health facility assessment - punjab district...
TRANSCRIPT
Health Facility Assessment - Punjab
District Gujranwala
TRFTechnical Resource
Facility
i
Acknowledgement
TRF acknowledges the cooperation and support of Contech International Health
Consultants, Lahore who worked on the assignment and authored the report. The final
reports were quality assured by Jennifer Sanchos, HLSP Health Systems Consultant, and
Ms. Pamela Sequeira, M&E Specialist TRF.
Disclaimer
This document is issued for the party which commissioned it and for specific purposes
connected with the above-captioned project only. It should not be relied upon by any other
party or used for any other purpose.
We accept no responsibility for the consequences of this document being relied upon by any
other party, or being used for any other purpose, or containing any error or omission which is
due to an error or omission in data supplied to us by other parties.
June 2012
ii
Table of Contents
Acknowledgement ......................................................................................................... i
Acronyms .................................................................................................................... vii
Executive Summary ...................................................................................................... 1
Section 1: Introduction ................................................................................................. 3
Survey objectives ....................................................................................................... 3
Assignment duration .................................................................................................. 3
Scope of the HFA ....................................................................................................... 3
Report organisation .................................................................................................... 4
Section 2: District Information ..................................................................................... 5
Administrative setup ................................................................................................... 6
Demographic information ........................................................................................... 6
Socioeconomic and health indicators ......................................................................... 7
Section 3: Assessment of Functional Capacities ....................................................... 8
MNCH services .......................................................................................................... 8
Basic health units (BHUs) .......................................................................................... 9
Rural health centres (RHCs) .................................................................................... 12
Secondary health care (SHC) hospitals .................................................................... 16
Tehsil headquarter (THQ) hospitals.......................................................................... 22
Management basics ................................................................................................. 24
Human resources ................................................................................................ 24
Work coordination and supervision ...................................................................... 30
Management information system......................................................................... 32
Drugs and supplies ............................................................................................. 36
Fee for services ................................................................................................... 38
Infection control ................................................................................................... 42
Death review ....................................................................................................... 44
Facility utilization ...................................................................................................... 45
Well baby clinic ........................................................................................................ 50
Donor contributions .................................................................................................. 51
Clients’ perspective .................................................................................................. 53
Procurement estimates ............................................................................................ 54
Equipment ........................................................................................................... 54
Civil works ........................................................................................................... 55
iii
Section 4: Key Findings.............................................................................................. 56
Infrastructure ............................................................................................................ 56
Human resources ..................................................................................................... 56
Equipment ................................................................................................................ 57
Drugs and supplies .................................................................................................. 57
Support services ...................................................................................................... 58
Management basics ................................................................................................. 58
Donor contributions .................................................................................................. 59
Clients’ perspective .................................................................................................. 59
ANNEX 1 ...................................................................................................................... 61
District health department ............................................................................................. 61
ANNEX 2 ...................................................................................................................... 69
Input criteria for MNCH services.................................................................................... 69
ANNEX 3 - A................................................................................................................ 87
Status of surveyed health facilities against the minimal level of inputs .......................... 87
ANNEX 3 - B................................................................................................................. 95
List of items required for hospitals in district Gujranwala ............................................... 95
ANNEX 4 .................................................................................................................... 111
Scope of civil works required at hospitals .................................................................... 111
iv
List of Tables
Table 1.1: Scope of HFA ................................................................................................ 4
Table 2.1: Demographic profile ....................................................................................... 6
Table 2.2: Population groups .......................................................................................... 6
Table 2.3: Socio-economic and health indicators ............................................................ 7
Table 3.1: Status of assessed infrastructure in BHUs ................................................... 10
Table 3.2: Status of MNCH related staff in BHUs ......................................................... 11
Table 3.3: Status of functional equipment in BHUs ....................................................... 11
Table 3.4: Status of drugs and supplies in BHUs .......................................................... 12
Table 3.5: Status of support services in BHUs .............................................................. 12
Table 3.6: Status of assessed infrastructure in RHCs ................................................... 13
Table 3.7: Status of MNCH related staff in RHCs ......................................................... 14
Table 3.8: Status of functional equipment in RHCs ....................................................... 15
Table 3.9: Status of drugs and supplies in RHCs .......................................................... 15
Table 3.10: Status of support services in RHCs ............................................................ 16
Table 3.11: Status of assessed infrastructure in SHC hospitals .................................... 16
Table 3.12: Status of MNCH related staff in SHC hospitals .......................................... 20
Table 3.13: Status of functional equipment in SHC hospitals ........................................ 20
Table 3.14: Status of drugs and supplies in SHC hospitals ........................................... 21
Table 3.15: Status of support services in SHC hospitals ............................................... 21
Table 3.16: Status of assessed infrastructure in THQHs .............................................. 22
Table 3.17: Status of MNCH related staff in THQHs ..................................................... 23
Table 3.18: Status of functional equipment in THQHs .................................................. 23
Table 3.19: Status of drugs and supplies in THQHs ..................................................... 24
Table 3.20: Status of support services in THQHs ......................................................... 24
Table 3.21: Status of HR at SHC hospitals ................................................................... 25
Table 3.22: Status of HR at RHCs ................................................................................ 25
Table 3.23: Status of HR at surveyed BHUs ................................................................. 26
Table 3.24: Reasons for the non-availability of HR 24/7 at RHCs ................................. 27
Table 3.25: Reasons for the non-availability of HR 24/7 at SHC hospitals .................... 27
Table 3.26: Capacity building of MNCH related staff..................................................... 28
Table 3.27: Status of work coordination and supervision .............................................. 30
Table 3.28: Status of MIS ............................................................................................. 32
Table 3.29: Reasons for stock out reported by surveyed facilities................................. 36
Table 3.30: Status of fees for services .......................................................................... 38
Table 3.31: Mechanisms of social protection available ................................................. 41
Table 3.32: Status of infection control & waste management practices......................... 42
v
Table 3.33: Status of death reviews .............................................................................. 44
Table 3.34: Status of services’ utilization ...................................................................... 45
Table 3.35: Average monthly MNCH services provided ................................................ 46
Table 3.36: Average monthly family planning services provided ................................... 48
Table 3.37: Status of WBCs established....................................................................... 50
Table 3.38: Status of donor contributions ..................................................................... 51
Table 3.39: Clients’ perspective .................................................................................... 53
Table 3.40: Summary of estimated cost for procurement of equipment & civil works .... 55
Table 2.4: Number of public sector health facilities in the district .................................. 61
Table 2.5: Human resources in the office oF EDO-Health ............................................ 61
Table 2.6: Availability of MNCH services staffing in Gujranwala ................................... 62
Table 2.7: Financial allocations in district Gujranwala .................................................. 64
Table 2.8: NMNCHP monitoring indicators (Year 2010) ................................................ 64
Table 2.9: Number of facilities with staff provided by the NMNCHP .............................. 66
Table 2.10: Number of staff trained on delivering MNCH services ................................ 67
Table 2.11: Status of CMWs’ training and deployment ................................................. 67
vi
List of Figures
Figure 1: Map of Gujranwala .......................................................................................... 5
Figure 2: Comparison of district and provincial indicators ............................................... 7
Figure 3: Range of services that signal fully functional MNCH services.......................... 8
Figure 4: Status of management basics ....................................................................... 26
Figure 5: Level of satisfaction ....................................................................................... 54
Figure 6: Availability of medicines and lab services ...................................................... 54
vii
ACRONYMS
ANC Antenatal Care
AVD Assisted Vaginal Deliveries
BB technician Blood Bank Technician
BHU Basic Health Unit
CBA Child Bearing Age
CEI Client Exit Interview
CH Civil Hospital
CMW Community Midwives
CWAQ Civil Works Assessment Questionnaire
CDC Communicable Disease Control
DCO District Coordination Officer
DDCT District Data Collection Teams
DHO District Health Officer
DHDC District Health Development Centre
DHIS District Health Information System
DHQHH District Headquarter Hospital
DLQ District Level Questionnaire
EDOs Executive District Officers
EmONC Emergency Obstetric and Newborn Care
ENC Emergency Newborn Care
EAQ Equipment Assessment Questionnaire
EPI Expanded Programme of Immunisation
FP & PHC Family Planning and Primary Health Care
HF Health Facilities
HFA Health Facility Assessments
HID Health Institution Database
HIV Human Immunodeficiency Virus
HMIS Health Management Information System
HR Human Resource
IDI – EDOH In-depth Interview of EDO Health
IMNCI Integrated Management of Neonatal and Childhood Illnesses
IMPAC Integrated Management of Pregnancy and Childbirth
JD Job Description
LHS Lady Health Supervisor
LHV Lady Health Visitor
LHW Lady Health Worker
MDGs Millennium Development Goals
M&E Monitoring and Evaluation
MICS Multiple Indicator Cluster Survey
MIS Management Information System
MNCH Maternal, Neonatal and Child Health
viii
MO Medical Officer
NMNCHP National Maternal Newborn and Child Health Programme
NVD Normal Vaginal Deliveries
OBGYN Obstetrics and Gynaecology
OPD Out Patient Department
OT Operation Theatre
PC-1 Planning Commission Proforma – 1
PDHS Pakistan Demographic and Health Survey
PNC Post Natal Care
PPHI Peoples Primary Health Care Initiative
PSLM Pakistan Social & Living Standards Measurement Survey
RHC Rural Health Centre
SBA Skilled Birth Attendants
SD&MB Service Delivery and Management Basics
SE Socioeconomic
SHC hospitals Secondary Health Care
SPSS Statistical Package for the Social Sciences
TA Technical Assistance
THQH Tehsil Headquarter hospital
TRF Technical Resource Facility
TT Tetanus Toxoid
WMO Women Medical Officer
WBC Well Baby Clinics
1
Executive Summary
The health facility assessment 2011 (HFA) is aimed at assessing the availability, functioning,
and quality of health care services in the public sector health facilities, with a focus on
maternal, newborn and child health services. This report provides the findings of the HFA for
each surveyed health facility in the district. It is baseline information for the district and the
national maternal newborn and child health programme (NMNCHP), to set performance
benchmarks and realign activities for bridging the gaps existing in maternal newborn and
child health (MNCH) services for achieving the objectives of the programme.
The health facilities were also assessed for the availability of enabling factors necessary for
the delivery of MNCH services. An assessment criteria was formulated to ascertain gaps in
the availability of inputs1, including infrastructure, human resources (HR), drugs and
supplies, equipment and level specific support services at the individual facilities. Detailed
findings are given in Section 4 of the health facility assessment report.
In order to assess the perceptions of the clients, a total of 70 client exit interviews were
conducted at the DHQH, THQH and RHCs. The findings of the clients’ perspective, on the
quality of health care revealed, that all of the clients were satisfied with the care provided at
the public facilities.
As for infrastructure, the majority of the building components were available and functional.
Major gaps existed in the availability of a paediatric ward at all three THQHs; a paediatric
nursery at THQHs Kamonke Noshehra Virkan; a residence for the gynaecologist at all of the
SHC hospitals; a residence for the anaesthetist at THQHs Kamonke Noshehra Virkan; and a
residence for the paediatrician at DHQH Gujranwala and THQH Wazirabad.
Findings related to human resources revealed, that all of the BHUs had the required staff
available, but none of the RHCs and SHC hospitals had the required staff. Major gaps were
related to the lack of a WMO at RHC Wahndo; gynaecologist at THQH Noshehra Virkan; an
anaesthetist at THQHs Kamonke Noshehra Virkan and technicians at all levels of health
facilities.
The complete set of required equipment items was not available at any of the surveyed
facilities. Major gaps were related to the availability of general equipment at 15 BHUs; LHV
1 Optimal level of inputs are proposed in the Planning Commission Proformas – 1 (PC-1) of NMNCHP required to deliver level
specific MNCH services; Minimal level of inputs, are bare minimum requirement of the inputs for delivering level specific MNCH
services. More explanation of these inputs has been provided at the start of ‘Section 3’ of the report and contents of the criteria
are given in ‘Annexure 1’
2
room equipment at 3 RHCs; paediatric nursery equipment at THQHs Kamonke and
Noshehra Virkan and paediatric ward equipment at DHQH Gujranwala.
Drugs, supplies, vaccines and family planning commodities were assessed using a facility
specific list of tracer items, for their availability on the day of the survey and stock-out status
during the last one month. The complete range of items was not available at any of the
surveyed facilities. The most common reasons for being out of the stock of drugs were
having an insufficient budget and delayed supply.
The complete range of required inputs for the delivery of support services was not available
at most of the surveyed facilities.
All of the health facilities were conducting regular performance review meetings; but their
record was being maintained by only 4 of the facilities.
The district health information system (DHIS) was being practiced in district Gujranwala and
the available DHIS tools were being maintained at the surveyed facilities.
The complete range of inputs required for infection control practices was deficient at all of
the surveyed facilities.
A well baby clinic was found to be established at 4 of the surveyed facilities.
3
Section 1: Introduction
This section includes the survey objectives, its scope and duration and the organisation of
the district report.
Survey objectives
The HFA was aimed at assessing the availability, functioning and quality of the health care
delivery system, in the public sector facilities, with a focus on maternal, newborn and child
health services.
Some of the specific objectives of the HFA were:
• To assess the health facility status and quality of MNCH services (comprehensive
and basic EmONC, preventive MNCH and family planning) at district level;
• To assess the clients’ satisfaction and perception of MNCH services;
• To provide information for the systematic planning for procurement and supply of
goods and commodities (listing the medical equipment and instruments which need
to be replaced or purchased); and
• To update and assess the contributions made by the development partners for
improving MNCH and family planning services in the selected districts.
Assignment duration
The estimated duration of the assignment was 7 months. The assignment started in October
2010 and ended in May 2011.
Scope of the HFA
The survey included the district headquarter hospital (DHQH), tehsil/taluka headquarter
hospitals (THQHs), rural health centres (RHCs) and 20% of the basic health units (BHUs),
randomly selected within the district. The selection of the BHUs was done through
geographical stratification, on the basis of proportionate distribution. Client exit interviews
were conducted at the surveyed facilities (10 at the DHQH, 5 at each the THQHs and
RHCs), excluding the BHUs. Table 1.1 shows the numbers of health facilities in the district
and health facilities surveyed.
4
TABLE 1.1: SCOPE OF HFA
District Gujranwala Number of health facilities by type
DHQH THQH RHC BHU Total
Number of facilities 1 3 9 88 101
Number of facilities surveyed 1 3 9 18 31
Report organisation
The HFA district report has been structured in five sections. While the introduction to the
survey, its scope and duration is described in Section 1, Section 2 ‘District Information’
contains information collected from the district health department, using the district level
questionnaire (DLQ) as well as secondary data sources. It comprises of demographic,
economic and education related information.
Section 3: This section presents information about enabling factors, that are essential for
the maintenance of quality MNCH service availability, across all the levels of health care
institutions. The health facilities were assessed against the availability of 5 specified inputs
including infrastructure, human resources, equipment, drugs and supplies and the availability
of support services, (which would enable them to perform their level-specific services).
Information on management basics like work coordination, MIS etc., is also contained in this
section. The information presented in this section gives a snapshot in time, of the surveyed
health facilities. At the end, there is information about the satisfaction and perspective of the
clients, on the MNCH services provided at the public sector health facilities.
Section 4 comprises of the key findings of the HFA at district level and recommendations for
rectifying the deficiencies or discrepancies that were identified during the assessment.
5
Section 2: District Information
This section includes the district brief, information on demographic, socioeconomic and
health indicators. It also contains information on health resources and the NMNCHP
indicator compiled at district level. The data sources of the information are the EDOH office
using the district level questionnaire (DLQ) and published documents. The information
collected from the EDOH office may not match the subsequent tables containing similar
information collected from respective health facilities included in survey. It is recommended
that the discrepancy should be investigated by the competent authority.
Gujranwala city appears to be 500 years old. The first name of the settlement, according to
the compilers of the first edition of the district gazette was Khanpur Shansi. After an
individual of the Jat caste called Khan Shansi, who founded 11 villages in the nearby area.
When the Jat tribe Gujar occupied the land, the town came to be known as Gujranwala. The
total area of Gujranwala district is 3198 sq. Km. It is surrounded by the districts, Gujrat,
Hafizabad, and Sheikhupura. Gujranwala lies about 67 Km north of Lahore; and is situated
on both sides of the G.T. Road. Gujranwala is connected by rail and the grand trunk road
with Peshawar and Lahore.
FIGURE 1: MAP OF GUJRANWALA
6
Administrative setup
Like other districts in the province, Gujranwala is headed by the district coordination officer
(DCO) assisting the divisional commissioner and is accountable to him. The DCO is
appointed by the provincial government from the federal or provincial civil service. The DCO
coordinates with executive district officers (EDOs), who head each of the district offices
including health2.
Demographic information
Demographic information3 is given in the following tables.
TABLE 2.1: DEMOGRAPHIC PROFILE
Indicators Value Indicators Value
Total population 4.76 million Urban population 2,431,285
Population of tehsil Gujranwala 2,773,297 Rural population 2,334,028
Population of tehsil Wazirabad 838,335 Population density (persons
per sq.km) 1315
Population of tehsil Noshehra
Virkan 559,422
Sex ratio (number of males
over 100 females) at birth 104
Population of tehsil Kamonke 594,259 Population annual growth rate 2.85%
SOURCE: DHIS CELL – EDOH OFFICE
TABLE 2.2: POPULATION GROUPS
Population
groups
Standard
demographic
(%)
Estimated
population
Population
groups
Standard
demographic
(%)
Estimated
population
Under 1 year 2.70 128,663 Women 15-49
years 22.00 1,048,369
Under 5 years 13.40 638,552 Married women of child bearing age
(CBAs)
16.00 762,450
Under 15 years 41.97 2,000,002 Pregnant women 3.40 162,021
Expected births 2.9 138,194
SOURCE: PDHS 2006-07
2 www.paiman.org.pk
3 Projected figures for the year 2010.
7
Socioeconomic and health indicators
Selected socio-economic (SE) and health indicators are given in Table 2.3. The sources
include the multiple cluster indicators survey (MICS) 2008, Pakistan demographic and health
survey (PDHS) 2006-7, immunisation coverage evaluation survey Pakistan (CES) 2006-7.
TABLE 2. 3: SOCIO-ECONOMIC AND HEALTH INDICATORS
Indicators Value Indicators Value
District specific figures MICS 2007-08
Literacy rate 72% Malnutrition 27%
Income per capita* -
Infant mortality rate
(IMR)
67 per 1000 live
births % children<12 months fully
immunized
96% (EDOH)
Under 5 mortality rate
(U5MR)
95 per 1000 live
births 85% (CES)
Provincial figures PDHS 2006-07
Maternal mortality ratio 227 per 100,000
live births
* Data not available
FIGURE 2: COMPARISON OF DISTRICT AND PROVINCIAL INDICATORS
59
34
77
111
72
27
67
95
Literacy (%) Malnutrition (%) IMR (per 1,000 births) U5 MR (per 1,000 births)
Punjab Gujranwala
8
Section 3: Assessment of Functional Capacities
MNCH services
The packages of MNCH services assessed include preventive MNCH services at BHUs,
basic EmONC services at RHCs and comprehensive EmONC services at the THQH and
DHQ hospitals4. The range of MNCH services are given below.
FIGURE 3: RANGE OF SERVICES THAT SIGNAL FULLY FUNCTIONAL MNCH SERVICES
4 NMNCHP PC -1
BHUs: Facility
available for
RHCs: Facility
available for
DHQ/THQ
Hospitals: Facility
available for
8/6 Preventive
MNCH Services
1. Antenatal
checkup
2. Lab (Anemia,
Malaria,
pregnancy test,
urine test for
sugar & Protein)
3. Normal delivery
4. Family planning
services (at least
3 methods)
5. TT immunisation
6. EPI vaccination
7. Growth
monitoring
8. Nutrition
counseling
9. HR (at least one
LHV or Doctor)
24/7 Basic EmONC
Services
1. Parenteral
antibiotics
2. Parenteral
oxytocic drugs
3. Parenteral
anticonvulsants
for pregnancy
induced
convulsions (due
to hypertension)
4. Manual removal
of placenta
5. Removal of
retained products
6. Assisted vaginal
delivery (vacuum
extraction,
forceps)
7. Newborn
resuscitation
8. +
9. Post abortion
care
10. HR (skilled
female providers-
WMO and LHVs),
11. Preventive
MNCH
24/7
Comprehensive
EmONC services
1. Surgery (C-
section)
2. Blood transfusion
3. Newborn care
(resuscitation &
incubator)
4. +
5. Gynaecological
care
6. Comprehensive
family planning
services
including
sterilisation
7. HR (skilled staff
for conducting,
C-section, Blood
transfusion and
anaesthesia),
8. Preventive
MNCH and Basic
EmONC
9
The health facilities were assessed against the availability of 5 specified inputs which would
enable them to perform their level-specific services, which include:
1. Infrastructure
2. Human resources
3. Drugs and supplies
4. Equipment
5. Level specific support services
The health facility assessment findings are presented against two levels of inputs including:
1. Optimal level of inputs, these are those proposed in the PC-1 of the national MNCH
programme required to make a health facility ‘fully functional’ for the provision of level
specific package of MNCH services (Annex 2).
2. Minimal level of inputs, which are the bare minimum requirement of the inputs, required
for delivering the package specific MNCH services at the health facilities (Annex 1). The
findings related to the minimal level of inputs are given as Annex 2.
The following tables present the status of assessed facilities for the availability of the optimal
level of inputs.
Basic health units (BHUs)
The BHUs operating within district Gujranwala, were assessed for the provision of preventive
MNCH services, available for 8 hours a day, 6 days a week (8/6). Eighteen BHUs were
assessed for the availability of the optimal level of inputs, as summarised in Tables 3.1 – 3.5
by individual BHU.
The infrastructure of the BHUs has been assessed for the availability of an OPD, LHV room
and labour room, as service provision areas and residences for the accommodation of
required staff. OPD and LHV rooms have been assessed, as a single room having facilities
for consultation, examination and hand washing. A labour room, is also assessed as a single
room having the facilities for delivery, a scrub area and attached toilet facility for the patient.
The findings are presented as status of building components available and functional, in
Table 3.1.
10
TABLE 3.1 : STATUS OF ASSESSED INFRASTRUCTURE IN BHUS
Infrastructure
Sta
tus
Status of building components at surveyed BHUs
BH
U A
ttaw
a
BH
U B
ota
la S
hara
m S
ing
h
BH
U F
ero
zew
ala
BH
U G
on
dla
nw
ala
BH
U T
alw
an
di M
us
a K
han
BH
U D
an
dia
n
BH
U G
ull
ok
e
BH
U K
otl
i N
aw
ab
BH
U A
rtali
Vir
ka
n
BH
U B
ud
da G
ora
ya
BH
U J
all
an
BH
U K
ot
La
dh
a
BH
U N
ok
har
BH
U B
uc
ha
Ch
ata
h
BH
U H
ard
o S
ah
ara
n
BH
U J
au
ra S
ian
BH
U M
oh
ala
nk
e
BH
U N
oia
nw
ala
OPD
1. Consultation area
A Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Y Y Y
F Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Y Y Y
2. Examination area A N N N N N N N N N N N N N Y N N N N
F N N N N N N N N N Y N N N Y N N N N
3. Hand washing A N N N N N N N N N Y Y N N N Y N N N
F N N N N N N N N N N Y N N N Y N N N
LHV’s room
1. Consultation area
A Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
F Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
2. Examination area A N N N N Y Y Y N N N N N N N Y Y Y N
F N N N Y Y N Y N N N N N N N Y N Y N
3. Hand washing A N N N N Y N N Y N N N N N N Y N N N
F N N N N Y N N Y N N N N N N Y N N N
Labour room
1. Delivery room
A Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
F Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
2. Scrub area A Y Y Y N Y Y N N N N Y Y Y N N N N N
F Y Y Y N Y N N N N N Y Y N N N N N N
3. Patient’s wash
room
A N N N N N N N N N N N N N N N N N N
F N N N N N N N N N N N N N N N N N N
Residence
Doctor
A Y N N Y Y N Y N Y Y Y N N Y Y Y Y Y
F N N N N N N N N N N N N N N N Y Y N
Residence
LHV
A Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Y Y Y
F N N N N N N N N N N N Y N N N Y N N
Key: A=Available, F=Functional
A doctor or LHV is required for the provision of preventive MNCH services. The status of the
assessed BHUs for the availability of human resources (HR), (both regular posted and
provided by the NMNCHP), against the required number mentioned in PC-1 of NMNCHP, is
presented in Table 3.2.
11
TABLE 3.2: STATUS OF MNCH RELATED STAFF IN BHUS
Staff categories
Req
uir
ed
nu
mb
er
Number of MNCH related staff available at each BHU
BH
U A
ttaw
a
BH
U B
ota
la S
hara
m
Sin
gh
BH
U F
ero
zew
ala
BH
U G
on
dla
nw
ala
BH
U T
alw
an
di M
us
a
Kh
an
BH
U D
an
dia
n
BH
U G
ull
ok
e
BH
U K
otl
i N
aw
ab
BH
U A
rtali
Vir
ka
n
BH
U B
ud
da G
ora
ya
BH
U J
all
an
BH
U K
ot
La
dh
a
BH
U N
ok
har
BH
U B
uc
ha
Ch
ata
h
BH
U H
ard
o S
ah
ara
n
BH
U J
au
ra S
ian
BH
U M
oh
ala
nk
e
BH
U N
oia
nw
ala
WMO/ MO 1 1 1 1 1 1 0 0 0 1 1 1 0 1 0 2 1 1 0
LHV 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
The equipment items (general items, equipment for OPD and LHV room) for BHUs are listed
in PC-1 of NMNCHP. The status of the functional quantity of these items at assessed BHUs
is presented in Table 3.3.
TABLE 3.3: STATUS OF FUNCTIONAL EQUIPMENT IN BHUS
Eq
uip
men
t
To
tal it
em
s r
eq
uir
ed
at
each
BH
U
Number of functional equipment items available at each surveyed BHU
BH
U A
ttaw
a
BH
U B
ota
la S
hara
m S
ing
h
BH
U F
ero
zew
ala
BH
U G
on
dla
nw
ala
BH
U T
alw
an
di M
us
a K
han
BH
U D
an
dia
n
BH
U G
ull
ok
e
BH
U K
otl
i N
aw
ab
BH
U A
rtali
Vir
ka
n
BH
U B
ud
da G
ora
ya
BH
U J
all
an
BH
U K
ot
La
dh
a
BH
U N
ok
har
BH
U B
uc
ha
Ch
ata
h
BH
U H
ard
o S
ah
ara
n
BH
U J
au
ra S
ian
BH
U M
oh
ala
nk
e
BH
U N
oia
nw
ala
General items
3 0 0 1 0 0 0 0 0 0 0 0 1 2 0 0 0 0 0
OPD 14 5 9 10 9 9 7 7 10 5 7 8 11 10 9 10 6 8 10
LHV room
12 7 11 9 11 11 9 9 0 10 8 9 10 9 10 9 10 10 10
A list of essential drugs and supplies for MNCH services is contained in PC-1 of NMNCHP.
Tracer items were selected from the list (Annex 2), for assessing their availability at
surveyed facilities. The status of the surveyed BHUs, regarding the available quantity of
tracer items is presented in Table 3.4.
12
TABLE 3.4: STATUS OF DRUGS AND SUPPLIES IN BHUS
Item groups
To
tal it
em
s r
eq
uir
ed
at
each
BH
U Number of items available at each surveyed BHU
BH
U A
ttaw
a
BH
U B
ota
la S
hara
m S
ing
h
BH
U F
ero
zew
ala
BH
U G
on
dla
nw
ala
BH
U T
alw
an
di M
us
a K
han
BH
U D
an
dia
n
BH
U G
ull
ok
e
BH
U K
otl
i N
aw
ab
BH
U A
rtali
Vir
ka
n
BH
U B
ud
da G
ora
ya
BH
U J
all
an
BH
U K
ot
La
dh
a
BH
U N
ok
har
BH
U B
uc
ha
Ch
ata
h
BH
U H
ard
o S
ah
ara
n
BH
U J
au
ra S
ian
BH
U M
oh
ala
nk
e
BH
U N
oia
nw
ala
Supplies 6 5 5 5 3 4 6 5 3 1 3 3 5 5 2 2 4 2 1
Drugs 12 7 9 7 9 8 7 7 9 6 5 7 8 9 5 6 5 6 7
Vaccines 5 5 4 4 5 5 5 4 5 0 5 4 4 4 5 4 5 4 5
Family planning
commodities 6 4 4 0 5 0 1 4 3 3 3 4 1 4 5 0 4 1 0
The facility for basic laboratory tests (test strips and human resources) was assessed at
surveyed BHUs and their status is presented in Table 3.5.
