Student Dissertation

Agency : Facility Survey; Healthcare Delivery; Gap Analysis; Monitoring

Objective : To find out the current status in the availability, functionality and utilization of the required inputs, including trained manpower, infrastructure, equipment and drugs at the delivery points in Panna, so as to plan and act to fill the gaps accordingly.

Background : The pregnancy-related mortality and morbidity continues to have a huge impact on the lives of Indian women and their newborn. Around 70 percent of maternal deaths can be prevented by small intervention which required availability and functionality of adequate essential equipments, drugs, skilled human resource, and infrastructure (WHO 2014). The load of Maternal Deaths and Neonatal Deaths can be reduced to a large extent if all the protocols regarding infrastructure, equipment and drugs, trained Human resource are followed as per the guidelines and standards. Also, the procedures which are to be followed in the labor room as well as during PNC are to be as per the standards. All these factors combined, along with a positive supportive supervision and good communication at all levels (block-district-state) in order to converse and fill the gaps, are the key to deliver satisfactory services to pregnant women.

Methodology : Using a Supportive Supervision checklist, a cross-sectional descriptive study was conducted to asses Gaps in inputs including infrastructure, equipment and drugs, trained Human resource in 8 delivery points in Panna, Madhya Pradesh

Findings : The majority of the respondents (73.8%) had good general knowledge of the protocols followed in labor room but lacked detailed and in-depth knowledge of the component parts of the partograph, AMTSL, PPH Management, Pre- eclampsia and eclampsia management. Knowledge of 7 Delivery trays setup, equipment functionality, drugs availability had a significant relationship with its utilization. Factors affecting utilization were: little or no knowledge of the partograph (50%) in monitoring labor, also lack of detailed knowledge on AMTSL, PPH management (60), non-availability of non- expired drugs (40%), shortage of staff (51.5%), and the fact that most of the staff were less motivated towards their work.

Recommendations :The load of Maternal Deaths and Neonatal Deaths can be reduced to a large extent if all the protocols regarding infrastructure, equipment and drugs, trained Human resource are followed as per the guidelines and standards. Also, the procedures which are to be followed in the labor room as well as during PNC are to be as per the standards. All these factors combined, along with a positive supportive supervision and good communication at all levels (block-district-state) in order to converse and fill the gaps, are the key to deliver satisfactory services to pregnant women. Only planning and initiating programs once is not the way to meet the goals or objectives of any programme. For this, regular monitoring and supervision is required, starting right from the ground level up to the highest administrative level. Only then will the gaps be identified in time, and corrective measures planned, and appropriate action taken.


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