form-iv regional offices of health & family welfare …

1

FORM-IV

REGIONAL OFFICES OF HEALTH & FAMILY WELFARE

DATA COLLECTION FORMATS FOR REVIEW OF PERIPHERAL INSTITUTES

Name of the Regional Office: Raipur

Report for the Month of: June 2010

1. ASSURED SERVICES:

Sl. No. Assured Services District Bastar(Jagdalpur)

I Formation of Programme Management

Unit (PMU) Yes

ii Plan and execute Health Related Activities

Yes

iii Formation of Health Planning & Health

Monitoring Committees No, separate

iv Release and account the funds to

subordinate Offices under NRHM Yes

v Development/Upgrade the peripheral

institute as per IPHS Yes

vi Arrange for procurement of the logistics required for the implementation of the

planned activities.

Yes

vii Implementation of National Health

programme

NRHM Yes

NVDDCP Yes

RNTCP Yes

NLEP Yes

NBCP Yes

HIV/AIDS Yes

NIDDCP Yes

IDSP Yes

viii Non Communicable Diseases

Tobacco control No

Injuries and Trauma No

CVD No

Mental Health No

NOHP No

Diabetes control No

2

ix IEC activities related to National Health

programmers Yes

x

Develop training institutes for providing

appropriate training to strengthen the

skills of the staff.

Yes but integrated setup

xi Work towards achievements of Set Mile

stones Yes

xii Generate Performance related indicators Yes

xiii Generate Indicators under Millennium Development Goals (MDGs)

Not available at time of district visit

xiv Monitoring and quality control Yes (Quality control)

Total Activities undertaken 18

% of activities undertaken 67%

2.1. Accessory services District Bastar(Jagdalpur)

Citizen's charter Yes

Electricity supply Yes

Emergency Lights Yes

Civil engineering Yes

Fire protection No

Water supply Yes

Waste disposal Yes

Total 6

%age 85%

Sl. No. Particulars District Bastar(Jagdalpur)

I Whether PMU formed Yes

ii Adequate Official Accommodation

available No

iii Planning unit Yes (Not sepate PU, as per programme)

iv Financial Management unit Yes ( as per programme )

v IEC management unit Yes

vi Training Unit Yes

vii Management Information System Unit Yes

viii Other (Specify) -

ix Other (specify) -

Total Units formed

% Units formed 85%

3

Sl. No. Manpower category-wise District Bastar(Jagdalpur)

I Programme managers DPM-1, BADA-7 (12), BPM-03 (12)

ii Technical Officers DDO,NVBD officers,RNTCP,NLEP ,IDSP officers

iii IT personnel Not available

iv Statistical personnel Not available

v Other Support staff Account Manager-1, Immunisation camp at 01

vi Other

Total Staff

% of staff available

Sl. No. Logistics District Bastar(Jagdalpur)

Office logistics (Specify)

I Necessary Furniture Yes

ii Computers Yes

iii Printers Yes

iv Telephones Yes

vi Faxes Yes

vii Storages Yes

viii Vehicle for Mobility (specify) No (PMU)

Total 6/7

%age 86%

I Whether HP&MC are constituted No (As per program NHP)

ii Whether the composition is as the

guidelines. Yes

iii Whether HP&MC convening meeting

regularly Yes

iv If Yes, at what interval Monthly

v Whether Discussion as agenda are

undertaken. Yes

vi Whether the Minutes prepared &

circulated Yes

vii Whether feed back on minutes is

received. Yes

Total 5/7

%age 71%

4

3(a). HEALTH INFRASTRUCTURE IN THE VISITED STATE/DISTRICT

3.5. Health Infrastructure available in the Stat/Districts


I # Districts Bastar

Ii # District Hospitals ONE

iii # Sub-Divisional Hospitals TWO

Iv # CHCs TEN

V # PHCs FIFTY-SIX

vi # SHCs 316

vii # Health NGOs 4 + 1 (M)

viii # instts. providing disability care services 1

Ix # CHC/PHC strengthened for BEmoNC

facilities 1

X # CHC/PHC strengthened for CEmoNC

facilities -

xi # CHC/District Hospital Strengthened for FRUs

03

xii # SHCs Strengthened with 2 ANMs NO

xiii # ASHAs functioning Yes(5002 (including Narayanpur)

xiv # AWWs Functioning Yes(4636)

Total Number of Units 11

% units Strengthened 79%

3.6 Staff Strength available against the sanctioned strength in the entire state/district visited


I # Programme Officers Yes-1

Ii # Medical Specialists Yes at district hospital only

iii # Surgical Specialist Yes at district hospital only

Iv # Pediatricians Yes at district hospital only

v # O&G Specialists Yes at district hospital only

vi # Anesthetics Yes at district hospital only

vii # Eye Surgeons Yes at district hospital only

viii # Dental Surgeons Yes at district hospital only

ix # Medical Officers Yes

x # Ayush Medical Officers No

xi # Health Supervisors Yes

5

xii # LHVs Yes

xiii # Key Technical staff Yes

xiv # Paramedical staff Yes

xv # Ministerial Staff

Total Staffs

% staff available

4. Budget Allocation


1 Balance from the previous Years -

2 Funds received under NRHM( current year)

36356533

3 Funds utilized under NRHM

32382689

4 Balance at the end 3973844

5 % Utilization funds 10.93%

5. Job Satisfaction


PMU

District staff

6. Quality Monitoring


i HIS Established

Diseases are classified as per ICD-10 pattern NO

MPR Format Developed Yes

QPR format developed

Half yearly report format developed

Annual Report Format developed

Monitoring Indicators Identified

All Necessary Records Registers maintained Yes

a NRHM Yes

b RNTCP Yes

c NLEP Yes

d NBCP Yes

e NVBDCP Yes

ii Admin Monitoring

Monthly Reports submitted Yes

Quarterly Reports submitted No

6

Half yearly Reports submitted No

Annual Reports Prepared Yes

Monitoring indicators developed No

If prepared , provide a copy of the Report for

the last Month/Quarter/year? Not available

iii Int. Audit

Monthly Review meeting organized Yes

Quarterly meeting organized Yes

Half Yearly Review meeting Organized Yes

Annual Meeting Organized Yes

National Review meeting organized Yes

If yes, provide a copy of ATR on the minutes -

iv Patient care (# Developed complications)

Ante-natal cases 24 (April 2010,HIMS data)

Post natal complication

New born/Infants Not available

IOL cases under NBCP Not available

TB cases Not available

Leprosy cases Not available

other cases Not available

If yes, provide a copy of the ATR

v Medical Audit (# Deaths reported

&reviewed)

Maternal Deaths Medical audit report are not available

Child deaths Medical audit report are not available

Malaria deaths No death

Tuberculosis Deaths 20 (district level ,ist quarter of 2009/10)

Others (specify)

If undertaken, provide a copy of the ATR ATR and audit report not available

vi Supervisory visits by State/National Prog.

Manager

what was checked Reports copy was not available

7

what gaps were found

what instructions were given Reports copy was not available

what administrative directions given Reports copy was not available

Provide a copy of the follow up action taken Reports copy was not available

vii External Audit

Independent Review Reports copy was not available

Review by Expert Groups Reports copy was not available

If undertaken, provide a copy of the ATR Reports copy was not available

Sl. No. Action points District Bastar(Jagdalpur)

I Whether district Rural Health Mission has been set up?

Yes

ii Whether HFW societies have been merged into one society?

Yes

iii Whether State and District Plans are prepared for implementation

of the identified activities. Yes

iv Whether Project Management Teams are in place and provided the necessary training. Yes

v Whether mobile medical units are sanctioned and functionalized.

No

vi Whether main streaming of AYUSH ha been undertaken. No

vii Whether networking with NGOs has been made. Yes

viii Whether Public Private Partnership has been established for

referring the BPL cases and out sourcing of some of the activities No

ix Whether JSY scheme is launched and practice of reporting every

maternal death to DM is followed. Yes

x Whether Quality Assurance Committee is Operational zed.

Yes

xi

Whether BEmONC facilities (including Civil hospitals, CHCs

and PHCs) are strengthened with 03 staff nurse to provide service guarantee as per IPHS.

Yes-1

xii

whether CEmONC institutions ( PHCs & CHCs) strengthened

with 7 Specialists with 9 Staff nurses to provide service guarantee

as per IPHS. No

8

xiii

Whether Sub-Centers Strengthened by providing 2 ANMs and

UNTIED funds of Rs. 10000/+ are given No

xiv

Whether Rogi Kalyan Samiti (RKS) at District/CHC/PHC are

formed and one time support to RKS are provided Yes

xv Whether streamlining of provisions for drug logistics at CHC, PHC and SHC for common ailments has been made under

mission.

Yes

xvi Whether access to Universal Immunization through introduction of Autosyrings, alternate delivery of vaccine is ensured.

Yes

xvii

Whether involvement of PRIs is ensured in the implementations

of Health Schemes at the village level (i.e. immunization, JSY,

sanitation, drinking water, etc.)

Yes

xviii Whether strengthening of Anganwadi through involvement of

AWW in MCH programme is done. Yes

xix Whether selection and training of ASHA @ 1 ASHA per 1000 population is done and ASHA Kit is given.

Yes

xx Whether Village Health & Sanitation Committee are constituted

and UNTIED grant is provided. Yes

xxi Whether SHC/PHC/CHC/DH are fully equipped to develop intra-Health sector convergence, coordination & services guarantees

for FW, NVBDCP, RNTCP, HIV/AIDS, etc.

