1. LABOUR ROOM & NEW BORN CARE SERVICES ASSESSMENT REPORT
PATNA,BHOJPUR AND BUXAR
Dr Priyanka Singh
Dept of Community Medicine,
Nalanda Medical College, Patna
Dr Manpret Singh Khurmi
UNICEF
Bihar, Patna

2. BACKGROUND
The majority of newborn problems are specific to the perinatal period. They cause not only deaths but also substantial morbidity and disability. These problems are the result of poor maternal health, inadequate care during pregnancy, inappropriate management and poor hygiene during delivery, lack of newborn care and discriminatory care.

3. cont….
Life expectancy of the neonates is increasing with the help of advances in neonatology, new life support techniques and new treatment modalities. But despite all these measures and the management of the nosocomial neonatal sepsis ,birth asphyxia and hypothermia is a big problem. The solution left is to control by implementing preventive measures in labour room and immediate newborn care services after birth at Health facilities.

5. OBJECTIVE
To assess availability of labour room facilities and new born care sevices at Primary Health Centre.

6. METHODOLOGY
An assessment of labour room and new born care services was conducted at PHCs of Patna,Bhojpur,Buxar by assessment team based on structured proforma designed.

7. PARAMETERS FOR LABOUR ROOM ASSESMENT
►Cleanliness of labour room. ► Toilet close to labour room. ► Labour room register is available. ► Labour room register is being filled correctly (all columns) ► Elbow operated tap is available. ► Bag and Mask is available. ► Glass on window.

8. CONT….. Curtains on window available. Duty roster displayed.
Is ambulance available in working condition.
Oxygen cylinder available in ambulance.
Weighing Machine available.
BP apparatus available.
Movable blinds available.
Partograph available and being filled regularly for each delivery
Delivery drug tray,trolley with medicines and vaccines available.

9. PARAMETERS FOR NEWBORN CARE SERVICES
Is newborn being immunised with BCG and OPV at birth.
Radiant warmer installed.
Oxygen source available.
Suction Machine available.
% of infants in whom breastfeeding has been initiated within 1hr .

10. LABOUR ROOM AND NEW BORN CARE SERVICES ASSESSEMENT: PATNA
NAME OF PHC
NAME OF MONITOR
Approx size of Labour room
No. of beds in Labour ward
Cleanliness of Labour room
Toilet close to Labour room
Labour room register is available
Labour room register is being filled correctly (All coloumns)
Elbow operated tap is available
Bag and Mask is available
Glass on window
Curtain on windows available
Duty roster displayed
Is Ambulance available in working condition
Oxygen Cylinder available in Ambulance
Weighing Machine available
BP Apparatus
Moveable blinds available
Partograph avaiable and is being filled regularly for each delivery
No. of SBA Trained ANM posted in Labour room
JBSY Payment paid upto…..
Delivery drug tray, trolley with medicines and vaccines available
Discharge Afer delivery takes place
Is Newborn being immunized with BCG and OPV 0 at birth
Radiant warmer installed
Oxygen source available
Suction Machine available
% of infants in whom Breastfeeding has been intiated with in 1 hr in this month (No. of deliveries in which breast feeding has been initiated with in 1 hr / Total No. of deliveries in this month X 100)
NRIPENDRA
BAKHTIYARPUR
24x14 6
Good
Yes No
Unbroken 2
NOV
after 24 hrs 98
DHANARUA
12x12
broken 1
OCT
same day
100
KHUSRUPUR
24X12 4
Poor NA Na no 95
MASAURHI
18X14
yes
Same Day
PALIGANJ
16x10 10
DEC
BIVISHAN JHA
BARH
20x20 8
Broken
MOKAMA
17x11 97
PANDARAK
12x10
PHULWARISHARIF
10x18 3
PUNPUN
8X10 NO
MANOJ KR RAO
DANIAWAN
12X8 5
SEPT 99
FATUHA
(10X6)X2
MANER
AUG 2010
SAMPAT CHAK
20X20
DEC 2010
RANWIR KUMAR
BIHTA
16X11
BIKRAM
14X12
DANAPUR
15X10 16
SEP 2010
NAUBATPUR 25
Dec-10

11. LABOUR ROOM AND NEW BORN CARE SERVICES ASSESSEMENT: BUXAR
NAME OF PHC
NAME OF MONITOR
Approx size of Labour room
No. of beds in Labour ward
Cleanliness of Labour room
Toilet close to Labour room
Labour room register is available
Labour room register is being filled correctly (All coloumns)
Elbow operated tap is available
Bag and Mask is available
Glass on window
Curtain on windows available
Duty roster displayed
Is Ambulance available in working condition
Oxygen Cylinder available in Ambulance
Weighing Machine available
BP Apparatus
Moveable blinds available
Partograph avaiable and is being filled regularly for each delivery
No. of SBA trained ANMs posted in labour room at PHC
JBSY Payment paid upto
Delivery drug tray, trolley with medicines and vaccines available
Discharge after delivery takes place
Is Newborn being immunized with BCG and OPV 0 at birth
Radiant warmer installed
Oxygen source available
Suction Machine available
% of infants in whom Breastfeeding has been intiated with in 1 hr in this month (No. of deliveries in which breast feeding has been initiated with in 1 hr / Total No. of deliveries in this month X 100)
Nripendra Kumar
Nawanager
10X12 5
Good
Yes
Unbroken No 3
10 DEC 2010
Same day 90
Chougai 2 1
10 NOV 2010
After 24 Hrs 95
Ranwir Kumar
Chousa
14X20 6
12 DEC 2010 98
Rajpur 7
15 DEC 2010 96
M.K. Rao
Simri
12X14
Brahmpur
12X20
100
Bivishan Jha
Dumraon
14X16
Ithari
30 NOV 2010
SDH
16X25 20
22 DEC 2010

