitable access to and utilization of the basic care& and ("
improving MC management. The project has four main components$ basic health care
delivery& health wor)er*s training& management improvement& and a national+level
component. ,nder the basic health care delivery component the project will improve services
at the village, township, and county referral levels. The health wor)er*s training component
will support in+service training of all health wor)ers concerned with MC care at the village,
township, and county levels in basic MC, clinical care and management s)ills. The
management improvement component will improve management of comprehensive MC
programs at different levels through training, supervisory support and improved management
information. The national level component will oversee the overall management and
monitoring of the project, carry out interdepartmental and interprovincial coordination,
provide technical support to the provinces, prepare and appraise the second phase of this
project and disseminate the project experiences to non+project areas.
TABLE OF CONTENTS
ii
PROJECT ON MATERNAL HEALTH CARE..............................................................i
By FAITH CHEBET CHEREN.................................................................................. i
LAP14/30097/12...................................................................................................... i
AGHE 332.............................................................................................................. i
APPROPRIET TECHNOLOGY II............................................................................. i
SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE
DEGREE IN COMMUNITY DEELOPMNT!.............................................................i
"ISII UNIERSITY................................................................................................ i
"ITALE CAMPUS.................................................................................................. i
ABSTRACT............................................................................................................ ii
LIST OF ABBREIATIONS................................................................................... iii
INTRODUCTION................................................................................................... 1
OBJECTIVES OF THE PROPOSAL.......................................................................... 1
PROFILE OF THE PROJECT AREA.......................................................................... 2
OBJECTIES!..................................................................................................... 4
PROJECT-DESIGN/STRATEGY:............................................................................... 5
Int!"#i$t L%&................................................................................................. 5
DETAILS OF PROJECT ACTIVITIES/I'PLE'ENTATION PLAN...................................(
TRAINING AND ED)CATION................................................................................. *
#$%&' B()*+ #, N,,' -$ D$ M$%, -$ H,&. #$/,)....................................................+
,HAT ARE THE OBJECTIVES-............................................................................ 1.
F)T)RE VISION PLAN........................................................................................ 12
A%,(0 $1 F$230+.................................................................................................... 12
'ATERNAL AND CHILD HEALTH:.......................................................................12
LIST OF ABBREIATIONS
iii
MC Maternal and Child ealth
-#C -nte #atal Clinic
.#C .ost #atal Clinic
.MTCT .revention from Mother to Child Transmission
.MC .opulation Media Centre
i%
INTRODUCTION
The comprehensive community health program for mother and child will provide primary
health care services to a population of '/ villages in Trans #zoia County. The project
includes 0irth -ttendant and Community 1rganizer at the village level, .ublic ealth
supervisor and #utritionist+cum+ealth 2ducator at Middle level and supervisory technical
staff providing support to field staff. The focus of the project is on health service family
planning, mother and child ealth, 3mmunization, low cost nutrition 4 food preparation, 1ral
5e+hydration. Thereby, 2ducation for women and 2nvironmental sanitation and on the
formation voluntary health wor)er in every house. This project will develop an innovation
system of Training, 5eporting and Monitoring. 5eporting system will be formulated by the
community organizer, which indicate the projects consistent emphasis on participative
training and development.
The .roject on Maternal and Child ealth derives from a vision for advancing women6s
empowerment, improving access to quality health care, eradicating preventable maternal
mortality, and preventing deaths of children whose mothers died during pregnancy or
childbirth in sub+7aharan -frica. 7upported by 8atie 9ogelheim and :ohn ansen, it will
create a coordinated framewor) for addressing )ey factors that threaten the lives and
livelihoods of women and families across all the sub+counties in Trans #zoia County, with
particular focus on small villages within the county.
OBJECTIVES OF THE PROPOSAL
a. To reduce the incidence of maternal mortality, child mortality and mortality and
morbidity, dehydration and malnutrition !and to introduce sense" antenatal care, post+
#atal care and 3mmunization services.
b. To enhance the capability of mother to loo) after the normal health and nutritional
needs of the child through proper nutrition and health education.
c. !To ma)e aware" of public health supervisor, community organizer, Traditional 0irth
-ttendant !;ai" and volunteers of youth clubs in mother and child health and to
enhance their s)ill and their respective rules towards service to be delivered in the
project.
