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Assam 1)Kamrup( Rural) District

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Assam 1)Kamrup( Rural) District Assam 1)Kamrup( Rural) district Major observations of Regional Evaluation Team, Kolkata about the Evaluation work in Kamrup (Rural) district of Assam in June, 2010. I. Details of the visited Institutions: District visited BPHCs, RH, PPCs and NGSCs visited visited Kamrup (Rural) BPHC: Uparholi Rajabaha, Maniari Tinali, Amranga Baihat, Tarap FRUs: Suailkuchi, Hajo Losana, Jamtal, Bongshser, Dampur, Bongshore CHC: Mirza Baradadhi, Damdama and Mirza II. Major Observations: 1. Health Human Resources: a. Some posts of medical personnel at the various health centres in the district were reported to be lying vacant i.e. 22 MOs (out of 206 sanctioned), 15 specialist (out of 38 sanctioned). b. Under the category of non-medical, 20 posts (out of 602 sanctioned) of ANM, 2 posts (out of 20 sanctioned) of MPW (M), 5 posts (out of 33 sanctioned) of LHV/HS (F), 19 post (out of 164 sanctioned) of Staff Nurse and 9 posts (out of 73 sanctioned) of Lab Technician were also lying vacant in the various institutions/ centres in the district. 2. Functioning of Rogi Kalyan Samiti (RKS): a. It was reported that as many as 70 RKS have been constituted and also were functioning in the district but only 3 RKS were registered till the time of visit. It was also reported that the members of RKS meet regularly. b. Funds provided to the RKSs and expenditure incurred were not made available to the team in the district. 3. Functioning of ASHA and VHSC: a. In view of total 991 villages in the district, 1615 ASHAs had been selected in the district and out of them 1523 ASHAs were provided training up to 5th modules. b. All selected ASHAs have been provided with Drug kits. c. As reported, there were 1456 Anganwadi centres and 1615 VHSCs were functioning in the district. d. All VHSCs were having ASHA as a member of the committee. 4. Services of Janani Suraksha Yojana (JSY): a. The team has interviewed of total 54 JSY beneficiaries in the area of all the centres visited in the district. Most of them had the Ante natal and Post natal services. All contacted mothers were registered during ANC in proper time and issued MCH cards. b. Mothers had institutional delivery and also received JSY benefits. They were mostly accompanied by the ANMs or ASHAs while going to the hospital for delivery. 5. Physical infrastructure (HSC/PHC/RH) (i) Health Sub Centres: a. The Sub centres visited at Maniari Tinali and Rajabaha were functioning in Govt. buildings. b. No supply of Mclntsh sheet and Ambu bag/suction, weighing machine (Infant) and DDKs found at Maniari Tinali sub centre. Labour room facility and Delivery table were also not found in the centres visited. c. Drugs like Metronidazole tablets, Ampicillin capsule and Gentamycin injection etc. were not available in both the sub centres visited. d. Skilled Birth Attendance training was not provided to the Auxiliary Nurse Midwives of both the visited Sub centres at Maniari Tinali and Rajabaha. (ii) BPHC/ CHC and FRU: a. Functional Operation Theatre with OT Table was not found at BPHC Uparhali. b. Jeep, X-ray facility, Blood storage unit, Anesthesia equipments and surgical equipments related to CHC expertise were not available at CHC Mirza. c. FRUs Suailkuchi and Hajo were well equipped and drugs were also available. 6. Opinion and awareness of the Community on the Health Services: (i). ANMs Services: a. Most of the mothers interviewed for assessing the opinion and knowledge about the services provided by the concerned ANMs at sub centre level were happy to have the ANMs available at village level as and when needed. b. Mothers found receiving ANC and PNC services and necessary advice for new born care. c. However, they need proper guidance about use of contraceptive and knowledge about all health facilities where they can get. (II). MPW (M) Services: a. The work of MPW (M) of Maniari Tinali Sub centre was assessed and it was observed that the MPW (M) participated in the programmes relating to Public Health in the villages under the jurisdiction of the sub centre. b. He was not staying at sub centre headquarter. (iii). Services of PHC/FRU: a. The team interviewed pregnant women, recently delivered women, mothers upto two year old child, ASHAs and also village leaders in the area of PHCs and FRUs and found that they were satisfied with the services provided by the PHC/FRU MO and staff. b. The Medical officers at Uparhali BPHC, Hajo FRU and Suailkuchi FRU were visiting the villages of their areas regularly. 7. Sample Verification of F.W. acceptors: a. The team selected a total of 164 F.W. acceptors for sample verification and out of that 115 (70.12%) could be contacted. Discrepancy was noticed in total number of children in 15 (13.04%) cases. b. 41 (35.65%) acceptors informed that they did not receive any follow up services after having accepted the services. 