Student Dissertation

Agency : Delivery points, Labour room, Protocols, Standards, Infrastructure, Training, Resources.

Objective : To develop detailed and focused action plans for each facility that would address gaps and help take preventive action to enhance the quality of services provided in labour rooms.

Background : The recent NFHS4 data shows that the institutional delivery is 80.8 percent which has increased from 26.2 percent in NFHS 3. Also, the HMIS data shows that the institutional delivery is nearly 90 percent for the last three years with high district wise variation. It is well known that the people will avail the services when the quality care will be available at the facility and of course improvement / established of labour room to an ideal condition is the most necessity in this regard. To improve the coverage of institutional delivery, the prime activities would be improving the functionality of the labour room in terms of infrastructure, manpower, equipment and drugs etc. And to do that the gap analysis of the labour room is most essential.

Methodology : The gap assessment has been based through standard tool in relation to Government of India stipulated norms. The districts comprise of 32 delivery points. Assessment was based on physical verifications and The gap assessment has been based through standard tool in relation to Government of India stipulated norms. The districts comprise of 32 delivery points. Assessment was based on physical verifications and observations of 15 delivery points (L3 (Cemoc centres), L2 (FRU, CHC and 24*7 PHC), L1 (24*7 PHC Non FRU) which comprises of the following:  1 District Hospital  1 Civil Hospital  10 CHC out of 12 CHC  3 PHC out of 26 PHC • Study design: Descriptive Study Design • Study area: delivery points of 11 blocks of Sagar district • Study duration: 3months • Data collection method: primary data was collected through physical variation and observation • Data collection tool: Standard tool in relation to Government of India stipulated norms. Data analysis: Analysis was done through Ms Excel and SPSS 16.0 version and the result was done in Ms Word

Findings : The findings revealed that the condition of labour rooms appears to be a major obstacle to the success of maternal and child health programmes in Sagar. The assessment reveals that some of the essential resources were less than 50 percent available. It was found that availability of antiretroviral (26.7%), ambu bag for babies (40%), B.P apparatus (60%) and HIV Kits (13.7%), nevirapine syrup(6.7%) , utility gloves, colour coded bins and other equipment’s is very poor. Less than half the labour rooms in facilities have adequate infrastructure to ensure safe delivery, sanitation, and hygiene maintenance. Overall Standard Achievement (%) out of 19 Protocols Standards of the facilities is also very poor. Labour Room assessment finds that availability of antibiotics drugs is also not adequate. Hanging of right protocols at right places is an issue of many of the labour rooms. The study shows gathered information about approx shortage / over manpower in the facility. Trained manpower on BeMOC, SBA, NSSK, Dakshata, skill lab at all level of facilities was almost missing. Delivery register were maintained and updated at 15 labour rooms but safe birth check list and NBCC register were maintained only in 1 or 2 facilities. Also, only 46.7 % of the case sheets were being filled properly.

Recommendations : Comparing the findings of the assessment with standard guidelines we see many gaps regarding infrastructure, availability of equipment’s, availability of drugs & consumables. Record and registers are not being maintained. Ensuring biomedical waste management and infection control practices needs special focus & must be adhered to. At baseline, the rapid assessment tells that the condition of labour rooms appears to be a major obstacle to the success of maternal and child health programmes in Sagar. The findings from the assessment provide a wealth of information on the aspects that need improvement and need to be taken into consideration in action plans.


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