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Facility Readiness Data Analysis forEssential Newborn Care and
Resuscitation (District-Rohtak)
Overall Training Status (n=15)
Number of Birth
Attendants
SBA NSSK IMNCI
68 55 56 56
Percentage (%) 81 82 82
Status of FBNC
• SNCU at GH Rohtak will be discussed in detail
• NBSU - Two Designated NBSUs at CHC Kalanour, CHC Meham.
• NBCC- Ideally should be in every labour room.
• Designated NBCCs in Baland, Bhalaut, Ghilore Kalan, Madina,mokhra, Kahanaur, Lakhan majra, Samar Gopal Pur, Meham (E-FRU), Kalanaur (P-FRU), GH (OT), GH (Labour Room)
Newborn Care corners (NBCC) (n=15)
NBCC
Established
NBCC with
Radiant
Warmers
NBCC with
200 W bulb
Vitamin- K
14
(Nidana not
established)
8 9 ( Five facility
having both
warmer and
radiant
warmer)
2
(Nidana,
Chamaria)
Newborn Corners (NBCC) (n=15)
Self
Inflating
Bag
Mask ‘0’ Mask ‘1’ Shoulder
Roll
Available
15 14 14 13
Not available
1
(PHC Sanghi)
1
(PHC Sanghi)
2
(PHC
Kiloi,
Nidana)
Newborn Corners (NBCC) (n=15)
Baby
Sheets
Mucus
Extractors
Suction
Machine
Suction
Catheter
Oxygen
Cylinder
Available 15 15 15 15 14
Not
available
1 (Nidana)
Our Strengths
• Availability of medical officers and staff nurses in most of the facilities.
• Almost all birth attendants trained in SBA, NSSK and IMNCI.
• All designated new born care corners are established.
• Availability of equipments and logistics in all the facilities.
• At birth immunization given at delivery points.
• Vitamin K administration
Issues
• Effective hand washing not in practice.
• Birth preparedness before delivery is not in practice.
• Skin to skin contact between mother and baby not in practice.
• Shifting of every baby to Newborn Corner (radiant warmer and to attendant) is still in practice.
• Milking of cord and immediate cord cutting is in practice
Issues• Record keeping in delivery rooms need improvement
especialy for new born care.
• Partograph are filled but need quality improvement in most of the facilities
• Disinfection protocols are not followed in majority of the facilities.
• Glutraldehyde can be indented on a monthly basis for ensuring infection prevention. (two bottles per month)
Issues
• Skills of the birth attendants need improvement
• Infection prevention of AMBU Bag and Mask not done regularly.
• Continued ventilation is not in practice
11
Read & Do Tools/Job Aids
Flat Surface
Thermal Care
Shoulder Roll
Mucus Extractor
Oxygen Cylinder
Ambu Bag
0 Type Mask
1 Type Mask
Baby Sheets
Cord Clamp
Examination Light
Suction Machine
Suction Cather Thermometer
New Born Care Corner
Feeding Tube
Flat Surface
Thermal Care
Shoulder Roll
Mucus Extractor
Oxygen Cylinder
Ambu Bag
0 Type Mask
1 Type Mask
Baby Sheets
Cord ClampExamination Light
Suction MachineSuction Cather Feeding Tube
Thermometer
NEW BORN CARE CORNER
New born care corner functionality
• Availability of flat surface
• Availability of Radiant warmer/200watt bulb in the delivery room
• Birth attendants trained in SBA and NSSK
• Availability of Bag and mask (Ambu Bag) with reservoirs and oxygen tubing, Mask (0 and 1 size) both available
New born care corner functionality
• Shoulder roll
• Mucus extractors (Disposable; single use only)
• Foot operated/ Electric suction machine available
• Suction tube/ catheter available
New born care corner functionality
• Oxygen cylinder available and functional with key or Spanner
• Baby Sheets, Cord Clamp, Sterile Surgical Blade, Vit. K are available
• Read and do tools for essential new born care (Birth Preparedness, etc) available
New born care corner functionality
• Protocols for Newborn resuscitation with bag and mask available
• All protocols/read and do tools present in the Delivery Room are Visible and at appropriate places.
