JHARKHAND 1. District Pakur Major Observations of Field Survey Unit, Patna About the Evaluation Work in Pakur, in December
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JHARKHAND 1. District Pakur Major observations of Field Survey Unit, Patna about the Evaluation work in Pakur, in December 2009 Districts of Jharkhand State in Feb. 2010 and March 2010 respectively. I. Details of the visited Institutions: District Visited PHCs visited HSCs visited 1. Pakur PHC-Hiranpur,Amarapara Mohanpur, Dangapara, Torai, and Maheshpur Dumarchir, Tilaipara, Alubera, Birkitinorth, Birkit south and Bankur II. Major Observations: 1. Formation of VHSCs and RKS: a. Village Health & Sanitation Committee was constituted in 821 villages in the district. It is reported that All VHSCs have ASHA(SAHIYA called in Jharkhand) as a member. b. Rogikalyan Samiti is called as Hospital Management Society in the state. HMS was constituted and its registration is under process but the meetings of these societies for improving the services are reported to be conducted regularly. 2. Services of ASHA: a. ASHA scheme is implemented and all existing 1209 villages of the district are undertaken for the scheme. b. It was reported that 855 ASHA were in position and also trained in all the modules. c. All 855 ASHAs were provided with drug kits. d. In the visited PHCs, the target of ASHA has been fulfilled and maximum villages were also covered. 3. Untied Fund: a. Partial details about untied funds could be available from the district office. Rs.688133 were released from DFWB to the PHCs during the financial year 2009-10 but no details about CHC and HSC level untied funds provided by the district office. b. As SOE from the District, Rs.49973 were spent by the PHCs during the period from 1.4.2009 to 31.1.2010. c. In the visited PHCs, Rs. 25,000 were received during 2009-10 but the details of expenditure were not made available. 4. Services of JSY: a. Janani Surakha Yojna has been implemented in the district but its progress report was not made available to the team. b. In visited PHC at Hiranpur out of 365 beneficiaries under JSY only 80 beneficiaries have been paid with their incentives during 2008-09 and rest 285 cases were pending. 5. Physical infrastructure: (i) Sub Centres: a. HSCs visited in the district were in Govt. building but labour room facility was not there. Residential quarters for ANM were provided but they were not staying there due to lack of facility of toilet and electiricty. b. Furniture and equipment like Cupboard, Meintsh Sheet, Ambu bag, torch, foot stool, BP apparatus, bench for clients and delivery table were not found there. (ii) PPC/CHC/FRU and PHC: a. There was no CHC/PPC/FRU in the district. b. All the visited pHCs were running in Govt. building with residential quarter of MO/Paramedical staff. PHCs were having telephone facility/Electricity and water supply facility. No scarcity of essential drugs was found there. 6. Knowledge & Opinion of the Community about health services : a. Mothers who were eligible for ANC and PNC services contacted and found to be satisfied with the services provided by the concerned ANMs. b. Mothers had FW as ell as RCH Services in due time for ANC, PNCand new born care from the health personnel. c. During the field visit the team found that the Meical officer and Paramedical staff of the concern institution were found prompted in discharging their duty and facilities under NRHM programme. 7. Maintenance of Records and Registers: a. Performance report for sterilization, IUD, OP and Nirodh for the year 2008-09 was not made available by the District Office. b. Due to lack of IUD registers, reported figures could not be verified at visited PHCs. c. Eligible couple survey register was not maintained at any of the visited PHCs since more than 5 years. d. Register for Sterilisation,Cu-T, OP Condom users Child Immunization and ANC services were not properly maintained at all PHCs. e. PNC services were not mostly updated in the service registers at PHCs visited. f. Stock register of spacing method were not found at Hiranpur and Maheshpur PHCs. The same register was not maintained properly at Amarapara PHC. g. Sterilization case cards were also not issued at the PHCs. h. Performance report was not being reported as per HMIS formats. 