NATIONAL HEALTH MISSION A REPORT ON MONITORING OF IMPORTANT COMPONENTS OF NHM PROGRAMME IMPLEMENTATION IN KANNAUJ DISTRICT, UTTAR PRADESH Dr. GAGANDEEP KAUR Ms. BINDIYA KUMARI Mr. RAHUL KUMAR POPULATION RESEARCH CENTRE INSTITUTE OF ECONOMIC GROWTH Delhi-110007 September, 2018 NHM Kannauj PIP 2018-19: Uttar Pradesh PRC IEG Delhi Table of Contents Executive Summary ........................................................................................................................ 8 Strengths ...................................................................................................................................... 8 Weaknesses ................................................................................................................................. 9 1. Introduction ............................................................................................................................... 10 1.1 Objectives of the Study ....................................................................................................... 11 1.2 Demographic Profile: Uttar Pradesh & Kannauj................................................................. 12 1.3 Health Profile ...................................................................................................................... 14 2. Human Resource & Health Infrastructure ................................................................................ 17 2.1 Human Resource ................................................................................................................. 18 2.2 Health Infrastructure ........................................................................................................... 21 3. Maternal Health ........................................................................................................................ 24 3.1 Overview ............................................................................................................................. 25 3.2 Janani Suraksha Yojana (JSY) ............................................................................................ 27 3.3 Janani Shishu Suraksha Karyakram (JSSK)........................................................................ 28 3.4 Maternal Death Review (MDR) .......................................................................................... 29 4. Child Health .............................................................................................................................. 30 4.1 Neonatal Health ................................................................................................................... 31 4.2 Nutrition .............................................................................................................................. 33 4.3 Management of Common Childhood Illnesses ................................................................... 33 4.4 Immunization ...................................................................................................................... 34 4.5. Rashtriya Bal Suraksha Karyakram (RBSK) ..................................................................... 35 5. Family Planning ........................................................................................................................ 36 6. Rashtriya Kishor Swasthya Karyakram (RKSK) ...................................................................... 37 7. Quality Management in Healthcare Services ............................................................................ 39 7.1 Bio-Medical Waste Management (BMW) .......................................................................... 39 7.2 Information, Education and Communication (IEC) ............................................................ 40 8. Community Process .................................................................................................................. 41 9. AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy).................. 42 10. Disease Control Programme ................................................................................................... 43 10.1 Communicable Diseases ................................................................................................... 43 September, 2018 Page 2 NHM Kannauj PIP 2018-19: Uttar Pradesh PRC IEG Delhi 10.2 Non-Communicable Diseases ........................................................................................... 43 11. Health Management Information System ............................................................................... 44 12. Budget Utilisation ................................................................................................................... 45 13. Facility Wise Observations ..................................................................................................... 46 13.1 Combined District Hospital, Kannauj ............................................................................... 47 13.2 Community Health Center, Tirva Janpath......................................................................... 50 13.3 Primary Health Centre (PHC) Thatiya .............................................................................. 52 13.4 Sub-Centre, Paithana ......................................................................................................... 54 13.5 Sub-Centre, Maurya Bujurg .............................................................................................. 55 14. Conclusion and Recommendation .......................................................................................... 58 14.1 Conclusion ......................................................................................................................... 58 14.2 Recommendations ............................................................................................................. 60 15. Annexure ................................................................................................................................. 61 September, 2018 Page 3 List of Table Table 1: List of Health Facilities visited, Kannauj .................................................................. 11 Table 2: Key Demographic Indicators: All India, Uttar Pradesh &Kannauj District ......... 13 Table 3:Status of Health and Health Care Service Delivery Indicators, Kannauj, 2017-18 14 Table 4: Status of Human Resource at District Hospital, Kannauj, 2017-18 ........................ 18 Table 5:Status of Human Resource in Kannauj District 2017-18 .......................................... 20 Table 6: Status of Health Infrastructure, Kannauj, 2017-18 .................................................. 23 Table 7: Status of Health Infrastructure in facilities visited, Kannauj ................................. 24 Table 8: Maternal Health indicators, Kannauj, 2017-18 ........................................................ 25 Table 9: Block wise Performance in Antenatal and Postnatal Care, Kannauj, 2017-18 ...... 26 Table 10: Status of JSY Payments in Kannauj, 2017-18 ......................................................... 27 Table 11: Block wise JSSK progress in Kannauj District in 2017-18 .................................... 28 Table 12: Maternal Deaths (place, reason and stages of pregnancy) in Kannauj District .. 29 Table 13: Block wise Place of Delivery and Status of Child birth, Kannauj, 2017-18 ......... 32 Table 14: Neonatal Health Service Delivery in Kannauj District, 2017-18 ........................... 32 Table 15: Status of Neonatal Health and Infrastructure in Kannauj District ...................... 34 Table 16: Block wise Immunization Coverage in Kannauj District....................................... 35 Table 17: Status of RBSK, Kannauj, 2017-18 .......................................................................... 36 Table 18: Block wise Status of Family Planning Achievement in Kannauj, 2017-18 ........... 37 Table 19: Block wise service delivery under RKSK in Kannauj, 2017-18 ............................ 38 Table 20: Health Care waste Management in Kannauj, 2017-18 ........................................... 39 Table 21: Status of ASHA Worker, Kannauj, 2017-18 ........................................................... 41 Table 22: Status of AYUSH in Kannauj, 2017-18 .................................................................... 42 Table 23: Status of Communicable Diseases in Kannauj, 2017-18 ........................................ 43 Table 24: Status of Non-Communicable Diseases in Kannauj, 2017-18 ................................ 44 Table 25: HMIS/MCTS status in Kannauj, 2017-18 ............................................................... 45 Table 26: Status of Budget Utilization, Kannauj, 2017-18 ...................................................... 46 Table 27: Service Delivery Indicators in the District Hospital, Kannauj .............................. 49 Table 28: Service Delivery Indicators at the Tirva Janpath CHC, Kannauj ........................ 52 Table 29: Service Delivery Indicators at the Paithana SC, Kannauj ..................................... 55 Table 30: Service Delivery Indicators at the Maurya Bujurg SC, Kannauj ......................... 57 List of Figures Figure 1: Integrated map of Uttar Pradesh and District and Sub-district of Kannauj ....... 13 Figure 2: Status of Vacant position of Regular and Contractual Man power, Kannauj ..... 21 Figure 3: Tier System and Population Norms for Healthcare Services/ Facility in India ... 22 Figure 4: Maternal Deaths (Place,