SSttaattee RReevviieeww MMiissssiioonn (Supportive Super vision) DISTRICT – BILASPUR IINNDDEEXX 1. BILASPUR DISTRICT PROFILE ......................................................... 2 2. PRIMARY HEALTH CENTRE, TENGANMAR ...................................... 7 3. PRIMARY HEALTH CENTRE , SIPAT............................................... 16 4. COMMUNITY HEALTH CENTER, BILHA ......................................... 27 5. COMMUNITY HEALTH CENTER,MASTURI ...................................... 44 6. DISTRICT HOSPITAL, BILASPUR ................................................... 61 Page 1 Aim – The aims of supportive supervision are the collective efforts to find out the strength of health facility as well as the gaps and provide handholding support to the facility by team to operationalize with available resource. Objective – 1. Constitution of joint team 2. Schedule field visit 3. Observation and recording the gaps 4. critical Analysis 5. supportive supervision 6. Documentation 7. Dissemination of findings and action taken 8. Follow-up and continuation of support 1. Team members :- S.N. Name Designation Institute/Department /organization 1 Dr. khemraj Sonwani Deputy Director Dept.Health & FW 2 Mr. Anand Kumar Prog Manager M&E NRHM Sahu 3 Medical College Dr. Anjana PG Student, PSM Raipur 4 Programme Mr. Mithun Dutta Cordinator(Quality DHS Assurance) 5 Dr. Nilesh Sharma Consultant - UNICEF Page 2 BILASPUR DISTRICT PROFILE 1. Bilaspur Profile: Indicators Chhattisgarh Bilaspur Total Population (In lakhs) (Census 2011) 256 Lakh 19.61 Lakh Rural Population (In lakhs) (Census 2011) 196.08Lakh 13.47 Lakh Number of Sub Division/ Talukas (Census 2011) 149 11 10 Number of Blocks (RHS 2012) 146 Number of Villages (Census 2011) 20126 1599 1 Number of District Hospitals (RHS 2012) 17 Number of Community Health Centres (RHS 2012) 149 10 80 Number of Primary Health Centres (RHS 2012) 755 Number of Sub Centres (RHS 2012) 5111 346 2. Status of Health Indicators Sl. Bilaspur (AHS Indicators Chhattisgarh No 2011) 1 Infant Mortality Rate (SRS- 2012) 48 46 2 Maternal Mortality Ratio (SRS 2007-09) 269 293 3 Total Fertility Rate (SRS 2011) 2.9 3.2 4 Under-five Mortality Rate (SRS 2011) 66 60 Institutional Deliveries(In %) 5 34.9 21.9 (AHS 2011) Full immunisation (In %) 6 74.1 63.5 (AHS 2011) Page 3 3. Demographic Profile Indicator Chhattisgarh Bilaspur (AHS 2011) Total Population (Census 2011) (In Crore) 2.56 crores 0.266 Crore Crude Birth Rate (SRS 2011) 23.9 26.2 Crude Death Rate (SRS 2011) 7.6 7.5 Natural Growth Rate (SRS 2011) 16.3 18.7 Sex Ratio (Census 2011) 991 972 Child Sex Ratio (Census 2011) 964 957 Total Literacy Rate (%) (Census 2011) 71.04 71.59 Male Literacy Rate (%) (Census 2011) 81.45 82.77 Female Literacy Rate (%) (Census 2011) 60.59 60.12 4. Information on selected MCH indicators (Source AHS 2010-11) Indicators Chhattisgarh Bilaspur (AHS-2011) Child feeding practices (%) Children under breastfed within one hour of 63.9 51.7 birth(15-44) Children age 6-35 months exclusively 47.5 38.7 breastfed for at least 6 months Avg Month by Children Received Foods other than Breast Milk(Animal or Formula 4.8 5.1 Milk) Awareness about Diarrhoea and ARI Women aware about danger signs of ARI 89.8 93 (%)(15-44) Treatment of childhood diseases Children with diarrhoea in the last 2 weeks 89.3 89 who received ORS (%)(15-44) Children with ARI in the last 2 weeks who 93.2 96.1 sought treatment (%)(15-44) Page 4 5. RoP Approvals in FY 2013-14 (As per District RoP approved by State) Summary of Approvals for Alwar District (FY 2013-14) FMR Activity Amount (in lakhs) A RCH 1461.47 B MISSION 1069.25 C Immunization 144.83 D NIDDCP 00 E IDSP 12.89 F NVBDCP 26.14 G NLEP 14.83 H RNTCP 64.03 Total 2793.44 3. Progress of NRHM in Bilaspur District Sl. Activity Status No 1 24x7 PHCs Total 24x7 PHC 18 and PHC are functioning on 24x7 basis is 10 ASHA 3365 sanctioned, 3365 are selected and working and have been 2 ASHA trained, 175 Mitanin required training of Vth module and 395 required 6th and 7th module training . Functioning as 3 1 DH and 1 CHC out of 8 CHC labelled as FRU is functioning as FRUs. FRUs Rogi Kalyan 4 64 facilities (1 DH, 8 CHCs, 55 PHCs & have been registered with RKS. Samitis (RKS) Village Health Sanitation & 5 Nutrition Out of 914 Villages , 907 Villages have constituted VHSNCs. Committees (VHSNCs) 6 MMUs 1 MMUs operational in this District in urban Bilaspur. ERS (108-type) 7 16 GVK (108-type) vehicles are operational and functional Basic rd 8 Recently 20 Janani Express (104) type vehicles are operational. From 23 Ambulances August 2013 9 Infrastructure Sr.N Name of No of Works in Works in Not Page 5 Strengthening o works works complete progress Started (till April 2013) sancti d oned 1 DH 0 0 0 0 2 MCH 3 0 0 3 Wing 4 CHC 0 0 0 0 6 PHC 0 0 0 0 8 SHC 19 10 9 0 Total 22 10 9 31 Civil work and Sick New Born Care unit (SNCU) electrical