Published in February 2017

Disclaimer

This document has been made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of JSI Research & Training Institute, Inc. and do not necessarily reflect the views of USAID or the United States Government.

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Contents

Acronyms ...... iv Acknowledgements ...... v Introduction ...... 1 Health Status of District Larkana ...... 1 Basic Amenities ...... 1 Facility Management ...... 2 DHIS Tools ...... 2 Infection Control & Waste Management ...... 3 Human Resource ...... 3 Diagnostic Services ...... 4 Infrastructure ...... 4 Functional Equipment ...... 5 Medicines and Supplies ...... 6 Conclusion ...... 6 Recommendations ...... 6 Database of THQ Hospitals ...... 8 Domain I Basic Amenities ...... 8 Domain II Facility Management ...... 9 Domain III Human Resource ...... 13 Training of Staff at THQ Hospitals ...... 16 Domain IV Diagnostics ...... 17 Domain V Infrastructure ...... 22 Domain VI Equipment ...... 35 Domain VII Medicines & Supplies ...... 63 Database of Rural Health Centers ...... 73 Domain I Basic Amenities ...... 73 Domain II Facility Management ...... 74 Domain III Human Resource ...... 78 Training of Staff at Rural Health Centers ...... 80 Domain IV Diagnostics ...... 81 Domain V Infrastructure ...... 86 Domain VI Equipment ...... 89 Domain VII Drugs & Supplies ...... 95 Database of Basic Health Units ...... 102 Domain I Basic Amenities ...... 102 Domain II Facility Management ...... 106 Domain III Human Resource ...... 123 Training of Staff at Basic Health Units ...... 131 Domain IV Diagnostics ...... 133 Domain V Infrastructure ...... 139 Domain VI Equipment ...... 143 Domain VII Medicines and Supplies ...... 154

i Health Facility Assessment Sindh-2015-16: District Larkana Report i List of Tables

Table 1: Services category, indicator and value (%) ...... 1 Table 2: Status of basic amenities at THQHs and RHCs ...... 2 Table 3: Diagnostic services at THQHs and RHCs ...... 4 Table 4: Status of infrastructure of THQHs and RHCs ...... 5 Table 5: Status of functional equipment of THQHs and RHCs ...... 5 Table 6: Basic Amenities at THQ Hospitals of District Larkana ...... 8 Table 7: Facility Management at THQ Hospitals of District Larkana ...... 9 Table 8: Human Resource at THQ Hospitals of District Larkana ...... 13 Table 9: Staff Training at THQ Hospitals of District Larkana ...... 16 Table 10: Diagnostic Services at THQ Hospitals of District Larkana ...... 17 Table 11: Infrastructure at THQ Hospitals of District Larkana ...... 22 Table 12: Equipment at THQ Hospitals of District Larkana ...... 35 Table 13: Medicines & Supplies at THQ Hospitals of District Larkana ...... 63 Table 14: Basic Amenities at Rural Health Centers of District Larkana ...... 73 Table 15: Facility Management at Rural Health Centers of District Larkana ...... 74 Table 16: Human Resource at Rural Health Centers of District Larkana ...... 78 Table 17: Staff Trainings at Rural Health Centers of District Larkana ...... 80 Table 18: Diagnostics Services at Rural Health Centers of District Larkana ...... 81 Table 19: Infrastructure at Rural Health Centers of District Larkana...... 86 Table 20: Equipment at Rural Health Centers of District Larkana ...... 89 Table 21: Medicines & Supplies at Rural Health Centers of District Larkana ...... 95 Table 22: Basic Amenities at Basic Health Units of District Larkana ...... 102 Table 23: Facility Management at Basic Health Units of District Larkana ...... 106 Table 24: Human Resource at Basic Health Units of District Larkana ...... 123 Table 25: Staff Trainings at Basic Health Units of District Larkana ...... 131 Table 26: Diagnostics at Basic Health Units of District Larkana ...... 133 Table 27: Infrastructure at Basic Health Units of District Larkana ...... 139 Table 28: Equipment at Basic Health Units of District Larkana ...... 143 Table 29: Medicines and Supplies at Basic Health Units of District Larkana ...... 154

ii Health Facility Assessment Sindh-2015-16: District Larkana Report

List of Figures

Figure 1: Percentage availability of DHIS Tools...... 2 Figure 2: Overall Vacant Positions in District Larkana ...... 3 Figure 3: Sanctioned vs. Vacant Posts of Specialist and Non-Specialist Doctors ...... 3 Figure 4: Availability of EmONC medicines ...... 6

Health Facility Assessment Sindh-2015-16: District Larkana Report iii Acronyms ANC Antenatal Care BCG Bacillus Calmette Guerin BHU Basic Health Unit CCU Cardiac Care Unit COCP Combined Oral Contraceptive Pills CT Computerized Tomography DHIS District Health Information System DHQH District Headquarter Hospital DHPMT District Health and Population Management Team DMS Deputy Medical Superintendent ECG Electrocardiogram EML Essential Medicines List EmONC Emergency Obstetric and Neonatal Care HFA Health Facility Assessment HSS Health Systems Strengthening ICU Intensive Care Unit IV Intravenous LHV Lady Health Visitor OPD Out Patient Department OT Operation Theatre PNC Prenatal Care POL Petroleum, Oil and Lubricants PPHI Peoples Primary Healthcare Initiative PSLM Pakistan Social and Living standards Measurement RHC Rural Health Center TB Tuberculosis THQH Taluka Headquarter Hospital USAID United States Agency for International Development WAPDA Water and Power Development Authority WMO Women Medical Officer

iv Health Facility Assessment Sindh-2015-16: District Larkana Report Acknowledgements The Department of Health (DOH), Sindh was cognizant of the fact that there is very little information available for planning and implementation in the post devolution scenario. The Health Systems Strengthening (HSS) Component was, therefore, requested to provide technical and financial support to conduct the Health Facility Assessment (HFA) in order to support the planning and monitoring activities. The HSS Component, hence, conducted the census of all public sector health facilities (15 District Headquarter Hospitals; 58 Taluka Headquarter Hospitals; 121 Rural Health Centers; and 722 Basic Health Units) in 23 districts of Sindh except Karachi, to provide an overview of functioning of healthcare delivery system and generate district and facility based information for DOH. This information will provide an updated status of health facilities with regards to provision and quality of services, systems and skills assessment, follow up on trainings received by health care providers, infrastructure, human resource, drugs and supplies and other support services, thus serving as a basis for informed planning, ensuring better management and efficient use of resources.

The HSS Component of USAID’s MCH Program, a five year project, was launched and implemented in 2013 by a consortium led by JSI Research and Training Institute Inc., and consortium partners: Contech International, RSPN and Heartfile working in collaboration with DOH Sindh to strengthen the health systems. The HFA along with capacity assessment, monitoring and evaluation situation and Health Information Systems readiness has helped bring transparency to the healthcare delivery system of Sindh. The structural reforms in the form of District Health and Population Management Teams (DHPMTs), District Action Plans (DAPs) and online integrated Dashboard are all steps in this direction.

The DOH, Sindh acknowledges and appreciates the contribution made by JSI Research and Training Inc., for conducting this HFA in collaboration with Contech International who designed and implemented the data collection, analysis and report writing. The DOH Sindh would like to particularly acknowledge the leadership of Dr. Naeem uddin Mian and Dr. Shehzad Awan, Dr. Ashraf Chaudhary and Dr. Adeel Alvi for working diligently and supervising the field work as well. The contribution of JSI team in managing the data entry and tabulation for data analysis is also acknowledged. It would not have been possible to complete this gigantic task without their technical assistance and USAID’s financial support.

Special thanks to Dr. Nabeela Ali, Chief of Party of the HSS Component for providing invaluable input that proved instrumental in the quality of the reports produced. Gratitude is also expressed to Dr. Arshad Mahmood, Dr. Yousaf Hayat, Dr. Dileep Kumar and Ms. Jamila Soomro for monitoring and coordinating with the DOH and field teams.

The unequivocal support of Dr. Riaz Memon CEO, PPHI, all DHOs and the staff of district health facilities is also appreciated, in cooperating with the assessment teams, sharing valuable information and providing assistance to complete the field wok.

Last but not least, the technical support of Secretary Health, Program Directors of vertical programs and the team of Directorate General of Health Services is also acknowledged for their oversight in making this happen.

Dr. Syed Hassan Murad Shah

Director General Health Services Sindh

v Health Facility Assessment Sindh-2015-16: District Larkana Report v

Introduction Health Status of District Larkana The post devolution scenario has provided an The service delivery indicators of district Larkana were opportunity to the provincial governments to review not much different from the rest of the Sindh and address the gaps in human, administrative, province. According to the findings of Multiple management and financial resources within their Indicator Cluster Survey (MICS) 2014-15, key maternal health systems. In this regard, the Government of and child health indicators showed that more than Sindh has developed a health sector strategy 2012-20 half of the pregnant women received assistance by to strategically set evidence based priorities for cost any skilled birth attendant at the time of their efficient and integrated service delivery mechanism. delivery. Similar was the case with postnatal care In order to ascertain gaps in available resources at the coverage, whereas antenatal care coverage was health facilities, the DOH requested Health Systems slightly better. However, one weak area of service Strengthening Component of USAID’s Maternal and utilization was vaccination coverage with less than Child Health (MCH) Program to conduct a census of half of the children in Larkana fully vaccinated. health facilities, with the aim to assess the structures Table 1: Services category, indicator and value (%) and functioning of existing primary and secondary Services Value healthcare facilities focusing primarily on service Services Indicator Category (%) availability and utilization, facility readiness and service specific readiness. The Health Facility Skilled Birth Delivery assisted by any skilled 55.8 Assessment was conducted in August-October 2015. Attendance attendant Comprehensive assessments tools were developed Antenatal based on MEASURE Service Provision Assessment Care Any skilled provider 72.6 (SPA) Tool, WHO’s Service Availability and Readiness Coverage Assessment (SARA), and documents of the DOH Sindh, Postnatal Postnatal health check within including PCs-1 of all levels of facilities, DOH notified Care two days of birth for both 55.3 Minimum Service Delivery Standards (MSDS) for Rural Coverage mothers and newborns Health Centers (RHCs) and Basic Heath Units (BHUs), Percentage of children with Essential Medicines List of 2014, and Human Resource Under 5 diarrhea for whom advice or 64.5 Yardsticks. Data collection tools were refined and Diarrhea treatment was sought from a updated through consultations with technical team of health facility or provider DOH and staff at health facilities. The data was Full Percentage of children aged 12- collected by interviewing the relevant staff and Vaccination 23 months who received Full 41.0 personnel in charge of the health facility as well as Coverage vaccination through physical validation, and observation of facility Percentage of children with records. Under 5 symptoms of ARI for whom 85.7 District Larkana has no District Headquarter Hospital Pneumonia treatment was sought from a health facility or provider (DHQH), so a total of 35 health facilities including three Taluka Headquarter Hospitals (THQHs), five This corroborates the findings of the Health Facility Rural Health Units and 27 Basic Health Units of district Assessment that show the limited capacity and Larkana were assessed to ascertain their general readiness of public sector healthcare facilities in the readiness for the mandated service packages, based district. on selective domains including basic amenities, human resource, facility management, infrastructure, Basic Amenities equipment, diagnostics, and medicines and supplies. The domain of basic amenities describes the extent to Specific recommendations have been provided for which the physical conditions of a health facility are bridging the identified gaps. The summary of status of welcoming and favourable for healthcare service each assessed domain is given below whereas item- delivery. wise details are provided in individual databases.

1 Health Facility Assessment Sindh -2015-16: District Larkana Report 1 1 Table 2: Status of basic amenities at THQHs and RHCs health managers had paid supervisory visits to the THQHs in the mentioned period. However, except for THQH RHC Status of Basic Amenities (n=3) (n=5) THQH Rato Dero no community staff meetings and methods for client opinion/feedback were reported at Running tap water supply 3 5 other two THQHs (THQH Arija and Larkana). Monthly community meetings, mechanism for obtaining client WAPDA electricity supply 3 5 feedbacks and quality assurance activities were Functional generator 3 5 comparatively better at the RHCs as compared to THQHs. All RHCs had conducted management Sufficient budget for POL of 0 1 generator meetings in the month preceding the assessment but decision making and follow up on actions was missing Landline telephone 2 1 at all RHCs except RHC Badah. There had been no external supervision of RHC Badah and RHC Gerelo by Latrines for females 3 5 their health managers in the month prior to survey. Functional ambulance 3 3 The details of management practices for individual health facility are given in the databases (Table 7, 15 Sufficient budget for POL of 0 1 and 23 of databases). ambulance

The status of most of basic amenities was satisfactory DHIS Tools at the THQHs and RHCs as all these facilities had The DHIS tools comprise of registers, charts, availability of running tap water, WAPDA electricity proformas and reporting sheets used for recording supply, functional generators and separate latrines and reporting at the health facility. for female clients. However landline telephone was Figure 1: Percentage availability of DHIS Tools not available at THQH Arija. Sufficient budget for POL of generators and ambulances was not allocated at THQHs RHCs any THQH but was available at RHCs Naudero and 3 Gerelo respectively. RHCs Banguldero and Garhi Khuda Bux did not have functional ambulances stationed at the health facilities. The item-wise details 2 of basic amenities in each facility are given in the databases (Table 6, 14 and 22 of databases). 1 1 1 Facility Management Facility management relates to all actions and activities directed to optimize the use of resources in <50% 50-79% 80-99% 100% order to deliver quality and patient centred healthcare in the facility. Each health facility was THQH Larkana had 100% of DHIS tools available while assessed on the basis of its management areas of THQHs Arija and Ratodero had 80-99% of DHIS tools external supervision, management meetings, staff- with OPD abstract forms missing at these facilities. community meetings, and client opinion and RHC Banguldero had adequate (88%) DHIS tools while feedback and quality assurance activities. RHCs Gerelo, Badah and Garhi Khuda Bux had 50-79% tools. The least (48%) availability of DHIS tools was The assessment findings showed that the status of recorded at RHC Naudero. Commonly missing tools at management activities was better at the THQHs as the RHCs were daily bed statement registers, OT compared to the RHCs as all of them had organized registers, community meeting registers, procedure management meetings in the month preceding the manual for DHIS and LQAS forms. assessment with minutes recorded and decision making included in the agenda items. Moreover

2 Health Facility Assessment Sindh-2015-16: District Larkana Report Infection Control & Waste significant gaps between sanctioned and filled staff Management positions for all cadres. Management of healthcare waste is an integral part Majority of positions for non-gazetted management of hospital hygiene and infection control. Each health staff, paramedics and support staff were filled while a facility was assessed for adequate sterilization of large number of positions for gazetted management, equipment, appropriate management of medical and nursing staff, specialist and non-specialist doctors sharps waste and availability of waste management were found vacant against the sanctioned seats. None guidelines. of the sanctioned posts for pediatrician, gynecologists and anesthetists were filled at any of the THQHs. All THQHs and RHCs had good infection control and Women medical officers were not appointed against adequate hospital waste management except THQH the sanctioned posts at RHC Gerelo and RHC Garhi Arija where appropriate methods for management of Khuda Bux. The details of sanctioned and filled status sharps and medical waste were not in use. Guidelines for each staff position as well as trainings data are for processing of equipment were available at THQH given in databases (Table 8, 16 and 24 of databases). Arija and Ratodero while waste management guidelines were available at all THQHs. On the other Figure 3: Sanctioned vs. Vacant Posts of Specialist and Non- Specialist Doctors hand, amongst the RHCs, infection control guidelines were missing at RHCs Banguldero, Gerelo and Garhi Sanctioned Vacant Khuda Bux while waste management guidelines were 33 available only at RHC Naudero. 29 Human Resource 21 20 The human resource domain is divided into two sub- domains: management staff and service provider 7 8 8 4 staff. The management staff sub-domain is further segregated into gazetted, non-gazetted and support staff while the service provider staff includes RHCs THQHs RHCs THQHs specialists, non-specialist doctors, nurses and Specialist Doctors Non-Specialist Doctors paramedics. The human resource assessment showed

Figure 2: Overall Vacant Positions in District Larkana

47

24

18 16

11

6

1

Gazetted Non-Gazetted Support Staff Specialist Non-Specialist Nurses Paramedics Management Management Doctors Doctors Staff Staff

Health Facility Assessment Sindh-2015-16: District Larkana Report 3 Diagnostic Services Infrastructure Healthcare practitioners use diagnostic services for The infrastructure at the health facilities was assessed information about the presence, severity, and cause according to the level of facility and its specific of diseases in patients. The diagnostic services that requirements as per DOH standards. were assessed included availability of diagnostic tests like complete blood count, blood glucose, pregnancy Assessment of Infrastructure test, malaria test, hepatitis B and C screening, blood ‘Good/No repair required’ means that the grouping and cross matching and availability of infrastructure is in good condition and does not diagnostic equipment like routine x-ray, ultrasound, require any type of repair to optimally perform its ECG and CT scan. functions.

Of the three THQHs, THQH Arija had the least ‘Minor repair’ includes small issues like availability of diagnostic services as blood glucose whitewash, polish or paint work, broken hinges, testing, urine chemistry testing, blood typing, malaria locks, or handles, leakage of water pipes without and tuberculosis testing, X-ray and ECG services were gross seepage, mal-functioning electricity wires. missing at the facility. On the other hand, lipid profile ‘Major repair’ comprises of major issues requiring testing and blood screening services for HIV and major plastering or concrete work, repair of major hepatitis B and C were missing at all three THQHs. seepage like roof treatment, re-fixing of THQH Ratodero had most of the diagnostic and doors/windows panels, drainage treatment for radiological services available. major blockage, replacement required for parts of water and sewage pipes and electricity rewiring. RHC Naudero had most of the diagnostic services available including hemoglobin testing, lipid profile ‘Under-construction’ means new construction for and urine chemistry testing. Other diagnostic and any building component is underway. radiological services including blood glucose, and ‘Non-availability’ means completely missing malaria testing, x-ray, ECG and ultrasound imaging infrastructure component that is required as per were available at RHC Naudero and RHC Badah but the level of assessed health facility. missing at the other RHCs. However, on site tuberculosis testing was available at three RHCs, (RHC The overall availability of infrastructure at the THQHs Badah, Gerelo and Naudero). The status of diagnostic presented a significant gap of 81% owing mainly to services at RHCs Garhi Khuda Bux and Gerelo was the non-existence of certain departments or below average as most of the diagnostic services were components within existing departments. For missing at these RHCs. The item-wise details of instance blood banks, infrastructure for certain OPDs diagnostics are given in the databases (Table 10, 18 (ENT, neuropsychiatry, surgical, urology, and 26 of databases). orthopedics), virtually all infrastructure for ICUs Table 3: Diagnostic services at THQHs and RHCs (medical, surgical, neonatal, CCUs), OTs (obgyn, THQH RHC Diagnostic Services orthopedics) and all inpatient wards (except labor (n=3) (n=5) rooms) and male and female medical wards were not Lipid Profile 0 1 found at any of the THQHs. Around 7% of Liver Function Tests 0 1 infrastructure was reported to be in a good state Renal Function Test 0 0 while 6% had major or minor issues. Although the Urine Complete THQHs had adequately developed admin section but 2 1 Examination Deputy Medical Superintendent and Nursing X-ray 2 2 Superintendent rooms were not available at any Ultrasound 2 2 THQH. Residences for all staff was also missing at all the THQHs. Moreover, THQH Arija had the least (15%) ECG 2 2 and THQH Ratodero had most (22%) of the required building components.

4 Health Facility Assessment Sindh-2015-16: District Larkana Report Table 4: Status of infrastructure of THQHs and RHCs

Status of Infrastructure

Health facilities No repair Minor repair Major repair Under Required infrastructure for required required required construction level of HF is not available (%) (%) (%) (%) (%)

THQH Arija 6.0 7.7% 0.0 0.0 85.3

THQH Larkana 5.2 12.9 1.2 0.0 79.9

THQH Ratodero 9.7 11.2 0.5 0.0 77.6

RHC Banguldero 13.2 3.9 0.0 0.0 82.9

RHC Garhi Khuda Bux 64.5 0.0 0.0 0.0 35.5

RHC Gerelo 36.8 3.9 5.3 0.0 53.9

RHC Badah 64.5 7.9 1.3 0.0 26.3

RHC Naudero 80.3 0.0 2.6 0.0 17.1

Majority of the building components at RHCs were All the THQHs had less than 25% of equipment found to be in a good state (52%) but at the same time availability due to lack of most of the infrastructure. a significant proportion of infrastructure was also THQH Arija was reported to have the least availability unavailable (43%) hampering their use for delivery of (9%) whereas THQHs Larkana and Ratodero had 15% services. RHCs Garhi Khuda Bux, Badah and Naudero and 16% of required equipment items respectively. were found to have most of building components The details of item-wise functional equipment against available but RHC Banguldero had the least the standards are given in the databases (Table 12, 20 infrastructure amongst all the RHCs as it lacked 83% and 28 of databases). of infrastructure. Admin staff room, casualty and Table 5: Status of functional equipment of THQHs and emergency, LHV room, mini lab, general OT, dental RHCs unit and most of the residences were missing at RHC Status of Functional Banguldero. In case of RHC Gerelo, infrastructure for Health Facility Equipment (%) dental unit, OT, admin staff room and general OT was THQH Arija 9.2 not available at RHC. The details of infrastructure for each facility are given in the databases (Table 11, 19 THQH Larkana 15.1 and 27 of databases). THQH Ratodero 16.3

Functional Equipment RHC Banguldero 15.1 The availability of functional equipment was also RHC Garhi Khuda Bux 24.3 assessed according to the specific requirements of RHC Gerelo 25.3 health facility. The unavailability of most of the equipment was due to the absence of required RHC Badah 37.9 infrastructure evaluated in the infrastructure RHC Naudero 75.9 assessment (discussed in details in previous section).

Health Facility Assessment Sindh-2015-16: District Larkana Report 5 Medicines and Supplies sector of Sindh. Due to the deficiencies in all assessed domains of the public sector health facilities, the The availability of medicines and supplies at the people of Sindh are forced to avail services from facility was assessed using Government of Sindh’s private hospitals. If these deficiencies are overcome notified Essential Medicines List (EML) prepared with through immediate remedial actions, the role of the support of USAID DELIVER. On the basis of EML, public sector will be enhanced leading to overall 312 items at THQHs and 219 items at RHCs were improvement in the health indicators. assessed. Most of the facilities showed optimum storage conditions and updated record for medicines Recommendations and supplies. The following recommendations are proposed for None of the THQHs was found to have IV improving the readiness of health facilities of district anticonvulsants (MgSO4) while IV obstetric antibiotics Larkana: were found in adequate quantities. All THQHs had IV  Submit demands for increased budgetary oxytocin except THQH Larkana. Amongst the RHCs, allocations regarding POL for fuel-operated anticonvulsants (MgSO4) were only found at RHC generators and ambulances especially at the Banguldero while IV oxytocin was found at RHCs THQHs and RHCs. Banguldero, Garhi Khuda Bux and Gerelo. The details  Ensure availability and maintenance of DHIS tools of item-wise status of medicines and supplies are and use of quality data for effective and efficient given in databases (Table 13, 21 and 29 of databases). decision making at each health facility. Figure 4: Availability of EmONC medicines  Ensure adequate supervision and management activities (monthly community staff meeting and Availability of EmONC Medicines appropriate decision making) particularly IV antibiotics IV Oxytocin IV MgSO4 focusing on the THQHs and RHCs.

80%  Review progress on all gaps identified by HFA data, making it an integral part of discussion in 67% 67% 60% DHPMT meetings.  Perform civil work assessment of priority components for repair, renovation, expansion, or new construction of building components 20% especially at the THQHs.  Engage individually with health facility managers to improve infection control and medical waste management practices at all health facilities THQHs RHCs especially at THQH Arija.

 Quantify non-functional medical equipment, and Conclusion ensure early procurement and timely supply to all The Health Facility Assessment has shown significant healthcare facilities. gaps, mainly related to insufficient infrastructure and  Ensure regular supply of EmONC medicines at the equipment, shortage of human resource and poor THQHs and RHCs. logistics support leading to routine stock-outs of medicine and supplies. This has resulted in poor health outcomes as depicted by various household surveys. According to provincial surveys like Multiple Indicator Cluster Survey (MICS) 2014-15 and Pakistan Social and Living standards Measurement (PSLM) survey, 2014-15, major gaps have been identified in the delivery of healthcare services by public health

6 Health Facility Assessment Sindh-2015-16: District Larkana Report

DATABASES

Database of Tehsil Headquarter Hospitals Database of Rural Health Centers Database of Basic Health Unit

7 Health Facility Assessment Sindh -2015-16: District Larkana Report 7 7 Database of THQ Hospitals This database provides complete and comprehensive results of all the areas assessed in each of the 3 THQ Hospitals of District Larkana. This database includes all the seven domains (up to the level of components and sub-components/items). Domain I Basic Amenities

Key:

Yes Available No Not Available - Not Applicable

Table 6: Basic Amenities at THQ Hospitals of District Larkana Status of Basic Amenities by type of THQ Hospitals

Availability at THQ Hospitals Basic Amenities District Larkana THQH Arija THQH Larkana THQH Ratodero

Type of Communication Functional landline telephone or vfone No Yes Yes Functional facility-owned/supported cellular phone No - - Source of Water Improved source of water inside facility Yes Yes Yes Improved source of water within 500 meters of facility - - - Water source beyond 500 meters of facility - - - Power Supply Supply from Electricity Grid (WAPDA) Yes Yes Yes Fuel-operated Generator Yes Yes Yes Solar System - - - POL for Fuel-operated Generator No No No Client Latrines Functional client latrine in outpatient services area Yes Yes Yes Separate latrine for female clients Yes Yes Yes Ambulance Service Functional ambulance at the facility Yes Yes Yes Linkage with functional ambulance at other facility or No No Yes community POL for ambulance No No No Components of Facility Cleanliness Cleanliness of floors Yes Yes Yes Cleanliness of counters, tables and chairs Yes Yes Yes Proper storage of sharp waste Yes Yes Yes Maintained sharp storage boxes Yes Yes Yes Proper storage of medical waste (non-sharps) Yes Yes Yes

8 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain II Facility Management Table 7: Facility Management at THQ Hospitals of District Larkana Status of Facility Management activities by type of THQ Hospitals

Situation at THQ Hospitals Facility Management District Larkana THQH Arija THQH Larkana THQH Ratodero External Supervision Visit during last 1 month Yes Yes Yes Visit during last 2-3 months - - - Visit during last 4-6 months - - - Visit more than 6 months - - - External Supervisory Activities Use of checklist for Data Quality Yes Yes Yes Using smartphone application based checklist No No No Signatures on registers Yes Yes Yes Report/Feedback Yes Yes Yes Discussion on staff performance Yes Yes Yes Supporting staff in decision-making based on data Yes Yes Yes Management Meetings of Staff Meeting during last 1 month Yes Yes Yes Meeting during last 2-3 months - - - Meeting during last 4-6 months - - - Meeting more than 6 months - - - Agenda Items of Management Meetings DHIS Data Quality No No No DHIS Reporting No No No Timeliness of DHIS Reporting No No No Quality of Services Yes Yes Yes Service Utilization No No No Diseases Data No No No Employment Conditions No No No Finance/Budget No No No Maintenance of Record Yes Yes Yes Decision-making Yes Yes Yes Follow-up of decisions Yes Yes Yes Meetings of Staff with Community Meeting during last 1 month - - - Meeting during last 2-3 months - - - Meeting during last 4-6 months - - - Meeting more than 6 months - - - Method for Client Opinion/Feedback Complaint Box No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 9 Situation at THQ Hospitals Facility Management District Larkana THQH Arija THQH Larkana THQH Ratodero Client Survey Form No No No Client Interview Form No No No Official meeting with community No No No Informal Discussions No No No Email No No No DOH Sindh’s Website No No No Letter from clients No No No Toll Free Number No No No Review of Client Opinion/Feedback No No No Quality Assurance Activities Activities Performed Yes Yes Yes Record Maintained Yes Yes Yes User Fees User fees charged No No No Posting/Display of user fees No No No Supporting Procedures for Non-Affording Exemption/Discount No No No Fees expected later No No No In-kind Payment No No No Revisit when have money No No No Services not provided/Other No No No DHIS Components DHIS In-Place Yes Yes Yes Compilation of DHIS Reports Yes Yes Yes Monthly Reporting Yes Yes Yes Dedicated Data Manager or Focal Person Yes Yes Yes Availability of DHIS Tools Central Registration Point Register Yes Yes Yes OPD Ticket Yes Yes Yes Medicine Requisition Slip Yes Yes Yes Outpatient Department Register Yes Yes Yes OPD Abstract Form No Yes Yes Laboratory Register Yes Yes Yes Radiology/Ultrasonography/CT Scan/ECG Register Yes Yes Yes Indoor Patient Register Yes Yes Yes Indoor Abstract Form Yes Yes Yes Daily Bed Statement Register Yes Yes Yes Operation Theater (OT) Register Yes Yes Yes Family Planning Register Yes Yes Yes

