Transcript Ajmer

108-Ambulance Service
in the State of Rajasthan
Ajmer tour
23-27th October, 2013
Anuja Agarwal
Consultant-108, NRHM
Department of Medical, Health and Family Welfare
Government of Rajasthan
1
CIVIL WORK
Location of Facility
Name of
work
Year of A/F Amount
Sanction
Remark
Goyala, Harrajpura(Bhinay),
Kelu(Masuda)Mewadia(Pisagan)
ANM Qtr
2012-13
8.00 each land not available
Badakhera,(Jawaja)
Devliyakalan,(Bhinay)Saradhna
(Pisagan)
PHC
2012-13
Qtr_L1/ L2
34.50, 41.00, land not available
44.00
Dolladatta (Masuda)
SHC LR, 2012-13
SHC Toilet
6.00, 2.00 land not available
Ramgarh (Masuda)
PHC
2010-11
28.00
Initially land problem / work
sanction before 31-03-12
could not be started.
Chousala(Kekri),
SHC
2010-11
10.00
Village in submergence of
Bisalpur Dam. Alternate
place kalera kanwarji / work
sanction before 31-03-12
could not be started.
Tabiji (Pisagan)
SHC
2010-11
10.00
land not available / work
sanction before 31-03-12
could not be started.
Badach
No sanction received
Good practices
• Cleanliness of Toilets/Wards
was good / satisfactory
• Hot food was being given as
per schedule after delivery.
• JSY payments were being
made on time and no gaps
were identified.
• Equipments/ medicines were
available and functional
• Disposal of Bio medical waste
was being done as per norms.
•
CHC
Issues/ gaps
• No/ dirty stained sheets on the beds &
Mackintosh was torn in all the centers
• % of male to female sterilization is very
low
• Branding of delivery points was not
observed at any center
• 49% of ANC within 12 wks against total
ANC registration
• EMOC/ LSAS trained doctor was
present at CHC Bijainagar and trained
doctor from CHC Pisangan is on
deputation for the last 6 months to CHC
Pushkar.
• MTC- pediatrician not available/
trained staff but no equipments/ no
facility available
Good practices
• Cleanliness of Toilets/Wards
was good
• Hot food was being given as
per schedule after delivery.
• JSY payments were being
made on time and no gaps
were identified.
• Equipments/ medicines were
available and functional
PHC
Issues/ gaps
• No/ dirty stained sheets on the beds &
Mackintosh was torn in all the centers
• % of male to female sterilization is very
low
• Branding of delivery points was not
observed at any center
• 63% of ANC within 12 wks against total
ANC registration
• 108 is being used for post delivery cases
• Funds not received/ not aware under
cleanliness head
• Funds lying ideal but not being used as
lack of knowledge about the guidelines
and usage of funds.
Sub Centre
• Urine and blood sticks not available at any Sub centre
• Cleanliness of Toilets/Wards was satisfactory.
• At Lidi (upgraded PHC) metal beds in ward had no mattresses.
Infrastructure is very good. It was informed that after Soma nurse left in
April’13 no deliveries are taking place. This centre was upgraded and
declared a delivery point due to the exceptional no of deliveries taking
place at this centre.
• At Lidi, nine ASHA cheques pending and VHSC fund still pending at sub
centre Rs 45343/- (No expenditure in 2013-14)
• At Sursura (upgraded PHC)name of the sub centre was not displayed,
Doctor posted due to upgraded PHC which could not be identified as a sub
centre also. Deliveries , outdoor etc every thing was being done in one
room which was very dirty with no water and dirty toilets.
• Availablility of family planning techniques (IUCD, oral contraceptives,
condoms, Ipills, pregnancy testing kits) in short supply.
• suction machine, amu bag, soap, partograph, attached toilet, new born
corner not available
Anganwari kendra
• 1) ROOPRA ANGANWADI KENDRA:- very bad
• no name or sign of Anganwadi displayed. ASHA not in
uniform Anganwadi karyakarta not present ,Sahika present
.Out of 27 children only 8 present. instead of khichdi only
bad quality rice was cooked. Open cooking which had insect.
No displays, toys or any learning aids for children & nothing
was being done at the centre. Children were very dirty
• 2) SHRINAGAR ANGANWADI KENDRA:• 8 children present. Khichdi was available but the quality was
bad children were only sitting & no work was being done.
ASHA not in uniform Anganwadi karyakarta present, Sahika
present. Gud, chana, kheel had insects and were stale .
ASHA
•Some ASHAs not trained in module 6/7
•ASHAs are encouraging women for spacing of children (copper T) home to
home distribution of contraceptives (nirodh/oral pills but are in short supply).
•ASHAs are holding VHSC meetings every month. Participants in VHSC
meetings: Sarpanch/Wardpunch, ANM, Anganwadi Karyakarta, ASHA Samuh ki
sadasya, sathin, janmangal joda.
•Beneficiaries are being mobilized for MCHN days and ASHAs are being paid in
the sector meetings under various heads like ASHA monthly meeting, JSY 3
ANC payment
•ASHA is not getting paid in VHSC meeting, HBNC meeting, child death
information, discharge children under FBNC/MTC
• Yes cash payments are being made on MCHN days at all centres, subcentres
•ASHAs were not found in uniform. Incentive upto September 13 has been paid
to ASHAs. PHC wise no dues received from blocks and instructed also to
complete the payments by end of month.
• 6-7 module training target- 360 ASHAs.
Weekly Iron-Folic acid program
• WIFS program is ongoing in all 3 schools visited.
• No complaint of any kind except an odd case of stomach ache.
• One school had stock of medicines whereas in 2 schools ironfolic acid was not given on last Monday as the medicine was in
short supply.
• In co-ed school the medicine was being given to both boys and
girls.
• De-worming done in all schools on 15/10/2013 (Albendazole
syrup)
108
• 108 staff working for 7 days continuously
• all cases are being bought to Bijainagar instead of nearest government
hospital
• EMT/pilot not in uniform
• spare tyre kept inside the ambulance, medicine cabinet doors were all
broken,Seats were torn, lights/AC not working, Gloves were lying open,
oxygen leaking from panel , vehicle body and flooring broken , water pump
not working, suction machine not working,
• ambulance dirty from inside and outside
• RTO has refused to give fitness certificate looking at the condition of the
ambulance (Mangliyawas: 9813)
• blood stains on stretcher not cleaned after patient transported.
• carrying only post delivery patients (both 104/ 108 are 12kms away) .
• medicines received on 24/10/2013
MMV/ MMU
• RJ14-pb-7630 (Roopangarh)
• AC/Fans not working
• MMU: RJ14-pb-2086 MMU was present at Pushkar where
migratory camp was in progress. During the camp 107 HIV tests
were done and none were found positive whereas at Jawaja out
of 313 cases 3 were found positive (HIV)
Thanks:)