Observations and conclusion on the Presenting reporting structure (DHIS II/NRHM/MCH) of surveyed blocks of District

● The RD team visited randomly selected 4 blocks of the districts, from each block one PHC was selected randomly. One sub center selected from selected PHC based on operation feasibility. (Annexure I) ● In the surveyed blocks, three parallel reports (MCH, NRHM and DHIS II) are generated from blocks and submitted to district within prescribed guidelines. DHIS II/HMIS reports are filled by ANM at sub centers; Sector Health supervisor compiles Sub centers reports and submit to CHC. At block, health supervisor, BE, BADA, along with DEO compile the reports. The facility wise reports were entered into online software provided at block. ● The team observed that there is lot of confusion about the reporting UNITS at peripheral health institute i.e. facility wise or area wise. The double reporting was observed in Ghumka and blocks and in some pockets of the other surveyed blocks. District HMIS officer should take IMMEDIATE step to correct the confusion. The DDO should focus on accuracy and relevance of the data and should ensure that all the columns are duly completed. If there is any problem in entering data in the prescribed format, he may discuss the same with the concerned and immediately sort out the matter then and there. The he should act like facilitator as well as instructor. ● The one day training on the reporting proforma of DHIS II completed at block level. The guidelines give broad instructions to various users on the forms which are to be filled up, and were available at blocks but none of the interviewed staff gone through that. The 21 interviewed health workers (related to reporting), are unable to understand some of data elements present in the proforma. They requested for orientation training at peripheral health institute especially to ANMs and PHC staff workers. ● The DEO, BADA and Supervisor are preparing 3 reports i.e. DHIS II, HMIS and MCH separately. Lot of discribancyhas been observed in the 3 reports. There should be coordination between the staff so that reports can be prepared based on the actual data. It has also been observed that coordination is

1 lacking at peripheral health institute and district level regarding parallel reporting. ● There should be interaction and feedback between DDO and DEO/BADA before and after submission of reports. ● The poor quality of Xerox proforma was still utilized for reporting while the DDO informed that the printed proforma booklets were distributed to block, but the DEO and BADA have no idea regarding the printed book, which clearly indicated communication gap between district and peripheral institute. ● Reporting variations is to be rectified and corrective actions are to be initiated at district level by mutual understanding of DDO and Assistant Statistical officer. ● More focus should be given at validation error at each levels of reporting units, for example BCG dosages are far more than actual live births in some surveyed blocks and PHC/HSC level. The BMO and Reporting staffs should vigil on such data items and establish inbuilt system of monitoring at block level. ● At Primary health centers, the Medical officer should involvement of in the data verification report in lieu of only signing. Interviewed medical officers urged refresh training on the present reporting system. ●The services of DEO are used for all sundry jobs, activities beyond their compass. There is a need to focus workforce in fruitful manner for improvement of the data quality.

2 Technical Supervision report of 4 blocks of Rajnandgaon GHUMKA BLOCK KAIRAGARH Reporting STAFF BADA Vacant Vacant Vacant Vacant DEO YES YES YES YES BADA YES YES - YES Status of training 1 DAY REFRESHER TRAINING Level of understanding of POOR POOR POOR POOR data items (HMIS/DHISII) in staff Reports generated at block DHIS YES YES YES YES NRHM YES YES YES YES MCH YES YES YES YES DISCRIBANCY in figures YES YES YES YES among generated REPORT Duplication in reporting YES YES YES YES Monitoring of reports No No No No HMIS/DHIS II reports NO NO NO NO verification Coordination among NO NO NO NO reporting staff and in charge Reporting linkage WEAK WEAK WEAK WEAK DDO feedback to DEO vice WEAK WEAK WEAK WEAK versa (April - June 2010 reporting) Confusing in facility wise YES YES YES YES reports Involvement of BMO in the verification of reports NO NO NO NO Validation reports LIMITED TO BLOCK ONLY, IT SHOULD BE DISTRIBUTED TO PRIMARY HEALTH CENTERS AS WELL AS EVERY SUBCENTERS Consensus related to reports NO NO NO NO at Block level meeting Mortality data report at block DHIS/NRHM/MCH VARIATION VARIATION VARIATION VARIATION Mortality data report at district DHIS/NRHM/MCH VARIATION

3

SOME OF THE INTERPRETATION REGARDING DATA OF THE DISTRICT AND SURVEYED BLOCKS; a) In month of May 2010, the district showing (3060/3066=99%) of the New mother registered for ANC. How reliable this data is?

Table shows district ANC registration and new registered JSY mother and its discrepancy

District level data HMIS was forwarded to state Surveyed Block 3 Surveyed block 4 and showing on the (Dongergarh) Dongergaon HMIS web site of Govt of Total number of pregnant women 3066 444 251 Registered for ANC

New women registered 3060 under JSY 147 129

Difference 6 297 122 The data needs to validate at each level before aggregation

Interpretation:

It looks nice to see the data of the district regarding achievement of JSY registration but it does not match if you verify the data of peripheral health institute.

Some health reporting area had JSY less than ANC registration while it was found exceeded in some health institute.

The overall data of the reporting units are equally important, if it has to be taken into account, that’s why it is essential that differences noticed in the data items needs to be verified at each level and data to be entered at each level very carefully and in correct manner.

The health supervisor should look sub center wise reports of the newly registered pregnant women and status of the JSY registration, so that errors are rectified and corrected at peripheral level. The DDO should also look into the mater and keep a watch at block data compilation.

4

b) BCG is more than Live Births: Facts from Field area

The data verified from the surveyed blocks of the district, there was discrepancy among the BCG and Live birth in the different reporting formats at blocks.

