Rapid Assessment of Maternal Health and Service Delivery Status in Five UNICEF Focused Districts of Rajasthan
Agency : NRHM, UNICEF, MCHN, ASHA, AWW, ANM
Objective : To analyze the preparedness of health facilities, to study the knowledge and skills of base line workers and to understand the knowledge, behavior and utilization pattern of community towards maternal care.
Background : Not Available
Methodology : The survey design was based on PPS, EPI 30 cluster technique, whereby villages with population less than 1000 were selected in the five districts of Baran, Barmer, Tonk, Sawai Madhopur and Dungarpur. The MCHN sessions, SC, PHC designated as 24*7 and FRU corresponding to these villages were also studied. 7 women per village (7*30=210) were studied per districts. A team of 3 research officers and 10 investigators were involved in the process of data collection.
Findings : The results show that the percentage of women who received any ANC ranged from a dismal low of 57% in Barmer to a maximum of 74 % in Dungarpur. Mostly the focus during ANC checkups seems to be on TT vaccine which had a decent coverage of around 70%. The trend again showed a steep decline in supply of IFA tablets. An average of 80% deliveries is conducted at institutions but the status is very dismal in Barmer where the home deliveries are not even catered by skilled birth attendants. The status of PNC services is extremely low at even the maximum being 16%. The knowledge, skill and practices of grass root level workers showed a similar trend of ignorance of all accurate methods and techniques. None of the ASHAs, AWWs, or ANMs interviewed had the complete knowhow and skillfulness to carry out her basic duties. The rates of trainings were also low. All of the public health facilities surveyed had lack of equipments, supplies and manpower. The referral system was also found to be inadequate and no formal information had been given. The items of central government supply are surplus in supply whereas those of need are lacking on most occasions.
Recommendations : Focus on decreasing the drop out of once registered women for ANC. Guarantee the delivery benefits assured under several of schemes to both beneficiaries and service providers to keep up with the motivation. Maintenance of drug/medical supplies indent, Recruitment of sufficient grass root level workers and support staff along with specialists and medical officers. Maintenance of the peripheral centers, like SC and AWC, for delivery at grass-root level should be ensured. Job responsibilities of base line worker should be made clear. Continuous on-job training of base line workers for better penetration into the community is required. Community based planning for improved micro planning and ownership of the society.
To analyze the preparedness of health facilities, to study the knowledge and skills of base line workers