DISTRICT HEALTH DEPARTMENT ZILLA PARISHAD ALIBAG RAIGAD.

DISTRICT HEALTH DEPARTMENTZILLA PARISHAD

ALIBAG RAIGAD

BEST PRACTICES

Maternal And Child Health Programme

MAHER GHAR YOJANA

Aims:- To Reduce Percentage of Home Deliveries in 3 block viz Karjat, Khalapur, Sudhagad Pali.

Action Plan:- We have reduce percentage of home deliveries in these 3 blocks by by taking

following action. 1) We take frequently block level meeting in the selected 3 blocks2) We included all health worker LHV, ANM, HA, MPW, ASHA and Aganwadi Workers, we

also seek the help Adolescent Girls and Local Political Leaders .3) In Block level meeting we calculated the expected number of deliveries in that month at

every PHCs/Subcenters, we also listed the expected place of deliveries4) Our Health workers continuously follows the ANC Mothers in there Visit and

Counseled/Insisted her for institutional delivery.5) LHV at PHC take review of ANM Regarding deliveries weekly.6) District level officer also take review of home deliveries in their visit 7) DRCHO took review of LHV about Home deliveries in their PHCs

Result & Outcome of Maher Ghar Yojana

Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-140

50

100

150

200

250

211

177

149

99

5782

62

Number of Home Deliveries

Home Deliveries in Raigad District

Sr.no Year No of Home Deliveries %

1 2009-2010

9567 25

2 2010-2011

7396 20

3 2011-2012

4196 15

4 2012-2013

2806 7

5 2013-2014

2080 6

Home Deliveries in Raigad District

2009-2010 2010-2011 2011-2012 2012-2013 2013-20140

2000

4000

6000

8000

10000

12000

95677396

41962806

2080

Home Deliveries

Home Deliveries

MMR And IMRYear Maternal

DeathMMR Infant Death IMR

2012-2013 33 0.9 729 18.9

2013-2014 28 0.8 555 16.1

MMR And IMR Year Wise Graphical Trend

2012-2013 2013-2014 0

5

10

15

20

25

0.9 0.8

18.9

16.1

IMR MMR

Family Welfare

Programme

Three YEARS PERFORMANCE OF STERILISATION AND TWO OR LESS THAN TWO CHILDREN

Sr.No.

Sterilisation Two or less than two children

Year Target Vas. Tub. Lap.Achive-

ment%age

      TargetAchive-

ment%age

1 2011-2012 10000 43 4579 3498 8124 81 6000 4628 77

2 2012-2013 9132 25 5218 3336 8579 94 5479 5452 100

3 2013-2014 11100 33 5475 3160 8668 78 7215 5801 80

Special Immunization Session in the High risk Areas

In Panvel block due to rapid urbanization of he city, construction sites,Brickling area and Urban Slums is increasing ,were the migrant population is high, Such areas are Categorized it as HIGH RISK AREAS.

One of such huge construction site Known as Shirke Constructions,under PHC NERE,Block Panvel were we started immunization Session as the beneficiaries (mother as well as 0-5yrs children) are more,here we also deal with Counselling of Mother rearding Diet, Anc Care, Immunization, Danger Signals In ANC Mothers and Childrens.

Immunization Session for Shirke Constructions–Kharghar,

(Under PHC-Nere,Tal.Panvel,Dist-Raigad)RCH Indicators No Of Beneficiaries

BCG 3DPT 1 5DPT 2 6DPT 3 6Hep.1 2

Hep.3 2Measles 6DPT B 5

Measles 2 5Vit 3 1Vit 4 4Vit 6 1

ANC (Res.) 2T.T.(P.W.) 1 2

T.T.(P.W.) II + B 2

Pulse Polio Programme

In Raigad Dist Panvel,Uran,Karjat,Khalapur these areas are categorized as High Risk Ares By Govt of India, as it is near to Mumbai due to which number of migrant people are more.In such we conducted 5 SNIDs(Sub National Immunization Drive) and 2 NIDs(National Immunization Drive) were we contributed to Polio Free INDIA.

Performance of Pulse Polio Round Year April 2013 to April 2014

Sr.No. Polio Round SNID/NID % Area (Block)

1 7-Apr-13 SNID 101 Panvel, Uran, Karjat,Khalapur

2 16-Jun-13 SNID 95 Panvel, Uran, Karjat,Khalapur

3 22 Sep. 2013 SNID 102 Panvel, Uran, Karjat,Khalapur

4 24 Nov. 2013 SNID 103 Panvel, Uran, Karjat,Khalapur

5 19 Jan.2014 NID 104 All Disrtict

6 23 Feb.2014 NID 106 All Disrtict

7 6-Apr-14 SNID 103 Panvel, Uran, Karjat,Khalapur

Leptospirosis

Factors responsible for occurrence of Leptospirosis

•Heavy rainfall

•Soil pH

•Agricultural Practices

•Close Association of humans with domestic animals

Reasons for resurgence of Leptospirosis

A typical rural setting conducive for Leptospirosis transmission – Kutcha residence in agriculture field A typical rural Kutcha human habitation – ‘people living closely with domestic animals’ – a cause of spread of Leptospirosis