The table showing the BCG and Live birth variation

HMIS web site Block 1 Dongergaon Dongergarh Ghumka District Rajnathgaon (NRHM)

April May June April May June April May Jun Apr Ma June

e il y

Live birth 2155 2001 2698 359 380 389 119 133 133 251 270

BCG 2105 2263 2538 371 377 388 168 168 134 268 251

Difference 50 -262 60 -12 -49 -35 -1 -7

Intra reporting variations Dongergarh block

NRHM report HMIS/DHIS II Sub Sub April May June April May June Total Total Difference Live Birth 251 305 330 886 133 251 270 654 232 BCG 268 290 309 867 134 268 251 653 214 Difference -17 -1 -17

Intra reporting variations Dongergaon block

NRHM report DHIS II Sub Sub May June May June Total Total Difference Live Birth 119 133 252 70 83 153 99 BCG 168 168 336 168 173 341 -5 Difference -49 -35 -98 -90 -188 Interpretations:

In surveyed blocks, BCG vaccination was reported twice/repetition of reports noticed at reporting units.

5 The CHC and PHCs reports are not added in the DHIS II reports in the Dongergarh blocks. The area wise reports are added in the compilation of PHC in Ghumka block. At visited CHC and PHC health facilities, it has been noted that no. of live birth are more than the BCG vaccination indicates that some of the new born babies are discharged after delivery without giving zero dose.

Private health institution deliveries are not added in the facility wise reporting while it was noted in MCH and other reporting. c) Sterilization complications:

At Dongargarh Block the sterilization complications was mentioned during April and June 2010 DHIS II reports, whereas it was not reflected in the NRHM report. 31 Quality in sterilization services* DHIS II April May June 2010 31.1 Number of complications following sterilization (a) Male 6 0 0 (b) Female 13 5 1 Total {(a) to (b)} 19 5 1 31.2 Number of failures following sterilization (a) Male 3 1 0 (b) Female 4 2 0 31.3 Number of deaths following sterilization (a) Male 1 0 0 (b) Female 0 0 0 Total {(a) to (b)} 0 0 0 ? Might be inadvertently mentioned but it should be verified by the concerned officer before forwarding such type of data d) Adverse events following immunization (DHIS II)

Adverse Event Following NRHM DHIS II Immunization (AEFI) April May June April May June Abscess 0 0 1

Death 1 0 0

Others 0 2 0

*Dongargarh Block

There was discrepancy among the parallel reporting of the block, data should be verified before uploading, the block needs reorientation training regarding filling the proforma with level of understanding of prescribed data items.

6

e) Mortality reports variation

Surveyed Blocks (Reported Reported deaths (all) GHUMKA KAIRAGARH DONGERGARH DONGERGAON Total A REPORTED Deaths IN 143 222 225 213 803 MCH REPORTS (April to June 2010) in surveyed blocks B REPORTED DEATHS IN 262 262 HMIS REPORTS AT DISTRICT RAJNANDGAON Discrepancy in reports

Interpretation:

There was also discrepancy in the morality data at each level, which needs to be corrected; it should tally at each level and at different reporting system also.

7

Annexure I Discrepancy in reports

Office of Block Medical Officer, Community Health Centre, Dongargaon

REPRODUCTIVE HEALTH

NRHM DHIS Differe May- Jun- Sub Ante Natal Care Services (ANC) May-10 Jun-10 Sub Total nce 10 10 Total Total number of pregnant 251 259 510 510 0 women Registered for ANC 251 259 Of which Number registered 1.1.1 148 176 324 326 -2 within first trimester 150 176 New women registered under 129 121 250 250 0 JSY 129 121 Number of pregnant women 129 121 250 250 0 received 3 check ups 129 121 Number of pregnant women 0 0 0 given 1.4.1 TT1 251 259 510 251 259 510 0 1.4.2 TT2 or Booster 223 247 470 223 247 470 0 Total number of pregnant 251 259 510 514 -4 women given 100 IFA tablets 251 263 Pregnant women with 0 0 0 Hypertension (BP>140/90) New cases detected at 1.6.1 44 38 82 37 45 institution 24 13 Number of eclampsia cases 1.6.2 0 0 0 0 0 managed during delivery 0 0 Pregnant women with Anaemia 0 0 0 Number having Hb level<11 1.7.1 163 108 271 167 104 (tested cases) 59 108 Number having severe 1.7.2 anaemia (Hb<7) treated at 1 1 2 0 2 institution 0 0 Deliveries Deliveries conducted at Home 0 0 0 Number of Home Deliveries 2.1.1 0 0 0 attended By SBA Trained (a) 0 0 0 0 0 (Doctor/Nurse/ANM) By Non SBA (Trained (b) 43 59 102 0 102 TBA/Relatives/etc.) Total {(a) to (b)} 43 59 102 0 102 Number of newborns visited 2.1.2 within 24 hours of Home 5 59 64 0 64 Delivery Number of mothers paid JSY 2.1.3 1 1 2 0 2 incentive for Home deliveries Deliveries conducted at Public 77 72 149 0 149 Institutions 0 0 Of which Number discharged 2.2.1 41 50 91 147 -56 under 48 hours of delivery 71 76

8 Number of cases where JSY 2.2.2 0 0 0 incentive paid to (a) Mothers 78 68 146 74 72 146 0 (b) ASHAs 76 61 137 74 72 146 -9 ANM or AWW (only for HPS (c) 0 4 4 0 4 States) 0 0 Number of Deliveries at 0 0 0 accredited Private Institutions Number of institutional delivery 2.3.1 cases where JSY incentive paid 0 0 0 0 0 0 0 to (a) Mothers 0 0 0 0 0 0 0 (b) ASHAs 0 0 0 0 0 0 0 ANM or AWW (only for HPS (c) 0 0 0 0 0 0 0 States) Number of Caesarean (C-Section) deliveries performed at Public facilities 0 0 0 3.1.1 PHC 0 0 0 0 0 0 0 3.1.2 CHC 0 0 0 0 0 Sub-divisional hospital/District 3.1.3 0 0 0 0 0 Hospital 0 0 At Other State Owned Public 3.1.4 0 0 0 0 0 Institutions Total {(3.1.1) to (3.1.4)} 0 0 0 0 0 0 0 Private facilities 0 0 0

