Embed Size (px)
DESCRIPTION
Quarterly Findings of the external monitoring project, projected against the baseline to study the trend
Citation preview
EVIDENCE-BASED IMNCI, VHND AND RI SERVICE DELIVERY THROUGH HEALTH
SYSTEM STRENGTHENING IN ODISHA – AN EXTERNAL MONITORING
DEMONSTRATION PROJECT(3RD QUARTER FINDINGS)
Public Health Foundation of India(IIPHB)In collaboration withUNICEF & Govt. of Odisha
PROJECT AREA
DISTRICT BLOCK SECTOR
BOLANGIR 8 8
NUAPADA 3 3
KORAPUT 8 8
NABRANGPUR
7 7
MALKANGIRI
4 4
TOTAL 30 30
SAMPLE SIZEBaseline (Jul-Sept)
1st Quarter (Oct-Dec)
2nd Quarter (Jan-Mar)
3rd Quarter(Apr-Jun)
RI VHND
IMNCI
RI VHND
IMNCI
RI VHND
IMNCI
RI VHND
IMNCI
Bolangir 32 32 64 8 21 29 8 13 18 9 17 24
Nuapada 11 12 23 9 10 14 7 10 8 3 4 5
Koraput 27 32 64 9 24 19 10 15 11 7 15 12
Nabarangpur
24 28 53 9 15 14 6 10 9 6 11 10
Malkangiri 14 14 34 8 13 12 7 9 16 6 11 10
Total 108
118 238 43
83 88 38 57 62 31
58 54
TREND ANALYSIS…(ROUTINE IMMUNIZATION)
VACCINE AVAILABILITY
98.5
99.5
99
100100 100
BolangirIn
%
88
94
100 100
93
100100
Nuapada
In %
88
94
100
9399
97100
Koraput
In %
8090
100
87100
100
93
NabarangpurIn
%
959799
97100
100
100
MalkangiriIn
%
AVAILABILITY OF SYRINGES
88
94
100 98 9692
100
BolangirIn
%
94
97
100 100
96
100100
Nuapada
In %
98.5
99.5
99
100
100100
Koraput
In %
9296
100
95100
100 100
NabarangpurIn
%
04080
100100
100
100
MalkangiriIn
%
AVAILABILITY OF BLANK MCP CARDS
04080
63 6382 78
BolangirIn
%
758595
89100
85
100Nuapada
In %
04080 85
44
50
29
Koraput
In %
0
6087
3317
33
NabarangpurIn
%
04080 64 100
100
67
MalkangiriIn
%
AVAILABILITY OF DRUGS (ORS & PARACETAMOL)
04080
98 10063
89
BolangirIn
%
04080 82 100 100
100Nuapada
In %
04080 94 100
85
57
Koraput
In %
0
6092 100 75
100
Nabarangpur
In %
758595
85100
100
100
MalkangiriIn
%
AVAILABILITY OF COUNTERFOILS
04080 72
25 25
67
BolangirIn
%
04080
4578 80
100Nuapada
In %
04080 85 100 60
43
Koraput
In %
0
6087
89 5083
Nabarangpur
In %
04080 79 100
86
50
MalkangiriIn
%
AVAILABILITY OF FUNCTIONAL HUB CUTTER
04080 81
63 5088
BolangirIn
%
04080
45 4486
100Nuapada
In %
758595
9389
100
86
Koraput
In %
85
95 92100
100
100
Nabarangpur
In %
04080 93
100
100
83
MalkangiriIn
%
USE OF TALLY SHEET
04080
47
100
5078
BolangirIn
%
04080 73 100
71
100Nuapada
In %
758595
89100 90
86
Koraput
In %
85
95 92100
100
100
Nabarangpur
In %
04080 79
8871
100
MalkangiriIn
%
WASTE DISPOSAL (SYRINGE CUT AFTER USE)
04080
10063 50
78
BolangirIn
%
04080 73
5643
100Nuapada
In %
758595
85 89
100
86
Koraput
In %
0
6092
6767
100
Nabarangpur
In %
04080 93
88
100
83
MalkangiriIn
%
AVD IMPLEMENTATION
04080
50 50 63 78
BolangirIn
%
04080
54100
86
100Nuapada
In %
04080
5944
4857
Koraput
In %
0
60 5844
5083
Nabarangpur
In %
04080
5050
57
67
MalkangiriIn
%
WASTE DISPOSAL (SEGREGATION)
04080 81 75 88 89
BolangirIn
%
04080
10089
71
100Nuapada
In %
04080 93 100
100
71
Koraput
In %
0
6071
78
100
100
Nabarangpur
In %
04080 93
100
100
83
MalkangiriIn
%
DELIVERY OF 4 KEY MESSAGES
04080 81
13 3878
BolangirIn
%
04080 82
3314
100Nuapada
In %
04080 85
20
80100
Koraput
In %
0
60 58
22
33 83
Nabarangpur
In %
04080 50
50
71100
MalkangiriIn
%
ASKING BENEFICIARIES TO WAIT FOR 30 MINS.