Reasons for resurgence of Leptospirosis contd

Unplanned development

All developmental projects are not referred for environmental impact assessment

Leptospirosis cases/deaths 2010 to 2014

Sr NoBlocks

2010 2011 20122013

2014

No.of susp-ects

No. of confirm

eddeath

No.of susp-ects

No. of confirmed

deathNo.of susp-ects

No. of confirmed

deathNo.of susp-ects

No. of confirmed

deathNo.of susp-ects

No. of confirmed

death

1 Pen 172 77 13 17 9 1 28 5 0 76 3 3 0 0 0

2 Alibag 141 89 4 24 4 2 16 4 0 34 10 0 0 0 0

3 Roha 68 46 4 3 3 0 0 0 0 0 0 0 0 0 0

4 Mangaon 15 2 0 10 1 0 0 0 0 5 1 0 0 0 0

5 Panvel 0 0 0 5 1 1 23 3 0 0 0 0 0 0 0

6 Sudhagad 29 10 2 16 8 1 0 0 0 0 0 0 0 0 0

7 Tala 21 7 0 6 1 0 0 0 0 0 0 0 0 0 0

8 Karjat 7 4 1 7 1 0 0 0 0 0 0 0 0 0 0

9 Khalapur 42 16 0 0 0 0 0 0 0 0 0 0 0 0 0

10 Mahad 0 0 0 0 0 0 0 0 0 5 1 0 0 0 0

11 Mhasala 0 0 0 0 0 0 0 0 0 13 1 0 0 0 0

Total 495 251 24 88 28 5 67 12 0 133 16 3 0 0 0

Suspect Cases 2010 to 2014

PenAlib

agRoha

Manga

on

Panve

l

Sudhag

ad

Tala

Karjat

Khalapur

Mahad

Mhasala

0

20

40

60

80

100

120

140

160

180

200

172

141

68

15

0

2921

7

42

0 0

1724

310 5

166 7

0 0 0

2816

0 0

23

0 0 0 0 0 0

76

34

05

0 0 0 0 05

13

2010 2011 2012 2013

2014

Confirmed Cases Year 2010 To 2014

PenAlib

agRoha

Man

gaon

Panve

l

Sudhag

ad

Tala

Karjat

Khalapur

Mah

ad

Mhasa

la 0

10

20

30

40

50

60

70

80

90

100

77

89

46

2 0

10 7 4

16

0 09

4 3 1 18

1 1 0 0 05 4

0 0 3 0 0 0 0 0 0310

0 1 0 0 0 0 0 1 1

2010

2011

2012

2013

2014

Deaths Year 2010 To 2014

PenAlib

agRoha

Manga

on

Panve

l

Sudhag

ad

Tala

Karjat

Khalapur

Mahad

Mhasala

0

2

4

6

8

10

12

1413

4 4

0 0

2

01

0 0 01

2

0 01 1

0 0 0 0 0

3

0 0 0 0 0 0 0 0 0 0

2010 2011

2012 2013

2014

Action taken for control of epidemic

•Daily House to House surveillance done by teams of Health Wrokers and suspected fever patients treated and serious patients refered to Civil Hospital, Alibag.

•All Grampanhcyats instructed to take sanitation measures in villages by written letter by Medical Officer, PHC.

* Daily Reporting of Fever Cases and Monitoring .

Health education

Keep Personal Hygiene.Wash hands and legs after working in farms.Use safe water for drinking.Keep Cleanliness in villages.Do not work or go outside without Shoes or Chappals.

Action taken for control of epidemic

Health Camps taken in affected villages.

Health Camps taken in Block Pen,Alibag,Roha.

Visits of Experts Team

• Expert team including Microbilogist and Physicians from B.J.Medical College, Pune visited the affected area in Gadab PHC.

• Clinical Experts team including Epidemiologist, Physicians and Surgeons from Thane.

• Pilot Project For Leptospirosis on 2011.

Action taken for control of epidemic

Serum samples collected and send for examination of Lepto. to

BJ Medical , Pune.Serum samples collected and send for examination of Dengue to NIV Pune. Due to early referral and admission death rate is decreased. One lacs pamphlets of information on Lepto. circulated in community. Also appeal given by DHO for prevention of Lepto. Published in local news papers.

Planning for Next 6 Month To Achieve The Targets

Indicators ELA Achievement

% Steps to Reach the Target Under the Responsibility of

BCG 41055 36911 90 1)Due to rapid urbanization of Panvel , construction sites,Brickling area in panvel is more were the migrant population is high,Such areas are Categorizedit as HIGH RISK AREA,and for such areas a)We have Alternative Micro Plan. b) Conducting Meeting with Contractors of Construction site and Brickling area by Concerened THO and Medical Officer.c) This meeting should regard of the tracking working ANC or Mother with there children,providing Knowledge of Health services Facility d)Special Immunization in such areas.e)MO,LHv,ANM Sholud give atleast 2 visit a month with sharing there contact numbers with Contractors,ANC,PNC Mother.2) Close Supervision should be done by MO,LHv,ANM in High Risk Areas and Low Performing areas3) Tracking Dropout Cases and converting them in Beneficiaries4)Inclusion of Reputed NGO’s as much as possible inoder to reach the grassroot level.5)Strong District and Taluka Level Monitoring of Low performing areas by THO,MO,LH,ANM

1)Medical officer,2)DLS,3)LHV,4)ANM,5)ASHA,6)Anganwadi Sevika,7)Social Leader,Social worker,NGO Volunteers.