Pregnancy outcome & weight of new-born

Pregnancy Outcome (in 0 0 0 number) 4.1.1 Live Birth 0 0 0 (a) Male 59 66 125 30 46 76 49 (b) Female 60 67 127 40 37 77 50 Total ({a} + {b}) 119 133 252 70 83 153 99 4.1.2 Still Birth 1 0 1 1 0 1 0 Abortion 4.1.3 11 14 25 23 2 (spontaneous/induced) 11 12 Details of Newborn children 0 0 0 weighed Number of Newborns weighed 4.2.1 119 133 252 153 99 at birth 70 83 Number of Newborns having 4.2.2 2 9 11 8 3 weight less than 2.5 kg 2 6 Number of Newborns breast 119 133 252 151 101 fed within 1 hour 70 81 Complicated pregnancies Number of cases of pregnant women with Obstetric 0 0 0 Complications and attended at Public facilities 5.1.1 PHC 0 0 0 0 0 5.1.2 CHC 0 0 0 0 0 Sub-divisional hospital/District 5.1.3 0 0 0 0 0 Hospital At Other State Owned Public 5.1.4 0 0 0 0 0 Institutions Total {(5.1.1) to (5.1.4)} 0 0 0 0 0

9 Number of cases of pregnant women with Obstetric 0 0 0 0 0 Complications and attended at Private facilities Number of Complicated 0 0 0 pregnancies treated with 5.3.1 IV antibiotics 0 0 0 0 0 0 0 IV antihypertensive/Magsulph 5.3.2 0 0 0 0 0 injection 0 0 5.3.3 IV Oxytocis 0 0 0 4 0 4 -4 5.3.4 Blood Transfusion 0 0 0 0 0 0 0 Post – Natal Care 0 0 0 Women receiving post partum checkup within 48 hours after 41 50 91 284 -193 delivery 150 134 Women getting a post partum check up between 48 hours 145 128 273 312 -39 and 14 days 139 173 -17 PNC maternal complications 0 0 0 17 attended 17 0 Medical Termination of Pregnancy (MTP) 0 0 0 Number of MTPs conducted at 0 0 0 Public Institutions 7.1.1 Up to 12 weeks of pregnancy 0 0 0 0 0 0 0 More than 12 weeks of 7.1.2 0 0 0 0 0 pregnancy 0 0 Total {(7.1.1) to (7.1.2)} 0 0 0 0 0 0 0 Number of MTPs conducted at 0 0 0 0 0 Private Facilities

RTI/STI Cases 0 0 0

Number of new RTI/STI for which 0 0 0 treatment initiated (a) Male 8 14 22 0 13 13 9 (b) Female 14 8 22 0 8 8 14 Total {(8.1.1) to (8.1.2)} 22 22 44 0 22 22 22 Number of wet mount tests 0 0 0 0 0 conducted 0 0

Family Planning 0 0 0

Number of NSV/Conventional 0 0 0 Vasectomy conducted 9.1.1 At Public facilities 0 0 0 (a) At PHCs 0 0 0 0 0 (b) At CHCs 3 2 5 0 5 At Sub-divisional hospitals/ (c) 0 0 0 0 0 District Hospitals At Other State Owned Public (d) 0 0 0 0 0 Institutions Total {(a) to (d)} 3 2 5 0 5 9.1.2 At Private facilities 0 0 0 0 0 Number of Laparoscopic 0 0 0 sterilizations conducted 9.2.1 At Public facilities 0 0 0 (a) At PHCs 0 0 0 0 0

10 (b) At CHCs 31 60 91 0 91 At Sub-divisional hospitals/ (c) 0 0 0 0 0 District Hospitals At Other State Owned Public (d) 0 0 0 0 0 Institutions Total {(a) to (d)} 31 60 91 0 91 9.2.2 At Private facilities 0 0 0 0 0 Number of Mini-lap 0 0 0 sterilizations conducted 9.3.1 At Public facilities 0 0 0 (a) At PHCs 0 0 0 0 0 (b) At CHCs 0 0 0 0 0 At Sub-divisional hospitals/ (c) 0 0 0 0 0 District Hospitals At Other State Owned Public (d) 0 0 0 0 0 Institutions Total {(a) to (d)} 0 0 0 0 0 9.3.2 At Private facilities 0 0 0 0 0 Number of Post-Partum 0 0 0 sterilizations conducted 9.4.1 Public facilities 0 0 0 (a) At PHCs 0 0 0 0 0 (b) At CHCs 0 0 0 0 0 At Sub-divisional hospitals/ (c) 0 0 0 0 0 District Hospitals At Other State Owned Public (d) 0 0 0 0 0 Institutions Total {(a) to (d)} 0 0 0 0 0 9.4.2 Private facilities 0 0 0 0 0 Number of IUD Insertions 0 0 0 9.5.1 Public facilities 0 0 0 (a) At Sub-Centres 49 56 105 0 105 (b) At PHCs 0 0 0 0 0 (c) At CHCs 0 0 0 0 0 At Sub-divisional hospitals/ (d) 0 0 0 0 0 District Hospitals At Other State Owned Public (e) 0 0 0 0 0 Institutions Total {(a) to (e)} 49 56 105 0 105 9.5.2 Private facilities 0 0 0 Number of IUD removals 50 28 78 0 78 Number of Oral Pills cycles 780 862 1642 0 1642 distributed Number of Condom pieces 0 910 910 0 910 distributed Number of Centchroman 0 0 0 0 0 (weekly) pills given Number of Emergency 0 0 0 0 0 Contraceptive Pills distributed Quality in sterilization services 0 0 0 Number of complications 9.11.1 0 0 0 following sterilization (a) Male 0 0 0 0 0 0 0 (b) Female 0 0 0 0 1 1 -1 Number of failures following 9.11.2 0 0 0 sterilization

