Manohara Community Health Center(MCHC)

Background
In Kathmandu valley, urban expansion of 25% per year has resulted in squatter settlements or “slums”, where 60% are homeless and 49.5% of the urban youth unemployed. The urban poor in Kathmandu are currently deprived of basic services, including health, water and sanitation, education and housing. Access to Safe Motherhood data shows that the poorest women had 12 times less access to skilled care in pregnancy, with more than 41% home delivery without the assistance of a skilled health worker (slum area of Kathmandu), compared to their richest counterparts, whilst maternity incentive payments were accessed by only 7.4% of the poor compared with 31.4% of the non poor.

Manahara slum is one of the biggest squatter slum settlements of Kathmandu valley with 589 households comprising of 2,422 populations. This settlement is located in the bank of Manahara river of Bhaktapur district.  Though this community lives near the capital city but they don’t have access and facility of basic health, sanitation and education services. So Health Research and Social Development Forum (HERD) formally established Manohara Community Health Centre (MCHC), popularly known as Manohara clinic on 2064/12/02 (15th March 2008) in Madhyapur Thimi Municipality, Ward 16, Lokanthali to deliver Essential Health Care Services (EHCSs) focused to Manohara slum dwellers and poor, marginalized people living in the areas of Lokanthali, Jadibuti and Manohara (Pragatinagar) area.

Aims
The MCHC aims to increase equity and access of Essential Health Care Services (EHCSs) to urban poor, slum dwellers, seasonal migrants, daily wages workers, socially excluded and marginalized groups through community participation and development approach.

Objectives

1. Provide quality and cost-effective basic health services including curative, preventive and promotive services based on primary health-care principles; and
2. Improve the health status of urban poor, slum dwellers, seasonal migrants, daily wages workers, socially excluded and marginalized groups, whose health needs often are not met. 

Targets Groups/Beneficiaries
The MCHC serve a minimum of 70,000 people per year, including the Manohara-Pragatinagar slum area. Following are the major target groups/beneficeries of MCHC;

• People living in slums,
• Migrants,
• The homeless,
• Daily wages laborers,
• Daily wages workers,
• Socially excluded and marginalized groups,
• Local indigenous people with low socio-economic status, and
• Women and children etc

Major Activities and Services of MCHC
MCHC implements EHCSs components in close coordination and collaboration with DHO/DPHO, Municipality, local social organization and users groups. MCHC activities fall under curative, preventive and promotive services. So it provides wide range of Essential Health Care Services (EHCSs) and it also organizes outreach camps/clinic, health education programs, visiting the local community, schools and places of work to raise awareness among the target groups. MCHC continuously organize meeting, interaction and discussion with users groups and community leaders to involve community people in programme planning and implementation.  Following are the major activities and services of MCHC;

Routine Services
MCHC provides following EHCSs to the targeted people through its routine services;
General OPD: Patient examination and treatment of common Illness.
Immunization: BCG, DPT, Polio, Hepatitis B and Measles for children and TT vaccination for women.
Family Planning: Distribution of temporary FP method and counseling for both men and women.
Ante Natal Care (ANC): Examination, routine lab investigation and counseling of pregnant women.
Laboratory service: About 17 types of routine laboratory investigation facilities available.
Dispensary facilities: Distribution of essential drugs from the dispensary at 50% discount rate.
Health education: Based on need of users and focused to health promotion, personal hygiene, nutrition, disease transmission etc.
DOTS service for TB patients: Free drug and counseling about prevention, compliance, nutrition etc.
Apart from these, weekly specialization services are organized based on needs and demand of the community.

Outreach Services
MCHC also provides EHCSs through its outreach clinic once a week at community level focused on squatter dweller, school children, migrants’ workers and other vulnerable groups. Outreach activities include home visit, school health program along with EHCSs such as, immunization and family planning services, ANC, community awareness activities, rally and health camps.

Achievements of MCHC