Healthcare Practices and Recommendations in Delhi - November 2016

Delhi Shahdara & Central Districts November 04-11, 2016

Good Practices Observed No user fees for drugs and diagnostics. Mobile dental clinics initiative for preventive and curative services. State of the Art CATS Control room for emergency response system for managing transport of patients State has a cadre specific assessment system for contractual staff. Information systems HMIS, MCTS(RCH) and PFMS are well placed along with requisite IT infrastructure. Review of health programmes including DSHM activities by Hon. Chief Minister and Health Minister. DAWA app introduced for reporting on non availability of medicines in facilities

Points of concern HR contractual appointments are vacant Lack of convergence in community processes NUHM CPMU not there VHND not taken place this year Delay in release of funds from treasury.Procedural difficulties faced by State for more that 200 account heads About 35% of RE is used by the State while number of activities are not taken up which need to be initiated Pending infrastructure work since 2011-12 SOPs, protocols and IEC not displayed at many of the observed facilities Progress on Kayalakp is slow

Recommendations SOPs, protocols, citizen charter, IEC material to be properly displayed Timely utilization of NHM allocations Pending infrastructure work need completion Set up and implement adolescent health programme To put in place JSY utilization, PMSMA, partograph, line listing, MDR, DIEC, NRC To develop mechanism for better coordination between SHM and MCD Communicable diseases to improve reporting, staff shortage and fund utilization NCDs to give more stress on community reach, preventive and promotive activities and set up functional NCD cell To have proper grievance redressal mechanism in place UHNDs to be conducted monthly Physical HMIS report to be signed by MO I/C before uploading To strengthen and do regular supportive supervision and monitoring of programmes Nirantar and Dawa app to be publicized and put to proper use State needs to take up HR Need Assessment exercise and to do rational deployment

Action Taken by State/UT

Action Taken Report S.NoArea of Concern Action Plan Process of rationalization of HR in being undertaken by respective programme officers. In principle approval for empanelment of recruitment agency has been accorded. A committee has been constituted for the recruitment through informed by Ministry of Health and Family Welfare, Government of India. HR-Contractual Appointments are Vacant 1 empanelled agencies Of the 5050 approved, 4973 were held in 2016-17. In 2017-18, one UHND for each ASHA has been proposed. Being an urban state with high population density UHND s for neighbouring ASHA Areas may be clubbed. UHND not taken placed this year 2 Repeated D.O's have been sent to MCD's for formation of CPMU. Also, Mission Director, DSHM had himself visited the office of Municipal Commissioner of Delhi to initiate the process of convergence. MCD s have informed inability of register City Health Societies , thus hiring of manpower by the local bodies to set up City PMU is not possible. MCD facilities are being managed through DPMU s NUHM-CPMU not there 3

Action Taken Report S.No Area of Concern Action Plan The State has dedicated portal for Public Grievance Management System (PGMS) to receive public grievances which are forwarded to the concerned officers for resolution. A State Cell is has been constituted to ensure proper complaints. Dawaa App has been developed to monitor Drug availability, SMS Helpline No-8745051111 is operative for complains related to drug availability Grievance Redressal Mechanism follow up and disposal of 4 Nirantar and Dawaa App to be publicized and put to proper use Flex boards have been displayed in patient areas(registration counters, pharmacy ) to ensure wide publicity of the app . 5

Action Taken Report S. No Area of Concern Action Plan Total Fund allocated for Communicable Diseases-39.88 Crores Total Fund received during 2016-17- Total expenditure incurred- Programme is being managed with inter-progmatic loans. As a part of health system strengthening multi skilling of available Human Resource is being undertaken. 30 Lab Technicians have been trained to undertake RNTCP activities. Under IDSP, reporting is being strengthened by involving all public facilities across the agencies. 10.78 Crores ~20 Crores Communicable Diseases 6 It pertains to the Municipal Corporations of Delhi. Funds have been approved for 30 facilities of EDMC. Work is completed in 8 facilities of EDMC. Work is not being taken up in 7 facilities. Extra funds have been requested for 7 facilities. The work shall be completed by March 2018 subjected to availability of funds . 7 Pending Infrastructure work

Action Taken Report S. No Area of Concern Action Plan SOPs , Protocols , Citizen s Charter , IEC Material display. Department-wise SOPs for the hospitals already disseminated . Hospitals provided funds for printing copies and work instructions . Judicious display of IEC material being undertaken. 8 41 Hospitals of GNCTD / MCD participated in Kayakalp Program. Internal / Peer / External assessments completed and winners announced . Internal / Peer / External assessments in PUHCs completed. District wise winners identified. 9 Progress on Kayakalp is slow Community processes convergence is well established. 50% of centers participating in ASHA programs belong to Local bodies. Common logistics provision mechanism . Common Trainings mechanism. Incentive dissemination and Convergence in Community Processes. 10

Action Taken Report S.N o Area of Concern Action Plan There has been % decline due to implementation of payments in Aadhaar based bank accounts. Efforts are being made to improve Aadhaar Based Linkage for the beneficiaries. 11 JSY utilization 262(51.57%) Maternal Deaths have been reviewed in 2016-17. Efforts are being made to ensure 100% MDR. 12Maternal Death Review Onsite trainings of partogram under Care around birth skill development trainings undertaken in all districts National Skill Labs linked for capacity enhancement under Dakshta programme. 13Partogram Progress update Pradhan implemented in Delhi State from 9th July 2016. Around 180 volunteers have registered on PMSMA portal to provide ANC services of which only 17-20 volunteers per month are providing consistent services. Mantri Surakshit Matritav Abhiyan (PMSMA) 14 PMSMA

Action Taken Report S. No Area of Concern Action Plan Adolescent friendly health clinics 17 out of a target of 22 functional. Status of WIFS Program in Delhi (F.Y. 2016-17) 50% ( 13.81 lacs ) and 38% ( 0.85 lacs) of School children and out of school children covered respectively. Peer Education Program 15Adolescent Health program Menstrual Hygiene program distribution of Sanitary Napkins is being implemented by Directorate of Education with the State budget. HR Need assessment and rational deployment . State has approached National Health Systems Resource center for conducting the HR need assessment study in a large secondary care hospital to facilitate dynamic , workload related norms. 16

Action Taken Report S.N o Area of Concern Action Plan 17NCDs To give more stress on NCDs . NCD program rollout planned in two districts in the CFY 17- 18. Provisions sought in State PIP 2017-18.

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