11 (a) Male 0 0 0 0 0 0 0 (b) Female 0 0 0 0 0 0 0 Number of deaths following 9.11.3 0 0 0 sterilization (a) Male 0 0 0 0 0 0 0 (b) Female 0 0 0 0 0 0 0 Number of Instituions having 0 0 0 0 0 0 0 NSV trained doctors CHILD IMMUNIZATION 0 0 0 Number of Infants 0 to 11 months old who received the 0 0 0 following: 10.1.01 BCG 168 168 336 168 173 341 -5 10.1.02 DPT1 174 183 357 174 183 357 0 10.1.03 DPT2 199 182 381 200 182 382 -1 10.1.04 DPT3 199 217 416 188 217 405 11 10.1.05 OPV 0 (Birth Dose) 131 133 264 131 133 264 0 10.1.06 OPV1 174 183 357 174 185 359 -2 10.1.07 OPV2 199 182 381 198 182 380 1 10.1.08 OPV3 199 217 416 188 217 405 11 10.1.09 Hep-B1 0 0 0 0 0 0 0 10.1.10 Hep-B2 0 0 0 0 0 0 0 10.1.11 Hep-B3 0 0 0 0 0 0 0 10.1.12 Measles 220 201 421 192 205 397 24 Total number of children aged between 9 and 11 months who 10.1.13 have been fully immunized 0 0 0 (BCG+DPT123+OPV123+Measle s) during the month (a) Male 112 97 209 112 99 211 -2 (b) Female 108 104 212 108 106 214 -2 Total {(a) to (b)} 220 201 421 220 205 425 -4 Number of children more than 16 months who received the 0 0 0 following 10.2.1 DPT Booster 274 175 449 260 175 435 14 10.2.2 OPV Booster 274 175 449 260 175 435 14 Measles, Mumps, Rubella 10.2.3 0 0 0 0 0 (MMR) Vaccine 0 0 Immunization Status 0 0 0 Total number of children aged between 12 and 23 months who have been fully 10.3.1 0 0 0 immunized (BCG+DPT123+OPV123+Measle s) during the month (a) Male 0 0 0 0 0 0 0 (b) Female 0 0 0 0 0 0 0 Total {(a) to (b)} 0 0 0 0 0 0 0 Children more than 5 years 10.3.2 382 298 680 680 0 given DT5 382 298 Children more than 10 years 10.3.3 245 277 522 521 1 given TT10 244 277 Children more than 16 years 10.3.4 242 274 516 515 1 given TT16 242 273

12 Adverse Event Following 10.3.5 0 0 0 Immunisation (AEFI) (a) Abscess 0 0 0 2 11 13 -13 (b) Death 0 0 0 0 0 0 0 (c) Others 0 0 0 10 9 19 -19 Number of Immunization 0 0 0 sessions during the month 10.4.1 Sessions planned 137 139 276 131 128 259 17 10.4.2 Sessions held 137 139 276 131 131 262 14 Number of sessions where 10.4.3 137 139 276 246 30 ASHAs were present 130 116 Others {Japanese Encephalitis 0 0 0 (JE) etc. Please Specify} 10.5.1 0 0 0 0 0 0 0 10.5.2 0 0 0 0 0 10.5.3 0 0 0 0 0

Number of Vitamin A doses 0 0 0

Administered between 9

months and 5 years 11.1.1 Dose-1 220 201 421 220 199 419 2 11.1.2 Dose-5 822 410 1232 822 408 1230 2 11.1.3 Dose-9 990 418 1408 990 418 1408 0 Number of cases of Childhood Diseases 0 0 0 reported during the month (0-5 years) Diphtheria 0 0 0 0 0 0 0 Pertussis 0 0 0 0 0 0 0 Tetanus Neonatorum 0 0 0 0 0 0 0 Tetanus others 0 0 0 0 0 0 0 Polio 0 0 0 0 0 0 0 Measles 0 0 0 0 0 0 0 Diarrhea and dehydration 2 8 10 26 8 34 -24 Malaria 0 0 0 1 0 1 -1 Nos. admitted with Respiratory 151 156 307 9 298 Infections 7 2 Other Programmes 0 0 0 Blindness Control Programme 0 0 0 Number of patients operated 0 0 0 62 -62 for cataract 20 42 Number of Intraocular Lens 97 42 139 42 97 (IOL) implantations 0 42 Number of school children 0 0 0 0 0 detected with Refractive errors 0 0 Number of children provided 0 0 0 0 0 free glasses 0 0 Number of eyes collected 0 0 0 0 0 0 0 Number of eyes utilised 0 0 0 0 0 0 0

Health Facility Services 0 0 0

Patient Services 0 0 0

Number of CHC/ SDH/ DH 0 0 0 0 0 functioning as an FRU Number of PHCs functioning 0 0 0 0 0 24X7 (3 Staff Nurses)

13 Number of Anganwadi centres reported to have conducted 98 98 196 0 196 VHNDs Number of facilities having a 7 7 14 0 14 Rogi Kalyan Samiti Number of RKS meetings held 0 0 0 0 0 during the month Number of facilities having Ambulance services (Assured 3 3 6 0 6 Referral Services) available Total Number of times the Ambulance was used for 8 8 16 0 16 transporting patients during the month Number of Institutions having operational Sick New Born and 0 0 0 0 0 Child Care Units Number of functional 0 0 0 0 0 Laparoscopes in CHC/SDH/DH Inpatients 0 0 0 #VAL 14.10.1 Admissions Total Total #VALUE! 0 UE! (a) Male #REF! #REF! #REF! 0 #REF! (b) Female #REF! #REF! #REF! 0 #REF! Total {(a) to (b)} #REF! #REF! #REF! 0 #REF! 14.10.2 Deaths 0 0 0 (a) Male 0 0 0 0 0 0 0 (b) Female 0 0 0 0 0 0 0 Total {(a) to (b)} 0 0 0 0 0 0 0 In-Patient Head Count at 154 136 290 290 0 midnight 153 137 Outpatients 0 0 0 14.12.1 OPD attendance (All) 3534 4155 7689 4583 2496 7079 610 Operation Theatre 0 0 0 0 0 Operation major (General and 14.13.1 0 0 0 0 0 spinal anesthesia) 0 0 Operation minor (No or local 14.13.2 55 62 117 126 -9 anesthesia) 64 62 Others (Include other services 0 0 0 like dental, optho, AYUSH etc.) 14.14.1 AYUSH 0 0 0 0 0 0 0 14.14.2 Dental Procedures 0 0 0 0 0 0 0 14.14.3 Adolescent counseling services 0 0 0 0 0 0 0 14.14.4 0 0 0 14.14.5 0 0 0

