Вы находитесь на странице: 1из 26

OFFICEOFTHECOMMISSIONEROFHEALTH&FAMILYWELFARE:AP::HYD

Rc.No.159/RCHII/S4/2011,

Dated:.07.2012

Sub: NRHM RCHII Project Policy to ensure free & cashless


deliveries of all pregnant women approaching the public
health institutions and free treatment of the sick neonates
RevisedGuidelinesissuedRegarding.

Ref: ThisofficeRc.Evenno.,dt.29.10.2011(JSSKguidelines
201112)

****

The attention of all the District Medical & Health Officers, District
Coordinator of Hospital Services and Hospital Superintendents of
Teaching & Maternity Hospitalsin the Stateareinvitedto reference and
subject cited and they are informed that the revised guidelines on
JananiSishuSurakshaKaryakram
isherewithenclosed.

Hence, all the DM&HOs, DCHS and Hospital Superintendents of


Teaching & Maternity Hospitals in the State arerequestedto follow the
guidelines while implementing the JSSK scheme strictly without any
deviations and communicate to all the concerned institutional heads to
implementtheJSSKschemeaspertheguidelines.

forCommissionerofHealth&Family
Welfare

To
AlltheDistrictMedical&HealthOfficersintheState.
AlltheDistrictCoordinatorofHospitalServicesintheState.
AlltheHospitalSuperintendentsofTeaching&MaternityHospitalsinthe
State.

Copyto
AlltheDistrictCollectors&MagistratesintheState
TheDirectorofMedicalEducation,A.P.,Hyderabad

TheCommissioner,APVVP,A.P.,Hyderabad
TheDirectorofPublicHealth&FamilyWelfare,A.P.,Hyderabad
AlltheProgrammeOfficers.O/oCH&FW,Hyderabad.
ThePeshi,CH&FW

OFFICEOFTHECOMMISSIONEROFHEALTH&FAMILYWELFARE:AP::HYD
RevisedOperationalGuidelinesJananiSishuSurakshaKaryakram

Over a period of last seven years,since the launch of NationalRural HealthMission, therehasbeena
significant fall in MMR in Andhra Pradesh (154 in 200406 SRS to 134 in 200709 SRS). The
institutional deliveriesincreased to 95.2%(50%inpublicHealthfacilities).Therearehowevermorethan
25% pregnant women who still hesitate to access public health facilities. Those who have opted for
institutional deliveriesarenotwilling to stayfor 48 hours,hampering the provision ofessentialservices
both to the mother and neonate, which arecriticalforidentification andmanagementofcomplications
duringthefirst48hoursafterdelivery.Importantfactorsaffectingaccessinclude:
Highoutofpocketexpenseson
Diagnosticstests,bloodtransfusion
Drugsandconsumables
Nonavailabilityofdietforpatients
Informalpayments
Transport from home to facility, to higher facility in case she is referred further and Return
transportfromhospitaltohome.
Outofpocket payments are,without doubt, amajorbarrierforpregnantwomenand childrenso
far astoaccess to institutional healthcareisconcerned. Theimpoverishingeffectofhealthcare
payments onIndian householdsis well established.Outofpocketspendinginpublicinstitutions
is bothcommon and substantial,partlybecauseofaweak supplychain managementofdrugs
and other logistics, and partly becauseofmalpractices. Prescriptions by doctorsevenin govt.
settings can be irrational & unnecessarily expensive and may include not just medicines but
consumables such as gloves, syringes, IV sets, cannula etc. Under these circumstances, the
goalsofNRHMtoprovisionofaffordable,equitableand accessiblehealthservicesaredefeated.
Under NRHM, it is expected that every pregnant women and infant get timely access to
healthcaresystemforrequiredqualitycare.
To ensurethis JSSKis launchedinstateLaunchedJSSKprogrammeatStatelevelon 22.10.2011.with
followingobjective:

Objective: Toprovidefreeandcashlessmaternityservicesandnew borncareinallGovernment health


care institutions including free diet, free diagnostic services, free drugs & consumables, free blood
transfusion, free referral transport with drop back facility without any out of pocket expenses for the
pregnantwomen&newborn.TheJSSKentitlementsare

EntitlementsforPregnantwomen:
1. FreeandZeroexpensedeliveryandcaesariansectionifrequired
2. FreerugsandConsumables
3. FreeEssentialDiagnostics(blood,UrineandUltraSonographyetc.)
4. Free Diet during stay in Health institutions (up to 3 days for normal delivery and 7 days for
Caesareansection)
5. FreeProvisionofBlood
6. Freetransport from Hometo HealthInstitutions,betweenHealthfacilitiesincaseofreferraland
dropbacktohomeafter48hoursstay.
7. Exemptionfromallkindsofusercharges

EntitlementsforSicknewborntill30daysafterbirth
1. Freeandzeroexpensetreatment
2. FreerugsandConsumables
3. FreeEssentialDiagnostics
4. FreeProvisionofBloodifindicated
5. Freetransport from Hometo HealthInstitutions,betweenHealthfacilitiesincaseofreferraland
dropbacktohomeafter48hoursstay.
6. Exemptionfromallkindsofusercharges

Some of the above entitlements are already beingprovided by the StateGovt., in TeachingHospitals
and at APVVP hospitals such as Diet, Diagnostics, Drugs & Consumables and Referral transport
through108ambulanceservicesfromtheexistingbudgetsunderstateGovernmentandunderNRHM.

In view of the launching of JSSK scheme by the GOI, the state Government have issued orders for
implementation of the JSSK scheme in the state vide G.O.Rt.No.1591 HM&FW (D2) Dept.,
dt.08.09.2011andtheStateGovt.,havelaunchedthisprogramon22.10.2011.
For effective implementation of Janani Sishu Suraksha karyakram (JSSK) following guidelines are
issued.

The Program shall be implemented in all Public Health facilities (Health facilities underDirectorate of
Public Health, APVVPandDirectorate of MedicalEducation).EveryCitizen whowishestoavailservices
(Ante Natal Care, Intra Natal care and Care of sick new born till 28 days) shall be provided assured
health services.The service delivery mechanism isproposed based on the servicesofferedatdifferent
levelandshallbeasfollows.
a. Subcentresservices:
i. Antenatalcare:
ConfirmationofPregnancy
ii. Early registration of all pregnancies, ideally within first trimester (before 12th

week of
Pregnancy)byProvidingMCHcard,
iii.
Recording of detailson General and Obstetric history and examination asperMCH
card
iv.
Associated services like general examination such as recording of height, weight,
B.P., anemia, abdominal examination and breast examination,FolicAcidSupplementation
in first trimester,Iron&FolicAcidSupplementation from 12weeks, injectiontetanustoxoid,
andtreatmentofanemia.
v. Investigations: HB estimation (Sahlis Tube), Urine Examination (Benedicts reagent),
Pregnancytesting
vi.
Line listingofanemic and severelyanemic pregnantwomenandrecordingfollowup
treatmentandimprovementinHemoglobinlevels.
vii.
Identification of highrisk pregnancies and appropriate and prompt referral after
checkupbyconcernedMOofthePHCtoFRUs.
viii.
Malariaprophylaxisinmalariaendemiczonesaspertheguidelinesof NVBDCP.
ix.
Counseling on diet & rest, pre birth preparedness (EDD of pregnant women,
identifying health facility for normal & Csection and referral transport facility) and
complication readiness,dangersignsinhighriskpregnancies,infant&youngchildfeeding,
initiation of breast feeding, exclusive breast feeding for 6 months, demand feeding,
supplementary feeding (weaning and starting semi solid and solid food) at 6 months,
contraception, advice on institutional deliveries, clean and safe delivery at homeby SBA
trained attendant/staff, postnatal care & hygiene, nutrition, care of new born and
registrationofbirth&recordingofweightofthenewborn.
x. Promotion of institutional deliveries,skilledattendance athome deliveries when called for
andappropriateandpromptreferral.
xi.
Aminimum of 3 postpartum home visitsbyANM (firstday, thirdday&seventhday)
andensureremainingthreepostnatalvisitson14th
28th
&42nd
daybyASHA.
xii.
Counseling on diet&rest,hygiene, contraception,essential newborncare,infantand
youngchildfeeding.
xiii.
Provide100IFA/200IFAtoPNwomenbasedonanemicstatus.

If any of the above services cannot bedelivered at Subcentres the abovementioned services haveto
beprovidedthrough104FixedDayhealthservicesatSubcentrevillages duringoutreachactivities,ANM
shallreimburse the cost incurred by pregnant women for notgettingabove investigationsatSubcentre
level and all suchcaseshave tobe provided servicesattheconcerned PHCandthecost of transport
hastobe reimbursed from the amountmeantofinvestigationunderJSSK.TheANMsofthesubcentres
have to keep ready sahilis hemoglobin meter, weighing machine, BP apparatus, Stethoscope,
Thermometer & Torch for providing Antenatal checkup servicesatsubcentres for whichUntied funds
allottedtosubcentrestobeutilizedforprocuring/repairs..

b. PrimaryHealthCentre:(24X7PHC):
Antenatalcare: Earlyregistration ofallpregnanciesideallyinthefirsttrimester(before12th

week
ofpregnancy). However, even ifawomancomes latein herpregnancyforregistration she should
beregisteredwithMCHcardandcaregiventoheraccordingtogestationalage.
i. Minimumfour antenatalcheckups and provisionofcompletepackageofservices,1stvisit:Within
12 weekspreferably assoon aspregnancy issuspectedforregistration ofpregnancyandfirst
antenatal checkup,2nd
visit:Between 16 and20 weeks,3rd visit: Between20and28weeks,4th

visit: Between 28 to 36 weeks and term compulsorily by theMOofthePHC/OBGspecialist of

CHC/AH/DH&TeachingHospitals.
ii. Associated services likeproviding iron andfolic acidtablets,injectionTetanusToxoidetc(asper
MCHcard)andtheMOofthePHChastoensureupdationofalldetailsintheMCHcard
iii.
Minimumlaboratory investigations likepregnancy testing&confirmationhemoglobin,Blood
groupdetection,urinealbumin,andsugar,bloodsmearformalaria.
iv.
Line listing of severe anaemic pregnant women, referral for treatment either with from
sucrose or Blood transfusion & follow up with recording of progress with follow up, recordingof
improvement.
v. Nutritionandhealthcounseling
vi.
Identificationofhighriskpregnancies/appropriatemanagement
vii.
ChemoprophylaxisforMalariainhighmalariaendemicareasasper
NVBDCPguidelines.

viii.
Referral to First Referral Units (FRUs)/other hospitals of highrisk pregnancy beyondthe
capabilityofMedicalOfficer,PHCtomanage.

