Abstract of Dissertation

Keyword : RMNCH+A, Supportive supervision, Situation Analysis

Objective : • To review the guidelines of the RMNCH+A Program and National RMNCH+A supportive supervision guidelines, related to standard operating procedures. • To analyze RMNCH+A data based on checklist created. • To study the processes being implemented under RMNCH+A subjecting to availability, accessibility of services. • To identify gaps in Infrastructure, human resources, capacity, quality, and resource availability needed to deliver a set of key RMNCH+A interventions in facilities of the district.

Background : RMNCH+A strategy determines the effectiveness of key and important interventions by the coverage achieved among the target population which needs to be indicated in terms of the availability, acceptability, and quality of services delivered to the community. The main objective of this situational analysis is to understand the gaps in the implementation of a set of strategic RMNCH+A interventions across life stages so that a baseline for monitoring the progress of RMNCH+A is established that can also be used for setting targets and strategies by the district administration.

Methodology : Study Location: Siwan district. Study Population: All health facilities providing RMNCH+A services Study Design: Cross-sectional (Descriptive Study). Study Duration: 3 Months. Sampling Technique: Universal sampling Sample size: 19 Data Collection: Checklist was prepared for data collection; reference was taken from supportive supervision checklist regarding RMNCH+A Strategy. Interactions with staff and clients and Reviewing of records and documents were done.

Findings : The assessment shows that most of the delivery points labor room lacks basic amenities and infrastructure. Mandate drugs and equipment are unavailable at the site. As far as newborn care is concerned functional radiant warmers are present at very few delivery points. Sterilization of instruments in the labor room is one of the major concerns. The training status of ANM And MO is not found satisfactory. There is a requirement for refresher training. As per observation during the study period, it was evident that there is a wide scope of work to be done in most of the facilities for ensuring the quality as well as quantity of services to achieve the health in all. Major areas which can be immensely improved with minimal assistance include Maintenance of equipment, record keeping, infection control, counseling, behavior with a patient, proper allocation of resources, Funds and Manpower. There is focus required on the part of administration on health facilities as well as from various supportive partners to strengthen these services, by using similar supportive supervision mechanism and enable the practice of follow up regarding any component of a health facility.