work New Born Care completed Units Sanctioned 2 10 New Born Stabilization Unit (NBSU) established Functional 2 Sanctioned 35 New Born Care Corner (NBCC) Functional 16 Page 6 SSttaattee RReevviieeww MMiissssiioonn (Supportive Super vision) PRIMARY HEALTH CENTRE, TENGANMAR DISTRICT BILASPUR Page 7 Detail observations and area of improvement 1. Approach and accessibility: i. The Primary Health Centre is connected through all weather road and is well connected and easily approachable from bus stand. ii. The fencing of Primary Health Centre is not present. iii. The Primary Health Centre does not have an identified parking space. iv. Proper signage for easy identification of Primary Health Centre from a distance has not been made available. 2. Security services: Security services in the Primary Health Centre is not available; 3. Entrance: i. The Primary Health Centre has one entrance at the front side. ii. Entrances to the Primary Health Centre is disable friendly with provision of ramp for easy access to wheel chairs, stretchers and ambulances but no hand rail is present. 4. Waiting area: i. The entrance of the Primary Health Centre is followed by a small waiting area with adequate sitting arrangement . ii. The waiting area is poorly equipped. Wheel chairs and stretchers are not available near the entrance. iii. Necessary signage related to direction of rooms national programmes, Citizen Charter, various services offered, rate lists, available human resource and complaint box are available in the OPD area iv. There is no Provision of separate toilets for males and females. v. Provision of drinking water is not available. Page 8 5. Registration counter: i. The Hospital has a common registration and Drug Dispensing Counter ii. The registration process is manual and pre printed format of OPD receipt is used. iii. The data of patients is properly maintained in the form of a register. iv. S.No, name, age, address, gender, caste BPL/APL, complaint and fee taken. v. The rate chart is displayed for various services provided. 6. Consultation rooms: i. Two Consultation room are available. One is for the Medical officer and other is for the RMA. ii. The rooms were well ventilated with proper provisions of sitting, and wash areas for Doctors. iii. Examination table with steps and screen were present to facilitate privacy of patient. iv. Basic Essential equipments like, adult weighing machine, BP apparatus, stethoscope and specialty wise were present. v. The Primary Health Centre lacked running water facility. vi. Requisition slips for drug prescription was maintained. vii. The records of patient examination are not being maintained by the Medical officer.The RMA records wer found to be complete and updated. Page 9 7. Injection room i. The injection room is available next to the Drug dispensary. ii. Emergency drug tray is not maintained, Needle Cutter present and was not in working condition iii. Proper infection control practices were not being followed, practices in relation to biomedical waste needs improvement. iv. Provisions for Privacy of patients with the help of movable screen not available. 8. Drug Dispensary i. The Primary Health Centre has a Single window dispensary. ii. Registers are poorly maintained with daily entry not being done in stock register. iii. Medicines record is not updated as expired medicines were found. iv. List of medicines available with expiry date and quantity was not being maintained 9. Pathology Laboratory: i. Is not functional and is operational in camp mode. 10. In patient Department i. The Primary Health Centre has a Two Bed Ward.. ii. Condition of beds was satisfactory. iii. Bed site lockers, IV stand and stools for attendants not present iv. Nurses station with emergency equipments and instruments like, emergency drug tray, oxygen cylinder, basic resuscitation kits is not present v. Needle cutter not present Page 10 11. Labor Room i. Labor table with steps is present. ii. Macintosh was present but Kelyes pad was not available iii. All the basic equipments required with various trays like , MVA tray, Emergency medicine tray, Epistomy tray, delivery tray, baby tray were not present iv. Running tap water with provision of hot water was not present. v. The Attached toilet was found to be present in a very poor condition. vi. Suction machine was not functional. NBCC(New born care corner) i. NBCC was present present within the Labor room ii. The NBCC was present was found to be non functional. 12. Waste Disposal and Infection control Practices: i. The overall waste disposal practices in the facility were not satisfactory, Application for authorization is in progress ii. Proper segregation was not followed. Colour coded bins are available but not in use. iii. Deep pit and sharp pit for Disposal of waste were not constructed and were not used for disposal of anatomical and sharp waste.