Intranatalcare:
(24hourdeliveryservicesbothnormalandassisted)
1. Provisionofinstitutionaldeliveryserviceswithregardtopreparationoflabourroom.
2. Conductingofnormaldeliveries
3. Assistedvaginaldeliveriesincludingforceps/vacuumdelivery
wheneverrequired

4. Appropriate andtimelyreferralofcasesneedingspecialist careatFRUswithreferralslipand


indicationforreferral.
5. PreliminaryManagementofPregnancyInducedhypertension,eclamsia,prematurelaborand
rupture membranesobstetricemergencies before referral toFRUs/DH& TeachingHospitals
byM.O/TrainedStaffNurses.
6. Adherance to the technical protocols and standard treatment guidelines and partograph
recordingandnewborncareservices
7. Ensuring availability of all logistics such as DDK, Drugs & Consumables, Oxygen supply,
emergencydrugkit&NBCC.
8. Preliminarycleaningofnewbornbaby,weightrecording.

PostnatalCare:
1. EnsureMinimum48hoursstayinfacilityafternormaldelivery
2. Initiationofearlybreastfeedingwithinhalfhourofbirth
3. Educationonnutrition,hygiene,contraception,essentialnewborn
care.

4. Diet provision during hospital stayasper the normseither through SHGs/ Hostels/ any of
theoutsourcingagencyorcontingencystaffofthePHC
5. Management of Postnatal sepsis, PPH, any other complication and timely referral of such
cases which cannot be managed at PHCs along with referral transport to reach referral
facility.

NewBorncare:
a. EssentialNewbornCare
b. Facilitiesandcareforneonatalresuscitation
c. Managementofneonatalhypothermia /jaundice /Sepsis/ Asphexia/ Lowbirthweight
&prematurenewborn,ARI&Diahria.
d. Early identification and prompt referral (transport by 108 or Hospital ambulance or
private)ofsicknewborntoNBSU/SCNU.

ix.
After Delivery at 48 hrs Drop back facilitiesshall bemade availablethrough108 or other
Govt.,Ambulances,donatedambulancesorprivateAmbulance.
x. IfbyanyreasonifPHCcannotdeliver,theycanhireservicesforprivatevehicle.
1. Shall only refer cases that require EmONC services with proper referral and referral slip.
He/sheshallberesponsibleforensuringtransport(preferablyby108ifnotavailablethencan
go forother Govt.,Ambulances, private vehicles) and follow upofthesereferralsandutilize
untiedfundsofHDSwithproperjustification.
xi.
If investigations such as USG, Hbs Ag, are not availableatconcerned FRUs theSupdt.,
OBG specialists& SPHO concerned toidentify a standard, registered /accreditedPvt. Lab with
DM&HO for outsourcing investigations such as Hb Urine examination, bloodgroup detection&
cross matching, USG/HbsAg whererequired costsforsuch investigationshavetobe reimbursed
within the JSSK allocation fromthefundsunderdiagnostic services component. This shouldbe
done only when in house lab services are not available at FRU &tobe reimbursed from JSSK
investigationsfund.

xii.
All reimbursements shall be audited by an external agency time to time and find the
reasonsfornotrenderingtheservicestobeneficiariesbyAmbulanceman.
xiii.
All normal deliveries have to be conducted at PHC unless the normal delivery does not
occur within reasonable time and such cases need to be examined by concerned MO/Nursing
Staff and then only if required such cases have to be referred to nearest FRUs/DH. The
Ayas/Contingentworkersshouldnotconductdeliveries.
xiv.
No drugs / consumables required during antenatal / intranatal & postnatal period to be
prescribed for purchase by pregnant women and for newborn treatment out of their pocket
expenditure.
xv.
Normal delivery cases should not be referred to Pvt. Hospital /Nursing homes without
referringtoFRUs/DH.
xvi.
All delivery cases have to beescorted by ASHAs andtohandovertotheOBGspecialist /
MO/StaffNursesatPHC/Referralhospital.

c. Community Health centres/Area Hospitals (FRUs): The FRUs shall provide following
servicesunderJSSKprogram
i. Antenatalservices: Antenatal check up by a obstetrician/Doctor(Registration, provideMCH card,
Obstetric history andexamination,InvestigationsuchasHb%,urine examinationforalbuminsugar,
Bloodgrouping&crossmatching,RHtyping,USGabdoming&bloodsmearformalaria.
ii. RecordingofAntenatalcheckup,detailsinMCHRcards.
iii.
Identification of high risk pregnancies & follow up examinations, treatment & guiding for
deliveryservices.
iv.
TreatmentforsevereanemicpregnantwomenwithIronsucrose/Bloodtransfusion.

Intranatalcare:
1. All directlycoming pregnantwomen& referrals (Pregnant women &Sicknewborn) shallbe
promptlyrenderedservicesfornormaldeliveries/Csections
2. Essential and Emergency Obstetric Care including surgical interventions like Caesarean
Sectionsandothermedicalinterventions
3. ManaginglabourusingPartograph.
4. Bloodtransfusionifrequired
5. Referral if needed or cannot be handled at CHC/AH with referral slip. Its responsibility of
treating Doctors or MS / OBG specialist / duty MO of CHC/AHfor providingtimelyreferral
services&reasonsforreferral.
6. Adherance to the technical protocols and standard treatment guidelines and partograph
recordingandnewborncareservices
7. Ensuring availability of all logistics such as DDK, Drugs & Consumables, Oxygen supply,
emergency drug kit, NBSU, functioning equipment such as boyles apparatus, suction
apparatus, foetal monitor, oxygen supply with ambu bag and instruments required for
Csections.
8. Timelyrecognitionofintranatalcomplication&referraltoDH/TH.
9. Ensuring availability of Blood unit for severe anaemicC.S/PPHand ifinhouseBloodbank/
BSC is not available either procure from nearest BB/BSC or refer to such facilitieswhere
BB/BSCisavailable.
10. Ensuring properpreoperativeexaminationbyOBGspecialist/AnaesthetistbeforeCsection,
ifrequiredbyphysician/concernedspecialistathigherfacility.

Postnatalcare:
1. Ensure Minimum 48 hours stay in hospital if normal delivery and 7 days stayif Cesarean
section.
2. Proficiency inidentificationandManagement of all complications includingPPH,Eclampsia,
Sepsis etc.during PNC and timely referral to DH/THif suchcasesaredifficulttomanageat
FRUsthrough108Ambulances.
3. Promotingearlyinitiationofbreastfeeding&exclusivebreastfeeding.
4. Counseling on breast feeding, exclusive breast feeding, contraceptive & sterilization
services.
5. Counselingonnutrition&personalhygiene.
6. Newborncare:
a. Essential Newborn Care, cleaning of newborn baby weight recording & zero dose
immunization.
b. Facilities and care for neonatal resuscitation including New born stabilization by

pediatrician/trainedM.OandtreatmentofARI/Diarrhea/jaundice
Early identification and prompt referral (transport by 108 or Hospital ambulance or
private)ofsicknewborntoSCNU.
Providediettopregnantwomenandlactatingwomenwhoareadmitted.
v. AfterDischargeDropbackfacilitiesshall bemade availablethrough108orAmbulancesorprivate
vehicles.
vi.
If by any reason if CHC/Area Hospital cannot deliver above mentioned, they can hire
servicesfromprivatesector (Obstetrician: 1200 per case forc section and Anesthetist:1000per
case for c section) due to non availability of OBG specialists / Anesthetist either regular or
contractatFRUs.
vii.
Shall only refer cases that require specialist care with proper referral and referral slip.
He/she shallbe responsiblefor ensuringtransport (preferably by 108ifnotavailablethencango
for otherGovt., / donated Ambulances, private vehicles) and follow upofthese referrals.Incase
ofprivatevehiclesfortransport servicesthe costforsuch serviceshastobereimbursedfromthe
fundsallocatedunderUntiedfundscomponentofHDS.
viii.
If investigations such as USG, Hbs Ag, are not availableatconcerned FRUs theSupdt.,
OBG specialists & SPHO concerned to identify a standard, registered /accreditedPvt. Lab for
outsourcing investigations such as Hb Urine examination, blood group detection & cross
matching, USG/HbsAg where required costs forsuchinvestigationshavetobereimbursed within
the JSSK allocation from the funds under diagnostic servicescomponent.This shouldbe done
onlywheninhouselabservicesarenotavailableatFRU.
ix.
All reimbursements shall be audited by an external agency time to time and find the
reasonsfornotrenderingtheservicestobeneficiaries.
x. For all severely anemic pregnant women i.e., below 7 gms %, for Csections and postpartum
haemarages blood transfusion to be provided freely at all Govt./IRCS BB/BSC. In caseofnon
availabilityofa particular Blood unitinsuch casescostofthebloodunitcanbereimbursedfrom
the JSSK budgets(Rs.300/ per unit) tothePvt.BBwhichshould beregisteredwithAPSACSand
DrugControlAuthorityandfollowingNACOguidelinesforBloodSafety.
xi.
No drugs / consumables required during antenatal / intranatal & postnatal period to be
prescribedforpurchasebypregnantwomenoutoftheirpocketexpenditure.
xii.
The Superintendents of the all CHCs / AHs have to utilize JSSK funds for provision of
entitlements to every pregnant women & new born child in addition to the regular budgets
providedfromthestate.

c.

DistrictHospitalsshallprovidefollowingservicesunderJSSKprogram
i. Antenatal services: Antenatal check upbyObstetrician/ Doctor(Registration, provideMCH card
& filling up of details,Obstetrichistory andexamination, conducting of Labinvestigation including
UltraSonography(USG)&updatingdetailsinMCHRcard.
ii. Timely identification of highrisk pregnanciesandcounselingfrequentlyonreviewcheckupandfor
delivery/Csectionservices.
iii.
TimelyreferraltoTHincaseifAntenatalcomplicationsarenottreatableatDH.
iv.
Treatment of Eclampsia, Hypertension, Diabetic, prefer a Obstetric complications after
admission.

