Abstract of Dissertation

Keyword : Maternal and Child Health; Child Health Services; Healthcare Delivery; National Health Mission; RMNCH+A

Objective : To assess the current availability of infrastructure and human resources needed to deliver maternal and child health as part of RMNCH+A intervention in all 7 blocks of Barwani district.

Background : Improving the maternal and child health and their survival are central to the achievement of national health goals under the National Health Mission (NHM) as well as Millennium Development Goals 4 and 5. Clear articulation of the strategic approach to reproductive, maternal, newborn, child and adolescent health (RMNCH+A) is an effort in this direction. This approach is based on the sound premise that health of an individual across the life stages is interlinked. Just as different stages in the life cycle are interdependent so are the aspects of where and how healthcare health facilities. Thus, there are two dimensions to healthcare – stages of the life cycle and places where care is provided. These two together constitute the ‘continuum of care’, and it provides an effective framework for seamless delivery of services at state and district levels. is provided.

Methodology : A descriptive cross sectional study is conducted over the period 3 months across the seven blocks of Barwani District.50 percent (17) of the total thirty-four delivery points were selected randomly keeping in view that all the levels and all 7 blocks are covered geographically. Structured questionnaire was used to identify availability of Infrastructure, equipments, drugs, human resource, training and knowledge of the human resource.

Findings : Availability of maternal health services, particularly safe delivery services, is critical for reducing maternal mortality and morbidity. This study indicated that 17 facilities have separate and functional labour room except Kajalmata which is under construction. Only 10 DP’s have Functional radiant warmer. The district reported significant gap between required and available health functionaries at all levels, specifically for nurses, ANMs and laboratory technicians. The data on availability of doctors indicates that most of the institutions have except Dhanora, Menimata and Moiyda on the top of it staff nurse was also unavailable at Dhanora. It is of high concern that six out of 16 facilities did not have Lab technician. In case of medical officers, it was observed that only nine facilities have trained medical officer, there is imbalance in training status at two MOs are trained in Warla and Rajpur. Moreover, none of the MOs are trained in LSAS. Major deficiency was seen in respect of NSSK training as only six facilities have trained MOs. Analysis of the status of trainings revealed large deficiencies only SN receiving training in FIMNCI is as low as 18 percent. Knowledge index and the findings shows five staff had low level; six had average level while five had no knowledge of basic maternal and child care.