TABLE 3.5: STATUS OF SUPPORT SERVICES IN BHUS
Support services
To
tal it
em
s r
eq
uir
ed
at
each
BH
U
Number of items available at each surveyed BHU
BH
U A
ttaw
a
BH
U B
ota
la S
hara
m S
ing
h
BH
U F
ero
zew
ala
BH
U G
on
dla
nw
ala
BH
U T
alw
an
di M
us
a K
han
BH
U D
an
dia
n
BH
U G
ull
ok
e
BH
U K
otl
i N
aw
ab
BH
U A
rtali
Vir
ka
n
BH
U B
ud
da G
ora
ya
BH
U J
all
an
BH
U K
ot
La
dh
a
BH
U N
ok
har
BH
U B
uc
ha
Ch
ata
h
BH
U H
ard
o S
ah
ara
n
BH
U J
au
ra S
ian
BH
U M
oh
ala
nk
e
BH
U N
oia
nw
ala
Basic lab tests
2 2 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1
Rural health centres (RHCs)
The RHCs operating within district Gujranwala, were assessed for the provision of basic
EmONC services, available for 24 hours a day, 7 days a week (24/7). Nine RHCs were
assessed for the availability of the optimal level of inputs, as summarised in Tables 3.6- 3.10
by individual RHC.
13
The infrastructure of the RHCs, has been assessed for the availability of an OPD, indoor
ward, LHV room, labour room and clinical laboratory, as service provision areas and the
residences for the accommodation of required staff. Service provision areas have been
assessed as a single room, having facilities like consultation, examination and hand washing
etc., as contained in Table 3.6. The findings are presented as the status of building
components available and functional.
TABLE 3.6: STATUS OF ASSESSED INFRASTRUCTURE IN RHCS
Infrastructure
Sta
tus
Status of building components at each RHC
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
OPD
1. Consultation area
A Y Y Y Y Y Y Y Y Y
F Y Y Y Y Y Y Y Y Y
2. Examination area A N N Y Y Y N N N N
F N N Y Y Y N N N N
3. Hand washing A N N Y Y N N Y Y N
F N N Y N N N Y Y N
Female ward
1. Patient area
A Y Y Y Y Y Y Y Y Y
F Y Y Y Y Y Y Y Y Y
2. Patient’s wash
room
A Y Y Y Y Y Y Y Y Y
F Y Y Y N Y Y Y N N
Labour room
1. Delivery room
A Y Y Y Y Y Y Y Y Y
F Y Y Y Y Y Y Y Y Y
2. Scrub area A Y Y Y Y Y N Y Y N
F Y Y Y Y Y N Y Y N
3. Patient’s wash
room
A Y Y Y Y Y Y Y Y Y
F Y Y Y Y Y Y Y Y N
Clinical lab
1. Laboratory room
A Y Y Y Y Y Y Y Y Y
F Y Y Y Y Y Y Y Y Y
2. Working area A N N Y Y Y N Y Y Y
F N N Y Y Y N Y Y Y
3. Patient’s wash
room
A Y Y Y Y Y Y Y Y Y
F Y Y Y N Y Y Y Y Y
LHV’s room
1. Consultation area
A Y Y Y Y N N Y Y Y
F Y Y Y Y N N Y Y Y
2. Examination area A N N Y N N N N N N
F N N Y N N N N N N
3. Hand washing A N N N N N N N Y Y
F N N N N N N N Y Y
Residence
Doctor
A Y Y Y Y Y Y Y Y N
F Y N N Y Y N N N N
14
Infrastructure
Sta
tus
Status of building components at each RHC
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
Residence
LHV
A Y Y Y Y Y Y Y Y Y
F Y N Y Y Y Y Y Y N
Key: A=Available, F=Functional
PC-1 of the NMNCHP, contains the category and number of staff required for basic EmONC
services. The status of the RHCs for the availability of human resources (both regular posted
and provided by NMNCHP), against the required numbers is presented in Table 3.7.
TABLE 3.7: STATUS OF MNCH RELATED STAFF IN RHCS
Staff categories Required number at each RHC
Number of MNCH related staff available at each RHC
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
WMO 2 1 2 2 1 1 2 1 2 0
LHV 2 3 3 4 2 3 2 2 3 3
Lab technician 1 0 1 1 1 1 1 1 1 0
Operation theatre technician
1 0 0 0 0 0 0 0 0 0
Ambulance driver 1 1 1 1 1 1 1 1 1 1
The equipment items, for various service components at RHCs are listed in PC-1 of the
NMNCHP. The status of the functional quantity of these items at RHCs, is presented in
Table 3.8.
15
TABLE 3.8: STATUS OF FUNCTIONAL EQUIPMENT IN RHCS
Equipment
Total items
required at
each RHC
Number of functional equipment items available at each RHC
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
General items 4 2 2 3 3 3 3 2 3 2
Female ward 9 8 5 4 6 5 7 5 6 2
WMO OPD 15 9 11 8 9 9 12 9 9 7
Labour room 19 16 14 7 11 13 11 18 14 13
LHV room 10 7 0 7 8 0 0 5 8 7
A list of essential drugs and supplies for MNCH services is contained in PC-1 of the
NMNCHP. Tracer items were selected from the list (Annex 2) for assessing their availability
at the surveyed facilities. The status of the surveyed RHCs, regarding the available quantity
of tracer items is presented in Table 3.9.
TABLE 3.9: STATUS OF DRUGS AND SUPPLIES IN RHCS
Item groups
Total items
required at
each RHC
Number of items available at each RHC
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
Supplies 6 5 6 6 6 6 6 4 4 4
Drugs 18 9 9 12 11 11 10 9 13 12
Vaccines 5 5 4 4 5 4 5 5 5 5
Family planning commodities
6 0 0 2 0 2 0 0 2 0
The facility for support services including basic laboratory tests (space, test strips and
human resources) and ambulance services (a functional vehicle and driver) was assessed at
the surveyed RHCs. The availability status of these services at RHCs, is presented in Table
3.10.
16
TABLE 3.10: STATUS OF SUPPORT SERVICES IN RHCS
Support services
Total items
required at
each RHC
Number of items available at each RHC
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
Basic lab tests 8 5 6 8 7 8 6 8 8 8
Ambulance service
2 2 2 2 2 2 2 2 2 2
Secondary health care (SHC) hospitals
The THQ and DHQ hospitals operating within district Gujranwala, were assessed for the
availability of inputs for functioning as a comprehensive EmONC facility, 24 hours a day, 7
days a week (24/7). A total of 4 secondary health care (SHC) hospitals, including 1 DHQ and
3 THQ hospitals, were assessed for the availability of the optimal level of inputs, as
summarised in Tables 3.11 – 3.15 by individual SHC hospital.
The infrastructure of the SHC hospitals has been assessed, for the availability of an OPD,
indoor wards, LHV room, labour room, operation theatre, paediatric nursery, blood bank,
ultrasound room and clinical laboratory, as service provision areas and residences for the
accommodation of required staff. Service provision areas have been assessed, for the
availability of essential space in respective areas e.g., consultation area, examination area
and hand washing in the OPD; patient area, nursing station, store rooms and attached
washrooms in indoor wards, etc., as contained in Table 3.11 The findings are presented as
the status of building components available and functional.
TABLE 3.11: STATUS OF ASSESSED INFRASTRUCTURE IN SHC HOSPITALS
Infrastructure Status
Availability of building components
DHHH
Gujranwala
THQH
Kamonke
THQH
Wazirabad
THQH
Noshehra
Virkan
OPD:
1. Consultation area
A Y Y Y Y
F Y Y Y Y
2. Examination area A N Y Y N
F N Y Y N
3. Privacy of examination area A N N N N
F N N N N
4. Hand washing A N Y N N
17
Infrastructure Status
Availability of building components
DHHH
Gujranwala
THQH
Kamonke
THQH
Wazirabad
THQH
Noshehra
Virkan
F N Y N N
Female ward:
1. Patient area
A Y Y Y Y
F Y Y Y Y
2. Nursing station A Y Y Y Y
F Y N Y Y
3. Patient’s washroom A Y Y Y Y
F Y Y Y N
4. Store for general items A Y Y Y Y
F Y Y Y Y
5. Store for equipment A N Y N N
F N Y N N
Labour room:
1. Delivery room
A Y Y Y Y
F Y Y Y Y
2. Preparation /stage room A N N N N
F N N N N
3. Scrub area A Y Y Y Y
F Y Y Y Y
4. Staff duty room A Y Y Y Y
F N N Y Y
5. Patient ‘s washroom A Y Y Y Y
F Y Y Y Y
6. Staff wash room A Y Y Y Y
F Y Y Y Y
7. Store for general items A Y Y Y Y
F Y Y Y Y
8. Store for equipment A Y N N N
F Y N N N
Operation theatre:
1. Patient preparation room
A N N N Y
F N N N Y
2. Operating room A Y Y Y Y
F Y Y Y Y
3. Recovery room A Y N Y Y
F Y N Y Y
4. Scrub area A Y Y Y Y
F Y N N Y
5. Sterilization area A Y Y Y Y
F Y Y Y Y
6. Doctor’s room A Y Y Y Y
F Y Y Y Y
7. Support staff duty room A Y N N N
F Y N N N
8. Store for general items A Y Y Y N
F Y Y Y N
18
Infrastructure Status
Availability of building components
DHHH
Gujranwala
THQH
Kamonke
THQH
Wazirabad
THQH
Noshehra
Virkan
9. Store for equipment A N N N N
F N N N N
10. Attached washroom for staff A Y N N N
F Y N N N
Paediatric ward:
1. Patient area
A Y N N N
F Y N N N
2. Nursing station A Y N N N
F Y N N N
3. Store for general
items/drugs or equipment
A Y N N N
F Y N N N
4. Patient’s washroom A Y N N N
F Y N N N
Paediatric nursery:
1. Patient area
A Y N Y N
F Y N Y N
2. Nursing station A Y N Y N
F Y N Y N
3. Store for general
items/drugs or equipment
A N N Y N
F N N Y N
4. Change room/area A N N N N
F N N N N
Clinical lab:
1. Laboratory room
A Y Y Y Y
F Y Y Y Y
2. Working area A Y Y N Y
F N Y N Y
3. Doctor’s duty room A Y N N N
F Y N N N
4. Store for general reagents
or equipment
A Y Y N N
F Y Y N N
5. Attached washroom A Y Y Y Y
F Y N Y Y
Blood bank:
1. Blood collection room
A Y Y Y Y
F Y Y Y Y
2. Working area A Y Y N N
F Y Y N N
3. Staff duty room A N N N N
F N N N N
4. Store for general reagents
or equipment
A Y N Y N
F Y N Y N
5. Attached washroom A Y Y Y Y
F Y N Y Y
19
Infrastructure Status
Availability of building components
DHHH
Gujranwala
THQH
Kamonke
THQH
Wazirabad
THQH
Noshehra
Virkan
LHV’s room:
1. Consultation area
A N Y N Y
F N Y N Y
2. Examination area A N Y N Y
F N Y N Y
3. Privacy for examination A N N N N
F N N N N
4. Hand washing facility A N Y N N
F N Y N N
Ultrasound room:
Examination area
A Y N Y Y
F Y N Y Y
Residence:
Gynaecologist
A N N N N
F N N N N
Residence:
Anaesthetist
A Y N Y N
F Y N Y N
Residence:
Paediatrician
A N Y N Y
F N Y N Y
Residence:
WMO
A N N Y N
F N N Y N
Residence:
LHV
A N N N N
F N N N N
Residence:
Nurses
A Y Y Y Y
F Y Y Y Y
Residence
Lab technician
A Y Y N Y
F Y Y N Y
Residence:
Blood bank technician
A N N Y N
F N N Y N
Residence:
Anaesthesia technician
A N N Y N
F N N Y N
Key: A=Available, F=Functional
PC-1 of the NMNCHP contains the category and number of staff required for comprehensive
EmONC services. The status of the SHC hospitals for the availability of human resources
(both regular posted and provided by NMNCHP), against the required numbers is presented
in Table 3.12.
20
TABLE 3.12: STATUS OF MNCH RELATED STAFF IN SHC HOSPITALS
Staff categories
Availability at DHQH Gujranwala
Availability at THQHs
Required number
Available number
Required number
Available number at
THQH Kamonke
Available number at
THQH Wazirabad
Available number at
THQH Noshehra
Virkan
Gynaecologist 2 3 1 1 2 0
Anaesthetist 2 2 1 0 1 0
Paediatrician 2 3 1 1 1 1
WMOs 6 28 4 0 0 2
Operation theatre technician
4 0 4 0 0 0
Blood bank technician
4 0 4 0 0 0
Lab technician 3 3 2 2 1 1
Anaesthesia technician
4 0 4 0 0 0
Nurses 20 158 12 12 12 14
LHVs 4 8 4 1 1 1
Ambulance drivers 4 7 4 1 1 2
The equipment items for various service components at SHC hospitals are listed in PC-1 of
the NMNCHP. The status of the functional quantity of these items at SHC hospitals, is
presented in Table 3.13.
TABLE 3.13: STATUS OF FUNCTIONAL EQUIPMENT IN SHC HOSPITALS
Equipment
Number of functional equipment items
available at DHQH Gujranwala
Number of functional equipment items available at THQHs
Total required
Items
Available items
Total required
Items
Available items at THQH Kamonke
Available items at THQH
Wazirabad
Available items at THQH
Noshehra Virkan
General items 4 3 4 3 3 3
Female ward 19 12 19 13 12 6
21
OPD 12 9 5 4 2 2
Paediatric nursery
13 9 13 0 8 0
Paediatric ward 10 0 10 7 3 6
Labour room 24 11 19 8 12 4
Operation theatre
31 23 31 23 25 17
Clinical laboratory
5 5 5 2 5 3
A list of essential drugs and supplies for MNCH services is contained in PC-1 of the
NMNCHP. Tracer items were selected from the list (Annex 2) for assessing their availability
at the surveyed facilities. The status of the SHC hospitals, regarding the available quantity of
tracer items is presented in Table 3.14.
TABLE 3.14: STATUS OF DRUGS AND SUPPLIES IN SHC HOSPITALS
Item groups Total
items
Number of items available at each SHC hospital
DHQH Gujranwala
THQH Kamonke
THQH Wazirabad
THQH Noshehra Virkan
Supplies 9 5 5 8 9
Drugs 21 9 9 13 13
Vaccines 5 5 5 5 4
Family planning commodities
7 6 0 3 0
The facility for support services including laboratory tests (space, test strips and human
resources), blood transfusion services (space, supplies and HR), ambulance services
(functional vehicle and driver), operation theatre (space, drugs and supplies, equipment
items and HR) was assessed at the surveyed SHC hospitals. The availability status of these
services at the SHC hospitals is presented in Table 3.15.
TABLE 3.15: STATUS OF SUPPORT SERVICES IN SHC HOSPITALS
Item groups Total
items
Number of items available at each SHC hospital
DHQH Gujranwala
THQH Kamonke
THQH Wazirabad
THQH Noshehra Virkan
Basic laboratory tests 17 16 11 10 11
Blood transfusion 5 4 3 5 4
22
Ambulance services 2 2 2 2 2
Radiology services 3 3 1 3 3
Operation theatre 62 46 38 47 35
Tehsil headquarter (THQ) hospitals
The THQ hospitals were also assessed for their capacity to provide 24/7 basic EmONC
services on similar inputs, as those used for the RHCs. The status of the THQ hospitals,
regarding the availability of inputs to deliver 24/7 basic EmONC services is presented in
Tables 3.16 – 3.20.
TABLE 3.16: STATUS OF ASSESSED INFRASTRUCTURE IN THQHS
Infrastructure Status
Availability of building components at THQHs
THQH Kamonke THQH Wazirabad THQH Noshehra
Virkan
OPD:
1. Consultation area
A Y Y Y
F Y Y Y
2. Examination area A Y Y N
F Y Y N
3. Hand washing A Y N N
F Y N N
Female ward:
1. Patient area
A Y Y Y
F Y Y Y
2. Patient’s washroom A Y Y Y
F Y Y N
Labour room:
1. Delivery room
A Y Y Y
F Y Y Y
2. Scrub area A Y Y Y
F Y Y Y
3. Patient’s washroom A Y Y Y
F Y Y Y
Clinical lab:
1. Laboratory room
A Y Y Y
F Y Y Y
2. Working area A Y N Y
F Y N Y
3. Attached washroom A Y Y Y
F N Y Y
LHV’s room: A Y N Y
23
Infrastructure Status
Availability of building components at THQHs
THQH Kamonke THQH Wazirabad THQH Noshehra
Virkan
1. Consultation area F Y N Y
2. Examination area A Y N Y
F Y N Y
3. Hand washing facility A Y N N
F Y N N
Residence:
WMO
A N Y N
F N Y N
Residence:
LHV
A N N N
F N N N
Key: A=Available, F=Functional
TABLE 3.17: STATUS OF MNCH RELATED STAFF IN THQHS
Staff categories Required number
Number of MNCH related staff available at THQHs*
THQH Kamonke THQH Wazirabad THQH Noshehra
Virkan
WMOs 2 0 0 2
LHV 2 1 1 1
Lab technician 1 2 1 1
OT technician 1 0 0 0
Ambulance driver 1 1 1 2
*Includes both regular and NMNCHP provided staff
TABLE 3.18: STATUS OF FUNCTIONAL EQUIPMENT IN THQHS
Equipment Total items
required at
each THQH
Number of functional equipment items available at THQHs
THQH Kamonke THQH Wazirabad THQH Noshehra
Virkan
General items 2 2 2 2
OPD 3 3 1 0
Female ward 6 5 2 4
Labour room 14 7 9 2
24
TABLE 3.19: STATUS OF DRUGS AND SUPPLIES IN THQHS
Item groups
Total items
required at each
THQH
Number of items available at THQHs
THQH Kamonke THQH Wazirabad THQH Noshehra
Virkan
Supplies* 6 4 5 6
Drugs* 18 8 10 13
Vaccines 5 5 5 4
Family planning commodities
6 0 3 0
* Tracer items were selected for assessment from list provided in the PC-1 NMNCHP
TABLE 3.20: STATUS OF SUPPORT SERVICES IN THQHS
Support services
Total items
required at each
THQH
Number of items available at THQHs
THQH Kamonke THQH Wazirabad THQH Noshehra
Virkan
Basic lab tests* 8 7 5 8
Ambulance service 2 2 2 2
*Includes facility for tests of pregnancy, haemoglobin, urine for protein and sugar, and malaria.
Management basics
The findings related to facility management basics are presented below:
Human resources
The filled posts of MNCH related staff at surveyed facilities, was assessed against the
sanctioned posts provided in the notified yard sticks of the provincial health department.
Posts for medical officers (MOs) and women medical officers (WMOs) are collectively
sanctioned, with a ratio of 3:1 for posting in clinical disciplines at the DHQH. Accordingly, a
gap in the filled positions of WMOs could be inferred at the DHQH.
The filled status of the staff categories, presented in the following tables, includes regular
posting only, as reported by the respective facility, on the day of the survey. The status of
human resource availability at each surveyed facility, is given in the Tables 3.21, 3.22 and
3.23.
25
TABLE 3.21: STATUS OF HR AT SHC HOSPITALS
Staff
Status of HR at DHQH
Status of HR at THQHs
DHQH Gujranwala S
THQH Kamonke
THQH Noshehra
Virkan
THQH Wazirabad
S F F F F
Gynaecologist 2 3 1 1 0 1
Anaesthetist 4 2 1 0 0 1
Paediatrician 2 3 1 1 1 1
WMO* 108 110 2 0 2 0
OT technician 0 0 0 0 0 0
Blood bank technician 0 0 0 0 0 0
Lab technician 3 3 1 2 1 1
Anaesthesia technician 0 0 0 0 0 0
Nurses 120 158 14 12 14 12
LHV 8 8 1 1 1 1
Ambulance drivers 6 7 2 1 2 1
Key: S= Sanctioned, F=Filled * Includes sanctioned and filled posts of both MOs and WMOs in DHQH.
TABLE 3.22: STATUS OF HR AT RHCS
Staff
Sanctioned
posts (at
each RHC)
Number of posts filled at RHCs
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
WMO 1 1 1 1 1 1 1 1 1 0
Lab technician 1 0 1 1 1 1 1 1 1 0
Nurse 2 6 6 6 6 6 6 6 5 6
LHVs 1 2 2 3 2 2 2 2 2 2
Ambulance
drivers 2 1 1 1 1 1 1 1 1 1
Key: S= Sanctioned, F=Filled
26
TABLE 3.23: STATUS OF HR AT SURVEYED BHUS
Staff
Sanctioned
posts (at
each BHU)
Number of posts filled at BHUs
BH
U A
rtali
Vir
ka
n
BH
U A
ttaw
a
BH
U B
ota
la S
hara
m S
ing
h
BH
U B
uc
ha
Ch
ata
h
BH
U B
ud
da G
ora
ya
BH
U D
an
dia
n
BH
U F
ero
zew
ala
BH
U G
on
dla
nw
ala
BH
U G
ull
ok
e
BH
U H
ard
o S
ah
ara
n
BH
U J
all
an
BH
U J
au
ra S
ian
BH
U K
ot
La
dh
a
BH
U K
otl
i N
aw
ab
BH
U M
oh
ala
nk
e
BH
U N
oia
nw
ala
BH
U N
ok
har
BH
U T
alw
an
di M
us
a K
han
WMO
/MO 1 1 1 1 0 1 0 1 1 0 1 1 1 0 0 1 0 1 1
LHV 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
The availability of job descriptions, service delivery protocols and staff as per duty roster was
assessed and the findings are presented in Figure 4.
FIGURE 4: STATUS OF MANAGEMENT BASICS
The reasons for the non-availability of staff on a 24/7 basis at the RHCs and SHCs are
provided in Tables 3.24 and 3.25.
0
2
4
6
8
10
12
14
16
18
DHQHTHQHs
RHCsBHUs
1
3
9
18
0 11
31 2
7
5
1
00
0
1
00
0
Total number
Availability of MNCH related job
descriptions (JDs)
Presence of duty staff
Availability of MNCH service
delivery protocols
Displayed MNCH service
delivery protocols
27
TABLE 3.24: REASONS FOR THE NON-AVAILABILITY OF HR 24/7 AT RHCS
Reasons for non-availability Status in RHCs
WMO LHV Ambulance driver
Residence not available 0 0 0
Residence available but damaged 1 0 0
Security reasons 0 0 0
Lack of basic amenities 0 0 0
TABLE 3. 25: REASONS FOR THE NON-AVAILABILITY OF HR 24/7 AT SHC HOSPITALS
Reasons for
non-
availability
Status of DHQ hospital Status of THQ hospital
Gyn
aec
olo
gis
t
An
ae
sth
eti
st
Pae
dia
tric
ian
Blo
od
ban
k
tec
hn
icia
n
Lab
bo
rato
ry
tec
hn
icia
n
W M
O
L H
V
Gyn
aec
olo
gis
t
An
ae
sth
eti
st
Pae
dia
tric
ian
Blo
od
ban
k
tec
hn
icia
n
Lab
bo
rato
ry
tec
hn
icia
n
W M
O
L H
V
Residence not available
0 0 0 0 0 0 0 1 1 0 0 0 0 0
Residence damaged
0 0 0 0 0 0 0 0 0 0 1 1 1 2
Security reasons
0 0 0 0 0 0 0 0 0 0 0 0 0 0
Lack of basic amenities
0 0 0 0 0 0 0 0 0 0 0 0 0 0
28
The list of health facilities having staff trained for providing MNCH services is presented in
Table 3.26.
TABLE 3.26: CAPACITY BUILDING OF MNCH RELATED STAFF
Health
facility
MNCH related training conducted
EmONC ENC IMNCI IMPAC FP surgical FP
counselling Client
centreedness
DHQH Gujranwala
Y Y N N N N N
THQH Kamonke
Y Y Y N N N N
THQH Noshehra
Virkan N N N N N N N
THQH Wazirabad
N N Y N N N N
RHC Ahmed Nagar
Y N Y N N N
RHC Ali Pur Chatta
Y N Y N N N
RHC Dounkal Y N N N N N
RHC Emin Abad
Y N Y N N N
RHC Gakhar Y Y Y N Y N
RHC Qila Didar Sing
N N N N Y N
RHC Rasool Nagar
Y N N N Y N
RHC Sohdra Y N Y N N N
RHC Wahndo N N N N N N
BHU Artali Virkan
N N N N N N
BHU Attawa N N N N Y N
29
Health
facility
MNCH related training conducted
EmONC ENC IMNCI IMPAC FP surgical FP
counselling Client
centreedness
BHU Botala Sharam Singh
N N N N N N
BHU Bucha Chatah
N N N N Y N
BHU Budda Goraya
Y N Y N N N
BHU Dandian N N N N N N
BHU Ferozewala
Y Y N N Y N
BHU Gondlanwala
Y N Y N N N
BHU Gulloke Y N Y N Y N
BHU Hardo Saharan
N N N N N N
BHU Jallan Y N N N N N
BHU Jaura Sian
Y N N N Y N
BHU Kot Ladha
N N N N N N
BHU Kotli Nawab
N N N Y Y N
BHU Mohalanke
Y N Y N N N
BHU Noianwala
Y N N N N N
BHU Nokhar N N N N N N
BHU Talwandi
Musa Khan Y N N N Y N
30
Work coordination and supervision
The health facilities in the district, were assessed for work coordination and supervisory
activities, including facility staff meetings, the participation of facility in-charges in district
level meetings and the conduction of supervisory visits and feedback by district health
managers. The findings of each surveyed health facility are presented in Table 3.27.
TABLE 3.27: STATUS OF WORK COORDINATION AND SUPERVISION
Health facility
Coordination and supervision
Regular facility PRM*
Participation in district PRM**
Monthly supervisory visit
Meeting held
Record maintained
Facility visited
Facility received visit feedback
DHQH Gujranwala Y N Y Y N
THQH Kamonke Y Y Y Y Y
THQH Noshehra Virkan
Y N Y Y N
THQH Wazirabad Y N Y Y N
RHC Ahmed Nagar Y Y Y Y N
RHC Ali Pur Chatta Y N Y Y N
RHC Dounkal Y N Y Y N
RHC Emin Abad Y N Y Y N
RHC Gakhar Y N Y Y N
RHC Qila Didar Sing Y N Y Y N
RHC Rasool Nagar Y N Y Y N
RHC Sohdra Y N Y Y N
RHC Wahndo Y N Y Y N
BHU Artali Virkan Y Y Y Y Y
BHU Attawa Y N Y Y N
31
Health facility
Coordination and supervision
Regular facility PRM*
Participation in district PRM**
Monthly supervisory visit
Meeting held
Record maintained
Facility visited
Facility received visit feedback
BHU Botala Sharam Singh
Y N Y Y Y
BHU Bucha Chatah Y N Y Y N
BHU Budda Goraya Y N Y Y N
BHU Dandian Y N Y Y N
BHU Ferozewala Y N Y Y Y
BHU Gondlanwala Y N Y Y N
BHU Gulloke Y N Y Y N
BHU Hardo Saharan Y N Y Y N
BHU Jallan Y N Y Y N
BHU Jaura Sian Y N Y Y N
BHU Kot Ladha Y N Y Y Y
BHU Kotli Nawab Y N Y Y N
BHU Mohalanke Y N Y Y N
BHU Noianwala Y N Y Y N
BHU Nokhar Y Y Y Y Y
BHU Talwandi Musa Khan
Y N Y Y N
* PRM=Performance Review Meeting
32
Management information system
District Gujranwala was practicing the district health information system (DHIS). The
surveyed facilities were assessed for the availability and maintenance of DHIS tools and the
findings are presented in Table 3.28.
