Академический Документы
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33
Status ot pcrtormancc ot Labour Boom
Tablc C 10: Status ot pcrtormancc ot Labour Boom during 2007-2008
Mumbcr ot dclivcrics pcrtormcd during
2007-2008
Mumbcr ot dclivcrics
CHC 1
(jai|aipur)
CHC 2
(Baloda)
Jotal Institutional Deliveries 299 163
Deliveries carried out lrom 8 pm to 8 am 122 39
Institutional deliveries lor ]SY card Lolders 299 163
umber ol neonates resuscitated 0 0
Tablc C11: Bcasons tor not conducting dclivcrics
Bcasons tor not conducting dclivcrics (Ycs: 1, Mo:
0)
CHC 1
(jai|aipur)
CHC 2
(Baloda)
on availability ol doctors/stall - -
Poor condition ol tLe labour room - -
o power supply in tLe labour room - -
Tablc C12: Status ot availability ot Equipmcnts and drugs
Status ot availability ot cquipmcnts
Equipmcnts availablc / working (Ycs:1,
Mo: 0)
CHC 1
(jai|aipur)
CHC 2
(Baloda)
Availablc Working Availablc Working
Boyles Apparatus 1 1 1 1
ECC MacLine 1 1 1 1
Cardiac Monitor lor CJ 0 - 0 -
Delibrillator lor CJ 0 - 0 -
Ventilator lor CJ 0 - 0 -
Horizontal HigL Pressure Sterilizer 0 - 0 -
Vertical HigL Pressure Sterilizer 2/3 drum
capacity
0 - 1 1
CJ Care Iumigation Apparatus 0 - 0 -
Cloves & Dusting MacLines 0 - 1 1
Cxygen Cylinder 1 1 1 1
Hydraulic Cperation Jable 1 1 1 1
Resuscitation trolley 0 - 0 -
PLototLerapy unit 0 - 1 1
MVA syringe 0 - 0 -
Baby incubator 0 - 0 -
Table Contd.
34
Status ot availability ot drugs
CHC rcporting stock out or irrcgular supply ot
spccitic drugs in last 6 months(Ycs: 1, Mo: 0)
CHC 1 (jai|aipur) CHC 2 (Baloda) Typc ot Drugs
Stock Cut Irrcgular
Supply
Stock Cut Irrcgular
Supply
Iron Iolic Acid (IIA) 1 1 1 1
Cral Pills (CPs) 0 0 0 0
ILD 380 0 0 0 0
CRS (Cral ReLydration Salts) 0 0 0 0
CRS witL Zinc adjutant as per
policy
-" - - -
Vitamin A 0 0 0 0
Jab. Iluconazole 0 0 1 1
Jab. Metronidazole 0 0 0 0
Jab. Co-trimoxazole (Kid) - - 1 1
Jab. elidipine - - - -
Inj. Cxytocin - - 0 0
Inj. Centamycin 0 0 0 0
Inj. Magnesium SulpLate - - - -
Jab. Misoprostal - - - -
Jab. Progestrone - - - -
Inj. Lignocaine HydrocLloride 0 0 0 0
Inj. Pentazocine Lactate 0 0 0 0
Inj. Adrenaline 0 0 0 0
Cap. Doxycycline - - 1 1
Silver SulpLadiazine oint. - - 1 1
IV Iluids 0 0 0 0
Inj. Prociane Penicillin - - 1 1
Inj. Atropine 0 0 0 0
Syp Amoxycyclin - - 1 1
IIA Syrup 1 1 - -
"-Drugs never supplied to CHC
35
Tablc C13. Availability ot Spccitic Scrviccs (Ycs: 1, Mo: 0)
Typc ot Scrvicc
CHC 1
(jai|aipur)
CHC 2
(Baloda)
Medicine
0 0
Surgery
0 1
Obstetric & Gynae
0 0
Pediatrics
0 0
DOTS
1 1
Cataract Surgery
0 0
Leprosy diagnosis management and reIerral services
1 1
Emergency Services (24 Hrs)
1 1
mobile medical unit
0 0
Separate neo-natal care unit
0 0
Emergency care Ior sick children
0 0
Full Range oI Family Planning Services including
Laproscopic ligation
0 0
SaIe abortion services
0 0
Treatment oI STI/RTI
0 0
Blood Storage Iacility
0 0
Counseling Facility on HIV/AIDS/STD etc
0 0
Voluntary Counselling and Testing Centre (VCTC)
0 0
AYUSH Iacility
0 0
Primary management oI wounds 1 1
Primary management Iracture 0 1
Primary management oI cases oI poisoning/snake, insect
or scorpion bite
1 1
Primary management oI dog bite 1 1
Primary management oI burns 1 1
Management oI RTI/STI 0 0
36
Tablc C14: Scrvicc Cutcomc (bascd on data tor last thrcc months)
Avcragc monthly tigurc rcportcd in CHC bascd on last thrcc months
Indicator
CHC 1 (jai|aipur) CHC 2 (Baloda)
SC SJ CtLers Jotal SC SJ CtLers Jotal
Jotal AC Registration 36 18 1+5 199 - - - +/
Jotal ]SY cases registered 36 18 1+5 199 - - - +/
Ist Jrimester Registration 20 5 /2 9/ - - - -
AC given 3 CLeckups as per RCH
ScLedule
3/ 3 60 100 - - -
Cut ol above, tLe no. ol ]SY beneliciaries 3/ 3 60 100 - - - -
AC given JJ (2
nd
doseBooster) 30 12 93 135 20 8 23 51
Cut ol above, tLe no. ol ]SY beneliciaries 30 12 93 135 20 8 23 51
AC completed IIA PropLylaxis 3/ 3 60 100 - - -
Cut ol above, tLe no. ol ]SY beneliciaries 3/ 3 60 100 - - - -
umber ol pregnant women identilied and
attended witL obstetric complications
- - - - - - -
Cut ol tLese, Low many Lave been relerred
lrom PHC/SHC
- - - - - - - -
Jotal Institutional Deliveries 20 1 32 53 20 8 23 51
o. ol ]SY cases (out ol total institutional
deliveries)
20 1 32 53 20 8 23 51
o. ol inlants given BCC 19 0 19 38 - - - 1+
o. ol inlants given DPJ3 5 1 1+ 20 - - - 0
o. ol inlants given Measles 13 1 15 29 - - - 3
o. ol inlants given Vit. A-lirst dose 13 1 15 29 - - - -
CLildren given IIA Syp. (6-60 MontLs) 0 0 0 0 - - - -
ILD Inserted 2 1 9 12 - - - -
Jotal Indoor Patients - - - 81 20 1+ 32 66
o. ol cases relerred beyond CHC 1 0 1 2 0 1 1 2
o. ol Leprosy cases currently under
treatment
/ + 16 2/ 10 8 2+ +2
o. ol new JB cases enrolled lor DCJS 8 16 1/ 31 1 3 + 8
o. ol cases given Blood Jranslusion in last
3 montLs
0 0
Bed occupancy rate in tLe last 12 montLs (As
on MarcL 31, 2008)
28.32 23.69
Average Daily CPD Attendance (Jotal)
Average Daily CPD Attendance
50 58
Average Daily CPD Attendance Male 20 21
Average Daily CPD Attendance Iemale 18 21
Average Daily CPD Attendance CLildren 13 16
Cut ol tLe total CPD attendance, specily tLe
relerred cases lrom PHC/ SHC
0 0
37
Chaptcr 4
Primary Hcalth Ccntrcs
As per tLe study design, two PHCs are selected under eacL selected CHC. JLe
selected PHCs are vertically under tLe CHCs. Lnder CHC ]aijaipur, tLe selected PHCs
are Hausoud and Raipura. Lnder CHC Baloda, tLe selected PHCs are Pantora and Catwa.
one ol tLe PHCs are lunctioning on 2+"/ basis. JLis cLapter presents tLe inlormation
collected lrom tLese lour PHCs.
Covcragc and Iacility
JLe number ol SCs covered by tLese lour PHCs varies lrom + to / and tLe
population covered varies lrom 8, 000 to 35,000. JLe distance lrom tLe nearest SCs in tLe
coverage areas to tLese PHCs varies lrom 0 to 18 kilometres and distance lrom tLe lartLest
SC varies lrom / to 28 kilometres. Jime taken to reacL tLe PHCs lrom tLe nearest SCs
varies lrom 0 to 60 minutes and lrom tLe lartLest SCs it varies lrom 20 to 120 minutes.
Cut ol tLe lour PHCs, one is Laving 6 beds (3 male and 3 lemale beds eacL) and tLe otLer
PHC Las + beds. one ol tLe PHCs are lunctioning on 2+"/ basis. one ol tLe lour PHCs
are equipped to provide basic obstetrics services.
Intrastructurc
All tLe lour PHCs are lunctioning lrom a designated government building and 2 ol
tLem Hasoud and Pantora Lave labour rooms and laboratory altLougL nonlunctional.
Since no deliveries are taking place at tLe PHCs tLey are not maintaining tLe records
containing tLe names ol ]SY beneliciaries. one ol tLe lour PHCs put up a prominent
display board regarding service availability in local language. PLarmacy lor drug dispensing
and drug storage is available in all lour PHCs. CPD rooms/cubicles, are available in all tLe
PHCs, but regular electricity supply is only available in Pantora PHC wLile otLers Lave
made some type ol temporary arrangements. Cenerator lor power backup is available in
none ol tLe lour PHCs and separate toilets lor males and lemales are available only in
Hausoud but not in use. In none ol tLese PHCs suggestion/complaint box is kept. Piped
water supply is available in none ol tLe PHCs. JelepLone is available only in Pantora
38
PHC, none ol tLe PHCs Lave a computer and none ol tLem Lave internet lacility. Jype ol
sewerage in tLese PHCs is eitLer a soak pit or open drain. JLe PHCs dispose tLeir bio-
medical waste by burying in a pit or by burning. Cut ol lour PHCs, none Lave ew Born
Care Corner. As per our observation, tLe cleanliness ol CPD, compound/premises and
rooms/wards are not good in Raipura PHC under ]aijaipur CHC as construction work is
going on bringing a lot ol dust in tLe building.
Statt Position
In none ol tLe PHCs all tLe sanctioned positions are lilled in. In PHCs Raipura,
Pantora and Catwa, out ol two sanctioned posts ol Medical Cllicers only one post is lilled
up.Cne medical ollicer in Raipura PHC is appointed on regular basis. PHC Hausoud is
being run by medical ollicers lrom ]aijaipur CHC wLo take turns to run tLe CPD as per
tLeir duty roster. one ol PHCs Lave sanctioned positions ol Medical Cllicer AYLSH,
urses, Stall urse, Block HealtL Education and Inlormation Cllicer, Lady HealtL
Visitor, Lab Assistant, and Statistical Assistant and Driver. Except lor a pLarmacist, dresser
or ward boy/ward ayaL Lardly any paramedical or otLer stall was available lor providing
inlormation and data. JLe stall position in none ol tLe PHCs eitLer medical or
paramedical can be said to be satislactory.
Status ot Training ot Pcrsonncl at PHC
JLe stall in none ol tLe PHCs Las undergone training in Pre -Service IMCI
(Integrated management ol eonatal and CLild Inlections) Sale Abortion MetLods, Skill
BirtL Attendant Jraining and ew Born Care Jraining. JLe training component is also
extremely poor in all tLe + PHCs.
Availability and Pcrtormancc ot Labour Boom
AltLougL labour rooms are available in Hausoud and Pantora PHCs due to non
availability ol doctors/stall AMs and stall nurses tLey are non lunctional. Poor
condition ol tLe labour room and no power supply in tLe labour room are also reasons lor
deliveries not being carried out at tLe PHCs. In case ol Raipura and Catwa PHCs, tLey are
still lunctioning lrom tLe old buildings wLicL do not Lave a labour room.
39
Availability ot Laboratory Tcsting in PHC
JLe two PHCs ol Raipura and Catwa Lave no separate laboratory or testing
lacilities available as tLey are lunctioning lrom old buildings witL no space lor laboratory
lacilities. In Hasuad and Pantora PHCs altLougL rooms are available lor laboratory
purpose tLere is no lab tecLnician available nor are tLere required laboratory testing
lacilities. JLus tLe tests lor Haemoglobin, Lrine RE, Blood Smear, Blood Smear
Examination lor malaria, Parasite, and Rapid Jest lor Pregnancy, Blood Sugar, Diagnosis
lor RJI/SJI and Rapid Jest lor HIV are not available in any ol tLe + PHCs.one ol tLe
PHCs also Lave tLe testing lacility lor Blood Crouping, Bleeding and Clotting Jime, and
RPR Jest lor SypLilis.
Mumbcr ot Tcsts Donc in PHCs
AltLougL no laboratory tests are carried out at tLe PHCs blood collection lor
preparation ol blood smear examination lor malaria parasite was reported in all + PHCs
and 9+, 38, 85 and 95 at Hausaud, Raipura, Pantora and Catwa respectively
Status ot Spccitic Intcrvcntions
IPHS lacility survey Las been done in all + PHCs altLougL none ol tLe medical
ollicers at tLe + PHCs Lad any knowledge about it. JLis inlormation was obtained lrom
tLe district ollicials. one ol tLe PHCs are lunctioning on 2+"/ basis (Lave 1 MC and 3 or
more AMs/Stall urses round tLe clock). o AYLSH doctors are providing services in
any ol tLe PHCs. In Pantora PHC tLere is an old ayurvedic dispensary adjoining tLe PHC
building. All tLe lour PHCs Lave registered RKS but tLere are no display boards sLowing
tLe composition ol tLe RKS witL tLe names ol tLe members and number ol meetings Leld.
In all + PHCs RKS is generating resources tLrougL user lees wLicL is being used locally. In
none ol tLe PHCs leedback mecLanism is in place lor grievances redressed by RKS.
Standard treatment guidelines and protocols are not available witL tLe PHCs. Citizens
cLarter is not publicly displayed in any ol tLe PHCs.
Availability ot Spccitic Scrviccs
All tLe lour PHCs Lave tLe specilic services lor primary management ol wounds
and lacility lor minor surgeries is available in all + PHCs. Burn cases are Landled in
40
Raipura PHC. Primary management ol lracture, care ol malnourisLed cLildren, treatment
ol poisoning/snake/insect/scorpion bite, dog bite and MJP is available in two PHCs and
management ol RJI/SJI is available in 3 PHCs. AYLSH services are not available in any
ol tLe PHCs.
Availability ot Sclcctcd Equipmcnts in PHC
Cut ol 23 equipments lor wLicL tLe inlormation collected lrom tLe PHCs,
Hausoud PHC Las 9 equipments all ol wLicL are in working order, Raipura PHC Las 12,
all in working condition Pantora Las 10 equipments in working condition and Catwa Las
1+ out ol wLicL 13 are lunctional and only a wLeel cLair is not in working condition. JLe
equipments wLicL are not available in any ol tLe PHCs are Inlant warmer, Radiant
warmer, Cradle and Auto Analyser. JLe equipments wLicL are available altLougL in
working condition are Lardly being used because tLe PHCs are not lunctioning in lull
capacity and are not providing a large number ol services.
Status ot Availability ot Drugs
Cut ol tLe 25 drugs 9 drugs (36 percent) Vitamin A, measles vaccine, ILDs, MVA
syringe, PartograpL, tablet Iluconazole AYLSH drugs, DCJS drugs, and MDJ drugs and
blister packs Lave never been supplied to any ol tLe + PHCs. Magnesium sulpLate is only
available at Catwa PHC, and injection Cxytocin at Pantora and Catwa PHCs. IIA tablets
and Iron syrup are eitLer not supplied or tLe supply is irregular. All tLe PHCs reported
stock out and irregular supply ol 2-+ drugs in last 6 montLs. one ol tLe drugs/vaccines
essential lor maternal and cLild LealtL as well as lamily planning services are available at
tLe PHCs as none ol tLem are providing tLese services at tLeir respective LealtL lacilities.
Scrvicc Cutcomc
JLe service outcome statistics was collected lrom tLe PHCs lor last tLree montLs
prior to tLe survey. Cut ol 2+ listed services tLe PHCs are only providing CPD services.
Castewise breakup is not being maintained. PHC wise breakup ol CPD cases is reported
as lollows: Hasuad 62+, Raipura 562, Pantora 62+, and Catwa 3085.
41
Status ot Bccord Maintcnancc
Except lor tLe untied lunds register ol PHC Hausoud and ]eevandeep meeting
register ol Panotora no otLer registers were available lor verilication because tLey are not
being maintained. Raipura and Catwa PHCs are not maintaining any registers at all.
Bcmarks and Suggcstions: PHCs undcr CHC jai|aipur
Bcmarks by MC (Baipura): All categories ol stall sLould be available in tLe PHC lor
implementation ol RHM and lor providing a range ol maternal and cLild LealtL services.
JLe new PHC building is under construction and tLe old building is not lully lunctioning
to provide all services under RHM. AMs and nurses are required lor providing
institutional delivery services wLicL is not available presently. We sLould get good
allowances like private doctors. I Lave not spent tLe ]eevandeep lunds because I Lave not
been given clear guidelines.
Bcmarks/suggcstions tor thc improvcmcnt ot scrviccs by thc obscrvcr: o maternal
and cLild care lacilities and no ol ]SY services are being provided at tLe PHC wLicL
indicates tLat tLe programme Las not made inroads in Raipura PHC and impact ol
RHM is not visible. JLe PHC is only providing skeletal CPD services due to lack ol
stall, equipments and drugs and laboratory lacilities. Most ol tLe equipments seen are not
being used or kept packed. Presently tLe PHC building is under construction and tLe
PHC is Lardly lunctional. JLere is no stall nurse or AM to provide maternal and cLild
LealtL services at tLe PHC. JLe MC lives at Sakti wLicL is about +0 kms away lrom
Raipura and does not visit tLe PHC regularly. o ]SY or LealtL and lamily wellare
services are being provided by tLe PHC. Lack ol involvement and poor motivation on tLe
part ol tLe M.C. is observed. A resident doctor is needed to improve perlormance. And
monitor tLe implementation ol tLe programme at tLe PHCs, and at tLe SCs lunctioning
under it.
42
Bcmarks/suggcstions tor thc improvcmcnt ot scrviccs by thc obscrvcr Hasoud PHC:
Hasuad PHC Las a new building but is totally underutilized because tLere is no doctor in
position against tLe sanctioned post. Doctors lrom CHC ]aijaipur visit tLe PHC by
rotation on Monday, Wednesday and Iriday. As a result patient inllow is low. JLe PHC is
only providing skeletal CPD services due to lack ol stall, equipments and drugs and
laboratory lacilities. o IPD services are being provided inspite ol tLe PHC Laving beds
lor patients. JLere is a major public demand lor a resident doctor. JLe record maintenance
is also poor. o ]SY or LealtL and lamily wellare services are being provided. A resident
doctor is needed to make it a lully lunctional PHC.
Bcmarks and Suggcstions: PHCs undcr CHC Baloda
Bcmarks by MC (PHC Pantora): We Lave acute paucity ol stall. JLere is no regular
water supply Lere at tLe Lospital. We need a regular supply ol regular supply ol drugs,
increase in tLe made permanent, and all tLe sanctioned post sLould be lilled up. I do not
Lave any drawing and disbursing power because I Lave been appointed on contractual
basis.
