Observations of Rajasthan T eam New Delhi, 12 th January, 2012 T - - PowerPoint PPT Presentation
5 th Common Review Mission Observations of Rajasthan T eam New Delhi, 12 th January, 2012 T eam Composition Ms Rita Chaterjee, JS (HRD) Dr. Sajjan Yadav, Director (NRHM) Dr. A C Baishya Director RRC- NE, NHSRC Dr Sanjeev Gupta,
Ms Rita Chaterjee, JS (HRD) Dr. Sajjan
Yadav, Director (NRHM)
Dr. A C Baishya Director RRC- NE, NHSRC Dr Sanjeev Gupta, Addl Dir (NVBDCP) Dr
V Shekhawat, RD I/C, Jaipur, Rajasthan
Sh. A.K.Deori, US (EPW) Dr. S.K. Mondal, PFI Dr. Sonali Rawal, Consultant, NRHM Asmita Jyoti Singh, Consultant, NRHM Ms Rajshree Panicker, PHFI Mr Rahul Govila, Consultant, FMG Mr. Vijay Paulraj, Family Planning, USAID
Good health Infrastructure Health facilities well equipped SNCUs established in District Hospitals Labour rooms and maternity wards are present in
all institutions- privacy and maintenance need improvement.
ANMs, GNMs, Lab Technicians are available Improved utilization of public health facilities-
increase in IPD, OPD and institutional deliveries. Free Drug Scheme likely to further increase the demand
towards PHC and SC which are taking up more of the normal delivery load over time – SC were handling 12.26 % of institutional deliveries in 2008-09 which increased to 27.68 % of institutional deliveries in 2010-11.
5 10 15 20 25 30 35 40 DH/SDH CHC PHC SC Private
2008-09 2009-10 2010-11
ASHAs
emerged as symbol
women empowerment and torch bearers of health issues in remote areas
Good Community involvement and ownership Establishment of Rajasthan Medical Services
Corporation Limited(RMSCL) for centralized procurement
Electronic funds transfer system is being used for
transfer of funds from State to districts and districts to blocks.
Redundancy in infrastructure and equipment. New
infrastructure being planned without taking into account availability, gap analysis and prioritization
Poor quality of civil work found in some cases Acute shortage of specialists and MOs Rational deployment Large number of Male nurses are posted in the
health facilities who are not conducting deliveries and are also not being utilized optimally
Doctors allowed private practice. Instances of
calling patients home and prescribing drugs and tests on their private prescription slips. But subsequently using government facilities for surgical interventions.
No training calendar. No follow up plan after
training.
Training capacity needs strengthening at district
level
System
for biomedical waste management, sterilization of equipment, infection control needs improvement.
Lack of privacy in labour rooms New MMUs procured but are not utilized due to
non selection of operator
Lack of awareness about 108 services among
headquarter
Funds of all VHSCs under a Gram Panchayat are
being operated through a single account.
Lack of awareness about JSSK among implementing
JSSK beneficiaries found spending thousands of rupees on purchasing medicine in DH Barmer.
Facility based new born care need to be expanded Requirement of vaccines not generated from the
doses of a vaccine regardless of population.
Reporting issues- All children reported vaccinated
even when vaccine was not available.
Meetings of RMRS are irregular and limited just
for fund utilization. Lack of awareness
Family Planning sterilization focused, greater focus on
spacing methods needed.
Midwifery was not included in GNMTC course till 2003.
These GNMs are not conducting delivery
Poor fund utilization in NDCPs Presumptive treatment is still being used for suspected
Malaria cases and Bivalent RDK is used for diagnosis of Malaria against the programme guidelines
Shortage of Ophthalmic Assistants in CHCs for screening
HIV testing for AFB positive cases not being done Media alert on IDSP portal not being used regularly
Budget allocation for Drugs and consumables for
different level health facilities is grossly inadequate and has impacted availability of drugs for JSSK and NVBDCP
Supply done without analyzing requirement of
health facility.
Due to pressure to operationalize Free Drug
Scheme, GoI Supplies of vaccines and drugs shifted outside the warehouses to office building and other unsuitable places
Financial management poor. Books of accounts not
properly maintained.
Shortage of manpower like BPM, PHC accountant
especially in high focus blocks
Medical Officers are managing funds with help of nurses,
The customized version of Tally ERP 9 software has been
installed at state, district and block level but its not implemented in most of the blocks due to lack of training and technical issues.
monitoring for settlement of longstanding advances to
implementing agencies like PWD, BDO etc.