10 Health Facility Assessment Sindh-2015-16: District Larkana Report Situation at THQ Hospitals Facility Management District Larkana THQH Arija THQH Larkana THQH Ratodero Family Planning Card Yes Yes Yes Maternal Health Register Yes Yes Yes Antenatal Card Yes Yes Yes Obstetric Register Yes Yes Yes Daily Medicine Expense Register Yes Yes Yes Stock Register (Medicine/Supplies) Yes Yes Yes Stock Register (Equipment/Furniture/Linen) Yes Yes Yes Community Meeting Register Yes Yes Yes Facility Staff Meeting Register Yes Yes Yes Secondary Facility Report Form Yes Yes Yes Catchment Area Population Chart Yes Yes Yes Procedures Manual for DHIS Yes Yes Yes LQAS Form Yes Yes Yes Maintenance of DHIS Tools Central Registration Point Register Yes Yes Yes OPD Ticket Yes Yes Yes Medicine Requisition Slip Yes Yes Yes Outpatient Department Register Yes Yes Yes OPD Abstract Form - Yes Yes Laboratory Register Yes Yes Yes Radiology/Ultrasonography/CT Scan/ECG Register Yes Yes Yes Indoor Patient Register Yes Yes Yes Indoor Abstract Form Yes Yes Yes Daily Bed Statement Register Yes Yes Yes Operation Theater (OT) Register Yes Yes Yes Family Planning Register Yes Yes Yes Family Planning Card Yes Yes Yes Maternal Health Register Yes Yes Yes Antenatal Card Yes Yes Yes Obstetric Register Yes Yes Yes Daily Medicine Expense Register Yes Yes Yes Stock Register (Medicine/Supplies) Yes Yes Yes Stock Register (Equipment/Furniture/Linen) Yes Yes Yes Community Meeting Register Yes Yes Yes Facility Staff Meeting Register Yes Yes Yes Secondary Facility Report Form Yes Yes Yes Catchment Area Population Chart Yes Yes Yes Procedure Management for DHIS Yes Yes Yes LQAS Form Yes Yes Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 11 Situation at THQ Hospitals Facility Management District Larkana THQH Arija THQH Larkana THQH Ratodero Infection Control Processing of Equipment Yes Yes Yes On-site Processing Yes Yes Yes Guidelines for Equipment Processing Yes No No Use & Availability/ Processing of Equipment Electric Autoclave Yes Yes Yes Non-Electric Autoclave Yes No No Electric Dry Heat Sterilizer No No No Electric Boiler/Steamer Yes No No Non-Electric Boiler/Steamer No Yes Yes Chemical HLD No Yes Yes Sharps Waste Management Burning in Industrial Incinerator - - - Burning in Non-Industrial Incinerator - Yes Yes Open Burning without Protection Yes - - Open Burning with Protection - - - Protected Dumping - - - Un-Protected Dumping - - - Protected storage for Removal offsite - - - Un-Protected storage for Removal offsite - - - Medical Waste Management Burning in Industrial Incinerator - - - Burning in Non-Industrial Incinerator - - - Open Burning without Protection Yes - - Open Burning with Protection - Yes Yes Protected Dumping - - - Un-Protected Dumping - - - Protected storage for Removal offsite - - - Un-Protected storage for Removal offsite - - - Waste Management Guidelines Availability of Guidelines Yes Yes Yes POL For Incinerator Availability of POL - Yes Yes Sufficiency of Budget - No No

12 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain III Human Resource Table 8: Human Resource at THQ Hospitals of District Larkana Status of sanctioned & filled staff position by type of positions

Status of Human Resource at THQ Hospitals District Larkana Staff Positions THQH Arija THQH Larkana THQH Ratodero S F S F S F Management Staff Medical Superintendent /Civil Surgeon 0 0 1 0 1 0 Additional Superintendent/Civil Surgeon 0 0 1 0 1 0 Deputy Medical Superintendent 0 0 1 1 1 0 Account Assistant 0 0 0 0 0 0 Office Assistant 0 0 0 0 0 0 Computer Operator 0 0 0 0 0 0 Senior Clerk 0 0 1 1 1 1 Junior Clerk 0 0 0 0 2 2 Medical Staff Medical Specialist/Physician 0 0 1 0 1 0 Surgical Specialist/General Surgeon 0 0 1 0 2 0 Child Specialist 0 0 1 0 1 0 Gynecologist 0 0 1 0 1 0 Ophthalmologist 0 0 1 0 1 1 ENT Specialist 0 0 1 0 1 0 Dermatologist 0 0 1 0 1 0 Anesthetist 0 0 1 0 2 0 Pathologist 0 0 1 0 2 0 Radiologist 0 0 0 0 0 0 Senior Medical Officer 0 0 5 3 2 2 Senior Women Medical Officer 0 0 3 1 1 1 Women Medical Officer 0 0 3 3 1 1 Medical Officer 1 1 5 3 3 3 Dental Surgeon 0 0 1 1 1 1 Casualty Medical Officer 0 0 3 0 7 4 Casualty Women Medical Officer 0 0 0 0 0 0 Assistant Physiotherapist 0 0 0 0 0 0 Nursing & Paramedical Staff Nursing Superintendent 0 0 0 0 0 0 Head Nurse 0 0 0 0 0 0 Staff Nurse/ In-charge Nurse 0 0 6 6 7 3 Lab Technician 0 0 1 1 2 2

Health Facility Assessment Sindh-2015-16: District Larkana Report 13 Status of Human Resource at THQ Hospitals District Larkana Staff Positions THQH Arija THQH Larkana THQH Ratodero S F S F S F Lab Assistant 0 0 1 1 1 1 Lab Attendant 0 0 0 0 1 1 OT Technician 0 0 1 0 5 2 OT Assistant 0 0 0 0 2 2 OT Attendant 1 1 1 1 2 2 ICU Technician 0 0 0 0 0 0 ICU Assistant 0 0 0 0 0 0 ICU Attendant 0 0 0 0 0 0 Blood Bank Technician 0 0 1 0 2 0 Blood Bank Assistant 0 0 0 0 0 0 Blood Bank Attendant 0 0 0 0 0 0 Ultrasound Technician 0 0 0 0 1 1 X-Ray Technician 0 0 1 1 1 1 X-Ray Assistant 0 0 0 0 1 1 X-Ray Attendant 0 0 0 0 0 0 ECG Technician 0 0 1 0 1 1 ECG Assistant 0 0 0 0 0 0 ECG Attendant 0 0 0 0 0 0 Dental Technician 1 1 1 1 1 1 Dental Assistant 0 0 0 0 0 0 Dental Attendant 0 0 0 0 1 1 Leprosy Technician 0 0 0 0 0 0 Leprosy Assistant 0 0 0 0 0 0 Leprosy Attendant 0 0 0 0 0 0 Lady Health Visitors 0 0 2 0 2 2 Health Technicians 1 1 0 0 0 0 Medical Technicians 0 0 0 0 0 0 Dispenser 1 1 6 6 6 6 EPI Vaccinator 1 1 2 2 6 6 Sanitary Patrol 0 0 0 0 0 0 Midwives 0 0 0 0 0 0 Support Staff Purchee Clerk 0 0 2 2 2 2 Naib Qasid 1 1 1 1 4 1 Bearer 0 0 0 0 0 0 Chowkidar 1 1 3 3 5 2

14 Health Facility Assessment Sindh-2015-16: District Larkana Report Status of Human Resource at THQ Hospitals District Larkana Staff Positions THQH Arija THQH Larkana THQH Ratodero S F S F S F Malhi 1 1 1 1 2 2 Sanitation Worker 0 0 5 3 8 5 Store Keeper 0 0 1 1 1 1 Ward Servants (Male) 0 0 8 8 15 11 Ward Servants (Female) 0 0 0 0 0 0 Attendant 1 1 4 4 5 5 Health Inspector 0 0 0 0 0 0 Dai/Aya 1 1 1 0 3 3 Dhobi 0 0 1 1 0 0 Ambulance Drivers 0 0 1 1 3 1 Bahishti 0 0 0 0 1 1 Cook 0 0 1 1 2 2 Masalchi 0 0 0 0 0 0 Plumber 0 0 0 0 0 0 Electrician 0 0 0 0 0 0 Generator Operator 0 0 0 0 0 0 Pump operator 0 0 0 0 0 0 Tailor Master 0 0 0 0 0 0 Store Attendant 0 0 0 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 15 Training of Staff at THQ Hospitals Codes Trainings A Integrated Management of Neonatal and Childhood Illnesses (IMNCI) B Emergency Obstetric and Newborn Care (EmONC) C Emergency Newborn Care (ENC) Helping Baby Breathe (HBB) D Pregnancy, Childbirth, Postpartum and Newborn Care (PCPNC) E Managing Complications in Pregnancy and Childbirth (MCPC) G Family Planning (FP) Surgical Non-Communicable Diseases H (e.g. Diabetes, Cardio-Vascular Diseases, Respiratory Diseases) I Malaria J TB-DOTS K Syndromic Management of Sexually Transmitted Infections L Infection Control M Waste Management N EPI (Pneumococcal) O District Health Information System (DHIS) P Malnutrition Q Anesthesia X No Training

Table 9: Staff Training at THQ Hospitals of District Larkana Status of Staff Training by type of THQ Hospitals

Situation at THQ Hospitals Trainings District Larkana THQH Arija THQH Larkana THQH Ratodero Gynecologist X X X Child Specialist X X X Anesthetist X X X Women Medical Officer DEG EG DEGJ Medical Officer AJN AC JL Staff Nurse G BDG G LHV G ACD G Additional Medical Superintendent X X X Chest Specialist X X X Lab Assistant/Technician X X X Midwife X X X Vaccinator X X X

16 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain IV Diagnostics Table 10: Diagnostic Services at THQ Hospitals of District Larkana Status of Diagnostic Services by type of THQ Hospitals

Situation at THQ Hospitals Diagnostic Services District Larkana THQH Arija THQH Larkana THQH Ratodero Hematology Hemoglobin Testing No Yes Yes Use & Availability Hematology analyzer (For total lymphocyte count, full blood - Yes No count, platelet count, etc.) Colorimeter or Hemoglobinometer - Yes No Drabkin's solution (For colorimeter and Hemoglobinometer) - No No Pipette (for measuring blood volume) - Yes Yes Litmus paper for hemoglobin test (with valid expiration - No No date) Blood Glucose Blood Glucose Testing No Yes Yes Use & Availability Glucometer - No No Glucometer Test Strips - No No Blood Chemistry Analyzer No No Yes Tests Blood Glucose - No Yes Lipid Profile - No No Liver FunctionTests (Such as ALT & AST) - No No Renal functionTest (Such as Serum Urea & Creatinine) - No No Urine Chemistry Urine Chemistry Testing No Yes Yes Use & Availability Dip Sticks for Urine Protein - No Yes Dip Sticks for Urine Glucose - No Yes Dip Stick for Urine Pregnancy test - Yes Yes Out of facility Testing Services Blood or Urine testing outside the facility No No No Record of Testing Results Blood Chemistry (Glucose, Sodium, Potassium etc.) - - - Liver Function Test (LFT) - - - Urinalysis - - - (Urine Detailed Report) Pregnancy Test - - -

Health Facility Assessment Sindh-2015-16: District Larkana Report 17 Situation at THQ Hospitals Diagnostic Services District Larkana THQH Arija THQH Larkana THQH Ratodero Parasitology/ Bacteriology/ Virology Use & Availability Light Microscope No Yes Yes Refrigerator in lab area No Yes Yes Incubator No No Yes Test Tubes No No No Centrifuge for CSF Microscopy No No No Culture Medium No No No Glass Slides & Covers No Yes Yes ELISA Machine No No No Malaria Test Onsite Malaria Testing No Yes Yes Use of Malaria Rapid Diagnostic Kit (RTD) - No No Availability of Training Manual Poster or Other Job aid for - No No Use of RTD Use & Availability Giemsa Stain No Yes Yes Field Stain No No No Gram Staining Gram Staining at facility No No No Use & Availability Crystal Violet or Gentian Violet - - - Lugol’s Iodine/Lugol’s solution - - - Acetone or Acetone Alcohol - - - Neutral Red, Carbol Fuchsin, or other Counter stain - - - Specimen Sent Out of Facility Gram Staining or Malaria Testing out of Facility No No No Record of Tests Conducted Outside Gram Stain - - - Malaria - - - Specimen for Culture - - - Stool Microscopy Stool Microscopy at Facility No No No Use & Availability Formal Saline - - - (for concentration method) Normal Saline - - -

18 Health Facility Assessment Sindh-2015-16: District Larkana Report Situation at THQ Hospitals Diagnostic Services District Larkana THQH Arija THQH Larkana THQH Ratodero (for direct microscopy) Lugol’s Iodine/Lugol’s Solution - - - Tuberculosis Onsite Tuberculosis Testing No Yes Yes Use & Availability Ziehl-Neelsen Test for AFB - No No Carbol-Fuchsin - No No Sulphuric Acid (20-25% Concentration) or Acid Alcohol - No No Methylene Blue - No No Microscope - No Yes Testing Availability of TB Rapid Diagnostic Test Kit (RDT) No No No Maintenance of Onsite Sputum container No Yes No Out of Facility Testing TB testing outside the facility No No Yes Maintenance of Sputum testing Record - - - Quality Control Internal or External Quality control System of TB Sputum No Yes Yes smears Type of Quality control Internal QC Only - Yes Yes External QC Only - No No Internal & External QC - No No Send Slide for Re-reading - No No Maintenance of Record Maintenance of Quality Control (Internal & external) - Yes Yes Records Record for Internal QC Only - Yes Yes Record for External QC Only - No No Record for Both Internal & External QC - No No Diagnostic Imaging X-Ray Services Availability of Diagnostic X-Ray Services No Yes Yes Use & Availability Digital X-Ray Machine - No No (Not Requiring Film) X-Ray Machine - Yes Yes Portable X-Ray Machine - No Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 19 Situation at THQ Hospitals Diagnostic Services District Larkana THQH Arija THQH Larkana THQH Ratodero Unexpired Film for X-Ray - Yes Yes Diagnostic Ultrasound & ECG Availability of Ultrasound & ECG Services No Yes Yes Use & Availability Ultrasound Machine - Yes Yes Gel for Ultrasound - Yes Yes Printer for Ultrasound - Yes Yes ECG Machine - Yes Yes Paper roll for ECG - Yes Yes Tomography (CT) Availability of Diagnostic Tomography Services No No No Use & Availability CT Scan - - - Unexpired film for CT Scan - - - Blood Typing & Compatibility Testing Blood Typing Services No Yes Yes Use & Availability Anti-A Reagent - Yes Yes Anti-B Reagent - Yes Yes Anti-D Reagent - Yes Yes COOMB’s Reagent - Yes No Blood Transfusion Services Blood Transfusion at Facility No Yes No Blood Transfusion in Obstetric Context - Yes - Source of Blood Transfused at Facility Government’s Blood Bank - - - Facility’s Own - - - Relatives Donating Directly - Yes - Others - - - Screening of Infectious Diseases Screening of Blood No No No Screened only at Facility - - - Screened Only at External Facility - - - Both Internally & Externally - - - Screening for HIV - - - Screening for Hepatitis B - - - Screening for Hepatitis C - - -

20 Health Facility Assessment Sindh-2015-16: District Larkana Report Situation at THQ Hospitals Diagnostic Services District Larkana THQH Arija THQH Larkana THQH Ratodero Screening of Blood Outside the Facility Specimen Ever Send Outside the Facility - - - Screening for HIV - - - Screening for Hepatitis B - - - Screening for Hepatitis C - - - Blood Storage Shortage of blood for more than 1 day in past 3 months - Availability of Refrigerator - Yes - Optimum Temperature for Blood Storage Between +2 and +6 Degrees - Yes - Above +6 Degrees - - - Below +2 Degrees - - - Thermometer not functional - - - Guidelines for Appropriate Use of Blood and Safe - No - Transfusion Practices Standard Precaution for Diagnostic Services Running Water No Yes Yes (Piped, bucket with tap or pour pitcher) Hand-washing Soap No Yes Yes (May be liquid Soap) Alcohol-based Hand Rub No No No Waste Receptacle (Pedal bin) with Lid and Plastic Bin Liner No No No Other Waste Receptacle No Yes Yes Sharps Container (Safety Box) No Yes No Disposable Latex Gloves No Yes Yes Disinfectant (e.g; Chlorine, Hibitane, Alcohol) No No No Single-Use Standard Disposable Syringes with Needles Or No Yes Yes auto Disposable Syringes with Needle Medical Masks No Yes No Gowns No Yes Yes Eye Protection No No No (Goggles or Face Protection) Guidelines for Standard Precautions No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 21 Domain V Infrastructure

Assessment of Infrastructure

‘Good/No repair required’ means that the infrastructure is in good condition and does not require any type of repair to optimally perform its functions.

‘Minor repair’ includes small issues like whitewash, polish or paint work, broken hinges, locks, or handles, leakage of water pipes without gross seepage, mal-functioning electricity wires.

‘Major repair’ comprises of major issues requiring major plastering or concrete work, repair of major seepage like roof treatment, re-fixing of doors/windows panels, drainage treatment for major blockage, replacement required for parts of water and sewage pipes and electricity rewiring.

‘Under-construction’ means new construction for any building component is underway.

‘Non-availability’ means completely missing infrastructure component that is required as per the level of assessed health facility.

Table 11: Infrastructure at THQ Hospitals of District Larkana Status of infrastructure by type of THQ Hospitals

Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Administration Section M.S. Room Good Good Good Additional. M.S. Room NA Minor NA Deputy. M.S. Room NA NA NA Chief Medical Officer Room NA NA NA Resident Medical Officer Room NA Good Minor Senior Women Medical Office Room Good NA Good Nursing Superintendent Room NA NA NA Head Nurse Room NA NA NA Superintendent Office NA NA NA Clerical Staff Room NA NA Good Accountant/s Room NA NA NA MIS/Computer Room NA Minor NA Conference Room NA Minor Good Library NA NA NA Kitchen / Pantry NA NA NA Casualty & Emergency Reception Area NA NA Major Male Ward/Area NA Minor Minor Female Ward/Area NA NA Good Consultation Area NA Good NA Hand Washing Area NA Minor Minor

22 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Emergency Operation Theater (EOT) NA NA NA Scrub Room/Space NA NA Minor Dressing & Plaster Room Minor Major Minor Nursing Station/Space Good NA NA RMO Room 1 NA Good Good RMO Room 2 NA NA NA Medico Legal Officer Room NA Good Minor Medicine Store NA Minor Good Daycare & Blood Bank Nursing Station/space NA NA NA Ward Area NA NA NA Space for Blood Transfusion Services NA Minor Minor Out Patient Services Information & Registration Area Good Good Good Waiting Area (Male) Good NA Minor Waiting Area (Female) Good Minor Minor Toilets (Male) Minor Good NA Toilets (Female) Minor Good NA Medical OPD Consultant Room NA Good Minor Examination Area (Providing Privacy) Minor NA Good Doctor/s Room Minor NA NA Hand Washing Area Minor Minor Minor Obstetrics & Gynecology OPD Consultant Room NA Good Good Examination Area (Providing Privacy) Good NA Minor Doctor/s Room Good NA NA Hand Washing Area Good Minor Minor LHV/Mid-wife Room Consultation Area NA Minor Minor Private Space for Examination & IUCD Insertion NA Good Minor Hand Washing Facility NA Minor Minor Pediatrics OPD Consultant Room NA Good Good Examination Area (Providing Privacy) NA Minor Good Doctor/s Room Minor NA NA Hand Washing Area Minor Minor Minor Chest Medicine OPD Consultant Room NA Minor NA

Health Facility Assessment Sindh-2015-16: District Larkana Report 23 Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Examination Area (Providing Privacy) Minor Major NA Doctor/s Room Minor NA Minor Hand Washing Area Minor Major Major Dermatology OPD Consultant Room NA Good Good Examination Area (Providing Privacy) NA NA Good Doctor/s Room NA NA NA Hand Washing Area NA Minor Minor Neuro-Psychiatry OPD Consultant Room NA NA NA Examination Area (Providing Privacy) NA NA NA Doctor/s Room NA NA NA Hand Washing Area NA NA NA Surgical OPD Consultant Room NA NA NA Examination Area (Providing Privacy) NA NA NA Doctor/s Room NA NA NA Hand Washing Area NA NA NA Dressing/Plaster Cutting Room NA NA NA Orthopedic OPD Consultant Room NA NA NA Examination area (Providing Privacy) NA NA NA Doctor/s Room NA NA NA Hand Washing Area NA NA NA Dressing/Plaster Cutting Room NA NA NA Urology OPD Consultant Room NA NA NA Examination area (Providing Privacy) NA NA NA Doctor/s Room NA NA NA Hand Washing Area NA NA NA Dressing Room NA NA NA Cardiology OPD Consultant Room NA Minor NA Examination area (Providing Privacy) NA Major NA Doctor/s Room NA NA NA Hand Washing Area NA Minor NA Ophthalmology OPD Consultant Room Good Good Good Doctor/s Room NA NA NA

24 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Dressing/procedure Room Minor NA Minor Hand Washing Area Minor Minor Good ENT OPD Consultant Room NA NA NA Doctor/s room NA NA NA Dressing/procedure Room NA NA NA Hand Washing Area NA NA NA Psychiatry OPD Consultant Room NA NA NA Examination area (Providing Privacy) NA NA NA Doctor/s Room NA NA NA Hand Washing Area NA NA NA Dental Surgery Unit Information & Registration Area Good NA NA Surgeon Office Good Minor Good Treatment Room Good NA Minor Hand Washing Area Minor Major Minor Store for Equipment, Drugs & Supplies Good Minor Minor Washroom Minor NA Minor Physiotherapy Physiotherapist Room NA NA NA Therapy Area/Room NA NA NA Nursing station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom NA NA NA In-Patients Services Medical Ward Male Doctor/s Room NA NA NA Ward Area Good Minor Good Nursing Station Good NA Minor Hand Washing Area Minor Minor Minor Store for Equipment, Drugs & Supplies Good NA Minor Washroom (Male) Minor Minor Minor Kitchen/Pantry NA NA NA Medical Ward Female Doctor/s Room NA Minor NA Ward Area Good Minor Good Nursing station Good NA Good

Health Facility Assessment Sindh-2015-16: District Larkana Report 25 Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Hand Washing Area Minor Minor Minor Store for Equipment, Drugs & Supplies Good NA Minor Washroom (Female) Minor Minor Minor Medical Intensive Care Unit (ICU) Doctor/s Room NA NA NA Nursing station NA NA NA Lockers Room Male NA NA NA Lockers room Female NA NA NA Changing room Male NA NA NA Changing Room Female NA NA NA Handwashing/Scrub Area NA NA NA Staff Washroom NA NA NA ICU Beds Area (Male) NA NA NA ICU Beds Area (Female) NA NA NA Gynecology Ward Doctor/s Room NA NA NA Ward Area NA NA NA Nursing Station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Female) NA NA NA Kitchen/Pantry NA NA NA Labor Room Delivery Room Good Good Good Preparation/Stage Room NA NA Minor Scrub Area NA Minor Good Staff Duty Room NA Minor NA Store for General Items NA NA Minor Store for Equipment Minor NA Minor Client Washroom Minor Good Minor Pediatric Ward Ward Area NA NA NA Nursing Station NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Doctor/s Room NA NA NA Scrub area NA NA NA Washroom NA NA NA Kitchen/Pantry NA NA NA

26 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Newborn & NICU Intensive Care Unit NA NA NA Doctor/s Room NA NA NA Nursing Station NA NA NA Hand Wash/Scrub Area NA NA NA Lockers Room Male NA NA NA Lockers Room Female NA NA NA Changing Room Male NA NA NA Changing Room Female NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Staff Washroom NA NA NA Pediatric Nursery Ward area NA NA NA Nursing Station NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Doctor/s Room NA NA NA Hand wash/Scrub area NA NA NA Surgical Ward (Male) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing Station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Dressing Room NA NA NA Washroom (Male) NA NA NA Kitchen/Pantry NA NA NA Surgical Ward (Female) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing Station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Female) NA NA NA Kitchen/Pantry NA NA NA Orthopedic Ward (Male) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing Station NA NA NA Hand Washing Area NA NA NA

Health Facility Assessment Sindh-2015-16: District Larkana Report 27 Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Store for equipment, drugs & supplies NA NA NA Washroom (Male) NA NA NA Dressing/Plaster Cutting Room NA NA NA Kitchen/Pantry NA NA NA Orthopedic Ward (Female) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing Station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Female) NA NA NA Kitchen/Pantry NA NA NA Urology Ward (Male) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing Station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Male) NA NA NA Dressing/Plaster Cutting Room NA NA NA Kitchen/Pantry NA NA NA Urology Ward (Female) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Female) NA NA NA Dressing/Plaster Cutting Room NA NA NA Kitchen/Pantry NA NA NA Surgical ICU/ Recovery Doctor/s Room NA NA NA Nursing Station NA NA NA Lockers Room Male NA NA NA Lockers Room Female NA NA NA Changing Room Male NA NA NA Changing Room Female NA NA NA Hand Wash/Scrub Area NA NA NA Recovery Beds Area NA NA NA

28 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Store for Equipment, Drugs & Supplies NA NA NA Burns & Dermatology Ward (Male) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing Station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Male) NA NA NA Burns & Dermatology Ward (Female) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Female) NA NA NA Kitchen/Pantry NA NA NA Cardiology Ward (Male) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Male) NA NA NA Kitchen/Pantry NA NA NA Cardiology Ward (Female) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing Station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Female) NA NA NA Kitchen/Pantry NA NA NA CCU Doctor/s Room NA NA NA Nursing Station NA NA NA Lockers Room Male NA NA NA Lockers Room Female NA NA NA Changing room male NA NA NA Changing room female NA NA NA

Health Facility Assessment Sindh-2015-16: District Larkana Report 29 Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Hand Wash/Scrub Area NA NA NA Recovery beds Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA ENT & Eye (Male) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Male) NA NA NA Kitchen/Pantry NA NA NA ENT & Eye (Female) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Female) NA NA NA Kitchen/Pantry NA NA NA Thalassemia Ward (Male) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing station NA NA NA Hand Washing Area NA NA NA Store for equipment, drugs & supplies NA NA NA Washroom (Male) NA NA NA Thalassemia Ward (Female) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing station NA NA NA Hand Washing Area NA NA NA Store for equipment, drugs & supplies NA NA NA Washroom (Female) NA NA NA Psychiatric Ward (Male) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing Station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA

30 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Washroom (Male) NA NA NA Kitchen/Pantry NA NA NA Psychiatric Ward (Female) Doctor/s Room NA NA NA Ward Area NA NA NA Nursing station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Female) NA NA NA Kitchen/Pantry NA NA NA Jail Ward Doctor/s Room NA NA NA Ward Area NA NA NA Nursing station NA NA NA Hand Washing Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom (Female) NA NA NA Kitchen/Pantry NA NA NA Dialysis Unit Doctor/s Room NA NA NA Ward Area NA NA NA Nursing station NA NA NA Hand Washing / Scrub Area NA NA NA Store for Equipment, Drugs & Supplies NA NA NA Washroom NA NA NA Kitchen/Pantry NA NA NA Operation Theaters OBGYN OT Surgeon Room NA NA NA Changing Room/space for Doctors NA NA NA Technician Room/Space NA NA NA Changing Room/space for staff NA NA NA Patient preparation room NA NA NA Scrub Room/ Space NA NA NA Operation Theater NA Minor NA Patient Hold Room NA NA NA Clean utility Room NA NA NA Dirty Utility Room NA NA NA Store NA NA NA

Health Facility Assessment Sindh-2015-16: District Larkana Report 31 Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Support staff duty room NA NA NA Staff Washroom NA Minor NA General Surgery/Urology OT Surgeon Room NA NA Good Changing Room/space for Doctors NA NA Minor Technician Room NA NA NA Changing Room/space for staff NA NA NA Patient preparation room NA NA NA Scrub Room/ Space NA NA Minor Operation Theater NA Minor Good Patient Hold Room NA NA NA Clean Utility Room NA NA NA Store NA NA NA Support staff duty room NA NA NA Staff Washroom NA NA Minor OT for Orthopedics Surgeon Room NA NA NA Changing Room/space for Doctors NA NA NA Technician Room NA NA NA Changing Room/space for staff NA NA NA Patient preparation room NA NA NA Scrub Room/ Space NA NA NA Operation Theater NA NA NA Patient Hold Room NA NA NA Clean Utility Room NA NA NA Store NA NA NA Support staff duty room NA NA NA Staff Washroom NA NA NA OT for ENT/EYE Surgeon Room NA Minor Good Changing Room/Space for Doctors NA NA Minor Technician Room NA Minor NA Changing Room/space for Staff NA NA NA Patient Preparation Room NA NA NA Scrub Room/ Space NA Minor Minor Operation Theater Good Minor Good Patient Hold Room NA NA NA Clean Utility Room NA NA NA Store NA Minor NA

32 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Support Staff Duty Room NA NA NA Staff Washroom NA Minor Minor Central Sterilization Supply Department (CSSD) Dirty Room (For cleaning & segregation) NA NA NA Autoclave/Sterilization Room Minor Minor Minor Clean Room/Packing Room NA NA NA Diagnostics Radiology Department Radiologist Room NA NA NA Ultrasound Room/space Minor Minor Good ETT, ECG Room/space NA Minor NA X-Ray room-1 Minor Good Good X-Ray room-2 NA NA NA Dark Room Minor Good Good Endoscopy Room NA NA NA Pathology Department Pathologist Room NA NA NA Hematology Room NA Minor Good Microbiology Room Minor Minor Good Biochemistry Room NA NA NA Blood Bank Room/space NA Minor NA Sample Collection Room/Space Minor Minor Good Staff Room NA NA Good Washroom (Patients) NA NA NA Washroom (Staff) Minor Minor Minor Miscellaneous Main Pharmacy Minor NA Good Dispensary Minor Minor Minor Medical Gases area NA NA NA Garage for Ambulance NA Good Good Medicine Store Minor Good Good General store NA Good Good Linen Store NA Minor Good Boundary Wall Good Minor Good Main Gate Good Minor Minor Residences Medical Superintendent NA Minor NA Physician NA NA NA Surgeon NA NA NA

Health Facility Assessment Sindh-2015-16: District Larkana Report 33 Availability at THQH Infrastructure Components District Larkana THQH Arija THQH Larkana THQH Ratodero Gynecologist NA NA NA Anesthetist NA NA NA Pediatrician NA NA NA Radiologist NA NA NA Pathologist NA NA NA Dental Surgeon NA NA NA WMO NA NA NA LHV NA NA NA Nurses NA NA NA Lab Technician NA NA NA BB Technician NA NA NA Anesthesia Technician NA NA NA

34 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain VI Equipment Table 12: Equipment at THQ Hospitals of District Larkana Status of functional equipment, furniture, & fixtures in Management Section, Emergency, & OPDs of THQ Hospitals in District Larkana

Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Management Section Medical Superintendent Room Large Office Table with Cabinet 1 1 1 Revolving Chair 1 1 1 Office Chair 11 14 11 Sofa Set 0 1 0 Computer with LCD Screen (complete set) 1 0 0 Telephone Set 0 1 1 LaserJet Printer 0 0 0 Fax Machine 0 0 0 Split Air Conditioner 1 1 1 Office Locker 1 1 1 Television Set 0 0 0 Additional MS Room Large Office Table with Cabinet 0 0 0 Office Chair (including for visitors) 0 6 0 Revolving Chair 0 1 0 Computer with LCD Screen (complete set) 0 0 0 Telephone Set 0 0 0 Office Locker 0 1 0 Deputy MS Room Large office table with cabinet 0 0 0 Office chair 0 0 0 Revolving chair 0 0 0 Computer with LCD screen (complete set) 0 0 0 Telephone set 0 0 0 Office locker 0 0 0 Admin Room Office table 0 0 0 Office chair 0 0 0 Revolving chair 0 0 0 Desktop computer with monitor (complete set) 0 0 0 Office locker 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 35 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Account Room Office table 0 0 0 Office chair 0 0 0 Revolving chair 0 0 0 Desktop computer with monitor (complete set) 0 0 0 Office locker 0 0 0 Conference Room Conference table 0 4 1 Chair 0 20 0 Multimedia 0 0 0 Screen 0 0 0 MIS/Computer Room Desktop computer with all accessories 0 1 0 Office table 0 2 0 Office chair 0 8 0 Library Book racks 0 0 0 Chairs 0 0 0 Table 0 0 0 Telephone set 0 0 0 Emergency & Casualty Reception/ Nursing Station Revolving Chair 0 0 0 Telephone Set 0 0 0 Cupboard 0 0 0 Sphygmomanometer 0 0 0 Stethoscope 0 0 0 RMO Room/S Office Table 0 1 1 Office Chair 0 6 3 Revolving Chair 0 1 1 X-Ray Illuminator 0 0 0 Examination Couch 0 0 0 Stethoscope 0 1 1 Sphygmomanometer 0 1 1 Diagnostic Set 0 0 0