Laboratory Testing 0 0 0

Laboratory Test Details 0 0 0 15.1.1 Hb Tests conducted 0 0 0 (a) No. of Hb tests conducted 221 180 401 653 487 1140 -739 Of which numbers having Hb < (b) 1 5 6 11 -5 7 mg 3 8 Numbers Numbers #VAL 15.1.2 HIV tests conducted #VALUE! 0 Positive Positive UE!

(a) Male 0 0 0 0 0 0 0 (b) Female-Non ANC 0 0 0 0 0 0 0

14 (c) Female with ANC 0 0 0 0 0 0 0 Total {(a) to (c)} 0 0 0 0 0 0 0 Widal tests conducted 0 0 0 0 0 Numbers Numbers #VAL VDRL tests conducted #VALUE! 0 tested tested UE! (a) Male 0 0 0 0 0 (b) Female-Non ANC 0 0 0 0 0 (c) Female with ANC 0 0 0 0 0 Total {(a) to (c)} 0 0 0 0 0 #VAL Malaria tests conducted Numbers Numbers #VALUE! 0 UE! 15.4.1 Blood smears examined 1421 1391 2812 1534 1479 3013 -201 15.4.2 Plasmodium Vivax test positive 7 6 13 8 1401 1409 -1396 Plasmodium Falciparum test 15.4.3 1 0 1 7 -6 positive 1 6

Monthly Inventory Status 0 0 0

Stock Position (During the Stock Stock #VAL #VALUE! 0 month) Distributed Distributed UE!

Mortality Details 0 0 0

Details of deaths reported during the month with probable 0 0 0 causes: Infant deaths within 24 hrs of 0 0 0 0 0 birth Infant Deaths up to 4 weeks by 0 0 0 cause 17.2.1 Sepsis 0 0 0 17.2.2 Asphyxia 0 0 0 17.2.3 LBW 0 0 0 17.2.4 Others 0 0 0 Infant/Child Deaths up to 5 0 0 0 years by cause 17.3.1 Pneumonia 0 0 0 17.3.2 Diarrhoea 0 0 0 17.3.3 Fever related 0 0 0 17.3.4 Measles 0 0 0 17.3.5 Others 0 0 0

Adolescent/Adult deaths by #VAL Total Total #VALUE! 0 cause UE!

17.4.1 Diarrhoeal diseases 0 0 0 0 0 17.4.2 Tuberculosis 1 0 1 0 1 Respiratory diseases including 17.4.3 0 0 0 0 0 infections (other than TB) 17.4.4 Malaria 0 0 0 0 0 17.4.5 Other Fever Related 5 0 5 0 5 17.4.6 HIV/AIDS 0 0 0 0 0 Heart disease/Hypertension 17.4.7 0 4 4 0 4 related Neurological disease including 17.4.8 0 0 0 0 0 strokes

15 17.4.9 Maternal Deaths 0 0 0 (a) Abortion 0 0 0 0 0 (b) Obstructed/prolonged labour 0 0 0 0 0 (c ) Severe hypertesnion/fits 0 0 0 0 0 (d) Bleeding 0 0 0 0 0 (e) High fever 0 0 0 0 0 Other Causes (including (f) 18 15 33 0 33 causes not known) 17.4.10 Trauma/Accidents/Burn cases 1 8 9 0 9 17.4.11 Suicide 2 2 4 0 4 17.4.12 Animal bites and stings 0 0 0 0 0 17.4.13 Other Diseases 0 0 0 (a) Known Acute Disease 5 3 8 0 8 (b) Known Chronic Disease 5 8 13 0 13 (c ) Causes not known 10 41 51 0 51

16

Annexure III

NRHM report HMIS /DHIS Differenc April May June Total April May June Total e Ante Natal Care Services (ANC) Total number of pregnant 376 474 397 1247 274 376 444 1094 153 women Registered for ANC Of which Number registered 1.1.1 123 172 141 436 109 123 164 396 40 within first trimester New women registered 99 0 75 174 116 99 147 362 -188 under JSY Number of pregnant women 30 203 310 543 92 30 227 349 194 received 3 check ups Number of pregnant women

given 1.4.1 TT1 283 354 309 946 175 283 339 797 149 1.4.2 TT2 or Booster 296 396 414 1106 166 296 335 797 309 Total number of pregnant 376 474 397 1247 162 376 420 958 289 women given 100 IFA tablets

Pregnant women with 0 0 Hypertension (BP>140/90) New cases detected at 1.6.1 2 3 2 7 11 2 51 64 -57 institution Number of eclampsia cases 1.6.2 0 0 0 0 0 0 0 0 0 managed during delivery Pregnant women with 0 0 Anaemia Number having Hb level<11 1.7.1 30 59 45 134 60 30 72 162 -28 (tested cases) Number having severe 1.7.2 anaemia (Hb<7gm) treated 0 0 0 0 0 0 0 0 0 at institution Deliveries Deliveries conducted at 0 0 Home Number of Home Deliveries 2.1.1 177 184 361 0 361 attended By SBA Trained (a) 0 0 0 0 0 0 (Doctor/Nurse/ANM) By Non SBA (Trained (b) 139 177 184 500 0 500 TBA/Relatives/etc.) Total {(a) to (b)} 139 177 184 500 0 500 Number of newborns visited 2.1.2 within 24 hours of Home 139 177 184 500 0 500 Delivery 12