04080
3125 50
89
BolangirIn
%
04080
27
67
29
67
Nuapada
In %
04080
7455
60 86
Koraput
In %
0
60 42
11
50
50
Nabarangpur
In %
04080
3663
86100
MalkangiriIn
%
HEALTH SUPERVISOR’S VISIT IN LAST 3 MONTHS
04080
56
75 88 100
BolangirIn
%
04080 91 78
71
100Nuapada
In %
04080 93
56
7071
Koraput
In %
0
60 79
33
50 100
Nabarangpur
In %
04080
93
75
7183
MalkangiriIn
%
VILLAGE HEALTH AND NUTRITION DAY
SESSION SITE-AWC
04080 75 81
6182
BolangirIn
%
04080
75 90 9050
Nuapada
In %
04080 69 75 80
67
Koraput
In %
04080
79 67 5082
NabarangpurIn
%
04080 64 77 78 73
MalkangiriIn
%
PRESENCE OF HEALTH SUPERVISORS
04080
11
52 6282
BolangirIn
%
04080
75 9070 75
Nuapada
In %
04080
25 17 20 33
Koraput
In %
04080
96 93 90 82Nabarangpur
In %
04080 79
3856
82
MalkangiriIn
%
PRESENCE OF ICDS SUPERVISORS
04080
0 0 8 0
BolangirIn
%
04080
0 0 025
Nuapada
In %
04080
6 4 6 7
Koraput
In %
04080
0 0 0 0
NabarangpurIn
%
04080
023 22 27
MalkangiriIn
%
AVAILABILITY OF EXAMINATION TABLE
04080 66 47 62 70
BolangirIn
%
04080
92 83 90100
Nuapada
In %
04080
47 2540 40
Koraput
In %
04080 67
33 5073
NabarangpurIn
%
04080
2950 44
91
MalkangiriIn
%
AVAILABILITY OF SCREENS FOR PRIVACY
04080
31 22 31 35
BolangirIn
%
04080 58 50
70 50
Nuapada
In %
04080
1230
50 47
Koraput
In %
04080 48
11 20
82Nabarangpur
In %
04080
7 1444
82
MalkangiriIn
%
AVAILABILITY OF DIAGNOSTIC EQUIPMENT(BP, HB, URISTIX, STETHO, MUAC, INCH TAPE, RDK, NISCHAY KIT, WEIGHING
MACHINE)
04080 73 56
83 78Bolangir
In %
04080
8267 76 70
Nuapada
In %
04080 77
5079 89
Koraput
In %
04080
77
3576
90Nabarangpur
In %
04080 79 63
86 95Malkangiri
In %
AVAILABILITY OF VHND DRUGS
04080 71
4579 63
BolangirIn
%
04080
8774
9461
Nuapada
In %
04080 68
4269 84
Koraput
In %
04080 48
3261
83Nabarangpur
In %
04080 75 83 88 96Malkangiri
In %
AVAILABILITY OF VHND DUELIST
04080 62
4169 65
BolangirIn
%
04080 42 58
8050
Nuapada
In %
04080 72 59
87 87Koraput
In %
04080
96
4880 82
NabarangpurIn
%
04080 50
79 78 91
MalkangiriIn
%
RELEVANT HISTORY TAKEN
04080 72
3862 76
BolangirIn
%
04080 50
17
80100
Nuapada
In %
04080
10075 80 93
Koraput
In %
04080
96
53 6091
NabarangpurIn
%
04080
29 38
8973
MalkangiriIn
%
ABDOMINAL PALPATION DONE AND RECORDED
04080
3763 64 65
BolangirIn
%
04080
0
75 6075
Nuapada
In %
04080
28
69 73 73
Koraput
In %
04080
1144 60
82Nabarangpur
In %
04080
14
8667 82
MalkangiriIn
%
FETAL HEART SOUND RECORDED
04080
37 22 1535
BolangirIn
%
04080
17 33 50 50
Nuapada
In %
04080
28 25 20 33
Koraput
In %
04080
11 7 1036
NabarangpurIn
%
04080
029 44
73
MalkangiriIn
%
URINE EXAMINATION DONE AND RECORDED
04080
1247 54
71
BolangirIn
%
04080
040 40
75Nuapada
In %
04080 81 59
73 73
Koraput
In %
04080
7452
80 82Nabarangpur
In %
04080
29
8667 82
MalkangiriIn
%
PRIVACY ENSURED DURING EXAMINATION
04080
37 38 50 53
BolangirIn
%
04080 67
17
80100
Nuapada
In %
04080
5063
2053
Koraput
In %
04080 63
37 40
82Nabarangpur
In %
04080
7
5778 82
