District Report and Tabulation for

PRC Study on Rapid Appraisal of

RHM

Madurai

1
 COTETS

Chapter 1. State Profile

Chapter 2. District Profile

Chapter 3. Community Health Centre

Chapter 4. Primary Health Centre

Chapter 5. Sub-centre

Chapter 6. Household Characteristics

Chapter 7. Gram Panchayat

Chapter 8. Exit Interview – In-patient

Chapter 9. Exit Interview – Out-patient

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 CHAPTER 1
STATE PROFILE

The state of Tamil Nadu, located in the southern part of the country is the sixth largest
state in India. The state of Tamil Nadu is located in the eastern side of the southern
extreme of peninsular India. In the north it is boarded by the states of Karnataka and
Andhra Pradesh, where as the southern tip is edged by the Indian ocean and the Arabian
sea. The state of Kerala in the west and the Bay of Bengal in the east. The state consist
of 32 districts, 206 Taluks, 385 blocks and 16317 revenue villages.

According to 2001 census, the population of Tamil Nadu is 62.4 million out of which
31.4 million are males and 31.0 million are females. About forty-four percent of the
population lives in urban area. The sex distribution of the population shows that 17.3
million are males and 13.8 million are females in rural. In urban the male and female
population are 17.5 million and 17.3 million respectively. The proportion of Scheduled
caste and Scheduled tribe population is 19 percent and one percent respectively.
According to recent estimates (2008) the Population of Tamil Nadu is 65.9 million out of
which 33.2 million were males and 32.7 million were females. The rural and urban
distribution shows that, 32.2 million belongs to rural (16.2 million males; 16.0 million
females) and 33.7 million (17.0 million male and 16.9 million female).

STATUS OF RHM ITERVETIOS

In Tamil Nadu state 29 district hospitals are functioning, all the district hospitals are first
referral units. Apart from this 234 sub divisional hospitals are functioning . As on June
2008, Madurai district has 8,706 sub-centres and 1,277 primary health centres. Among
them 1166 were 24x7 PHC’s. At present, 256 CHCs and 385 mobile medical units and
25 AYUSH hospitals are functioning. IPHS facility survey was carried out in all the
districts hospitals. In addition to that, 2,208 private hospitals (more than 30 bedded) and
nursing homes (less than 30 bedded) were also providing health care services.

3
 Rogi Kalyan samities were registered and functioning in all the 29 district hospitals, 234
Sub divisional hospitals. 256 PHCs and 1,277 PHCs. Janani Suraksha Yojana (JSY) was
implemented in all the rural primary level public health facilities. Public Private
Partnership was not undertaken in the state for implementation of the JSY Scheme.
During 2007-08, totally 8,29,490 institutional deliveries were reported. In Tamil Nadu,
all the vertical health programmes functioning under different programmes were merged
into State Health Society under NRHM. This was implemented in all the districts and for
all the health programmes had a common bank account in the state Health society. State
health plan was prepared for the year 2008-09. All the 29 districts have District Action
Plan for the current year (2008-09) and it was approved by the state society. The funds
are allocated to the district according to activity wise. All the funds are being transferred
electronically. All the sub-centers have operational joint bank account of ANM and
village president (Sarpanch). For all the PHCs, CHCs and Sub Centers Untied fund for
the current year has been transfered.

SURVEY PERIOD
A. Household Survey:
Survey Period Team I Team II Team III
CHC : Chellampatty, PHC : Thummagundu
02.12.08 to 03.12.08 Nallaperumalpatti Mettupatti Poothipuram
04.12.08 to 05.12.08 Ramanathpuram Peyampatti Iyyankoilpatti
06.12.08 Nallaperumalpatti & Mettupatti & Poothipuram &
Ramanathpuram Peyampatti Iyyankoilpatti
07.12.08 Sunday – Holiday
CHC : Chellampatty, PHC : Vikkramangalam
08.12.08 to 09.12.08 Nadumudalaikulam Kannanur Sakkarappanayackanur
10.12.08 to 11.12.08 Kasbamudalaikulam Keelapatcheri Poollakkapatti
12.12.08 Nadumudalaikulam & Kannanur & Sakkarappanayackanur
Kasbamudalaikulam Keelapatcheri & Pullakkapatti
CHC : Samayanallur, PHC : Koilpapakudi
13.12.08 to 15.12.08 Athalai Pillaiyarnatham Thodanerry
14.12.08 Sunday – Holiday
16.12.08 to 17.12.08 Rengarajapuram Vitankulam Kallikudi
18.12.08 Athalai & Pillaiyarnatham & Thodanerry &
Rengarajapuram Vitankulam Kallikudi
CHC : Samayanallur, PHC : Kancharampettai
19.12.08 to 20.12.08 Chatrapatti Kodimangalam Thirupalai
21.12.08 Sunday – Hoiday
22.12.08 to 23.12.08 Kallampatti Sundarajanpatti Ayyarpudur
24.12.08 Chatrapatti & Kodimangalam & Thirupalai &
Kallampatti Sundarajanpatti Ayyarpudur

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B. Facility Survey :
Type of
Date ame of the Facility
Facility
04.12.08 & 05.12.08 PHC Thummagundu
08.12.08 & 09.12.08 CHC Chellampatti
District
10.12.08 to 12.12.08 Usilampatti
Hospital
13.12.08 to 15.12.08 PHC Vikkaramangalam
16.12.08 & 17.12.08 PHC Koilpapakudi
18.12.08 & 19.12.08 PHC Samayanallur Block
22.12.08 & 23.12.08 PHC Kancharampattai

ote : Sub-centre were covered along with the Households survey by the supervisors of
the team.

LIST OF FACILITIES COVERED:

CHC PHC Sub-centre
Nallaperumalpatti
Thummagundu Mettupatti
Poothipuram
Cellampatty
Nadumudalaikulam
Vikkaramangalam Kannanur
Sakkarappanayackanur
Athalai
Koilpappakudi Pillaiyarnatham
Thodanerry
Samayanallur
Chatrapatti
Kancharampettai Kodimangalam
Thirupalai

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HOUSEHOLD AD EXIT ITERVIEW COVERED

Exit Interview Households

o. o. o. o. o. of o. of

District
CHC of of PHC of of Sub-centre Village House Village House
Hospital
IPD OPD IPD OPD holds holds

Nallaperumalpatti 50 Ramanathapuram 50
Thummagundu 10 5 Mettupatti 50 Peyampatti 50
Poothipuram 50 Iyyankoilpatti 50
Cellampatty 10 10
Nadumudalaikulam 50 Kasabamudalaikulam 50
Vikkaramangalam 10 5 Kannanur 50 Keelapatcheri 50
IPD – 10 Sakkarappanayackanur 50 Pollakkapatti 50
OPD - 10 Athalai 50 Rengarajapuram 50
Koilpappakudi 10 10 Pillaiyarnatham 50 Vitankulam 50
Thodanerry 50 Kallikudi 50
Samayanallur 10 10
Chatrapatti 50 Kallampatti 50
Kancharampettai 10 8 Kodimangalam 50 Sundarajanpatti 50
Thirupalai 50 Ayyar Pudur 50

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 CHAPTER – 2
DISTRICT PROFILE
PART-A
Madurai district is one of the important district of the Tamil Nadu state. The district has
13 blocks. The total land area of the district is 3,696 sq.km., which is very high compared
to 480 of the state. As per 2001 census, population of Madurai district is about 26 lakhs
and it constitutes four percent of the population of the state population.. The sex ratio of
the district is 978 females for 1000 population.

POPULATIO CHARACTERISTICS
According to 2001 census, the population of is 25.8 lakhs out of which 13.0 lakhs are
males and 12.8 lakhs are females. About 56 percent of the population of the district
lives in urban areas. The sex distribution of the population shows that 5.7 lakh are males
and 5.6 lakh are females in rural. In urban the male and female population are 7.3 lakh
and 7.1 lakh respectively. The proportion of Scheduled caste and Scheduled tribe
population is 12.7 percent, 6.9 percent of the urban and 19.7 percent of the rural
population belongs to SC/ST.

STATUS OF RHM ITERVETIOS

Health Infrastructure
As on June 2008, Madurai district has 314 sub-centres and 42 primary health
centres. Among them 29 were 24x7 PHC’s and 13 were block PHC’s. IPHS facility
survey was carried out in all the Sub-Centre and PHC’s . In addition to this one District
hospital, six first referral units, three mobile medical units, five sub divisional, hospitals
and 16 AYUSH hospitals were functioning in Madurai. IPHS facility survey was not
carried out in these facilities. New building were under construction in three PHC’s and
two sub divisional hospitals. Five private hospitals (more than 30 bedded) were also
located in Madurai district. IPHS upgradation was not completed.

One district hospital, five sub divisional hospitals, one CHC, 42 PHC’s, 17 public
maternity homes and four other public sector hospitals like Medical College hospital,
ESI, Railway are available in this district for delivery services. Among them all the
PHC’s (42), public maternity homes (17) and other public sector hospitals like Railway

7
and ESI were providing (Basic Emergency Obstetric Care (BeMOC). District hospital
(1) and two sub divisional hospitals are providing Comprehensive Emergency and
Obstetric Care, (CeMOC), .i.e., having Blood storage, Anesthetist and Gynaecologist,
with new born care unit. Private health facilities were not accredited for JSY.