TABLE 3.28: STATUS OF MIS
Health facility
OP
D t
icke
t
OP
D r
eg
iste
r
Mo
ther
he
alt
h r
eg
iste
r
Bir
th r
eg
iste
r
Ch
ild
he
alt
h r
eg
iste
r
Fa
mil
y p
lan
nin
g r
eg
iste
r
EP
I re
gis
ter
Meeti
ng
reg
iste
r
Med
icin
e s
toc
k r
eg
iste
r
Dail
y e
xp
en
se
reg
iste
r
DH
IS m
on
thly
re
po
rt
TB
re
gis
ter
Dis
eas
e e
arl
y w
arn
ing
sy
ste
m
DE
WS
ch
art
Gro
wth
mo
nit
ori
ng
reg
iste
r
MIS tools - Available
DHQH Gujranwala
Y Y Y Y Y Y Y Y Y Y Y Y N N Y
THQH Kamonke
Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
THQH Noshehra
Virkan Y Y Y Y Y Y Y Y Y Y Y Y N N Y
THQH Wazirabad
Y Y Y Y N Y Y Y Y Y Y Y N N Y
RHC Ahmed Nagar
Y Y Y Y Y Y Y Y Y Y Y Y N N Y
RHC Ali Pur Chatta
Y Y Y Y N Y Y Y Y Y Y Y N N Y
RHC Dounkal Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
RHC Emin Abad
Y Y Y Y Y Y Y Y Y Y Y Y Y N Y
RHC Gakhar Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
RHC Qila Didar Sing
Y Y Y Y N Y Y Y Y Y Y Y N N Y
RHC Rasool Nagar
Y Y Y Y Y Y Y Y Y Y Y Y N N Y
RHC Sohdra Y Y Y Y Y Y Y Y Y Y Y Y N N Y
33
Health facility
OP
D t
icke
t
OP
D r
eg
iste
r
Mo
ther
he
alt
h r
eg
iste
r
Bir
th r
eg
iste
r
Ch
ild
he
alt
h r
eg
iste
r
Fa
mil
y p
lan
nin
g r
eg
iste
r
EP
I re
gis
ter
Meeti
ng
reg
iste
r
Med
icin
e s
toc
k r
eg
iste
r
Dail
y e
xp
en
se
reg
iste
r
DH
IS m
on
thly
re
po
rt
TB
re
gis
ter
Dis
eas
e e
arl
y w
arn
ing
sy
ste
m
DE
WS
ch
art
Gro
wth
mo
nit
ori
ng
reg
iste
r
RHC Wahndo Y Y Y Y Y Y Y Y Y Y Y Y N N Y
BHU Artali Virkan
Y Y Y Y Y Y Y Y Y Y Y N N N Y
BHU Attawa Y Y Y Y N Y Y N Y Y Y Y N N N
BHU Botala Sharam Singh
Y Y Y Y Y Y Y Y Y Y Y Y N N Y
BHU Bucha Chatah
Y Y Y Y N Y Y N Y Y Y Y N N Y
BHU Budda Goraya
Y Y Y Y N Y Y N Y Y Y Y N N N
BHU Dandian Y Y Y Y Y Y Y Y Y Y Y N N N Y
BHU Ferozewala
Y Y Y Y Y Y Y Y Y Y Y Y N N Y
BHU Gondlanwala
Y Y Y Y Y Y Y Y Y Y Y Y N N Y
BHU Gulloke Y Y Y N N Y Y Y Y Y Y Y N N Y
BHU Hardo Saharan
Y Y Y Y N Y Y N Y Y N Y N N Y
BHU Jallan Y Y Y Y Y Y Y Y Y Y Y Y N N Y
BHU Jaura Sian
Y Y Y Y Y Y Y Y Y Y Y Y N N Y
BHU Kot Ladha
Y Y Y Y Y Y Y Y Y N Y Y N N Y
BHU Kotli Nawab
Y Y Y Y Y Y Y Y Y Y Y Y N N Y
34
Health facility
OP
D t
icke
t
OP
D r
eg
iste
r
Mo
ther
he
alt
h r
eg
iste
r
Bir
th r
eg
iste
r
Ch
ild
he
alt
h r
eg
iste
r
Fa
mil
y p
lan
nin
g r
eg
iste
r
EP
I re
gis
ter
Meeti
ng
reg
iste
r
Med
icin
e s
toc
k r
eg
iste
r
Dail
y e
xp
en
se
reg
iste
r
DH
IS m
on
thly
re
po
rt
TB
re
gis
ter
Dis
eas
e e
arl
y w
arn
ing
sy
ste
m
DE
WS
ch
art
Gro
wth
mo
nit
ori
ng
reg
iste
r
BHU Mohalanke
Y Y Y Y Y Y Y Y Y Y Y Y Y N Y
BHU Noianwala
Y Y Y Y Y Y Y N Y Y Y Y N N Y
BHU Nokhar Y Y Y Y Y Y Y Y Y Y Y Y N N Y
BHU Talwandi Musa Khan
Y Y Y Y Y Y Y Y Y Y Y Y N N Y
MIS tools – Maintained
DHQH Gujranwala
Y Y Y Y Y Y Y Y Y N Y Y N N
THQH Kamonke
Y Y Y Y Y Y Y Y Y Y Y Y Y N
THQH Noshehra
Virkan Y Y Y Y Y Y Y N Y Y Y Y N N
THQH Wazirabad
Y Y Y Y N Y Y Y Y Y Y Y N N
RHC Ahmed Nagar
Y Y Y Y Y Y Y Y Y Y Y Y N N
RHC Ali Pur Chatta
Y Y Y Y N Y Y Y Y Y Y Y N N
RHC Dounkal Y Y Y Y Y Y Y Y Y Y Y Y Y Y
RHC Emin Abad
Y Y Y Y Y Y Y N N Y Y Y N N
RHC Gakhar Y Y Y Y Y Y Y Y Y Y Y Y Y Y
RHC Qila Didar Sing
Y Y Y Y N N Y Y Y Y Y Y N N
RHC Rasool Nagar
Y Y Y Y Y Y Y N Y Y Y Y N N
35
Health facility
OP
D t
icke
t
OP
D r
eg
iste
r
Mo
ther
he
alt
h r
eg
iste
r
Bir
th r
eg
iste
r
Ch
ild
he
alt
h r
eg
iste
r
Fa
mil
y p
lan
nin
g r
eg
iste
r
EP
I re
gis
ter
Meeti
ng
reg
iste
r
Med
icin
e s
toc
k r
eg
iste
r
Dail
y e
xp
en
se
reg
iste
r
DH
IS m
on
thly
re
po
rt
TB
re
gis
ter
Dis
eas
e e
arl
y w
arn
ing
sy
ste
m
DE
WS
ch
art
Gro
wth
mo
nit
ori
ng
reg
iste
r
RHC Sohdra Y Y Y Y Y Y Y N Y Y Y Y N N
RHC Wahndo Y Y Y Y Y Y Y Y Y Y Y Y N N
BHU Artali Virkan
Y N N N N Y N Y Y N N N N N
BHU Attawa Y Y Y Y N Y Y N Y Y Y Y N N
BHU Botala Sharam Singh
Y Y Y Y Y Y Y Y Y Y Y Y N N
BHU Bucha Chatah
Y Y Y Y N Y Y N Y Y Y Y N N
BHU Budda Goraya
Y Y Y Y N Y Y N Y Y Y Y N N
BHU Dandian Y Y N Y Y Y Y N Y Y N N N N
BHU Ferozewala
Y Y Y Y Y Y Y Y Y Y Y Y N N
BHU Gondlanwala
Y Y N Y Y N Y Y Y Y Y Y N N
BHU Gulloke Y Y Y N N Y Y Y Y Y Y Y N N
BHU Hardo Saharan
Y Y Y Y N Y Y N Y Y N Y N N
BHU Jallan Y Y N Y N Y Y Y Y Y Y Y N N
BHU Jaura Sian
Y Y Y Y Y Y Y N Y Y Y Y N N
BHU Kot Ladha
Y N Y Y Y Y Y Y Y N N Y N N
36
Health facility
OP
D t
icke
t
OP
D r
eg
iste
r
Mo
ther
he
alt
h r
eg
iste
r
Bir
th r
eg
iste
r
Ch
ild
he
alt
h r
eg
iste
r
Fa
mil
y p
lan
nin
g r
eg
iste
r
EP
I re
gis
ter
Meeti
ng
reg
iste
r
Med
icin
e s
toc
k r
eg
iste
r
Dail
y e
xp
en
se
reg
iste
r
DH
IS m
on
thly
re
po
rt
TB
re
gis
ter
Dis
eas
e e
arl
y w
arn
ing
sy
ste
m
DE
WS
ch
art
Gro
wth
mo
nit
ori
ng
reg
iste
r
BHU Kotli Nawab
Y Y Y Y N Y Y N N Y Y Y N N
BHU Mohalanke
Y Y Y Y Y Y Y Y Y Y Y Y N N
BHU Noianwala
Y Y Y Y Y Y Y N Y Y N Y N N
BHU Nokhar N Y Y Y Y Y N Y Y Y Y N N N
BHU Talwandi Musa Khan
Y Y Y Y Y Y Y Y Y Y Y Y N N
Drugs and supplies
The availability of drugs and supplies has been described under individual MNCH service
packages. The reasons for their non-availability were identified at the surveyed facilities and
presented in the Table 3.29.
TABLE 3.29 : REASONS FOR STOCK OUT REPORTED BY SURVEYED FACILITIES
Health facilities
citing running out
of stock
Reasons for running out of stock
Po
or
qu
an
tifi
cati
on
Dela
ye
d d
em
an
d
su
bm
issio
n
Un
av
ail
ab
ilit
y o
f b
uff
er
sto
ck
Lac
k o
f s
tora
ge
cap
acit
y
Dela
ye
d s
up
ply
Un
der
su
pp
ly
No
pro
cu
rem
en
t p
ow
ers
Ins
uff
icie
nt
bu
dg
et
Lac
k o
f c
old
-
ch
ain
DHQH Gujranwala N N N N Y Y N N N
THQH Kamonke N N N N Y Y N N N
THQH Noshehra Virkan
N N N N N Y N N N
THQH Wazirabad N N N N N N N Y N
37
Health facilities
citing running out
of stock
Reasons for running out of stock
Po
or
qu
an
tifi
cati
on
Dela
ye
d d
em
an
d
su
bm
issio
n
Un
av
ail
ab
ilit
y o
f b
uff
er
sto
ck
Lac
k o
f s
tora
ge
cap
acit
y
Dela
ye
d s
up
ply
Un
der
su
pp
ly
No
pro
cu
rem
en
t p
ow
ers
Ins
uff
icie
nt
bu
dg
et
Lac
k o
f c
old
-
ch
ain
RHC Ahmed Nagar N N N N N Y N Y N
RHC Ali Pur Chatta N N N N N N N Y N
RHC Dounkal N N N N N Y N Y N
RHC Emin Abad N N N N N N N Y N
RHC Gakhar N N N N N Y N Y Y
RHC Qila Didar Sing N N N N Y N N Y N
RHC Rasool Nagar N N N N Y Y N Y N
RHC Sohdra N N N N N N N Y N
RHC Wahndo N N N N N Y N Y N
BHU Artali Virkan N N N N N Y N N N
BHU Attawa N N N N N N N N Y
BHU Botala Sharam Singh
N N N N N Y N N N
BHU Bucha Chatah N N N N N Y N Y N
BHU Budda Goraya N N N N N Y N N N
BHU Dandian N N N N N Y N N N
BHU Ferozewala N N N N N Y N N N
BHU Gondlanwala N N N N N Y N N N
BHU Gulloke N N N N N Y N N N
BHU Hardo Saharan N N N N N Y N N N
38
Health facilities
citing running out
of stock
Reasons for running out of stock
Po
or
qu
an
tifi
cati
on
Dela
ye
d d
em
an
d
su
bm
issio
n
Un
av
ail
ab
ilit
y o
f b
uff
er
sto
ck
Lac
k o
f s
tora
ge
cap
acit
y
Dela
ye
d s
up
ply
Un
der
su
pp
ly
No
pro
cu
rem
en
t p
ow
ers
Ins
uff
icie
nt
bu
dg
et
Lac
k o
f c
old
-
ch
ain
BHU Jallan N N N N Y Y N N N
BHU Jaura Sian N N N N Y N N N N
BHU Kot Ladha N N N N N Y N Y N
BHU Kotli Nawab N N N N N Y N N N
BHU Mohalanke N N N N N Y N N N
BHU Noianwala N N N N N Y N N N
BHU Nokhar Y N N N Y N N N N
BHU Talwandi Musa Khan
N N N N Y Y N N N
Fee for services
The charging of a fee for MNCH services and availability of social protection mechanisms for
the poor were assessed at surveyed facilities and their findings are presented in Table 3.30
and 3.31.
TABLE 3.30: STATUS OF FEES FOR SERVICES
Health facilities
where services
are charged
Services provided free of cost
OPD Indoor
Am
bu
lan
ce s
erv
ices
OP
D t
icke
t
OP
D la
bo
rato
ry
OP
D u
ltra
so
un
d
OP
D X
-ra
ys
OP
D m
ed
icin
es
Ad
mis
sio
n f
ee
Ward
be
d
Inp
ati
en
t la
bo
rato
ry
Inp
ati
en
t u
ltra
so
un
d
Inp
ati
en
t X
-ray
s
Blo
od
gro
up
ing
&
cro
ss m
atc
hin
g
Inp
ati
en
t m
ed
icin
es
DHQH Gujranwala N N N N Y N N Y Y Y Y Y N
THQH Kamonke N N Y N Y N N Y Y Y Y Y N
39
Health facilities
where services
are charged
Services provided free of cost
OPD Indoor
Am
bu
lan
ce s
erv
ices
OP
D t
icke
t
OP
D la
bo
rato
ry
OP
D u
ltra
so
un
d
OP
D X
-ra
ys
OP
D m
ed
icin
es
Ad
mis
sio
n f
ee
Ward
be
d
Inp
ati
en
t la
bo
rato
ry
Inp
ati
en
t u
ltra
so
un
d
Inp
ati
en
t X
-ray
s
Blo
od
gro
up
ing
&
cro
ss m
atc
hin
g
Inp
ati
en
t m
ed
icin
es
THQH Noshehra Virkan
N N Y N Y N N N Y N Y N Y
THQH Wazirabad N N Y N Y N N N Y N N N N
RHC Ahmed Nagar
N N N N Y N N N N N Y N
RHC Ali Pur Chatta
N N Y N Y N N N Y N Y N
RHC Dounkal N N Y N Y N N N Y Y Y N
RHC Emin Abad N N Y N Y N N N Y N Y N
RHC Gakhar N N Y N Y N N Y Y Y Y Y
RHC Qila Didar Sing
N N Y N Y N N N Y N Y N
RHC Rasool Nagar
N N Y N Y N N N Y N Y N
RHC Sohdra N N Y N Y N Y Y Y N Y N
RHC Wahndo N N N N Y N N Y N N Y N
BHU Artali Virkan N N Y
BHU Attawa N N Y
BHU Botala Sharam Singh
N N Y
BHU Bucha Chatah
N N Y
BHU Budda Goraya
N N Y
40
Health facilities
where services
are charged
Services provided free of cost
OPD Indoor
Am
bu
lan
ce s
erv
ices
OP
D t
icke
t
OP
D la
bo
rato
ry
OP
D u
ltra
so
un
d
OP
D X
-ra
ys
OP
D m
ed
icin
es
Ad
mis
sio
n f
ee
Ward
be
d
Inp
ati
en
t la
bo
rato
ry
Inp
ati
en
t u
ltra
so
un
d
Inp
ati
en
t X
-ray
s
Blo
od
gro
up
ing
&
cro
ss m
atc
hin
g
Inp
ati
en
t m
ed
icin
es
BHU Dandian N N Y
BHU Ferozewala N N Y
BHU Gondlanwala N N Y
BHU Gulloke N N Y
BHU Hardo Saharan
N N Y
BHU Jallan N N Y
BHU Jaura Sian N N Y
BHU Kot Ladha N N Y
BHU Kotli Nawab N N Y
BHU Mohalanke N N Y
BHU Noianwala N N Y
BHU Nokhar N N Y
BHU Talwandi Musa Khan
N N Y
41
TABLE 3.31: MECHANISMS OF SOCIAL PROTECTION AVAILABLE
Health facilities with available
social protection
Social protection mechanism
Zakat Bait-ul-Maal Patient welfare society
DHQH Gujranwala Y Y Y
THQH Kamonke N N N
THQH Noshehra Virkan N N Y
THQH Wazirabad N N Y
RHC Ahmed Nagar N N N
RHC Ali Pur Chatta N N N
RHC Dounkal N N N
RHC Emin Abad N N N
RHC Gakhar N N N
RHC Qila Didar Sing N N N
RHC Rasool Nagar N N N
RHC Sohdra N N N
RHC Wahndo N N N
BHU Artali Virkan N N N
BHU Attawa N N N
BHU Botala Sharam Singh N N N
BHU Bucha Chatah N N N
BHU Budda Goraya N N N
BHU Dandian N N N
BHU Ferozewala N N N
BHU Gondlanwala N N Y
BHU Gulloke N N N
BHU Hardo Saharan N N N
BHU Jallan N N N
BHU Jaura Sian N N N
BHU Kot Ladha N N N
BHU Kotli Nawab N N N
BHU Mohalanke N N N
42
Health facilities with available
social protection
Social protection mechanism
Zakat Bait-ul-Maal Patient welfare society
BHU Noianwala N N N
BHU Nokhar N N N
BHU Talwandi Musa Khan N N N
Infection control
The health facilities were assessed for practices of infection control and waste management,
and the availability of related material. The findings from the individually surveyed facilities
are presented in Table 3.32.
TABLE 3.32: STATUS OF INFECTION CONTROL & WASTE MANAGEMENT PRACTICES
Health facilities
Availability of materials Infection control practices
Wa
ste
man
ag
em
en
t p
lan
Wa
ste
co
lle
cti
on
ma
teri
als
Pers
on
al p
rote
cti
on
mate
rials
Wa
ste
tre
atm
en
t eq
uip
men
t
Fu
ncti
on
al
incin
era
tors
Han
d w
ash
ing
pra
cti
ce
s o
f H
CP
Dis
infe
cti
on
of
serv
ice p
rovis
ion
are
a
Hep
B v
ac
cin
ati
on
of
sta
ff
Wa
ste
se
gre
gati
on
Dis
po
sal
of
wa
ste
th
rou
gh
bu
rnin
g
Dis
po
sal th
rou
gh
th
row
ing
-aw
ay
Dis
po
sal th
rou
gh
mu
nic
ipal
arr
an
ge
me
nt
DHQH Gujranwala Y N N N N N Y N N Y N N
THQH Kamonke N N N N N N Y Y N Y N N
THQH Noshehra Virkan
N N N N N N Y Y N Y N N
THQH Wazirabad N N N N N N Y N N Y N N
RHC Ahmed Nagar N N N N N Y Y N N N
RHC Ali Pur Chatta N N N N N Y Y N N N
RHC Dounkal N N N N Y Y N N N N
RHC Emin Abad N N N N N Y N N N N
RHC Gakhar N N N N N Y N N N N
43
Health facilities
Availability of materials Infection control practices
Wa
ste
man
ag
em
en
t p
lan
Wa
ste
co
lle
cti
on
ma
teri
als
Pers
on
al p
rote
cti
on
mate
rials
Wa
ste
tre
atm
en
t eq
uip
men
t
Fu
ncti
on
al
incin
era
tors
Han
d w
ash
ing
pra
cti
ce
s o
f H
CP
Dis
infe
cti
on
of
serv
ice p
rovis
ion
are
a
Hep
B v
ac
cin
ati
on
of
sta
ff
Wa
ste
se
gre
gati
on
Dis
po
sal
of
wa
ste
th
rou
gh
bu
rnin
g
Dis
po
sal th
rou
gh
th
row
ing
-aw
ay
Dis
po
sal th
rou
gh
mu
nic
ipal
arr
an
ge
me
nt
RHC Qila Didar
Sing N N N N N Y N N N N
RHC Rasool Nagar N N N N N N Y N N N
RHC Sohdra N N N N N Y N N N N
RHC Wahndo N N N N Y Y N N N N
BHU Artali Virkan N N N N N N Y N N N
BHU Attawa Y N N N Y Y Y N N N
BHU Botala
Sharam Singh Y N N Y Y Y Y N N Y
BHU Bucha Chatah N N N N N Y Y N N N
BHU Budda Goraya N N N N N Y Y N N N
BHU Dandian Y N N N Y Y Y N N N
BHU Ferozewala Y N N N Y Y Y N N N
BHU Gondlanwala N N N N N Y Y N N N
BHU Gulloke Y N N N N Y Y N N N
BHU Hardo
Saharan N N N N N Y Y N N N
BHU Jallan N N N N N Y Y N N N
BHU Jaura Sian N N N N N N N N N N
BHU Kot Ladha Y N N N N Y Y N N N
BHU Kotli Nawab Y N N N Y Y N N N N
BHU Mohalanke N N N N N Y N N N N
44
Health facilities
Availability of materials Infection control practices
Wa
ste
man
ag
em
en
t p
lan
Wa
ste
co
lle
cti
on
ma
teri
als
Pers
on
al p
rote
cti
on
mate
rials
Wa
ste
tre
atm
en
t eq
uip
men
t
Fu
ncti
on
al
incin
era
tors
Han
d w
ash
ing
pra
cti
ce
s o
f H
CP
Dis
infe
cti
on
of
serv
ice p
rovis
ion
are
a
Hep
B v
ac
cin
ati
on
of
sta
ff
Wa
ste
se
gre
gati
on
Dis
po
sal
of
wa
ste
th
rou
gh
bu
rnin
g
Dis
po
sal th
rou
gh
th
row
ing
-aw
ay
Dis
po
sal th
rou
gh
mu
nic
ipal
arr
an
ge
me
nt
BHU Noianwala N N N N N N N N N N
BHU Nokhar Y N N N N Y Y N N N
BHU Talwandi
Musa Khan N N N N N Y Y N N N
Death review
The findings related to the availability and functioning of death review committees are
presented in Table 3.33.
TABLE 3.33: STATUS OF DEATH REVIEWS
Health facility
Status of death review
Death review
committee available
Maternal deaths Neonatal deaths
Annual number Reviewed by committee
Annual number Reviewed by committee
DHQH Gujranwala Y 9 0 318 0
THQH Kamonke Y 1 0 0 0
THQH Noshehra Virkan
N 0 0 0 0
THQH Wazirabad N 18 0 0 0
RHC Ahmed Nagar N 0 0 0 0
RHC Ali Pur Chatta Y 0 0 0 0
RHC Dounkal Y 0 0 0 0
45
Health facility
Status of death review
Death review
committee available
Maternal deaths Neonatal deaths
Annual number Reviewed by committee
Annual number Reviewed by committee
RHC Emin Abad N 0 0 0 0
RHC Gakhar N 0 0 0 0
RHC Qila Didar Sing N 0 0 0 0
RHC Rasool Nagar N 0 0 0 0
RHC Sohdra N 0 0 0 0
RHC Wahndo N 0 0 0 0
Facility utilization
The findings related to services utilization at the surveyed facilities are given as a monthly
aggregate from July to December 2010. The annual utilization for the year 2010 and facility-
wise average monthly utilization are presented in Tables 3.34, 3.35 and 3.36.
TABLE 3.34: STATUS OF SERVICES’ UTILIZATION
Type of service
Monthly utilization (July to December 2010) Annual utilization
(2010) July Aug Sep Oct Nov Dec
1st Antenatal care visits (ANC-1) 4,655 5,430 5,148 6,050 5,053 5,115 43,077
Normal vaginal deliveries 804 778 780 798 776 780 8,017
Assisted vaginal deliveries 2 3 1 3 3 6 35
C-sections 209 247 323 324 231 228 2,717
1st Postnatal care visits (PNC-1) 813 664 799 855 926 957 9,988
Pregnant women given TT2 vaccine
2,470 2,548 2,417 2,496 2,216 2,297 29,246
Family planning services 1,155 1,296 986 1,264 1,088 1,339 14,771
Diarrhoea/dysentery cases treated (< 5 years of age)
2,537 2,915 3,305 2,603 1,760 1,796 26,497
46
Type of service
Monthly utilization (July to December 2010) Annual utilization
(2010) July Aug Sep Oct Nov Dec
Pneumonia cases treated (< 5 years of age)
379 547 368 393 763 693 5,790
TABLE 3.35: AVERAGE MONTHLY MNCH SERVICES PROVIDED
Health facility
Average monthly utilization
ANC -1 NVD Assisted
VD C –
section PNC -1 TT2
Diarrhoea/
dysentery (in <5 yr)
Pneumonia (in <5 yr)
DHQH Gujranwala
1,332 374 0 220 283 158 264 27
THQH Kamonke
642 79 0 1 19 280 70 23
THQH Noshehra
Virkan 221 14 0 0 22 310 103 14
THQH Wazirabad
385 44 0 40 74 73 101 59
RHC Ahmed Nagar
169 17 0 0 25 48 44 0
RHC Ali Pur Chatta
197 19 0 0 18 72 123 45
RHC Dounkal
103 21 0 0 11 38 157 38
RHC Emin Abad
290 27 0 0 8 158 265 42
RHC Gakhar 252 16 0 0 11 130 52 0
RHC Qila Didar Sing
355 22 0 0 105 100 84 3
RHC Rasool Nagar
123 8 0 0 9 58 126 6
RHC Sohdra 91 18 0 0 18 47 47 0
RHC Wahndo
124 20 0 0 13 51 9 0
47
BHU Artali Virkan
45 4 0 0 3 59 42 1
BHU Attawa 61 5 0 0 17 34 69 137
BHU Botala Sharam Singh
67 24 0 0 27 44 23 0
BHU Bucha Chatah
47 3 0 0 5 59 70 0
BHU Budda Goraya
70 5 0 0 16 59 49 0
BHU Dandian
44 2 0 0 2 42 13 0
BHU Ferozewala
61 5 0 0 12 26 42 9
BHU Gondlanwala
40 2 0 0 2 37 18 10
BHU Gulloke 29 2 0 0 4 11 31 5
BHU Hardo Saharan
21 4 0 0 9 31 78 9
BHU Jallan 49 3 0 0 9 67 15 4
BHU Jaura Sian
101 19 0 0 43 37 48 8
BHU Kot Ladha
51 6 0 0 6 66 22 2
BHU Kotli Nawab
71 3 0 0 9 43 0 0
BHU Mohalanke
21 4 0 0 17 140 289 0
BHU Noianwala
30 7 0 0 19 28 38 25
BHU Nokhar 48 2 3 0 5 65 52 58
BHU Talwandi
Musa Khan 107 11 0 0 19 40 142 0
48
TABLE 3.36: AVERAGE MONTHLY FAMILY PLANNING SERVICES PROVIDED
Health facility
Average monthly utilization of family planning services
COC POP DPMA Net-en Condoms IUCDs Implants
Surgical (Tubal
ligation+ vasectomy)
DHQH Gujranwala
277 80 32 32 27 1,526 41 63
THQH Kamonke
40 13 0 11 0 7 7 0
THQH Noshehra
Virkan 39 8 5 3 4 118 7 1
THQH Wazirabad
31 4 1 7 2 12 2 0
RHC Ahmed Nagar
26 6 0 5 3 5 7
RHC Ali Pur Chatta
32 0 12 0 8 9 1
RHC Dounkal
18 0 0 14 0 5 0
RHC Emin Abad
22 3 3 4 3 4 3
RHC Gakhar 10 2 0 5 0 0 2
RHC Qila Didar Sing
34 6 1 9 1 8 12
RHC Rasool Nagar
13 4 0 1 39 2 0
RHC Sohdra 21 1 0 8 1 13 0
RHC Wahndo
30 0 8 6 1 9 7
BHU Artali Virkan
51 5 12 2 6 33 2
BHU Attawa 16 6 0 8 0 4 0
BHU Botala Sharam Singh
36 2 0 13 1 78 3
49
BHU Bucha Chatah
27 4 3 5 6 9 1
BHU Budda Goraya
21 3 0 11 0 92 0
BHU Dandian
29 17 0 9 0 6 0
BHU Ferozewala
77 14 0 10 0 94 3
BHU Gondlanwala
24 4 0 6 3 47 2
BHU Gulloke 39 18 13 3 0 5 0
BHU Hardo Saharan
31 4 6 4 3 16 3
BHU Jallan 34 3 3 6 0 17 5
BHU Jaura Sian
36 4 3 3 3 18 5
BHU Kot Ladha
32 0 0 0 0 0 0
BHU Kotli Nawab
23 5 0 2 2 9 3
BHU Mohalanke
28 11 0 4 4 7 6
BHU Noianwala
14 5 0 5 0 0 4
BHU Nokhar 41 6 5 5 2 0 6
BHU Talwandi
Musa Khan 37 4 0 13 1 105 1
KEY: COC=Combined Oral Contraceptive, POP=Progesterone-Only Pills, DPMA=Depot Medroxyprogesterone Acetate,
Net-en=Norethisterone enanthate, IUCDs=Intrauterine Contraceptive Devices.
50
Well baby clinic
The surveyed health facilities were assessed for having an established well baby clinic
(WBC) and the findings are presented in Table 3.37.
TABLE 3.37: STATUS OF WBCS ESTABLISHED
Name of health facility WBC established Name of health facility WBC established
DHQH Gujranwala Y BHU Bucha Chatah N
THQH Kamonke N BHU Budda Goraya N
THQH Noshehra Virkan N BHU Dandian N
THQH Wazirabad N BHU Ferozewala N
RHC Ahmed Nagar N BHU Gondlanwala N
RHC Ali Pur Chatta N BHU Gulloke Y
RHC Dounkal Y BHU Hardo Saharan N
RHC Emin Abad N BHU Jallan N
RHC Gakhar N BHU Jaura Sian N
RHC Qila Didar Sing N BHU Kot Ladha N
RHC Rasool Nagar N BHU Kotli Nawab N
RHC Sohdra N BHU Mohalanke N
RHC Wahndo N BHU Noianwala N
BHU Artali Virkan N BHU Nokhar N
BHU Attawa Y BHU Talwandi Musa
Khan N
BHU Botala Sharam Singh
N
51
Donor contributions
Donor contributions during the last three years were assessed regarding human resources,
infrastructure, equipment (including ambulances), drugs and supplies and the findings are
presented in Table 3.38.
