1. Presented By : Dr Mahendra Raj Neupane Chief Medical Officer

2. NAMASTE

3. BHARATPUR HOSPITAL

4. BHARATPUR HOSPITAL,CHITWAN 2012 B.SEstablishment of the hospital, with the help of American Government in collaboration with Rapti Dun Bikash Samitee. 2020 B.S.Infrastructure allocation with the help of American Government. 2039 B.S.Establishment of Hospital Help and development committee. 2059 B.S. – current date. Establishment of Bharatpur Hospital Development Committee. 2067 B.S - current date. The number of sanctioned beds grew to a total of 400. 300 sanctioned by Nepal Government and 100 beds sanctioned by Bharatpur hospital development committee. Around 35 lacs people from chitwan,surrounding districts and neighboring countries are being facilitated by the Bharatpur Hospital annually.

5. Infrastructure Hospital ownership land: -30-11-06 bigaha LEFT FOR HOSPITAL: 12-00-06 Own Building: Hospital area: (Inadequate) Doctor quarter: (Inadequate) Staff quarter: (Inadequate) Other: Inaducate Ambulance : …0 Functioning ….0 Non Functioning Major Medical Equipment: ___X-Ray____________ … Functioning ___USG____________ … Functioning ___LAB.MACHINE___________ … Functioning _________EEG, ECT______ … Functioning ANESTHESIA_MACHINE_____ Functioning Monitor-6 Functioning& 3 non functioning. Ventilater-2 Functioning & 3 non functioning Histopathology Machine non functioning

6. Infrastructure No of Sectioned Bed: 300 No of available bed: 415 General: 334 Paying: 33 Emergency: 11 Cabin: 37(old+new)

7.  General Medicine  General Surgery  Laparoscopic Surgery  Gynaecology  Orthopaedics  ENT  Paediatrics  Gereatric  Psychiatry  Dermatology  Dental  Physical Rehabilitation  ECG /ECT  EHS  Spinal injury Center DOTS Computerized EEG  Digital X-ray  24 hours Emergency Services  Clinical, Histo & Cyto & Microbiology Lab Services Hospital Services: Curative

8. Public Heath Services: Preventive HIV/ AIDS STD Family planning CAC/PAC ANC Checkup I. P. Training program Safe Motherhood Program Uterine Prolapse Surgery MLP/ASBA/SBA

9. Financial Situation ActivitiesBudget Allocated 2070/071 Budget Released 2070/71 Budget Expenditure 2070/71(in %) Irregularities (BERUJU) Amount Clearanc es % Clearances 3700223 ( Talab )61800000 61768939 (99.94%) -- 3708043(Ama surksha) 42023000 38393609 (91.36%) --- 3701343( building)50200000 50200000 (100 %) ----- 3701153(prolaps)6500000 1544000 (23.75 %) --- 3701013 (Population Programme ) 4000000 4000000 (100%) 3701243 (Ra swa ta ) 3260000 2134215 (65.46%) 3708044 (Intregated jilla Swa. Programe) 500000 493100 (98.62%)

10. Human resource SNPOSTS GOVERNMENTCURRENTLY AVAILABLE Sanctioned post (in number) Fulfilled (in number) Among government sanction (in number) Local and other resources (in number) Technical Staffs - 1Doctor5029- 2Nursing4031- 3Other Technical Staff2037- Administrative (Non-Technical) 1Administrative Staff55- 2Helper15 - Total130117- Source:........................ Data as of Shrawan, 2071

11. Human resources at Hospitals ( Hospital development committee) S.NPostSanctioned post (in number) Fulfilled post (in number) 1Doctor1516 2Staff Nurse58 3ANM1513 4CMA99 5Physiotherapist11 6Lab technician / assistant 44 7Radiographer33

12. Human resources at Hospitals ( Hospital development committee) S.NPostSanctioned post (in number) Fulfilled (in number) Contract 8Supervisor11 9Computer Operator11 10Assistant (kharidar)22 11Assistant (Mukhiya)109 12E. Plumber11 13Driver11 14Security Guards11 15Office Helper4337

13. Hospital Information SN Information 067/068068/69069/70070/71 1Number of sanction Bed 300 2Number of Available Beds 253400415 3Total Number of OPD cases 99892112348127788125044 4 Total Number of Emergency cases 32681345273526425242 5 Total number cases (OPD+Emergency) 132573146875163052150286 6 Total Number of Inpatient Discharged 25672274723015131097 7 Total number of Preventive service provided 84699894105728166 8 Total Number of DOTS services Provided NA80102107 9 Total Number of ART services provided NA801856873

14. Hospital Information contd.. SN Information 067/068 068/69 069/70070/71 8 Total Number of Lab service provided210201 523021 286810364597 9 Total number of hospital service provided170782189934180307158452 10 Total number of Delivery Conducted8589 9588 957210292 11Total Referral In casesNOT RECORDED 12Total Referral out cases818 745739846 13Total Maternal Deaths4 122 14Brought DeathNA99120127 15Total Hospital Deaths191 226270377

