Quarterly Review 4 – 2021

COVID19:  A consultant hired by the Cambodian NCD Alliance held Focus Group Discussions (FGD) with patients and interviews with stakeholders from the health system in rural and urban operational districts. These included FGD in districts where patients are member of peer educator networks for diabetes and hypertension. The study objective was to document the Impact of Covid19 on NCD patients and publish. The study gave voice to concerns from patients and stakeholders about the problems NCD patients experience and makes recommendations for policy and practice. The NCDA report (click) highlighted structural challenges that have persisted for decades such as lack of low-cost routine medication in primary care for chronic patients notably diabetes patients. Among different issues this came out as important now because it increases their mortality risk from COVID-19.

During October medical consultations services in the OD Posenchey, Svay Chrum and Thmar Pouk remained suspended because there counterpart health staff was too busy with COVID19 vaccination activities, but during the remainder of Q4 all routine activities were resumed in all OD’s. At the end year 2021, all our employees had 3 vaccinations. Among Peer Educators it is 174 (=93%) out of 186 had 2 doses, while 89 (47%) out of 186 had 3 doses. There are 12 (6%) PE unvaccinated. All MoPoTsyo staff were tested with Rapid Tests. Some sick MoPoTsyo employees recovered but others became positive. Recovered staff first isolated at home before returning to office and then, before entering the office, first got RT. At year end no one is sick or isolating. Air filters were installed in office rooms and ventilation was applied.

Expansion: After (COVID-19 related) delays in trainings and set-up, the Referral Hospital at Kampong Tralach OD in Kampong Chhnang province during last week of October 2021 finally launched the new services for the newly created peer educator network there: The first blood- and urine collections for lab service was done on 26 October and first consultation session on October 29th. As Center of Hope had not been able to train doctors during this COVID year, we had hired a consultant to run 3 days special sessions with the local doctors to discuss protocols and case-studies to make sure the public service maintains a standardized way of working with the community of patients. Also, the Revolving Drug Fund and automation system were installed and staff trained on how to use it.  Despite the COVID19 obstacles everything was ready at the right moment. Next, we turned our attention to Ksach Kandal OD in Kandal province. During November and December, we met with our future partners to discuss details of the cooperation and MoU, which was signed off. Then we began the selection of candidates. We found enough candidate diabetes patients ready to get training to become Peer Educator. To benefit from online communication, MoPoTsyo bought space in Moodle Cloud, an open-source program for an online school. As our staff has completed the software-course during 2021, we plan to use it in 2022 for training of peer educators and doctors.

Ministry of Health held a meeting to discuss the draft for a follow-up National Strategic Plan for NCD 2021-2030. As the previous plan (2013-2020) the new strategic plan also contains “peer educator networks” and that they must be continued and expanded to all OD’s. MoPoTsyo can therefore continue to be a counterpart NGO to MoH in its implementation. Also, the HEQIP-II draft was discussed by MoH and development partners in a Zoom Meeting. It has good elements, including the continuation and expansion of the peer educator networks to all OD’s but also innovative schemes for financing of essential medicines for primary care.

NCD Database: The long awaited NCD database has been officially installed in a special server room at MoH 3rd floor. This challenging project is not finished yet. The NCD Database of MoH was discussed in Zoom meeting to collect ideas for future upgrades. PMD explained there will be an important investment from development partners in creating an Electronic Medical Record to link data from different sources. In the future, MoPoTsyo intends to contribute by providing data to the MoH database through an API (Application Program Interface). We have conducted meetings to get a quote from an IT company to estimate cost.

Working with other agencies:

World Diabetes Foundation (WDF): MoPoTsyo is implementing partner through Angkor Chey OD in this partnership project with MoH, WHO and Centre of Hope (mostly funded by WDF) to create a new model for diabetes care in primary care including community involvement. On 03-12-2021 there was a Zoom meeting to discuss progress and achievements and organize the reporting for WDF. This project ends in May 2022. The project’s Mid Term Evaluation highlighted some useful insights and recommendations. MoPoTsyo has been a considerable contributor with human- and financial resources resulting in achievements that are relevant for the partnership-project.

Other partner meetings: A meeting with Korean NGO Heart to Heart to discuss ideas for Thmar Koul OD in Battambang province. Several meetings with WB by Zoom to talk about HEQIP II. Meetings with KOFIH research team for NCD for design.

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