TABLE 3.38: STATUS OF DONOR CONTRIBUTIONS
Health facilities
Donor contributions
Human resources Infrastructure Equipment Drugs and supplies
Pro
vis
ion
of
key
sta
ff
Cap
acit
y b
uil
din
g
Sta
ff i
nc
en
tiv
e
Co
nstr
ucti
on
of
new
bu
ild
ing
Ren
ovati
on
of
exis
tin
g b
uil
din
g
Pro
vis
ion
of
new
eq
uip
men
t
Pro
vis
ion
of
new
veh
icle
/ am
bu
lan
ce
Pro
vis
ion
of
me
dic
ine
s
Pro
vis
ion
of
co
nsu
ma
ble
s
DHQH Gujranwala N N N N N N N N N
THQH Kamonke N N N N N N N N N
THQH Noshehra Virkan
N N N N N N N N N
THQH Wazirabad N N N N N N N N N
RHC Ahmed Nagar N N N N N N N N N
RHC Ali Pur Chatta N N N N N N N N N
RHC Dounkal N N N N N N N N N
RHC Emin Abad N N N N N N N N N
RHC Gakhar N N N N N N N N N
RHC Qila Didar Sing N N N N N N N N N
RHC Rasool Nagar N N N N N N N N N
RHC Sohdra N N N N N N N N N
RHC Wahndo N N N N N N N N N
BHU Artali Virkan N N N N N N N N N
52
Health facilities
Donor contributions
Human resources Infrastructure Equipment Drugs and supplies
Pro
vis
ion
of
key
sta
ff
Cap
acit
y b
uil
din
g
Sta
ff i
nc
en
tiv
e
Co
nstr
ucti
on
of
new
bu
ild
ing
Ren
ovati
on
of
exis
tin
g b
uil
din
g
Pro
vis
ion
of
new
eq
uip
men
t
Pro
vis
ion
of
new
veh
icle
/ am
bu
lan
ce
Pro
vis
ion
of
me
dic
ine
s
Pro
vis
ion
of
co
nsu
ma
ble
s
BHU Attawa N N N N N N N N N
BHU Botala Sharam Singh
N N N N N N N N N
BHU Bucha Chatah N N N N N N N N N
BHU Budda Goraya N N N N N N N N N
BHU Dandian N N N N N N N N N
BHU Ferozewala N N N N N N N N N
BHU Gondlanwala N N N N N N N N N
BHU Gulloke N N N N N N N N N
BHU Hardo Saharan N N N N N N N N N
BHU Jallan N N N N N N N N N
BHU Jaura Sian N N N N N N N N N
BHU Kot Ladha N N N N N N N N N
BHU Kotli Nawab N N N N N N N N N
BHU Mohalanke N N N N N N N N N
BHU Noianwala N N N N N N N N N
BHU Nokhar N N N N N N N N N
BHU Talwandi Musa Khan
N N N N N N N N N
53
Clients’ perspective
Client exit interviews (CEIs) were conducted within the scope of the health facility
assessment survey, to assess the clients’ perspective on services provided. The findings
from these interviews, were analyzed for assessing their perspective on access, quality and
preferences for health care and are presented in Table 3.39 and Figures 5 and 6.
TABLE 3.39: CLIENTS’ PERSPECTIVE
No of interviewed clients (Total: 70)
DHQH THQHs RHCs
Time to reach facility
Less than 30 minutes 1 11 33
30 minutes to 1 hour 3 4 11
More than 1 hour 6 0 1
Means of transport
Walking 0 6 15
Personal transport 1 2 6
Public transport 9 7 24
Waiting time at facility
Less than 10 minutes 0 5 15
10 minutes to 20 minutes
1 5 22
20 minutes to 30 minutes
2 0 1
More than 30 minutes 7 5 7
Paid fee for services 10 14 45
Received education material
0 0 2
Preference for healthcare
Public health facilities 6 11 39
Private sector 4 4 6
Reasons for visiting public health facilities
Close to home 0 8 22
Good quality 6 6 27
Staff attitude 1 0 8
Affordability 2 5 19
54
Lack of choice 1 6 19
Overall satisfaction
Very satisfied 0 2 17
Satisfied 10 12 26
Not satisfied 0 1 2
FIGURE 5: LEVEL OF SATISFACTION
FIGURE 6: AVAILABILITY OF MEDICINES AND LAB SERVICES
Procurement estimates
Equipment
Based on the information collected, the procurement needs for the provision of required
equipment, have been identified for individual surveyed facilities, in order to strengthen
MNCH services. A summary of the estimated cost for the procurement of required
equipment is given below. A list of required equipment for each surveyed facility, is
presented as Annex 3 A and details about the cost estimates for individual facilities are
given in Annex 3 B.
27
34
0
21
64
63
93
78
9
3
7
1
0% 20% 40% 60% 80% 100%
Clinical Examination
Attitude of care provider
Attitude of other staff
Communication
Very satisfied
Satisfied
Not satisfied
16
97
58 26
3
0% 20% 40% 60% 80% 100%
Medicines
Lab services
Received (all)
Received (some)
Not received
55
Civil works
A yardstick has been used for assessing the scope of civil works of various MNCH related
building components (Annex 2). The identified scope of work to complete the infrastructure
needs of the individual surveyed facilities is presented in Annex 4. A summary of the
estimated cost for the execution of civil works, including repair and maintenance, renovation
and new construction of missing facilities; is given in table below and the details about cost
estimates for individual facilities are given in Annex 4.
TABLE 3.40: SUMMARY OF ESTIMATED COST FOR PROCUREMENT OF EQUIPMENTS & CIVIL
WORKS
Procurement Estimated cost (PKR in millions)
DHQH THQHs RHCs BHUs Total
Equipment
18.3 29.7 11.6 5.8 65.4
Civil works 12.5 44.6 51.5 41.0 149.6
56
Section 4: Key Findings
In district Gujranwala, thirty-one (31) health facilities were assessed, including 1 DHQ
hospital, 3 THQ hospitals, 9 RHCs and 18 BHUs. The BHUs were assessed for the
availability of 8/6 preventive MNCH services; RHCs were assessed for the availability of 24/7
basic EmONC services; and the DHQ and THQ hospitals were assessed for the availability
of 24/7 comprehensive EmONC services.
The key findings based on the availability of specified inputs including, infrastructure, human
resources, equipment, drugs and supplies and support services, are presented in the
following sections. The status of each input has been described at one place for all of the
levels. This is followed by key findings on management basics, donor contributions and the
clients’ perspective on the quality of MNCH services.
Infrastructure
• An OPD and labour room were available at all of the BHUs. A scrub area was not
available in the labour rooms of 10 BHUs. LHV’s residences were available at all of
the BHUs, except for BHU Dandian. They were in a good condition only at BHUs Kot
Ladha and Jaura Sian.
• An OPD, female ward, labour room and clinical laboratory were available at all of the
RHCs. A residence for the WMO was not available at RHC Wahndo.
• An OPD, female ward, labour room, operation theatre, clinical laboratory and blood
bank, were available at all of the SHC hospitals. A paediatric ward was not available
at any of the THQHs; whereas a paediatric nursery was not available at THQHs
Kamonke and Noshehra Virkan. A residence for the gynaecologist was not available
at any of the SHC hospitals. Residences for the anaesthetist were not available at
THQHs Kamonke Noshehra Virkan. Residences for the paediatricians were not
available at DHQH Gujranwala and THQH Wazirabad.
Human resources
• The required staff was available at all of the BHUs.
• WMOs were available at all of the RHCs, except for RHC Wahndo. The required
number of WMOs was available only at 4 of the RHCs. Laboratory technicians were
57
not available at RHCs Ahmed Nagar Wahndo; while operation theatre technicians
were not available at any of the RHCs. Ambulance drivers were available at all of the
RHCs.
• The required number of gynaecologists, anaesthetists and paediatricians were
available at DHQH Gujranwala and THQH Wazirabad. A gynaecologist was not
available at THQH Noshehra Virkan; while anaesthetists were not available at
THQHs Kamonke and Noshehra Virkan. No WMO was available at any of the SHC
hospitals, except for THQH Noshehra Virkan. Operation theatre, blood bank and
anaesthesia technicians were not available at any of the SHC hospitals.
• Staff residences being damaged or unavailable were the most common reasons for
the non-availability of staff around the clock.
• Staff at 23 of the surveyed facilities received MNCH related training. Most of the
training was related to EmONC, ENC and IMNCI and family planning counselling. No
training was provided on IMPAC, surgical family planning and client centreedness.
Equipment
• The complete set of required equipment items was not available at any of the
surveyed facilities.
• General equipment items were not available at 15 of the surveyed BHUs.
• The complete range of equipment required for the delivery of MNCH services was
not available at any RHC. No LHV room equipment was available at RHCs Alipur
Chatta, Gakhar and Qila Didar Singh.
• Paediatric nursery equipment was not available at THQHs Kamonke and Noshehra
Virkan; while paediatric ward equipment was not available at DHQH Gujranwala. All
of the required clinical laboratory equipment was available at DHQH Gujranwala and
THQH Wazirabad.
Drugs and supplies
• The complete list of tracer drugs, supplies, vaccines and family planning commodities
was not available at any of the surveyed facilities.
58
• All of the required supplies were available at BHU Dandian. All of the vaccines were
available at 9 out of the 18 BHUs. No vaccines were available at BHU Artali Virkan.
None of the family planning commodities were available at 4 out of the 18 BHUs.
• All of the required supplies were available at 5 RHCs, while all of the vaccines were
available at 6 RHCs. No family planning commodities were available at 6 of the
RHCs.
• All of the the supplies were available at THQH Noshehra Virkan. Whereas all of the
vaccines were available at all of the SHC hospitals, except for THQH Noshehra
Virkan. No family planning commodities were available at THQHs Kamonke and
Noshehra Virkan.
• The most common reasons for running out of the stock of drugs, were having an
insufficient budget and delayed supply.
Support services
• The complete range of required inputs for the delivery of support services was not
available at most of the surveyed facilities.
• All of the required inputs for the provision of basic laboratory tests were available
only at BHUs Dandian and Attawa.
• All of the inputs required for the provision of basic lab tests were available at 5 RHCs;
while all of the inputs for the provision of an ambulance service were available at all
of the RHCs.
• All the required inputs for blood transfusion services were available at THQH
Wazirabad, while all of the inputs required for an ambulance service were available
at all of the SHC hospitals. All of the inputs required for radiology services were
available at DHQH Gujranwala, THQHs Wazirabad and Noshehra Virkan.
Management basics
Management basics assessed at the surveyed facilities included the availability of a job
description and service delivery protocols, work coordination and supervision, MIS, infection
control measures, death reviews of maternal and neonatal deaths, the charging of a fee for
services and the availability of mechanisms of social protection.
59
• All of the surveyed facilities were conducting regular performance review meetings, but
their record was being maintained at only 4 of the surveyed facilities. All of the facility in-
charges reported regular participation in district level performance review meetings.
• All of the the facilities reported supervisory visits by the district health managers; but only
6 facilities received feedback from these supervisory visits.
• The district health information system (DHIS) was being practiced in district Gujranwala.
The complete range of tools was available only at THQH Kamonke, RHCs Dounkal and
Gakhar. Major gaps were related to the availability of the DEWS chart, DEWS form and
child health register.
• Social protection mechanisms for the poor (including zakat, bait-ul maal and patient
welfare societies) were available at DHQH Gujranwala, THQHs Noshehra Virkan and
Wazirabad and BHU Gondlanwala.
• The complete range of inputs required for infection control practices, were deficient at all
of the surveyed facilities. Out of 31 facilities, 9 facilities reported the availability of a
waste management plan but materials for waste collection, personal protection and
waste treatment were not available at any of the facilities.
• Well baby clinics were established at DHQH Gujranwala, RHC Dounkal, BHUs Attawa
and Gulloke.
• A death review committee was available at 4 of the surveyed facilities; but they had not
conducted a review of any maternal and neonatal deaths.
Donor contributions
Donor contributions for supporting the delivery of MNCH services were assessed at the
surveyed facilities for the provision of human resources, infrastructure, equipment, drugs and
supplies. In the district, no facility reported any such contributions.
Clients’ perspective
Client exit interviews were conducted to assess the clients’ perspective on their satisfaction
with the quality of services at the facility. A total of 70 interviews were conducted in the
district. The findings concluded that 27% of the clients were very satisfied and 69% were
satisfied, while 4% were not satisfied with the availed services.
60
Annexes
61
ANNEX 1
District health department
The public sector district health system consists of secondary health care (DHQH, THQH)
and primary health care (RHCs, BHUs) facilities. The EDOH acts as the head of the district
health department, under the supervision of the DCO.
Health resources
Health facilities (Public sector)
Public sector facilities providing MNCH services are given in table 2.4:
TABLE 2.4: NUMBER OF PUBLIC SECTOR HEALTH FACILITIES IN THE DISTRICT
Type Number Bed strength
Teaching hospital 0 0
District headquarter hospital 1 450
Tehsil headquarter hospitals 3 180
Rural health centres 9 180
Basic health units 88 176
Govt. rural dispensary 5
MCH centre 9
Sub health centre 34
SOURCE: DHIS CELL, EDO-H OFFICE
Human resources at the EDO-H office
Table 2.5 summarises the human resources situation at the EDO-H office.
TABLE 2.5: HUMAN RESOURCES IN THE OFFICE OF EDO-HEALTH
Name of post Sanctioned Filled % Filled
Executive district officer health 1 1 100
District officer health 2 2 100
Deputy district officer health 4 4 100
Programme director, district health development centre 1 1 100
District coordinator national programme for FP & PHC 1 1 100
District coordinator EPI surveillance 1 0 0
District coordinator NMNCHP 1 1 100
District sanitary inspector 1 1 100
62
Name of post Sanctioned Filled % Filled
Communicable disease control (CDC) Officer 2 2 100
Communicable disease control inspector 3 0 0
Drug inspector 7 1 14
District superintendent vaccination 1 1 100
Assistant superintendent vaccination 2 2 100
Tehsil sanitary inspector 2 1 50
Inspector vaccination 2 2 100
Total 31 20 64%
SOURCE: EDO-H OFFICE
MNCH staff in district Gujranwala
Table 2.6 summarises the status of MNCH staffing in health facilities, including the DHQH,
and all of the THQHs, RHCs and BHUs in the district. The information was collected from the
office of the EDOH during the survey.
This information may not match with the subsequent tables, containing similar information on
human resources (HR) collected from the respective surveyed health facilities (No. 3.9, 3.14,
3.19, 3.23 and 3.24).
TABLE 2.6: AVAILABILITY OF MNCH SERVICES STAFFING IN GUJRANWALA
Posts
San
ctio
ned
Fille
d
% F
illed
Filled posts
R= Regular, C= On Contract
DHQH (1) THQH (3) RHC (9) BHU (88)
R C R C R C R C
Gynaecologist 9 7 78 3 0 2 2
Paediatrician 5 5 100 1 1 2 1
Anaesthetist 6 4 67 3 0 1 0
Radiologist 6 3 50 2 0 1 0
Pathologist 5 3 60 2 0 1 0
Women medical
officers (WMOs)
/Medical officers
(MOs)*
278 238 85 - - - - - - - -
63
Blood transfusion
officers 4 1 25 1 0 0 0
Blood bank
technician 0 0 0 0 0 0 0
Operation theatre
technician 0 0 0 0 0 0 0
Anaesthesia
technician 0 0 0 0 0 0 0
LHVs 119 126 100 8 0 3 0 18 9 88 0
Nurses 252 255 100 83 77 22 19 54 0
Lady health workers
(LHWs)** 1761 1761 100
Laboratory
technician 18 3 17 3 0 0 0 0 0
X-ray technician 2 2 100 2 0 0 0 0 0
Dispenser 199 182 91 18 0 20 2 54 0 88 0
Vaccinators 179 134 75
Ambulance drivers 38 10 26 6 0 4 0 - -
Total 2861 2718 95
*Community based worker **Facility wise breakup of filled posts not available
SOURCE: DHIS CELL, EDO-H OFFICE
Financial allocations
Budgetary allocations and expenditure over the last three years for the district (in PKR
Million) are presented in Table 2.7. The allocations mentioned below are a lump sum as
provided by office of the EDOH/EDOF&P.
64
TABLE 2.7: FINANCIAL ALLOCATIONS IN DISTRICT GUJRANWALA
District health budget
2007-08 2008-09 2009-10
Allocation Expenditure Allocation Expenditure Allocation Expenditure
Non-development
426.64 360.43 597.77 535.30 780.35 761.79
Development 89.75 82.04 134.23 27.12 122.10 62.27
Total 516.39 442.47 732 562.42 902.45 824.06
Donor contributions
Information about donor contributions for MNCH services was retrieved from the EDOH
office, in terms of financial input. It was reported that no donor contributions were provided to
district Gujranwala in the last three years. During the survey, information about donor inputs
at surveyed health facilities was also collected and none of the facilities reported receiving
any donor contributions.
NMNCH programme indicators
Information on NMNCHP indicators is being compiled at the office of the EDOH and this
information has been gathered on the sets of indicators, which is reproduced as such in
the following tables. It is important to note, that the services utilization data reported by the
district office takes into account utilisation of all the public sector facilities in the district.
This information may not match with the subsequent tables containing information on drugs
and supplies (Table No. 3.6, 3.11, 3.16, 3.21 and 3.31) and C-sections (Table No. 3.36)
collected from the health facilities included in the survey.
TABLE 2.8: NMNCHP MONITORING INDICATORS (YEAR 2010)
Services management
Number of district monthly performance review meetings held during last year 12
Number of facilities out of the stock of family planning commodities -
Number of facilities out of the stock of essential EmONC drugs 0
Support services
Number of facilities with laboratory services available 14
Number of facilities with blood transfusion services available 4
65
Service utilization
Antenatal care coverage 82556
Percentage of children <12 months fully vaccinated 96%
TT-2 coverage 117162
Number of deliveries at health facilities 14525
Number of live births at health facilities 13665
Postnatal coverage 18541
Number of family planning visits (by type of modern method) at health facilities 44795
Number of caesarean sections at comprehensive EmONC facilities 2720
Morbidity and mortality (at public health facilities)
Number of maternal deaths 34
Number of neonatal deaths 324
Number of diarrhoea / dysentery in <5 years age group 92479
Number of pneumonia in <5 years age group -
Lady health workers (NP FP & PHC)
Number of new pregnant mothers registered 43803
Number of SBA deliveries reported 30091
Number of maternal deaths reported 42
Number of modern family planning methods users 902017
Number of infant deaths reported 806
Community mid-wives (NMNCHP)
Number of first antenatal care visits (ANC 1) 1007
Number of ANC revisits 712
Number of TT 2 given 347
Number of deliveries 158
Number of post natal visits 218
Number of family planning visits (both new and follow-up) 33
Number of family planning commodities provided 39
Number of maternal complications referred 417
Number of neonates referred 0
Number of clean / safe delivery kits used 103
66
Out of the stock of clean / safe delivery kits 0
Out of the stock of family planning commodities 0
Number of pregnant women referred by lady health workers 70
Number of maternal deaths 0
Number of neonatal deaths 0
SOURCE: DHIS CELL, MNCH CELL, EPI CELL , MIS NP FOR FP&PHC- EDOH OFFICE
Provision of staff by the NMNCHP
The NMNCHP is providing support in terms of human resources at targeted health facilities,
including specialists, doctors and paramedics. The programme is currently under
implementation and the number of facilities having staff provided by the NMNCHP is given in
Table 2.9.
TABLE 2.9: NUMBER OF FACILITIES WITH STAFF PROVIDED BY THE NMNCHP
Staff cadre Number of health facilities
DHQH THQHs RHCs BHUs
Gynaecologist 0 0 0 0
Anaesthetist 0 0 0 0
Paediatrician / Neonatologist 0 0 0 0
Women medical officers 0 0 6 0
Operation theatre technician 0 0 0 0
Blood bank technician 0 0 0 0
Lab technician 0 0 0 0
Anaesthesia technician 0 0 0 0
Nurses 0 0 0 0
Lady health visitors 0 0 9 0
Ambulance drivers 0 0 0 0
SOURCE: MNCH CELL – EDOH OFFICE
MNCH staff training
Part of the mandate of the programme is to build the capacity of MNCH related staff, through
conducting skill development training in the standards of service provision, counselling
techniques and client centreedness. Information about the training of MNCH staff is
presented in Table 2.10. It is important to note here, that this information collected from the
67
district office, may not match with the similar information contained in Table no. 3.28,
collected from the surveyed facilities.
TABLE 2.10: NUMBER OF STAFF TRAINED ON DELIVERING MNCH SERVICES
Category of staff
Number of staff trained (during last three years)
EmONC ENC IMNCI IMPAC FP
surgical FP counselling
Client centreedness
Gynaecologist 2 0 1 0 0 0 0
Paediatrician 0 0 3 0 0 0 0
Anaesthetist 0 0 0 0 0 0 0
WMO 13 0 18 0 0 0 0
MO 0 0 48 0 0 0 0
OT technician 0 0 0 0 0 0 0
Nurse 5 0 2 0 0 0 0
LHV 9 0 7 0 0 0 0
SOURCE: MNCH CELL – EDOH OFFICE
CMWs’ training and deployment
Part of the mandate of the programme is to train and deploy community mid-wives for
improving community based MNCH services. Information collected from the district NMNCH
cell, related to the training and deployment of community mid-wives, is presented in Table
2.11.