36 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Medico Legal Officer Room Office Table 0 1 1 Office Chair 0 5 3 Revolving Chair 0 0 1 X-Ray Illuminator 0 0 0 Examination Couch 0 0 0 Emergency Ward For Male Emergency Resuscitation Trolley 0 0 0 Multifunction Monitor 0 0 0 ECG Machine With Trolley 0 0 0 Two Crank Fowler Bed 0 0 0 Bed Side Locker 0 0 0 Suction Machine 0 0 0 Cardiac Monitor 0 0 0 Diagnostic Set 0 0 0 Pulse Oximeter 0 0 0 Dinamap 0 0 0 Sphygmomanometer 0 1 0 Stethoscope 0 1 0 Defibrillator 0 0 0 Glucometer 0 0 0 Nebulizer Machine 0 1 0 Steamer 0 0 0 Oxygen Flow Meter 0 2 0 Central Oxygen Line 0 0 0 Oxygen Cylinder 0 3 0 Emergency Ward For Female Two Crank Fowler Bed 0 0 6 Bed Side Locker 0 0 0 Suction Machine 0 0 1 Cardiac Monitor 0 0 0 Emergency Resuscitation Trolley 0 0 0 ECG Machine With Trolley 0 0 0 Diagnostic Set 0 0 0 Pulse Oximeter 0 0 0 Dinamap 0 0 0 Sphygmomanometer 0 0 1

Health Facility Assessment Sindh-2015-16: District Larkana Report 37 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Stethoscope 0 0 1 Defibrillator 0 0 0 Glucometer 0 0 0 Nebulizer Machine 0 0 1 Steamer 0 0 0 Oxygen Flow Meter 0 0 1 Central Oxygen Line 0 0 0 Oxygen Cylinder 0 0 1 Portable Spot Light 0 0 0 Medicine Store Revolving Chair 0 0 0 Racks For Medicines 0 0 0 Refrigerator 0 0 0 Portable X-Ray Portable X-Ray Machine 100 MA 0 0 0 X-Ray Castes 0 0 0 Emergency Operation Theater O.T Top Light 0 0 0 O.T Table 0 0 0 Revolving Stool 0 0 0 Foot Step 0 0 0 Telephone Set 0 0 0 Cardiac Monitor Multifunction 0 0 0 Minor Instruments Set 0 0 0 Dressing Set 0 0 0 Circumcision Set 0 0 0 Defibrillator 0 0 0 Instrument Trolley 0 0 0 Crush Trolley 0 0 0 Suction Machine 0 0 0 X-Ray Illuminator 0 0 0 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Surgical Drums 0 0 0 Oxygen Flow Meter 0 0 0 Central Oxygen Line 0 0 0 Central Oxygen Cylinder 0 0 0

38 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Dressing & POP Room Dressing Trolley 1 0 0 Minor Instrument Set 0 1 1 Instrument Tray/Trolley 1 1 1 Portable Spot Light 0 0 0 Examination Couch 1 1 3 P.O.P Cutter 0 0 0 Scrub Room Dispenser For Scrub Solution 1 0 1 Outpatient Services Medical And Chest OPD Office Table 1 2 3 Office Chair 1 5 8 Revolving Chair 1 1 0 Telephone Set 0 0 0 X-Ray Illuminator 0 0 1 Examination Couch 1 2 1 Stethoscope 1 2 4 Sphygmomanometer 0 2 2 Diagnostic Set 0 0 0 Weighing Scale 0 1 1 Height Scale 0 0 0 Obstetrics & Gynecology OPD Office Table 1 1 2 Office Chair 3 6 4 Revolving Chair 1 1 1 Telephone Set 0 0 0 X-Ray Illuminator 0 0 0 Examination Couch 1 2 1 Stethoscope 1 1 1 Sphygmomanometer 0 1 1 Diagnostic Set 0 0 0 Vaginal Speculum 0 0 3 Portable Spot Light 0 0 2 Dressing Set 1 0 1 Pediatrics OPD Office Table 1 1 1

Health Facility Assessment Sindh-2015-16: District Larkana Report 39 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Office Chair 1 6 4 Revolving Chair 1 2 1 Telephone Set 0 0 0 X-Ray Illuminator 0 0 0 Examination Couch 1 2 1 Stethoscope 1 1 1 Sphygmomanometer 1 1 1 Diagnostic Set 0 0 0 Baby Weighing Scale 1 1 1 Dermatology OPD Office Table 0 1 1 Office Chair 0 3 3 Revolving Chair 0 1 1 Telephone Set 0 0 0 X-Ray Illuminator 0 0 0 Examination Couch 0 0 1 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Diagnostic Set 0 0 0 Weighing Scale 0 0 0 Height Scale 0 0 0 Dressing Trolley 0 0 0 Portable Light 0 1 0 Examination Lens 0 1 0 Surgical OPD Office Table 0 0 0 Office Chair 0 0 0 Revolving Chair 0 0 0 Telephone Set 0 0 0 X-Ray Illuminator 0 0 0 Examination Couch & Privacy 0 0 0 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Diagnostic Set 0 0 0 Proctoscopes (Set) 0 0 0 Portable Spot Light 0 0 0 Dressing Trolley/Tray 0 0 0

40 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Dental OPD Dental Chair 1 1 1 Light 0 0 1 Hand Piece Unit 1 0 1 Suction Machine 0 0 1 Compressor 1 0 1 Dental Hand Instruments (Set) 1 2 1 Aseptic Trolley 1 1 0 Dental Autoclave 0 0 1 Amalgamator 0 0 0 Dental X-Ray Unit 0 0 1 Intraoral X-Ray Film Processor 0 0 97 X-Ray View Box 0 0 1 Lead Apron 0 0 0 Ultrasonic Scalar 0 0 3 Dental Operating Stool 1 0 1 Ultraviolet Sterilizer 0 0 0 Eye OPD Office Table 1 1 1 Office Chair 2 2 6 Revolving Chair 1 1 1 Telephone Set 0 0 0 X-Ray Illuminator 0 0 0 Examination Couch 1 1 0 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Diagnostic Set 0 1 0 Refraction Set 2 1 1 Slit Lamp 2 1 1 Snellen Chart 2 1 1 Field Analyzer 0 0 0 Ophthalmoscope 1 1 1 Retinoscope 1 1 1 A Scan 1 0 0 Weighing Scale 0 0 0 ENT OPD Office Table 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 41 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Office Chair 0 0 0 Revolving Chair 0 0 0 Telephone Set 0 0 0 X-Ray Illuminator 0 0 0 Examination Couch 0 0 0 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Diagnostic ENT Set 0 0 0 Medical Ward (Male) Nursing Station Revolving Chair 1 0 1 Telephone Set 0 0 0 Cupboard 0 0 1 Sphygmomanometer 0 0 0 Stethoscope 0 0 0 Ward Two Crank Fowler Bed 0 0 0 Ordinary Patient Bed 0 8 10 Bed Side Locker 0 6 1 Mattress With Cover 0 0 0 Over The Bed Table 0 0 0 Bed Side Bench 0 0 0 Medicine Trolley 0 6 1 Steel Almirah 0 0 0 Ward Screen 0 0 0 Stretcher 0 1 0 Wheel Chair 0 0 0 Drip Stand 0 4 3 Stainless Steel Bucket 0 0 0 Urinal 0 0 0 Bedpan 0 0 0 Medical Ward Female Duty Doctor Room Office Table 0 1 0 Office Chair 0 4 0 Revolving Chair 0 1 0 X-Ray Illuminator 0 0 0

42 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Stethoscope 0 1 0 Sphygmomanometer 0 1 0 Examination Couch 0 1 0 Office Table 0 1 0 Nursing Station Revolving Chair 1 0 1 Telephone Set 0 0 0 Cupboard 0 0 1 Sphygmomanometer 0 0 1 Stethoscope 0 0 0 Ward Two Crank Fowler Bed 4 0 6 Ordinary Bed 3 8 2 Bed Side Locker 2 7 1 Mattress With Cover 0 0 0 Over The Bed Table 0 0 0 Bed Side Bench 0 0 0 Medicine Trolley 2 7 1 Steel Almirah 0 0 0 Ward Screen 0 0 0 Stretcher 1 1 0 Wheel Chair 0 0 0 Drip Stand 1 4 1 Urinal 0 0 0 Bedpan 0 0 0 Stainless Steel Bucket 0 0 0 Ward Screen 0 0 0 Isolation Room Two Crank Fowler Bed 0 0 0 Bed Side Locker 0 0 0 Settee 0 0 0 Oxygen Cylinder With Flow Meter 0 0 0 Split Air Conditioner 0 0 0 Cardiac Monitor Multi-Function 0 0 0 Suction Machine 0 0 0 Treatment Room Two Crank Fowler Bed 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 43 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Bed Side Locker 0 0 0 Settee 0 0 0 Suction Machine 0 0 0 Oxygen Flow Meter 0 0 0 Syringe Cutter 0 0 0 Drug Racks (Drug Room) 0 0 0 Medical Intensive Care Unit I.C.U Bed 0 0 0 Bed Side Locker 0 0 0 Suction Machine 0 0 0 Cardiac Monitor 0 0 0 Central Monitoring System 10 Channel 0 0 0 Crush Trolley 0 0 0 Pulse Oximeter 0 0 0 Dinamap 0 0 0 Sphygmomanometer 0 0 0 Stethoscope 0 0 0 E.C.G Machine 0 0 0 Ventilator 0 0 0 Infusion Pump 0 0 0 Defibrillator 0 0 0 Glucometer 0 0 0 Nebulizer Machine 0 0 0 Laryngoscope (Set) 0 0 0 Refrigerator 0 0 0 Steamer 0 0 0 Instrument Trolley 0 0 0 Cupboard 0 0 0 Split Air Conditioner 0 0 0 Oxygen Flow Meter 0 0 0 Central Oxygen Line 0 0 0 Oxygen Cylinders 0 0 0 Duty Doctor Room Office Table 0 0 0 Office Chair 0 0 0 Revolving Chair 0 0 0 Telephone Set 0 0 0

44 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero X-Ray Illuminator 0 0 0 Examination Couch 0 0 0 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Nursing Station Revolving Chair 0 0 0 Telephone Set 0 0 0 Cupboard 0 0 0 Sphygmomanometer 0 0 0 Stethoscope 0 0 0 Locker Rooms Male & Female Lockers Rack Metal 0 0 0 Obstetrics & Gynecology Nursing Station Revolving Chairs 0 0 0 Counter 0 0 0 Telephone Set 0 0 0 Sphygmomanometer 0 0 0 Stethoscope 0 0 0 Steel Almirah 0 0 0 File Cabinet 0 0 0 Ward Stretcher Trolleys 0 0 0 Wheel Chairs 0 0 0 Ward Screen 0 0 0 Dirty Linen Trolley 0 0 0 Two Crank Fowler Bed 0 0 0 Ordinary Beds 0 0 0 Mattress With Cover 0 0 0 Bed Side Locker 0 0 0 Clean Linen Trolley 0 0 0 Over The Bed Table 0 0 0 Bed Side Bench 0 0 0 Medicine Trolley 0 0 0 Weighing Scale 0 0 0 Couch For Mother Feed 0 0 0 Drip Stand 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 45 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Stainless Steel Bucket 0 0 0 Urinals 0 0 0 Bedpans 0 0 0 Isolation Rooms Two Crank Fowler Bed 0 0 0 Mattress With Cover 0 0 0 Bed Side Locker 0 0 0 Over The Bed Table 0 0 0 Bed Side Bench 0 0 0 Medicine Trolley 0 0 0 Treatment Room Medicine Trolley 0 0 0 Examination Couches 0 0 0 Revolving Stool 0 0 0 Foot Stepper 0 0 0 Syringe Cutter 0 0 0 Suction Machine Portable 0 0 0 X - Ray Illuminator 0 0 0 Portable B.P Apparatus 0 0 0 Stretcher Trolley 0 0 0 Nebulizer 0 0 0 Drip Stand 0 0 0 Glucometer 0 0 0 Medicine Store Racks 0 0 0 Pantry/Kitchen Utensils / Equipment 0 0 0 Frying Pan 0 0 0 Cooking Pan 0 0 0 Refrigerator 0 0 0 Water Cooler 0 0 0 Food Distribution Trolley 0 0 0 Stove 0 0 0 Labor Room Multipurpose Monitor 0 0 0 Suction Machine (Heavy Duty) 1 1 1 Ambu Bag (Adults) 1 0 0

46 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Ambu Bag (Pediatrics) 0 0 2 Cardiotocograph Machine 0 0 0 D & C. Set 1 1 1 D & E. Set 1 1 1 Episiotomy Set 1 1 1 Delivery Set 1 1 1 Defibrillator 0 1 0 Oxygen Flow Meter 1 1 1 Central Oxygen Line 0 0 0 Oxygen Cylinders 1 1 1 Nitrous Oxide Cylinder 0 0 0 Instrument Trolley 1 0 3 Medicine Trolley/Tray 0 0 3 Surgical Drums 0 2 2 Emergency Resuscitation Trolley 0 0 1 Refrigerator 0 0 0 Portable OT Light 0 1 1 Delivery Table 1 2 4 Suction Machine 1 0 1 Baby Running Trolley With Warmer 0 0 1 Normal Delivery Set 1 2 1 Vacuum Extractor 0 1 1 Pulse Oximeter 0 0 0 Drip Stand 1 2 4 Foot Stand 1 1 4 Stainless Steel Bucket 0 0 2 Split A/C (1 Ton) 0 0 1 Pediatrics Reception / Nursing Station Revolving Chair 0 0 0 Telephone Set 0 0 0 Cupboard 0 0 0 Crush Trolley 0 0 0 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Ward Doctor Room Office Table 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 47 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Office Chair 0 0 0 Visitor Chair 0 0 0 Ward Two Crank Fowler Bed 0 0 0 Ordinary Beds 0 0 0 Mattress With Cover 0 0 0 Bedside Lockers 0 0 0 Over The Bed Table 0 0 0 Bed Side Bench 0 0 0 Glucometer 0 0 0 Weighing Machine 0 0 0 Portable B.P Apparatus 0 0 0 Drip Stand 0 0 0 X- Ray Illuminator 0 0 0 Medicine Trolley 0 0 0 Stainless Steel Bucket 0 0 0 Portable Screens 0 0 0 Ward Screen 0 0 0 Isolation Room Two Crank Fowler Bed 0 0 0 Bed Side Locker 0 0 0 Mattress With Cover 0 0 0 Over The Bed Table 0 0 0 Bed Side Bench 0 0 0 Medicine Trolley 0 0 0 Treatment Room Medicine Trolley 0 0 0 Two Crank Fowler Bed 0 0 0 Examination Table 0 0 0 Foot Stepper 0 0 0 Bed Side Locker 0 0 0 Syringe Cutter 0 0 0 Suction Machine Portable 0 0 0 X - Ray Illuminator 0 0 0 Portable B.P Apparatus 0 0 0 Stretcher Trolley 0 0 0 Nebulizer 0 0 0

48 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Drip Stand 0 0 0 Glucometer 0 0 0 Racks (Medicine Store) 0 0 0 Pantry/Kitchen Utensils / Equipment 0 0 0 Frying Pan 0 0 0 Cooking Pan 0 0 0 Refrigerator 0 0 0 Water Cooler 0 0 0 Food Distribution Trolley 0 0 0 Stove 0 0 0 Waiting Area Chairs 0 0 0 Newborn & NICU Baby Incubator 0 0 1 Multipurpose Monitors 0 0 0 Pulse Oximeter 0 0 0 Infusion Pumps 0 0 0 Suction Machine (Heavy Duty) 0 0 0 Phototherapy Unit 1 0 1 Ventilator 0 0 0 Baby Weighing Scale 1 0 1 Radiant Warmer 1 0 0 Overhead Warmer 0 0 1 Resuscitation Trolley 1 0 0 ECG Machine 0 0 0 Defibrillator With ECG Display 0 0 0 Medical Trolley 0 0 0 Lactometer 0 0 0 Nebulizer 0 0 0 Baby Cot 0 0 1 Ward Screen 0 0 0 Drip Stand 0 0 0 Pediatric Nursery Baby Cot 0 0 0 Two Crank Fowler Bed 0 0 0 Mattress With Cover 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 49 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Bedside Locker 0 0 0 Drip Stand 0 0 0 Multipurpose Monitors 0 0 0 Infusion Pumps 0 0 0 Suction Machine 0 0 0 Surgical Reception / Nursing Station Revolving Chair 0 0 0 Telephone Set 0 0 0 Cupboard 0 0 0 Crush Trolley 0 0 0 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Emergency Resuscitation Trolley/Tray 0 0 0 Glucometer 0 0 0 Weighing Machine 0 0 0 Surgical Ward Male Drip Stand 0 0 0 Stainless Steel Bucket 0 0 0 Urinals 0 0 0 Bedpans 0 0 0 Two Crank Fowler Bed 0 0 0 Ordinary Patient Bed 0 0 0 Bed Side Locker 0 0 0 Mattress With Cover 0 0 0 Settee 0 0 0 Suction Machine 0 0 0 Oxygen Flow Meter 0 0 0 Oxygen Central Supply Line 0 0 0 Oxygen Cylinder 0 0 0 Ward Screen 0 0 0 Surgical Ward Female Two Crank Fowler Bed 0 0 0 Ordinary Patient Bed 0 0 0 Mattress With Cover 0 0 0 Bed Side Locker 0 0 0 Settee 0 0 0

50 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Suction Machine 0 0 0 Glucometer 0 0 0 Oxygen With Flow Meter 0 0 0 Drip Stand 0 0 0 Stainless Steel Bucket 0 0 0 Urinals 0 0 0 Bedpans 0 0 0 Ward Screen 0 0 0 Dermatology Derma/Burn Ward (Male) Glucometer 0 0 0 Weighing Machine 0 0 0 Portable B.P Apparatus 0 0 0 Emergency Resuscitation Trolley 0 0 0 Drip Stand 0 0 0 X - Ray Illuminator 0 0 0 Suction Machine 0 0 0 Laryngoscopes (Set) 0 0 0 Infusion Pump 0 0 0 Defibrillator 0 0 0 Ventilator 0 0 0 Dressing Set 0 0 0 Refrigerator 0 0 0 Two Crank Fowler Bed 0 0 0 Mattress With Cover 0 0 0 Bed Side Locker 0 0 0 Bed Side Bench 0 0 0 Split A/C (1 Ton) 0 0 0 Ward Screen 0 0 0 Urinal 0 0 0 Bedpan 0 0 0 Derma/Burn Ward (Female) Glucometer 0 0 0 Weighing Machine 0 0 0 Portable B.P Apparatus 0 0 0 Emergency Resuscitation Trolley 0 0 0 Drip Stand 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 51 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero X - Ray Illuminator 0 0 0 Suction Machine 0 0 0 Laryngoscopes (Set) 0 0 0 Infusion Pump 0 0 0 Defibrillator 0 0 0 Ventilator 0 0 0 Dressing Set 0 0 0 Refrigerator 0 0 0 Two Crank Fowler Bed 0 0 0 Mattress With Cover 0 0 0 Bed Side Locker 0 0 0 Bed Side Bench 0 0 0 Split A/C (1 Ton) 0 0 0 Ward Screen 0 0 0 Eye & ENT Eye & ENT Ward Male Reception / Nursing Station Revolving Chair 0 0 0 Telephone Set 0 0 0 Cupboard 0 0 0 Crush Trolley 0 0 0 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Ward Two Crank Fowler Bed 0 0 0 Ordinary Patient Bed 0 0 0 Mattress With Cover 0 0 0 Bed Side Locker 0 0 0 Settee 0 0 0 Suction Machine 0 0 0 Oxygen Flow Meter 0 0 0 Oxygen Central Supply Line 0 0 0 Oxygen Cylinder 0 0 0 Drip Stand 0 0 0 Ward Screen 0 0 0

52 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero ENT & Eye Ward (Female) Reception / Nursing Station Revolving Chair 0 0 0 Telephone Set 0 0 0 Cupboard 0 0 0 Crush Trolley 0 0 0 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Ward Two Crank Fowler Bed 0 0 0 Ordinary Patient Bed 0 0 0 Mattress With Cover 0 0 0 Bed Side Locker 0 0 0 Settee 0 0 0 Suction Machine 0 0 0 Oxygen Flow Meter 0 0 0 Oxygen Central Supply Line 0 0 0 Oxygen Cylinder 0 0 0 Drip Stand 0 0 0 Ward Screen 0 0 0 Dentistry Ward Two Crank Fowler Bed 0 0 0 Bed Side Locker 0 0 0 Settee 0 0 0 Suction Machine 0 0 0 Oxygen Flow Meter 0 0 0 Oxygen Cylinder 0 0 0 Operation Theater Suite Main Operation Theater Surgeon Room Table 0 0 0 Settee 0 0 0 Telephone Set 0 0 0 X-Ray Illuminator 0 0 0 Hooks In Changing Room 0 0 0 Anesthetist Room Office Table 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 53 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Office Chair 0 0 0 X-Ray Illuminator 0 0 0 Preparation Room Two Crank Fowler Bed With Drip Stand 0 0 0 Cardiac Monitor Multifunction 0 0 0 Dinamap Monitor 0 0 0 Oxygen Flow Meter 0 0 0 Patient Hold Room Two Crank Fowler Bed 0 0 0 Cardiac Monitor Multifunction 0 0 0 Dinamap 0 0 0 Oxygen Flow Meter 0 0 0 Scrub Room Dispenser For Scrub Solution 0 0 0 Utility Store Racks 0 0 0 Obstetrics & Gynecology Anesthesia Machine With Ventilator 0 0 0 Hydraulic O.T Table 0 0 0 Diathermy Machine 0 0 0 Multipart Monitor 0 0 0 Suction Machine (Heavy Duty) 0 0 0 Over Head Operating Light 0 0 0 Ambu Bag (Adults) 0 0 0 Ambu Bag (Pediatrics) 0 0 0 Digital Video Colposcope 0 0 0 C.T.G Machine 0 0 0 Hysterectomy Set 0 0 0 L.S. Caesarean Section Set 0 0 1 D & C Set 0 0 1 D & E Set 0 0 1 Episiotomy Set 0 0 1 General Surgery Set 0 0 1 Defibrillator 0 0 0 Oxygen Flow Meter 0 0 0 Oxygen Central Line 0 0 0 Oxygen Cylinder 0 0 0

54 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Nitrous Oxide Central Line 0 0 0 Nitrous Oxide Cylinder 0 0 0 Instrument Trolley (Fixed) 0 0 0 Instrument Trolley (Adjustable) 0 3 0 Surgical Drums 0 0 0 Instrument Tray 0 0 0 Emergency Resuscitation Trolley 0 0 0 Split A/C (1 Ton) 0 1 0 Portable Spot Light 0 0 0 Normal Delivery Set 0 1 1 Vacuum Extractor 0 0 1 Pulse Oximeter 0 0 0 Drip Stand 0 0 0 General Surgery Oxygen Flow Meter 1 0 1 Oxygen Central Line 0 0 0 Oxygen Cylinder 2 0 0 Nitrous Oxide Central Line 0 0 0 Laryngoscopes 2 0 1 Pneumatic Tourniquet 0 0 0 Diathermy Machine 1 0 1 Hydraulic Operating Table 1 0 2 O T Halogen Top Light 1 0 2 Revolving Stool 0 0 0 Cardiac Monitor Multifunction 0 0 1 Minor Set 0 0 2 Major General Surgery Set 0 0 0 Appendectomy Set 0 0 0 Fine Set For Plastic & Vascular 0 0 0 Urethral Dilators (Set) 0 0 0 Instrument Trolley 2 0 1 Crush Trolley 0 0 0 Suction Machine 1 0 1 Defibrillator 0 0 0 X-Ray Illuminator 0 0 0 Stethoscope 0 0 1 Sphygmomanometer 2 0 1

Health Facility Assessment Sindh-2015-16: District Larkana Report 55 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero ENT Surgery Oxygen Flow Meter 0 0 0 Oxygen Central Line 0 0 0 Oxygen Cylinder 0 0 0 Nitrous Oxide Central Line 0 0 0 Desk Top Microscope 0 0 0 Projector Multimedia 0 0 0 Laser Diode Microscope (complete set) 0 0 0 Plethysmography (complete set) 0 0 0 Tympanometer 0 0 0 Auditory Brain Stem Response Test Meter 0 0 0 Rigid Esophagoscope 0 0 0 Rigid Bronchoscope 0 0 0 Fiber optic Dilators (Gum Elastic B) 0 0 0 Stroboscope With Monitor 0 0 0 Diathermy Machine 0 0 0 OT Top Light 0 0 0 Revolving Stool 0 0 0 Cardiac Monitor Multifunction 0 0 0 Instrument Trolley 0 0 0 Crush Trolley 0 0 0 Suction Machine 0 0 0 Defibrillator 0 0 0 Operating Table 0 0 0 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Laryngoscopes (Set) 0 0 0 ENT Instrument Set 0 0 0 Telephone Set 0 0 0 Split Unit 1.5 Ton 0 0 0 Eye Surgery Oxygen Flow Meter 0 0 0 Oxygen Central Line 0 0 0 Oxygen Cylinder 0 0 0 Nitrous Oxide Central Line 0 0 0 Slit Lamp 0 0 0 Direct Ophthalmoscope 1 0 1

56 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Indirect Ophthalmoscope 1 0 1 Phoropter 1 0 0 Retinoscope 0 1 1 Autorefractors 0 0 0 A/B Scan 0 1 0 Autoclave 0 0 0 Surgical Instruments Set 0 0 1 Lensometer/Lensmeter 1 0 0 Air Puff (Non-Touch) 0 0 0 Keratometer 1 0 0 Operating Table 1 0 2 Phaco Machine 0 0 0 Posterior Vitrectomy 0 0 0 Cryomachine 0 0 0 Surgical Magnet 0 0 0 CCT System 0 0 0 Surgical Chair 0 0 0 Operating Microscope 1 0 2 Revolving Stool 0 0 0 Telephone Set 0 0 0 Cardiac Monitor Multifunction 0 0 0 Instrument Trolley 1 0 1 Crush Trolley 0 0 0 X-Ray Illuminator 0 0 0 Diathermy Machine 0 0 0 Defibrillator 0 0 0 Stethoscope 0 0 0 Sphygmomanometer 0 0 0 Laryngoscopes (Set) 0 0 0 Recovery / Surgical ICU Multipurpose Monitor 0 0 0 ECG Machine 0 0 0 Defibrillator With ECG Display 0 0 0 Suction Machine (Heavy Duty) 0 0 0 Kidney Tray 0 0 0 Infusion Pump 0 0 0 Ventilator 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 57 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Emergency Resuscitation Trolley 0 0 0 Two Crank Fowler Beds 0 0 0 Bedside Lockers 0 0 0 Mattress With Cover 0 0 0 Drip Stand 0 0 0 Portable X-Ray Machine 100 MA 0 0 0 A/C Split (1.5 Ton) 0 0 0 Central Sterilization Services Department Autoclave Double Door 0 0 0 Autoclave Double Steam. Single Door 1 1 2 Disinfecting Instrument Washer Double Door 0 0 0 Rotary Sealing Machine With Work Station 0 0 0 Instrument Cleaner Super Sonic 0 0 0 Auto Fine Lumen Cleaner 0 0 0 Dry Cabinet Single Door 0 0 0 Water Distiller Complete 0 0 0 Diagnostics Pathology Department Sample Collection Room Collection Chair 0 1 1 Examination Couch 1 1 1 Blood Sample Rotator 0 0 0 Rack For Tubes 0 2 2 Syringe Cutter 1 1 0 Pathologist Office Office Table 0 3 0 Office Chair 0 3 0 Revolving Chair 0 0 0 Computer With Monitor (complete set) 0 0 0 Examination Couch 0 0 0 Office Locker 0 0 0 Split AC 0 0 0 Hematology Section Hematology Analyzer 0 0 0 Microscope 0 1 1 Refrigerator 0 1 1 Hb Electrophoresis Fully Automatic 0 0 0

58 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Blood Sample Rotator 0 0 0 Juster Fixed 0 0 0 Juster Adjustable 0 0 1 Modified Microtome 0 0 0 Micropipettes (Set) 0 0 0 Electronic Balance 0 0 0 Centrifuge Machine 0 1 1 Set Of Glassware 0 0 0 Rack For Tubes 0 1 1 Slides Rack 0 2 1 Office Table 0 1 2 Revolving Chair 0 0 0 Revolving Stool 0 1 4 Split Air Conditioner 0 0 0 Microbiology Section Office Table 2 1 1 Revolving Chair 0 0 1 Revolving Stool 0 0 0 Microscope 2 2 2 Centrifuge Machine 1 0 0 Incubator 0 0 0 Oven 0 0 0 Autoclave 0 0 0 Computer With Monitor (complete set) 0 0 0 Split Air Conditioner 0 0 0 Refrigerator 1 0 0 Urine Analyzer 0 0 0 Water Bath 0 1 0 Slides Rack 2 2 1 Chemistry Section Office Table 0 0 0 Revolving Chair 0 0 0 Revolving Stool 0 0 0 Refrigerator 0 0 0 Split Air Conditioner 0 0 0 Centrifuge Machine 0 0 0 Water Bath 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 59 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Biochemistry Analyzer 0 0 0 Arterial Blood Gases Machine 0 0 0 Electrolytes Analyzer 0 0 0 Electronic Balance 0 0 0 Blood Bank Office Table 0 1 0 Revolving Chair 0 0 0 Examination Couch 0 0 0 Blood Storage Refrigerator 0 1 0 Water Bath 0 0 0 Microscope 0 0 0 Hematology Analyzer 0 0 0 Blood Bag Sealer 0 0 0 Platelet Agitator 0 0 0 Chelation Therapy Infusion Pump 0 0 0 Hb Electrophoresis (Fully Automatic) 0 0 0 Fresh Plasma Separator 0 0 0 Chemistry Analyzer 0 0 0 Incubator 0 0 0 Blood Bag Rotator 0 0 0 Digital Blood Shaker/Flow 0 0 0 Precision Calibration Weight For Shaker 0 0 0 Centrifuge Machine 0 0 0 Centrifugal Cell Washer (Electronic) 0 0 0 Hot Air Oven 0 0 0 Ultrasound Water Bath 0 0 0 Sphygmomanometer 0 0 0 Stethoscope 0 0 0 Weighing Scale 0 0 0 Spring Scale 500 Ml 0 0 0 Ordinary Fridge 0 0 0 Split Air Conditioner 0 0 0 Laboratory In Charge Room Office Table 0 0 0 Office Chair 0 0 0 Revolving Chair 0 0 0 Computer With Monitor (complete set) 0 0 0