Intranatalcare:
1. Directly coming / referred (Pregnant women & Sick new born) shall bepromptlyrendered
services
2. Essential and Emergency Obstetric Care including surgical interventions like Caesarean
Sectionsandothermedicalinterventions
3. ManaginglabourusingPartograph.
4. Bloodtransfusionifrequired.
5. Checkupofnormaldeliveriesbeforedischarge&Csections(P.Ocare)dailyupto7days.
6. ProperadvicetoallCsectiondischargesforreviewcheckupwithin6weeksafterdelivery.

Postnatalcare:
1. Ensure Minimum 48 hours stayinhospitalif normaldeliveryand 7days stayfor Cesarean
section.
2. Proficiency inidentificationandManagement of all complications includingPPH,Eclampsia,
Sepsisetc.duringPNC.
3. Promotingearlyinitiationofbreastfeeding&exclusivebreastfeeding.
4. AdequateNursingcare,careofthewound&dressingforCsectionmothers.
d.

5.

Newborncare:
a. EssentialNewbornCare
b. FacilitiesandcareforneonatalresuscitationincludingSickNewborncare.
c. Early identification and prompt referral (transport by 108 or Hospital ambulance or
private)ofsicknewborntoSCNU.
Provide diet to pregnant women and lactating women who are admitted 3 days for normal
delivery&7daysforCsectiondelivery.
v. AfterDischargeDropbackfacilitiesshall bemade availablethrough108orAmbulancesorprivate
vehicles.
vi.
Shallonlyrefer cases that require Highercare withproperreferralandreferralslip.He/she
shall be responsible for ensuring transport (preferably by 108 if not available then can go for
Ambulances,privatevehicles)andfollowupofthesereferrals.
vii.
For all severely anemic pregnant women i.e., below 7 gms %, for Csections and
postpartumhemorrhagebloodtransfusion tobeprovidedfreelyatallGovt./IRCSBB/BSC.Incase
of non availability of a particular Blood unit in such cases cost of the blood unit can be
reimbursed from the JSSK budgets(Rs.300/ per unit) to the Pvt.BB which should be registered
withAPSACSandDrugControlAuthorityandfollowingNACOguidelinesforBloodSafety.
viii.
No drugs / consumables required during antenatal / intranatal & postnatal period to be
prescribedforpurchasebypregnantwomen&forNewbornoutoftheirpocketexpenditure.
ix.
The Superintendents oftheall DistrictHospitals have to utilize JSSKfundsforprovisionof
entitlements to every pregnant women&new born child asadditionalsupplementinaddition to
theregularbudgetsprovidedfromthestate.
x. All reimbursementsshall beaudited by anexternalagencytime to timeand find the reasonsfor
notrenderingtheservicestobeneficiaries.

Teaching Hospitals (SRUs): The SRUs shall provide following services under JSSK
program
i. Antenatalservices: Antenatal check upbyobstetrician/Doctor(Registration, provideMCH card,
Obstetric history and examination, Investigation including Ultra Sonography (USG) & updating
obstetricdetails&investigationsinMCHRcard.
ii. Timely identification of high risk pregnancies and counseling frequently review check up andfor
delivery/Csectionservices.
iii.
Separate ward & treatment for Eclamsia, Hypertension, APH, obstetric complication with
propertreatment.
iv.
Complete physical exam & check up of pregnant women for fitness before Csection &
indication.

ii.Intranatalcare:
1. Directly coming / referred (Pregnant women & Sick new born) shall bepromptlyrendered
services
2. Essential and Emergency Obstetric Care including surgical interventions like Caesarean
Sectionsandothermedicalinterventions
3. ManaginglabourusingPartograph.
4. Bloodtransfusionifrequired.
5. AdequateresuscitationmeasuresafterCsection&complicateddeliveries underobservation
ofOBGspecialist&immediatenewborncarewithweightrecording.

iii.Postnatalcare:
1. Ensure Minimum 48 hours stay in hospital if normal delivery and 7 days stayif Cesarean
section.
2. Proficiency inidentificationandManagement of all complications includingPPH,Eclampsia,
Sepsisetc.duringPNC.
3. Promotingearlyinitiationofbreastfeeding&exclusivebreastfeeding.
4. Newborncare:
a. EssentialNewbornCare
b. FacilitiesandcareforneonatalresuscitationincludingSickNewborncare.
c. Early identification and prompt referral (transport by 108 or Hospital ambulance or
private)ofsicknewborntoSCNU.
5.Providediettopregnantwomenandlactatingwomenwhoareadmitted.
v. AfterDischargeDropbackfacilitiesshall bemade availablethrough108orAmbulancesorprivate
vehicleswithreimbursementfromJSSKfunds.
e.

vi.
For all severely anemic pregnant women i.e., below 7 gms %, for Csections and
postpartum haemerages blood transfusion to be provided freely at all Govt./IRCS BB/BSC. In
case of non availability of a particular Blood unit in such cases cost of the blood unitcanbe
reimbursed from the JSSK budgets(Rs.300/ per unit) to the Pvt.BB which should be registered
withAPSACSandDrugControlAuthorityandfollowingNACOguidelinesforBloodSafety.
vii.
No drugs / consumables required during antenatal / intranatal & postnatal period to be
prescribedforpurchasebypregnantwomen&forNewbornoutoftheirpocketexpenditure.
viii.
The Superintendents of the all Teaching & Maternityhospitalshave toutilize JSSKfunds
for provision of entitlements toeverypregnant women&new born childasadditionalsupplement
inadditiontotheregularbudgetsprovidedfromthestate.
ix.
All reimbursements shall be audited by an external agency time to time and find the
reasonsfornotrenderingtheservicestobeneficiaries.

ActionPlanforJSSKimplementation:
ActionsatStatelevel
:
Government has issued orders for implementations of JSSK scheme in the state vide
G.O.Rt.No.1591HM&FW(D2)Dept.,dt.08.09.2011.
StateGovernmenthastonominateaStateNodalOfficerbyCH&FW.
Grieviance redressalcellatStatelevelthrough104callcentre,monitoringtheimplementationof
JSSKbyMD(NRHM)AdditionalDirector(MCH),JD(MHN),JD(CHI)&HODs.
Sensitizationof HODs Directors,DM&HOs, DCHS,AdditionalDM&HOs,HODsof OBGdept.,
ofmedicalcollegesatStatelevel.
MassiveIEC campaignintheformofadvertisements, TV scrollingand procurement ofDisplay
boardsonJSSKentitlementsinallGovt.,healthinstitutionstobetakenup.
Ensure regular procurement and availability of drugs and consumables at the public health
institutions.
Taking necessary steps for ensuringfunctionallabfacilitiesanddiagnosticservices atthepublic
healthinstitutions.
Establishing district wise assured referral linkages with GPS fitted vehicles and centralized
controlrooms.
Regularlymonitorandreportondesignatedformatseverymonth.
Financially empower the district and facility incharges for the above activities, particularly in
emergencysituations/stockouts.
ReviewtheimplementationstatusduringdistrictDMHOsmeetings

ActionsatDistrictlevel
:
AdditionalDM&HOatdistrictlevelisnominatedasDistrictNodalOfficer.
The Additional DM&HO in coordination with Statistical Officer (UIP) are responsible for
collecting monthly reports from health institutions under administrative control of DM&HOi.e.,
24x7 MCH centres, PHC & CHCs & other PHCs and to submit reports to CH&FWby 5th

of
every month after analyzing& consolidating the reports i.e., to DD(DEMO) with a copy to
JD(MHN)&JD(CHI).
Sensitizationof programme officersandSPHOs, M.OsofCHCs/PHCs,DEMOs,SOs,DPMUs,
PDICDS,PDDRDAatdistrictlevelunderchairmanshipofDistrictCollector.
To prepare budgetary estimates facility wise for expected no. of deliveries (normal &
Csections) & newborn to be provided free& cashless servicesfordiet, freediagnostics, free
drugs & consumables & free blood by DM&HO/DCHS/Supdt., of Teaching & Maternity
Hospitals.
District level committee under chairmanship of District Collector with DM&HO, DCHS, PD
ICDS,PDDRDA,DPO&DPROhavetorevieweverymonthontheJSSKimplementation.
Monitoring&Grievanceredressal cell to beestablishedat DistrictlevelwithNames,Telephone
numbers of Additional DM&HO/DPMO/DPO to be displayed at all Government health
institutions i.e., Superintendents & RMOs of Teaching hospitals, District hospitals, Area
hospital, CHCs & M.Os of 24x7 MCH centres & PHCs & CHCs of DPH&FW, Additional
DM&HO,DPMO,SO and DPO of DPMU and apprisetheDM&HO,DCHS & DistrictCollector
through districtlevel reportseverymonthand take necessary actions forgrievance redressal,
fundsutilizationandanyissuesofJSSKimplementation.

RoleofDM&HO
:
Ensureandfacilitate implementationof JSSKatallPHCs,CHCs,underadministrativecontrol
ofDM&HO.

ToinspectJSSKimplementationduringfieldvisitstoGovt.,healthinstitutions.
To conductreview meeting onJSSK with SPHOs, MOsofPHCsalong withotherprogramme
officers,Addl.DMHO,DPMO,DPO,SOs,DEMOonceinamonth.
To organize review meeting under chairmanship of DistrictCollector along with Districtlevel
members i.e., DCHS, PD ICDS, PD DRDA, DPO, DPRO &submit JSSKreports i.e, PHCs,
CHCsinthemeeting.
Toreviewgrievinacesreceived&solvedatdistrictlevel.
The SPHOs to frequently visit PHCs/CHCs of DM&HO for monitoring the JSSK scheme at
CHNClevel&tosubmittheirreportstoDM&HOforfollowupaction.
DM&HOshouldensurefree&cashlessdeliveryservicesinthedistrict.
Responsible forsending districtlevel JSSK report everymonthtotheO/oCH&FWandSOEs
&UCsofJSSKschemeeverymonthtoCH&FW&MD(NRHM).
The DM&HO have to arrange for submission of records,registers, vouchers, Bills,receipts,
accountsbooks,Bankstatementssheetsonwhencalledforverification&auditpurpose.

