117

(Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

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Page 1: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Area (in lac sq kilometers) ndash 342

Population Densitysq km ndash 201

Population ndash 68621 lacs

(Male ndash 35620 Female ndash 33001)

Literacy Rate () ndash 6706

(Male ndash 8051 Female ndash 5266)

Decadal Population Growth (2001-2011) - 2144 (It was 2841 as per census 2001)

Sex Ratio ndash 926

Child sex ratio-883

Total number of Districts ndash 33

High Priority Districts ndash 10

Tribal Districts ndash 06 (03 under HPD)

Desert Districts ndash 11

STATE DEMOGRAPHY

Tribal District

Other District

High Priority District

State Health Infrastructure SNo Particulars Numbers

1 District Hospitals 33

2 Sub divisional hospitals 19

3 Satellite hospitals 8

4 Other hospitals 52

5 Community Health Centers 567

6 Primary Health Centres (Rural) 2082

7 Primary Health Centres (Urban) 51

8 Sub CentresAid Post City 14420

9 Dispensaries 194

10 Mother amp Child Welfare Centers 118

11 Beds 46603

Note -25 Institutions affiliated with medical college are not included in the list

Our geographical spread huge size of admn units population density and limited availability of manpower makes e-governance for our state not a fancy idea but a structural requirement

Biggest challenge to e-gov

bull It has been observed so many times in many e-governance initiatives that they are planned executed and even followed up to some extent and for some time but

bull Either the initiative is personality-based or

bull Sustainability is not in-built in it for long run

So many successful e-gov models are not visible now helliphelliphelliphelliphelliphellip

I am going to discuss few

bullPCTSHMIS

bullASHA Soft

bullOJAS

bullSNA databasewebsite

bullArogya online

bull IMPACT

bullCHRIS

I am going to discuss

bullKuposhan Watch

bullSNCU Online

bulle-Aushadhi

bulle- Upkaran

bullGPS on AmbulancesMMUMMV

bullUse of M-app for better communication transparency and governance

Home page of PCTS (Pregnancy Child

Tracking amp Health Services Management System)

Dashboard of health services on PCTS to assist in better planning and decision-making

Pregnancy Child Tracking amp Health Services Management System

Maternal Care New born care population control and

better health services have always been issues of

national concern PCTS is a Citizen centric

application which is used as an effective tool in

Rajasthan for this purpose Beneficiaries include

Pregnant women Children ANMs amp other health

officials at health facilities and health

administrators

bull Implemented through out the state since 2008

bull All 16500+ health institutions and all 44000+ villages are

covered

bull Data capturing directly from PHCCHCBlock and hospitals

bull Directly connects the citizen with the government as the

government can reach individual citizen through Swasthya

Sandesh Sewa

bull Integrated with other portals

bull PCTS exports data to MCTS of GoI on daily basis

bull PCTS provides data to HMIS of GoI on monthly basis

bull Has been integrated with ASHA Soft for online payment to ASHAs

bull Has been integrated with OJAS for Direct Benefit Transfer to JSY

and Shubhlaxmi Beneficiaries

PCTS - Outreach amp Coverage

The system presently hosts

bull More than 7000000 (70 lac) Records of ANC registration

bull More than 6000000 (60 lac) Records of deliveries

bull More than 43000000 (43 crore) Records of immunisation

PCTS - Outreach amp Coverage

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 2: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

State Health Infrastructure SNo Particulars Numbers

1 District Hospitals 33

2 Sub divisional hospitals 19

3 Satellite hospitals 8

4 Other hospitals 52

5 Community Health Centers 567

6 Primary Health Centres (Rural) 2082

7 Primary Health Centres (Urban) 51

8 Sub CentresAid Post City 14420

9 Dispensaries 194

10 Mother amp Child Welfare Centers 118

11 Beds 46603

Note -25 Institutions affiliated with medical college are not included in the list

Our geographical spread huge size of admn units population density and limited availability of manpower makes e-governance for our state not a fancy idea but a structural requirement

Biggest challenge to e-gov

bull It has been observed so many times in many e-governance initiatives that they are planned executed and even followed up to some extent and for some time but

bull Either the initiative is personality-based or

bull Sustainability is not in-built in it for long run

So many successful e-gov models are not visible now helliphelliphelliphelliphelliphellip

I am going to discuss few

bullPCTSHMIS

bullASHA Soft

bullOJAS

bullSNA databasewebsite

bullArogya online

bull IMPACT

bullCHRIS

I am going to discuss

bullKuposhan Watch

bullSNCU Online

bulle-Aushadhi

bulle- Upkaran

bullGPS on AmbulancesMMUMMV

bullUse of M-app for better communication transparency and governance

Home page of PCTS (Pregnancy Child

Tracking amp Health Services Management System)

Dashboard of health services on PCTS to assist in better planning and decision-making

Pregnancy Child Tracking amp Health Services Management System

Maternal Care New born care population control and

better health services have always been issues of

national concern PCTS is a Citizen centric

application which is used as an effective tool in

Rajasthan for this purpose Beneficiaries include

Pregnant women Children ANMs amp other health

officials at health facilities and health

administrators

bull Implemented through out the state since 2008

bull All 16500+ health institutions and all 44000+ villages are

covered

bull Data capturing directly from PHCCHCBlock and hospitals

bull Directly connects the citizen with the government as the

government can reach individual citizen through Swasthya

Sandesh Sewa

bull Integrated with other portals

bull PCTS exports data to MCTS of GoI on daily basis

bull PCTS provides data to HMIS of GoI on monthly basis

bull Has been integrated with ASHA Soft for online payment to ASHAs

bull Has been integrated with OJAS for Direct Benefit Transfer to JSY

and Shubhlaxmi Beneficiaries

PCTS - Outreach amp Coverage

The system presently hosts

bull More than 7000000 (70 lac) Records of ANC registration

bull More than 6000000 (60 lac) Records of deliveries

bull More than 43000000 (43 crore) Records of immunisation

PCTS - Outreach amp Coverage

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 3: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Our geographical spread huge size of admn units population density and limited availability of manpower makes e-governance for our state not a fancy idea but a structural requirement

Biggest challenge to e-gov

bull It has been observed so many times in many e-governance initiatives that they are planned executed and even followed up to some extent and for some time but

bull Either the initiative is personality-based or

bull Sustainability is not in-built in it for long run

So many successful e-gov models are not visible now helliphelliphelliphelliphelliphellip

I am going to discuss few

bullPCTSHMIS

bullASHA Soft

bullOJAS

bullSNA databasewebsite

bullArogya online

bull IMPACT

bullCHRIS

I am going to discuss

bullKuposhan Watch

bullSNCU Online

bulle-Aushadhi

bulle- Upkaran

bullGPS on AmbulancesMMUMMV

bullUse of M-app for better communication transparency and governance

Home page of PCTS (Pregnancy Child

Tracking amp Health Services Management System)