Yes

xxii Annual need for FW and RCH services has been calculated in the district as per operation manual and monitoring of state

programme implementation plans? Yes

xxiii Whether performance report is submitted by the district in revised

MIES Formats Yes

xxiv whether Annual State and District Specific Public Reports on Health are Published Yes

xxv Whether institute wise assessment of performance against assured

services guarantee carried out. Inspection carried out for Yes

Total Number of activities completed

% miles stones completed

9


13 Under Five mortality rate Not Available at time of Visit

14 infant mortality rate Not Available at time of Visit

15 proportion of 1 year-old children immunized

against measles

Not Available at time of Visit

Target 6 - Reduce three quarters, between 1990

and 2015, the maternal mortality ratio


16 Maternal Mortality ratio Not Available at time of Visit

17 Proportion of births attended by skilled health personnel


18 HIV prevalence among women aged 15-24

years


19 Condom use rate of the contraceptive

prevalence rate


19A Condome use of last high risk sex Not Available at time of Visit

19B percentage of population of aged 15-24 years with comprehensive correct knowledge of

HIV/AIDS


19C Contraceptive prevalence rate Not Available at time of Visit

20 Ratio of school attendance of orphans to school attendance of no-orphans aged 10-14 years


21 prevalence and death rate associated with

malaria


22

Proportion of population in malaria risk areas

using effective malaria prevention and treatment measures


23 Prevalence and death rates associated with

Tuberculosis ( 2009)

20

24 Proportion of tuberculosis cases detected and

cured under DOTS ( first quarter of 2010)

New smear positive cases -187, New smear

Negative P TB-141, New extra PTB-54,

Relapse-18

No. of Indicators Developed

%age

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FORM-IV


DATA COLLECTION FORMATS FOR REVIEW OF NATIONAL HEALTH PROGRAMME

Name of the Regional Office:

Report for the Month of:

REVIEW OF NATIONAL HEALTH PROGRAMMES AT THE DISTRICT HQ LEVEL

Sl. No. Assured services under NHP NRHM NVBDCP RNTCP NLEP NBCP NACP NIDDCP IDSP NCD

I ASSURED SERVICES

1.1 NHPs implemented in the District

I Human Control

I Diagnostic Services Yes Yes Yes Clinical Yes Yes Yes Yes Yes

ii Treatment Yes Yes Yes yes Yes yes Yes yes yes

iii Disability management Not visible

II Vector Control

I Interval Residual Spray Not Applicable Yes as per API

Not Appl- Not Appl Not Appl Not Appl

ii Space spray Not Applicable No Not Appl Not Appl Not Appl Not Appl

iii Impregnated Bed Net Provision Not Applicable Yes Not Appl Not Appl Not Appl Not Appl

III Biological Control

I Maintenance of Hatcheries Not Applicable No Not Appl Not Appl Not Appl Not Appl

ii Release of Anti-larval Fishes Not Applicable No Not Appl Not Appl Not Appl Not Appl

iii Others Not Applicable Not Appl Not Appl Not Appl Not Appl

IV Chemical Control

I Oil spray on water surface Not Applicable No Not Appl Not Appl Not Appl Not Appl

ii Others Not Applicable No Not Appl Not Appl Not Appl Not Appl

iii Others Not Applicable No Not Appl Not Appl Not Appl Not Appl

V Others Activities

I Health Education Yes Yes Yes Yes Yes Yes Yes Yes Yes

ii Training Yes Yes Yes Yes Yes Yes Yes Yes Yes

iii Conversance Yes Yes Yes Yes Yes Yes Yes Yes Yes

Total Services provided

% services provided

11

1.2. NRHM

1 Ante-natal Care Services Yes

I Intra-natal care services Yes

ii Post natal care services Yes

iii JSY care Services Yes

iv Immunization of Children Yes

v Full Range of FP Services Yes

vi Health Education Yes

vii Training Yes

Total Services provided All

% services provided 100%

2 Essential Services Expand

2.1 Support services

2.1.1 Health Education

I Individual - HE Material Yes

ii Group - HE Material Yes

iii Mass media - HE Material NA

2.1.2 Training

I Training Material Yes

ii Training Insstts No

separate

iii TOT Yes

iv Training Equipments

Details not

available

2.1.3 Conversance

I Allied Departments NA

12

ii NGOs NA

iii Pvt. Institutes NA

iv Others NA

Total No. of support services 5

% support services

3

ESSENTIAL

INFRASTRUCTURE

NRHM NVBDCP RNTCP NLEP NBCP NACP NIDDCP IDSP NCD

3.1 Physical Structures

3.1.1

Infrastructure of Diagnostic

Services

I # Facilities undertaking active

surveillance Yes

ii # Facilities undertaking passive

surveillance Yes

iii # Programme dedicated facilities NA

iv # Treatment proving centers Yes

v # Residual Spray teams employed Yes

vi # Space spray teams Yes

vii # Oil spray teams No

viii # Bed-net Impregnation teams Through

PDS

ix # hatcheries maintained No

x # water bodies released ant larval

fishes

Not

available

3.1.2 Laboratory Services

I Pathology (Clinical Laboratory) Yes

ii Bacteriology Laboratory Yes(MC)

iii Hematological laboratory Yes

13

iv Serological Laboratory Yes

v Biochemistry Laboratory Yes

vi Ophthalmologic Laboratory

vii Imaging/Radiological Laboratory Yes

3.1.3 Disability prevention services

I Physical Rehabilitation NA

ii Medical Rehabilitation NA

iii Surgical Rehabilitation NA

iv Vocational Rehabilitation NA

v Social Rehabilitation NA

Total I/S Items available 0

% I/S Items available 0%

3.2 Manpower

I Specialists

ii Doctors

iii Technicians

iv Others

Total Health staff in place

available

% staff in place

3.3 Logistics

3.3.1 Equipments (Specify)

I OPD equipment Available

ii Laboratory equipment Available

iii Vector control equipments Available

iv Chemical control equipments Available

v Biological control Appliances NA

14

3.3.2 Drugs, chemicals and others

I Availability of adequate quantity

of Routine Programme Drugs Yes

ii

Availability of drugs for

management of complicated,

resistant, relapsed cases, etc.

Yes

iii Availability other supportive drugs required under programme.

Yes

iv

Availability of Chemicals &

insecticides Yes

v Bed nets LLIN

vi Biological (anti-larval fishes) No

3.3.3 Referral & Mobility

I Vehicle/s Ambulance

ii other modes of transport Own vehicle

Total Logistic items available

% Logistic Items available

4 Funds utilization NRHM NVBDCP RNTCP NLEP NBCP NACP NIDDCP IDSP NCD

I Funds allocated 36356533 4381668 1237424 Not available

Not available

Not available 200219

ii Funds Utilized 32382689 4158000 336688

Not

available

Not

available Not available

1708

iii % Utilization 10.93% 94.90% 27.21% 0%

Not

available

Not

available Not available

0.85% Not

available

5 Cross-checking

I Laboratories Yes

ii Blood/sputum slides of Malaria

Send to RD

and central lab

15

6 Satisfaction studies

I Staff

ii Beneficiaries

iii Therapeutic efficacy studies

iv Entomological studies

7 SUPERVISION, M&E

Sl. No. Particulars

i MIS Established

Diseases are classified on ICD-10 pattern

Not visible

MPR Format Developed

HIMS is established

at District

QPR format developed

Half yearly report format

developed

Annual Report Format developed

All Necessary Records Registers

maintained


If MIS is functional, provide a

copy of the consolidated Report of last month

ii(a)

Necessary Registers &Records

maintained

A All necessary files and records as per programme at different programme manager of current national

Programmes at district levels.

B

C

D

E

17

ii Admin Monitoring

Monthly Reports submitted Yes

Quarterly Reports submitted Yes

Half yearly Reports submitted Yes

Annual Reports Prepared Yes

Monitoring indicators developed Yes

If prepared , provide a copy of the

Report for the last year? Yes

iii Int. Audit

Monthly Review meeting

organized

Yes-programme

meeting

Quarterly meeting organized

Half Yearly Review meeting

Organized

Not

available

Annual Meeting Organized

Not available

National Review meeting

organized

Not

available

If yes, provide a copy of ATR on

the minutes

Not

available

iv Patient care (# Developed

complications)

Ante-natal cases

Post natal complication

New born/Infants

IOL cases under NBCP

TB cases

Leprosy cases

other cases


18

v Medical Audit (# Deaths

reported &reviewed)

NRHM NVBDCP RNTCP NLEP NBCP NACP NIDDCP IDSP NCD

Maternal Deaths

Child deaths

Malaria deaths

Tuberculosis Deaths

Others (specify)

If undertaken, provide a copy of the ATR

vi Supervisory visits by

State/National Prog. manager

what was checked

Not

available


Not

available

what instructions were given Not available

what administrative directions

given

Not

available

If provided, a copy of the follow up action taken

vii External Audit

Independent Review

Not

available

Review by Expert Groups

Not

available


Not available

Total No. of Monitoring items

% Monitoring Items

19

8

PERFORMANCE OF

INDICATORS

Sl. No. Particulars

8.1 Current Status

1 NCDR (NLEP) 19.99

2 PR 1.85

3 Proportion of Sever cases NA

4 Proportion of Child cases 15.23%

5 Proportion of Female cases 33.44%

6 Proportion of Deformity cases 11.25%

7 # Put on treatment among NCD Not available

8 # Relapsed & Resistant cases Not available

9 # completed the treatment Not available

10 # Under treatment at the end Not available

11 # Deaths Not available

12 IMR Not available

13 MMR Not available

14 Under Five Mortality rate Not available

8.2 Trends of New Cases

I NRHM

IMR Not available

MMR Not available

ii NVDDCP Downtrend

iii RNTCP Not available

iv NLEP Downtrend

v NBCP Not available

vi HIV/AIDS Not available

vii NIDDCP Not available

viii IDSP Not available

ix NCD Not available

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FORM-IV


DATA COLLECTION FORMATS FOR REVIEW OF PERIPHERAL INSTITUTES

Name of the Regional Office: REGIONAL OFFICE FOR HEALTH AND FAMILY WELFARE, RAIPUR

Report for the Month of: JUNE 2010

1. ASSURED SERVICES

Sl. No. Services CHC 1 CHC 2 CHC 3 CHC 4 Total

Lohandiguda Bakawand Tokapal Pharasgaon 4

i Specialists medical Care services available No No No No 0/4

ii Care of routine & emergency cases of surgery No No No No 0/4

iii Care of routine & emergency cases of Medicine No No No No 0/4

iv Care of routine & emergency cases of Obstetrics No No No No 0/4

v

Care of routine & emergency cases of Sick

Children No No No No 0/4

vi 24 Hrs Delivery Services Yes Yes Yes Yes 4/4 (100%)

vii Safe abortion services No No No No 0/4

viii New Born Care Services No No No No 0/4

ix Full Range of Family Planning Services Yes Yes Yes Yes 4/4 (100%)

x Other Medical care for management of nasal

packing, Snake bite, dog bite, etc.

