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This report evaluates the current status of maternal health services in Assam and provides a comprehensive plan for operationalizing facilities, improving training programs, and implementing innovative strategies. It also reviews targets set in previous plans and identifies areas for improvement.
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Strategies Outcome • FRU Operationalization: DH/Sub DH/ WCH/ CHCs • 24 X 7 PHCs Operationalization: PHCs • Maternal Health Trainings • JSY scheme. • SCs Operationalization. • Referral transport. • Out Reach: VHNDs./ RCH Camps. • Innovations: Assessment of earlier Innovations. • Funding: JSY/ technical/Quality. • Procurement of Drugs. • Health Facilities delivering Comprehensive RCH services. • Provision of Quality ANC, INC and PNC. • Complication: Management and Referral. • Other services-Safe Abortion and RTIs/STIs. • Capacity Building. • JSY linked with micro plan and Institutional delivery. • Outreach RCH services. • Linkages with finance. • Regular supply of Delivery/OT Equipments, RCH Kits, Obstetric Care Drugs, SBA kits, RTI/STI Drugs, MVA Syringes etc.
Points of Appraisal. • Current Status and Future Targets. • Review of Targets set in last PIP with current achievements. • Comprehensive planning for Operationalization of the facilities and its linkage with Manpower/Skilled Based trainings. • Action Plan for the above and its linkage with Finance/ Infrastructure/ HR/ Procurement for e.g. In Assam 82% 24 X 7 PHCs are conducting Normal Delivery but availability of New Born Resuscitation is in just 42% while Functional LR in only 41%.
Points of Appraisal : FRU & 24 X 7 PHCs • Action Plan based on: • 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.
Points of Appraisal – JSY • Targets: • Utilization Pattern: • % of Total Expenditure out of Total Fund Allocated in 2007-08. • Proportion of Expenditure on JSY out of Total Expenditure under Maternal Health.
Points of Appraisal – JSY • Beneficiary: BPL/APL. • Institutional Delivery Linked with Micro birth Planning- No. of Districts. • Plan for Accreditation of Private Health Facilities for JSY: • Redressal mechanism: for delay/grievances. • Remuneration: • In accordance with GoI package. • Payment package for BPL/APL.-ASHA-Urban/Rural. • Mechanism suggested for payment (eg. Documents required, services ensured etc.) • Administrative Charge: • Institutional Strengthening for Administrative work. • Monitoring Mechanism:
Points of Appraisal: SC • Plan for Operationalization of SCs: linked with following: • Infrastructure: Labour Room/ Residential Quarters. • Drugs/ Equipments: • Hiring additional ANMs : • Plan for Trainings: SBA/IMNCI etc. • Plan for Out Reach /VHNDs: • Supportive supervision:
Points for Appraisal: Referral Transport • Plan for Referral Transport: • Strategies deployed. • Linkages with private sector. • Involvement of PRIs/NGOs/ other Stakeholders. • Budgeting been done including recurring expenditure.
Points for Appraisal: VHNDs • Targets and Achievements for 2007-08: • VHNDs planned for 2008-09: • Services offered: • Health personnel involved: • Monitoring mechanism/ Supervision ensured: • Fund for VHNDs allotted:
Maternal Health Training: LSAS/EmOC/SBA • Target for LSAS/EmOC Training under RCH II (2010): • Rationalization of Specialist available with the State along with the Specialist to be hired on contractual basis and the MOs to be trained in Skilled Based Trainings. • Current Status of these Skilled Based Trainings: • Targets achieved and facilities operationalized in 2007-08.. E.g Gujarat trained 60 MOs in LSAS and 34 MOs in EmOC and had committed for operationalising 60 FRUs. • Targets of these Skilled Based Trainings: • Should be rationalized with the target set for FRU Operationalization and hiring of specialist. • Strengthening of facilities where these Skilled Based Trainings are to be undertaken. • Mapping of facilities where the trained personnel will be posted along with their strengthening. • Monitoring Plan: QA Cells. • Funding: • Strengthening of Training institutes. • Strengthening of facilities where Trainees will be posted. • Expenditures incurred during training.
Maternal Health Training (contd)…. • Other Maternal Health Training: • MTP, BEmOC, RTI/STI, Blood Bank • Review: • Whether State Plans for these Trainings. • Review the Training Strategy as per National protocols: • Linked with Operationalization of facilities. • Funding – Both for conduction of Training and Facility Strengthening. • Monitoring.
Points for Appraisal: Innovations • Appraisal of the New Innovations planned by the State: • Target Area/Service. • Target Population. • Implementation Strategy. • Cost to System/ Cost Effectiveness. • Monitoring & Evaluation Mechanism. • Reproducibility. • Self Sustaining Mechanism. • Review the Innovations launched by the State during the Year 2007-08.: • Has the assessment/ evaluation of cost effectiveness been done. • Have the bottlenecks been identified? • Does the State plans to replicate it at a larger level? • Are the newer innovations planned, taken care of the evaluations from the past strategies.