1 Puducherry 1. District Puducherry: Major Observations of Regional
Total Page：16
File Type：pdf, Size：1020Kb
Puducherry 1. District Puducherry: Major observations of Regional Evaluation Team, Chennai about evaluation work conducted in Puducherry district of the UT in May 2011. I. Details of the visited Institutions: GH / PHCs and PVT Hospitals visited HSCs Visited GH Puducherry Seliamedu and Karkadu Maneli CHC: Karikalambakkam, PHC: Bahur and Villayanur, Sono Scan Centre and Aruna Scan Centre II. Major Observations: 1. Health Human Resources: a. Some of the key posts were reported to be lying vacant in the district. 13 posts of ANM against 231 sanctioned, 5 posts of LHV against 29 sanctioned, 8 posts of Male Supervisor against 29 sanctioned, 79 posts of MO against 337 sanctioned, 39 posts of Specialist against 119 sanctioned and 23 posts of Lab Technician against 88 sanctioned were lying vacant in the district. b. In GH, Puducherry, out of 27 posts of Staff Nurses, 8 were vacant and out of 46 Posts of Cleaning Staff, 12 were vacant. Further, 3 posts of Specialist Doctor, 5 posts of Medical Officer, 4 Head Nurses, 6 Staff Nurses, 2 Technical Assistant, 3 Senior Lab Technician, 55 group ‘D’ Staff, 5 Group ‘C’ Ministerial Staff and 4 group ‘D’ Ministerial Staff were also vacant. 2. Services of Janani Surakha Yojna (JSY): a. Details of JSY beneficiaries and amount received and spent for the period 2009-10 and 2010-11 in the district are given below. 1 S.NO PARTICULARS 2009-10 2010-11 1 No. of JSY beneficiaries in the district 3951 3627 2 No. of mothers received JSY incentive 3951 3627 3 Expenditure incurred under JSY 25,91,400 23,77,000 b. The contacted 3 JSY mothers informed that they had received the JSY amount as per rules. 3. Untied Funds: a. Status of availability and utilization of Untied Funds during 2010-11 is given as follows: Amount in Rs. Sl.No States of Centres Untied Fund 2010-2011 Opening Received Expenditure balance In the year 1 Primary Health Centres 37,202 6,88,072 7,10,843(98%) 2 Community Health Centres 213 1,02,008 1,02,221(100%) 3 Health Sub Centres 71,298 5,43,225 5,89,930(96%) b. All the records of Untied Funds were properly maintained in the visited centres in Puducherry district. 4. Rogi Kalyan Samiti (RKS) and Village Health & Sanitation Communities (VHSCs) a. In GH Puducherry, Patient Welfare Committee was functioning with Governing Body and Executive Body. Likewise PHCs / CHCs were also having Patient Welfare Society with only Governing Body constituted in the district. b. In the district, there were 92 VHSCs formed. All the VHSCs in the visited areas conducted their meeting but not in regular basis in the visited centers. 5. 24 Hours Delivery Care System: 2 15 PHCs were working as 24 hours delivery care service centers. As per the district statement, institutional deliveries were increasing gradually in the district. 6. Physical Infrastructures and Stock Position: i) Government District HQ Hospital: District hospital Puducherry with 738 beds provides the services of all specialties. Anesthetists and Surgeons were available for 24 hours. Acute trauma care wards and separated wards for male and female patients were available. Blood bank was functioning round the clock; blood is collected from voluntary donors and supplies to all Government Institutions. ii) CHC Karikalambakkam a. CHC Karikalambakkam is a 36 bedded hospital. There were seven Medical Officersbut Specialists posts were vacant and blood storage unit was not available. residential quarters for MOs and 23 quarters for paramedical staff were available. iii) PHC a. The facilities were good in Villianur PHC which is a 7 beded PHC. having seven MOs. There was no AYUSH MO and also no residential quarters for MO. Around 6 deliveries are conducted in a month and 500 OPD are attended daily. b. In PHC Baghour there was no autoclave and OT facility. iii) HSCs a. The team visited the HSCs at Korkadu, Manaveli and Seliamed. All the three HSCs had building and the ANMs were staying at the HSC HQ. b. HSC Korkadu was having Hemoglobinometer but not in a working condition. Disposable syringes, Thermometer, Gas cylinder were not available. IFA tablets (small) were not available for the last one and half year. c. None of the visited HSCs had Ambu bag suction apparatus, RDT kit, Thermometer, Oxytocin, Ampicillin and Gentamycine - inj. d. None of the ANMs received training for SBA and IMNCI. e. Kit A and Kit B were not issued by the HSCs for the current year. 7. Opinion of Community on the Health Services:- 3 a. The team selected and contacted 9 mothers to know about the work of ANMs and their knowledge on various health related issues. All the contacted mothers informed that ANMs were available when needed. b. All contacted mothers were aware of exclusive breast feeding, use of ORS and Contraception. Mothers were aware of nearest government health facilities. c. First breast feeding within half an hour of delivery was initiated by 6 (67%) mothers. 