Yes Yes Yes Yes 4/4 (100%)

xi Blood Storage Unit No No No No 0/4

xii Implementation of NHP activities

NRHM Yes Yes Yes Yes 4/4 (100%)

NVDDCP Yes Yes Yes Yes 4/4 (100%)

RNTCP Yes Yes Yes Yes 4/4 (100%)

NLEP Yes Yes Yes Yes 4/4 (100%)

NBCP Yes Yes Yes Yes 4/4 (100%)

HIV/AIDS No No No No 0/4

NIDDCP Yes Yes Yes Yes 4/4 (100%)

IDSP Yes Yes Yes Yes 4/4 (100%)

xiii Non Communicable Diseases

Tobaccos control No No No No 0/4

Injuries and Trauma Yes Yes Yes Yes 4/4 (100%)

CVD No No No No 0/4

Mental Health No No No No 0/4

NOHP No No No No 0/4

Diabetes control No No No No 0/4

Total Assured Services 11/25 11/25 11/25 11/25 44/100

% Assured Services 44% 44% 44% 44% 44%

21

2. Other Services

Sl. No. Services CHC 1 CHC 2 CHC 3 CHC 4 Total

Lohandiguda Bakawand Tokapal Pharasgaon 4

2.1 Support Services

i Standards Treatment protocols No No No No 0/4

ii IEC Material Yes Yes Yes Yes 4/4 (100%)

iii Training manuals Yes No No No ¼ (25%)

iv Skill Strengthening Training of staff Yes No Yes Yes ¾ (75%)

v Diet to patients No No No No 0/4

vi Sterilization room Yes No No No ¼ (25%)

vii Central Sterilization storage Depot. (CSSD) No No No No 0/4

viii Laundry No No No No 0/4

ix Storage Yes Yes No Yes ¾ (75%)

5/9 (56%) 2/9 (22%) 2/9 (22%) 3/9 (33%) 12/36 (33%)

2.2. Accessory Services

i Citizen's charter Yes Yes Yes Yes 4/4 (100%)

ii Electricity supply Yes Yes Yes Yes 4/4 (100%)

iii Emergency Lights No No Yes No 1/4 (25%)

iv Telephone Yes Yes Yes Yes 4/4 (100%)

v Civil engineering Yes No No No 1/4(25%)

vi Fire protection No No Yes No 1/4(25%)

vii Water supply Yes Yes Yes Yes 4/4 (100%)

viii Waste disposal No No No No 0/4

ix Mortuary Yes Yes No Yes ¾(75%)

2.3. Diagnostic Laboratory) (180 Sq. Mts)

i Pathology (Clinical Laboratory) Yes Yes Yes Yes 4/4 (100%)

ii Bacteriology Laboratory No No No No 0/4

iii Hematological laboratory Yes Yes Yes Yes 4/4 (100%)

iv Serological Laboratory No No No No 0/4

v Biochemistry Laboratory Yes No No No ¼(25%)

vi Cardiac laboratory (ECG) No No No No 0/4

vii Ophthalmologic Laboratory No No No No 0/4

viii Imaging/Radiological Laboratory Yes Yes Yes Yes 4/4 (100%)

4/8 (50%) 3/8 (38%) 3/8 (38%) 3/8 (38%) 13/32 (41%)

2.4. Activities of NHP

I Human Control

i Diagnostic Services Yes Yes Yes Yes 4/4 (100%)

ii Treatment Yes Yes Yes Yes 4/4 (100%)

iii Disability management Yes No No Yes 2/4 (50%)

3/3 (100%) 2/3 (67%) 2/3 (67%) 3/3 (100%) 10/12 (83%)

22

II Vector Control Lohandiguda Bakawand Tokapal Pharasgaon Total

I Interval Residual Spray Yes Yes Yes Yes 4/4 (100%)

ii Space spray No No No No 0/4(0%)

iii Impregnated Bed Net Provision No Yes Yes


I Maintenance of Hatcheries No No No No 0/4(0%)

ii Release of Anti-larval Fishes No No No No 0/4(0%)

iii others No No No No 0/4(0%)

IV Chemical Control

I Oil spray on water surface No No No No 0/4(0%)

ii Others No No No No 0/4(0%)

V Others Activities

I Health Education Yes Yes Yes Yes 4/4 (100%)

ii Training No Yes Yes Yes ¾ (75%)

iii Conversance No No Yes Yes 2/4 (50%)

2.5 NRHM

1 Ante-natal Care Services Yes Yes Yes Yes 4/4 (100%)

I Intra-natal care services Yes Yes Yes Yes 4/4 (100%)

ii Post natal care services Yes Yes Yes Yes 4/4 (100%)

iii JSY care Services Yes Yes Yes Yes 4/4 (100%)

iv Immunization of Children Yes Yes Yes Yes 4/4 (100%)

v Full Range of FP Services (Camps) Yes Yes Yes Yes 4/4 (100%)

vi Health Education Yes Yes Yes Yes 4/4 (100%)

vii Training Yes Yes Yes Yes 4/4 (100%)

Total Services provided 8/8 8/8 8/8 8/8

% services provided 100% 100% 100% 100%

3. INFRASTRUCTURE AVAILABLE

3.1. Physical Infrastructure (1503.32 Sq Mts)

Sl. No. Services Lohandiguda Bakawand Tokapal Pharasgaon Total

I Review by VH&SC

i Whether VH&SC are constituted Yes Yes Yes Yes 4/4 (100%)

ii Whether the composition of the VH&SC is as the

guidelines.


iii Whether VH&SC are convening the meeting

regularly No No No No

(0/4)

iv If Yes, at what interval N.A. N.A. N.A. N.A.

23

v Whether Discussion as agenda are undertaken. N.A. N.A. N.A. N.A.

vi Whether the Minutes of the meeting are prepared

and circulated to all the concerned N.A. N.A. N.A. N.A.

vii Whether the feed back on the minutes is received. N.A. N.A. N.A. N.A.

viii Village Health day & Health camps are organized N.A. N.A. N.A. N.A.

ii Entrance Zone: (72 Sq. Mts)

Location & Floor Area Good N.A. N.A. N.A.

Registration & Records Yes Yes Yes Yes 4/4 (100%)

Pharmacy Yes Yes Yes Yes 4/4 (100%)

Drugs Storage Yes Yes Yes Yes 4/4 (100%)

Public Utility Yes No No No ¼ (25%)

Circulation space Yes Yes Yes Yes 4/4 (100%)

iii Ambulatory Zone (OPD) (321.4 Sq. Mts)

Causality/Emergency No Yes No Yes 2/4 (50%)

GDMO Room Yes Yes Yes Yes 4/4 (100%)

AYUSH MO Room No No No No 0/4

8 Specialists Room No No No No 0/4

Treatment Room No Yes Yes Yes 3/4 (75%)

Refraction Room Yes Yes Yes Yes 4/4 (100%)

Nursing station Yes Yes Yes Yes 4/4 (100%)

Causality/Emergency No Yes Yes Yes ¾ (75%)

Dress Room Yes Yes Yes Yes 4/4 (100%)

Injection Room Yes Yes Yes Yes 4/4 (100%)

Female Injection Room No No No No 0/4

Public Utilities Yes No No No ¼ (25%)

Waiting Room No No No No 0/4

iv In-Patient Zone (313.76 Sq. Mts) Lohandiguda Bakawand Tokapal Pharasgaon Total

Male Wards No Yes Yes Yes

Female wards No Yes Yes Yes

Private Room No No No No

Isolation Room No No No No

Nursing station No Yes Yes Yes

Patient areas No No N.A. N.A.

Ancillary areas N.A. No N.A. N.A.

Rest Rooms N.A. No N.A. N.A.

24

v Critical Zone (Operation Room/Labour Room)-(240 Sq. Mts)

Patient Area N.A. No N.A. N.A.

Staff Area N.A. N.A. N.A. N.A.

Supply areas N.A. N.A. N.A. N.A.

OT/LR area N.A. N.A. N.A. N.A.

Public Utility N.A. N.A. N.A. N.A.

Circulation area N.A. N.A. N.A. N.A.

vi Administration Zone ( 60 Sq. Mts)

General administration Yes Yes Yes Yes

Establishment - No N.A. N.A.

Accounts - No N.A. N.A.