OPV 0 41055 29728 72DPT 3 41055 36749 90OPV 3 41055 36668 89

Hepatitis B 3 41055 35321 86

Measles 41055 37407 91Fully

Immunized Children 41055 37121 90

DPT B 37284 33272 89OPV B 37284 33115 89

Indicators

ELA Achieveme

nt

% Steps to Reach the Target Under the Responsibilit

y of

Vit A 1 41055 40784 99

6)Detailed and Repeated Review of Low performing areas until the Target is reached.7)As Medical Mobile Team is Active in Karjat Block covering 60 villages as present,in such village many beneficiaries are left out ,considering such data We can reach the unreached with special immunization schemes.8)Inclusion Of Private Hospital Data.9)With the help of Anganwadi Sevika,ANM,Asha,Adoloscent Girls,and Sarpanch ,Counselling and motivation of Anc Mothers Will be done regarding Early Registration, Early immnuzation,Folic acid suplementatiopn and Danger signs during the pregnancy and child health.

1)Medical officer,2)DLS,3)LHV,4)ANM,5)ASHA,6)Anganwadi Sevika,7)Social Leader,Social worker,NGO Volunteers.

Vit A 2 37284 39530 106

DPT (5 Yrs) 47315 31961 68

TT (10 Yrs) 48956 41746 85

TT (16 Yrs) 50597 44289 88

ANC Registered

(Total) 45160 38242 85

T.T.(P.W.) 1 45160 28370 63

T.T.(P.W.) II + B 45160 31545 70

Indicators ELA Achievement %

Steps to Reach the Target Under the Responsibility of

Sterilisation 11100 78%

1) Appraisal of the Concerned Staff for good performance.

2) To take routing review of low performing phc & block

3) To find alternatives for the rapid increase in the ELA4) To distribut the work according to

manpawar in such areas in order to rapid the target achivment

5 ) Raising Incentives Based Schemes for worker. Inclusion of Reputed NGO’s as much as possible inoder to reach the grassroot level.6) Strong District and Taluka Level Monitoring of Low performing

areas. Detailed and Repeated Review of Low performing areas until the Target is reached7) Inclusion Of Private Hospital Data

1)Medical officer,2)DLS,3)LHV,4)ANM,5)ASHA,6)Anganwadi Sevika,7)Social Leader,Social worker,NGO Volunteers.

Two or less than two children

7215 80%

Indicators ELA Achievement %

Steps to Reach the Target Under the Responsibility of

Sterilisation 11100 78%8 ) Close Supervision should be done by MO,LHv,ANM in Low Performing areas9 ) Strong District and Taluka Level Monitoring of Low performing THO,MO,LHv,ANM10 )Regular follow up to camp

& benifishary & cuselling them11) Trained newly appointed medical officer for nsv ,tubectomy to increase the no of surgeons12) We reopen closed operation thaeater

13) We gives health education about family planning programme to unsecured couples

1)Medical officer,2)DLS,3)LHV,4)ANM,5)ASHA,6)Anganwadi Sevika,7)Social Leader,Social worker,NGO Volunteers.

Two or less than two children 7215 80%

INNOVATIVE SCHEME

Shrafalya Yojana (Early Detection, Safe motherhood)

• Aims & Objectives :-

• 1) 100 % ANC registration at six weeks.

• 2) Supplementation of Doxinet plus tablet if hypermesis is there otherwise providing folic acid tablet for ANC mothers.

• 3) To give early advice about MTP.

Action Plan • 1) Surveillance and line listing of mothers in the reproductive age group

between 19 to 49.• 2) Taking date of monthly period of these mothers by ASHAs.• 3) Doing 1st UPT if monthly period extend up to 7 to 10 days. If this UPT

comes positive then registration of it to the ANM of SC in that area through phone. And if the test is negative then again doing UPT after 15 days. If the test is positive registration of it to the ANM of SC in that area through phone. And if negative advice to consult to the Medical Officer.

• 4) By the observation of palms grading as severe anemia, anemia and normal and advice accordingly.

• 5) Advice to Conduct to medical officer if the PV bleeding is more the 3-5 days during meustrual period.

• Information on copper T, Condoms, Contraceptive pills and family planning can be given on the same day.

Expected Budget Contingency 10000

UPT kit (10 for each ASHA) 50000

Tablet folic acid 5 MG 50000

Tablet Doxinet 50000

ASHA Incentives (Rs. 5 per Case) 558000

ASHA Incentives

Within 45 days Rs. 50 50000

Within 60 days Rs. 25

768000

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