Dashboard of health services on PCTS to assist in better planning and decision-making

Pregnancy Child Tracking amp Health Services Management System

Maternal Care New born care population control and

better health services have always been issues of

national concern PCTS is a Citizen centric

application which is used as an effective tool in

Rajasthan for this purpose Beneficiaries include

Pregnant women Children ANMs amp other health

officials at health facilities and health

administrators

bull Implemented through out the state since 2008

bull All 16500+ health institutions and all 44000+ villages are

covered

bull Data capturing directly from PHCCHCBlock and hospitals

bull Directly connects the citizen with the government as the

government can reach individual citizen through Swasthya

Sandesh Sewa

bull Integrated with other portals

bull PCTS exports data to MCTS of GoI on daily basis

bull PCTS provides data to HMIS of GoI on monthly basis

bull Has been integrated with ASHA Soft for online payment to ASHAs

bull Has been integrated with OJAS for Direct Benefit Transfer to JSY

and Shubhlaxmi Beneficiaries

PCTS - Outreach amp Coverage

The system presently hosts

bull More than 7000000 (70 lac) Records of ANC registration

bull More than 6000000 (60 lac) Records of deliveries

bull More than 43000000 (43 crore) Records of immunisation

PCTS - Outreach amp Coverage

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 4: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Biggest challenge to e-gov

bull It has been observed so many times in many e-governance initiatives that they are planned executed and even followed up to some extent and for some time but

bull Either the initiative is personality-based or

bull Sustainability is not in-built in it for long run

So many successful e-gov models are not visible now helliphelliphelliphelliphelliphellip

I am going to discuss few

bullPCTSHMIS

bullASHA Soft

bullOJAS

bullSNA databasewebsite

bullArogya online

bull IMPACT

bullCHRIS

I am going to discuss

bullKuposhan Watch

bullSNCU Online

bulle-Aushadhi

bulle- Upkaran

bullGPS on AmbulancesMMUMMV

bullUse of M-app for better communication transparency and governance

Home page of PCTS (Pregnancy Child

Tracking amp Health Services Management System)

Dashboard of health services on PCTS to assist in better planning and decision-making

Pregnancy Child Tracking amp Health Services Management System

Maternal Care New born care population control and

better health services have always been issues of

national concern PCTS is a Citizen centric

application which is used as an effective tool in

Rajasthan for this purpose Beneficiaries include

Pregnant women Children ANMs amp other health

officials at health facilities and health

administrators

bull Implemented through out the state since 2008

bull All 16500+ health institutions and all 44000+ villages are

covered

bull Data capturing directly from PHCCHCBlock and hospitals

bull Directly connects the citizen with the government as the

government can reach individual citizen through Swasthya

Sandesh Sewa

bull Integrated with other portals

bull PCTS exports data to MCTS of GoI on daily basis

bull PCTS provides data to HMIS of GoI on monthly basis

bull Has been integrated with ASHA Soft for online payment to ASHAs

bull Has been integrated with OJAS for Direct Benefit Transfer to JSY

and Shubhlaxmi Beneficiaries

PCTS - Outreach amp Coverage

The system presently hosts

bull More than 7000000 (70 lac) Records of ANC registration

bull More than 6000000 (60 lac) Records of deliveries

bull More than 43000000 (43 crore) Records of immunisation

PCTS - Outreach amp Coverage

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 5: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

I am going to discuss few

bullPCTSHMIS

bullASHA Soft

bullOJAS

bullSNA databasewebsite

bullArogya online

bull IMPACT

bullCHRIS

I am going to discuss

bullKuposhan Watch

bullSNCU Online

bulle-Aushadhi

bulle- Upkaran

bullGPS on AmbulancesMMUMMV

bullUse of M-app for better communication transparency and governance

Home page of PCTS (Pregnancy Child

Tracking amp Health Services Management System)

Dashboard of health services on PCTS to assist in better planning and decision-making

Pregnancy Child Tracking amp Health Services Management System

Maternal Care New born care population control and

better health services have always been issues of

national concern PCTS is a Citizen centric

application which is used as an effective tool in

Rajasthan for this purpose Beneficiaries include

Pregnant women Children ANMs amp other health

officials at health facilities and health

administrators

bull Implemented through out the state since 2008

bull All 16500+ health institutions and all 44000+ villages are

covered

bull Data capturing directly from PHCCHCBlock and hospitals

bull Directly connects the citizen with the government as the

government can reach individual citizen through Swasthya

Sandesh Sewa

bull Integrated with other portals

bull PCTS exports data to MCTS of GoI on daily basis

bull PCTS provides data to HMIS of GoI on monthly basis

bull Has been integrated with ASHA Soft for online payment to ASHAs

bull Has been integrated with OJAS for Direct Benefit Transfer to JSY

and Shubhlaxmi Beneficiaries

PCTS - Outreach amp Coverage

The system presently hosts

bull More than 7000000 (70 lac) Records of ANC registration

bull More than 6000000 (60 lac) Records of deliveries

bull More than 43000000 (43 crore) Records of immunisation

PCTS - Outreach amp Coverage

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 6: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

I am going to discuss

bullKuposhan Watch

bullSNCU Online

bulle-Aushadhi

bulle- Upkaran

bullGPS on AmbulancesMMUMMV

bullUse of M-app for better communication transparency and governance

Home page of PCTS (Pregnancy Child

Tracking amp Health Services Management System)

Dashboard of health services on PCTS to assist in better planning and decision-making

Pregnancy Child Tracking amp Health Services Management System

Maternal Care New born care population control and

better health services have always been issues of

national concern PCTS is a Citizen centric

application which is used as an effective tool in

Rajasthan for this purpose Beneficiaries include

Pregnant women Children ANMs amp other health

officials at health facilities and health

administrators

bull Implemented through out the state since 2008

bull All 16500+ health institutions and all 44000+ villages are

covered

bull Data capturing directly from PHCCHCBlock and hospitals

bull Directly connects the citizen with the government as the

government can reach individual citizen through Swasthya

Sandesh Sewa

bull Integrated with other portals

bull PCTS exports data to MCTS of GoI on daily basis

bull PCTS provides data to HMIS of GoI on monthly basis

bull Has been integrated with ASHA Soft for online payment to ASHAs

bull Has been integrated with OJAS for Direct Benefit Transfer to JSY

and Shubhlaxmi Beneficiaries

PCTS - Outreach amp Coverage

The system presently hosts

bull More than 7000000 (70 lac) Records of ANC registration

bull More than 6000000 (60 lac) Records of deliveries

bull More than 43000000 (43 crore) Records of immunisation

PCTS - Outreach amp Coverage

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 7: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Home page of PCTS (Pregnancy Child