General Store - Yes Yes Yes

Total No. I/S items Present

% of I/S items Present

3.2. Manpower available in the CHCs as per IPHS

Sl. No. Categories of staff Lohandiguda Bakawand Tokapal Pharasgaon Total

Specialist Staff

I General Surgeon No No No No 0/4

ii Physician No No No No 0/4

iii O&G No No No No 0/4

iv Pediatrics No No No No 0/4

v Anesthetist No No No No 0/4

vi Public Health manager No Yes Yes No 2/4(50%)

vii Eye Surgeon (1for every 5 CHC) No No No No 0/4

viii Dental Surgeon No No No No 0/4

Total # Staff 0/8 1/8 1/8 0/8 2/32 (6%)

% staff against sanctioned

Key Essential Staff

ix GDMOs with at least 2 female MO) No No No No 0/4

(50%)

x Specialist of AYUSH No No No No 0/4

xi GDMO (AYUSH ) No No 1 No ¼ (25%)

xii Staff Nurse 1 3 3 3

xiii PHN No No No No 0/4

xiv ANM 1 1 1 1 4/4 (100%)

xv Pharmacist/Compounder 2 1 1 2

xvi Pharmacist – AYUSH No NO No No 0/4

xvii Lab. Technician 1 1 1 1 4/4 (100%)

xviii Radiographer 1 1 1 1 4/4 (100%)

xix Ophthalmic Assistant 1 1 1 1 4/4 (100%)

xx Dresser 1 3 1 2

Total # Staff 9 12 11 12

% staff against sanctioned 58% 58% 67% 58% 60%

25

Other staff Lohandiguda Bakawand Tokapal Pharasgaon Total

xxi Ward boy /Nursing orderly 2 6 2 1 11

xxii Sweeper 3 1 1 1 6

xxiii Chowkidar 1 1 1 0 3

xxiv Dhobi No No No No

xxv Mali No No No No

xxvi Aya 1 1 1 1 4

xxvii Peon ` 2 1 4 3 10

xxviii OPD attendant No No No No

xxix Registration Clerk No No No No

xxx Statistical Assistant /Data entry operator 1 1 1 1 4

xxxi Accountant/Administrative Assistant NO No 1 No 1

xxxii OT Technician No 1 1 1 3

Total 10 12 12 8 42

% staff against sanctioned 50% 42% 67% 42% 50%

Grand Total # Staff

% staff against sanctioned

3.3. Logistic Support

Sl. No. Logistics Lohandiguda Bakawand Tokapal Pharasgaon Total

3.3.1 Logistics - Vehicle/Referral transport Model

i Bicycles/ Moped No No No No

ii Ambulances 3 2 3 3

iii Call vehicles - - 1 -

iv Out sourced vehicles No No No

3.3.2 Logistic Equipments Lohandiguda Bakawand Tokapal Pharasgaon

i Surgical Instruments Set I No No No No 0/4

ii Surgical Instruments Set II No No No No 0/4

iii Surgical Instruments Set III No No No No 0/4

iv Surgical Instruments Set IV No No No No 0/4

26

v Surgical Instruments Set V No No No No 0/4

vi Surgical Instruments Set VI No No No No 0/4

vii IUD insertion Equipment Kit Yes Yes Yes Yes 4/4 (100%)

viii Normal Delivery Kit Yes Yes Yes Yes 4/4 (100%)

ix Equipment for Anesthetic No No No No 0/4

x Equipment for Neonatal Resuscitation Yes Yes Yes Yes 4/4 (100%)

xi Material Kit for Blood transfusion No No No No 0/4

xii Equipment for OT Yes Yes No No 2/4 (50%)

xiii Equipment for LR Yes Yes No No 2/4 (50%)

xiv Equipments for Radiology Yes Yes Yes Yes 4/4 (100%)

3.3.3 Logistics- Drugs Lohandiguda Bakawand Tokapal Pharasgaon

i Routine Drugs Yes Yes Yes Yes 4/4 (100%)

ii Tablets Yes Yes Yes Yes 4/4 (100%)

iii Capsules Yes Yes Yes Yes 4/4 (100%)

iv Injections Yes Yes Yes Yes 4/4 (100%)

v Vaccines & Antiserum Yes Yes Yes Yes 4/4 (100%)

vi Ayurvedic drugs No No No No 0/4

vii Unani drugs No No No No 0/4

viii Sidha Drugs No No No No 0/4

ix Homeopathic drugs No No No No 0/4

x Programme related drugs

Programme related drugs

NRHM Yes Yes Yes Yes 4/4 (100%)

NVDDCP Yes Yes Yes Yes 4/4 (100%)

RNTCP Yes Yes Yes Yes 4/4 (100%)

NLEP Yes Yes Yes Yes 4/4 (100%)

NBCP Yes Yes Yes Yes 4/4 (100%)

HIV/AIDS No No No No 0/4

NIDDCP Yes Yes Yes Yes 4/4 (100%)

IDSP Yes Yes Yes Yes 4/4 (100%)

NCD No No No No 0/4

Total No. of Logistic Items Present 7/9 7/9 7/9 7/9 28/36

% logistic items present 78% 78% 78% 78% 78%

27

4 Funds allocation & Utilization Lohandiguda Bakawand Tokapal Pharasgaon Total

i Funds allocated N.A. 1 lac 13 lac

6 lack

96775

ii Funds utilized N.A. 1 lac 7 lac 3 lack 46 426

iii % funds utilized N.A. 100% 52% 46% 66%

5 CROSS-VERIFICATION/FIELD VERIFICATION

I Malaria Slides Lohandiguda Bakawand Tokapal Pharasgaon Total

# +ve slides cross examined 1 5 0 NA

# Discrepancies found 0 0 0 NA

# -ve blood slides cross-examined 4 5 15 NA

# Discrepancies found 0 0 0 NA

Total Slides cross-examined 5 10 15 NA

Total discrepancies found 0 0 0 NA

% discrepancies found 0 0 0 NA

ii Peripheral Laboratories

Adequacy of Infrastructure of the laboratories NO YES NO NO ¼ (25%)

Trained Technician in-position 1 2 1 1

Adequate testing equipments in place No Yes No Yes 2/4 (50%)

adequate chemicals in place Yes Yes No Yes ¾ (75%)

Average no. of tests undertaken per day 30 15-17 20-30 40-100

Is it overburdened Yes No No Yes

Adequacy of records maintained No Yes Yes No 2/4 (50%)

Validity of results by cross checking No No No No 0/4

Quality of slides and tests No No No No 0/4

SOP/ Guidelines in place No No No No 0/4

Test results are given on the same day. No No No No 0/4

% of quality items present

6 SATISFACTION STUDIES Lohandiguda Bakawand Tokapal Pharasgaon Total

I Job Satisfaction (as per format) 1 1 2 2

ii Patient's Satisfaction (as per format) 1 1 1 2

28

7. SPERVISION & MONITORING

Sl. No. Particulars Lohandigu

da

Bakawan

d Tokapal Pharasgaon

Total

i MIS Established

Diseases are classified as per ICD-10 pattern No No No No 0/4

MPR Format Developed Yes Yes Yes Yes 4/4 (100%)

QPR format developed Yes Yes Yes Yes 4/4 (100%)

Half yearly report format developed Yes Yes Yes Yes 4/4 (100%)

Annual Report Format developed Yes Yes Yes Yes 4/4 (100%)

Monitoring Indicators Identified No Yes Yes Yes 3/4 (75%)

If MIS is functional, provide a copy of the

consolidated Report of last month


All Necessary Records Registers maintained

a HIMS Yes Yes Yes Yes 4/4 (100%)

b JSY Yes Yes Yes Yes 4/4 (100%)

c ANC, PNC Yes Yes Yes Yes 4/4 (100%)

d Immunization Yes Yes Yes Yes 4/4 (100%)

e ODDI IOD Yes Yes Yes Yes 4/4 (100%)

f NLEP Yes Yes Yes Yes 4/4 (100%)

g RNTCP Yes Yes Yes Yes 4/4 (100%)

h NVBDCP Yes Yes Yes Yes 4/4 (100%)

i JDS Yes Yes Yes Yes 4/4 (100%)

j F.P. Register Yes Yes Yes Yes 4/4 (100%)

k MCH Register Yes Yes Yes Yes 4/4 (100%)

l Death Register Yes Yes Yes Yes 4/4 (100%)

m Contraceptive Register Yes Yes Yes Yes 4/4 (100%)

ii Admin Monitoring Lohandigu

da

Bakawan


Total

Monthly Reports submitted Yes Yes Yes Yes 4/4 (100%)

Quarterly Reports submitted Yes Yes Yes Yes 4/4 (100%)

Half yearly Reports submitted Yes Yes Yes Yes 4/4 (100%)

Annual Reports Prepared Yes Yes Yes Yes 4/4 (100%)

Monitoring indicators developed No No No No 0/4

If prepared, provide a copy of the Report for the

last year?

iii Int. Audit

Monthly Review meeting organized Yes Yes No No 2/4 (50%)

Quarterly meeting organized Yes Yes Yes Yes 4/4 (100%)

29

Half Yearly Review meeting Organized Yes Yes Yes Yes 4/4 (100%)

Annual Meeting Organized Yes Yes No No 2/4 (50%)

National Review meeting organized Yes Yes No No 2/4 (50%)

If yes, provide a copy of ATR on the minutes - - - -

iv Patient care (# Developed complications) Lohandigu

da

Bakawan


Total

Ante-natal cases 42 N.A. 513 212

Post natal complication NIL N.A. 519 159

New born/Infants - N.A. - 77

IOL cases under NBCP - N.A. - 0

TB cases 36 N.A. - 0

Leprosy cases 3 N.A. - 0

other case - - - 0

If yes, provide a copy of the ATR - - - 0

v Medical Audit (# Deaths reported &reviewed)

Maternal Deaths 0 0 0 2

Child deaths 0 0 21 47

Malaria deaths 0 0 0 NIL

Tuberculosis Deaths 0 0 0 -

Others (specify) 0 0 0 -

If undertaken, provide a copy of the ATR - - - -

vi Supervisory visits by State/National Prog.

manager

what was checked Yes Yes Yes No

what gaps were found Yes - No No

what instructions were given Yes - N.A. No

what administrative directions given Yes - N.A. N.A.

