Abstract of Dissertation

Keyword : Health Facilities; Healthcare System Delivery; Facility Survey;

Objective : The objective of study is to assess inputs (essential equipment’s, human resources and their training status, infrastructure and protocols) in labor room of health facilities in Damoh district.

Background : The institutional delivery rate in India has improved around sixty four percent in last ten years. Neonatal and Maternal mortality has also shown a declining trend but the decline has not been proportional to increase in institutional delivery rates. Studies have suggested that one of the reasons of this situation could be unavailability of required inputs like infrastructure, skilled human resource, essential equipment’s and drugs at the health facility. Damoh a high priority district in Madhya Pradesh is also facing such a situation. In order to understand the reasons there was a need to assess the facilities on the basis of the required inputs.

Methodology : Descriptive study was conducted to assess required inputs in labor rooms at health facility in Damoh. Damoh district has 7 blocks and a total of 36 facilities. Only three blocks Hindoriya, Patera, Jabera were selected as good, medium, and low performing blocks on the bases of percentage of institutional deliveries against target from 22 HMIS 2014-15 report. Study was conducted at all the facilities CHC, PHC and SHCs of these selected blocks.

Findings : Data was analyzed by facilities and by blocks. Sub centers were found with inadequate availability of inputs. All the Sub centers of the district had water supply problem, hub cutter sterile towel for baby, yellow dustbin near labor table, uninterrupted water supply, Vitamin k1, refrigerator, autoclave, oxytocin, macntosh, Kelly’s pad and functional radiant warmer were not available. Two sub centers of Jabera block Banwar, Kodakala and Bansakala of Hindoriya block did not have restricted entry in labor room. All the PHCs have inadequate essential drugs, wash area did not have elbow operated tap in labor room, machntoch, Kelly’s pad, yellow buckets near labor table, autoclave in labor room, wall clock, slipper, functional radiant warmer, yellow dustbin near labor table were not available at any PHC. It was found that functional wash area, elbow operated tap was not available in any CHC which were studied. Jabera CHC did not have machntosh sheet for labor tables, yellow bucket near labor tables, fetoscope, autoclave and slipper in labor room. Whereas Hindoriya block had adequately available inputs, except functional wash area. Patera block did not have sterile towels for baby, vitamin k1, hub cutter, Kelly’s pad for both labor tables in the labor room.

Recommendations : Availability, accessibility, affordability, equity, efficiency, and quality of MNH services highly depend on the distribution, functionality availability and quality of infrastructure, equipment’s, human resource. Therefore, it is concluded that adequate/ inadequate availability of inputs can be one of the reasons affecting the performance of these blocks.