district action plan: implementation status progress...

BIH

AR

Progress District Action Plan (DAP)

DISTRICT WISE CUMULATIVE SCORING (TFR, mCPR, UNMET NEED)

District Action Plan: Implementation Status

Family Planning Division

Ministry of Health and Family Welfare Government of India

TRAINING CENTRES Divisional Level Training Centers =8 District Training Centers =6 ANM Training Centers =21 Indicators Value

Population # 10.4 Cr. mCPR* 36.5 Total Unmet Need* 31.5 Unmet Need Spacing * 17.3 Unmet Need Limiting* 14.2 IMR** 42 MMR* 274

Socio Demographic Indicators* Value % Married women >18 years 13.8 % Married women illiterate 56.7 Women Reporting Birth Order 3 & above 44.9 % of Birth Interval > 36 months 45.2

*AHS 2012, **SRS 2013, #Census 2011

4.2 4.3 4.3 4.2 3.9 3.9 3.9 3.7 3.6 3.53.4

Trends in TFR - Bihar Year Wise (SRS 2013)

57%

0%

43%

38%

0%

20%

40%

24%

0%

11%

33%

4%

0%

2%

28%2%

Minilap

Laparoscopic

NSV

IUCD

% F

acili

ties

oper

atio

naliz

edag

ains

t non

func

tiona

l

% Facilities operationalized for FP Services

SC PHC-APHC CHC SDH DH

100%

25%

21%

5%

DH

SDH/CHC/RH

PHC-APHC

SC

% Delivery Point Facilities Operationalized for PPIUCD

Contraceptive Usage in Bihar AHS 2012

30.7

0.32.8

1.4

0.64.7

Female Sterilization Male sterilization Condoms

Pills IUCD Traditional Method


QUALITY SERVICE DELIVERY

ASHA Schemes: Addressing FP needs in the community

Home Delivery of Contraceptives

Ensuring Spacing at Birth (ESB)

ESB Scheme is popularly known as Adarsh Dampati Yojana in the State. The limiting component of this scheme especially opting for sterilization after 2nd child has been well taken but the spacing component still needs to gear momentum.

(Physical Report 2014-15)

Pregnancy Testing Kits (PTK)

The State has report 29.7 % utilization of PTK in the year 2014-15 .Utilization through ASHAs' is (12.3%) and through SC(17.4%).


107 counsellors are in position as against the approved 161. All the counselors have been trained to assess and address the client's FP needs.

RMNCH+A counselors

Female Sterilization (Minilap) is the predominant method of choice in the state. NSV contributes only 1% to total sterilization share.

(Source : HMIS 2014-15)

37.4

12

4.9

%S

tock

dis

trib

ute

d

8760874615

62291 65384

2013-14 2014-15

OCP Users & Condom Users

Condoms OCP

33777

52226

2013-14 2014-15

PPIUCD INSERTION

PPIUCD Insertion

515267

514777

574825

496902

513541

306940

371703

390971

384018

317893

228959

177495

2014-15

2013-14

2012-13

2011-12

2010-11

2009-10

Ste

riliz

atio

n a

nd

IU

CD

Y

earw

ise

per

form

ance

(H

MIS

)

IUCD Sterilization

Ministry of Health & Family Welfare, FP 2020 District Action Plan (DAP) - Bihar

A slight decline is observed for IUCD when compared against last year (2013-14) whereas sterilization have remained static since last 2years

QUALITY ASSURANCE COMMITTEE DQACs have been formed in all 38 districts of

Bihar 106 DQAC Meetings have been undertaken in

the year 2014-15

FAMILY PLANNING INDEMNITY SCHEMEIn the year 2014-15 Bihar State reported 18 deaths attributed to sterilization 3 cases of complication 6 sterilization failures.


84082 ASHAs' in the state are involved in the HDC Scheme.37.4% Condoms, 12% OCP and 4.9% EC were distributed through them across Bihar in the year 2014-15


With the strengthening of PPIUCD services at each level there has been 55 % increase in PPIUCD insertion as compared to last year. This year the acceptance rate for PPIUCD was 8% and with the emphasis on post partum services there wil l be a significant rise further.