Provide a copy of the follow up action taken

vii External Audit

Independent Review No No No No

Review by Expert Groups Yes No No No

If undertaken, provide a copy of the ATR No No - -

vii Whether the feed back on the minutes is received. No No N.A. N.A.

viii Village Health day & Health camps are organized Yes Yes Yes Yes

Total No. of Monitoring Items present

% Monitoring Items Present

30

8 Performance of services Lohandigu

da

Bakawan


Total

8.1 Hospital performance

# patients reported in OPD in last one year 21352 16668 15911 23863

# days hospital OPD operated 362 362 362 362

# Patient days in Hospitals N.A. 90 N.A. N.A.

# Patients admitted in Hospital 2160 3347 1409 9036

# of Bed days - N.A. N.A. N.A.

# patients died in hospital 4 NIL NIL N.A.

# Patients Discharged 2156 3347 1409 9036

# Live births occurred in hospital during reference

period 393 407 199 286

# of infant deaths 0 0 88

# of Maternal Death 0 0 0 0

# of abortions 10 0 0 0

8.2 Hospital Performance Indicators

Average daily Attendance in OPD in last one year 45 3347 80 80-85

Average duration stay in hospital N.A. N.A. N.A. N.A.

Bed Occupancy Ratio N.A. N.A. N.A. N.A.

Bed Turn over rate N.A. N.A. N.A. N.A.

Death rate N.A. N.A. 8/100 N.A.

IMR N.A. N.A. N.A. N.A.

MMR N.A. N.A. N.A. N.A.

8.3 NHP (Leprosy) NLEP

Prevalence rate N.A. 0.4/1000 N.A. 0.4/10,000

New cases detection rate N.A. N.A. N.A. 0.8/10,000

Prop. Of Sever cases N.A. - N.A. N.A.

Prop. Of Child cases N.A. 10% N.A. N.A.

Prop. Of female cases N.A. 30% N.A. 0%

Prop. Of Deformity cases N.A. 0% N.A. -

Prop. Of cases put on treatment among the new

cases N.A. No N.A. N.A.

Number of cases completed treatment among those

put on treatment N.A. 7 N.A. N.A.

Number of Prevalent cases on record at the end of

report month N.A. 33 N.A. N.A.

Number of resistant/relapse cases N.A. NIL N.A. N.A.

# of CHCs developed Indicators

31

FORM-IV


DATA COLLECTION FORMATS FOR REVIEW OF PRIMARY HEALTH CENTERS

Name of the Regional Office: Regional Office for Health & Family Welfare

Report for the Month of: June 2010

1 ASSURED SERVICES:

Sl. No. Assured Services Under

PHCs PHC1

(Nagar nar)

PHBAKAWA

ND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

1.1 Medical Care Services

I OPD services Yes yes Yes Yes Yes

ii Emergency Services (24 Hrs) Yes no Yes Yes Yes

iii Referral services Yes no Yes Yes Yes

iv In-patient Services Yes yes Yes Yes Yes

1.2 Treatment of Specific cases

I Cataract surgeries No no No No No

ii Primary management of

Wounds Yes no Yes

Yes Yes

iii Primary management of

Fractures No no Yes

No No

iv Minor Surgeries Yes no No No Yes

v Primary management of Poisoning, snake bite, dog bite,

etc.

No no No No No

vi Primary management of Burns No no No No No

1.3 MCH & FP Services PHC1

(Nagar nar)

PHBAKAWA

ND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

I ANC Yes yes Yes Yes Yes

ii INC (24x7 Hrs services) Yes yes No No Yes

iii PNC Yes yes Yes Yes Yes

iv JSY Yes yes No No Yes

v Immunization No no No No No

vi MTP services No no No No No

vii RTI/STD management No no Yes Yes Yes

viii FP methods Yes yes Yes Yes Yes

ix New Born care No no No No No

x Sick child care No no No No No

1.4 Other Services

I Nutritional Services No no No No No

ii School Health Services Yes yes Yes Yes Yes

iii Safe drinking water Yes na No No No

iv Control of locally endemic

diseases Yes yes Yes

Yes Yes

v Surveillance & control of epidemic diseases

Yes yes Yes Yes Yes

vi Collection of vital Statistics Yes yes Yes Yes Yes

vii Health Education Yes yes Yes Yes Yes

32

viii AYUSH services Yes no No No No

ix Rehabilitation services

No no No

No No

1.5 National Health programme PHC1

(Nagar nar)

PHBAKAWA

ND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

I NRHM Yes yes yes Yes Yes

ii HIV/AIDS No no No No No

iii NVBDCP Yes yes yes Yes Yes

iv RNTCP Yes yes yes Yes Yes

v NLEP Yes yes yes Yes Yes

vi NBCP Yes no No No No

vii NIIDCP No no No No No

viii IDSP Yes yes yes Yes Yes

iv NCD-Newer initiatives No no No No No

1.6 Field Activities

Monitor activities of the SHCs Na na Na Na Na

Activities of the ASHAs Na na Na Na Na

MO to visit all SHC once in a month

Na na Na Na Na

HS/LHV to visit once a week Na na Na Na Na

Total activities undertaken

% of activities against total

2 Other Services PHC1

(Nagar nar)

PHBAKAWA

ND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

2.1 Basic Laboratory Services

I Routine -Urine, stool & blood Hb only Hb only NA NA NA

ii BT&CT No no Na NA NA

iii Bacteriology-RTI, Sputum AFB only no Na NA No

iv Blood smear for malaria parasite

Yes yes NA NA No

v Rapid test for pregnancy No yes No Yes Yes

vi RPR test Syphilis/yaws No no No NA No

vii Rapid Diagnostic test for

Typhoid No no No

NA No

viii Rapid test kit for fecal

contamination of water No no No

NA No

2.2 Support Services

i Standards Treatment protocols NA NA NA NA NA

ii IEC Material Yes NA yes No Yes

iii Training Manuals NA NA na NA No

iv

Skill Strengthening Training of

staff No no no

No No

v Diet to patients No no no No No

vi Sterilization room No no no No No

vii

Central Sterilization storage

Depot. (CSSD) No no no

No No

33

viii Laundry No no no No No

ix Storage Yes yes no Yes No

2.3 Amenities/Accessory Services PHC1

(Nagar nar)

PHBAKAWA

ND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

Citizen's charter NA NA NO NA NA

Adequate Residential

Accommodation with all amenities

NA NA NO

NA NO

Lecture Hall for training NA NA NO NA NO

Electricity with adequate back-

up NO NA NO

NA NO

Adequate water supply YES NA NO NA NO

Telephone NA NA NO NA YES

Garden NA NA NO NA NO

Waste disposal facilities NA NA NO NA NO

2.4. Activities of NHP

PHC1

(Nagar nar)

PHBAKAWA

ND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

I Human Control

I Diagnostic Services YES YES YES YES YES

ii Treatment YES YES YES YES YES

iii Disability management NO NO NO NO NO

II Vector Control

I Interval Residual Spray YES YES YES YES YES

ii Space spray NO NO NO NO NO

iii Impregnated Bed Net Provision YES YES YES YES YES


I Maintenance of Hatcheries NO NO NO NO NO

ii Release of Anti-larval Fishes NO NO NO NO NO

iii others

IV Chemical Control

I Oil spray on water surface NO NO NO NO NO

ii Others

iii Others

V Others Activities PHC1

(Nagar nar)

PHBAKAWA

ND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

I Health Education YES YES YES YES YES

ii Training NO NO NO NO NO

iii Conversance NA NA NA NA NA

34

2.5 NRHM

1 Ante-natal Care Services YES NO YES YES YES

I Intra-natal care services YES YES NO NO YES

ii Post natal care services YES NO YES YES YES

iii JSY care Services YES YES NO

NO

YES

iv Immunization of Children NO NO NO NO NO

v Full Range of FP Services NA NA NA NA NO

vi Health Education YES YES YES YES YES

vii Training NO NO NO NO NO

Total activities undertaken

% of activities against total

Sl. No. Infrastructure

PHC1

(Nagar nar)

PHBAKAWA

ND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

3.1 Review by HP&HM

Committee/RKS

i Whether VH&SC are

constituted YES YES YES

YES YES

ii Whether the composition of the

VH&SC is as the guidelines. NOT KNOWN NA NA

NA NA

iii Whether VH&SC are

convening the meeting regularly NO NO NO

NA NO

iv If Ye, at what interval

v Whether Discussion as agenda

are undertaken. NA NA NA

NA NA

vi Whether the Minutes opf the

meeting are prepared and circulated to all the concerned NA NA NA

NA NA

vii Whether the feed back on the

minutes is received. NO NO NO

NO NO

viii Village Health day & Health

camps are organized NOT KNOWN NO NO

NA NA

3.2 Physical Infrastructure PHC1

(Nagar nar)

PHBAKAWA

ND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

I PHC Building

Easily accessible within locality YES YES YES YES YES

Building government or rented GOVT GOVT GOVT GOVT GOVT

Wheel chair friendly NO NO NO NO NO

Well Lit & Ventilated YES YES YES YES YES

Plinth Area 375 to 450 Sq. mtrs YES YES NO YES NO

Boundary wall/fence NO NO NO NO NO

ii Entrance

Registration and Record Room NA NO NO NO NO

Drug dispensing room NA NO NO YES NO

Waiting area for patients YES YES NO YES YES

Ramps at the doorways NO NO NO NO NO

35

iii Waiting area

Adequate seating YES NO NO YES NO

Display of HE Material YES NO YES NO YES

Separate Public utility NO NA NO YES NO

Facility for drinking water NO NO NO NO NO

Proper sign boards YES NO NO NO NO

Complaint box NO NO NO NO NO

clean surrounding, no water

logging YES YES YES

YES NO

36

iv Outpatient Department PHC1

(Nagar nar)