TABLE 2.11: STATUS OF CMWS’ TRAINING AND DEPLOYMENT
Training and deployment of community mid-wives (NMNCHP)
Number of selected community mid-wives verified for their residential status 39
Number of community mid-wives with completed training 39
Number of community mid-wives deployed by NMNCHP 45
68
Training and deployment of community mid-wives (NMNCHP)
Number of community mid-wives’ schools where renovation / construction is completed
0
Community mid-wives’ manual / books available (Number of sets) 39
Community mid-wives’ training equipment / models available (Number) 0
Number of community mid-wives sponsored / supported by partners 0
SOURCE: MNCH CELL – EDOH OFFICE
69
ANNEX 2
Input criteria for MNCH services
A. Civil works criteria
CIVIL WORKS SCOPE FOR BHUS
OPTIMAL ITEMS
Ob/Gyn OPD or LHV’s room
1. Consultation area
2. Examination area
3. Hand washing facilities
Labour room
1. Delivery room
2. Scrub area
3. Functional attached washroom for patients
WMO or LHV’s residence
1. Available
2. Good condition
MINIMAL ITEMS
LHV’s room Available
CIVIL WORKS SCOPE FOR RHCS
OPTIMAL ITEMS
Ob/Gyn OPD
1. Consultation area
2. Examination area
3. Hand washing facilities
Ob/Gyn ward
1. Patient area 2. Functional attached washroom
Labour room
1. Delivery room
2. Scrub area
3. Functional attached wash room for patients
Clinical laboratory
1. Laboratory room
2. Working area
3. Functional attached washroom
LHV’s room
1. Consultation area
2. Examination area
3. Hand washing facilities
Residence - WMO 1. Available
2. Good condition
Residence - LHV 1. Available
2. Good condition
MINIMAL ITEMS
Ob/Gyn OPD Available
70
CIVIL WORKS SCOPE FOR RHCS
OPTIMAL ITEMS
Ob/Gyn ward Available
Labour room Available
LHV’s room Available
Residence - WMO 1. Available
2. Good condition
Residence - LHV 1. Available
2. Good condition
CIVIL WORKS SCOPE FOR DHQH & THQH
OPTIMAL ITEMS
Ob/Gyn OPD
1. Consultation area
2. Examination area
3. Privacy of examination area
4. Hand washing facilities
Ob/Gyn ward
1. Patient area
2. Nursing station
3. Store for general items/drugs
4. Functional attached wash room
Labour room
1. Delivery room
2. Preparation/ stage room
3. Scrub area
4. Staff duty room
5. Store for general items/drugs
6. Store for equipment
7. Functional attached washroom for patients
8. Functional attached washroom for staff
Operation theatre
1. Patient preparation room
2. Operating room
3. Recovery room
4. Scrub area
5. Sterilization area
6. Doctor’s room
7. Support staff duty room
8. Store for general items/drugs or equipment
9. Store for equipment
10. Functional attached washroom for staff
Paediatric ward
1. Patient area
2. Nursing station
3. Store for general items/drugs or equipment
4. Functional attached washroom
Paediatric nursery
1. Patient area
2. Nursing station
3. Store for general items/drugs or equipment
4. Change room
Clinical laboratory
1. Laboratory room
2. Working area
3. Doctors’ duty room
4. Store for chemical / reagents or equipment
5. Functional attached washroom
71
Blood bank
1. Blood collection room
2. Working area
3. Staff duty room
4. Store for equipment / reagents
5. Functional attached washroom
LHV’s room
1. Consultation area
2. Examination area
3. Privacy of examination area
4. Hand washing facilities
Ultrasound room Examination area
Residence - Gynaecologist · Available
· Good condition
Residence - Anaesthetist · Available
· Good condition
Residence - Paediatrician · Available
· Good condition
Residence - WMO · Available
· Good condition
Residence - LHV · Available
· Good condition
Residence - Nurse · Available
· Good condition
Residence - Lab technician · Available
· Good condition
Residence - Blood bank technician · Available
· Good condition
Residence - Anaesthesia technician · Available
· Good condition
MINIMAL ITEMS
Ob/Gyn OPD Available
Ob/Gyn ward Available
Labour room Available
Operation theatre Available
Paediatric ward Available
Clinical laboratory Available
Residence - Gynaecologist · Available
· Good condition
72
Residence - Anaesthetist · Available
· Good condition
Residence - Paediatrician · Available
· Good condition
Residence - WMO · Available
· Good condition
Residence - Lab technician · Available
· Good condition
B. Human resources criteria
HUMAN RESOURCES FOR PREVENTIVE
EmONC HUMAN RESOURCES FOR 24/7 BASIC EmONC
OPTIMAL HR FOR BHUS OPTIMAL HR FOR RHCS
Category Number Category Number
MO, or 1 WMOs 2
LHV 1 OT technician 1
- - Lab technician 1
- - LHVs 2
- - Ambulance driver 1
MINIMAL HR FOR BHUS MINIMAL HR FOR RHCS
MO, or 1 WMO 1
LHV 1 Lab technician 1
- - LHV 1
- - - -
HUMAN RESOURCES FOR 24/7 COMPREHENSIVE EmONC
OPTIMAL HR FOR DHQH OPTIMAL HR FOR THQH
Category Number Category Number
Gynaecologist 2 Gynaecologist 1
Anaesthetist 2 Anaesthetist 1
Paediatrician 2 Paediatrician 1
WMOs 6 WMOs 4
OT technician 4 OT technician 4
Blood bank technician 4 Blood bank technician 4
Lab technician 3 Lab technician 2
Anaesthesia technician 4 Anaesthesia technician 4
Nurses 20 Nurses 12
LHVs 4 LHVs 4
73
Ambulance drivers 4 Ambulance drivers 4
MINIMAL HR FOR DHQH MINIMAL HR FOR THQH
Gynaecologist 1 Gynaecologist 1
Anaesthetist 1 Anaesthetist 1
Paediatrician 1 Paediatrician 1
WMOs 4 WMOs 2
OT technician 1 OT technician 1
Lab technician 1 Lab technician 1
Nurses 6 Nurses 4
LHVs 1 LHVs 1
C. Equipment criteria
EQUIPMENT FOR BHUS
OPTIMAL ITEMS
General hospital equipment
1. Electric water cooler
2. Water filter
3. Incinerator
OPD / WMO’s office
1. Office / Plain chairs
2. Examination couch
3. Office tables with drawers
4. Steel almirah (Large)
5. Patient’s stool
6. Weighing machine (Adult)
7. Weighing machine (Infant)
8. Height measuring board
9. Height measuring device
10. B.P Apparatus mercury-desk type
11. Foetal stethoscope
12. Steam inhaler
13. Nebulizer
14. Examination lamp
Lady health visitor’s room
1. Weight scale (Adult)
2. Weight scale (Infant)
3. Height measuring device
4. Height measuring board
5. Disposable syringe cutter
6. D & C instruments set
7. P.V. examination light
8. Examination couch
9. Office chairs
10. Office tables with drawers
11. Patient’s stool
12. Steel almirah (Large)
MINIMAL ITEMS
1. Office chairs
2. Office tables with drawers
3. B.P Apparatus mercury-desk type
4. Foetal stethoscope
5. Weight scale (Adult)
6. Weight scale (Infant)
7. Height measuring device
8. Height measuring board
9. D & C instruments set
10. Examination couch
74
EQUIPMENT FOR RHCS
OPTIMAL ITEMS
General hospital
1. Ambulance
2. Electric water cooler
3. Water filter
4. Incinerator
Female ward Items
1. Fowler bed (Iron)
2. Attendant's bench
3. Bed side locker
4. Overhead food trolley
5. Dust bin (Stainless steel)
6. Screen folding complete
7. Baby cot
8. B.P Apparatus mercury-desk type
9. Stethoscope
OPD / WMO’s office
1. Office chairs
2. Plain chairs
3. Examination couch
4. Office tables with drawers
5. Steel almirah (Large)
6. Patient’s stool
7. Weight machine (Adult)
8. Weight machine (Infant)
9. Height measuring board
10. Height measuring device
11. B.P Apparatus mercury-desk type
12. Foetal stethoscope
13. Steam inhaler
14. Nebulizer
15. Examination lamp
Labour room
1. UPS power supply system (2000W)
2. Suction machine electric
3. Infant weighing machine
4. Foetal stethoscope
5. Electric instrument sterilizer (12"x6")
6. Jar for forceps
7. Spring type dressing forceps (S.s)
8. Sim's speculum (Right angle, small)
9. Sim's speculum (Right angle, medium)
10. Sim’s speculum (Right angle, large)
11. Sponge forceps
12. Artery forceps (Long, straight)
13. Uterine sound
14. Vulsellum forceps
15. Scissors (Dissecting, blunt pointed)
16. Artery forceps
17. Blunt-ended scissors
18. D & C instruments set
19. Infant ambo bag
Lady health visitor’s room
1. Weight scale (Adult)
2. Weight scale (Infant)
3. Height measuring device
4. Height measuring board
5. P.V. examination light
6. Examination couch
7. Office chairs
8. Office tables with drawers
9. Patient’s stool
10. Steel almirah (Large)
MINIMAL ITEMS
Female ward items
1. Fowler bed (Iron)
2. B.P Apparatus mercury-desk type
3. Stethoscope
OPD / WMO’s office
1. Office chairs
2. Examination couch
4. Office tables with drawers
5. B.P Apparatus mercury-desk type
6. Foetal stethoscope
75
EQUIPMENT FOR RHCS
OPTIMAL ITEMS
Labour room
1. Electric instrument sterilizer (12"x6")
2. Sim's speculum (Right angle, medium)
3. Sponge forceps
4. Uterine sound
5. Vulsellum forceps
6. Scissors (Dissecting, blunt pointed)
7. Artery forceps
8. D & C instruments set
Lady health visitor’s room
1. Office chairs
2. Office tables with drawers
3. Weight scale (Adult)
4. Weight scale (Infant)
5. Height measuring device
6. Height measuring board
7. Examination couch
EQUIPMENT FOR DHQ HOSPITAL
OPTIMAL ITEMS
General hospital
1. Ambulance
2. Defibrillator
3. Desktop computer with monitor and
accessories
4. Electric water cooler
Gynae/Obs. ward items
1. Cabinet Instrument (Large)
2. Fowler bed (Iron)
3. Attendant's bench
4. Bed side locker
5. Screen folding complete
6. Weighing machine (Adult)
7. Artery forceps 7 inch
8. B P Apparatus mercury – sesk type
9. Dissecting forceps (Plain, 7 inch)
10. Scissors (Curved, 5 inch)
11. Scissors (Sharp, 5 inch straight)
12. Chital forceps
13. Kidney tray (S.s,10 inch)
14. Jar for forceps
15. Infusion / drip stands
16. Foetal monitor (foetal doppler - desk type)
17. Infant B.P apparatus
18. Infant weighing machine
19. Baby cot
OPD / Gynaecologist’s office
1. Weighing machine (Adult)
2. Infant weighing machine
3. Screen folding complete
4. Ultrasound machine
5. Examination lamp
6. Stethoscope (Adult size)
7. B.P apparatus desktop type
8. Office chair
9. Office table with drawers
10. Patient’s stool
11. Patient’s waiting bench
12. Examination couch
Paediatric nursery
1. Air ways 2 size
2. Infant ambo bag
3. Infant laryngoscope set
4. Suction apparatus: electrically
operated
5. Infant incubators
6. Phototherapy unit
7. Baby warmer
8. Infant B.P apparatus (Cuff 2.5 cm)
9. Room thermometer
10. Baby cot
11. Steam inhaler
12. Oxygen cylinder complete with trolley
13. Infusion / drip stands
76
EQUIPMENT FOR DHQ HOSPITAL
OPTIMAL ITEMS
Paediatric ward
1. Suction machine
2. Infant B.P apparatus (Cuff 2.5 cm)
3. Stethoscope Paediatric Littman type
4. Nebulizer
5. Oxygen cylinder complete with trolley
6. Emergency medicine trolley
7. Patient's attendant bench
8. Fowler bed (Iron)
9. Bed side locker (S.s top)
10. Screen folding complete
Labour room
1. Foetal stethoscope
2. Electric instrument sterilizer (12”x6”)
3. Jar for forceps
4. Spring type dressing forceps (S.s)
5. Sim’s speculum (Right angle, small)
6. Sim’s speculum (Right angle,
medium)
7. Sim’s speculum (Right angle, large)
8. Sponge forceps
9. Long straight artery forceps
10. Uterine sound
11. Vulsellum forceps
12. Scissors (Dissecting, blunt pointed)
13. Artery forceps
14. Blunt-ended scissors
15. Episiotomy instruments set (Complete)
16. D&C instruments set complete
17. Delivery forceps set
18. Infant ambo bag
19. Portable light & rechargeable batteries
20. Sterilizing drum
21. Vacuum extractor
22. Delivery table
23. Infusion / drip stands
24. Oxygen cylinder complete with trolley
Operation theatre
1. Needle holder
2. Stitch scissors
3. Dissecting forceps (Toothed)
4. Sim’s speculum (Large)
5. Sim’s speculum (Medium)
6. Vacuum extractor
7. Obstetric forceps
8. Rectangular instrument tray ē lids
9. Towel clips
10. Sponge forceps (22.5 cm)
11. Artery forceps (Straight, 16 cm)
12. Uterine homeostasis forceps (20 cm)
13. Hysterectomy forceps (Straight, 22.5
cm)
14. Mosquito forceps (12.5 cm)
15. Tissue forceps (19 cm)
16. Needle holder (Straight, 17.5 cm)
17. Surgical knife handle # 3
18. Surgical knife handle # 4
19. Abdominal retractors, double-ended
(Richardson)
20. Curved operating scissors, blunt pointed
(Mayo), 17 cm
21. Straight operating scissors, blunt pointed
(Mayo), 17 cm
22. Aesthetic face masks (3 sizes)
23. Anaesthesia machine
24. Laryngoscopes
25. X-Ray illuminator
26. Gynae Instrument set
27. General Instrument set
28. Adult ambo bag and mask
29. D & C instruments set
30. Myomectomy screw
31. Air conditioners
Laboratory
1. Spin machine
2. Chemistry analyzer
3. Counter (Hand tally differential)
4. Steel almirah (Large)
5. Lab cabinet
MINIMAL ITEMS
Gynae/Obs. ward items 1. Fowler bed (Iron)
77
EQUIPMENT FOR DHQ HOSPITAL
OPTIMAL ITEMS
OPD / Gynaecologist’s office
1. Weighing machine (Adult)
2. Examination lamp
3. Stethoscope (Adult size)
4. B.P apparatus desktop type
5. Office chair
6. Office table with drawers
7. Examination couch
Paediatric nursery
1. Air ways 2 size
2. Infant ambo bag
3. Infant laryngoscope set
4. Suction apparatus: electrically operated
5. Infant incubators
6. Phototherapy unit
Paediatric ward
1. Stethoscope Paediatric Littman type
2. Nebulizer
3. Oxygen cylinder complete with trolley
4. Fowler bed (Iron)
Labour room
1. Foetal stethoscope
2. Electric instrument sterilizer (12”x6”)
3. Spring type dressing forceps (S.s)
4. Sim’s speculum (Right angle,
medium)
5. Sponge forceps
6. Uterine sound
7. Vulsellum forceps
8. Episiotomy instruments set (Complete)
9. D&C instruments set complete
10. Delivery forceps set
11. Delivery table
Operation theatre
1. Anaesthesia machine
2. Laryngoscopes
3. Gynae instrument set
4. D & C instruments set
EQUIPMENT FOR THQ HOSPITAL
OPTIMAL ITEMS
General hospital
1. Ambulance
2. Defibrillator
3. Desktop computer with monitor and
accessories
4. Electric water cooler
Gynae/Obs. ward items
1. Cabinet instrument (Large)
2. Fowler bed (Iron)
3. Attendant's bench
4. Bed side locker
5. Screen folding complete
6. Weighing machine (Adult)
7. Artery forceps (7 inch)
8. B P Apparatus mercury – desk type
9. Dissecting forceps (Plain, 7 inch)
10. Scissors (Curved, 5 inch)
11. Scissors (Sharp, 5 inch, straight)
12. Chital forceps
13. Kidney tray (S.s,10 inch)
14. Jar for forceps
15. Infusion / drip stands
16. Foetal monitor (foetal doppler-desk type)
17. Infant B.P apparatus
18. Infant weighing machine
19. Baby cot
OPD / Gynaecologist’s office
1. Weighing machine (Adult)
2. Infant weighing machine
3. Screen folding complete
4. Ultrasound machine
5. Examination lamp
78
EQUIPMENT FOR THQ HOSPITAL
OPTIMAL ITEMS
Paediatric nursery
1. Air ways 2 size
2. Infant ambo bag
3. Infant laryngoscope set
4. Suction apparatus: electrically
operated
5. Infant incubators
6. Phototherapy unit
7. Baby warmer
8. Infant B.P apparatus (Cuff 2.5 cm)
9. Room thermometer
10. Baby cot
11. Steam inhaler
12. Oxygen cylinder complete with trolley
13. Infusion / drip stands
Paediatric ward
1. Suction machine
2. Infant B.P apparatus (Cuff 2.5 cm)
3. Stethoscope Paediatric Littman type
4. Nebulizer
5. Oxygen cylinder complete with trolley
6. Emergency medicine trolley
7. Patient's attendant bench
8. Fowler bed (Iron)
9. Bed side locker (S.s top)
10. Screen folding complete
Labour room
1. Foetal stethoscope
2. Electric instrument sterilizer (12”x6”)
3. Jar for forceps
4. Spring type dressing forceps (S.s)
5. Sim’s speculum (Right angle, small)
6. Sim’s speculum (Right angle,
medium)
7. Sim’s speculum (Right angle, large)
8. Sponge forceps
9. Artery forceps (Long,straight)
10. Uterine sound
11. Vulsellum forceps
12. Scissors (Dissecting, blunt pointed)
13. Artery forceps
14. Blunt-ended scissors
15. Episiotomy instruments set (Complete)
16. Infant ambo bag
17. Portable light & rechargeable batteries
18. Sterilizing drum
19. Vacuum extractor
Operation theatre
1. Needle holder
2. Stitch scissors
3. Dissecting forceps (Toothed)
4. Sim’s speculum (Large)
5. Sim’s speculum (Medium)
6. Vacuum extractor
7. Obstetric forceps
8. Rectangular instrument tray & lids
9. Towel clips
10. Sponge forceps (22.5 cm)
11. Artery forceps (Straight, 16 cm)
12. Uterine homeostasis forceps (20 cm)
13. Hysterectomy forceps (Straight, 22.5
cm)
14. Mosquito forceps (12.5 cm)
15. Tissue forceps (19 cm)
16. Needle holder (Straight, 17.5 cm)
17. Surgical knife handle # 3
18. Surgical knife handle # 4
19. Abdominal retractors, double-ended
(Richardson)
20. Curved operating scissors, blunt pointed
(Mayo), 17 cm
21. Straight operating scissors, blunt pointed
(Mayo), 17 cm
22. Aesthetic face masks (3 sizes)
23. Anaesthesia machine
24. Laryngoscopes
25. X-Ray illuminator
26. Gynae Instrument set
27. General Instrument set
28. Adult ambo bag and mask
29. D & C instruments set
30. Myomectomy screw
31. Air conditioners
79
EQUIPMENT FOR THQ HOSPITAL
OPTIMAL ITEMS
Laboratory
1. Spin machine
2. Chemistry analyzer
3. Counter (Hand tally differential)
4. Steel almirah (Large)
5. Lab cabinet
MINIMAL ITEMS
Gynae/Obs. ward items 2. Fowler bed (Iron)
OPD / Gynaecologist’s office
1. Weighing machine (Adult) 2. Examination lamp
Paediatric nursery
1. Air ways 2 size
2. Infant ambo bag
3. Infant laryngoscope set
4. Suction apparatus: electrically operated
5. Infant incubators
6. Phototherapy unit
Paediatric ward
1. Stethoscope Paediatric Littman type
2. Nebulizer
3. Oxygen cylinder complete with trolley
4. Fowler bed (Iron)
Labour room
1. Foetal stethoscope
2. Spring type dressing forceps (S.s)
3. Sim’s speculum (Right angle,
medium)
4. Sponge forceps
5. Uterine sound
6. Vulsellum forceps
7. Episiotomy instruments set (Complete)
Operation theatre
1. Anaesthesia machine
2. Laryngoscopes
3. Gynae Instrument set
4. D & C instruments set
D. Drugs and supplies criteria
DRUGS & SUPPLIES FOR BHUS
OPTIMAL ITEMS
Supplies
1. Gloves
2. Clean / Safe delivery kit
3. Disposable/ Auto disable syringes
4. Reagents/ strips for routine lab tests
5. Surgical spirit
6. Oral Rehydration Salt – ORS
Tracer drugs
1. Capsule Amoxicillin
2. Syrup Amoxicillin
3. Tablet Metronidazole
4. Syrup Metronidazole
5. Tablet Iron
6. Tablet Folic acid
7. Tetracycline Ointment
8. Injection Oxytocin
9. IV solutions
10. Syrup Salbutamol
11. Syrup Chloroquine
12. Syrup Zinc Sulphate
80
DRUGS & SUPPLIES FOR BHUS
OPTIMAL ITEMS
Vaccines
1. BCG
2. OPV
3. Penta-valent
4. Measles
5. TT
Family planning commodities
1. Condoms
2. COC
3. POP
4. IUCDs
5. Injection DMPA
6. Injection Net-En
MINIMAL ITEMS
Supplies
1. Clean / Safe delivery kit
2. Disposable/ Auto disable syringes
3. Reagents/ strips for routine lab tests
Tracer drugs 1. Tablet Iron
2. Tablet Folic acid
Vaccines
1. BCG
2. OPV
3. Penta-valent
4. Measles
5. TT
Family planning commodities (any three)
1. Condoms
2. IUCDs
3. COC or POP
4. Injection DMPA or Net-En
DRUGS & SUPPLIES FOR RHCS
OPTIMAL ITEMS
Supplies
1. Gloves
2. Clean / Safe delivery kit
3. Disposable/ Auto disable syringes
4. Reagents/ strips for routine lab tests
5. Surgical spirit
6. Oral Rehydration Salt – ORS
Tracer drugs
1. Injection Dexamethasone
2. Injection Adrenaline
3. Injection Atropine
4. Injection Ampicillin
5. Capsule Amoxicillin
6. Syrup Amoxicillin
7. Tablet Metronidazole
8. Syrup Metronidazole
9. Tablet iron
10. Tablet Folic acid
11. Tetracycline Ointment
12. Injection Oxytocin
13. Injection Magnesium Sulphate
14. IV solutions
15. Syrup Salbutamol
16. Syrup Chloroquine
17. Syrup Zinc Sulphate
18. Injection Diclofenac Sodium
Vaccines
1. BCG
2. OPV
3. Penta-valent
4. Measles
5. TT
81
DRUGS & SUPPLIES FOR RHCS
OPTIMAL ITEMS
Family planning commodities
1. Condoms
2. COC
3. POP
4. IUCDs
5. Injection DMPA
6. Injection Net-En
MINIMAL ITEMS
Supplies
1. Clean / Safe delivery kit
2. Disposable/ Auto disable syringes
3. Reagents/ strips for routine lab tests
Tracer drugs
1. Injection Ampicillin
2. Injection Oxytocin
3. Injection Magnesium Sulphate
Vaccines
1. BCG
2. OPV
3. Penta-valent
4. Measles
5. TT
Family planning commodities (any three)
1. Condoms
2. IUCDs
3. COC or POP
4. Injection DMPA or Net-En
DRUGS & SUPPLIES FOR DHQH & THQH
OPTIMAL ITEMS
Supplies
1. Gloves
2. Clean / Safe delivery kit
3. Disposable/ Auto disable syringes
4. Reagents/ strips for routine lab tests
5. Screening kits for Hep B,C & HIV
6. Blood grouping reagents
7. Blood bags with transfusion sets
8. Surgical spirit
9. Oral Rehydration Salt – ORS
Tracer drugs
1. Injection Dexamethasone
2. Injection Adrenaline
3. Injection Atropine
4. Injection Ampicillin
5. Capsule Amoxicillin
6. Syrup Amoxicillin
7. Tablet Metronidazole
8. Syrup Metronidazole
9. Tablet Iron
10. Tablet Folic acid
11. Tetracycline Ointment
12. Injection Oxytocin
13. Injection Magnesium Sulphate
14. IV solutions
15. Syrup Salbutamol
16. Syrup Chloroquine
17. Syrup Zinc Sulphate
18. Injection Diclofenac Sodium
19. Injection Thiopentone Sodium
20. Injection Neostigmine
21. Injection Propofol
Vaccines
1. BCG
2. OPV
3. Penta-valent
4. Measles
5. TT
82
Family planning commodities
1. Condoms
2. COC
3. POP
4. IUCDs
5. Injection DMPA
6. Injection Net-En
7. Implants
MINIMAL ITEMS
Supplies
1. Gloves
2. Clean / Safe delivery kit
3. Disposable/ Auto disable syringes
4. Reagents/ strips for routine lab tests
5. Screening kits for Hep B,C & HIV
6. Blood grouping reagents
Tracer drugs
1. Injection Dexamethasone
2. Injection Adrenaline
3. Injection Atropine
4. Injection Ampicillin
5. Injection Oxytocin
6. Injection Magnesium Sulphate
7. Injection Thiopentone Sodium
8. Injection Neostigmine
9. Injection Propofol
Vaccines
1. BCG
2. OPV
3. Penta-valent
4. Measles
5. TT
Family planning commodities (any three)
1. Condoms
2. IUCDs
3. COC or POP
4. Injection DMPA or Net-En
5. Implants
E. Support services criteria
SUPPORT SERVICES FOR BHUS SUPPORT SERVICES FOR RHCS
OPTIMAL CRITERIA OPTIMAL CRITERIA
Basic lab tests 1. Doctor or LHV
2. Reagents and strips
Basic lab tests 1. Space
2. Doctor or LHV or Lab technician
3. Reagents and strips
Ambulance services
1. Functional ambulance
2. Ambulance driver
MINIMAL CRITERIA FOR BHUS MINIMAL CRITERIA FOR RHCS
Basic lab tests 1. Doctor or LHV
2. Reagents and strips
Basic lab tests 1. Space
2. Doctor or LHV or Lab technician
3. Reagents and strips
83
SUPPORT SERVICES CRITERIA FOR SHC HOSPITALS
OPTIMAL CRITERIA
Basic lab tests 1. Space
2. Labboratory technician
3. Reagents and strips
4. Laboratory equipment
Blood transfusion services 1. Blood bank technician or lab technician
2. Screening strips for Hep B, C & HIV
Radiology services 1. Space
2. Ultrasound equipment
Operation theatre services 1. Space
2. Anaesthetist
3. Operation theatre technician
4. Anaesthesia technician
5. Operation theatre equipment
6. Drugs and supplies
Ambulance services 1. Functional ambulance
2. Ambulance driver
MINIMAL CRITERIA
Basic lab tests 1. Space
2. Lab technician
3. Reagents and strips
Blood transfusion services 1. Laboratory or blood bank technician
2. Screening strips for Hep B, C & HIV
Radiology services 1. Space
2. Ultrasound equipment
Operation theatre services 1. Space
2. Anaesthetist or anaesthesia technician
3. OT equipment
4. Drugs and supplies
F. Infection control & waste management criteria
ASSESSMENT CRITERIA
Infection control – Hand washing
1. Hand washing basin with running water 2. Soap
3. Towel 4. Gloves
Personal protection materials
1. Face masks 2. Safety goggles 3. Heavy duty leather gloves
4. Gowns 5. Industrial boots
Waste collection materials
1. Safety boxes 2. Colour-coded plastic bags
84
Waste treatment equipment
1. Autoclave for waste treatment 2. Autoclave test strips
Disinfection of service provision areas
1. Cleaning materials 2. Chemical disinfectant
G. Input criteria for basic EmONC services at the THQ hospital
G.1 - Civil works
CIVIL WORKS SCOPE
OPD 1. Consultation area
2. Examination area 3. Hand washing facilities
Female ward 1. Patient area
2. Functional attached washroom
Labour room 1. Delivery room
2. Scrub area 3. Functional attached washroom for patients
Clinical laboratory 1. Laboratory room
2. Working area 3. Functional attached washroom
LHV’s room 1. Consultation area
2. Examination area 3. Hand washing facilities
Residence - WMO · Available · Good condition
Residence - LHV · Available · Good condition
G.2 - Human resources
HUMAN RESOURCES
Category Number
WMOs 2
Operation theatre technician 1
Lab technician 1
Lady health visitors 2
Ambulance drivers 1
85
G. 3 - Equipment
EQUIPMENT
General hospital
1. Ambulance 2. Electric water cooler
Female ward
1. Fowler bed (Iron)
2. Attendant's bench
3. Bed side locker
4. Screen folding complete
5. B P Apparatus mercury – desk type
6. Baby cot
OPD
1. Weighing machine (Adult)
2. Infant weighing machine
3. Examination lamp
Labour room
1. Foetal stethoscope
2. Electric instrument sterilizer (12”x6”)
3. Jar for forceps
4. Spring type dressing forceps (S.s)
5. Sim’s speculum (Right angle, small)
6. Sim’s speculum (Right angle,
medium)
7. Sim’s speculum (Right angle, large)
8. Sponge forceps
9. Artery forceps (Long, straight)
10. Uterine sound
11. Vulsellum forceps
12. Scissors (Dissecting, blunt pointed)
13. Artery forceps
14. Blunt-ended scissors
G.4 - Drugs and supplies
DRUGS & SUPPLIES
Supplies
1. Gloves
2. Clean / Safe delivery kit
3. Disposable/ Auto disable syringes
4. Reagents/ strips for routine lab tests
5. Screening kits for Hep B,C & HIV
6. Blood grouping reagents
Tracer drugs
1. Injection Dexamethasone
2. Injection Adrenaline
3. Injection Atropine
4. Injection Ampicillin
5. Capsule Amoxicillin
6. Syrup Amoxicillin
7. Tablet Metronidazole
8. Syrup Metronidazole
9. Tablet Iron
10. Tablet Folic acid
11. Tetracycline Ointment
12. Injection Oxytocin
13. Injection Magnesium Sulphate
14. IV solutions
15. Syrup Salbutamol
16. Syrup Chloroquine
17. Syrup Zinc Sulphate
18. Injection Diclofenac Sodium
Vaccines
1. BCG
2. OPV
3. Penta-valent
4. Measles
5. TT
Family planning commodities
1. Condoms
2. COC
3. POP
4. IUCDs
5. Injection DMPA
6. Injection Net-En
86
G.5 - Support services
SUPPORT SERVICES
Laboratory services 1. Basic laboratory tests
Ambulance services 1. Functional ambulance
2. Ambulance driver
87
ANNEX 3 - A
Status of surveyed health facilities against the minimal level of inputs
A. Status of BHUs
i. STATUS OF ASSESSED INFRASTRUCTURE IN BHUS
Infr
astr
uctu
re
Status of building components at Surveyed BHUs B
HU
Att
aw
a
BH
U B
ota
la S
hara
m S
ing
h
BH
U F
ero
zew
ala
BH
U G
on
dla
nw
ala
BH
U T
alw
an
di M
us
a K
han
BH
U D
an
dia
n
BH
U G
ull
ok
e
BH
U K
otl
i N
aw
ab
BH
U A
rtali
Vir
ka
n
BH
U B
ud
da G
ora
ya
BH
U J
all
an
BH
U K
ot
La
dh
a
BH
U N
ok
har
BH
U B
uc
ha
Ch
ata
h
BH
U H
ard
o S
ah
ara
n
BH
U J
au
ra S
ian
BH
U M
oh
ala
nk
e
BH
U N
oia
nw
ala
LHV room available
Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Y Y Y
LHV room functional
Y Y Y Y Y N Y Y Y Y Y Y Y Y Y Y Y Y
ii. STATUS OF MNCH RELATED STAFF IN BHUS
Sta
ff c
ate
go
ries
Req
uir
ed
nu
mb
er
Availability of MNCH related staff at surveyed BHUs*
BH
U A
ttaw
a
BH
U B
ota
la S
hara
m S
ing
h
BH
U F
ero
zew
ala
BH
U G
on
dla
nw
ala
BH
U T
alw
an
di M
us
a K
han
BH
U D
an
dia
n
BH
U G
ull
ok
e
BH
U K
otl
i N
aw
ab
BH
U A
rtali
Vir
ka
n
BH
U B
ud
da G
ora
ya
BH
U J
all
an
BH
U K
ot
La
dh
a
BH
U N
ok
har
BH
U B
uc
ha
Ch
ata
h
BH
U H
ard
o S
ah
ara
n
BH
U J
au
ra S
ian
BH
U M
oh
ala
nk
e
BH
U N
oia
nw
ala
WMO/MO, or LHV
1 2 2 2 2 2 1 1 1 2 2 2 1 2 1 3 2 2 1
*Includes both regular and NMNCHP provided staff
88
iii. STATUS OF FUNCTIONAL EQUIPMENT IN BHUS
Eq
uip
men
t
To
tal it
em
s
Availability of functional equipment items at surveyed BHUs
BH
U A
ttaw
a
BH
U B
ota
la S
hara
m S
ing
h
BH
U F
ero
zew
ala
BH
U G
on
dla
nw
ala
BH
U T
alw
an
di M
us
a K
han
BH
U D
an
dia
n
BH
U G
ull
ok
e
BH
U K
otl
i N
aw
ab
BH
U A
rtali
Vir
ka
n
BH
U B
ud
da G
ora
ya
BH
U J
all
an
BH
U K
ot
La
dh
a
BH
U N
ok
har
BH
U B
uc
ha
Ch
ata
h
BH
U H
ard
o S
ah
ara
n
BH
U J
au
ra S
ian
BH
U M
oh
ala
nk
e
BH
U N
oia
nw
ala
Assessed items
10 5 9 8 8 8 7 9 6 7 6 7 10 7 8 9 7 7 8
iv. STATUS OF DRUGS AND SUPPLIES IN BHUS
Item groups
To
tal it
em
s
Availability of tracer drugs and supplies at surveyed BHUs
BH
U A
ttaw
a
BH
U B
ota
la S
hara
m S
ing
h
BH
U F
ero
zew
ala
BH
U G
on
dla
nw
ala
BH
U T
alw
an
di M
us
a K
han
BH
U D
an
dia
n
BH
U G
ull
ok
e
BH
U K
otl
i N
aw
ab
BH
U A
rtali
Vir
ka
n
BH
U B
ud
da G
ora
ya
BH
U J
all
an
BH
U K
ot
La
dh
a
BH
U N
ok
har
BH
U B
uc
ha
Ch
ata
h
BH
U H
ard
o S
ah
ara
n
BH
U J
au
ra S
ian
BH
U M
oh
ala
nk
e
BH
U N
oia
nw
ala
Supplies* 3 3 2 2 1 2 3 2 2 1 1 1 2 2 1 1 2 1 0
Drugs* 2 1 2 1 2 2 1 1 2 2 0 1 2 2 1 1 0 1 1
Vaccines 5 5 4 4 5 5 5 4 5 0 5 4 4 4 5 4 5 4 5
Family planning
commodities 4 4 4 0 4 0 1 4 3 2 3 4 1 4 4 0 3 1 0
* Tracer items were selected for assessment from list provided in the PC-1 NMNCHP
89
v. STATUS OF SUPPORT SERVICES IN BHUS
Support services
Total items
required at
each BHU
Number of items available at each surveyed BHU
BH
U A
ttaw
a
BH
U B
ota
la S
hara
m S
ing
h
BH
U F
ero
zew
ala
BH
U G
on
dla
nw
ala
BH
U T
alw
an
di M
us
a K
han
BH
U D
an
dia
n
BH
U G
ull
ok
e
BH
U K
otl
i N
aw
ab
BH
U A
rtali
Vir
ka
n
BH
U B
ud
da G
ora
ya
BH
U J
all
an
BH
U K
ot
La
dh
a
BH
U N
ok
har
BH
U B
uc
ha
Ch
ata
h
BH
U H
ard
o S
ah
ara
n
BH
U J
au
ra S
ian
BH
U M
oh
ala
nk
e
BH
U N
oia
nw
ala
Basic lab tests*
2 2 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1
*Includes the facility for tests of pregnancy, haemoglobin, urine for protein and sugar, and malaria.
