24 x 7 Hours Delivery Care Services in PHCs/CHCs
One of the remarkable achievements over the last three years has been the manifold increase in the number of the deliveries conducted in the PHCs. This proportion has increased from 5% in 2005 to 30% in the current year with 272073 deliveries being conducted from April 2009 to March 2010. There is a marginal reduction in the number of government hospital deliveries enabling these hospitals to spend more time on complicated cases. The important feature of this change is that it has resulted in a fall of deliveries in private institutions by 8%, thus reducing the burden of health care costs on the poorest families. This has been made possible by the introduction of 24 x 7 hour services in every PHC by posting 3 staff nurses for rendering round the clock duty. The confidence that trained personnel are always available in the PHCs has increased not only the number of deliveries but also the daily OP attendance and IP attendance.
All 1539 PHCs functioning as 24 x 7 delivery care services
The GoI during the NRHM and RCH reviews held in July/ August have introduced the concept of identifying health facilities for offering various levels of MCH care. While Level 1 care refers to 24x7 delivery services through trained personnel, Level II care refers to the provision of emergency obstetric care and management of obstetric emergencies. Based on this concept, a policy decision has been taken that all the PHCs in the state will continue to function as Level I centres for MCH care for which adequate infrastructure and staff is already available. In addition, the Director of Public Health and Preventive Medicine in consultation with district level Deputy Directors has identified 31 Health Sub Centres which are remote and do not have access to the PHCs to function as Level 1 care centres. Further, out of the existing CHCs, 42 facilities have been identified at the rate of 1 per Health Unit District to function as Level II MCH Centres. These centres will be developed as comprehensive Level II MCH centers to provide the RCH package of AN& PN care, Emergency Obstetric Care, Safe Abortion Services, Sterilization Services including temporary methods, Adolescent Clinics, RTI/ STI management etc. New Born Stabilization Units will also be set up in these centres. Adequate supervision will be provided to guide and improve quality of care in such centers. The HSCs identified as Level I MCH centres will be provided with 2 more VHNs, Sanitary worker, necessary drugs and equipments as well as , renovation of the existing building to provide round the clock delivery services. The CHCs identified as Level II MCH centres will be provided with 2 additional doctors (preferably specialists), 3 more Staff nurses, pharmacist ,junior assistant , hospital workers , sanitary workers, necessary drugs and equipments and renovation of the existing building etc as additional inputs to achieve the necessary objectives.