0
20
40
60
80
100
MINIMUM 4VISITS
BIRTH PLAN
TT AND IFA
HIGH RISKMOTHER
DETECTION
DANGER SIGN
PROMOTE EBF
ROUND 1
KNOWLEDGE ABOUT EFFECTIVE ANC
76
64
61
60
60
57
56
53
52
49
48
43
42
39
38
36
36
31
61
58
59
0 20 40 60 80
JJR
RTK
PKL
KNL
MWT
HSR
FTB
KTL
GUR
JND
KKR
PWL
SNP
SRS
BWN
NNL
PNP
YNR
ROUND 2 ROUND 1
n=15
0
20
40
60
80
100PREVIOUS CS
5 OR MOREDELIVERIES
LESS THEN 2YEARS BIRTH
INTERVAL
AGE OF PRIMI<18 OR >30
YEARS
PREVIOUS STILLBIRTH
PREVIOUSNEONATAL
DEATH
PREVIOUSINSTRUMENTAL
DELIVERY
H/O ABORTIONSOR OTHER
COMPLICATIONS
H/ONEONATAL/INF
ANT DEATH
ROUND 1
n=15
KNOWLEDGE OF DETECTION OF HIGH RISK MOTHERS
74
65
63
55
54
53
53
52
51
44
43
43
41
39
36
30
29
25
62
49
53
0 20 40 60 80
JJR
RTK
KNL
KKR
FTB
PKL
MWT
HSR
KTL
GUR
SNP
JND
PWL
BWN
SRS
PNP
NNL
YNR
ROUND 2 ROUND 1
0
20
40
60
80
100
REGULARUTRINE
CONTRACTION
DILATION OFCERVIX
DISCHARGE OFBLOOD AND
MUCUS
BREAKING OFWATERS AND
RUPTIORMEMBRANE
ROUND 1
KNOWLEDGE ABOUT LABOUR PROGRESS
86
84
82
80
80
79
78
76
76
73
71
71
65
63
62
60
56
51
83
77
73
0 20 40 60 80 100
PKL
KNL
RTK
KTL
JJR
HSR
MWT
KKR
JND
FTB
SNP
GUR
PWL
SRS
BWN
PNP
NNL
YNR
ROUND 2 ROUND 1
n=15
0
20
40
60
80
100
FETALHEARTBEAT
COLOUR OFAMNIOTIC
FLUID
DEGREE OFMOLDING
DILATION OFCERVIX
DESCENT OFHEAD
UTERINECONTRACTIONS
MATERNAL BP
MATERNALTEMPERATURE
MATERNALPULSE
ROUND 1
LABOUR PROGRESS MONITORING KNOWLEDGE
77
76
75
73
73
70
68
66
65
65
64
64
57
57
55
51
49
38
62
73
69
0 20 40 60 80 100
KNL
HSR
RTK
FTB
JJR
KKR
PKL
SNP
KTL
GUR
BWN
MWT
PWL
JND
SRS
NNL
PNP
YNR
ROUND 2 ROUND 1
n=15
0
20
40
60
80
100
ONPARTOG
RAPH
ONPATIENTCLINICA
LRECORD
S
ONPIECE
OFPAPER
ROUND 1
RECORDING OF OBSERVATIONS
46
44
43
42
41
41
40
40
39
38
35
32
31
30
30
28
23
18
41
45
37
0 10 20 30 40 50
BWN
JJR
HSR
KNL
FTB
KKR
KTL
RTK
PKL
SNP
GUR
MWT
PNP
SRS
JND
YNR
NNL
PWL
ROUND 2 ROUND 1
n=15
IMMEDIATE
OXYTOCIN
CCTUTRINEMASSA
GE
ROUND 1
KNOWLEDGE ABOUT 3 STAGE OF LABOUR MANAGEMENT
99
93
93
89
88
81
78
77
74
73
73
69
66
65
54
53
52
47
92
85
68
0 50 100 150
JJR
KNL
RTK
PKL
HSR
KKR
FTB
GUR
KTL
Jind
SNP
MWT
SRS
BWN
YNR
PWL
NNL
PNP
ROUND 2 ROUND 1
n=15
0
20
40
60
80
100BREATHING OF BABY
DRY THE BABY
OBSERVE FOR COLOROF BABY
WEIGHT THE BABY
CARE FOR UMBLICALCORD
INITIATE BF WITH IN30 MIN
EXAMIN NEWBORNWITHIN 1 HRS
ADMINISTER VIT K
ROUND 1
KNOWLEDGE ABOUT IMMEDIATE CARE TO NEWBORN
WITHIN 1 Hr
78
77
70
65
64
60
58
57
56
56
52
51
50
47
46
42
38
32
75
56
64
0 20 40 60 80 100
JJR
RTK
PKL
KNL
MWT
KKR
HSR
KTL
JND
SNP
FTB
BWN
PWL
SRS
GUR
PNP
NNL
YNR
ROUND 2 ROUND 1
n=15
0
20
40
60
80
100
LESS MOVEMENT(POOR MUSCLE
TONE)
POOR OR NO BF
HYPO/HYPERTHERMIA
RESTLESSNESS/IRRITABILITY
DIFFICULTY/FASTBREATHING
INFECTION ONEYE/THROAT/SKI
N
DEEPJAUNDICE
SEVEREABDOMINALDISTENTION