Number of mothers paid JSY 2.1.3 3 8 1 12 0 incentive for Home deliveries

Deliveries conducted at 0 0 Public Institutions

17 Of which Number discharged 2.2.1 0 0 0 0 155 -155 under 48 hours of delivery 55 100 Number of cases where JSY 2.2.2 0 0 incentive paid to (a) Mothers 83 77 33 193 70 78 148 45 (b) ASHAs 88 52 27 167 55 71 126 41 ANM or AWW (only for HPS (c) 0 5 1 6 2 4 States) 1 1 Number of Deliveries at 0 0 0 0 0 0 0 0 0 accredited Private Institutions Number of institutional 2.3.1 delivery cases where JSY 0 0 0 0 0 0 0 0 0 incentive paid to (a) Mothers 0 0 0 0 0 0 0 0 0 (b) ASHAs 0 0 0 0 0 0 0 0 0 ANM or AWW (only for HPS (c) 0 0 0 0 0 0 0 0 States) Number of Caesarean (C-Section)

deliveries performed at Public facilities 0 0 3.1.1 PHC 0 0 0 0 0 0 3.1.2 CHC 5 0 5 0 5 Sub-divisional hospital/District 3.1.3 0 0 0 0 0 Hospital At Other State Owned Public 3.1.4 0 0 0 0 0 Institutions Total {(3.1.1) to (3.1.4)} 5 0 5 0 5 Private facilities 0 0 Pregnancy outcome & weight of new-

born Pregnancy Outcome (in 0 0 number) 4.1.1 Live Birth 0 0 (a) Male 129 162 162 453 72 129 142 343 110 (b) Female 122 143 168 433 61 122 127 310 123 Total ({a} + {b}) 251 305 330 886 133 251 270 654 232 4.1.2 Still Birth 7 9 13 29 3 7 6 16 13 Abortion 4.1.3 4 2 10 16 4 15 1 (spontaneous/induced) 2 9 Details of Newborn children 0 0 weighed Number of Newborns 4.2.1 251 305 330 886 251 645 241 weighed at birth 132 262 263 Number of Newborns having 4.2.2 115 189 159 463 115 200 weight less than 2.5 kg 23 62 Number of Newborns breast 251 305 330 886 251 652 234 fed within 1 hour 131 270 Complicated pregnancies Number of cases of pregnant women with Obstetric Complications and attended at Public facilities 5.1.1 PHC 5 3 5 13 0 0 13 5.1.2 CHC 25 13 16 54 0 0 54 Sub-divisional hospital/District 5.1.3 0 0 0 0 0 0 Hospital 0 5.1.4 At Other State Owned Public 0 0 0 0 0 0

18 Institutions

Total {(5.1.1) to (5.1.4)} 30 16 21 67 0 0 67 Number of cases of pregnant women with Obstetric Complications and 30 16 21 67 0 67 attended at Private facilities 0 Number of Complicated pregnancies 30 30 -30 treated with 0 0 5.3.1 IV antibiotics 0 3 3 6 0 6 IV 5.3.2 antihypertensive/Magsulph 0 2 2 4 0 0 4 injection 0 0 5.3.3 IV Oxytocis 0 0 0 0 0 0 0 0 0 5.3.4 Blood Transfusion 0 0 0 0 0 0 0 0 0 Post - Natal Care Women receiving post partum 251 266 233 750 251 551 199 checkup within 48 hours after delivery 106 194 Women getting a post partum check 7 48 110 165 7 251 -86 up between 48 hours and 14 days 90 154 PNC maternal complications attended 5 3 2 10 0 5 0 5 5 Medical Termination of Pregnancy 0 0 (MTP) Number of MTPs conducted 0 0 at Public Institutions 7.1.1 Up to 12 weeks of pregnancy 3 2 0 5 0 3 0 3 2 More than 12 weeks of 7.1.2 0 0 0 0 0 pregnancy 0 0 Total {(7.1.1) to (7.1.2)} 3 2 0 5 0 3 0 3 2 Number of MTPs conducted 0 0 at Private Facilities RTI/STI Cases 0 0 Number of new RTI/STI for

which treatment initiated (a) Male 25 15 21 61 0 25 0 25 36 (b) Female 29 15 30 74 0 29 0 29 45 Total {(8.1.1) to (8.1.2)} 54 30 51 135 0 54 0 54 81 Number of wet mount tests 0 0 conducted Family Planning 0 0 Number of NSV/Conventional 0 0 Vasectomy conducted 9.1.1 At Public facilities 0 0 (a) At PHCs 0 0 (b) At CHCs 5 1 0 6 0 6 At Sub-divisional hospitals/ (c) 0 0 District Hospitals At Other State Owned Public (d) 0 0 Institutions Total {(a) to (d)} 5 1 0 6 0 6 9.1.2 At Private facilities 0 0 Number of Laparoscopic 0 0 sterilizations conducted 9.2.1 At Public facilities 0 0

19 (a) At PHCs 0 0 (b) At CHCs 33 0 0 33 0 33 At Sub-divisional hospitals/ (c) 0 0 District Hospitals At Other State Owned Public (d) 0 0 Institutions Total {(a) to (d)} 33 0 0 33 0 33 9.2.2 At Private facilities 0 0 Number of Mini-lap 0 0 sterilizations conducted 9.3.1 At Public facilities 0 0 (a) At PHCs 0 0 (b) At CHCs 4 0 2 6 0 6 At Sub-divisional hospitals/ (c) 0 0 District Hospitals At Other State Owned Public (d) 0 0 Institutions Total {(a) to (d)} 4 0 2 6 0 6 9.3.2 At Private facilities 0 0 Number of Post-Partum 0 0 sterilizations conducted 9.4.1 Public facilities 0 0 (a) At PHCs 0 0 (b) At CHCs 0 0 At Sub-divisional hospitals/ (c) 0 0 District Hospitals At Other State Owned Public (d) 0 0 Institutions Total {(a) to (d)} 0 0 9.4.2 Private facilities 0 0 Number of IUD Insertions 9.5.1 Public facilities 0 0 (a) At Sub-Centres 10 26 30 66 0 66 (b) At PHCs 10 10 10 30 0 30 (c) At CHCs 1 3 1 5 0 5 At Sub-divisional hospitals/ (d) 0 0 District Hospitals At Other State Owned Public (e) 0 0 Institutions Total {(a) to (e)} 21 39 41 101 0 101 9.5.2 Private facilities 0 0 Number of IUD removals 46 34 37 117 52 52 65 Number of Oral Pills cycles 1382 1403 1391 4176 638 3538 distributed 638 Number of Condom pieces 14590 14330 16000 44920 3847 41073 distributed 3847 Number of Centchroman 202 -202 (weekly) pills given 202 Number of Emergency 45 -45 Contraceptive Pills distributed 45 Quality in sterilization services 0 0 Number of complications 9.11.1 0 0 following sterilization (a) Male 6 0 6 -5 (b) Female 13 5 18