NSV, 1%

Laparoscopic, 0.24%

Minilap, 96%

PPS, 3%

Contribution of different Sterilization Services

Decline of condom usage is observed where as slight OCP usage has increased as compared to last year(2013-14)

(Source HMIS)

Condoms OCP ECP


ENSURING AVAILABILITY OF OPERATIONALIZED STATIC SERVICES

Status of Facilities Training Snapshot

Minilap Sterilization Services

Laparoscopic Sterilization Services

Vasectomy Services


732

29

23

4 12

DH SDH

Nu

mb

er o

f F

acili

ties

Non-Functional FunctionalOperationalized

46

1743

24

140

11 78CHC PHC-APHCN

um

ber

of

Fac

iliti

esFunctional Non-Functional

7

15

22

Nu

mb

er o

f P

rovi

der

s tr

ain

ed in

201

4-1

5

Minilap (Specialist/ MBBS)

3

0 0

9

DH SDH CHC PHC

Nu

mb

er o

f P

rovi

der

s tr

ain

ed in

201

4-1

5

NSV (Specialist/ MBBS)

63

1839

7

44

744

CHC PHC-APHCNu

mb

er o

f F

acili

ties

Functional Non-Functional

Operationalized

3655

700

00

0

00

DH SDH CHC

Nu

mb

er o

f F

acili

ties

Non-Functional Functional Operationalized

14

4622

9

6 9

DH SDHNu

mb

er o

f F

acili

ties

Functional Non-FunctionalOperationalized

M i n i l a p b e i n g t h e mainstay of female sterilization; the state h a s t r a i n e d 3 5 providers , out of which 7 are posted at DH,1 at SDH,5 at CHC and and 22 at PHC-APHC to enhance the service provision .

State has been focusing more on minilap trainings as it is the preferred choice. Laparoscopic sterilization is yet to strengthen its grip. In the year 2014-15 no providers were trained for laparoscopic sterilization. The Laparoscopic trainings for the providers is yet to pick up pace in the state .

In line with GOI priority to increase the service provision of NSV till PHC level, 3 providers of DH and 9 of PHC were trained for NSV against the proposed.

The provision of minilap services were accentuated by operation-alizing 4DH, 12 SDH, 11CHC/RH & 78 PHC-APHC.

This accounts for 57% DH, 38% SDH, 24% CHC and 4% PHC operationalized against non functional at each level.

State's emphasis on enhancing the NSV service provision 6 DH,9 SDH,7 CHC and 44 PHC-APHC accounting for 43%, 20% 11% and 2% were operationalized r e s p e c t i ve l y a g a i n s t n o n functional facilities at each level.

Bihar is Minilap predominant state and laparoscopy is not the preferred choice of the providers .Therefore the state needs to build capacity of the providers for the wider provision of sterilization services.None of the facilities upto CHC level have been operationalized in the year 2014-15.

Operationalized


Interval IUCD Services

Highlights: DAPs helped in identifying the facilities for onsite training through Jhpiego The gap analysis done during the DAPs preparation guided the evidence based strategies

incorporated in state PIP 2015-16

With greater thrust on spacing , the state has trained more staff nurses as compared to medical officers at DH, SDH,CHC level. Additionally the state took an initiative of providing integrated training to Medical Officers including AYUSH service providers for delivering IUCD & PPIUCD services at PHC-APHC level.

As in line with GOI priorties more emphasis was laid on training of staff nurses to doctors with delivery points prioritized for PPIUCD Training. Integrated IUCD & PPIUCD training has been imparted to 410 doctors , including AYUSH providers at PHC-APHC level.

PPIUCD Services


A l l D H w e r e a l r e a d y operationalized for IUCD Services. During the year 8 SDH(40%), 9 CHC/RH(33%), 338 (28%) and 176(2%) SC were operationalized against non functional facilities for rendering IUCD services .

State's efforts to operationalize PPIUCD services is evident with increasing service provision by operationalizing facilities at all levels.While all DH are now operationalized for rendering PPIUCD services. 4 SDH ,10 RH/CHC , 148 PHC-APHC were also operationalized.10 Delivery Point Subcentres were also operationalized among non functional facilities for providing PPIUCD services.

20 27

36

35

43

8 9

DH SDH CHCNu

mb

er o

f F

acili

ties

Non-Functional Functional

Operationalized

1220

7325

663

2404

338 176PHC-APHC SCN

um

ber

of

Fac

iliti

es

Functional Non-Functional

Operationalized

156

701

1953566

97

0

1 14148

10DH SDH/CHC/RH PHC-APHC SC

Nu

mb

er o

f F

acili

ties

Non Functional Functional Operationalized

8 6 9

410

17 26 23

245

79

DH SDH CHC PHC SC

IUCD Training

MO Nursing cadre

8 6 9

410

44 34 49

613

2

DH SDH CHC PHC SC

PPIUCD Training

MO Nursing cadre

district action plan: implementation status progress...

Documents