Bcmarks/suggcstions tor thc improvcmcnt ot scrviccs by thc obscrvcr: Pantora PHC
is not providing any maternal and cLild care lacilities under RHM or ]SY services. JLis
indicates tLat tLe programme Las not made inroads in Pantora PHC and impact ol
RHM is not visible. JLe M.C. wLo is contractually appointed Lardly visits tLe PHC and
resides at ]anjgir-CLampa tLe district Lead quarters. JLere is lack ol orientation among tLe
M.C. and Lis stall regarding goals to be acLieved under RHM. JLe PHC is lunctioning
lrom a new building but is grossly underutilized due to non availability ol M.C. and otLer
stall. JLe PHC is only providing skeletal CPD services due to lack ol stall, equipments
and drugs and laboratory lacilities.An ayurvedic doctor lrom an adjacent government
ayurvedic dispensary is seeing CPD patients at tLe PHC. An RMA was also seeing patients
at tLe CPD. JLe record maintenance is also poor.. Most ol tLe equipments are not being
used at tLe PHC. JLe BMC ( Baloda CHC) needs to monitor tLe MCs activities because
tLe PRI Las also complaints against Lis long absence and irregular visits to tLe PHC.
43
Bcmarks by MC (PHC Catwa): We are lunctioning lrom an old donated pancLyat
building wLicL is not sullicient lor running a laboratory and also tLere is no labour room
to carry out institutional deliveries. Most ol tLe drugs are purcLased lrom tLe district and
no need assessment is done at our level. We Lave urine pots but no IPD services are being
provided. I am working as a contractual doctor and tLerelore Lave not mucL Lold over my
stall I will spend lunds lor establisLing a laboratory.
Bcmarks/suggcstions tor thc improvcmcnt ot scrviccs by thc obscrvcr: JLe new PHC
building is in tLe linal stage ol construction. Catwa PHC Las yet to sLilt to a new building
but is totally underutilized because tLere is no resident doctor. JLe MC wLo is
contractually appointed stays at Balaoda and is a visiting doctor lor two PHCs Catwa and
Pantora. He visits tLem on alternate days. JLerelore tLe CPD services are mostly being
Landled by a dresser or pLarmacist. A resident doctor is essential lor smootL lunctioning
ol tLe PHC. JLe record maintenance is also poor. JLe PHC is just providing skeletal
CPD services. JLe PHC is only providing skeletal CPD services due to lack ol stall,
equipments and drugs and laboratory lacilities. o ]SY or LealtL and lamily wellare
services are being provided by tLe CHC. Lack ol involvement and poor motivation on tLe
part ol tLe M.C. is observed. A resident doctor is needed to improve perlormance. And
monitor tLe implementation ol tLe programme at tLe PHCs, and at tLe SCs lunctioning
under it.
44
Primary Hcalth Ccntrcs
Tablc P1: Covcragc and tacilitics ot Primary Hcalth Ccntrc
CHC 1 jai|aipur CHC 2 Baloda
Covcragc and tacilitics
PHC 1 (Hasoud) PHC 2
(Baipura)
PHC 1 (Pantora) PHC 2 (Catwa)
umber ol Sub-Centres
covered by PHC
+ + 3 6
Population covered 31908 318/9 8000 35000
PHC 1 (Hausoud) PHC 2 (Baipura) PHC 1 (Pantora) PHC 2 (Catwa)
Distance & Jime Jaken
to travel in public
transport / available
mode lrom
Distance
(in Kms)
Time (in
Minutes)
Distance
(in Kms)
Time (in
Minutes)
Distance
(in Kms)
Time (in
Minutes)
Distance
(in Kms)
Time (in
Minutes)
earest Sub Centre
in tLe coverage area
3 25 18 60 0
_
0 0
$
0
IartLest Sub Centre
in tLe coverage area
1/ 120 28 120 10 20 / 20
earest CHC 20 60 28 120 25 +0 22 60
o. ol Beds available
Male 2 0" 3 0
#
Iemale 2 0 3 0
Jotal + 0 6 0
PHC lunctioning on
2+x/ basis (Yes:1; o: 0)
0 0 0 0
PHC equipped to
provide basis obstetric
services (Yes:1; o: 0)
0 0 0 0
PHC witL +-6 beds
(Yes:1; o: 0)
1 0 1 0
_ Sub-centre Pantora located in PHC village $Sub-centre Catwa located in PHC village
" In Raipura new 6 bedded PHC building under construction.
#
In Catwa new 6 bedded PHC building to be Landed over.
45
Tablc P2: Primary Hcalth Ccntrcs by Intrastructurc
CHC 1 jai|aipur CHC 2 Baloda
Intrastructurc
PHC 1
(Hausoud)
PHC 2
(Baipura)
PHC 1
(Pantora)
PHC 2
(Catwa)
PHC lunctioning in designated govt. Building
(Ycs:1, Mo: 0)
1 1 1 1
Labour Room (Ycs:1, Mo: 0) 1 0 1 0
Laboratory(Ycs:1, Mo: 0) 0 0 0 0
Prominent display boards regarding service availability
in local language (Ycs:1, Mo: 0)
0 0 0 0
ames ol ]SY beneliciaries maintained in
record(Ycs:1, Mo: 0)
0 0 0 0
PLarmacy lor drug dispensing and drug storage (Ycs:1,
Mo: 0)
1 1 1 1
Separate public utilities (toilets) lor males and lemales
(Ycs:1, Mo: 0)
1 0 0 0
Suggestion / complaint box (Ycs:1, Mo: 0) 0 0 0 0
CPD rooms / cubicles (Ycs:1, Mo: 0) 1 1 1 1
Piped Water Supply (Ycs:1, Mo: 0) 0 0 0 0
Electricity Supply
o regular electricity supply(Ycs:1, Mo: 0)
Regular electricity supply in all parts(Ycs:1, Mo: 0)
1
-
1
-
-
1
1
-
JelepLone (Ycs:1, Mo: 0) 0 0 1 0
Computer (Ycs:1, Mo: 0) 0 0 0 0
Internet (Ycs:1, Mo: 0) 0 0 0 0
Typc ot scwcragc systcm(Ycs:1, Mo: 0)
Soak pit
Connected to Municipal
Sewerage
Cpen Drain
CtLer
1
-
-
-
-
-
-
-
-
-
1
-
1
-
-
-
-
-
-
-
-
-
1
-
Wastc disposal(Ycs:1, Mo: 0)
Buried in a pit
Collected by an agency
Incineration
/
Burning
JLrown in open
1
-
-
-
1
-
-
-
-
-
1
-
-
-
1
-
Standby lacility (generator etc.) available in working
condition(Ycs:1, Mo: 0)
0 0 0 0
Separate areas lor septic and aseptic deliveries available:
(Ycs:1, Mo: 0)
- - - -
ew Born Care Corner available: (Ycs:1, Mo: 0) 0 0 0 0
Status ol Cleanliness ol CPD reported good or lair
1 0 1 1
Status ol Cleanliness ol Compound / Premises
reported good or lair
1 0 1 1
Status ol Cleanliness ol Room/Wards reported good or
lair
1 0 1 1
"Laboratory tacilitics arc not availablc in thc PHC # burning in opcn
46
Tablc P 3: Statt Position ot in Primary Hcalth Ccntrc
S: Sanctioncd, B: Bcgular, C: Contractual, T: Total
Post ol 1dresser, 1opLtLalmic assistant, 1sweeper, 1ayaL, and1 ward boy are sanctioned in tLe above PHCs
CHC 1 ( jai|aipur) CHC 2 ( Baloda)
PHC 1 (Hausoud) PHC 2 (Baipura) PHC 1 (Pantora) PHC 2 (Catwa)
umbers in
Position
umbers in Position umbers in
Position
umbers in Position
Typc ot Statt
S
R C J
S
R C J
S
R C J
S
R C J
Medical OIIicer 1 0 0 0 2 1 0 1 2 0 1 1 2 0 1 1
Pharmacist 1 1 0 1 2 1 0 1 1 1 0 1 1 1 0 1
Nurses 0 - - - 0 - - - 0 - - - 0 - - -
ANM 1 0 0 0 1 0 0 0 1 0 0 0 1 0 0 0
Lab Technician 1 0 0 0 1 0 0 0 1 0 0 0 1 0 0 0
Driver 0 - - - 0 - - - - - - - 0 - - -
Medical OIIicer AYUSH 0 - - - 0 - - - - - - - 0 - - -
StaII Nurse 0 - - - 0 - - - - - - - 0 - - -
Lady Health Visitor 0 - - - 0 - - - - - - - 0 - - -
Lab Assistant 0 - - - 0 - - - - - - - 0 - - -
Block Health Education
and InIormation OIIicer
0 - - - 0 - - - - - - - 0 - - -
Statistical Assistant 0 - - - 0 - - - 0 - - - 0 - - -
47
Tablc P4: Status ot training ot pcrsonncl at Primary Hcalth Ccntrc
PHC having pcrsonncl traincd in spccitic catcgory ot
training during 2007 (Ycs:1, Mo: 0)
CHC 1 (jai|aipur) CHC 2 (Baloda) Training
PHC 1
(Hausoud)
PHC 2
(Baipura)
PHC 1
(Pantora)
PHC 2
(Catwa)
Pre Service IMCI 0 0 0 0
Sale Abortion MetLods 0 0 0 0
Skill BirtL Attendant
Jraining
0 0 0 0
ew Born Care 0 0 0 0
Tablc P5: Availability ot Labour Boom in Primary Hcalth Ccntrc
(Ycs:1, Mo: 0)
CHC 1 (jai|aipur) CHC 2 (Baloda)
Labour Boom
PHC 1
((Hausoud)
PHC 2
(Baipura)
PHC 1
(Pantora)
PHC 2
(Catwa)
Availability ol Labour Room 1 0 1 0
Labour Room Currently in Lse 0 - 0 -
Reasons lor not using Labour
Room
on availability ol doctors/stall 1 - 1 -
Poor condition ol tLe labour
room
1 - 0 -
o power supply in tLe labour
room
1 - 0 -
CtLer 0 - 0 -
Tablc P6 : Status ot pcrtormancc ot Labour Boom during 2007-2008
Mumbcr ot dclivcrics pcrtormcd in PHC
during 2007-2008
CHC 1 (jai|aipur) CHC 2 (Baloda)
Mumbcr ot dclivcrics
PHC 1
(Hausoud)
PHC 2
(Baipura)
PHC 1
(Pantora)
PHC 2
(Catwa)
Jotal Institutional Deliveries - - - -
Deliveries carried out lrom 8
pm to 8 am
- - - -
Institutional deliveries lor
]SY card Lolders
- - - -
umber ol neonates
resuscitated
- - - -
Dclivcrics not conductcd at thc PHCs
48
Tablc P 7: Availability ot laboratory tcsting in PHC
(Ycs:1, Mo: 0)
CHC 1 (jai|aipur) CHC 2 (Baloda)
Availability Laboratory
Tcsting"
PHC 1
(Hasoud)
PHC 2
(Baipura)
PHC 1
(Pantora)
PHC 2
(Catwa)
Haemoglobin - - - -
Urine RE - - - -
Blood sugar - - - -
Blood grouping - - - -
Blood Smear - - - -
Bleeding time, clotting time - - - -
Diagnosis oI RTI/ STIs with wet
mounting, grams stain etc.
- - - -
Blood smear examination Ior
malaria parasite
- - - -
Rapid test Ior Pregnancy - - - -
RPR test Ior Syphilis - - - -
Rapid test Ior HIV - - - -
"Mo laboratory tcsting tacility in thc abovc PHCs
Tablc P 8: Mumbcr ot tcsts donc in PHC in last thrcc calcndar months
Mumbcr ot tcsts donc in last 3 calcndar months
CHC 1 (jai|aipur) CHC 2 (Baloda)
Typc ot Tcst"
PHC 1
(Hausoud)
PHC 2
(Baipura)
PHC 1
(Pantora)
PHC 2
(Catwa)
Haemoglobin - - - -
Urine RE - - - -
Blood sugar - - - -
Blood grouping - - - -
Blood Smear - - - -
Bleeding time, clotting time - - - -
Diagnosis oI RTI/ STIs with wet
mounting, grams stain etc.
- - - -
Blood smear examination Ior
malaria parasite
- - - -
Rapid test Ior Pregnancy - - - -
RPR test Ior Syphilis - - - -
Rapid test Ior HIV - - - -
"Mo tcsts donc in thc PHCs
49
Tablc P 9: Status ot Spccitic Intcrvcntions
(Ycs:1, Mo: 0)
CHC 1 (jai|aipur) CHC 2 (Baloda)
Status ot Spccitic Intcrvcntions
PHC 1
(Hausoud)
PHC 2
(Baipura)
PHC 1
(Pantora)
PHC 2
(Catwa)
IPHS Iacility Survey done 1 1 1 1
PHC Iunctioning on 24 x 7 basis (have 1
MO and 3 or more ANMs / StaII Nurses
round the clock)?
0 0 0 0
AYUSH doctor providing services 0 0 0 0
Registered Rogi Kalyan Samiti 1 1 1 1
RKS generating resources tLrougL user
lees
1 1 1 1
Money generated by RKS being used 1 1 1 1
Display board sLowing no. ol meetings
& members ol RKS
0 0 0 0
Ieedback mecLanism in place lor
grievances redressed by RKS
0 0 0 0
Citizens CLarter publically displayed 0 0 0 0
All Standard Jreatment Cuidelines and
Protocols available
0 0 0 0
Availability ot Spccitic Scrviccs
Primary management ol wounds 1 1 1 1
Primary management lracture 0 0 0 0
Management ol eonatal aspLyxia,
sepsis
0 0 0 0
Management ol malnourisLed cLildren 0 0 0 0
Minor surgeries like draining ol abscess
etc
1 1 1 1
Primary management ol cases ol
poisoning/snake, insect or scorpion bite
0 0 0 0
Primary management ol dog bite cases 0 0 0 0
Primary management ol burns 0 1 0 0
Iacility lor MJP available 0 0 0 0
Management ol RJI/SJI 0 0 0 0
AYLSH services 0 0 0 0
50
Tablc P 10: Availability ot sclcctcd cquipmcnts in PHC
Availability ot sclcctcd cquipmcnts in PHC
(Ycs:1, Mo: 0)
CHC 1 (jai|aipur) CHC 2 (Baloda)
PHC 1
(Hasoud)
PHC 2 (Baipura) PHC 1 (Pantora) PHC 2 (Catwa)
Equipmcnts availablc
/ working
Availa-
blc
Work
-
ing
Availa-
blc
Work-
ing
Avail-
ablc
Work-
ing
Avail-
ablc
Work-
ing
Patient Trolley 1 1 1 1 1 1 0 -
Examination table 1 1 1 1 1 1 1 1
Delivery table 1 1 1 1 0 - 1 1
Wheel chair 0 - 0 - 1 1 1 0
Stretcher/ trolley 1 1 1 1 1 1 1 1
Oxygen Cylinder 0 - 0 - 1 1 1 1
Suction Apparatus 0 - 1 1 0 - 1 1
InIant warmer 0 - 0 - 0 - 0 -
Radiant Warmer 0 - 0 - 0 - 0 -
Cradle 0 - 0 - 0 - 0 -
Autoclave 1 1 1 1 1 1 1 1
Sterlisation equipment 1 1 0 0 1 1 1 1
Bag & Mask 0 - 1 1 0 - 1 1
Laryngoscope 0 - 0 - 0 - 0 -
Oxygen Mask 0 - 0 - 0 - 1 1
Thermometer 1 1 1 1 1 1 1 1
Suction Machine 0 - 1 1 0 - 1 1
Water PuriIier 0 - 0 - 0 - 0 -
Microscope 0 - 0 - 0 - 0 -
Haemoglobinometer 1 1 1 1 0 - 0 -
Auto Analyser 0 - 0 - 0 - 0 -
Autoclave 1 1 1 1 1 1 1 1
Resuscitation
equipment
0 - 1 1 1 1 1 1
51
Tablc P 11: Status ot Availability ot Drugs
PHC rcporting stock out or irrcgular supply ot spccitic drugs in last 6
months (Ycs:1, Mo: 0)
CHC 1 (jai|aipur) CHC 2 (Baloda)
PHC 1
(Hasoud)
PHC 2
(Baipura)
PHC 1
(Pantora)
PHC 2
(Catwa)
Typc ot Drugs
Stock
Cut
Irregula
r
Supply
Stock
Cut
Irregula
r
Supply
Stock
Cut
Irregula
r
Supply
Stock
Cut
Irregular
Supply
IIA tablets - - 1 1 1 1 1 1
Iron Syrup 0 1 1 1 1 1 1 1
Cral Pills 0 0 1 1 0 0 0 0
Vitamin A - - - - - - - -
Measles Vaccine - - - - - - - -
CRS 0 0 0 0 0 0 0 0
Jab. MetLergin - - - - - - - -
Jab. Albendazole/
Mabendazole
0 0 0 0 1 0 1 0
ILDs - - - - - - - -
Inj oxytocin - - - - 0 0 0 0
Magnesium sulpLate - - - - - - 0 0
Jab. Iluconazole - - - - - - 1 1
PartograpL - - - - - - - -
MVA syringe - - - - - - - -
Jab Ciprolloxacin 1 1 0 0 0 0 1 0
Syp Cotrimoxazole 0 0 1 1 0 0 1 0
Syp Paracetamol 0 0 0 0 0 0 1 0
Ringers Lactate 0 0 0 0 0 0 0 0
Haemoccele - - - - - - - -
AD syringes - - - - - - 1 0
Disposable Cloves 0 1 0 0 0 0 0 0
Bandages 1 1 0 0 0 0 0 0
AYLSH drugs - - - - - - - -
DCJS drugs - - - - - - - -
MDJ drugs, blister
packs
- - - - - - - -
52
Tablc P12 A: Scrvicc Cutcomc (bascd on data tor last thrcc months)
CHC 1 (jai|aipur)
Avcragc monthly numbcr rcportcd
in PHC 1 ( Hausoud)
Indicator
SC ST Cthcrs Total
Jotal AC Registration -" - - -
Jotal ]SY cases registered - - - -
Ist Jrimester Registration - - - -
AC given 3 CLeckups - - - -
AC given JJ1 - - - -
AC given JJ2Booster - - - -
AC completed IIA PropLylaxis - - - -
Jotal Institutional Deliveries0 - - - -
o. ol ]SY cases (out ol total institutional
deliveries)
- - - -
o. ol inlants given BCC - - - -
o. ol inlants given DPJ3 - - - -
o. ol inlants given Measles - - - -
o. ol inlants given Vit. A-lirst dose - - - -
CLildren given IIA Syp. - - - -
ILD Inserted - - - -
Male sterilisation carried out - - - -
Iemale sterilisation carried out - - - -
Jotal indoor patients - - - -
Jotal outdoor patients A A A 62+
RJI/SJI cases treated - - - -
umber ol maternal deatLs in 200/-2008 - - - -
o. ol cases ol obstetric complications
relerred beyond PHC
- - - -
o. ol cataract surgeries carried out - - - -
o. ol new JB cases enrolled lor DCJS - - - -
o. ol new leprosy cases registered lor
MDJ
- - - -
o. ol leprosy cases completed treatment
lor leprosy
- - - -
" Monc ot thc abovc scrviccs arc bcing providcd at thc PHC
53
Tablc P12 B: Scrvicc Cutcomc (bascd on data tor last thrcc months)
CHC 1 (jai|aipur)
Avcragc monthly numbcr rcportcd
in PHC 2 ((Baipura)
Indicator
SC ST Cthcrs Total
Jotal AC Registration -" - - -
Jotal ]SY cases registered - - - -
Ist Jrimester Registration - - - -
AC given 3 CLeckups - - - -
AC given JJ1 - - - -
AC given JJ2Booster - - - -
AC completed IIA PropLylaxis - - - -
Jotal Institutional Deliveries - - - -
o. ol ]SY cases (out ol total
institutional deliveries)
- - - -
o. ol inlants given BCC - - - -
o. ol inlants given DPJ3 - - - -
o. ol inlants given Measles - - - -
o. ol inlants given Vit. A-lirst dose - - - -
CLildren given IIA Syp. - - - -
ILD Inserted - - - -
Male sterilisation carried out - - - -
Iemale sterilisation carried out - - - -
Jotal indoor patients - - - -
Jotal outdoor patients A A A 562
RJI/SJI cases treated - - - -
umber ol maternal deatLs in 200/-2008 - - - -
o. ol cases ol obstetric complications
relerred beyond PHC
- - - -
o. ol cataract surgeries carried out - - - -
o. ol new JB cases enrolled lor DCJS - - - -
o. ol new leprosy cases registered lor
MDJ
- - - -
o. ol leprosy cases completed treatment
lor leprosy
- - - -
" Monc ot thc abovc scrviccs arc bcing providcd at thc PHC
54
Tablc P12 C: Scrvicc Cutcomc (bascd on data tor last thrcc months)
CHC 2 (Baloda0
Avcragc monthly numbcr rcportcd
in PHC 1 (Pantora)
Indicator
SC ST Cthcrs Total
Jotal AC Registration -" - - -
Jotal ]SY cases registered - - - -
Ist Jrimester Registration - - - -
AC given 3 CLeckups - - - -
AC given JJ1 - - - -
AC given JJ2Booster - - - -
AC completed IIA PropLylaxis - - - -
Jotal Institutional Deliveries - - - -
o. ol ]SY cases (out ol total
institutional deliveries)
- - - -
o. ol inlants given BCC - - - -
o. ol inlants given DPJ3 - - - -
o. ol inlants given Measles - - - -
o. ol inlants given Vit. A-lirst dose - - - -
CLildren given IIA Syp. - - - -
ILD Inserted - - - -
Male sterilisation carried out - - - -
Iemale sterilisation carried out - - - -
Jotal indoor patients - - - -
Jotal outdoor patients A A A 62+
RJI/SJI cases treated - - - -
umber ol maternal deatLs in 200/-2008 - - - -
o. ol cases ol obstetric complications
relerred beyond PHC
- - - -
o. ol cataract surgeries carried out - - - -
o. ol new JB cases enrolled lor DCJS - - - -
o. ol new leprosy cases registered lor
MDJ
- - - -
o. ol leprosy cases completed treatment
lor leprosy
- - - -
" Monc ot thc abovc scrviccs arc bcing providcd at thc PHC
55
Tablc P12 D: Scrvicc Cutcomc (bascd on data tor last thrcc months)
CHC 2 (Baloda)
Avcragc monthly numbcr rcportcd
in PHC 2 (Catwa)
Indicator
SC ST Cthcrs Total
Jotal AC Registration -" - - -
Jotal ]SY cases registered - - - -
Ist Jrimester Registration - - - -
AC given 3 CLeckups - - - -
AC given JJ1 - - - -
AC given JJ2Booster - - - -
AC completed IIA PropLylaxis - - - -
Jotal Institutional Deliveries - - - -
o. ol ]SY cases (out ol total
institutional deliveries)
- - - -
o. ol inlants given BCC - - - -
o. ol inlants given DPJ3 - - - -
o. ol inlants given Measles - - - -
o. ol inlants given Vit. A-lirst dose - - - -
CLildren given IIA Syp. - - - -
ILD Inserted - - - -
Male sterilisation carried out - - - -
Iemale sterilisation carried out - - - -
Jotal indoor patients - - - -
Jotal outdoor patients A A A 3085
RJI/SJI cases treated - - - -
umber ol maternal deatLs in 200/-
2008
- - - -
o. ol cases ol obstetric complications
relerred beyond PHC
- - - -
o. ol cataract surgeries carried out - - - -
o. ol new JB cases enrolled lor
DCJS
- - - -
o. ol new leprosy cases registered lor
MDJ
- - - -
o. ol leprosy cases completed
treatment lor leprosy
- - - -
" Monc ot thc abovc scrviccs arc bcing providcd at thc PHC
56
Tablc P 13: Status ot rccord maintcnancc (Ycs:1, Mo: 0)
Typc ot Bccords CHC 1 CHC 2:Baloda
PHC 1
(Hausoud)
PHC 2
(Baipura)
PHC 1
(Pantora)
PHC 2
(Catwa)
Ante atal Register 0 0 0 0
Eligible Couple Register 0 0 0 0
Post atal Care Register 0 0 0 0
Iamily Planning Register 0 0 0 0
BirtL & DeatL Register 0 0 0 0
Immunisation Register 0 0 0 0
Meeting Register 0 0 1 0
]SY Register 0 0 0 0
Lntied Iunds Register 1 0 0 0
Chaptcr
5WD%GPVTG
As per tLe study design, tLree SCs are to be covered lor tLe survey under eacL
selected PHCs and one ol tLe tLree SCs sLould be lartLest lrom tLe PHC. Accordingly, 12
SCs were under lour PHCs but in Malni SC no regular AM was available tLerelore SC
inlormation is available only lor 11centres. JLe list ol selected SCs as per tLe study design
is given in Jable 2 ol tLe introductory cLapter.
