Internship Report

Submitted to fulfill partial requirement of Master of Public Health (Health Promotion

Education) of the course Issue in HPE- 621

Submitted by: Submitted To:

Astha Lamichhane Masters of Public Health (HPE)
MPH (HPE) Nobel College
Roll No. 19700014 Pokhara University
2022
Practicum in field Internship at District Health Office Kathmandu
Nepal: Report
Submitted to fulfill partial requirement of Master of Public Health (Health Promotion
Education) of the course Issue in HPE- 621

Submitted by:
Astha Lamichhane
MPH (HPE)
Roll No. 19700014
Reg No. 2019-4-70-0005

Organization
District Health Office, Kathmandu
Teku, Kathmandu

Contact
Anjana Khadka
Public Health Nursing Officer
Phone: 9842690908

Faculty Advisor
Balkrishna Bhatta
Lecturer
Nobel College

Submitted To:
Master of Public Health (HPE)
Nobel College
Pokhara University
2022
 Report on Practicum in field Internship at District Health Office Nepal

Submitted by
Astha Lamichhane
for
Master of Public Health (HPE)
of
Nobel College Pokhara University, Nepal

Is reviewed and accepted accepted with condition Not accepted

……………………………… ………………………
……………………………. ………………………
Reviewer Reviewer

…………………………………. …………………………………………
Supervisor Coordinator

………………………………………………
Program Director
Masters of Public Health
 PREFACE
This report is the output of the three weeks long internship posting in one of the pioneer
organization of Nepal, District Health Office, Kathmandu, Nepal (DHO). The main objective of
this Report is to provide the details of the practical knowledge I gained during this internship
period.
On completion of this internship program, I gathered enough experience about the working
mechanism of the organization in the field of Health Promotion Education which has been shared
in different chapters of the report. During the posting based on the analysis I have prepared a
mini projects which will definitely will take DHO to the further wider horizon.
 ACKNOWLEDGMENT

I would like to extend my sincere thanks to District Health Office Kathmandu Nepal, for giving
me the opportunity to intern in their organization from 7th Kartik to 8th Mangsir 2078 and
developed the mini Project.
We would like to express special thanks and gratitude to all faculty of Nobel College MPH
Sinamangal, Kathmandu for their guidance, suggestion and advice to complete this report. I
would like to express my sincere thanks and gratitude to DHO Kathmandu for allowing me to
complete my internship of 3 weeks in the DHO and make this report. Last but not the least, i
would extend my sincere gratitude to all the staff of DHO for their cooperation and guidance in
spite of their busy schedule for the preparation of project report. This task would not have been
completed without their valuable responses.
I perceive this opportunity as a big milestone in my career development. I will use gained skills
and knowledge in the best possible way, and I will continue to work on their improvement, in
order to attain desired career objectives.
Astha Lamichhane
MPH (HPE)
Nobel College
Table of Contents
Chapter I. Introduction.....................................................................................................................8
1.1 Background.......................................................................................................................8
1.2 Objective of Course...............................................................................................................8
1.3 Objective of internship..........................................................................................................8
1.3.1 General Objective...........................................................................................................8
1.3.2 Specific Objective...........................................................................................................8
Chapter II. Organizational Background...........................................................................................9
2.1 Introduction............................................................................................................................9
2.2 Objectives..............................................................................................................................9
2.4 Organization and Staffing....................................................................................................10
Chapter III. Methodology..............................................................................................................11
3.1 Organization Selection.........................................................................................................11
3.2 Practicum Area....................................................................................................................11
3.3 Practicum Duration..............................................................................................................11
3.4 Sources of Data Collection..................................................................................................11
3.5 Tools and Techniques..........................................................................................................11
3.6 Limitation............................................................................................................................11
CHAPTER IV: RESULT AND ANALYSIS................................................................................12
4.1 Background and Characteristics of District Health Office Kathmandu..............................12
4.2 Current Health Programs.....................................................................................................13
4.3 Health Promotion and Education Program..........................................................................14
4.4 Data Analysis.......................................................................................................................15
Chapter V: Conclusion..................................................................................................................18
Chapter VI: Recommendations......................................................................................................18
REFERENCES..............................................................................................................................19
APPENDIXES...............................................................................................................................20
Mini project details....................................................................................................................20
Appendix A: Completion letter by District Health Office Kathmandu.....................................23
Appendix B: Supporting Photographs.......................................................................................24
Executive Summary