Human Resources

As per as human resources are concerned at the district level 104 medical officers
were sanctioned and all the posts were regular and are in position. Separate information
regarding number of Gynecologists, Anaesthetist, Paediatrician and, other specialists
were not available. On the whole, 138 staff nurses were sanctioned, among them 136
were regular in position. Forty-eight ANM posts were sanctioned as regular and are in
position.

RKS and JSY

Rogi Kalyan Samities were registered in the district hospital, all the sub divisional
hospital (5), CHC (1) and PHC’s (42) and all are functioning. Initiative on Public Private
Partheship (PPP) was not under taken in the district for the implementation of Janani
Suraksh Yojana (JSY) scheme.

Totally 20,929 institutional deliveries were reported during 2007-08. Number of

women registered under JSY during 2007-08 were 10,978. Among them nearly one-
fourth (23 percent) were SC/ST, and three-fourth (77 percent) belongs to general
population. Ninety-two percent (10,075) of the registered JSY women were opting
institutional delivery during 2007-08. Among them twenty-three percent (2259) were
SC/ST women.

FIACIAL MECHAISMS

In Madurai district all the vertical health programmes were merged with
the District Health Society. The district health society is registered. The district health
society has common bank account for all the health programmes which are functioning
under the district health society.. District Action Plan was prepared for the current year,

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2009-10 and it was approved by the district society. The funds are received from the
state according to activity wise, based on to set formula like size of district and previous
year’s expenditure. All the funds are being transferred electronically. All the 314 sub-
centers, one CHC and 42 PHCs got United grant for the Current year and it was
transfered through electronically. Sub centres are having operational joint account of
ANM and village President (Sarpanch)

A. LOCATIO OF THE DISTRICT HOSPITAL AD STATUS OF IPHS

District hospital is located in Usilampatti, 20 kms away from the district Head
Quarters. Chellampatti is the nearest CHC to the district head quarter hospital which is
located with a distance of 10 Kms and it will take 30 minutes to reach the Government
head quarters hospital. Elumalai is the farthest CHC in the coverage area which is
located a distance of 20 kms and it will take 45 minutes to reach the facility. Distance
between the nearest bus stop and the district hospital is less than 0.5 kms. IPHS facility
survey was not carried out in the district hospital.

B. PHYSICAL IFRASTRUCTURE

Total land area of the hospital is 6680.38 square meters. Totally 135 beds were available
in the hospital. Hospital is located in the residential area. The hospital building is disable
friendly as per the provisions of Disability Act (Ramp, Lift, Wheel Chair movement
etc.,).
Waiting space is not adjacent to each consultation and treatment room in all the
blocks. It is available only in some places. Registration counter, Blood bank / Blood
storage unit, doctor’s duty room, Treatment room, Pharmacy (Dispensary) , Intensive
Care Unit (ICU) and high dependency wards were available. Isolation room, Critical
care area, and examination and preparation room were not available.

C. OTHER FRAME WORK AD STRUCTURAL ISSUES

Hospital kitchen (Dietary Service), Medical and General stores, Engineering

services backup, round the clock water supply, overhead water storage tank with
pumping and boosting arrangements were the available in the hospital. Central sterile

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and supply department (CSSD), Laundry, Ventilation (Natural on Mechanical exhaust) in
the ward, water coolers / Refrigerators, provision for fire fighting and drainage and
sanitation system for waste water, surface water, sub-soil water and sewerage services
were not available. Bio medical wastages are disposed by using incarnation and some
time outsourced. As per the norm the bio-medical waste were segregated in different
bins.
Residential quarters were not available for medical staff as well as paramedical
staff. Medical records section, telephone, fax, computers and internet services were
available. Parking place for vehicles is inadequate.
.
OBSTETRICS AD GYAECOLOGY SECTIO

Female patients have separate ward for obstetrics and gynaecology section. This
section has 26 beds, and the bed occupancy rate as on March 31, 2008 was 1:4. Total
OPD during the last three calendar months is 471. There is no separate operation theatre
(OT) for gynaecology and obstetrics.

During 2007-08, totally 1,565 deliveries were conducted. Among them 501 were
caesarean section deliveries, 17 were assisted delivery and 25 forceps delivery. Total
MTP’s conducted during 2007-08 was 106, among this five were mid-trimester abortions,
and four belongs to ectopic pregnancy. Eclampsia and retained placenta cases treated
were two each. Ten PPH, 551 sterilization, two suturing cervical and 15 hysterectomy
were carried out. Infertility treatment was not carried out.

SURGICAL

During the last three months, totally 1,579 surgical OPD’s and 404 IPDs were
attended. Separate data for male and female was not available. Services like Emergency
(Accident & other Emergency surgery), Abdomen surgery and Breast surgery were also
available. Pancreas surgery, Spleen and Portal hypertension surgery, and Leprosy
reconstructive surgery were not done.

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MEDICAL
In the medical section 35,320 female OPD and 41,000 male OPD and 1,446
female and 960 male IPD were registered during the last three months. Services such as
Dermatology and Venerology (Skin & VD) RTI / STI, NLEP, Pleural Aspiration, Pleural
Biopsy and Psychiatry were available. Services such as bronchoscopy, Lumber Puncture,
Pericardial tapping, Skin scraping for fungus / AFB, Bone Marrow Biopsy and
Endoscopic specialized procedures were not available.

PEDIATRIC

Under pediatric section 6,273 female and 7,061 male OPD were registered in
2007-2008. Four beds were specially designated / identified for newborns. During
2007-2008, 1,812 pediatric patients (732 neonates, 480 infants (0-1 year) and 600
children under 5 years.) were admitted in the Pediatric section

Services such as birth Asphyxia management, management of severe

malnourished children, neonatal sepsis, dehydration and diarrhoea management and
respiratory tract / pneumonia management were available.

Equipments like cradle, incubator, Radiant Heat Warmer, Phototherophy Unit,

Bag with Mask, Laryngoscope, Oxygen Mask, Suction Machine and Thermometer were
available and are in working condition. Except Laryngoscope, ORS (WHO new formula)
all the Paediatric Antibiotics were available. But Vitamin A solution and Iron folic Acid
syrup were not in stock.

DIAGOSTIC AD LABORATORY FACILITIES

Totally 3,550 diagnostics OPD were carried out in the last three months. X-ray,
Ultrasound and ECG were the diagnostic facilities available in the Madurai district
hospital. During the last three months 1,172 X-ray, 1806 Ultrasound and 322 ECG were
done. Provision for Ultrasound guided Biopsy was not available.

Totally 14,021 persons were utilizing the lab services in the last three months.
Number of tests carried out in the last three months includes Haematology (12, 580),

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Urine analysis (7,770), Biochemistry (2810), Sputum (454), Serology (2101), Stool
Analysis (73) and Semen Analysis (4).

Lab services like CSF Analysis (Cell count, Culture sensitivity etc., gram staining),
Aspirated fluids (Cell count cytology), PAP smear, split skin smear examination for
leprosy, Histopathology, Microbiology and Physiology (Pulmonary function test) were
not available.

C. HUMA RESOURCES
C. A. MEDICAL

Hospital Superintendent (1), Surgery specialist (2), Gynaecologist (1),

Gynaecologist (Regular / Short term trained MO-3), Anesthetist (regular shorterm
trained) (1), General duty doctors (14), AYUSH Physician(1) Head Quarters,
Microbiologist (4), Dental Surgeon (1) were the medical personnel available in the
Madurai district hospital. Except contractual under NRHM general duty doctors (2) and
Microbiologist (1) all are sanctioned posts.

C. B. PARAMEDICAL STAFF

Paramedical staff like, Staff Nurse (28), Hospital Worker (OP Ward + OT +
Blood Bank) (10) and sanitary workers (9) were sanctioned among them only seven staff
nurses and two sanitary workers were regular in position.

Other Category of Personnel such as Ophthalmic Assistant / Refractionist (1),

Social Worker / Counselor (7), Laboratory Technician (Lab + Blood Bank), Laboratory
Attendant (Hospital Worker) (10), LHV (2), Radiographer (2), Pharmacist (6), Matron
(1), Physiotherapist (1), Medical Records Officer / Technician (2) were the sanctioned
post in the district hospital. Among them social worker / counselor (7), Laboratory
Attendant (4), Radiographer (1), Pharmacist (1), Physiotherapist (1), Medical Records
Officer / Technician (2) were posted under contract.

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C. ADMIISTRATIVE STAFF

For administrative purpose, Manager (Administration), Junior Administrative

Officer (1), Office Superintendent (3), and Driver (5) were sanctioned. Among them
three drivers, two office superintendents and one junior administrative officer were under
contract.

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 CHAPTER 3
COMMUITY HEALTH CETERS
I. COVERAGE AD AVAILABILITY OF IFRASTRUCTURE

A. COVERAGE

In Madurai District, Chellampattyis the only CHC functioning is selected.and the

Samayanallur block PHC is considered as a CHC is also selected. Chellampatty
Community Health Center covering nearly ninety thousand(87,867) population and the
Community Health Center (Block Primary Health Centre) in Samayanallur covers about
60,000 population.

