NATIONAL HEALTH MISSION A REPORT ON MONITORING OF IMPORTANT COMPONENTS OF NHM PROGRAMME IMPLEMENTATION IN EAST DISTRICT, SIKKIM Dr. SURESH SHARMA Ms. GARGEE SARKAR POPULATION RESEARCH CENTRE INSTITUTE OF ECONOMIC GROWTH Delhi-110007 October, 2018 NHM East District PIP 2018-19: Sikkim PRC IEG Delhi Contents List of Tables .................................................................................................................................. 4 Acknowledgement .......................................................................................................................... 6 List ofAcronyms and Abbreviations ............................................................................................... 7 Executive Summary ........................................................................................................................ 8 Strengths ......................................................................................................................................... 9 Weaknesses ................................................................................................................................... 11 Introduction ................................................................................................................................... 12 Objectives ..................................................................................................................................... 13 1.District Profile: East Sikkim ...................................................................................................... 14 1.1 Health Profile .......................................................................................................................... 17 2. Human Resource and Health Infrastructure .............................................................................. 19 2.1. Human Resource .................................................................................................................... 19 2.2. Health Infrastructure .............................................................................................................. 20 3. Maternal Health ........................................................................................................................ 23 3.1.Overview ................................................................................................................................. 23 3.2. Janani Suraksha Yojana (JSY) ............................................................................................... 25 3.3. Janani Shishu Suraksha Karyakram (JSSK) .......................................................................... 26 3.4. Maternal Death Review ......................................................................................................... 27 4. Child Health .............................................................................................................................. 28 4.1. Neonatal Health ..................................................................................................................... 29 4.2. Nutrition ................................................................................................................................. 30 4.3. Management of Common Childhood Illnesses ...................................................................... 31 4.4. Immunisation ......................................................................................................................... 32 4.5. Rashtriya Bal Swasthya Karyakram (RBSK) ........................................................................ 33 5. Family Planning ........................................................................................................................ 34 6. Rashtriya Kishor Swasthya Karyakram (RKSK) ...................................................................... 35 7. Quality Management in Health Care Services .......................................................................... 36 7.1. Health Care Waste Management ........................................................................................... 36 7.2. Information Education Communication (IEC) ...................................................................... 37 October, 2018 Page | 2 NHM East District PIP 2018-19: Sikkim PRC IEG Delhi 8. Community Process .................................................................................................................. 38 9. Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy ..................................... 39 10. Disease Control Programme ................................................................................................... 40 10.1. Communicable Diseases ...................................................................................................... 40 10.2. Non-Communicable Diseases .............................................................................................. 41 11. Health Management Information System ............................................................................... 42 12. Budget Utilisation ................................................................................................................... 43 13. Facility Wise Observations ..................................................................................................... 45 13.1. District Hospital, Singtam .................................................................................................... 45 13.2. Community Health Centre (CHC) Rhenock ...................................................................................... 48 13.3. Primary Health Centre (PHC) Pakyong ............................................................................................. 51 13.4. Sub-Centre Rorathang, Block Rhenock ............................................................................... 54 13.5. Sub-Centre Changey Senti, Block Changey ........................................................................ 56 14. Conclusion and Recommendations ......................................................................................... 58 14.1 Recommendations ................................................................................................................. 59 15. Annexure ................................................................................................................................. 60 DH level Monitoring Checklist ..................................................................................................... 60 FRU level Monitoring Checklist ................................................................................................... 68 PHC/CHC (NON FRU) level Monitoring Checklist .................................................................... 75 Sub Centre level Monitoring Checklist......................................................................................... 82 October, 2018 Page | 3 NHM East District PIP 2018-19: Sikkim PRC IEG Delhi List of Tables Table 1: Health Facilities visited in the PIP Monitoring of East District…………….….……....13 Table 2: Key Demographic Parameters of East District, Sikkim and India…………….……….15 Table 3: Health and Health Care Service Delivery Indicators, East District……………….……17 Table 4: Human Resource (HR) position in the District, East District……………….………….20 Table 5: Details of Health Infrastructure, East District…………………………………....….…21 Table 6: Status of Health Infrastructure in facilities visited, East District……………….……...22 Table 7: Maternal Health indicators, East District…………………………………….…….…..24 Table 8: Status of JSY Payments in East District…………………………………………..……25 Table 9: Status of JSSK in East District……………………………………………..………......26 Table 10: Status of Maternal Death Review (MDR), East District………………………......…27 Table 11: Status of Neonatal Health, East District……………………………………..………..29 Table 12: Neonatal Health Infrastructure Status, East District……………………………..……29 Table 13: Status of Incidence of all Childhood Illness, East District……………………………31 Table 14: Immunization coverage of all blocks in East District…………………………………32 Table 15: Status of RBSK in East District……………………………………………………….33 Table 16: Status of Non-Injectable Family Planning Methods, East District…………………....34 Table 17: Status of RKSK program in East District……………………………………………..35 Table 18: Health Care waste Management in East District…………………………………...…37 Table 19: ASHA Status, East District……………………………………………………………39 Table 20: Status of AYUSH in East District……………………………………………….....…39 Table 21: Status of Communicable Diseases Programme, East District………………………...41 Table 22: Status of Non-Communicable Diseases in East District……………………………...42 Table 23: HMIS Status, East District……………………………………………………….……43 Table 24.1: Status of Budget Utilization, East District……………………………….………….43 Table 24.2: Status of Budget Utilization, East District………………………………..…………44 October, 2018 Page | 4 NHM East District PIP 2018-19: Sikkim PRC IEG Delhi List of Figures Figure 1: Integrated map of Sikkim and East District……………………………..………....….14 Figure 2: Status of Child Health Nutrition, East District……………………...…………………30 Figure 3: Color-coded Bins…………………………………………………………...………….36 Figure 4: IEC display in Health Facilities in East District…………………………………….....38 Figure 5: District Hospital, Singtam………………………………………………………..……45 Figure 6: Community Health Center Rhenock……..……………………………………..…..…48 Figure 7: Primary Health Center Pakyong…………………………………………………..…...51 Figure