MalkangiriIn
%
COUNSELING DONE ON DIET, DANGER SIGNS, IFA, PPTCT AND BREASTFEEDING
04080 65 54
77 66
BolangirIn
%
04080 69 70 87 86Nuapada
In %
04080 53 55
73 84
Koraput
In %
04080 52
3456
91Nabarangpur
In %
04080 59 69 86 81
MalkangiriIn
%
GROUP MEETING DONE WITH WOMEN
04080
8153 69 53
BolangirIn
%
04080
10075 60
75Nuapada
In %
04080
47 5020
67
Koraput
In %
04080 44 41
2055
NabarangpurIn
%
04080
36
8667 64
MalkangiriIn
%
GROUP MEETING DONE WITH MEN
04080
0
63
15 23
BolangirIn
%
04080
0
67
0 0
Nuapada
In %
04080
322 0 13
Koraput
In %
04080
0 11 0 0
NabarangpurIn
%
04080
029
11 9
MalkangiriIn
%
AVAILABILITY OF OC, EC, CONDOMS
04080 56 52 61 57
BolangirIn
%
04080
80 80 80100
Nuapada
In %
04080 76 64 55 69
Koraput
In %
04080
85
43 40
85Nabarangpur
In %
04080 57 69
92 91
MalkangiriIn
%
FP COUNSELING DONE
04080
78
28
92 82Bolangir
In %
04080
100
25
80100
Nuapada
In %
04080
97 93 100 100Koraput
In %
04080
10070 60
91Nabarangpur
In %
04080
93
21
100 91
MalkangiriIn
%
INTEGRATED MANAGEMENT OF NEONATAL AND
NEONATAL ILLNESSES
HOME VISIT AS PER IMNCI GUIDELINES
04080
12
2839 54
BolangirIn
%
04080
13 2163
60
Nuapada
In %
04080
27 47
82
75
Koraput
In %
0
6012 57
7890
Nabarangpur
In %
04080
35
42
63
70
MalkangiriIn
%
IMNCI ASSESSMENT SHEETS FILLED UP
04080
2534
39 50
BolangirIn
%
04080
6129
88100
Nuapada
In %
04080
17 3227
33
Koraput
In %
0
6017 29
3160
Nabarangpur
In %
04080
35
42
63
60
MalkangiriIn
%
IMNCI MONTHLY REPORTING DONE
04080
2731
2846
BolangirIn
%
04080
029
88100
Nuapada
In %
04080
14 26
36
33
Koraput
In %
0
60
7 29
58
60
Nabarangpur
In %
04080
35
25
75
70
MalkangiriIn
%
SKILL OF WORKER (FOR 0-2 MONTHS)
04080
3547
47 56
BolangirIn
%
04080
34 4496
100Nuapada
In %
04080
20 42
5376
Koraput
In %
0
60
7 29
58
60
Nabarangpur
In %
04080
34 77
93
70
MalkangiriIn
%
SKILL OF WORKER (FOR 2 M – 5 Y)
04080
2835
40 56
BolangirIn
%
04080
28 30
9483
Nuapada
In %
04080
6 3
11 67
Koraput
In %
0
60
4 229
43
Nabarangpur
In %
04080 55
76
91
70
MalkangiriIn
%
AVAILABILITY OF IMNCI BOARD
04080
53
6 8
BolangirIn
%
04080
34 29 38 20
Nuapada
In %
04080
9 11
9 50
Koraput
In %
0
60
7 140
20
Nabarangpur
In %
04080
1533
4470
MalkangiriIn
%
AVAILABILITY OF IMNCI DRUGS
04080
5458
6134
BolangirIn
%
04080
54 3877 65
Nuapada
In %
04080
36 56
6479
Koraput
In %
0
6030 58
4665
Nabarangpur
In %
04080 62
82
74
55
MalkangiriIn
%
AVAILABILITY OF IMNCI FORMS AND FORMATS
758595
85
9694 92
BolangirIn
%
04080 95 92
8077
Nuapada
In %
04080 95 90
97
80
Koraput
In %
85
95 9594
9294
Nabarangpur
In %
04080 59
76
94
80
MalkangiriIn
%
SUMMARY OF PROGRAMME INDICATORS Continuously Improving Fluctuating Not Improving
RI
• Vaccine availability at session site
• Availability of MCP Cards
• AVD Implementation
• Availability of syringes and drugs • Use of counterfoil
• Delivery of 4 key messages • Waste Disposal
• Asking beneficiaries to wait for 30 mins after vaccination