RoleofDCHS:
Ensure&facilitateimplementationofJSSKinthehospitalsundertheircontrol.
To review physical & financial performance every month and reimbursements with
Superintendents & RMOs of the hospitals and send the reports to Commissioner APVVP /
MD(NRHM)/JD(MHN).
ToinspectJSSKimplementationduringinspectionvisitstothehospitals.
To receive, consolidate & send JSSK reports to the Commissioner APVVP / MD(NRHM) /
JD(MHN)everymonthwithoutfail.
To attend district level meeting chaired by District Collector every month along with other
members.
To monitor & attend Grievances on JSSKimplementationfromthehospitals for24x7hrsperiod
inthedistrictthroughgrieviancecellatdistrictlevel.
ToarrangeforreleaseofbudgetsforJSSK implementationto theconcernedSuperintendentsof
the hospitals every month in advance & to send SOEs / UCs along with physical &financial
performancereports to the to the concernedHODi.e,.CommissionerofAPVVP/MD(NRHM) /
JD(MHN.
To arrangefor submission of records,registers, Bills,vouchers&receipts,chequebooks,bank
pass books & bank balance sheets on when called for verificationto the O/o CH&FW /Audit
party.

Role of Superintendent of the Teaching, APVVP hospital / MOs of PHCs and CHCs of
DPH&FW:
TheyareresponsibleforimplementationofJSSKatinstitutionlevel.
To monitor & supervise diet supply, diagnostic services, drugs & consumables, free blood
provisionandreferraltransport&dropbackfacility.
Proper maintenance of separate Registers, Accounts Books, Records, Referral registers,
Deliverycasesheets,Issueofdischargecardsattheirinstitutions.
Responsible for sending physical performance reports, SOEs &UCs to the DCHSconcerned
every month regularly and to send requirements of budgets for implementation of free
entitlementsinadvancetotheconcerneddistrictheadsi.e.,DCHS.
To arrangea monitoring& supervisory committeefor checkingimplementationofJSSKandfor
Grieviance redressal at the institution level with RMO, OBG specialist & Nursing Supdt.along
with display of names &Tel.No. of the committee members as well as names and Tel.No. of
DCHSatallGovt.healthinstitutions.
Responsiblefortimelypaymentofbills&tomaintainvouchers/receiptsfortheamounts.
Responsible forprocurementof emergencydrugs&consumables,diagnosticreagentsfollowing
theGovt.,procurementnormsthroughacommitteeatthehospital/PHClevel.

ActionsatHospitallevel:
Superintendent,RMO,OBGspecialist &SPHOandforPHClevelSPHO/MOtoworkasJSSK
implementationCommittee.
The MOs of PHCs & Supdts of the hospitals have to sensitize all Nursing Staff,Supervisory
staff,ANMs,AWWs,ASHAs,SHGs,Pharmacists&LabTechniciansontheJSSKscheme.
The physical & financialperformancereports have to besent totheDM&HO throughDCHSby
theSupdts.ofthehospitals&byMedicalOfficersofDHs/AHs/CHCs.
The Superintendents APVVP hospitals / Teaching hospital & MOs of PHCs & Civil hospitals

(under DH) have submit records / registers and vouchers, bills & receipts as when called for
crosscheckingverificationandforauditpurpose.

A grievance redressal cell has to be established under Supdts. of hospitals & RMO, OBG specialist /
PediatricianatAPVVP &Teaching hospitals and SPHO &MOat PHC leveland tosubmit actiontaken
reportongrievanceseverymonthtotheDCHS&DM&HOs.

Hospital superintendent/Medical officerinchargeis accountable andresponsible for implementationof


JSSKprograminthefacility.

GuidelinesforvariousinterventionsunderJSSK
1. Disseminationoftheentitlementsinthepublicdomain:
Widely publicize these entitlements through print and electronic media.Display them prominently on
adequate size hoardings & Boards, which is clearly visible from distance in all Government health
facilities e.g. SCs, PHCs, CHCs, SDHs and DHs/FRUs (main entrance, labour rooms, female and
neonatalwards and outside outpatient areas) aspertheenclosedformat atAnnexure1.(Alreadygiven
todistrict). TheIEC BCC bureau shall make an action plan&implementforensuringwidepublicityon
JSSK.

2. Ensuredrugsandconsumables:
Notify the essential druglist forRCHservices to benotifiedat all theServicedeliverypoints in
district(AnnexureI).

Drugs & consumables under JSSK have to be procured by a committee at health institution
level:
1. For Teaching&Maternity hospitals: The concerned Superintendents, RMOs,headoftheOBG,
Pediatrician & concerned EE APMSIDC to form a committee for prolcurement of Diagnostic
regents,Drugs& Consumables. They have to follow Govt., tender procedures &normsasper
APMSIDCgivenmarketrates.
2. For APVVP Hospitals (DCHS): The concerned Superintendent, RMO, OBG specialist,
Pediatrician & EE of APMSIDC to form a committee for procurement of Diagnostic regents,
Drugs& Consumables.Theyhave tofollowGovt.,tenderprocedures&normsasperAPMSIDC
givenmarketrates.
3. For CHCs/24x7 PHCs & PHCs conducting deliveries (DM&HO): The SPHO, M.O of PHC &
MPDO of HDS committee has to form a committee for procurement of Diagnostic regents,
Drugs& Consumables.Theyhave tofollowGovt.,tenderprocedures&normsasperAPMSIDC
givenmarketrates.

Ensure regularprocurement, uninterruptedsupply and availability ofdrugs & consumablesat all public
health institutions. Thedaily availability of the drugsshould bedisplayedat the healthfacility.Empower
the headoftheDistrict/healthfacilitytoprocuredrugs&consumablestopreventstockouts.Ensurethe
quality and shelf life of drugs supplied. Ensure a properinventory of drugsand consumables ateach
health facility fortimelyreportingon stockouts and expiry.Inchargepharmacistofthefacility toensure
availability of drugs at dispensing points i.e. labour room, OT, indoors, casualty, etc after the routine
hours. Ensure that firstexpirydrugs andconsumables are used first."FIRST in &FIRST out"protocol.
Ensure proper storage of drugs and consumables by keeping drug stores clean & tidy with adequate
ventilationandcooling.
Budget provision: Under JSSK scheme free delivery kits, drugs & consumables Rs.300/ will be
providedfor each normaldeliveryof apregnant woman during intranatal& postnatal period,Rs.1600/
for each Cesareansectionand forsick new born Rs.200/ upto 30days after birth. TheDeliverykitfor
normaldeliveryincludes
1. Plasticdrapesheet

1
2. Disposablegown

1
3. CuttingBlade(Sterile)

1
4. Cordclampsformother&newborn

2pieces
5. Sanitarypads

2
6. LatexGloves

3pairs
7. Smallbowlforcleanhotwater

1
8. Pediatricnasogastrictube

1
9. Soap

3. Strengthendiagnostics:
Ensure lab and diagnosticservices at DH,SDH,FRU, CHC,& 24x7PHCs. Ensure availability of basic
routine investigations like pregnancy test, Hb & routine urine at subcentre level, particularly those
designated asdeliverypoints.EnsurerationalpostingofLabtechniciansforintegrated&comprehensive
utilization in all the programs.Makeemergency investigationsavailable roundtheclock, at least atTH,
DHand FRU level. Ensureuninterruptedsupplyofreagents,consumables andotheressentialsrequired
for lab investigations.EmpowertheheadoftheDistrict/healthfacility toprocurereagents,consumables
andother essentials toprevent theirshortage/stock out.Incase inhouse lab & diagnostic servicesare
not available, free investigations can be provided through PPP/outsourcing through a recognized &
standardPvt.Labinthesamegeographicalarea.

Budgetprovision: Underfree essential diagnostics Rs.40/ will beprovidedforeachpregnantwoman


&sicknewbornfordiagnosisofHB%estimation,Urineexamforalbumin& sugar,Bloodgroupdetection
at all Govt., health institutions. Ultrasonography will be provided at free of cost at all FRUs, DHs &
Teachinghospitals.Thelabshouldfunctionon24x7hrsbasisatalldeliverypoints.

4. Ensureprovisionofdiet:
Ensure provision of diet (cooked food)atalldelivery pointsfromDistrictHospital/ Teaching&Maternity
Hospitals/FRUs&24x7PHCs&otherPHCs,CHCswheredeliveriesareconducted.
1. In all teaching and maternity hospitals & APVVP hospitals, diet supply should be arranged
through diet contractors after entering into agreementwith districtdietmanagementcommittee.
ThemenushouldbeasperGoMsno.325.
2. Inall24X7PHCsandCHCunderDirectorateofPublicHealthandfamilywelfare,thedietshall
arranged either through self help groups or local hostels/any out sourcing agency. The menu
shouldbeasperGoMsno.325.

Local seasonal foods, vegetables, fruits,milkand eggscanbe given to herfor a propernutritiousdiet.


Hospitalincharge/MOincharge shouldmonitorthequalityoffoodbeingservedatthehealthfacility.Diet
is to beprovided up tothree daysfor normaldeliveryand uptoseven daysstayforcaesarean section
(CSection). Thehealth facility should receive the fundsinadvanceforensuringprovisionof freedietfor
thepregnantwomenanddeliveredmother.

Budgetprovision: Free dietwill be providedatacostofRs.56/perdayforeverypregnantwomanfor


3 daysstay at Govt., health institutionsin plain area and 5 daysstayat Tribal area PHCs/CHCsunder
DPH&FW through SHGs/NGOs/any local arrangements and through diet contractors at APVVP
hospitalsaspertheG.O.Ms.No.325HMN&FW(M1)Dept.,dt.01.11.2011.
Freedietat all Teaching hospitals &Maternity hospitalsunder DMEwillbeprovidedaspertheexisting
Govt., orders in G.O.Ms.No.325 HMN&FW (M1) Dept., dt.01.11.2011. For diet provision, budgetary
provision under JSSK to be utilized when there is shortfall / deficit in theState budget andnottobe
drawnfromState&JSSKbudgetatatimeforssinglepregnantwomen.

DietChartforPregnantWoman
:
Menu
Breakfast(7.30AMto8.30AM

Idly(150gms)withSambar/Chatnee(100ml)
3Nos.
Pongal / Kichidi / Upma (with 100 gmsravva and10 gmsBlack 300gms
gramdal+chatneeBread100gms
Milkwith10gms.Sugar
150ml
Lunch(12.00Noonto1.00P.M)

CookedRice/6Phulka(6.inch.Dia)
450gms
GreenLeafyVegetableDal(1/2cup)
50gms
VegetableCurrie(1cup)
100gms
Sambar(with25gmsredgramDal)
150ml
Curd/ButterMilk(200ml)
100ml
Dinner(6.00PMto8.00P.M)

CookedRice/6Phulka(6.inch.Dia)
450gms
VegetableCurrie
100gms
Sambar(with25gmsredgramDal)
150ml
Eggboiled
1no.
Curd/ButterMilk(200ml)
100ml

Banana
1no.