Tracking amp Health Services Management System)

Dashboard of health services on PCTS to assist in better planning and decision-making

Pregnancy Child Tracking amp Health Services Management System

Maternal Care New born care population control and

better health services have always been issues of

national concern PCTS is a Citizen centric

application which is used as an effective tool in

Rajasthan for this purpose Beneficiaries include

Pregnant women Children ANMs amp other health

officials at health facilities and health

administrators

bull Implemented through out the state since 2008

bull All 16500+ health institutions and all 44000+ villages are

covered

bull Data capturing directly from PHCCHCBlock and hospitals

bull Directly connects the citizen with the government as the

government can reach individual citizen through Swasthya

Sandesh Sewa

bull Integrated with other portals

bull PCTS exports data to MCTS of GoI on daily basis

bull PCTS provides data to HMIS of GoI on monthly basis

bull Has been integrated with ASHA Soft for online payment to ASHAs

bull Has been integrated with OJAS for Direct Benefit Transfer to JSY

and Shubhlaxmi Beneficiaries

PCTS - Outreach amp Coverage

The system presently hosts

bull More than 7000000 (70 lac) Records of ANC registration

bull More than 6000000 (60 lac) Records of deliveries

bull More than 43000000 (43 crore) Records of immunisation

PCTS - Outreach amp Coverage

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 8: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Dashboard of health services on PCTS to assist in better planning and decision-making

Pregnancy Child Tracking amp Health Services Management System

Maternal Care New born care population control and

better health services have always been issues of

national concern PCTS is a Citizen centric

application which is used as an effective tool in

Rajasthan for this purpose Beneficiaries include

Pregnant women Children ANMs amp other health

officials at health facilities and health

administrators

bull Implemented through out the state since 2008

bull All 16500+ health institutions and all 44000+ villages are

covered

bull Data capturing directly from PHCCHCBlock and hospitals

bull Directly connects the citizen with the government as the

government can reach individual citizen through Swasthya

Sandesh Sewa

bull Integrated with other portals

bull PCTS exports data to MCTS of GoI on daily basis

bull PCTS provides data to HMIS of GoI on monthly basis

bull Has been integrated with ASHA Soft for online payment to ASHAs

bull Has been integrated with OJAS for Direct Benefit Transfer to JSY

and Shubhlaxmi Beneficiaries

PCTS - Outreach amp Coverage

The system presently hosts

bull More than 7000000 (70 lac) Records of ANC registration

bull More than 6000000 (60 lac) Records of deliveries

bull More than 43000000 (43 crore) Records of immunisation

PCTS - Outreach amp Coverage

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 9: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Pregnancy Child Tracking amp Health Services Management System

Maternal Care New born care population control and

better health services have always been issues of

national concern PCTS is a Citizen centric

application which is used as an effective tool in

Rajasthan for this purpose Beneficiaries include

Pregnant women Children ANMs amp other health

officials at health facilities and health

administrators

bull Implemented through out the state since 2008

bull All 16500+ health institutions and all 44000+ villages are

covered

bull Data capturing directly from PHCCHCBlock and hospitals

bull Directly connects the citizen with the government as the

government can reach individual citizen through Swasthya

Sandesh Sewa

bull Integrated with other portals

bull PCTS exports data to MCTS of GoI on daily basis

bull PCTS provides data to HMIS of GoI on monthly basis

bull Has been integrated with ASHA Soft for online payment to ASHAs

bull Has been integrated with OJAS for Direct Benefit Transfer to JSY

and Shubhlaxmi Beneficiaries

PCTS - Outreach amp Coverage

The system presently hosts

bull More than 7000000 (70 lac) Records of ANC registration

bull More than 6000000 (60 lac) Records of deliveries

bull More than 43000000 (43 crore) Records of immunisation

PCTS - Outreach amp Coverage

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 10: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

bull Implemented through out the state since 2008

bull All 16500+ health institutions and all 44000+ villages are

covered

bull Data capturing directly from PHCCHCBlock and hospitals

bull Directly connects the citizen with the government as the

government can reach individual citizen through Swasthya

Sandesh Sewa

bull Integrated with other portals

bull PCTS exports data to MCTS of GoI on daily basis

bull PCTS provides data to HMIS of GoI on monthly basis

bull Has been integrated with ASHA Soft for online payment to ASHAs

bull Has been integrated with OJAS for Direct Benefit Transfer to JSY

and Shubhlaxmi Beneficiaries

PCTS - Outreach amp Coverage

The system presently hosts

bull More than 7000000 (70 lac) Records of ANC registration

bull More than 6000000 (60 lac) Records of deliveries

bull More than 43000000 (43 crore) Records of immunisation

PCTS - Outreach amp Coverage

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 11: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

The system presently hosts

bull More than 7000000 (70 lac) Records of ANC registration

bull More than 6000000 (60 lac) Records of deliveries

bull More than 43000000 (43 crore) Records of immunisation

PCTS - Outreach amp Coverage

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 12: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

PCTS

LokLF lUnsrsquok lsok PCTS

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 13: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

cPps ds ekrkampfirk

dks

Vhdkdjk gsrq

Lejk lansk

LokLF lUnsrsquok lsok PCTS

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 14: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

LokLF lUnsrsquok lsok PCTS

ANM dks

vkxkeh 15 fnol

dh vofk esa

lEHkkfor izloksa gsrq

ikfkd lwpuk

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 15: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

ldquovkkkamplkWparaV dh dgkuh ampvkadM+ksa dh tqckuh rsquorsquo

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 16: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Current scenario bull A woman hired by Women amp Child deptt

but works for Medical amp health also bull Fixed Rs 1600 from WCD and MampH pays

incentives bull Currently around 47000 ASHA Sahyogini are

working in the State bull They are given a small village or a cluster of

houses for ensuring better awareness about health RCH activities and family welfare services in the village

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 17: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Why ASHA Soft

bull To ensure timely and transparent online payment to ASHAs

bull To improve the system for effective monitoring their performance on 26 parameters

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 18: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Strengths of ASHA Soft bull No capital investment in any manner and at any level (Existing PCs

are used)

bull Existing information AssistantsComputer operators used ndashNo new HR hired

bull Existing SMS Gateway is usedhellipbetter used

bull Existing banker is our partner

bull Utility of PCTSMCTS which in turn strengthens entry regime

bull No need to compile information manually

bull Informed decisions are encouraged

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 19: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

ASHA Soft integrated with PCTS

For name based reporting and verification of beneficiary

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 20: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