ROUND 1
KNOWLEDGE ABOUT SIGN AND SYMPTOMS OF
SEPSIS/INFECTION IN NEWBORN
70
70
60
56
56
53
49
46
45
43
40
38
36
35
34
31
27
25
57
46
44
0 20 40 60 80
JJR
RTK
KNL
PKL
MWT
HSR
KKR
KTL
FTB
GUR
JND
SNP
SRS
BWN
PNP
NNL
PWL
YNR
ROUND 2 ROUND 1
n=15
0
20
40
60
80
100
EXPLAINSITUATION
TO MOTHER
CONTINUETO BF
KEEPAIRWAYS
OPEN
BEGINANTIBIOTICS
REFER
ROUND 1
KNOWLEDGE OF MANAGEMENT ABOUT INFECTION IN
NEWBORN
57
51
49
44
40
40
38
33
31
31
31
30
30
28
25
25
24
20
47
36
37
0 10 20 30 40 50 60
RTK
KNL
JJR
KKR
PKL
MWT
KTL
FTB
HSR
JND
BWN
PNP
GUR
SNP
SRS
NNL
PWL
YNR
ROUND 2 ROUND 1
n=15
0
20
40
60
80
100WARMTH OF BABY
PROVIDE EXTRASUPPORT TO
MOTHER FOR BF
MONITOR ABLITYTO BF/SUCKING
CAPACITY OF BABY
MONITOR BABYFOR FIRST 24 Hr
ENSURE INFCETIONPREVENTION
REFER
ROUND 1
KNOWLEDGE ABOUT MANAGEMENT OF LBW (<2.5 KG)
BABIES
67
60
58
57
52
49
47
47
46
41
38
38
37
35
34
33
32
23
58
45
57
0 20 40 60 80
JJR
RTK
MWT
KNL
PKL
FTB
HSR
KTL
KKR
GUR
SRS
JND
PWL
SNP
NNL
BWN
PNP
YNR
ROUND 2 ROUND 1
n=15
0
20
40
60
80
100
DEPRESSEDBREATHING
FLOPPINESS
NOT CRIED ATBIRTH
DELAYEDCRYING AT
BIRTH
HEART RATEBELOW 100
CENTRALCYNANOSIS
ROUND 1
KNOWLEDGE ABOUT SIGN AND SYMPTOMS OF BIRTH
ASPHYXIA
64
61
60
58
54
53
52
47
44
43
42
42
40
37
34
31
27
21
61
51
57
0 20 40 60 80
JJR
KNL
PKL
RTK
HSR
MWT
FTB
KKR
KTL
BWN
NNL
JND
GUR
SRS
SNP
PWL
YNR
PNP
ROUND 2 ROUND 1
n=15
0
20
40
60
80
100CALL FOR HELP
EXPLAIN SITUATIONTO MOTHER
PLACE NEWBORNFACE UP
WRAP OR COVERBABY EXCEPT FACEAND UPPER CHEST
EXTENDED POSITIONOF NECK OFNEWBORN
SUCTION MOUTHTHEN NOSE
START VENTILATIONUSING BAG AND
MASK
ROUND 1
KNOWLEDGE ABOUT STEPS OF RESUSCITATION
58
57
51
49
49
48
45
44
42
41
38
36
35
35
32
28
26
19
56
35
45
0 20 40 60 80
RTK
KNL
PKL
KTL
HSR
JJR
FTB
MWT
BWN
JND
KKR
SNP
NNL
GUR
SRS
PWL
YNR
PNP
ROUND 2 ROUND 1
n=15
0
20
40
60
80
100
PLACE BABYMASK ANDFORM SEAL
ENSUREAPPROPRIATE
SEAL
VENTILATE 1OR 2 TIMESFOR CHEST
RISING
VENTILATE 40-60 PER
MINUTE
DETERMINESPONTINIOUSBREATHING
ROUND 1
KNOWLEDGE ABOUT RESUSCITATION STEP CONT…
61
53
52
52
49
43
40
38
38
37
34
33
32
31
28
23
20
14
53
32
50
0 20 40 60 80
RTK
KNL
HSR
PKL
JJR
FTB
MWT
KKR
KTL
JND
NNL
GUR
BWN
SNP
SRS
YNR
PWL
PNP
ROUND 2 ROUND 1
n=15
Knowledge about what to do if newborn start breathing after initial resuscitation
0
20
40
60
80
100KEEP BABY WARM
INITIATE BFMONITORING THE
BABY
ROUND 158
56
49
48
43
42
36
36
36
35
31
26
24
23
22
22
22
17
52
33
55
0 20 40 60 80
RTK
JJR
KNL
HSR
JND
PKL
KTL
PWL
MWT
KKR
NNL
BWN
PNP
SNP
FTB
YNR
SRS
GUR
ROUND 2 ROUND 1
n=15
0
20
40
60
80
100
CONTINUE TO
VENTILATE
ADMINISTER
OXYGEN
ASCESSNEED FORSPECIAL
CARE
INTUBATEBABY
REFERBABY
ROUND 1
What to do ? If Newborn is not breathing after initial Resuscitation
55
49
45
