Project title: Provision of life-saving health services for vulnerable communities in Eastern Libya.
Period of project: 01/08/2019 - 30/06/2020
Reporting period: 01/08/2019 - 31/05/2020 (Benghazi), 01/01/2020- 31/05/2020 (Al Kufrah)
Duration of project in months: 11 Months (from August 2019 to June 2020)
I - Benghazi intervention
Reporting period: from 1 st of August 2019 to 31st of May 2020 (10 months)
1- General information
Since the start of the present action in August 2019, PUI has provided lifesaving services to the most vulnerable conflicted-affected populations in the view to improve access to comprehensive and free health care services in Eastern Libya through the following:
Direct service delivery via the provision of comprehensive primary health care package free of charge including a range of curative and preventive medical services in the areas deprived of functional health public system. PUI deployed two mobile health teams (MHTs) each of them composed of one medical doctor, one nurse, one psychosocial support officer (psychologist) and one health assistant in charge of registration and health & hygiene promotion. Additionally, one specialized medical doctor in sexual reproductive health is alternating between both teams depending on the needs identified. The package consisted in general practitioners’ consultations, both on common communicable and non-communicable diseases(e.g. hypertension and diabetes), sexual and reproductive health services (antenatal and post-natal consultations, family planning services, and gynaecological examination), integrated management of childhood illness, psychosocial support (PSS) interventions including individual consultations and group activities.
From August 2019 until the end of the month of May 2020, two MHTs were deployed in Great Benghazi. The teams provided 13,927 PHC consultations. 11,336 patients benefitting from medical consultations preventive or curative, and 755 PSS sessions held individually or by group benefitted to a total of 2,591 individuals. Among them 74% were initial consultation whereas 26% were follow-up ones.
The COVID-19 epidemic that emerged worldwide has led to a significant drop in the use of MHT services from March onwards, with patients fearing contamination despite the protective measures implemented as part of care activities. In order to encourage attendance, awareness sessions were organized to disseminate key messages about the virus such as modes of transmission, individual and collective protective measures. Topics such as the prevention of social stigmatization were also developed to encourage patients to come and consult when their health condition required it.
Provision of free of charge referral to enhance access to secondary and tertiary care. PUI team set up a referral pathway for both public and private health system following a Referral Mapping & Capacity Assessment conducted in late 2018. Upon medical needs, PUI patients were referred for further medical investigations, and severe cases management in appropriate healthcare facilities located in the area of intervention. Although, PUI privileges referral into the public health system, some of them are conducted into the private system due to identified gaps observed in the first one.
From August 2019 until the end of the month of May 2020, 213 referrals were made to public health facilities, mainly Benghazi Medical Center for obstetrics, pediatrics and other medical referrals. Orthopedic and surgical emergencies, such as fractures, are referred to the Al-Jalaa hospital, which has a more developed technical capacities for such procedures. Finally, one severe mental case was referred to the Benghazi Psychiatric Hospital, which is the only psychiatric care facility in the East of the country.
In addition to referrals made to the public sector, 23 patients were referred to a private health facility for which a memorandum of understanding (MOU) has been developed. Indeed, the Ibn Sina hospital offers specialist consultations (particularly in neurology and rheumatology) and a comprehensive medical imaging center. In order to mitigate the problems of financial accessibility and as mentioned in the description of the action, PUI covers the costs for examinations, care and/or medication received by patients in this private healthcare facility.
Promotion of health and hygiene key messages and good practices In a holistic approach, PUI mobile teams offered awareness sessions on both health and hygiene related topics to improve the overall health status of the targeted populations. Various approaches were developed to inform about good practices and to seek change of behaviours.
From August 2019 until the end of the month of May 2020, 8,686 individuals benefitted from awareness sessions, 6,911 through individual counselling following the medical consultation received. In parallel, 109 group sessions have been organized in favor of 1,775 individuals in order to encourage changes in individual and collective practices aimed at improving the general health status of populations. The COVID-19 epidemic has led to a sharp decline in the organization of group sessions. Those that have been maintained are small group meetings with limited number of participants framed by appropriate physical distancing measures.