PHBAKAWA

ND (Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

Separate consultation &

examination room NO NO NO

NO NO

Privacy for physical examination NO NO YES NO YES

Public utility NO YES NO NO NO

v In-patient Wards

4-6 beds separate wards for Male

& females NO NO NO

NO NO

Facility for drinking water NA NO NO NO NO

clean toilet NO NO NO NO NO

separate nursing duty room NO NO NO NO NO

Nursing station NO NO NO NO NO

clean linen NO NO NO NO NO

provisions of Diet NO NO NO NO NO

Cleaning of wards FAIR FAIR POOR FAIR POOR

vi Operation Theater

change room NA NA NA NA NO

Separate storing sterile & other material NA NA NA

NO NO

Adequate Equipments NA NA NA NO NO

Simple Surgical Procedures YES YES YES NO NO

vii Labour Room

Separate septic & aseptic deliveries NA NO NO NO NO

well lit & ventilated YES YES NO NO NO

Toilet YES YES NO NO NO

Drinking water NO NO NO NO NO

separate storing of dirty & clean linen NO NO NO

NO NO

Baby care room NA NO NO NO NO

viii Minor OT

Minor surgeries YES YES YES NO NO

Emergencies/causality

management YES YES YES

NO NO

well equipped to handle

emergencies NO NO NO

NO NO

ix Laboratory

Sufficient space YES YES NO NO NO

Separate areas for collection &

Screening NO NO NA

NO NO

should have marble /stone tables & bash basins NO YES NA

NO NO

x General Stores

Separate sterile & common linen,

drugs etc. NO NO NO

NO NO

well lit & ventilated YES YES YES YES NO

Sufficient space YES NO NO YES NO

dispensing cum store NO NO NO YES NO

Vaccine & antiserum NO YES NO NO NO

Grand total Infrastructure Facilities

% of physical infrastructure Facilities

37

3.3. MANPOER IN PHC

Sl. No. Action points PHC1

(Nagar nar)

PHBAKAWA

ND (Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

I Medical officer

(Exiting-1, Recommended -3) 01 01 02 AMO

2 2

AYUSH Practioner

(Exiting-0, Recommended -1) 01 00 00

0 0

Account Manager


0 0

ii Pharmacist


1 1

iii Nurse – Midwife/Staff Nurse


0 0

iv Health Worker (female)


1 1

v Health Educator


0 0

vi Health Assistant (1 (M), 1 (F)


0 0

vii Clerks


0 0

viii Laboratory technician (Exiting-1, Recommended -2)

02 01 00 0 0

ix Driver


0 0

x Class IV (Exiting-4, Recommended -4)

01 02 01 2 3

TOTAL

(Exiting-15, Recommended -

24/25)

08 07 05

6 7

RMA 0 1 1 1 1

3.4. LOGISTICS SUPPORT IN PHC

Sl. No. Logistics PHC1

(Nagar nar)

PHBAKA

WAND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

I Equipment:

Physical Examination in OPD YES YES YES NO NO

Ophthalmologic examination & Eye

care YES NO NO

NO NO

Equipment required under NHP NA NA NO NO NO

Set for Labour Room for Normal/assisted delivery NO NO NO

NO NO

Equipment for IUD NA NO NO NO NO

Equipment for pap smear NA NO NO NO NO

Equipment for laboratory NA NO NO NO NO

Necessary Furniture YES YES NA NO YES

ii Drugs

General Drugs AVL AVL AVL AVL AVL

Ayush drugs NA NO NO NO NO

Drugs for RCH programme NA NO NO NO NO

Drugs for RTI/STI NA NO NO YES YES

38

Ayurvedic Drugs NA NA NO NO NO

Unani medicines NA NA NO NO NO

Sidha Medicines NA NA NO NO NO

Homeopathy medicines NA NA NO NO NO

iii Transport Facilities

Referral facilities for emergency

patients NA NA NO

NO NO

Supervision & other out reach activities NA NA NO NO NO

4

FUNDS ALLOCATION &

UTILIZATION

I Funds allocated 175000 APRX 400000 NIL

175000 NA

ii Funds Utilized NIL 91000 NIL NIL NA

iii % utilization 00 NIL 0

5 CROSS-VERIFICATION/FIELD VERIFICATION

I Malaria Slides

PHC1

(Nagar nar)

PHBAKA

WAND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

# +ve slides cross examined NA NA NA NA NA

# discrepancies found NA NA NA NA NA

# -ve blood slides cross-examined NA NA NA NA NA

# Discrepancies found NA NA NA NA NA

Total Slides cross-examined NA NA NA NA NA

Total discrepancies found NA NA NA NA NA

% discrepancies found NA NA NA NA NA

ii Peripheral Laboratories

Adequacy of Infrastructure of the laboratories POOR YES NA

NA NA

Trained Technician in-position 02 01 00 0 0

Adequate testing equipments in place NO NO NO NA NA

adequate chemicals in place NO NO NO NA NA

Average no. of tests undertaken per day 60 10 00 0 0

Is it overburdened NO NO NA NA NA

Adequacy of records maintained YES POOR YES POOR NA NA NA

Validity of results by cross checking NA NA NA NA NA

Quality of slides and tests POOR POOR NA NA NA

SOP/ Guidelines in place NA NA NA NA NA

Test results are given on the same day. YES NO NO NA NA

% of quality items present

6 SATISFACTION STUDIES

I Job Satisfaction (as per format)

ii Patient's Satisfaction (as per format)

39

7. SPERVISION & MONITORING

Sl. No. Particulars PHC1

(Nagar nar)

PHBAKA

WAND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

i MIS Established

Diseases are classified as ICD-10 Pattern

NO NO NA NA NA

MPR Format Developed YES YES YES YES YES

QPR format developed NA NA NO NA NA

Half yearly report format

developed NA NA NA

NA NA

Annual Report Format developed NA NA NA NA NA


If MIS is functional, provide a

copy of the consolidated Report of

last month

All Necessary Records Registers maintained

YES YES NO POOR POOR

a NLEP AVL AVL NA AVL NA

b RNTCP AVL AVL NA AVL NA

c NVBDCP AVL AVL NA AVL NA

d

e

ii Admin Monitoring

Monthly Reports submitted YES YES YES YES YES

Quarterly Reports submitted NA NA NA NA NA

Half yearly Reports submitted NA NA NA NA NA

Annual Reports Prepared YES YES NA NA NA

Monitoring indicators developed

If prepared , provide a copy of the

Report for the last year?

iii Int. Audit

Monthly Review meeting organized

YES YES YES YES YES

Quarterly meeting organized NA NA NA NA NA

Half Yearly Review meeting

Organized NA NA NA

NA NA

Annual Meeting Organized NA NA NA NA NA

National Review meeting organized

NA NA NA NA NA

If yes, provide a copy of ATR on

the minutes

40

iv Patient care (# Developed

complications)

PHC1

(Nagar nar)

PHBAKA

WAND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

Ante-natal cases NA NA NA NA NA

Post natal complication NA NA NA NA NA

New born/Infants NA NA NA NA NA

IOL cases under NBCP NA NA NA NA NA

TB cases NA NA NA NA NA

Leprosy cases NA NA NA NA NA

other cases


v Medical Audit (# Deaths

reported &reviewed)

Maternal Deaths NA NA NA NA NA

Child deaths NA NA NA NA NA

Malaria deaths NA NA NA NA NA

Tuberculosis Deaths NA NA NA NA NA

Others (specify)


vi Supervisory visits by

State/National Prog. manager

what was checked NA NA NA NA NA

what gaps were found NA NA NA NA NA

what instructions were given NA NA NA NA NA

what administrative directions given

NA NA NA NA NA

Provide a copy of the follow up

action taken

vii External Audit

Independent Review NA NA NA NA NA

Review by Expert Groups NA NA NA NA NA


Total No. of Monitoring Items

present

% Monitoring Items Present

41

8 Performance of services

PHC1

(Nagar nar)

PHBAKA

WAND

(Kachnar)

PHC 3

(Lajonda)

PHC 4

(Belar)

PHC 5

(Kalepal)

8.1 Hospital performance

# patients reported in OPD in last

one year NA NA NA

3500 NA

# days hospital OPD operated NA NA NA NA NA

# Patient days in Hospitals NA NA NA NA NA

# Patients admitted in Hospital NA NA NA NA NA

# of Bed days NA NA NA NA NA

# patients died in hospital NA NA NA NA NA

# Patients Discharged NA NA NA NA NA

# Live births occurred in hospital

during reference period NA NA NA

NA NA

# of infant deaths NA NA NA NA NA

# of Maternal Death NA NA NA NA NA

# of abortions NA NA NA NA NA

8.2 Hospital Performance Indicators

Average daily Attendance in OPD in last one year 25 10 12

10 18

Average duration stay in hospital NA NA NA 6 HRS NA

Bed Occupancy Ratio NA NA NA NA NA

Bed Turn over rate NA NA NA NA NA

Death rate NA NA NA NA NA

IMR NA NA NA NA NA

MMR NA NA NA NA NA

8.3 NHP

Prevalence rate NA NA NA NA NA

New cases detection rate NA NA NA NA NA

Prop. Of Sever cases NA NA NA NA NA

Prop. Of Child cases NA NA NA NA NA

Prop. Of female cases NA NA NA NA NA

Prop. Of Deformity cases NA NA NA NA NA

Prop. Of cases put on treatment among the new cases NA NA NA

NA NA

Number of cases completed

treatment among those put on

treatment NA NA NA

NA NA

Number of Prevalent cases on

record at the end of report month NA NA NA

NA NA

Number of resistant/relapse cases NA NA NA NA NA

42

FORM-IV


DATA COLLECTION FORMATS FOR REVIEW OF SUB-HEALTH CENTERS

Name of the Regional Office:


1. ASSURED SERVICES BY HSC:

Sl. No. Services Badanjee Kinjoly Dimarapal Alore

1.1 Maternal Health

Antenatal Care Yes Yes Yes Yes

Intranasal care Yes Yes Yes Yes

Postnatal Care Yes Yes Yes Yes

JSY Scheme Yes Yes Yes Yes

1.2 Child Health:

Newborn Care Services Yes Yes Yes Yes

Promotion of exclusive breast feeding Yes Yes Yes Yes

Full Immunization of Children Yes Yes Yes Yes

Vitamin A prophylaxis Yes Yes Yes Yes

Assistance to school health services Yes Yes Yes Yes

Prevention & control of Childhood diseases Yes Yes Yes Yes

1.3 Family planning & Contraceptive:

IEC to ECs for adopting FP methods Yes Yes Yes Yes

Provision of contraceptives Yes Yes Yes Yes

Follow up services to Ecs adopting CCs Yes Yes Yes Yes

1.4 Counseling for safe abortion (MTP) & proper referral

Yes Yes Yes Yes

1.5 Assistance for School Health Services Yes Yes Yes Yes

1.6 Control of locally endemic diseases Yes Yes Yes Yes

1.7 Disease Surveillance & Control:

Surveillance of abnormal increase of cases No No Yes Yes

Weekly reporting of information on syndromes

surveillance

Yes Yes Yes Yes

High level of alertness for unusual events & action

No No No No

1.8 Water Quality Monitoring No No No No

Disinfections of water No No No No

testing of water quality No No No No

1.9 Promotion of sanitation & disposal of garbage Yes Yes No No

1.1 Curative Services

Treatment of minor ailments Yes Yes Yes Yes

Proper referral Yes Yes Yes Yes

Organizing Health days Yes Yes Yes Yes

Provide treatment as per AYUSH No No No No

Total

%age

43

2 Other Services Badanjee Kinjoly Dimarapal Alore

2.1 Support services

Availability of the Guidelines Yes Yes Yes Yes

Laboratory -Routine tests No No No No

Regular Skill development training/CME No No No No

IEC material No No No No

Waste disposal Yes Yes No No

2.2 Accessory Services

Availability of Regular Electricity Yes Yes Yes Yes

Availability of safe drinking Water Yes No No No

Telephone Yes Yes Yes Yes

Transport No No No No

Citizen's Charter Yes Yes Yes No

2.3 Others field activities Badanjee Kinjoly Dimarapal Alore

field visits Yes Yes Yes Yes

Community need assessment Yes Yes Yes Yes

Training No No No No

Records of vital events Yes Yes Yes Yes

2.40 National Health programme Badanjee Kinjoly Dimarapal Alore

NRHM Yes Yes Yes Yes

HIV/AIDS No No No No

NVBDCP Yes Yes Yes Yes

RNTCP Yes Yes Yes Yes

NLEP Yes Yes Yes Yes

NBCP Yes Yes Yes Yes

IDSP Yes Yes Yes Yes

NCD & Cancer Control No No No No

Total

%age

3 INFRASTRUCTURE

REQUIREMENTS: Badanjee Kinjoly Dimarapal Alore

3.1 Review by VH&SC

i Whether VH&SC are constituted Yes Yes Yes Yes

ii Whether the composition of the VH&SC is as the guidelines.

Yes Yes Yes Yes

iii Whether VH&SC are convening the

meeting regularly No No No No

iv If Yes, at what interval No No No No

v Whether Discussion as agenda are undertaken.

No No No No

vi Whether the Minutes of the meeting are

prepared and circulated to all the

concerned

No No No No

vii Whether the feed back on the minutes is

received. No No No No

viii Village Health day & Health camps are

organized

Yes Yes Yes Yes

44

3.2 Physical Infrastructure Badanjee Kinjoly Dimarapal Alore

I Building

SHCs located within locality Center Center Center Center

Government building for SHCs Yes Yes Yes Yes

Compound wall / Fencing gate Yes No No No

Residential facility for HW (F)? Yes Yes Yes Yes

Separate public utilities for M&F 1 1 Yes No

Plinth area (73.50 to 100.20 Mtrs) - 1200 sq. ft. Old 1500 sq. ft

Present condition of building. Good Good Good Good

Condition of plaster on walls Good Good Good Good

Condition of floor. Good Good Good Good

Whether the cleanliness is maintained Good Good Good Good

ii Waiting Area Badanjee Kinjoly Dimarapal Alore

Prominent display boards in local language Yes No Yes No

Visit Schedule of ANM Yes Yes Yes Yes

Suggestion / complaints box No No No No

Display of IEC material Yes Yes Yes Yes

Seating arrangements Yes Yes Yes Yes

iii Clinical Room Badanjee Kinjoly Dimarapal Alore

Examination table Yes Yes Condemn No

OPD Equipment (stethoscope, BP

apparatus, Weight Machine, etc) Yes Yes Yes Yes

Necessary furniture Yes No Yes Yes

iv Labour room available Badanjee Kinjoly Dimarapal Alore

Labour room available Yes Yes Yes Yes

Lithotomy table Yes Yes Yes Yes

Equipment trolly Yes Yes No No

Linen No No No No

Delivery Set No Yes Yes Yes

Suction apparatus Yes Yes Yes No

Newborn case set Yes Yes No No

v Residential Accommodation Badanjee Kinjoly Dimarapal Alore

Living Room - 2 1 1 1 2

Kitchen 1 1 1 1

W.C. 1 1 1 1

Bath Room 1 1 1 1

ANM Stays at Sub-center Yes Yes Yes Yes

HW(M) stays at Sub-center No No No No

3.3 Man power Badanjee Kinjoly Dimarapal Alore

ANM 1 1 1 1

Additional ANM N N N N

HW (Male) 1 1 1 1

AWW Yes No No No

ASHA Yes Yes Yes Yes

Volunteer Worker Yes No No No

Total

%age

LOGISTIC SUPPORT Badanjee Kinjoly Dimarapal Alore

45

3.4

I Equipments

OPD set Yes Yes Yes Yes

Delivery Set Yes Yes Yes Yes

IUD set Yes Yes Yes Yes

First Aid set Yes Yes Yes Yes

DDKs Yes Yes Yes Yes

Furniture Yes No Yes No

ii Drugs

Drug Kit-A (ORS, IFA, Vit.A,Co-tri) Yes Yes Yes Yes

Drug kit-B (Drugs related to delivery) Yes Yes Yes Yes

Additional drugs (used for sever infection) Yes Yes Yes Yes

Other Drugs & vaccine (UIP Vaccine) Yes Yes Yes Yes

NHP drugs (Malaria, MDT, DOT Yes Yes Yes Yes

Contraceptive supplies (Nirodh, OP, Cu.T) Yes Yes Yes Yes

AWW drug Kit No No No No

ASHA drug Kit No No No No

iii Referral Services

Provisions of referral Yes Yes Yes Yes

Total

%age

4 Funds allocated & Utilization

Un-Tied Funds of Rs. 10000/annum Yes Yes Yes Yes

Funds allocated & Utilization 500 3261 7072 4664

Funds utilized 9500 6739 2928 5336

% utilization 95% 67% 29% 53%

4 Field verifications

4.1 Field Verification CC Users

Sterilization Yes Yes Yes Yes

IUD Yes Yes Yes Yes

Oral Pill Yes Yes Yes Yes

Nirodh Yes Yes Yes Yes

4.2 Field verification of the Mothers

ANC Yes Yes Yes Yes

PNC Yes Yes Yes Yes

JSY mothers Yes Yes Yes Yes

4.3 Field Verification of the Children

5 Satisfaction studies

5.1 Client satisfaction Badanjee Kinjoly Dimarapal Alore

Client satisfaction towards ANM Yes Yes Yes Yes

Client satisfaction towards ASHA Yes Yes Yes No

Satisfaction of PRI

5.2 Job Satisfaction

SHC staff 2 2 2 1+1

PHC staff - - - -

CHC staff - - - -

6 Record Maintenance

Sl. No. Registers Maintained Badanjee Kinjoly Dimarapal Alore

46

I Eligible Couples Register Yes Yes Yes Yes

ii Maternal & Child Health Register Yes Yes Yes Yes

a Antenatal, Intra-natal, postnatal Yes Yes Yes Yes

b Under five Register - Immunization Yes Yes Yes Yes

c Under five Register - Growth Monitoring No No No No

iii Birth & Death Register Yes Yes Yes Yes

iv Drug Register Yes Yes Yes Yes

v Equipment/Furniture Register Yes Yes Yes Yes

vi Communicable diseases/ Epidemic Register Yes Yes Yes Yes

vii Passive surveillance register for malaria

cases Yes Yes Yes Yes

viii Register for record pertaining to JSY Yes No No No

ix Register for maintenance of account

including untied funds Yes Yes No -

x Register for water quality and sanitation No No Yes

xi Minor ailments Register OPD-Reg. OPD-Reg. OPD-Reg. OPD-Reg.

xii Records/registers as per various National

Health Programme guidelines Yes Yes Yes Yes

No of Register Maintained properly

% of Maintained properly

7 SPERVISION & MONITORING

Sl. No. Particulars

i HIS Established Badanjee Kinjoly Dimarapal Alore

Diseases are classified as per ICD-10

Pattern No No No Yes

Monthly Progress Report Format used Yes Yes No Yes

MPR received from all reporting units Yes Yes Yes Yes

MPR Summarized & Reviewed Yes Yes Yes Yes

Feedback on MPR given Yes Yes No Yes

ii Admin Monitoring

Monthly Reports submitted Yes Yes Yes Yes

Quarterly Reports submitted No No No Yes

Half yearly Reports submitted No No No No

Annual Reports Prepared Yes Yes Yes Yes

iii Int. Audit

Monthly Review meeting organized Yes Yes Yes Yes

Quarterly meeting organized No No No No

Half Yearly Review meeting Organized No No No No

Annual Meeting Organized Yes Yes Yes Yes

iv Medical Audit (# Deaths/complications

reported and reviewed iro)

