1. Key findings District Nagaur October 23-27, 2013 National Rural Health Mission Consultant -plan

2. Health facilities Visited S.NOType of facility NO. of facility Name of facility 1CHC4Khinwsar, Maulasar, Basni, and Nimbijhodha 2PHC7Deh, Karod, Alay, Roll, Dangawas, Padukala, Lampoli 3Sub-center5SC-Ahmadpura, SC shinodh, SC-Ratong, SC-begsar, SC- badana 4School visit4Rajkiya uch madyamic vidhyalaya Bakrod, Butati, Roll, padukala

3. District observation District had functional labour rooms but the quality of care was found variables,privacy,absence of separate toilet in PHCs Deh, Bakrod and lampoli Awarness lacking about programs among community and befeneficiary. few pregnant /mothers interviewed had made own arrangement to the deliveries. Some PHCs don’t have separate JSY ward. Infection prevention practices appeared poor at labour and JSY ward. Community ownership found at CHC basni

4. 48hrs stay after delivery not practiced at most PHCs Padukala, deh and bakrod. Grievance redressal box not established at facilities As regards WIFS scheme, low level of awareness are found among the ASHAs about roll out the program. In 2 Govt school giving IFA tablet out of 4 visited and no awareness about program. Utilization of funds low at PHC and sub-centre. District vigilance and monitoring committee established but not any meeting held. Most visited sub-centers listed in delivery point but don’t have any delivery in last three months.

5. Pharmacists were not available at most health facilities. Drug stores were being handled by male nurse Payment of JSSY and sublakhmi yojna in time but sublakhmi yojana payment along with JSY payment at time of discharge. Infection prevention practice appeared to be poor at labour room and JSY wards. Rational deployment of available staff for optimum utilization need to be worked out on case load basis. Only MMV deployed in the districts, all MMVs are functional and done 930 camps. Strickering was done Out of 24 only 15 Ambulance 108 are functional, stickering work was not done but in process ASHA Payment chart related to all programs was prepared by district

6. Branding at CHC khinsar Branding at Subcenter Ahmendpura

7. Cleanliness issue at CHC maulasar Garbage bin under patient’s bed Cleanliness issue at toilet

8. JSY at PHC ALAYI very clean but no bed in JSY ward Cleanliness condition at Labour Room PHC ALYAI

9. Findings at CHCs  Radiant warmer and weighing machine not available at labour room khinwasar, maulasar  hot food was being given as per schedule expect PHC Roll  Branding was done in all CHCs/PHCs/Subcenters  Infection prevention practices appeared to be poor at labour and JSY ward except Basni CHC  In Basni CHC, sitting seats provided by local community and cleanliness was good.

10.  No Functional OT found at facility  Grievance redressal box not established at facilities  Low utilization of funds at khinwasar, maulasar

11.  infection prevention practices appeared to be poor at labour and JSY ward. Alay, Lampoli and Roll PHC  48 hrs stay not practices in most PHCs, padukala, Alay and bakrod and lampoli  PHC has two room at lampoli only one doctor and one ANM placed  No Bank A/C at PHC lampoli, only ANM has account beneficiaries were refer to other PHC for JSSY payments. Average 10 deliveries per month in PHC Lampoli.  No management for Bio medical waste at lampoli.  MO are not aware about utilization of available funds  Labour table was soiled with blood in all visited PHCs  Low utilization of funds at facility National Rural Health Mission Findings at PHC

12. Findings at Sub-center No facility at the sub center although there is SBA trained ANM at ahmedpura, ratong and begsar Running water is a major problem in all sub- centers There is no toilet facility nor electricity at ahmedpura. Labor room is found unhygienic Only shinodh ANM stay in night There is no mattress on labor table, No delivery in last two months in ahmedpura, ratong. There is leakeage at roof of sub-centre budilding ahmedpura and brick wall Low utilization of funds National Rural Health Mission

13. Thanks