60 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Office Locker 0 0 0 Staff Room Office Table 0 0 1 Chair 0 0 1 Office Locker 0 0 0 Radiology Department X-Ray / Dark Room X-Ray Machine 500 MA (complete set) 0 0 1 X-Ray Machine 800 MA (complete set) 0 1 0 Cassettes 8*10 0 0 1 Cassettes 10*12 0 1 1 Cassettes 12*15 0 1 1 Cassettes 14*17 0 0 0 X-Ray Illuminator 0 0 0 Mammography Equipment 0 0 0 Tank For Fixer, Developer & Running Water 0 1 1 Computer With Monitor (complete set) 0 0 0 Laser Jet Printer 0 0 0 Office Table 0 1 1 Office Chair 0 2 4 Revolving Chair 0 0 0 Revolving Stool 0 0 0 Ultrasound Room Color Doppler Echocardiograph 0 0 0 Grey Scale Ultrasound 0 1 1 Office Table 0 1 1 Office Chair 0 4 3 Revolving Chair 0 1 0 Examination Couch 0 1 1 E.C.G Room ECG Machine 0 1 0 Office Table 0 1 0 Office Chair 0 2 0 Revolving Chair 0 0 0 Examination Couch 0 1 0 Medicine Store Revolving Chair 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 61 Availability at THQ Hospitals Equipment, Furniture & Fixtures District Larkana THQH Arija THQH Larkana THQH Ratodero Rack For Medicines 4 6 9 Refrigerator 1 1 1 Computer With Monitor (complete set) 0 0 0 Office Table 0 1 1 Office Chair 0 2 3 Telephone Set 0 0 0 Miscellaneous Items Submersible Pump For Tube Well 0 0 0 Transfer Pump From UGT to OHT 2 3 4 Sub-Station Equipment 0 0 0 Cold Storage (For Morgue) 0 0 0 Central Liquid Oxygen Plant 0 0 0 Incinerator 0 1 0 Automobile Ambulances 1 2 2 Electrical Generator 550 KV 2 0 2 Generator Installation 0 0 0 Lift 0 0 0 Security Office Table 0 0 0 Chair 0 0 0

62 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain VII Medicines & Supplies Table 13: Medicines & Supplies at THQ Hospitals of District Larkana Status of Drugs & Supplies by type of THQ Hospitals

Availability at THQ Hospitals Drugs & Supplies District Larkana THQH Arija THQH Larkana THQH Ratodero Anesthetics (General) Halothane/Isoflurane (Inhalation) No No No Nitrous Oxide (inhalation) No No No Oxygen Cylinder Yes Yes Yes Inj. Ketamine No No No Inj. Thiopental No No No Muscle Relaxants Inj. Neostigmine No No No Tab. Neostigmine No No No Suxamethonium (Ampoule) No No No Anesthetics Local Bupivacaine (Vial) No No No Injection for Spinal Anesthesia (Ampoule) No Yes No Lidocaine (Vial) No No No Lidocaine (Topical) No No No Inj. Lignocaine + Epinephrine No No Yes Inj. Lignocaine + Epinephrine (Dental) Yes No Yes Ephedrine (Ampule) No No No Analgesics (Opioid/Central Acting) Morphine (Ampule) No No No Pethidine (Ampule) No No No Inj. Nalbuphine No No No Inj. Pentazocin No No Yes Analgesics (NSAIDs) Tab. Acetylsalicylic Acid No No No Tab. Diclofenac Yes No Yes Diclofenac (Ampule) Yes No Yes Diclofenac (Gel) No No No Tab. Naproxen No No No Tab. Ibuprofen Yes Yes No Ibuprofen (Gel) No No No Syp. Ibuprofen Yes No No Tab. Paracetamol Yes Yes Yes Syp. Paracetamol Yes Yes Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 63 Availability at THQ Hospitals Drugs & Supplies District Larkana THQH Arija THQH Larkana THQH Ratodero Inj. Paracetamol No No No Paracetamol (Suppository) No No No Gout Tab. Allopurinol No No No Anti-Allergics (Anaphylaxis) Tab. Chlorpheniramine Yes No Yes Inj. Chlorpheniramine Yes No Yes Syp. Chlorpheniramine Yes No Yes Tab. Cetirizine No No No Syp. Cetirizine No No No Tab. Loratadine Yes No No Syp. Loratadine No No No Tab. Promethazine No No No Syp. Promethazine No No No Inj. Promethazine No No No Inj. Dexamethasone No Yes Yes Tab. Dexamethasone No No No Epinephrine (Ampule) No No No Inj. Hydrocortisone No No No Tab. Prednisolone No No No Antibiotics/Antimicrobial Tab./Cap. Amoxicillin Yes Yes Yes Amoxicillin (Powder for Suspension) Yes Yes Yes Inj. Amoxicillin No Yes No Cap. Ampicillin No No Yes Ampicillin (Powder for Suspension) Yes No No Inj. Ampicillin Yes Yes No Cap. Azithromycin No Yes No Azithromycin Suspension No No No Tab. Amoxicillin + Clavulanic Acid No No No Inj. Amoxicillin + Clavulanic Acid No No No Inj. Benzathine Penicillin Yes No No Cap. Cloxacillin No No No Cloxacillin (Powder for Suspension) No No No Cap. Cefixime No No No Ceftriaxone (Powder for Injection) No No Yes Cap. Chloramphenicol No No No

64 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Drugs & Supplies District Larkana THQH Arija THQH Larkana THQH Ratodero Syp. Chloramphenicol No No No Inj. Chloramphenicol No No No Tab. Ciprofloxacin Yes No Yes Tab. Clarithromycin No No No Cap. Clindamycin No No No Inj. Clindamycin No No No Tab. Cotrimoxazole Yes Yes Yes Syp. Cotrimoxazole No Yes Yes Cap. Doxycycline Yes Yes No Syp. Doxycycline No No No Inj. Gentamicin Yes Yes No Tab. Levofloxacin Yes Yes Yes Tab. Metronidazole No No No Inj. Metronidazole No No No Syp. Metronidazole Yes No Yes Tab. Nitrofurantoin No No No Inj. Procaine Benzylpenicillin No No No Tab. Phenoxymethylpenicillin No No No Syp. Phenoxymethylpenicillin No No No Antidotes & Other Substances Used in Poisoning Atropine (Ampule) No No No Charcoal Activated (Powder) No No No Methylene Blue (Ampule) No No No Naloxone (Ampule) No No No Anti-Epileptics / Anticonvulsants Tab. Carbamazepine No No No Syp. Carbamazepine No No No Inj. Magnesium Sulphate No No No Tab. Phenobarbital No No No Inj. Phenobarbital No No No Tab. Phenytoin No No No Syp. Phenytoin No No No Anti-Helminthic Tab. Albendazole No No No Syp. Albendazole Yes No No Tab. Mebendazole Yes No No Tab. Pyrantel No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 65 Availability at THQ Hospitals Drugs & Supplies District Larkana THQH Arija THQH Larkana THQH Ratodero Syp. Pyrantel No No No Anti-Fungal Clotrimazole (vaginal cream) No No No Clotrimazole (vaginal tablet) No No No Inj. Fluconazole No No No Syp. Fluconazole No No No Tab. Nystatin No No No Nystatin (Drops) No No No Anti-Tuberculosis Drugs Tab. Ethambutol Yes Yes Yes Ethambutol (Oral Liquid) No No No Tab. Isoniazid Yes No Yes Syp. Isoniazid No No No Tab. Pyrazinamide Yes Yes Yes Cap. Rifampicin No Yes Yes Syp. Rifampicin No No No Inj. Streptomycin No Yes Yes Tab. Ethambutol + Isoniazid Yes Yes Yes Tab. Isoniazid + Rifampicin Yes Yes Yes Tab. Isoniazid + Pyrazinamide + Rifampicin Yes Yes Yes Tab. Rifampicin + Isoniazid + Pyrazinamide + Yes Yes Yes Ethambutol Tab. Ethambutol + Isoniazid + Rifampicin Yes Yes Yes Anti-Herpes Medicines Tab. Acyclovir No No No Syp. Acyclovir No No No Acyclovir (Cream) No No No Anti-Leishmaniosis Medicines Inj. Amphotericin B No No No Inj. Sodium Stibogluconate No No No Anti-Diabetics Tab. Glibenclamide No No Yes Tab. Glimepiride No No No Tab. Metformin No No Yes Inj. Insulin Regular No No No Inj. Insulin Comp No No No

66 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Drugs & Supplies District Larkana THQH Arija THQH Larkana THQH Ratodero Antimalarial Tab. Choloroquine Yes Yes Yes Tab. Primaquine No No Yes Tab. Sulfadoxine + Pyrimethamine No No No Tab. Artesunate No No No Tab. Artesunate + Sulfadoxine + Pyrimethamine No No No Tab. Artesunate + Sulfadoxine and Pyrimethamine No No No Artemether (Ampule) Yes No No Tab. Artemether + Lumefantrine No No No GIT Medicines Inj. Hyoscine No No No Tab. Hyoscine No No No Tab. Phloroglucinol No No No Tab. Metoclopramide No No No Syp. Metoclopramide No No No Inj. Metoclopramide No No No Tab. Dimenhydrinate No No No Cap. Omeprazole Yes Yes No Inj. Ranitidine No No No Tab. Ranitidine Yes No No Tab. Aluminium Hydroxide + Magnesium Trisilicate No No No ORS (Sachet) Yes No Yes Sodium Phosphate (Enema) No No No Tab. Bisacodyl No No No Glycerin (Suppository) No No No Magnesium Oxide and Hydroxide (Suspension) No No No Antivirals for Hepatitis Inj. Interferon Alpha 2b No No Yes Tab. Ribavirin No No Yes Cardiovascular Medicines Tab. Acetylsalicylic Acid No No No Tab. Bisoprolol No No No Tab. Digoxin No No No Inj. Digoxin No No No Inj. Dopamine No No No Tab. Enalapril No No No Glyceryl Trinitrate (Sublingual) No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 67 Availability at THQ Hospitals Drugs & Supplies District Larkana THQH Arija THQH Larkana THQH Ratodero Tab. Hydralazine No No No Inj. Hydralazine No No No Isosorbide Dinitrate (Sublingual) No No No Tab. Methyldopa No No No Inj. Methyldopa No No No Tab./Cap. Propranolol No No No Tab. Simvastatin No No No Tab. Verapamil No No No Diuretics Tab. Furosemide No Yes Yes Inj. Furosemide No No Yes Tab. Hydrochlorothiazide No No No Tab. Spironolactone No No No Medicines Affecting Coagulation Inj. Heparin No No No Inj. Tranexamic Acid No No No Cap. Tranexamic Acid No No No Tab. Warfarin No No No Oxytocic Medicines Inj. Ergometrine No No Yes Tab. Misoprostol No No No Inj. Oxytocin Yes No Yes Respiratory Medicines Inj. Aminophylline Yes No No Tab. Aminophylline No No No Beclomethasone (Inhaler) No No No Tab. Salbutamol Yes Yes Yes Inj. Salbutamol No No No Salbutamol (Inhaler) No No No Salbutamol (Solution for Nebulizer) Yes Yes No Ammonium Chloride+ Chloroform + Menthol + Diphenhydramine + Sodium Citrate (Antitussive No No No Expectorant) Syp. Dextromethorphan + Diphenhydramine No No No Ophthalmic Medicines Dexamethasone (Eye Drops) Yes No Yes Gentamicin (Eye Drops) No No No

68 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Drugs & Supplies District Larkana THQH Arija THQH Larkana THQH Ratodero Tropicamide (Eye Drops) No No No Pilocarpine (Eye Drops) No No No Polymyxin B (Eye Drops) No No No Tetracycline (Eye Drops) No No No Tetracycline (Eye Ointment) No No No Tetracaine (Eye Drops) No No No Timolol (Eye Drops) No No No ENT Medicines Boroglycerine (Ear Drops) No No No Polymyxin B + Lignocaine (Ear Drops) No No No Ciprofloxacin (Ear Drops) No No No Ephedrine (Nasal Drops) No No No Lignocaine (Topical Solution) No No No Saline Nasal Drops No No No Xylometazoline (Nasal Spray) No No No I/V Infusions (Plasma Substitutes) Plasma Expander (Infusion) No No Yes Glucose/Dextrose (Infusion) Yes Yes Yes Glucose/Dextrose (Ampule) No No No Normal Saline (Infusion) Yes Yes Yes Dextrose + Saline (Infusion) Yes Yes Yes Ringer’s Lactate (Infusion) Yes Yes Yes Potassium Chloride (Solution) No No No Inj. Sodium Bicarbonate No No No Mannitol (Infusion) No No No Water for injection (Ampule) Yes Yes Yes Vitamins and Minerals Tab. Ascorbic Acid No No No Inj. Calcium Gluconate No No No Tab. Calcium Lactate No No No Tab. Ergocalciferol (Vit. D) No No No Tab. Ferrous salt No Yes No Syp. Ferrous salt No No No Tab. Folic Acid Yes Yes No Tab. Ferrous salt + Folic Acid No Yes Yes Inj. Vitamin K No No No Hydroxocobalamin (Ampule) No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 69 Availability at THQ Hospitals Drugs & Supplies District Larkana THQH Arija THQH Larkana THQH Ratodero Multiple Micronutrients (Sachet) No No No Tab. /Cap. Retinol (Vitamin A) Yes No Yes Tab. Zinc Sulphate No No No Tab. B Complex No Yes Yes Tab. Multivitamins Yes No No Dermatologicals Benzyl Benzoate Lotion Yes No Yes Betamethasone Cream No No No Calamine Lotion No No No Coal tar Lotion No No No Clotrimazole Cream No No No Hydrocortisone Cream No No No Permethrin Cream/Lotion No No No Salicylic Acid (Solution) No No No Polymyxin B + Bacitracin Zinc (Ointment) No No Yes Silver Sulfadiazine Cream No No No Sodium Thiosulfate (Solution) No No No Medicines for Mental and Behavioral Disorders & Tranquilizers Inj. Chlorpromazine No No No Tab. Clomipramine No No No Tab. Haloperidol No No No Tab. Diazepam No No No Inj. Diazepam No No No Tab. Alprazolam No No No Contraceptives Condoms Yes Yes No Combined Oral Pills No No No Progesterone Only Pills (Levonorgestrel) No No Yes Emergency Contraceptive Pills (Levonorgestrel) No Yes Yes IUCS (Copper T/Multiload) No Yes Yes Inj. Medroxyprogesterone Acetate (DPMA) No No Yes Inj. Norehisterone Enantate (Net-En) No No No Inj. Estradiol Cypionate + Medroxyprogesterone No No No Acetate Levonorgestrel-releasing Implant (Subdermal) No No No Etonogestrel-releasing Implant (Sub dermal) No No No

70 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at THQ Hospitals Drugs & Supplies District Larkana THQH Arija THQH Larkana THQH Ratodero Vaccines and Sera BCG Vaccine Yes Yes Yes Oral Polio Vaccine Yes Yes Yes Injectable Polio Vaccine Yes No Yes Hepatitis B vaccine No Yes Yes Measles Vaccine Yes Yes Yes Tetanus Toxoid Yes Yes Yes Pentavalent Vaccine Yes Yes Yes Pneumococcal Vaccine Yes Yes Yes Meningococcal Vaccine No No Yes Anti-Rabies Vaccines (PVRV) No Yes No Anti-Snake Venom Serum No Yes Yes Anti-D Immunoglobulin (Single-dose Vial) No No No Diphtheria Antitoxin (Vial) No No No Inj. Tetanus Immunoglobulin No Yes No Rabies Immunoglobulin (Vial) No No No Antiseptics/ Disinfectants Povidone-Iodine (Solution) No Yes No Chlorhexidine + Cetrimide (Solution) No No Yes Halogenated Natrium Phosphate (Powder) No No No Acriflavine (Cream) No No No Tincture Benzoin Compound (Solution) No Yes Yes Chlorhexidine Digluconate (7.1%) for cord care (Gel) No Yes No Disposable Supplies Syringe (Auto disable) No Yes Yes Disposable Syringe Yes Yes Yes IV Set No Yes Yes Scalp Vein Set No Yes No Volumetric Chamber No No No (IV Burette) IV Cannula Yes No Yes Adhesive Tape No Yes Yes Sterile Gauze Dressing No Yes Yes Cotton Bandage Yes Yes Yes Absorbent Cotton Wool Yes Yes Yes Crepe Bandage No No Yes Examination Gloves Yes Yes Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 71 Availability at THQ Hospitals Drugs & Supplies District Larkana THQH Arija THQH Larkana THQH Ratodero Sterile Surgical Gloves Yes No Yes Silk Sutures Sterile No No Yes Chromic Catgut Sterile Sutures No No No Prolene/Vicryl Sterile Sutures No No No Plaster of Paris Bandage Yes No No Face Mask Disposable Yes Yes Yes Blood Lancets No No Yes Slides Yes No Yes Endotracheal Tube No No No Nasogastric Tube No No Yes Foley Catheter No No Yes Urine Bags No No Yes Blood Bags No Yes No Disposable Airways No No No Suction Catheter No No No Disposable Cord Clamps No No No Spinal Needle No No No Surgical Blades Yes No Yes Clean Delivery Kits Yes No No Radio Contrast Media Inj. Amidotrizoate No No No Barium Sulfate (Suspension) No No No Inj. Iohexol No No No

72 Health Facility Assessment Sindh-2015-16: District Larkana Report Database of Rural Health Centers This database provides complete and comprehensive results of all the areas assessed in five Rural Health Centers of District Larkana. This database includes all the seven domains (up to the level of components and sub-components/items). Domain I Basic Amenities

Key:

Yes Available No Not Available - Not Applicable

Table 14: Basic Amenities at Rural Health Centers of District Larkana Status of Basic Amenities by type of RHCs

Availability at Rural Health Centers District Larkana Basic Amenities RHC Garhi RHC RHC RHC RHC Khuda Badah Banguldero Gerelo Naudero Bux

Type of Communication Functional landline telephone or vfone No No No No Yes Functional facility owned/supported cellular phone No No No No No Source of Water Improved source of water inside facility Yes Yes Yes Yes Yes Improved source of water within 500 meters of No No No No No facility Water source beyond 500 meters of facility No No No No No Power Supply Supply from Electricity Grid (WAPDA) Yes Yes Yes Yes Yes Fuel operated Generator Yes Yes Yes Yes Yes Solar System No No No No No POL for Fuel operated Generator No No No No Yes Client Latrines Functional client latrine in outpatient services area Yes Yes Yes Yes Yes Separate latrine for female clients Yes Yes Yes Yes Yes Ambulance Service Functional ambulance at the facility Yes No Yes No Yes Linkage with functional ambulance at other facility No No No No No or community POL for ambulance No No Yes No No Components of Facility Cleanliness Cleanliness of floors Yes Yes Yes Yes Yes Cleanliness of counters, tables and chairs Yes Yes Yes Yes Yes Proper storage of sharp waste Yes Yes Yes Yes Yes Maintained sharp storage boxes Yes Yes Yes Yes Yes Proper storage of medical waste (non sharps) Yes Yes Yes Yes Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 73 Domain II Facility Management Table 15: Facility Management at Rural Health Centers of District Larkana Status of Facility Management activities by type of RHCs

Situation at Rural Health Centers District Larkana Facility Management RHC Garhi RHC RHC RHC RHC Khuda Badah Banguldero Gerelo Naudero Bux

External Supervision Visit during last 1 month No Yes Yes No Yes Visit during last 2-3 months Yes No No Yes No Visit during last 4-6 months No No No No No Visit more than 6 months No No No No No External Supervisory Activities Use of checklist for Data Quality Yes Yes Yes Yes Yes Using smartphone application based checklist No No No No No Signatures on registers Yes Yes Yes Yes Yes Report/Feedback Yes Yes Yes No Yes Discussion on staff performance Yes Yes Yes No Yes Supporting staff in decision-making based on data Yes Yes Yes No Yes Management Meetings of Staff Meeting during last 1 month Yes Yes Yes Yes Yes Meeting during last 2-3 months No No No No No Meeting during last 4-6 months No No No No No Meeting more than 6 months No No No No No Agenda Items of Management Meetings DHIS Data Quality No No No No No DHIS Reporting No No No No No Timeliness of DHIS Reporting No No No No No Quality of Services No No No No No Service Utilization No No No No No Diseases Data Yes No No No No Employment Conditions No No No No No Finance/Budget No No No No No Maintenance of Record Yes No Yes No Yes Decision-making Yes No No No No Follow-up of decisions Yes No No No No Meetings of Staff with Community Meeting during last 1 month Yes Yes Yes No Yes Meeting during last 2-3 months No No No No No Meeting during last 4-6 months No No No No No Meeting more than 6 months No No No No No

74 Health Facility Assessment Sindh-2015-16: District Larkana Report Situation at Rural Health Centers District Larkana Facility Management RHC Garhi RHC RHC RHC RHC Khuda Badah Banguldero Gerelo Naudero Bux Method for Client Opinion/Feedback Complaint Box No No No No No Client Survey Form No No No No No Client Interview Form No No No No No Official meeting with community No No No No No Informal Discussions Yes Yes Yes Yes Yes Email No No No No No DOH Sindh’s Website No No No No No Letter from clients No No No No No Toll Free Number No No No No No Review of Client Opinion/Feedback Yes No Yes Yes No Quality Assurance Activities Activities Performed Yes Yes Yes Yes Yes Record Maintained Yes Yes Yes No Yes User Fees User fees charged No No No No Yes Posting/Display of user fees No No No No No Supporting Procedures for Non-Affording Exemption/Discount No No No No Yes Fees expected later No No No No No In-kind Payment No No No No No Revisit when have money No No No No No Services not provided/Other No No No No No DHIS Components DHIS In-Place Yes Yes Yes Yes Yes Compilation of DHIS Reports Yes Yes Yes Yes Yes Monthly Reporting Yes Yes Yes Yes Yes Dedicated Data Manager or Focal Person No Yes No No No Availability of DHIS Tools Central Registration Point Register Yes Yes Yes Yes Yes OPD Ticket Yes Yes Yes Yes Yes Medicine Requisition Slip Yes Yes Yes Yes No Outpatient Department Register Yes Yes Yes Yes Yes OPD Abstract Form Yes Yes Yes No No Laboratory Register Yes No Yes No No Radiology/Ultrasonography/CT Scan/ECG Register Yes Yes No No No Indoor Patient Register No Yes Yes No No Indoor Abstract Form No Yes Yes No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 75 Situation at Rural Health Centers District Larkana Facility Management RHC Garhi RHC RHC RHC RHC Khuda Badah Banguldero Gerelo Naudero Bux Daily Bed Statement Register No Yes No No No Operation Theater (OT) Register No No Yes No No Family Planning Register Yes Yes Yes Yes Yes Family Planning Card Yes Yes Yes Yes Yes Maternal Health Register Yes Yes Yes Yes Yes Antenatal Card Yes Yes Yes Yes Yes Obstetric Register Yes Yes Yes Yes Yes Daily Medicine Expense Register Yes Yes Yes Yes No Stock Register (Medicine/Supplies) Yes Yes Yes Yes Yes Stock Register (Equipment/Furniture/Linen) Yes Yes Yes Yes Yes Community Meeting Register No Yes No No No Facility Staff Meeting Register Yes Yes No No No Secondary Facility Report Form Yes Yes Yes Yes Yes Catchment Area Population Chart Yes Yes Yes No Yes Procedures Manual for DHIS No No No No No LQAS Form No Yes No No No Maintenance of DHIS Tools Central Registration Point Register Yes Yes Yes Yes Yes Medicine Requisition Slip Yes No Yes Yes No Outpatient Department Register Yes Yes Yes Yes Yes OPD Abstract Form Yes Yes Yes No No Laboratory Register Yes No No No No Radiology/Ultrasonography/CT Scan/ECG Register No No No No No Indoor Patient Register No No No No No Indoor Abstract Form No No No No No Daily Bed Statement Register No Yes No No No Operation Theater (OT) Register No No No No No Family Planning Register Yes Yes Yes Yes Yes Maternal Health Register Yes Yes Yes Yes Yes Obstetric Register Yes Yes Yes Yes Yes Daily Medicine Expense Register Yes Yes Yes Yes No Stock Register (Medicine/Supplies) Yes Yes Yes Yes Yes Stock Register (Equipment/Furniture/Linen) Yes Yes Yes Yes Yes Community Meeting Register No Yes No No No Facility Staff Meeting Register Yes No No No No Secondary Facility Report Form Yes Yes Yes Yes Yes Catchment Area Population Chart No Yes Yes No No LQAS Form No Yes No No No

76 Health Facility Assessment Sindh-2015-16: District Larkana Report Situation at Rural Health Centers District Larkana Facility Management RHC Garhi RHC RHC RHC RHC Khuda Badah Banguldero Gerelo Naudero Bux Infection Control Processing of Equipment Yes Yes Yes Yes Yes On-site Processing Yes Yes Yes Yes Yes Guidelines for Equipment Processing Yes No No No Yes Use & Availability/ Processing of Equipment Electric Autoclave Yes Yes Yes Yes Yes Non-Electric Autoclave No No No No No Electric Dry Heat Sterilizer No No No No No Electric Boiler/Steamer No No Yes Yes No Non-Electric Boiler/Steamer No No No No Yes Chemical HLD No Yes No Yes Yes Sharps Waste Management Burning in Industrial Incinerator No No No No No Burning in Non-Industrial Incinerator No No No No No Open Burning without Protection No No No No No Open Burning with Protection Yes Yes Yes Yes Yes Protected Dumping No No No No No Un-Protected Dumping No No No No No Protected storage for Removal offsite No No No No No Un-Protected storage for Removal offsite No No No No No Medical Waste Management Burning in Industrial Incinerator No No No No No Burning in Non-Industrial Incinerator No No No No No Open Burning without Protection No No No No No Open Burning with Protection Yes Yes Yes Yes Yes Protected Dumping No No No No No Un-Protected Dumping No No No No No Protected storage for Removal offsite No No No No No Un-Protected storage for Removal offsite No No No No No Waste Management Guidelines Availability of Guidelines No No No No Yes POL For Incinerator Availability of POL No No No No No Sufficiency of Budget No No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 77 Domain III Human Resource Table 16: Human Resource at Rural Health Centers of District Larkana Status of sanctioned & filled staff position by type of positions

Status of Human Resource at RHCs

District Larkana

Staff Positions RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero S F S F S F S F S F

Management Staff

Medical Superintendent/Civil Surgeon 1 1 0 0 0 0 0 0 1 1

Additional Superintendent/Civil Surgeon 1 0 0 0 0 0 0 0 1 0

Deputy Medical Superintendent 1 0 0 0 0 0 0 0 0 0

Junior Clerk 1 0 0 0 0 0 1 1 1 1

Support Staff

Naib Qasid 2 1 2 0 0 0 2 2 2 1

Chowkidar 3 3 2 0 2 2 2 2 3 3

Malhi 1 0 1 0 0 0 2 2 0 0

Sanitation Work 2 2 1 1 1 0 4 4 3 3

Store Keeper 0 0 0 0 0 0 0 0 0 0

Ward Servant 4 2 0 0 1 1 2 2 4 4

Female Ward Servant 0 0 0 0 0 0 0 0 0 0

Attendant 0 0 0 0 0 0 0 0 2 2

Dai/Aya 2 0 0 0 1 1 0 0 1 1

Dhobi 0 0 0 0 0 0 0 0 0 0

Ambulance Drivers 2 0 0 0 1 1 0 0 1 1

Medical Staff

Medical Specialist/ Physician 0 0 0 0 0 0 0 0 0 0

Surgeon 0 0 0 0 0 0 0 0 0 0

Child Specialist/Pediatrician 0 0 0 0 0 0 0 0 1 0

Gynecologists 0 0 0 0 0 0 0 0 1 1

Ophthalmologist 1 0 0 0 0 0 0 0 1 0

Dental Surgeon 1 1 0 0 1 0 0 0 1 1

Anesthetist 0 0 0 0 0 0 0 0 0 0

Women Medical Officer 1 1 3 2 1 0 1 0 1 1

Medical Officer 3 3 4 4 3 2 3 3 4 4

Health Technician (Male) 0 0 1 1 0 0 2 2 0 0

Health Technician (Female) 0 0 0 0 0 0 0 0 0 0

Medical Assistant Health Technician 0 0 0 0 0 0 0 0 0 0

78 Health Facility Assessment Sindh-2015-16: District Larkana Report Status of Human Resource at RHCs

District Larkana

Staff Positions RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero S F S F S F S F S F

Sister Nurse 0 0 0 0 0 0 0 0 0 0

Staff Nurse 1 0 0 0 0 0 2 1 1 1

Lab Technician 0 0 0 0 0 0 0 0 0 0

Lab Assistant 2 1 0 0 2 2 0 0 2 2

OT Technician 0 0 0 0 0 0 0 0 0 0

OT Assistant 0 0 0 0 0 0 0 0 0 0

Ultrasound Technician 1 1 0 0 0 0 0 0 1 1

X-Ray Technician 0 0 0 0 0 0 0 0 0 0

Dental Technician 1 0 0 0 1 1 1 1 1 1

Lady Health Visitors 2 1 0 0 2 2 3 0 2 2

Dispenser 2 2 1 1 1 1 2 2 3 3

EPI Vaccinator 1 1 0 0 0 0 0 0 0 0

Sanitary Patrol 0 0 1 1 0 0 0 0 0 0

Midwives 1 0 1 1 1 1 3 2 3 2

Health Inspector 1 0 0 0 0 0 0 0 1 1

Senior Medical Officer 1 0 0 0 1 0 1 0 1 1

Senior Women Medical Officer 1 0 0 0 0 0 0 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 79 Training of Staff at Rural Health Centers Codes Trainings A Integrated Management of Neonatal and Childhood Illnesses (IMNCI) B Emergency Obstetric and Newborn Care (EmONC) C Emergency Newborn Care (ENC) Helping Baby Breathe (HBB) D Pregnancy, Childbirth, Postpartum and Newborn Care (PCPNC) E Managing Complications in Pregnancy and Childbirth (MCPC) G Family Planning (FP) Surgical Non-Communicable Diseases H (e.g. Diabetes, Cardio-Vascular Diseases, Respiratory Diseases) I Malaria J TB-DOTS K Syndromic Management of Sexually Transmitted Infections L Infection Control M Waste Management N EPI (Pneumococcal) O District Health Information System (DHIS) P Malnutrition Q Anesthesia X No Training

