Evaluation of Hypothermic Kit Program in West Bangal

Agency : HSDI- Technical Assistance Support Team (TAST Extension), West Benga

The Government of West Bengal has developed a comprehensive Health Sector Strategy 2004-13 (HSS), which provides a unique opportunity to the government to align its own and donors' resources to meet the state's priorities and help address the major shortcomings in both public and private health provision. One of the important initiatives taken by the state under the HSS was distribution of hypothermic kit (HT) to new mothers who gave birth at primary health centers and rural hospitals. The initiative aimed to encourage institutional deliveries in the state. To know the impact of the program on rural people and to find out deterrents and motivators encountered during the implementation of the scheme DHFW had commissioned the study.

The objectives of the assignment were: i) to assess the programmatic inputs and processes, ii) to understand their impact on the beneficiaries, iii) to understand the factors that acted for its successes or failures, and iv) to identify key issues which need to be addressed to make the scheme more functional and effective.

Method: The study used both qualitative and quantitative techniques to evaluate the Hypothermic Kit program. Stratified sampling was used in the study. A total of 756 women who had had institutional deliveries during the last two years were interviewed from six districts (3 poor performing districts and 3 high performing districts). Block and district medical officers were also interviewed in this regard. Results: More than half of the women were satisfied by the HT kits. A similar percentage of women received the kits immediately after their deliveries whereas one-third received at the time of discharge. Nearly 88 percent (against 23.4% reported in NFHS report) had breastfed their children immediately after their birth which implies that the program had very positive impact on improving breastfeed practices. Two-thirds of the respondents knew other women in their area who got motivated for institutional deliveries after hearing about the kit.

Interaction with block and district medical officers, revealed that eleven out of twelve block medical officers had either surplus or shortage of supply of HT kits sometime during the last one year. Seven blocks had short supply for more than six months. Over 81 percent of the BMO were satisfied by the quality of HT kits. However, less than one-fifth (19%) of the respondents were not satisfied with the quality of kits (mainly the mosquito nets).

Recommendations: The key recommendations were: i) Among those women who received the promotional activities none were counseled for reading the manual. Therefore, the health workers should make efforts to explain the manual and advise them to read it. ii) No mother got all the components of HT kits. Therefore, the health department should ensure that a complete kit is given to every woman. iii) Since most of the block medical officers and CMOHS reported their unhappiness with the supply of the HT Kits, the government needs to strengthen the supply. iv) Since most of the CMOHs and BMOs faced the problem of space to store the HT Kits, separate space be identified at each facility and/or regular supply system backed by modern inventory management be initiated. v) Since different BMOs maintain different kinds of record, a definite recording protocol be developed and communicated to all the officers.



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