1
d. To educate the community as to the concept and philosophy of family planning and its
importance for the family, community and society and to create confidence among the
people in adopting this practice and to expedite <overnmental action for promotion of
various measures to meet relevant needs of the people.
e. To support and supplement special health related activities and preventive programs
such as literacy training for female, sanitation and low cost methods of providing safe
drin)ing water, smo)eless woven, latrine etc.
f. To encourage and support programs to integrate traditional and western systems of
health care.
g. To eradicate illiteracy and to run post literacy and continuing education program for
development through establishment of functional literacy center and other
complementary activities.
h. To involve participation in the planning, implementation and maintenance of activities
envisaged and to raise income levels and expand employment opportunities of the
wea)er sections of society, particularly of women and of those living below the poverty
line.
i. To treat needy patients particularly to destitute women and children, to admit them in
the hospital for their treatment and to supply nutritious and food for bed patients.
j. To raise the nutritional status of the community, especially mothers and children by the
use of cheap, locally available and nutritious foods. To impart nutrition, education and
nutrition coo)ing demonstration to convince mothers.
). To arouse adequate consciousness about health and hygiene among villagers.
PROFILE OF THE PROJECT AREA
=e want to start this intervention in remote rural area of the county where illiteracy is
rampant, superstition is supreme and poverty in the accepted fact of their daily livelihood. -s
per '>>? census about '>>,>>> people live in this 0loc) out of which @>,''/ are scheduled
casts and %A,BA> are scheduled people. They depend only on one ' bedded primary ealth
center. 3n a total of 'A,?(((,(? sq. )m. area there are '>C villages and @/D of the people
2
depend on agriculture. 3t has been seen that most of the village do not have tube+wells and
which are sun) previously are not wor)ing since long bac). #aturally most of the villagers
depend on pond water, which is highly polluted in some areas most of the villagers prefer
open field for excretion. There is a great need of low cost sanitary latrine to reduce the case of
health hazards li)e malnutrition and dehydration etc. ;ue to inadequate communicative have
to depend on quac). 1ne health officer has to loo) after /+%> villages. -s per our diagnosis
through in depth interview, observation and group discussions it has been seen that the ealth
;elivery system is not at all adequate enough and due to various socioeconomic reasons C>D
villagers cannot migrate from the village. 7o for any chronic or severe disease they have to
depend solely on quac) and untrained ;ai, naturally the maternal mortality, child mortality
and morbidity, dehydration and malnutrition rate is increasing day after day. The family size
is /+C on an average in our adopted villages. The people are ignorant about family welfare.
The percentage of literacy among women of lower middle classes are having education of
primary standard. 7o any intervention with mobile health delivery system and with referral
services in case of high+ris) pregnancies and children will help those village peoples to equip
themselves for the betterment of their standard of health and hygienic condition.
%. 7ize of the problems$
;ue to lac) of )nowledge, information and orientation in health and hygiene the grass root
level villagers cannot understand the need of immunization, importance of growth
monitoring, technique of low cost nutritious food preparation, different methods of birth
control, spacing between two children, importance using sanitary or pit type latrine,
preparation of safe drin)ing water, maintenance of personal hygiene and disposal of waste
products from the home and practices to maintain good health. 3n fact sound health
deteriorates herewith the increase of superstition and wrong method of treatment. 7o the
incidence of maternal mortality, child mortality, morbidity, dehydration and malnutrition rate
and other infectious diseases are quite high as per our community diagnosis. The existing
health officer are not qualified so they cannot diagnosis in the case of high+ris) pregnancies
properly. The quac)s are not trained. They depend on limited indigenous )nowledge. The
diversity and multiplicity of the problem can be decreased with some comprehensive program
in this matter. -t the time of feeling pain, they have to ta)e to distant primary ealth center
but on the way the pregnant women face great problem. 7ometime the pregnant women are
compelled to give birth their children under the open s)y. =hen they come to the health
/
center of <overnment, there is no adequate arrangement for delivery and treatment. 7o most
of the patients have to go to the government hospital which is the nearby district hospital but
some of them die in the street.
