check lists for rch ii related strategies: common …

November 2012

October 2012

TECHNICAL AND MANAGEMENT SUPPORT AGENCY DONOR COORDINATION DIVISION

MINISTRY OF HEALTH & FAMILY WELFARE GOVERNMENT OF INDIA

CHECK LISTS

FOR

RCH II RELATED STRATEGIES:

COMMON REVIEW MISSION 6

CONTENTS

CHECK LIST # NAME OF THE CHECKLIST PAGE NO.

1 Planning and prioritizing of facilities for assured RCH services 3

2 Discussion Guide For Visit To Facilities 4

3A Implementation Status Of Janani Shishu Suraksha Karyakaram (JSSK):

State Level 14

3B Implementation Status Of Janani Shishu Suraksha Karyakaram (JSSK):

District Level 16

4 Check List For Village Health Nutrition Days (VHNDS) 17

Checklist 1: PLANNING AND PRIORITIZING OF FACILITIES FOR ASSURED RCH SERVICES

Facility

Total No.

existing

Total No. Declared

As delivery points

Maternal Health Child Health FP* ARSH

Inst. deliv

C -section

MTP

RTI/STI

NBCC

NBSU

SNCU

NRC

Terminal methods

AFHCs

Sub-Centres

24x7 PHCs

Other PHCs

CHCs (Non-FRU)

CHCs (FRU)

Other FRUs (excl. CHC-FRUs)

DH & DWH

Medical colleges

Total Public

Total Accredited PHF

*Family Planning: all the delivery points are expected to provide all spacing methods (OCPs, condoms, IUCD). In case facilities are not providing spacing services please note separately. CRM to assess availability of comprehensive RMNCH A+ services as well as adequacy of infrastructure (including staff quarters etc.)

Checklist 2: DISCUSSION GUIDE FOR VISIT TO FACILITIES

First Referral Unit (FRU)/ District Hospital/24x7 PHC Purpose: The discussion guide is proposed for use by the teams during visits to the facilities in the districts. The purpose is to collect information on quality of services being provided, identify gaps and problems faced and understand how bottlenecks can be resolved to provide better quality of services. The information from these facility level discussions will then be used to guide the problem analysis and solution seeking at the district level and with the State Government. Date of Visit: …………………………….. 1. Facility Identification

Name

Type of Facility: o (District Hospital/ CHC/FRU/24x7)

Location (State, District, Block)

Is this a designated FRU/24x7?

o Since when 2. Availability of Services The Government of India (GOI) guidelines on operationalising an FRU prescribes 3 critical areas for a fully operational FRU. These are: (i) caesarean sections; (ii) newborn care; and, (iii) blood storage, whereas guidelines on operationalising a 24X7 PHC prescribes 3 critical areas for a fully operational 24X7 PHC. These are: (i) 24 hour delivery service; (ii) newborn care; and, (iii) provision for timely referrals. In addition to these, there are other services which are part of a fully functioning FRU/24x7. Please check for availability of each of these services and specifically identify bottlenecks and issues with regard to: (i) human resources – staff, whether trained/hired (details in annex 1); (ii) infrastructure for the services being provided; (iii) functional equipment; (iv) drugs and other supplies; (v) utilization of services; (vii) IEC/BCC at the facilities; and (vi) quality of care. FRU An FRU should have all the services listed below. However, the first 3 are Critical and FRU cannot be classified as fully operational if any one of these 3 is not available. Critical Services 1. Caesarean Section (Visit the OT and verify/ check OT register) 2. Newborn Care (Visit OT, Labour room and ward and see for)

2.1. Resuscitation (Both size Ambu bags and masks) 2.2. Thermal protection (Radiant warmers) 2.3. Practice of initiating breastfeeding in normal deliveries: time period.......

