Programme Implementation Plan of Rajasthan 2012-2013 :
A Study of Quality Monitoring of Rajsamand and Dungarpur districts
Objectives
The main
objectives
of this study is to examine whether the State is
adhering to key conditionalities while implementing the approved PIP and to
what extent the key strategies identified in the PIP are implemented and
also to what extent the road map for priority action and various
commitments are adhered by the State.
Findings
1.
The meeting of District Health Society, RMRS and VHSC organized
regularly.
2.
The departments of Health, Family Welfare and AYUSH have been
integrated.
3.
Essential drugs, consumables and equipments
being procured
through transparent bids.
4.
Facilities of free drugs and consumables, free essential diagnostics,
free diet during stay, free provision of blood, free transport etc provided
to delivery and caesarean section mothers.
5.
Payments made to JSY beneficiaries by cheque at the time of
discharge.
6.
PCTS has been made fully functional for regular and effective
monitoring of service delivery.
Weakness
1.
Vacancies of Medical Officer, Specialists, GNM and AYUSH personnel
exist at various facilities.
2.
IMNCI training for ANMs in the districts needs augmentation.
Research Study -2
Programme Implementation Plan of Rajasthan 2012-2013 :
A Study of Quality Monitoring of Bhilwara and Sirohi districts
Objectives
The main
objectives
of this study is to examine whether the State is
adhering to key conditionalities while implementing the approved PIP and to
what extent the key strategies identified in the PIP are implemented and
also to what extent the road map for priority action and various
commitments are adhered by the State.
Findings
1. The State has a full time Mission Director for NRHM and a Finance
Officer to look after the NRHM Finances.
2. Monthly review meetings take place at State, Divisional, District, block
and sector level, in these meetings, PCTS data is generally used for
review of RCH indicators.
3. Inter-departmental convergence available.
4. Supply of essential drugs is streamlined at the health facilities; all the
public health facilities provide free generic medicines.
5. Janani express (Ambulances) provided in both the districts under JSSK.
NRHM logos are displayed on all vehicles.
6. Rural posting for newly appointed doctors by Public Service Commission
(PSC) has been made compulsory.
7. The SNCU in both the District hospitals have been made functional. All
CHCs have functional NBSUs and PHCs have been established New
Born Care Corner (NBCC) in both the districts.
8. MHS has been operationalized
district.
Weaknesses
in Bhilwara district but not in Sirohi
1. Health facilities constructed with NRHM funds do not display the Logo of
NRHM.
2. Training of Model 6&7(IMNCI plus) for ASHA in the districts needs to
augmentation.
3.
State is facing the problem of shortage of Medical officers, Specialists
and Surgeons in its health institutions.
Research Study -3
Programme Implementation Plan of Rajasthan 2012-2013 :
A Study of Quality Monitoring of Chittorgarh and Pratapgarh
districts
Objectives
The main
objectives
of this study is to examine whether the State is
adhering to key conditionalities while implementing the approved PIP and to
what extent the key strategies identified in the PIP are implemented and
also to what extent the road map for priority action and various
commitments are adhered by the State.
Findings
1. Maternal and Infant Deaths Review committee has been established in
all districts. Death reviews are done by the CM&HO or RCHO. The
chairman of this committee is District collector.
2. In high focus districts
has provided
additional man power and
infrastructure The time table/job responsibilities of the 2 ANMs have
been devised.
3. MIS system of computerized drugs exists at district hospital, CHCs and
PHCs in both the districts.
4. All the newborns delivered at health facilities given birth doze of
immunization.
5. Complain box and toll free number provided for redressal of grievances
under JSSK.
6. IMNCI training for ANMs has been completed. The medical officers and
staff nurses posted at DHs, CHCs, PHCs have been trained in F-IMNCI
in both the districts
Weaknesses
1. Health facilities constructed with NRHM funds do not display the Logo of
NRHM.
2. Vacancies of persons of programme unites, ANM, GNM, Pharmacists
and AYUSH personnel exist at various levels in both the districts.
