Dungarpur Tour Visit (23-27 Oct, 2013) Manoj Kr. Swarankar State Coordinator- SNCU Room no. 212, DMHS Jaipur

GOOD PRACTICES MCHN day was observed on Thursday. ANM was giving Immunization to pregnant women, child. Due list was complete. Expected dates of delivery maintained. Supplementary food by ICDS (Soyabean+sugar+oil+wheat flour) is given to pregnant and lactating mothers. JSY payments and Shubh laxmi payments are given promptly.

Gaps/Issues Doctors/Contractual staff posts are vacant. Eg. only 2 BPMs are working out of which one has additional charge of DPM also. Accountant post at PHC level vacant, due to which MO has to look after the accounts and that creates problem. Tenders are usually completed by October month. Therefore, for ASHA trainings, one is left with only 5 months.(This process should be started up immediately after receiving sanctions from the state) MMU was standing in CHC Punjpur and used only for X-ray for OPD.

Contd….. CHC Damri did not received AMG, Corpus grant, Shubh laxmi yojana. (The concerned district officials should speed up and ensure transfer of funds timely) The fund for cleanliness is approved for the first time, therefore some confusion raised during tendering and process delayed up. (The format of tender could have been sent to districts with the sanction itself)

Contd….. The fund expenditure in Untied fund, AMG and corpus grant is quite low. (This should be supervised regularly by CMHO and in DHS meeting. DAM should keep informing higher officials regarding fund expenditure and proper action needed to be taken up like quarterly review of DAM with CMHO. Also in the April month of financial year itself, CMHO may ask to all concerned facilities to submit their requirement/action plan on how they are going to spend these funds with strict deadlines) Sodium hypochlorite solution not available in few health facilities. Control room for JE vans established in Distt. Hospital, but no HR recruited in absence of any clear cut guidelines. (Guidelines should be resend if not sent by State or by CMHO office)

Recommendations ASHAs should be owned/or be responsible to only one department may be Health department or ICDS department. SDR filling- Training required for Frontline workers- General instructions on How, When and What to fill. RI Micro plan -Uneven distribution of ANMs workload. Eg, some ANMs cater services to 2 villages and some having 4 villages. Clearance of TA/DA for ASHA supervisors/LHVs/ANMs takes long which hampers field supervision. Refresher training for ANMs/LHVs should be carried out to sustain their capacity building.

Contd….. Introduction of stock register cum ASHA diary for record keeping, drug listing available with ASHA, and also to make them aware how many programmes/components they have to look and what is the incentive they will receive. This will help them as they have ready reference available with them. It should be ensured that all staff should be trained in desired skills like SBA, NSSK etc,. as staff are rotated in health facilities, and that creates problem if trained staff is transferred somewhere else.

Thank You