Assessment of health care facilities for maternal and child health care at Bal Mahila chikitsalyas in Lucknow district, India (original) (raw)
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International Journal Of Community Medicine And Public Health, 2019
Background: Availability of emergency obstetric care (EmOC) is one of interventions to reduce maternal and newborn deaths. The health system fails when effective and affordable health interventions do not reach the population, when Poor infrastructure, drugs and equipment are lacking, and qualified human resources are scarce. The objective of the present study was to assess the availability of EmOC infrastructure in first referral units (FRUs) of Surguja division, Chhattisgarh.Methods: A cross sectional study was designated with 13 FRUs of Surguja division. A semi structured, closed-ended questionnaires was observed on the basis of check list, reviewing record, and interview by available staff.Results: FRUs of Surguja division for physical infrastructure scored 68.5%, for essential medicine 69.2%, for equipments 50.7%, for instruments 45.3% and for availability of blood 34.6%, for health man power category of specialist score was 25.7% but for supportive staff 65.4%.Conclusions: Our...
Assessment of Facility based newborn care at various health care facilities in Rajkot district
International Journal Of Community Medicine And Public Health
Background: India carries the single largest share (around 25-30%) of neonatal deaths in the world. It has been estimated that about 70% of neonatal deaths could be prevented if proven interventions are implemented effectively with high coverage.Methods: A cross-sectional observational study was conducted at various health facilities of Rajkot district where facility based newborn care are created as per the guidelines under NRHM. It was conducted during August 2013 to October, 2013. The data entry was done in Microsoft Office Excel 2007 and analyzed in Epi info software from CDC Atlanta. Results: This study included total 32 health facilities including 10 Primary Health Centers (PHC) (24X7), 15 Community Health Centers (CHC), 5 Sub District Hospitals (SDH), one District Hospital (DH) and one Medical College (MC). There are a total of 36 facilities of different level available in government set up for newborn care starting from NBCC to SNCU. All (100%) of the health centers visited ...
International Journal of Medical Science and Public Health, 2019
best possible start in life. The 1 st week of life is most crucial for the survival of an infant. Childhood and infant mortality rates have been decreasing in India in the last decade, and the rate of neonatal mortality is still high. The 1 st day and week of life are the most crucial for the survival of a child. The majority (75%) occur in the 1 st week, particularly on the 1 st day (25-50%). [1-3] The risk of deaths in the neonatal period in developing countries is over 7 times greater than in developed countries. The risk of deaths in the neonatal period in developing countries is over 7 times greater than in developed countries. Out of these 4, die in the 1 st week of life,1 of 3 dying in 1 st week, and dies in the 1s t day of life. Background: The Ministry of Health and Family Welfare of India has come up with this essential newborn care services (ENBC) to reduce the neonatal mortality rates, and it is provided free of cost at all Government Healthcare facilities. This study was done to see the impact of ENBC services. Objectives: The objectives of this study are (1) to evaluate the provision of ENBC services in all maternity homes under the aegis of Ahmedabad Municipal Corporation (AMC) and (2) to assess the availability of adequate human resources, infrastructure, and equipment. Materials and Methods: A study design is cross-sectional. The study was conducted at all maternity homes in AMC. Sampling technique is the purposive type. Observation of health-care facility infrastructure under which assessment of availability of essential drugs, infrastructure and ENC equipment, observation of type of care, eye care and umbilical cord care at birth, infrastructure etc was done. Written permission from the Institutional Review Board, NHLMMC, Medical Officer of Health, AMC, Dean, was taken. Results: It was found out that a total number of rooms ranged from 3 to 20, number of beds ranged from 8 to 36, and deliveries per year ranged from 90 to 1646. Two of the maternity homes had assisted deliveries and cesarean section facilities. All the maternity homes had 100% availability of the medical. Resuscitator was present in 75% of the maternity homes.100% maternity homes were equipped with radiant warmers, 91.67 % had pump suction, weight scale was present in 100%, 83.33% had thermometer, and 91.67% had Hub Cutter. Cotton swabs, bag mask, gloves, mucus extractor, and needle syringe were present in all the maternity homes in our study. Conclusion: All maternity homes are providing sufficient ENBC. Only two maternity homes are providing cesarean section delivery. Essential infrastructure and service facilities are provided in all maternity homes except a few minor things like less nursing staff. Newborn care corner is present in all the maternity homes.