20 Number of failures following 9.11.2 0 -1 sterilization (a) Male 3 1 4 -2 (b) Female 4 2 6 0 Number of deaths following 9.11.3 0 0 sterilization (a) Male 1 0 1 0 (b) Female 0 0 0 Number of Institutions having 1 1 1 3 0 0 0 3 NSV trained doctors

CHILD IMMUNIZATION 0 0 Number of Infants 0 to 11 months old who received the following: 10.1.01 BCG 268 290 309 867 134 268 251 653 214 10.1.02 DPT1 291 311 281 883 181 291 259 731 152 10.1.03 DPT2 291 309 289 889 177 291 279 747 142 10.1.04 DPT3 276 354 327 957 164 276 300 740 217 10.1.05 OPV 0 (Birth Dose) 89 178 267 89 197 286 -19 10.1.06 OPV1 291 311 281 883 161 291 265 717 166 10.1.07 OPV2 291 309 289 889 158 291 255 704 185 10.1.08 OPV3 276 354 327 957 146 276 295 717 240 10.1.09 Hep-B1 0 0 0 0 0 0 0 0 0 10.1.10 Hep-B2 0 0 0 0 0 0 0 0 0 10.1.11 Hep-B3 0 0 0 0 0 0 0 0 0 10.1.12 Measles 270 358 291 919 157 270 333 760 159 Total number of children aged between 9 and 11 months who have been fully 10.1.13 0 0 immunized (BCG+DPT123+OPV123+Meas les) during the month (a) Male 145 180 164 489 102 145 173 420 69 (b) Female 125 178 127 430 80 125 166 371 59 Total {(a) to (b)} 270 358 291 919 183 270 339 792 127 Number of children more than 16 months who received 0 0 the following 10.2.1 DPT Booster 187 213 150 550 105 187 343 635 -85 10.2.2 OPV Booster 187 226 121 534 109 187 341 637 -103 Measles, Mumps, Rubella 10.2.3 0 0 0 0 0 (MMR) Vaccine 0 0 Immunization Status 0 0 0 0 0 Total number of children aged between 12 and 23 months who have been fully 10.3.1 0 0 0 0 0 immunized (BCG+DPT123+OPV123+Meas les) during the month (a) Male 0 0 0 0 80 156 98 80 -80 (b) Female 0 0 0 0 80 153 88 80 -80 Total {(a) to (b)} 0 0 161 310 186 161 -161 Children more than 5 years 10.3.2 19 254 51 324 28 296 given DT5 28 169 84 10.3.3 Children more than 10 years 3 52 21 76 4 56 20 4 72

21 given TT10 Children more than 16 years 10.3.4 10 24 78 112 10 102 given TT16 10 41 49 Adverse Event Following 10.3.5 0 0 Immunisation (AEFI) (a) Abscess 0 0 1 0 0 (b) Death 1 0 0 1 -1 (c) Others 0 2 0 0 0 Number of Immunization 0 0 sessions during the month 10.4.1 Sessions planned 164 211 171 546 90 183 130 90 456 10.4.2 Sessions held 159 196 165 520 86 168 126 86 434 Number of sessions where 10.4.3 159 196 165 520 83 437 ASHAs were present 83 163 129 Others {Japanese Encephalitis (JE) etc. Please 0 0 Specify} Number of Vitamin A doses 0 0 Administered between 9 0 0 months and 5 years 11.1.1 Dose-1 270 358 291 919 140 485 432 140 779 11.1.2 Dose-5 69 896 654 69 -69 11.1.3 Dose-9 31 1022 880 31 -31 Number of cases of Childhood Diseases 0 0 reported during the month (0-5 years) Diphtheria 0 0 0 0 0 0 0 Pertussis 0 0 0 0 0 0 0 Tetanus Neonatorum 0 0 0 0 0 0 0 Tetanus others 0 0 0 0 0 0 0 Polio 0 0 0 0 0 0 0 Measles 0 0 2 19 3 2 -2 Diarrhea and dehydration 119 119 46 38 11 46 73 Malaria 0 0 53 135 55 53 -53 Nos. admitted with 119 119 0 119 Respiratory Infections 0 0 0 Other Programmes 0 0 Blindness Control Programme 0 0 Number of patients operated 16 24 23 63 0 63 for cataract 0 0 0 Number of Intraocular 16 24 23 63 0 63 Lens(IOL) implantations 0 0 0 Number of school children detected with Refractive 0 0 0 0 0 0 errors 0 0 0 Number of children provided 0 0 0 0 0 0 free glasses 0 0 0 Number of eyes collected 0 0 0 0 0 0 0 0 0 Number of eyes utilised 0 0 0 0 0 0 0 0 0 Health Facility Services 0 0 Patient Services 0 0 Number of CHC/ SDH/ DH 1 1 1 3 0 3 functioning as an FRU 0 0 0 Number of PHCs functioning 0 0 0 0 0 0 24X7 (3 Staff Nurses) 0 0 0