2.3.1.1. And in caesarean cases: time period.......

3. Blood Transfusion services (Blood Bank/Blood Storage facility; discuss with officer in charge; if facility not available discuss reasons; if available, visit the area, observe, record): 3.1. Is service available 24 hours 3.2. Does it have required approval from drug authorities (refer GOI guidelines for blood storage

units) 3.3. Availability of reagents and equipment

24X7 PHC A 24x7 PHC should have all the services listed below. However, the first 3 are critical and the facility cannot be classified as fully operational if any one of these 3 is not available. Critical Services

1. 24 hrs delivery services (visit labour room and verify) 1.1. Normal Delivery. 1.2. Assisted (Forceps delivery/Vacuum) 1.3. Manual removal of placenta 1.4. Administration of

1.4.1. Parental Oxytocins 1.4.2. Parental Antibiotics 1.4.3. Inj. Magnesium Sulphate

1.5. Management of Post Partum Haemorrhage/other complications

2. Newborn Care (Visit Labour room and ward and see for) 2.1. Resuscitation 2.2. Thermal protection (Radiant warmers) 2.3. Practice of initiating breastfeeding in normal cases

3. Referral Services 3.1. Mechanism of referral to higher facilities 3.2. Ambulance/hired 3.3. Power to spend on referral

Other Functions

1. 24 hrs delivery services

1.1. Normal Delivery. 1.2. Assisted (Forceps delivery/Vacuum) 1.3. Manual removal of placenta (is it being done or not? Please check records/ please test the

knowledge skills of provider if possible 2. Administration of

2.1. parental oxytocics 2.2. parental antibiotics 2.3. inj. magnesium sulphate 2.4. Management of Post Partum Haemorrhage/other complications

3. Family Planning

3.1. Tubectomy (Laparoscopic)

3.2. Tubectomy (Minilap) 3.3. Postpartum Sterilization 3.4. NSV/conventional vasectomy 3.5. Spacing Methods including

3.5.1.1. IUD 380A 3.5.1.2. OP 3.5.1.3. Condoms

3.6. Emergency contraception 4. Safe Abortion Services – MTP - specify MVA/EVA/MMA 5. Treatment of RTI/STI 6. Care of Sick neonates and Children

6.1. Management of neonatal sepsis 6.2. Management of neonatal jaundice 6.3. Management of diarrhoea 6.4. Management of ARI/Pneumonia 6.5. Management of Malnutrition

7. Immunization services at facility – (frequency and look for cold chain)

8. Essential Laboratory Services

8.1. BT/CT 8.2. Blood sugar 8.3. Blood cross-matching 8.4. Urine albumin and sugar

9. Referral Services

9.1. Mechanism of referral to higher facilities 9.2. Ambulance/hired 9.3. Power to spend on referral

3. Performance during 2011-12 and the current year 2012 (April to September). If possible compare with performance before it started functioning as fully operational FRU (Review Records/ Obtain Data)

Total

1. No. of deliveries in the facility normal assisted (Forceps delivery/Vacuum) complications handled caesarean section

(Check for plotted partographs)

2. No. of live Births No. of neonates weighed at birth No. of low birth weight babies

3. No. of postnatal visits (at homes by workers) No. of mother –neonate dyad who have received at

Total

least 3 home visits

4. No. of Neonatal deaths in the facility Infant deaths in the facility

(get causes if possible)

5. No. of maternal deaths reported and reviewed in the facility in last 6 months

6. No. of maternal cases given blood transfusion

7. No. of MTPs MVA EVA MMA

8. No. of sterilizations Male (conventional/NSV) Female (Laparoscopic) Female (Minilap) Female (Post partum)

9. No. of FP Spacing Methods IUD insertions; OP cycles distributed Condoms distributed ECPs distributed

10. No. of cases of RTIs/STIs treated Male Female

11. No of laboratory investigations

12. No. of high risk pregnancies identified during ANC

4. Patient/ Exit Interviews to assess quality of services

To the extent feasible, interview 2 or 3 patients at the facility / those leaving the facility. Ask about issues such as:

In case of delivered women/ women who had come for delivery ask how and in which vehicle they travelled to the facility

Quality and promptness of services Infrastructure: Could they access clean toilets? Did they get a bed promptly with

clean linen? etc Availability of information, drugs, any payments- formal/ informal which had to be

made to access services? Knowledge of and Access to Grievance redressal

5. Interview the Medical Officer in charge for

Understanding of his/her role, priorities and performance/ accountability parameters; constraints to meeting performance standards; delegation of powers. Problems with availability of staff and staff motivation levels.