'. Target area
=e want to start the intervention in (> cluster villages under in Trans #zoia 2ast and =est,
where ealth problems are more acute and <overnmental primary ealth Center is %>+%/ )m
away from those villages. The ealth posts will be situated in some of the villages through
direct community participation. =e can ensure that a total of approximately A>,>>> people
will be directly and about />,>>> people would be indirectly benefited by this program.
Moreover, we will be able to achieve our ultimate goal of ealth for all by '>>> -.;. and
self+reliance and it will act as a model for a comprehensive approach in community ealth
and 2nvironmental preservation program in the whole County.
OBJECTIES!
i" <eneral 1bjectives
a" To improve the status of health among mothers and children within / years in our adopted
villages.
b" To arouse adequate consciousness about health and hygiene among villages.
c" To improve the standard of education for better community participation.
d" To establish a networ) for effectiveness and long term effect of our program
e" To maintain small family and increase acceptors of different methods for birth control
amongst all castes, creed and religion.
ii" 7pecific objectives operational targets.
a" To reduce the incidence of maternal mortality, child mortality and morbidity re+hydration
and malnutrition rate and to provide both antenatal and post+natal a care to at least @>D of
the rural women within the next five years.
b" To ma)e the people conscious through basic literacy, hygiene, nutritional and
environmental education.
4
c" To improve the nutritional and health standard of mother and children suffering
malnutrition in our target area.
d" To ma)e the people of the target communities conscious about basic health needs within /
years.
PROJECT-DESIGN/STRATEGY:
-t the grass rootEvillage level$ -t this level we have to formed Community 1rganizations as
cluster of village in (> villages. The community organizer will preliminarily detect the high+
ris) mother and children through home visit and person+to+person communication method
and she will also conduct group discussion to identify the rural need of the community
people. This grass root level organization will help us to form an institutional base and for
better participation in any program implementation. The community organizer will also help
the village level ;ai and people to ma)e them conscious about the importance of birth control
through different methods, immunization, regular health chec) up for pregnant mother and
children up to >+/ years of age, to diagnosis the high ris) pregnant mothers and children
prevention of epidemic diseases, oral re+hydration therapy. They will arouse general health
consciousness amongst housewives, school students and youth clubs members. =e will also
arrange for mothers meeting, baby show, immunization camp and mother and child health on
a regular basis. =e can ensure for strengthening our existing resources to wor) with birth
attendant and community organizer for successful implementation of the program of the grass
root level.
3ntermediate Fevel
-t this level ealth post will be conducted by public ealth supervisor and physician
!M.0.0.7" through Mobile Clinic on monthly basis at our adopted (> villages. The village
people including women and children will assemble at the health post at village level. They
will consult with the doctor. The doctor will ma)e them aware through treatment, advice,
lecture, showing, chart poster, health seminar etc. The high ris) mother and children will be
attended to by the Mobile unit and referral service will be rendered to relevant mother and
children at our ospital and on the basis of the severity of the patients they will be referred
central level hospital. -t this stage we will follow a scientific management information
system for quic) decision+ma)ing and to ta)e up appropriate treatment for the poorest of the
poor mother and children. -t this stage all information will come to the physician through
5
community organizer!s" for quic) action and referral services to reduce maternal mortality,
child mortality and morbidity malnutrition and re+hydration rate. This system will be
followed from the inception of the program. The Mobile unit will also arrange camp from
time to time for better coverage and will monitor the activities of birth attendants and
community organizers.
Central FevelE5eferral services$
-t this level under the leadership of a Medical 1fficer !.hysician" and ealth supervisor all
the activities of the project will be monitored and corrective measure will be ta)en from time
to time for effectiveness of the program and for better outcome to achieve our ultimate goal
ealth and education for all and economic self+reliance amongst women fol) in our target
group. The high+ris) mothers and children will be treated in our 5eferral ospital li)e 8itale
;istrict ospital for safe delivery and good health for children and mothers. -t this stage
referral services will be given to mother and children during emergency. To ensure whether
we are proceeding as per plan and scheduled we will form an impact 2valuation Team. 3t will
loo) into outcome of the program and its effectiveness and suggest corrective measures. -n
outdoor Clinic and counseling center for rural fol) at the Central level will be organized from
the central community ealth Center !Maternity ospital". 1utdoor and indoor patients will
be treated from this health center.