This is a report of an internship program instituted by Nobel College, Pokhara University with
the aim of exposing students to gain experience and sharpen their employability skills by gaining
practical knowledge of the field before the completion of Master in Public health studies.
This internship was undertaken at the District Health Office, Kathmandu Nepal(DHO) it is the
major technical and administrative unit of health in the district. Health office ensure proper
delivery of preventive and curative health services through different health institutions in the
district. Health office Kathmandu is a government office, facilitating and managing health
interventions in all 11 Palika of Kathmandu district. The goal of internship program was to
upgrade knowledge and skill towards professionalism and Health Promotion aspects of
governmental organization.
The main objective of the study is to earn practical knowledge and experience on how the
organization works in the field of health promotion education as an intern. Hence this report
includes the analysis of how the governmental organization focused on HPE aspects. The
findings are generated from review of annual reports, registration records, and interview with
focal persons and observation of daily working processes.
 Chapter I. Introduction
1.1 Background
The purpose of this report is to explain what I did and learned during my 20 days of
internship period in District Health Office Kathmandu Nepal. The report is also a
requirement for the partial fulfillment of Nobel College, Pokhara University. It focuses
primarily on the assignments handled, project implementation processes, delivering the
project and mini-project on Integrated Health Promotion Education and Communication
based on the needs and on-going programs of DHO. Kathmandu district is situated in
Bagmati province, covers area of 413.69km.sq and most densely populated district of Nepal.
It functions to plan, implement and manage the different national health program in all 11
palikas of Kathmandu district.
1.2 Objective of Course
i. To critically appraise the present state and mode of Health Promotion Education in
DHO
ii. To prepare and carry out a prototype mini-project following systematic steps of a
project preparation and implementation
1.3 Objective of internship
1.3.1 General Objective
To enhance practical knowledge about system, services and health promotion aspects
of health office Kathmandu through participation, Observation and discussion in the
different sections of the organizations as an intern.
1.3.2 Specific Objective
i. To observe the organizational planning, implementation and evaluation of health
promotion education and communication programs in the DHO.
ii. To Prepare and implementation of a mini-project on Integrated Health Promotion
Education and Communication based on the needs and on-going programs of DHO.
iii. To involve at day-to-day activities of organization gaining practical skills
 Chapter II. Organizational Background

2.1 Introduction
Health office Kathmandu is the major technical and administrative unit of health in the district.
Health office ensures proper delivery of preventive and curative health services through different
health institutions in the district.
It is one of the government organizations which ensure effective implementation of public health
programs in the district. It runs different health services like: nutrition, IMNCI, HIV & AIDS,
Immunization, epidemiology, health education, urban health promotion, family planning
services, safe motherhood, tuberculosis and leprosy services.
2.2 Objectives
o To determine requirement of manpower for health institutions in the district.
o To ensure supply of drugs, equipment, instruments and other materials at different health
institutions in the district.
o To ensure effective implementation of public health programs in the district.
o To manage the immediate solution of problems arising from natural disasters and epidemics
in the district at different levels.
o To foster coordination with external development partners for effective delivery of resources
and health services in the district.
o To systematically maintain data, statements and information regarding health services in the
district, update and publish them as required.
o To identify gaps in health service delivery in the district and seek for solution.
o Supervision/Monitoring in all health institutions in the district.
2.4 Organization and Staffing
Sanctioned post: 18
Fulfilled Post: 8
Vacant Post: 10

Chief Public
Health
Administration
(9th/10th)

Technical Administration and

Account

Public Health Administration Officer

Statistic
officer (6th)
Officer
(7th/8th)
(7th/8th)