Quality of services (Are standard treatment protocols available? if not, how is quality assured/ monitored? If yes, have staff been trained in using the protocol?)

Operational Plan for the setting up of FRU/24x7

Availability of guidelines for GOI operationalising FRUs/24x7 PHC; blood storage facilities (where applicable), RTI/STI management, standards in sterilization services, compensation for sterilization services, FP Insurance Scheme, Quality Assurance Committee, any other.

State guidelines for RKS, use of flexible funds, JSY any other

Problems with availability & maintenance of equipment

Gaps observed during the visit 6. Drugs and Supplies

Availability of adequate supplies of drugs

Have powers been delegated to MO I/c to spend from Rogi Kalyan Samiti funds for purchase of drugs during emergency situations for hiring transport for referral of patients to higher facilities for immediate compensation for death following sterilization (to be recouped later from

FPIS) 7. IEC

List the IEC materials (theme and type of material) which have been displayed

Are any IEC/BCC activities undertaken by the facility

If yes, who is responsible (designation) for undertaking these

Provider communication to clients especially for FP/post partum or STIs

Has any training been provided to this person (get details)

What activities are undertaken

Are any job aides available for undertaking these

8. Please write down what plans are in place to upgrade the facility with respect to the following: (i) Human Resources; (ii) infrastructure; (iii) equipment; (iv) supplies and drugs; and (v) facility level IEC/BCC

9. Janani Suraksha Yojana

Number of institutional deliveries during previous year and cumulative during current year (mention months: e.g. April to _____________).

Number of institutional deliveries registered under JSY

Number of JSY deliveries who have received monetary benefit

Have funds been received by this facility under JSY

Are these sufficient for catering to all registered beneficiaries 10. Compensation for sterilization services

Number of sterilization acceptors during previous year and cumulative during current year (mention months: e.g. April to _____________).

Number of sterilization acceptors who have received monetary benefit

Whether funds have been received by this facility under compensation for sterilization services

Human Resources

Sanctioned (No.s)

In-Position (No.s)

Residing on

campus

Whether any of the staff listed received training in any of following?

(Pl. put code and number of staff trained against each in the rows below)

Re

gula

r

Co

ntr

actu

al a. SBA/ BEmOC

b. IMNCI c. MTP incl MVA d. Blood storage e. RTI/STI

f. IUCD g. Minilap h. NSV i. EmOC j. LSAS

*Ob/Gyn

*Anaesthetist

*Paediatrician

*Surgeon

Other

Medical Officers

Nurses

ANMs

Lab technicians

Other support staff

*For FRU only Instructions: Please ask for the duration of each of the training attended/received. Indicate as trained, only if, they have undergone the training for the following durations.

Type of training Duration

1. SBA for ANMs/LHVs and Staff Nurses 21 days

2. SBA/ BEmOC for Medical Officers 10 Days

3. IMNCI 8 Days

4. MVA / Comprehensive abortion care 2 weeks

5. Blood Banking 3 days

6. RTI/STI 3 days

7. IUCD 6 days

8. Minilap/Lap 12 days

9. NSV 5 days

10. *Em Obst Care 16 weeks

11. *Life Saving Anaesthesia Skills 18 weeks

12. F-IMNCI 11 days

13. NSSK 2 days

(* for FRU only)

Infrastructure, Equipment and Functionality

ITEM STATUS Remarks

1 Total number of sanctioned and functional beds in this facility?

Sanctioned beds

Functional beds

OPERATION THEATRE (For FRU only)