Research Study -4
Programme Implementation Plan of Rajasthan 2012-2013 : A Study
of Quality Monitoring of Kota and Banswara districts
Objectives
The main
objectives
of this study is to examine whether the State is
adhering to key conditionality while implementing the approved PIP and to
what extent the key strategies identified in the PIP are implemented and
also to what extent the road map for priority action and various
commitments are adhered by the State.
Findings
1. Monthly review meetings take place at State, Divisional, District, block
and sector level, in these meetings, PCTS data is generally used for
review of RCH indicators.
2. Nutrition Rehabilitation Centers established in the
both
district
hospitals.
3. Training of Model 6&7(IMNCI plus) for ASHA in progressing in the both
districts.
Weaknesses
1. Health facilities constructed with NRHM funds do not display the Logo of
NRHM.
2. Vacancies of persons of programme unites, ANM, GNM, Pharmacists
and AYUSH personnel exist at various levels in both the districts.
Research Study -5
Level of Reporting of Maternal and Child Health Services Mainl y
Institutional Delivery and Immunization in the HMIS in Public and
Private Institutions : A Study of Bhilw ara and Sirohi districts
Objectives
1.
To identify whether all service providing units are reporting for HMIS
or not, if yes, since when.
2.
To identify the units which are not reporting for HMIS.
3.
Whether the reporting units are providing data on all maternal and
child health indicators as per HMIS.
4.
Whether proper mechanism to collect data from hospitals in the
public/ private sector exists in the system.
5.
System of record maintenance of services rendered.
6.
Other related issue.
Findings
1.
Every unite reported the services rendered to pregnant women and
children by them in separate registers.
2.
The cases of ANC registration is similar reported in the register and
PCTS.
3.
The cases of institutional delivery seem to be higher as compared
ANCregistration.The C- section delivery facility is available at district
hospital hence, majority of C- section delivery take place.
4.
Emergency contraceptive distribution reported in sirohi district.
5.
Individual records of
NIrodh pieces was not available at district
hospital.
6. The cases TT2/ booster was higher than the ANC registration in
mandal CHC of Bhilwara district and both the CHCs of Sirohi districts.
Recommendations
1. Some variables are repetitively recorded error. Such variables should be
discussed in details in monthly meeting of CHC and PHC and find out
the cause of repetitively wrong reporting.
2. LHV and Medical Officer should be carefully in checking the HMIS data
format submitted by ANM. If any data error in the format is found, it
should be correct at their own level.
Research Study -6
Level of reporting of Maternal and Child Health Services Mainl y
Institutional Delivery and Immunization in the HMIS in Public and
Private Institutions: A Study of Chittorgarh and Pratapgarh
Districts
Objectives
1.
To identify whether all service providing units are reporting for HMIS or
not, if yes, since when.
2.
To identify the units which are not reporting for HMIS.
3.
Whether the reporting units are providing data on all maternal and child
health indicators as per HMIS.
4.
Whether reporting units are regular in reporting or not.
5.
Whether proper mechanism to collect data from hospitals in the public/
private sector exists in the system.
6.
System of record maintenance of services rendered.
7.
Other related issue.
Findings
1.
About 67 percent of registered women of chittorgarh and 76 percent
of Pratapgarh district hospitals, received 100 IFA tablets.
2.
In Chittorgarh district hospital 69 percent new born were given BCG at
birth while in Pratapgarh
district hospital 96 percent new born were
given BCG at birth.
3.
There were no complication and failure of sterilization recorded in both
the district hospital.
4.
MIS system of computerized drugs exists at district hospital, CHCs and
in both the districts.
5.
All the delivered women of selected PHCs were discharged under 48
hours of delivery.
6.
The wide variation is noticed in between the number of live births
and doses of BCG and OPV-0 given to newborn at birth in the
selected PHCs of Chittorgarh district.
7.
Data of measles and fully immunization children were seems to be
correct.
8.
One case of sterilization complication reported in salamgarh PHC.
9.
The most of sub centres had the facility of conduction of delivery.
10. The cases of institutional delivery was correct reported in boththe
set of data in all the sub centres of both the districts.
Recommendations
1.
Training of HMIS reporting and recording should be provided to newly
appointed ANMs and NRHM staff.
2.