PCTS - some facts bull Pregnancy amp Child Tracking System

bull Rajasthan has been pioneer in starting this

bull Started since October 2008

bull For 7 main RCH activities

bull Progress has been not very encouraging

bull GoI places a lot of reliance on this system

bull Based on ANMSDR for reporting and computer operators for feeding the data

ASHA Soft was decided to be converged with existing PCTS rather then creating a parallel system for monitoring the RCH

activities

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 21: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

What is ASHA Soft bull It is a web-based software for online

payment to their bank account and monitoring the performance bull It captures beneficiaries details of services given by ASHA to the

community

bull It generates various reports to monitor the progress of the programme

bull It is developed by the NIC-Rajasthan State Unit and for online payment Bank of Baroda is our partner

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 22: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Verification of ASHA Claim

Form by ANM

Online data entry of ASHA

Claim Form and verification on

ASHA Soft by IA PHC Health

Supervisor Data Entry Operator

Release of Sanction or

Fund Transfer Order (FTO) by

MOIC with assistance of

LHV Accountant

Release of payment using

Digital Signature

Certificate by CMHO

Payment is being

transferred directly to the

Bank AC of ASHA

SMS is being sent to ASHA

for information of online payment

Flow diagram of Payment process in ASHA-Soft

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 23: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Important Timelines SNo Activity Responsibility Date

1 Verification of ASHA Claim Form

ANM

Between 26th ndash 30th of the

month 2 Online data entry of ASHA Claim Form and its verification on ASHA Soft

IA PHC Health Supervisor Data Entry Operator

3 Release of sanction or fund transfer order

MOIC with assistance of

LHV Accountant

By 4th of the next month

4 Release of payment (using DSC)

CMHO Between 5th to 7th of the next month

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 24: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Home page of ASHA Soft

Website address

httpashasoftrajnicin

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 25: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Line List Verification amp Sanction menu (Major category of services)

1 Maternal Health Services

2 Child Health Services

3 Immunization Services

4 Family Planning Services

5 National Health Programmes

6 Meetings

Continuehellip

Between 26th to 30th of the month IA PHC Health Supervisor Data Entry Operator are performing the online data entry of certified ASHA Claim Forms By 4th of the next month MOIC with assistance of LHV Accountant are ensuring to Release of Sanction or Generate Fund Transfer Order

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 26: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

1 Maternal Health Services bull3 ANC Checkups bullInstitutional Delivery

Promotions bullMaternal Death Reporting

2 Child Health Services bullHBNC bullHBNC + (Only in Dausa Alwar amp

Bharatpur districts)

bullInfant Death Reporting bullReferral of SAM Child bullFollow up of SAM Child bullSNCU Follow ups

3 Immunization Services bullSocial Mobilization bullFull Immunization bullDPT Booster

4 Family Planning Services bullSterilization bullDelay of Child Birth after

marriage bull3 Year spacing between

two children bullPPIUCD

5 National Health Programme bullTreatment of TB Cases bullCataract Operations bullTreatment of Leprosy Cases bullPreparation of Blood Slides bullTreatment of Malaria Cases

6 Meetings bullMonthly Meeting Payments bullRoutine Monthly Activities

Line List

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 27: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Release Payment using DSC

Between 5th to 7th of the next month CMHOrsquos are releasing the payment (using DSC)

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 28: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

For payment information to ASHA SMS are being sent on ASHArsquos registered mobile no

SMS

Aapke bank account mein July 2015 mahine ki protsahan rashi Rs 3500- jama kara di gayi hai Swasthya sewaye

pradan karne ke liye dhanyawad ASHA Soft NHM Rajasthan

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 29: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Reporting The most powerful tool

bull After complication of the entries and verification for a given month the reports can been seen

bull The programme generates the reports based on the fixed parameters in master and data entries done under various heads

bull System is providing many useful reports for Statedistrict and blocks to making further plan of action

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 30: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Report which are available bull Non-functional ASHAs

bull Cases where payments are extraordinarily high

bull ASHAs who are performing good

bull Supervisors with ASHAs with low performance

bull PHCCHC with lowest performing ASHAs

bull Blocks with ASHAs who are not performing as per need in RCH activities

bull Districts with lower ASHA performance indices

bull Which activities are not generally taken up by the ASHAs

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 31: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Decisions based on reports-Example

bull Post graduate Graduate ASHAs doing excellent work may be preferred in Supervisory job after following a process

bull Can we reserve seats in ANM course

bull Training need assessment would be based on actual evidences rather than guess work

bull BHSPHS cadre would also be exposed as ASHAs with goodbad performance will be directly linked to their supervision quality

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 32: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Advantage bull Better monitoring and transparent payments

bull A very big boost to PCTS entry system

bull Line listing needs would lead to better health indicators

bull Repeated transactions wonrsquot be possible hence quality of data has improved

bull Transactions are now transparent and at the same time no payment without verification can be possible

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 33: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Contact details Email ashasoft-rjnicin Phone no 0141-2225685

Mob no 9829930053 9414254324 9413417399

ASHA Helpline Mobile no 8290266668 8290266669

(ASHA can inform payment related grievances on ASHA Helpline)

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 34: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Changes

by

ASHA Soft

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 35: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

There was no evidence about payment to ASHA (in how many days it is being paid) but ASHArsquos were getting the payment in average time period of 67 days

Nowhelliphellip

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 36: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

67

12

0

10

20

30

40

50

60

70

80

Before After

No of days for payments Before and After ASHASoft

Before

After

Now the time taken in payment of incentives is 12 days

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 37: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Whether we were able to see how much payments we are paying every month

Nowhelliphellip

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 38: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

41

5

44

2

16

38

77

7

73

73

7

72

5

72

3

82

7

81

4

73

6

0

2

4

6

8

10

12

14

16

18

Dec

1

4

Jan

1

5

Feb

1

5 amp

Mar

ch

15

Ap

ril

15

May

15

Jun

e 1

5

July

15

Au

gu

15

Sep

t 1

5

Oct

1

5

No

v 1

5

Month wise incentive paid (Rs In crore)

It is possible

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 39: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Average Reporting Status (from Dec 14 to Nov 15)

40839 39162 38649 38387

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

Data Enterd Verified Sanction Payment Realease

DataEnterd

Verified

Sanction

PaymentRealease

During this year total 45937 ASHArsquos benefited through ASHA Soft

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 40: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Earlier we were not able to know who is the best performing ASHA and how much incentive she was getting

Nowhelliphellip

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 41: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Best Performing ASHA in some districts (Dec 14 to Nov 15)

53

79

56

24

95

10

91

52

71

10

68

10

57

40

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

SanjanaDevi

KaushalyaSuthar

BhagwariDevi

Dhiranjana Savitri SoniGeeta Devi Indra Sen

Ajmer Banswara Barmer Bikaner Bundi Churu Chittorgarh

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 42: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Earlier we were not able to know whether qualification of ASHAs are related to activeness or not

