1. MONITORING OPERATIONALIZATION OF HEALTH FACILITIES and MATERNAL HEALTH STRATEGIES DURING CRM VISIT

2.  FRU Operationalization.  24 X 7 PHCs Operationalization.  SCs Operationalization.  Janani Suraksha Yojana.  Referral transport.  VHNDs.  Safe Abortion Services.  RTI/STI  Maternal Health Trainings: LSAS, EmOC, SBA..

3.  Quality ANC: At least 4 ANC (including registration) which includes full clinical/Abdominal examination along with measurement of Weight. Hb and Urine Examination. 2 TT injections. Consumption of at least 100 IFA tablets. Counselling including preparation of Birth Plan.  Institutional Delivery: Increased Institutional Delivery with Quality of Care. Institutional Stay for 48 hrs.  Post Partum Care: 2 Post Partum Check up. Quality Of care during Post Partum.  Detection of Complications, Referral and Management.

4. MONITORING OPERATIONALIZATION OF FRUs.

5. FRUs selected: X Doctor: (Hired/Contractual) 1)OBG/MO (EmOC) = X 2)Paed/MO (IMNCI/ENBC)= X 3) Anesthetic/MO (LSAS) =X Paramedical : SNs: Hired/Contractual LTs: Hired/Contractual for X no. of facilities. Ambulance/R eferral transport. Procuring Equipments /Drugs for: LR/OT/BSC/New Born Equipments.=X Availability of Genset. 24 hr Water Supply Infrastructure Strengthen/C onstructions: X Blood Storage Centre

6. Action Plan: Identification of Nodal person both at State and District Level. Mapping of resources done. Bottlenecks identified. Linkages with manpower/ training/ BSC etc. Has the budgeting been done under different heads (as mentioned in earlier slide). Has the running cost been taken in account e.g. for gensets has the allocation for POL done or funds have been marked for AMC. Salary Component taken into account. Monitoring Mechanism established. Administrative actions undertaken.

7. MONITORING OPERATIONALIZATION OF PHCs.

8. 24 X 7 PHCs selected: X Doctor: (Hired/Contractua l) 1) MO (BEmOC/MTP/RTI/ IMNCI/ENBC/FP)= X Paramedical : 3SNs or ANMs & LTs: Hired/Contractua l For X No. of facilities Ambulance/R eferral transport. Remapping/pro curing Equipments/Dru gs for: LR/New Born Equipments.=X Availability of Genset. 24 hr Water Supply Infrastructure Strengthen/C onstructions: X,

9.  Plan for Operationalization of SCs.  Infrastructure: Labour Room/ residential Quarters.  Drugs/ Equipments: Partographs/ Misoprostol.  Hiring additional ANMs.  ANMs being nominated for SBA/ IMNCI Trainings.  VHNDs organized.  Out Reach Services offered: ANC/PNC/Immunization/FP/ Counselling etc.  Supportive supervision.

10. Strategies deployed. Linkages with private sector. Involvement of PRIs/NGOs/ other Stakeholders. Budgeting been done.

11.  VHNDs planned for 2008-09:  Services offered:  Health personnel involved:  Monitoring mechanism/ Supervision ensured:  Fund for VHNDs allotted:

12.  Training Centre: Adequate Funds Released. Adequate and Devoted Trainers. Training Curriculum being followed. Monitoring during training. Focus on Quality.  Posting of trained MOs: Should be posted at FRUs/ 24 * 7 PHCs. Linkage of training/ Availability of Specialist. Strengthen the FRU/ 24 * 7 PHCs in terms of other logistics like equipments, drugs, infrastructure etc.  Monitoring: District/ State Program Officers.  Focus on quality.

13. Mapping of facilities where the trained personnel will be posted along with their strengthening. Strengthening of facilities where these Skilled Based Trainings are to be undertaken. Monitoring Plan: QA Cells. Funding:  Strengthening of Training institutes.  Strengthening of facilities where Trainees will be posted.  Expenditures incurred during training.

14.  Facility Observation Checklist  District: __________Name of Institution: _______ Date of visit: ________________  Service provision  Routine Delivery Services (24 hours)Yes/ No  Manage common obstetric complicationsYes/ No  C section Yes/ No  MTPRegular/ Periodic  Staff availability  Obgyn Specialist/Trained M.OYes/ No  Anesthesiologist/trained M.OYes/ No  Staff Nurses/ANMs at least (3)Yes/ No  Lab Technicians Yes/ No  Equipments and Supplies Injection Magnesium SulphateYes/ No  MVA kits Yes/ No  Inj. Oxytocin Yes/ No  Boyles appratus Yes/ No  Partographs Yes/ No  Colour coded waste bins Yes/ No  Ambu Bag/ Radiant Warmer  Equipments for CS. 

15.  Facility Infrastructure  Labour room conditionYes/ No  Running water supply Yes/ No  Plans for hospital bio-waste disposalYes/ No  Visual Privacy in labour roomYes/ No  Visual privacy in OPDYes/ No  Back-up power facilityYes/ No  Autoclave/sterilization.  Referral Services  Availability of ambulance /outsourced vehicle: Yes/ No  Client Convenience  Covered waiting area Yes/ No  Separate fn & clean toilets for M/F Yes/ No  Signage to guide clients Yes/ No  Record Review Average no of monthly Institutional Deliveries for last 5 months

19. THANK YOU