Time to time refresher training should be organized for PMU, ANMs
and those involved in collection of HMIS information.
Research Study -7
Level of reporting of Maternal and Child Health services mainl y
Institutional Delivery and Immunization in the HMIS in public and
private institutions: a study of Kota and Bansw ara Districts .
Objectives
1.
To identify whether all service providing units are reporting for HMIS
or not, if yes, since when.
2.
To identify the units which are not reporting for HMIS.Whether the
reporting units are providing data on all maternal and child health
indicators as per HMIS.
3.
Whether reporting units are regular in reporting or not.
4.
Whether proper mechanism to collect data from hospitals in the
public/ private sector exists in the system.
Findings
1.
The cases of Ist trimester registration about 47.88 percent of the
pregnant women of district hospital Kota and 33.06 percent of district
hospital Banswara registered within 12 weeks of pregnancy.
2.
In Banswara district hospital above 96 percentage pregnant women
were received TT2\Booster while in kota district hospital only 33
percentage pregnant women were received TT2 \Booster doses.
3.
More than 91 percent and 84 percent of the pregnant women
received TT2 or booster doses in kota and Banswara District
respectively.
4.
All the sub centres reported the cases of IUD, Oral Pills and Nirodh.
Recommendations
1.
At the most of subcenters, second ANM has been posted but they are
not trained in preparation of HMIS data format. It is suggested that
training should be given to these ANMs for preparation of HMIS format.
2.
During the visit LHV should check the validation of data in SDR
maintained by ANM at sub- centre and should be corrected at check
point.ANM should be instructed that it should not be repeated in future.
Research Study- 8
ASSESS THE CORRECTNESS OF REPORTED CASES OF
PREGNANT WOMEN AND CHILDREN TRACKING : A STUDY OF
SELECTED BLOCK OF BHILWARA A DISTRICT
Objectives
1. To examine the correctness of reported cases of pregnant women and
children tracking
2. To assess the validation and completeness of services provided by ANM
3. To assess the role of ANM and ASHA- SAYOGANI in tracking of
pregnant women and children.
4. To assess the matching of PCTS entries with services delivery register
(SDR) maintained by ANM for pregnant women and children tracking.
Findings
1. All the registered cases of pregnant women give the benefits of JSY
hence; every pregnant woman likes to register for ANC.
2. The formal training were given to all the ANM of both the selected
PHCs in records keeping of pregnant women and children tracking.
3. In most of cases at the time of delivery of women ASHA- SAYOGANI
accompanied with the women at link facility of delivery.
4. ANM takes BP, Hb, weight at each ANC of pregnant women.
5. Hepatitis B vaccination is available at sub center , PHC and CHC
6. At grass root level ASHA- SAYOGANI coordinated the nutritional and
health services of pregnant women and children.
Recommendations
1. The Block Programme Management Units should be carefully examine
the completeness, accuracy, data validation issues and inconsistencies
in reporting formats before uploading all HMIS formats of their area.
2. LHV should visit sub centers frequently and check the validation of data
in SDR
maintained by ANM at sub-centre and it should be corrected
at check point .
Research study -9
Improve the HMIS data quality of Rajasthan 2012-13
Objectives
1. To assess month wise completeness of data uploading-State and district
level, (data uploaded and committed).
2. To assess completeness of data element wise (Coverage/Zero and
Blanks).
3. To
analyse district wise consistency checks through validation
error/outlier checks.
4. To find out the district wise institutional availability of services ; based on
quarterly and annual reports.
Findings
1. The Overall validation errors were reported 177 in 2011-12 while this
figure for 2012-13 was increased at level of 608.
2. Maximum error 167 reported in variable of BCG.
3. The highest validation error reported in Kota district (38) followed by
Baran (32) and Barmer (31).
4. About 85 percent of the errors reported from October 2012 to march
2013.
Suggestion
The data of HMIS format of various level of facility shows that higher
facilities like District hospital and Sub district hospital
had more
validation error in HMIS data because of lack of HMIS trained
manpower in preparation of HMIS format. Therefore it is suggested
that who are involved in preparation of HMIS data format at higher
facility should be trained.