B. Status of RHCs
i. STATUS OF ASSESSED INFRASTRUCTURE IN RHCS
Infrastructure Status
Status of building components at each RHC
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
OPD A Y Y Y Y Y Y Y Y Y
F Y Y Y Y Y Y Y Y Y
Female ward A Y Y Y Y Y Y Y Y Y
F Y Y Y Y Y Y Y Y Y
Labour room A Y Y Y Y Y Y Y Y Y
F Y Y Y Y Y Y Y Y Y
LHV room A Y Y Y Y N N Y Y Y
F Y Y Y Y N N Y Y Y
Residence -
Doctor
A Y Y Y Y Y Y Y Y N
F Y N N Y Y N N N N
Residence - LHV A Y Y Y Y Y Y Y Y Y
F Y N Y Y Y Y Y Y N
90
ii. STATUS OF MNCH RELATED STAFF IN RHCS
Staff categories
Required number at each
RHC
Number of MNCH related staff available at each RHC*
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
WMO 1 1 2 2 1 1 2 1 2 0
LHV 1 3 3 4 2 3 2 2 3 3
Lab technician
1 0 1 1 1 1 1 1 1 0
*Includes both regular and NMNCHP provided staff
iii. STATUS OF FUNCTIONAL EQUIPMENT IN RHCS
Equipment
Total
items
required
at each
RHC
Number of functional equipment items available at each RHC
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
Female ward
3 3 3 2 3 2 3 3 3 1
WMO OPD 5 4 4 4 4 4 5 5 4 4
Labour room
8 8 7 4 6 8 6 8 7 6
LHV’s room
7 5 0 5 5 0 0 3 5 5
iv. STATUS OF DRUGS AND SUPPLIES IN RHCS
Item groups
Total
items
required
at each
RHC
Number of items available at each RHC
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
Supplies* 3 3 3 3 3 3 3 2 2 2
Drugs* 3 1 2 2 2 2 2 2 2 2
91
Item groups
Total
items
required
at each
RHC
Number of items available at each RHC
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
Vaccines 5 5 4 4 5 4 5 5 5 5
Family planning
commodities 4 0 0 2 0 2 0 0 2 0
* Tracer items were selected for assessment from list provided in the PC-1 NMNCHP
v. STATUS OF SUPPORT SERVICES IN RHCS
Support services
Total
items
required
at each
RHC
Number of items available at each RHC
RH
C A
hm
ed
Nag
ar
RH
C A
lip
ur
Ch
att
a
RH
C D
ou
nk
al
RH
C E
min
Ab
ad
RH
C G
ak
har
RH
C Q
ila
Did
ar
Sin
gh
RH
C R
aso
ol
Nag
ar
RH
C S
oh
dra
RH
C W
ah
nd
o
Basic lab tests*
4 3 4 4 4 4 4 4 4 4
Ambulance service
2 2 2 2 2 2 2 2 2 2
*Includes the facility for tests of pregnancy, haemoglobin, urine for protein and sugar, and malaria.
C. Status of SHC hospitals
i. STATUS OF ASSESSED INFRASTRUCTURE IN SHC HOSPITALS
Infrastructure Status
Status of building components in SHCs
DHQH Gujranwala
THQH Kamonke
THQH Wazirabad
THQH Noshehra Virkan
Gynae OPD A Y Y Y Y
F Y Y Y Y
Gynae ward A Y Y Y Y
F Y Y Y Y
Labour room A Y Y Y Y
F Y Y Y Y
Operation theatre A Y Y Y Y
F Y Y Y Y
Paediatric ward A Y N N N
92
ii. STATUS OF MNCH RELATED STAFF IN SHC HOSPITALS
Staff categories
Availability* at DHQH Availability* at THQHs
Required number
DHQH Gujranwala
Required number
THQH Kamonke
THQH Wazirabad
THQH Noshehra
Virkan
Gynaecologist 1 3 1 1 2 0
Anaesthetist 1 2 1 0 1 0
Paediatrician 1 3 1 1 1 1
WMOs 4 0 2 0 0 2
OT technician 1 0 1 0 0 0
Lab technician 1 3 1 2 1 1
Nurses 6 158 4 12 12 14
LHVs 1 8 1 1 1 1
*Includes both regular and NMNCHP provided staff
F Y N N N
Laboratory A Y Y Y Y
F Y Y Y Y
Residence - Gynaecologist A N N N N
F N N N N
Residence - Anaesthetist A Y N Y N
F Y N Y N
Residence - Paediatrician A N Y N Y
F N Y N Y
Residence - WMO A N N Y N
F N N Y N
Residence - Lab technician A Y Y N Y
F Y Y N Y
93
iii. STATUS OF FUNCTIONAL EQUIPMENT IN SHC HOSPITALS
Equipment
Availability of functional equipment items
Required number
DHQH Gujranwala
Required number
THQH Kamonke
THQH Wazirabad
THQH Noshehra
Virkan
Female ward 1 1 1 1 1 1
OPD 7 6 2 2 1 0
Paediatric nursery 6 5 6 3 4 2
Paediatric ward 4 0 4 2 1 3
Labour room 11 4 7 0 5 0
Operation theatre 4 4 4 2 4 3
iv. STATUS OF DRUGS AND SUPPLIES IN SHC HOSPITALS
Item groups Total
items
Number of items available at each SHC hospital
DHQH Gujranwala
THQH Kamonke
THQH Wazirabad
THQH Noshehra
Virkan
Supplies* 6 3 4 5 6
Drugs* 9 5 5 7 5
Vaccines 5 5 5 5 4
Family planning commodities
5 5 0 3 0
* Tracer items were selected for assessment from list provided in the PC-1 NMNCHP
94
v. STATUS OF SUPPORT SERVICES IN SHC HOSPITALS
Support services Total
items
Number of items available at each SHC hospital
DHQH Gujranwala
THQH Kamonke
THQH Wazirabad
THQH Noshehra
Virkan
Basic laboratory tests* 9 9 6 8 7
Blood transfusion 5 4 3 5 4
Ambulance services 2 2 2 2 2
Radiology services 3 3 1 3 3
Operation theatre 16 12 10 16 11
*Includes facility for tests of pregnancy, haemoglobin, urine for protein and sugar, and malaria.
95
ANNEX 3 - B
Each item is assessed against the standard quantity, in different assessed components of
service provision areas. The standard quantity of the same item may vary in each
component. The annexed tables, include the aggregate quantity of each item in all the
surveyed components. Therefore, the table may show the requirement of an item, despite
having the same aggregate quantity with respect to standard, available and functional as
explained in the following table. The annexed table shows the aggregate quantities of each
assessed item; therefore, the requirement may arise, even though the overall standard
quantity is available and functional in the facility.
Component Quantity of an item
STD* AVL* FUNC* RQRD*
OPD 2 3 3 0
Ward 4 3 3 1
Aggregate 6 6 6 1
*STD: Standard, AVL: Available, FUNC: Functional, RQRD: Required.
A. List of items required for DHQ and THQ hospitals in district Gujranwala
DHQ hospital Gujranwala
Item name Item quantities
Standard Available Functional Required
Abdominal retractors, double-ended
(Richardson) 20 34 34 -
Adult ambo bag and mask 4 5 5 -
Air conditioner (Split) 1.5 Ton (with heating
system) 17 - - 17
Air ways 2 size 2 - - 2
Ambulance 2 8 6 -
Anaesthesia machine 4 8 8 -
Anaesthetic face masks (3 sizes) 4 8 8 -
Artery forceps (7”) 10 - - 10
Attendant's bench 40 35 30 10
Auto-clave for treatment of hospital waste 1 11 7 -
B P Apparatus mercury – desk type 6 1 1 5
Baby cot 33 7 7 26
Baby warmer 4 6 4 -
Bed side locker (S.s top) 80 68 37 43
Blunt-ended scissors 6 - - 6
C.T.G. machine 1 1 1 -
96
Cabinet instrument (Large) 3 3 3 -
Chemistry analyzer 2 6 3 -
Chital forceps 4 3 - 4
Counter (Hand tally differential) 4 1 1 3
Curved operating scissors, blunt pointed
(Mayo), 17 cm 10 84 74 -
D & C instruments set 10 2 2 8
Defibrillator 1 - - 1
Delivery forceps set 1 - - 1
Delivery table 4 6 - 4
Desktop computer with monitor and accessories 6 3 3 4
Dissecting forceps (Plain, 7”) 4 10 10 -
Dissecting forceps (Toothed) 6 55 55 -
Dust bin (Stainless steel) 40 - - 40
ECG machine 1 - - 1
Electric instrument sterilizer (12”x6”) 3 1 - 3
Electric water cooler 2 7 4 -
Emergency medicine trolley 1 - - 1
Episiotomy instruments set (Complete) 4 1 1 3
Examination couch 3 3 3 -
Foetal Monitor (foetal doppler-desk type) 2 1 1 1
Foetal stethoscope 4 - - 4
Fowler bed (Iron) 80 40 34 46
General Instrument set 1 1 1 -
Glucometer 2 - - 2
Gynae Instrument set 4 2 2 2
Haematology analyzer 2 1 1 1
Hysterectomy forceps (Straight, 22.5 cm) 30 - - 30
Incinerator (50kg) 1 - - 1
Infant ambo bag 4 7 7 1
Infant B.P apparatus (Cuff 2.5 cm) 6 - - 6
Infant laryngoscope set 2 - - 2
Infant weighing machine 5 3 2 3
Infusion / drip stands 22 21 20 4
Infusion pump 2 - - 2
Jar for forceps 6 1 1 5
Kidney tray (S.s, 10”) 4 2 2 2
Lab cabinet 3 1 1 2
Lab incubator 9 9 4 6
Laryngoscopes set (Adult) 8 1 1 7
LaserJet printer 6 4 4 3
Artery forceps (Long, straight,10”) 3 9 9 -
Mosquito forceps (12.5 cm) 60 114 114 -
Myomectomy screw 2 2 2 -
Nebulizer 3 - - 3
Needle holder (Straight, 17.5 cm) 20 40 40 -
Needle holder (Straight, 8”) 6 20 20 -
Obstetric forceps 2 - - 2
Office chair 3 5 5 -
Office tables with drawers 3 1 1 2
Ophthalmoscope 1 - - 1
97
Overhead food trolley 40 - - 40
Oxygen cylinder complete with trolley &
regulator 9 6 4 5
P.V. examination light 6 1 1 5
Patient’s stool 3 2 2 1
Patient’s waiting bench 3 5 - 3
Patient's attendant bench 40 - - 40
Phototherapy unit 1 10 3 -
Portable light & rechargeable batteries (OT) 1 2 - 1
Power generator 50 Kva (Diesel) 1 - - 1
Pulse oximeter 3 2 1 2
Rectangular instrument tray & lids 5 - - 5
Refrigerator (10 cuft) 4 3 3 1
Room thermometer 2 1 1 1
Scissors (Curved, 5”) 4 - - 4
Scissors (Dissecting, blunt pointed) 3 - - 3
Scissors (Sharp, straight, 5”) 4 - - 4
Screen folding complete 15 4 3 12
Shredder (500 litre) 1 - - 1
Sim’s speculum (Large) 6 2 2 4
Sim’s speculum (Medium) 6 2 2 4
Sim’s speculum (Right angle, large) 3 2 2 1
Sim’s speculum (Right angle, medium) 3 2 2 1
Sim’s speculum (Right angle, small) 3 2 2 1
Spin machine (centrifuge) 1 5 2 -
Sponge forceps (22.5 cm) 9 61 61 -
Spring type dressing forceps (S.s) 2 - - 2
Steam inhaler 5 - - 5
Steel almirah (Large) 3 1 1 2
Sterilizing drum 4 1 - 4
Stethoscope (Adult size) 3 - - 3
Stethoscope Paediatric Littman type 4 - - 4
Stitch scissors 6 - - 6
Artery forceps (Straight, 16 cm) 60 160 160 -
Straight operating scissors, blunt pointed
(Mayo), 17 cm 10 50 50 -
Suction apparatus: electrically operated 5 5 5 3
Surgical knife handle # 3 5 10 10 -
Surgical knife handle # 4 5 36 36 -
Tissue forceps (19 cm) 60 142 142 -
Towel clips 60 112 112 -
Ultrasound machine 3 1 1 2
UPS for computer 6 1 1 5
UPS power supply system (2000W) 5 - - 5
Uterine homeostasis forceps (20 cm) 30 - - 30
Uterine sound 4 2 2 2
Vacuum extractor 2 1 - 2
Vulsellum forceps 3 - - 3
Water distillation unit 2 2 1 1
Water filter 2 7 4 -
Weighing machine (Adult) 2 2 2 -
98
X-Ray illuminator 2 - - 2
Total quantities 1,118 1,307 1,197 551
Item name
THQH Kamonki THQH Noshera
Virkan THQH Wazirabad
Item quantities Item quantities Item quantities
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Abdominal retractors,
double-ended (Richardson) 2 - - 2 2 - - 2 2 6 6 -
Adult ambo bag and mask 2 2 1 1 2 1 1 1 2 2 2 -
Air conditioner (Split) 1.5
Ton (with heating system) 7 2 1 6 5 1 1 4 7 - - 7
Air ways 2 size 2 - - 2 2 - - 2 2 2 2 -
Ambulance 1 2 2 - 1 2 2 - 1 2 2 -
Anaesthesia machine 1 2 2 - 1 2 - 1 1 2 1 -
Anaesthetic face masks (3
sizes) 2 1 1 1 2 2 - 2 2 - - 2
Artery forceps (7”) 14 4 2 12 14 - - 14 14 8 8 10
Attendant's bench 15 15 15 - 10 13 13 - 15 12 12 3
Auto-clave for treatment of
hospital waste 1 5 3 - 1 3 2 - 1 1 1 -
B P Apparatus mercury –
desk type 2 3 3 - 2 1 1 1 2 - - 2
Baby cot 12 4 4 8 10 - - 10 12 4 4 8
Baby warmer 2 - - 2 2 - - 2 2 - - 2
Bed side locker (S.s top) 30 30 30 - 20 14 14 6 30 15 15 15
Blunt-ended scissors 6 - - 6 6 - - 6 6 2 2 4
C.T.G. machine 1 - - 1 1 1 1 - 1 - - 1
Cabinet instrument (Large) 2 1 1 1 1 1 1 - 2 1 1 1
Chemistry analyzer 1 1 1 - 1 - - 1 1 1 1 -
Chital forceps 2 1 1 1 2 - - 2 2 2 2 -
Clean delivery kits 200 - - 200 100 25 25 75 200 - - 200
Counter (Hand tally
differential) 1 - - 1 1 1 1 - 1 1 1 -
Curved operating scissors,
blunt pointed (Mayo), 17 cm 2 2 2 - 2 - - 2 2 6 6 -
D & C instruments set 2 1 - 2 2 5 5 - 2 2 2 -
Defibrillator 1 - - 1 1 - - 1 1 - - 1
Desktop computer with
monitor and accessories 3 1 1 2 3 2 2 1 3 1 1 2
Disposable syringe cutter 2 1 1 1 2 1 1 1 2 2 2 -
Dissecting forceps (Plain,
7”) 2 2 2 - 2 - - 2 2 2 2 -
Dissecting forceps
(Toothed) 2 - - 2 2 - - 2 2 12 8 -
Dust bin (Stainless steel) 15 15 15 - 10 - - 10 15 - - 15
99
ECG machine 1 - - 1 1 - - 1 1 2 1 -
Electric instrument sterilizer
(12”x6”) 2 - - 2 1 1 - 1 2 1 - 2
Electric water cooler 2 2 1 1 2 2 2 - 2 4 2 -
Emergency medicine trolley 1 1 1 - 1 1 1 - 1 1 1 -
Episiotomy instruments set
(Complete) 4 - - 4 4 1 - 4 4 2 - 4
Foetal Monitor (foetal
doppler-desk type) 1 1 - 1 1 - - 1 1 1 1 -
Foetal stethoscope 3 - - 3 2 - - 2 3 1 - 3
Fowler bed (Iron) 30 6 6 24 20 7 7 13 30 27 27 3
General Instrument set 1 2 2 - 1 3 3 - 1 2 2 -
Glucometer 2 - - 2 2 - - 2 2 - - 2
Gynae Instrument set 2 - - 2 2 1 1 1 2 2 2 -
Haematology analyzer 1 - - 1 1 - - 1 1 - - 1
Hysterectomy forceps
(Straight, 22.5 cm) 2 3 3 - 2 - - 2 2 8 8 -
Incinerator (50kg) 1 - - 1 1 - - 1 1 - - 1
Infant ambo bag 3 1 1 2 3 1 1 2 3 2 2 1
Infant B.P apparatus (Cuff
2.5 cm) 4 - - 4 4 - - 4 4 - - 4
Infant laryngoscope set 1 - - 1 1 - - 1 1 1 1 -
Infant weighing machine 5 3 3 2 5 1 1 4 5 2 2 4
Infusion / drip stands 10 1 1 9 10 10 10 4 10 16 16 -
Infusion pump 1 - - 1 1 - - 1 1 - - 1
Jar for forceps 3 8 4 - 3 - - 3 3 2 2 1
Kidney tray (S.s, 10”) 2 2 2 - 2 - - 2 2 3 3 -
Lab cabinet 2 - - 2 1 1 1 - 2 1 1 1
Lab incubator 2 1 1 1 2 - - 2 2 4 4 -
Laryngoscopes set (Adult) 2 1 1 1 1 3 3 - 2 2 2 -
LaserJet printer 3 1 1 2 3 2 2 1 3 1 1 2
Artery forceps (Long,
straight,10”) 3 2 2 1 3 - - 3 3 2 2 1
Mosquito forceps (12.5 cm) 2 - - 2 2 - - 2 2 6 6 -
Myomectomy screw 2 2 2 - 2 - - 2 2 2 2 -
Nebulizer 3 2 2 1 3 1 1 2 3 - - 3
Needle holder (Straight,
17.5 cm) 2 1 1 1 2 2 2 - 2 2 2 -
Needle holder (Straight, 8”) 2 1 1 1 2 4 4 - 2 8 6 -
Obstetric forceps 1 1 1 - 1 - - 1 1 - - 1
Ophthalmoscope 1 - - 1 1 - - 1 1 - - 1
Overhead food trolley 15 - - 15 10 - - 10 15 - - 15
Oxygen cylinder complete
with trolley & regulator 6 2 2 4 6 2 2 4 6 2 2 4
P.V. examination light 2 1 1 1 2 - - 2 2 - - 2
Patient's attendant bench 15 15 15 - 10 4 4 6 15 - - 15
Phototherapy unit 1 - - 1 1 - - 1 1 - - 1
Portable light &
rechargeable batteries (OT) 1 - - 1 1 - - 1 1 1 1 -
Power generator 50 Kva
(Diesel) 1 2 2 - 1 2 2 - 1 1 1 -
100
Pulse oximeter 2 - - 2 2 - - 2 2 2 2 1
Rectangular instrument tray
& lids 2 4 4 - 2 - - 2 2 3 3 -
Refrigerator (10 cuft) 2 2 1 1 2 1 1 1 2 1 - 2
Room thermometer 1 - - 1 1 - - 1 1 - - 1
Scissors (Curved, 5”) 2 1 - 2 2 - - 2 2 - - 2
Scissors (Dissecting, blunt
pointed) 3 1 1 2 3 - - 3 3 1 1 2
Scissors (Sharp, straight,
5”) 2 - - 2 2 - - 2 2 2 2 -
Screen folding complete 21 2 1 20 16 1 1 15 21 1 - 21
Shredder (500 litre) 1 - - 1 1 - - 1 1 - - 1
Sim’s speculum (Large) 2 1 1 1 2 2 2 - 2 1 1 1
Sim’s speculum (Medium) 2 1 1 1 2 2 2 - 2 2 2 -
Sim’s speculum (Right
angle, large) 3 1 1 2 3 - - 3 3 1 1 2
Sim’s speculum (Right
angle, medium) 3 - - 3 3 - - 3 3 1 1 2
Sim’s speculum (Right
angle, small) 3 - - 3 3 - - 3 3 - - 3
Spin machine (centrifuge) 1 4 2 - 1 1 1 - 1 3 2 -
Sponge forceps (22.5 cm) 5 8 8 - 5 10 10 1 5 10 10 1
Spring type dressing
forceps (S.s) 2 - - 2 2 - - 2 2 - - 2
Steam inhaler 3 - - 3 3 - - 3 3 - - 3
Steel almirah (Large) 2 - - 2 1 - - 1 2 1 1 1
Sterilizing drum 6 - - 6 4 2 2 2 6 2 2 4
Stethoscope Paediatric
Littman type 3 - - 3 2 - - 2 3 - - 3
Stitch scissors 2 - - 2 2 32 32 - 2 3 3 -
Artery forceps (Straight, 16
cm) 2 46 46 - 2 15 15 - 2 6 6 -
Straight operating scissors,
blunt pointed (Mayo), 17 cm 2 2 2 - 2 12 12 - 2 - - 2
Suction apparatus:
electrically operated 2 1 1 1 2 - - 2 2 1 1 1
Surgical knife handle # 3 2 3 3 - 2 3 2 - 2 1 1 1
Surgical knife handle # 4 2 7 7 - 2 3 3 - 2 5 5 -
Tissue forceps (19 cm) 2 6 6 - 2 - - 2 2 6 6 -
Towel clips 2 17 17 - 2 30 30 - 2 7 6 -
Ultrasound machine 1 1 1 - 1 1 1 - 1 1 1 -
UPS for computer 3 - - 3 3 2 2 1 3 1 1 2
UPS power supply system
(2000W) 4 - - 4 4 2 2 2 4 - - 4
Uterine homeostasis
forceps (20 cm) 2 2 2 - 2 - - 2 2 2 2 -
Uterine sound 3 1 1 2 3 2 2 1 3 1 1 2
Vacuum extractor 2 - - 2 2 - - 2 2 - - 2
Vulsellum forceps 3 1 1 2 3 - - 3 3 2 2 1
Water distillation unit 1 2 2 - 1 1 1 - 1 - - 1
Water filter 2 - - 2 2 - - 2 2 4 2 -
101
Weighing machine (Adult) 3 2 1 2 3 - - 3 3 2 2 1
X-Ray illuminator 1 1 1 - 1 - - 1 1 - - 1
Total items 595 274 255 425 437 246 238 306 595 268 248 416
B. List of items required for RHCs in district Gujranwala
Item name
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RHC Ahmad
Nagar -
Gujranwala
RHC Alipur
Chatta -
Gujranwala
RHC Dounkal -
Gujranwala
Item quantities Item quantities Item quantities
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Ambulance 1 1 1 - 1 1 - 1 1 -
Artery forceps (7”) 4 2 2 2 1 1 3 - - 4
Attendant's bench 20 10 10 10 10 10 10 4 4 16
B P Apparatus mercury – desk
type 2 2 2 - 2 2 - 1 1 1
Baby cot 4 2 2 2 - - 4 - - 4
Bed side locker (S.s top) 20 10 10 10 7 7 13 4 4 16
Blunt-ended scissors 2 3 3 - 2 2 - 2 2 -
Clean delivery kits 100 - - 100 77 77 23 - - 100
D & C instruments set 2 1 1 1 1 1 1 1 1 1
Disposable syringe cutter 1 - - 1 1 1 - - - 1
Dust bin (Stainless steel) 20 2 2 18 - - 20 - - 20
Electric instrument sterilizer
(12”x6”) 1 1 1 - - - 1 - - 1
Electric water cooler 1 1 1 - 1 1 - 1 1 -
Examination couch 2 2 2 - 1 1 1 2 2 -
Foetal stethoscope 2 1 1 1 - - 2 - - 2
Fowler bed (Iron) 20 8 8 12 10 10 10 4 4 16
General Instrument set 1 1 1 - 1 1 - 1 1 -
Height measuring board 2 - - 2 - - 2 - - 2
Height measuring device 2 - - 2 - - 2 - - 2
Incinerator (50kg) 1 - - 1 - - 1 - - 1
Infant ambo bag 1 - - 1 1 1 - - - 1
Infant weighing machine 3 2 2 1 2 2 1 2 2 1
Jar for forceps 1 - - 1 - - 1 - - 1
Artery forceps (Long, straight,10”) 2 1 1 1 1 1 1 - - 2
Nebulizer 1 1 1 - 1 1 - - - 1
Office chair 6 6 6 - 3 3 3 3 3 3
Office tables with drawers 2 2 2 - 1 1 1 2 2 -
Overhead food trolley 20 - - 20 - - 20 - - 20
P.V. examination light 2 - - 2 1 1 1 - - 2
Patient’s stool 2 2 2 - 1 1 1 4 4 -
Plain chairs 2 1 1 1 1 1 1 1 1 1
102
Scissors (Dissecting, blunt
pointed) 2 2 2 - 1 1 1 - - 2
Screen folding complete 2 2 2 - - - 2 - - 2
Sim’s speculum (Right angle,
large) 2 1 1 1 1 1 1 1 1 1
Sim’s speculum (Right angle,
medium) 2 1 1 1 3 3 - - - 2
Sim’s speculum (Right angle,
small) 2 - - 2 2 2 - - - 2
Sponge forceps (22.5 cm) 2 3 3 - 5 5 - 1 1 1
Spring type dressing forceps (S.s) 2 2 2 - - - 2 - - 2
Steam inhaler 1 - - 1 - - 1 - - 1
Steel almirah (Large) 2 2 2 - 1 1 1 2 2 -
Stethoscope (Adult size) 1 1 1 - 1 1 - 1 1 -
Suction apparatus: electrically
operated 1 1 1 - 2 2 - 1 1 -
UPS power supply system
(2000W) 1 1 1 - - - 1 - - 1
Uterine sound 2 2 2 - 4 3 - 3 3 -
Vulsellum forceps 2 2 2 - 3 3 - - - 2
Water filter 1 - - 1 - - 1 1 1 -
Weighing machine (Adult) 2 2 2 - 1 1 1 2 2 -
Total 277 84 84 195 151 150 134 45 45 235
Item name
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RHC Emanabad -
Gujranwala
RHC Gakhar -
Gujranwala
RHC Qila Didar
Sing -
Gujranwala
Item quantities Item quantities Item quantities
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Ambulance 1 1 1 - 10 1 - 2 2 -
Artery forceps (7”) 4 2 2 2 5 5 - 2 2 2
Attendant's bench 20 10 10 10 5 5 15 10 10 10
B P Apparatus mercury – desk
type 2 2 2 - 1 1 1 3 3 -
Baby cot 4 - - 4 - - 4 1 1 3
Bed side locker (S.s top) 20 10 10 10 3 3 17 10 10 10
Blunt-ended scissors 2 1 1 1 1 1 1 2 2 -
Clean delivery kits 100 50 50 50 100 100 - 10 10 90
D & C instruments set 2 1 1 1 1 1 1 1 1 1
Disposable syringe cutter 1 - - 1 - - 1 1 1 -
Dust bin (Stainless steel) 20 - - 20 1 1 19 - - 20
Electric instrument sterilizer
(12”x6”) 1 1 - 1 1 1 - 1 1 -
Electric water cooler 1 1 1 - 1 1 - 1 1 -
Examination couch 2 2 2 - 1 1 1 1 1 1
Foetal stethoscope 2 - - 2 - - 2 1 1 1
103
Fowler bed (Iron) 20 10 10 10 5 5 15 10 10 10
General Instrument set 1 1 1 - 1 1 - 1 1 -
Height measuring board 2 - - 2 - - 2 - - 2
Height measuring device 2 - - 2 - - 2 - - 2
Incinerator (50kg) 1 - - 1 - - 1 - - 1
Infant ambo bag 1 - - 1 1 1 - 1 1 -
Infant weighing machine 3 2 2 1 1 1 2 3 2 1
Jar for forceps 1 - - 1 - - 1 - - 1
Artery forceps (Long,
straight,10”) 2 1 1 1 - - 2 2 2 -
Nebulizer 1 1 1 - - - 1 - - 1
Office chair 6 3 3 3 1 1 5 3 3 3
Office tables with drawers 2 2 2 - 1 1 1 1 1 1
Overhead food trolley 20 - - 20 - - 20 - - 20
P.V. examination light 2 2 2 - 1 1 1 1 1 1
Patient’s stool 2 2 2 - 1 1 1 1 1 1
Plain chairs 2 2 2 - 6 6 - 1 1 1
Scissors (Dissecting, blunt
pointed) 2 1 1 1 1 1 1 - - 2
Screen folding complete 2 1 1 1 - - 2 1 1 1
Sim’s speculum (Right angle,
large) 2 1 1 1 1 1 1 2 2 -
Sim’s speculum (Right angle,
medium) 2 - - 2 1 1 1 - - 2
Sim’s speculum (Right angle,
small) 2 - - 2 - - 2 - - 2
Sponge forceps (22.5 cm) 2 2 2 - 6 6 - 5 5 -
Spring type dressing forceps
(S.s) 2 1 1 1 - - 2 - - 2
Steam inhaler 1 - - 1 - - 1 1 1 -
Steel almirah (Large) 2 2 2 - 1 1 1 1 1 1
Stethoscope (Adult size) 1 1 1 - 1 1 - 1 1 -
Suction apparatus: electrically
operated 1 1 1 - 1 1 - 1 1 -
UPS power supply system
(2000W) 1 - - 1 - - 1 - - 1
Uterine sound 2 1 1 1 1 1 1 1 1 1
Vulsellum forceps 2 - - 2 2 2 - - - 2
Water filter 1 1 1 - 1 1 - 1 1 -
Weighing machine (Adult) 2 1 1 1 1 1 1 1 1 1
Total 277 120 119 158 165 156 130 85 84 198
104
Item name
Sta
nd
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qu
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RHC Rasool
Nagar -
Gujranwala
RHC Sohdra -
Gujranwala
RHC
Wahndo -
Gujranwala
Item quantities Item quantities Item
quantities
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Ambulance 1 1 1 - 1 1 - 2 1 -
Artery forceps (7”) 4 4 4 - 3 3 1 2 2 2
Attendant's bench 20 4 4 16 6 6 14 - - 20
B P Apparatus mercury – desk type 2 2 2 - 2 2 - 1 1 1
Baby cot 4 - - 4 2 2 2 - - 4
Bed side locker (S.s top) 20 4 4 16 6 6 14 3 3 17
Blunt-ended scissors 2 3 3 - 3 3 - 1 1 1
Clean delivery kits 100 98 98 2 - - 100 - - 100
D & C instruments set 2 1 1 1 1 1 1 1 1 1
Disposable syringe cutter 1 - - 1 - - 1 1 1 -
Dust bin (Stainless steel) 20 - - 20 - - 20 - - 20
Electric instrument sterilizer
(12”x6”) 1 1 1 - 1 1 - 1 1 -
Electric water cooler 1 - - 1 1 1 - 1 1 -
Examination couch 2 2 2 - 2 2 - 2 2 -
Foetal stethoscope 2 2 2 - - - 2 1 1 1
Fowler bed (Iron) 20 4 4 16 2 2 18 2 2 18
General Instrument set 1 1 1 - 1 1 - 1 1 -
Height measuring board 2 - - 2 - - 2 - - 2
Height measuring device 2 - - 2 - - 2 - - 2
Incinerator (50kg) 1 - - 1 - - 1 - - 1
Infant ambo bag 1 1 1 - 1 1 - 1 1 -
Infant weighing machine 3 1 1 2 2 2 1 3 3 1
Jar for forceps 1 1 1 - 1 1 - - - 1
Artery forceps (Long, straight,10”) 2 2 2 - 3 3 - 1 1 1
Nebulizer 1 1 1 - 1 1 - - - 1
Office chair 6 6 6 - 5 5 1 7 7 -
Office tables with drawers 2 2 2 - 2 2 - 2 2 -
Overhead food trolley 20 - - 20 - - 20 - - 20
P.V. examination light 2 - - 2 1 1 1 1 1 1
Patient’s stool 2 4 4 - 2 2 - 1 1 1
Plain chairs 2 2 2 - 1 1 1 2 2 -
Scissors (Dissecting, blunt pointed) 2 3 3 - 2 2 - - - 2
Screen folding complete 2 - - 2 - - 2 - - 2
Sim’s speculum (Right angle, large) 2 2 2 - - - 2 2 2 -
Sim’s speculum (Right angle,
medium) 2 2 2 - 1 1 1 - - 2
Sim’s speculum (Right angle,
small) 2 2 2 - - - 2 - - 2
Sponge forceps (22.5 cm) 2 3 3 - 2 2 - 1 1 1
Spring type dressing forceps (S.s) 2 2 2 - - - 2 - - 2
Steam inhaler 1 - - 1 - - 1 - - 1
105
Steel almirah (Large) 2 2 2 - 2 2 - 2 2 -
Stethoscope (Adult size) 1 1 1 - 1 1 - - - 1
Suction apparatus: electrically
operated 1 1 1 - 1 1 - 1 1 -
UPS power supply system (2000W) 1 - - 1 - - 1 1 1 -
Uterine sound 2 1 1 1 1 1 1 - - 2
Vulsellum forceps 2 3 3 - 2 2 - 1 1 1
Water filter 1 1 1 - 1 1 - - - 1
Weighing machine (Adult) 2 2 - 2 2 2 - 1 1 1
Total 277 172 170 113 65 65 214 46 45 234
C. List of items required for surveyed BHUs in district Gujranwala
Item name
Sta
nd
ard
qu
an
tity
BHU Artali
Virkan -
Gujranwala
BHU Attawa -
Gujranwala
BHU Botala
Sharam Singh -
Gujranwala
Item quantities Item quantities Item quantities
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
B P Apparatus mercury – desk type 1 - - 1 1 1 - 1 1 -
Clean delivery kits 50 - - 50 80 80 - 180 18 32
D & C instruments set 1 1 1 - - - 1 2 2 -
Disposable syringe cutter 1 - - 1 - - 1 1 1 -
Electric water cooler 1 - - 1 - - 1 - - 1
Examination couch 2 2 2 - 2 2 - 1 1 1
Foetal stethoscope 1 - - 1 - - 1 1 1 -
Height measuring board 2 1 1 1 - - 2 1 1 1
Height measuring device 2 - - 2 - - 2 - - 2
Incinerator (50kg) 1 - - 1 - - 1 - - 1
Infant weighing machine 2 1 1 1 - - 2 1 1 1
Nebulizer 1 - - 1 - - 1 1 1 -
Office chair 4 4 4 1 2 2 2 6 6 1
Office tables with drawers 2 2 2 - 2 2 - 2 2 -
P.V. examination light 2 1 1 1 1 1 1 2 2 -
Patient’s stool 2 2 2 - 2 2 - 2 2 -
Plain chairs 4 - - 4 2 1 3 1 1 3
Steam inhaler 1 - - 1 - - 1 - - 1