8. Reconciliation of the reporting performance under Sterilization: a. Sterilization performance reported by the district office for FRU at Suailkuchi for the year 2009- 10 did not tally with the report of FRU and the number was less by 20 sterilizations. In fact the figures were 632 but district office showed as 612. b. The service register for CuT was not completed at Uparhali BPHC and Hajo FRU as such the reported figure could not be verified at these centres. c. CuT performance reported by the district office for the BPHC, CHC and FRUs for the year 2009-10 also not tally with the figures reported at PHC, CHC and FRUs visited by the team. 9. Registers, records and reports maintained at the visited centres: a. Updated Eligible couple register neither maintained nor made available to the team at BPHC Uparhali and FRU at Suailkuchi. b. Service registers for Sterilization cases was not maintained properly and updated at FRU at Suailkuchi and Hajo. c. Service register for CuT acceptors was found incomplete at the visited centres. d. Stock register of contraceptive items was not maintained properly in all the institutions visited. Some essential information like supply and expenditure of medicines and other materials etc. were not recorded. 10. Miscellaneous observation and suggestions: a. JSY payment register was not maintained properly. Date of delivery, addresses of beneficiaries and also date of payment in some of the cases were not recorded by the accounts personnel in the visited institutions at FRUs at Suailkuchi and Hajo and at Mirza CHC. b. It was observed that the monitoring and regular supervision at periphery level was not effective. The LHVs, BEE and Health Educators supervised Sub centre and dispensaries but no feedback as the discrepancies found by these officials was given for immediate rectification. As such there was very little improvement in the maintenance of record and registers. c. It was observed that the Accountant/ Account Clerks need orientation training for preparation of SOE and UC as well as maintenance of cash registers and records. District NRHM Unit officials could not provide proper integrated statement of expenditure of NRHM activities for the period 2009-10, so team could not examine the actual position of the programme in the district. 2). District: Kamrup (Metropolitan) Major observations of Regional Evaluation Team, Kolkata about the Evaluation work in Kamrup (Metropolitan) districts of Assam in June, 2010. I .Details of the visited Institutions: District visited BPHCs, RH, PPCs and NGSCs visited visited Kamrup (Metrop BPHC: Sonapur Kamarkuchi, Bomani Jorabad, Gota Nagar (Urba FRU: Pandu and Ganshpa area MCW: Dhirenpara II .Major Observations 1. Functioning of Rogi Kalyan Samiti (RKS): a. It was reported that total 26 RKS had been constituted and functioning in the district b. It was also reported that the members of RKS meet regularly. 2. Functioning of ASHA Scheme: a. In view of total 298 villages in the district, 211 ASHAs had been selected and all ASHAs have been trained up to 5th modules. b. The distribution of Drug kits to all trained ASHAs has been completed in the district. 3. Untied Funds: The District received an amount of Rs. 9,33,408 in 2008-09 and Rs. 11,10,535 in 2009-10 as Untied Funds for strengthing the services of PHCs and out of that Rs. 4,82,873 was spent during 2008-09 but no fund was utilized in 2009-10. 4. Services of Janani Suraksha Yojana (JSY): a. Regular and sufficient flow of funds was available and the beneficiaries were being provided with cash assistance under the scheme. b. The district had spent Rs. 2,60,38,818 for providing incentive to 17875 JSY beneficiaries against the provision of Rs. 2,52,97,858 in the year 2008-09 and Rs. 2,44,51,915 have been spent in the year 2009-10 for 15122 JSY beneficiaries out of Rs 3,02,59,039 provided during the year. c. 28 recently delivered mothers and JSY beneficiaries contacted in the district for on the spot verification. All contacted beneficiaries had received cash incentives in time and also availed the services under the scheme. However, quality of Post Natal visit by field workers was required to be increased involving ASHAs/ AWW. d. Referral Transport funds Rs. 24,50,000 was also allotted to the institutions for providing to JSY beneficiaries and out of that Rs.1,62,279 in the year 2008-09 and Rs. 22,87,721 have been spent during 2009-10. 5. Physical infrastructure (HSC/PHC/RH) (i) Health Sub Centres: a. The Sub centres visited at Bomani Jorabad and Kamarkuchi were functioning in Govt. buildings. Water and Electricity supply was not available in these centres.
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