%QXGTCIGD[5WD%GPVTGU
Jable S1 sLows tLat tLe number ol villages covered by tLe SCs varies lrom 2 to 5
and tLe population covered varies lrom 102+ to 83+1. JLe average number ol villages
covered by tLe SCs is +.2 and average population covered is 5921. JLe average distance
between tLe PHC and SC is 10.+ kilometres and tLe actual distance varies between 0 to 25
kilometres. JLe average time taken to travel in public/available mode ol transport lrom
lurtLest village to SC is 5+ minutes, lrom SC to PHC is +3 minutes and SC to CHC is 8+
minutes. Cut ol tLe 11 SCs, ASHAs are providing services in all tLe SCs .JLe number ol
ASHAs working under tLe eleven SCs is 1/9 and tLe average lor all tLe 12 SCs turns out
to be 16.3.
#XCKNCDKNKV[QH+PHTCUVTWEVWTG
Cut ol tLe 12 SCs, only 1 (9 percent) is running lrom designated government
building. JLe remaining SCs are lunctioning lrom tLe AMs/male LealtL workers own
Louse (10 SCs). IPHS lacility survey Las been done in 100 percent ol tLe SCs altLougL
none ol tLe AMs or MPW knows about it. Labour room is available only in 1 out ol 11
SCs. Piped water supply and regular electricity are available to none ol tLe SCs. JelepLone
lacility is available majority (9) ol tLe SCs. JLe type ol sewerage system ol tLe SCs sLows
tLat tLe single sub centre in Catwa releases its sewerage tLrougL an open drain. JLirty six
percent ol tLe SCs dispose tLeir bio-medical waste by burying in a pit, 36 percent by
burning and 2/ percent tLrow it in open.
4GUKFGPVKCN5VCVWUQH#0/
Cnly 2 SCs one in KLisora and tLe otLer in Catwa Lave residential quarters lor
AM. Between tLe two SCs witL AM quarters, only in one SC tLe AM is occupying
tLe quarters. JLe otLer AM is staying outside tLe village. JLe reason cited by tLe AM
ol KLisora lor not staying in SC quarter is tLe remoteness ol tLe SC and lamily reasons.
#XCKNCDKNKV[QH5VCHH
All tLe 11 SCs are Laving at least one LealtL worker (male or lemale) working in
regular position and 3 SCs Lave botL male and lemale workers in regular position. JLe
stall availability sLows tLat 100 percent ol SCs Lave male and lemale LealtL workers in
regular positions. one ol SCs Lave any contractual AMs.
#XCKNCDKNKV[QH.CDQWT4QQOCPFPWODGTQHFGNKXGTKGUEQPFWEVGF
As mentioned above, only 1 out ol 11 SCs (9.1percent) Lave labour rooms. At
Catwa SC tLe labour room is being used but it is not in a very Lygienic condition. AM
ol Catwa reported tLat most women preler delivery at Lome. JLe AM ol Pantora SC
also Las converted a room in Ler Louse lor delivery purpose. Cnly 3 deliveries were
conducted at Catwa CHC during tLe year 200/-2008.At Catwa PHC tLere is provision lor
delivery between 8PM to AM but most ol tLe deliveries are conducted at Lome in tLe
nigLt.
#XCKNCDKNKV[QH'SWKROGPVU
one ol tLe SCs Lave all tLe listed 12 equipments available witL tLem. Steriliser,
JLermometer, BP Apparatus and WeigLing MacLine are tLe common equipments
available at all tLe 11 SCs. Ietoscope (91 percent) Haemoglobinometer (82 percent) and
mucus extractor (/3 percent) are tLe tLree otLer most commonly available equipments at
tLe SCs ranking second, tLird, and lourtL in order ol availability. Cuscos Speculum is
available witL / SCs. Bag and mask and Suction MacLine are available at one-tLird ol tLe
SCs . HeigLt Measuring Scale is available witL only one SC. Surprisingly Regent Strips lor
Lrine Jest used lor testing pregnancy is not available witL a single SC. Cut ol tLe 12
equipments listed, only one SC Las reported tLe availability ol 10 equipments and all tLe
remaining SCs Lave reported less tLan 10 equipments. Except lew cases, most ol tLe
equipments available witL tLe SCs are by and large in working condition. AltLougL BP
macLine is available in all SCs it is lound in not working condition in +SCs.
#XCKNCDKNKV[QH&TWIU
Availability ol drugs on tLe date ol survey was collected lrom tLe SCs. JLe
inlormation was obtained lor 16 drugs. JLe availability ol drugs sLows tLe mixed picture.
Cut ol 16 drugs, only Deori SC sLowed tLe availability ol 12 drugs lollowed by Catwa SC
reporting availability ol 9 drugs. Except lor tLese two otLer SCs reported availability ol 3-
8 drugs. JLe availability ol drugs in tLe SCs under ]aijaipur CHC is comparatively poorer
tLan tLose lunctioning under Baloda CHC. Vitamin A was available in all tLe11 SCs on
tLe date ol survey. Condom (82 percent), oral pills and CRS (/3 percent) were tLe otLer
most available drugs. Pregnancy test kit was not available in any ol tLe SCs. Iron lolic
Acid, Emergency Contraceptive Pill, Syp Paracetamol, Syp Cotrimoxazole and DDK were
present in 2-+ SCs. PartograpL and Syp Ciprolloxacin were available only at one SC.
5RGEKHKE5MKNNUCPF2TQEGFWTGU
AMs in all tLe 11 SCs reported tLat tLey register pregnancy witLin tLree montLs,
identily LigL risk pregnancies, providing JJ and IIA and Immunisation Services. inety
one percent ol tLe AMs carryout 3 AC visits as per tLe RCH scLedule and reported
tLat tLey are trained in syndromic treatment ol RJI/SJI. EigLty two percent ol tLe
AMs reported tLat tLey carryout specilic examinations like Blood Pressure,
Haemoglobin and Lrine and stated tLat tLey are carrying out ILCD insertion/removal.
Among tLe AMs wLo reported tLat tLey carry out ILCD insertion/removal, one tLird
said tLat ILCD A380 is used and its supply is regular. Also only one- tLird ol tLe AMs
reported tLat tLey are trained on insertion/removal ol ILCD A380.
5GTXKEG1WVEQOG
JLe service outcome data lor tLe last tLree montLs sLow tLat, on an average, eacL
AM Las registered +9 ACs. Cut ol tLe total ACs, tLe average number registered by
tLe AMs in 1st Jrimester is 19.6. JLe average number lor tLe tLree AC visits as per
RCH scLedule is 2/.8 in last tLree montLs. Cn an average, eacL AM Las identilied 3./
LigL-risk cases, conducted zero deliveries at tLe sub-centre and relerred +.3 pregnant
women to next LigLer lacility. eonate inlections reported during tLe last tLree montLs
on an average is 1.1. Among tLe nine SCs wLere AM is carrying out ILCD
insertion/removal, tLe average ILCD insertion is 56 during 200/-2008. JLe service
outcome data reveal tLat tLe perlormance ol tLe AMs varies across tLe SCs.
5VCVWUQH4GEQTF/CKPVGPCPEG
Jo know tLe status ol record maintenance, tLe inlormation was collected lor 11
registers lrom tLe SCs. Registers lor Antenatal Cases, Immunisation, and ]SY are
maintained by10 (92 percent) out ol 11 SCs. Iamily Planning and BirtL and DeatL registers
are maintained by 9 (82 percent) SCs. early two-tLirds (6+ percent) ol tLe SCs maintain
Lntied Iunds register, CasL Book and Meeting registers. Eligible Couple registers
HouseLold register and Postnatal care register is maintained in only 6 out ol tLe 11 sub-
centres. WLile + sub-centres maintain 10 registers, tLe sub-centre at agridi maintains only
3 registers.
#YCTGPGUUCDQWV,5;
Awareness about tLe ]SY and tLe amounts to be given to tLe beneliciaries are
universal among tLe AMs. EigLt out ol eleven AMs reported tLat tLere is an increase
in tLe demand lor institutional deliveries alter tLe implementation ol tLe ]SY scLeme.
2TQEGFWTGWPFGT,5;5EJGOG
EigLty two percent ol tLe AMs reported tLat tLe ]SY beneliciaries are being paid
in casL and remaining 18 percent reported tLat tLe beneliciaries are being paid by cLeque
or voucLer. A little more tLan Lall (5+ percent) ol tLe AMs reported tLat tLe ]SY
beneliciaries are paid witLin a week and +6 percent said tLat tLe beneliciaries are paid alter
two weeks (1/ percent) later. Cnly two out ol 11 AMs reported tLat tLe transport
support is available under ]SY lor sLilting tLe pregnant woman lrom SC to PHC, in case
ol emergency but it is done on private basis and tLere is no government support. Jen out
ol 11 AMs said tLat tLe Register is available witL tLem to record ]SY expenditure.
2GTHQTOCPEGQH#0/WPFGT,5;5EJGOG
All tLe 12 SCs togetLer Lave registered 116 ]SY cases during tLe last tLree calendar
montLs and tLe average number per SC turns out to be 10.5 cases. JLree out ol 11 SCs
Lave not registered a single ]SY case in tLe last tLree montLs. JLe average number ol ]SY
cases resulted in institutional deliveries during tLe last tLree montLs is 2.3. JLe average
amount disbursed lor ]SY cases in last tLree calendar montLs tLe SCs is Rs.111+. JLe
perlormance ol SCs/AMs under ]SY varies considerably across tLe SCs.
During tLe linancial year 200/-2008, tLe average amount disbursed under ]SY by tLe SCs
lor Lome deliveries are Rs. 9+32. ot a single SC Las made payments to tLe beneliciaries
money lor institutional delivery. one ol tLe SCs Lave reported tLe transport costs under
tLe ]SY. one ol tLe SCs Lave even reported payments to ASHA.
5VCVWUQH7PVKGF)TCPVU
All tLe 11 SCs Lave received tLe Lntied Crants. All except Catwa PHC Lave
reported tLe expenditure lrom tLe grants. All tLe SCs are Laving joint bank account witL
tLe SarpancL/any otLer CP lunctionary. Sixty lour percent ol tLe SCs maintain written
record ol transactions being carried out on Lntied Iunds and +6 percent SCs reported
maintenance ol register to record tLe decisions taken to spend tLis amount. Iorty six
percent ol tLe SCs are maintaining tLe register to record tLe decision taken to spend tLe
grant. Jen SCs except Pantora Las reported tLat tLe SarpancL/otLers Lave reviewed tLe
expenditure records. SCs (90 percent) Lave reported tLe lollowing expenditure lrom tLe
Lntied Crants: purcLase ol stationaries, pLotocopy, and lurniture like table, cLair carpet,
lan, signboard, cup, kettle, cup and glasses.
4GOCTMUD[5WD%GPVTGU
JLe remarks given by some ol tLe AMs regarding tLe programmes are given below in
tLeir own words (tLe name ol tLe SC is given brackets):
1. I sLould be provided a building lor running tLe SC and carrying out institutional
deliveries. Currently I am running tLe SC lrom my own residence. Jraining on all
components ol ]SY is essential lor us. (SC Pantora).
2. JLere sLould be government building along witL lacilities ol oxygen cylinder,
drugs and delivery kit (SC CLeora).
3. We need training regarding tLe guidelines to utilise tLe grants given under RHM,
and Lntied Iund (SC BLutia).
+. Jraining regarding tLe various scLemes under RHM sLould be given to AMs.
We also need a building, medicines and transport lacility (SC CLikLalraunda).
5. Water and electricity lacility sLould be made avialble at tLe earliest so tLat we can
sLilt to tLe new SC building and start providing services.(SC KLisora).
6. Stall quarters sLould be provided in tLe SC village to lacilitate our stay (
SCKurma).
/. Suction macLine, examination table, water and electricity lacility is essential at tLe
LealtL centre (SC Catwa).
5WIIGUVKQPUD[VJGQDUGTXGTHQTVJGKORTQXGOGPVQHUGTXKEGU
1. Except lor Catwa and KLisora all tLe 10 SCs need buildings wLicL are lully
equipped to make tLe lunctioning ol tLe SC more ellicient. JLe AMs require
residential quarters so tLat tLey are able to stay in tLe SC village and provide active
services.
2. ew building Las been constructed lor tLe SC lor past six montLs. But electricity
and
water connection Las not yet been given to tLe SC. Due to tLis; tLe AM is not
staying in tLe SC village (SC KLisora).
3. Deliveries are conducted in Catwa SC, wLicL urgently needs a separate labour
room, water and electricity connection (SC Catwa).
+. Many ol tLe SCs do not Lave pregnancy test kit, BP macLines, wLicL are
lunctional, DDK wLicL are bare essentials to identily pregnancy conduct cLeckups,
and delivery.
5. JLe AMs Lave not received clear instructions or guidelines lor utilizing Lntied
Crants. Most ol tLe expenditures Lave been made under otLer Lead instead ol
relerral transport services or emergency drugs lor wLicL tLese lunds are meant.
AMs need clear guidelines on expenditures to be made lrom untied grants.
6. Most ol tLe AMs lack orientation about tLe importance ol institutional delivery
and preparation ol microplan lor institutional delivery under ]SY. o linkages
witL ASHA/Mitanin ol tLeir area are observed in tLis connection. Most ol tLe
AMs reported tLat tLey are still encouraging Lome delivery because it is
convenient lor tLem and tLeir clients.
/. AMs need training and orientation regarding ]SY to ellectively implement tLe
programme and to create awareness in tLe community about importance ol
institutional delivery.
8. Mostly, tLe SCs are lunctioning witL single AMs. JLey need additional stall to
improve tLe quality ol services.
9. Carelul monitoring ol tLe implementation ol RHM programme at SC level by
Medical Cllicers ol tLe PHCs is essential to give it an impetus.
10.one ol tLe AMs are aware ol tLe IPHS survey conducted lor tLeir LealtL
lacility by tLe district level LealtL ollicials. JLe inlormation about IPHS survey
was obtained lrom tLe district. Communication needs improvement among tLe
stakeLolders ol RHM.