5. ReferralTransport:
Ensure universal reachof thereferraltransport(noarealeftuncovered),with24x7referralservices.The
district has to coordinatewithdistrict108for assuredtransportfacilities.For drop backfacilityinfacilities
with highdelivery load additionalambulancescanbehired.Establish callcentre(s)withasingletollfree
number, at District orState level. Establish linkagesfor the inaccessible areas (hilly terrain,flooded or
tribal areasetc) to the road head /pickup points.Widelypublicize thefree&assuredreferraltransport
through print and electronic media. Monitor andsupervise services atalllevels,including utilization of
theeachvehicleandnumberofcasestransported.
The concerned ASHA/ANM for Rural &Urban areas& pregnantwomencandirectlyutilize108
tollfreetelephonenumberforreferraltransportservicesasfollow.
a.
Fromhometohealthinstitution
b.
Inbetweenhealthfacilitiesincaseofreferral.
c.
Dropbackathome.

At districtlevel DM&HO, DCHS, Superintendentsof Teachinghospitalshave toreviewwith108


district Coordinatorsforanygapsinreferral transportservices suchasnonattendance,delayin reacting
to the point of referral, long distances incase of referral to other Govt., health facilities& inter district
transport.

At CHNClevel theSPHOtocoordinate&monitorutilizationoffreereferraltransportservicesby
all pregnant women & sick new born every month & to inform108 coordinator forany lapses/gapsin
utilization widepublicitythroughSHG group meetings,IPC during Antenatal checkups,throughposters
&other forums have to be given. TheSPHO preview how manypregnant women expectedforreferral
transport utilization &howmanyutilized&analyze&takenecessaryfollowupactioninconsultationwith
DM&HO/DCHS.

Urban Health Centres / Urban Health Posts: TheASHA/ANMs areresponsible to sensitizeall


pregnant women during Antenatal checkup examinations to utilize free referral transport services
through 108 Ambulance. The M.O concerned has to review the no. of pregnant women utilized 108
services& how manydid not utilize& reasons fornotutilizing 108Ambulanceservices. Incaseofnon
availability/ shortage of 108Ambulanceservices particularly at highload delivery pointsi.e.,Teaching
hospitals / District hospitals. The concerned Superintendenthave toarrangePvt. Ambulanceson hire
basisforreferraltransport&dropbackbyutilizinguntiedfundscomponentofHDSfunds.

GVK EMRIhastomaintainthedata onhow many women &neonates actually transported on


daily basis at District level & State level andfurnishthereporttotheCH&FW from time totime.Name
based recordson freeentitlementsof every pregnantwoman &sicknewborn haveto bemaintained at
all Govt., health institutions.For dropback facility either108 orHospitalambulance or Private vehicles
canebeused.

6. Ensureavailabilityofbloodincaseofneed:
Prepare time boundactionplansforestablishing and operationalizing.Blood BankatDistrict level and
Blood Storage Centres at identified FRUs. Maintain adequate stocks for each blood group. Ensure
availability of reagents and consumables for blood grouping, crossmatching and bloodtransfusion.
Blood Banks to ensure mandatory screening of blood before storage, andorganizeperiodic voluntary
blooddonationcampsfor maintainingadequatenumberofblood units.Provideadequatefundsto blood
banksforelectric backupandPOL, andalternate source ofpowerbackupforbloodbagrefrigeratorsfor
blood storage units. MO incharge/lab technicianoftheblood bankperiodicallyvisit blood storage units
formonitoringandsupervision.

Budgetprovision: Rs.300/ will beprovidedforeachseverelyanaemicpregnantwoman, forcesarean


sections and for PPH per each case on reimbursement basis through concerned hospital
Superintendentsto the respectiveBloodbanks.AlltheBloodBanks/BloodStorageCentresunderDME
/ APVVP & IRCS, RCHII shall invariably supply to the needy pregnant women who require blood
transfusionatfreeofcost.

7. GrievanceRedressal:
Prominentlydisplay thenames,addresses,emails, andtelephone,mobileandfaxnumbersofgrievance
redressal authorities at healthfacilitylevel, districtlevel and state level,anddisseminatethemwidelyin

the public domain. Setup helpdesksand suggestion /complaintboxes at governmenthealthfacilities.


Keep fixed hours (at least 1 hour) on any two working days per week, in all the healthy facilities for
meeting the complainants and redressing their grievances related to free entitlements. Take actionon
the grievances within a suitable timeframe, and communicate to the complainants. Maintain proper
recordsofactionstaken.

8. Funds:
Under the JSSKprogramme the GOI will provide the fundsunderNRHMforprovidingfreeentitlements
tothepregnantwomen&sickneonate.

The CH&FWwillreleasetherequired budgettotheHealthInstitutionsunderthecontrolofDME, APVVP


and to the DM&HOs for 24x7PHCs, CHCs &other PHCs wheredeliveriesare conducted for thefree
entitlements Drugs& ConsumablesandDiagnostic regentsunderJSSK to beprocured throughHealth
Institutions Committees mentioned above. TheSuperintendent/InchargeMOsshallensurecontinuous
availabilityofessentialdrugsrequiredduringAntenatal,Intranatal &Postnatalperiod forevery pregnant
women&sicknewbornandtheyshallnotbeanystockoutsofessentialdrugs.

The budget towards free Diet at 24x7 MCH centres the DM&HOs have to release the budget to the
MedicalOfficers of all the 24x7MCH centres/ otherPHCs&CHCsattheir control wheredeliveriesare
conductedtoprovidefreediettopregnantwomanaspertheaboveguidelinesmentioned.

TheSuperintendentsofTeaching&Maternity HospitalsunderDMEshallsubmitmonthlyreportonJSSK
utilization for all normal deliveries &Csections foreachentitlementunderJSSKtotheCH&FWthrough
concernedHODs(Physical&Financialdetails).

The Superintendents ofDHs/AHs & CHC HospitalsunderAPVVP shall submit monthlyreportonJSSK


utilization for all normal deliveries &Csections foreachentitlementunderJSSKtotheCH&FWthrough
concernedHODs(Physical&Financialdetails).

All the DM&HOs have to furnish the SOEs & UCs to CH&FWeverymonthfor the amount released to
them for all the components of JSSK at 24x7 PHCs and other PHCs / CHCs where deliveries are
conducted.

The DME / Commissioner of APVVP shall not release funds to Govt., health facilities where normal
deliveries & caesarian sections are not conducted. Similarly the DM&HOs shall not release funds to
PHCs/ CHCs wheredeliveries / Csections arenotconducted.DMHOto releasefundstoFacilitiesand
review theutilizationoffundstoensuretheentitlementsunderJSSK
.Districtshallsendthestatementof
expendituresmonthlytostatenodalofficer.

9. MonitoringandFollowUp:
At Stateand District level, the StateNodalOfficer andDistrict NodalOfficers will monitorand follow up
the progress inimplementationoftheScheme. InDMHOs meeting at Statelevel,the Mission Director
and during MOs meeting at district level, DMHO & DCHS will review the progress of the scheme.
MonitoringStateandDistrictlevelisatAnnexureII.

10. Arogya/SwasthyaLokpalsystem:
A retired Judge shall be Ombudsman for Arogya Lokpal. The role of Ombudsman is auditing of all
reimbursements.All efforts shall be made todecreasenumberofreimbursements byutilizingJSSKand
HDS funds andstrengtheningthepublichealth facilities. Eachreimbursement shallbe dealtaseparate
caseandauditedtostrengthenthepublichealthsystem.

AnnexureI
A.Drugsduringantenatalperiod
1. Tab.IronFolicAcidlargeDriedFerrousSulphateIPeq.toFerrousIronlOOmg&
FolicAcidIP0.5mgasentericcoatedtablets
2. TabMethyldopaIPeq.toMethyldopaanhydrous250mg
3. CapNifedipineNifedipineIP,5mgsoftgelatinecapsule
4. TabNifedipine,NifedipineIP,10mg
5. TabLabetalol100mg,
6. InjLabetalol,20mgin2mlampoule

7.
8.
9.

TabDigoxinDigoxinIP250pg/tab
InjMagsulphMagnesiumSulphateIP50%w/v10ml'containing5.0gmintotal
volume,
Tab.FolicAcidIP400pg

B.DrugsduringIntranatalperiod:
1. CapsuleAmpicillinAmpicillinTrihydrateIPeq.toampicillin500mg
2. InjGentamycinGentamycinsulphateIPeq.togentamycin40mg/ml2mlineach
vial
3. AmpicillinInjectionAmpicillinSodiumIPeq.toAmpicillinanhydrous500mg/vial
4. CapAmoxycillinAmoxycillineTrihydrateIPeq.toamoxycilline250mg
5. Tab.MetronidazoleMetronidazoleIP400mg
6. TabNitrofurantoinIP100mg
7. CapDoxycyclineDoxycyclineHydrochlorideIPeq.toDoxycyclinelOOmg
8. Inj.MethylergometrineMethylergometrinemaleateIP,0.2mg/ml01mlineach
ampoule
9. TabMisoprostolMisoprostolIP200megoral/vaginal
10. TabDicyclomine,500mgoraltab
11. InjMagnesiumSulphateMagnesiumSulphateIP50%w/v10mlvials,containing
S.Ogmintotalvolume
12. injOxytocinOxytocinIP5.0I.U./ml02mlineachampoule
13. inj.HyoscineButylBromide20mgin1mlampoule
14. TabHyoscineButylBromide500mg
15. Menadionelnjection(VitaminK3)MenadioneUSPlOmg/ml01mlineach
ampoule)
16. CompoundSodiumLactateIVInjectionIP(Ringerslactate)0.24%V/VofLactic
Acid(eq.to0.32%w/vofSodiumLactate),0.6%w/vSodiumChloride,0.04%w/v
PotassiumChlorideand0.027%w/vCalciumChloride500mlineachplasticbottle
17. SodiumChlorideIVInjectionSodiumChlorideIP0.9%w/v500mlineachplastic
bottle
18. DextroseIVInjection,I.PDextroseeq.toDextroseanhydrous5%ofw/v,500mlin
eachplasticbottle
19. SodiumBicarbonate,IVInjectionSodiumBicarbonateIP7.5%w/v10mlineach
ampoule
20. SterileWaterforinjections,I.P05mlineachampoule
21. Inj.CalciumGluconate,1gm,I.V.lOmlampcontaining10%calciumgluconate
22. TabDrotavarine500mg
23. PovidoneIodineOintment,I.PcontainingPovidoneIodine,I.P5%w/w15gineach
tube
24. Inj.LignocaineHydrochlorideIP2%w/v30mlineachvialforlocalanesthesia
Consumables:
1. AbsorbentCottonIP1kg/roll
2. PovidoneIodineSolution
3. DisposableexaminationGloveslatexfreesize,6.0,6.5,7.0
4. SurgicalglovessterileBISsize7.5
5. HypodermicSyringeforsingleuseBP/BIS,5ml,10ml,20ml
6. HypodermicNeedleforsingleuseBP/BIS,Gauze23and22,
7. CottonBandage(asperscheduleFll)EachBandageof7.6cmXlm
8. AbsorbentGauze
9. SurgicalSpirit,B.P500mlineachbottle
10. InfusionEquipmentBIS,IVsetwithhypodermicneedle,21Gof1.5inchlength.
11. IntracathCannulasforsingleuse(IntravascularCatheters)BISauz18,Length
45mm,flowrate90mlperminuteGauze22,Length25mm,flowrate35mlper
minute