Items 2 to 9 - Physically verify and record (Yes, functional - 1; Yes, but not functional – 2; No – 3)

2 OT Table

3 OT light

4 Air conditioners

5 Boyles apparatus for anaesthesia (physical verification may not be possible)

6 Autoclave

7 Equipments for Caesarean Section (get details from Obstetrician/Surgeon)

8 Laparoscopes

9 Oxygen supply

Observe and record the condition of the OT (Items 10 to 14)

10 Condition of the flooring in the OT

11 Condition of walls in the OT

12 Condition of ceiling in the OT

13 Condition of lighting in the OT

14 Overall condition of the OT Room

LABOUR ROOM


15 Labour table with McIntosh sheet

16 Suction machine

17 Autoclave/sterilizer

18 24 hr running water supply (may be from an overhead tank)

19 Attached toilet in the labour room Yes, functional ......................... 1 Yes, but not functional .......... 2 No ........................................ 3

D21 D21

20 Condition of the toilet Clean/Dirty

21 Whether the following emergency drugs are available (emergency drug tray)? (Y/N)

a. Oxytocin injection

b. Diazepam Injection

c. Magnesium Sulphate Injection

d. Lignocaine Hydrochloride Injection

e. Nifedipine Tablet

22 Oxygen cylinder with face mask, wrench & regulator

Observe and record the condition of the Labour Room (Items 23 to 28)

23 Privacy in the labour room

ITEM STATUS Remarks

24 Condition of the flooring in the Labour Room

25 Condition of walls in the Labour Room

26 Condition of ceiling in the Labour Room

27 Condition of lighting in the Labour Room

28 Overall condition of the Labour Room

OTHER ITEMS

Items 29 to 34 – Ask and record (Yes/No)

29 Normal delivery kit available

30 Equipment for assisted vacuum delivery available

31 Equipment for forceps delivery (outlet forceps) available

32 Surgical set for Episiotomy and minor procedures available

33 Manual Vacuum Aspiration (MVA) equipment with adequate canulas

34 Whether the following items are available in the labour room (Observe & Record)

a. Gloves

b. Sterilized cotton gauze

c. Sterile syringes and needles

d. Sterile drip sets

e. IV infusions like Dextrose 5%

WASTE MANAGEMENT

35 How many staff of this hospital received any training in the waste management/ infection prevention? Ask and record

Number trained

Items 36 to 38 - Ask, observe and record

36 Are colour coded waste bags available for segregated waste?

Yes ........................................... 1 No ............................................ 2

37 What is the mode of disposal of infectious/ biological waste?

Bury in a pit ........................................... 1 Thrown in common/public disposal pit 2 Thrown outside hospital compound .... 3 Thrown inside hospital compound ....... 4 Use incinerator ..................................... 5 Out sourced .......................................... 6 Other (specify_______________) ........ 7

38 What is the mode of disposal of non-infectious waste?

Bury in a pit ........................................... 1 Thrown in common/public disposal pit 2 Thrown outside hospital compound .... 3 Thrown inside hospital compound ....... 4 Use incinerator ..................................... 5 Out sourced .......................................... 6 Other (specify_______________) ........ 7

39 OBSERVE AND RECORD Are any discarded/used sharps visible in the facility?

Yes ................................................... 1 No .................................................... 2

ITEM STATUS Remarks

40 OBSERVE AND RECORD Overall cleanliness of the facility

Satisfactory ...................................... 1 Unsatisfactory ................................. 2

NEWBORN CARE EQUIPMENTS


41 Designated newborn baby corner

42 Ambu bag with mask

43 Radiant warmer

44 Any other mechanism available in the facility to keep the baby warm, like 200wt bulb at a height of 18 inches above newborn baby corner.

