EVID

ENCE-

BASED IM

NCI, VHND A

ND RI S

ERVIC

E

DELIV

ERY T

HROUGH HEA

LTH S

YSTEM

STREN

GTHEN

ING IN

ODIS

HA – AN E

XTERNAL

MONIT

ORING D

EMONSTR

ATION P

ROJECT

IMNCI

• Integrated Management of Neonatal and Childhood Illnesses

• Management = Assessment, Classification, Treatment, Referral and Appropriate Counseling

• Platform: Home Visits on 1st, 3rd, 7th, 14th, 21st and 28th days after birth

• By Community Health Worker

• Beneficiaries: Children from birth up till 5 years of age

VHND

• Village Health and Nutrition Day

• Beneficiaries: Pregnant women, lactating mothers, 0 to 3 years children, 3 to 6 years under weight children/sick children, other members of the community with any health complains

• Services Provided: Antenatal check-ups, post-natal check-ups, family planning counseling, health and nutrition education, child health service delivery

• By Community Health Workers

• Fixed Day Programme – Biweekly in each village

RI

• Routine Immunization

• Beneficiaries: All children within 1 year of age, Pregnant Mothers, Children due for booster doses

• Vaccination provided against six killer diseases

• By Community Health Workers

• Fixed Day Programme – Weekly Once in each Village

STAKEHOLDERS

1. COMMUNITY-AWARENESS & HEALTH SEEKING

2. HEALTH & FW

3. WCD/ICDS

DUTY & SOCIAL RESPONSIBILITY DUTY & SOCIAL RESPONSIBILITY

D

B

S

F

D

B

S

F

District Level

Managers

ASHA, ANM, HWM

Sector Supervisors

Block Level Managers

DSWO

AWW

Lady Supervisors

CDPO

STUDY SETTING ODISHA

STUDY SAMPLE (BASED ON WHO 30 CLUSTER SAMPLING)

Sl. No.

DISTRICT BLOCK SECTOR

1 BOLANGIR 8 8

2 NUAPADA 3 3

3 KORAPUT 8 8

4 NABRANGPUR 7 7

5 MALKANGIRI 4 4

TOTAL 30 30

STUDY DESIGN

• Baseline (2 months)

• Intervention Phase (1 year)

• Quarterly Analysis (Every Quarter)

• End line (2 months)

• Dissemination of Findings (1 month)

BASELINE

• Assessment of existing practices and knowledge & opinion of supervisors

• 108 RI Sessions, 118 VHND Sessions, 238 IMNCI Sessions and 84 Supervisors

• Major findings:• Availability of drugs and logistics about 60%• Quality indicators of the three programmes ranged from 20% to

80%• Knowledge of supervisors on components of supervision was

found to be dissatisfactory

• Report Generation and Dissemination

OUR INTERVENTION

• Supportive Supervision through external monitoring

• Capacity Building of supervisors and data handlers

• Streamlining availability of essential logistics

• Strengthening review at all levels

• Facilitating convergence among stakeholders

• Scaling up best practices

• Innovations

ACHIEVEMENTS SO FAR

The overall availability of drugs and logistics increased from 60% to 75% -• 2% in availability of hub cutters,

• 5% in examination beds,

• 10% in screens,

• 10% in VHND drugs,

• 28% in six IMNCI drugs

ACHIEVEMENTS SO FAR

The overall quality indicators improved by 20% • correct needle cutting by 10%,

• proper disposal of immunization waste by 2%,

• abdominal palpation by 5%,

• privacy during examination by 6%,

• communication of danger signs of newborns to parents by 26% and weight recording by 22%

• IMNCI assessment skills improved by 27%; home visits increased by 44% and timely submission of monthly reports improved by 34%.

WAY FORWARD

• End line survey and report generation

• Documentation of best practices and case studies

• Scientific Writing and Dissemination

• Scale up to other districts

PROJECT TEAM

Dr. Bhuputra Panda

Principal Investigator

Dr. Gyanaranjan Pradhan PT Mr. Subhrabhanu Panda

State Program Coordinator Regional Coordiantor

Ms. Shatabdi Das Ms. Anindita Pattnaik

Project Officer Project Officer

THANK YOU