22 Number of Anganwadi centres reported to have 179 179 179 537 0 537 conducted VHNDs 0 0 0 Number of facilities having a 7 7 7 21 0 21 Rogi Kalyan Samiti 0 0 0 Number of RKS meetings held 4 2 2 8 0 8 during the month 0 0 0 Number of facilities having Ambulance services 1 1 1 3 0 3 (Assured Referral Services) available 0 0 0 Total Number of times the Ambulance was used for 2 8 8 18 0 18 transporting patients during the month 0 0 0 Number of Institutions having operational Sick New Born 0 0 0 0 0 and Child Care Units 0 0 0 Number of functional Laparoscopes in 1 1 1 3 0 3 CHC/SDH/DH 0 0 0 Inpatients 0 0 14.10.1 Admissions 0 0 (a) Male #REF! #REF! 0 0 0 0 #REF! (b) Female #REF! #REF! 0 0 0 0 #REF! Total {(a) to (b)} #REF! #REF! 0 0 0 0 #REF! 14.10.2 Deaths 0 0 (a) Male 0 2 3 5 0 0 0 0 5 (b) Female 0 0 0 0 0 0 0 0 0 Total {(a) to (b)} 0 2 3 5 0 0 0 0 5 In-Patient Head Count at 0 0 midnight Outpatients 0 0 14.12.1 OPD attendance (All) 2485 2230 4715 284 461 658 284 4431 Operation Theatre 0 0 Operation major (General 14.13.1 5 0 5 0 5 and spinal anesthesia) 0 0 0 Operation minor (No or local 14.13.2 55 49 8 112 0 0 0 0 112 anesthesia) Others (Include other services like dental, optho, 0 0 AYUSH etc.) 14.14.1 AYUSH 0 0 0 0 0 0 0 0 0 14.14.2 Dental Procedures 0 0 0 0 0 0 0 0 0 Adolescent counseling 14.14.3 0 0 0 0 0 0 0 0 0 services 14.14.4 0 0 14.14.5 0 0 Laboratory Testing 0 0 Laboratory Test Details 0 0 15.1.1 Hb Tests conducted 107 114 49 270 0 0 270 (a) No. of Hb tests conducted 107 114 49 270 113 335 175 113 157 Of which numbers having Hb (b) 2 2 2 6 12 -6 < 7 mg 12 7 15

23 Numb Numb Numb ers ers ers 15.1.2 HIV tests conducted 0 0 Positiv Positiv Positiv e e e

(a) Male 0 0 0 0 0 0 0 (b) Female-Non ANC 0 0 0 0 0 0 0 (c) Female with ANC 0 0 0 0 0 0 0 Total {(a) to (c)} 0 0 0 0 0 0 0 Widal tests conducted 0 0 VDRL tests conducted 0 0 (a) Male 0 11 0 11 0 0 0 0 11 (b) Female-Non ANC 0 9 0 9 0 0 0 0 9 (c) Female with ANC 0 40 0 40 0 0 0 0 40 Total {(a) to (c)} 0 60 0 60 0 0 0 0 60 Numb Numb Numb Malaria tests conducted 0 0 0 ers ers ers 15.4.1 Blood smears examined 1105 1602 2000 4707 0 0 0 0 4707 Plasmodium Vivax test 15.4.2 0 0 0 0 0 0 0 0 0 positive Plasmodium Falciparum test 15.4.3 0 0 0 0 0 0 0 0 0 positive Mortality Details 0 0 0 Details of deaths reported during the month with 0 0 0 probable causes: Infant deaths within 24 hrs of 0 0 0 birth Infant Deaths up to 4 weeks 0 0 0 by cause 17.2.1 Sepsis 0 0 0 17.2.2 Asphyxia 0 0 0 17.2.3 LBW 0 0 0 17.2.4 Others 0 0 Infant/Child Deaths up to 5 0 0 0 years by cause 17.3.1 Pneumonia 0 0 0 17.3.2 Diarrhoea 0 0 0 17.3.3 Fever related 0 0 0 17.3.4 Measles 0 0 0 17.3.5 Others 0 0 Adolescent/Adult deaths by 0 0 0 cause 17.4.1 Diarrhoeal diseases 0 0 0 17.4.2 Tuberculosis 0 0 0 Respiratory diseases including 17.4.3 0 0 0 infections (other than TB) 17.4.4 Malaria 0 0 0 17.4.5 Other Fever Related 0 0 0 17.4.6 HIV/AIDS 0 0 0 Heart disease/Hypertension 17.4.7 0 0 0 related Neurological disease 17.4.8 0 0 0 including strokes

24 17.4.9 Maternal Deaths 0 0 0 (a) Abortion 0 0 0 (b) Obstructed/prolonged labour 0 0 0 (c ) Severe hypertesnion/fits 0 0 0 (d) Bleeding 0 0 0 (e) High fever 0 0 0 Other Causes (including (f) 0 0 0 causes not known) Trauma/Accidents/Burn 17.4.10 0 0 0 cases 17.4.11 Suicide 0 0 0 17.4.12 Animal bites and stings 0 0 0 17.4.13 Other Diseases 0 0 0 (a) Known Acute Disease 0 0 0 (b) Known Chronic Disease 0 0 0 (c ) Causes not known 0 0 0 0 0 0 0

Annexure III Surveyed Health facility Date Health Name of health Interacted officials institute facility 09/08/2010 PHC Somni Medical officer, Health assistant (Female), Staff nurse, Data Entry Operator

HSC Beghera ANM 10/08/2010 CHC Khairagarh BMO, BADA, Data entry operator, Health supervisor, PHC Jalbandha Medical officer, HSC Madura Kohli ANM 11/08/2010 CHC Ghumaka BMO,BADA, Data entry operator, Health supervisor, PHC Sukaldehan Medical officer and staff HSC Bhanpuri ANM 13/08/2010 CHC Dongargaon Data entry operator, Health supervisors, PHC Arjuni Medical officer and staff HSC Kotrasarar ANM,MPW

12/08/2010 CHC Dongargarh BMO, Data entry operator, Health supervisor, BE PHC LB Nagar Medical officer and staff HSC Ramatola ANM

25