MONITORING OPERATIONALIZATION OF HEALTH FACILITIES and MATERNAL HEALTH STRATEGIES

1. MONITORING OPERATIONALIZATION OF HEALTH FACILITIES and MATERNAL HEALTH STRATEGIES DURING CRM VISIT

2. Major MH Strategies • FRU Operationalization. • 24 X 7 PHCs Operationalization. • SCs Operationalization. • Janani Suraksha Yojana. • Referral transport. • VHNDs. • Safe Abortion Services. • RTI/STI • Maternal Health Trainings: LSAS, EmOC, SBA..

3. Outcome • Quality ANC: • At least 4 ANC (including registration) which includes full clinical/Abdominal examination along with measurement of Weight. • Hb and Urine Examination. • 2 TT examinations. • Consumption of at least 100 IFA tablets. • Counselling including preparation of Birth Plan. • Institutional Delivery: • Increased Institutional Delivery with Quality of Care. • Institutional Stay for 48 hrs. • Post Partum Care: • 2 Post Partum Check up. • Quality Of care during Post Partum. • Detection of Complications, Referral and Management.

4. MONITORING OPERATIONALIZATION OF FRUs.

5. Analysis: FRU Operationalization Action Plan: • Identification of Nodal person both at State and District Level. • 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. • Administrative actions undertaken.

6. MONITORING OPERATIONALIZATION OF PHCs.

7. VHNDs • VHNDs planned for 2008-09: • Services offered: • Health personnel involved: • Monitoring mechanism/ Supervision ensured: • Fund for VHNDs allotted:

8. Skilled Based Training: LSAS, EmOC & SBA • Training Centre: • Adequate Funds Released. • Adequate and Devoted Trainers. • Training Curriculum being followed. • Monitoring during training. • Focus on Quality. • Posting of trained MOs: • Should be posted at FRUs/ 24 * 7 PHCs. • Linkage of training/ Availability of Specialist. • Strengthen the FRU/ 24 * 7 PHCs in terms of other logistics like equipments, drugs, infrastructure etc. • Monitoring: District/ State Program Officers. • Focus on quality.

9. Maternal Health Training: LSAS/EmOC/SBA • Mapping of facilities where the trained personnel will be posted along with their strengthening. • Strengthening of facilities where these Skilled Based Trainings are to be undertaken. • Monitoring Plan: QA Cells. • Funding: • Strengthening of Training institutes. • Strengthening of facilities where Trainees will be posted. • Expenditures incurred during training.

10. CHECKLIST • Facility Observation Checklist • District: __________Name of Institution: _______ Date of visit: ________________ • Service provision • Routine Delivery Services (24 hours) Yes/ No • Manage common obstetric complications Yes/ No • C section Yes/ No • MTP Regular/ Periodic • Staff availability • Obgyn Specialist/Trained M.O Yes/ No • Anesthesiologist/trained M.O Yes/ No • Staff Nurses/ANMs at least (3) Yes/ No • Lab Technicians Yes/ No •  Equipments and Supplies Injection Magnesium Sulphate Yes/ No • MVA kits Yes/ No • Inj. Oxytocin Yes/ No • Boyles appratus Yes/ No • Partographs Yes/ No • Colour coded waste bins Yes/ No • Ambu Bag/ Radiant Warmer • Equipments for CS.

11. Checklist (contd…) • Facility Infrastructure • Labour room condition Yes/ No • Running water supply Yes/ No • Plans for hospital bio-waste disposal Yes/ No • Visual Privacy in labour room Yes/ No • Visual privacy in OPD Yes/ No • Back-up power facility Yes/ No • Autoclave/sterilization. •  Referral Services • Availability of ambulance /outsourced vehicle: Yes/ No •  Client Convenience • Covered waiting area Yes/ No • Separate fn & clean toilets for M/F Yes/ No • Signage to guide clients Yes/ No •  Record Review Average no of monthly Institutional Deliveries for last 5 months

12. THANK YOU