Public Health Account

HA 5th/6th/7th -3
Nurse 5th/6th/7th -1 Officer 6th

Lab Technician
5th/6th/7th -1 Driver-1

Cold Chain
4th/5th/6th -1 Office Assistant-1

Malaria Inspector
4th/5th/6th -1
 Chapter III. Methodology

The information and data are collected from both primary and secondary source of data for
this report.
3.1 Organization Selection
 District Health Office Kathmandu was selected as an organization to complete the
requirement of practicum. Formal letter was Submitted to District Health office
Kathmandu. Then, with formal letter I approached District Health office Kathmandu
respectively.

3.2 Practicum Area

 District Health Office Kathmandu
3.3 Practicum Duration
 2078/07/07 to 2078/08/08 in District Health Office Kathmandu. Overall Practicum
duration was 20 days.
3.4 Sources of Data Collection
 Information was collected through interaction and discussion with the different staff for
the information collection. Primary as well as secondary sources of data have been used.
Primary data was collected by informally interacting with staff of the organizations while
secondary data were extracted from annual report and other organizational documents.

3.5 Tools and Techniques

Tools and Techniques Respondent
District Health Office Kathmandu
Interview questionnaire Mr. Badri Bahadur Khadka: Focal Person
Mrs. Anjana Khadka: PHNO 7th level

DHIS tool/Records and Organizational chart, Annual Report

Documents

3.6 Limitation
Duration of practicum is very short as it is difficult to learn about the organization and
to plan for and conduct the mini project. Also, there was no any supervision and
coordination from college during the overall practicum period.
 CHAPTER IV: RESULT AND ANALYSIS

My practicum was completely focused on understanding the Health Promotion Education

Program of District Health Office Kathmandu. There were various programs to understood and
undergone for performing various activities during the practicum period. During this period
various types of learning and work experience were obtained based on the objective which gives
practical exposure of the health program.
a. District Health Office Kathmandu
4.1 Background and Characteristics of District Health Office Kathmandu
 Types of Facility: Government
 Total Population: 1,081,845
 Number of women of child bearing age (15-49 years): 24156
 Number of children under 5 years: 93389
 Sex ratio: The male to female ratio of Kathmandu district is 92.43 where male population
is 477496 and female 516594.
 Average literacy rate: literacy rate in Kathmandu district is around 75%. (68 percent
female and 82 percent male are literate)

List of Metropolitan city /Municipalities

S.N Name
1. Kathmandu Metropolitan City
2. Budhanilkantha Municipality
3. Tarakeshwar Municipality
4. Gokarneshwar Municipality
5. Chandragiri Municipality
6. Tokha Municipality
7. Kageshwari- Manohara Municipality
8. Nagarjun Municipality
9. Kirtipur Municipality
10 Dakshinkali Municipality
11 Shankharapur Municipality
Top ten diseases with the highest rate in the district (According to HMIS data)
o Surgical Problems
o Gastritis
o Falls/ Injuries/ Fracture
o Headache
o Hypertension
o Diabetes Mellitus
o URTI
o Refractive errors
o Backache
o Acute Gastro Enteritis
However, the officers in the interview addressed the most common communicable diseases in the
communities are URTI, Diarrhoea, Tuberculosis, Typhoid and Hypertension followed by COPD
are the non-communicable disease.

Major Activities of Program during my practicum period are as follows

⸻ Data entry and data management of COVID case.
⸻ Participation in orientation and training program of, HMIS tools, DHIS tools.
⸻ Review and Prepared Annual Report