Maternal Deaths No No No No

Child deaths No No No No

Malaria deaths No No No No

Tuberculosis Deaths No No No Yes

Others (specify) No No No No

v Supervisory visits by State/National

Prog. Manager Badanjee Kinjoly Dimarapal Alore

what was checked

47


what instructions were given

what administrative directions given

what follow up action taken

vi External Audit

Independent Review

Review by Expert Groups

8 Performance Indicators Badanjee Kinjoly Dimarapal Alore

I

# ECs using CCs methods for more than 6 months continuously. 10 4 5 7

ii # ANC mothers Registered 34 10 22 24

iii # Mothers gone through the delivery 16 13 17 20

iv # mothers have hospital deliveries 9 8 7 14

v # Children upto 23 months immunized 5 5 3 4

vi # Infant deaths - - - -

vii # Maternal Deaths - - - -

viii # Malaria cases treated 500/35 N.A. 23 + 5 267

ix # TB cases under treatment 1 Yes 1 5

x # Leprosy cases under treatment No No No No

xi

# cases blindness & refractive errors

treated No No No No

xii # HIV/AIDS cases under treatment No No No No

MONTHLY PERFORMANCE REPORT ON TECHNICAL ACTIVITIES FOR ROH&FW

INFORMATION ON SHCs

48

Name of the ROH&FW:


5.1. Field verification Children for fully immunization at SHCs

. Action points Badanjee Kinjoly Dimarapal Alore

1 Total beneficiaries selected 03 02 06 02

2 Total beneficiaries contacted 01 01 01 01

3 Beneficiaries could not be contacted due to

A) No such person living in the area.

B) Left the place temporarily.

C) Left the place permanently

D) Dead

E) Wrong /Incomplete address

F) Others

Total 01 01 01 01

4 No. of beneficiaries confirmed with full doses 01 01 01 01

5 No. of beneficiaries not confirmed with dose - - - -

6 Discrepancies in entries in the age of beneficiaries No No No No

7 Children have Complication after receiving the

services

No No No No

8 Satisfied with the services Yes Yes Yes Yes

5.2. Field verification of ANC and PNC mothers at SHCs

Sl. No. Action points Badanjee Kinjoly Dimarapal Alore

1 Total No of beneficiaries selected 02 02 02 02


3

Beneficiaries could not be contacted due to




D) Dead

E) Wrong/Incomplete address

F) Others

Total 02 02 02 02

4 Discrepancy in age of beneficiaries No No No No

5 TT received during the pregnancy No No No No

6 IFA tablet received during the pregnancy No No No No

7 IFA consumed as per instruction No No No No

8 Received three Ante natal check up No No No No

9 No of women have gone through delivery No No No No

9.1. No. of Instts Deliveries 01 01 01 01

10 DDK used during delivery Yes Yes Yes Yes

11 Child fed within 30 minute of delivery Yes Yes Yes No

12 Used colostrums as per advise No No No No

13 Exclusive Breast feeding Yes Yes Yes Yes

14 Three post natal check up No Yes Yes Yes

5.3. Field verification of JSY beneficiaries at SHCs


1 Total No of beneficiaries selected 02 02 02 02

49


3

Beneficiaries could not be contacted due to - - - -




D) Dead

E) Wrong/Incomplete address

F) Others

Total

4 Discrepancy in reporting of beneficiaries No No No No

5 TT received during the pregnancy Yes Yes Yes Yes

6 IFA tablet received during the pregnancy Yes Yes Yes Yes

7 IFA consumed as per instruction Yes Yes Yes Yes

8 Received three Ante natal check up Yes Yes Yes Yes

9 Three post natal check up Yes Yes Yes Yes

10 Monetary benefit under JSY Yes Yes Yes Yes

11 Satisfied with services Yes Yes Yes Yes

50

5.4. Field verification of Clients practicing Contraceptive methods – Sterilization


1 # of selected cases 01 01 01 01

2 # of contacted cases 01 01 01 01

3 Cases not contacted due to

a NSP

b IA/WA

h PO

d TO

e Others

Total

4 Discrepancy

a Age of acceptors No No No

b Age of spouse No No No

d No. of Total child No No No

e No.of Male child No No No

Total 0 0 0

5 Ineligible Cases No No No

6 Denial/ Fake No No No

a Denial cases No No No

b Fake cases No No No

c Double reported cases No No No

Total 0 0 0

7 Follow up by Staff out of found genuine cases yes yes yes

8 Pregnancy during the use of method out of found

genuine cases No No No

9 Complaints if any out of found genuine cases No No No

10 Satisfied with method out of found genuine cases yes yes yes

52

5.4. Field verification of Clients practicing Contraceptive methods – IUDs

Sl. No. Action points Badanjee Kinjoly

Dimarap

al Alore




A NSP

B IA/WA

H PO

D TO

E Others

Total

4 Discrepancy

A Age of acceptors No No No

B Age of spouse No No No

D No. of Total child No No No

E No.of Male child No No No

Total



A Denial cases No No No

B Fake cases No No No

C Double reported cases No No No

Total

7 Follow up by Staff out of found genuine cases Yes yes Yes


genuine cases

No No No


10 Satisfied with method out of found genuine cases Yes yes yes

53

5.4. Field verification of Clients practicing Contraceptive methods - Oral Pills





a NSP

b IA/WA

h PO

d TO

e Others

Total

4 Discrepancy





Total






Total



genuine cases

No No No



54

5.4. Field verification of Clients practicing Contraceptive methods – Condom





a NSP

b IA/WA

h PO

d TO

e Others

Total

4 Discrepancy





Total






Total



genuine cases

No No No



56

6.1. Community satisfaction of Mother for Work of ASHAs


1 ASHA visited mothers during period from pregnancy to

delivery yes

yes yes yes

2 Mothers Received three ANC yes yes yes yes

3 Mothers had some problem in last pregnancy

4 Mothers received timely advices for getting treatment yes yes yes yes

5 Institutional deliveries Home Inst Inst Inst

6 Babies weighed after birth

7 Mothers received three PNC yes yes yes yes

8 Mothers get information about proper breast feeding Yes yes Yes yes

9 Mothers have knowledge about the dangerous sign of

ARI.

No No No No

10 Mothers have knowledge about fluid that is to be given

during diarrhea

No No No No

11 Mothers have knowledge about the immunization given to

their child

yes yes yes No

12 Mothers nave knowledge about that the immunization

against measles given in the ninth month

No No No No

57

MONTHLY PERFORMANCE REPORT ON TECHNICAL ACTIVITIES FOR ROH&FW

INFORMATION ON community satisfaction

Name of the ROH&FW:



1 ANMs visited village regularly Yes Yes Yes Yes

2 Mothers had some problem in last pregnancy No No No No

3 Mothers received timely advices for getting treatment Yes Yes Yes Yes

4 Institutional deliveries House House Institute Institute

5 Babies weighed after birth NA NA NA NA

6 Mothers aware about JSY No No yes No

7 Mothers received three PNC Yes No Yes Yes

8 Mothers advised regarding colostrums No No Yes No

9 Mothers get information about proper breast feeding Yes Yes Yes Yes


ARI- No No No No

11 Mothers have knowledge about fluid that is to be given

during diarrhea Yes Yes Yes Yes

12 Mothers have knowledge about schedule of Child

immunization No No No No

13 Mothers aware about the disease for which immunization

given to their child - No No No No

14 Mothers aware about the immunization against measles to be given in the 9th month No No Yes No

15 Awareness of mothers about the contraceptive method - Oral Oral Yes Oral

16 Mothers aware about the side effect of the contraceptive. No No Yes No

17 Awareness about the ideal gap between two children 2 to 3 Years yes Yes 2 to 3 Years

58

Sl. No. 6.1. Community satisfaction of Mother for Work of

ASHAs Action points Badanjee Kinjoly Dimarapal Alore

1 ASHA visited mothers during period from pregnancy to

delivery No Yes Yes No

2 Mothers Received three ANC Yes Yes Yes Yes

3 Mothers had some problem in last pregnancy No No No No

4 Mothers received timely advices for getting treatment Yes Yes Yes Yes

5 Institutional deliveries Yes Yes Yes Yes

6 Babies weighed after birth Yes Yes Yes Yes

7 Mothers received three PNC Yes Yes Yes Yes

8 Mothers get information about proper breast feeding No No No No


ARI.

No No No No

10 Mothers have knowledge about fluid that is to be given during diarrhea

No No No No

11 Mothers have knowledge about the immunization given to

their child

No No No No

12 Mothers nave knowledge about that the immunization

against measles given in the ninth month

No No No No

60

6.1. Key Information from sarpanchs on the work of ANMs

Sl. No. Action points Badanjee Kinjoly

Dimara

pal Alore

No. of Pancvhayat Members contacted

1 Do you know about NRHM?

2 Activities of NRHM are smoothly functioning ?

3 Whether the JSY benefited to all the villagers?

4 Do you know about untied funds?

5 Do you have a Joint account with ANM in bank for

untied funds?

6 Is there proper utilization of untied funds?

7 Are the Villagers are benefited out of the untied funds?

8 In your village when and where the health camps are

organized?

9 Who is ASHA in your Village?

10 You know about the functioning of ASHA?

11 Know about the how many Link Worker are working in

your Village?

12 In your village whether the cases of Institutional

deliveries are increased?

13 Any Polio case found in your Village?

14 Is there regular immunization of children from time to

time in your Village?

form-iv regional offices of health & family welfare …

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