45 Suction catheter/canula

46 Pedal suction machine/mucus extractor

47 Separate drug tray

48 Baby weighing machine of any type

49 Phototherapy Unit in ward

FAMILY PLANNING

Items D50 & D51 – Ask and record (Yes, functional - 1; Yes, but not functional – 2; No – 3)

D50 IUCD insertion kit available

D51 Equipment for sterilization operations

a. Tubectomy

b. Vasectomy

DRUGS/REAGENTS

Item D52 - Verify Lab Register & Record

D52 Ask if Lab services available (Yes/No)

a. BT/CT

b. Blood sugar

c. Hb Test

d. Blood cross-matching

e. Urine albumin and sugar

f. Wet Mount

Item D53 – Ask and record

D53 Are following drugs/supplies available in the facility?

a. Injection Gentamycin/ Ampicillin

b. Tablet Misoprostol

c. MVA Syringes

d. Fluconazole/ Clotrimazole tablets

e. Emergency Contraceptive Pills

f. Reagents for cross matching of blood

g. Low Osmolarity ORS packets (and Zinc)

h. Co-trimoxazole/ Amoxycillin

i. IFA Tablets

j. Oral pills

k. Condoms (Nirodh)

LICENSED BLOOD STORAGE (only for FRU)

Items D54 to D60 - Physically verify and record (Yes, functional - 1; Yes, but not functional – 2; No – 3)

D54 Blood storage refrigerator

ITEM STATUS Remarks

D55 Centrifuge

D56 Microscope

IMMUNIZATION

D57 Ice Lined Refrigerator (ILR)

D58 Deep Freezer

GENERATOR

D59 Is there a generator installed in this facility?

Yes, functional ......................... 1 Yes, but not functional .......... 2 No ........................................ 3

D63 D63

D60 What is the capacity of the generator? KW

D61 Whether the generator supply is connected to the following areas:

a. Operation Theatre. If, yes, whether the generator backup is assured at all times?

Yes, at all times ........................ 1 Yes, but not all times ............... 2 No ............................................ 3

b. Blood storage. If, yes, whether the generator backup is assured at all times?


c. Labour room. If, yes, whether the generator backup is assured at all times?


d. Ice Lined Refrigerator (ILR)


e. Wards Yes ........................................... 1 No ............................................ 2

D62 Do you have adequate funds available for operating the generator?

Yes ........................................... 1 No ............................................ 2

D63 Telephone connection Yes, functional ......................... 1 Yes, but not functional ............ 2 No ............................................ 3

Checklist 3A: IMPLEMENTATION STATUS OF JANANI SHISHU SURAKSHA KARYAKARAM (JSSK): STATE LEVEL

State/ UT: ............................................ No. of districts: ........ No. of Blocks: ………… Reporting Month/Year: …………… State Nodal Officer in place (Y/N): ……..…………. State Grievance Redressal Officer in place (Y/N): ………………….. No. of District Nodal Officers in place: ….………… No. of District Grievance Redressal Officers in place: …………….. A) ENTITLEMENTS: CASHLESS SERVICES & USER CHARGES

Sno. Provision for Cashless deliveries for all pregnant women and sick newborns at all public health facilities

Whether G.O. issued (Y/ N)

Month when started / proposed timeline

No. of districts implementing

1. Provision of Free drugs/ consumables

2. Provision of Free Diagnostics

3. Provision of Free Diet

4. Provision of Free blood (inclusive of testing fee)

5. Provision of free treatment to Sick newborns up to 30 days

6. Free Referral Transport for PW (to & fro, 2nd referral)

7. Free Referral Transport for Sick newborns (to & fro, 2nd referral)

8. Exemption from all user charges for all PW and sick newborns

9. Empowerment of MO in-charge to make emergency purchases

NOTE: Pls. provide a copy of relevant Govt. Order(s)(provide one time, and when any updation/ revision is done)

B) ENTITLEMENTS: REFERRAL TRANSPORT (RT)