For the Chellampatty, Community Health Center the nearest primary health centre is
located with in a distance of 10 kms and it takes 15 minutes to reach the CHC by public
transport. Farthest PHC is 20 kms away from the CHC, it takes 30 minutes to reach the
CHC from the PHC by public transport. The District headquarter hospital is located with
in a distance of 11 kms and the time taken to travel the District Hospital from the CHC is
only 15 minutes. All the PHC and CHC are having good public transportation facilities to
reach the higher facility.

In Samayanallur Community Health Center the nearest PHC is located in a distance of six
kms and the farthest PHC is located with a distance of 30 kms. The time taken to reach
the CHC from the nearest and farthest PHC’s in public transport is 30 minutes and 120
minutes respectively. District Hospital is located in a distance of 60 kms from the CHC
and it takes 120 minutes to reach this hospital by public transport.

As per the IPHS norm the Chellampatty Community Health Center had 30 beds. i.e 15
for males and 15 for females. But the BPHC in Samayanallur had only four beds, this is
only for women.

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B. AVAILABILITY OF IFRASTRUCTURE

All the Community Centers are having good infrastructure facilities, they are functioning
under their own government building, having regular electric supply in all parts. They
have their own Generators, Telephone, Computer, Internet, Vehicle/ Ambulance
(Running) and laboratory services except difference in number of beds. Chellampatty
CHC is having 30 beds and the CHC in Samayanallur is not having adequate beds (only
four beds).

Investigative facilities such as ECG, Ultrasound, OT (Operation Theatre), Labour room

were available in both the CHCs. But X ray and newborn care corner were available only
in the Chellampatty CHC. It was observed that in both the CHCs Operation Theatre was
not used for Gynaecology and there is no separate areas for septic and aseptic deliveries.

Records of JSY beneficiaries were maintained properly. Both the CHCs are having
separate pharmacy for drug dispensing and drug storage, separate counters to obtain
contraceptives, ORS packets, vitamin A and medicines, separate public utilities (toilets)
for males and females, OPD rooms/cubic waiting room for patients and drinking water
facilities in the waiting area.

Suggestion/ Complaint box was seen only in Samayanallur CHC. Chellampatty CHC is
not having adequate sitting place in the waiting room and separate wards for males and
females. Emergency room/ causality is not seen in both the CHCs. For drainage, soak pits
are available in both the CHCs. In Samayanallur waste materials were buried in a pit but
the Chellampatty CHC is having incarnation for waste disposal.

While considering about the cleanliness, in both the CHCs the OPD is very clean,
compound premises are good without carbage, rooms and wards are very neat and boards
displaying the availability of services in local languages.

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Table C1 : Coverage and Availability of Infrastructure
CHC CHC
Coverage
Chellampatti Samayanallur
Population served by CHC 87,867 57,930

Distance & Time Taken to travel to CHC Distance Time Distance Time
in public transport / available mode from (in Kms.) (in (in Kms.) (in
Minutes.) Minutes.)
Nearest PHC in the coverage area 10 15 6 30
Farthest PHC in the coverage area 20 30 30 120
District Hospital 11 15 60 120
No. of Beds available
Male 15 0
Female 15 4
Availability of Infrastructure CHC CHC
(Yes:1; o: 0) Chellampatti Samayanallur
Status of Building

Own government Building 1 1

Rented premises 0 0
Other Rent-free Building 0 0
Electricity in all parts:
No regular electricity supply 0 0
Regular electricity supply in all parts 1 1
30 or more beds 1 0
Generator 1 1
Telephone 1 1
Computer 1 1
Internet 1 1
Running Vehicle/Ambulance 1 1
Laboratory 1 1
Investigative facilities
ECG 1 1
X-Ray 1 0
Ultrasound 1 1
OT (Operation Theatre) 1 1
OT used for Gynaecology 0 0
Labour Room 1 1

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Separate areas for septic and 0 0
aseptic deliveries
New Born Care Corner 1 0
Names of JSY beneficiaries maintained in 1 1
record?
Pharmacy for drug dispensing and drug 1 1
storage
Counter near entrance of CHC to obtain 1 1
contraceptives, ORS packets, Vitamin A
and medicines
Separate public utilities (toilets) for males 1 1
and females
Suggestion / complaint box 0 1
OPD rooms / cubicles 1 1
Waiting room for patients 1 1
Does the waiting room have adequate 1 0
sitting place
Is drinking water available in the waiting 1 1
area?
Emergency Room / Casualty 0 0
Separate wards for males and females 1 0
Sewerage
Type of sewerage system
Soak pit 1 1
Open drain 0 0
Connected to Municipal 0 0
Sewerage
Other 0 0
Waste disposal
Buried in a pit 0 1
Collected by an agency 0 0
Incernation 1 0
Thrown in open 0 0
Status of Cleanliness of OPD reported 1 1
good or fair
Status of Cleanliness of Compound / 1 1
Premises reported good or fair
Status of Cleanliness of Room/Wards 1 1
reported good or fair
Prominent display boards regarding 1 1
service availability in local language
Names of JSY beneficiaries maintained in 1 1
record?
Pharmacy for drug dispensing and drug 1 1
storage
Counter near entrance of CHC to obtain 1 1
contraceptives, ORS packets, Vitamin A
and medicines

17
Position of Medical and Paramedical Staff

Table C2 explains the human resources available in the selected CHCs. While
considering about the position of medical staff and paramedical staff, there is a shortfall
(lacunae) found in both the CHCs. Both the CHCs are having only one regular medical
staff trained with short term obstetrics course. General surgeon, physician, obstetrician/
Gyneacologist, Anaesthetist, eye surgeon and public health nurse were not sanctioned.
But on behalf of them in Chellampatty five general duty medical officers were sanctioned
and working in regular position. The Samayanallur Block PHC is having four sanctioned
regular general duty medical officers.

Position of Paramedical and supportive staff is sufficient in both the CHCs.

Chellampatty CHC is having two lady health visitors (LHV), one block extension
educator (BEE), ANM, Dresser, Pharmacist/ compounder, Lab technician, Opthalmic
assistant, OT attendent, four staff nurses and two ambulance drivers under regular. All
the sanctioned posts were filled.

The CHC in Samayanallur is having one Lady Health Visitor (LHV), ANM, Dresser,
Pharmacist/ Compounder, Opthalmic Assistant, OT attendant and one lab technician, one
registration clerk, two ANMs and two ambulance drivers in regular. Staff nurses (3) are
appointed under contractual i.e., Under NRHM. Radiographer, OT attendant, Block
Extension Educator (BEE) and statistical Assistant /Data Entry Operator are not
sanctioned. The posts like Radiographer and statistical assistant/ data entry operator were
not sanctioned in both the CHC’s.

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Table C2 : Position of Medical Staff and Paramedical Staff
CHC 1 Chellampatti CHC 2 Samayanallur
umbers umbers in position umbers umbers in position
Type of Staff
Sanctione Regular Contractual Total Sanctioned Regular Contractual Total
d
Position of Medical Staff (clinical)
General Surgeon 0 0 0 0 0 0 0 0
Physician 0 0 0 0 0 0 0 0
Obstetrician / Gynaecologist 0 0 0 0 0 0 0 0
Medical Officer trained with short 1 1 0 1 1 1 0 1
term obstetrics course)
Paediatrician 0 0 0 0 0 0 0 0
Anaesthetist 0 0 0 0 0 0 0 0
Medical Officer trained with short 1 1 1 0 0 0 0
term Anesthesia course)
General Duty Medical Officer 5 5 5 4 4 4
Eye Surgeon 0 0 0 0 0 0 0 0
Public Health Nurse 0 0 0 0 0 0 0 0
Position of Paramedical and
Support Staff
Lady Health Visitor (LHV) 2 2 0 2 1 1 0 1
Block Extension Educator (BEE) 1 1 0 1 1 0 0 -
ANM 1 1 0 1 2 2 0 2
Staff Nurse 5 0 4 4 3 0 3 3
Dresser 1 1 0 1 1 1 0 1
Pharmacist / Compounder 1 1 0 1 1 1 0 1
Lab. Technician 1 1 0 1 1 0 1 1
Radiographer 0 0 0 0 0 0 0
Ophthalmic Assistant 1 1 0 1 1 1 0 1
Statistical Assistant / Data entry 0 0 0 0 0 0 0 0
operator
OT attendant 1 1 0 1 0 0 0 0
Ambulance Driver 2 2 0 2 2 2 0 2
Registration Clerk 0 0 0 0 1 1 0 1

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3. AVAILABILITY OF SPECIFIC SERVICES

The selected two CHCs are functioning as 24X7, but they are not first referral units.