4.2 Current Health Programs

Immunization program
Maternal and Child Health Program
Family Planning Program
Malaria Control Program
TB- Leprosy control Program
Non-Communicable disease control program
COVID preparedness and response
Nutrition, IMNCI, HIV and AIDS program
Epidemiology, Health Education, Urban health promotion program
Safe Motherhood Program
4.3 Health Promotion and Education Program

i. Ensure adequate individual level services: Manage/ organize treatment, care and
rehabilitation services.
 Arrange in-service training of general health workers from district hospital, PHCs,
HP on different health topics.
 Arrange training of mid-level community workers.
 Orient FCHVs on different health issues and their responsibilities.
ii. Provide population services: Campaigns, awareness, programs, screening programs.
 COVID 19 awareness program.
 Conduct at least one promotive and one preventive activity per year.
iii. Take intersectoral actions: DHOs take leadership role in coordinating multisectoral
collaborations, advocacy for improved policy and legislation and mobilization of
resources from private NGO, governmental sectors as well as community.
iv. Other Health Promotion Services
 Immunization program
 Maternal and Child Health Program
 Family Planning Program
 Malaria Control Program
 TB- Leprosy control Program
 Non-Communicable disease control program
 COVID preparedness and response
 Nutrition, IMNCI, HIV and AIDS program
 Epidemiology, Health Education, Urban health promotion program
 Safe Motherhood Program

4.4 Data Analysis

 During my practicum I have learnt to use DHIS2 tool and developed few charts and
graphs of the data showing the health status of district as a whole.
 Chapter V: Conclusion

District Health Office Kathmandu is the central body specially focused on planning regulating
the health activities throughout the district. During my 20 days practicum I found staffs were so
motivated and dedicated towards their roles and responsibilities. Regular monitoring and follow-
up visit to health facilities and contacts with health workers support and encourage volunteers to
do the work properly. During the practicum I got opportunity to participate in different trainings
and field activities. I also facilitated for the session on safe abortion. I was also able to learn
about HMIS system and analyzed and presented to health officers.

Chapter VI: Recommendations

To organization
 Equal participation of the staffs should be ensured in training and orientation
 Monitoring and supervision must be done in regular basis.
 Timely recording and reporting of the information should be done.

To college/university
 Duration of practicum should be at least 2 months.
 If possible, college and university should identify the organization for the practicum.
 Supervision should be done at practicum so that it will be easy for us to conduct mini
action project.
 REFERENCES

 DHIS2, Kathmandu (2078). Data visualization. Health management Information System.

 Annual Report. 2077/78.
APPENDIXES

Mini project details

Report on Health Education on Safe Abortion Services

Submitted to
Prepared by Mrs. Anjana Khadka
Astha Lamichhane
Public Health Nursing Officer,
MPH 4th Semester
DHO Kathmandu
Nobel College, Sinamangal

Date: 2078/07/12
Duration: 1 day
Date: 2078/7/12
Time: 12- 2pm
Venue: District Health Office Kathmandu, Training Hall

Objectives
 To provide health education on safe abortion services to DHO staffs and Interns

Schedule
S.N. Activities Methods Resource Person

1 Introduction Participatory Astha Lamichhane

2 Welcome Speech Speech Anjana Khadka, PHNO

3 Introduction to safe abortion Power Point Presentation Astha Lamichhane

4 WHO guidelines on safe abortion Power Point Presentation Astha Lamichhane

5 Types of abortion services Power Point Presentation Astha Lamichhane

6 Safe abortion care Power Point Presentation Anjana Khadka, PHNO

7 Health workers role in providing safe Group discussion/ PPT Anjana Khadka, PHNO
abortion care

8 Review of Learnings Participatory Participants/ facilitated

by PHNO

Achievements:
o Information regarding safe abortion care was provided to DHO staffs.
o Health workers roles in providing safe abortion care was explained.

Participants:
o DHO staffs
o Msc. Microbiology students from xaviers college

Orientation/Health Education methodologies:

 PowerPoint presentations

 Group discussion
 Brain storming
 Question and answer
Presentation/Discussion
1. Introduction to safe abortion and safe abortion care was given.
2. WHO guidelines on safe abortion was also explained.
3. Types of safe abortion services was explained.
4. A video was displayed on surgical abortion.
5. Health workers role on providing safe abortion care was explained.
Appendix A: Completion letter by District Health Office Kathmandu
Appendix B: Supporting Photographs