64
Sub Ccntrc
Tablc S1: Sub Ccntrcs Covcragc
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC ( Raipura) PHC 1 (Pantora) PHC 2 (Catwa)
Covcragc ot
Sub-Ccntrc
CLeora agaridi CLisda BLutia CLikalrounda Malni Pantora KLisora Kurma Catwa KLeja Deori
Average
per Sub
Centre
umber ol
villages covered
by Sub Centre
3 5 + + + -" 3 2 6 6 + 5 +.2
Population
coverage
102+ 83+1 8500 8200 /003 - 6502 +800 5500 5/9+ 5000 ++66 5920.9
Distance
between PHC
and Sub Centre
13 1+ 5 2+ / - 00 10 25 00 10 6 10.+
Jime Jaken (In
minutes) to
travel in public
transport /
available mode
lrom
IartLest village
to Sub Centre
60 60 30 60 150 - 30 30 60 20 60 30 53.6
Sub Centre to
PHC
60 60 30 90 30 - 00 30 120 00 60 30 +3.3
Sub Centre to
CHC
120 90 90 90 90 - 60 30 30 150 80 90 83.6
o. ol ASHAs
working in tLe
Sub Centre area
21 5 21 19 18 - 16 13 16 21 1+ 15 16.3
"Bcgular AMM not availablc at SC
65
Tablc S 2: Sub Ccntrcs Intrastructurc
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC ( Raipura) PHC 1 (Pantora) PHC (Catwa)
Availability ot
Intrastructurc in Sub
Ccntrcs (Ycs:1, Mo: 0)
CLeora agaridi CLisda BLutia CLikalrounda Malni Pantora KLisora Kurma Catwa KLeja Deori
% ol SCs
Laving
respective
lacility
Iunctioning in designated
government building
0 0 0 0 0 - 0 0 0 1 0 0 9.1
IPHS Iacility Survey
Done
1 1 1 1 1 1 1 1 1 1 1 1 100.0
Labour Room 0 0 0 0 0 - 0 0 0 1 0 0 9.1
Piped water supply 0 0 0 0 0 - 0 0 0 0 0 0 0.0
Regular electricity supply 0 0 0 0 0 - 0 0 0 0 0 0 0.0
JelepLone 1 1 1 0 1 - 1 1 1 1 1 0 81.8
Type of sewerage system
Soak pit
Connected to any
Sewerage line
Open Drain
0
0
0
0
0
0
-
-
-
0
0
0
0
0
0
-
-
-
-
-
-
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0.0
0.0
9.1
Waste disposal
Buried in a pit
Collected by an agency
Incineration*
Thrown in open
0
0
1
0
0
0
1
0
1
0
0
0
0
0
0
1
1
0
0
0
-
-
-
-
0
0
0
1
0
0
0
1
1
0
0
0
0
0
1
0
0
0
1
0
1
0
0
0
36.+
36.+
2/.2
"By Burning
66
Tablc S3: Sub Ccntrcs with AMM staying with or away trom SC villagc by distancc trom Sub Ccntrc and rcasons tor not staying in Sub Ccntrc
quartcr
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC ( Raipura) PHC 1 (Pantora) PHC (Catwa)
Bcsidcntial status ot
AMM (Ycs:1, Mo: 0)
CLeora agaridi CLisda BLutia CLikalrounda Malni Pantora KLisora Kurma Catwa KLeja Deori
% ol sub
centres
Sub Centre witL AM
quarter
0 0 0 0 0 - 0 1 0 1 0
0 18.2
Sub Centre witL AM
staying in SCs quarters - - - - - - - 0 - 1 - - 9.1
staying witLin SCs village 0 0 0 1 1 - 1 0 0 1 0 0 2/.l
staying outside SCs
village
1 1 1 0 0 - 1 1 1 0 1 1 /2./
Reason lor AM not
staying on SC quarter:
Quality ol quarter 0 0 0 0 0 - 0 0 0 0 0 0 0
Iamily related reason 0 0 0 0 0 - 0 1 0 0 0 0 0
Security reason 0 0 0 0 0 - 0 0 0 0 0 0 0
Tablc S 4: Sub Ccntrcs with Statt in Position
Sub Ccntrc (Mamcs to bc givcn)
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Harsoud) PHC ( Raipura) PHC 1 (Pantora) PHC (Catwa)
Availability ot Statt
(Ycs: 1, Mo: 0)
CLeora agaridi CLisda BLutia CLikalrounda Malni Pantora KLisora Kurma Catwa KLeja Deori
% ol SCs
witL
specilic
stall
available
HealtL Worker Male in
position
0 0 1 0 0 - 0 1 1 0 0 1 2/.1
HealtL Worker Iemale
in position
1 1 1 1 1 - 1 1 1 1 1 0 90.9
Additional AM
contractual
0 0 0 0 0 - 0 0 0 0 0 0 0.0
67
Tablc S 5: Availability ot Labour Boom in Sub Ccntrc
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC ( Raipura) PHC 1 (Pantora) PHC (Catwa)
Labour Boom
(Ycs: 1, Mo: 0)
CLeora agaridi CLisd
a
BLutia CLikalround
a
Malni Pantora KLisora Kurma Catwa KLeja Deori
% ot
Sub
Ccntrcs
Availability ol
Labour room
0 0 0 0 0 0 0 0 0 1 0 0 9.1
Labour Room
currently in use
0 0 0 0 0 0 0 0 0 1 0 0 9.1
Reasons lor not
using Labour Room
AM not staying
- - - - - - - - - - - - -
Poor condition/no
power/electric
supply
- - - - - - - - - - - - -
CtLer - - - - - - - - - - - - -
Tablc S 6 A: Mumbcr ot dclivcrics pcrtormcd during 2007-2008
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC ( Raipura) PHC 1 (Pantora) PHC (Catwa)
Dclivcrics
Pcrtormcd
CLeora agaridi CLisda BLutia CLikalrounda Malni Pantora KLisora Kurma Catwa KLeja Deori
Average
deliveries
conducted
per Sub
Centre
Jotal deliveries
conducted
0 0 0 0 0 - 0 0 0 3 0 0
3
68
Tablc S6 B: Sub-Ccntrcs with arrangcmcnt tor dclivcrics bctwccn 8 PM to 8 AM
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC ( Raipura) PHC 1 (Pantora) PHC (Catwa)
Arrangcmcnt tor Dclivcrics
(Ycs:1, Mo:0)
CLeora agaridi CLisda BLuti
a
CLikalround
a
Malni Pantora KLisora Kurma Catwa KLeja Deori
% ot Sub
Ccntrcs
Deliveries conducted at Sub Centre
itsell and il required relerred to
LigLer lacility
0
0
0
0
0
-
0
0
0
1
0
0
100.0
Deliveries not conducted at Sub
Centre but relerred to LigLer
lacility
-
-
-
-
-
-
-
-
-
0
-
-
-
Relerred to Private/CC lacility
-
-
-
-
-
-
-
-
-
0
-
-
-
Tablclc S7 A : Sub Ccntrcs with availability ot cquipmcnts
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC (Raipura) PHC 1 (Pantora) PHC (Catwa)
Availability ot thc
cquipmcnts
(Ycs: 1, Mo: 0)
CLeora agaridi CLisda BLutia CLikalrounda Malni Pantora KLisora Kurma Catwa KLeja Deori
% ol SCs
witL
equipment
available
Sterliser 1 1 1 1 1 - 1 1 1 1 1 1 100.0
Haemoglobinometer 1 1 0 1 1 - 1 1 1 0 1 1 81.8
Bag & Mask 0 1 0 0 1 - 0 0 0 0 1 1 36.+
Suction Machine 0 1 1 1 0 - 1 0 0 0 0 0 36.+
Thermometer 1 1 1 1 1 - 1 1 1 1 1 1 100.0
BP Apparatus 1 1 1 1 1 - 1 1 1 1 1 1 100.0
Weighing Machine 1 1 1 1 1 - 1 1 1 1 1 1 100.0
Height Measuring Scale 0 0 0 0 0 - 0 0 0 0 1 0 9.1
Reagent Strips lor Lrine Jest 0 0 0 0 0 - 0 0 0 0 0 0 0.0
Cuscos Speculum 0 1 1 1 1 - 0 1 0 0 1 1 63.6
Mucus Extractor 1 1 1 1 1 - 0 0 1 1 1 0 /2./
Fetoscope 1 1 1 1 1 - 1 1 1 1 1 0 90.9
69
Tablc S7 B: Pcrccntagc ot SCs with tunctional cquipmcnts
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC (Raipura) PHC 1 (Pantora) PHC (Catwa)
Iunctional
cquipmcnts (Ycs: 1,
Mo: 0)
CLeora agaridi CLisda BLutia CLikalrounda Malni Pantora KLisora Kurma Catwa KLeja Deori
% ol Sub
Centres witL
lunctional
equipment
Sterliser 1 1 1 1 1 - 1 1 1 1 1 1 100.0
Haemoglobinometer 1 1 - 0 0 - 1 1 1 - 1 1 //.8
Bag & Mask - 1 - - 1 - - - - - 1 0 /5.0
Suction Machine - 1 1 0 - - 1 - - - - - /5.0
Thermometer 1 1 1 1 1 - 1 1 1 1 1 1 100.0
BP Apparatus 0 1 1 1 1 - 1 0 0 1 1 0 63.6
Weighing Machine 1 1 1 0 1 - 1 1 1 1 1 1 90.9
Height Measuring
Scale
- - - - - - - - - - 0 -
0.0
Reagent Strips Ior
Urine Test
- -- - - - - - - - - - - 0.0
Cuscos Speculum 0 1 1 1 1 - 0 1 0 0 1 1 100.0
Mucus Extractor 1 0 1 1 1 - - - 1 1 1 - 8/.5
Fetoscope 1 1 1 1 1 - 1 1 1 1 1 - 100.0
JLe denominator is tLe number ol SCs witL tLe available equipment.
70
Tablc S 8: Status ot availability ot drugs
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC (Raipura) PHC 1 (Pantora) PHC (Catwa)
Typc ot Drugs
Availablc (Ycs: 1,
Mo: 0)
CLeor
a
agarid
i
CLisda BLutia CLikalround
a
Malni Pantora KLisora Kurma Catwa KLeja Deori
% ol Sub
Centres
reporting
availability ol
drug on date ol
survey
Iron/ Folic acid 0 0 0 0 0 - 0 0 1 1 1 1 36.+
Disposable Delivery Kit 1 0 0 0 1 - 0 0 0 0 0 1 2/.3
Oral Pills 0 0 1 1 0 - 1 1 1 1 1 1 /2./
Emergency contraceptive
pills
0 1 0 0 1 - 0 0 0 1 0 1 36.+
Condoms 1 1 1 1 1 - 1 1 0 0 1 1 81.8
IUD 1 0 1 1 0 - 1 1 1 0 1 1 /2./
ORS 0 0 1 0 0 - 0 1 0 1 1 1 +5.5
Tab. Ilucanazole Vaginal 0 0 0 0 0 - 0 0 1 0 0 0 9.1
Tab. Misoprostal 0 0 0 0 0 - 0 0 0 1 0 1 18.2
Partograph 0 0 0 0 0 - 0 0 0 0 0 1 9.1
Pregnancy test kit 0 0 0 0 0 - 0 0 0 0 0 0 0.0
Syp. Cotrimoxazole 0 0 0 0 0 - 1 1 0 1 1 0 36.+
Syp. Paracetamol 0 0 0 0 0 - 1 1 0 1 0 1 36.+
Vi. A 1 1 1 1 1 - 1 1 1 1 1 1 100.0
Tab. CiproIloxacin 0 0 0 1 0 - 0 0 0 0 0 0 9.1
Disposable Gloves 0 0 0 0 0 - 1 0 0 1 1 1 36.+
71
Tablc S 9: Status ot Spccitic Skills and Proccdurcs
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC (Raipura) PHC 1 (Pantora) PHC (Catwa)
Typc ot Skill / Proccdurc
(Ycs: 1, Mo: 0)
CLeora
agaridi
CLisd
a
BLutia
CLikalrounda
Malni
Pantora
KLisora
Kurma
Catwa
KLeja
Deori
oI SCs
reporting
availability oI
drug on date
oI survey
Register pregnancy within three
months
1 1 1 1 1 - 1 1 1 1 1 1
100.0
Carry out 3 ANC visits as per
the RCH schedule (1
st
: 6
month, 2
nd
: 7
th
Month, 3
rd
: 9
th
Month)
1 1 1 1 1 - 1 1 1 1 1 0
90.9
Carry out speciIic examinations
like Blood Pressure,
Haemoglobin, and Urine
1 1 1 1 0 - 1 1 1 1 0 1
81.8
Provision oI TT, IFA etc. 1 1 1 1 1 - 1 1 1 1 1 1 100.0
IdentiIication oI High Risk
Pregnancies
1 1 1 1 1 - 1 1 1 1 1 1
100.0
Is the ANM carrying out IUCD
Insertion/ Removal
1 1 1 1 1 - 1 1 0 1 1 0
81.8
Is IUCD insertion being carried
out using IUD A380*
0 1 0 0 0 - 0 0 0 1 1 0
33.3
Is the supply oI IUD A380
regularly available *
0 1 0 0 0 - 0 0 0 1 1 0
33.3
Has the ANM been trained on
the insertion/ Removal oI IUD
A380
0 1 0 0 0 - 0 0 0 1 1 0
33.3
Is the ANM trained in
syndromic treatment oI
RTI/STI?
1 1 1 1 1 - 0 1 1 1 1 1
90.9
Immunisation services 1 1 1 1 1 - 1 1 1 1 1 1 100.0
" Among tLe SCs wLere AM is carrying out ILCD Insertion/Removal
72
Tablc S 10: Scrvicc Cutcomc(bascd on Data tor last 3 months)
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC (Raipura) PHC 1 (Pantora) PHC (Catwa)
Indicator
CLeora agaridi CLisda BLutia CLikalrounda Malni Pantora KLisora Kurma Catwa KLeja Deori
Average
per Sub
Centre
Jotal AC
registered
/0
1+
59
36
38
- 33 // 111 +8 15 +1
+9.3
Cut ol total AC,
o. Registered in 1
st
Jrimester
30 8 +0 2+ 1+ - 8 2/ 3/ 1 11 16 19.6
o. given 3 AC
visits as per tLe RCH
scLedule
30 10 62 36 3 - 38 22 20 29 2+ 32 2/.8
o. ol HigL Risk
Cases identilied
8 2 6 0 8 - 3 8 0 0 2 + 3./
Deliveries conducted
by AM at Sub
Centre
0 0 0 0 0 - 0 0 0 0 0 0 0.0
Pregnancies relerred
and attended by tLe
next LigLer lacility
8 2 6 0 8 - 1 8 5 2 3 + +.3
o. ol neonate
inlections identilied
and relerred
0 0 0 0 0 - 0 + 0 0 5 3 1.1
o. ol ILCD
insertions in 200/-
2008"
22 0 0 +3 0 - 30 0 0 +9 35 0 55.5
73
Tablc S 11 : Status ot Bccord Maintcnancc
Sub Ccntrc (Mamcs to bc givcn)
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC (Raipura) PHC 1 (Pantora) PHC (Catwa)
Typc ot
Bccords
maintaincd
(Ycs: 1, Mo: 0)
CLeora agaridi CLisda BLutia CLikalrounda Malni Pantora KLisora Kurma Catwa KLeja Deori
% ol SCs
reporting
maintenance
ol record "
Household
Survey Register
1 0 0 1 0 - 1 1 0 1 1 0 5+.5
Ante Natal
Register
1 1 1 1 1 - 1 1 0 1 1 1 90.9
Eligible Couple
register
1 0 0 0 0 - 1 1 0 1 1 1 5+.5
Post Natal care
Register
1 0 0 1 0 - 1 1 0 1 1 0 5+.5
Family
Planning
Register
1 1 1 1 1 - 1 1 0 1 1 0 81.8
Birth & Death
register
1 0 1 1 1 - 1 1 0 1 1 1 81.8
Immunisation
Register
1 1 1 1 1 - 1 1 0 1 1 1 90.9
Meeting
Register
1 0 1 1 1 - 1 1 0 0 0 1 63.6
JSY register 0 1 1 1 1 - 1 1 1 1 1 1 90.9
Untied Funds
register
0 0 1 1 1 - 0 1 0 1 1 1 63.6
Cash Book 1 0 1 1 1 - 1 0 0 1 1 0 63.6
74
Tablc S12 A: Status ot Awarcncss ot AMM about jSY Schcmc
Mumbcr ot AMMs AMMs awarcncss about jSY
Intcrvicwcd Bcporting Awarcncss
Aware about ]SY 11 11
Aware about amounts to be given to beneliciaries 11 11
AM reporting increase in demand lor Institutional
delivery alter implementation ol ]SY ScLeme
11 8
Tablc S12 B: Status ot proccdurc undcr jSY Schcmc
AMMs awarcncss about jSY % ot AMMs according to rcsponsc
Funds being paid to beneIiciaries by
Cash
Cheque
Vouchers
81.8
9.1
9.1
Average time taken aIter birth Ior JSY payment to beneIiciary
Less than 1 week...1
1- 2 weeks..... 2
More than 2 weeks....3
54.5
0.0
45.5
Transport support Ior shiIting oI cases available Irom Sub Centre
to PHC/CHC
18.2
Register available Ior recording oI JSY Expenditure 90.0
Total no. of ANMs interviewed 11
75
Tablc S 13: Status ot pcrtormancc ot AMM undcr jSY Schcmc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC (Raipura) PHC 1 (Pantora) PHC (Catwa)
Pcrtormancc ot AMM
undcr jSY Schcmc
CLeora agaridi CLisda BLutia CLikalrounda Malni Pantora KLisora Kurma Catwa KLeja Deori
Avcragc
pcr Sub
Ccntrc
Jotal cases ol ]SY
registered in last 3
calendar montLs
10 0 10 15 20 - 33 15 1 12 0 0 10.5
Jotal ]SY cases
resulted in Institutional
deliveries in last tLree
montLs:
10 0 0 0 0 - 5 1 1 2 2 + 2.3
Jotal casL disbursed in
last 3 calendar montLs
lor ]SY cases: (Rs.)
3000 500 0 0 0 - 0 3000 0 2000 1/50 2000 1113.6
Cut ol total amount
disbursed, tLe amount
disbursed on tLe
lollowing
-
Home Deliveries
(Rs.)
3000 500 0 10500 1+000 - 1/500 18500 20000 1/000 1/50 18000 9+31.8
Institutional
deliveries: (Rs.)
0 0 0 0 0 - 0 0 0 0 0 0 0.0
Jransport Costs
(Rs.)
0 0 0 0 0 - 0 0 0 0 0 0 0.0
Amount given to
ASHA (Rs.)
0 0 0 0 0 - 0 0 0 0 0 0 0.0
76
Tablc S 14: Status ot Lnticd Crants
Sub Ccntrc
CHC 1 (]aijaipur) CHC 2 ( Baloda)
PHC 1 (Hasoud) PHC (Raipura) PHC 1 (Pantora) PHC (Catwa)
Status ot Lnticd Crants
(Ycs: 1, Mo:0)
CLeora agaridi CLisda BLutia CLikalrounda Malni Pantora KLisora Kurma Catwa KLeja Deori
% ol sub
centre
Sub Centre received Lntied Crant 1 1 1 1 1 - 1 1 1 1 1 1 100.0
Sub Centre reported expenditure
lrom Lntied Crant"
1 1 1 1 1 - 1 1 1 0 1 1 90.9
AM Laving a joint account witL
tLe SarpancL/any otLer CP
lunctionary"
1 1 1 1 1 - 1 1 1 1 1 1 100.0
Sub Centre reporting maintenance
ol register to record tLe decisions
taken to spend tLis amount"
1 1 0 1 1 - 0 0 0 1 1 1 63.6
Sub Centre reporting written
record ol transactions being carried
out on Lntied Iunds
1 1 0 0 0 - 0 0 0 1 1 1 +5.5
Sub Centre reporting tLat
SarpancL/otLers ever reviewed tLe
expenditure records "
1 1 1 1 1 - 0 1 1 1 1 1 90.9
Sub Centre reporting expenditure
lrom Lntied Crant on tLe
lollowing:
Spent on PurcLase ol Drugs"" 0 0 0 0 0 - 0 0 0 0 0 0 0.0
Arranging Jransport"" 0 0 0 0 0 - 0 0 0 0 0 0 0.0
Paying ol Power/ Jele"pLone
bills""
0 0 0 0 0 - 0 0 0 0 0 0 0.0
Arranging lacilities like Water
Cooler etc. lor patients""
0 0 0 0 0 - 0 0 0 0 0 0 0.0
CtLer (like wLite wasL,
maintenance etc.)""