DETAILS OF PROJECT ACTIVITIES/I'PLE'ENTATION PLAN
d" Gormation of ealth .ost$
=e will organize health posts for group meetings and clinic in '/ villages in Trans #zoia
County where community organizer, occasionally nutritionist+cum+health 2ducator and
Gemale public health supervisor will give education on health and nutrition one in a month
amongst mother and newly married women to improve their health condition and a regular
monthly counseling center will be conducted by our mobile clinic and these posts will
arrange immunization camp and other necessary arrangement to ma)e the people aware of
health.
e" ome visitE3ndividual Counseling$
To create an ideal mother and baby with small family norm in every home with adoption of
temporary contraceptive method and permanent sterilization in our target village, our
(
community organizer, birth attendants and volunteers will visit to every home to collect
information regarding immunization coverage among pregnant mother and children, eligible
couple, practices of low cost nutritious supplementary food, identification of high ris)
pregnant mothers and children.
c" -#C and .#C 7ervices$
=ill be -#C and .#C services rendered by Community 1rganizer !Gemale" through our
mobile health care unit once in a month at ealth post to identify high ris) pregnant and
lactating mothers and children suffering from malnutrition and they will be referred for
consultation with medical officer to our Central level Clinic where daily service will be made
available. 5egular grant monitoring and advice on diet control will also be given to the
expected mothers lactating mothers and children. -t the health post minor iron and vitamin
deficiency diseases will also be treated by community organizer at villages level.
d" Training of 0irth -ttendant and Community 1rganizer.
1n a regular basis we will arrange training program for birth attendants and Community
organizers to impart )nowledge and information to change their attitude and practices and to
equip themselves with )nowledge for safe delivery, identification of high ris) pregnancies
and children, malnourished mothers and child first aid, ome #ursing, treatment of common
and minor ailments, different methods of birth control, motivation technique, supplementary
nutritious food preparation and preparation of hand made oral re+hydration thereby etc. and
their wor) will be monitored by ealth 7upervisor and #utrition+cum+ealth educator from
time to time.
TRAINING AND ED)CATION
=e will arrange Training for youth club, local leaders and school teachers to act as volunteers
for full participation in our program implementation regarding immunization schedule,
different methods of birth control, importance of functional literacy, low cost supplementary
food preparation basic )nowledge about community health, environmental sanitation,
hygiene, supply of safe drin)ing water, smo)eless woven low+cost latrine etc. with
community organization, community participation first aid and ome #ursing to change their
practice toward achieving better health.
*
To change rural odd practices pertaining to health we will impart rural people necessary
Training to acquire )nowledge through our functional literacy center at grass root level and
for youth club member, community leader and school teacher training will be given at Center
level regarding ealth and Gamily =elfare 7anitation and supply of safe drin)ing water and
preparation of low cost nutrition supplementary food preparation to achieve our ultimate goal
of ma)ing at least one ealth wor)er in every house and to create general consciousness
about health hazards amongst the target community member.
e" Maternity ome$
=e will also open a Maternity home with indoor and outdoor facilities for -#C, #atal and
.#C services with A beds for safe delivery in case of high ris) mother and normal mother
who is in need, the poor and the deserving patients referred by our grass root level
community organizer and village birth attendants. 3n case of special health care for
malnourished children of >+/ years of age, they will be admitted to this ome for proper
systemic treatment. 1ther than this different patients suffering from different diseases will be
treated from this health center.
1ver the last two decades, maternal deaths have decreased by nearly />D worldwide. 7till,
every day, C>> women die from pregnancy+ or childbirth+related complications. -lmost all of
these deathsH??DHoccur in developing countries. -nd for every woman who dies in
childbirth, another '> to /> survive but suffer devastating injuries, such as obstetric fistula.
2ngenderealth6s woman+centered approach to maternal health addresses women6s sexual
and reproductive health needs throughout their lives, including adolescence. 2nsuring the
availability of quality services helps pave the path for appropriate, specialized care during
pregnancy, labor, and delivery. 7till, for many women, pregnancy mar)s their first contact
with the health care system, which provides an unmatched opportunity not only to help ma)e
pregnancy and delivery safe for both mother and child, but also to address broader aspects of
women6s health, including family planning, 39, and other sexually transmitted infections
!7T3".