International Journal of Community Medicine and Public Health, 2016
India's achievements in the field of health have been steadily improving. Indicators like Infant Mortality Rate has improved from 68 (NFHS II) to 57 per 1000 live births in 2005-2006 (NFHS III), and 47 in the year 2010 according to SRS Bulletin, December 2011. 1-3 Maternal mortality ratio has declined to 250 per 100,000 live births in the year 2010. 4 Utilization of antenatal services has also increased to 77% as has institutional deliveries and immunisation coverage. 2 But we still lag behind the proposed goals under National Rural Health Mission or the Millennium Development Goals. Many of these ABSTRACT Background: India's achievements are lagging behind the proposed goals under National Health Mission or the Sustainable Development Goals. Studies shown that inconvenient and ineffective services in primary health care institutions are leading cause of non-utilization. The aim and objectives was to evaluate the adequacy of health services being provided to the patients by Urban and Rural Health Training Centres under GMCH, Chandigarh. Methods: It was a cross sectional study was adopted among patients attending special clinics at Urban Health Training Centre and Rural Health Training Centre, attached with GMCH, Chandigarh. A stratified random sampling technique with proportional allocation was adopted. Based on this 50% anticipated satisfaction rate, 10% permissible error, and 95% confidence interval the optimum sample size was found to be 384. The data was collected using checklists, interview schedules, and consulting medical records at the centres as well as the records with the clients. Services were evaluated using checklists and exit interviews. Results: Our study found that the filling of registration cards of antenatal mothers and blood investigations were done properly. Clinical components like measurement of pulse (14.1%), pallor (9%), oedema (12.8%), examination of breasts (33.3%), fundal height (46.2%) and foetal heart rate (15.4%) were not done as per protocol. Forty percent of patients were not compliant to iron folic acid tablets. Deliveries were conducted in less than 10% of total beneficiaries. Checklist was not filled in most of the cases; following of clean practices, partograph plotting and APGAR scoring was not done properly. Over all antenatal and postnatal counselling part was unsatisfactory. Conclusions: It can be concluded that in spite of adequate manpower, utilization rates of services provided are not very good. The training and health education component had some gaps. Efforts should be made to fill the gaps by corrective measures like deploying counsellors and health educators, in-service training of the staff and strengthening of referral linkages to ensure optimum utilization of services and better manpower management.
Study to assess the maternal and new born services in Primary health centres of Kurnool district
National Journal of Research in Community Medicine, 2019
Background: There is no reliable way to predict which woman will develop pregnancy-related complications, it is essential that all pregnant women have access to high quality obstetric care throughout their pregnancies. The objective of this study to assess the maternal and new born services in Primary health centres of Kurnool district. Methods: This study is a facility based cross sectional study carried out from November 2014-May 2015 in administrative limits of Kurnool district. Questionnaire is attempted to assess the Maternal and new born services available-Antenatal care, Intranatal care, Post natal care, Newborn care and BEmONC services etc. Results: all PHCs health personnel were practicing administration of parenteral antibiotics, uterotonic drugs, performing manual removal of placenta, in 16/21(76.19%) PHCs health personnel were performing neonatal resuscitation, in 4/21(19.04%) PHCs health personnel were practicing administration anticonvulsants and in 1/21 (4.76%) PHCs health personnel were performing removal of retained products and performing assisted deliveries. Most of PHCs (85.71%) were providing birth preparedness services. 9/21(42.58%) PHCs health personnel were noting time of rupture of membranes.In 16/21(76.19%) PHCs, health personnel were providing resuscitation services. Conclusions: Antenatal, intranatal, postnatal and newborn services were adequate in most of the PHCs.