Table C3: Availability of Specific Services in CHC

Availability of Specific Services(Yes: 1; o: 0) CHC 1 CHC 2
Chellampatti Samayanallur
Functioning on 24x7 1 1
Functioning as FRU 0 0

4. STATUS O SPECIFIC ITERVETIOS

In both the CHCs, IPHS facility survey was done, Rogi Kalyan Samiti(RKS) was
registered, RKS was used and display boards showing number of meetings and members
of RKS. Both the CHCs have all standard treatment, Guidelines and protocols.

In both the CHCs funds are not being transferred electronically from district. RKS is not
generating resources through user fees; citizens character are not publicly displayed and
feed back mechanism was not taken for grievances redressed by RKS. All standard /
treatment guidelines and Protocols are available with the in-charge of the facility.

Table C4: Status of Specific Interventions

CHC 1 CHC 2
Status of Specific Interventions (Yes: 1; o: 0)
Chellampatti Samayanallur
IPHS Facility Survey done 1 1
Funds being electronically transferred from District 0 0
Registered Rogi Kalyan Samiti 1 1
RKS generating resources through user fees 0 0
Money generated by RKS being used 1 1
Display board showing no. of meetings & members of 1 1
RKS
Feedback mechanism in place for grievances redressed 0 0
by RKS
Citizens Charter publically displayed 0 0
All Standard Treatment Guidelines and Protocols 1 1
available

20
C5. STATUS OF RESIDETIAL FACILITIES
Table C5 explains about the availability of residential facilities for healthcare providers in the
CHCs. Both the CHCs have residential facilities for doctors and other staff and all are
occupied.
Table C5: Status of Residential Facilities for Doctors and Other Staff
Residential Facilities (Yes: 1; o: 0) CHC 1 CHC 2
Chellampatti Samayanallur
For Doctors
Residential Facility for Doctors 1 1
Non-Occupied Residential Quarters 0 0
Reason for non-occupancy being poor condition /
- -
insecurity/ lack of electricity and water supply
For Other Staff
Residential Facility for Staff 1 1
Non-Occupied Residential Quarters 0 0
Reason for non-occupancy being poor condition /
- -
insecurity / Lack of electricity and water supply

C6. AVAILABILITY OF LABORATORY FACILITIES.

Table C6 : Availability of Laboratory Facilities
(Yes: 1; o: 0)
Laboratory Testing CHC 1 CHC 2
Chellampatti Samayanallur
Type of Laboratory Testing
Heamoglobin 1 1
Urine RE 1 1
Blood sugar 1 1
Blood grouping 1 1
Blood Smear 1 1
Bleeding time, clotting time 1 0
Diagnosis of RTI/ STIs with wet mounting, grams stain etc. 0 0
Blood smear examination for malaria parasite 1 1
Rapid test for Pregnancy 1 1
RPR test for Syphilis 1 1
Rapid test for HIV 1 1

Table C6 explains the availability of laboratory facilities in the CHC. Haemoglobin,

Urine RE, Blood sugar, Blood grouping, Blood smear, Blood smear for malarial parasite,
rapid test for pregnancy, RPR test for syphilis and rapid test for HIV were available in
both the CHCs. Diagnosis of RTI/STIs with wet mounting, grass stains were not
available in both the CHCs. Bleeding time, clotting time was available only in
Chellampatty CHC.

21
Table C7 indicates the number of lab tests done in the CHCs in the last three calendar
months. In general more number of lab tests were done in Samayanallur BPHC than in
Chellampatty CHC. The number of tests done during the last three months in the
Chellampatty and Samayanallur CHC were Haemoglobin (242;894), Urine R.E
(667;1014). Blood sugar (180;812). Blood grouping (180;313), Blood smear (494; 433)
RPR test for syphilis (160;245), Rapid test for HIV (864;809), Blood smear examination
for malarial parasite (937;433) and Rapid test for Pregnancy (97;67).

Table C7 : umber of Lab. tests done in CHC in last 3 calendar months

Type of tests done CHC 1 - Chellampatti CHC 2 - Samayanallur
Haemoglobin 242 894
Urine RE 677 1014
Blood sugar 180 812
Blood grouping 180 313
Blood Smear 494 433
Bleeding time, clotting time 1 NA
Diagnosis of RTI/ STIs with wet NA NA
mounting, grams stain etc.
Blood smear examination for malaria 937 433
parasite
Rapid test for Pregnancy 97 67
RPR test for Syphilis 160 245
Rapid test for HIV 864 809
Note: NA- Not available
Surgeries were not preferred in CHCs except tubectomy. Surgeries such as caesarian
sections, surgical, cataract, Laproscopic sterilization, NSV, conventional vasectomy and
laprotomy were not performed during 2007-2008; only tubectomy was performed in
Chellampatty CHC (316 cases) and only one MTP was done (Table C8)

Table C 8: umber of surgeries performed during 2007-2008

umber of surgeries
performed during 2007-2008
Type of surgeries
CHC 1 CHC 2
Chellampatti Samayanallur
Caesarean Sections 0 0
No. of C-section deliveries for JSY Card holders 0 0
Surgical cases 0 0
Cataract 0 0
Tubectomy 316 0
Laproscopic Sterlisation 0 0
NSV 0 0
Conventional Vasectomy 0 0
MTP 1 0
Laprotomy 0 0

22
Non-availability of surgeon / anesthetist staff is the only reason for not performing
surgeries in CHCs (Table C9).

Table C9 : Reasons for not conducting surgeries

(if OT available, but surgeries not conducted)
Reasons for not conducting deliveries(Yes: 1; o: 0) CHC 1 CHC 2
Chellampatti Samayanallur
Non availability of doctor/anaesthetist/staff 1 1
Lack of equipment/poor physical state of the operation 0 0
theatre
No power supply in the OT 0 0
Other 0 0

Table C10, explains the performace of labour room during 2007-2008. In general
performance of labour room is well in both the CHCs. During 2007-08 total number of
institutional deliveries conducted in Chellampatty CHC was 384 and in Samayanallur
CHC it was 211. More number of deliveries were carried out from 8 pm to 8 am in
Chellampatty (161) than in Samayanallur (121). Fifteen neo-nates were resuscitated in
Chellampatty and it was 11 in Samayanallur.

Table C10 : Status of performance of Labour Room during 2007-2008

umber of deliveries performed during
umber of deliveries 2007-2008
CHC 1 Chellampatti CHC 2 Samayanallur
Total Institutional Deliveries 384 211
Deliveries carried out from 8 pm to 8 am 161 121
Institutional deliveries for JSY card 0 0
holders
Number of neonates resuscitated 15 11

STATUS OF AVAILABILITY OF EQUIPMET AD DRUGS

Boyles Apparatus, ECG machine, vertical high pressure sterilizer 2/3 drum capacity,
oxygen cylinder, Hydraulic operation table and phototheraphy unit were available in both
the CHCs and are in working condition. Cardiac monitors for OT, Gloves & dusting
machines were available and in working condition in the Chellampatty CHC, but they
were not available in the Samayanallur CHC. Horizontal high pressure sterilizer and
MVA syringe are available in Samayanallur CHC and are in working condition. These
are not available in Chellampatty CHC. Defi. brillator for OT, Ventilator for OT, OT care
Fumigation Apparatus, Resuscitation trolley and baby incubator were not available in
both the CHC’s

23
Table C12 : Status of availability of Equipments & drugs
Equipments available / working
(Yes:1; o: 0)
CHC 1 -Chellampatti CHC2- Samayanallur
Available Working Available Working
Boyles Apparatus 1 1 1 1
ECG Machine 1 1 1 1
Cardiac Monitor for OT 1 1 0 0
Defibrillator for OT 0 0 0 0
Ventilator for OT 0 0 0 0
Horizontal High Pressure Sterilizer 0 0 1 1
Vertical High Pressure Sterilizer 2/3 1 1 1 1
drum capacity
OT Care Fumigation Apparatus 0 0 0 0
Gloves & Dusting Machines 1 1 0 0
Oxygen Cylinder 1 1 1 1
Hydraulic Operation Table 1 1 1 1
Resuscitation trolley 0 0 0 0
Phototherapy unit 1 1 1 1
MVA syringe 0 0 1 1
Baby incubator 0 0 0 0
CHC reporting stock-out or irregular supply of
specific drugs in last 6 months (Yes: 1; o: 0)
Type of Drugs CHC 1- Chellampatti CHC 2-Samayanallur
Stock Out Irregular Stock Out Irregular
Supply Supply
Iron Folic Acid (IFA) 0 0 0 0
Oral Pills (OPs) 0 0 0 0
IUD 380 0 0 0 0
ORS (Oral Rehydration Salts) 0 0 0 0
ORS with Zinc adjutant as per policy 1 1 1 1
Vitamin A 1 1 1 1
Tab. Fluconazole 0 0 0 0
Tab. Metronidazole 0 0 0 0
Tab. Co-trimoxazole (Kid) 0 0 0 0
Tab. Nefidipine 0 0 0 0
Inj. Oxytocin 0 0 0 0
Inj. Gentamycin 0 0 0 0
Inj. Magnesium Sulphate 0 0 0 0
Tab. Misoprostal 0 0 0 0
Tab. Progestrone 0 0 1 1
Inj. Lignocaine Hydrochloride 0 0 0 0
Inj. Pentazocine Lactate 0 0 0 0
Inj. Adrenaline 0 0 0 0
Cap. Doxycycline 0 0 0 0
Silver Sulphadiazine oint. 0 0 0 0
IV Fluids 1 0 0 0
Inj. Prociane Penicillin 1 1 0 0
Inj. Atropine 0 0 0 0
Syp Amoxycyclin 1 1 1 1
IFA Syrup 1 1 1 1

24
Drugs position in both the CHCs are good. Almost all the drugs are available in both the
CHCs especially ORS with Zinc adjutant as per policy. Vitamin A, Syrup Amoxyciline
and IFA syrup were the stock-out drugs/irregular supply drugs during the last six months.