• Availability of hub cutter • Visit of health supervisor • Use of Tally Sheet
VHND
• Visit of health supervisor• Availability of VHND
drugs• Group meeting with
men• Availability of examination table
and screens• Ensuring privacy
• Visit of ICDS supervisors
• Availability of other essential logistics
• Counseling of beneficiaries
• Participation of PRI Members
• Implementation of VHND Duelist• Group meeting with
women
• Relevant history taking prior to 1st ANC
• Recording fetal heart sound • Abdominal palpation
IMNCI
• Home visits• Availability of IMNCI
drugs • Availability of IMNCI
Board
• Filling up of assessment sheets• Availability of other
support logistics
• Monthly reporting
• Skills of workers
KEY OBSERVATIONS (RI)
Open vial policy is not followed
Poor quality of hub cutters
Waste disposal is not as per guidelines
Need of training on session management
KEY OBSERVATIONS (VHND)
Examination bed and screen have yet not been ensured in all sites
Need of second set of logistics
Replacement of Talquist Paper by Sahil’s Meter
Mobilization and IEC is not proper
Validation of digital BP machine
Availability of Uristix
Supply and use of MCP card is improper
KEY OBSERVATIONS (IMNCI)
Non-availability of IMNCI drugs with AWW
AWW does not report to ANM leading to false reporting by ANM at block level
Review of IMNCI at ICDS project meeting
Convergence meeting of health and ICDS staff
Importance of IMNCI
WAY FORWARD
Facilitating refresher training at block level for health
and ICDS supervisors
Complete end-line survey by mid-November
Dissemination of end-line findings
SUPPORT REQUIRED FROM DISTRICT LEVEL
Initiation to start 3rd sector convergence meeting
Conduct block level refresher training for supervisors
Provide necessary support for streamlining the indenting mechanism to project staff
Initiate performance monitoring of supervisors based on integrated supervision plan
SUPPORT REQUIRED FROM STATE LEVEL
Guidelines for implementation of recording minutes of meetings at block and sector level meeting
Facilitate the use of specific review format for district level review in monthly convergence meetings
Streamline the supply of MCP cards
Streamline the distribution of programme supervision checklists to both health and ICDS departments across districts
PROPOSED STRATEGY FOR THE NEXT PHASE
Intensifying monitoring visits under RMNCH+A approach External Internal
Skill up-gradation of service providers and supervisors on Technical Communication Managerial
Strengthening information management by use of personalized devices for on the site data entry and analysis on a piloting basis
Performance monitoring of supervisors and service providers
with specific focus on community mobilization, information submission, home visits, indenting and review meetings
Using a pre-session checklist to ensure availability of logistics on site
THANK YOU