Table 17: Staff Trainings at Rural Health Centers of District Larkana Status of Staff Trainings at Rural Health Centers

Training Received by RHC Staff District Larkana Staff Trainings RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Gynecologist X X X X ABCDE Child Specialist X X X X A Anesthetist X X X X X Women Medical Officer DGL X BG X X Medical Officer X X X X X Staff Nurse X X X X X LHV X X X X ABCDE Midwife X X CDG X X

80 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain IV Diagnostics Table 18: Diagnostics Services at Rural Health Centers of District Larkana Status of Diagnostic Services in RHCs

Availability at RHC District Larkana Diagnostics RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Hematology Hemoglobin Testing No No No No Yes Use & Availability Hematology analyzer (For total lymphocyte count, full blood count, No No No No No platelet count, etc.) Colorimeter or Hemoglobinometer No No No No Yes Drabkin's solution (For colorimeter No No No No No and Hemoglobinometer) Pipette (for measuring blood No No No No No volume) Litmus paper for hemoglobin test No No No No No (with valid expiration date) Blood Glucose Blood Glucose Testing Yes No No No Yes Use & Availability Glucometer Yes No No No Yes Glucometer Test Strips No No No No Yes Blood Chemistry Analyzer No No No No Yes Tests Blood Glucose No No No No Yes Lipid Profile No No No No Yes Liver FunctionTests (Such as ALT & No No No No Yes AST) Renal functionTest (Such as Serum No No No No No Urea & Creatinine) Urine Chemistry Urine Chemistry Testing No No No No Yes Use & Availability Dip Sticks for Urine Protein No No No No Yes Dip Sticks for Urine Glucose No No No No Yes Dip Stick for Urine Pregnancy test No No No No Yes Out of facility Testing Services Blood or Urine testing outside the No No No No No facility

Health Facility Assessment Sindh-2015-16: District Larkana Report 81 Availability at RHC District Larkana Diagnostics RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Record of Testing Results Blood Chemistry No No No No No (Glucose, Sodium, Potassium etc.) Liver Function Test (LFT) No No No No No Urinalysis No No No No No (Urine Detailed Report) Pregnancy Test No No No No No Parasitology/ Bacteriology/ Virology Use & Availability Light Microscope Yes No No Yes Yes Refrigerator in lab area No No No No No Incubator No No No No No Test Tubes No No No Yes No Centrifuge for CSF Microscopy No No No No No Culture Medium No No No No No Glass Slides & Covers Yes No No No Yes ELISA Machine No No No No No Malaria Test Onsite Malaria Testing Yes No No No Yes Use of Malaria Rapid Diagnostic Kit No No No No No (RTD) Availability of Training Manual Poster or Other Job aid for Use of No No No No No RTD Use & Availability Giemsa Stain Yes No No No Yes Field Stain No No No No No Gram Staining Gram Staining at facility No No No No No Use & Availability Crystal Violet or Gentian Violet No No No No No Lugol’s Iodine/Lugol’s solution No No No No No Acetone or Acetone Alcohol No No No No No Neutral Red, Carbol Fuchsin, or No No No No No other Counter stain Specimen Sent Out of Facility Gram Staining or Malaria Testing No No No No No out of Facility

82 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at RHC District Larkana Diagnostics RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Record of Tests Conducted Outside Gram Stain No No No No No Malaria No No No No No Specimen for Culture No No No No No Stool Microscopy Stool Microscopy at Facility No No No No No Use & Availability Formal Saline No No No No No (for concentration method) Normal Saline No No No No No (for direct microscopy) Lugol’s Iodine/Lugol’s Solution No No No No No Tuberculosis Onsite Tuberculosis Testing Yes No No Yes Yes Use & Availability Ziehl-Neelsen Test for AFB No No No No No Carbol-Fuchsin No No No No No Sulphuric Acid (20-25% No No No No No Concentration) or Acid Alcohol Methylene Blue No No No No No Microscope No No No No No Testing Availability of TB Rapid Diagnostic No No No No No Test Kit (RDT) Maintenance of Onsite Sputum Yes No No Yes Yes container Out of Facility Testing TB testing outside the facility No No No Yes No Maintenance of Sputum testing No No No Yes No Record Quality Control Internal or External Quality control Yes No No Yes Yes System of TB Sputum smears Type of Quality control Internal QC Only Yes No No Yes Yes External QC Only No No No No No Internal & External QC No No No No No Send Slide for Re-reading No No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 83 Availability at RHC District Larkana Diagnostics RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Maintenance of Record Maintenance of Quality Control Yes No No No No (Internal & external) Records Record for Internal QC Only Yes No No No No Record for External QC Only No No No No No Record for Both Internal & External No No No No No QC Diagnostic Imaging X-Ray Services Availability of Diagnostic X-Ray Yes No No No Yes Services Use & Availability Digital X-Ray Machine No No No No Yes (Not Requiring Film) X-Ray Machine Yes No No No Yes Portable X-Ray Machine No No No No No Unexpired Film for X-Ray Yes No No No Yes Diagnostic Ultrasound & ECG Availability of Ultrasound & ECG Yes No No No Yes Services Use & Availability Ultrasound Machine Yes No No No Yes Gel for Ultrasound Yes No No No Yes Printer for Ultrasound Yes No No No Yes ECG Machine Yes No No No Yes Paper roll for ECG Yes No No No Yes Tomography (CT) Availability of Diagnostic No No No No No Tomography Services Use & Availability CT Scan No No No No No Unexpired film for CT Scan No No No No No Standard Precaution for Diagnostic

Services Running Water (Piped, bucket with tap or pour Yes No No Yes Yes pitcher) Hand-washing Soap Yes No No Yes Yes (May be liquid Soap)

84 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at RHC District Larkana Diagnostics RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Alcohol-based Hand Rub No No No No No Waste Receptacle (Pedal bin) with No No No Yes Yes Lid and Plastic Bin Liner Other Waste Receptacle Yes No No No No Sharps Container (Safety Box) Yes No No Yes Yes Disposable Latex Gloves Yes No No Yes Yes Disinfectant (e.g; Chlorine, Hibitane, No No No No No Alcohol) Single-Use Standard Disposable Syringes with Needles Or auto Yes No No Yes Yes Disposable Syringes with Needle Medical Masks Yes No No Yes No Gowns Yes No No Yes No Eye Protection No No No No No (Goggles or Face Protection) Guidelines for Standard Precautions No No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 85 Domain V Infrastructure Assessment of Infrastructure

‘Good/No repair required’ means that the infrastructure is in good condition and does not require any type of repair to optimally perform its functions.

‘Minor repair’ includes small issues like whitewash, polish or paint work, broken hinges, locks, or handles, leakage of water pipes without gross seepage, mal-functioning electricity wires.

‘Major repair’ comprises of major issues requiring major plastering or concrete work, repair of major seepage like roof treatment, re-fixing of doors/windows panels, drainage treatment for major blockage, replacement required for parts of water and sewage pipes and electricity rewiring.

‘Under-construction’ means new construction for any building component is underway.

‘Non-availability’ means completely missing infrastructure component that is required as per the level of assessed health facility.

Table 19: Infrastructure at Rural Health Centers of District Larkana Status of infrastructure by type of RHC

Situation at RHC District Larkana Infrastructure Components RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Management/Admin Medical Superintendent Room Good Good Minor Good Good Senior Medical Officer Room NA Good Good Good Good Admin Staff Room NA Good NA NA Good MIS/Computer Room NA Good NA Good Good Casualty & Emergency Reception Area NA Good Good Good Good Male Ward/Area NA Good Good Good Good Female ward/Area NA Good Good Good Good Consultation Area NA Good Good Good Good Hand Washing Area NA Good Good Good NA Emergency Operation Theater (EOT) NA NA NA Good Good Scrub Room/Space NA NA NA Good Good Dressing & plaster room NA NA NA Good NA Nursing station/space NA NA NA NA Good Doctor/s room NA NA Good Good Good Medicine Store NA NA NA NA Good Out Patient Department OPD Good Consultation area Good Good Good Good Good Examination area Good Good Good Good Good Privacy of examination area Good Good NA Good NA

86 Health Facility Assessment Sindh-2015-16: District Larkana Report Situation at RHC District Larkana Infrastructure Components RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Scrub area Good Good Good Good Good OPD Minor Consultation area Good Good Good Good Good Examination area Good Good Good Good Good Privacy of examination area Good Good NA Good NA Scrub area NA Good Good Good Good OPD Major Consultation area NA Good Good Good Good Examination area NA Good Good Good Good Privacy of examination area NA Good NA Good Minor Scrub area NA Good Good Good Good OPD NA Consultation area NA Good NA NA Good Examination area NA Good NA NA Good Privacy of examination area NA Good NA NA Minor Scrub area NA Good NA NA Good Mini Laboratory Laboratory area NA NA Good Good Good Working area NA NA Good Good Good Patient Washroom NA NA NA NA Good LHV Room Consultation area NA Good Good Good Good Examination area NA Good Good Good Good Hand washing NA Good Good Good Good Operation Theater Operation Theater NA NA NA Good Good Recovery room NA NA NA NA Good Sterilization room NA NA NA Good Good Room for technical Staff NA NA NA Good Good Changing room NA NA NA Good Good Scrub area NA NA NA Good Good Surgeon office NA NA NA NA Good Dental Unit Consultation area NA Good NA Good Good Examination area NA Good NA Good Good Scrub area NA Good NA Good Good Medical Male Ward Ward area NA Good Good Good Good

Health Facility Assessment Sindh-2015-16: District Larkana Report 87 Situation at RHC District Larkana Infrastructure Components RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Nursing station NA Good NA NA Good Store for general items/drugs or NA Good NA Good Good equipment Patient Washroom NA Good Good Good Good Doctor/s room NA Good Good NA Good Medical Female Ward Ward area NA Good Good Good Good Nursing station NA Good NA NA Good Store for general items/drugs or NA Good NA Good Good equipment Patient Washroom NA Good Good Good Good Doctor/s room NA Good Good NA Good Miscellaneous Dispensary Good Good Good Good Good Medicine Store Good Good Minor Good Good General Store NA Good Minor Good Good Linen Store NA NA NA Good Good Garage for Ambulances NA NA Minor Good Good Kitchen / Pantry NA NA NA Minor NA Clean Utility/ Dirty Utility Area NA NA NA Good NA Residences MS Major Good Major NA Good SMO NA NA Major NA NA SWMO NA NA NA NA NA Gynecologist NA NA NA NA NA Anesthetist NA NA NA NA NA Pediatrician NA NA NA NA NA MO Major NA Major Major Good WMO NA Good NA Major Good LHV Major Good NA Major Good Dental Surgeon NA Good NA Major Good Nurses NA Good NA Major NA Lab Technician NA NA NA Major NA

88 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain VI Equipment Table 20: Equipment at Rural Health Centers of District Larkana Status of functional equipment, furniture, & fixtures in RHC

Availability at RHC District Larkana Equipment, Furniture & Fixtures RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero

Mini Laboratory Centrifuge (Bench Top) 0 0 0 0 0 Centrifuge Machine 0 0 0 1 1 Stop Watch 0 0 0 1 0 Refrigerator 0 0 5 1 4 X-ray Machine 0 0 1 1 1 Dark room accessories 0 0 0 1 1 X-ray films (All Size) 0 0 0 3 1 X-ray illuminator 0 0 0 1 1 Needle cutter/ Safety Boxes 1 0 2 2 10 ECG Machine 0 0 0 1 1 Laboratory Chemicals 0 0 3 0 10 Binocular Microscope 0 0 1 2 2 Urine meter (bag) 0 0 0 1 3 DLC Counter 0 0 0 0 0 Hemocytometer 0 0 0 1 0 ESR Racks 0 0 0 1 1 ESR Pipettes 0 0 0 2 5 Water Bath 0 0 0 1 1 Centrifuge Tubes (Plastic) 0 0 0 2 97 Centrifuge Tubes (Glass) 0 0 0 2 5 Glass Pipettes various sizes corrected 0 0 0 0 4 Jester Pipettes Fixed – various sizes 0 0 0 0 1 Jester Pipettes Adjustable – various sizes 0 0 0 0 1 Test tube 0 0 0 0 97 Test Tube Racks 0 0 0 0 1 Pipette Stands 0 0 0 2 2 Hemoglobinometer 0 0 1 2 2 Table lamp 0 0 0 1 1 Lancets (pack) 0 0 0 97 1 Beds 0 0 0 0 30 Tube Sealer 0 0 0 0 1 Blood grouping Viewing Box 0 0 0 0 1

Health Facility Assessment Sindh-2015-16: District Larkana Report 89 Availability at RHC District Larkana Equipment, Furniture & Fixtures RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Surgical Blades 0 0 0 0 15 Test Tube Holder 0 0 0 1 1 Baskets 0 0 0 0 0 Wooden Boxes 0 0 0 0 0 Hepatitis B & C and HIV AIDS Kits 0 0 0 0 1 Reagent 0 0 0 3 4 Gas Burner 0 0 0 0 0 Stainless Steel Test Tube Racks 0 0 0 1 1 Wooden Slides Box 0 0 0 1 0 Emergency Electric Sterilizer 0 2 4 1 1 Beds 0 2 4 8 5 Emergency OT light 0 0 0 0 1 Oxygen Cylinder with flow- meter 0 1 5 3 0 Ambu Bag (Pediatric) 1 1 0 1 1 Ambu Bag (Adult) 1 1 0 1 1 Suction Machine Heavy Duty 0 1 1 0 1 Laryngoscope with 4 blades (Adult & Peds) 0 0 0 0 2 Endotracheal tubes (all sizes) 0 0 0 0 1 Oral Air Way (all sizes) 0 0 0 0 1 Resuscitation Trolley 0 0 0 0 1 Nebulizer 1 1 0 1 3 Stethoscope 2 2 5 3 10 BP apparatus Mercury (Adult & Peds) 2 2 10 3 2 Dressing Set for Ward 0 2 2 0 3 Thermometer 2 1 2 0 2 Drip stands 1 3 3 9 6 Instrument Trolley 0 0 2 2 2 LHV/ Labor Room Delivery table (Labor Room) 1 1 1 1 2 Delivery set (each contain) 1 1 1 0 3 Partogram 0 1 0 0 1 Kocher Clamp 6 inch 0 0 0 0 2 Plain Scissors 1 2 3 12 4 Tooth Forceps 1 2 2 3 3 1 Kidney Tray 1 1 2 3 6

90 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at RHC District Larkana Equipment, Furniture & Fixtures RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Needle Holder 7 inch 3 2 2 17 4 Medium size Bowl 1 2 2 0 5 Outlet Forceps 8 inch 1 1 1 0 1 D & C set (each Contain) Metallic Catheter 1 2 1 1 2 Uterine Sound 1 1 1 1 1 Sim’s Speculum medium 2 1 1 1 2 Set D&E Sponge Holders 1 1 2 1 2 Hagar’s Dilator 0-8 cm 0 1 2 1 3 Kidney Tray 0 1 2 1 6 Bowl 4 inch 0 1 4 1 4 Vulsellum 8 inch 0 1 1 1 1 Set Uterine Curette 1 1 3 1 2 Plain Forceps 8 inch 0 3 2 1 1 Caesarean Section Set (each Contain) Doven’s retractor 0 0 0 0 2 Green Army tag 0 0 0 0 0 Big Bowl 0 0 0 0 1 Cord Clamp 7 inch 0 0 0 0 20 Kocher Clamp Straight 8 inch 0 0 0 0 1 Kocher Clamp Curved 8 inch 0 0 0 0 1 Towel Clip 0 0 0 0 2 Artery Forceps 6 inch 0 0 0 0 3 Allis Tissue Forceps 8 inch 0 0 0 0 1 Needle Holder 8 inch 0 0 0 0 3 Needle Holder 6 inch 0 0 0 0 3 Kidney Tray 0 0 0 0 6 Bowl 4 inch 0 0 0 0 4 Vulsellum 8 inch 0 0 0 0 1 Knife Holder 4 number 0 0 0 0 2 Plain Forceps 7 inch 0 0 0 0 3 Tooth Forceps 7 inch 0 0 0 0 3 Curve Scissors 0 0 0 0 3 Thread Cutting Scissors 0 0 0 0 4 Sponge Holder 10 inch 0 0 0 0 2 Vacuum Suction Apparatus 0 0 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 91 Availability at RHC District Larkana Equipment, Furniture & Fixtures RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Baby Resuscitation Apparatus 0 0 0 0 0 Adult weighing scale 0 0 0 0 2 Electric Suction Machine 0 0 0 0 1 Autoclave 0 0 0 0 3 Fetal Heart Detector 0 0 0 0 1 Obs/Gyne: General Set 0 0 0 0 1 Dressing Set for Ward 0 0 0 0 2 Eclampsia beds with railing 0 0 0 0 2 Baby Intubation set 0 0 0 0 2 Examination Couch 0 0 0 0 2 Mucus Extractor 0 0 0 0 1 Neonatal Resuscitation Trolley 0 0 0 0 2 Inpatient (Beds/Wards) Bed with side table/locker 1 3 0 0 20 Electric Suction Machine 0 1 1 3 3 Electric Sterilizer 0 1 1 0 1 Oxygen Cylinder with flow-meter and Stand 1 1 3 1 1 Stretchers 1 1 1 2 3 Examination Couch 0 1 6 0 6 Wheel Chair 1 1 6 1 2 Patient Screen 0 0 0 0 4 Air Ways 0 0 0 0 2 Suction Pump (Manual) 0 0 0 0 0 Drip Stand 1 4 0 4 5 Operation Theater Hydraulic Operation Table OT Light 0 0 0 0 2 (Shadow less Lamps with 9 Illuminators) 0 0 0 1 2 Anesthesia machine with ventilator 0 0 0 0 0 Multi-parameter 0 0 0 0 0 McGill forceps 0 0 0 0 1 Patient Trolley 0 0 0 0 2 Oxygen Cylinder (large size with regulator) 0 0 0 1 1 Oxygen Cylinder (medium size with 0 0 0 1 1 regulator) Nitrous oxide cylinder with regulator 0 0 0 0 0 Instruments trolley 0 0 0 1 2

92 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at RHC District Larkana Equipment, Furniture & Fixtures RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Dressing Drum (large size) 0 0 0 2 6 Stands for Dressing 0 0 0 1 2 Basin 0 0 0 1 1 Basin stands 0 0 0 1 1 Towel Clips 0 0 0 2 2 BP handle 0 0 0 0 1 BP Blades 0 0 0 0 1 Dissecting Forceps (Plain) 0 0 0 1 4 Needle Holder (Large size) 0 0 0 4 3 Sponge Holder Forceps (large size) 0 0 0 0 2 Skin Retractor (small size) 0 0 0 0 2 Metallic Catheter (1-12) 0 0 0 1 2 Dilator Complete Set 0 0 0 0 1 Surgical Scissors (various size) 0 0 0 6 4 Proctoscope 0 0 0 1 1 Thames Splint V.S 0 0 0 0 0 Rubber Sheet 0 0 0 0 3 Scalpels 6” 0 0 0 0 1 Allis Forceps Long 0 0 0 4 1 Allis Forceps 6 inches 0 0 0 3 1 Cheatle Sterilize Forceps 10:long 0 0 0 2 1 Introducer for Catheter 0 0 0 0 1 Smith Homeostatic Forceps Curved 0 0 0 5 1 Arm Splint different sizes 0 0 0 0 1 Instrument Cabinet Large size 0 0 0 1 1 Spot Light 0 0 0 1 2 Hand Scrub set with chemical 0 0 0 0 6 Thermometer 0 0 0 0 2 Laryngoscope adult/peds 0 0 0 0 4 Kidney Tray S.S 0 0 0 2 6 Stand for Drip 0 0 0 1 5 Bucket 0 0 0 0 10 Air Cushion (Rubber) 0 0 0 0 3 Gastric Tube 0 0 0 0 1 Urine Collection Bags instrument trolley 0 0 0 0 1 Air-Conditioner (split 1.5 tons) 0 0 0 1 2

Health Facility Assessment Sindh-2015-16: District Larkana Report 93 Availability at RHC District Larkana Equipment, Furniture & Fixtures RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Ambulance 0 2 0 2 1 Generator 0 0 0 0 1 Dental Unit Chair 0 3 0 0 1 Light 0 0 0 0 1 Hand piece unit 0 1 0 0 1 Suction 0 0 0 0 1 Compressor 0 0 0 0 1 Dental hand instruments (set) 0 1 0 0 2 Aseptic Trolley 0 1 0 0 1 Dental Autoclave 0 0 0 0 1 Amalgamator 0 0 0 0 0 Dental X-ray unit 0 0 0 0 1 Intraoral X-ray film Processor 0 0 0 0 1 X-ray view box 0 0 0 0 0 Lead apron 0 0 0 0 0 Ultrasonic Scalar 0 0 0 0 1 Dental Operating stool 0 1 0 0 1 Ultraviolet sterilizer 0 1 0 0 0 Miscellaneous Office tables 3 1 12 0 1 Officer Chairs 11 3 30 0 5 Iron bench 0 0 0 0 0 Steel Almirah 2 0 2 0 1 Wooden File Racks 1 1 1 0 1 Four Seater Chairs 5 0 2 0 1

94 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain VII Drugs & Supplies Table 21: Medicines & Supplies at Rural Health Centers of District Larkana Status of Drugs & Supplies by type of RHC

Availability at RHC District Larkana Drugs & Supplies RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero

Anesthetics Local Lidocaine (Vial) No No Yes Yes No Lidocaine (Topical) Yes No Yes No Yes Inj. Lignocaine + Epinephrine Yes No No No Yes Inj. Lignocaine + Epinephrine (Dental) No Yes No No Yes Analgesics(Opioid/Central Acting) Morphine (Ampule) No No No No No Pethidine (Ampule) No No No No No Analgesics (NSAIDS) Tab. Acetylsalicylic Acid No No No No No Tab. Mefenamic Acid Yes Yes Yes Yes Yes Mefenamic Acid (Suspension) Yes Yes No Yes Yes Tab. Diclofenac Yes Yes Yes Yes Yes Diclofenac (Ampule) Yes Yes Yes No Yes Tab. Ibuprofen No Yes Yes Yes Yes Syp. Ibuprofen No Yes Yes Yes No Tab. Paracetamol Yes Yes Yes Yes Yes Syp. Paracetamol No Yes Yes No No Inj. Paracetamol No No No No No Paracetamol (Suppository) No Yes Yes No No Anti-Allergics (Anaphylaxis) Tab. Chlorpheniramine Yes Yes Yes Yes Yes Inj. Chlorpheniramine Yes Yes Yes Yes Yes Syp. Chlorpheniramine Yes Yes Yes No Yes Tab. Loratadine No Yes Yes No Yes Syp. Loratadine No Yes Yes No No Inj. Dexamethasone Yes Yes Yes Yes Yes Tab. Dexamethasone No No No No No Epinephrine (Ampule) No No No No No Inj. Hydrocortisone No Yes No Yes No Tab. Prednisolone No No No No No Antidotes and other substances used in poisoning Atropine (Ampule) No No No Yes No Charcoal Activated (Powder) No No Yes No No Inj. Diazepam Yes No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 95 Availability at RHC District Larkana Drugs & Supplies RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Methylene Blue (Ampule) No No Yes No No Naloxone (Ampule) No No No No No Anti-Epileptics/Anticonvulsants Tab. Carbamazepine No No No No No Syp. Carbamazepine No No No No No Inj. Magnesium Sulphate Yes No No No No Tab. Phenobarbital No No No No No Inj. Phenobarbital No No No No No Tab. Phenytoin No No No No No Antibiotics/Antimicrobial Tab./Cap. Amoxicillin No Yes Yes Yes Yes Syp. Amoxicillin (Powder For Suspension) No Yes Yes No No Inj. Amoxicillin No Yes No No No Cap. Ampicillin No Yes No No Yes Ampicillin (Powder For Suspension) Yes Yes Yes Yes Yes Inj. Ampicillin No Yes Yes Yes Yes Inj. Benzathine Penicillin Yes Yes Yes No Yes Cap. Cefixime No No No No No Cap. Chloramphenicol No No No No No Syp. Chloramphenicol No No No No No Inj. Chloramphenicol No No No No No Tab. Ciprofloxacin No Yes Yes Yes Yes Cap. Azithromycin No Yes No No No Azithromycin (Suspension) No No No No No Tab. Cotrimoxazole No Yes Yes No Yes Syp. Cotrimoxazole No Yes Yes Yes Yes Cap. Doxycycline No Yes Yes Yes Yes Inj. Gentamicin Yes Yes Yes Yes Yes Tab. Metronidazole No Yes Yes No No Inj. Metronidazole Yes Yes Yes No Yes Syp. Metronidazole Yes Yes No No Yes Tab. Nitrofurantoin No No No No No Inj. Procaine Benzylpenicillin Yes Yes Yes No No Tab. Phenoxymethylpenicillin No No No No No Syp. Phenoxymethylpenicillin No No No No No Anti-Helminthic Tab. Albendazole No Yes No No No Syp. Albendazole No Yes No No Yes

96 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at RHC District Larkana Drugs & Supplies RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Tab. Mebendazole Yes Yes No No No Tab. Pyrantel No No No No No Syp. Pyrantel No No No No No Anti-Fungal Clotrimazole (Vaginal Cream) No No No Yes No Clotrimazole (Vaginal Tablet) No No No No No Clotrimazole (Topical Cream) No No No No No Tab. Nystatin No No No No No Nystatin (Drops) No No No No No Nystatin (Pessary) No No No No No Anti-Tuberculosis Drugs Tab. Ethambutol No No Yes Yes No Ethambutol (Oral Liquid) No No Yes Yes No Tab. Isoniazid No No Yes Yes No Syp. Isoniazid No No No No No Tab. Pyrazinamide No No Yes Yes No Cap. Rifampicin No No Yes Yes No Syp. Rifampicin No No No No No Inj. Streptomycin No No Yes Yes Yes Tab. Ethambutol + Isoniazid No No Yes Yes No Tab. Isoniazid + Rifampicin No No Yes Yes Yes Tab. Isoniazid + Pyrazinamide + Rifampicin No No Yes Yes No Tab. Rifampicin + Isoniazid + Pyrazinamide + No No Yes Yes Yes Ethambutol Tab. Ethambutol + Isoniazid + Rifampicin No No Yes Yes Yes Anti-Diabetics Tab. Glibenclamide No Yes No No No Tab. Metformin Yes No Yes Yes Yes Inj. Insulin Regular No No No No Yes Inj. Insulin Comp No No No No No Anti-Malarial Tab. Choloroquine No Yes No Yes Yes Tab. Primaquine No No No No Yes Tab. Sulfadoxine + Pyrimethamine No No No No Yes Tab. Artesunate + Sulfadoxine + No No No No No Pyrimethamine Tab. Artesunate + Sulfadoxine And No No No No No Pyrimethamine Artemether (Ampule) No No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 97 Availability at RHC District Larkana Drugs & Supplies RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero GIT Medicines Inj. Hyoscine No No No No No Tab. Hyoscine No No No No No Tab. Phloroglucinol No No No No No Tab. Metoclopramide No No No No No Syp. Metoclopramide No No No No No Inj. Metoclopramide No Yes No No No Cap. Omeprazole No Yes Yes Yes Yes Inj. Ranitidine No No No No No Tab. Ranitidine No Yes No No No Tab. Aluminium Hydroxide + Magnesium No Yes No Yes No Trisilicate Ors (Sachet) Yes Yes Yes Yes Yes Tab. Bisacodyl No No No No No Glycerin (Suppository) No No Yes No No Cardiovascular Medicines Glyceryl Trinitrate (Sublingual) No No No No No Isosorbide Dinitrate (Sublingual) No No No No No Tab. Enalapril No No No No No Tab. Atenolol Yes Yes Yes Yes Yes Tab. Methyldopa No No No No No Inj. Methyldopa No No No No No Tab. Hydrochlorothiazide No No No No No Inj. Hydrochlorothiazide No No No No No Tab. Furosemide Yes Yes Yes Yes Yes Inj. Furosemide Yes Yes No Yes Yes Tab. Amlodipine No Yes No No No Medicines Affecting Coagulation Inj. Tranexamic Acid Yes No No No No Cap. Tranexamic Acid Yes Yes Yes Yes Yes Oxytocic Medicines Inj. Ergometrine No No No No No Tab. Misoprostol No No No No No Inj. Oxytocin Yes Yes Yes No No Respiratory Medicines Tab. Salbutamol No Yes Yes Yes Yes Salbutamol (Inhaler) No No No No No

