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Effect of Concurrent Monitoring on Cognitive Load and Performance of Ante Natal Care, Natal Care and Post Natal Care Services


  • Hemlata Sarswat
  • Agency : ANC, Natal AND PNC Services
  • Objective : Focus district of UNICEF:There are five focus district of UNICEF in Rajasthan- Tonk, Sawai Madhopur, Barmer, Baran and Dungerpur
  • Background : National Rural Health Mission has provided an opportunity to strengthen the Public Health system by correcting its overall architecture so as to ensure quality preventive and promotive and curative services accessible to all the groups particularly with the focus on women and children. Investments have been made in building infrastructure by creating buildings, supplying equipments etc. A large number of Human resources have also been deployed right from Sub-centre, Primary Health Centre, and Community Health Centre District Hospitals to Medical Colleges. Many trainings are designed specifically to build the skills of Doctors and paramedical staff, however still to provide quality of services through public health system is a challenge.Strengthening Monitoring and supportive supervision for operationalisation of First Referral Units: Setting up of a Concurrent Monitoring Cell.
  • Methodology : Selection of institutions: The institutions have been selected on the basis of delivery load. In the first phase institutions catering the 50 percent institutional load have been covered. Initially 80 institutions were selected under this monitoring (list enclosed) and gradually institutions in the near vicinity of these overloaded institutions were identified to make them operational. All the indicators were analysed and feedback was sent to the districts on monthly basis. It was expected that on quarterly basis reports will be shared with all the institution in-charges at the state level. 
  • Findings : Bio-medical waste management of CHC Deoli in first visit was found to be 66.7 percent and in second visit it was found to be 100 percent which claims improvement by 37 percent in bio-medical waste management of CHC Deoli during two visits. Infrastructure of ANC, Natal and PNC care of DH Tonk in first visit was found to be 78.8 percent and in second visit it was found to be 51.5 percent which claims difference by - 27.3 percent in infrastructure of ANC, Natal and PNC care of DH Tonk during two visits. Reporting of DH Sawai Madhopur in first visit was found to be 60 percent, where as in second visit it was found to be 80 percent which means improvement by 20 percent in reporting of DH Sawai Madhopur during two visits. Antenatal care services of CHC Balotra in first visit was found to be 19 percent and in second visit it was found to be 70.7 percent which means improvement by 52 percent in antenatal care services of CHC Balotra during two visits. Natal care records of CHC Balotra in first visit was found to be reported to be 44.7 percent and in second visit it was found to be 72 percent which claims improvement by 27 percent in natal care records of CHC Balotra during two visits. Knowledge and skills of CHC Kelwara in first visit was found to be 42.9 percent and in second visit it was found to be 100 percent which means improvement by 58 percent in knowledge and skills of CHC Kelwara during two visits. Consumables and supplies of CHC Sagwara in first visit was found to be 55.2 percent and in second visit it was found to be 96.5 percent which means improvement by 41percent in consumables and supplies of CHC Sagwara during two visits. Reporting of DH Dungarpur in first visit was found to be reported to be 20 percent and in second visit it was found to be 40 percent which claims improvement by 20 percent in reporting of DH Dungarpur during two visits.
  • Recommendations : Record maintenance and reporting part improved by 14 percent to 43 percent in most of the health institutions of the focus district of UNICEF. Infrastructure, consumables and supply part improved by 18 percent to 43 percent in most of the health institutions of the focus district of UNICEF except DH Tonk where difference in infrastructure found was -27.27 percent. Net improvement in quality of ANC, Natal and PNC services occurs in all the health institutions.
The institutions have been selected on the basis of delivery load