Journal of health, population, and nutrition, 2014
India faces a formidable burden of neonatal deaths, and quality newborn care is essential for reducing the high neonatal mortality rate. We examined newborn care services, with a focus on essential newborn care (ENC) in two districts, one each from two states in India. Nagaur district in Rajasthan and Chhatarpur district in Madhya Pradesh were included. Six secondary-level facilities from the districts-two district hospitals (DHs) and four community health centres (CHCs) were evaluated, where maximum institutional births within districts were taking place. The assessment included record review, facility observation, and competency assessment of service providers, using structured checklists and sets of questionnaire. The domains assessed for competency were: resuscitation, provision of warmth, breastfeeding, kangaroo mother care, and infection prevention. Our assessments showed that no inpatient care was being rendered at the CHCs while, at DHs, neonates with sepsis, asphyxia, and p...
BMJ Open, 2019
IntroductionPoor access to quality healthcare is one of the most important reasons of high maternal and neonatal mortality in India, particularly in poorer states like Bihar. India has implemented initiatives to promote institutional maternal deliveries. It is important to ensure that health facilities are adequately equipped and staffed to provide quality care for mothers and newborns.MethodsWe conducted a cross-sectional study of 190 primary health centres (PHCs) and 36 district hospitals (DHs) across all districts in Bihar to assess the readiness of facilities to provide quality maternal and neonatal care. Infrastructure, equipment and supplies and staffing were assessed using the WHO service availability and readiness assessment and Indian public health standard guidelines. Additionally, we used household survey data to assess the quality of care reported by mothers delivering at study facilities.ResultsPHCs and DHs were found to have 61% and 67% of the mandated structural compo...
Process evaluation of access & quality of emergency obstetric & neonatal care North Zo
Solomon Niguse Gebrehiwot, 2019
Abstract Background: Emergency obstetric care (EmOC) has averted maternal mortality by 68% and could contribute up to 10–15% reduction in all-cause neonatal mortality, and 20–60% reduction in mortality due to birth asphyxia. However, there was limited evidence of emergency obstetric care service in Ethiopia. Hence, the objective of this study was to evaluate access and Utilization of emergency obstetric care services at North Western Tigray Zone, from June 20 - July 20/ 2014. Methods: Facility-based cross-sectional study designs both quantitative and qualitative method of data collection method was used. All public health facilities (N=40) providing obstetric service in the zone were included from eight districts. Retrospective document review of delivery service, obstetric complications, and a cesarean section of one-year registers from July 1/2013 to June 2014 were used. Resource inventory of bin card and stock card of 35 items of drugs and 27 items of equipment were done. Interview of 40 midwives, 40 pharmacy technicians, two gynaecologists, 40 health centre and 8 health office managers were conducted. Exit interview of 424 mothers attending delivery service from 14 randomly selected health facilities was conducted. SPSS 16.0 version software was used to analyze the quantitative data and Qualitative data was analyzed thematically. Result: Sixteen (43%) of the health centres and 3(100%) of the hospitals have provided fully functional basic and comprehensive EmOC service. However, 85.8% and 89.4% of key essential drugs and equipment have available. Seven (19%) of the health centres have dry season only roads. Only 25(62.5%) and 21(52.5%) of the health facilities have electricity and piped water supply. The availability dimension was the judge as well based on the preset criteria. Only 139(36%) and 16(38%) of the mothers were received basic and comprehensive services have a walking distance of greater than two hours for basic and twelve hours for comprehensive services. The accessibility dimension was the judge as fair. Moreover, 28(6.6%) and 61(14.4%) of the mothers have paid for the treatment of direct obstetric complications and transportation services. The affordability dimension was judged as excellent. A total of 10652(39.2%) and 5649(35%) of the deliveries were taking place in fully functional and partially functioning EmOC facilities. Only 706(2.6%) of the mothers were delivered with a cesarean section. A total of 2,922(71.8%) of the mothers with obstetric complication were treated in fully functioning EmOC facilities. The utilization dimension was judged as fair. Mothers with a walking distance of greater than twelve hours from their home to health facility were by 82% less likely to be satisfied (AOR=0.177, 95% CI= 0.076-0.413) as compared to mothers with a walking distance of fewer than two hours. The satisfaction dimension was judged as very good. Conclusion: The overall judgment of the evaluation of EmOC service was ‘good’ (82%). However, the absence of essential drugs and equipment, the absence of infrastructure (roads, electricity, and water supply) and long distance of the periphery health facilities to the referral unit were the main problems of the service. It is recommended that there should be the provision of essential drugs and equipment, accessing infrastructure, and expansion of additional referral health facilities to the very distant target beneficiaries should be strengthened and revised.