98 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at RHC District Larkana Drugs & Supplies RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Ammonium Chloride+ Chloroform + Menthol + Diphenhydramine + Sodium Citrate No Yes Yes No Yes (Antitussive Expectorant) Inj. Aminophylline No Yes No Yes Yes Ophthalmic Medicines Chloramphenicol (Eye Drops) No Yes Yes No Yes Ciprofloxacin (Eye Drops) No No Yes No No Tetracycline (Eye Ointment) Yes No Yes No Yes ENT Medicines Boroglycerine (Ear Drops) No No Yes No Yes Polymyxin B + Lignocaine (Ear Drops) No No No No No Ciprofloxacin (Ear Drops) No No No No No Xylometazoline (Nasal Drops) No No No No No IV Infusions (Plasma Substitutes) Plasma Expander (Infusion) No No No No No Glucose/Dextrose (Infusion) Yes No Yes Yes Yes Glucose/Dextrose (Ampule) No No Yes No No Normal Saline (Infusion) Yes Yes Yes Yes No Dextrose + Saline (Infusion) Yes Yes Yes Yes Yes Ringer’s Lactate (Infusion) Yes Yes Yes Yes Yes Potassium Chloride (Solution) No No No No No Inj. Sodium Bicarbonate No No No No No Water For Injection (Ampule) Yes Yes Yes Yes Yes Vitamins and Minerals Tab. Ascorbic Acid No No No No No Inj. Calcium Gluconate No No No No No Tab. Calcium Lactate No No No No No Inj. Calcium Chloride No No No No No Tab. Ergocalciferol (Vit. D) No No Yes No No Tab. Ferrous Salt No No Yes No No Syp. Ferrous Salt No No Yes No No Tab. Folic Acid No Yes Yes No No Tab. Ferrous Salt + Folic Acid No No Yes No No Inj. Vitamin K No Yes No No No Multiple Micronutrients (Sachet) No No No No No Tab./Cap. Retinol (Vitamin A) Yes No Yes No No Tab. Zinc Sulphate Yes No No No No Tab. B Complex (B1, B6 And B12) Yes Yes Yes No Yes Tab. Multivitamins No Yes Yes Yes Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 99 Availability at RHC District Larkana Drugs & Supplies RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Dermatologicals Benzyl Benzoate Lotion No Yes Yes Yes No Permethrin Cream/Lotion No No No No Yes Calamine Lotion No No No No No Coal tar Lotion No No No No No Clobetasol Cream No No No No No Hydrocortisone Cream No No No No No Polymyxin B + Bacitracin Zinc (Ointment) No No No Yes No Silver Sulfadiazine Cream No No No No No Anxiolytics Tab. Alprazolam Yes Yes No Yes Yes Tab. Diazepam No No No No No Contraceptives Condoms Yes Yes Yes Yes Yes Ethinylestradiol + Norethisterone (Combined Yes No Yes Yes Yes Oral Pills) Progesterone Only Pills (Levonorgestrel) No No Yes No No Emergency Contraceptive Pills No Yes Yes No No (Levonorgestrel) IUCD (Copper T/Multiload) Yes Yes Yes Yes Yes Inj. Medroxyprogesterone Acetate (Dmpa) No Yes No No Yes Inj. Norethisterone Enanthate (Net-En) No No No No No Inj. Estradiol Cypionate + No No No No No Medroxyprogesterone Acetate Levonorgestrel-Releasing Implant (Subdermal) No Yes No No No Etonogestrel-Releasing Implant (Subdermal) No No No No No Vaccines and Sera BCG Vaccine No Yes Yes Yes Yes Oral Polio Vaccine Yes Yes Yes Yes Yes Injectable Polio Vaccine No No Yes No Yes Hepatitis B Vaccine No No No No Yes Measles Vaccine No Yes Yes Yes Yes Tetanus Toxoid Yes Yes Yes Yes Yes Pentavalent Vaccine Yes Yes Yes Yes Yes Pneumococcal Vaccine No Yes Yes Yes Yes Anti-Rabies Vaccines (PVRV) No No No No No Anti-Snake Venom Serum No No No Yes Yes Antiseptics/ Disinfectants Povidone-Iodine (Solution) No Yes Yes No No

100 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at RHC District Larkana Drugs & Supplies RHC RHC Garhi RHC RHC RHC Banguldero Khuda Bux Gerelo Badah Naudero Halogenated Natrium Phosphate (Powder) No No No No No Chlorine Base Compound (Powder) No No No No No Chlorhexidine + Cetrimide (Powder) No No No No No Chlorhexidine Digluconate (7.1%) For Cord No No No No No Care (Gel) Disposable Supplies Syringe (Auto disable) No Yes Yes Yes No Disposable Syringe Yes Yes Yes Yes Yes IV Set Yes Yes Yes Yes Yes Scalp Vein Set No No No No No Volumetric Chamber (Iv Burette) Yes No No No No IV Cannula Yes Yes Yes No No Adhesive Tape Yes Yes Yes No Yes Sterile Gauze Dressing No Yes No No No Cotton Bandage Yes Yes Yes Yes Yes Absorbent Cotton Wool No No Yes No No Crepe Bandage No No No No No Examination Gloves Yes Yes Yes Yes No Sterile Surgical Gloves No Yes Yes Yes No Silk Sutures Sterile Yes No Yes Yes Yes Chromic Catgut Sterile Sutures No No No No No Face Mask Disposable Yes Yes No Yes Yes Blood Lancets No No No Yes Yes Slides No No Yes Yes Yes Endotracheal Tube No No No No No Nasogastric Tube No No No No No Resuscitator Bag With Mask No No No No No Disposable Airways No No No No No Clean Delivery Kits No No Yes Yes Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 101 Database of Basic Health Units This database provides complete and comprehensive results of all the areas assessed in each of the 27 Basic Health Units of District Larkana. This database includes all the seven domains (up to the level of components and sub-components/items). Domain I Basic Amenities

Key:

Yes Available No Not Available - Not Applicable

Table 22: Basic Amenities at Basic Health Units of District Larkana Status of Basic Amenities by type of BHUs

Availability at Basic Health Units District Larkana

Basic Amenities

Pur Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU BHU Dhamrah BHU

Type of Communication

Functional landline telephone or vfone Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes No Functional facility owned/supported No No No No No No No No No No No No No cellular phone Source of Water Improved source of water inside facility Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Improved source of water within 500 No No No No No No No No No No No No No meters of facility Water source beyond 500 meters of No No No No No No No No No No No No No facility Power Supply Supply from Electricity Grid (WAPDA) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

102 Health Facility Assessment Sindh -2015-16: District Larkana Report 10 2 Availability at Basic Health Units District Larkana

Basic Amenities

Pur Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU BHU Dhamrah BHU Fuel operated Generator Yes No No Yes No No No No No No No No No Solar System No No No No No No No No No No No No No UPS Yes No No Yes No No No No No No No No No POL for Fuel operated Generator Yes No No No No No No No No No No No No Client Latrines Functional client latrine in outpatient Yes No Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes services area Separate latrine for female clients Yes No Yes Yes Yes No Yes Yes No No Yes Yes No Ambulance Service Functional ambulance at the facility Yes No No Yes No No No No No No No No No Linkage with functional ambulance at No No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes other facility or community POL for ambulance Yes No No Yes No No No No No No No No No Components of Facility Cleanliness Cleanliness of floors Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Cleanliness of counters, tables and Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes chairs Proper storage of sharp waste Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Maintained sharp storage boxes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Proper storage of medical waste (non- Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes sharps)

Health Facility Assessment Sindh-2015-16: District Larkana Report 103 Availability at Basic Health Units District Larkan

-

Basic Amenities jo

-

Machi

Gud BHU BHU Jatoi Daro abad Deero Sanghi BHUtto BHUtto kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU Masodero BHU Sajan Sajan BHU BHU Waris Waris BHU BHU Seehar BHU BHU Pir Bux Pir Bux BHU Usman BHU Dino BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU BHU Moen BHU

Type of Communication

Functional landline telephone or vfone No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes

Functional facility owned/supported No No No No No No No No No No No No No No cellular phone Source of Water Improved source of water inside facility Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Improved source of water within 500 No No No No No No No No No No No No No No meters of facility Water source beyond 500 meters of No No No No No No No No No No No No No No facility Power Supply Supply from Electricity Grid (WAPDA) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Fuel operated Generator No No Yes No No No No No No No No No No No Solar System No No No No No No No No No No No Yes No No UPS No No Yes No No No No No No No No No No No POL for Fuel operated Generator No No Yes No No No No No No No No No No No Client Latrines Functional client latrine in outpatient Yes Yes Yes No Yes Yes Yes No Yes No Yes Yes Yes No services area Separate latrine for female clients Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No

104 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at Basic Health Units District Larkan

-

Basic Amenities jo

-

Machi

Gud BHU BHU Jatoi Daro abad Deero Sanghi BHUtto BHUtto kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU Masodero BHU Sajan Sajan BHU BHU Waris Waris BHU BHU Seehar BHU BHU Pir Bux Pir Bux BHU Usman BHU Dino BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU BHU Moen BHU Ambulance Service Functional ambulance at the facility No No Yes No No No No No No No No No No No Linkage with functional ambulance at Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No other facility or community POL for ambulance No No Yes No No No No No No No No No No No Components of Facility Cleanliness Cleanliness of floors Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Cleanliness of counters, tables and Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes chairs Proper storage of sharp waste Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Maintained sharp storage boxes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Proper storage of medical waste (non- Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes sharps)

Health Facility Assessment Sindh-2015-16: District Larkana Report 105 Domain II Facility Management Table 23: Facility Management at Basic Health Units of District Larkana Status of Facility Management activities by type of BHUs

Availability at BHU

District Larkana

Facility Management

Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU BHU Dhamrah BHU BHU Fateh Pur Fateh BHU

External Supervision

Visit during last 1 month Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Visit during last 2-3 months No No No No No No No No No No No No No

Visit during last 4-6 months No No No No No No No No No No No No No

Visit more than 6 months No No No No No No No No No No No No No

External Supervisory Activities

Use of checklist for Data Quality Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Using smartphone application based checklist Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Signatures on registers Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Report/Feedback Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Discussion on staff performance Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Supporting staff in decision-making based on Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes data

Management Meetings of Staff

Meeting during last 1 month Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Meeting during last 2-3 months No No No No No No No No No No No No No

106 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

Facility Management

Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU BHU Dhamrah BHU BHU Fateh Pur Fateh BHU

Meeting during last 4-6 months No No No No No No No No No No No No No

Meeting more than 6 months No No No No No No No No No No No No No

Agenda Items of Management Meetings

DHIS Data Quality No No No No No No Yes No Yes No No No No

DHIS Reporting Yes No No Yes Yes No Yes Yes No Yes Yes Yes No

Timeliness of DHIS Reporting No No No No No Yes No No No No No No No

Quality of Services No No No No No No Yes No No Yes No Yes No

Service Utilization No No No No Yes No No No No No No No No

Diseases Data No No No No No Yes No No No No No No Yes

Employment Conditions No No Yes Yes Yes No No Yes Yes No Yes No No

Finance/Budget No No No No No No No No No No No No No

Maintenance of Record Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Decision-making Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Follow-up of decisions Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Meetings of Staff with Community

Meeting during last 1 month Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Meeting during last 2-3 months No No No No No No No No No No No No No

Meeting during last 4-6 months No No No No No No No No No No No No No

Meeting more than 6 months No No No No No No No No No No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 107 Availability at BHU

District Larkana

Facility Management

Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU BHU Dhamrah BHU BHU Fateh Pur Fateh BHU

Method for Client Opinion/Feedback

Complaint Box Yes Yes Yes No Yes Yes Yes No Yes Yes Yes Yes Yes

Client Survey Form No No No No No No No No No No No No No

Client Interview Form No No No No No No No No No No No Yes No

Official meeting with community No No No No No No No No No No No No No

Informal Discussions No Yes No Yes No No Yes Yes Yes No No No Yes

Email No No No No No No No No No No No No No

DOH Sindh’s Website No No No No No No No No No No No No No

Letter from clients No No No No No No No No No No No No No

Toll Free Number No No No No No No Yes No No No No No No

Review of Client Opinion/Feedback Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Quality Assurance Activities

Activities Performed Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Record Maintained Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

User Fees

User fees charged No No No Yes No No No No No No No No No

Posting/Display of user fees No No No Yes No No No No No No No No No

Supporting Procedures for Non-Affording

Exemption/Discount No No No Yes No No No No No No No No No

108 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

Facility Management

Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU BHU Dhamrah BHU BHU Fateh Pur Fateh BHU

Fees expected later No No No No No No No No No No No No No

In-kind Payment No No No No No No No No No No No No No

Revisit when have money No No No No No No No No No No No No No

Services not provided/Other No No No No No No No No No No No No No

DHIS Components

DHIS In-Place Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Compilation of DHIS Reports Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes

Monthly Reporting Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Dedicated Data Manager or Focal Person Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Availability of DHIS Tools

Central Registration Point Register No No No No No No No No No No No No No

OPD Ticket Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Medicine Requisition Slip Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes

Outpatient Department Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

OPD Abstract Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Laboratory Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Radiology/Ultrasonography/CT Scan/ECG Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Register Indoor Patient Register No No No No No No No No No No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 109 Availability at BHU

District Larkana

Facility Management

Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU BHU Dhamrah BHU BHU Fateh Pur Fateh BHU

Indoor Abstract Form No No No No No No No No No No No No No

Daily Bed Statement Register No No No No No No No No No No No No No

Operation Theater (OT) Register No No No No No No No No No No No No No

Family Planning Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Family Planning Card Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Maternal Health Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Antenatal Card Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Obstetric Register Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Daily Medicine Expense Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Stock Register (Medicine/Supplies) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Stock Register (Facility Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Management/Furniture/Linen) Community Meeting Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Facility Staff Meeting Register Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Secondary Facility Report Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Catchment Area Population Chart Yes Yes No No Yes No Yes Yes No Yes Yes Yes No

Procedures Manual for DHIS No Yes Yes Yes Yes No Yes No No Yes Yes Yes No

LQAS Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

110 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

Facility Management

Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU BHU Dhamrah BHU BHU Fateh Pur Fateh BHU

Maintenance of DHIS Tools

Central Registration Point Register No No No No No No No No No No No No No

Medicine Requisition Slip Yes No Yes No No Yes Yes Yes Yes Yes Yes Yes Yes

Outpatient Department Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

OPD Abstract Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Laboratory Register Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Radiology/Ultrasonography/CT Scan/ECG Yes No Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Register

Indoor Patient Register No No No No No No No No No No No No No

Indoor Abstract Form No No No No No No No No No No No No No

Daily Bed Statement Register No No No No No No No No No No No No No

Operation Theater (OT) Register No No No No No No No No No No No No No

Family Planning Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Maternal Health Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Obstetric Register Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Daily Medicine Expense Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Stock Register (Medicine/Supplies) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Stock Register (Facility Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Management/Furniture/Linen) Community Meeting Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 111 Availability at BHU

District Larkana

Facility Management

Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU BHU Dhamrah BHU BHU Fateh Pur Fateh BHU

Facility Staff Meeting Register Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Secondary Facility Report Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Catchment Area Population Chart Yes No No No No No Yes Yes No Yes No Yes No

LQAS Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Infection Control

Processing of Facility Management Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

On-site Processing Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Guidelines for Equipment Processing Yes No Yes Yes Yes No Yes No Yes Yes Yes Yes Yes

Use & Availability/ Processing of Facility

Management Electric Autoclave No No No Yes No No No No No No No No Yes n-Electric Autoclave No No No No No No No No No No No No No

Electric Dry Heat Sterilizer No No No No No No No No No No No No No

Electric Boiler/Steamer Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes No n-Electric Boiler/Steamer No No No No No No No No No No No No No

Chemical HLD Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Sharps Waste Management

Burning in Incinerator: 2-chamber industrial No No No No No No No No No No No No No Burning in Incinerator: 1-chamber drum/brick No No No No No No No No No No No No No (n-industrial)

112 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

Facility Management

Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU BHU Dhamrah BHU BHU Fateh Pur Fateh BHU

Open burning: Flat ground- protection No No No No No No No No No No No No No

Open burning: Pit or protected ground Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Dump without burning: Flat ground- protection No No No No No No No No No No No No No

Dump without burning: Covered pit or pit latrine No No No No No No No No No No No No No

Dump without burning: Open pit- protection No No No No No No No No No No No No No

Dump without burning: Protected ground or pit No No No No No No No No No No No No No

Remove offsite: Stored in covered container No No No No No No No No No No No No No Remove offsite: Stored in other protected No No No No No No No No No No No No No environment Remove offsite: Stored unprotected No No No No No No No No No No No No No

Medical Waste Management

Burning in Incinerator: 2-chamber industrial No No No No No No No No No No No No No Burning in Incinerator: 1-chamber drum/brick No No No No No No No No No No No No No (n-industrial) Open burning: Flat ground- protection No No No No No No No No No No No No No

Open burning: Pit or protected ground Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Dump without burning: Flat ground- protection No No No No No No No No No No No No No

Dump without burning: Covered pit or pit latrine No No No No No No No No No No No No No

Dump without burning: Open pit- protection No No No No No No No No No No No No No

Dump without burning: Protected ground or pit No No No No No No No No No No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 113 Availability at BHU

District Larkana

Facility Management

Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU BHU Dhamrah BHU BHU Fateh Pur Fateh BHU

Remove offsite: Stored in covered container No No No No No No No No No No No No No

Remove offsite: Stored in other protected No No No No No No No No No No No No No environment Remove offsite: Stored unprotected No No No No No No No No No No No No No

Availability of Guidelines

Availability of Guidelines No No No No No No No No No No No No No

POL For Incinerator

Availability of POL No No No No No No No No No No No No No

Sufficiency of Budget No No No No No No No No No No No No No

114 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

-

jo

- Facility Management

BHU BHU Jatoi Daro abad Deero Sanghi BHUtto BHUtto kalhoro BHU Shah Shah BHU BHU Sono Sono BHU Masodero BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU BHU New Gud New BHU BHU Moen BHU External Supervision

Visit during last 1 month Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Visit during last 2-3 months No No No No No No No No No No No No No No

Visit during last 4-6 months No No No No No No No No No No No No No No

Visit more than 6 months No No No No No No No No No No No No No No

External Supervisory Activities

Use of checklist for Data Quality Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Using smartphone application based checklist Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Signatures on registers Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Report/Feedback Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Discussion on staff performance Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Supporting staff in decision-making based on data Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Management Meetings of Staff

Meeting during last 1 month Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes

Meeting during last 2-3 months No No No No No No No No No No Yes No No No

Meeting during last 4-6 months No No No No No No No No No No No No No No

Meeting more than 6 months No No No No No No No No No No No No No No

Agenda Items of Management Meetings

DHIS Data Quality No No No No No No No No No No No No No No

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BHU BHU Jatoi Daro abad Deero Sanghi BHUtto BHUtto kalhoro BHU Shah Shah BHU BHU Sono Sono BHU Masodero BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU BHU New Gud New BHU BHU Moen BHU DHIS Reporting Yes Yes No Yes No Yes Yes No No Yes No No Yes Yes

Timeliness of DHIS Reporting No No No No No No No No No No No No No No

Quality of Services No No No No No No Yes Yes No No Yes No No No

Service Utilization No No No No No No No No No Yes No Yes Yes No

Diseases Data No No No No No No Yes Yes No No Yes Yes No No

Employment Conditions No Yes Yes Yes Yes Yes No Yes Yes No No No No Yes

Finance/Budget No No No No No No No No No No No No No No

Maintenance of Record Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Decision-making Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Follow-up of decisions Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Meetings of Staff with Community

Meeting during last 1 month Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Meeting during last 2-3 months No No No No No No No No No No No No No No

Meeting during last 4-6 months No No No No No No No No No No No No No No

Meeting more than 6 months No No No No No No No No No No No No No No

Method for Client Opinion/Feedback

Complaint Box Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Yes No

Client Survey Form No No No No No No No No No No No No No No

Client Interview Form No No No No No No No No No No No No No No

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BHU BHU Jatoi Daro abad Deero Sanghi BHUtto BHUtto kalhoro BHU Shah Shah BHU BHU Sono Sono BHU Masodero BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU BHU New Gud New BHU BHU Moen BHU Official meeting with community No No No No No No No No No No No No No No

Informal Discussions No No No No Yes No No Yes No Yes No No No Yes

Email No No No No No No No No No No No No No No

DOH Sindh’s Website No No No No No No No No No No No No No No

Letter from clients No No No No No No No No No No No No No No

Toll Free Number No No No No No No No Yes No No Yes Yes No No

Review of Client Opinion/Feedback Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes

Quality Assurance Activities

Activities Performed Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Record Maintained Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

User Fees

User fees charged No No No Yes No No No No No No No No No No

Posting/Display of user fees No No No Yes No No No No No No No No No No

Supporting Procedures for Non-Affording

Exemption/Discount No No No Yes No No No No No No No No No No

Fees expected later No No No No No No No No No No No No No No

In-kind Payment No No No No No No No No No No No No No No

Revisit when have money No No No No No No No No No No No No No No

Services not provided/Other No No No No No No No No No No No No No No

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BHU BHU Jatoi Daro abad Deero Sanghi BHUtto BHUtto kalhoro BHU Shah Shah BHU BHU Sono Sono BHU Masodero BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU BHU New Gud New BHU BHU Moen BHU DHIS Components

DHIS In-Place Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Compilation of DHIS Reports Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Monthly Reporting Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Dedicated Data Manager or Focal Person Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Availability of DHIS Tools

Central Registration Point Register No No No No No No No No No No No No No No

OPD Ticket Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Medicine Requisition Slip Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Outpatient Department Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

OPD Abstract Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Laboratory Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Radiology/Ultrasonography/CT Scan/ECG Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No

Indoor Patient Register No No No No No No No No No No No No No No

Indoor Abstract Form No No No No No No No No No No No No No No

Daily Bed Statement Register No No No No No No No No No No No No No No

Operation Theater (OT) Register No No No No No No No No No No Yes No No No

Family Planning Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Family Planning Card Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

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BHU BHU Jatoi Daro abad Deero Sanghi BHUtto BHUtto kalhoro BHU Shah Shah BHU BHU Sono Sono BHU Masodero BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU BHU New Gud New BHU BHU Moen BHU Maternal Health Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Antenatal Card Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Obstetric Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No

Daily Medicine Expense Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Stock Register (Medicine/Supplies) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Stock Register (Facility Management/Furniture/Linen) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Community Meeting Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Facility Staff Meeting Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Secondary Facility Report Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Catchment Area Population Chart Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No

Procedures Manual for DHIS Yes No No Yes Yes Yes Yes Yes No Yes Yes Yes Yes No

LQAS Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Maintenance of DHIS Tools

Central Registration Point Register No No No No No No No No No No No No No No

Medicine Requisition Slip Yes Yes Yes No No Yes Yes Yes No Yes Yes Yes Yes Yes

Outpatient Department Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

OPD Abstract Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Laboratory Register Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes

Radiology/Ultrasonography/CT Scan/ECG Register Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No

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BHU BHU Jatoi Daro abad Deero Sanghi BHUtto BHUtto kalhoro BHU Shah Shah BHU BHU Sono Sono BHU Masodero BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU BHU New Gud New BHU BHU Moen BHU Indoor Patient Register No No No No No No No No No No No No No No

Indoor Abstract Form No No No No No No No No No No No No No No

Daily Bed Statement Register No No No No No No No No No No No No No No

Operation Theater (OT) Register No No No No No No No No No No Yes No No No

Family Planning Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Maternal Health Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No

Obstetric Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No

Daily Medicine Expense Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Stock Register (Medicine/Supplies) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Stock Register (Facility Management/Furniture/Linen) Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Community Meeting Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Facility Staff Meeting Register Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Secondary Facility Report Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Catchment Area Population Chart Yes Yes No Yes No Yes Yes Yes No Yes Yes Yes Yes No

LQAS Form Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Infection Control

Processing of Facility Management Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

On-site Processing Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Guidelines for Equipment Processing Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No

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BHU BHU Jatoi Daro abad Deero Sanghi BHUtto BHUtto kalhoro BHU Shah Shah BHU BHU Sono Sono BHU Masodero BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU BHU New Gud New BHU BHU Moen BHU Use & Availability/ Processing of Facility Management

Electric Autoclave No Yes Yes Yes Yes No No No No Yes No No No No n-Electric Autoclave No No No No No No No No No No No No No No

Electric Dry Heat Sterilizer No No No No No No No No No No No No No No

Electric Boiler/Steamer Yes Yes No Yes Yes Yes Yes Yes Yes No Yes Yes Yes No n-Electric Boiler/Steamer No No No No No No No No No No No No No No

Chemical HLD Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Sharps Waste Management

Burning in Incinerator: 2-chamber industrial No No No No No No No No No No No No No No

Burning in Incinerator: 1-chamber drum/brick (n-industrial) No No No No No No No No No No No No No No

Open burning: Flat ground- protection No No No No No No No No No No No No No No

Open burning: Pit or protected ground Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Dump without burning: Flat ground- protection No No No No No No No No No No No No No No

Dump without burning: Covered pit or pit latrine No No No No No No No No No No No No No No

Dump without burning: Open pit- protection No No No No No No No No No No No No No No

Dump without burning: Protected ground or pit No No No No No No No No No No No No No No

Remove offsite: Stored in covered container No No No No No No No No No No No No No No

Remove offsite: Stored in other protected environment No No No No No No No No No No No No No No

Remove offsite: Stored unprotected No No No No No No No No No No No No No No

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BHU BHU Jatoi Daro abad Deero Sanghi BHUtto BHUtto kalhoro BHU Shah Shah BHU BHU Sono Sono BHU Masodero BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU BHU New Gud New BHU BHU Moen BHU Medical Waste Management

Burning in Incinerator: 2-chamber industrial No No No No No No No No No No No No No No

Burning in Incinerator: 1-chamber drum/brick (n-industrial) No No No No No No No No No No No No No No

Open burning: Flat ground- protection No No No No No No No No No No No No No No

Open burning: Pit or protected ground Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Dump without burning: Flat ground- protection No No No No No No No No No No No No No No

Dump without burning: Covered pit or pit latrine No No No No No No No No No No No No No No

Dump without burning: Open pit- protection No No No No No No No No No No No No No No

Dump without burning: Protected ground or pit No No No No No No No No No No No No No No

Remove offsite: Stored in covered container No No No No No No No No No No No No No No

Remove offsite: Stored in other protected environment No No No No No No No No No No No No No No

Remove offsite: Stored unprotected No No No No No No No No No No No No No No

Availability of Guidelines

Availability of Guidelines No No No Yes No No No No No No No No No No

POL For Incinerator

Availability of POL No No No No No No No No No No No No No No

Sufficiency of Budget No No No No No No No No No No No No No No

122 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain III Human Resource Table 24: Human Resource at Basic Health Units of District Larkana Status of Human Resource by type of BHUs

Availability at Basic Health Units District Larkana Human Resource BHU BHU Bakhar BHU Beero BHU BHU BHU Haji BHU Izat Ji Akil Karira Chandio Dhamrah Fateh Pur Dadhro Wandh S F S F S F S F S F S F S F Management Staff Senior Medical Officer 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Computer Operator 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Support Staff Naib Qasid 1 0 0 0 1 1 1 1 1 1 0 0 1 1 Chowkidar 2 1 0 0 1 0 1 1 1 1 0 0 1 1 Malhi 0 0 0 0 1 0 1 0 0 0 0 0 1 1 Sanitation Worker 1 0 0 0 1 0 1 0 1 0 0 0 1 1 Attendant 1 0 0 0 2 0 1 1 0 0 0 0 0 0 Sanitary Inspector 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Aya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Dai 0 0 0 0 0 0 0 1 0 0 0 0 0 0 Medical Staff Women Medical Officer 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Medical Officer 1 1 0 0 0 0 1 1 0 0 0 0 1 0 Ultrasonologist 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Lady Health Visitors 1 1 0 0 1 0 1 0 1 0 0 0 1 0 Health Technician 1 0 0 0 2 1 1 0 1 1 0 0 1 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 123 Availability at Basic Health Units District Larkana Human Resource BHU BHU Bakhar BHU Beero BHU BHU BHU Haji BHU Izat Ji Akil Karira Chandio Dhamrah Fateh Pur Dadhro Wandh S F S F S F S F S F S F S F Microscopist 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Dispenser 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Vaccinator 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CDC Supervisor 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Midwife 1 0 0 0 1 1 2 0 1 0 0 0 1 0 Community Midwife 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Lady Health Supervisor 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Lady Health worker 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SH & NS 0 0 0 0 0 0 0 0 0 0 0 0 0 0

124 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at Basic Health Units District Larkana Human Resource BHU BHU BHU Khan BHU BHU BHU Mad Jumo Agham Karani Wah Kothi Lashari Bahu S F S F S F S F S F S F Management Staff Senior Medical Officer 0 0 0 0 0 0 0 0 0 0 0 0 Computer Operator 0 0 0 0 0 0 0 0 0 0 0 0 Support Staff Naib Qasid 1 0 1 1 1 0 0 0 1 1 0 0 Chowkidar 1 1 1 1 1 0 0 0 1 0 0 0 Malhi 1 0 0 0 1 0 0 0 1 0 0 0 Sanitation Worker 1 0 0 0 1 0 0 0 1 0 0 0 Attendant 0 0 0 0 2 0 0 0 0 0 0 0 Sanitary Inspector 0 0 0 0 0 0 0 0 0 0 0 0 Aya 0 0 0 0 0 0 0 0 0 0 0 0 Dai 0 0 0 0 0 0 0 0 0 0 0 0 Medical Staff Women Medical Officer 0 0 0 0 0 0 0 0 0 0 0 0 Medical Officer 1 0 0 0 1 0 0 0 1 1 1 1 Ultrasonologist 0 0 0 0 1 0 0 0 0 0 0 0 Lady Health Visitors 1 1 0 0 1 0 0 0 1 1 0 0 Health Technician 1 1 0 0 1 0 0 0 1 1 0 0 Microscopist 0 0 0 0 0 0 0 0 0 0 0 0 Dispenser 0 0 0 0 0 0 0 0 0 0 0 0 Vaccinator 0 0 0 0 0 0 0 0 0 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 125 Availability at Basic Health Units District Larkana Human Resource BHU BHU BHU Khan BHU BHU BHU Mad Jumo Agham Karani Wah Kothi Lashari Bahu S F S F S F S F S F S F CDC Supervisor 0 0 0 0 0 0 0 0 0 0 0 0 Midwife 1 1 1 1 1 1 0 0 2 0 0 0 Community Midwife 0 0 0 0 0 0 0 0 0 0 0 0 Lady Health Supervisor 0 0 0 0 0 0 0 0 0 0 0 0 Lady Health worker 0 0 0 0 0 0 0 0 0 0 0 0 SH & NS 0 0 0 0 0 0 0 0 0 0 0 0

126 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at Basic Health Units District Larkana

Human Resource BHU BHU BHU BHU BHU Pir Bux BHU BHU Masodero Moen-jo-Daro New Gud Pathan BHUtto Saeedo Deero Sajan Sanghi

S F S F S F S F S F S F S F

Management Staff Senior Medical Officer 1 0 0 0 0 0 0 0 0 0 0 0 0 0

Computer Operator 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Support Staff Naib Qasid 1 1 1 0 1 1 2 0 1 1 1 0 1 1 Chowkidar 1 1 1 1 1 1 2 1 1 1 1 1 2 2 Malhi 1 0 0 0 1 0 1 0 0 0 0 0 2 1 Sanitation Worker 1 0 0 0 0 1 2 0 0 0 0 1 1 0 Attendant 1 1 1 1 1 1 0 1 0 0 0 0 0 0 Sanitary Inspector 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Aya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Dai 0 0 0 0 1 1 0 1 0 0 1 0 0 1 Medical Staff Women Medical Officer 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Medical Officer 0 0 0 0 0 0 0 0 1 1 1 1 0 0 Ultrasonologist 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Lady Health Visitors 1 1 1 0 1 0 2 0 0 0 0 0 2 0 Health Technician 1 1 1 1 1 0 2 1 0 0 0 0 2 0 Microscopist 0 0 0 0 0 0 0 0 0 0 0 0 0 0

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Human Resource BHU BHU BHU BHU BHU Pir Bux BHU BHU Masodero Moen-jo-Daro New Gud Pathan BHUtto Saeedo Deero Sajan Sanghi

