Panjab District- Firozpur Evaluation Report of Firozpur District (Punjab
Total Page：16
File Type：pdf, Size：1020Kb
Panjab District- Firozpur Evaluation Report of Firozpur District (Punjab) The Regional Evaluation Team, located at Regional Office for Health and Family Welfare (Patna), Ministry of Health and Family Welfare, Government of India carried out sample checks of activities covered under NRHM / RCH in Firozpur District of Punjab State during July, 2011. The findings / observations of the team which are based on the sample checks are detailed below: I. Details of the visited Institutions: As part of evaluation, the team visited Sub District Hospitals (SDH), Community Health Centres (CHCs), Primary Health Centres (PHCs) and Sub Centres (SCs) in both Districts of Firojpur and Faridkot as per the details given below: Districts S.D.H./CHC/PHC Sub Centres Firojpur S.D. Hospital: Fazilka Saraiah, Khuranj, Karma, Chhanga- CHC: Jandwala, Mandot & Guruharsahai khurd, Prabjb & Sohangarh PHC: Jandwala Bhim Shah II. Major Observations: 1. Human Resources: Shortage is a common phenomenon across all categories of clinical staff. More than 30% Posts of Medical Officers and about 24 % posts of Specialists were lying vacant in the District. The details of posts sanctioned, in position and vacancies are as given below: Post Post sanctioned In position Vacant M.O 159 111 48 Specialists 80 61 19 GNM 266 213 53 Lab Technician 75 41 34 2. Rogi Kalyan Samiti (RKS) and Village Health Sanitation & Nutrition Committee (VHSNC): a) Rogi Kalyan Samitis (RKS) were constituted in all the PHC and above level Health facilities covered in the evaluations study but their meetings were not being conducted regularly. b) Details of funds allocated / available, expenditure incurred during 2010-11 in different institutes are as given below: (in Rs.) Type of Institution 2010-11 Fund Available Expenditure Balance D.H 5,00,000 4,96,481 3,519 S.D.H & Others 3,00,488 2,93,305 7,183 CHCs 8,00,000 7,94,500 5,500 PHCs 54,20,125 52,73,538 1,46,587 c) No funds were released up to July, 2011 to any health facilities during 2011-12. d) It was reported to the team that a total of 1217 Village Health Sanitation & Nutrition Committees were functioning in the district and out of the total budget allocation of Rs. 1,29, 85,544, an amount of Rs. 1, 22, 92,031 was utilized by these VHSNCs during 2010-11. e) The budget allocation for the current year (2011-12) was reported as Rs. 6,93,515 and the utilization up to June, 2011 was only Rs. 1,03,746. 3. Services of Janani Suraksha Yojana (JSY): a) During the field visit, the team observed that necessary information was not recorded in JSY cards and JSY registers were not maintained properly at the facilities covered in the evaluation. b) Mothers of young children (13 Nos.) contacted by the team reported to have received 3 consecutive post natal check-ups after delivery. c) The team was provided details of allocation and utilization funds during evaluation. It was reported that an amount of Rs. 65,60,580 was spent out of the budget allocation of Rs.65,90,480 under JSY. However, during the year 2011-12, funds are not allocated to the district under JSY; an expenditure of Rs.7, 65, 625 has been incurred up to June, 2011. d) It was also reported that the district had spent full amount of Rs.13,69,000 that was provided for Referral Transport for the year 2010-11 under JSY scheme. No allocation for the current year (2011-12) has been made to the district but Rs.2,16,800 spent up to June, 2011. 4. Functioning of ASHA Scheme: a) It was reported to the team that out of a target 1393 ASHAs for the district, 1337 were in position and 1278 were trained in all modules and provided drug kits. b) It was also reported that ASHAs were receiving incentive money on monthly basis. 5 Untied funds: a) It was observed that the untied funds allocated to the SCs were utilised and cash books maintained properly. b) The fund utilization position was quite encouraging during 2010-11 but not so in 2011-12.The details of utilization of untied funds at CHCs, PHCs and SCs level for both the years reveals the position. Type of 2010-11 2011-12 (up to June,2011) Institution Fund Available Expenditure Balance Fund Available Expenditure Balance CHCs 4,00,573 4,01,227 348 4,00,346 NIL (0%) 4,00,346 (100%) PHCs 8,52,620 8,40,247 12,373 8,62,373 11,000 (1%) 8,62,373 (99%) Sub Centre 25,59,942 22,77,491(89 2,82,451 25,92,451 10,000 (0%) 25,82,451 %) 6. 24 x 7 hours Delivery Care Services: It was reported that there were 16 institutions providing 24 x 7 hours delivery services in the district. 