12. LABOUR ROOM AND NEW BORN CARE SERVICES ASSESSEMENT: BHOJPUR DATED NOV 30 - DEC 1, 2010
NAME OF PHC
NAME OF MONITOR
Approx size of Labour room
No. of beds in Labour ward
Cleanliness of Labour room
Toilet close to Labour room
Labour room register is available
Labour room register is being filled correctly (All coloumns)
Elbow operated tap is available
Bag and Mask is available
Glass on window
Curtain on windows available
Duty roster displayed
Is Ambulance available in working condition
Oxygen Cylinder available in Ambulance
Weighing Machine available
BP Apparatus
Moveable blinds available
Partograph avaiable and is being filled regularly for each delivery
No. of SBA trained ANMs posted in labour room at PHC
JBSY Payment paid upto
Delivery drug tray, trolley with medicines and vaccines available
Discharge after delivery takes place
Is Newborn being immunized with BCG and OPV 0 at birth
Radiant warmer installed
Oxygen source available
Suction Machine available
% of infants in whom Breastfeeding has been intiated with in 1 hr in this month (No. of deliveries in which breast feeding has been initiated with in 1 hr / Total No. of deliveries in this month X 100)
Barhara
Manoj
16 X 20 6
good
yes No
Yes
unbroken
2/1 1
Oct - 10
same day 99
Sandesh
6 X 10
poor
No(Adult) no
4/3 3
Sahar
14X 12
Yes(Non functional)
broken
3/3 94
Koelwar
14 X 16
Yes (but not available in labour room)
7/6
after 24 hrs 95
Shahpur
Bivishan Jha 9
8/2 2
100
SDH Arrah
24X30 18 NA
14/12 12 y
Behiya
14X14 8
4/4 4
Jagdishpur
Ranwir
18X10
Udwantnagar
15X12 98
Trari
Nripendra
24x16
average
Charpokhri
24X18 na
FEB 09
Piro
12X15

15. BHOJPUR LABOUR ROOM AND NEW BORN CARE SERVICES ASSESSEMENT IN (%)

16. INFERENCE - Mean of Different Parameters of Three Districts.

17. INFERENCE-Mean of Different Parameters of Three Districts.

18. RECCOMENDATION FOR NEWBORN CARE SERVICES-
Low birth babies are at higher risk of the mortality and morbidity.Weighing machine should be made available at all centres.
Breastfeeding is one of the main pillars of newborn care. Promotion of early initiation and exclusive of breast feeding through trainings,BCC,Campaign in community through media,advertisement etc.

19. CONT…
Community sensitization for availing regular immunization through ANM,AWW, ASHA and NGO.
Regular and sufficient supply of vaccines at all health centers.
Regularization of RI card.
Provision for supply and availability of all requisite equipment and adequate
supplies like; Baby warmer, Incubator, Ambubag, Suction Machine etc .

20. MATERNAL HEALTH-
Despite the WHO recommendation that it be used to monitor all labours, the partograph is still not widely used .
Basic Equipment for Labour Room / Delivery Room should be available.
Adequate supply of essential drugs.
Provision of All Labour room to have an attached toilet with water.

21. INFRASTRUCTURE
Provision of All Labour room to have an attached toilet with water.
Availability of ambulance (outsource or otherwise) 24 hrs at the PHC.
Maintainance of proper cleanliness in delivery/labour room.
i. Basic Equipment for Labour Room / Delivery Room in place .
New Born Corner in every facility

22. TRAININGS AND CAPACITY BUILDING-
Capacity building on : IMNCI, FP, SBA,FIMNCI,HBNCC,RI etc. Organizing regular orientation and refresher trainings for Doctors, ANMs, AWWs, ASHAs, and TBAs.

23. REFERENCES
Indian Public Health Standards (IPHS) for Primary Health Centre. National Facility Report RCH 11. ASHAs Involvement in Newborn Care: A Feasibility Study. Stalin P, Krishnan A, Rai SK, Agarwal RK. The Partograph: An Essential Tool for Decision-Making during Labor, USAID. Use of the Partograph: What do we know, what do we need to find out ?Findings from a Literature Review Dr. Jeanne d’Arc Kabagema and Karen Levin Why Invest in Newborn Health? Population Reference Bureau and Saving Newborn Lives.

24. “Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India.” Lancet 1999;354: