Facility Assessment of CHCs in Bharatpur District, Rajasthan: with Special Reference to Newborn Care
Agency : NRHM, WHO, MCH, IIHMR
Objective : (a) To understand the Indian Public Health Standards for Community Health Centers, (b). To analyze the current situation of availability of investigative services, human resources, infrastructure, facility based newborn care services and drugs (sick newborn and child care drug kit) at CHCs, (c) To identify the existing gap with respect to IPHS in investigative services, human resources, infrastructure, facility based newborn care services and drugs (sick newborn and child care drug kit) at CHCs.
Background : National Rural Health Mission (NRHM) has provided the opportunities to develop a standard for SCs, PHCs, CHCs and DHs in the country, popularly known as Indian Public Health Standards (IPHS).
Methodology : The study was conducted in Bharatpur district of Rajasthan. Health care delivery in India has been envisaged at three levels namely primary, secondary and tertiary. The secondary level of health care essentially includes Community Health Centers (CHCs) and the District Hospitals. In rural areas, the CHCs are designed to provide referral health care for cases from the Primary level and for cases in need of specialist care approaching the CHCs directly. Therefore, CHCs are the very important public health facilities in rural areas. Keeping this in mind, the present study focused on assessing CHCs for providing newborn care services. To assess the community health centers for newborn care services, a facility assessment schedule was developed by reviewing the Indian Public Health Standards developed by the Ministry of Health and Family Welfare, Government of India. The study is based on data gathered under the ongoing project of “Baseline studies for developing implementation model for strengthening maternal and newborn health services in district Bharatpur, Rajasthan”. Data collection for the project was done during September-October, 2010. Data was also generated with the discussion with key informants such as RCHO, CMHO, DPM, BCMO and Consultant- MCH.
Findings : All the CHCs have pathological test facility while 3 and 8 CHCs shows availability of ECG and X-Ray facility respectively. Huge gap of specialist and other para medical staff was observed. None of the CHC had fully equipped newborn care corner and newborn care stabilization unit. Findings shows a very less availability of drugs as recommended under sick newborn and child care drug kit as per IPHS norms.
Recommendations : Study revealed important deficiencies as per IPHS norms in the studied CHCs of Bharatpur District of Rajasthan. (a). The Government shall make adequate efforts to provide human resources support at all CHCs to effectively provide newborn health care services. As the unfilled positions are huge in number at CHCs, efforts shall be done to encourage partnership with private sector for these human resources especially OBG/GYN, Pediatrician and Anesthetic, (b). Government need to strengthen the procurement system to procure equipments and drugs in time, (c). Efforts shall be made to utilize RMRS funds for improving service delivery and investigative facilities especially for newborn care at CHC level, as all the 13 CHCs are having RMRS in operational. Government shall develop Guidelines in this regard and circulate it to CHCs for using the funds accordingly, (d). RMRS shall make adequate efforts to generate more resources to provide adequate supply of drugs for sick newborn at CHC level.
To understand the Indian Public Health Standards for Community Health Centers