Sno. Referral transport services State owned EMRI/ EMTS PPP Other

1. Total number of ambulances/ referral vehicles in the State/ UT

2. Whether vehicles fitted with GPS (specify no.)

3. Call centre(s) for the ambulance network: Districts (no.s) - ……………………… State (Y/N): …………………………………

4. Toll free number (provide number, if available): ……………………………………….. C) IMPLEMENTATION: CASHLESS SERVICES

Sno. Provision for Cashless deliveries for all pregnant women and sick newborns at all Govt. health facilities Status

1. No. of districts where free entitlements are displayed at all health facilities

2. No. of districts where free diet is available to PW (at all facilities 24x7 PHC and above level)

3. No. of districts where lab is functional for basic tests for PW (at all facilities 24x7 PHC and above level)

3a. No. of districts where any facility has stock outs of lab reagents / equipment not working

4. No. of districts where any facility has stock outs of essential drugs / supplies for PW and sick newborns

5. No. of districts where any facility has user charges for PW / sick newborns for: i. OPD

ii. Admission / delivery / C-section

iii. Lab tests / diagnostics

iv. Blood

6. Total no. of govt. medical colleges in the State

7. Total no. of govt. medical colleges not levying any type of user charges

D) SERVICE UTILISATION: REFERRAL TRANSPORT (RT)

Sno. Referral transport services State vehicles EMRI/ EMTS PPP Other

1. No. of PW who used RT services for:

i. Home to health institution

ii. Transfer to higher level facility for complications

iii. Drop back home

2. No. of sick newborns who used RT services for:



iii. Drop back home

E) GRIEVANCE REDRESSAL

Sno. Grievance redressal Status detail

1. No. of complaints/ grievance cases related to free entitlements

2. No. of cases addressed / no. of cases pending

Checklist 3B: IMPLEMENTATION STATUS OF JANANI SHISHU SURAKSHA KARYAKARAM (JSSK): DISTRICT LEVEL

District / State: .....................................................………….. Total no. of blocks: .......... Reporting Month/ Year: …………..…… District Nodal Officer in place (Y/N): …………..… District Grievance Redressal Officer in place (Y/N): …………………..

A) CASHLESS SERVICES

Sno. Provision for Cashless deliveries for all pregnant women and sick newborns at all Govt. health facilities

Sub-centre

PHC Block PHC/ CHC

SDH DH

1. No. of govt. health facilities in the district

1a. No. of facilities where deliveries take place (“Delivery points”)

2. No. of facilities where free entitlements displayed

3. No. of facilities where free diet is available to PW

4. No. of facilities where lab is functional for basic tests for PW 1

4a. No. of facilities with stock outs of lab reagents / equipment not working

5. No. of facilities with stock outs of essential drugs / supplies

6. No. of facilities with user charges for PW / sick newborns for:

i. OPD

ii. Admission / delivery / C-section

iii. Lab tests / diagnostics

iv. Blood

B) REFERRAL TRANSPORT (RT)

Sno. Referral transport services State vehicles EMRI/ EMTS PPP Other

1. Total no. of ambulances/ referral vehicles in the district

2. Whether fitted with GPS (specify no.)

3. No. of PW who used RT services for:



iii. Drop back home

4. No. of sick newborns who used RT services for:



iii. Drop back home

5. No. of blocks where referral transport service is available: …………………………….. 6. Whether district level call centre in place (Y/N): ……………. C) GRIEVANCE REDRESSAL

Sno. Grievance redressal Status detail

1. No. of complaints/ grievance cases related to free entitlements

2. No. of cases addressed / no. of cases pending

3. Average no. of days taken per case

1 Lab technician is in place and pregnancy test, Haemoglobin, urine routine for sugar and protein are available

Checklist 4: CHECK LIST FOR VILLAGE HEALTH NUTRITION DAYS (VHNDs) Purpose:

The purpose is to collect information on operational status of VHNDs, identify gaps and problems faced. The information will be used for discussions on policy issues with the District/State Government during CRM.

There may be more information specific to the facility than has been included in the check list – please note on separate sheets. Government of India guidelines on operationalising VHNDs are available and it is suggested that these may also be referred to.

