SUPPORTIVE SUPERVISION REPORT Singrauli, MADHYA PRADESH Dr. Arpana Kullu Consultant NRHM-1 Ministry of Health and Family Welfare, New Delhi 1 Contents District Profile ....................................................................................................................................4 Health Infrastructure in the District ....................................................................................................8 Key Observations ...............................................................................................................................9 Infrastructure .................................................................................................................................9 Referral Transport Services ........................................................................................................... 11 Human Resource .......................................................................................................................... 11 Community Processes .................................................................................................................. 14 Service Delivery............................................................................................................................ 18 Inspection of Health Facilities ........................................................................................................... 19 District Hospital ........................................................................................................................... 19 CHC Khuttar and CHC Deosar ........................................................................................................ 21 PHC Bargaon and PHC Morwa ....................................................................................................... 25 SHC Chaura and SHC Raj Milan ...................................................................................................... 28 ANNEXURES ............................................................................................. 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Bookmark not defined. 2 ABBREVIATIONS ANC- Antenatal Care IMNCI- Integrated Management of Neonatal and Childhood Illnesses ANM- Auxillary Nursing Midwife IMR- Infant Mortality Rate ASHA- Accredited Social Health Activist IUD- Intrauterine Device AWW- Anganwadi Worker LHV- Lady Health Visitor BCC- Behaviour Change Communication LSAS- Life Saving Anesthesia Skills BEmONC- Basic Emergency Obstetric and Newborn Care LTT- Laproscopic Tubectomy BPM- Block Program Manager MMR- Maternal Mortality Rate CEmONC- Comprehensive Emergency NSV- Non Scalpel Vasectomy Obstetric and Newborn Care PHC-Primary Health Centre CHC- Community Health Centre PNC- Post natal Care DCM- District Community Mobiliser PRI- Panchayati Raj Institution DH- District Hospital SBA- Skilled Birth Attendant DHAP- District Health Action Plan SHC- Sub Health Centre DPM-District Program Manager SNCU- Sick Newborn Care Unit DPMU- District Program Management Unit SPMU- State Program Management Unit FRU- First Referral Unit VHND- Village Health and Nutrition Day HBNC- Home Based Newborn Care VHSC- Village Health and Sanitation HMIS- Health Management Information System Committee IEC- Information Education and Communication 3 Supportive Supervision, Singrauli, Madhya Pradesh District Profile Singrauli is the 50th district of Madhya Pradesh. It was ranted district status on 24th May 2008, with its headquarters at Waidhan to fulfill the aspirations of people of this place. It has been formed after dividing it from Sidhi district. Singrauli has three tehsils namely Singrauli Deosar and Chitrangi. It has three development blocks by the same name. Singrauli town is a Municipal Corporation with a population of about 2 lakhs. The population of Singrauli district is about 11 lakhs. Singrauli is fast emerging as the power hub of India, especially for electric power and coal and therefore locally it is also call as Urjanchal (a Hindi word which means land of energy). The total installed capacity of all thermal power plants at Singrauli is around 10% total installed capacity of India. Table 1: Statistics of District Singrauli, M.P. S.No. Description Nos. 1. No. of Sub Divisions 3 2. No. of Tehsils 3 3. No. of Blocks 3 4. No. of Gram Panchayats 401 5. No. of Zila Panchayat 0 6. No. of Villages 738 4 Table 2:Block and Village Detail No. of Size of Villages Block No. of No. of No. of Villages Sr.No. (Population-wise) Name Towns Panchayats Villages having Trans. Facility 0-499 500-999 1000 + 1 Waidhan 1 104 265 237 56 86 137 2 Deosar 