AVAILABILITY OF SPECIFIC SERVICES.

Table C13 explains the services available in the CHCs. Services like DOTs, obstetric
and Gynaecology, Leprosy diagnosis management and referral services, Emergency
services (24 hrs), RTI/STI treatment , counseling in facility on HIV/AIDS/STD etc,
Voluntary Counseling and Testing Centre (VCTC), AYUSH, Primary management for
wounds and dog bites, management of RTI/STI were available in both the CHCs.
Table C13. Availability of Specific Services (Yes: 1; o: 0)
Type of Service CHC 1- CHC 2-
Chellampatti Samayanallur
Medicine 0 1
Surgery 0 0
Obstetric & Gynae 1 1
Pediatrics 0 0
DOTS 0 1
Cataract Surgery 0 0
Leprosy diagnosis management and referral 1 1
services
Emergency Services (24 Hrs) 1 1
mobile medical unit 0 0
separate neo-natal care unit 0 0
emergency care for sick children 0 0
Full Range of Family Planning Services including 1 0
Laparoscopic ligation
Safe abortion services 1 0
Treatment of STI/RTI 1 1
Blood Storage facility 0 0
Counseling Facility on HIV/AIDS/STD etc 1 1
Voluntary Counselling and Testing Centre 1 1
(VCTC)
AYUSH facility 1 1
Primary management of wounds 1 1
Primary management fracture 0 0
Primary management of cases of poisoning/snake, 1 0
insect or scorpion bite
Primary management of dog bite 1 1
Primary management of burns 1 0
Management of RTI/STI 1 1

25
Services like Surgery, Pediatrics, cataract surgery, mobile medical unit, separate neo-
natal care unit , emergency care for sick children, blood storage facility and primary
management for fracture were not available in both the CHCs. In addition to that full
range of family planning service including laproscopic ligation ,safe abortion services,
primary management of poisoning/ snake, insect or scorpion bite and primary
management of burns were available in Chellampatty CHC. These services were not
available in Samayanallur CHC (Table C13).

SERVICE OUTCOME

Table C14 indicates the service outcome of the CHCs based on data for last three months.
Data related to total ANC registration. JSY cases registered, 1st trimester registration,
three ANC checkups given as per RCH schedule, number of JSY beneficiaries, ANC
given TT (2nd Dose + booster) were not available in both the CHCs. These are
maintained by the PHC’s. Data on SC/ST break up is also not available. The total service
outcome based on the data shows that during the last three months in Chellampatty 32
ANCs were completed with IFA prophylaxis, 13 pregnant women were identified and
attended with obstetric complications, three cases were referred from PHC/CHC, 178
institutional deliveries were conducted, 53 infants were given BCG, 46 received DPT,
95 given and measles, 16 IUDs were inserted. Total indoor patients were 117 and 17
cases were referred beyond CHC. Only one was currently under treatment. Six new cases
were enrolled for DOTs and the bed occupancy rate as on March 31st 2008 is 25. Average
daily OPD attendance reported is 304. Among them 95 were male , 160 were female and
49 were children. Among these three cases were referred from PHC/SHC.

In Samayanallur BPHC 40 JSY beneficiaries were reported, three cases were completed
ANC with IFA prophylaxis and all the three were JSY beneficiaries. Sixteen pregnant
women were identified and attended with Obstetric complications among them 10 were
referred from PHC/SHC. Total institutional deliveries were 86 out of these intuitional
deliveries 40 were JSY cases. The number of children given BCG, DPT3 and measles
were 92, 95 and 101 respectively. Twenty-nine IUD’s were inserted. During the last three
months 105 indoor patients were reported among them 36 were referred from PHC and
these cases were currently under treatment. Only one new TB case was enrolled for

26
DOTs. Bed occupancy rate in the last 12 months is 35. Average daily OPD attendance is
332, among them female OPD attendance (211) is more than male (104) and children
(17). Among them only two OPD attendance were referred from PHC/HSC(Table C14)
Table C14 : Service Outcome (based on data for last three months)

Average monthly figure reported

Indicator in CHC based on last three months

CHC 1 – CHC 2-
Chellampatti Samayanallur
Total ANC Registration NA NA
Total JSY cases registered NA NA
Ist Trimester Registration NA NA
ANC given 3 Checkups as per RCH Schedule NA NA

Out of above, the no. of JSY beneficiaries NA NA

ANC given TT (2nd dose+Booster) NA NA
Out of above, the no. of JSY beneficiaries 0 40
ANC completed IFA Prophylaxis 32 3
Out of above, the no. of JSY beneficiaries 0 3
Number of pregnant women identified and attended
13 16
with obstetric complications
Out of these, how many have been referred from
3 10
PHC/SHC
Total Institutional Deliveries 178 86
No. of JSY cases (out of total institutional deliveries) 0 40
No. of infants given BCG 53 92
No. of infants given DPT3 46 95
No. of infants given Measles 95 101
No. of infants given Vit. A-first dose 0 0
Children given IFA Syp. (6-60 Months) 0 0
IUD Inserted 16 29
Total Indoor Patients 117 105
No. of cases referred beyond CHC 17 36
No. of Leprosy cases currently under treatment 1 3
No. of new TB cases enrolled for DOTS 6 1
No. of cases given Blood Transfusion in last 3
0 0
months
Bed occupancy rate in the last 12 months? (As on
25 35
March 31, 2008)
Average Daily OPD Attendance (Total) Average
304 332
Daily OPD Attendance
Average Daily OPD Attendance Male 95 104
Average Daily OPD Attendance Female 160 211
Average Daily OPD Attendance Children 49 17
Out of the total OPD attendance, specify the referred
3 2
cases from PHC/ SHC
ote: A- ot applicable.

27
 CHAPTER 4
PRIMARY HEALTH CETRE
Thummakundu and Vikkaramangalam Primary Health Centres (PHC) were selected
under Chellampatty Community Health Centre and Koilpappakudi and Kancharam patti
PHC’s were selected under the Chellampatty BPHC.

Table P1: Coverage and facilities of Primary Health Centre

CHC 1- Chellampatti CHC 2 - Samayanallur
Coverage and
PHC 1 - PHC 2 - PHC 1 - PHC 2 -
facilities
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
Number of Sub- 7 7 6 6
Centres covered
by PHC
Population 29034 30291 24051 55558
covered
PHC 1 – PHC 2 – PHC 1 – PHC 2 –
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
Distance & Distance Time Distance Time Distance Time Distance Time
(in Kms.) (in (in Kms.) (in (in Kms.) (in (in Kms.) (in
Time Taken to Minutes.) Minutes.) Minutes.) Minutes.)
travel in public
transport /
available mode
from
Nearest Sub 1 5 1 5 2 5 2 10
Centre in the
coverage area
Farthest Sub 18 60 8 20 12 60 8 30
Centre in the
coverage area
Nearest CHC 25 75 8 30 10 40 25 120
No. of Beds
available
Male 0 1 0 0
Female 2 4 2 2
Total 2 5 2 2
PHC functioning 1 1 1 1
on 24x7 basis
(Yes:1; o: 0)
PHC equipped 1 1 1 1
to provide basis
obstetric
services (Yes:1;
o: 0)
PHC with 4-6 0 1 0 0
beds
(Yes:1; o: 0)

28
.In Chellampatty CHC, Thummakundu and Vikkaramangalam PHC’s each covers seven
sub-centres and 29,034 and 30,291 population respectively. In both the PHCs the nearest
sub centre is located in a distance of only one kms and it will take only five minutes to
reach the PHC. In Thummakundu PHC, the farthest sub centre is located at a distance of
18 kms and the time taken to reach the sub centre is 60 minutes. In the Vikkramangalam
PHC the farthest sub centre in the coverage area is located at a distance of eight kms and
the time taken to reach the PHC is 20 minutes. For Thummakundu PHC the nearest CHC
is located in a distance of 25 kms and it will take 75 minute to reach the CHC from the
PHC. For Vikkramangalam PHC the nearest CHC is located at a distance of eight kms
and it takes 30 minutes to reach that CHC. Thummakundu PHC has only two beds i.e.,
females, it is functioning on a 24X7 basis and well equipped to provide basic obstetric
services. Vikkramangalam PHC has five beds i.e., four female beds and one male beds
and it is also functioning on 24X7 basis well equipped to provide basic obstetric services

In Samayanallur BPHC, Koilpappakudi and Kancharampettai PHCs covers six sub

centers each. The nearest sub centre is located with in a distance of 2kms and the time
taken to reach these sub centers is 5 minutes and 10 minutes respectively. In
Samayanallur the farthest sub centre for the Koilpappakudi is located in 12 kms and it
will take 60 minutes to reach this sub centre. In Kancharampettai PHC, the farthest sub
centre is located at a distance of eight kms and the time taken to reach this sub centre is
30 minutes..For Koilpappakudi and Kancharampetti PHCs the nearest CHC are located in
a distance of 10 and 25 kms respectively and the time taken to reach these nearest sub-
centres from the PHCs were 40 minutes and 120 minutes respectively. . Koilpappakudi
and Kancharampettai PHCs have two beds i.e Female beds both are functioning on 24X7
basis and are well equipped to provide basic obstetric services. They are not belongs to
the PHC with 4-6 beds (Table P1).

