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National Rural Health Mission

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Article Index
National Rural Health Mission
Objectives & Strategy
Activities
Activities: Schemes
Child Survival Services
Implementation of PNDT Act
Non–health issues needing behavioral change
Achievements & Role Of NGO
Facility Survey
All Pages
Historical Background/Periodical Development
National Rural Health Mission
Under the mandate of National Common Minimum Programme (NCMP) of United Progress Alliance government, health care is one of the seven trust areas of NCMP, wherein, it is proposed to increase the expenditure in health sector from current 0.9% Gross Domestic Product (GDP) to 2–3% of GDP over the next five years, with main focus on Primary Health Care. The National Rural Health Mission (NRHM) has been conceptualized and the same is being operationalized from April,2005 throughout the country, with special focus on 18 state which includes 8 Empowered Action Group Stastes.

The main aim of NRHM is to provide accessible, affordable, accountable, effective and reliable primary health care, especially, to the poor and vulnerable sections of the population. It also aims at bridging the gap in Rural Health Care through creation of a cadre of Accredited Social Health Activists (ASHA), improved hospital care measured through Indian Public Health Standards (IPHS), decentralization of programme to district level to improve intra and inter–sectoral convergence and effective utilization of resources. The NRHM further aims to provide overarching umbrella to the existing programmes of Health and Family Welfare including Reproductive & Child Health–II (RCH), Malaria, Blindness, Iodine deficiency, Filaria, Kala Azar, T.B., Leprosy and Integrated Disease Surveillance. Further, it addresses the issue of Health in the context of sector–wise approach addressing sanitation and hygiene, nutrition and safe drinking water as basic determinants of good health in order to have greater convergence among the related social sector Departments i.e. Ayush, Women & Child Development, Sanitation, Elementary Education, Panchayati Raj and Rural Development.

The Mission further seeks to build grater ownership of the programme among the community through involvement of Panchayati Raj institutions, Non Govermental Organisations (NGOs )and other stake holders at National, State, District and Sub – District levels to achieve the goals of National Population Policy 2000 and National Health Policy.

RCH – II
India was the first country to launch Family Planning Programme during 1952. The programme was initiated in Maharashtra State during 1956. Initially the programme envisaged hospital based interventions and Local Information Education & Communication (IEC) activities for promotion of Contraceptive Methods. The programme achieved a boost during the third five–year plan, wherein infrastructural inputs were provided. Supportive programmes like All India Post Partum programme (1971), Control of Diarrhoeal Diseases, Community Health Guide (CHG )scheme, Multipurpose Worker (MPW) scheme etc. were introduced during after years.

The programme passed through various phases of expansion or modification. Universal Immunisation Programme (UIP) (1985–86) introduced a programme with systematic delivery of services even at remote places. Child Survival & Safe Motherhood (CSSM) (1992–93) encompassed crucial Maternal and Child Health interventions along with immunization services. International Conference on Population and Development (ICPD) (1994) led towards consideration of holistic and integrated services based on life cycle approach with special emphasis on Reproductive Health.

The concept of RCH is to provide to the beneficiaries need based, client centred, demand driven, high quality & integrated RCH Services. The RCH Programme is a composite Programme incorporating the inputs of Govt. of India as well as funding support from external donor agencies including World Bank & the European Commission. From April 2005, the RCH II Programme implementation started in the State.

Reproductive and Child Health Programme initiated during 1997 intended to provide need based demand driven, integrated and quality services, based on decentralized and participatory planning with the whole hearted involvement of the community. The RCH I did not covered the important aspects of life cycle like adolescent health, 40 plus care, Sexually Transmitted Infections/ Reproductive Tract Infections (STI/RTI). Additional inputs were provided for capacity building, infrastructure development, strengthening supervision and monitoring, strengthening of out reach services and neonatal care as well as involvement of NGOs and Panchayat Raj Institutions (PRI) along with implementation of certain innovative schemes.

The indicator wise status and Goals are as given below
Indicator–wise status and Goals

Goal Indicators Maharashtra
Current status Goal
2010
MMR 149(MMR in India 1997 –2003 by RG) 100
IMR 35(SRS – 2006) 27
NMR 24(SRS – 2004) 27
TFR 2.1(NFHS III) =<2.0
  • Indian Institute of Health and Family Welfare, Hyderabad. There is a large difference between the SRS and IIHFW figure for MMR. This may lead to change in Goals.
  • IIHFW – Indian Institute of Health and Family Welfare, MMR–Maternal Mortality Rate.
    IMR – Infant Mortality Rate.
    NMR – Neonatal Mortality Rate.
    TFR – Total Fertility Rate.
    SRS – Sample Registration System.
The Components of RCH Programme
  • Safe Motherhood Services.
  • Child Survival Services.
  • Adolescent Health.
  • Family Planning.
  • 40 + Services.
  • Implementation of Preconception & Prenatal Diagnostic Techniques (PNDT) Act.
  • Maharashtra State.
Demographic and Administrative Profile
Maharashtra is situated in the western part of India between 15 0 45’ to 22 00 North latitude and 720 45’ to 800 45’ east longitude. The state is rich in its social and cultural heritage. In the 2001 Census, population wise Maharashtra was the second largest state in India after Uttar Pradesh having 9.42% population of the nation, i.e. 9.6752 crores. With an area of 3.08 lakh Sq. Km, the state also ranks second in area after Uttar Pradesh. The state has the highest percentage of urban population i.e. 43.3%, but has very meager public health infrastructure.

According to 1991 census, spread over 15 districts, 9% of the state population is tribal. The districts of Gadchiroli and Nandurbar have highest tribal population at 39% and 41% respectively. The population below poverty line decreased to 25% in 1999–2000 from 36.9% in 1993–94 and 53.2% in 1973–74. Maharashtra is considered as one of the most economically developed states in India. The per capita income of the state increased from Rs.7,612 in 1990–91 to Rs.24,248 in 2001–02 third highest in the country after Punjab & Haryana.

As far as the two key indicators of social development – Literacy and Infant Mortality – are concerned, Maharashtra occupies the second position among the major states, next to Kerala. During the period 1961–2001, the literacy rate for males increased from 49% to 86% and amongst female the rate increased more than three times from 20% to 68% during the same period. In 1999 the IMR for Maharashtra was 48, whereas for Kerala it was 14 (as per National Family Health Survey 2(NFHS).

Demographic indicators of Maharashtra as per census 2001

Particular Maharashtra India
Area (Sq.Km.) 314 3287
Proportion of State Area to Total Area 9.5 100
Population (Million) 96.87 1028
Percentage of state Population to total Population 9.42 100
Population Density per Sq.Km. 314 324
Urban Population 42.43 27.82
Sex Ratio 922 933
Sex Ratio 0–6 Years 913 927
Literacy Percentage 77.27 64.8
Female Literacy Percentage 67.51 54.16

Sex ratio is considered a sensitive indicator of development. Data indicates a decline in sex ratio from 934 in 1991 to 922 in 2001 census. This is a very alarming situation especially since the sex ratio of the country increased from 927 in 1991census to 933 in 2001. The sex ratio of 0 to 6 years age groups has declined from 946 in 1991 census to 913 in 2001 census, indicating a gender bias and poor status of women.

Administrative Units
The 35 districts –33 rural and 2 fully urban districts (of Mumbai) are divided into 6 revenue divisions.

There are 41095 villages and 27247 gram panchayats spread over 353 blocks.

There are 22 municipal corporations and 222 municipal councils along with 7 Cantonment boards, which have no organized health infrastructure as per need.

Manpower position
Manpower available at district level

Category Number
Maharashtra Medical Health Services (MMHS) Class I 1177
MMHS Class II 5075
General Staff Services (GSS) Class I 57
GSS Class II 384
Health Assistant (M) 4642
Health Assistant (F) 3586
Health Assistant (M) 12646
Health Assistant (F) 11915
Village Health Guide 44050
Trained Traditional Birth Attendant 45681

Health Infrastructure and facilities
The state has well developed health infrastructure in public sector
  • No. of Medical College hospitals – 8.
  • No. of District hospitals – 23.
  • No. of Rural Hospitals(CHC)/Cottage Hospital– 365.
  • No. of Primary Health centers – 1816.
  • No. of Sub centers – 10579.
  • No. of Primary Health Units – 172.
  • No. of Mobile Health Units – 61.
  • Urban Health Posts – 285.
  • Urban Family Welfare Centers – 81.

Objectives of National Rural Health Mission
Reduction in early neonatal mortality within first 48 hrs. of the delivery.

Reduction in post neonatal mortality due to diarrhea and ARI.

Reduction in neonatal deaths by timely transfer of sick neonates to referral hospitals.

Strategy of National Rural Health Mission
The overall strategy is aimed at minimizing the shortcomings of and constraints faced in RCH Phase I and to adopt innovative processes/activities along with institutional strengthening to improve service delivery in infant, child and maternal health.

  • Enhancing, Quality of services and access of services by poorer, i.e. SC/ST and BPL population with in respect to following indicators.
    • Fully protected mother (3 ANC checkups, Full Dose of Iron and Folic Acid(IFA) consumed, Tetanus Toxoid (TT) 2/B, Promoting Institutional Deliveries, Delivery by Skilled Birth Attendent (SBA) and adequate PNC care).
    • Fully immunized children (BCG, 3 DPT, 3OPV, and Measles).
    • No. of issues at sterilization.
    • Issue wise couple protection rate (especially for couples with 1 and 2 issues).
  • Streamlining management systems at various levels esp. procurement and inventory, material supply (drugs and vaccines) and human resource development.
  • Broad-basing existing monitoring and evaluation system to report status of process and impact indicators – in addition to (quantitative) outputs of the various activities and inputs; various process and impact indicators.
  • e - reporting.
  • Systematic provision of training inputs to improve technical & managerial competence and performance of service providers at various levels within the health system.
  • Facilitating convergence (by taking initiative) within various health programmes, with other government departments & Dept. partners with overlapping goals and objectives.
  • Contracting services and outsourcing services where provision for permanent functionaries is not available – this will maintain tempo of work and guarantee outreach to underserved areas like Urban Slums, tribal areas & hilly areas.
  • Linking (wherever possible) with private medical practitioners for specialized services.
  • Collaborating with NGOs and other external agencies to extend outreach in remote tribal areas and to address non-health issues with a bearing on health impact.
  • Replicating successful approaches, systems and activities from earlier and existing, externally funded projects.
  • Women and community empowerment initiatives for demand generation and for establishing interface of women’s groups with health institutions especially for quality assurance initiatives.
  • Partnership with suitable personnel, agencies, NGO for BCC and demand generation- There is urgent need for creating awareness and change in behavior of the community towards danger sings related to EmOC and EmPC, need for routine immunization and MCH services, popularizing use of ORS / Home available fluids, need for early and exclusive breast feeding, Limiting family size and issues related to non health interventions. State as well as districts will give priority for this activity through in-house efforts and involvement of suitable personnel, agencies, NGO's and CBO's partnership.
  • Adolescent Reproductive Health Initiatives for in school and out of school adolescents, for enhancing their knowledge and skills on ARSH issues and for developing life skills in them for healthy practices. ARH initiatives addressing environment building for adolescents to seek information and to develop their life skills, Information on ARH issues through life skills approach, and providing needs based services including counseling services to adolescents.

Activities of National Rural Health Mission Interventions listed
Institutional strengthening
The institutional strengthening component is sub–divided in following parts
  • Physical infrastructure strengthening.
  • Human Resource (HR) & Capacity Building.
  • Developing management systems.
Physical infrastructure strengthening
  • Repairs/ Renovations to existing health institutions.
  • Construction of delivery room at sub center level.
  • Construction of warehouses for logistics management at Regional Level.
  • Provision of Blood Storage facilities at First Referral Units (FRU).
  • Developing a center of excellence.
  • Establishment of new born care corner at Community Health Center (CHC)/Primary Health Center (PHC).
  • Establishment of neo natal intensive care unit.
  • Improvement of Pediatric ward at District Hospitals.
  • Strengthening of State Reproductive and Child Health (RCH) Society.
  • Strengthening of District Reproductive and Child Health (RCH) society.
HR and Capacity Building
Staff benefits/incentives for working in remote/tribal areas

State has identified difficult and tribal areas for providing suitable benefits/ incentives to the staff working in these areas. State already has given consideration for Medical Officers and staff working in tribal and difficult areas. Medical Officers are given preference for In–service Post Graduation, enhanced Non Practicing Allowance (NPA) and choice of posting.

Rewarding the work of health teams and institutions
Ensuring availability of human resources at institutional level
Utilization of existing staff
  • Redeployment of DP project staff.
  • Block Health Officer Scheme.
Addition of new staff
Appointment of Auxillary Nurse Midwifes (ANM) on contract basis
In some districts ,few sub centers have population more than 10,000,which affects reach of services. At such places additional ANMs are proposed in rural areas.

Cantonments
These areas will be provided with Contractual ANMs.

Supplementation through private specialists
  • Contractual Services of Private Gynecologist and Anesthetist.
  • Operationalization of First Referral Units (FRU) has been a critical action area.
Considering the need for reduction in Infant Mortality Rate (IMR), state desires to utilize the services of private pediatrician at FRUs where their services are not available.

Strengthening of Public Private Partnership
Reproductive and Child Health (RCH), being a crucial part of public health programmes, Government Of Maharashtra envisages to reach the services to both rural and urban areas. However, the public health services are deficient in most of the urban areas and remote and tribal parts of the state. Hence, Government Of Maharashtra has decided to take concrete steps to overcome these deficiencies through public private partnerships.


Schemes will be
  • ‘Vande Mataram’ scheme of Government Of India (GOI).
  • Subsidized Medical Practitioner (SMP) specialist scheme.
Accreditation scheme
Private hospitals who wish to join on voluntary basis by developing a criteria and standard of performance
  • Scheme of social franchising: Involving the interested private practitioners to popularize contraceptives like oral pills, emergency contraceptives and life saving Oral Rehydration Salt (ORS) packets etc.
  • Government facilities will be shared with the private doctors on cost basis (e.g. X ray machines, laboratory investigations). The private practitioners will be oriented on government protocols of services through Continues Medical Education(CME).
  • Supplementation through private specialists: Contractual Services of Private Gynecologist and Anesthetist.
  • Outsourcing activities like Cleaning, Laundry, Ambulance Services, & Catering Services.
Promotion of entrepreneurship oriented schemes for sustainability
Subsidized Medical Practitioner Scheme in select districts: Availability of Medical and Health services through Govt. or private doctors is a critical issue in difficult and remote areas, To address this problem a scheme for newly passed out Indian System of Medicine (ISM) practitioners has been envisaged under European Commission (EC) –Sector Invensetment Programme (SIP).

Nurse practitioner scheme: The percentage of Home deliveries in some districts is between 20 to 30%. As it has been noticed that training of TBA will not be sufficient to reduce Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR). There is a need of Skilled Birth Attendants, i.e. Nurses in areas where population of Sub centers is more than the norm prescribed and the distance from Sub center head quarter, which makes ANM difficult to reach these villages for attending deliveries.

Appointment of Laboratory Technician on contractual basis: It is proposed to ask the lab. Technician to work on par as mentioned in the scheme of subsidized medical practitioner. It means initial support, for setting up the laboratory, is proposed under the project and honorarium to laboratory technician will be given on tapering basis. Another alternative is the Medical Officer will give the service voucher and the contract will be made with laboratory technician to extend the service against the service voucher, which will be reimbursed in later course by the Medical Officer.

Training and Capacity Building
Infrastructure Strengthening
  • Strengthening of Training institutions.
  • Clinical Training package.
  • Institutional linkages.
  • Exposure visits & study tours.
  • Continuing Medical Education Bulletin.
Innovative strategies under training were initiated under externally aided projects
Continuing Medical Education (CME): Bulletin for Professionals.
Organization of seminars/hands on training with the help of private sector.
Discussions are going on with Federation of Obstetric and Gynaecological Societies of India (FOGSI) to develop the training course for basic Emergency Obstetric Care and Comprehensive Emergency Obstetric Care, which will be at par with the competency–based training organized at Vellore.

Comprehensive Training Policy.
Training organization and management.

Improving Management Systems
Financial Management System
The Programme Management Unit (PMU) proposes to establish a separate section for Finance and Accounts by pooling resources of other DP projects and developing a common Finance Section at state Level. The staff of Finance and audit section will be trained to fulfill the needs. Similar trainings and arrangement will be done at districts level. The state PMU will prepare and furnish financial reports on a quarterly basis.
Similarly District Level PMU having Manegerial & Accounts Staff as Contractual basis.

Procurement and Distribution System for drug and equipment
  • Provision for drugs kits supplies.
  • Provision of Equipment kits.
  • Provision Of Vaccines, Cold Chain Equipments And Contraceptives.
  • Improving Logistics Manegement at Divisional & District Level.
Safe Motherhood Services
Maharashtra is one of the four States implementing Integrated Financial Envelope by including need based special interventions/ innovative schemes under the Reproductive and Child Health (RCH) program.

The various initiatives started to strengthen MCH components are
  • Dai (Traditional Birth Attendant (TBA)) Training.
  • Promotion of institutional delivery: (24 Hour delivery scheme) – Janani Suraksha Yojana.
  • Referral Transport Scheme: Dept. of Referral plan at village level.
  • Reproductive and Child Health (RCH) Camps: At selected 5 – 6 Primary Health Center (PHC)s per district twice a year.
  • Contractual services of Gynecologist and Anesthetist.
New Initiatives
State proposes to implement following new initiatives during Reproductive and Child Health (RCH) II
Nutrition demonstration
Considering the importance of nutritional status of women and children in reducing morbidity and mortality, the activity of nutritional demonstration will be taken up on priority during Reproductive and Child Health (RCH) II. It is planned to implement this activity with the help ofIntegrated Child Development Services(ICDS) functionaries and like Self Help Groups (SHG), who will be taking up this activity on a regular basis considering the local customs and availability of food articles. Especially the concept of providing formula F–75 and F–100 to the grade III and grade IV children.

Comprehensive EmOC Training (CEmOC)
Medical officers will be trained to get confidence for performing the skills like, tubectomy, Medical Termination of Pregnancy (MTP), General and Emergency Obstrective Care (EmOC)/Emergency EmPC at selected institutions. Postgraduates in DGO/ MO Gyn./MS (G.S) will be trained in Laproscopic Sterilisation & Lower Section Cesarian Section(LSCS).

‘Dada–Dadi’ (Ajoba–Aaji) scheme
Under this scheme, state proposes to identify and recognize the senior citizens as ‘Dada’ or ‘Dadi’, who will be joining voluntarily in the scheme to create awareness and demand generation. They will be given orientation especially about need of ANC, Neonatal care and child care as well as mother and child nutrition. Publicity will be given to this scheme. These ‘Dada’ and ‘Dadis’ will be recognized by govt. They will be working voluntarily in their own area at the time, which is convenient for them.

40 Plus Services
Care of 40 Plus population is an important component under Reproductive and Child Health (RCH).Hypertension, Diabetes, Cancer (preventive oncology), Cataract, Rerpoductive Tract Infection/Sexually Transmitted Infenction (RTI/STI) are the problems commonly observed in this population. Fornightly clinics at District Hospital & identified Rural Hospitals will be initiated in a phased manner.

EmOC/EmPC protocols
UNICEF has developed Protocols for management of EmOC, and EmPC. These will be adopted and monitored for the state.

Provision of Tab. Vitamin C Tab Calcium to Pregnant Women
To improve Hemoglobin level and reducing incidence of hyper– tensive disorders (Pre – eclampcia and Eclampcia) during pregnancy. Various reseaReproductive and Child Health (RCH) initiatives have indicated utility of supplementing Vitamin C and Calcium.


Child Survival Services
The state IMR and NMR are 45 and 29 (SRS 2002) respectively, which are better than national average. However, it is observed that, these rates have not improved since last 5 to 6 years.

The activities for reduction of IMR, NMR revolve around
  • Increasing awareness up to grassroots level for home based care.
  • Increasing reach and availability of items for home based care such as ORS and Septran etc.
  • Improving nutritional status of pregnant women and children including promotion of early and exclusive breast feeding, weaning, nutrition demonstrations.
  • Developing village level referral plans and provisions for referral transport for EmPC.
    Establishing Neonatal Intensive Care Unit (NICU), at District Hospitals & selected tribal First Referral Unit (FRU) New born care units and new born care corners at appropriate levels, improving the environment of pediatric wards at district hospitals etc.
Capacity building and trainings are other important action areas covering
  • Trainings IMNCI with priority to tribal area.
  • MCHN training & New Born Care.
  • TBA training.
  • Promotion on Early and exclusive breast feeding.
  • Orienting community members and CBOs on identification of danger signs for EmPC in diarrhea, Acute Respiratory Tract Infection (ARI), etc.
  • Provision of training equipments and models (to be procured under EC component).
Various incentive schemes exist in tribal areas state which promote maternal care, new born care and care of child illness including diet for parent and compensation for loss of wages for parent/guardian are promoted by the state government apart from the national maternity benefit scheme for Below Poverty Line (BPL) families.

Reproductive and Child Health (RCH) II proposes to allocate special resources for the tribal areas like Innovative schemes of Subsidized Medical Practitioners, and Nurse practitioners to give thrust on IMR related activities.In addition to these, major thrust will be given on promoting joint working of ICDS and Health functionaries through better convergence and close monitoring at all levels.

Technical Aspects
  • Promotion of early and exclusive breast–feeding.
  • Health checkup of malnourished children by Medical Officer (MO), Primary Health Center (PHC) at Aanganwadi .Though the ICDS functionaries.
  • New Born Care (NBC) & Maternal and Child Health Nurse (MCHN) training.
  • Integrated Management of Neonatal and Child Illnesses (IMNCI).
High Neo natal, Infant and under % mortality is the most important challenge in child health in tribal and urban areas of the state.Most neo natal deaths occur at home because of home delivery conducted by untrained persons who do not practice aseptic procedures during deliveries. There are difficulties in transporting of sick neonates to hospitals.

Specific interventions
  • Observing ‘Five cleans’ while conducting home delivery.
  • Protecting the new born from hypothermia, infection and starting early and exclusive breast–feeding.
  • Insuring all home deliveries are visited within 48 hrs. by Anganwadi Worker (AWW).
  • Prevention and management of neo natal sepsis by giving treatment.
  • Identification of warning signals and prompt referral of neonate to referral hospital.
  • Home based correct case management of diarrhea and Acute respiratory infection with involvement or TBA’s and Aanganwadi workers.
Monitoring of growth records
UNICEF & ICDS along with health department has developed innovative growth and health checkup cards for mothers and under five children. (–9 to 5 years).

Healthy Baby Competition
To create awareness about good nutritional practices and maintaining child in good health, state proposes to take this initiative in selected districts by organizing Healthy Baby Competition on periodic basis after good publicity along with prizes to children.

Social franchising
Providing easy access to contraceptives, ORS Packets etc
Adolescent Health Services
Adolescent issues will be incorporated in all the Reproductive and Child Health (RCH) training programmes and all Reproductive and Child Health (RCH) materials developed for communication and behaviour change. This will entail that interventions for addressing unmet need for contraception and pregnancy care, prevention of STIs including HIV/AIDS Adolescent Health initiative.

The activity will be in two areas. One being through School based activity for student group and will be implemented through the Education department, similar to program run for HIV/AIDS awareness by State AIDS society.

Second approach is through the ICDS/SHG/NGOs for non–school adolescents. UNFPA and UNICEF are piloting in this direction to evolve an agreeable srategy.

Orientation of health staff: It is essential to equip the health staff with knowledge and skills so as to enable them to cater to reproductive and sexual health needs of adolescents are critical.

Adolescent Health Clinics: The controlling/preventing reproductive tract infections in adolescent girls at District Hospital & select Rural Hospitals in phased manner.

Role of SHGs
The State is proposing to undertake an initiative to involve SHGs for local production of low cost sanitary pads which will serve as an economic support to SHG groups.

Family Planning – Reducing Total Fertility Rate
Population stabilization is the mandate of State Family Welfare Bureau. Maharashtra has major regional variation due to socio–cultural groups. Actions are planned to identify need–based districts to focus area specific issues. The broad classification of districts brings forth the division of districts in tribal districts – where age at first pregnancy, ignorance about family planning, traditional beliefs and neonatal mortality are main causes of larger family size.

Further, in Marathwada and Vidarbha region, the problem is more of having a preference to male child. The decreasing sex ratio of 0–6 years age group indicates a need of stringent actions and implementation of PNDT act.

The state is implementing F.W. activities with top priority since last 2–3 decades. Annual eligible couple survey as a process to identify community needs assessment is carried out to know the current status of target couples for spacing and terminal methods of contraception.

State regularly monitors the performance of sterilization on 2 issues and promotion of No Scalpel Vasectomies (NSV) has been given priority in last 5–6 years.

State also implements a incentive scheme from state resopurses for promoting sterilization of BPL couples with only 1–2 females issues and no male issue, under the auspices of ‘Savitribai Phule Kanya Kalyan Yojana’. Such couples are given cash certificates in the name of female issues, which mature at their age of 18 years. State is receiving good response to this scheme.

State will implement following activities in Reproductive and Child Health (RCH) Phase II for reducing TFR

1. Yearly expected level of achievements (ELA) to be decided on local situation and CNA approach.
2. Identification and promotion of village level depot holders to provide contraceptives like oral pills and Nirodh at local level.
3. Social franchising with private doctors and other outlets.
4. Social marketing through agencies like Population Services Health Organization (PSHO).
5 Promotion of NSV through Behavioural Change Communication (BCC) & training of medical officers to reduce stress on female sterilization.
6 Organization of Newly Married Couple Meet at grass root level two times a year
7 BCC activities to reduce male preference through Non health intervention.
8 Felicitation of couples accepting sterilization on 1–2 female issues fr4om Above BPL group.
9 Promotion of spacing method especially emergency contraceptive through FOGSI.
10 Revitalization of & establishment of MTP centers to take care of unwanted pregnancies mainly due to failure of contraceptive use with routine monitoring.
11 IEC and implementation of activities related PNDT helping to reduce male preference.
12 Involvement of private practitioners not only in sterilization programmes but also in spacing especially IUD programme. Under this one would like to improve training if private practitioner desire and also necessary logistic support.
13 Plan to have 2–3 Laproscopy surgeons with necessary no. of laproscopes in each district as it is observed that beneficiaries prefer to undergo laproscopic surgery as minimum stay is required.
14 State is negotiating with insurance companies for reimbursement claim in case of complication occurring during or post sterilization not only for the beneficiary undergoing sterilization but also for the child of sterilized couple below 3–5 years.


Implementation of PNDT Act
The sex ratio in Maharashtra is 933 (2001 census) and in 0–6 years age group it is 917. This will have grave social implications for next generation, mainly for women’s status and their security.

Considering the tendency for male preference in Indian culture, it has become essential to initiate activities to reduce this tendency. This had lead to more no. of female foeticide cases affecting sex ratio, with special reference to sex ratio in –0–6 years age group.

The PNDT act provides important initiative for reduction of female foeticide and male preference. State has issued notification for implementation of PNDT act. All the centers providing facility of prenatal and pre–concept ional sex diagnosis have been registered under revised PNDT act.

IEC activities through media for community and medical profession are being conducted in the state. Special sensitization of doctors running/operating such facilities are conducted. State, and district level structures for monitoring PNDT activities have been set. Strict vigil over functioning of such facilities through quarterly and surprise monitoring visits are conducted in the state. Punitive action including sealing the machines and court cases has been taken in the state.

MTP Services
MTPs are mainly considered as a means of termination of unwanted pregnancy due to failure of contraception. Currently a large Number of maternal deaths occur due to aseptic abortions and other complications. An illegal abortion carried out at illegal institutes by illegal persons is the main cause. The state has following No. of registered MTP centers both in public and private sector.

Public MTP facilities: 473
Private MTP facilities: 2324
Total: 2797

Safe Abortion Services
Despite a liberal abortion law that encompasses a broader range of indications, illegal abortions far outnumber legal procedures in India. About nine percent of all reported maternal deaths could be attributed to unsafe abortions, which translates to about 12000 – 15000 deaths annually.

The causes of unsafe abortion are numerous and include unavailability of health centers providing these services in rural areas, dearth of trained providers and women who largely remain unaware of availability of service outlets and their rights to legal abortion.

Manual Vacuum Aspiration (MVA) technique
India’s National Population Policy 2000 delineates strategies to decentralize abortion services adopting new and easy technologies like Manual Vacuum Aspiration (MVA) and drug induced abortion simplifying "provider certification requirements" increasing the number of training centers and education communities.

Considering the success of the pilot and keeping in line with the policy of making all Reproductive and Child Health (RCH) services available to the people of the state, it is planned to introduce Safe Abortion Services in all health centers in the state.

Manual Vacuum Aspiration and Drug–induced abortion techniques will be introduced in a phased manner in all the health centers in the state. It is planned to initiate these services in all RH and Primary Health Center (PHC)s where 24 hr. EmOC services are to be provided.

Services to the Tribal Population and Underserved Areas
Pada worker scheme:(State funded activity)
In tribal areas the distance between villages and health institutions is more and the terrain is difficult, which leads to difficulty in reaching for medical care. Even the information of epidemics reaches the health institution very late leading to delayed actions. Hence State has initiated a Pada worker scheme (Link worker) in all the 15 tribal districts of the state from tribal funds. The pada worker is a local resident and interested in social work.

She/He is given sensitization in first aid, water disinfections and is expected to inform the nearest Primary Health Center (PHC) of any epidemic of water borne diseases or fever cases. She/He is paid an honorarium of Rs. 300/– per month. These pada worker will be involved in Reproductive and Child Health (RCH) activities, mainly in providing guidance for referral for EmOC, EmPC and helping in MCP sessions and nutrition demonstration. Currently a total of 10091 pada workers are engaged for 6 months during June to December every year.

The State is planning to appoint pada workers throughout the year considering morbidity and mortality of under five children in these areas. This being a state funded activity no budget is requested.

Matrutava Anudan Yojana for Tribal areas:(State funded activity)
Maharashtra state is implementing ‘Matrutava Anudan Yojana’ in tribal districts of Maharashtra under the auspices of "Nav Sanjivani"yojana, and is similar to National Maternity Benefit Scheme (JSY) of GOI. Every pregnant mother is provided with Rs. 400/– for improving nutrition and other needs. In addition Rs. 400/– are kept with nearest Primary Health Center (PHC)/Community Health Center (CHC) for necessary medical treatment i.e. cost of drugs.

Tribal Area activities through E.C. supported Sector investment prog.

The state of Maharashtra has a considerable tribal population spread across several district. The tribal people live in remoteareas in hamlets. All these tribals have their own taboos and customs. Usually during the illness of women & children, they approach the Bhagats. They immensely trust in Bhagats for all religious purposes including severely ill children and women.

Interventions for tribal areas
  • Dai training.
  • Dai training in the field.
  • Provision of Dai kits to trained Dais.
  • Female Pada Worker scheme.
In order to tackle the problem of maternal and child health, a female Pada worker will be selected and they will be suitably trained.

Training of healt staff on human approach regarding tribal issues
The training will be given to M.O.s and Paramedical staff working in Primary Health Center (PHC)s about the tribal culture and taboos at block level.

Training to Traditional Healers Traditional Medical Prcatitioners(TMPs/Bhagats)
Traditional healers/Bhagats Traditional Medical Practitioner(TMP) are very influential people in tribal population.In order to curb this tradition, it is necessary to involve the traditional healers in Reproductive and Child Health (RCH) Programme.

Referral incentives to TMPs
Compentency based training for Specialist MOs of FRUs in these areas
Basic Emergency Obstretic Care Training by FOGSI initiative to Doctor
M.O.s working at tribal Primary Health Center (PHC)s are supposed to conduct normal deliveries as well as refer high risk and obstructed labour cases to FRUs or District Hospitals. They are suppose d to handle cases as preacampcia and also PPH cases.Under the circumstances they need to be trained in handling such EmOC cases at Primary Health Center (PHC) level.
  • Integrated Management of Neonatal and Child lllnesses(IMNCI) Training.
  • Sensitization of Panchayat Raj Institutions personnel for supporting referral advocacy and demand generation.
  • Management of paediatric asthma cases.
  • Reimbursement of Travel Cost in ITDP Area.
  • Maintenace & repaiors of vehicles (RH & PHCs).
  • Pol for vehicles.
  • Provision for repairs of opertion theatres and labour rooms at Primary Health Center (PHC)s.
  • Provision of Motorcycles./Mopeds to Health Staff to increase mobility in Ttibal districts.
  • IEC Activities.
Behavioral Change Communication (BCC)
It is a well–known fact that investment in health care improves well–being of the person directly affecting his capacity to work, production and thus helps in improving economic status of the person and community.

Health issues needing behavioral change
  • Breast feeding.
  • Complimentary feeding.
  • Male preference leading to sex determination and female foeticide.
  • Male sterilization.
  • Early detection and treatment of RTI/STI.
  • Responsible sexual behavior related to HIV/AIDS Immunization.

Non–health issues needing behavioral change
There are a number of non–health issues, which cannot be totally dealt by the health staff. However, they have direct bearing on MMR, IMR and TFR. Some of the important non–health issues are listed below:
  • Age at marriage, age at first pregnancy.
  • Decision for limiting family size by spacing and terminal methods.
  • Male child preference, preference for female sterilization.
  • Male participation in identification/decision of high–risk issues related.
  • IMR and MMR and for timely referral.
  • Nutritional issues.
  • Availing/demanding essential health services linked to status of women.
  • Involvement of Panchayat Raj Institutes (PRI)/community in monitoring public health services.
  • Gender issues.
  • Gender violence.
  • Women empowerment.
Providing humane and sensitive treatment to the beneficiaries is an essential requirement of all health institutions. For this purpose, bringing about attitudinal and behavioral change in the health staff is very critical. A number of initiatives such as social labs, trainings, exposure visits, appreciative inquiry etc will be undertaken to improve the responsiveness of the system.

List of Hospitals selected for IPHS

District Hospitals 2005–06 Hospitals 2006–07
Raigad Uran  
  Roha  
    Mangaon
    Mahad
Ratnagiri Dapoli  
  Kamthe  
    Rajapur
Thane Shahapur  
  Kasa  
    Dahanoo
Jalgaon Chopada  
  Mehunbare  
    Muk’nagar
    Parola
Nashik Kalwan  
  Niphad  
    Chandwad
Dhule Shirpur  
  Sakri  
Nandurbar Nawapur  
  Taloda  
    Akkalkuwa
Ahmadnagar Pathardi  
  Sangamner  
  Karjat  
    Newasa
Pune Baramati  
  Ghodegaon  
  Indapur  
    Saswad
    Narayangaon
    Daund
Satara Phaltan  
  Wai  
    Karad
Solapur Akluj  
  Pandharpur  
    Kurduwadi
Kolhapur Dattawad  
  Gargoti  
    Nesari
    Gadhinglaj
Sangli Jath  
  Atpadi  
    Islampur
Sindhudurg Devgad  
  Kudar  
    Kankawali
Aurangabad Pachod  
  Sillod  
    Vaijapur
Jalna Ambad  
  Bhokardan  
    WH Jalna
Parbhani Gangakhed  
  Seloo  
Hingoli Basmat  
  Kalmanoori  
Beed Neknur  
  Majalgaon  
  Kej  
    P’Vaijanath
Nanded Mahur  
  Naigaon  
    Hadgaon
    Degloor
Latur Nilanga  
  Udgir  
    WH Latur
Osmanabad Urmarga  
  Paranda  
    Ashti
Akola Murtizapur  
  Akot  
    WH Akola
    Morshi
Amravati Achalpur  
  Dharni  
Buldhana Khamgaon  
  Shegaon  
    Deulgaon
    Malkapur
Yeotmal Pusad  
  Ralegaon  
    Darwha
Washim Mangrul Pir  
  Karanja  
Bhandara Tumsar  
  Pavani  
    Sakoli
Chandrapur Rajura  
  Brahmapuri  
    Varora
Gadchiroli Aheri  
  Armori  
    Kurukheda
Nagpur Ramtek  
  Kamthi  
    Katol
Wardha Pulgaon  
  Arvi  
    Hinganghat
Gondia Tiroda  
  Devarai  
    BGW Gondia

24x7 PHCs Operationalisation – Status & Plan for 2006–07 – Maharashtra State

Sr. No.District Functional PHCs
1 2 3 4
1 Raigad        
2 Ratnagiri        
3 Thane        
4 Dhule Lamkani Betawad Dahiwel Jaitane
5 Nandurbar        
6 Jalgaon Bhalod Anturli Erandol Nagardewala
7 Nashik Shinde Vavi Andarsul Taharabad
8 A’nagar        
9 Pune Dimbhe Nidgursar Peth Kude
10 Solapur        
11 Satara Malharpeth Vathar Umbraj Chinchner (B)
12 Kolhapur Kowad Kadagaon(B) Walawa Borapadale
13 Sangli Kharsundi Sankh Deshing Manerajuri
14 Sindhudurg        
15 Aurangabad Lasurstation Chincholi Limbaji Shibur Bidkin
16 Jalna Rajur      
17 Parbhani Sonpeth Gangakhed Jintur  
18 Hingoli        
19 Latur        
20 Osmanabad Salgara Jagaja    
21 Beed        
22 Nanded Limbgaon Mudkhed Malakoli Pethwadaj
23 Akola        
24 Washim        
25 Buldhana Jalgaon Jamod      
26 Amravati Walgaon Pathrot Kholapur Kurha
27 Yavatmal Naza      
28 Bhandara        
29 Gondia        
30 Chandrapur        
31 Gadchiroli        
32 Nagpur        
33 Wardha Anji Devali Dahegaon Nachgani

To be operationalised during 2006–07

Sr. No. District 1 2 3
1 Raigad Revdanda Nagothane Ambewadi
2 Ratnagiri Kumbale Dabhol Asud
3 Thane Vangaon Jamsar Talwa
4 Dhule Borkund Vikhran Dusane
5 Nandurbar Shanimandol Natawad Umran
6 Jalgaon Janve Adawad Chahardi
7 Nashik Jaikheda Khedgaon Dalvat
8 A’nagar walki Brmhanwada Shendi
9 Pune Khed Kadus Wada
10 Solapur Kamati Marwade Kola
11 Satara Kanher Mayani Sakharwadi
12 Kolhapur Tudiye Halakarni Mahagaon
13 Sangli Dighanchi Shegaon Dalgaon
14 Sindhudurg Umbarde Phonda Mangaon
15 Aurangabad Adool Verul Aurala
16 Jalna K. Pimpalgaon Jamkhed Sheoli
17 Parbhani Pathari Purna Manvat
18 Hingoli A. Balapur Narsi Jawala BZ
19 Latur Gangapur Javalga Pumadevi Bhada
20 Osmanabad Anala Shelgaon Pargaon
21 Beed Tadasonna Madakmohi Talwada
22 Nanded      
23 Akola Apatapa Mahan Wadegaon
24 Washim Shirpur Dhanaj (Bu)  
25 Buldhana Raipur Atrikodekar Kingaonraja
26 Amravati Sategaon Karanjgaon Amla Vishveshwar
27 Yavatmal Loni mahagaon Dhanki
28 Bhandara Shahapur Varathi Konda
29 Gondia Wadegaon Bangaon Satgaon
30 Chandrapur Gangalwadi Nehari Dhaba
31 Gadchiroli Amirza Vairagad Kurud
32 Nagpur Kondhali Veltur Kelwade
33 Wardha Talegaon D. Sindi Re. Rohana

Click here to view details

List of 162 FRUs

%3>CHC Devgad
Sr. No. District Sr. No. of FRU + SDH Name of rural hospitals (FRU/SDH 50/SDH 100/SDH 30 PI)
1 Raigad 1 CHC Roha
    2 CHC Pen (50)
    3 CHC Mahad
    4 CHC Mangaon(100)
    5 Karjat (50)
2 Ratnagiri 6 CHC Mandangad
    7 CHC Dapoli (50)
    8 CHC Guhagar
    9 CHC Rajapur
    10 Kamthe (50)
3 Thane 11 CHC Murbad (30)
    12 CHC shahapur (100)
    13 CHC Jawahar
    14 CHC Dahanu(100)
    15 CHC Mokhada
    16 Wada (30)
    17 MH Ulhasnager
    18 Kasa(50)
4 Dhule 19 CHC Sakri (30)
    20 CHC shirpur (100)
    21 CHC Dondaicha (50)
5 Nandurbar 22 CHC Shahada
    23 CHC Navapur (50)
    24 +Akkalkuwa(30)
    25 +Dhadgaon (30)
6 Jalgaon 26 CHC Edlabad (50)
    27 CHC Jamner (50)
    28 CHC Parola
    29 CHC Chopda (100)
    30 Amalner(30)
    31 Pachora(30)
7 Nashik 32 CHC Ghoti
    33 CHC Kalwan(100)
    34 CHC Dabhadi
    35 CHC Niphad (50)
    36 Zodgaon (30)
    37 Wani (30)
    38 Manmad (50)
    39 Chandwad(50)
8 A’nagar 40 CHC Kopargaon
    41 CHC Sangamner
    42 CHC Pathardi (50)
    43 CHC Newasa (30)
    44 Akole (30)
    45 Karjat (50)
    46 +Rahata (30)
9 Pune 47 CHC Bhor(50)
    48 CHC Saswad
    49 CHC Khed
    50 CHC Ghodegaon (30)
    51 CHC Wadgaon Maval
    52 CHC Narayangaon
    53 CHC Velha
    54 Indapur (50)
    55 Daund (50)
    56 + Rui (30)
10 Solapur 57 CHC Karmala (50)
    58 CHC Pandharpur(100)
    59 CHC Akluj
    60 CHC Kurduwadi
    61 Sangola (30)
11 Satara 62 CHC Karad (100)
    63 CHC Wai
    64 CHC Phaltan (50)
    65 CHC Waduj
    66 Patan (30)
    67 Khandala (30)
12 Kolhapur 68 CHC Gargoti
    69 CHC Nesari
    70 CHC Kodoli (50)
    71 CHC Dattawad (30)
    72 Gadhinglaj (100)
13 Sangli 73 CHC Atpadi (30)
    74 CHC Jat
    75 CHC Shirala
    76 CHC Islampur (50)
    77 Kavathe Mahankal (50)
14 Sindhudurg 78   87 CHC Mantha (30)
    88 CHC Partur
    89 CHC Tembhurni
    90 +WH Jalna(OH)
17 Parbhani 91 CHC Selu (50)
    92 CHC Gangakhed (50)
18 Hingoli 93 CHC Basmat (50)
    94 Kalamnuri (30)
19 Latur 95 CHC Murud
    79 CHC Kankawali (100)
    80 CHC Shiroda (50)
    81 CHC Sawantwadi (100)
15 Aurangabad 82 CHC Pachod (30)
    83 CHC Sillod (50)
    84 CHC Vaijapur (100)
    85 CHC Gangapur (50)
16 Jalna 86 CHC Ambad (50)
      96 CHC Ahmadpur (30)
    97 CHC Nilanga (50)
    98 CHC Udgir (100)
20 O’bad 99 CHC Kalamb
    100 CHC Washi
    101 CHC Umerga (100)
    102 CHC Paranda (50)
    103 Tuljapur (30)
21 Beed 104 CHC Ashti
    105 CHC Kej
    106 CHC Georai (50)
    107 CHC Parali Baijanath (100)
    108 Majalgaon (30)
22 Nanded 109 CHC Kandhar
    110 CHC Naigaon
    111 CHC Hadgaon (50)
    112 CHC Gokunda (50)
    113 Loha (30)
    114 Mukhed(100)
    115 Deglur (50)
23 Akola 116 Women Hosp.Akola (OH)
    117 CH Murtijapur (100)
    118 Akot (30)
24 Washim 119 CHC Mangrulpir
    120 Karanja (30)
25 Buldhana 121 CHC Chikhali
    122 CHC Deulgaon Mahi
    123 CHC Mehkar (30)
    124 W Hosp. Khmgaon (GH)
    125 Shegaon (100)
    126 Malkapur (50)
26 A’vati 127 CHC Achalpur (100)
    128 CHC Dharni (50)
    129 CHC Morshi (50)
    130 CHC Tiwsa
    131 Daryapur (50)
    132 +WH Amravati(OH)
27 Yavatmal 133 CHC Pandharkawada (50)
    134 CHC Dharva (50)
    135 CHC Umerkhed
    136 CHC Pusad (50)
    137 CHC Wani (30)
    138 W. Hosp.Yavatmal
    139 Ner (30)
    140 Digras (30)
28 Bhandara 141 CHC Tumsar (100)
    142 CHC Sakoli (50)
29 Gondia 143 CHC Devri
    144 BGW Gondia (PI)
    145 Tirora (50)
30 C’pur 146 CHC Varora (50)
    147 CHC Mul (50)
    148 CHC Rajura (30)
    149 CHC Bramhapuri (30)
31 Gadchiroli 150 CHC Armori (50)
    151 CHC Kurkheda (50)
    152 CHC Aheri (50)
    153 Charmoshi (30)
32 Nagpur 154 CHC Ramtek(50)
    155 CHC Katol (30)
    156 CHC Umred
    157 RTC Savner
    158 Kamptee (50)
33 Wardha 159 Med.Coll.Sevagram
    160 CHC Hinganghat(100)
    161 CHC Pulgaon (30)
    162 CHC Arvi (50)

District & Sub District Hospitals
Information of Rugna Kalyan Samittee as on 15/9/06

Name of Circle Name of District Name of Institute Rugna Kalyan Samittee Reg. No. A/C No.
Thane Raigad DH Alibag 358/06 600235 BOM
  SDH 100 SDH Mangaon 373/06 1100005312 SBI
  SDH 50 SDH Pen 363/06 01100005297 SBI
    SDH Karjat 370/06 120510110001694 BOI
  Thane DH Thane 637/06 01100005691 SBI
  SDH 100 Sahapur 655/06 12259 BOM
    Dahanu 663/06 01100005407 SBI
    Jawhar 691/06 01100005339 SBI
  SDH 50 Kasa 707/06 8428 BOM
  OH CH U – 3 644/06 01100005274 SBI
  WH MHUNR – 4 643/06 01100005275 SBI
  Ratnagiri DH Ratnagiri 3288/06 01100005672 SBI
  SDH 50 Dapoli 3290/06 01100005280 SBI
    Kamthe–Chiplun 3291/06 0100005498 SBI
Pune Pune Aundh Gen. Hosp 1585/06 30070836084 SBI
  SDH 50 Indapur 1914/06 01100051067 SBI
    Duand 1546/06 1190005191 SBI
    Bhor 1587/06 6084 SBI
  Satara DH Satara 11024/06 BOI 23794
  SDH 100 Karad 11055/06 010001000060283 SBI
  SDH 50 Phaltan 11058/06 1498 Canara Bank
  Solapur      
  SDH 100 Pandharpur 922/06 28282 BOB
  SDH 50 Karmala 913/06 01100061196 SBI
    Akluj 908/06 16750 SBI
Nashik Nashik DH Nashik 281/06 17660100009015 BOB
  SDH 100 Kalwan 284/06 01100005195 SBI
  SDH 50 Chandwad 304/06 01100065255 SBI
    Niphad 277/06 01100030200 SBI
    Manmad 299/06 0110000570 SBI
  Jalgaon DH Jalgaon 9203/06 24112 BOB
  SDH 100 Chopda 9222/06 01100005356 SBI
  SDH 50 Muktainagar 9210/06 01100005066 SBI
    Jamner 9211/06 01190030375 SBI
  A’nagar DH A’nagar 282/06 26033 IOB
  SDH 50 Karjat 287/06 01100060181 SBI
    Pathardi 299/06 01100005284 SBI
  SDH 200 Malegaon 324/06 7838UB
  Dhule      
  SDH 100 Shirpur 7945/06 1100005440 SBI
  SDH 50 Dondaicha 7946/06 1100005415 SBI
  Nandurbar DH Nandurbar 7951/06 01000006143 SBI
  SDH 50 Navapur 7995/06 01100005338 SBI
    Taloda 7954/06 100391 BOB
Kolhapur Kolhapur DH Kolhapur 22546/06 01000005734 SBI
  SDH 100 Gadhinglaj 22589 01000005128 BOI
  SDH 50 Kodoli 22593 100509462 SBI
    Gandhinagar Hosp. 22582 6243 SBI
    Services Hosp 22575 01100005733 SBI
  Siindhudurg DH Sindhudurg 2432/06 0100005436 SBI
  SDH 100 Sawantwadi 2433/06 1100005446
    Kankawli 2440/06 01100005355 SBI
  SDH 50 Shiroda 2439/06 01000005228 SBI
  Sangli      
  SDH 50 Islampur 422/06 19127 BOI
    Kawthe Mahakal 423/06 21649 BOI
Aurangabad A’bad      
  SDH 100 Vaijapur 549/06 62012351909 SBH
  SDH 50 Sillod 548/06 62012350097 SBH
    Gangapur 551/06 62012398325 SBH
  Jalna DH Jalna 372/06 12834 BOB
  SDH 50 Ambad 381/06 62012738704 SBH
  WH Jalna 371/06 12832 BOB
  Parbhani DH Parbhani 436/06 12302 BB
  SDH 50 Selu 470/06 62011634819 SBH
    Gangakhed 469/06 62011634819 SBH
  WH Parbhani 11312/06 12380 BOB
  Hingoli DH Hingoli 462/06 62011669014 SBH
  SDH 50 Basmat 459/06 62012058195 SBH
Latur Latur DH Latur 15444/06 1100005415 SBH
  SDH 100 Udgir 15437/06 62010972315SBH
  SDH 50 Nilanga 15460/06 62011096197SBH
  WH Latur 15445/06 1100005416 SBI
  Osmanabad DH Osmanabad 325/06 62012421129 SBH
  SDH 100 Omerga 331/06 62013263238 SBH
  SDH 50 Paranda 330/06 01000005330 SBH
  Beed DH Beed 50930/06 01190034688 SBI
  SDH 100 Parli 796/06 1100005556 SBI
  SDH 50 Georai 4891/06 62011037528 SBH
  WH Neknor 4809/06 62011271536 SBH
  Nanded      
  SDH 100 Mukhed 631/06 62012356781 SBH
  SDH 50 Deglur 639/06 01100050341 SBI
    Hadgaon 636/06 62012074693 SBI
    Gokunda 634/06 620112011021 SBH
Akola Akola DH Akola 728/06 011000005782 SBI
  SDH 100 Murtizapur 712/06 7555 CBI
  WH Akola 713/06 62011718870 SBI
  Amrawati DH Amrawati 529/06 25170 BOB
  SDH 100 Achalpur 582/06 249 CBI
  SDH 50 Dharani 559/06 2676 BOM
    Daryapur 546/06 01000050621 SBI
    Morshi 527/06 01090045297 SBI
  WH Amrawati 580/06 0100000732 Andhra Bank
  Buldhana DH Buldhana 452/06 01100050824 SBI
  SDH 100 Khamgaon 468/06 1100050314
    Shegaon 477/06 01150055452 SBI
  SDH 50 Malkapur 479/06 01100050240 SBI
  Yeotmal      
  SDH 50 Darwha 766/06 01100050483 SBI
    Pandharkawada 759/06 01100055556 SBI
    Pusad 758/06 01100055402 SBI
  Washim DH Washim 747/06 01050050518 SBI
Nagpur Nagpur      
  SDH 50 Ramtek 585/06 01000050351 SBI
    Kamthi 600/06 30067769113 SBI
  WH Daga Memorial Hosp 671/06 04801010328272 UTI
  Wardha DH Wardha 186/06 0100005036 SBI
  SDH 100 Hinganghat 193/06 110050381 SBI
  SDH 50 Arvi 195/06 1000005223 SBI
  Bhandara DH Bhandara 550/06 01100050747 SBI
  SDH 100 Tumsar 567/06 01100021203 SBI
  SDH 50 Sakoli 565/06 01100050208 SBI
  Gadchiroli DH Gadchiroli 95/06 01120050916 SBI
  SDH 50 Kurkheda 104/06 0110050666 SBI
    Aheri 107/06 1880 SBI
    Armori 103/06 3160 SBI
  Chandrapur DH Chandrapur 302/06 BOI 961210110000363
  SDH 50 Mul 315/06 20113011 BOM
    Warora 316/06 18805 BOI
  Gondia DH Gonidia 502/06 0182000100254249 PNB
  SDH 50 Tiroda 533/06 01100050512 SBI
  WH BGW Gondia 534/06 01100050921 SBI

List of 30 Bedded Rural Hospital Rugna Kalyan Samiti

SN Name of Rural Hospital (T) Date Registration No. Bank Accont No.
Thane        
1 Wada 19/7/06 658/06 01100005275
2 Mokhada 27/7/06 690/06 7135
3 Talasari 21/7/06 674/06 01100005247
4 Manor 20/7/06 668/06 11977
5 V.gad 21/7/06 672/06 6795
6 Virar 21/7/06 675/06 01100005250
7 Goveli 20/7/06 667/06 01000005349
8 Murbad 28/7/06 697106 01100005311
9 Palghar 20/7/06 669/06 01100005527
Raigad        
10 Kashele 31–7–2006 369/06 6872
11 Shriwardhan – C 31–7–2006 368/06 01000/005125
12 Roha 08/02/2006 374/06 0 1100005250
13 Uran 29–7–2006 365/06 0 1100005359
14 Chowk 31–7–2006 371/06 C.D.108
15 Panvel 26–7–2006 359/06 0 1100005442
16 Murud 27–7–2006 364/06 0 1000005110
Ratnagiri        
17 Mandangad 20/7/06 3101/06 16364
18 Kalambani 18/7/06 3397/06 1100005183
19 Guhagar 18/7/06 3295/06 16705
20 Sangmeshwar 14/7/06 3290/06 01100005338
21 Devrukh 14/7/06 3289/06 01100005343
22 Lanja 15/7/06 3294/06 17726
23 Rajapur 15/7/06 3293/06 01000050250
24 Raipatan 15/7/06 3292/06 0100050251
Nashik        
25 Deola 24/7/06 295/06 30064083887
26 Harsul 18/7/06 280/06 105491
27 Igatpuri 24/7/06 294/06 011900005208
28 Dangsoundane 19/7/06 285/06 2584
29 Peith 21/7/06 289/06 01100060281
30 Surgana 21/7/06 590/06 111661
31 Ghoti 18/6/06 274/06 "01000005205
32 Trimbak 20/7/06 270/06 01100060281
33 Vani 18/7/06 278/06 100129
34 Abhona 18/7/06 276/06 01100050014
35 Girnare 18/7/06 279/06 17660100009054
36 Nandgaon 08/04/2006 339/06 01100005270
37 Dindori 21/7/06 291/06 01100005334
38 Lasalgaon 25/7/06 300/06 01100032560
39 Nampur 18/7/06 269/06 104445
40 Umrane 2/8/06 327/06 01100005233
41 Yeola 24/7/06 297/06 01190050271
42 Dodi Bu. 18/7/06 275/6 01100032560
43 Dabhadi 28/7/06 320/06 201594
44 Malegaon 27/7/06 324/06 7838
45 Satana 18/7/06 282/06 01100005253
Dhule        
46 Sakri 25/7/06 7949/06 01100005245
47 Shindkheda 25/7/06 7947/06 01100050248
48 Songir 25/7/06 7948/06 01190005244
Nandurbar        
49 A.Kuwa 30/7/06 7980/06 01100050368
50 Mhasawad 25/7/06 7953/06 SD–23
51 Dhanora 25/7/06 7958/06 3132
52 Khandbara 25/7/06 7955/06 01100005339
53 Dhadgaon 25/7/06 7952/06 01170032350
54 Khondamali 25/7/06 7957/06 01000006144
55 Ranala 25/7/06 7965/06 01000006142
Jalgaon        
56 Pal 10/7/06 9205/06 01000005512
57 Pahur 10/7/06 9204/06 03871
58 Amalner 12/7/06 9219/06 01100005652
59 Amalgaon 12/7/06 9220/06 01100005651
60 Chalisgaon 11/7/06 9215/06 01000/005285
61 Mehunbare 11/7/06 9209/06 01000/0052947
62 Dharangaon 12/7/06 8223/06 01100060352
63 Bodwad 12/7/06 9208/06 8787/17
64 Pimpalgaon (H) 11/7/06 9214/06 01100005317
65 Pachora 10/7/06 9207/06 01100005316
66 Varangaon 11/7/06 9213/06 10576
67 Yawal 12/7/06 9224/06 01100005309
68 Nhavi 12/7/06 9225/06 01100005310
69 Bhadgaon 10/7/06 9206/06 100371
70 Raver 12/7/06 9118/06 1000005511
71 Parola Cottage 12/7/06 9221/06 01100060200
72 Erandol 11/7/06 9212/06 01100005122
Pune        
73 Khed–Rajgurunagar 09/08/2006 1541 01100005218
74 Junner 21/9/06 1728 01100005449
75 Chakan 12/9/06 1562 01100050193
76 Rui 12/9/06 1588 01000005448
77 Baramati 12/9/06 1591/06 01000005447
78 Supa 21/9/06 1707/06 2019605
79 Ghodegaon 8/9/06 1543 01100005250
80 Manchar 14/9/06 1617 01100005247
81 Shirur 8/9/06 1544 01100005157
82 Nvaware 8/9/06 1540 120
83 Shikrapur 8/9/06 1542 12245
84 Velha 8/9/06 1553 7540
85 Paud 30/9/06 1798 8855
86 Vadgaon 12/9/06 1584/06 2015522
87 Saswad 4/10/06 1814/06 01000005244
88 Jejuri 5/10/06 1821/06 01000005245
89 Narayangaon 12/9/06 1727 1006
90 Kalecolany 12/9/06 1586 5271
91 Yavat 8/9/06 1545 13636
Solapur        
92 Pangri 7/8/06 957/06 6079
93 Natepute 28/7/06 907/06 14193
94 Mangalwedha 31/7/06 917/06 10626
95 Kurduwadi 1/8/06 926/06 18304
96 Sangola 7/8/06 953/06 01100005107
97 Akkalkot 3/8/06 931/06 01100050209
98 Barshi 29/7/06 916/06 62011957308
99 Madha 29/7/06 914/06 01100065039
100 Mandrup 08/07/2006 955/06 9511
Kolhapur        
101 Panhala 25/7/06 22587/06 032011
102 Pargaon 25/7/06 22576/06 92510210000
103 Malkapur   egk 22616 dks– 020113681
104 Hatkanagle 25/7/06 22583/06 01000060124
105 Ajara 26/7/06 22596/06 14625
106 Kagal 20/7/06 22556/06 20115922
107 Neseri 25/7/06 egk 22590 9400
108 Chandgad 26/7/06 22594/06 0433401409732
109 Gargoti 26/7/06 egk 22595 dks 01000005148
110 Solankur 25/7/06 22591/06 78
111 Dattawad 27/6/06 egk 22608 dks 023010
112 Khupire 26/7/06 egk 22598 dks 043401409732
113 Gaganbawda 25/7/06 22586/06 6353
114 Radhanagari 25/7/06 22588/06 12537
115 Shirol 25/7/06 22584/06 01000050286
Aurangabad        
116 Pachod   554/06 8340
117 Pishor   550/06 9781
118 Soyegaon   553/06 6538
119 Khultabad   555/06 6201196411
120 Kannad   552/06 11319
Jalna        
121 Tembhurni 11/8/06 388/06 11029
122 Partur 11/8/06 389/06 6201281606
Parbhani        
123 Palam 19/7/06 450/06 6201150940
Latur        
124 Murud 6/7/06 15448/06 01190010294
125 Babhalgaon 6/7/06 15446/06 01100005417
126 Ausa 6/7/06 15449/06 01000005380
Beed        
127 Chinchwan 30/10/06 874/06 01100005014
128 Talkhed 19/8/06 734/06 01100050003
129 Kaij 5/9/06 754/06 62011186253
130 Raimoha 18/8/06 4922/06 62011364704
131 Dharur 15/9/06 794/06 01100050430
132 Ashti 21/9/06 799/06 62011386886
133 Patoda 6/10/06 825/06 62013555050
134 Neknur Cottage 17/07/06 egk 731/06 Beeds 62011271558
135 Majalgaon 4/10/06 820/06 01190034688
136 Dhanora 31/10/06 875/06 62011930512
137 Nandurghat 6/9/06 791/06 6211363336
Nanded        
138 Mandavi 1/8/06 629/06 01100065189
139 Mahur 1/8/06 635/06 01100050408
140 Loha 1/8/06 638/06 01100065343
141 Kandhar 1/8/06 628/06 62012025170
142 Biloli 5/8/06 647/06 62012344270
143 Naigaon 1/8/06 632/06 01100050121
144 Dharmabad 11/8/06 637/06 62011992842
145 Umari 1/8/06 630/06 01100065243
146 Bhokar 1/8/06 633/06 62012888842
147 Barad 1/8/06 626/06 30067319540
Akola        
148 Akot 18/9/06 727/06 1306
149 Telhara 18/9/06 725/06 01100065048
150 Chatari 18/9/06 3439/–96/12–8–2006 727/ 28013
151 Balapur 31/8/06 3439/–96/ 12–8–2006 718/ 01000/050111
152 Barshi–Takali 18/9/06 723/ 0110009076
Washim        
153 Karanja 3/10/06 755/06 01100050156
154 Kamargaon 7/10/06 774/06 01100050231
155 Risod 27/9/06 744/06 01100050276
156 Mangrul Pir 29/9/06 745/06 01100050144
157 Manora 9/10/06 781/06 01100050210
158 Malegaon 4/10/06 761/06 01100050336
Amravati        
159 Chikhaldara 3/7/06 537/06 6213
160 Churni 3/7/06 581/06 25202
161 Chandur Baz. 3/7/06 535/06 01100050389
162 Chandur Rly. 3/7/06 525/06 01100050048
163 Anjangaon S. 4/7/06 534/06 01100012061
164 Tiwasa 3/7/06 538/06 01190011205
165 Dhamangaon 13/7/06 528/06 472
166 Nandgaon (K) 4/5/06 545/06 133
167 Warud 3/7/06 526/06 3790
Yeotmal        
168 Maregaon 27/7/06 765/06 01100050359
169 Ralegaon 27/7/06 761/06 01100050425
170 Zarijamani 27/7/06 760/06 01100055560
171 Digras 27/7/06 762/06 13310
172 Ghatanji 9/8/06 802/06 01000/050832
173 Wani 27/7/06 764/06 1415
174 Babulgaon 19/8/06 833/06 01100050208
175 Ner 27/7/06 761/06 01100065310
176 Arni 28/7/06 773/06 8339
177 Sawana 31/7/06 788/06 6144
178 Kalamb 28/7/06 774/06 13343
179 Loni 27/7/06 763/06 01100060030
180 Umarkhed Cottage(32) 28/7/06 775/06 01100055402
Buldhana        
181 Mehekar 29/9/06 513/06 01100050300
182 De. Mahi 7/9/06 486/06 62012810568
183 Bibi 27/9/06 509/06 01190007312
184 Lakhanwada 1/9/06 476/06 01100050316
185 Warwatbakal 2/11/06 570/06 10478
186 Motala 14/9/06 491/06 01100050204
187 Dhad 12/9/06 489/06 01100050839
188 Lonar 20/9/06 502/06 0110006525
189 Deulgaonraja 09/07/2006 485/06 62012383475
Nagpur        
190 Deolapar 27/7/06 589/06 8460
191 Kuhi 27/7/06 588/06 20011472
192 Umred 27/7/06 586/06 2019307
193 Narkhed 27/7/06 584/06 01000050351
194 Parshioni 27/7/06 583/06 1100050260
195 Katol 27/7/06 587/06 0100050447
196 Hingna 27/7/06 582/06 4210
197 Kalmeshwar 27/7/06 580/06 871310110000551
198 Bhiwapur 27/7/06 581/06 17696
Wardha        
199 Pulgaon 08/04/2006 200/06 10000503330
200 Bhidi /8/06 398/06 100050553
201 Karanja 27/7/06 198/06 1100050174
202 Wadner 27/7/06 194/06 01100050382
203 Selu 28/7/06 196/06 3000
204 Samudrapur 27/7/06 192/06 1100050224
Bhandara        
205 Lakhandur 4/8/06 561/06 01190050284
206 Mohadi 5/8/06 566/06 01100050759
207 Adyal 22/8/06 590/06 01100050761
208 Lakhani 2/8/06 555/06 18871
209 Sihora 8/8/06 574/06 01100050760
Gondiya        
210 Arjuni(Morgaon) 25/7/06 529/06 11667
211 Navegaon bandh 26/7/06 535/06 6247
212 Deori 24/7/06 525/06 11490
213 Chichgad 29/7/06 546/06 11480
214 Salekasa 27/7/06 532/06 6910
215 Arjuni (Sadak) 25/7/06 530/06 3738
216 Amgaon 25/6/06 528/06 01100050446
217 Goregaon 25/6/06 531/06 182000100254531
Chandrapur        
218 Rajura 12/7/06 330/06 62011968116
219 Gadchandur 12/7/06 319/06 01100005107
220 Korpana 12/7/06 352/06 6763
221 Sindevahi 12/7/06 321/06 13272
222 Bramhapur 12/7/06 320/06 01100050633
223 Gondpipari 12/7/06 322/06 10219
224 Bhadravati 12/7/06 324/06 19991
225 Chimur 12/7/06 327/06 14055
226 Nagbhid 12/7/06 318/06 21273
227 Saoli 12/7/06 334/06 77604
228 Ballarpur 18/7/06 309/06 5074
Gadchiroli        
229 Dhanora 25/7/06 106/06 4911
230 Chamorshi   117/06 20111841
231 Etapalli 27/7/06 116/06 01100369
232 Sironcha 26/7/06 112/06 10586
233 Ashti 27/7/06 115/06 10030
234 Bhamragad 26/7/06 113/06 10050
235 Mulchera 27/7/06 119/06 5396
236 Korchi 26/7/06 110/06 5360

Achievements
Rugna Kalyan Samiti for PHC & SDH/RH/DH Village Health Nutrition and Water Supply Committee (population 1500+)
Infrastructure development wing - A.Establishment Wing
Appointment of Personnel & ASHA List of IPHS (RH)

Sr. No. District Rural Hospital
1 Aurangabad Pachhod
Sillod
2 Akola Vaijapur
Murtizapur
Akot
DWH-Akola
3 Amravati Achalpur
Dharni
Morshi
4 Ahmednagar Pathardi
Karjat
Newasa
San'ner
Kopargaon
Rahata
Akole
5 Beed Kaij
Parali
Majalgaon
Ashti
Neknoor
6 Bhandara Tumsar
Sakoli
Pauni
7 Buldhana Khamagaon
Sheagaon
Malkapur
Deogaon
 Mahi
8 Chandrapur Warora
Rajura
Bhrampuri
9 Dhule Sakri
Shirpur
10 Gadchiroli Aheri
Armori
Kurkheda
11 Gondiya Tirora
Devri
Gondiya
12 Hingoli Basmat
Kalmnuri
13 Jalana Ambad
Bhokardan
WH Jalna
14 Jalgaon Chopda
Mehunbare
Parola
Muk'nagar
15 Kolhapur Nesari
Gadinglaj
Gargoti
Dattawad
16 Latur Udgir
Nilanga
Women Hosp.
17 Nagpur Kamptee
Ramtek
Katol
18 Nanded Naigaon
Hadgaon
Deglur
Mahur
19 Nandurbar Akkalkuwa
Navapur
Taloda
20 Nashik kalwan
Naiphad
Chandvad
21 Osmanabad Omerga
Paranda
22 Parbahani Sailu
Gangakhed
23 Pune Daund
Narayangaoan
Ghodegaon
Saswad
Baramati
24 Raigad Roha
Uran
Mahad
Mangaon
25 Ratnagiri Dapoli
Kamathe
Rajapur
26 Sangli Jath
Atpadi
Islampur
27 Satara Wai
Karad
Phaltan
28 Sindhdurg Kankavali
Kudal
Deogad
29 Solapur Pandharpur
Akluj
Kurduwadi
30 Thane Dahanu
Shahpur
Kasa
31 Wardha Arvi
Pulgaon
Hinganghat
32 Washim Megrul pir
Karanja
33 Yevatmal Ralegaon
Pusad
Darwha
Role of NGOs Involvement of NGO
Govt. has identified the crucial role of NGO to reach the community. At present NGOs are involved under various programmes. As far as health department goes the role was limited to increase the awareness in the community.

Scheme proposed
MNGO Scheme
Involvement of NGOs is a crucial component under World Bank funded Reproductive and Child Health Programme. Initially 4 organizations were selected as Mother NGOs in Maharashtra State by Govt. of India viz. Sevadham Trust, Pune, SOSVA, Pune, Godavari Foundation, Jalgaon and Pravara Medical Trust, Loni, District Ahmednagar.Funds were directly released by Govt. of India to these 4 Mother NGOs and each FNGO used to receive about Rs. 1 to 1.5 lakhs for one year. State representative used to participate in the meetings called by MNGOs for approval of the projects submitted by FNGOs once in a year. State Family Welfare Bureau organized quarterly meetings for the 4 Mother NGOs to review the progress and performance. State Family Welfare Bureau also organize workshops for Mother NGOs and FNGOs to share their experiences and to share the IEC material prepared by the FNGOs.

In a process of decentralization, Govt. of India issued revised guidelines for the involvement of NGOs under RCH Programme. The overall responsibility for implementation and monitoring of the programme has been given to State RCH Society as well as District RCH Societies. The fund flow will also be channelized accordingly.

The 4 MNGOs already functioning in the State since 1998 have been continued as Mother NGOs and each has been allotted 2 districts as follows:

A) NGOs functioning as MNGOs
1) Sevadham Trust, Pune: Solapur, Kolhapur.
2) SOSVA, Pune: Pune, Raigad.
3) Godavari Foundation, Jalgaon: Jalgaon, Nashik.
4) Pravara Medical Trust, Loni: Ahmednagar, Aurangabad Dist. Ahmednagar.

Above four M.N.G.Os are in Preparatory Phase. Grants of Rs. 1.00 lakh are already released to MNGO to prepare district plan for RCH activities for under serve and relatively unnerved rea.

B) Newly selected 21 MNGO

Sr.No. Name of the NGO District Allotted
1 Shri Rajiv Yuvak Vikas Sanstha Wardha
2 Bhartiya Aushadhi Anusandhan Sanstha Bhandara
3 Centre for Study of Social Change Mumbai sub-urban
4 Matru Seva Sangh Nagpur
5 Halo Medical Foundation Osmanabad
6 Shramjivi Janata Sahayak Mandal Satara
7 Vivekanand Ashram Buldhana
8 Apeksha Homoeo Society Amaravati
9 Bhartiya Adim Jati Sevak Sangh, Nagpur Chandrapur
10 Mahila Utkarsh Pratishthan, Civil Lines, Risod, Dist. Washim 444 506 Washim
11 Shriram Ahirrao Memorial Trust, At.Post - Betawad, Tal. Sindhkheda Dhule
12 Shri Ganesh Gramin Vikas Sanstha, Gondia -441614 Gondia
13 Saiprem Gramin Vikas Sanstha, Yavatmal 445 001 Yavatmal
14 Manavlok (Marathwada Navanirman Lokayat), P.Box No. 23, Dhadpad Office, Ring Rd., Ambejogai, Dist. Beed 431 517. Beed
15 Karmavir Pratishthan, Ramnagar, Post Savargaon, Tal. Dist Jalna 431 203 Jalna
16 MGM Medical College and Hospital, N-6, CIDCO, Aurangabad, Mahatma Gandhi Mission, 12 Bhagyanagar Nanded 431 602. Nanded
17 Shri Ganesh Shikshan Prasarak Mandal, Khatgaon Rd. Dist - Latur 413 531. Latur
18 Ujwal Shikshan Prasarak Mandal "Ujwal" Vidya Nagar, Tal.Dist. Hingoli 431 513. Hingoli
19 Vanavasi Kalyan Kendra, 36 Piroja Mension, Grant Rd. (E), Mumbai -400 007. Mumbai
20 Matru Mandir -At & Tal.  Devrukh, District - Ratnagiri Ratnagiri
21 Yerala Projects Society, Yerala Bhavan, Near Guest House, Sangli 416 415. Sangli

Field Appraisal for selection of MNGO in Akola and Sindhudurg districts has completed. The report of the field appraisal for these districts will be kept for perusal of State MNGO Committee. Selection of MNGO for Mumbai, Parbhani, Nandurbar and Gadchiroli was initiated by giving advertisement in the local leading newspaper in the concerned districts. 80 Proposals have been received from NGOs for selection as MNGO. The scrutiny of these proposals is under process.

Service NGO Scheme
Government of India has indicated availability of funds under service NGO scheme, wherein suitable private establishments having indoor facilities will be selected in urban and hilly tribal areas where public infrastructure is deficient.
Click here to view details of MNGOs/FNGOs: Maharashtra
Evaluation report
Section 1: Facility Survey of CHCs
Compliance to Indian Public Health Standards (IPHS) developed under National Rural Health Mission (NRHM)

1. Preamble
Facility Survey of CHCs – Compliance to Indian Public Health Standards (IPHS) developed under the National Rural Health Mission (NRHM).

Under the National Rural Health Mission (NRHM) every state is required to upgrade their health facilities (PHCs and CHCs) to the prescribed Indian Public Health Standards (IPHS). The IPHS have been developed by the Ministry of Health and circulated to all states.

As part of the State’s commitment, Public Health Department (PHD), Government of Maharashtra, invited proposals for conducting the assessment of existing Rural Hospitals – RHs (CHCs) in Maharashtra against the prescribed IPHS. PHD identified 105 RHs (CHCs) which were assessed against the prescribed IPHS. Based on the findings of the assessment, these 105 RHs (CHCs) will be upgraded to the IPHS in the year 2007–08.

The following were the Terms of Reference (ToR) for the assessment assignment

The consultant organization would undertake the following
  • Finalize the checklist (IPHS) and get it vetted by appropriate authority.
  • Field visits to the 105 facilities by appropriate assessment teams*.
  • Assess and record observations as per the checklist except the civil component.
  • Submission of draft report with
    1. Identified gaps.
    2. Recommendations.
  • Submission of final report after discussion with appropriate authority.
2. Survey Design & Methodology
Following is the technical outline for assessment of the 105 community health centres (CHCs) against the Indian Pubic Health Standards (IPHS).

Objectives
  1. Collect data for planning purposes*
  2. Assess the financial implications for upgradation.
* Gaps identified during the survey will be helpful in planning for the upgradation of the existing CHCs to the IPHS.

The micro–detailing (human resources, equipments, services etc) of the identified gaps will also bring forth the financial implications involved in the upgradation of each CHC to IPHS.

Sample
Survey 105 CHCs across the State. These were the facilities identified by the Public Health Department across the State.

3. Scope of work
The following was the scope of work (SOW) for this survey
  • Finalize the checklist and get it vetted by appropriate authority.
  • Schedule visits to the 105 facilities.
  • Assess and record observations as per the checklist.
  • Submission of draft report with
    1. Identified gaps.
    2. Cost implications for upgradation of the facility/ facilities to IPHS, except the civil component.
    3. Any policy decisions required (GR – related to HR, contracting etc.)
  • Submission of final report after discussion with appropriate authority.
4. Target group

Personnel Purpose
Medical Superintendent Facility assessment – checklist
Director Policy
Addl. Director Policy
Jt. Director Medical Cost

5. Survey team
Total 8 teams of investigators, each comprising of 2 specialists – 1 Public Health specialist, and 1 Bio Medical Engineer conducted the assessment of the 105 CHCs. Each team was assigned a circle. Further, 2 coordinators were involved to supervise and facilitate this survey. They were also the key personnel who were responsible for the activities listed under the scope of work section. 4 data entry operators were hired to quicken the process along with 2 statisticians. A total of 24 members formed the assessment workforce.

Following table gives an overview of the workforce that was involved in the assessment

Survey team Nos.
Public health specialist 8
Bio medical engineer 8
Coordinator 2
Data entry operator 4

All the 16 investigators underwent training in the use of the assessment tool for conducting the interviews so as to ensure the quality of the data to be collected. This training was imparted by the coordinators.

6. Survey design
One–to–one interviews
The interviewer used the assessment tool to gather information from the Medical Superintendent. Observations were recorded in the prescribed format.

A list of common items related to upgradation was prepared.
The Director, Additional Director and the indicated Joint Directors were interviewed on issues related to policy and cost.

7. Data collection
  • Primary data: Primary data for the study was collected by conducting interviews of target audience (mentioned above) at each of the 105 CHCs.
  • Secondary data: Secondary data was collected at the Directorate level.
8. Data management
Data collection
Considering 8 teams are involved in the data collection, a total of 4 weeks were required to assess 105 hospitals. 1 week was required to collect information from the Directorate level on issues related to policy and cost.
Data entry, analysis and report (first draft)
The collected data was entered into SPSS statistical software for further analysis and giving recommendations. 3 weeks were required for this process. This included sharing the draft report. 1 week was required for finalizing the report.
Data quality
The coordinators overlooked the entire process of data collection and data entry and ensured the quality of the processed data.

9. Study tool
The assessment tool/check list (attached in annexure) was used to conduct the interviews at the facility level.

10. Study structure
The study structure is as shown in figure
Click Here to see the Study Structure – Figure

11. Time frame
This study was completed in 10 weeks

Task Time
Revise the IPHS checklist and get it vetted by the Client 1 week
Scheduling of visits to the identified facilities  
Field visit for facility assessment and documentation of observations 4 weeks
Information related to policy and cost from Directorate 1 week
Data entry and data analysis and submission of draft report 3 weeks
Submission final report after discussions 1 week
Total 10 weeks

Section 2: Assessment findings
The following text presents the assessment findings of the facility. As indicated earlier, the findings are presented under 8 broad categories as prescribed by the Indian Public Health Standards.
  • Status of the CHC against the IPHS
Category 1 – Services
The following table 1 presents the current status of availability of services

S.No. Category 1 (services) Status
1.1 Specialist Services available (Yes/No)  
a. Medicine No
b. Surgery No
c. OBG. No
d. Paediatrics No
e. National Health Programmes (Specify) No
f. Emergency Services (24 Hours) – medical & surgery Yes
g. 24 hour delivery services (normal & assisted) Yes
h. EmOC incl. Surgical interventions like Caesarean sections & other medical interventions No
i. New born care No
j. Emergency care of sick children No
k. Family planning services incl. sterilization Yes
l. Safe abortion services (MVA) No
  MTP services No
m. Treatment of STI/RTI Yes
n. Laboratory  
  Routine blood examination Yes
  Urine examination Yes
  Stool examination Yes
  Biochemistry Yes
  Serology Yes
  Microscopy Yes
o. Blood storage facility  
  1. In the institution No
  2. Tie up local blood bank Yes
p. Referral transport service Yes
  Bed Occupancy Rate in the last 12 months (1– 1
1.2. less than 40%, 2–40–60%, 3–More than 60%  
1.3 Average daily OPD Attendance 100
a. Male 50
b. Female 50
1.4 Types of Surgeries performed (specify) – under additional information  
1.5.a. Availability of counseling facility on HIV/AIDS/STD etc. (Yes/No) Yes
b. Is it a voluntary council and testing center Yes
1.6.    
a. Ante –natal Clinics 4
b. Post –natal Clinics 0
c. Immunization Sessions 4
1.7. Is separate septic labour room available No
1.8 Availability of facilities for out –patient No
  department in Gynaecology/obstetric (Yes/No)  
a. Board/Name plates to guide the clients No
b. Adequate working space Yes
c. Privacy during examination Yes
d. Facility for counselling Yes
e. Separate toilet with running water Yes
f. Facility for sterilizing instruments Yes
g. Male specialist (OBGY) No
h. Female specialist (OBGY) No

Category 2 – Manpower
This category is further divided into – a. clinical manpower, b. support manpower and c. training of Medical Officers (MO)

Following table 2a indicates the status of clinical manpower in the CHC.

Table 2a: Clinical manpower available at the CHC

S.No. Personnel IPHS Norm Status
1 General Surgeon 1 0
2 Physician 1 0
3 Obstetrician/Gynecologist 1 0
4 Pediatrician 1 0
5 Anesthetist 1 0
6 Public Health Programme Manager 1 0
7 Eye Surgeon 1 0
8 Other specialists (if any)   Ortho
9 General duty officers (Medical Officer)    

Following table 2b indicates the status of support manpower at the CHC.

Table 2b: Support Manpower at the CHC

S.No. Personnel IPHS Norm Status
10 Nursing staff 7+3  
a. Public Health Nurse 1 0
b. ANM 1 0
c. Staff Nurse 7 0
d. Nurse Midwife (Nursing sister) 1 7
11 Dresser 1 0
12. Pharmacist 1 0
13. Lab. Technician 1 1
14 Radiographer 1 1
15 Ophthalmic Assistant 1 1
16 Ward boys/nursing orderly 2 1
19. OPD Attendant 1 4
0.2 Statistical Assistant/Data entry Operator 1 1
21 OT Attendant 1 0
0.22 Registration Clerk 1 0
23. Any other staff (specify)

Following table 2c indicates the status of training of MOs at the CHC.

Table 2c: Training of MOs in last 1 year at the CHC

2.24 Available training in Status
1. Sterilizations  
  Mini lap tubectomy 0
  i. Laparoscopic tubectomy 0
  ii. Vasectomy 0
  iii. N.S.V 0
1. IUD Insertions 0
2. Emergency contraception 0
3. RTI/STI,HIV/AIDS 2
4. Newborn care 0
5. Emergency obstetric care 0
6. Other subjects (mention)  

Category 3 – Investigation Facilities
Following table 3 indicates the status of investigation facilities at the CHC.

Table 3: Investigation facilities at the CHC

S.No IPHS Norm Status
1 Availability of ECG facilities (Yes/No) Yes
2 X–Ray facility (Yes/No) Yes
3 Ultrasound facility (Yes/No) No
4 Appropriate training to a nursing staff on ECG (Yes/No) No
5 Any lab test/ diagnostic test outsourced to private lab/hospital (specify the test) No
6 All necessary reagents, glassware and facilities for collection and transportation of samples (Yes/No) Yes

Category 4 – Physical Infrastructure
Following table 4 indicates the status of physical infrastructure at the CHC.

Table 4: Physical infrastructure at the CHC

Sr.No.   Status
4.1 Where is this CHC located  
a Within Village Locality Yes
b Far from village locality
c If far from locality specify in km
4.2 Building  
a Is a designated government building available for the CHC Yes
b If there is no designated government building then where does the CHC located  
  Rented premises
  Other government building
  Any other specify
c Area of the building (Total area in sq.mts.)  
d What is the present stage of construction of the building  
  Construction incomplete Complete
e Compound Wall/Fencing(1–All around;2–Partial;3–None) 2
f Condition of plaster on walls (1–Well plastered with plaster intact every where; 2–plaster coming off in some places; 3–plaster coming off in many places or no plaster) 1
g Condition of floor (1–floor in good condition;2–Floor coming off in some places;3– Floor coming off in many places or on proper flooring) 1
h Whether the cleanliness is Good/Fair/ Poor? (Observe)  
  OPD Fair
  OT Fair
  Rooms Fair
  Wards Fair
  Toilets Fair
  Premises (compound) Poor
I. Are any of the following close to the hospital? (Observe) (Y/No)  
i Garbage dump No
ii Cattle shed No
iii Stagnant pool No
iv Pollution from industry No
4.3 Location of CHC  
a Whether located at less than 2 hours of travel distance from the farthest village (Yes/No) Yes
b Whether the district headquarter hospital is located at a distance of less than 4 hours travel time? (Yes/No) Yes
c Feasibility to hold the workforce (e.g. availability of degree college railway station municipality industrial/mining belt) Yes
4.4 Availability of private Sector Health Facility in the area  
a Private laboratory/Hospital/Nursing Home (Yes/No) Yes
b Charitable Hospital (Yes/No)(specify) No
c Hospital run by NGO (Yes/No) Yes
4.5 Prominent display boards in local language/Charter of Patient Rights (Yes/No) No
4.6 Registration counters (Yes/No) Yes
4.7 Pharmacy  
a Pharmacy for drug dispensing and drug storage (Yes/No) Yes
b Counter near entrance of hospital to obtain contraceptives ORS packets Vitamin A and Vaccination (Yes/No) No
4.8 Separate Public utilities for males and females (Yes/No) Yes
4.9 Suggestion/ complaint box (Yes/No) No
4.1 OPD rooms/cubicles (Yes/No)(Give numbers) 2
4.11 Adequate no of windows in the room for light and air in each room (Yes/No) Yes
4.12 Family Welfare clinic (Yes/No) No
4.13 Waiting room for patients (Yes/No) Yes
4.14 Emergency Room/Casualty (Yes/No) No
4.15 Separate wards for males and females (Yes/No) Yes
4.16 No. of beds : Male 15
4.17 No. of beds : Female 15
  No. of beds : Pediatrics 0
4.18 Operation Theatre  
a Operation Theatre available (Yes/No) Yes
b If operation theatre is present are surgeries carried out in the operation theatre  
  Yes  
  No No
  Sometimes  
  If operation theatre is present but surgeries are not being conducted there then what are the reasons for the same?
c    
  Non–availability of doctors/anesthetist/staff Yes
  Lack of equipment/poor physical state of the operation Yes
  No power supply in the operation theatre  
  Any other reason (specify)  
d Operation Theatre used for obstetric/gynecological purpose (Yes/No) Yes
e Has OT enough space (Yes/No) Yes
f Is OT fitted with air conditioner? (Yes/No) Yes
g Is the air conditioner working (Yes/No) Yes
h Is generator available for OT? (Yes/No) Yes
i Is emergency light available in OT (Yes/No) Yes
j Is fumigation done regularly? (Yes/No) Yes
k Is the days of sterilization in a week displayed on the public notice on OT (Yes/No) No
4.19 Labour room  
a Labour room available (Yes/No) Yes
b If labour room is present are deliveries carried out in the labour room  
  Yes Yes
  No  
c If labour room is present but deliveries are not being conducted there then what are the reasons for the same  
  Non–availability of doctors/staff
  Seepage in the labour room  
  No power supply in the labour room  
  Any other reason (specify)  
4.2 X–Ray Room with dark room facility (Yes/No) Yes
4.21 Laboratory  
a Laboratory (Yes/No) Yes
b Are adequate equipment and chemicals available? (Yes/No) Yes
c Is laboratory maintained in orderly manner? (Yes/No) Yes
4.22 Ancillary Rooms–Nurses rest room (Yes/No) Yes
4.23 Water Supply :–  
a Source of water  
  1–piped  
  2–Bore well Yes
  3–well  
  4–Other (specify)  
b Whether overhead tank and pump exist (Yes/No) Yes
c If overhead tank exist whether its capacity sufficient? (Yes/No) Yes
d If pump exist whether it is in working condition? (Yes/No) Yes
4.24 Sewerage  
  Type of sewerage system  
  1–soak pit  
  2–connected to local body/municipality Yes
  3–open drainage  
4.25 Wasted disposal  
a Is there an incinerator? (Yes/No) No
b If yes type (1–electric)  
  2–Other (specify)  
c If no how the medical waste disposed off? Deep B P
4.26 Electricity  
a Is there electric line in all parts of the hospital?  
  1–In all Parts 1
  2–In some parts
  3– None
b Regular power supply (1–Continuous Power Supply; 4
  2– Occasional power failure;  
  3–Power cuts in summer only;  
  4– Regular power cuts; in summer only; 4– Regular power cuts;  
  5–No power supply  
c Stand by facility (generator) available (Yes/No) Yes
4.27 Laundry facilities  
a Laundry facility available (Yes/No) No
b If no is it outsourced? On Contract basis
4.28 Communication facilities  
a Telephone (Yes/No) Yes
b No. of diff. Telephone lines available 1
c Personal Computer (Yes/No) Yes
d NIC Terminal (Yes/No) No
e E. Mail (Yes/No) Yes
f. Is CHC accessible by  
i Rail (Yes/No) Yes
ii All whether road (Yes/No) Yes
iii Others (Specify)  
4.29 Vehicles (number of vehicles) 1
a If running  
  Sanctioned  
  Ambulance 1
  Jeep
  Car
  Available  
  Ambulance 1
  Jeep
  Car  
  On road  
  Ambulance 1
  Jeep
  Car
b If vehicle is not running (reason)
  Driver not available  
  Ambulance  
  Jeep  
  Car  
  Money for POL not available  
  Ambulance  
  Jeep  
  Car  
  Money for repairs not available  
  Ambulance  
  Jeep  
  Car  
4.3 Office room (Yes/No) Yes
4.31 Store room (Yes/No) Yes
4.32 Kitchen room (Yes/No) No
4.33 Diet (Yes/No)  
a Diet provided by hospital (Yes/No) No
b If no how diet is provided to the indoor patients? Patient’s Own
4.34 Residential facility for the staff with living condition  
  General Surgeon No
  Physician No
  Obstetrician/Gynecologist No
  Pediatrics No
  Anesthetist No
  General Duty Medical Officer No
  Public Health Programme Manager No
  Eye Surgeon No
  Public Health Nurse No
  ANM No
  Staff Nurse No
  Nurse/Midwife No
  Dresser No
  Pharmacist/ Compounder No
  Lab. Technician No
  Radiographer No
  Ophthalmic Assistant No
  Ward boys/nursing orderly No
  Sweepers No
  Chowkidar No
  OPD Attendant No
  Statistical Assistant/Data entry operator No
  OT Attendant No
  Ambulance driver No
  Registration Clark No
4.35 Dharamshala  
a Facility for stay available (Yes/No) No
b Attached toilet available (Yes/No) No
c Cooking facility available (Yes/No) No
4.36a. Is the CHC open for outpatient services for the stipulated OPD time  
  Yes on all days excepting designated holidays Yes
  No it always closes before time
  Only on some days it function for the stipulated time
b. If yes, specify stipulated OPD hours 9am to 12pm
    5 –6pm
4.37 In cases where a patient needs to be admitted for inpatient.  
  Yes patients who can be managed at CHC are always admitted Yes
  Some deserving patients are not admitted but are referred to other facilities  
  Patients usually refused admission  
4.38 Does the CHC provide treatment to emergency patients/victims of accident medical emergencies etc) at any time of the day/night?  
  Emergency patients are given treatment where necessary they are referred higher level govt. hospital Yes
  Emergency patients are often not treated referred to a public health care facility
  Emergency patients are often not treated referred to a private health care facility
4.39 If referred to a higher –level health care facility how is the patient taken there?  
  Free transport by hospital ambulance Yes
  By Hospital ambulance but fuel and other charges have to be made by the patient Yes
  Private/personal conveyance  
4.4 Behavioral aspects  
a How is the behavior of the CHC staff with the patient  
  Courteous Yes
  Casual/indifferent
  Insulting/indifferent
b Is there corruption in terms of charging extra money for any of the services? No
c Is a receipt always given for the money charged at the CHC Yes
d Is there any incidence of any sexual advances oral or physical abuse, sexual harassment by the doctors or any other paramedical? (Yes/ No) No
e Are woman patients interviewed in an environment that ensures privacy and dignity (Yes/ No) Yes
f Are examinations on woman patients conducted in presence of a woman attendant and procedures conducted under conditions that ensure privacy? (Yes/No) Yes
g Do patients with chronic illnesses receive adequate care ? Yes
h If the health center is unequipped to provide the services needed, are patients transferred immediately without delay, with all the relevant papers, to a site where the desired service is available? (Yes/ No) Yes
i Is there a publicly displayed mechanism whereby a complaint/ grievance can be registered (Yes/ No) No

Category 5 – Equipments
Following table 5 indicates the status of equipments at the CHC.

Table 5: Status of equipments at the CHC

Equipment Status
Blood storage unit N
ECG machine Y
X – Ray 100 mA Y
OT air conditioner Y(N.Wor)
Boyles apparatus Y(N.Wor)
EMO machine (anaesthesia) N
Cardiac monitor (OT) Y
Defibrillator (OT) N
Ventilator (OT) N
Horizontal High Pressure Sterilizer N
Vertical High Pressure sterilizer 2/3 drum capacity Y
Shadow less lamp ceiling trek mounted Y(N.Wor)
Shadow less lamp Pedestal for minor OT Y(N.Wor)
OT care/fumigation apparatus Y
Gloves dusting machines N
   
Oxygen cylinder 660 Ltrs10 cylinders for 1 Boyles Apparatus N
Nitrous Oxide cylinder 1780Ltr. 8 for one Boyles Apparatus N
Hydraulic Operation Table N
Ice lined freezers Y
Deep freezers Y
Refrigerators Y
Intercom system N
Personal Computer Y
Ultra sound N
KIT E – Laparotomy set Y
KIT F – Standard surgical set Y
KIT G – Inspection of IUD devise set Y
KIT H – Vasectomy set Y
KIT I – general purpose set Y
KIT J – Standard surgical set Y
KIT K – Embryotomy set Y
KIT L – Evacuation of uterus set Y
KIT M – Anaesthesia set Y
KIT N – Neo natal resuscitation set Y
KIT O – Lab test & blood transfusion set Y
KIT P – Donor blood transfusion set Y

Category 6 – Drugs
Following table 6 indicates the status of drugs at the CHC.

Table 6: Status of Drugs at the CHC

Sr.No. Drug Name Status
1 Oxygen Y
2 Lignocaine Hydrochloride Y
3 Diazepam N
4 Acetyl Salicylic Acid Y
5 Ibuprofen Y
6 Paracetamol Y
7 Pentazocine Lactate N
8 Chloroquine Phosphate Y
9 Adrenaline bititrate Y
10 Chlorpheniramine Maleate Y
11 Prednisolone Y
12 Promethazine HCL N
13 Phenobarbitone N
14 Phenytoin Sodium N
15 Albendazole Y
16 Amoxicillin Powder Y
17 Ciprofloxacin Hydrochloride Y
18 Co–Trimoxazole Y
19 Norfloxacine Y
20 Doxycyline Y
21 Metronidazole Y
22 Clotrimazole Y
23 Sulfadoxine + Pyrimethamine N
24 Ferrous Salt Y
25 Folic Acid Y
26 Isosorbide Mononitrate/Dinitrate N
27 Amlodipine N
28 Digoxin N
29 Benzioc Acid + Salicylic Acid N
30 Miconazole Y
31 Neomycin + Bacitracin N
32 Silver Sulphadiazine N
33 Benzyl Benzoate Y
34 Acriflavin + Glycerin N
35 Gentian Violet N
36 Hydrogen Peroxide Y
37 Povidone Iodine Y
38 Bleaching Powder N
39 Potassium Permanganate N
40 Furosemide Y
41 Aluminium Hydroxide + Magnesium Hydroxide N
42 Domperidone Y
43 Local Anaesthetic, Astringent and Antiinflammatory Medicine N
44 Dicyclomine Hydrochloride N
45 Oral Rehydration Salts Y
46 Dexamithasone Sodium Y
47 Ciprofloxacin Hydrochloride Y
48 Tetracycline Hydrochloride N
49 Alprozolam N
50 Salbutamol Sulphate Y
51 Etophyline Anhydrous Y
52 Glucose N
53 Glucose with Sodium Choride N
54 Normal Saline Y
55 Ringer Lactate Y
56 Plasma Volume Expander Y
57 Water for Injection Y
58 Ascorbic Acid N
59 Calcium Salts Y
60 Multivitamins (As per Schedule V) Y
61 Atentol N
62 Floxitin N
63 Amitryptiline Hcl N
64 Bisacodyl N
65 General Anaesthetic Drugs Y
66 Tinidazole Y
67 Daonil Y
68 Haloperidol Y
69 Sulpacetamide Eye Drops N
Sr No. Injections  
1 Cryst. Penicillin Y
2 Inj. Procaine Penicillin Y
3 Inj. Benzathine Penicilline (1.2) N
4 Inj. Phenytoin Sodium 50mg/ml N
5 Inj. Ampicillin Y
6 Inj. Gentamicin Y
7 Inj. Soda Bicarb Y
8 Inj. Calcium Gluconate N
9 Inj.KCI N
10 Inj. Atropine Y
11 Inj. Hyoscine N–butyl Bromide N
12 Inj. Hydrocortisone N
13 Inj. Syntocinon (synthetic oxytocin) N
14 Inj. Methyl Ergometrine Maleate Y
15 Inj. Isoxsuprine Hydrochloride N
16 Inj. Aminophyllin Y
17 Inj. Chloramphenicol N
18 Inj. Mannitol Y
19 Inj. Pethidine Y
20 Inj Chlorpromazine N

Category 7 – Furniture
Following table 7 indicates the status of furniture at the CHC.

Table 7: Status of furniture at the CHC

Sr. No. Item Norm Status
1. Examination Table 5 2
2. Delivery Table 2 2
3. Footstep 7 4
4. Bed side Screen 10 2
5. Stool for patients 10 5
1. Arm board for adult & child 2 0
2. Saline stand 10 10
3. Wheel Chair 3 3
4. Stretcher on trolley 2 2
5. Oxygen trolley 3 4
6. Height measuring stand 1 1
7. Iron bed 26 30
8. Bed side locker 35 35
9. Dressing trolley 3 3
10. Mayo trolley 1 1
11. Instrument cabinet 2 2
12. Instrument trolley 2 3
13. Bucket 8 2
14. Attendant stool 35 5
15. Instrument tray 10 6
16. Chair 20 20
17. Wooden table 10 14
18. Almirah 10 16
19. Swab rack 1 1
20. Mattress 30 35
21. Pillow 30 0
22. Waiting bench for patients/attendants 4 2
23. Medicine cabinet 3 2
24. Side rail 2 0
25. Rack 10 2
26. Bed side attendant chair 30 20

Category 8 – Quality Control
Following table 8 indicates the status of quality control at the CHC.

Table 8: Status of quality control at the CHC

S.No. Category 1 (services) Status
1.1 Specialist Services available (Yes/No)  
a. Medicine No
b. Surgery No
c. OBG. No
d. Pediatrics Yes
e. National Health Programmes (Specify) Yes
f. Emergency Services (24 Hours) – medical & surgery Yes
g. 24 hour delivery services (normal & assisted) Yes
h. EmOC incl. Surgical interventions like Caesarean sections & other medical interventions No
i. New born care Yes
j. Emergency care of sick children Yes
k. Family planning services incl. sterilization Yes
l. Safe abortion services (MVA) No
  MTP services No
m. Treatment of STI/RTI Yes
n. Laboratory  
  Routine blood examination Yes
  Urine examination Yes
  Stool examination Yes
  Biochemistry Yes
  Serology Yes
  Microscopy Yes
o. Blood storage facility  
  1. In the institution Yes
  2. Tie up local blood bank No
p. Referral transport service Yes
  Bed Occupancy Rate in the last 12 months (1– 3
1.2. less than 40%, 2–40–60%, 3–More than 60%  
1.3 Average daily OPD Attendance 250
a. Male 40
b. Female 60
1.4 Types of Surgeries performed (specify) – under additional information  
1.5.a. Availability of counseling facility on HIV/AIDS/STD etc. (Yes/No) Yes
b. Is it a voluntary council and testing center Yes
1.6.    
a. Ante –natal Clinics 4
b. Post –natal Clinics 4
c. Immunization Sessions 4
1.7. Is separate septic labour room available No
1.8 Availability of facilities for out –patient No
  Department in Gynaecology/obstetric (Yes/No)  
a. Board/Name plates to guide the clients No
b. Adequate working space Yes
c. Privacy during examination Yes
d. Facility for counseling Yes
e. Separate toilet with running water Yes
f. Facility for sterilizing instruments Yes
g. Male specialist (OBGY) No
h. Female specialist (OBGY) No

Additional Information
R.H. Akot CHC
R.H. Akot CHC is located in Akot block of Akola district.
It is not recognized as a FRU.
It is a 30 bedded hospital.
Blood Storage and tie up with local blood bank not present.
Types of surgeries performed at R.H. Akot CHC – FP.

Section 3
GAPS at the facility
Cost implications for upgradation to IPHS
The following text indicates the GAPS at the assessed CHC against the 8 broad categories. It also indicates, wherever relevant, the approximate cost implication to upgrade this CHC to Indian Public Health Standards (IPHS).

GAPS at the CHC and cost implications for upgradation to IPHS
Category 1 – Services The following table 1 presents the GAPS related to services at the CHC.

Table 1: Services GAPS at the CHC

Category 1 (services) GAPS
Medicine X
Surgery X
OBG. X
Paediatrics X
National Health Programmes (Specify) X
EmOC incl. Surgical interventions like Caesarean sections & other medical interventions X
New born care X
Emergency care of sick children X
Safe abortion services (MVA) X
MTP services X
Is separate septic labour room available X
Board/Name plates to guide the clients X
Female specialist (OBGY) X

Category 2 – Manpower
Following table 2a indicates the GAPS in clinical manpower at the CHC and its cost implication for upgradation.

Table 2a: Clinical manpower GAPS at the CHC

Personnel GAPS Requirement Unit cost Annual cost
Public Health Nurse X 1 12000/mth 144000
ANM X 1 8000/mth 72000
Staff Nurse X 7 10000/mth 840000
Dresser X 1 6000/mth 72000
Ward boy X 1 6000/mth 72000
OT Attendant X 1 6000/mth 72000
Registration clerk x 1 8000/mth 96000
Total       1368000

Following table 2c indicates the GAPS in training of MOs at the CHC.

Table 2c: Training of MOs in last 1 year at the CHC

Available training in GAPS
Sterilizations  
Mini lap tubectomy X
Laparoscopic tubectomy X
Vasectomy X
N.S.V X
IUD Insertions X
Emergency contraception X
Newborn care X
Emergency obstetric care X

Category 3 – Investigation Facilities
Following table 3 indicates the GAPS in investigation facilities at the CHC.

Table 3: Investigation facilities GAPS at the CHC

IPHS Norm GAPS
Ultrasound facility X
Appropriate training to a nursing staff on ECG X
Any lab test/ diagnostic test outsourced to private lab/hospital X

Category 4 – Physical Infrastructure
Following table 4 indicates the GAPS in physical infrastructure at the CHC and its cost implication for upgradation to IPHS.

Table 4: Physical infrastructure GAPS at the CHC

  GAPS Cost
Compound Wall/Fencing X 200000
Prominent display boards in local language/Charter of Patient Rights (Yes/No) X  
Family Welfare clinic (Yes/No) X  
Emergency Room/Casualty (Yes/No) X  
No. of beds : Pediatrics X  
If operation theatre is present are surgeries carried out in the operation theatre X  
Is the days of sterilization in a week displayed on the public notice on OT (Yes/No) X  
Dharamshala X 500000
Is there a publicly displayed mechanism whereby a complaint/ grievance can be registered (Yes/ No) X  
Total   700000

Category 5 – Equipments
Following table 5 indicates the GAPS in equipments at the CHC and its cost implication for upgradation to IPH.

Table 5: GAPS of equipments at the CHC

Equipment GAPS Cost
Blood storage unit X 75000
EMO machine (anaesthesia) X 50000
Defibrillator (OT) X 100000
Ventilator (OT) X 500000
Horizontal High Pressure Sterilizer X 150000
Gloves dusting machines X 15000
Oxygen cylinder 660 Ltrs10 cylinders for 1 Boyles Apparatus X 5500
Nitrous Oxide cylinder 1780Ltr. 8 for one Boyles Apparatus X 7000
Hydraulic Operation Table X 39000
Intercom system X 98000
Ultra sound X 300000
Total   1339500

Category 6 – Drugs
Following table 6 indicates the GAPS in drugs at the CHC.

Table 6: GAPS of Drugs at the CHC

Drug Name GAPS
Diazepam X
Pentazocine Lactate X
Promethazine HCL X
Phenobarbitone X
Phenytoin Sodium X
Sulfadoxine + Pyrimethamine X
Isosorbide Mononitrate/Dinitrate X
Amlodipine X
Digoxin X
Benzioc Acid + Salicylic Acid X
Neomycin + Bacitracin X
Silver Sulphadiazine X
Acriflavin + Glycerin X
Gentian Violet X
Bleaching Powder X
Potassium Permanganate X
Aluminium Hydroxide + Magnesium Hydroxide X
Local Anaesthetic, Astringent and Antiinflammatory Medicine X
Dicyclomine Hydrochloride X
Tetracycline Hydrochloride X
Alprozolam X
Glucose X
Glucose with Sodium Choride X
Ascorbic Acid X
Atentol X
Floxitin X
Amitryptiline Hcl X
Bisacodyl X
Sulpacetamide Eye Drops X
Injections  
Inj. Benzathine Penicilline (1.2) X
Inj. Phenytoin Sodium 50mg/ml X
Inj. Calcium Gluconate X
Inj.KCI X
Inj. Hyoscine N–butyl Bromide X
Inj. Hydrocortisone X
Inj. Syntocinon (synthetic oxytocin) X
Inj. Isoxsuprine Hydrochloride X
Inj. Chloramphenicol X
Inj Chlorpromazine

Category 7 – Furniture
Following table 7 indicates the GAPS in furniture at the CHC and its cost implication for upgradation to IPHS.

Table 7: GAPS in furniture at the CHC

Item Gaps Requirement Unit Cost Cost
Examination Table X 3 5000 15000
Bed side Screen X 8 2000 16000
Stool for patients X 5 1500 7500
Arm board for adult & child X 2 500 1000
Bucket X 6 150 900
Attendant stool X 30 1500 45000
Instrument tray X 4 150 600
Pillow X 30 200 6000
Medicine cabinet X 1 5000 5000
Side rail X 2 2000 4000
Rack X 8 3000 24000
Bed side attendant chair X 10 500 5000
Total       130000

Category 8 – Quality Control
Following table 8 indicates the GAPS in quality control at the CHC.

Table 8: GAPS in quality control at the CHC

Particular GAPS
Patients charter (Yes/No) X
External monitoring (Gradation by PRI (Zilla Parishad) Rogi Kalyan Samitis X
Availability of standard Operating procedures (SOP)/ Standard Treatment Protocols (STP)/Guidelines(Please provide a list) X

Section 4: Comments
The following comments are related to the 8 categories against which the CHC was assessed
  • Overall this CHC needs inputs under all the categories of the IPHS.
  • Inputs related to this CHC include specialist, equipments, drugs, physical infrastructure, and improvement in quality control mechanism.


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