S F S F S F S F S F S F S F

Dispenser 0 0 0 0 0 0 0 0 0 0 1 0 0 0 Vaccinator 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CDC Supervisor 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Midwife 2 0 0 0 2 0 2 0 0 0 1 0 2 0 Community Midwife 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Lady Health Supervisor 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Lady Health worker 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SH & NS 0 0 0 0 0 0 0 0 0 0 0 0 0 0

128 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at Basic Health Units District Larkana Human Resource BHU BHU BHU BHU Usman BHU BHU Waris Dino BHU Wasayo Seehar Shah abad Sono Jatoi kalhoro Veehar Machi BHUtto S F S F S F S F S F S F S F Management Staff Senior Medical Officer 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Computer Operator 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Support Staff Naib Qasid 0 0 2 1 1 2 2 2 0 0 1 0 0 0 Chowkidar 2 2 2 1 2 1 2 1 1 1 1 1 0 0 Malhi 0 0 0 0 1 1 0 0 0 0 0 0 0 0 Sanitation Worker 1 1 1 1 0 0 0 0 0 0 1 0 0 0 Attendant 0 0 1 0 1 0 1 1 0 0 0 0 0 0 Sanitary Inspector 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Aya 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Dai 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Medical Staff Women Medical Officer 1 0 0 0 0 0 0 0 0 0 0 0 0 0 Medical Officer 0 0 0 0 0 0 1 0 1 0 1 1 0 0 Ultrasonologist 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Lady Health Visitors 0 0 1 0 1 0 1 0 0 0 1 0 0 0 Health Technician 0 0 2 0 1 1 1 1 0 0 1 0 0 0 Microscopist 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Dispenser 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Vaccinator 2 2 0 0 0 0 0 0 0 0 0 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 129 Availability at Basic Health Units District Larkana Human Resource BHU BHU BHU BHU Usman BHU BHU Waris Dino BHU Wasayo Seehar Shah abad Sono Jatoi kalhoro Veehar Machi BHUtto S F S F S F S F S F S F S F CDC Supervisor 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Midwife 0 0 0 0 2 0 2 0 0 0 1 0 0 0 Community Midwife 0 0 2 1 0 0 0 0 0 0 0 0 0 0 Lady Health Supervisor 1 1 0 0 0 0 0 0 0 0 0 0 0 0 Lady Health worker 10 10 0 0 0 0 0 0 0 0 0 0 0 0 SH & NS 0 0 0 0 0 0 0 0 0 0 0 0 0 0

130 Health Facility Assessment Sindh-2015-16: District Larkana Report Training of Staff at Basic Health Units Codes Trainings Codes Trainings A Integrated Management of Neonatal and Childhood Illnesses (IMNCI) K Syndromic Management of Sexually Transmitted Infections B Emergency Obstetric and Newborn Care (EMONC) L Infection Control C Emergency Newborn Care (ENC) Helping Baby Breathe (HBB) M Waste Management D Pregnancy, Childbirth, Postpartum and New-born Care (PCPNC) N EPI (Pneumococcal) E Managing Complications in Pregnancy and Childbirth (MCPC) O District Health Information System (DHIS) G Family Planning (FP) Surgical P Malnutrition Non-Communicable Diseases (e.g. Diabetes, Cardio-Vascular H Q Anesthesia Diseases, Respiratory Diseases) I Malaria X No Training J TB-DOTS

Table 25: Staff Trainings at Basic Health Units of District Larkana Status of Staff Trainings by type of BHUs

Availability at Basic Health Units District Larkana

Staff Trainings

Khan Wah BHU BHU BHU BHU BHU BHU Bahu

Kothi

Karira Karani Lashari Agham Wandh Dadhro

Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU MadBHU Fateh Pur Fateh BHU BHU BHU Jumo Jumo BHU BHU Izat Ji Izat Ji BHU BHU Beero BHU BHU Bakhar Bakhar BHU

Dispenser JN X N X X X X X X X X N J

Health Technician X X X X X X X X X X X X X

LHV ACL X AGLO X GL BCGL G LO X X X AGL LO

Medical officer AGN GN AGLN AGJN AGN AGN A AGLM AGN AGN AGN A AGL Senior medical officer X X X X X X X X X X X X X ACD ACDGL Women medical officer X ACDGLO X CDGL X ACGLN CGLP D ACDEGL ACDGL ABCGL GL O

Health Facility Assessment Sindh-2015-16: District Larkana Report 131 Availability at Basic Health Units District Larkana

Daro

Staff Trainings -

jo - Machi BHU Seehar BHU BHU Pathan BHU BHU Veehar BHU BHU New Gud New BHU BHU Masodero BHU BHU Sono Jatoi Sono BHU BHU Shah abad Shah BHU BHU Waris Dino Dino Waris BHU BHU Sajan Sajan Sanghi BHU BHU Saeedo Deero Saeedo BHU BHU Moen BHU BHU Pir Bux BHUtto Pir Bux BHU BHU Usman kalhoro BHU BHU Wasayo BHUtto BHU

Dispenser X X N X X JN N GL X X O GJ X G

Health Technician X X X X X X X X X X X X X X

LHV CL CN CL X CL LOP X DEGL DL X CDGL CGLN GL X

Medical officer AGLN AGLN AGHIJN AGJLN GJLN JL K IL AJN AGN AGIJLN AGLO AGJO A

Senior medical officer X X X X X X X X X X X X X X

Women medical officer CL X CDGL X ACGL ACEGLP CDGL X ADGL ABCDGL AIJL ABCDEGL CGLN X

132 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain IV Diagnostics Table 26: Diagnostics at Basic Health Units of District Larkana Status of Diagnostics by type of BHUs

Availability at Basic Health Units District Larkana

Diagnostics

Pur BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU

Malaria Testing Onsite malaria testing No No Yes Yes No No No No Yes No No No No Light Microscope No No No No No No No No Yes No No No No Refrigerator in Lab Area No No No No No No No No No No No No No Test Tubes No No No No No No No No No No No No No Glass Slides and Covers No Yes Yes No No No No No Yes No No No No Availability of Malaria rapid diagnostic test (RDT) kit No No No No No No No No No No No No No Guidelines for rapid diagnostic test No No No No No No No No No No No No No Send specimen outside for malaria testing No Yes Yes No No No No No No No Yes No No Giemsa stain No No No No No No No No Yes No No No No Field stain No No No No No No No No Yes No No No No Maintenance of record of results for malaria tests No Yes No No No No No No No No No No No conducted outside Tuberculosis Testing Onsite Tuberculosis Testing No No No No No No No No No No No No No Ziehl-Neelsen Test for AFB No No No No No No No No No No No No No Carbol-Fuchsin No No No No No No No No No No No No No

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Diagnostics

Pur BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU

Sulphuric Acid (20-25% Concentration) or Acid Alcohol No No No No No No No No No No No No No Methylene Blue No No No No No No No No No No No No No Microscope No No No No No No No No No No No No No Availability of TB Rapid Diagnostic Test Kit (RDT) No No No No No No No No No No No No No Maintenance of Onsite Sputum container No No No No No No No No No No No No No TB testing outside the facility No No No No No No No No No No No No No Maintenance of Sputum testing Record No No No No No No No No No No No No No Internal or External Quality control System of TB Sputum No No No No No No No No No No No No No smears Quality Control Internal QC Only No No No No No No No No No No No No No External QC Only No No No No No No No No No No No No No Internal & External QC No No No No No No No No No No No No No Send Slide for Re-reading No No No No No No No No No No No No No Maintenance of Quality Control (Internal & external) No No No No No No No No No No No No No Records Record for Internal QC Only No No No No No No No No No No No No No Record for External QC Only No No No No No No No No No No No No No Record for Both Internal & External QC No No No No No No No No No No No No No

134 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at Basic Health Units District Larkana

Diagnostics

Pur BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU Bakhar Bakhar BHU BHU Lashari BHU

Standard Precautions for Diagnostic Services Running Water Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (Piped, bucket with tap or pour pitcher) Hand-washing Soap Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (May be liquid Soap) Alcohol-based Hand Rub No No Yes Yes Yes Yes No No No No No No No Waste Receptacle (Pedal bin) with Lid and Plastic Bin Liner No No No No No No No No No No No No No Other Waste Receptacle Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Sharps Container (Safety Box) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Disposable Latex Gloves Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Disinfectant (e.g; Chlorine, Hibitane, Alcohol) Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Single-Use Standard Disposable Syringes with Needles Or Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes auto Disposable Syringes with Needle Medical Masks Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Gowns Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Eye Protection No No Yes Yes Yes No No No Yes Yes Yes No No (Goggles or Face Protection) Guidelines for Standard Precaution No No No No No No No No No No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 135 Availability at Basic Health Units District Larkana

Daro - Diagnostics

jo - Veehar Machi BHUtto BHU Seehar BHU BHU Pathan BHU BHU BHU BHU Wasayo BHU BHU New Gud New BHU BHU Masodero BHU BHU Sono Jatoi Sono BHU BHU Shah abad Shah BHU BHU Waris Dino Dino Waris BHU BHU Sajan Sajan Sanghi BHU BHU Saeedo Deero Saeedo BHU BHU Moen BHU BHU Pir Bux BHUtto Pir Bux BHU BHU Usman kalhoro BHU

Malaria Testing Onsite malaria testing No No Yes No No No No Yes No No No No No No

Light Microscope No No Yes No No No No No No No No No No No

Refrigerator in Lab Area No No Yes No No No No No No No No No No No Test Tubes No No Yes No No No No Yes No No No No No No Glass Slides and Covers No No Yes No No No No Yes No No No No No No Availability of Malaria rapid diagnostic test (RDT) No No No No No No No No No No No No No No kit Guidelines for rapid diagnostic test No No No No No No No No No No No No No No Send specimen outside for malaria testing No No No No No No No Yes No No No No No No Giemsa stain No No No No No No No No No No No No No No Field stain No No No No No No No No No No No No No No Maintenance of record of results for malaria tests No No No No No No No Yes No No No No No No conducted outside Tuberculosis Testing Onsite Tuberculosis Testing No No No No No No No No No No No No No No Ziehl-Neelsen Test for AFB No No No No No No No No No No No No No No Carbol-Fuchsin No No No No No No No No No No No No No No

136 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at Basic Health Units District Larkana

Daro - Diagnostics

jo - Veehar Machi BHUtto BHU Seehar BHU BHU Pathan BHU BHU BHU BHU Wasayo BHU BHU New Gud New BHU BHU Masodero BHU BHU Sono Jatoi Sono BHU BHU Shah abad Shah BHU BHU Waris Dino Dino Waris BHU BHU Sajan Sajan Sanghi BHU BHU Saeedo Deero Saeedo BHU BHU Moen BHU BHU Pir Bux BHUtto Pir Bux BHU BHU Usman kalhoro BHU

Sulphuric Acid (20-25% Concentration) or Acid No No No No No No No No No No No No No No Alcohol Methylene Blue No No No No No No No No No No No No No No Microscope No No No No No No No No No No No No No No Availability of TB Rapid Diagnostic Test Kit (RDT) No No No No No No No No No No No No No No Maintenance of Onsite Sputum container No No No No No No No No No No No No No No TB testing outside the facility No No No No No No No No No No No No No No Maintenance of Sputum testing Record No No No No No No No No No No No No No No Internal or External Quality control System of TB No No No No No No No No No No No No No No Sputum smears Quality Control Internal QC Only No No No No No No No No No No No No No No External QC Only No No No No No No No No No No No No No No Internal & External QC No No No No No No No No No No No No No No Send Slide for Re-reading No No No No No No No No No No No No No No Maintenance of Quality Control (Internal & No No No No No No No No No No No No No No external) Records Record for Internal QC Only No No No No No No No No No No No No No No Record for External QC Only No No No No No No No No No No No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 137 Availability at Basic Health Units District Larkana

Daro - Diagnostics

jo - Veehar Machi BHUtto BHU Seehar BHU BHU Pathan BHU BHU BHU BHU Wasayo BHU BHU New Gud New BHU BHU Masodero BHU BHU Sono Jatoi Sono BHU BHU Shah abad Shah BHU BHU Waris Dino Dino Waris BHU BHU Sajan Sajan Sanghi BHU BHU Saeedo Deero Saeedo BHU BHU Moen BHU BHU Pir Bux BHUtto Pir Bux BHU BHU Usman kalhoro BHU

Record for Both Internal & External QC No No No No No No No No No No No No No No Standard Precautions for Diagnostic Services Running Water No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (Piped, bucket with tap or pour pitcher) Hand-washing Soap Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (May be liquid Soap) Alcohol-based Hand Rub Yes No Yes No No Yes Yes No No No No Yes No No Waste Receptacle (Pedal bin) with Lid and Plastic No No Yes No No No No No Yes No Yes No No No Bin Liner Other Waste Receptacle No Yes No Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Sharps Container (Safety Box) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Disposable Latex Gloves Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Disinfectant (e.g; Chlorine, Hibitane, Alcohol) Yes Yes Yes Yes Yes Yes Yes No Yes Yes No No Yes Yes Single-Use Standard Disposable Syringes with Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Needles Or auto Disposable Syringes with Needle Medical Masks Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Gowns Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Eye Protection No Yes Yes Yes No Yes No Yes Yes No Yes Yes No No (Goggles or Face Protection) Guidelines for Standard Precaution No No No No No No No No No No No No No No

138 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain V Infrastructure Assessment of Infrastructure

‘Good/No repair required’ means that the infrastructure is in good condition and does not require any type of repair to optimally perform its functions.

‘Minor repair’ includes small issues like whitewash, polish or paint work, broken hinges, locks, or handles, leakage of water pipes without gross seepage, mal-functioning electricity wires.

‘Major repair’ comprises of major issues requiring major plastering or concrete work, repair of major seepage like roof treatment, re-fixing of doors/windows panels, drainage treatment for major blockage, replacement required for parts of water and sewage pipes and electricity rewiring.

‘Under-construction’ means new construction for any building component is underway.

‘Non-availability’ means completely missing infrastructure component that is required as per the level of assessed health facility.

Table 27: Infrastructure at Basic Health Units of District Larkana Status of Infrastructure at BHUs

Availability at BHU

District Larkana

Infrastructure Component

Pur BHU BHU BHU BHU BHU BHU BHU Wah Bahu Beero Karira Karani Bakhar Bakhar Agham Lashari Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU

OPD Consultation area Good Good NA Good NA NA Good Good Good Good Good Good NA NA

Examination area Good Good NA Good NA NA NA Minor Good Good Good Good NA NA

Hand washing Good Good NA Good NA NA Good NA Good Good Good Good NA NA Labor Room Delivery room Good Good NA Good NA NA Good Minor Good Good Good Good NA NA

Scrub area Good NA NA Good NA NA NA Minor Good Good Good Good NA NA

Patient washroom Good Good NA Good NA NA Good NA Good Good Good Good NA NA

Health Facility Assessment Sindh-2015-16: District Larkana Report 139 Availability at BHU

District Larkana

Infrastructure Component

Pur BHU BHU BHU BHU BHU BHU BHU Wah Bahu Beero Karira Karani Bakhar Bakhar Agham Lashari Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU

LHV Room

Consultation area Good Good NA Good NA NA Good Minor Good Good Good Good NA NA

Examination area Good Good NA Good NA NA Good Minor Good Good Good Good NA NA

Hand washing facility Good NA NA Good NA NA Good NA Good Good Good Good NA NA

Laboratory Area

Laboratory room NA NA NA NA NA NA NA NA NA NA NA NA NA NA

Working area Good Good NA NA NA NA Good NA Good Minor Good Good NA NA

Attached washroom NA NA NA NA NA NA NA NA Minor NA NA NA NA NA

Residences

Medical Officer Minor Major Major Good Major Major Major NA Major Major Minor Major Major NA

LHV Minor Major Minor Good Major Major Major NA Major Minor Minor Major Major NA

Medical Technician Minor Major Major Good Major Major Major NA Major NA Minor Major Major NA

Chowkidar Minor Major Minor Good Major Major Major NA Major Major Minor Major Major NA

Miscellaneous

Electricity Wiring Good Good NA Good NA NA Good Minor Minor Good Good Minor NA Good

Water Pipes Good Good NA Good NA NA Good NA NA Good Good Good NA Good Store (Medicines and Good Good NA Good NA NA Good Good Good Good Good Good NA Good Vaccines) Boundary Wall Good Major Good Major NA NA Good Good NA Good Major Major NA Good

Main Gate Good Minor Good Major NA NA Good Good NA Good NA NA NA Good

140 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

-

Infrastructure Component

Shah Shah Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU OPD

Consultation area Good Good NA Major Major Good Good Good Minor Good Good Good Good

Examination area Good Good NA Major Good Good Good Good Minor Good Good Good Good

Hand washing Good Good NA Major Good Good Good Good Minor Good Good Minor Good

Labor Room

Delivery room Good Good NA Major Major Good Good Good Minor Good Good Good Good

Scrub area Good Good NA Major Good Good Good Good Minor Good Good Minor Good

Patient washroom Good Good NA Major Good Good NA NA Minor NA Good Minor NA

LHV Room

Consultation area Good Good NA Major Major Good Good Good Minor Good Good Major Good

Examination area Good Good NA Major Good Good Good Good Minor Good Good Major Good

Hand washing facility Good Good NA Major Good NA Good NA Minor Good Good NA Good

Laboratory Area

Laboratory room NA Good NA NA NA NA Good NA NA NA NA Major NA

Working area Good Good NA Major Good Good Good Good Minor Good Good Major Good

Attached washroom NA NA NA NA NA NA NA NA NA Good NA NA Good

Residences

Medical Officer Minor Good Major Major Major Minor Major Good Major Major Major Major Major

LHV Minor Good Major Major Major Minor Major Good Major Major Minor Major Major

Health Facility Assessment Sindh-2015-16: District Larkana Report 141 Availability at BHU

District Larkana

-

Infrastructure Component

Shah Shah Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU Medical Technician Minor Good Major Major Major Minor Major NA Major NA Minor Major Major

Chowkidar Minor Good Major Major Major Minor Major Good Major NA Minor Major Major

Miscellaneous

Electricity Wiring Good Good NA Good Minor Minor Good Good Good Good Good Minor Good

Water Pipes Good Good NA Good Good Good Good Good Good Good Good Minor Good

Store (Medicines and Vaccines) Good Good NA Good Good Good Good Good Good Good Good Good Good

Boundary Wall NA Good NA NA Major Major Major Good Good NA Good NA Major

Main Gate NA Good NA NA NA Major Major Good Good NA Good NA Good

142 Health Facility Assessment Sindh-2015-16: District Larkana Report Domain VI Equipment Table 28: Equipment at Basic Health Units of District Larkana Status of functional equipment, furniture, & fixtures at BHUs

Availability At BHU District Larkana

Equipment, Furniture & Fixtures

Pur BHU BHU BHU Wah Samgi Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Sajan Sajan BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU BakerBHU BHU Beero BHU BHU Karani BHU BHU Lashari BHU

OPD B P Apparatus Digital 0 0 0 0 0 0 0 0 0 0 0 0 0 0 B P Apparatus Manual 2 2 1 2 1 3 2 2 2 2 1 2 2 2 Examination Couch 0 2 1 2 1 2 2 1 0 0 2 2 1 2 Fetal Stethoscope 0 0 0 0 0 0 0 0 0 0 0 0 0 0 P.V. Examination Light 0 0 0 1 0 0 0 0 0 0 0 0 0 0 Steam Inhaler 1 1 1 1 1 1 1 1 1 1 1 1 1 1 X-Ray Illuminator 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Fetoscope 0 0 1 1 0 1 1 1 1 1 1 1 2 2 Glucometer 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Dressing Kit 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Weight Machine Adult 1 1 1 2 1 1 1 1 1 0 1 1 1 1 Height Measuring Board 0 0 0 1 0 0 1 1 1 0 1 0 1 1 Height Measuring Device 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Infant Weight Machine 1 0 1 1 0 1 1 1 1 1 1 1 1 1 Measuring Tape 1 1 1 2 1 1 1 1 1 1 2 0 2 1 Thermometer 1 1 2 2 3 2 2 1 2 2 2 2 2 2 Office Chair 16 8 7 13 8 11 8 4 5 2 6 11 11 4 Office Tables With Drawer 2 4 3 5 3 2 2 1 1 1 2 2 5 4 Patient Stool 2 1 2 3 2 2 3 1 1 1 1 2 2 3

Health Facility Assessment Sindh-2015-16: District Larkana Report 143 Availability At BHU District Larkana

Equipment, Furniture & Fixtures

Pur BHU BHU BHU Wah Samgi Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Sajan Sajan BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU BakerBHU BHU Beero BHU BHU Karani BHU BHU Lashari BHU

Chairs 0 0 0 0 0 0 0 12 8 6 8 0 11 4 Steel Almirah 0 2 0 3 1 2 1 0 0 1 0 0 3 1 Wooden Benches 4 11 10 9 7 5 7 4 5 0 2 0 6 5 Folding Screen 1 1 0 1 1 1 1 0 1 0 1 1 1 1 Jug (Stainless Steel) 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Needle Holder 1 1 1 1 2 1 2 1 1 0 1 1 1 4 Scalpel Handle With Blade 1 1 0 1 0 0 1 0 1 0 0 1 0 0 Surgical Scissors 1 2 1 1 2 2 2 1 1 0 2 1 1 3 Nasogastric Tube (10-16G) 2 0 0 6 0 1 2 0 0 0 4 1 4 0 Tourniquet 1 0 1 1 0 2 1 1 1 0 1 1 1 1 LHV/LABOR ROOM Clean Delivery Kits 1 3 0 2 2 2 1 1 1 1 1 1 3 1 D & C Instruments Set 1 2 0 1 1 2 1 1 1 1 1 1 1 1 Labor Table 1 2 0 1 2 1 1 1 1 1 1 1 1 1 Disposable Syringe Cutter 0 1 0 1 2 2 1 0 1 0 0 0 1 1 Examination Couch 1 2 0 2 2 1 1 1 1 1 1 1 1 1 Height Measuring Board 0 1 0 1 0 1 1 1 1 0 1 1 1 1 Height Measuring Device 0 0 0 0 1 0 0 0 0 0 0 0 0 0 Infant Weight Machine 1 1 0 1 1 0 0 1 1 0 1 0 1 1 Instrument Tray 1 2 0 4 1 1 2 1 1 1 1 1 1 1 Kidney Tray 1 3 0 2 3 2 3 1 1 2 1 1 1 2 Bowl 0 2 0 1 2 2 1 2 1 0 1 0 1 1 Artery Forceps (Straight) 1 2 0 2 2 2 1 1 1 1 1 1 4 2

144 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability At BHU District Larkana

Equipment, Furniture & Fixtures

Pur BHU BHU BHU Wah Samgi Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Sajan Sajan BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU BakerBHU BHU Beero BHU BHU Karani BHU BHU Lashari BHU

Artery Forceps (Curved) 0 2 0 2 2 2 0 1 1 0 1 0 0 2 Needle Holders 1 2 0 1 3 1 1 1 1 0 1 2 4 2 Dressing Drum 1 2 0 2 1 2 1 1 1 0 1 1 2 1 Dissecting Forceps 1 1 0 2 4 1 0 2 0 0 0 0 2 3 Fetoscope 1 2 0 2 2 1 1 2 1 1 2 1 2 2 Dressing Scissors 1 1 0 3 2 2 1 1 2 1 2 1 1 2 Cheatle Forceps 1 1 0 1 1 2 1 1 1 0 1 1 0 2 Sponge Holders Forceps 2 2 0 2 2 2 4 1 1 2 1 3 2 2 Blood Pressure Instruments 1 1 0 1 1 1 1 0 1 1 0 1 1 1 Stethoscope 1 2 0 1 2 1 1 2 1 1 1 1 1 1 Tongue Depressor 0 50 0 50 50 50 50 20 30 0 30 20 50 50 Instruments Cabinet 1 1 0 2 1 1 1 1 1 1 0 1 2 0 Drums 0 2 0 1 0 0 0 2 1 0 0 0 2 0 Office Chair 4 4 0 4 4 3 3 3 3 3 3 2 3 2 Office Tables With Drawer 1 1 0 2 1 1 1 1 1 1 1 1 1 1 P.V. Examination Light 0 1 0 1 1 0 0 0 0 0 0 0 0 0 Patient Stool 1 2 0 2 3 1 1 1 1 1 1 1 1 1 Plain Chairs 0 0 0 0 0 0 0 0 3 0 3 0 0 0 Steam Inhaler 0 0 0 0 1 0 0 0 0 0 1 0 0 0 Steel Almirah 0 1 0 0 0 1 0 0 0 0 0 0 1 0 Weight Machine Adult 1 2 0 1 1 1 1 1 1 1 1 1 1 1 Rechargeable Portable Lamp 0 1 0 1 1 0 0 0 0 0 0 0 0 0 Stretcher Trolley 0 1 0 0 1 1 0 0 0 0 0 1 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 145 Availability At BHU District Larkana

Equipment, Furniture & Fixtures

Pur BHU BHU BHU Wah Samgi Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Sajan Sajan BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU BakerBHU BHU Beero BHU BHU Karani BHU BHU Lashari BHU

Oxygen Cylinder With Gas 0 1 0 1 1 0 0 1 0 0 1 1 1 1 Regulator Laboratory Area Beaker 1 Liter 0 0 0 0 2 0 0 0 0 0 0 0 0 0 Bottles Reagent Glass 0 0 0 0 97 0 0 0 0 0 0 0 0 0 Urine Glass 0 0 0 0 30 0 0 0 0 0 0 0 0 0 ESR Tube With Stand 0 0 0 0 10 0 0 0 0 0 0 0 0 0 Test Tube With Stand 0 0 0 0 40 0 0 0 0 0 0 0 0 0 Spirit Lamp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Test Tube Holder 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Funnel 0 0 0 0 1 0 0 0 0 0 0 0 0 0 Hemoglobin Meter 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Centrifuge Machine 0 0 0 0 1 0 0 0 0 0 0 0 0 0 Microscope 0 0 0 0 1 0 0 0 0 1 0 0 0 0 Day Care Area Temperature Chart Folder 0 0 0 1 1 1 0 0 0 0 0 1 0 0 Bed Side Lockers 1 1 1 1 2 2 0 0 0 1 0 2 0 1 Visitors Benches 8 11 10 9 7 5 7 11 5 8 7 6 15 5 Drip Stand 2 2 1 2 2 2 1 2 1 1 2 2 2 2 Bedpan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Urinal Male 0 0 0 0 1 0 0 0 0 0 0 0 0 0 Urinal Female 0 0 0 0 1 0 0 0 0 0 0 0 0 0 Iron Bed Without Foam Mattress 1 6 1 3 3 2 2 2 1 1 1 2 2 1

146 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability At BHU District Larkana

Equipment, Furniture & Fixtures

Pur BHU BHU BHU Wah Samgi Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Sajan Sajan BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU BakerBHU BHU Beero BHU BHU Karani BHU BHU Lashari BHU

Miscellaneous Refrigerator 1 2 0 1 2 1 0 1 1 1 2 1 1 1 Electric Water Cooler 0 0 0 0 1 0 0 0 0 0 0 0 0 0 Stabilizer 3000 W 1 2 0 1 3 1 0 2 0 1 2 1 0 1 Incinerator 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Water Filter 0 0 0 0 1 0 0 0 0 0 0 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 147 Availability At BHU

District Larkana

Daro

Equipment, Furniture & Fixtures - Jo - BHU Seehar BHU BHU Pathan BHU BHU Veehar BHU BHU New Gud New BHU BHU Mad Bahu BHU Jatoi Sono BHU BHU Shah Shah Abad BHU BHU Saeedo Deero Saeedo BHU BHU Moen BHU BHU Pir Bux BHUtto Pir Bux BHU BHU Usman Kalhoro BHU BHU Wasayo BHUtto BHU BHU Waris Dino Machi Dino Waris BHU

OPD

B P Apparatus Digital 0 0 0 0 0 0 0 0 0 0 0 0 0

B P Apparatus Manual 2 1 3 2 2 2 2 2 2 2 2 1 2

Examination Couch 1 0 2 2 1 2 2 2 1 2 2 1 2

Fetal Stethoscope 0 0 0 0 0 0 2 0 0 2 0 0 0

P.V. Examination Light 0 1 1 0 0 0 1 1 0 0 0 0 0

Steam Inhaler 1 1 1 1 1 1 1 1 1 1 1 1 1

X-Ray Illuminator 0 0 0 0 0 0 0 0 0 0 0 0 0

Fetoscope 1 1 2 2 1 1 1 1 1 1 1 0 1

Glucometer 1 1 2 0 1 1 1 1 1 1 2 1 1

Dressing Kit 1 1 1 0 1 1 1 1 1 2 1 1 1

Weight Machine Adult 2 1 2 1 1 1 1 2 1 1 1 1 1

Height Measuring Board 0 0 0 0 0 0 1 0 0 1 0 0 1

Height Measuring Device 0 0 0 0 0 0 0 0 0 0 0 0 0

Infant Weight Machine 1 0 2 1 1 1 1 1 1 1 1 1 1

Measuring Tape 1 0 1 1 2 1 1 2 1 1 2 1 1

Thermometer 1 3 1 1 2 2 2 2 2 4 3 1 2

148 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability At BHU

District Larkana

Daro

Equipment, Furniture & Fixtures - Jo - BHU Seehar BHU BHU Pathan BHU BHU Veehar BHU BHU New Gud New BHU BHU Mad Bahu BHU Jatoi Sono BHU BHU Shah Shah Abad BHU BHU Saeedo Deero Saeedo BHU BHU Moen BHU BHU Pir Bux BHUtto Pir Bux BHU BHU Usman Kalhoro BHU BHU Wasayo BHUtto BHU BHU Waris Dino Machi Dino Waris BHU

Office Chair 16 8 14 3 8 8 5 6 12 8 14 4 11

Office Tables With Drawer 6 1 6 3 4 2 3 2 2 5 4 2 5

Patient Stool 2 1 2 2 2 2 2 2 2 2 2 2 2

Chairs 0 0 0 17 10 14 7 6 12 9 14 0 20

Steel Almirah 1 0 1 1 0 0 0 0 0 2 1 1 2

Wooden Benches 17 1 23 6 0 2 4 0 2 4 2 6 5

Folding Screen 1 1 2 2 2 1 0 0 0 1 0 1 1

Jug (Stainless Steel) 1 1 1 1 1 1 1 1 1 1 1 1 1

Needle Holder 1 1 1 1 1 1 1 1 0 2 1 1 1

Scalpel Handle With Blade 1 0 1 1 1 0 1 0 0 0 1 1 0

Surgical Scissors 1 1 2 1 2 1 3 1 0 2 2 1 2

Nasogastric Tube (10-16G) 0 0 0 2 10 2 1 0 0 4 10 0 2

Tourniquet 1 1 2 1 1 1 1 1 0 1 1 1 1

LHV/Labor Room

Clean Delivery Kits 1 1 2 1 1 2 2 1 1 2 2 0 1

D & C Instruments Set 1 1 1 1 1 1 1 1 1 1 1 0 1

Labor Table 1 1 2 1 1 1 1 1 1 1 1 0 1

Health Facility Assessment Sindh-2015-16: District Larkana Report 149 Availability At BHU