It should be possible for the teams to include visit to ongoing VHNDs during the visit by planning it with the district administration.

The organization of the Village Health and Nutrition Day on a regular basis as per the guidelines will result in the achievement of the following outcomes (source- VHND guidelines of GOI).

Hundred per cent coverage with preventive and promotive interventions, especially for pregnant women, children, and adolescents.

Preventive and promotive coverage for the National Disease Control Programmes Increased awareness about the determinants of health such as nutrition, sanitation,

timely care, etc. Improved knowledge about the services offered under the various National Health

Programmes. Greater emphasis on the community's role in making the health system responsive to

the health needs of the community and in demanding and ensuring accountability. 1. General information:

Session site Anganwadi/ Other place (is it suitable, is it centrally located)

Session Date (is Programme for VHN Days displayed) How many of planned sessions have been held What alternate arrangements are made when ANM is on leave on a session day

Timing Displayed

Availability of staff at the session site ANMs Male MPW (if available) ASHA AWW PRI member Helper of AWW

2. Check Records of ASHA

Does she have an updated list of pregnant women?

How many have been registered during Ist trimester (Does she face any problems in locating pregnant women during first trimester)

Has she made a list of pregnant women who need to come for ANC For first time in this session Repeat visits. Check if these women are there & talk to them

How many deliveries/how many are JSY/how many have got JSY benefits/are any payments pending and if so why?

Does she have updated list of infants who need immunization

Has she identified drop outs

For routine immunization For polio Reasons for drop outs/any difficult cases

Does she have a list of children who need care for malnutrition?

Does she have list of children with special needs, particularly girl children?

Does she have a list of pregnant women in high risk category (severe anaemia, high BP etc.)?

Does she have a list of TB patients who need anti-TB drugs? Check record if she regularly visits the households/ of these how many are SC/ST households.

3. Check records of ANM

Is there a record of delivered women?

Is there a record of Post Natal Services provided through home visits? 4. Check an ongoing VHND for Clients

Have children who are scheduled to come for immunization, come (check record)

How many are from vulnerable sections. Supplies

Drugs & related supplies

Check availability of vaccine

Cold chain: Vaccine carrier with ice packs

VVM's status on vaccine vials

How does vaccine reach the session site

Are AD Syringes available-how are these being disposed

IFA tablets, Vitamin A

ORS, and Cotrimoxazole

Anti-helminthic drug

Chloroquin

Anti-TB drugs

Paracetamol

Condoms, OCPs,ECPs,

Stains for fixing BF

Hemoglobin meters- check if Hb is being done

Kits for urine examination- check utilisation

Gloves

IEC material for communication and counselling

Equipment, Instruments

Weighing scale-adult, child

Is examination table, bed screen/curtain available/ is privacy there for ANC women

Slides – are blood films being made-check record

Stethoscope and blood pressure instrument (check if BP is regularly measured in ANC)

Measuring tape

Foetoscope

Nischay kits

Talk to ASHA & ANM for their knowledge on use of the drugs, use of instruments and doing investigations. Is ANM using flexi funds to procure supplies? Client satisfaction Exit interviews with some clients about the dates of repeat visits for immunization, birth preparedness, and the institution identified for delivery 5. Disbursement of incentives to ASHA for mobilizing clients to get Immunization, JSY. 6. Coordination with AWW and PRI – discuss 7. Does a VHSC exist in the village? Talk to members:

What according to VHSC member(s) is their role?

How many houses have been identified for construction of latrines, how many have done it, how many of these are SC/ST households.

Action taken for breeding sites of mosquitoes

Disposal of household refuse

How has the fund provided by GOI been spent?

8. IEC/BCC: Find out from the community if any demand generation activities were conducted prior to the VHND. Also, find out from ASHA, ANMs and AWWs if they received any training on interpersonal communication.

check lists for rch ii related strategies: common …

Documents