Nowhelliphellip

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 43: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

64

4

68

4

55

5

55

2

71

3

80

5

78

1

88

3

82

7

11

14

11

99

12

99

14

45

14

14

17

51

59

21

59

18

59

51

62

78

58

69

000

1000

2000

3000

4000

5000

6000

7000

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

age of totalAshas

Post Graduate Graduate 12th 10th 8th

5000-and below

5001 to10000

10001 to15000

15001 andabove

Asharsquos incentive (in Rs) according to their Educational qualification (Dec 14 to Nov 15)

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 44: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

85

69

86

81

88

34

90

71

94

48

000

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

age of total Ashas age of total Ashas age of total Ashas age of total Ashas age of total Ashas

Post Graduate Graduate 12th 10th 8th

Activeness according to Qualification based on Education

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 45: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Earlier we were not able to know how much incentive ASHAs were taking in different type of activities

Nowhelliphellip

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 46: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Maternal Health 3211

Child Health 1591

Immunization Services 1517

Family Planning Services 886

National Programme 135

Monthly Meetings 2659

Activity wise contribution of ASHAs

On the basis

of one year data

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 47: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Activity wise contribution of ASHAs

Maternal Health

3211

Child Health 1591

Immunization Services 1617

Family Planning Services 786

National Programme

135

Monthly Meetings 2659

Nov 2015

Maternal Health

21

Child Health 10

Immunization Services

16

Family Planning Dervices

16 National

Programme 1

Monthly Meetings

36

Nov 2014

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 48: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Earlier we were not able to know performance of different districts with respect to many activities as per contribution by ASHAs

Nowhelliphellip

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 49: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Performance of Districts under various services (Dec 2014 to Nov 2015)

Ajm

er

Alw

ar

Ban

swar

a

Bar

an

Bar

mer

Bh

arat

pu

r

Bh

ilwar

a

Bik

aner

Bu

nd

i

Ch

itto

rgar

h

Ch

uru

Dau

sa

Dh

olp

ur

Du

nga

rpu

r

Gan

gan

agar

Han

um

anga

rh

Jaip

ur

I

Jaip

ur

II

Jais

alm

er

Jalo

re

Jhal

awar

Jhu

njh

un

u

Jod

hp

ur

Kar

auli

Ko

ta

Nag

aur

Pal

i

Pra

tap

garh

Raj

sam

and

Saw

ai M

adh

op

ur

Sika

r

Siro

hi

Ton

k

Ud

aip

ur

Maternal Health Child Health Immunization Services

Family Planning Dervices National Programme Monthly Meetings

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 50: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Earlier district level analysis of ASHArsquos contribution in different activities eg maternal health activities were not possible at all Which activities ASHAs do or they ignore

Nowhelliphellip

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 51: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Maternal Health Services (in ) 3

61

7

35

85

31

67

30

11

29

55

28

76

28

72

25

55

23

88

22

76

22

49

22

48

22

28

21

57

21

05

21

02

20

94

20

84

20

16

19

16

19

16

18

65

18

61

17

56

16

77

16

74

16

63

14

62

14

01

13

61

11

48

10

71

10

33

56

1

32

9

Ch

uru

Bik

aner

Dh

olp

ur

Bh

ilwar

a

Du

nga

rpu

r

Siro

hi

Jalo

re

Jhu

njh

un

u

Sika

r

Pal

i

Ch

itto

rgar

h

Gan

gan

agar

Ajm

er

Nag

aur

Jaip

ur

I

Ban

swar

a

Raj

asth

an

Han

um

anga

rh

Bar

an

Ton

k

Bh

arat

pu

r

Ud

aip

ur

Bu

nd

i

Raj

sam

and

Kar

auli

Alw

ar

Ko

ta

Jod

hp

ur

Jaip

ur

II

Jhal

awar

Saw

ai M

adh

op

ur

Jais

alm

er

Dau

sa

Bar

me

r

Pra

tap

garh

During Dec 2014

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 52: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Maternal Health Services (in ) Nov 2015 4

48

2

44

38

42

62

41

13

41

12

40

81

39

70

39

46

37

85

36

72

36

65

36

17

35

89

35

87

34

65

34

57

34

46

34

44

34

40

34

31

34

09

33

85

33

61

33

61

33

37

32

89

32

88

32

62

31

25

27

65

27

58

27

42

27

30

27

08

26

41

000

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 53: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

National Programme (in ) (Dec 14) 2

00

19

4

16

8

16

7

16

1

15

4

14

5

14

0

13

0

13

0

12

8

12

5

11

5

10

4

10

2

10

1

09

6

09

3

09

2

08

6

08

3

08

3

07

6

07

4

07

3

07

0

06

1

05

6

05

3

04

7

04

6

03

0

02

4

01

6

00

0

Han

um

anga

rh

Ch

itto

rgar

h

Jalo

re

Dh

olp

ur

Sika

r

Ud

aip

ur

Pal

i

Raj

sam

and

Bik

aner

Jaip

ur

I

Gan

gan

agar

Jais

alm

er

Ton

k

Saw

ai M

adh

op

ur

Bh

ilwar

a

Ajm

er

Raj

asth

an

Ch

uru

Jaip

ur

II

Bar

an

Alw

ar

Nag

aur

Jhal

awar

Bar

me

r

Dau

sa

Jod

hp

ur

Siro

hi

Bu

nd

i

Ko

ta

Kar

auli

Jhu

njh

un

u

Bh

arat

pu

r

Du

nga

rpu

r

Ban

swar

a

Pra

tap

garh

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 54: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

National Programme (in ) Nov 2015

36

0

26

9

26

9

26

8

26

6

20

0

19

6

19

6

19

6

19

6

19

4

19

4

18

5

18

2

17

3

16

1

15

9

15

7

15

1

14

4

14

2

14

1

13

7

13

4

13

2

12

3

11

1

10

7

10

0

09

1

08

3

07

9

07

2

03

9

03

5

000

050

100

150

200

250

300

350

400

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 55: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Monthly Meetings (in ) Dec 14

