Supportive supervision of Dhamtari District Chhattisgarh Mr. Pradeep Tandan Consultant NRHM I Ministry of Health and Family Welfare, Nirman Bhavan New Delhi. [email protected] Contents Executive summery ....................................................................................................................................... 3 Approach and methodology: ........................................................................................................................ 9 Background ................................................................................................................................................. 10 Health facility in the district .................................................................................................................... 15 Performance in last one year (2009-10 ...................................................................................................... 20 Qualitative report of Dhamtari district ....................................................................................................... 22 Health Sub Centers:- ............................................................................................................................... 22 Primary Health Centers ........................................................................................................................... 25 Community Health Centers ..................................................................................................................... 25 District Hospital ....................................................................................................................................... 26 Maternal and child heath ........................................................................................................................ 26 Janani Suraksha Yojana ........................................................................................................................... 27 Home delivery ......................................................................................................................................... 27 Village Health and Nutrition Day ............................................................................................................ 27 Mitanin .................................................................................................................................................... 27 Communitization Processes .................................................................................................................... 29 Bio Medical waste management ............................................................................................................ 29 Human Resource ..................................................................................................................................... 30 District Hospital Dhamtari ....................................................................................................................... 31 CHC Magarlod-CHC ................................................................................................................................. 34 CHC Nagri ................................................................................................................................................ 36 CHC Gujra ................................................................................................................................................ 38 CHC Kurud ............................................................................................................................................... 39 PHC Kareli bodi ........................................................................................................................................ 41 PHC Bhatgaon ......................................................................................................................................... 43 HSC Bandha ............................................................................................................................................. 45 HSC Kukrel ............................................................................................................................................... 45 HSC Dokal ................................................................................................................................................ 46 HSC Gajkhanhar ...................................................................................................................................... 46 Appendix .................................................................................................................................................. 116 2 Executive summery For the Supportive Supervision of High Focused Districts, first visit to the district of Dhamtari in Chhattisgarh from 16th June 2010 to 19th June 2010 was done. The facilities visited and key persons visited for monitoring are enumerated in the Table 1 shown below. The monitoring visit was made to all 4 blocks. In this visit consultant interact with programme management unit at district and block level both. Consultant also interacted with Health staff including the Medical Officers, Nursing Staff and Mitanin and attained the meeting of district health society, to gain a better understanding of the processes and difficulties in functioning of health system of Dhamtari district. Table 1: Blocks and Persons visited for Supportive Supervision Date District/ Block Places/Health Persons Visited Activity Facilities Visited 16.06.2010 Dhamtari District hospital SPM, MO Visit of district (night visit 10:30 ) hospital and meet with some patient at night 17.06.2010 Dhamtari District Hospital DPM, Civil Baseline data Dhamtari Surgeon, MO, collected from Administrative staff district hospital Discussions with the Civil Surgeon about the functioning of the various components of the District hospital. Inspection of the District Hospital 17.06.2010 Magarload CHC Magarlod BPM, BMO Collect base line PHC Kareli(bodi) Administrative, data from facilities VHSC VHSC members, Visit to CHC Mitanin Magarlod and PHC Karelibodi 18.06.2010 Gugja PHC Bhatgaon MO, District Collect base line Kurud CHC Gujra Magistrate Dhamtari data from visited DM Dhamtari BMO Kurud and facility and attained CHC Kurud some Beneficiaries regular meeting of Mitanin district health society. 19.06.2010 Nagri CHC Nagri BMO Nagri Collect base line HSC Bandha ANM and Mitanin data from visited HSC Kukrel health facility. HSC Dokal HSC Kajkanhar 3 Brief Review: - Dhamtri District is located in eastern part of Chhattisgarh state, with total population of 7, 03,569 (2001 Censes). The Public health system is existent in the form of one district hospital , 4 CHCs, 22PHCs ,165 HSCs and catering health services to the rural and urban population The District’s visit depict that, there is need to address the following issues. Major issues are BPM post of 2 block is vacant, and Maintenance fund and JDS among that is affecting the monitoring part BMOs and MOs in the district. in Kurud and Gujra Bock. Security issue in the PHCs like in Immunization storage point, during Bhatgaon , all the glass window were visit it was found that none of the broken by some people in the visited centres had not maintained village( There was no boundary wall the records properly. in Bhatgaon and Karelibodi PHC) There is no biomedical disposal OPD area of the district hospital is mechanism in the district. None of very less. the visited facilities had the Very less IEC material display in the recommended waste segregation and PHC and CHC (in visited CHC and disposal mechanisms. PHC). Poor maintenance and repairs of the Labour room condition in the Gujra equipments in health facilities (PHC, CHC, Bhatgaon PHC was very poor. CHC) and laboratory is noted. Accreditation of all sub centres for Lack of awareness and utilization JSY. process about Untied Fund Situation: 5 PHCs and 16 HSCs are in construction phase. Additional construction work is going on CHC Gujra and CHC Nagri .It was noticed during the interaction that the health officials (especially district hospital staff) in Dhamtari district they are enthusiastic for improvement of health services delivery. Their motivation can be maintained with periodic encouragement from the state officials. District collector is also taking interest to improve the health indicator of district and her approach towards district health system is good and hope on her leadership district will make some difference in next one year. 4 List of Tables Table 1: Blocks and Persons visited for Supportive Supervision Table 2 Major health indicator of Dhamtari District Table 3 Demographic Characteristics of Dhamtari District Table 4 Public Health Facilities in Dhamtari District Table 5 Catchment area of CHCs in Dhamtari District Table 6 Public Health infrastructure in Dhamtari District Table 7 Private Health Facility in Dhamtari District Table 8 Private Health Facility Accredited for JSY and Family Planning Table 9 Details of Mitanin and DRP in Dhamtari District Table 10 Trainings situation of Mitanin 5 List of Graphs and Figures Figure 1 Dhamtari District Figure 2 Health Facility Dhamtari District Graph 1 Electricity in Sub Centers of Dhamtri District Graph 2 Water Facility in The Sub Centers of Dhamtari District Graph 3 Stay Facility for ANM in the Sub Centre of Dhamtari District Graph 4 Sub Centre New Born Baby Corner in Dhamtari District Graph 5 Percentage of Sub