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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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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