62

51

55

73

48

42

46

08

45

09

44

34

43

83

43

57

43

24

40

43

39

81

38

58

38

04

36

92

36

90

36

66

36

59

36

44

36

43

36

40

36

30

35

33

34

93

34

27

33

45

33

16

32

92

32

25

32

10

30

36

28

02

27

15

26

15

24

49

24

20

Jais

alm

er

Bar

me

r

Raj

sam

and

Pra

tap

garh

Nag

aur

Ud

aip

ur

Du

nga

rpu

r

Gan

gan

agar

Dau

sa

Bar

an Pal

i

Jod

hp

ur

Ban

swar

a

Saw

ai M

adh

op

ur

Jhu

njh

un

u

Han

um

anga

rh

Jaip

ur

II

Bh

arat

pu

r

Raj

asth

an

Alw

ar

Siro

hi

Sika

r

Jhal

awar

Ton

k

Kar

auli

Ch

itto

rgar

h

Jaip

ur

I

Ajm

er

Jalo

re

Bik

aner

Bu

nd

i

Ch

uru

Bh

ilwar

a

Ko

ta

Dh

olp

ur

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 56: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Monthly Meetings (in ) Nov 2015

40

52

37

62

36

65

35

05

34

55

34

32

33

80

31

39

31

28

30

64

28

66

28

63

28

63

28

55

28

15

27

90

27

80

27

68

27

64

27

54

27

03

26

90

26

42

26

37

26

11

26

01

25

73

25

08

24

47

23

16

22

47

21

05

20

74

19

40

18

76

000

500

1000

1500

2000

2500

3000

3500

4000

4500

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 57: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Comparison between regular and National programme activities

(Rs in Crore)

ANC 1447

Inst Delivery

1301

HBNC 1198

RI (full amp

booster) 675

Steril amp steril on

1-2 children

554

DOTs 097

Catract 003

Leprosy 0002

Maleria Slide 014

0

PCTS Regular Activities Nation Programme Activities

VISION It shows ASHArsquos are not taking interest in national programme activities they should be motivated towards these activities

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 58: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

IMPACT of ASHA Soft

Improvement in line list data of MCTSPCTS

Mother Count (+ 31 )

Child Count (+19)

One ASHA One Aganwadi + Charge of One Additional Aganwadi (1+1)

Performance of Block PHC Health Supervisors has been improved

Follow-up visits of HBNC has improved care of infants and referral of sick neonates

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 59: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

IMPACT of ASHA Soft

In HBNC follow-up one ANM visit is mandatory

55 days gaps have been made between two ANC services

On the basis of data 359 zero performing ASHA has been removed

516 new ASHA recruited against vacancy Government has agreed to provide Tablet PC to

ASHAs on pilot basis to improve their skills 7 districts have been taken up

Now ANC services will become realistic Dummy data cant be entered

ASHArsquos experience in there own words

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 60: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

ASHA empowerment due to ASHA Soft

250 Best performing ASHAs has been identified as lsquoHead ASHArsquo These ASHAs will get additional incentive of Rs 1000- per month

More than 1020 Best performing ASHA have been selected for higher education through open board for 10th and 12th Std Course fees will be borne by Government

ASHA Diwas

Mobile Academy

ASHA Reward

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 61: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

ASHA Soft backed by m-App

bull There is a Whatsapp group of all the state level and district level officers employees connected with ASHA Soft

bullContinuous mentoring and monitoring

bull Technical and managerial issues are resolved

bull Exchange of ideas and best practices

bullMoral boost and motivation

bull Sense of competition

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 62: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

In just one year of implementation bull It has attracted the attention of GoI

bull It has been included as one of the best replicable practices in 2015-16

bull 6 states have already visited us Karnataka Maharashtra Punjab Uttarakhand Haryana amp Bihar

bull 3 states are coming - Himachal Pradesh Tripura and Gujarat

bull It has been presented on many platforms- workshops and seminars also

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 63: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Way Forward bull Time lag in payment to ASHAs would be further

reduced

bull Urban ASHAs would also be covered once the concerned PHC CHC get PC with internet

bull ASHAs with tablets some other tool like mobiles feeding their data directly on the system provided system is also strengthened enough to respond to those entries

bull 104 helpline to be used for ASHA related queries soon

bull Reservation for ASHAs in ANM course under consideration

bull Proposal for ASHA Club under consideration

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 64: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

ASHA Soft Raises Hopes in Healthcare

httpehealtheletsonlinecom201506ashasoft-raises-hopes-healthcare

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 65: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

ASHA Soft in News

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 66: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Recognisationshellip

Certificate of Recognition awarded to ldquoMampH Deptt GoR at 4th eHealth Healthcare LEADERSrsquo AWARDS on

12th March 2015rdquo

Elets Knowledge Exchange Awards 2015 on 5th May 2015

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 67: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Recognisationshellip

SKOCH AWARD ndash ldquoOrder of Meritrdquo in 41st SKOCH Summit for Transformative Governance on 22nd ndash 23rd Sept 2015

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 68: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

National Award for e-Governance 2015-2016

ldquoSilver Awardrdquo to ldquoMampH Deptt GoR at Nagpur Maharashtra on 22nd

January 2016rdquo

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 69: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Our vision is to turn ASHA into

Medical Entrepreneurs One dayhellip

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 70: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Home page of OJAS (Online JSY and Shubhlaxmi Payment System)

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 71: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

OJAS bull DIRECT BENEFIT TRANSFER (online payment system

for JSY amp SLY)

bull Started from 1st August 2015

bull At CHC amp Above (CHC Sat Hosp SDH DH MedCol)

bull Coverage ndash More than 600 Govt Health inst

bull Payment transferring ndash more than 2000 cases per

day daily basis FTOs issued without fail

bull Payment transferred ndash Aug 15 to Jan 16

JSY ndash 4868 Crore for 344 Lacs cases

SLY ndash 3495 Crore for 170 Lacs cases

bull Payment Realization (online) - 97

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 72: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Saghan Nirikshan Abhiyaan (Inspection at a click)

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 73: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

SNA Inspection monitoring with a difference

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 74: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Why Saghan Nirikshan Abhiyaan was devised Online

bull

Institution wise information in the form of check list

bull Better monitoring of inspections

bull Analysis of gaps

bull Hospital Infrastructure

bull Cleanliness

bull Human resource

bull Residence quarters

All health facilities including district hospitals Sub-

divisional and satellite hospitals CHCs PHCs

were visited from 10-24 December 2014

AND follow up visits in Feb 2015

Website address httpsnarajmedicalorg

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 75: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Position of Labour Room DHs SDHs Sat Hospitals S No Question DH SH SDH

ह ा नह ी ह ा नह ी ह ा नह ी 1 लबर टबल स फ ह य नह ी 34 0 7 1 20 0

2 लबर टबल पर कल स पड लग ह 28 6 7 1 17 3

3 लबर टबल पर गदद व मककनटॉस बबछ ह 33 1 7 1 17 3

4 लबर टबल पर जीग तो नह ी लगी ह 8 26 0 8 1 19 5 दव की टर उपलबध ह 34 0 5 3 18 2

6 डडल वर उपकरण की टर उपलबध ह 34 0 5 3 20 0 7 आईयसीडी पीपीआईयसीडी टर उपलबध ह 34 0 5 3 19 1 8 सभी नवज त को ववट ममन k-1 क इीजकशन ददय ज रह ह कय 31 3 5 3 19 1 9 जो भी टर उपलबध नह ी हो उसको बन न हत ननदमशत कर 22 12 5 3 14 6

