ANNUAL HEALTH BULLETIN 2004 - Ministry of Health

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• Establishment of goals and strategies in the health care plans according to the priorities. . • Legislation and nationwide coordination in implementing QA&S systerrl. in the health care settings. ' • Coordinate / facilitate to oversee and ensure that the health systems are standardized, that the health facilities follow the minimum standards and quality of services to the beneficiaries are ensured. • Standardize the infrastructures, services, supplies and staffing pattern for all health care settings in the ministry The Joint Director, QA&S Division will spearhead and coordinate QA activities through the HTQC and institutionalize the QA&S in the health care system. Taking into account the geographical and communication barriers, three support structures are proposed; National, Regional and District. District level: District QA teams headed by DMOs and DHSOs based at district hospitals. QA teams will be formed at each level, which the individual will have a continuing responsibility for the quality of their work in their own facility. QA teams will meet at regular intervals to discuss and consider the quality issues and improving the overall quality of the services they provide. Within the QA & S structure, some of theses teams will take on additional responsibility of providing support to the less quality performing districts or the Regional QA teams supporting the districts in their region and districts supporting the BHUs in their region.
As a general principle QA responsibilities should be decentralized as far as possible, consistent with the ability of lower levels to take decisions and manage the QA implementation in their own area. The proposed QA teams at various levels: • National QA teams: Lead by Joint Director, QASD • Regional QA teams: Lead by Superintendents • District QA teams: Lead by DMO • BOO QA teams: Lead by DHSO • Review and discuss their prior quality problems at their level and develop quality management plans. • Conduct and coordinate the QAS training in their respective areas. • Submit the annual work plans to the QASD. • Submit quarterly reports to the J1, Director, QASD for feedback and for effective monitoring and evaluation. The Joint Director, QASD coordinates QA activities through the HTQC. The HTQC forum discusses the priority issues for quality improvements and standards setting and for developing policy on how quality of care issues should be taken forward within the health services as a whole. This body is comprised of a broad representation of personnel committed to assessing quality of care at all levels and their roles and functions are: To provide leadership and advocacy for QA & S in Bhutan To assess priorities for quality improvement and standards setting To maintain an equitable and appropriate distribution of health technology and human resources at each level of the health services. To promote and enhance the skills of health staff in quality improvement of health care. To review progress on quality improvements nationally The health care authorities at the Regional and District levels will put quality assurance in focus by establishing goals and policies in their own priority health care areas and ensure that they are incorporated in the health care plans of their service centers. As part of each plan, the authorities will ensure that each health care institution takes part in
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Page 26 and 27: 1. The National Institute of Tradit
Page 28 and 29: Introduction The laboratory service
Page 30 and 31: • Hematology services for routine
Page 32 and 33: • Since 2000, annual intake of la
Page 34 and 35: The vision of IC&HWM program is to
Page 36 and 37: Nursing services in Bhutan is the b
Page 38 and 39: Nilme of Hospit41s/ Bed Patients lo
Page 40 and 41: Besides the routine curative care,
Page 42 and 43: Oral health is an important compone
Page 44 and 45: An X-Ray service in the country was
Page 46 and 47: History In the 1990s, radio telepho
Page 48 and 49: Some of the main constraints faced
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Str~gthen the DOTS component of DOT
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v. Treatment outcome (%) 2000 2001
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The National Control of Dirrhoeal D
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Background The Village Health Worke
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Donor supported vertical programme.
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SI.No Gender No. of cases 1 Male 39
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Malaria case load contributed by f"
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45 40 .. - . Malaria mortality 35T
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13. Professional Human Resource Dev
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The integration of Community Based
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District ANC atte"dances Average 1s
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Child attendances Total District In
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District IUD Cycles of DMPA Male Fe
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Procedures Cases % Caesarian sectio
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District Caesarian General General
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District X-ray X-ray X-ray Ultrasou
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Outreach Clinic Tsimalakha Hospital
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Districts Hospitals Basic Health Un
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~ ICD Priority Health ProblemlDisea
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ICD Priority Health Problem/Disease
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ANNUAL HEALTH BULLETIN 2004 - Ministry of Health

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