District Larkana

Daro

Equipment, Furniture & Fixtures - Jo - BHU Seehar BHU BHU Pathan BHU BHU Veehar BHU BHU New Gud New BHU BHU Mad Bahu BHU Jatoi Sono BHU BHU Shah Shah Abad BHU BHU Saeedo Deero Saeedo BHU BHU Moen BHU BHU Pir Bux BHUtto Pir Bux BHU BHU Usman Kalhoro BHU BHU Wasayo BHUtto BHU BHU Waris Dino Machi Dino Waris BHU

Disposable Syringe Cutter 0 1 3 1 1 1 1 1 1 1 1 0 0

Examination Couch 1 1 2 1 1 1 1 1 1 1 0 0 1

Height Measuring Board 0 0 0 0 0 0 0 0 0 1 1 0 1

Height Measuring Device 0 0 1 0 0 0 0 0 0 0 0 0 0

Infant Weight Machine 0 0 1 1 1 1 1 1 1 1 0 0 1

Instrument Tray 1 1 1 1 0 1 1 3 1 1 1 0 1

Kidney Tray 1 2 5 3 2 2 1 3 1 1 1 0 1

Bowl 1 0 4 1 2 1 1 2 0 1 1 0 3

Artery Forceps (Straight) 2 1 5 1 2 1 1 2 2 1 1 1 2

Artery Forceps (Curved) 2 0 1 0 1 1 1 1 1 0 1 1 1

Needle Holders 2 1 3 1 2 1 1 1 1 1 1 1 1

Dressing Drum 0 1 2 1 2 1 1 2 1 1 1 0 0

Dissecting Forceps 0 1 0 2 2 1 4 1 1 1 1 0 9

Fetoscope 1 1 2 2 1 1 1 2 2 1 1 0 1

Dressing Scissors 1 1 1 1 2 1 1 3 1 1 1 1 1

Cheatle Forceps 1 1 1 1 2 1 1 1 1 1 1 0 0

Sponge Holders Forceps 2 2 4 3 2 1 1 2 2 1 1 0 2

150 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability At BHU

District Larkana

Daro

Equipment, Furniture & Fixtures - Jo - BHU Seehar BHU BHU Pathan BHU BHU Veehar BHU BHU New Gud New BHU BHU Mad Bahu BHU Jatoi Sono BHU BHU Shah Shah Abad BHU BHU Saeedo Deero Saeedo BHU BHU Moen BHU BHU Pir Bux BHUtto Pir Bux BHU BHU Usman Kalhoro BHU BHU Wasayo BHUtto BHU BHU Waris Dino Machi Dino Waris BHU

Blood Pressure Instruments 1 1 1 1 1 1 1 1 1 1 1 0 0

Stethoscope 1 1 2 1 1 1 1 1 1 1 1 0 1

Tongue Depressor 50 10 50 97 30 30 30 50 50 31 40 50 20

Instruments Cabinet 1 1 1 1 1 1 1 0 1 1 1 0 0

Drums 0 0 1 0 0 0 2 0 1 1 0 0 0

Office Chair 2 2 4 3 3 4 3 3 2 8 2 0 3

Office Tables With Drawer 1 1 2 1 1 1 1 1 1 1 1 0 1

P.V. Examination Light 0 1 2 1 1 0 1 1 0 1 0 0 0

Patient Stool 1 1 1 1 1 1 1 1 1 1 1 0 0

Plain Chairs 0 0 0 0 2 0 2 0 0 9 2 0 0

Steam Inhaler 0 1 0 0 1 0 0 1 0 0 0 0 0

Steel Almirah 0 0 0 0 0 0 0 0 0 1 0 0 0

Weight Machine Adult 1 1 1 1 1 1 1 1 1 1 1 0 1

Rechargeable Portable Lamp 0 0 1 1 0 0 0 1 0 0 0 0 0

Stretcher Trolley 0 0 1 1 0 0 1 0 0 1 0 0 0

Oxygen Cylinder With Gas Regulator 1 1 1 0 1 1 1 1 1 0 1 0 1

Health Facility Assessment Sindh-2015-16: District Larkana Report 151 Availability At BHU

District Larkana

Daro

Equipment, Furniture & Fixtures - Jo - BHU Seehar BHU BHU Pathan BHU BHU Veehar BHU BHU New Gud New BHU BHU Mad Bahu BHU Jatoi Sono BHU BHU Shah Shah Abad BHU BHU Saeedo Deero Saeedo BHU BHU Moen BHU BHU Pir Bux BHUtto Pir Bux BHU BHU Usman Kalhoro BHU BHU Wasayo BHUtto BHU BHU Waris Dino Machi Dino Waris BHU

Laboratory Area

Beaker 1 Liter 0 0 0 0 0 0 0 0 0 0 0 0 0

Bottles Reagent Glass 0 0 2 0 0 0 0 0 0 0 0 0 0

Urine Glass 0 0 97 0 0 0 0 0 0 0 0 0 0

ESR Tube With Stand 0 0 3 0 0 0 0 0 0 0 0 0 0

Test Tube With Stand 0 0 97 0 0 0 0 0 0 0 0 0 0

Spirit Lamp 0 0 0 0 0 0 0 0 0 1 0 0 0

Test Tube Holder 0 0 0 0 0 0 0 0 0 0 0 0 0

Funnel 0 0 0 0 0 0 0 0 0 1 0 0 0

Hemoglobin Meter 1 1 1 1 0 1 1 1 0 1 1 1 1

Centrifuge Machine 0 0 1 0 0 0 0 0 0 0 0 0 0

Microscope 0 0 1 0 0 0 0 0 0 0 0 0 0

Day Care Area

Temperature Chart Folder 0 1 1 1 1 0 0 1 0 1 1 0 0

Bed Side Lockers 0 0 2 2 2 0 0 2 0 2 2 0 0

Visitors Benches 8 22 7 14 9 6 11 8 6 14 10 6 5

Drip Stand 2 2 4 2 2 1 2 2 1 2 2 1 2

152 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability At BHU

District Larkana

Daro

Equipment, Furniture & Fixtures - Jo - BHU Seehar BHU BHU Pathan BHU BHU Veehar BHU BHU New Gud New BHU BHU Mad Bahu BHU Jatoi Sono BHU BHU Shah Shah Abad BHU BHU Saeedo Deero Saeedo BHU BHU Moen BHU BHU Pir Bux BHUtto Pir Bux BHU BHU Usman Kalhoro BHU BHU Wasayo BHUtto BHU BHU Waris Dino Machi Dino Waris BHU

Bedpan 0 0 0 0 0 0 0 0 0 0 0 0 0

Urinal Male 0 0 0 0 0 0 0 0 0 0 0 0 0

Urinal Female 0 0 2 0 0 0 0 0 0 0 0 0 0

Iron Bed Without Foam Mattress 1 2 2 1 2 1 1 2 2 1 1 0 2

Miscellaneous

Refrigerator 1 1 2 2 1 1 1 2 0 2 1 0 2

Electric Water Cooler 0 0 0 0 0 0 0 0 0 0 0 0 0

Stabilizer 3000 W 0 1 2 2 1 2 1 2 1 2 2 0 2

Incinerator 0 0 0 0 0 0 0 0 0 0 0 0 0

Water Filter 0 0 0 0 0 0 0 0 0 0 0 0 0

Health Facility Assessment Sindh-2015-16: District Larkana Report 153 Domain VII Medicines and Supplies Table 29: Medicines and Supplies at Basic Health Units of District Larkana Status of drugs and supplies at BHUs

Availability at BHU

District Larkana

Drugs & Supplies

Bakhar Bakhar Pur BHU BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU BHU BHU Lashari BHU

Anesthetics Local

Inj. Lignocaine Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes

Lidocaine 2% Gel No No No No No No No No No No No Yes No No

Analgesics (NSAIDs)

Tab. Acetylsalicylic Acid (Soluble) No No No No No Yes No Yes No No No No No No

Tab. Mefenamic Acid Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Diclofenac Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Diclofenac Yes Yes Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Ibuprofen Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Ibuprofen Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Paracetamol Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Paracetamol Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Paracetamol Suppository No Yes No No No No No No No No No No Yes No

Anti-Allergic (Anaphylaxis)

Tab. Chlorpheniramine Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Chlorpheniramine No No No No No No No No No No No No No No

154 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

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Drugs & Supplies

Bakhar Bakhar Pur BHU BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU BHU BHU Lashari BHU

Syp. Chlorpheniramine Yes No Yes No No No Yes Yes No Yes No Yes No Yes

Inj. Dexamethasone Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Epinephrine (Ampule) No No No No No No No No No No No No Yes No

Inj. Hydrocortisone Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes

Tab. Prednisolone Yes No Yes No Yes Yes No Yes Yes No Yes Yes Yes Yes

Tabs Loratadine No No No No No No No No No No No No No Yes

Syp Loratadine No No No No No No No No No No No No No No

Antidotes and other substances

Atropine (Ampule) Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Anti-Epileptics Anticonvulsants (For Eclampsia Only)

Inj. Magnesium Sulphate Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Antibiotics/Antimicrobial

Tab./Cap. Amoxicillin 2 mg Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab./Cap. Amoxicillin No mg Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes Yes Yes

Amoxicillin 125mg/1.25ml, 1ml Drop Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes

Amoxicillin 2mg/5ml, 6ml Suspension Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Ampicillin (Powder for suspension) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Ampicillin Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Cap. Cephradine Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 155 Availability at BHU

District Larkana

Drugs & Supplies

Bakhar Bakhar Pur BHU BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU BHU BHU Lashari BHU

Inj. Lincomycin Yes No No No No Yes No No No Yes Yes Yes No Yes

Tab. Erythromycin No No No No No Yes Yes No No No No No No No

Tab. Ciprofloxacin Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Co-Trimoxazole DS Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Co-Trimoxazole DS 2 Yes No Yes No No No No Yes No No No Yes Yes Yes

Syp. Co-Trimoxazole DS No Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Yes No

Cap. Doxycycline Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Gentamicin Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Metronidazole Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Metronidazole Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Metronidazole Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Anti-Helminthic

Tab. Albendazole No No No No No No No Yes Yes No No No No No

Syp. Albendazole No No No No No No No No No No No No No No

Syp. Mebendazole Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes

Anti-Fungal

Clotrimazole (vaginal cream) Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes

Nystatin Tabs No No No No No Yes No No No No No No No No

Nystatin Drops No No No No No Yes No No No No No No No No

156 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

Drugs & Supplies

Bakhar Bakhar Pur BHU BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU BHU BHU Lashari BHU

Nystatin Pessary No No No No No Yes No No No No No No No No

Anti-Diabetics

Tab. Glibenclamide Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes

Tab. Metformin Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Insulin Regular No No No No No No No No No No No No No No

Insulin Comp No No No No No No No No No No No No No No

Antimalarial

Tab. Chloroquine Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Chloroquine Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Primaquine (diphosphate) Yes No No No No No No No No No No No No No Tab. Artesunate plus Sulfadoxine and No No No No No No No No No No No No No No Pyrimethamine (co-blister) Tab. Artesunate No No No No No No No No No No No No No No

GIT Medicines

Tab. Hyoscine Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tabs Phloroglucinol No No No No No No No No No Yes No No No No

Tab. Metoclopramide Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Metoclopramide No No No No No No Yes No No No No No No No

Inj. Metoclopramide No No No Yes No No No No No No No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 157 Availability at BHU

District Larkana

Drugs & Supplies

Bakhar Bakhar Pur BHU BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU BHU BHU Lashari BHU

Cap. Omeprazole Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Cimetidine Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj Ranitidine No No Yes No No No No No No No No No No No Tab. Magnesium Trisilicate + Yes Yes Yes Yes Yes Yes No Yes No Yes Yes Yes Yes Yes Aluminium Hydroxide Tab. Aluminium Hydroxide + Magnesium Hydroxide + Dimethicone Yes No Yes Yes Yes Yes Yes Yes Yes No No No Yes Yes (Suspension) ORS (Sachet) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Bisacodyl No Yes No Yes Yes Yes No No No No No No No Yes Sodium Biphosphate + Sodium No No No No No No No No No No No No No No Phosphate (12 ml liquid) Glycerin Suppository No No Yes No No No No No No No No No No No

Cardiovascular Medicines

Tab. Atenolol Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Methyldopa Yes No Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Furosemide Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes

Inj. Furosemide No No No No No No No No Yes No No No No Yes

Enalapril (Maleate) No No No No No No No No No No No No No No

Glyceryl Trinitrate No No No No No No No No No No No No No No

158 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

Drugs & Supplies

Bakhar Bakhar Pur BHU BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU BHU BHU Lashari BHU

Medicines Affecting Coagulation

Inj. Tranexamic Acid No No No Yes Yes Yes Yes No No No No No Yes No

Cap. Tranexamic Acid No Yes No Yes Yes Yes No No No No No No No No

Oxytocic Medicines

Tab. Misoprostol Yes No Yes Yes Yes Yes Yes No No Yes Yes No Yes Yes

Inj. Oxytocin Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Ergometrine (Hydrogen Maleate) No No Yes No No No No Yes No No No No No Yes

Respiratory medicines

Tab. Salbutamol Yes Yes Yes No Yes Yes No No No Yes Yes Yes No Yes Syp. Ammonium Chloride+ Sodium Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Citrate + CPM Syp. Aminophylline + Ammonium Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Chloride Inj Aminophylline No No No No No No No No No No No No No No

Ophthalmic Medicines

Chloramphenicol (Eye Drops) Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Dexamethasone (Eye Drops) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Gentamicin (Eye Ointment) Yes Yes Yes No Yes Yes Yes Yes No No No No No Yes Polymyxin B (Sulphate)+ Bacitracin Yes No Yes No No No No Yes Yes No Yes No No No Zinc (Eye Ointment)

Health Facility Assessment Sindh-2015-16: District Larkana Report 159 Availability at BHU

District Larkana

Drugs & Supplies

Bakhar Bakhar Pur BHU BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU BHU BHU Lashari BHU

Boroglycerine (Ear Drops) No No No No No No No No No No No No No No

Polymyxin B Sulphate + lignocaine (Ear No No No No No No No No No No No No No No Drops) I/V Infusions (Plasma Substitutes)

Dextrose 5% (Infusion) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Normal Saline (Infusion) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Ringer’s Lactate (Yes ml Infusion) No No No No No No No No No No No No No Yes

Ringer’s Lactate (No ml Infusion) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Vitamins and Minerals

Inj. Calcium Carbonate No No No No No No No No No No No No No No

Inj. Calcium Gluconate No No No No No No No No No No Yes No No No

Ascorbic Acid Yes No No No No No No No No No No No No No

Calcium Lactate No No No No Yes No Yes No Yes No No No No Yes

Ergocalciferol (Vit D) Yes No No No No No No No No No No No No No

Tab. Folic Acid Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Ferrous Sulphate + Folic Acid No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Zinc Sulphate Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Multiple Micronutrients Yes No No No No No No No No No No No No No

Tab. B Complex (B1, B6 and B12) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

160 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

Drugs & Supplies

Bakhar Bakhar Pur BHU BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU BHU BHU Lashari BHU

Syp. B Complex (B1, B6 and B12) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Dermatologicals

Permethrin Cream/Lotion (BB) Yes No Yes Yes Yes Yes No No Yes Yes Yes No Yes Yes

Benzyl Benzoate Lotion No No No No No No No No No No No No No No

Calamine Lotion No No No No No No No No No No No No No No

Hydrocortisone Cream Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Polymyxin B + Bacitracin Zinc No Yes No Yes Yes Yes Yes No No No No No Yes Yes (Ointment)

Silver Sulfadiazine Cream No No No No No No No No No No No No No No

Contraceptives

Condoms Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Ethynylestradiol + Norethisterone Yes No Yes No Yes No No Yes Yes No No No No No (Combined Oral Pills) Progesterone Only Pills No No No No Yes Yes Yes No No Yes No Yes No Yes (Levonorgestrel) Emergency Contraceptive Pills No Yes Yes Yes Yes No No No No No No Yes Yes Yes (Levonorgestrel)

IUCD (Copper T/Multiload) Yes No Yes No Yes Yes Yes Yes No No Yes Yes Yes Yes Inj. Medroxyprogesterone Acetate Yes No Yes Yes Yes Yes Yes Yes No Yes Yes Yes No Yes (DPMA) Inj. Norethisterone Enanthate (Net- No No No No No No No No No No No No No No En)

Health Facility Assessment Sindh-2015-16: District Larkana Report 161 Availability at BHU

District Larkana

Drugs & Supplies

Bakhar Bakhar Pur BHU BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU BHU BHU Lashari BHU

Inj. Estradiol Cypionate + No No No No No No No No No No No No No No Medroxyprogesterone Acetate Levonorgestrel-releasing Implant Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (Subdermal) Etonogestrel-releasing Implant Yes No No No Yes No No No No No No No No No (Subdermal) Antiseptics/ Disinfectants

Povidone-Iodine (Solution) Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Chloroxylenol Liquid Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Chlorine Base Compound No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Chlorhexidine + Cetrimide Sol No No No No No No No No No No No No No No Chlorhexidine Digluconate (7.1%) for No No No No No No No No No No No No No No cord care Disposable Supplies

Disposable Syringe 3cc Yes Yes Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Yes

Disposable Syringe 5cc Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Auto disposable Syringe 3cc No No No No No No No No No No No No No No

Auto disposable Syringe 5cc No No No No No No No No No No No No No No

IV Set Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Blood Sugar Test Strips Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

IV Cannula Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

162 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

Drugs & Supplies

Bakhar Bakhar Pur BHU BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU BHU BHU Lashari BHU

Adhesive Tape Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Cotton Bandage Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Absorbent Cotton Wool Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Examination Gloves Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Sterile Surgical Gloves Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Clean Delivery Kit No Yes No No Yes No No No No Yes Yes Yes No Yes

Vaccines and Sera

BCG Vaccine Yes No Yes Yes Yes No Yes Yes Yes No No Yes Yes Yes

Oral Polio Vaccine Yes No Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes

Injectable Polio Vaccine No No No Yes Yes No No No No No No No No No

Hepatitis B vaccine No No Yes No No No No No No No No No No No

Measles Vaccine Yes No Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes

Tetanus Toxoid Yes No Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes

Pentavalent Vaccine Yes No Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes

Pneumococcal Vaccine Yes No Yes Yes Yes No Yes Yes Yes Yes No Yes Yes Yes

Anti-Rabies Vaccines (PVRV) No No No No No No No No No No No No No No

Anti-Snake Venom Serum No No No No No No No No No No No No No No

Miscellaneous

Charcoal Activated Powder Yes No No No No No No No No Yes Yes Yes Yes Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 163 Availability at BHU

District Larkana

Drugs & Supplies

Bakhar Bakhar Pur BHU BHU BHU Wah Bahu Karira Agham Wandh Dadhro Chandio BHU Akil BHU BHU Haji Haji BHU Dhamrah BHU Mad BHU BHU Khan Khan BHU Masodero BHU Jumo Jumo BHU Kothi BHU BHU Izat Ji Izat Ji BHU BHU Fateh Fateh BHU BHU Beero BHU BHU Karani BHU BHU BHU BHU Lashari BHU

Inj. Diazepam Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Diazepam Gel No No No Yes No No No No No No No No No No

Oxygen Cylinder Yes No Yes Yes No No Yes No No Yes Yes Yes Yes Yes

164 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

-

Drugs & Supplies

Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU Anesthetics Local

Inj. Lignocaine No Yes Yes No Yes Yes Yes Yes No Yes Yes Yes Yes

Lidocaine 2% Gel Yes No No No No No No No No No Yes No No

Analgesics (NSAIDs)

Tab. Acetylsalicylic Acid (Soluble) Yes No No No No No Yes No No Yes Yes Yes Yes

Tab. Mefenamic Acid Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Diclofenac Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Diclofenac Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Ibuprofen Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Ibuprofen Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Paracetamol Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Paracetamol Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes

Paracetamol Suppository Yes No No Yes No No No No No No No No No

Anti-Allergic (Anaphylaxis)

Tab. Chlorpheniramine Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Chlorpheniramine No No No No No No Yes No No No No No No

Syp. Chlorpheniramine Yes Yes No Yes Yes Yes Yes No Yes Yes Yes Yes Yes

Inj. Dexamethasone Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Epinephrine (Ampule) No No No No No No Yes No No No No No No

Health Facility Assessment Sindh-2015-16: District Larkana Report 165 Availability at BHU

District Larkana

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Drugs & Supplies

Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU Inj. Hydrocortisone No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Prednisolone Yes No No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tabs Loratadine No No No No No No Yes No No No No No No

Syp Loratadine No No No Yes No No Yes No No No No No No

Antidotes and other substances

Atropine (Ampule) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes

Anti-Epileptics Anticonvulsants (For Eclampsia Only)

Inj. Magnesium Sulphate No Yes Yes Yes Yes Yes Yes Yes Yes No Yes No Yes

Antibiotics/Antimicrobial

Tab./Cap. Amoxicillin 2 mg Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab./Cap. Amoxicillin No mg Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Amoxicillin 125mg/1.25ml, 1ml Drop Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Amoxicillin 2mg/5ml, 6ml Suspension Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Ampicillin (Powder for suspension) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Ampicillin Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Cap. Cephradine Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Lincomycin Yes Yes Yes Yes Yes No Yes No Yes Yes Yes Yes No

Tab. Erythromycin No No No Yes No No No No No No No No No

Tab. Ciprofloxacin Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

166 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

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Drugs & Supplies

Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU Tab. Co-Trimoxazole DS Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Co-Trimoxazole DS 2 Yes No No No Yes No Yes No Yes No Yes Yes Yes

Syp. Co-Trimoxazole DS No Yes Yes Yes No Yes Yes Yes No Yes No Yes No

Cap. Doxycycline Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Gentamicin Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Metronidazole Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Metronidazole Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Metronidazole Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Anti-Helminthic

Tab. Albendazole No No No No No No Yes No No No No No Yes

Syp. Albendazole No No No No No No Yes No No No Yes No Yes

Syp. Mebendazole Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes

Anti-Fungal

Clotrimazole (vaginal cream) Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes No

Nystatin Tabs No No No No No No No No No No No No No

Nystatin Drops No No No No No No No No No No No No No

Nystatin Pessary No No No No No No No No No No No No No

Anti-Diabetics

Tab. Glibenclamide Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 167 Availability at BHU

District Larkana

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Drugs & Supplies

Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU Tab. Metformin No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Insulin Regular No No No No No No No No No No No No No

Insulin Comp No No No No No No No No No No No No No

Antimalarial

Tab. Chloroquine Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Chloroquine Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Primaquine (diphosphate) No No No Yes No No Yes No No No No No No Tab. Artesunate plus Sulfadoxine and No No No No No No Yes No No No No No No Pyrimethamine (co-blister) Tab. Artesunate No No No No No No Yes No No No No No No

GIT Medicines

Tab. Hyoscine Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tabs Phloroglucinol No No No No No No Yes No No No No No No

Tab. Metoclopramide Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Metoclopramide No No No Yes No No Yes No Yes No No No No

Inj. Metoclopramide No No Yes No No No Yes No No No No No No

Cap. Omeprazole Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Cimetidine Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes

Inj Ranitidine No Yes No No No No No No No No No No No

168 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

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Drugs & Supplies

Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU Tab. Magnesium Trisilicate + Aluminium Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Hydroxide Tab. Aluminium Hydroxide + Magnesium No Yes Yes Yes Yes Yes Yes Yes No Yes No Yes Yes Hydroxide + Dimethicone (Suspension) ORS (Sachet) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Bisacodyl No Yes Yes No No No Yes No No No No Yes No Sodium Biphosphate + Sodium Phosphate No No No No No No Yes No No No No No Yes (12 ml liquid) Glycerin Suppository No No No No Yes No No No No Yes No No No

Cardiovascular Medicines

Tab. Atenolol Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Methyldopa Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes

Tab. Furosemide Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj. Furosemide No No No No No No Yes No No No No No No

Enalapril (Maleate) No No No No No No Yes No No No No No No

Glyceryl Trinitrate No No No No No No Yes No No No No No No

Medicines Affecting Coagulation

Inj. Tranexamic Acid Yes Yes Yes No No No Yes Yes No No No No No

Cap. Tranexamic Acid No Yes Yes No No No Yes No No No No Yes No

Oxytocic Medicines

Tab. Misoprostol Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes No Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 169 Availability at BHU

District Larkana

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Drugs & Supplies

Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU Inj. Oxytocin Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes

Ergometrine (Hydrogen Maleate) No Yes No No No No Yes No No No No No No

Respiratory medicines

Tab. Salbutamol Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No Yes Syp. Ammonium Chloride+ Sodium Citrate Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes + CPM Syp. Aminophylline + Ammonium Chloride Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Inj Aminophylline No No No No No No No No No No No No No

Ophthalmic Medicines

Chloramphenicol (Eye Drops) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Dexamethasone (Eye Drops) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Gentamicin (Eye Ointment) Yes Yes No Yes Yes No No No Yes No Yes Yes Yes Polymyxin B (Sulphate)+ Bacitracin Zinc Yes No No Yes Yes No Yes No No No Yes Yes Yes (Eye Ointment) Boroglycerine (Ear Drops) No No No No No No No No No Yes No No No Polymyxin B Sulphate + lignocaine (Ear No No No No No No No No No No No No No Drops)

I/V Infusions (Plasma Substitutes)

Dextrose 5% (Infusion) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Normal Saline (Infusion) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Ringer’s Lactate (Yes ml Infusion) No No No Yes No No Yes Yes No No Yes No Yes

170 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

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Drugs & Supplies

Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU Ringer’s Lactate (No ml Infusion) Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes

Vitamins and Minerals

Inj. Calcium Carbonate No No No No No No Yes No No No No No No

Inj. Calcium Gluconate No No No No No No No No No No No No No

Ascorbic Acid No No No No No No No No No No No No No

Calcium Lactate Yes Yes Yes No No No No No No Yes Yes No No

Ergocalciferol (Vit D) No No No No No No Yes No No No No No No

Tab. Folic Acid Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes

Tab. Ferrous Sulphate + Folic Acid Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. Zinc Sulphate Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Multiple Micronutrients No No No No No No Yes No No No No No No

Tab. B Complex (B1, B6 and B12) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Syp. B Complex (B1, B6 and B12) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Dermatologicals

Permethrin Cream/Lotion (BB) Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes

Benzyl Benzoate Lotion No No No No No No No No No No No No No

Calamine Lotion No No No No No No No No No No No No No

Hydrocortisone Cream Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Polymyxin B + Bacitracin Zinc (Ointment) No Yes Yes Yes Yes Yes No Yes Yes Yes No Yes Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 171 Availability at BHU

District Larkana

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Drugs & Supplies

Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU Silver Sulfadiazine Cream No No No No No No No No No No No No No

Contraceptives

Condoms Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Ethynylestradiol + Norethisterone Yes No No Yes Yes No No Yes No Yes No Yes No (Combined Oral Pills) Progesterone Only Pills (Levonorgestrel) No No No No No Yes Yes No No No No No No Emergency Contraceptive Pills No Yes Yes Yes No No Yes No Yes No No No No (Levonorgestrel) IUCD (Copper T/Multiload) Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes No Yes

Inj. Medroxyprogesterone Acetate Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes (DPMA) Inj. Norethisterone Enanthate (Net-En) Yes No No No No No No No No No No No No Inj. Estradiol Cypionate + No No No No No No No No No No No No No Medroxyprogesterone Acetate Levonorgestrel-releasing Implant Yes Yes Yes Yes No Yes Yes No Yes No No Yes No (Subdermal) Etonogestrel-releasing Implant Yes No No No No No No No No No No No No (Subdermal)

Antiseptics/ Disinfectants

Povidone-Iodine (Solution) Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes

Chloroxylenol Liquid Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes

Chlorine Base Compound Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes No

172 Health Facility Assessment Sindh-2015-16: District Larkana Report Availability at BHU

District Larkana

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Drugs & Supplies

Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU Chlorhexidine + Cetrimide Sol Yes No No No No No Yes No No No No No No

Chlorhexidine Digluconate (7.1%) for cord No No No No No No Yes No No No No No No care Disposable Supplies

Disposable Syringe 3cc Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Disposable Syringe 5cc Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Auto disposable Syringe 3cc No No No No No No No No No No No No No

Auto disposable Syringe 5cc No No No No No No No No No No No No No

IV Set Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Blood Sugar Test Strips Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

IV Cannula Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Adhesive Tape Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes

Cotton Bandage Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Absorbent Cotton Wool Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Examination Gloves Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Sterile Surgical Gloves Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Clean Delivery Kit Yes No No No No No Yes No No Yes No No Yes

Vaccines and Sera

BCG Vaccine Yes Yes No No No No Yes No Yes Yes No No Yes

Oral Polio Vaccine Yes Yes Yes Yes Yes No Yes Yes No Yes Yes No Yes

Health Facility Assessment Sindh-2015-16: District Larkana Report 173 Availability at BHU

District Larkana

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Drugs & Supplies

Daro - Gud Jatoi Abad Deero Sanghi BHUtto BHUtto Jo Kalhoro BHU New New BHU BHU Shah Shah BHU BHU Sono Sono BHU BHU Sajan Sajan BHU BHU Waris Waris BHU Dino Machi Dino BHU Moen BHU BHU Seehar BHU BHU Usman BHU BHU Pir Bux Pir Bux BHU BHU Pathan BHU BHU Veehar BHU BHU Saeedo Saeedo BHU BHU Wasayo BHU Injectable Polio Vaccine No Yes No No No No Yes No No No No No No

Hepatitis B vaccine Yes No No No No No Yes No Yes No No No No

Measles Vaccine Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes No Yes

Tetanus Toxoid Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes No Yes

Pentavalent Vaccine Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes No Yes

Pneumococcal Vaccine Yes Yes Yes Yes Yes No No Yes Yes Yes Yes No Yes

Anti-Rabies Vaccines (PVRV) No No No No No No No No No No No No No

Anti-Snake Venom Serum No No No No No No No No No No No No No

Miscellaneous

Charcoal Activated Powder No No No Yes Yes No No No Yes No Yes No No

Inj. Diazepam Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

Diazepam Gel No No Yes No No No No No No No No No No

Oxygen Cylinder Yes Yes No Yes Yes No Yes Yes Yes No Yes No Yes

174 Health Facility Assessment Sindh-2015-16: District Larkana Report

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