10 भर हआ ऑकसीजन मसलडर मय ररीच व म सक 33 1 7 1 20 0 11 बचच क वज़न की मशीन 34 0 6 2 20 0 12 बचचो क अमब बग 34 0 5 3 20 0

13 थम ामीटर बीपी मशीन मय सथटोसकोप 33 1 6 2 20 0 14 फट ऑपरटड सकशन मशीन 24 10 5 3 18 2

15 रडडयनट व मार (यदद ह तो लबर रम सदहत सीसथ म कल की सीखय मलख) 32 2 5 3 20 0 16 हब कटर 31 3 5 3 19 1 17 एडलट अमब बग 33 1 5 3 18 2

18 कचर ननसत रण हत पॉल बग एवी ब लट 33 1 6 2 18 2 19 प वर बकअप 30 4 6 2 17 3

20 प नी मय एलबो ऑपरटड नल 21 13 6 2 15 5 21 बबजल 34 0 6 2 19 1

22 टॉयलट (स फ) मय स बन मग व प नी 26 8 6 2 16 4 23 परद लग ह य नह ी 31 3 6 2 15 5 24 आईईसी एवी परोटोकॉल 33 1 6 2 17 3 25 अन वशयक स म नक टानस आदद रख ह यदद हॉ तो तरीत हट व 7 27 2 6 4 16

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 76: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

m-SNA mobile app Strengthening monitoring to improve healthcare delivery

Developed by Raj IT

Saghan

Abhiyaan Nirikashan

Government of Rajasthan

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 77: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Module 2 simplified PHC SC proforma The template evaluates PHCs SCs

on

8 key criteria

Staff vacancy and attendance

Services provided

Availability of free laboratory tests

Availability of free medicines

Utilization of PHC SC

Physical and medical infrastructure

Monitoring of PHC SC

Quality of service delivery

1

2

3

4

5

6

7

8

PHC SC spot-check template have

been created

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 78: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Module 3 reports and action items (tickets) generated to track status as well as prompt action (12)

Reports on key parameters of facility

performance

Reports on progress of monitoring

activity

Compliance of officers at all levels can be

monitored by CMHO state officers

visits conducted versus planned will be

tracked real-time

Reports on each metric will be generated with

a state district as well as block view

Example HR availability report at block

level

District CMHO RCHO Dy CMHO DPM

District 1 62 70 69 67

District 2 54 59 61 59

District 3 54 63 59 58

District 4 61 70 71 67

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 79: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Module 3 reports and action items (tickets) generated to track status as well as prompt action (22)

Ticket generation and tracking system

Officer to conduct

PHCSC inspection

using m-SNA

Action-items or

tickets generated

automatically

Concerned officer

can view all tickets

and mark tickets as

completed when

action is taken

Tickets auto-

allocated to

concerned officer

(eg vacancy will be

allocated to state

officer absent staff to

district officer etc)

State officers can

monitor status of

tickets and hence

track actions that are

taken (or not taken)

to improve

performance of the

health facility

1 2 3

4 5

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 80: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

IMPACT Software Integrated Monitoring system for PCPNDT Act

Website Address - httppcpndtrajnicin

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 81: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Why IMPACT Software

In compliance to the order of Honble High Court

All sonography centres are registered online through IMPACT website

Sonography machines are connected with tracking devices (Active Tracker or Silent Observer)

To improve the monitoring on the centres for the effective implementation of the PCPNDT Act in the State (User-Id and Password have been issued to all concerned)

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 82: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

IMPACT Software The website was launched on 1st Oct 2012

The website address is httppcpndtrajnicin

The system is designed and developed by the National Informatics Centre ndash Rajasthan

More than 1460 sonography centres are registered online

More than 78 Lacs Form-F have been submitted online till date (since launch date)

More than 8000 online Form-F are being submitted by centres on daily basis

More than 2000 Tracking devices have been installed

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 83: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

IMPACT Software - features Real-time Anytime Anywhere access monitoring of Form-F and Day End Summary

Robust database of centres and associated information eg Equipment Radiologist Tracking device etc

Inclusion of latest amended Form-F

Integrated SMS facility

Reminder for renewal of centre registration and daily submission of Form-F

To create awareness about 104 Toll Free Number for complaining sex-determination activity

For complaining against patients who demands sex-determination

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 84: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

IMPACT Software - features Generate analytical reports

Centres

o Functional and Non functional (Sealed Suspended Surrendered Closed etc)

o Not submitted Form-F Day End Summary

o Centre created during the month

o Centre whose renewal not done

o Centre not having radiologist

o Govt and PrivateOther type

o Many morehellip

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 85: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

IMPACT Software - features Generate analytical reports

Patients

o Different Age Group

o Female Children Wise

o Pregnancy Week Wise

o Many morehellip

Search tool for Pregnant woman Radiologist etc

Query and feedback are being handled by help-desk at 0141-5112527 pcpndtcsrgmailcom

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 86: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Dashboard showing graphs for Total Woman Registered for Sonography Pregnancy Week wise and Notice Board for new facilities provided in the software

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 87: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

SMS to Pregnant woman mobile number To create awareness about 104 Toll Free Number for complaining sex-determination activity

कनया भरण हतया जघनय अपराध ह | ल िग परीकषण की लिकायत 104 निबर पर ननिलक दजज की जा सकती ह |

चिककतसा एवि सवासय ववभाग राजसथान सरकार |

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 88: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Complaint against patients demanding sex-determination Click here

On complaint an Alert SMS will be sent to PCPNDT Cell

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 89: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Screen showing the various parameters on which pregnant woman can be within the system and her movement can be tracked

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 90: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Home page of Kuposhanwatch

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 91: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Home page of SNCU Online

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 92: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Services available at Special Newborn Care Units

1 Essential Care to all Newborns

2 Special Care to Sick Newborns 3 Follow-up of sick newborns

Special Newborn Care Unit

Care at Birth

bull Prevention of Infection bull Provision of Warmth bull Early initiation of Breast feeding bull Weighing the Newborn bull Immunization

Care of Sick Newborn

bull Managing of Low birth weight infants lt1800 grams bull Managing all Sick Newborns (Except those requiring mechanical ventilation and major surgical interventions) bull Follow-up of all babies discharged from the unit and high risk newborns bull Immunization services bull Referral Services

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 93: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

e-Aushadhi Treating medicinal problems

Provides inventory management at all DDWs and at sub stores DDCs of Medical college hospitals