Steel almirah (Large) 2 2 2 - 1 1 1 2 2 -
Water filter 1 - - 1 - - 1 1 - 1
Weighing machine (Adult) 2 1 1 1 1 1 1 2 2 -
Total 85 17 17 69 94 93 22 207 44 45
106
Item name
Sta
nd
ard
qu
an
tity
BHU Bucha Chatah -
Gujranwala
BHU Budda Goraya -
Gujranwala
BHU Dandian - Gujranwala
Item quantities
Item quantities
Item quantities
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
B P Apparatus mercury – desk
type 1 1 1 - 1 1 - - - 1
Clean delivery kits 50 - - 50 10 10 40 50 50 -
D & C instruments set 1 1 1 - 1 1 - 1 1 -
Disposable syringe cutter 1 1 1 - 1 1 - 1 1 -
Electric water cooler 1 - - 1 - - 1 - - 1
Examination couch 2 2 2 - 3 3 - 2 2 -
Foetal stethoscope 1 - - 1 - - 1 1 1 -
Height measuring board 2 1 1 1 - - 2 - - 2
Height measuring device 2 - - 2 - - 2 - - 2
Incinerator (50kg) 1 - - 1 - - 1 - - 1
Infant weighing machine 2 2 2 - 2 1 1 1 1 1
Nebulizer 1 - - 1 1 1 - 1 1 -
Office chair 4 4 4 - 5 5 - 2 2 2
Office tables with drawers 2 2 2 - 2 2 - 2 2 -
P.V. examination light 2 1 1 1 1 1 1 1 1 1
Patient’s stool 2 2 2 - 2 2 - 1 1 1
Plain chairs 4 1 1 3 1 1 3 1 1 3
Steam inhaler 1 - - 1 - - 1 - - 1
Steel almirah (Large) 2 2 2 - 2 1 1 2 2 -
Water filter 1 - - 1 - - 1 - - 1
Weighing machine (Adult) 2 2 2 - 1 - 2 1 1 1
Total 85 22 22 63 33 30 57 67 67 18
Item name
Sta
nd
ard
qu
an
tity
BHU
Ferozewala -
Gujranwala
BHU
Gondlanwala -
Gujranwala
BHU Gulloke -
Gujranwala
Item
quantities
Item
quantities
Item
quantities
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
B P Apparatus mercury – desk type 1 1 1 - 1 1 - 1 1 -
Clean delivery kits 50 2 2 48 - - 50 24 24 26
D & C instruments set 1 2 2 - 1 1 - 1 1 -
Disposable syringe cutter 1 1 1 - 1 1 - - - 1
Electric water cooler 1 1 1 - - - 1 - - 1
107
Examination couch 2 2 2 - 2 2 - 2 2 -
Foetal stethoscope 1 1 1 - - - 1 2 2 -
Height measuring board 2 - - 2 2 2 - 1 1 1
Height measuring device 2 - - 2 - - 2 - - 2
Incinerator (50kg) 1 - - 1 - - 1 - - 1
Infant weighing machine 2 1 1 1 2 2 - 1 1 1
Nebulizer 1 1 1 - 1 - 1 1 1 -
Office chair 4 3 3 2 3 3 1 6 6 1
Office tables with drawers 2 2 2 - 2 2 - 2 2 -
P.V. examination light 2 3 3 - 1 1 1 1 1 1
Patient’s stool 2 1 1 1 2 2 - - - 2
Plain chairs 4 1 1 3 2 2 2 1 1 3
Steam inhaler 1 - - 1 - - 1 - - 1
Steel almirah (Large) 2 2 2 - 2 2 - 2 2 -
Water filter 1 - - 1 - - 1 - - 1
Weighing machine (Adult) 2 2 2 - 2 2 - 2 1 1
Total 85 26 26 62 24 23 62 47 46 43
Item name
Sta
nd
ard
qu
an
tity
BHU Hardo
Saharan -
Gujranwala
BHU Jallan -
Gujranwala
BHU Jaura Sian
- Gujranwala
Item quantities Item quantities Item quantities
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
B P Apparatus mercury – desk type 1 1 1 - 1 1 - 1 1 -
Clean delivery kits 50 49 49 1 5 5 45 3 3 47
D & C instruments set 1 1 1 - 1 1 - 1 1 -
Disposable syringe cutter 1 - - 1 - - 1 1 1 -
Electric water cooler 1 - - 1 - - 1 - - 1
Examination couch 2 2 2 - 2 2 - 1 1 1
Foetal stethoscope 1 1 1 - - - 1 - - 1
Height measuring board 2 1 1 1 - - 2 - - 2
Height measuring device 2 - - 2 - - 2 - - 2
Incinerator (50kg) 1 - - 1 - - 1 - - 1
Infant weighing machine 2 2 2 - 1 1 1 1 1 1
Nebulizer 1 1 1 - 1 1 - 1 1 -
Office chair 4 8 8 - 3 3 1 6 6 -
Office tables with drawers 2 2 2 - 2 2 - 2 2 -
P.V. examination light 2 1 1 1 3 2 1 1 1 1
Patient’s stool 2 1 1 1 2 2 - 2 2 -
Plain chairs 4 - - 4 2 2 2 - - 4
Steam inhaler 1 - - 1 - - 1 - - 1
Steel almirah (Large) 2 2 2 - 2 2 - 2 2 -
Water filter 1 - - 1 - - 1 - - 1
Weighing machine (Adult) 2 2 2 - 2 2 - 1 1 1
Total 85 74 74 15 27 26 60 23 23 64
108
Item name
Sta
nd
ard
qu
an
tity
BHU Kot
Ladha -
Gujranwala
BHU Kotli
Nawab -
Gujranwala
BHU
Mohalanke -
Gujranwala
Item
quantities Item quantities Item quantities
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
B P Apparatus mercury – desk
type 1 1 1 - 1 1 - 1 1 -
Clean delivery kits 50 2 2 48 - - 50 - - 50
D & C instruments set 1 1 1 - - - 1 1 1 -
Disposable syringe cutter 1 3 3 - - - 1 1 1 -
Electric water cooler 1 - - 1 - - 1 - - 1
Examination couch 2 1 1 1 1 1 1 2 2 -
Foetal stethoscope 1 1 1 - 1 1 - - - 1
Height measuring board 2 1 1 1 - - 2 - - 2
Height measuring device 2 1 1 1 - - 2 - - 2
Incinerator (50kg) 1 1 1 - - - 1 - - 1
Infant weighing machine 2 1 1 1 - - 2 1 1 1
Nebulizer 1 1 1 - 1 - 1 1 1 -
Office chair 4 4 4 1 3 3 3 4 4 -
Office tables with drawers 2 2 2 - 1 1 1 2 2 -
P.V. examination light 2 2 2 - 1 1 1 1 1 1
Patient’s stool 2 1 1 1 1 1 1 2 2 -
Plain chairs 4 - - 4 - - 4 1 1 3
Steam inhaler 1 1 1 - 1 1 - - - 1
Steel almirah (Large) 2 5 5 - 1 1 1 2 2 -
Water filter 1 - - 1 - - 1 - - 1
Weighing machine (Adult) 2 4 4 - 1 1 1 2 2 -
Total 85 33 33 60 13 12 75 21 21 64
Item name
Sta
nd
ard
qu
an
tity
BHU Noianwala -
Gujranwala
BHU Nokhar -
Gujranwala
BHU Talwandi
Musa Khan -
Gujranwala
Item quantities Item quantities Item quantities
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
Avail
ab
le
Fu
ncti
on
al
Req
uir
ed
B P Apparatus mercury – desk
type 1 1 1 - 2 2 - 1 1 -
Clean delivery kits 50 - - 50 12 12 38 90 90 -
D & C instruments set 1 1 1 - - - 1 2 2 -
Disposable syringe cutter 1 1 1 - 2 2 - 1 1 -
Electric water cooler 1 - - 1 1 1 - - - 1
109
Examination couch 2 2 2 - 2 2 - 2 2 -
Foetal stethoscope 1 - - 1 - - 1 - - 1
Height measuring board 2 1 1 1 1 1 1 1 1 1
Height measuring device 2 - - 2 - - 2 - - 2
Incinerator (50kg) 1 - - 1 1 1 - - - 1
Infant weighing machine 2 2 2 - 2 2 - 2 2 -
Nebulizer 1 1 1 - - - 1 1 1 -
Office chair 4 4 4 1 3 3 1 6 6 -
Office tables with drawers 2 2 2 - 2 2 - 2 2 -
P.V. examination light 2 1 1 1 2 2 - 3 3 -
Patient’s stool 2 2 2 - 3 3 - 2 2 -
Plain chairs 4 1 1 3 2 2 2 2 2 2
Steam inhaler 1 - - 1 - - 1 - - 1
Steel almirah (Large) 2 2 2 - 7 7 - 1 1 1
Water filter 1 - - 1 - - 1 - - 1
Weighing machine (Adult) 2 2 2 - 3 3 - 2 2 -
Total 85 23 23 63 45 45 49 118 118 11
D . Estimated cost of required equipment at surveyed facilities
Health facility Estimated cost
(in PKR) Health facility
Estimated cost (in PKR)
DHQH Gujranwala 18,304,238 BHU Bucha Chatah 441,527
THQH Kamonke 9,940,854 BHU Budda Goraya 343,789
THQH Noshehra Virkan 11,184,022 BHU Dandian 344,030
THQH Wazirabad 8,665,649 BHU Ferozewala 173,085
RHC Ahmed Nagar 1,182,296 BHU Gondlanwala 434,627
RHC Ali Pur Chatta 1,112,521 BHU Gulloke 327,316
RHC Dounkal 1,583,926 BHU Hardo Saharan 314,005
RHC Mean Abad 913,310 BHU Jallan 323,752
RHC Gakhar 1,449,474 BHU Jaura Sian 337,041
RHC Qila Didar Sing 1,207,171 BHU Kot Ladha 87,690
110
RHC Rasool Nagar 1,436,306 BHU Kotli Nawab 524,976
RHC Sohdra 1,308,014 BHU Mohalanke 323,652
RHC Wahndo 1,483,788 BHU Noianwala 313,866
BHU Artali Virkan 470,061 BHU Nokhar 184,215
BHU Attawa 494,608 BHU Tawlwandi Musa
Khan 182,271
BHU Botala Sharam Singh
190,537
111
ANNEX 4
A. Scope of civil works required at SHC hospitals
Rough cost estimate for improvement / renovation
DHQH, district Gujranwala, Punjab
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 753 115 86,538
Hospital
Main building
Covered
area
Repair 216331.6
-
Restoration of brick work Cft 415 120 49,811
Restoration of roof tiles Sft 3,972 60 238,294
Restoration of plaster work Sft 16,839 20 336,776
Restoration of floor Sft 4,570 60 274,184
Restoration of distempering Sft 81,088 10 810,882
Restoration of almirah Sft 120 500 60,000
Restoration of doors/windows Sft 444 500 222,000
Tile work in bathrooms
1 20,000 20,000
Restoration of toilets
64,899 10 648,995
Restoration of electric components
19,667 25 491,663
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 217 115 24,955
External development
Repair
Internal roads (Tuff Pavers) Sft
25,795 70
1,805,65
0
Sewerage system ( 9 “ dia )
including manholes Rft
1,255 350 439,294
Water supply system ( 3” dia) Rft 94 350 32,725
New construction 3848.5 Sft
1,500
5,772,75
0
Residence
Covered
area
Repair 4059
-
Restoration of brick work Cft 1,995 120 239,400
Restoration of roof tiles Sft 750 60 45,000
RCC roof Sft 956 400 382,500
Restoration of plaster work Sft 3,640 20 72,800
112
Restoration of floor Sft 1,313 60 78,750
Restoration of distempering Sft 11,200 10 112,000
Restoration of almirah Sft 12 500 6,000
Restoration of doors/windows Sft 169 500 84,500
Tile work in bathrooms
3 20,000 60,000
Restoration of toilets
1,450 50 72,482
Restoration of electric components
1,184 50 59,194
New construction 0 Sft 1,500 -
Total 12,527,141
Total without new construction 6,754,391
Rough cost estimate for improvement / renovation
THQH Wazir Abad, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 2152.5 115 247,538
Hospital
Main building Covered
area
Repair 36058
Restoration of brick work
Cft 484.815 120 58,178
Restoration of roof tiles
Sft 180.147 60 10,809
Restoration of plaster work
Sft 755.73 20 15,115
Restoration of floor
Sft 2572.3 60 154,338
Restoration of distempering
Sft 35502.3 10 355,023
Restoration of almirah
Sft 96 500 48,000
Restoration of doors/windows
Sft 258 500 129,000
Tile work in bathrooms
1 20000 20,000
Restoration of toilets
12019.3 50 600,967
Restoration of electric components
6181.37 50 309,069
Compound walls
Repair of compound walls ( 4 1/2 " )
Sft 231.5 115 26,623
External development
Repair
Internal roads (Tuff Pavers)
Sft 3465 70 242,550
Sewerage system ( 9 “ dia ) including
manholes
Rft 376.75 350 131,863
Water supply system ( 3” dia)
Rft 67.5 350 23,625
New construction 2721 Sft 0 1500 4,081,500
113
Rough cost estimate for improvement / renovation
THQH Noshera Virkan, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 1980 115 227,700
Hospital
Main building Covered
area
Repair 31994
Restoration of brick work
Cft 1258.19 120 150,982
Restoration of roof tiles
Sft 1211.9 60 72,714
Restoration of plaster work
Sft 5682.14 20 113,643
Restoration of floor
Sft 1262.15 60 75,729
Restoration of distempering
Sft 31496.1 10 314,961
Restoration of almirah
Sft 24 500 12,000
Restoration of doors/windows
Sft 310 500 155,000
Tile work in bathrooms
6 20000 120,000
Restoration of toilets
20796.1 30 623,883
Restoration of electric components
5748.92 50 287,446
Compound walls
Repair of compound walls ( 4 1/2 " )
Sft 253.75 115 29,181
External development
Repair
Internal roads (Tuff Pavers)
Sft 1285.63 70 89,994
Sewerage system ( 9 “ dia ) including
manholes
Rft 1210 350 423,500
Water supply system ( 3” dia)
Rft 31.25 350 10,938
New construction 3548 Sft 0 1500 5,322,000
Residence
Repair 4472
Restoration of brick work
Cft 329.625 120 39,555
Restoration of roof tiles
Sft 521.25 60 31,275
Restoration of floor
Sft 1118 60 67,080
Restoration of distempering
Sft 4998 10 49,980
Restoration of doors/windows
Sft 165 500 82,500
Tile work in bathrooms
5 20000 100,000
Restoration of toilets
2236 50 111,800
Restoration of electric components
2236 50 111,800
New construction 4660 Sft 0 1500 6,990,000
Total 14,038,185
Total without new construction 2,966,685
114
Residence
Repair 3818.13
Restoration of brick work Cft 752.813 120 90,338
Restoration of roof tiles Sft 1349.06 60 80,944
Restoration of plaster work Sft 1003.75 20 20,075
Restoration of floor Sft 826.563 60 49,594
Restoration of distempering
Sft 4015 10 40,150
Restoration of almirah
Sft 36 500 18,000
Restoration of doors/windows
Sft 438 500 219,000
Tile work in bathrooms
3 20000 60,000
Restoration of toilets
1909.07 50 95,453
Restoration of electric components
2863.6 50 143,180
New construction 4112 Sft 0 1500 6,168,000
Total 15,014,403
Total without new construction 3,524,403
Rough cost estimate for improvement / renovation
THQH Kamonki, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 4,428 115 509,163
Hospital
Main building
Covered
area
Repair 62460
-
Restoration of brick work Cft 99 120 11,880
Restoration of plaster work Sft 8,856 20 177,120
Restoration of floor Sft 3,600 60 216,001
Restoration of distempering Sft 50,255 10 502,555
Restoration of almirah Sft 120 500 60,000
Restoration of doors/windows Sft 195 500 97,500
Tile work in bathrooms
4 20,000 80,000
Restoration of toilets
26,025 20 520,500
Restoration of electric
components 4,732 50 236,591
External development
Repair
Internal roads (Tuff Pavers) Sft 1,829 70 128,013
Sewerage system ( 9 “ dia )
including manholes Rft
803 350 280,875
Water supply system ( 3” dia) Rft 338 350 118,125
115
New construction 4368 Sft 1,500 6,552,000
Residence
Covered
area
Repair 2945.25
-
Restoration of brick work Cft 347 120 41,580
Restoration of roof tiles Sft 1,473 60 88,358
Restoration of plaster work Sft 1,158 20 23,160
Restoration of floor Sft 736 60 44,179
Restoration of distempering Sft 4,632 10 46,320
Restoration of doors/windows Sft 316 500 158,000
Tile work in bathrooms
3 20,000 60,000
Restoration of toilets
1,473 50 73,631
Restoration of electric
components 1,473 50 73,631
New construction 3680 Sft 1,500 5,520,000
Total 15,619,180
Total without new construction 3,547,180
B. Scope of civil works required at surveyed RHCs
Rough cost estimate for improvement / renovation
RHC Ahmed Nagar, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 2200 115 253,000
Hospital
Main building Covered
area
Repair 9880.45
Restoration of roof tiles
Sft 33 60 1,980
Restoration of plaster work
Sft 1620 20 32,400
Restoration of floor
Sft 478 60 28,680
Restoration of distempering
Sft 11636.4 10 116,364
Restoration of doors/windows
Sft 123 500 61,500
Tile work in bathrooms
1 20000 20,000
Restoration of toilets
3293.48 50 164,674
Restoration of electric components
1543.82 50 77,191
Compound walls
Repair of compound walls ( 4 1/2 " )
Sft 117 115 13,455
116
External development
Repair
Internal roads (Tuff Pavers)
Sft 3245 70 227,150
Sewerage system ( 9 “ dia ) including
manholes
Rft 873.75 350 305,813
New construction 1620 Sft 0 1500 2,430,000
Residence
Repair 3522
Restoration of floor
Sft 468 60 28,080
Restoration of distempering
Sft 4268.25 10 42,683
Restoration of almirah
Sft 48 500 24,000
Restoration of doors/windows
Sft 244 500 122,000
Tile work in bathrooms
3 20000 60,000
Restoration of toilets
1761 50 88,050
Restoration of electric components
1761 50 88,050
New construction 560 Sft 0 1500 840,000
Total 5,025,069
Total without new construction 1,755,069
Rough cost estimate for improvement / renovation
RHC Ali Pur Chatta, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 2,789
115
320,678
Hospital
Main building Covered
area
Repair 15189.5
Restoration of brick work Cft 115 120 13,748
Restoration of roof tiles Sft 80 60 4,800
Restoration of plaster work Sft 1,812 20 36,249
Restoration of floor Sft 634 60 38,054
Restoration of distempering Sft 12,244 10 122,435
Restoration of doors/windows Sft 147 500 73,500
Tile work in bathrooms
1
20,00
0 20,000
Restoration of toilets
5,063 50 253,158
Restoration of electric components
7,595 50 379,738
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 278 115 31,941
117
New construction 1396 Sft - 1,500 2,094,000
Residence
Repair 4390
Restoration of roof tiles
Sft 790 60 47,400
Restoration of plaster work
Sft 501 20 10,010
Restoration of floor
Sft 1,098 60 65,850
Restoration of distempering
Sft 5,428 10 54,280
Restoration of almirah
Sft 24 500 12,000
Restoration of doors/windows
Sft 694 500 347,000
Tile work in bathrooms
5
20,00
0 100,000
Restoration of toilets
2,195 50 109,750
Restoration of electric components
4,390 50 219,500
New construction 560 Sft - 1,500 840,000
Total 5,194,090
Total without new construction 2,260,090
Rough cost estimate for improvement / renovation
RHC Dounkal, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 2392.5 115 275,138
Hospital
Main building Covered
area
Repair 10072
Restoration of brick work
Cft 118.53 120 14,224
Restoration of roof tiles
Sft 43.112
2
60 2,587
Restoration of plaster work
Sft 452.04 20 9,041
Restoration of floor
Sft 97.622
2
60 5,857
Restoration of distempering
Sft 13235 10 132,350
Restoration of almirah
Sft 24 500 12,000
Restoration of doors/windows
Sft 73 500 36,500
Restoration of electric components
5036 50 251,800
Compound walls
Repair of compound walls ( 4 1/2 " )
Sft 395.5 115 45,483
External development
Repair
Internal roads (Tuff Pavers)
Sft 650 70 45,500
Sewerage system ( 9 “ dia ) including
manholes
Rft 372.5 350 130,375
118
Water supply system ( 3” dia)
Rft 94.375 350 33,031
New construction 1872 Sft 0 1500 2,808,000
Residence
Repair 4035
Restoration of brick work
Cft 677.25 120 81,270
Restoration of roof tiles
Sft 405 60 24,300
Restoration of plaster work
Sft 1326 20 26,520
Restoration of floor
Sft 708.75 60 42,525
Restoration of distempering
Sft 5304 10 53,040
Restoration of almirah
Sft 48 500 24,000
Restoration of doors/windows
Sft 358 500 179,000
Tile work in bathrooms
4 20000 80,000
Restoration of toilets
2017.5 50 100,875
Restoration of electric components
3698.7
5
50 184,938
New construction 784 Sft 0 1500 1,176,000
Total 5,774,353
Total without new construction 1,790,353
Rough cost estimate for improvement / renovation
RHC Mean Abad, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 2937 115 337,755
Hospital
Main building Covered
area
Repair 10209.9
Restoration of brick work Cft 132.75 120 15,930
Restoration of roof tiles Sft 13 60 780
Restoration of plaster work Sft 537.75 20 10,755
Restoration of floor Sft 574.011 60 34,441
Restoration of distempering Sft 10839 10 108,390
Restoration of almirah Sft 96 500 48,000
Restoration of doors/windows Sft 138 500 69,000
Tile work in bathrooms 2 20000 40,000
Restoration of toilets 5104.95 50 255,248
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 120 115 13,800
External development
Repair
Internal roads (Tuff Pavers) Sft 1828.75 70 128,013
Sewerage system ( 9 “ dia ) including
manholes
Rft 333.925 350 116,874
119
Water supply system ( 3” dia)
Rft 68.75 350 24,063
New construction 1304 Sft 0 1500 1,956,000
Residence
Repair 5423.5
Restoration of floor
Sft 1355.88 60 81,353
Restoration of distempering
Sft 6992 10 69,920
Restoration of almirah
Sft 72 500 36,000
Restoration of doors/windows
Sft 304 500 152,000
Tile work in bathrooms
3 20000 60,000
Restoration of toilets
2711.75 50 135,588
Restoration of electric components
2711.75 50 135,588
0 0 -
New construction 0 Sft 0 1500 -
Total 3,829,494
Total without new construction 1,873,494
Rough cost estimate for improvement / renovation
RHC Gakhar, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 4523.75 115 520,231
Hospital
Main building Covered
area
Repair 11301
Restoration of brick work Cft 256.5 120 30,780
Restoration of roof tiles Sft 102.49 60 6,149
Restoration of plaster work Sft 3131.52 20 62,630
Restoration of floor Sft 944.163 60 56,650
Restoration of distempering Sft 17283.8 10 172,838
Restoration of doors/windows Sft 56 500 28,000
Restoration of toilets 2825.25 50 141,263
Restoration of electric components 2825.25 50 141,263
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 702.875 115 80,831
External development
Repair
Internal roads (Tuff Pavers) Sft 2268.75 70 158,813
Sewerage system ( 9 “ dia ) including
manholes
Rft 968.125 350 338,844
Water supply system ( 3” dia) Rft 40 350 14,000
New construction 1928 Sft 0 1500 2,892,000
120
Residence
Repair 5948.36
Restoration of brick work Cft 348.75 120 41,850
Restoration of roof tiles Sft 1534.31 60 92,059
Restoration of plaster work Sft 1822.02 20 36,440
Restoration of floor Sft 1095.03 60 65,702
Restoration of distempering Sft 7288.08 10 72,881
Restoration of almirah Sft 72 500 36,000
Restoration of doors/windows Sft 525 500 262,500
Tile work in bathrooms 5 20000 100,000
Restoration of toilets 3345.95 50 167,298
Restoration of electric components 5204.82 50 260,241
New construction 0 Sft 0 1500 -
Total 5,779,261
Total without new construction 2,887,261
Rough cost estimate for improvement / renovation
RHC Qila Didar Sing, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 2112 115 242,880
Hospital
Main building Covered
area
Repair 9584
Restoration of floor Sft 490.75 60 29,445
Restoration of distempering Sft 7848.68 10 78,487
Restoration of doors/windows Sft 85 500 42,500
Restoration of toilets 2396 50 119,800
Restoration of electric components 4792 50 239,600
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 506 115 58,190
External development
Repair
Sewerage system ( 9 “ dia ) including
manholes
Rft 270.25 350 94,588
Water supply system ( 3” dia) Rft 247.5 350 86,625
New construction 2137 Sft 0 1500 3,205,500
Residence
Repair 3734.75
Restoration of plaster work Sft 534 20 10,680
Restoration of floor Sft 933.688 60 56,021
Restoration of distempering Sft 4716.63 10 47,166
Restoration of doors/windows Sft 12 500 6,000
121
Tile work in bathrooms 4 20000 80,000
Restoration of toilets 1867.38 50 93,369
New construction 560 Sft 0 1500 840,000
Total 5,330,851
Total without new construction 1,285,351
Rough cost estimate for improvement / renovation
RHC Rasool Nagar, district Gujranwala
Description
Unit Qty Rate Amount
Hospital
Main building Covered
area
Repair 7472.82
Restoration of brick work Cft 278.768 120 33,452
Restoration of roof tiles Sft 42.75 60 2,565
Restoration of plaster work Sft 556.875 20 11,138
Restoration of floor Sft 273.05 60 16,383
Restoration of distempering Sft 5451.49 10 54,515
Restoration of almirah Sft 120 500 60,000
Restoration of doors/windows Sft 140 500 70,000
Restoration of toilets 1868.21 50 93,410
Restoration of electric components 4203.46 50 210,173
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 247.5 115 28,463
Construction of new Compound walls
(9 " Thick)
Rft 80 1500 120,000
External development
Repair
Sewerage system ( 9 “ dia ) including
manholes
Rft 256.25 350 89,688
Water supply system ( 3” dia) Rft 31.25 350 10,938
New construction 1112 Sft 0 1500 1,668,000
Residence
Repair 3787.5
Restoration of brick work Cft 1153.64 120 138,437
Restoration of roof tiles Sft 447 60 26,820
RCC roof Sft 1499.63 400 599,850
Restoration of plaster work Sft 1538.19 20 30,764
Restoration of floor Sft 1722.25 60 103,335
Restoration of distempering Sft 4318 10 43,180
Restoration of almirah Sft 24 500 12,000
Restoration of doors/windows Sft 835 500 417,500
Tile work in bathrooms 4 20000 80,000
Restoration of toilets 2525 50 126,250
Restoration of electric components 3787.5 50 189,375
122
New construction 560 Sft 0 1500 840,000
Total 5,076,234
Total without new construction 2,568,234
Rough cost estimate for improvement / renovation
RHC Sohdra, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 3217.5 115 370,013
Hospital
Main building Covered
area
Repair 9856.31
Restoration of brick work Cft 2536.61 120 304,393
Restoration of roof tiles Sft 827.314 60 49,639
RCC roof Sft 164.5 400 65,800
Restoration of plaster work Sft 3571.17 20 71,423
Restoration of floor Sft 1050.45 60 63,027
Restoration of distempering Sft 15108.1 10 151,081
Restoration of doors/windows Sft 160 500 80,000
Tile work in bathrooms 6 20000 120,000
Restoration of toilets 4928.16 50 246,408
Restoration of electric components 3222.26 50 161,113
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 456.063 115 52,447
External development
Repair
Sewerage system ( 9 “ dia ) including
manholes
Rft 701.25 350 245,438
Water supply system ( 3” dia) Rft 102.5 350 35,875
New construction 1472 Sft 0 1500 2,208,000
Residence
Repair 3451
Restoration of brick work Cft 1139.53 120 136,744
Restoration of roof tiles Sft 814 60 48,840
Restoration of plaster work Sft 1837.88 20 36,758
Restoration of floor Sft 2083.75 60 125,025
Restoration of distempering Sft 5245.5 10 52,455
Restoration of almirah Sft 48 500 24,000
Restoration of doors/windows Sft 739 500 369,500
Tile work in bathrooms 5 20000 100,000
Restoration of toilets 2300.67 50 115,033