15. Key Hospital Indicators SNIndicators067/68068/70069/70070/71 1 Total OPD Visit as % of Total Population 17.4319.2121.9121.44 2 % of Emergency Visits among Total OPD Visits 24.5530.7327.5920.18 3 Bed Occupancy Rate 84.3376.4276.5382.63 4 Delivery Conducted as a % of expected Pregnancy 48.8156.3354.2364.81 5 Number of CAC Service Provided 459503441435

16. SN Indicators067/68068/69069/70070/71 6 Death Rate Among in-patients0.740.750.790.89 7 % of Major Surgery among Total surgery cases72.9671.763.5221.10 8 % of Intermediate Surgery Among Total Surgery Cases8.8613.421.6025.00 9 Percentage of Minor Surgery among Total Surgery Cases18.1614.914.8753.89 10 Doctors: Inpatients Ratio1:5341:552.41:7731:429 11 Doctors: OPD Ratio1:20811:20801:32761:1242 12 Nurse: Inpatient Ratio1:2241:3551:3631:232 Key Hospital Indicators

17. OPD Information Ward F. Y. 2068/069F. Y. 2069/2070 F. Y. 2070/071 Surgical 802191648342 Gyne 849691499944 Padeatric 150071743414569 General 232212787428414 ENT 107951124711576

18. Pregnancy104071172611066 Skin 93981067711248 Dental 788896868794 Orthopdic 149221645016576 Mental 419345812288 Gyne+ Pregnancy 189032087521010 Total Cases 112384127788122878

19. S. N.F. Y. 2069/070 F. Y. 2070/071 Old CabinNew CabinPaying Ward ND 68867881741281165 Complicated 90153671797 CS 178518753812271144 Total 9572102924623722406 VH 13011014781

20. Free Health Services F. Y. 2070/71 No of Patient Served ( Target grops ) No of Persons Served Ultra Poor& poor2864 Helpless176 Persons with Disability102 Senior citizen1171 Victims of GBV16 F. H. V.42 Others52

21. Free Health Services F. Y. 2070/71 Cases No of persons Patients with Valid ID1942 Repeated old Patients4457 Men4801 Women4691 Total patients served9492

22. Free Health Services F. Y. 2070/71 CasteNo of persons Dalit527 Disadvantages Janajati1284 Disadvantages Terai caste Groups197 Religious minorit31 Relatively advantaged Janajati161 Upper caste Groups131

23. Free Health Services F. Y. 2070/71 Cases No Served Reffred Patients296 Patients from Other Districts993 Patients from Rural Area2616 Emergency Patients805 Outdoor Patients1817 Indoor Patients1441

24. Free Health Services F. Y. 2070/71 Cases Cost Medicines1569126 Subsidy provided1569096 Investigation2408201 Subsidy provided2345781 Operation237100 Subsidy provided206450

25. Free Health Services F. Y. 2070/71 Cases cost Other Costs966295 Subsidy provided965525 Total Costs5180722 Total Subsidy5086852 Average cost per patient546 Average Subsidy per patient536

26. Top 10 Morbidity and Mortality among Inpatients FY 2070/071 Morbidity FY 2070/071Mortality FY 2070/071 Top Ten Diseases among inpatients Top Ten causes of Mortality among inpatients 1. LRTI 1.COPD 2. COPD 2.CVA 3. AFI 3.CCF 4. AGE 4.Crisis of liver 5. UTI 5.Pneumonia 6. HTN 6.Poisoning 7. NNS/NNJ 7.DM/DCM 8. APD 8.HTN 9.PTB9.RTA 10. Pneumonia 10.AGE

27. LAB Cases F. Y.2067/2068 F. Y. 2068/2069 F. Y. 2069/2070 F. Y. 2070/071 BACTERIOLGY2361361925341817 BIOCHEMISTRY5090234048080151119558 VIROLOGY806091631186522998 HISTOLOGY01227 PARASITOLOGY24633224902721132111 IMMUNOLGY16826141461620820534 HAEMATOLGY101403107650142356157492 ENDOCRINOLOG Y 22834584647310060

28. Major Innovations PCL nursing program is started & running currently. Paying clinic is running smoothly. Regular Hospital services even in general holydays. Post-mortem house is under construction.

29. Hospital Strength Increased service coverage as compared to preceding F.Y. Medical Doctors and other staffs are Recruited. from Hospital Development Committee. Most of the services are in operation now. ICU department is also functioning. Nursing campus is running now.

30. MAJOR CHALLENGES 1. High Cost of hiring new staffs by Hospital development committee. 2. Competition with private medical colleges and private hospitals. 3. Less number of skilled human resource to run the I.C.U. 4. Lack of skilled professionals to train the new comers. 5. Epidemic of communicable diseases. 6. Lack of manpower in Hospital development committee. 7. Improper sewage and drainage system. 8. Inadequate no of Specialists. 9. Inadequate no of staff in recording & reporting system in 415 beded big Hospital. 10. Not fulfillment of sanctioned staff.

31. Suggestion for Improvements Proper care should be given for construction of A block. Prompt and in time allocation of staff and release of budget for salary, reconstruction of old infrastructure & others expenditures. Necessities of counseling system to raise the awareness about diseases & their consequences. Hospital security should be in chain ways system. There should be strong policy on Free Health Service in such type of hospital. Sanctioned post should be planned according to the current population growth rate.

32. Welcome to all For