Table P2 explains the infrastructure of the selected primary health centers. All the four
PHCs are functioning in designated government buildings. They have labour room,
laboratory services, prominent display boards regarding service availability in local
language, pharmacy for drug storage and drug dispensing, OPD room / cubic ; piped
water supply; regular electricity supply in all parts telephone, computer, internet facility,
standby facility in working condition and new born care corner.

29
 Table P2 : Primary Health Centres by Infrastructure

CHC 1- Chellampatti CHC 2- Samayanallur

Infrastructure PHC 1 PHC 2 PHC 1 PHC 2
Thummakundu Vikkramangalam Koilpapakudi Kancharampetti
PHC functioning in designated govt. 1 1 1 1
Building (Yes:1; o: 0)
Labour Room (Yes:1; o: 0) 1 1 1 1
Laboratory(Yes:1; o: 0) 1 1 1 1
Prominent display boards regarding 1 1 1 1
service availability in local language
(Yes:1; o: 0)
Names of JSY beneficiaries maintained in 1 1 0 0
record(Yes:1; o: 0)
Pharmacy for drug dispensing and drug 1 1 1 1
storage (Yes:1; o: 0)
Separate public utilities (toilets) for males 0 1 1 1
and females (Yes:1; o: 0)
Suggestion / complaint box (Yes:1; o: 0) 0 0 0 0
OPD rooms / cubicles (Yes:1; o: 0) 1 1 1 1
Piped Water Supply (Yes:1; o: 0) 1 0 0 0
Electricity Supply
No regular electricity supply 0 0 0 0
(Yes:1; o: 0)
Regular electricity supply in all parts 1 1 1 1
(Yes:1; o: 0)
Telephone (Yes:1; o: 0) 1 1 1 1
Computer (Yes:1; o: 0) 1 1 1 1
Internet (Yes:1; o: 0) 1 1 1 1
Type of sewerage system (Yes:1; o: 0)
Soak pit 0 0 1 1
Connected to Municipal 0 0 0 0
Sewerage 0 0 0 0
Open Drain 0 1 0 0
Other 1 0 0 0
Waste disposal (Yes:1; o: 0)
Buried in a pit 0 1 0 0
Collected by an agency 0 0 0 0
Incernation 1 0 1 1
Thrown in open 0 0 0 0
Standby facility (generator etc.) available 1 1 1 1
in working condition (Yes:1; o: 0)
separate areas for septic and aseptic 0 0 0 0
deliveries available? (Yes:1; o: 0)
New Born Care Corner available? 1 1 1 1
(Yes:1; o: 0)
Status of Cleanliness of OPD reported 1 1 1 1
good or fair
Status of Cleanliness of Compound / 1 1 1 1
Premises reported good or fair
Status of Cleanliness of Room/Wards 1 1 1 1
reported good or fair

In all the PHCs suggestion/ complaint box, separate areas are septic and aseptic deliveries
are not available. Sewerage system of these PHCs varied from each other. PHC like
Koilpappakudi and Kancharampettai have soak pits and in Vikkramangalam it is open
drain. In Thummakundu, Koilpappakudi and kancharampettai PHCs wasted materials

30
were disposed by incarnation and in Vikkaramangalam it was buried in a pit. In all the
PHCs the OPD, compound / premises and rooms/wards were clean and the status of
cleanliness is good.

STAFF POSITIO I PRIMARY HEALTH CETRES

Table P3 details the staff position of Primary Health Centres. In all the PHCs the medical
officer (2), Pharmacist (1), Nurses (7), ANM (1), Driver (1), Staff Nurse (3), Lady Health
Visitor (1) and Lab assistant (1) posts were sanctioned under regular in position.

Table P4 shows the status of training of personnel at Primary Health Centre during 2007.
Skilled birth Attendant training and training on new born care were attended by all the
health personnals at the Primary Health Centres. Training on safe abortion methods were
not attended by any of the health personnels. Health personnel in Thummakundu,
Koilpapakudi and Kancharampettai were trained on pre service IMNCI.

31
Table P3 : Staff Position of in Primary Health Centre
CHC 1- Chellampatti CHC 2 - Samayanallur
PHC 1 - Thummakundu PHC 2 - Vikkramangalam PHC 1- Koilpappakudi PHC 2 - Kancharampetti
S Numbers in S Numbers in Position S Numbers in Position S Numbers in Position
Type of Staff
Position
R C T R C T R C T R C T
Medical Officer 2 1 0 1 2 2 0 2 2 2 0 2 2 2 - 2
Pharmacist 1 1 0 1 1 1 0 1 1 1 0 1 1 1 - 1
Nurses 7 7 0 7 7 7 0 7 6 6 0 6 6 6 - 6
ANM 1 1 0 1 1 1 0 1 1 1 0 1 1 1 - 1
Lab Technician 0 0 0 0 0 0 0 0 1 0 0 0 1 1 - 1
Driver 1 0 0 0 0 0 0 0 0 0 0 0 - - - -
Medical Officer 0 0 0 0 0 0 0 0 0 0 0 - - - -
AYUSH
Staff Nurse 3 3 0 3 3 3 0 3 3 3 0 3 3 3 - 3
Lady Health Visitor 1 1 0 1 1 1 0 1 1 1 0 1 1 1 - 1
Lab Assistant 1 1 0 1 1 1 0 1 0 0 0 0 1 1 - 1
Block Health Education 0 0 0 0 0 0 0 0 0 0 0 0 - - - -
and Information Officer
(BHEIO)
Statistical Assistant 0 0 0 0 0 0 0 0 0 0 0 0 - - - -

S: Sanctioned; R: Regular; C: Contractual; T: Total

32
Table P4 : Status of training of personnel at Primary Health Centre
PHC having personnel trained in specific category of training during
2007 (Yes:1; o: 0)
Training CHC 1- Chellampatti CHC 2- Samayanallur
PHC 1 PHC 2 PHC 1 PHC 2
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
Pre Service 1 0 1 1
IMNCI
Safe Abortion 0 0 0 0
Methods
Skill Birth 1 1 1 1
Attendant
Training
New Born 1 1 1 1
Care

Table P5 indicate that in all the four selected PHCs labour rooms are available and are
currently in use.

Table P5: Availability of Labour Room in Primary Health Centre

Labour (Yes:1; o: 0)
Room
CHC 1- Chellampatti CHC 2- Samayanallur
PHC 1 - PHC 2 - PHC 1 - PHC 2 -
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
Availability 1 1 1 1
of Labour
Room
Labour 1 1 1 1
Room
Currently in
Use
Reasons for
not using
Labour
Room
Non 0 0 0 0
availability
of
doctors/staff
Poor 0 0 0 0
condition of
the labour
room
No power 0 0 0 0
supply in the
labour room
Other 0 0 0 0

33
During 2007-2008 the number of institutional deliveries ranged from 92-238. It was less
in Thummakundu (92) and Vikkramangalam (111) PHCs than in Koilpapapkudi (238)
and Kancharampettai(216). In Thummakundu and Vikkramangalam PHCs totally 41 and
62 deliveries were carried out from 8 PM to 8 am and this was 105 and 66 respectively in
Koilpapakudi and Kancharampettai PHCs. Two in Thummakundu, eight in Koilpapakudi
and nine in Kancharampettai PHC (Table P6). The number of neonates resuscitates were
2 in Thummakundu, 8 and 9 in Koilpappakudi and Kancharampettai PHCs.
Table P6: Status of performance of Labour Room during 2007-2008

umber of umber of deliveries performed in PHC during 2007-2008

deliveries
CHC 1- Chellampatti CHC 2- Samayanallur
PHC 1 PHC 2 PHC 1 PHC 2
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
Total Institutional 92 111 238 216
Deliveries
Deliveries carried 41 62 105 66
out from 8 pm to 8
am
Institutional 0 0 0 0
deliveries for JSY
card holders
Number of neonates 2 0 8 9
resuscitated

Table P7 explains the availability of laboratory testing in PHC. Haemoglobin, urine RE,
Blood grouping and blood smear tests were available in all the PHCs. RPR test for
syphilis is not available in all the PHCs, testing for blood sugar and Rapid test for HIV,
diagnostic of RTI/STIs with wet mounting, grams stain etc were available in the
Koilpapappakudi and Kancharampettai PHCs (Table P7).