International Journal of Nursing & Midwifery Research, 2018
Introduction: A descriptive survey was done on assessment of the program management factors, services and level of performance of Reproductive Maternal Newborn Child Health and Adolescent Plus Program (RMNCH+A) at selected block primary health centers and rural hospitals in North 24 Parganas, West Bengal. The conceptual framework was based on the Chen' Program Theory for program evaluation. Methods: The sample under the study consisted of eleven block primary health centers and rural hospitals of North 24 Parganas, West Bengal. A validated and reliable tool was used to collect data, e.g., the background data and data on the program management factor in terms of adequacy of human resources and their training status was collected by an interview schedule through interviewing health service providers, data on the program management factor in terms of infrastructural facilities, equipment, drugs, record maintenance and services of RMNCH+A Program was collected by observation checklist through observation by the investigator, and data on performance of services and referrals by block primary health centers and rural hospitals was collected by means of record analysis by Record Analysis Proforma. Results: The result showed that most of the community health centers are block primary health centers (64%). There are shortfalls in human resources like general duty medical officers (24.68%), obstetricians and pediatricians (90.90%), surgeons (100%), staff nurses (29.13%), laboratory technicians (42.86%), pharmacists AYUSH (47.82%), drivers (66.67%), GDA (51.25%). Lowest training of medical officers is found in CEmOC, F-IMNCI, LSAS (2.70%) and of nurses in RBSK (2.58%). Major non-availability of infrastructural facilities is separate ANC ward (45.45%), observation room and eclampsia room (100%), laboratory facility (63.63%), NRC (100%), etc. Non-availability of IEC displays found like SBA protocol on APH (18.18%); adult resuscitation kit (90.90%), pulse oximetry (81.81%), wall suction machine (100%), etc. were not available. Inj. Insulin (100%), Tab. Mifepristone (36.36%), Tab. Nevirapine (72.72%), Inj. Gentamycin (27.27%) drugs were not available. E mOC (90.90%), CAC service (36.36%), SNSU (63.
Assessment of existing referral system of newborn in Madhya Pradesh, India
INTRODUCTION A newborn infant, or neonate, is a child under 28 days of age. During these first 28 days of life, the child is at highest risk of dying. 1 It is thus crucial that appropriate feeding and care are provided during this period, both to improve the child's chances of survival and to lay the foundations for a healthy life. 2 Neonatal mortality is the predominant cause of high infant and under five mortality rates. Globally every year four million babies die in the neonatal period (1st 4 weeks of life), 75% of the neonatal deaths occur in the first week of life and at least 50% occur in the first day of life. 3 While India contributes to ABSTRACT Background: The objectives of present study was to assess referral system of newborns, bed occupancies of referring facilities and receiving facility and assessment of rationality of referrals made by referring facilities to receiving facility leading to congestion at receiving facility.22.08%). Conclusions: Discordant bed occupancy at referring SNCU and receiving SNCU and low rationality of referrals are reason for congestion at receiving SNCU. Optimum utilization of beds and cordant bed occupancy between referring and receiving SNCU may improve the working conditions in SNCU and newborn outcome. Referral system should be close loop system with the provision of Down Referral.