38
37
36
36
34
33
30
26
26
20
18
13
11
10
9
50
37
34
0 20 40 60
RTK
JJR
PKL
HSR
MWT
JND
KNL
KKR
FTB
NNL
SNP
GUR
BWN
KTL
PWL
YNR
SRS
PNP
ROUND 2 ROUND 1
n=15
8684 84
8078
76 75 73 7371
69 69 69 69 68
57
0
20
40
60
80
100
Over all Readiness of facilities in Infrastructure
80
70 70
60 60 60 60 60 60 60 60
54
40 40
30
00
20
40
60
80
100
Availability of Protocols Guideline at Facilities
71 71 71
57 57
4543 43 43 43
29 29 29 29 29 29
0
20
40
60
80
100
Knowledge of Infection Prevention
63 61
56 56 56 54 5452
47
4239
36
9
2 0 00
20
40
60
80
100
Registers and Client Case records
82 81 7975 75 74
71 71 70 70 70 70 69
59
50 50
0
20
40
60
80
100
ESSENTIAL DRUGS, EQUIPMENT AND SUPPLIES
79
7469
6765 65 64
62 61 60 5955 55
5248
46
0
20
40
60
80
100
Over All Status of facilities for ENBC/R Skills
71 69 69 68 68 65 63 63 61 61 59 59 58
49 4843
0
20
40
60
80
100
Over All Status of facilities for ENBC/R
0
80
20
GOOD (75 AND ABOVE) AVERAGE (51 TO 74 ) POOR (BELOW 50)
District Position after1st ROUND
FACILITIES CLASSIFICATION FOR ENBC/R FACILITY READINESS
n=15
NAME OF THE FACILITIES
INFRASTRUCTURE
DELIVERY AND
NEWBORN CARE
SERVICES
ESSENTIAL DRUGS,
EQUIPMENT AND
SUPPLIES
PROTOCOLS AND
GUIDELINES
KNOWLEDGE ABOUT
INFECTION PREVENTIO
N
PROVIDER K0WLEDGE AND SKILLS
REGISTERS AND CLIENT
CASE RECORDS
FACILITY’S OVERALL AVERAGE
PHC KHARAWAR 68 80 75 60 71 79 63 71
PHC BHALAUT 71 83 74 70 57 74 54 69
CHC MEHAM 86 94 79 60 57 60 47 69
CHC KALANORE 84 100 82 60 29 65 56 68
PHC SANGHI 73 70 81 80 43 69 56 68
PHC KAHNOR 76 83 75 60 43 64 56 65
CHC KILOI 84 83 71 60 29 62 54 63
PHC BANIYANI 80 83 70 60 29 65 52 63
DISTT AVG 75 83 70 54 45 61 39 61
Where we are… ?
Score 75% and Above Score 51% to 74% Score 50% and less
NAME OF THE FACILITIES
INFRASTRUCTURE
DELIVERY AND
NEWBORN CARE
SERVICES
ESSENTIAL DRUGS,
EQUIPMENT AND
SUPPLIES
PROTOCOLS AND
GUIDELINES
KNOWLEDGE ABOUT
INFECTION PREVENTIO
N
PROVIDER K0WLEDGE AND SKILLS
REGISTERS AND CLIENT
CASE RECORDS
FACILITY’S OVERALL AVERAGE
PHC GILOD 69 89 70 60 43 55 42 61
DISTT AVG 75 83 70 54 45 61 39 61
PHC SAMAR GOPALPUR
78 83 69 40 29 55 61 59
PHC LAKHAN MAJRA
73 83 71 70 29 48 36 59
PHC BALAND 69 78 70 40 71 67 9 58
SC NIDANA 69 83 50 60 29 52 0 49
CHC MADINA 69 72 59 0 71 59 2 48
SC CHAMARIYA 57 72 50 30 43 46 0 43
Where we are… ?
Score 75% and Above Score 51% to 74% Score 50% and less
61
6160
59
57
56
54
54
52
52
51
49
49
49
47
47
45
43
41
39
0 20 40 60 80
HSR
RTK
JJR
KNL
PKL
RWR
KKR
MWT
BWN
JND
AMB
YNR
KTL
GUR
SRS
FTB
PNP
SNP
PWL
NNL
ROUND 1
Essential Newborn Care District Average
65
56
52
52
45
41
0 10 20 30 40 50 60 70
JIND
PNP
PWL
ROUND 1 ROUND 2
District Position after1st ROUND After 2nd ROUND
Thank You
46