1 1 1 1 1 - 1 1 1 0 1 1 90.9
" Among tLe SCs received Lntied Crant. "" Among tLe SCs reported tLe expenditure lrom Lntied Crants
//
CJCRVGT- 6
Houschold Survcy
JLis cLapter presents tLe lindings ol tLe LouseLold survey on RHM. Ior tLe
survey, two-tLree villages were selected lrom eacL selected Sub Centre area. Jo complete
tLe sample size ol 50 LouseLolds 15 additional villages were covered to lullil tLe
LouseLold selection criteria as per tLe sampling design. HouseLolds were selected lrom
eacL ol tLe selected village by lollowing tLe systematic circular random sampling
procedure. JLus, altogetLer 39 villages were selected lor tLe LouseLold survey. Ior
selecting tLe LouseLolds, tLe total number ol LouseLolds in a village was divided by 50 to
lind out tLe selection interval. Alter tLat, tLe lirst LouseLold situated at tLe nortL-west
corner ol tLe village was randomly selected and subsequently every rtL LouseLold was
selected moving in an anti-clock wise direction till 50 LouseLolds were selected. In tLe
district, lrom tLe selected i villages, we Lave covered about 2 percent more tLan tLe
stipulated 1200 LouseLolds. HouseLolds lrom wLicL incomplete inlormation was received
were linally dropped. In all 1200 LouseLolds are considered lor data analysis, tLe coverage
rate being 100 percent. Presented below are tLe lindings ol tLe LouseLold survey.
Charactcristics ot thc Bcspondcnts
Jable H1 presents tLe background cLaracteristics ol tLe respondents (Lead/senior
member ol tLe LouseLold). RougLly, about Lall ol tLe respondents are aged +0 years and
above and tLe rest lilty percent are less tLan +0 years ol age. More tLan tLree liltLs ol tLe
respondents are males and two-liltLs are lemales. Cne tLird ol tLe respondents are
illiterates. Majority ol respondents are currently married (85 percent) and tLe rest are
unmarried (9 percent), divorced/separated (1 percent) or widowed (5 percent).
Charactcristics ot thc Houscholds
Jable H2 presents tLe percentage distribution ol tLe rural LouseLolds by selected
background cLaracteristics. Distribution ol tLe LouseLolds by social category sLows tLat
Lall ol tLe LouseLolds belong to CBC, 29 percent belongs to Caste (SC) 19 ScLedule Jribe
(SJ), and 2 percent to otLer castes. Distribution ol LouseLolds by religion sLows tLat 99
percent ol tLe LouseLolds are Hindus. Seventy lour percent ol LouseLolds Lave electricity.
Cnly one-tLird ol tLe LouseLolds are living in pucca Louses. Joilet lacility is available
/8
only in 1+ percent ol tLe LouseLolds. Piped water is used by only 6 percent ol tLe
LouseLolds. Hardly + percent ol LouseLolds use LPC/Biogas lor cooking. More tLan two
tLirds (68 percent) ol tLe LouseLolds own/cultivate agricultural land. Jwenty percent ol
tLe LouseLolds own a mobile pLone. About Lall ol tLe LouseLolds (+9 percent) possess a
colour/B&W television. Sixty percent ol tLe LouseLolds belong to BPL category. JLe BPL
status is also exactly rellected in tLe LouseLolds witL tLe low standard ol living index (+/
percent). JLe standard ol living index is calculated by using tLe various LouseLold items
possessed by tLe LouseLolds. Among tLe living cLildren born in tLese rural LouseLolds
during tLe last live years, Lardly 1+ percent ol tLem were born in institutions.
Wastc Disposal, Stagnation ot Watcr and Mosquito Brccding and Systcm ot Mcdicinc
Prctcrrcd
MetLod ol waste disposal sLows tLat majority ol tLe rural LouseLolds (9+ percent)
tLrow tLeir waste in tLe open space and tLe remaining bury in a pit (Jable H3).
Percentage ol LouseLolds tLrowing tLe waste in open space is sligLtly more in tLe
LouseLolds located in otLer villages (96 percent) tLan tLose LouseLolds located in SC
Leadquarter village (92 percent). During tLe survey, in 22 percent ol tLe LouseLolds,
investigators Lave observed tLe stagnation ol wastewater around tLe LouseLold.
Among tLe LouseLolds wLere tLe stagnation ol wastewater was observed, tLe
investigators Lave lurtLer observed tLe mosquito breeding in tLe stagnant water in almost
all tLese LouseLolds (99 percent). JLere is no dillerence in tLe stagnation ol wastewater
and tLe instances ol mosquito breeding between tLe LouseLolds located in tLe SC
Leadquarter village and LouseLolds located in otLer villages. System ol medicine prelerred
by tLe rural LouseLolds reveals tLat tLe allopatLic medicine is universally prelerred (99
percent). In addition to tLis, 2 percent ol tLe LouseLolds preler Ayurveda and tLere is
Lardly any prelerence lor traditional Lealing.
Intormation about Hcalth Workcrs and Hcalth Iacilitics
About tLree-lourtLs respondents (/+ percent) Lave Leard about AM and only 38
percent ol tLem Lave Leard about Male HealtL Worker (Jable H+). Hardly one-liltL (21
percent) ol tLe respondents reported tLat tLe LealtL worker Las visited tLem in last one
montL. JLere is a little dillerence in tLese aspects between tLe LouseLolds located in tLe
/9
SC Leadquarter village (23 percent) and LouseLolds located in otLer villages (19 percent).
IurtLer two liltLs ol tLe respondents reported tLat tLe LealtL workers are available to
tLem wLen needed. A LigLer proportion ol respondents living in SC Leadquarter village
(53 percent) reported tLat tLe LealtL workers are available to tLem wLen needed tLan tLe
respondents living in otLer villages (29 percent).
Respondents were asked about tLe availability ol tLe LealtL lacilities to tLe
LouseLolds wLen required. JLe responses reveal tLe combination ol public and private
lacilities available to tLem wLen required. RMP was reported by Lardly one percent ol tLe
respondents and private clinic/CC was reported by 10 percent respondents. Public
LealtL lacilities like SC, 8 and 5 percent ol tLe respondents mentioned PHC respectively.
Cnly tLose respondents living in SC Leadquarter village (1/ percent) reported tLat tLe SC
and PHC (9 percent) is available to tLem wLen required. one ol tLe respondents living in
otLer villages Lave reported about availability ol government lacility. Majority ol tLe
respondents Lave stated about tLe availability ol otLer lacility, wLicL lor tLem is a jLola
cLLap doctor (8+ percent), or quack. JLe presence ol quack is more prominently reported
in tLe otLer village (9+ percent). Respondents were lurtLer asked about tLe LealtL lacility
wLere tLe serious patients are taken. Majority ol tLe respondents (5+ percent) mentioned
tLat tLey take tLe serious patients to tLe CC Lospital/ clinic. PHC, CHC and District
Hospital were mentioned by / percent, 18 percent and 33 percent ol tLe respondents
respectively. JLere is not mucL dillerence in tLe responses ol tLe respondents lrom SC
Leadquarter villages and otLers villages.
Mode ol transport used to take serious patients wLen required was asked lrom tLe
respondents. Majority ol tLe respondents mentioned otLer means ol transport (/1
percent) wLicL is generally a Lired veLicle or sometimes on motorcycle to carry serious
patients. Bus/public transport are used by one tLird respondents are used to take tLe
serious patients, wLen required. Hardly / percent respondents are reported ol Laving
access to private veLicles and only very lew reported tLat tLe bullock cart is used.
80
MBHM, ASHA/Mitanin and jSY
Jable H5 presents tLe distribution ol respondents by tLeir knowledge about
RHM, ASHA and Ler activities, VHD, VHSC and ]SY. A little more tLan one liltL ol
tLe respondents (22 percent) Lave Leard about RHM and tLere is very little dillerence in
tLis between LouseLolds located in SC HQ villages (2+ percent) and otLer villages (21
percent). Ior tLose wLo Lave Leard about RHM, radio/television is tLe major source ol
inlormation (52 percent) lollowed by community member (25 percent), otLers (13
percent), PancLayat (8 percent), ASHA (8 percent) and newspaper (6 percent).
Cverall, majority ol tLe respondents (9+ percent) ol tLe respondents Lave Leard
about ASHA wLo is popularly known as Mitanin in tLe local community. JLose wLo
Lave Leard about ASHA were lurtLer asked about tLeir awareness/knowledge regarding
various activities ol ASHA. More tLan two-tLirds (/0 percent) ol tLe respondents are
aware tLat ASHA carries a kit, 82 percent are aware tLat ASHA provide common
medicines lree ol cost, +8 percent are aware tLat ASHA Leld discussions about Land
wasLing, +2 percent aware tLat ASHA Leld discussions about construction ol LouseLold
toilets and +9 percent aware tLat ASHA Leld discussions about sale drinking water. JLe
percentage ol tLe respondents wLo are aware about dillerent activities ol ASHA is sligLtly
LigLer in SC Leadquarter villages tLan in otLer villages. Jwo liltLs ol tLe respondents (+2
percent) reported tLat tLe Village HealtL and utrition Day (VHD) is being organised
in tLe village. Hardly 11 percent ol tLe respondents Lave reported about tLe presence ol
Village HealtL and Sanitation Committee (VHSC) in tLe village. More tLan Lall ol tLe
respondents (5/ percent) Lave reported tLat VHD is being organised once in a montL in
tLe village. JLe percentage ol tLe respondents reporting tLe lrequency ol tLe VHD as
quarterly and annually is 1+ percent and 19 percent respectively. VHSC Las not made
mucL impact at tLe community level, as awareness about it is low among beneliciaries.
All tLe respondents were asked about tLeir awareness regarding ]SY scLeme. It
sLows tLat Lall ol tLe respondents are aware about ]SY scLeme and tLere is very little
dillerence in tLe awareness level ol respondents lrom SC HQ villages (51 percent) and
tLose lrom otLer villages (+9 percent). JLose wLo are aware about tLe ]SY scLeme were
lurtLer asked about tLeir source ol inlormation about tLe ]SY. It sLows tLat tLe major
81
sources ol inlormation about ]SY are ASHA worker (32 percent) lollowed by
Radio/television (25 percent). CtLers (35 percent) Lave also inlormed tLem about tLe
scLeme.
JLose wLo said tLat tLey are aware about tLe ]SY scLeme were lurtLer asked
wLetLer anyone in tLe LouseLold is a beneliciary ol ]SY scLeme. Among tLose wLo are
aware about tLe ]SY scLeme, twelve percent ol tLem reported tLat tLe LouseLold is a
beneliciary ol tLe ]SY scLeme. JLe percentage ol tLe beneliciary LouseLolds is sligLtly
more in SC HQ villages (13 percent) tLan in otLer villages (11 percent). Among tLe total
surveyed LouseLolds, 6 percent (/2 out ol 1200) are beneliciaries ol tLe ]SY scLeme.
jSY Bcncticiarics
Selected cLaracteristics ol tLe beneliciaries are presented in Jable H6. Age
distribution ol tLe beneliciaries sLows tLat, as expected, majority ol tLem are aged 20-2+
years (61 percent). More tLan one liltL (21 percent) ol tLe beneliciaries are aged 25-29 years
and 11 percent are less tLan 20 years. Parity ol tLe beneliciaries sLows tLat nearly 53
percent are second parity woman and +/ percent are second tLird parity woman.
CLLattisgarL being one ol tLe EAC states, cent percent LouseLolds are eligible lor ]SY
benelits irrespective ol tLe social category tLese represent. Social category ol tLe
beneliciaries reveals tLat about Lall ol tLem (+/ percent) are CBCs lollowed by ScLeduled
Castes (33 percent) and ScLeduled Jribes (18 percent). All tLe beneliciaries are Hindus.
Distribution ol beneliciaries by Standard ol Living Index (SLI) sLows tLat more tLan Lall
ol tLem (53 percent) belong to low SLI LouseLolds, 31 percent belong to medium SLI
LouseLolds and 1/ percent to LigL SLI LouseLolds. More tLan two tLirds (6/ percent) ol
tLe beneliciaries are lrom BPL category. In more tLan Lall ol tLe LouseLolds (5/ percent)
place ol tLe last delivery is reported at Lome ratLer tLan a LealtL institution. JLus casL
incentives may Lave motivated beneliciaries lor institutional deliveries.
Bcgistration ot jSY Bcncticiarics
]SY lirst starts witL tLe registration ol tLe pregnant woman lor receiving tLe
benelits. Cnly 25 percent ol tLe beneliciaries Leard about tLe ]SY scLeme belore being
pregnant and tLe rest /5 percent during pregnancy. Stage ol pregnancy wLen beneliciary
got registered lor ]SY scLeme reveals tLat about two liltL (38 percent) ol tLe beneliciaries
82
got registered during tLe lirst trimester ol tLe pregnancy and more tLan Lall (53 percent)
during and 5tL montL ol tLe pregnancy or even later. early Lall ol tLe beneliciaries were
registered by AM/IHW (+/ percent), 21 percent by Anganwadi worker, 1+ percent by
ASHA and tLe remaining 18 percent by Doctor/LHV/CtLers. Place ol registration ol
beneliciaries sLows tLat 25 percent ol tLem were registered in Anganwadi Centre. JLe
percent ol beneliciaries registered in CHC is 21 percent; SC is 15 percent DH 1+ percent
and at Lome is 18 percent (Jable H/).
jSY Card
Cnly 19 percent ol tLe beneliciaries reported tLat tLey received tLe ]SY card (Jable
H8). Among tLose wLo received tLe ]SY card, more tLan Lall ol tLem were Lelped by
ASHA in getting ]SY card. one ol tLe beneliciaries reported any dilliculty in getting tLe
]SY card. (It may be mentioned tLat separate ]SY cards Lave not been provided in tLe
district. Maternal and cLild LealtL cards provided by Aganwadis or tLose provided by
AMs may Lave been reported as ]SY cards. o ]SY registration is being done in tLe
district on cards printed witL ]SY wLicL is a prerequisite lor receiving ]SY benelits).
Bolc ot ASHA/Mitanin during thc Prcgnancy ot thc Bcncticiarics
In CLLattisgarL, 3 to 5 ASHAs/Mitanins are appointed in eacL village depending
upon tLe population size and most respondents are aware about tLem. In ]anjgir-CLampa
district, among tLe villages surveyed, ASHAs/Mitanins are appointed in all tLe villages ol
tLe two blocks selected lor tLe study. In spite ol a large presence ol ASHA /mitanins tLere
involvement in tLe ]SY programme is negligible. Jable H9 presents tLe role ol ASHAs
during tLe pregnancy ol tLe beneliciaries. In spite ol a large presence ol ASHA /mitanin in
all tLe villages only 35 percent ol tLe beneliciaries said tLat tLe ASHA worker provided
specilic Lelp during last pregnancy. A little more tLan two-liltLs beneliciaries received
advice about diet lrom ASHA. JLe percentage ol beneliciaries wLo received advice lrom
ASHA on delivery care, breastleeding and newborn care is only 25-26 percent. A small
proportion ol beneliciaries received advice lrom ASHA on danger signs during pregnancy
(21 percent), and lamily planning (13 percent). Beneliciaries were lurtLer asked about tLe
type ol inlormation received during tLe antenatal period (micro birtL planning) lrom
Doctor/AM/ASHA. It sLows tLat tLe percent beneliciaries received tLe inlormation
83
regarding date ol next cLeck up is 5+ percent, place ol next cLeck up is 38 percent,
expected date ol delivery is 33 percent and place ol delivery is 32 percent. Cnly 25 percent
beneliciaries were told about tLe relerral place, il complications arise.
Placc ot Dclivcry and Bcason tor Cpting Institutional Dclivcry
Among tLe beneliciaries, only +/ percent (3+ out ol /2) delivered in institutions and
tLe remaining 53 percent delivered at Lome (Jable H10). Most ol tLese institutional
deliveries (32 out ol 3+) took place in public institutions (DH and CHC). Major reasons
cited by tLe beneliciaries lor delivering in institutions are: better care lor motLer and new
born cLild (+/percent); support services provided by ASHA (32 percent); money available
under ]SY scLeme (2+ percent) and better access to institutional delivery (21 percent).
Transport ot thc Bcncticiarics to Bcach thc Hcalth Institutions
Among tLe beneliciaries wLo delivered in LealtL institutions, / ol tLem received a
relerral slip lrom ASHA/LealtL personnel to access delivery services (Jable H11). Cut ol
tLe 3+ beneliciaries wLo delivered in institutions, 11 ol tLem laced dilliculty in reacLing
LealtL institution due to late non availability ol transport, insullicient money and nigLt
timing. JLe average distance to tLe ultimate place ol delivery lrom tLe beneliciaries
residence is about 22 kilometres. Majority ol tLe beneliciaries (9/ percent) used otLer
transport like Lired veLicle, auto, train, motorcycle cycle, carried pregnant woman on cot,
and on loot to reacL tLe ultimate place ol delivery, Cnly 3 percent used a private veLicle
to reacL tLe LealtL lacility. Ior majority ol tLe beneliciaries mainly lamily members
/relatives /Lusbands Lad arranged tLe veLicle, and 3 percent were lacilitated by ASHA in
arranging tLe transport.
Majority ol tLe beneliciaries (91 percent) Lad tLe money to pay lor tLe transport
services. JLree beneliciaries Lad no money to pay lor tLeir transport. Average amount ol
transport assistance received by beneliciaries is Rs.158. JLirty two beneliciaries spent
money on transport. JLe amount spent is mucL more tLan tLe transport assistance
received under ]SY casL assistance. JLe average amount spent by tLese beneliciaries on
transport is Rs 952. Ior 85 percent ol tLe beneliciaries, relatives accompanied tLem to tLe
LealtL institution.
8+
Waiting Timc, Typc ot Dclivcry and Satistaction Bcgarding Scrviccs
JLe average waiting time at tLe lacility until someone attended tLe beneliciary is 12
minutes. Cut ol 3+ beneliciaries 22 Lad tLe normal delivery (65 percent) and tLe remaining
12 Lad delivery assisted by lorceps or caesearean . JLe average number ol days spent in tLe
LealtL lacility till discLarge is 3.1 days. More tLan tLree-lourtLs (// percent) ol tLe
beneliciaries Lad to pay at tLe LealtL centre and tLe average amount paid is Rs. 1383.
Among tLe 3+ beneliciaries, 22 were satislied witL tLe services available in tLe
LealtL centre, 8 were somewLat satislied and + were not satislied. JLe reason lor tLe non
satislaction stated by tLem was poor quality ol services beneliciary and tLe rudeness ol tLe
stall at tLe LealtL lacility.