ChromicCatgutNo.1onroundbodyneedle
CordClamp
MucusSucker
MedicatedSoap
K90,PlainCatheter
Foleyscatheter,16NoBIS,selfretainingcatheter
SanitaryNapkins(2pktspercase)
C.Postnatalperiod
Drugs&Consumables
Tab.IronFolicAcidlargeDriedFerrousSulphateIPeq.toFerrousIron100mg&
FolicAcidIP0.5mgasentericcoatedtablets
TabDigoxinDigoxinIP250pg/tab
TabMethyldopaIPeq.ToMethyldopaanhydrous250mg
CapNifedipineNifedipineIP,5mgsoftgelatinecapsule
TabNifedipine,NifedipineIP,10mg
TabLabetalol100mg,
InjLabetalol,20mgin2mlampoule
Inj.OxytocinOxytocinIP5.0I.U./ml02mlineachampo
InjMagsulphMagnesiumSulphateIP50%w/v10mlvials,containingS.Ogmin
totalvolume
Hydroxyethylstarch6%IPHydroxyethylstarch130/04,6%salinesolutionfor
infusion
TabParacetamol,I.P500mg
TabIbubrufen400mg
Tab/Cap,Multivitamin
TabDomperidone10mg
AntiDImmunoglobulinInjPolyclonalHumanAntiRhDimmunoglobulin100mg,
300mg
D.ForCsection:
Drugs
1. Inj.MetronidazoleMetronidazoleIP5mg/ml:100mlineachbottle
2. Inj.GentamycinGentamycinSulphateIPeq.togentamycin40mg/ml02mlin
eachvial
3. Inj.CefotaximeCefotaximeSodiumIP1gmpervial
4. Inj.CloxacillinCloxacillinSodiumIPeq.toCloxacillin500mg/vial
5. Inj.OxytocinOxytocinIP5.0I.U./ml02mlineachampoule
6. Inj.Sensorcain,containingSensorcainI.P0.5mg
7. Inj.LignocaineHydrochlorideIP5%w/vlignocainehydrochloride50mg/mlwith
7.5%dextrosehyperbaric(heavy),02mlineachampouleHyperbaricforspinal
anaesthesia
8. Inj.LignocaineHydrochlorideIP2%w/v30mlineachvialforlocalanaesthesia
9. Inj.Promethazine,I.PPromethazineHydrochloride25mg/ml2mlineachampoule
10. InjDeclofenac,25mgin3ml
11. CompoundSodiumLactateIVInjectionIP(Ringerslactate)0.24%V/VofLactic
Acid(eq.to0.32%w/vofSodiumLactate),0.6%w/vSodiumChloride,0.04%w/v
PotassiumChlorideand0.027%w/vCalciumChloride500mlineachplasticbottle
12. SodiumChlorideIVInjectionSodiumChlorideIP0.9%w/v500mlineachplastic
bottle
13. DextroseIVInjectionDextroseeq.toDextroseanhydrous5%w/v500mineach
plasticbottle.
14. InjSodabicarbonateSodiumBicarbonateIP7.5%w/v10mlineachampoule
15. Inj.Menadione(VitaminK3)MenadioneUSPlOmg/ml01mlineachampoule)
16. Inj.PentazocineLactateI.P,PentazocineLactate,I.Peq.ToPentazocine30mgper
ml1mlineachamp.
12.
13.
14.
15.
16.
17.
18.

Consumables
1. AbsorbentCotton,IP1kg/roll
2. PovidineIodineSolution
3. StickingPlaster(SurgicalTape)2.5cmX9.10m
4. HypodermicSyringeforsingleuseBP/BIS,5ml,10ml,20ml
5. HypodermicNeedleforsingleuseBP/BIS,Gauze23and22
6. Foleyscatheter,16NoBIS,selfretainingcatheter
7. InfusionEquipmentBIS,IVsetwithhypodermicneedle,21Gof1.5inchlength
8. IntracathCannulasforsingleuse(IntravascularCatheters)BISGauze18,Length
45mm,flowrate90mlperminuteGauze22,Length25mm,flowrate35mlper
minuteGauze20,Length33mm,Gauze16,ChromicCatgutNo.lonroundbody
needle,No.20onroundbodyneedle
9. CordClamp
10. SuctionTube
11. SpinalNeedleDisposableAdultasperBIS,23Gauze(7090mmwithouthub)
12. MedicatedSoap
13. K90PlainCatheter
14. Foleyscatheter,16NoBIS,selfretainingcatheter
15. Urobag
16. Sponges
17. CottonBandage(asperscheduleFll)EachBandageof7.6cmXlm
18. AbsorbentGauze
19. SurgicalSpirit,B.P500mlineachbottle
20. MucusSucker
21. MersilkNo20,10oncuttingneedle
22. Polyglycolicacid,braided,coatedandabsorbable,No.1onJ4circleroundbody
needles

D.MiscellaneousDrugs(mayberequiredinsomecasesofCSection)
1. InjAdrenaline0.18%w/vofAdrenalineTartrateorAdrenalineTartrateIPeq.to
adrenaline1mg/ml01mlineachampoule
2. InjAtropine,I.PAtropineSulphateIP600uj*/ml01mlineachampoule
3. InjDopamineDopamineHydrochlorideUSP40mg/ml05mlineachvial
4. InjBupivacaine0.5%IPeq.toBupivacainehydrochlorideanhydrous5mg/ml20ml
ineachvial
5. InjBetamethasonesod.Phosphate,I.Pbetamethasone4mgper1mlin1ml
ampoule
6. HalothaneIP,Containing0.01%w/wthymolIP200mlineachBottles
7. InjThiopentone,Thiopentone500mgandsodiumcarbonate(anhydrous)
8. InjVecuroniumBromide,VecuroniumBromideUSP4mgperampoule
9. InjKetamine,KetamineHydrochlorideinj.eq.toKetaminehydrochloridebase10
mg/ml10mlineachvial
10. TabSalbutamolSalbutamolsulphateIPeq.toSalbutamol4mg
11. TabFrusemideFrusemideIP40mg
12. TabDiazepamDiazepamIP5mg
13. Inj.Diazepam,I.P10mgin2mlampoule
14. DexmethsoneInjectionIP,DexamethasoneSodiumPhosphateIPeq.to
DexamethasonePhosphate,4mg/ml.02mlineachampoule
15. EtofyllinBPlus,AnhydrousTheophyllineIPCombinationInjection,EtofyllineBP84.7
mg/ml&TheophyllineIPeq.ToTheophyllineanhydrous,25.3mg/ml02mlin
eachampule.

F.Essentialdruglistforsicknewborncare
1. Inj.AdrenalineIP:0.18%w/vAdrenalinetartrateorAdrenalineTartrateIPeq.to
adrenaline1mg/ml01mlineachampoule
2. Inj.Amikacin:AmikacinSulphateIPeqtoAmikacin100mgper2mlinvials.
3. Inj.AminophyllineIP:AminophyllineIP25mg/mlin10mlampoule
4. Inj.AmplicillinIP:AmpicillinSodiumIPeq.toampicillinanhydrous250mg/vial
5. InjcalciumGloconateIP:10%w/vcalciumgluconateIPin10mlampoule
6. Inj.Dopamine:Dopamine40mg/ml05mlineachampoule
7. Inj.DextroseIP(IVsolution):DextroseIPeq.toDextroseanhydrous10%w/v500ml
ineachpouch/bottle
8. Inj.GentamycinIP:Gentamycinsulphateeq.toGentamycin10mgperml02mlin
eachvial
9. Inj.PhenobarbitoneIP:PhenobarbitonesodiumIP100mg/ml:0.2mlineachampule
10. Inj.PhenytoinBP:PhenytoinSodiumIP50mgperml02mlineachampoule
11. Inj.Potassiumchloride:150mg/ml10mlineachampoule
12. Inj.Sodiumbicarbonate:SodiumBicarbonateIP7.5%w/vin10mlampoule
13. Inj.SodiumchlorideinIP:SodiumChlorideIP0.9%w/v500mlineachpouch/bottle
14. Inj.SterilewaterforIP:Eachampoulecontaining5ml

AnnexureII:Monitoringformats
IMPLEMENTATIONSTATUSOFJANANISHISHUSURAKSHAKARYAKARAM(JSSK):STATELEVEL
State/UT:...........................................No.ofdistricts:........No.ofBlocks:ReportingMonth/Year:
StateNodalOfficerinplace(Y/N):...StateGrievanceRedressalOfficerinplace(Y/N):
No.ofDistrictNodalOfficersinplace:.

No.ofDistrictGrievanceRedressalOfficersinplace:.

A. ENTITLEMENTS:CASHLESSSERVICES&USERCHARGES
Sno. ProvisionforCashlessdeliveriesforallpregnantwomen
andsicknewbornsatallpublichealthfacilities

1. ProvisionofFreeDrugs/Consumables
2. ProvisionofFreeDiagnostics
3. ProvisionofFreeDiet

WhetherG.O.
issued(Y/N)

Monthwhenstarted/
proposedtimeline

No.ofdist
implemen

4. ProvisionofFreeBlood(inclusiveoftestingfee)
5. ProvisionofFreetreatmenttoSicknewbornsupto30days
6. FreeReferralTransportforPW(to&fro,2nd
referral)
7. FreeReferralTransportforSicknewborns(to&fro,2nd
referral)
8. ExemptionfromalluserchargesforallPWandsicknewborns
9. EmpowermentofMOinchargetomakeemergencypurchases
NOTE:
Pls.provideacopyofrelevantGovt.Order(s)
(provideonetime,andwhenanyupdation/revisionisdone)
Sno.Referraltransportservices
Stateowned EMRI/EMTS
1. Totalnumberofambulances/referralvehiclesintheState/UT
2. WhethervehiclesfittedwithGPS(specifyno.)
B. ENTITLEMENTS:REFERRALTRANSPORT(RT)
3.
Callcentre(s)fortheambulancenetwork:Districts(no.s)State(Y/N):

4.
Tollfreenumber(providenumber,ifavailable):..
C.

PPP

Other

IMPLEMENTATION:CASHLESSSERVICES

Sta

Sno. ProvisionforCashlessdeliveriesforallpregnantwomenandsicknewbornsatallGovt.healthfacilities
atallhealthfacilities
1. No.ofdistrictswherefreeentitlementsaredisplayed
atallfacilities24x7PHCandabovelevel)

2. No.ofdistrictswherefreedietisavailabletoPW(
atallfacilities24x7PHCandabovelevel)

3. No.ofdistrictswherelabisfunctionalforbasictestsforPW(
3a.No.ofdistrictswhereanyfacilityhasstockoutsoflabreagents/equipmentnotworking
4. No.ofdistrictswhereanyfacilityhasstockoutsofessentialdrugs/suppliesforPWandsicknewborns
i.OPD
5. No.ofdistrictswhereanyfacilityhasuserchargesforPW/sicknewbornsfor:

ii.Admission/delivery/Csection
iii.Labtests/diagnostics
iv.Blood

6. Totalno.ofgovt.medicalcollegesintheState
7. Totalno.ofgovt.medicalcollegesnotlevyinganytypeofusercharges

D. SERVICEUTILISATION:REFERRALTRANSPORT(RT)
Sno. Referraltransportservices

Statevehicles

1. No.ofPWwhousedRTservicesfor:

i. Hometohealthinstitution

ii. Transfertohigherlevelfacilityforcomplications

iii.
Dropbackhome
2. No.ofsicknewbornswhousedRTservicesfor:

i. Hometohealthinstitution

ii. Transfertohigherlevelfacilityforcomplications

iii.
Dropbackhome
E. GRIEVANCEREDRESSAL
Sno. Grievanceredressal
1. No.ofcomplaints/grievancecasesrelatedtofreeentitlements
2. No.ofcasesaddressed/no.ofcasespending

EMRI/EMTS

PPP

Other

Statusdetail

IMPLEMENTATIONSTATUSOFJANANISHISHUSURAKSHAKARYAKARAM(JSSK):DISTRICTLEVEL
District/State:.......................................................Totalno.ofblocks:..........
Reporting
Month/
Year:..DistrictNodalOfficerinplace(Y/N):..
DistrictGrievanceRedressalOfficerinplace(Y/N):..
A. CASHLESSSERVICES
Sno. ProvisionforCashlessdeliveriesforallpregnantwomenandsicknewbornsatSubcentre PHC BlockPHC/
allGovt.healthfacilities
CHC
1. No.ofgovt.healthfacilitiesinthedistrict
1a.No.offacilitieswheredeliveriestakeplace(Deliverypoints)
2. No.offacilitieswherefreeentitlementsdisplayed
3. No.offacilitieswherefreedietisavailabletoPW
4. No.offacilitieswherelabisfunctionalforbasictestsforPW1
4a.No.offacilitieswithstockoutsoflabreagents/equipmentnotworking
5. No.offacilitieswithstockoutsofessentialdrugs/supplies
6. No.offacilitieswithuserchargesforPW/sicknewbornsfor:

i. OPD

ii. Admission/delivery/Csection

iii. Labtests/diagnostics

iv. Blood

B. REFERRALTRANSPORT(RT)
Sno. Referraltransportservices
Statevehicles EMRI/EMTS
PPP
1. Totalno.ofambulances/referralvehiclesinthedistrict
2. WhetherfittedwithGPS(specifyno.)
3. No.ofPWwhousedRTservicesfor:

i. Hometohealthinstitution

ii. Transfertohigherlevelfacilityforcomplications

SDH

DH

Other


iii. Dropbackhome
4. No.ofsicknewbornswhousedRTservicesfor:

i. Hometohealthinstitution

ii. Transfertohigherlevelfacilityforcomplications

iii. Dropbackhome
No.ofblockswherereferraltransportserviceisavailable:..
Whetherdistrictlevelcallcentreinplace(Y/N):.

5.
6.

C. GRIEVANCEREDRESSAL
Sno.
1.
2.
3.

Grievanceredressal
No.ofcomplaints/grievancecasesrelatedtofreeentitlements
No.ofcasesaddressed/no.ofcasespending
Averageno.ofdaystakenpercase

Statusdetail

CommissionerofHealth&FamilyWelfare

AnnexureIII

Activities
Antenatal

SubCentrelevelServicesunderJSSK

Entitlements
1. Registrationofallpregnantwomenby12wks&issue
ofMCHRcard.
2. 4ANCcheckups&updationofANCdetailsinMCHR
card.
3. Hb%,Urineexam,weight&B.Precordingforall4
checkups
4. TT/100IFATablets
5. Namebasedlinelistingofanaemic&severeanaemic
pregnantwomenabout7gms%12gms%&below
7gms%
6. Linelistingofhighriskpregnantwomen.
7. MicroBirthPlanning
8. EDDofpregnantwomen
9. IdentificationofreferralFRUincaseofhighrisk
10. FreeReferralTransportthrough108Ambulance

1.
2.

3.
4.
5.
6.
7.
8.

IntraNatal
Postnatal

1. Monitoring/recordingofoutcomeofdelivery

Requirements
IssuingofMCHRCards.
ANCexamtable,Mekentashsheet,T
Foetoscope.Hemoglobinometer(sah
Weighingmachine,BPapparatus&
stethoscope,Thermometer.Reagents
urineexam.
AdequatesupplyofInj.T.T&TabIFA
ReportingtoPHCfortreatmentofane
cases&forrecordingimprovement.
Arrangingmonthlycheckupduring7th

month&weeklycheckupat9th
month
DisplayofEDDatS/c&referralFRU
detailsofMCHteam
ReferraltransportHometoHealth
institution,interfacilitytransfer&drop
by108Ambulances.
Tosensitizeallpregnantwomentopr
MCHRcardatdeliverypoint.

PHClevelServicesunderJSSK

Activities
Antenatal

1.
2.

3.
4.
5.
6.

IntraNatal

1.
2.
3.
4.
5.
6.
7.

Postnatal

1.
2.
3.

Entitlements
Registrationofallpregnantwomenby12wks&issueof 1.
MCHRcard.
4ANCcheckupsat3,4,5months&onecheckupbyM.O 2.
at7th
monthandincaseofhighriskpregnancyonceis15
daysat8th
monthandweeklycheckupin9months&
updationofANCdetailsinMCHRcard.
Investigations:pregnancytesting&confirmation,Hb%,
Urineexam,Albesugarweight&B.Precording.
Drugs:Inj.TT/100IFATablets,Tablets200toanemia
pregnantwomen
Namebasedlinelistingofanaemic&severeanaemic
pregnantwomenandhighriskpregnantwomen.
MicroBirthPlanning:
DisplayofEDDofpregnantwomen
IdentificationofFRU&displayofnameoftheMCHteam
specialistwithTel.Nos
Arrangingreferraltransportthrough108ambulances
Disposabledeliverykits.
1.
Drugs&consumablesaspertheessentiallistunderJSSK.2.
Providingsafenormaldeliveryserviceson24x7hrsbasis. 3.
Provisionoffreedietfor3daysfornormaldeliveries.
EntryofdetailsofoutcomeofdeliveryinMCHRcard.
4.
Weightrecording&entryofdetailsofconditionofnewborn5.
baby.
6.
D.D.K.

Ensuring48hrsstayafterdelivery&JSYpaymentthrough 1.
cheque.
2.
CheckupbyM.Obeforedischarge.
3.
InitiationofBreastfeedingwithinonehour.
4.

Requirements

Provisionofsafedrinkingwater,h
water,Hemoglobinometer(sahilis
Reagentsforurineexam.Weighi
machine,BPapparatus,stethosc
Thermometer.Oxygencylinder.

48hrsstay.
Breastfeedingwithinonehour
EmergencydrugsforcontrollingP
andsepsis.
Nursingcareonpersonnelhygien
Zerodoseimmunization.
CheckupbyM.Obeforedischarg
deliveredpregnantwomen.

Newborncarecorner.
48hrsstayafterdelivery.
Breastfeedingwithinonehour.
Counselingonpersonnelhygiene

4. Counselingonexclusivebreastfeeding&Nutrition.
nutrition,zerodose
5. Checkupofnewbornbabyforanydangersymptoms&
5. Immunization
signsofsepsis,jaundice,ARIprovisionofinitialtreatment
tonewbornupto30daysafterbirth.
6. IncaseofreferralprovisionofreferraltransporttoFRU.
7. Referralofsevereanemicpregnantwomenforblood
transfusion/IronsucrosetherapyatFRU/DHfortreatment
&followupafterdischarge.

Note:
TheprovisionofoutsourcingDiagnosticinvestigations,referraltransport,bloodtransfusionfrom
privatesectorhavetobeutilizedfor3monthsi.e.,uptoSeptember2012.Theconcerned
MedicalOfficerofPHCshavetodevelopcapacityforconductingDiagnosticinvestigationsas
wellassupplyofDrugs&consumablesandfunctioningNBCCandotherequipments&
instrumentsrequiredforconductingnormaldeliveries.

Activities
Antenatal

1.
2.

3.

4.

5.
6.