2ngender ealth6s programs ensure that health facilities are equipped with supplies and well+
trained staff to provide high+quality services for 7afe pregnancy
7afe pregnancy
0
2ssential and emergency obstetric services
-ntenatal care
Treatment of pre+eclampsia and eclampsia
.ost+abortion care
Gistula prevention and repair
39 and 7T3 screening, prevention, treatment, and counseling
Gamily planning
Male involvement
3n addition, we advocate for policy changes globally and locally to ma)e motherhood safer,
such as increased availability of a lifesaving drug to treat pre+eclampsia and eclampsia.
2ngenderealth currently is involved with maternal and child health activities in countries
throughout -frica and 7outh -sia.
#$%&' B()*+ #, N,,' -$ D$ M$%, -$ H,&. #$/,)
1f all the M;<s, the least progress has been made toward the maternal health goal. 2very
day, nearly C>> women across the globe die due to complications during pregnancy and
childbirth& ?? percent of these deaths occur in developing countries. 0etter women6s health is
therefore a priority for the =orld 0an). 0an) projects allow women wider access to effective
and functioning health systems, with s)illed and motivated health wor)ers. 0an) investments
also support infrastructure and innovations in financing to improve maternal health. Through
such investments, the 0an) continues to support reproductive health and family planning
programs, nutrition initiatives, facility+based deliveries, disease prevention, and new and
innovative methods to provide more help to mothers.
The =omen and ealth 3nitiative is leading programmatic efforts in 2thiopia and Tanzania to
prevent maternal deaths by improving the quality of health care& mitigate the impact of
mothers6 death on their children by strengthening specific components of ongoing health
programs& and train policy ma)ers and program managers from the region to increase their
capacity to implement effective maternal and child health initiatives in their countries.
+
7imultaneously, the GranIois+Javier 0agnoud Center for ealth and uman 5ights is leading
a research agenda that combines the analysis of large data bases to establish the impact of
maternal deaths on children6s health and survival, and a set of in+depth qualitative studies to
understand the factors and processes that lead to children6s deaths and other dire effects of
maternal mortality on families. #ew evidence will provide the basis for far+reaching global
and country+level policy and advocacy and will inform the programmatic efforts of the
=43 in 2thiopia and Tanzania.
,HAT ARE THE OBJECTIVES-
1! E)&456-,)/,)- $1 -6, P37&420
.rimary objective of the project K5eduction of Maternal and Child Mortality + .revention and
Treatment of 1bstetric Gistula in Trans #zoia CountyL is a comprehensive enlightenment of
the population, particularly of the % million birth giving females of the target area. This
enlightenment aims at informing about preventive health care, child spacing, pregnancy, birth
and the period thereafter, including 39E-3;7 prevention. The enlightenment is conducted
by s)illed health care wor)ers throughout the entire project duration. Thus, it is important to
integrate dignitaries and traditional rulers into enlightenment and awareness campaigns, so
they can support the endeavour. Gurthermore, training and education will be provided to
employees of the national ealth Care 7ervice and to traditional birth attendants. 7o far,
Kradio serialsL proved to be the best in+depth tool for such public awareness campaigns as
they are produced and broadcasted by the .opulation Media Centre !.MC".
Main objective of these informational campaigns is to create awareness among opinion
leaders and the public about )ey health care aspect such as 39E-3;7 prevention, health care
for pregnant women, problems associated with early marriage, female genital mutilation and
Kobstetric fistulasL. Therefore, relationships are being established and maintained with the
traditional rulers aiming at holding enlightenment seminars even on a village level.
2. E1)IP'ENT PROC)RE'ENT
another important aspect of the project is the procurement of material for the enlightenment
campaigns, such as posters and flyers, medical equipment for the 5otary Gistula Centres and
the 1bstetric departments of the ten selected hospitals as well as contraceptives. Gor women
who face complications during home deliveries !about @> D of all deliveries in the target
area", transportation facilities are required to ma)e sure patients can be provided treatment in
a timely manner.
1.
/. ED)CATION AND TRAINING
-n additional )ey initiative is the education and training of medical staffs in the target area*s
hospitals and of members of the national health service organisation who are engaged in
dealing with pregnant women. 7pecial education of nurses for the treatment of fistula patients
in four hospitals is planned. 1n top of that, %/> additional health wor)ers and %/> traditional
birth attendant will be trained to better understand pregnancy related issues, infection
prevention and the development of fistulas. -lso, certified nurses will be trained to perform
caesarean cut operations and vaginal+surgery practices in remote areas in cases of emergency.
