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Haryana 1. District: Hisar Major Observations of Regional

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Haryana 1. District: Hisar Major Observations of Regional Haryana 1. District: Hisar Major observations of Regional Evaluation Team, Lucknow about the Evaluation work in Hisar district of Haryana State in August, 2009 I. Details of the visited Institutions: District PHCs/CHCs SCs Visited Visited Hisar CHCs: Arya Nagar,Mangali, Narnaud Kirtan, Rawal Bas Khurd, Nalwa, PHC: Nalwa Bhojpur, Sulchani and Baini Hamirpur PPC: Hisar II. Major Observations: 1. Health Human Resources: a. It was observed that the services of specialists in the visited CHCs at Arya Nagar, Mangali and Narnaud were not provided as per sanctioned provision of Indian Public Health Standard in the district. Only Dental Surgeon was posted at Arya Nagar and Narnaud. b. The availability of staff position in the visited PHC was better than that of CHC, near about 91% of the sanctioned staff was in position in the visited PHC. 2. Functioning of Rogi Kalyan Samittee: a. Rogi Kalyan Samittees which are called Swasthya Kalyan Samittee (SKS) in the State have been constituted at all the visited CHCs and PHCs in the district. The SKS have been registered in all visited PHCs and CHCs. b. Meeting of SKS was being conducted on regular basis though proper representation from PRI was not there. c. During the visit to PHC at Nalwa and CHC at Narnaund, the team has observed that the quorum i.e. the minimum attendance of 50% members was not there to finalise the proposal in the meeting of SKS at Nalwa and items were purchased at Narnaund without getting the proposal approved as per guidelines. 3. Services of ASHA: a. It was observed that the Scheme was well functioning in all the Institutions visited in the district. b. 860 ASHAs were in position in the district as against sanctioned strength of 1060 ASHAs. c. 457 ASHAs have been trained in only 1st module. d. Drug Kits to the ASHAs were not provided in the district. 4. Functions of VHSCs: a. 307 VHSCs have been set up in the district during 2008-09, and were renamed as Village Level Committee (VLC) in 2009-10. a. The meeting of VLC-cum VHSCs were not being conducted at any of the centres/villages visited in the district. b. ASHA is a member in the VHSC. c. During 2008-09, 45% (Rs. 2691675) of the funds allotted to the VHSC’s was spent in the district. 5. Utilization of Untied Funds: a. Utilization of funds released to the HSCs/PHCs and CHCs under the scheme during 2008- 09 was found poor in the district. b. It was reported that due to non utilization of the funds during last year at most of the centres, no funds for the year 2009-10 has been allotted under the scheme. c. District authority need to monitor the scheme on regular basis for proper utilization of funds. 6. Services of Janani Suraksha Yojana: a. Sufficient funds were available under the scheme in the district for providing incentives to the beneficiaries. b. However it was observed that during 2008-09, 63 % of the allotted budget could be utilized for providing cash benefits to 2877 JSY beneficiaries in the district under the scheme. c. There were many centres in the district which could only spend their allotted budget in between 0 to 14% in the district. d. Team contacted 27 JSY beneficiaries, out of them 26 told that they got their incentives after 1 to 2 months of delivery due to procedural work delay. 7. 24 hours delivery Scheme: 24 hours delivery scheme for promoting the Institutional delivery care in rural areas was not setup in the district. 8. Physical infrastructure (HSC/PHC/CHC) (i) Health Sub Centres: a. All the visited sub centres were functioning in Govt. accommodation. b. Electricity connection, Toilet facility and Labour room facility was not there in one half of the visited centres. c. Ambu bag/suction, DDKs and EC Pills etc. were not available at any of the centres. d. Delivery table, Mclntsh sheet, Delivery kits, Chlorine solution/bleaching powder, and Metronidazole tablets etc. were also not available at most of the visited Sub centres. e. Skilled Birth Attendance training to the Auxiliary Nurse Midwives of Sub centres Kirtan, Rawal Bas Khurd, Bhojpur and Baini Hamirpur was not provided. (ii) PHCs and CHCs: a. X-ray facility, Neonatal Resuscitation equipment and OT with OT- table were not provided to the CHC at Mangoli. b. Ambulance/ Jeep and Weighing machine (infant) was not there at CHC Aryanagar. c. Weighing machine, Resuscitation equipment and Neonatal Resuscitation equipment were not provided to the CHC at Narnaund. d. Blood storage unit and Anesthesia equipments were not provided at CHCs Aryanagar, Mangoli and Narnaund. e. Telephone facility, Ambulance/Jeep, Resuscitation equipment, Operation Theater with OT table, Condoms, IFA syrup and Vitamin- A tablets were not available at PHC Nalwa. f. It was also found that AYUSH Medical officer was not posted in PHC at Nalwa. 