IMNCI Trained ASHA in Respect to Integrated Management of Neonatal and Childhood Illness in Chhipabarod Block of Baran Distrct
Agency : Integrated Management of Neonatal and Childhood Illness, Integrated Management of Childhood Illness, Knowledge, Logistics and Practice, Accredited Social Health Activist.
Objective : To classify IMNCI trained ASHA into groups on the basis of their knowledge levels. To assess the logistics and supply that is required for optimal functioning of ASHA, and to assess their current skills and practices.
Background : IMR of Rajasthan (ranks 30) still pops to 59 per thousand live births (SRS 2009) which is quite high as compared to other states of India. IMNCI was started in Rajasthan in 2006 and Baran is one of the first 10 districts where IMNCI strategy was implemented. Chhipabarod block of Baran is quite poor in indicators due to its inaccessibility and socio-economic status. Although training of ASHA was 86.3% completed, still required outcomes are awaited.
Methodology : Non random preference sampling in which IMNCI trained ASHA was interviewed at sector level meetings of PHC.
Findings : It was found that out of sample of 50 IMNCI trained ASHA, 16% have knowledge less than 50%, in logistics it was seen that out of 42 IMNCI trained ASHA (with knowledge level more than 50%) 26 % were having logistics, drugs and supply less than 50%. Out of 35 IMNCI trained ASHA who were having IMNCI registers, not a single ASHA detected and referred all 4 type of cases (Malnutrition, Fever, ARI, diarrhea) in last 3 months and 23% ASHA have not even detected a single type of case. It was shocking to observe that out of 33 ASHA (who were having 0-2 m IMNCI register) only 9% out of them were completely and correctly filling their IMNCI registers.
Recommendations : It could be concluded that still there is a huge challenge in implementing IMNCI strategy, although trainings were almost completed but skills to detect and classify is found average among IMNCI trained ASHA. Moreover supply of logistics is quite poor and none is accountable for the supply. Hence, system of line supervision should be developed and at each level one person should be made accountable for logistics. Refresher trainings should be conducted yearly at block or PHC level.
To classify IMNCI trained ASHA into groups on the basis of their knowledge levels