0 97 223 112 14 56 145 3 Chitrangi 0 115 311 123 75 158 68 Source: Census 2001 5 The area in the eastern part of the state of MP and the adjoining southern part of Sonebhadra district in the state of UP is collectively known as Singrauli. Singrauli is emerging as India’s Energy capital, the place earlier known as Shringavali, named after the sage Shringi, was once upon a time covered with dense and unnavigable forests and inhabited by wild animals. The place was considered so treacherous that it was used by the Kings of Rewa State, who ruled the area till 1947, as an open air prison for detaining errant civilians and officers. Table 3 : Population Details of the District Name of Blocks Total Population Male Population Female Population Chitrangi 258489 134409 124080 Deosar 243959 125030 118929 Waidhan 417721 219194 198527 Total 920169 478633 441536 Source: Census 2001 Table 4 (a):Socio-Demographic Details of the District Sr.no. Block Population Sex Ratio Families Name Male Female Over all 0-6 age BPL APL group 1 Waidhan 219194 198527 906 949 26768 21891 2 Deosar 125030 118929 951 982 31759 19124 3 Chitrangi 134409 124080 923 940 36022 17153 Source: Census 2001 Table 4 (b):Socio-Demographic Details of the District Sr.No Block Literacy Rate Castwise Population % Birth Death Rate Name Rate Male Female ST % SC % Other % 1 Waidhan 72% 38.2% 19% 13.9% 59.99% 35 11% 6 2 Deosar 59.2% 25.8% 42.5% 12.7% 44.8% 27.27 12% 3 Chitrangi 59.2% 26.0% 44.0% 10.3% 54.3% 21.97 13% Tribal Population The living standard of tribals is very simple. their houses are made of mud, bamboo sticks, paddy straw and local tiles. Tribal men wear Dhoti, Bandi, Fatohi and head gear. Women wear saree named kaansh saree in the local dialect. The saree is always of body colour. women in tribal community prefer to get their body parts hands, legs and neck encovered with colours, They wear different kinds of ornaments made of bamboo, seeds and metals. They have greate faith upon traditional remady (like Jhar-Phunk, Totka-Tona, Jadi Buti). Area(Squire Sr.No. Block Total Population S.C population S.T Population k.m) 1 Waidhan 1904 232531 34255 112878 2 Deosar 1822 243959 31080 103766 3 Chitrangi 1946 251352 25767 112878 Source:Census 2001 7 Health Infrastructure in the District Table 5: Health Infrastructure in the District Health Facility Numbers District Hospital 1 Community Health Center 6 Primary Health Center 14 Sub Health Center 157 Mobile Medical Unit 1 Source: District Programme Management Unit 8 Table 6: Block-wise Distribution of Health Institutions Blocks Population District Hospital CHC PHC SHC Waidhan 515626 1 1 4 60 Deosar 289976 0 3 5 48 Chitrangi 317537 0 2 5 49 Total 1123139 1 6 14 157 Source: Distric Programme Management Unit Key Observations Singrauli is a newly formed district hence it is currently in the process of upgrading its infrastructure thus renovations and re-constructions are in the pipelines and are likely to be completed in the year 2010-11. Currently the number of health facilities in the district is not sufficient to meet the needs the whole population of 11lakhs. And there hasn’t been any proposal in the district health plan within last year for construction of any PHC or CHC. Due to presence of private players in the district head quarters at Waidhan there is an unequal distribution of services in the block Chitrangi block remains ignored since the terrains are difficult and the facilities are largely under- equipped in terms of human resource in the institutions. Out of the total of 154 SHC’s in the district 31 SHC (block-wise details are given below in the table) do not have a building of their own, hence the service delivery is compromised. Since they have to function from limited space and cannot expand the current spaces. Infrastructure Table 7: Block wise Number of Health Facilities which does not have Govt. building Name of the Block CHC’s PHC’s SHC 0 Deosar 0 0 7 Waidhan 0 0 21 Chitrangi 0 0 3 Total 0 0 31 Source: District Programme Management Unit 9 There are currently 9 SHC’s, 12 PHC’s and 6 CHC’s which are conducting deliveries in the district. And 2 CEmONC and 8 BEmONC centres (mentioned in the table below) in the district. And none of these facilities fulfils the criterion for CEmOC and BEmOC facilities, in terms of human resource, infrastructure and equipments at present (human resource details are mentioned in the later part ) Table 8: Names of CEmONC and BEmONC Health facilities in the district CEmONC BEmONC PHC CHC/ DH PHC CHC District Hospital Nil PHC Bargawa CHC Niwas Waidhan CHC Chitrangi PHC Mada CHC Sarai PHC Morwa CHC Khutar PHC CHC Deosar Lamsarai(Naudhihava)