Bcason tor Cpting Homc Dclivcry
As mentioned earlier, 38 out ol /2 beneliciaries (53 percent) opted lor tLe Lome
delivery in spite ol casL incentives being available under tLe ]SY scLeme. All tLese 38
beneliciaries were asked lor tLe reason lor opting Lome delivery. JLe major reasons cited
are Lome delivery is more convenient (81 percent); non availability ol transport (11
percent); lack ol allordability (11 percent); and cultural/social reasons (3 percent).
Cash Inccntivc Bcccivcd by thc Bcncticiary undcr jSY Schcmc
Cut ol tLe /2 beneliciaries, 60 (83 percent) Lad received tLe casL incentive under
]SY scLeme and tLe average amount received by tLem is Rs. 913 JLe average amount is
low because beneliciaries wLo deliver at Lome receive Rs.500). Cut ol tLose wLo received
tLe casL incentive, all received it in one installment. Among tLose wLo received tLe casL
incentive, 10 percent received immediately alter tLe delivery, 18 percent received witLin a
week alter tLe delivery and /2 percent received it mucL later. Iorty percent beneliciaries
received casL incentive lrom tLe doctor, AM/IHW delivered tLe casL incentive to +9
percent beneliciaries, and a lew received it lrom Anganwadi worker. Ior 10 percent
beneliciariesotLer like Lospital clerk, compounder, MPW and SarpancL delivered it. Place
ol delivery ol casL incentive sLows tLat tLe beneliciaries Lave mainly received tLe casL
incentive at tLe lollowing places: Lome (10 percent), DH (22 percent) CHC (22 percent)
PHC (12 percent) and SC (12 percent). Cne beneliciary reported tLat sLe Lad laced
dilliculty in getting tLe incentive. ine (15 percent beneliciaries) reported tLat tLey laced
85
dilliculty in getting tLeir incentive. Iive ol tLem reported ol Laving to pay bribes,
payment tLrougL cLeque (2) and Lad to visit twice to get tLe incentive money (2).
7VKlK\CVKon ot Covcrnmcnt Hcalth Iacility in Last Six Months
JLis section addresses some ol tLe issues related to tLe quality ol care in
government LealtL lacilities. Iirst, to understand tLe extent ol utilisation ol tLe
government LealtL lacilities in last six montLs, all tLe surveyed LouseLolds were asked
wLetLer anyone lrom tLe LouseLold availed tLe services in any government LealtL lacility
in last six montLs. It sLows tLat 10 percent ol tLe rural LouseLolds (120 out ol 1200) Lave
availed tLe LealtL services in government LealtL lacility in last six montLs. (in case tLe
LouseLold availed tLe services lor tLe cLildren below 16 years ol age, tLe adult LouseLold
member accompanied tLe cLild was interviewed). JLe proportion ol LouseLolds availed
tLe services in government LealtL lacility is sligLtly more in LouseLolds located in SC
Leadquarter villages (11 percent) tLan in otLer villages (9 percent).
JLe selected cLaracteristics ol tLe patients/respondents wLo Lave availed tLe LealtL
services in government LealtL lacilities are presented in Jable H16. JLe age distribution ol
tLe respondents sLows tLat ++ percent are age below 30 years and 13 percent are age 60
years and above. Sex ol tLe respondents sLow tLat 5/ percent are lemales and +3 percent
are males. JLe socioeconomic cLaracteristics ol tLe respondents reveal tLat more tLan Lall
(53 percent) ol tLem are illiterates, 53 percent are ScLeduled Castes and ScLedule Jribes,
and more tLan two tLirds ol tLem (66 percent) belong to BPL LouseLolds. JLe percentage
ol LouseLolds witL low SLI is +8 percent. JLe cLaracteristics ol tLe respondents clearly
reveal tLat most ol tLem come lrom poor LouseLolds.
Clicnt Satistaction
Jable H1/ presents tLe type ol LealtL lacility visited and purpose ol visit; and
satislaction regarding beLaviour ol LealtL worker, privacy and availability ol medicine at
tLe lacility. JLe type ol LealtL lacility visited by tLe respondents sLow tLat 3/ percent
visited District Hospital 29 percent visited PHC, 25 percent visited tLe CHC and 5 percent
visited tLe SC. JLe major reason reported by tLe respondents lor tLe visit sLows tLat more
tLan lour-liltLs (85 percent) visited lor tLe treatment ol minor ailment and otLer services
tLe remaining 15 percent visited lor AC care, cLild care, and immunization.
86
Regarding tLe beLaviour ol tLe stall at tLe LealtL lacility, 95 percent ol tLe
respondents said tLat tLe stalls were courteous. Cnly lew (1 percent) respondents reported
tLat tLe beLaviour ol tLe stall were insulting/derogatory. inety two percent ol tLe
respondents said tLat tLe doctor/stall at tLe LealtL lacility listened to tLeir complaints, 6
percent said tLat tLey Lave somewLat listened and 2 percent said tLat tLey did not listen. It
appears tLat, except lew, tLe respondents are generally satislied witL tLe beLaviour ol stall
at tLe LealtL lacility.
Cne ol tLe problems olten cited lor tLe government LealtL lacilities is tLe lack ol
privacy lor tLe woman patients. JLe problem can be easily addressed witL eitLer a simple
partition ol tLe examination room or witL a clotL curtain. Jo know about tLis, tLe
respondents were asked wLetLer women patients treated witL privacy and dignity. JLree
lourtL ol tLe respondents reported tLat women patients are treated witL privacy and
dignity and 18 percent said tLat tLey are not treated witL privacy and dignity.
Regarding tLe availability ol medicines, +1 percent ol tLe respondents said tLat
patients witL cLronic illnesses (like joint pains, Leart disease, blood pressure, diabetes etc.)
get medicines regularly lrom tLe government LealtL lacility. However, 19 percent ol tLe
respondents said tLat tLey dont get medicines and two liltL said tLey dont know wLetLer
medicines are supplied at tLe LealtL lacility. Respondents were lurtLer asked wLetLer
doctor lrom government LealtL lacility do private practice during or alter tLe duty Lours.
Ior tLis question, one tLird said tLat tLey dont know, one tLird ol tLem said no, and
3+ percent said yes. Satislaction ol tLe respondents regarding tLe overall services ol tLe
government LealtL lacility reveals tLat 63 percent are satislied, 21 percent are somewLat
satislied and 16 percent are not satislied. Satislaction ol tLe respondents regarding tLe
beLaviour ol stall at tLe government LealtL lacility also sLows a similar level ol LigLer
satislaction witL // percent satislied, 16 percent somewLat satislied and / percent are not
satislied. JLougL tLe level ol satislaction appears to be LigLer, even a smaller level ol
dissatislaction regarding services and beLaviour ol stall Las to be looked into.
7scr Iccs and Extra Chargcs
In ]anjgir-CLampa, user lees are cLarged lor various services in tLe government
LealtL lacilities witL some categories ol patients exempted lor tLe cLarges. In tLe survey,
8/
among tLe respondents wLo Lave availed tLe services in government LealtL lacility in last
six montLs, 6/ percent said tLat tLey were cLarged user lees by tLe LealtL lacility (Jable
H18). Among tLose wLo paid tLe user lees, /8 percent paid lor registration, 13 percent lor
X-ray, 13 percent lor lab test and + percent lor ultrasound and 19 percent lor otLer like
medicines, injections, drips etc.. Among tLose wLo Lave paid user lees, about tLree lourtLs
(/+ percent) said tLat tLey Lave received tLe receipt lor tLe same and tLe remaining two
tLird said tLat receipts was not given. Among tLose wLo paid user lees, 30 percent said tLat
extra money was cLarged lrom tLem lor tLe services provided.
Scrviccs tor thc BPL Paticnts
BPL respondents were asked wLetLer BPL patients were provided lree/subsidized
services (Jable H19). Ior tLis question, 38 percent ol tLe respondents said tLat tLey are
provided lree/subsidized services, 38 percent said tLat tLey are not provided
lree/subsidized services and 2+ percent said tLat tLey dont know. About Lall ol tLe BPL
respondents (+8 percent) said tLat tLey dont lace dilliculty in getting lree/subsidized
services wLereas; 12 percent ol tLem said tLat BPL patients lace dilliculty in getting
lree/subsidized services. Cnly 10 percent BPL respondents said tLat RKS lacilitates tLe
paper work lor BPL patients. Lack ol awareness among BPL respondents regarding
availability ol lree treatment is seen.
Cutbrcak ot Discascs
All tLe respondents were asked wLetLer tLere is any outbreak ol malaria, measles,
gastroenteritis, jaundice and otLer diseases in tLeir area in tLe last six montLs (Jable H20).
JLe percentage ol respondents wLo reported tLe outbreak ol tLe above diseases in tLeir
area in tLe last six montL is 26 percent, 12 percent, 1/ percent, 5 percent and 3 percent
respectively. JLese ligures sLould be noted witL caution, as tLese are orally reported
outbreaks by tLe respondents. However, it indirectly indicates tLat mosquito breeding is a
major issue in tLe villages as outbreak ol malaria is reported by 26 percent ol tLe
respondents.
Action to bc takcn tor Sclcctcd Discascs
All tLe respondents were asked about tLe lollowing: steps lor prevention ol
diarrLoea; actions to be taken il a lamily member Las a LigL lever, persistent cougL lor
88
more tLan two weeks and loose motions lasting lor more tLan 2+ Lours; and action to be
taken il a cLild in tLe lamily Las persistent cougL and breatLing problems (Jable H21).
Ior tLe prevention ol diarrLoea, tLe proportion ol respondents mentioned tLe Land
wasLing; use ol sale lood and water, and use ol covered containers is 32 percent, +/ percent
and 19 percent respectively. JLe proportion ol respondents wLo do not know any simple
steps lor tLe prevention ol diarrLoea is +6 percent, wLicL is considerably LigL. Actions to
be taken lor LigL lever, persistent cougL and loose motions lor a lamily member and
persistent cougL and breatLing problems lor tLe cLild in tLe lamily sLows tLat percentage
ol respondents wLo will take tLe lamily member/cLild to tLe jLola cLaap or quack
doctor wLo visits tLe village is /8-88 percent lollowed by 26-30 percent to tLe nearest
government LealtL lacility. Jaking tLe lamily member/cLild to tLe jLola cLaapdoctor
wLo lrequent tLe village and to tLe nearest government LealtL lacility are tLe two
prominent actions reported by respondents. It indicates tLat tLere is lack ol tLe availability
ol government LealtL lacility nearer to tLe people at tLe times ol need and tLerelore tLe
otLer option becomes prominent. JLe proportion wLo reported tLat tLey will try witL
Lome remedies vary between 28 to 30 percent lor persistent cougLing and diarrLoea. It is
Leartening to know tLat, lor tLe loose motions, atleast 2+ percent ol tLe respondents said
tLat tLey will start giving CRS.
Awarcncss about Spacing Mcthods and Idcal Cap bctwccn Childrcn
JLe ideal spacing between 1st and 2nd cLild mentioned by tLe respondents reveals
tLat majority ol tLem (// percent) preler tLe ideal spacing to be 3 and more years (Jable
H22). AnotLer 20 percent said tLat tLe ideal spacing sLould be 2 years. Cnly a lew
respondents mentioned tLe ideal spacing as one year. JLe ideal spacing ol 3 years
reported by majority ol tLe respondents clearly indicate tLe need lor spacing metLods in
our lamily planning programme. Knowledge regarding tLe spacing metLods reveals tLat
Cral Pills is known to 88 percent ol tLe respondents lollowed by Condom (+3 percent)
and only 19 percent respondents know about ILD. About one lourtL (23 percent) ol tLe
respondents said tLat tLey dont know tLe lamily planning metLods available lor spacing.
Publicity lor temporary metLods ol lamily planning is needed.
AIDS and VCTC
89
JLe awareness, modes ol getting and source ol inlormation lor HIV/AIDS are
presented in Jable H23. Among tLe respondents, 5+ percent are aware about tLe
HIV/AIDS. WitL regard to knowledge about tLe modes ol translormation ol HIV/AIDS,
tLe table rellects tLat /6 percent ol tLe respondents are aware tLat unsale sexual contact, 61
percent sLaring ol needles/syringes and +6 percent blood translusion are tLe very
important modes ol translormation. About 12 percent ol tLe respondents are aware tLat
HIV/AIDS translorms lrom inlected motLer to cLild. JLe percent ol respondents do not
know about tLe modes ol getting HIV/AIDS is +6 percent, wLicL is considerably LigL.
Hardly any respondent reported tLe misconceptions like sLaking Lands, sneezing and
insect bite are tLe modes ol getting HIV/AIDS. Source ol inlormation lor tLe HIV/AIDS
reveals tLat JV is tLe single most prominent source ol inlormation (/5 percent) lor tLe
respondents. Some (10 percent) Lave got inlormation lrom lriends /relatives /neigLbours /
community etc. JLose wLo were aware about HIV/AIDS were lurtLer asked about tLeir
awareness regarding tLe HIV/AIDS Counselling Centre/Voluntary Counselling and
Jesting Centre (VCJC) nearby. JLe response sLows tLat, only / percent (+5) ol tLe
respondents are aware about tLe nearby Counselling Centre/VCJC. JLose wLo are aware
about tLe nearby Counselling Centre/VCJC were lurtLer asked about tLe location ol
Counselling Centre/VCJC. JLe percent ol respondents said tLat tLe Counselling
Centre/VCJC is located in PHC is 9 percent, CHC is ++ percent, District Hospital is +0
percent and Sub District Hospital is / percent. Among tLose wLo are aware about tLe
location ol VCJC, most ol tLem (93 percent) reported tLat tLat it is located in tLe
government LealtL lacility.
Suggcstions Providc by thc Bcspondcnts
JLe suggestions given by tLe respondents lor tLe improvement ol services in tLe
villages are given in Jable H2+. It sLows tLat respondents generally expect government
Lospital/PHC/SC in tLe village, doctor/AM are needed in tLe village, Doctor/AM/
LealtL worker sLould stay in tLe village, lacility lor delivery sLould be available witLin tLe
village, toilet lacility, LealtL lacility, LealtL workers, cleanliness, sanitation, sale drinking
water, pucca road and transport lacility lor tLeir villages. Some ol tLese suggestions given
by tLem reveal tLe genuine expectations ol tLe villagers lor tLe improvement ol tLe LealtL
and sanitation in tLeir villages.
90
Houschold Charactcristics
Tablc H1. Charactcristics ot thc rcspondcnts
Percent distribution ol respondents by background cLaracteristics
Charactcristics ot thc rcspondcnts Pcrccnt
Agc
< 30 years
30-39 years
+0-+9 years
50-59 years
60 years or more
30.0
26.3
22.3
12.2
9.3
Scx
Male
Iemale
61.9
38.1
Ycars ot Schooling
Illiterate
1-5 years
5-9 years
10 years or more
33.3
23.2
22.5
21.0
Marital Status
Lnmarried
Currently Married
Widowed/Divorced
Separated
9.5
8+.6
0./
5.3
Total numbcr ot rcspondcnts 1200
91
Tablc H 2. Charactcristics ot thc houschold
Percent distribution ol LouseLolds by tLeir background cLaracteristics
Charactcristics ot thc houschold Pcrccnt
Social Catcgory
SC
SJ
CBC
CtLers
28.5
19.2
50.2
2.1
Bcligion
Hindu
Muslim
CLristian
SikL
CtLers
99.+
0.5
0.1
-
-
HouseLolds Laving BPL status
HouseLolds living in pucca Louse
HouseLolds witL electricity
HouseLolds witL toilet lacility
HouseLolds witL piped water supply
HouseLolds using LPC/Biogas lor cooking
HouseLold Laving own agricultural land /cultivating any
agricultural land
HouseLold own a colour/B&W television
HouseLold Lave a mobile pLone
HouseLolds witL low Standard ol Living Index
% ol cLildren born in HealtL Institutions during last 5 years
60.1
33./
/+.3
1+.1
6.3
3.6
6/.5
+8.8
26.8
+6.5
1+.0
Total numbcr ot houscholds 1200
92
Tablc H 3. Pcrccnt distribution ot houscholds by thcir wastc disposal, stagnation ot
wastcwatcr and mosquito brccding around thc housc and systcm ot mcdicinc
prctcrrcd by thcm.
Wastc disposal, stagnation ot watcr and
mosquito brccding and systcm ot
mcdicinc prctcrrcd
Houscholds
locatcd in
Sub Ccntrc
HQ Villagc
Houscholds
locatcd in othcr
villagc
All
Mcthod ot wastc disposal by thc
houschold
JLrown in tLe open
Buried in a pit
Burnt
CtLer metLods
92.2
6.8
1.0
-
96.0
3.3
0./
-
9+.1
5.1
0.8
-
Stagnation ot wastc watcr around thc
houschold (stagnation ol waste water
observed by tLe interviewer)
23.5
20./
22.1
Instancc ot mosquito brccding in thc
stagnant watcr
(among tLe LouseLolds wLere stagnation ol
water is observed)
98.6
98.+
98.5
Systcm ot mcdicinc prctcrrcd OWNVKRNG
CPUYGT
AllopatLic
Ayurveda
Yoga and aturopatLy
Lnani
SiddLa
HomeopatLy
Jraditional Healing
Any otLer
one
98.3
2./
-
-
-
-
0.5
-
-
98./
1.3
-
-
-
-
0.3
-
-
98.5
2.0
-
-
-
-
-
-
-
Total numbcr ot houscholds 600 600 1200
93
Tablc H 4. Pcrccnt distribution ot houschold rcspondcnts by thcir intormation about
availability ot hcalth workcr, hcalth tacilitics and transport uscd to takc scrious
paticnts
Intormation about hcalth workcrs and
hcalth tacilitics
Houscholds
locatcd in
Sub Ccntrc
HQ Villagc
Houscholds
locatcd in
othcr
villagc
All
Availability ot hcalth workcrs
Heard about AM
Heard about Male HealtL Worker
Visited by a HealtL Worker in last one
montL
HealtL Workers are available wLen needed
/3.2
+1.0
23.3
52.8
/5./
35.0
19.2
29.2
/+.+
38.0
21.3
+1.0
Availability ot hcalth tacilitics to thc
houscholds, whcn rcquircd (multiplc
rcsponscs)
RMP
Private Clinic/CC
Sub Centre
PHC
CHC
CtLers
2.0
13.5
16.5
9.0
-
/+.0
0.2
6./
-
0.2
-
9+.3
1.1
10.1
8.3
+.6
-
8+.2
Iacility tor which scrious paticnts arc takcn,
whcn rcquircd (multiplc rcsponscs)
RMP/private Clinic
CC Hospital Clinic
PHC
CHC
District/Sub Divisional Hospital
CtLers
2.2
5+.8
/.8
1/.0
28.8
12.0
+.5
53.8
6.3
18.2
36.5
9.0
3.3
5+.3
/.1
1/.6
32./
10.5
Modc ot transport uscd to takc scrious
paticnts, whcn rcquircd (multiplc rcsponscs)
Bullock Cart
Bus
Private VeLicle
Ambulance
CtLers
0./
35./
9.3
-
66.2
0.5
30.2
5.0
-
/5.0
0.6
32.9
/.2
-
/0.6
Total numbcr ot houschold rcspondcnts 600 600 1200
94
Tablc H 5. Pcrccnt distribution ot houschold rcspondcnts by thcir knowlcdgc about
MBHM, ASHA and hcr activitics, VHMD, VHSC and jSY
MBHM, ASHA and jSY
Houscholds
locatcd in
Sub Ccntrc
HQ Villagc
Houscholds
locatcd in
othcr villagc
All
Hcard ot MBHM 23./
(1+2)
21.0
(126)
22.3
(268)
It hcard ot MBHM, sourcc ot intormation
about MBHM (multiplc rcsponscs)
ASHA
Radio/television
ewspaper
PancLayat
Community Member
CtLer
8.5
52.1
/./
+.9
25.+
1+.1
6.3
52.+
+.0
10.3
23.8
12./
/.5
52.2
6.0
/.5
2+.6
13.+
Hcard ot ASHA 95.2
(5/1)
92.5
(555)
93.8
(1126)
ASHA and hcr activitics, VHMD and VHSC
ASHA carry a kit
ASHA provide a common medicines lree ol
cost
ASHA Leld discussions about Land wasLing
ASHA Leld discussions about construction ol
LouseLold toilets
ASHA Leld discussions about sale drinking
water
Village HealtL and utrition Day being
organized
in tLe village
Presence ol Village HealtL and Sanitation
Committee in tLe village
/0./
82.+
51.3
+5.0
51.8
+2.0
10./
68.9
81.8
++.9
39.8
+6.2
+2.5
11.2
69.8
82.1
+8.1
+2.+
+9.0
+2.3
10.9
Ircqucncy ot Villagc Hcalth and Mutrition
Day
Weekly
MontLly
Quarterly
Annual
13./
61.0
10.0
15.3
5.+
53.1
18.1
23.2
9.6
5/.1
1+.1
19.2
Awarc about thc jSY schcmc 51.2
(30/)
+8./
(292)
+9.9
(599)
It awarc about jSY, sourcc ot intormation
about thc jSY OWNVKRNGQRVKQPU
Radio/Jelevision
PampLlets
Hoardings at SC/PHC etc.
