1. VISIT OF DISTRICT BHILWARA ( 23.10.13 TO 26.1013) A RAPID FEEDBACK

2. Major Observations at CHC Aasind (L3 DP) Only 02 doctors – JS Medicine and JS surgery BSU not functional for last 02 months due to accident of LT MTP / C-section not conducted due to non availability of Gync. or trained MO No Gync / Pediatrician / Anesthetist No EmOC / LSAS trained MO Recently, 01 Gync. is retired but she is ready to join on contractual basis but due to procedural formalities hiring is delayed if she joined MTP and C-section may start Sanitary condition of labour room is satisfactory Sanitary condition of ward is satisfactory Sanitary condition of toilet is satisfactory Presently, all vaccines are available but earlier there were shortage of BCG and Measles Partograph chart not available but format available Radiant warmer at LR not functional, 200 watt bulb taken in work At OT radiant warmer and weighing machine not available ARSH clinic not functional but clinic is there NBSU not established yet. Training of staff is required Cleanliness work not started

3. Major Observations at CHC Jahajpur (L3 DP) 01 SMO, 01 MO, 01 lady MO BSU not functional for last 02 months MTP / C-section not conducted due to non availability of Gync. or trained MO No Gync / Pediatrician / Anesthetist No EmOC / LSAS trained MO MTP services not available Sanitary condition of toilets of maternal ward was very bad Sanitary condition of ward is satisfactory Sanitary conditon of toilet is satisfactory Labour table in poor condition and it is urgently required UF, AMG, CG not a single paisa is utilized due to internal conflict Presently, all vaccines are available but earlier there were shortage of BCG and Measles Partograph chart available and format available not fill up for each case ARSH clinic not functional but clinic is there NBSU not established but not functional. 01 nursing staff already trained. Cleanliness work not started

4. Major Observations at CHC Suwana Deliveries only 3-5 per month Sanitary condition of labour room is satisfctory Sanitary condition of ward is satisfactory Sanitary condition of toilet is satisfactory Tablet misoprostol not available MTP services not available Radiant warmer not available only 200 watt bulb is taken in use Presently, all vaccines are available but earlier there were shortage of BCG and Measles Partograph chart not available and only format available. ARSH clinic not functional but clinic is there Cleanliness work not started

5. Major Observations at CHC Gulabpur (L3 DP) 01 Gync, 01 Physician, 01 MO (01 MO on deputation) BSU not functional due to non functional DG set C-section not conducted due to non availability of Anesthetist No Pediatrician No EmOC / LSAS trained MO Sanitary condition of toilet and ward adjacent to labour room was not good Sanitary condition of ward was not good Branding work incomplete only front of the CHC is coloured Presently, all vaccines are available but earlier there were shortage of BCG and Measles Partograph chart available and format available CTF connectivity is there but service is not regular ARSH clinic not functional but clinic is there Raiant warmer and weighing machine not available at OT room Cleanliness work not started

6. Major Observations at SH Shahpura(L3 DP) 01 Gync, 01 Pediatrician and 03 MO out of 08 sanction post are working BSU functional but shortage of blood, personally met PMO for supply of blood C-section conducted – Upto September 24 No Anesthetist / LSAS trained MO. Services hired. EmOC and LSAS trg. required Sanitary condition of toilet and ward was good L 3 level all the services are available, work order issued for branding work. It can be identified as model DP. Presently, all vaccines are available but earlier there were shortage of BCG and Measles Partograph chart available and format available, maitained ARSH clinic not functional but clinic is there Cleanliness work started More UF / AMG / CG are required. All the funds are utilized.

7. Major Observations of PHCs Visited 04 PHCs out of which 03 are delivery points (Phooliyankalan, Sawaipur and Rayla) and another NDP (Badnor) At PHC Badnor condition of LR required to be improved Radiant warmer not available at any PHC. 200 watt bulb is used At sector Sawaipur due to shortage contraceptives not supplied to ASHA ARSH clinics are not functional Almost 80% VHSC accounts are opened but funds are not transferred Sometimes there are shortage of BCG / Measles vaccines At PHC Rayla (Block – Banera) average 70 deliveries conducted per month but no MO is there. Charge given to a MO posted at nearby DP PHC Rupalikhurd. He also look after the work of another PHC. Sanitary condition of all the PHCs are satisfactory Cleanliness work not initiated

8. Initiations Taken by District - Organization sector wise camp for rectification in SDR and maintaining quality data entry, accounts record - Line listing near about 80% - SH Shahpura is well maintained inspite of shortage of doctors - Regular block meetings are organized - Special focus given on ASHA payment during ASHA monthly meeting between 25 to 30 th of the month Major Gaps Identified -Under JSY, payment for ensuring institutional deliveries not given to ASHA. Only payment given if ASHA escorted the case. -Under HBNC payment not given to ASHA. Though ASHA who are already get trained in IMNCI they are conduction regular home visit as per guideline

9. Major Gaps Continues….. At district level ASHA work and payment related data not compiled? VHSC meetings are conducted but other members not participated Children of Grade 3 or 4 are identified but referral are not done for MTCs ASHA are totally unaware about the work / package regarding follow up of MTC / FBNC discharge cases At school level IFA tablets are distributed every Monday and at AWC tablets are distributed on every Thursday but reporting is irregular from schools. Sanitary napkins are supplied to ASHA but it is under utilized due to lack of acceptance among the community At block level vehicles are under utilized. No supervision plan is there especially at Block Jahajpur

10. Major Gaps Continues….. Out of 12 allotted JE 01 is non-functional (Koshithol) due unavailability of driver, 05 JE have only 01 driver and remaining 06 JEs only have 02 drivers JE generally covers only 01 PHC area where it is allotted NGO / Agency not final, drivers hired only from Saineek Kalyan Board Out of 22 ‘108’ ambulance 06 are off road due to repair work. 01 ambulance visited at DH. Collapsible stretcher broken, suction apparatus not functional, foot operated suction pump not working, pulse oxymeter not available, surgical items not available, medicines not available

11. Thanks