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
- Identified gaps.
- 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
- Collect data for planning purposes*
- 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
- Identified gaps.
- Cost implications for upgradation of the facility/ facilities to IPHS, except the civil component.
- 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.