ASHA Worker
Anganwadi Centre/Worker
AM
Doctor
Cram PancLayat
CCs/SHCs
CtLer
23.1
3.6
3.9
31.3
/.8
15.3
6.2
6.5
1.6
3+.9
2/./
3.+
0./
31.8
/.5
9.6
/.9
9.6
1.0
35.6
25.+
3.5
2.3
31.6
/./
12.5
/.0
8.0
1.3
35.2
Houschold is a bcncticiary ot jSY Schcmc 12.7
(38)
11.3
(3+)
12.0
(/2)
Total numbcr ot houschold rcspondcnts 600 600 1200
95
Tablc H 6. Pcrccnt distribution ot jSY bcncticiarics by thcir background
charactcristics
Charactcristics ot thc jSY bcncticiarics Pcrccnt
Agc
< 20 years
20-2+ years
25-29 years
30-3+ years
35-39 years
+0-++ years
+5-+9 years
11.1
61.1
20.8
2.8
+.2
-
-
Parity
0
1
2
3 & 3
-
-
-
52..8
+/.2
Social catcgory
SC
SJ
CBC
CtLers
33.3
18.1
+/.2
1.+
Bcligion ot thc houschold
Hindu
Muslim
CLristian
SikL
CtLers
100.0
-
-
-
-
SLI ot thc houschold
Low
Medium
HigL
52.8
30.6
16./
BPL houschold 66./
Placc ot last dclivcry (dclivcry prcvious to this dclivcry)
HouseLold
HealtL Institution
56.9
+3.1
Total numbcr ot jSY bcncticiarics intcrvicwcd 72
96
Tablc H 7. Timing, pcrson and placc ot rcgistration tor jSY schcmc
Timing, placc ot rcgistration tor jSY schcmc and jSY card Pcrccnt
Timing ot hcaring about jSY schcmc
Belore being pregnant
During pregnancy
25.0
/5.0
Stagc ot prcgnancy whcn bcncticiary got rcgistcrcd tor jSY
schcmc
1
st
montL
2
nd
montL
3
rd
montL
+
tL
montL
5
tL
montL or later
5.2
10.3
22.+
8.6
53.+
Pcrson who rcgistcrcd thc bcncticiary tor jSY schcmc
Doctor
LHV
AM/IHW
Anganwadi worker
ASHA worker
CtLers
11.1
2.8
+/.2
20.8
13.9
+.2
Placc whcrc thc bcncticiary was rcgistcrcd tor jSY schcmc
District/Sub-district Hospital
Community HealtL Centre
PHC
Sub-Centre
Anganwadi Centre
Private Lospital accredited by tLe government
At Lome
CtLer places
13.9
20.8
2.8
15.3
25.0
-
18.1
+.2
Total numbcr ot jSY bcncticiarics 72
Tablc H 8. Bcccipt ot jSY card, rolc ot ASHA in gctting jSY card and ditticultics taccd by thc
bcncticiary in gctting thc jSY card
jSY Card Pcrccnt
jSY card rcccivcd by thc bcncticiary
19.+
ASHA workcr hclpcd thc bcncticiary in gctting jSY card
5/.1
Bcncticiary taccd ditticulty in procuring jSY card
0.0
It taccd ditticulty, typc ot ditticultics taccd by bcncticiary
(OWNVKRNGQRVKQPU
Cards were not available
Iormalities lor making cards were too cumbersome
Was asked to pay money lor tLe card
CtLer dilliculties
-
-
-
Total numbcr ot jSY bcncticiarics 72
97
Tablc H 9. Bolc ot ASHA during thc prcgnancy ot thc bcncticiarics
Bolc ot ASHA during thc prcgnancy ot thc bcncticiarics Pcrccnt
ASHA workcr providcd spccitic hclp during last prcgnancy
3+./
Bcncticiary rcccivcd advicc trom ASHA during prcgnancy tor
thc tollowing OWNVKRNGQRVKQPU
Diet
Danger signs
Delivery care
Breastleeding
ewborn care
Iamily planning
ot applicable (ASHA not appointed in tLe village)
++.+
20.8
25.0
25.0
26.+
12.5
-
Intormation givcn to thc bcncticiary (Micro Birth Planning)
during antcnatal pcriod by Doctor/AMM/ASHA OWNVKRNG
QRVKQPU
Date ol next cLeck-up
Place ol next cLeck-up
Date ol expected delivery
Place ol delivery
Place ol relerral, il complications arise
5+.2
3/.5
33.3
31.9
25.0
Total numbcr ot jSY bcncticiarics 72
Tablc H 10. Placc ot dclivcry and rcason tor opting institutional dclivcry
Placc ot dclivcry and rcason tor opting institutional dclivcry Pcrccnt
Placc ot dclivcry
District/Sub-district Hospital
Community HealtL Centre
PHC
Sub-Centre
Jrust/CC Hospital
Private Lospital
Private Lospital accredited by tLe government
At Lome
20.8
22.2
1.+
-
1.+
-
1.+
52.8
Bcasons tor opting Institutional Dclivcry OWNVKRNGTGCUQPU
Money available under ]SY scLeme
Better access to institutional delivery
Better care lor motLer and new born cLild
Services in tLe area
Support provided by ASHA
Availability ol transport assistance
Previous cLild was born in an institutions
CtLer
Jotal
23.5
20.6
+/.1
-
32.+
-
2.9
1+./
(34)
Total numbcr ot jSY bcncticiarics 72
98
Tablc H 11. Transport ot thc bcncticiarics to rcach thc Hcalth Institution
Proccss ot Transport Pcrccnt
Bcccivcd rctcrral slip trom ASHA/hcalth pcrsonncl to acccss
dclivcry scrviccs
20.6
Iaccd ditticulty in rcaching Hcalth Institution
It taccd ditticulty, typc ot ditticultics taccd in rcaching thc
Hcalth Institution by thc bcncticiarics OWNVKRNGQRVKQPU
It was late in tLe nigLt
Did not Lave sullicient money
Jransport was not immediately available
Male members in tLe LouseLold were not present
ASHA was not readily available
CtLers
32.+
18.2
36.+
/2./
-
9.1
-
Avcragc distancc to thc ultimatc placc ot dclivcry trom thc
bcncticiarys rcsidcncc (in kms)
22.2
Modc ot transport uscd by thc bcncticiary to rcach thc ultimatc
placc ot dclivcry
Covernment Ambulance
Private veLicle
VeLicle arranged by Local HealtL Committee
CtLer
-
2.9
-
9/.1
Pcrsons tacilitatcd in arranging thc transport
ASHA
AM/HealtL Worker
Village HealtL Committee
Iamily members/relatives
CtLers
2.9
-
-
9/.1
Bcncticiary had moncy to pay tor thc transport scrviccs 91.2
Avcragc amount spcnt on transport (in Bs.) 951.5
Avcragc amount ot transport assistancc rcccivcd undcr jSY
schcmc by thc bcncticiary (in Bs.)
15/.6
Cascs whcrc amount spcnt on transport is morc than thc
amount rcccivcd
32
Pcrsons accompanicd thc bcncticiary to thc Hcalth Institution
ASHA
Relatives
MotLer/MotLer-in-law
Husband
AM/LealtL Worker
CtLers
11.8
85.3
-
-
-
2.9
Total numbcr ot jSY bcncticiarics 34
99
Tablc H 12. Waiting timc at thc hcalth tacility, typc ot dclivcry, amount spcnt at thc
hcalth tacility and satistaction rcgarding scrviccs availablc in thc hcalth tacility
Waiting timc, typc ot dclivcry and satistaction rcgarding scrviccs Pcrccnt
Avcragc waiting timc at thc tacility until somconc attcndcd thc
bcncticiary (in minutcs)
11.5
Typc ot dclivcry (Pcrccnt)
ormal
Assisted (Iorceps, Vacuum)
Caesarean
6+./
1/.6
1/.6
Avcragc numbcr ot days spcnt in thc tacility till dischargc 3.1
Pcrccnt bcncticiary who havc to pay at thc hcalth ccntrc /6.5
Avcragc amount paid to thc hcalth ccntrc (Bs.) 1382./
Satistaction rcgarding thc scrviccs availablc in thc hcalth ccntrc
(Pcrccnt)
Satislied
SomewLat satislied
ot satislied
6/.6
20.6
11.8
Bcasons tor not satisticd with thc scrviccs in thc hcalth ccntrc (Pcrccnt)
Stall was rude
Iacility was not clean
Poor quality ol services
CtLer
25.0
-
50.0
25.0
Total numbcr ot jSY bcncticiarics 34
Tablc H 13. Bcason tor thc jSY bcncticiary to opt homc dclivcry, in spitc ot cash
inccntivcs bcing availablc undcr thc jSY Schcmc
Bcason tor thc bcncticiary to opt homc dclivcry Pcrccnt
Bcasons tor homc dclivcry OWNVKRNGQRVKQPU
Home delivery is more convenient
Iear ol stitcLes/caesarean
Indillerent beLaviour ol Medical/paramedical stall
Cultural/social reasons
Jransport not being available
Cant allord
CtLers
81.6
-
-
2.6
10.5
10.5
-
Total numbcr ot jSY bcncticiarics undcr Homc Dclivcry 38
100
Tablc H 14. Cash inccntivc rcccivcd by thc bcncticiary undcr jSY schcmc
Cash inccntivc
Pcrccnt
Mo. ot bcncticiary rcccivcd cash inccntivc undcr jSY schcmc 60
Pcrccnt ot bcncticiary rcccivcd cash inccntivc undcr jSY schcmc 83.3
Avcragc amount rcccivcd by bcncticiary as cash inccntivc (in Bs.) 912.5
Bcccivcd thc cash inccntivc:
In one go
In 2 instalments
In 3 instalments
100.0
-
-
Timing ot thc rcccipt ot thc cash inccntivc by bcncticiary
At tLe time ol registration
At tLe time ol antenatal cLeckups
MucL belore tLe delivery
WitLin a week belore tLe EDD
Immediately alter tLe delivery
WitLin a week alter tLe delivery
MucL later
ot received yet
Do not know/Lusband knows
CtLer
-
-
-
-
10.0
18.3
/1./
-
-
-
Thc pcrson who dclivcrcd thc cash inccntivc to thc bcncticiary
Doctor
LHV
AM/IHW
Anganwadi worker
ASHA worker
CtLers
+0.0
1./
+6./
1./
-
10.0
Placc whcrc thc cash inccntivc rcccivcd by thc bcncticiary
District/Sub-district Hospital
Community HealtL Centre
PHC
Sub-Centre
Anganwadi Centre
Private Lospital accredited by tLe government
At Lome
CtLer place
21./
21./
11./
11./
6./
-
10.0
16./
Iaccd ditticulty in gctting inccntivc moncy 15.0
It taccd ditticulty, typc ot ditticulty taccd by thc bcncticiary
Was asked to pay tLe bribe
WLen paid by cLeque/dralt
CtLer dilliculty
55.6
22.2
22.2
Total numbcr ot jSY bcncticiarics 63
101
Tablc H 15. Ltilization ot govcrnmcnt hcalth tacility in last 6 months
Ltilization ot govcrnmcnt hcalth tacility
Houscholds
locatcd in
Sub Ccntrc
HQ Villagc
Houscholds
locatcd in
othcr
villagc
All
Percent ol LouseLold wLo availed LealtL services in
government LealtL lacility in last 6 montLs
11.0
(66)
9.0
(5+)
10.0
(120)
Total numbcr ot houscholds 600 600 1200
Tablc H 16. Charactcristics ot thc rcspondcnts who havc availcd thc scrviccs in
govcrnmcnt hcalth tacility in last 6 months
Charactcristics ot thc rcspondcnt Pcrccnt
Agc
<16 years
16-19 years
20-29 years
30-39 years
+0-+9 years
50-59 years
60 years or more
19.2
10.0
15.0
13.3
15.8
1+.2
12.5
Scx
Male
Iemale
+3.3
56./
Ycars ot schooling complctcd
Illiterate
1-5 years
6-9 years
10 years
52.9
21.8
11.8
13.+
Marital status
Lnmarried
Currently Married
Divorced/Separated
Widowed
2+.2
66./
-
9.2
Social catcgory ot thc houschold
SC
SJ
CBC
CtLers
29.2
23.3
+2.5
5.0
Bcligion ot thc houschold
Hindu
Muslim
CLristian
SikL
CtLers
100.
-
-
-
-
BPL Houschold 66./
Standard ot Living Indcx ot thc houschold
Low SLI
Medium SLI
HigL SLI
+/.5
36./
15.8
Total rcspondcnts who havc availcd thc scrviccs in govcrnmcnt
hcalth tacility in last 6 months
120
102
Clicnt Satistaction
Tablc H 17. Typc ot hcalth tacility visitcd, purposc ot visit and clicnt satistaction
rcgarding bchaviour ot hcalth workcr, privacy and availability mcdicincs
Typc ot hcalth tacility visitcd, purposc ot visit and clicnt
satistaction
Pcrccnt
Typc ot hcalth institution whcrc scrvicc availcd
District/Sub District Hospital
CHC
PHC
Sub Centre
AYLSH
36./
25.0
29.2
5.8
3.3
Purposc ot visit to thc hcalth tacility
Jreatment ol minor ailment
AC care
CLild care
Immunization
CtLer
85.0
5.8
+.2
-
Bchaviour ot thc statt at thc hcalth tacility
Courteous
Casual/Indillerent
Insulting/Derogatory
95.0
+.2
0.8
Listcning ot complaints by Doctor/statt
Listened to complaints
SomewLat listened
ot listened
Cant say
92.5
5.8
1./
-
Womcn paticnts trcatcd with privacy and dignity
Yes
o
Dont know
/+.2
1/.5
8.3
Paticnts with chronic illncsscs (likc |oint pains, hcart discasc,
blood prcssurc, diabctcs ctc.) gct mcdicincs rcgularly trom hcalth
tacility
Yes
o
Dont know
+0.8
19.2
+0.0
Privatc practicc ot thc doctors during and attcr thc duty hours
Yes
o
Dont know
3+.2
33.3
32.5
Satistaction with thc ovcrall scrviccs ot thc govt hcalth tacility
Satislied
SomewLat satislied
ot satislied
63.3
20.8
15.8
Satistaction with bchaviour ot statt at thc govt hcalth tacility
Satislied
SomewLat satislied
ot satislied
/6./
15.8
/.5
Total rcspondcnts who havc availcd thc scrviccs in govcrnmcnt
hcalth tacility in last 6 months
120
103
Tablc H 18. Lscr tccs and cxtra chargcs
Lscr tccs and cxtra chargcs tor thc scrviccs providcd
Pcrccnt
Lscr tccs chargcd trom thc uscrs
Yes
o
66./
33.3
It uscr tccs chargcd, typc ot uscr tccs
Registration
X-ray
Lltrasound
Lab test
CtLer
//.5
12.5
3.8
12.5
18.8
Bcccipt givcn tor thc uscr tccs
Civen
ot given
/3.8
26.3
Extra moncy chargcd tor thc scrviccs providcd
Yes
o
Dont know
30.0
65.0
5.0
Total rcspondcnts who havc paid thc uscr tccs 80
Tablc H 19. Scrviccs tor thc BPL paticnts
BPL Patcnts Pcrccnt
BPL paticnts providcd trcc/subsidizcd scrviccs
Yes
o
Dont know
3/.9
3/.9
2+.1
BPL paticnts tacc ditticulty in gctting trcc/subsidizcd
scrviccs
Yes
o
Dont know
12.1
+8.3
39./
BKS tacilitatcs thc papcrwork tor BPL paticnts
Yes
o
Dont know
10.3
51./
3/.9
Total BPL rcspondcnts who havc availcd thc scrviccs in
govcrnmcnt hcalth tacility in last 6 months
58
104
Tablc H 20. Cutbrcak ot sclcctcd discascs (Malaria, Mcaslcs, Castrocntcritis,
jaundicc and Cthcr Discascs) in thc rcspondcnts arca in thc last six months
Cutbrcak ot discascs Pcrccnt
Cutbrcak ot Malaria in thc last six months
Yes
o
Dont know
26.+
63.2
10.3
Cutbrcak ot Mcaslcs in thc last six months
Yes
o
Dont know
12.3
/5.9
11.8
Cutbrcak ot Castrocntcritis in thc last six months
Yes
o
Dont know
1/.0
/3.0
10.0
Cutbrcak ot jaundicc in thc last six months
Yes
o
Dont know
5.3
81.8
12.9
Cutbrcak ot Any Cthcr Discascs in thc last six months
Yes
o
Dont know
3.+
/8.+
18.2
Total numbcr ot houschold rcspondcnts 1200
105
Tablc H 21. Action to bc takcn tor sclcctcd discascs (diarrhoca, high tcvcr,
pcrsistcnt cough, loosc motion, pcrsistcnt cough and brcathing problcms
or a child)
Action to bc takcn tor sclcctcd discascs (Multiplc rcsponscs) Pcrccnt
Prcvcntion ot diarrhoca
Hand wasLing
Lse ol sale lood and water
Lse ol covered containers
Proper disposal ol garbage
CtLer
Dont know
31./
+6.8
19.0
8.0
3.0
+5.8
Action to bc takcn it a tamily mcmbcr has a high tcvcr
Cet tLe blood tested lor malaria
Jaken to tLe RMP
Jake to tLe nearest govt. LealtL lacility
Consult ASHA
Jry Lome remedies
CtLer
Dont know
6.1
0.8
30.0
3.0
6.8
8/./
0.1
Action to bc takcn it a tamily mcmbcr has a pcrsistcnt
cough tor morc than two wccks
Jaken lor sputum testing
Jaken to tLe RMP
Jake to tLe nearest govt. LealtL lacility
Consult ASHA
Jry Lome remedies
CtLer
Dont know
3.0
0.8
28.2
3.3
2/.6
2/.6
86.3
0.3
Action to bc takcn it a tamily mcmbcr has loosc motions
lasting tor morc than 24 hours
Stop giving Cral Iluids/Iood etc
Start giving CRS
Jaken to tLe RMP
Jake to tLe nearest govt. LealtL lacility
Consult ASHA
Jry Lome remedies
CtLer
Dont know
3.5
23.6
1.5
26.3
5.0
29.8
/8.+
0.6
Action to bc takcn it a child in thc tamily has pcrsistcnt
cough and brcathing problcms
Jry Lome remedies
Jaken to tLe RMP
Jake to tLe nearest govt. LealtL lacility
Consult ASHA
CtLer
Dont know
31.6
1.1
2/.+
+.1
81.8
0.8
Total numbcr ot houschold rcspondcnts 1200
106
Tablc H 22. Awarcncss about spacing mcthods and idcal gap
bctwccn 1
st
and 2
nd
child
Awarcncss about spacing mcthods and idcal gap bctwccn
childrcn
Pcrccnt
Awarc about thc tamily planning mcthods
//.2
Idcal gap bctwccn 1
st
and 2
nd
child
1 year
2 year
3 and more years
3.8
19.8
/6.5
Mcthods availablc tor spacing
ILD
Cral Pills
irodL/Condom
Any otLer
Dont know
18.6
88.0
+/.+
1.5
5.0
Total numbcr ot houschold rcspondcnts awarc ot spacing
mcthods
926
107
Tablc H 23. Awarcncss about modcs ot gctting AIDS, sourcc ot intormation
about AIDS and awarcncss about VCTC
AIDS and VCTC Pcrccnt
Hcard ot HIV/AIDS 5+.1
(6+9)
Awarcncss about modcs ot gctting HIV/AIDS (out ot
rcspondcnts who havc hcard ot AIDS)
Lnsale sexual contact
Blood translusion
SLaring needles/syringes
Irom motLer to cLild
SLaking Lands
Sneezing
Insect bite
Kissing
CtLers
/6.+
+6.1
60.9
/.6
0.8
-
0.5
-
10.3
Sourcc ot intormation tor HIV/AIDS (out ot rcspondcnts
who havc hcard ot AIDS)
Radio
JV
HealtL workers
Posters
ewspapers
CtLers
11.+
/+.9
+.8
2.6
+.8
10.6
Awarc about HIV/AIDS counsclling ccntrc/VCTC
ncarby(out ot rcspondcnts who havc hcard ot AIDS)
6.9
(+5)
Bcspondcnts by rcportcd location ot HIV/AIDS
counsclling ccntrc/VCTC(out ot rcspondcnts who arc
awarc about HIV/AIDS counsclling ccntrc/VCTC ncarby)
PHC
CHC
District Hospital
Sub-District Hospital
Private Hospital
CtLer
8.9
++.+
+0.0
6./
-
-
Total numbcr ot houschold rcspondcnts 1200
108
Tablc H 24: Suggcstions givcn by thc rcspondcnts
x Covt. Hospital/PHC/SC needed in tLe village
x Doctor/AM needed in tLe village
x Doctor/AM/ LealtL worker sLould stay in tLe village
x Iacility lor delivery sLould be available witLin tLe village
x Jreatment sLould be available lor all types ol diseases
x Medicines sLould be available regularly
x Jreatment sLould be lree ol cost
x Joilets needed in tLe village
x eed transport lacility lrom tLe village
x Cleanliness needed in tLe village
x Pucca roads needed/roads sLould be repaired
x Inlormation/publicity about LealtL scLemes needed
x Closed drainage system needed/gutters sLould be repaired or
closed
x Sale/clean drinking water needed
x o suggestions/cant say/satislied-5+
CJCRVGT-7
Status and Pcrtormancc ot Mitanin (ASHA)
CLLattisgarL state Las pioneered tLe concept ol Mitanin wLicL is now popularly
known as ASHA in tLe country as wLole. JLere is a network ol 60,000 mitanins spread across
tLe lengtL and breadtL ol tLe state in all 16 districts. EacL village Las atleast one Mitanin and
many villages Lave 3-5 mitanins. Jwenty six ASHAs /Mitanin were interviewed lrom tLe SC
as well as lartLest villages covered under tLe 2 CHCs in ]anjgir-CLampa district. Presented
below is tLe status and perlormance ol Mitanin, role and perlormance ol Mitanin and tLeir
awareness about dillerent programmes.