Restoration of electric components 2300.67 50 115,033
123
New construction 560 Sft 0 1500 840,000
Total 6,188,043
Total without new construction 3,140,043
Rough cost estimate for improvement / renovation
RHC Wahndo, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 3877.5 115 445,913
Hospital
Main building Covered
area
Repair 10133
Restoration of roof tiles Sft 815.99 60 48,959
Restoration of plaster work Sft 3178.56 20 63,571
Restoration of floor Sft 1125.23 60 67,514
Restoration of distempering Sft 14550.5 10 145,505
Restoration of almirah Sft 96 500 48,000
Restoration of doors/windows Sft 64 500 32,000
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 5066.5 50 253,325
Restoration of electric components 2533.25 50 126,663
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 172.5 115 19,838
External development
Repair
Approach road Sft 250 70 17,500
Sewerage system ( 9 “ dia ) including
manholes
Rft 1885 350 659,750
Water supply system ( 3” dia) Rft 227.5 350 79,625
New construction 2124 Sft 0 1500 3,186,000
Residence
Repair 2716.49
Restoration of roof tiles Sft 679.121 60 40,747
Restoration of plaster work Sft 894.54 20 17,891
Restoration of floor Sft 1039.29 60 62,357
Restoration of distempering Sft 3578.16 10 35,782
Restoration of doors/windows Sft 196 500 98,000
Tile work in bathrooms 2 20000 40,000
Restoration of toilets 1358.25 50 67,912
Restoration of electric components 2037.37 50 101,868
124
New construction 2384 Sft 0 1500 3,576,000
Total 9,294,719
Total without new construction 2,532,719
C. Scope of civil works required at surveyed BHUs
Rough cost estimate for improvement / renovation
BHU Attawa, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 1628 115 187,220
Hospital
Main building Covered
area
Repair 2294
Restoration of plaster work Sft 424.98 20 8,500
Restoration of floor Sft 136.74 60 8,204
Restoration of distempering Sft 1834.98 10 18,350
Restoration of almirah Sft 48 500 24,000
Restoration of doors/windows Sft 31 500 15,500
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 160.875 115 18,501
External development
Repair
Internal roads (Tuff Pavers) Sft 907.5 70 63,525
Sewerage system ( 9 “ dia ) including
manholes
Rft 380 350 133,000
Water supply system ( 3” dia) Rft 68.75 350 24,063
New construction 924 Sft 0 1500 1,386,000
Residence
Repair 1361.625
Restoration of brick work Cft 470.25 120 56,430
Restoration of roof tiles Sft 680.625 60 40,838
Restoration of plaster work Sft 627 20 12,540
Restoration of floor Sft 340.313 60 20,419
Restoration of distempering Sft 2508 10 25,080
Restoration of doors/windows Sft 376 500 188,000
Tile work in bathrooms 2 20000 40,000
Restoration of toilets 1021.22 50 51,061
Restoration of electric components 1361.63 50 68,081
New construction 0 Sft 0 1500 -
125
Total 2,389,310
Total without new construction 1,003,310
Rough cost estimate for improvement / renovation
BHU Botala Sharam Singh, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 1650 115 189,750
Hospital
Main building Covered
area
Repair 1596
Restoration of floor Sft 66 60 3,960
Restoration of distempering Sft 1930.5 10 19,305
Restoration of doors/windows Sft 13 500 6,500
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 85.25 115 9,804
External development
Repair
Internal roads (Tuff Pavers) Sft 550 70 38,500
Sewerage system ( 9 “ dia ) including
manholes
Rft 143.75 350 50,313
Water supply system ( 3” dia) Rft 12.5 350 4,375
New construction 1016 Sft 0 1500 1,524,000
Residence
Repair 1848
Restoration of brick work Cft 387 120 46,440
Restoration of roof tiles Sft 462 60 27,720
Restoration of plaster work Sft 516 20 10,320
Restoration of floor Sft 462 60 27,720
Restoration of distempering Sft 2064 10 20,640
Restoration of doors/windows Sft 231 500 115,500
Tile work in bathrooms 2 20000 40,000
Restoration of toilets 1386 50 69,300
Restoration of electric components 1386 50 69,300
New construction 0 Sft 0 1500 -
Total 2,273,446
Total without new construction 749,446
126
Rough cost estimate for improvement / renovation
BHU Ferozewala, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 1567.5 115 180,263
Hospital
Main building Covered
area
Repair 1720
Restoration of floor Sft 93.5 60 5,610
Restoration of almirah Sft 48 500 24,000
Compound walls
Construction of new Compound walls
(9 " Thick)
Rft 70 1500 105,000
External development
Repair
Internal roads (Tuff Pavers) Sft 120 70 8,400
Sewerage system ( 9 “ dia ) including
manholes
Rft 31.25 350 10,938
New construction 952 Sft 0 1500 1,428,000
Residence
Repair 679.61
Restoration of brick work Cft 195.938 120 23,513
Restoration of roof tiles Sft 339.804 60 20,388
Restoration of plaster work Sft 522.5 20 10,450
Restoration of floor Sft 339.804 60 20,388
Restoration of distempering Sft 1045 10 10,450
Restoration of doors/windows Sft 240 500 120,000
Tile work in bathrooms 1 20000 20,000
Restoration of toilets 509.708 50 25,485
Restoration of electric components 679.61 50 33,981
New construction 0 Sft 0 1500 -
Total 2,046,865
Total without new construction 618,865
127
Rough cost estimate for improvement / renovation
BHU Gondlanwala, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 3333 115 383,295
Hospital
Main building Covered
area
Repair 2299.5
Restoration of roof tiles Sft 64.5 60 3,870
Restoration of floor Sft 132.825 60 7,970
Restoration of distempering Sft 2805 10 28,050
Restoration of doors/windows Sft 52 500 26,000
Restoration of toilets 574.875 50 28,744
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 556.5 115 63,998
External development
Repair
Internal roads (Tuff Pavers) Sft 495 70 34,650
Sewerage system ( 9 “ dia ) including
manholes
Rft 266.75 350 93,363
Water supply system ( 3” dia) Rft 113.125 350 39,594
New construction 376 Sft 0 1500 564,000
Residence
Repair 2250.5
Restoration of brick work Cft 537.281 120 64,474
Restoration of roof tiles Sft 1125.25 60 67,515
Restoration of plaster work Sft 716.375 20 14,328
Restoration of floor Sft 562.625 60 33,758
Restoration of distempering Sft 2865.5 10 28,655
Restoration of doors/windows Sft 564 500 282,000
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 1687.88 50 84,394
Restoration of electric components 2250.5 50 112,525
New construction 0 Sft 0 1500 -
Total 2,021,180
Total without new construction 1,457,180
128
Rough cost estimate for improvement / renovation
BHU Tawlwandi Musa Khan, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 1718.75 115 197,656
Hospital
Main building Covered
area
Repair 2290
Restoration of floor Sft 58.98 60 3,539
Restoration of distempering Sft 4315.52 10 43,155
Restoration of doors/windows Sft 38 500 19,000
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 104.25 115 11,989
External development
Repair
Internal roads (Tuff Pavers) Sft 3680 70 257,600
Sewerage system ( 9 “ dia ) including
manholes
Rft 187.5 350 65,625
Water supply system ( 3” dia) Rft 161.25 350 56,438
New construction 683 Sft 0 1500 1,024,500
Residence
Repair 2260
Restoration of brick work Cft 544.5 120 65,340
Restoration of roof tiles Sft 565 60 33,900
Restoration of plaster work Sft 726 20 14,520
Restoration of floor Sft 171.875 60 10,313
Restoration of distempering Sft 2904 10 29,040
Restoration of doors/windows Sft 151 500 75,500
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 1695 50 84,750
Restoration of electric components 2260 50 113,000
New construction 0 Sft 0 1500 -
Total 2,165,864
Total without new construction 1,141,364
129
Rough cost estimate for improvement / renovation
BHU Dandian, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 5346 115 614,790
Hospital
Main building Covered
area
Repair 2299.5
Restoration of brick work
Cft 373.5 120 44,820
Restoration of roof tiles Sft 413.188 60 24,791
Restoration of plaster work Sft 1371 20 27,420
Restoration of floor Sft 660.709 60 39,643
Restoration of distempering Sft 5484 10 54,840
Restoration of doors/windows Sft 391 500 195,500
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 1341.38 50 67,069
Restoration of electric components 1724.63 50 86,231
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 118.125 115 13,584
External development
Repair
Internal roads (Tuff Pavers) Sft 2450 70 171,500
Sewerage system ( 9 “ dia ) including
manholes
Rft 345 350 120,750
Water supply system ( 3” dia) Rft 206.25 350 72,188
New construction 748 Sft 0 1500 1,122,000
Total 2,715,126
Total without new construction 1,593,126
130
Rough cost estimate for improvement / renovation
BHU Gulloke, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 2117.5 115 243,513
Hospital
Main building Covered
area
Repair 2257.73
Restoration of floor Sft 100.625 60 6,038
Restoration of distempering Sft 1698 10 16,980
Restoration of doors/windows Sft 31 500 15,500
Tile work in bathrooms 1 20000 20,000
Restoration of toilets 1128.87 50 56,443
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 261.901 115 30,119
External development
Repair
Internal roads (Tuff Pavers) Sft 440 70 30,800
Sewerage system ( 9 “ dia ) including
manholes
Rft 142.5 350 49,875
Water supply system ( 3” dia) Rft 49.5 350 17,325
New construction 516 Sft 0 1500 774,000
Residence
Repair 2258.873
Restoration of brick work Cft 360 120 43,200
Restoration of roof tiles Sft 564.718 60 33,883
Restoration of plaster work Sft 788.52 20 15,770
Restoration of floor Sft 564.718 60 33,883
Restoration of distempering Sft 3154.08 10 31,541
Restoration of doors/windows Sft 362 500 181,000
Tile work in bathrooms 2 20000 40,000
Restoration of toilets 1411.8 50 70,590
Restoration of electric components 2258.87 50 112,944
New construction 0 Sft 0 1500 -
Total 1,823,403
Total without new construction 1,049,403
131
Rough cost estimate for improvement / renovation
BHU Kotli Nawab, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 1650 115 189,750
Hospital
Main building Covered
area
Repair 1720
Restoration of plaster work Sft 240 20 4,800
Restoration of floor Sft 154.946 60 9,297
Restoration of distempering Sft 3720 10 37,200
Restoration of doors/windows Sft 39 500 19,500
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 109.688 115 12,614
External development
Repair
Internal roads (Tuff Pavers) Sft 2420 70 169,400
Sewerage system ( 9 “ dia ) including
manholes
Rft 165.5 350 57,925
New construction 632 Sft 0 1500 948,000
Residence
Repair 666
Restoration of brick work Cft 232.515 120 27,902
Restoration of roof tiles Sft 332.338 60 19,940
Restoration of plaster work Sft 620.04 20 12,401
Restoration of floor Sft 332.338 60 19,940
Restoration of distempering Sft 1240.08 10 12,401
Restoration of doors/windows Sft 180 500 90,000
Tile work in bathrooms 1 20000 20,000
Restoration of toilets 499.5 50 24,975
Restoration of electric components 666 50 33,300
New construction 0 Sft 0 1500 -
Total 1,709,345
Total without new construction 761,345
132
Rough cost estimate for improvement / renovation
BHU Artali Virkan, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 2332 115 268,180
Hospital
Main building Covered
area
Repair 2059
Restoration of distempering Sft 3023.24 10 30,232
Restoration of doors/windows Sft 6 500 3,000
Restoration of toilets 514.75 50 25,738
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 264.25 115 30,389
External development
Repair
Internal roads (Tuff Pavers) Sft 701.25 70 49,088
Sewerage system ( 9 “ dia ) including
manholes
Rft 326.75 350 114,363
Water supply system ( 3” dia) Rft 80 350 28,000
New construction 788 Sft 0 1500 1,182,000
Residence
Repair 2169.25
Restoration of roof tiles Sft 542.313 60 32,539
Restoration of plaster work Sft 678.75 20 13,575
Restoration of floor Sft 542.313 60 32,539
Restoration of distempering Sft 2715 10 27,150
Restoration of doors/windows Sft 556 500 278,000
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 1626.94 50 81,347
Restoration of electric components 2169.25 50 108,463
New construction 0 Sft 0 1500 -
Total 2,364,601
Total without new construction 1,182,601
133
Rough cost estimate for improvement / renovation
BHU Budda Goraya, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 1581.25 115 181,844
Hospital
Main building Covered
area
Repair 2050.49
Restoration of roof tiles Sft 72.5625 60 4,354
Restoration of plaster work Sft 154 20 3,080
Restoration of floor Sft 25 60 1,500
Restoration of distempering Sft 2783 10 27,830
Restoration of doors/windows Sft 7 500 3,500
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 255 115 29,325
External development
Repair
Internal roads (Tuff Pavers) Sft 1925 70 134,750
Sewerage system ( 9 “ dia ) including
manholes
Rft 101.75 350 35,613
Water supply system ( 3” dia) Rft 330 350 115,500
New construction 778 Sft 0 1500 1,167,000
Residence
Repair 2310
Restoration of brick work Cft 538.875 120 64,665
Restoration of roof tiles Sft 987 60 59,220
Restoration of plaster work Sft 718.5 20 14,370
Restoration of floor Sft 577.5 60 34,650
Restoration of distempering Sft 2874 10 28,740
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 1732.5 50 86,625
Restoration of electric components 2310 50 115,500
New construction 0 Sft 0 1500 -
Total 2,333,065
Total without new construction 1,166,065
134
Rough cost estimate for improvement / renovation
BHU Jallan, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 2117.5 115 243,513
Hospital
Main building Covered
area
Repair 1727.5
Restoration of plaster work Sft 125.125 20 2,503
Restoration of floor Sft 209.375 60 12,563
Restoration of distempering Sft 1833 10 18,330
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 110.688 115 12,729
External development
Repair
Internal roads (Tuff Pavers) Sft 921.25 70 64,488
Sewerage system ( 9 “ dia ) including
manholes
Rft 212.5 350 74,375
Water supply system ( 3” dia) Rft 206.25 350 72,188
New construction 677.3125 Sft 0 1500 1,015,969
Residence
Repair 2397
Restoration of brick work Cft 601.875 120 72,225
Restoration of roof tiles Sft 1198.5 60 71,910
Restoration of plaster work Sft 802.5 20 16,050
Restoration of floor Sft 1058.5 60 63,510
Restoration of distempering Sft 3210 10 32,100
Restoration of doors/windows Sft 178 500 89,000
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 1797.75 50 89,888
Restoration of electric components 2397 50 119,850
New construction 0 Sft 0 1500 -
Total 2,131,188
Total without new construction 1,115,219
135
Rough cost estimate for improvement / renovation
BHU Kot Ladha, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 2543.75 115 292,531
Hospital
Main building Covered
area
Repair 5789
Restoration of brick work Cft 288.765 120 34,652
Restoration of roof tiles Sft 32.3125 60 1,939
Restoration of plaster work Sft 385.02 20 7,700
Restoration of floor Sft 32.3125 60 1,939
Restoration of distempering Sft 8752.08 10 87,521
Restoration of doors/windows Sft 34 500 17,000
Tile work in bathrooms 2 20000 40,000
Restoration of toilets 3618.13 50 180,906
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 118.365 115 13,612
External development
Repair
Approach road Sft 911.625 70 63,814
Internal roads (Tuff Pavers) Sft 321.75 70 22,523
Sewerage system ( 9 “ dia ) including
manholes
Rft 314.875 350 110,206
Water supply system ( 3” dia) Rft 204.75 350 71,663
New construction 0 0 -
Internal roads (Tuff Pavers) Sft 500 70 35,000
New construction 728 Sft 0 1500 1,092,000
Residence
Repair 1062
Restoration of distempering Sft 1573.92 10 15,739
Restoration of doors/windows Sft 24 500 12,000
Tile work in bathrooms 1 20000 20,000
Restoration of toilets 531 50 26,550
New construction 0 Sft 0 1500 -
Total 2,147,294
Total without new construction 1,055,294
136
Rough cost estimate for improvement / renovation
BHU Nokhar, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 1897.5 115 218,213
Hospital
Main building Covered
area
Repair 2073.5
Restoration of distempering Sft 1931.6 10 19,316
Restoration of doors/windows Sft 76 500 38,000
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 223.5 115 25,703
External development
Repair
Internal roads (Tuff Pavers) Sft 1672 70 117,040
Sewerage system ( 9 “ dia ) including
manholes
Rft 98.5 350 34,475
Water supply system ( 3” dia) Rft 20 350 7,000
New construction 704 Sft 0 1500 1,056,000
Residence
Repair 667
Restoration of brick work Cft 194.063 120 23,288
Restoration of roof tiles Sft 333.438 60 20,006
Restoration of plaster work Sft 517.5 20 10,350
Restoration of floor Sft 333.438 60 20,006
Restoration of distempering Sft 1035 10 10,350
Restoration of doors/windows Sft 316 500 158,000
Tile work in bathrooms 1 20000 20,000
Restoration of toilets 667 50 33,350
Restoration of electric components 667 50 33,350
New construction 0 Sft 0 1500 -
Total 1,844,446
Total without new construction 788,446
137
Rough cost estimate for improvement / renovation
BHU Bucha Chatah, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 3564 115 409,860
Hospital
Main building Covered
area
Repair 1765
Restoration of brick work Cft 582.356 120 69,883
Restoration of roof tiles Sft 49.5553 60 2,973
Restoration of plaster work Sft 940.538 20 18,811
Restoration of floor Sft 210.525 60 12,632
Restoration of distempering Sft 3762.15 10 37,622
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 882.5 50 44,125
Restoration of electric components 882.5 50 44,125
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 181.156 115 20,833
External development
Repair
Internal roads (Tuff Pavers) Sft 1750 70 122,500
Sewerage system ( 9 “ dia ) including
manholes
Rft 365.75 350 128,013
Water supply system ( 3” dia) Rft 101.25 350 35,438
New construction
Internal roads (Tuff Pavers) Sft 2000 70 140,000
New construction 660 Sft 0 1500 990,000
Residence
Repair 2076.443
Restoration of brick work Cft 651.92 120 78,230
Restoration of roof tiles Sft 225.656 60 13,539
Restoration of plaster work Sft 1302.83 20 26,057
Restoration of floor Sft 519.111 60 31,147
Restoration of distempering Sft 2605.66 10 26,057
Restoration of doors/windows Sft 740 500 370,000
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 1557.33 50 77,867
Restoration of electric components 2076.44 50 103,822
New construction 0 Sft 0 1500 -
Total 2,979,531
Total without new construction 1,989,531
138
Rough cost estimate for improvement / renovation
BHU Hardo Saharan, district Gujranwala
Description Covered
area Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 1430 115 164,450
Construction of new Boundary wall (9 "
Thick)
Rft 1430 1500 2,145,000
Hospital
Main building
Restoration of plaster work Sft 282 20 5,640
Restoration of floor Sft 207.75 60 12,465
Restoration of distempering Sft 4327.92 10 43,279
Restoration of doors/windows Sft 54 500 27,000
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 162.75 115 18,716
External development
Repair
Internal roads (Tuff Pavers) Sft 756.25 70 52,938
Sewerage system ( 9 “ dia ) including
manholes
Rft 344.5 350 120,575
Water supply system ( 3” dia) Rft 315 350 110,250
New construction 792 Sft 0 1500 1,188,000
Residence
Repair 2312
Restoration of brick work Cft 598.5 120 71,820
Restoration of roof tiles Sft 746 60 44,760
Restoration of plaster work Sft 798 20 15,960
Restoration of floor Sft 168 60 10,080
Restoration of distempering Sft 3192 10 31,920
Restoration of doors/windows Sft 329.88 500 164,940
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 1734 50 86,700
Restoration of electric components 1734 50 86,700
New construction 0 Sft 0 1500 -
Total 4,461,193
Total without new construction 3,273,193
139
Rough cost estimate for improvement / renovation
BHU Jaura Sian, district Gujranwala
Description
Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 1210 115 139,150
Hospital
Main building Covered
area
Repair 2059
Restoration of plaster work Sft 261.625 20 5,233
Restoration of distempering Sft 4368.75 10 43,688
Restoration of toilets 514.75 50 25,738
Restoration of electric components 1029.5 50 51,475
Repair of compound walls ( 4 1/2 " ) Sft 241.5 115 27,773
External development
Repair
Sewerage system ( 9 “ dia ) including
manholes
Rft 287.5 350 100,625
New construction 703 Sft 0 1500 1,054,500
Residence
Repair 2360
Restoration of brick work Cft 542.203 120 65,064
Restoration of roof tiles Sft 415 60 24,900
Restoration of plaster work Sft 722.938 20 14,459
Restoration of floor Sft 590 60 35,400
Restoration of distempering Sft 2891.75 10 28,918
Restoration of doors/windows Sft 251 500 125,500
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 1180 50 59,000
Restoration of electric components 1770 50 88,500
New construction 0 Sft 0 1500 -
Total 1,973,421
Total without new construction 918,921
140
Rough cost estimate for improvement / renovation
BHU Mohalanke, district Gujranwala
Description Covered
area Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 2442 115 280,830
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 102 115 11,730
External development
Repair
Sewerage system ( 9 “ dia ) including
manholes
Rft 330 350 115,500
Water supply system ( 3” dia) Rft 62.5 350 21,875
New construction 590 Sft 0 1500 885,000
Residence
Repair 2295.26
Restoration of roof tiles Sft 1134.07 60 68,044
Restoration of floor Sft 169.19 60 10,151
Restoration of distempering Sft 4048.13 10 40,481
Restoration of doors/windows Sft 228 500 114,000
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 1434.54 50 71,727
Restoration of electric components 2295.26 50 114,763
New construction 0 Sft 0 1500 -
Total 1,814,342
Total without new construction 929,342
141
Rough cost estimate for improvement / renovation
BHU Noianwala, district Gujranwala
Description Covered
area Unit Qty Rate Amount
Boundary wall
Repair of boundary wall Sft 1485 115 170,775
Compound walls
Repair of compound walls ( 4 1/2 " ) Sft 255 115 29,325
External development
Repair
Sewerage system ( 9 “ dia ) including
manholes
Rft 142.5 350 49,875
Water supply system ( 3” dia) Rft 43.75 350 15,313
New construction
Internal roads (Tuff Pavers) Sft 1025 70 71,750
New construction 606 Sft 0 1500 909,000
Residence
Repair 2338.84
Restoration of brick work Cft 711.536 120 85,384
Restoration of roof tiles Sft 752.71 60 45,163
Restoration of plaster work Sft 688.715 20 13,774
Restoration of floor Sft 168 60 10,080
Restoration of distempering Sft 2754.86 10 27,549
Tile work in bathrooms 3 20000 60,000
Restoration of toilets 1754.13 50 87,707
Restoration of electric components 2046.49 50 102,324
New construction 0 Sft 0 1500 -
Total 1,849,018
Total without new construction 940,018
142
D. Estimated cost for execution of civil works at surveyed facilities
Health facility Estimated cost
(in PKR) Health facility
Estimated cost (in PKR)
DHQH Gujranwala 12,527,141 BHU Bucha Chatah 2,979,531
THQH Kamonke 15,619,180 BHU Budda Goraya 2,333,065
THQH Noshehra Virkan 15,014,403 BHU Dandian 2,715,126
THQH Wazirabad 14,038,185 BHU Ferozewala 2,046,865
RHC Ahmed Nagar 5,025,069 BHU Gondlanwala 2,021,180
RHC Ali Pur Chatta 5,194,090 BHU Gulloke 1,823,403
RHC Dounkal 5,774,353 BHU Hardo Saharan 4,461,193
RHC Mean Abad 3,829,494 BHU Jallan 2,131,188
RHC Gakhar 5,779,261 BHU Jaura Sian 1,973,421
RHC Qila Didar Sing 5,330,851 BHU Kot Ladha 2,147,294
RHC Rasool Nagar 5,076,234 BHU Kotli Nawab 1,709,345
RHC Sohdra 6,188,043 BHU Mohalanke 1,814,342
RHC Wahndo 9,294,719 BHU Noianwala 1,849,018
BHU Artali Virkan 2,364,601 BHU Nokhar 1,844,446
BHU Attawa 2,389,310 BHU Tawlwandi Musa
Khan 2,165,864
BHU Botala Sharam Singh
2,273,446
TRF is funded by UKaid from the Department for International Development and AusAID, and managed by HLSP