7. Physical Infrastructure and Stock Position: i. CHCs and SDH: a) Blood storage unit was not established at the CHCs at Mandot and Guruharsahai. b) Some of the surgical equipments, Anaesthesia equipment and Inj. Quinine were not available at CHC Mandot. c) Sick New Born Care Unit was not established in CHC Mandot and SDH, Fazilka. ii. PHCs: a) PHC, Jandwala Bhimshah had its own building with Regular water supply, electricity connection and Toilet facility. Maintenance of the hospital building was satisfactory. Telephone facility was also available. b) Most of the essential equipments and supplies were available in the PHC. Stock of OPV, DT. Vit. „A‟ solution etc. was not available on the day of visit. c) There was no residential accommodation at PHC for MO. iii. HSCs: It was observed that the availability of medicines, clinical consumables, equipment etc. was poor at HSCs visited, the details are: a) Sub Centres at Saraiah and Khuranj were having own government building with regular water supply, electricity connection and toilet facility. b) Labour room, Delivery table, McIntosh sheets, Ambu bag / suction, Delivery Kit and RDT Kit for malaria were not available at both the above visited Sub Centres. c) Steam sterilizer, Nischay pregnancy test kit, Torch and stove were not available at Sarrian Sub Centre. c) EC pills, Co-trimoxazole, Misofrostol, Magsulth and Oxitocine tablet, Ampicillin Capsule and Gentamycine injection were not available at both the Sub Centres. d) Slides for blood test, IFA Tablet/syrup, chloroquine tablets and Metronidazole tablets was not available at Khuranj S/C whereas Kit-A and Kit-B was not available at Sarrian S/C. d) Printed Eligible couple Registers were not available at Khurang Sub Centre. e) SBA training was not given to the ANMs. 8. Community Satisfaction on overall service: i. Services of ANMs: a) Mothers (18) of young children (up to one year of age), who had institutional deliveries, expressed their satisfaction with the services provided by ANMs. b) Though 40% of the contacted mothers were not aware of ARI & ORT, all of them were aware of the benefits of exclusive breast feeding, complementary feeds and the services available at Government Health Facilities. ii. Services of MPW (Male): a) Work of MPW (Male) was assessed at SC Saraich and his service delivery was up to the mark. b) Popularization and distribution of Nirodh by MPW needs further boost. iii. Services of PHC/CHC: a) It was reported that Medical officer of Mandot CHC, Guruharsahai CHC and PHC Jandwala Bhim Shah did not pay regular visits to villages on regular basis. b) Though the community was satisfied with the services provided at CHC/PHC headquarters, some of the contacted mothers were not aware about the ANC, ARI, ORT and AIDS/HIV. 9. Sample Verification of Family Welfare Acceptors: a) Out of 113 acceptors of family planning selected, 63 (55.8%) could be contacted for sample verification in the district. Eleven FP accepters (18.0%) reported that they did not receive any follow-up services. b) Out of 23 selected samples of child immunization, 20 (87%) were contacted in which all beneficiaries confirmed the receipt of immunization doses and expressed their satisfaction. 10. Reconciliation of Reported performance: a) The team observed variations in the performance (Sterilizations) between the figures reported by the District authorities compared with data available at the CHCs for the years 2010-11 and 2011-12 (Table). Sr. Name of centres Sterilization performance reported at No. 2010-11 2011-12 (upto June, 2011) District office Centres District office Centres 1. Guruharsahai CHC 452 450 39 57 2. Jandwala CHC 618 NA 75 NA 3. Fazilka CHC 206 204 57 57 4. Mandot CHC 681 676 73 106 b) While conducting verification of the performance of family planning acceptors, there was no reports and registers available for the year 2010-11 and 2011-12 at CHC Jandwala. It was also observed that CHCs located at Guruharsahai and Mandot did not prepare similar registers for sterilization for the year 2011-12 till visit of the team. c) There were only 192 sterilization cases recorded in the services register at CHC Mandot as against the reported figure of 676 for the year 2010-11. 11. Maintenance of Register & Record: The team observed that: a) Eligible Couple and Child Register were not maintained / not made available at Fazilka CHC, Fazilka and Jandwala CHC. b) Service Registers were not made available at most of the visited centres. c) Stock Register of Cu-T, OP and CC were not maintained properly and not up to date at all visited PHC/CHC and HSC. d) JSY beneficiaries Register was not maintained properly and up to date at all the visited centres. 12. Other Important Observations : a) SBA Training for Staff Nurse & HW(F) and NSV training for MOs was not provided.