9. Opinion and knowledge of the Community on Health Services: a. 54 Mothers were interviewed by the team in the area of the visited Sub centres for assessing their opinion about the services provided by the ANMs. b. They were found to be satisfied on the regular availability of the ANMs at the sub centres. c. However, it was observed that more than 24% of mothers were not aware of contraceptive methods. d. The villagers in the area of the PHCs were satisfied about the services provided at PHC/CHC level by the Medical officers and other staff. 10. Maintenance of Service registers: a. Reported figures for CuT for the year 2008-09 and 2009-10 could not be verified due to absence of service register at the headquarter of reporting units. These registers for sterilization cases were not maintained at CHCs Arya Nagar and Mangoli. The units may be asked to maintain proper record of the health care services provided. b. An urgent action is needed to provide relevant registers for proper record maintenance at periphery level centres. 11. Reconciliation of the reporting performance under Sterilization: a. Sterilization performance reported by district office for CHCs at Arya Nagar, Mangoli and Narnaund did not tally with the reported figures at the CHCs headquarter. b. The data of the performance report received in the district is shown varying the figures as below- Sr. Name of the During the year 2008-09 During the year 2009-10 No. Centres Sterilizations reported by Sterilizations reported by District Reporting Recorded District Reporting Recorded office Centres in registers office Centres in registers 1 CHC, Arya Nagar Nil 1196 * No record Nil 453 * No record 2 CHC, Mangoli Nil 1357 * No record Nil 552 * No record 3 CHC, Narnaund 278 1043 * 278 55 363 * 55 4 PPC, Hisar 808 808 808 343 344 * 343 * These figures differs with the district figures 2. District: Sirsa Major observations of Regional Evaluation Team, Lucknow about the Evaluation work in Sirsa district of Haryana State in August, 2009 I. Details of the visited Institutions: I Sirsa CHCs: Raniya, Bara Gudhan and Raniya, Nakora, Madho Singhana, Bara Madho Singhana Gudhan, Chatariya, Shauwala and Mangala. II. Major Observations: 1. Health Human Resources: a. It is reported that the post of SMO in CHC Madhosinghana, 1 post (out of 2 sanctioned) of MO at PHC Panihari and 2 posts (out of 3 sanctioned) of MO at CHC Rania were lying vacant. b. Under the category of non-medical posts, 4 post (out of 5 sanctioned) of MPHS (M), 4 posts (out of 6 sanctioned) of MPHS (F), 13 posts (out of 21 sanctioned) of MPHW (M) and 1post (out of 22 sanctioned) of MPHW (F) were laying vacant at sub centre level in the CHC Madhosinghana. Similarly, 15 posts (out of 18 sanctioned) of MPHW (M) and 3 posts (out of 19 sanctioned) of MPHW (F) were also laying vacant at CHC Rania. c. It was also observed that some of the post of specialists at CHCs was lying vacant in the district. 1. Functioning of Rogi Kalyan Samittee: a. Rogi Kalyan Samittees called as Swasthya Kalyan Samittee (SKS) in the State have been constituted at CHCs and PHCs in the district. b. SKS were not functioning as per guidelines, meetings were not held regularly, following up actions of the meetings were also not being taken in these centres. c. During the visit of CHCs at Madho Singhana , Raniya and Bara Gudhan, the team has observed that the quorum (i.e. the minimum attendance or 50% members) was not there to finalise the proposal in the meeting of SKS at Madho Singhana. 3. Services of ASHA: c. It was observed that the Scheme was well functioning in all the Institutions visited in the district. d. 770 ASHAs have been selected in the district during 2008-09. e. 543 ASHAs have been trained in only 1st module. f. Drug Kits to the ASHAs were not provided in the district. 4. Functions of VHSCs: a. 331 VHSCs have been set up in the district during 2008-09, and were renamed as Village Level Committee (VLC) in 2009-10. b. The meetings of VLC-cum VHSCs were not being conducted at any of the centres/villages visited in the district. c. During 2008-09, 58% of the allotted funds (Rs. 6190338) were spent by these VLCs and the balance funds were carried forward for utilization in 2009-10. d. ASHA is a member of each VLC cum VHSC. 5. Utilization of Untied Funds: a. Funds are being provided regularly to the centres in the district. b. Most of the CHCs/PHCs had not utilised the full funds previous year, and the balance amount carried forward to the year 2009-10.
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