Student Dissertation

Agency : Delivery point, DH, CHC, PHC, Labour Room

Objective : To assess the Human Resource (HR) available against the sanctioned strength of the institution and their training status. 2. To assess the availability of required Infrastructure for effective functioning of the labour room. 3. To assess the availability of functional equipment’s, instruments and required consumables in the labour room. 4. To assess the adherence to infection prevention practices in the labour room.

Background : Maternal mortality and infant mortality are sensitive indicators which show evidence for describing the health care system of a country and indicate the prevailing socio-economic scenario. These major health indicators of Madhya Pradesh are far behind the national targets. As per 2013 SRS (sample registration system) report Maternal Mortality Rate of Madhya Pradesh is 221 and Infant Mortality Rate is 54 that is highest among all the states. The highest proportion of maternal and newborn deaths takes place during and immediately after childbirth which can be preventable through appropriate care of mothers during and after labour and appropriate care of the newborns immediately after birth. This points out to the need for improving the quality of practices in the labour room. Labour rooms are fundamental to provide quality intra and immediate postpartum services, hence playing a vital role in reducing maternal and newborn mortality. It therefore is essential to lay substantial emphasis on developing the preparedness of labour rooms for high-efficiency and high quality service deliver.

Methodology : This was a descriptive study (to assess the gaps in labor room of level 2 and level 3 delivery Points. This study was conducted in Anuppur district, Madhya Pradesh. Staff nurses & ANM’s of all the level 2 and level 3 Delivery points were the respondents for gap assessment (Through checklist). Census study was done. All the level 2 and level 3 delivery points of the district were taken for the study (11 MCH level 2 and 2 MCH level 3 delivery points). Checklist was prepared with reference to the MNH toolkit and gap assessment was done.

Findings : There are two (one DH and One CHC) under level 3 and 11 (Six CHC and five PHC) under level 2 delivery points were covered in Anuppur district. From the study, it has been found that in Anuppur district hospital there are 89 percent of staffs are in positioned against the sanctioned post and they all were trained. Cent percent of infrastructure, equipments, consumables, new born care corner are available and well maintained. About 89% basic amenities are available and infection prevention practices are only 67% which is a matter of attention. There is a chronic shortage (only 50% available) of manpower in level 3 Pusprajgarh CHC. Only 80% staffs are trained which is affecting the service delivery system. About 85% infrastructures are well maintained and 81% amenities are available. Only 65% infection prevention practices are followed. Under level 2 delivery points, out of 6 CHCs only at one CHCs 100% HR are available and at 4 CHCs 100% hr are trained. Infection prevention practice is a matter of serious attention in all the facilities except Jaitahari CHCs. About 58% infrastructure is maintained in Bijuri and Benibari PHCs and no PHC has 100% consumables available.

Recommendations : The study was aimed to assess gaps of labour room in level 2 and level 3 delivery points in Anuppur district, Madhya Pradesh. There are some gaps in each and every delivery point. Hence, there is a need to improve the availabilities of human resources as well as need to equip the delivery points with better facilities, which will ultimately advance the quality of care & the outcomes.