6 mothers (67%) had knowledge on ARI and contraceptive side effects was known to 7(78%) mothers only. 8. Maintenance of Records/Registers:- a. Register maintenance was found satisfactory in the centers visited. Consolidated service register for IUD was not maintained in the PHCs and CHCs visited. Register for EC, ANC, PNC, Immunization and other activities were seen maintained in all the centers visited by the team. 9. Other observations: 1. IUD performance in Bahur PHC was poor. During 2010-11 only nine cases were reported. The PHC was having four HSCs. In view of this there was tremendous scope for improvement in IUD performance. 2. The District of Puducherry 79% of total Institutional deliveries in government institutions. 3. Puducherry District was having a very good internet network. HMIS was sent through internet and printed forms of ANC and Child tracking were available at all HSCs. **** 4 2. District Yanam: Major observations of Regional Evaluation Team, Chennai about evolution work conducted in Yanam district of Puducherry August 2011. I Details of the visited Institutions: GH visited HSCs Visited GH Yanam HSC Farampetta, Gueriampetta, Dariyalarthippa and Kamakalpetta II. Major Observations: 1. Health Human Resources: In the Yanam district, there are 254 total sanctioned posts under various categories. Out of these 33 are group ‘A’, 5 in group ‘B’, 137 in Group ‘C’, 78 in Group ‘D’ and 1 of part time staff. Out of 254 posts, sanctioned under various categories 170 post were filled up and 84 posts were lying vacant. a. Out of 20 General Duty Medical Officers, (Group ‘A’), 3 post each of General surgeon, ENT and Dentist were only filled up. The post of Anesthetist, DGO, and Medical specialist, T.B, Ophthalmologist and Radiologist were lying vacant. b. Out of 5 posts sanctioned under Group ‘B’, 4 posts were lying vacant; only 1 of 2 sanctioned posts of office superintendent was filled. c. There were 39 vacancies of Group ‘C’ posts against the sanctioned strength of 137 in the district. There was major vacancy in the sanctioned strength of Staff Nurse; only 53 out of 62 posts were filled in. Similarly all 4 sanctioned posts of radiographer, 5 of the 6 sanctioned posts of Head Nurse, all 2 sanctioned posts of X-ray Technician, one sanctioned post of SO, all 2 sanctioned posts of Store keeper (Gr.III) and 3 of 5 sanctioned posts of Driver, were lying vacant. 5 d. Out of 78 sanctioned Group ‘D’ category posts, 14 posts were vacant in the district. Mainly each one of the sanctioned post of Boiler Attend, Theatre Assistant, Peon and Inset Collector was lying vacant. e. There was no post of DPM under NRHM in Yanam district. f. In all the visited 4 HSCs, in addition to the regular ANMs, there was an additional ANM posted. 2. Services of Janani Surakha Yojna (JSY): a. In the district, 200 JSY mothers benefitted with the cash assistance in the year 2009- 10 and 201 mothers during 2010-11. Most of the deliveries were conducted in Kakinada of Andhra Pradesh. Rs. 600/- are given to each JSY mother for institutional delivery. b. In Yanam, none of the HSCs have conducted any delivery. The number of deliveries conducted in GH Yanam is also very few for want of sufficient manpower especially DGO and Anesthetist. c. The team interviewed 15 JSY beneficiaries in the field. All have reportedly received JSY incentive. 3. The district has received a total of Rs. 52.77 lakhs under various heads during 2009-10. Out of which Rs. 27.96 lakhs were spent. During 2010-11, a total of Rs. 59.38 lakhs received out of which 53.85 lakhs were spent under various heads. The observations of the team regarding funds are as follows. a. No AMG and VHSC fund given to any of the HSCs visited. b. Full details of funds received and spent in GH Yanam not made available. c. All 4 HSCs had received untied funds from the GH Yanam when ever required instead of getting untied funds @ Rs. 10000 per year. For example HSC Kanakalpathu received Rs. 4000 during 2009-10 and Rs.6483 during 2010-11 instead of Rs.10000 per year. HSC Gueriampet received only Rs. 5620 and Rs.7539 for the same period. HSC Dariyalitippa received Rs. 2760 and Rs.2960 and HSC Farampeta received Rs.7000 and Rs. 3487 for the above period. d. It was informed that PWD was entrusted with the maintenance work of 4 HSCs @ Rs. 49000 per HSC. It was observed by the team that out of 4 HSCs, buildings are fully leaking in 3 HSCs. Only some white wash was done at the leaking side of the building.