2. District Sahibganj Major observations of Field Survey Unit, Patna about the Evaluation work in Simdega in December 2009 Districts of Jharkhand State in Feb. 2010 and March 2010 respectively. I. Details of the visited Institutions: 2. Sahibganj PHC-Sadar, Rajmahal, Barharwa Bhaga-bandh,Lakhimpur, and Barhet Mahadev Ganj, Jaamnagar, Mandai, Maalin,Ranigram and Ghobdiah II. Major Observations: 1. Services of ASHA: a. ASHA is called SAHIYA in the state. It was reported that all 1406 villages in the district were covered under the scheme and there were 1251 ASHA in position. b. The district was targeted for 1406 SAHIYA but presently selected 1251 and trained them up to fourth module. c. No Drug Kit provided to any SAHIYA in the district. d. In the visited PHCs no ASHA was working with the kits. 2. Untied Fund: Details of Untied fund at visited PHCs are as below: Sl.No. Particulars Sadar PHC Rajmahal PHC Barharwa PHC Barhet PHC 08-09 09-10 08-09 09-10 08-09 09-10 08-09 09-10 1 Untied Fund Received 25000 50000 25000 50000 25000 50000 25000 50000 2 Expenditure Incurred 25000 29590 25000 50000 17637 NIL NIL 39700 3 Balance NIL 20410 NIL 50000 7363 50000 25000 10300 b. Funds provision for the whole district was not made available at district office. 3. Services of JSY: a. The funds under Janani Surakha Yojna are being provided to the institutions at periphery level in the district. b. It is observed that maximum beneficiaries in the visited PHCs were not paid with their incentives inspite of the funds were available. c. As reported 2482 beneficiaries in the PHC Sadar, 889 in PHC Rajmahal and 350 beneficiaries in PHC Barhet in the year 2008-2009 were waiting for their incentive. Similarly, 601 in PHC Sadar, 1830 in PHC Rajmahal and 413 beneficiaries in PHC Barhet were yet to be paid during 2009-10. 4. Physical infrastructure: (i) Sub Centres Lakhimpur In Lakhipur sub centre, there was no electricity and toilet facilties. Furniture like examination table, foot stool and delivery table were also not provided to this centre. (ii) PHCs: a. The visited PHCs at Rajmahal and Barhet had Govt. building but maintenance of hospital building at these centres was poor. Cleanliness was also observed not up to the mark. b. Surgical equipments for minor operation was not available in the PHCs. 5. Maintenance of Records and Registers: a. Eligible couple survey register was not maintained at any of the visited PHCs. b. Register for Sterilisation,Cu-T, OP/ Condom Users, Child Immunization and ANC/PNC Services were not properly maintained at PHCs Sadar, Rajmahal and Barhet and same was not provided at PHC Barharwa. c. Stock register of spacing method were not maintained properly at PHCs Rajmahal and Barhet and not provided at PHCs Sadar Barharwa d. Sterilization case cards were also not issued at any PHC. 6. Miscellaneous Observations: a. Due to lack of Supervision, proper guidance in periphery level staff was not getting in time b. The meeting of the Rogi Kalyan Samiti is not being conducted on regular basis. c. In some of the places during visit to Barharwa PHC the labour room was locked since a long period. d. The posts of the Health workers (M) at HSCs were vacant. e. Performance of NSV was found poor in the district. 3. District Hazaribag Major observations of Regional Evaluation Team, Patna about the Evaluation work in Hazaribag Districts of Jharkhand State in July, 2009. I. Details of the visited Institutions: District Visited PHCs visited HSCs visited 1.Hazaribag PHCs- Barkattha, Sadar, HSCs- Surajkund, Harhad, Barkagaon, Katkamsandi Sindur, Sikari, Kathautiya, and Chauparan Hatkauna, Pabara, Sahpur, Pandey Bara, Chaikala and Bedna II. Major Observations: 1. Functioning of Village Health & Sanitation Committee (VHSCs) and Hospital Management Society (HMS): a. Only 359 Village Health & Sanitation Committee were functioning out of 1211 VHSCs set up in the district. It was reported that all VHSCs have ASHA( known as SAHIYA in the State ) as a member. b. Hospital Management Society (HMS) is functioning in the state as Rogi kalyan Samithi. HMS was Constituted in the Sadar Hospital and all PHCs in the district. It is observed that the meetings of HMS were not being conducted regularly at visited PHCs. 2. Services of ASHA: a. District has Population of 1565262 and all 1202 villages were covered under the scheme. b. As per requirement 2657 ASHAs have been selected in the District and process of training in all modules was going on the status of training was not made available to the team at the district level. However, it was reported at PHCs that ASHAs are undergoing training indifferent modules. 3. Untied Fund: a. It is observed that untied funds to the centres are not being provided in time in the district. b. Untied funds in two installments for the year 2006-07 and 2007-08 were released to the PHCs during 2007-08, but the funds for 2009-10 not povided. c. No funds have been provided to the sub centres during the year 2008-09 & 2009-10. d. The funds to 359 VHSCs were released first time in the district during the current financial year. 4. Services of JSY: a. There was no scarcity of funds in the visited PHCs for providing incentives to the beneficiaries. b. As per record there were 352 beneficiaries waiting for their payments from last year under the scheme at PHC Katkamsandi c.