Status ot Mitanin
Average population served by Mitanins is 393 i.e lor every 393 persons tLere is one
Mitanin to provide LealtL related services in tLe village. Average number ol
village/Labitations served by Mitanin is 1.6. Regarding tLeir selection process majority
Mitanins (86 percent) Lave been selected on tLe recommendation ol AM, 19 percent on
recommendation ol Cram PradLan and 15 percent on tLe recommendation ol Anganwadi
Worker and Village HealtL Committee. JLus AMs Lave played a major role in identilying
and selecting tLe Mitanin ol tLeir areas.
All tLe Mitanins Lave undergone training (100 percent). Majority (96 percent) ol tLe Mitanins
Lave completed tLe tentL round ol training wLicL is comparable to 1-+ modules ol ASHA in
otLer states. JLus tLe training component is very strong in tLe Mitanin Programme. Majority
(96 percent) ol tLe Mitanins Lave received a kit popularly known as dawa peti .
Bolc and Pcrtormancc ot Mitanin
Jwelve percent Mitanins are DCJs provider in tLeir villages and only 1.2 ]SY cases
Lave been lacilitated by tLem in tLe last tLree montLs. Mitanins on an average Lave Landled
3./ cases ol diarrLoea and given CRS to cLildren in tLe last tLree montLs. Mitanins Lave
accompanied Lardly any institutional delivery cases (0.2). Cn an average a Mitanin Las
distributed 2 Cral Pills. Cn an average 6 Malaria patients Lave been given drugs, and tLe
number ol new pregnancies identilied is 2.0. umber ol group meetings like MaLila mandals
arranged by a mitanin is 2.2. umber ol HealtL & utrition days arranged is 1.+. Average
money incentive received by a Mitanin during one montL lor tLe dillerent LealtL activities
carried out by tLem is Rs. 1+ lor ]SY Rs. 28 lor Sterlisation, Rs. 8 lor VHD, and Rs 35 lor
otLer activities like motivating lor immunization. Cn an average tLe total amount received by
a Mitanin is Rs. 85 lor dillerent types ol services given by Ler.
Ditticultics taccd by Mitanins
Mitanins were asked about tLe types ol dilliculties laced in implementing programme
activities under RHM. Iorty two percent Mitanins stated tLat lunds are not available in
time to carry out dillerent activities and +2 percent reported delayed supply ol drugs wLicL
allected tLeir work. and tLe same proportion reported tLat lunds are not available on time.
BeLaviour ol stall in LealtL lacilities is not appropriate (15 percent) and adequate training is
not provided (12 percent) is also reported by tLem.
Support rcquircd by Mitanin
Mitanins were asked about tLe type ol support tLey required lor ellective lunctioning
and implement tLe programme in tLeir area. Jwo issues wLicL were stated by majority ol
tLem are payments sLould be made timely (65 percent) and Mitanins sLould be paid a lixed
remuneration (62 percent). Some Mitanins expressed tLe necessity ol more training to be
arranged lor Mitanin and community members(2/ percent) wLile some ol tLem also raised
otLer (2/ percent) issues like provision ol traveling allowance and transport lacilities, more
medicines sLould be provided and a LealtL lacility sLould be nearby.
Awarcncss Lcvcl ot Mitanins
JLe Awareness level ol tLe Mitanins on dillerent LealtL aspects is LigL. Majority (92
percent) ol tLem know about one or more steps about tLe prevention ol diarrLoea. Breast
leeding sLould be started soon alter birtL is known to all tLe 26 Mitanins. Correct age ol cLild
till wLen Le/sLe sLould be exclusively breastled is also known to all tLe Mitanins. Amount ol
casL incentive given under ]SY is also known to all tLe Mitanins. However, majority know
tLat amount ol casL incentive given under ]SY is Rs 500 lor Lome delivery and Rs.1800
including transportation lor institutional delivery.
Bcmarks ot Mitanins
JLe remarks given by some ol tLe Mitanins regarding tLe programmes are given below in
tLeir
own words (tLe name ol tLe village is mentioned in tLe brackets):
1. We must receive our drugs like CRS; oral pills etc regularly so tLat continuity is
maintained in providing tLese to tLe local people. Il we stop distributing medicines
people lose laitL in us (Beltukri).
2. We Lardly receive Rs. 50 per montL lor bringing cLildren lor immunization. JLis
amount is meager and insullicient lor sustaining our interest in providing services. We
are tLerelore looking lor alternative source ol income as we do not receive any otLer
incentive (avapara /Levai).
3. We sLould receive a lixed montLly remuneration to provide regular services and it
sLould be paid on time (Deori and KarLi).
+. JLe PancLyat Secretary does not provide tLe details ol expenditure made lrom VHSC
lunds and does not sLow tLe bank accounts. Lnder tLese circumstances it is dillicult to
work jointly witL Lim (avapara /Levai).
5. Clear instructions regarding Low to spend untied lunds Lave not been provided to us.
AltLougL I Lave a joint account witL tLe SarpancL I Lave not spent tLe money
(agaridi).
Bcmarks /Suggcstions by thc obscrvcr tor thc improvcmcnt ot scrviccs
1. Mitanins ol majority ol tLe villages covered in tLe district are well trained, inlormed,
vocal and motivated workers wLo Lave a presence in tLe local community. In most ol
tLe villages tLey were identilied by tLe local people. JLey are an asset at tLe grassroots
lor lacilitating tLe RHM programme.
2. Mitanins Lave received ten rounds ol training (covering tLe + Modules ol ASHA) by
SHRC
and awareness levels are LigL. JLey can be a uselul link lor LealtL promotion and BCC
activities under RHM.
3.JLe services ol Mitanins are grossly underutilized lor RHM programme (as tLere is a
mismatcL between tLe training received and actual perlormance).JLis is due to total
lack ol dissemination ol inlormation and monitoring by district LealtL ollicials about
tLeir expected role in lacilitating tLe programme.
+. AltLougL Mitanins are expected to be tLe key lacilitators lor ]SY programme, tLey are
not
motivating women lor institutional delivery. JLis is largely due to tLeir ignorance
about tLe
programme. JLey Lave tLus accepted Lome deliveries as a norm.
5. Mitanins are totally ignorant about tLeir expected role and linkages witL AMs in
preparation ol micro-birtL plan and promoting institutional delivery at tLe
community level lor ]SY.
6. Mitanins also lack awareness about tLe casL incentives tLey are likely to get in case
tLey promote institutional delivery.(In ]angir-CLampa a total package ol Rs. 1+00
plus +00 as transport cLarges is being directly paid to tLe beneliciary leaving only Rs.
200 lor tLe Mitanin).
/. Presently, majority ol tLe Mitanins are only receiving a paltry sum ol Rs. 50 per
montL lor lacilitating immunization programme. JLis amount is also not being paid
on time wLicL Las led to lrustration among majority ol tLem.
8. Majority ol tLe Mitanins are not clear about utilization ol untied lunds lrom VHSC
altLougL all ol tLem Lave received tLe lunds. Clear guidelines lrom tLe district are
essential so tLat tLe money does not remain unutilized.
9. JLe Mitanins are still motivated to provide services to tLe community. Jo elicit
maximum services lrom tLem and to retain tLe Mitanins active support in lacilitating
tLe RHM programme, tLe state government ellorts sLould be made to resolve tLe
issues related to incentives by concretizing payments.
Status and Pcrtormancc ot ASHA
Tablc A1. Status ot ASHA
A. umber ol ASHA interviewed in tLe district 26
B. Average population served by ASHAs interviewed 392.5
C. Average number ol village / Labitations served by AHSAs covered 1.6
D. Percentage ol ASHAs by metLod ol selection
Selected on recommendation ol AM 85./
Selected on recommendation ol Cram PradLan 19.2
Selected on recommendation ol Anganwadi Worker 15.+
Selected by Village HealtL Committee 15.+
Previously working as Dai 0
CtLer 0
E. Percentage ol ASHAs undergone training 100.0
I. Percentage ol ASHAs undergone training by modules
Module 1 96.2
Module 2 23.1
Module 3 0
Module + 0
C. Percentage ol ASHAs issued ASHA Kit 96.2
Tablc A2: Bolc and Pcrtormancc ot ASHA
A. Percentage ol ASHAs wLo are DCJS provider 11.5
B. Average montLly no. ol ]SY cases lacilitated in last 3 montLs by
ASHA
1.2
C. Average no. ol cases Landled in last tLree montLs
CLildren witL diarrLea given CRS 3./
Accompanied Institutional deliveries cases 0.2
umber ol Cral Pills distributed 1.8
umber ol Malaria Patients given drugs 6.3
umber ol new pregnancies identilied 2.0
umber ol group meetings like MaLila mandals arranged 2.2
umber ol HealtL & utrition days arranged 1.+
D. Average money incentive received by an ASHA on an average
during one montL
]SY 1+
Sterlisation 28
VHD 8
CtLer 35
Jotal 85
Tablc A3. Distribution ot ASHAs by rcportcd typcs ot ditticultics taccd and kind ot
support rcquircd
A. Percentage ol ASHAs by types ol dilliculties laced in
implementing programme activities under RHM
Iunds not available in time +2.3
Adequate training is not provided 11.5
Delayed supply ol drugs +2.3
BeLaviour ol stall in LealtL lacilities is not appropriate 15.+
Inadequate lacilities lor institutional deliveries 23.1
B. Reported kind ol support require ASHA to enable Ler to
implement tLe programme more ellectively
More training is to be arranged lor ASHA & Community
members
26.9
ASHA sLould be paid a lixed remuneration 61.5
Payments sLould be made timely 65.+
CtLer 26.9
Tablc A4 Distribution ot ASHAs by rcportcd awarcncss on dittcrcnt aspccts
A. Percentage ol ASHAs reporting awareness about
Important steps lor prevention ol diarrLea 92.3
Jime ol initiating Breast Ieeding 100.0
Age ol cLild till wLen Le/sLe sLould be exclusive breastled 100.0
Amount ol casL incentive given under ]SY 100.0
%JCRVGT
)TCO2CPEJC[CV
Cram PancLayat scLedule was canvassed to tLe member ol CP/SarpancL
representing tLe selected village. It covered tLe basic inlormation about tLe Cram
PancLayat (population and LouseLolds covered), IEC activities carried out, lunctioning ol
tLe VHSC, implementation ol Mitanin and ]SY, and awareness about tLe Mitanin at tLe
Cram PancLayat level. Cut ol 39 villages covered lor tLe survey, interview ol 23 Cram
PancLayatsMembers/SarpancLes was done lrom 2+ PancLayat villages.
JLe average population ol tLe 23 villages is 2660 witL an average SC population ol
686 (10.+ percent) and SJ population ol +/9 (18 percent). JLe average number ol
LouseLolds per village is 598 witL an average ol 12/ SC and 86 SJ LouseLolds. JLe average
number ol BPL lamilies per village is 300 witL an average ol 8/ SC and 59 SJ LouseLolds.
#YCTGPGUUCPF+PXQNXGOGPVQH)TCO2CPEJC[CVUKP04*/
Regarding tLe regular availability ol AM, less tLan Lall (++ percent) ol tLe Cram
PancLayats reported tLat tLe AM is regularly available in tLe village. Less tLan one
tLird Cram PancLayats (30 percent) reported tLat tLey know tLe tour plan ol tLe AM
and little more tLan one lourtL (26 percent) reported tLat tLe Sub Centre is providing
timely services to tLe patients in tLe village. More tLan tLree lourtLs (/8 percent) ol tLe
Cram PancLayats reported tLat it Lad a role in conducting/linalising IEC programme in
tLe village.
Cut ol 23 Cram PancLayats (95 percent) Lave reported tLe existence ol tLe VHSC
in tLeir village and tLe receipt ol Lntied Iunds lor tLe VHSC is reported by 95 percent.
Moreover, two-tLird (65 percent) ol tLe Cram PancLayats reported about tLe regular
meetings ol tLe VHSC but only Lall ol tLem (50 percent) Lave reported about tLe
preparation ol tLe Village HealtL Plan. More tLan Lall (52 percent) ol tLe Cram
PancLayats reported conducting ol IEC activities during last 6 montLs
All tLe 23 Cram PancLayats (100 percent) reported tLe appointment ol Mitanins in
tLeir respective villages. Awareness about tLe benelits under tLe ]SY scLeme was reported
by 96 percent ol tLe Cram PancLayats. Jwelve out ol 23 (52 percent) pancLyats reported
about conducting IEC activities during last 6 montLs. Hardly + (1/ percent) pancLyat
members reported tLat tLe RHM Las brougLt improvement in tLeir area. Among tLose
Cram PancLayats wLicL Lave reported improvements due to RHM Lave stated tLat
lunds are available lor maintenance ol Sub-Centres (50 percent), Community support is
available as Mitanin worker (50 percent), tLere is availability ol lunds/lacilities under ]SY
(25 percent), and availability ol transport lacilities lor delivery (25 percent). Seven Cram
PancLayats (30 percent) Lave reported tLe dilliculties in implementing programme
activities under RHM. Some ol tLe reported dilliculties are inadequate lacilities lor
institutional deliveries (22 percent), ASHA Las not been adequately trained (13 percent)
lunds are not available on time (9 percent) and /+ percent reported otLer dilliculties like
lack ol adequate publicity about RHM, lack ol transport lacilities and lack ol adequate
LealtL services and lacilities at tLe village level. JLe PancLayats were asked about tLe kind
ol support required to enable tLem to implement RHM more ellectively. EigLteen (/8
percent) out ol twenty tLree PancLayat members stated tLat support was required. JLe
kind ol support required reported by tLe Cram PancLayats are: more lunds (+8 percent)
lor maintenance/ellective lunctioning, and more training lor ASHA and community
members (35 percent) control over lunds (22 percent), and otLer like lacilities lor
transportation to tLe Lospital, Mitanin sLould get regular salary, regular meetings ol
VHSC, and adequate publicity ol RHM.
4GOCTMUQHVJG1DUGTXGT
x Lack ol orientation and involvement is seen among PRI members regarding
RHM. RHM Las not percolated lrom tLe top to tLe community level.
Communitization ol tLe programme is possible only il PRI members Lave a
tLorougL knowledge about tLe programme and tLe level ol participation expected
lrom tLem.
x Lack ol clear guidelines regarding VHSC untied lunds Lave created dillerences
between PRI members and Mitanins and lund management is poor. District
programme managers and DPML sLould reorient tLem about tLese issues so tLat
lunds do not remain unutilized.
Bolc, Awarcncss and Involvcmcnt ot Cram Panchayats
Tablc A1: Status ot Cram Panchayats Covcrcd
A. umber ol Cram PancLayats covered in tLe district 23
B. Average population ol tLe Cram PancLayat covered
ScLeduled Caste 685.5
ScLeduled Jribe +/9.2
Jotal 2,660.0
C. Average number ol HouseLolds in tLe Cram PancLayats
covered
ScLeduled Caste 12/.2
ScLeduled Jribe 86.3
Jotal 598.+
D. Average number ol BPL lamilies in tLe Cram PancLayats
covered
ScLeduled Caste 8/.+
ScLeduled Jribe 58.6
Jotal 300.3