In Vikkramangalam and Koilpapakudi PHCs. Blood smear examination for malaria

parasite and Rapid test for pregnancy were available. Table P8 shows the number of tests
done in each PHC during the last three calendar months. In Thummakundu PHC the
number of tests done includes Haemoglobin (288), Urine RE (762), Blood grouping (361)
and Blood smear (764). In Vikkramangalam PHC, 60 Haemoglobin, 96 Urine RE, 60
Blood grouping, 210 Blood smear, 210 blood smear examination for malaria parasite and
51 rapid test for pregnancy were conducted during the last three calendar months.

34
 Table P7 : Availability of laboratory Testing in PHC

Availability Laboratory Testing (Yes:1; o: 0)

CHC 1- Chellampatti CHC 2- Samayanallur
PHC 1 PHC 2 PHC 1 PHC 2
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
Haemoglobin 1 1 1 1
Urine RE 1 1 1 1
Blood sugar 0 0 1 1
Blood grouping 1 1 1 1
Blood Smear 1 1 1 1
Bleeding time, clotting 0 0 0 1
time
Diagnosis of RTI/ STIs 0 0 1 1
with wet mounting,
grams stain etc.
Blood smear 0 1 1 0
examination for malaria
parasite
Rapid test for Pregnancy 0 1 1 0
RPR test for Syphilis 0 0 0 0
Rapid test for HIV 0 0 1 1

In Koilpapakudi PHC almost all the test like Haemoglobin (177), Urine RE (327), Blood
sugar (110), Blood grouping (153), Blood smear (1299), Diagnosis of RTI/STI and with
wet mounting., grams stain etc (121), blood smear examination for malaria parasite
(1299), Rapid test for Pregnancy (28), and Rapid test for HIV(128) were done during the
last three calendar months, except bleeding time, clothing time and RPR test for syphilis.
Table P8 : umber of tests done in PHC in last three calendar months

Type of Test umber of tests done in last 3 calendar months

CHC 1 - Chellampatti CHC 2 - Samayanallur
PHC 1 PHC 2 PHC 1 PHC 2
Thummakund Vikkramangala Koilpappakudi Kancharampetti
u m
Haemoglobin 388 60 177 257
Urine RE 762 96 327 632
Blood sugar 0 0 110 52
Blood grouping 361 60 153 382
Blood Smear 764 210 1,299 1,356
Bleeding time, clotting time 0 0 0 1,396
Diagnosis of RTI/ STIs with 0 0 121 121
wet mounting, grams stain
etc.
Blood smear examination 0 210 1,299 0
for malaria parasite
Rapid test for Pregnancy 0 51 28 0
RPR test for Syphilis 0 0 0 0
Rapid test for HIV 0 0 128 128

35
In Kancharampettai PHC during the last three months more number of tests on bleeding
time, clothing time (1356) and Blood smear (1356) were done than Urine RE (632),
Haemoglobin (257), Rapid test for HIV (128), Diagnosis of RTI/ STIs with wet
mounting, grams stain etc (121) and blood Sugar (52). (Table P8).

Status of specific interventions

Table P9 indicates the status of specific interventions conducted in the selected PHCs.
IPHS facility survey was done in all the selected four PHCs. They are functioning on
24X7 basis (have 1 MO and 3 or more ANMs/ Staff Nurse round the clock). In all the
selected PHCs Rogi Kalyan Samiti was registered , the money generated by RKS was
utilized and feed back mechanism and grievances were redressed by RKS. All the
standard treatment guideline and protocols were available with the medical officer in
charge.

AYUSH doctors were not providing services, RKS is not generating resources through
user fees, display boards are not showing number of meeting and members of RKS and
also citizens character is not publicly displayed.

AVAILABILITY OF SPECIFIC SERVICES

Services such as primary management of wards, minor surgeries like draining of abscess,
primary management of poisoning/snake, insect or scorpion bite and primary
management of dog bite and management of RIT/STI is available in all the PHCs.
Services on Primary Management of wounds, Management of Neonatal Asphyxia,
Sepsis, Management of malnourished children, primary management for burns,
AYUSHC services, facility for MTP is not available.

36
Table P9: Status of Specific Interventions
Status of Specific Interventions (Yes:1; o: 0)
CHC 1- Chellampatti CHC 2- Samayanallur
PHC 1 PHC 2 PHC 1 PHC 2
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
IPHS Facility Survey 1 1 1 1
done
PHC functioning on 24 x 1 1 1 1
7 basis (have 1 MO and 3
or more ANMs / Staff
Nurses round the clock)?
AYUSH doctor 0 0 0 0
providing services
Registered Rogi Kalyan 1 1 1 1
Samiti
RKS generating 0 0 0 0
resources through user
fees
Money generated by 1 1 1 1
RKS being used
Display board showing 0 0 0 0
no. of meetings &
members of RKS
Feedback mechanism in 1 1 1 1
place for grievances
redressed by RKS
Citizens Charter 0 0 0 0
publically displayed
All Standard Treatment 1 1 1 1
Guidelines and Protocols
available
Availability of Specific
Services
Primary management of 1 1 1 1
wounds
Primary management 0 0 0 0
fracture
Management of Neonatal 0 0 0 0
asphyxia, sepsis
Management of 0 0 0 0
malnourished children
Minor surgeries like 1 1 1 1
draining of abscess etc
Primary management of 1 1 1 1
cases of poisoning/snake,
insect or scorpion bite
Primary management of 1 1 1 1
dog bite cases
Primary management of 0 0 0 0
burns
Facility for MTP 0 0 0 0
available
Management of RTI/STI 1 1 1 1
AYUSH services 0 0 0 0

37
 AVAILABILITY OF EQUIPMET I PHC

Table P10 explains the availability of equipments in the selected PHCs. Examination
table, delivery table, Oxygen Cylinder, Suction apparatus, cradle, oxygen mask,
Thermometer, Suction machine, Microscope and Haemoglobinometer were available in
all the PHCs and are in working condition. Patient trolley, wheel chair, Stretcher/trolley,
Radiant warmer, laryngoscope and auto analyzer are not available in the selected PHCs.

Table P10 : Availability of selected equipments in PHC

Equipments available / working (Yes:1; o: 0)

CHC 1- Chellampatti CHC 2- Samayanallur
PHC 1 - PHC 2 - PHC 1 - PHC 2 -
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
Equipments Available Working Available Working Available Working Available Working
Patient Trolley 0 0 0 0 0 0 0 0
Examination 1 1 1 1 1 1 1 1
table
Delivery table 1 1 1 1 1 1 1 1
Wheel chair 0 0 0 0 0 0 0 0
Stretcher/ trolley 0 0 0 0 0 0 0 0
Oxygen 1 1 1 1 1 1 1 1
Cylinder
Suction 1 1 1 1 1 1 1 1
Apparatus
Infant warmer 0 0 1 1 1 1 1 1
Radiant Warmer 0 0 0 0 0 0 0 0
Cradle 1 1 1 1 1 1 1 1
Autoclave 0 0 1 1 1 1 1 1
Sterlisation 1 1 1 1 0 0 0 0
equipment
Bag & Mask 0 0 1 1 0 0 0 0
Laryngoscope 0 0 0 0 0 0 0 0
Oxygen Mask 1 1 1 1 1 1 1 1
Thermometer 1 1 1 1 1 1 1 1
Suction 1 1 1 1 1 1 1 1
Machine
Water Purifier 0 0 0 0 1 1 1 1
Microscope 1 1 1 1 1 1 1 1
Haemoglobinom 1 1 1 1 1 1 1 1
eter
Auto Analyser 0 0 0 0 0 0 0 0
Autoclave 1 1 1 0 1 1 1 1
Resuscitation 1 1 0 0 1 1 1 1
equipment

38
 STATUS OF AVAILABILITY OF DRUGS

Table P11 shows that during the last six months there is stock out/ irregular supply of
iron syrup, Vitamin A, MVA syringe, Haemoccele and AYUSH drugs in all the selected
PHCs.