Ginally, in each of the A@ project counties, two employees of the health care authorities will
be trained to become instructors in topics of birth attending and medical support.
4. REHABILITATION AND INTEGRATION
another important program of the project KMaternal ealth Care in Trans #zoia CountyL is
the rehabilitation of %,>>> fistula patients and their successful re+integration into their rural
society. 7uccessfully treated patients will be educated to act as health wor)ers and
subsequently as KambassadorsL for a co+ordinated approach to pregnancy and birth
attendance. 3n state+owned rehabilitation units, healed fistula patients can enhance basic
qualifications such as sewing and )nitting, and they can improve their literacy s)ills to ma)e
a better living, thereafter. Gor such women, micro+credits can be made available.
T6, )3/,%$30 1(2-$%0 4)1&3,)24)5 M(-,%)(& M$%-(&4-y and Morbidity go far beyond the
percentage of attended births or reachable emergency services. 1ur approach addresses all of
them including social behaviour, infrastructure and quality of prenatal and antenatal care. =e
identify the main ris)s of pregnant mothers in our target area. 1ur activities are$ -dvocacy
and .ublic -wareness, 0ehaviour Change, Training of ealth .ersonnel, ;elivery of Medical
2quipment, 3mprovement of quality of structure and process, 7afe =ater Management,
9ouchers for Gistula .atients.
M(4) O78,2-49,0 are$ 5eduction of the number of obstetric fistula by surgical repair. 1ur
focus is on prevention as arising new cases cannot be repaired in a foreseeable future. =e
wor) upon$ The increase of well attended pregnancies and births also in rural areas. 0etter
accessibility to health facilities by pregnant women in labour. 2ducation with blan)et
coverage about child spacing, avoidance of early marriage and behaviour change in general
by radio serials. 1ne of our interim evaluation reports demonstrate that patients watch radio
serials and change their behaviour. 5outine 39E-3;7 test and .revention from Mother to
Child Transmission !.MTCT".5ehabilitation of fistula patients. 7atellite projects are
11
rounding up our core project and increase not only the amount of the project but its effect.
P(%-),%064. ()' 2$&&(7$%(-4$) is required for Maternal Mortality. #o single #<1 or
government agency can do it all+alone. 0efore we started our project we informed all
sta)eholders, invited them to a meeting and we )eep in touch with them. =e strongly believe
that too often efforts and resources are spoiled by lac)ing cooperation between sta)eholders,
by actions which are not coordinated, by not sharing best practices. =e would li)e to share
with the conference attendants our experiences so far$ 7ta)eholders are ready to join common
efforts, 5eduction of Maternal Mortality is last not least a management challenge with s)ills
of planning and organization, mobilization and motivation, logistics and coordination which
might have been neglected so far. 3n theory all aspects of maternal mortality are well )nown.
3n practice they have to be put together to find most successful ways and means of a
comprehensive approach. -s there are many causes for maternal deaths the interventions
have to be comprehensive. <overnments will realize best that their contributions are
indispensable in a comprehensive approach.
F)T)RE VISION PLAN
The Guture 9ision .lan is The 5otary Goundation6s initiative to focus efforts in order to
achieve greater impact, more public recognition, and streamlined operations for improved
efficiency. 3t will also help meet the priorities and goals of 5otary*s 7trategic .lan. The Guture
9ision .lan includes a new grant model to support 5otary club and district projects and
identifies six -reas of Gocus in which these projects shall be implemented.
A%,(0 $1 F$230+
.eace and conflict preventionEresolution
;isease prevention and treatment
=ater and sanitation
Maternal and child health
0asic education and literacy
2conomic and community development
12
'ATERNAL AND CHILD HEALTH:
;ue to its %/ years of experience and its continuous efforts within this area of focus, e.g. the
initiation and organization of the successful *signature project* I/.%$9,/,)- $1 M(-,%)(&
H,(&-6, the 5otarian -ction <roup for .opulation 4 ;evelopment !5G.;" now is one of
5otary 3nternational*s !53" official resources for the area of focus *Maternal and Child ealth.
1/