7.

IntraNatal

8.
1.
2.
3.
4.
5.
6.

CHC/AH(FRUs)levelServicesunderJSSK

Entitlements
Registrationofallpregnantwomenby12wks&issueof
1.
MCHRcard.
4ANCcheckupsat3,4,5months&onecheckupbyM.Oat 2.
7th
monthandincaseofhighriskpregnancyonceis15days
at8th
monthandweeklycheckupin9months&updationof
ANCdetailsinMCHRcard.
Investigations:pregnancytesting&confirmation,Hb%,Urine 3.
exam,Albesugarweight&B.Precording,Ultrasound,Blood
group&RHsubgroupdetection,Malariasmearwith24x7hrs
functionalLab.
Drugs:Inj.TT/100IFATablets,Tablets200toanemia
pregnantwomen,IronSucrosetherapyforsevereanemic
pregnantwomen/bloodtransfusionforsevereanemic
pregnantwomenwhereneeded.
ANCothergeneraldrugsundertobesuppliedfromregular
budgetprovision.
Linelistingofhighriskpregnantwomen,counselingfor
deliveryservices(normal&Csection)alongwith
identificationofhealthfacilityandtimelyreferraltransportin
caseifFRUcannothandlethecomplications.
FreeBloodfreebloodtobeprovidedduringAntenatal,
Intranatal&Postnatalperioddependingtherequirementfrom
inhouseBB/BSC.
FreeReferraltransport:interfacilitytransfer&dropback.
Disposable/otherdeliverykits.
1.
Providingsafenormaldelivery/Csectionservices.
ProvisionoffreeDrugs&consumablesfornormaldelivery/ 2.
Csection.
FreeDiet3daysfornormaldeliveriesand7daysfor
csection.
3.
ExaminationofdeliveredwomandailybyconcernedOBG 4.
specialist.
ExaminationofnewbornchilddailybyPediatrician&
provisionoffreeinvestigation&treatmenttosicknewborn 5.
upto30daysafterbirth.

Requirements
Provisionofsafedrinkingwate
water,
Hemoglobinometersahilis,We
machine,BPapparatus,steth
Thermometer,functioningUltr
machine,equipment
ReagentsforBloodgroupdete
reagentsforurineexam.

Practiceinfectioncontrolmea
Biomedicalwastemanageme
Checkupofmother&neonate
concernedOBG/Pediatricspe
duringstayandbeforedischa
NBSUfornewborncare.
Oxygensupply,requiredemer
drugs&consumablesfortreat
complications.
Adherencetotechnicalprotoc
standardtreatmentprotocolsm
ensuredatalldeliverypoints.

Postnatal

1.
2.
3.
4.

Ensure48hrsstay.
ProvisionoftreatmentforPPH,Sepsis.
Initiationofbreastfeedingwithinonehour.
Counselingonpersonnelhygiene&Breastfeeding&
Nutrition.

1. Examinationofallnormaldeliv
andcsectioncasesbyconce
specialistsbeforedischarge.
2. Counselingonreviewcheckup
csectioncasesandpersonne
exclusivebreastfeeding.

Note:
TheprovisionofoutsourcingDiagnosticinvestigations,referraltransport,bloodtransfusionfrom
privatesectorhavetobeutilizedfor3monthsi.e.,uptoSeptember2012.Theconcerned
SuperintendentsofCHCs/AHshavetodevelopcapacityforconductingDiagnostic
investigations(24x7hrslabfacility)aswellassupplyofDrugs&consumablesandfunctioning
NBSUandotherequipments&instrumentsrequiredforconductingnormaldeliveries&
Csections.

DistrictHospitalslevelServicesunderJSSK


Activities
Antenatal

IntraNatal

Entitlements
1. Registrationofallpregnantwomenby12wks&issue 1.
ofMCHRcard.
2. 4ANCcheckupsat3,4,5months&onecheckupby
M.Oat7th
monthandincaseofhighriskpregnancy
onceis15daysat8th
monthandweeklycheckupin9
months&updationofANCdetailsinMCHRcard.
3. Investigations:Labtofunctionfor24x7hrsHb%,Urine
exam,Albesugarweightfor4times,Bloodgroup&
RHsubgroupdetection,USG1to2times,HbsAGin
suspect,HIVscreening&tensiononce,Malariasmear,
weight&B.Precordingotherinvestigationsrequiredfor
Csectionhavetobedone
4. linelistingofsevereanemicatthefacility&highrisk
pregnantwomen&managementofsuchcaseswith
BirthPreparedness.
5. Drugs&Consumables:alldrugs&consumables
notifiedunderessentialdrugslist.
6. FreeDiet.
7. FreeBloodforallsevereanemicpregnantwomen.
8. Freereferraltransportinterfacilitytransfer&drop
back.

1. D.D.K.
1.
2. ProvisionofnormaldeliveriesandCesareansection
services.
2.
3. Properpreoperativescreeningbeforecsectionalong
withrequiredinvestigations.
4. Provisionofdietfor3/7days.
5. DailyrecordingofvitaleventslikeB.P,Pulse,R.Rin
caseofCsection.
3.
6. Freebloodforcsections.
4.

Postnatal

Requirements
Allequipments&reagentstobe
availableforconductingfree
investigations

Practiceinfectioncontrolmeasu
Biomedicalwastemanagement
Allequipmentsi.e.,instruments
Boylesapparatus,O2cylinders
madeavailableforconducting
csections.FunctioningUltrasou
machine&BB
Adherencetotechnicalprotocol
standardtreatmentprotocolsmu
ensuredatalldeliverypoints.
NoprescriptionforpurchaseofD
beneficiaries.
Freeprovisionofblood.

5.

1. Ensuring48hrsstay.
1. Freetransportfordropbackthro
2. Dailyexaminationofdeliveredmotherupto48hrsfor
108Ambulances/otherGovt.
normaldeliveries&upto7daysforcsections.
ambulance/hireambulancesw
3. ProvisionoftreatmentforPPH,Sepsisetc.
fundsincaseofhiredvehicles.
4. Provisionoftreatmenttosicknewborn.
2. NoprescriptionforpurchaseofD
5. CheckupbyOBG/Pediatricianbeforedischargeof
beneficiaries.
mother&newborn.
3. Freeprovisionofblood.
6. FreebloodforPPH.

7. Referraltransport:interfacilitytransporttoTertiary
carehospital.Dropbackathomethrough108
Ambulance/otherGovt./donatedambulances/Hire
ambulances.

Note:
TheprovisionofoutsourcingDiagnosticinvestigations,referraltransport,bloodtransfusionfrom
privatesectorhavetobeutilizedfor3monthsi.e.,uptoSeptember2012.Theconcerned
SuperintendentsofDistrictHospitalshavetodevelopcapacityforconductingDiagnostic
investigations(24x7hrslabfacility)aswellassupplyofDrugs&consumablesandfunctioning
NBSUandotherequipments&instrumentsrequiredforconductingnormaldeliveries&
Csections.

Teaching&MaternityHospitalsServicesunderJSSK

Activities
Entitlements
Requirements

Antenatal

1.
2.

3.
4.
5.
6.
7.

1.
2.
3.

IntraNatal

4.
5.
6.

7.

Postnatal

1.
2.
3.
4.

4ANCcheckupsforalldirectlycomingpregnant
1.
women&forhighriskreferredcases.
Investigations:Labtofunctionfor24x7hrsHb%,Urine
exam,Albesugarweightfor4times,Bloodgroup& 2.
RHsubgroupdetection,USG1to2times,HbsAGin
suspect,HIVscreening&tensiononce,Malariasmear,
weight&B.Precordingotherinvestigationsrequiredfor
Csection
3.
Drugs&Consumables:Inj.T.T,TabIFA(100),any
othergeneraldrugsrequiredforsickpregnantwomen 4.
notifiedintheessentialdruglistduringANCperiod.
IronSucroseTherapyforsevereanemicpregnant
womenlessthan7gms%.

FreeDiet.
FreeBloodforallsevereanemicpregnantwomen.
Freereferraltransportinterfacilitytransfer&drop
back.

Allequipments&reagentstobe
availableforconductingfree
investigations
Allequipmentsi.e.,instruments
Boylesapparatus,O2cylinders
madeavailableforconducting
csections.
NoprescriptionforpurchaseofD
beneficiaries.
Ironsucrosetherapy/Freeprov
bloodforsevereanemicpregna
women.

D.D.K.
1.
Safenormaldeliveryservices,Csectionservices.
Freedrugs&consumablesasperessentialdruglistof 2.
JSSK.
Freedietfor3/7days.
FreeBloodtransfusionforcsection&PPH.
Freetreatmenttosicknewbornupto30daysafter
birth.Dailyexaminationofallnormaldeliveredwomen 3.
forPPH/Sepsis&otherdiseases&examination&
treatmentofcsectionmothers.
Recordingofpartographforeverydeliveryand
4.
Apgarscorefornewborn.

Practiceinfectioncontrolmeasu
Biomedicalwastemanagement
Separatelaborroomforseptic&
deliveries.Separateemergency
treatmentroomwithbedsfortre
eclamsia,hypertension,severe
diabetics,bleedingcases.
Adherencetotechnicalprotocol
standardtreatmentprotocolsmu
ensuredatalldeliverypoints.
Freetransportfordropbackthro
108Ambulances/otherGovt.
ambulance/hireambulancesw
fundsincaseofhiredvehicles.

Ensuring48hrsstay.
Initiationofbreastfeedingwithinonehour
Counselingonpersonnelhygiene&nutrition.
AdvinereviewcheckupforcsectionMothers.

1.

2.

Qualitynursingcarewithadequ
nursingstaffon24x7hrsservice
Freetransportfordropbackthro
108Ambulances/otherGovt.
ambulance/hireambulancesw
/JSSKfundsincaseofhiredve

Note:
TheprovisionofoutsourcingDiagnosticinvestigations,referraltransport,bloodtransfusionfrom
privatesectorhavetobeutilizedfor3monthsi.e.,uptoSeptember2012.Theconcerned
SuperintendentsofTeachingHospitalshastodevelopcapacityforconductingDiagnostic
investigations(24x7hrslabfacility)aswellassupplyofDrugs&consumablesandfunctioning
NBSUandotherequipments&instrumentsrequiredforconductingnormaldeliveries&
Csections.

forCommissionerofHealth&FamilyWelfare