District Hospitals CHCs and PHCs

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 94: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

bull Complete Supply Chain Management Solution for drugs surgical items and sutures bullImplemented across 5139 locations spread across the state bull Provides detailed information from the stage of procurement of the drug to its consumption by the end users Key Features of e-Aushadhi bull Facilitates online annual demand submission bull Online purchase order generation to suppliers bull Provision to maintain expiry dateshelf life bull Provides details of Quality control bull Ability to track drug inventory online bull Ability to generate customized reports bull Facilitates inter ware house transfer of drugs bull Alert generation in different colours for expired drugs re-order level bull Maintains daily stock ledger of drugs

12 e-Aushadhi Software for Inventory management

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 95: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

e-Upakaran Inventory Management by Technology bull Inherent problems with equipment management

bull A module aiming at

bull Status

bull Repair

bull Usage

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 96: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

e-Upkaran will be implemented at all 2971 MCDHSDHSATELLITECHCPHCDispensary across the state of

Rajasthan

e-Upkaran

e-Upkaran Users

Zonal BME PHCs amp Dispensa

ry

RMSC

HQSIMC

MCHs

Labstores

DH SDH amp SHs

LabStores

CHCs

LabStores

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 97: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Coverage

bull Primary Health Centres 2117 in Nos

bull Central Health Centres 565 in Nos

bull City Dispensaries 196 in Nos

bull District Hospitalrsquos 35 in Nos

bull Sub Divisional Hospitalrsquos 20 in Nos

bull Satellite Hospitalrsquos 8 in Nos

bull Other Hospitalrsquos 8 in Nos

bull Medical College and Hospitalrsquos 23

Total facilities covered= 2971

bull Total equipments = 58544

bull Functional = 56312

bull Installation Pending = 27

bull Non functional repairable = 793

bull Non functional not repairable = 647

bull Not in use = 701

Result

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 98: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Result- Costing of Equipments

By- NHSRC

SlNo Medical devices Unit Total Cost (in Rs)

1 X-Ray above 500 mA (HF) 59 3835000000

2 5 Part Haematology analyser 55 5500000000

3 CT Scan 18 21600000000

4 Cobalt Radiotherapy Machine 6 18000000000

5 Dialysis Machine 74 11100000000

6 Mammography Machine 4 1200000000

7 Radiant warmer 2884 17304000000

8 Phototheraphy unit 725 2537500000

9 Dental X-ray unit 104 1300000000

The total tentative cost of 58066 equipment is 486 Crore

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 99: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Key Observations

bull Distribution of devices is not uniform at same level of facilities large variations in devices observed For example at PHCs the number of equipment varies from 1 to 38 at CHCs from 4 to 145 there is uneven distribution of equipments

bull Basic equipment for Maternal and child health like infant radiant warmer phototherapy and sphygmomanometer etc is not available at PHCs level

bull Need to transfer those equipments which is not in use at institutions

bull As per the population load in govt facilities the quantum of equipment is low

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 100: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

bull Improved Health services bull Centralized monitoring for optimum utilizations bull Regular updated information and reporting bull Ascertain the new needs and need base rationalization bull Established biomedical equipment repair and maintenance

system bull Reduced equipments breakdown time bull Quick win response with better coordination in health

programs

Better Hospitals Management in State

Defined and possible Outcomes

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 101: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Homepage of GPS Monitoring website for MMUMMV

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 102: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Mobile Medical Units and Vans Rajasthan have tribal desert and several outreach areas where health services are far away from the poor families especially from women and children To take care the problem one prestigious programme namely Rajiv Gandhi Rural Mobile Medical Unit was implemented in the state in 2008

All people of any category residing in the outreach areas or villages would be the targeted beneficiaries

Totally free medical services including investigations and medicine distribution are provided to the beneficiaries during the planned camps

MMU consists of two type of vehicles (a staff vehicle and a diagnostic van which contains modern instruments like ECG Machine etc)

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 103: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 104: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

GPS Monitoring of MMU MMV from Control Room at Swasthya Bhawan Jaipur

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 105: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Mobile Recharge Scheme ldquoRs 200- mobile recharge to the caller

informing the death of female of age 15 to 49 yearrdquo

Department of Medical Health and Family Welfare Government of Rajasthan

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 106: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Maternal death

Definition of Maternal death

bullDeath of woman during ANC Delivery or within 42 days after delivery is called Maternal Death OR

bullMaternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 107: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Current scenario Rajasthan Population 686 Crore MMR 208 (As per AHS 2012-13) 244 (SRS 2011-13)

Maternal Deaths Approx 4000 are expected in an year (for 16 Lacs Live Births)

Female Deaths Approx 72000 are expected in a year (As per population)

Major causes of Maternal Deaths are Haemorrhage Sepsis Hypertension Disorders Obstructed Labour Abortion amp Other

() Female of age 15 to 49 year

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 108: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Solution Mobile Recharge Scheme

Reporting by the caller or informer about female death within 36 hours of the death at Toll Free No 104 or E-Mitra Kiosk

Time of death (not exact but approximate as far as possible) is to be ascertained by ANMASHA on the basis of a summary survey The report is to be given within 5 days

Verification of the information by CMampHO through BCMOMOIC concerned who can get it checked from Health Worker (ANM ASHA)

() Female of age 15 to 49 year

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 109: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Process Flow Chart

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 110: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Projects in pipeline

bullIntegrated Ambulance System

bullTele-medicine tele-consultancy

bullArogya Online for CHCs

bullRBSK Online Software

bullPublic Finance Mgt System

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 111: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

The entire health system is put on a dashboard where we are getting information on health incidents continuously and we are in a position to intervene from the control room settings Just think that we are getting continuous feed on points like------ -maternal death -accidents and ambulances - FRUs and Delivery points status -Attendance of staff

THE BIGGER PICTURE FOR TOMORROW CAN BE LIKE THIS

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 112: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

Control room for integrated monitoring of health services

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 113: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –

What is the message bull Understand the old process

bull See where it is not user-friendly

bull Re-engineer the process

bull Try to adopt the most easy-to-do method to save time

bull Search for some common uniformity in the process

bull Always keep in mind- what is implementable amp doable

bull Now bring in it easily adoptable and understandable technology

bull Implement it in such a way that all in the process get to know their revised roles

bull Donrsquot divert attention from the minute details

bull Always keep supporthelplinefeedback mechanism in place

bull Evaluate the efforts saved and costs incurred

bull Watch the results and be ready for amendments if required

Page 114: (Male - Centre for Innovations in Public Systems · Area (in lac sq. kilometers) – 3.42 Population Density/sq km – 201 Population – 686.21 lacs (Male – 356.20, Female –