Student Dissertation

Agency : RMNCH+A interventions, Facility Based Survey, Situational Analysis, Maternal And Child Health

Recommendations : Improving the maternal and child health and their survival are central to the achievement of national health goals under NRHM as well as the Millennium Development Goals and also the Milestone year 2015. The 12th Five Year Plan has defined the national health outcomes and the three goals that are relevant to RMNCH+A strategic approach as follows: Health Outcome Goals established in the 12th Five Year Plan • Reduction of Infant Mortality Rate (IMR) to 25 per 1,000 live births by 2017 • Reduction in Maternal Mortality Ratio (MMR) to 100 per 100,000 live births by 2017 • Reduction in Total Fertility Rate(TFR) to 2.1 by 2017 38 The main objective of this gap analysis is to rapidly understand the gaps in the implementation of a set of strategic RMNCH+A interventions across life stages. The general objective was to access resource availability in terms of infrastructure, human resources, capacity, fund availability, needed to deliver a set of key RMNCH+A interventions in facilities in the district. The study design was Descriptive cross-sectional analysis and was conducted at Aligarh district covering District Hospital, First Referral Units, Community Health Centers, Primary Health Centers and Sub- Centers of Aligarh. All twelve Blocks were covered for the situational analysis of health facilities in Aligarh for RMNCH+A program. The primary data for District Hospital (Male and female), Community Health Centers, Primary Health Centers, First Referral Unit, was collected by visiting the facility, through observation and interviewing the facility human resources. For the sub-centers the data was collected by interviewing the ANM of the sub-center at the regular ANM meetings. Also the HMIS report was collected from the facilities for identifying case loads. Structured questionnaire as per the NRHM guidelines were used as tools for collecting the data. Total 102 health facilities were covered. The total of 4 first referral units and district hospital were included to identify gaps and it was found that the higher health facilities have only 60 percent of trained manpower and only one-third of the non first referral unit PHC’s and three-fourth of the Non FRU CHC’s have trained manpower. Also gaps in the availability of essential drugs and equipments were observed at the FRU’s and Non-FRU CHC and PHC. The recommendations for reducing the gaps analyzed from study were, timely and regular supervision of the higher authority and providing quarterly refresher training to trained manpower for one or two days in which they can revise the training module and guidelines. The analysis highlights the identified gaps in terms ofinfrastructure, human resource, essential drugs, supplies and equipments. Efforts should be made by higher authorities, so as to make the implementation of RMNCH+A program effective at all facility level.