PHC reporting stock out or irregular supply of specific drugs in last 6

months (Yes:1; o: 0)
CHC 1- Chellampatti CHC 2- Samayanallur
Type of Drugs
PHC 1 - PHC 2 - PHC 1 - PHC 2 -
Thummakundu Vikkramangala Koilpappakudi Kancharampetti
m
Stock Irregular Stock Irregular Stock Irregular Stock Irregular
Out Supply Out Supply Out Supply Out Supply
IFA tablets 0 0 0 0 0 0 0 0
Iron Syrup 1 1 1 1 1 1 1 1
Oral Pills 0 0 0 0 0 0 0 0
Vitamin A 1 1 1 1 1 1 1 1
Measles Vaccine 0 0 0 0 0 0 0 0
ORS 0 0 0 0 0 0 0 0
Tab. Methergin 0 0 0 0 0 0 0 0
Tab. Albendazole/ 0 0 0 0 0 0 0 0
Mabendazole
IUDs 0 0 0 0 0 0 0 0
Inj oxytocin 0 0 0 0 0 0 0 0
Magnesium sulphate 0 0 0 0 0 0 0 0
Tab. Fluconazole 0 0 1 1 1 1 1 1
Partograph 0 0 0 0 0 0 0 0
MVA syringe 1 1 1 1 1 1 1 1
Tab Ciprofloxacin 0 0 0 0 0 0 0 0
Syp Cotrimoxazole 0 0 0 0 0 0 0 0
Syp Paracetamol 0 0 0 0 0 0 0 0
Ringer’s Lactate 0 0 0 0 0 0 0 0
Haemoccele 1 1 1 1 1 1 0 0
AD syringes 0 0 0 0 0 0 0 0
Disposable Gloves 0 0 0 0 0 0 0 0
Bandages 0 0 0 0 0 0 0 0
AYUSH drugs 1 1 1 1 1 1 1 1
DOTS drugs 0 0 0 0 0 0 0 0
MDT drugs, blister 0 0 0 0 0 0 0 0
packs

Drugs such as IFA tablets , orall pills, Measles vaccine, ORS, Tab. Methergin, Tab.
Albendazole/ Mabendazole, IUDs, oxytocin injection, Magnesium sulphate, Tab
Fluconazole Partograph Tab Ciprofloxin, Syp Contrimoxazole, Syp Paracetamol, and
Ringer’s Lactate, AD syringes, Disposable Gloves, Bandages, DOTS drugs and MDT

39
drugs, blaster packs are available in all the selected PHC and there is no stock out or
irregular supply was reported during the last six months.

SERVICE OUTCOME

Table P12indicates the service outcome of the selected PHCs during the last three
months. The average monthly ANC registration varied from 41 to 105. Total JSY cases
registered from 15-53. Average number of first trimester registration ranged from
33-102. The number of total institutional deliveries varies from 40-105. Out of total
institutional deliveries, number of JSY cases registered were from 8 to 30. Total reported
indoor patients is 17 to 42. The lowest number of outdoor patients registered were in
Koilpapakudi and it is registered as 39 and it is highest in Vikkramangalam PHC (5,135).
Average number of indoor patient reported was low in Themmakudu PHC (17) and the
highest is in Vikkaramangalam PHC (42). More number of IUD was inserted in
Koilpapakudi (12). In Kancharampettai PHC, IUD insertion was not reported. Number
of new TB cases enrolled for DOTS in Vikkramangalam (4), Thummakundu PHC (5),
Kancharampettai (2) was very less. Leprosy cases registered for MDT is very less it
ranged for 0 – 1. Data on number of Children given Vitamin A first dose was not
available. Cataract surgeries were not carried out in PHCs. During 2007- 2008, not a
single male sterilization was carried out. Maternal deaths were also not reported.

STATUS OF RECORD MAITEACE

Registers on antenatal care, postnatal care, family planning, and immunization were
maintained in all the PHCs. Eligible couple register was maintained by only in
Vikkramangalam PHC. Family planning register, meeting register and untied fund
registers were maintained by all the PHC’s except Kancharamanpettai. JSY register was
maintained by PHC’s under Chellampatty (Table P 13)
.

40
Table P12. Service Outcome (based on data for last three months)

Average monthly number reported

Chellampatti Samayanallur
CHC 1 CHC 2

Vikkramangalam

Kancharampetti
Thummakundu

Koilpappakudi
Indicator

PHC 1

PHC 2

PHC 1

PHC 2
Total ANC Registration 54 105 41 105
Total JSY cases registered 30 53 15 17
Ist Trimester Registration 40 102 33 89
ANC given 3 Checkups 54 105 30 63
ANC given TT1 42 34 25 61
ANC given TT2+Booster 53 37 41 102
ANC completed IFA Prophylaxis 35 105 24 56
Total Institutional Deliveries 53 28 40 94
No. of JSY cases (out of total institutional 30 28 8 17
deliveries)
No. of infants given BCG 52 38 37 95
No. of infants given DPT3 52 48 33 75
No. of infants given Measles 71 64 42 136
No. of infants given Vit. A-first dose 0 0 0 0
Children given IFA Syp. 0 0 0 0
IUD Inserted 6 2 12 26
Male sterilisation carried out 0 0 0 0
Female sterilisation carried out 13 0 0 22
Total indoor patients 17 42 39 30
Total outdoor patients 4975 5135 4343 5201
RTI/STI cases treated 22 0 4 0
Number of maternal deaths in 2007-2008 0 0 0 0
No. of cases of obstetric complications 9 2 0 7
referred beyond PHC
No. of cataract surgeries carried out 0 0 0 0
No. of new TB cases enrolled for DOTS 5 4 0 2
No. of new leprosy cases registered for MDT 0 0 1 1
No. of leprosy cases completed treatment for 0 0 0 0
leprosy

41
Table P13 : Status of record maintenance (Yes:1; o: 0)

CHC 1- Chellampatti CHC 2- Samayanallur

Type of Records PHC 1 PHC 2 PHC 1 PHC 2
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
Ante Natal Register 1 1 1 1
Eligible Couple 0 1 0 0
Register
Post Natal Care 1 1 1 1
Register
Family Planning 1 1 1 0
Register
Birth & Death Register 0 1 1 1
Immunisation Register 1 1 1 1
Meeting Register 1 1 1 0
JSY Register 1 1 0 0
Untied Funds Register 1 1 1 0

42
 Chapter - 5

SUB-CETRE

In Chellampattai CHC, Nallaperumalpatty, Mettupatty and Boothipatty sub-centre

were selected under Thumakkundu PHC. Nadumuthalaikulam, Kannur and
Sakkarappanayakkanur sub-centre were selected under Vikkramangalam PHC. in
Samayanallur Block Primary Health Centre,. Athalai, Pillayarnatham and Thodaneri sub-
centres were selected under Koilpapakudi PHC and Chatrapatti, Kodimangalam and
Thirupalai sub-centres were selected under Kancharampettai PHC.
Table S1: Sub Centres Coverage
CHC1- Chellampatti CHC2- Samayanallur
PHC1- PHC2- PHC1- PHC2-
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
Averag

Sakkarappanayak
Nallaperumalpatt

Nedumuthalaikul

Kodimangulam
Pillayarnatham
Coverage of Sub- e per

Boothipuram
P.Methupatti

Chatrapathi

Thirupalai
Thodaneri
Kannanur
Centre Sub

Athalai
anur
am
Centre
1

y
2

3
Number of villages
covered by Sub
Centre 8 10 10 9 10 14 4 6 2 6 11 6 8
Population on
coverage 4,223 4,130 3,910 4,957 4,636 4,387 2,343 3,146 2,002 5,418 6,676 11827 4804
Distance between
PHC and SC (in
kms) 10.0 8.0 18.0 5.0 8.0 5.0 4.0 9.0 19.0 2.0 6.0 8.0 8.5
Time Taken (In
minutes) to travel in
public transport /
available mode
from
Farthest village to
Sub Centre 30 60 20 60 15 15 45 60 60 15 36 45 38.0
Sub Centre to PHC 30 30 30 15 25 20 15 30 45 5 6 30 23.4
Sub Centre to CHC 90 120 25 60 30 60 90 60 10 75 45 80 62.1
No. of ASHAs NA NA NA NA NA NA NA NA NA NA NA NA NA
working in the Sub
Centre
ote: A ot applicable

43
Table S1 shows that on an average 8 villages were covered by each sub-centre, it varied
from 2 to 11. Pillaiyarnatham sub-centre covers only two villages and at the highest of
14 villages were covered by Sakkarappanayakkanur. The sub-centres, P. Methupatti,
Boothipuram, and Nedumuthalaikulam were covering 10 villages each. Pillaiyarnatham,
Chatrapatti and Thiruppalai sub-centre each covering six villages. Nallaperumalpatty and
Nedumuthalaikulam sub-centres covering eight and nine villages respectively.

In Madurai district each sub-centre covering a population 4,804. The coverage

population of the sub-centre varies form at the lowest of 2002 at the highest of 11,827.
The coverage population of the sub-centres under Thummakundu is around 4,000. The
population coverage of sub-centres under Vikkaramangalam PHC varies from 4000 –
5000 (Nedumuthalaikulam 4,957: Kannanur, 4,636: Sakkarappanayakkanur, 4,387) Sub-
centres under Koilpapakudi PHC serves a population of 2000 – 3000 (Athalai, 2,343:
Pillayarnatham, 3,146; Thodaneri, 2,002), sub-centre under Kancharampettai PHC serves
a population of 5000 – 10,000 population (Chatrapatti, 5,418; Kodimangalam, 6,676 and
Thirupallai, 11,827). On an average

Distance between the sub-centres and PHC ranged the lowest of 2 Kms to the
highest of 19 Kms. The average distance between sub-centres and PHC’s is 8.5 Kms.
The distance between SC and PHC under Thumakundu PHC is 8 –18 Kms (P. Mettupatti,
8 kms; Nallaperumalpatti, 10 kms; Boothipuram, 18 kms), sub-centres under
Vikkramangalam PHC are located at a distance of 5 – 8 kms (Kannanur, 8 kms;
Nedumuthalaikulam and Sakkarappanayakkanur, 5 kms each). In Koilpapakudi PHC, the
sub-centres located at distance of 4 –19 kms (Athalai, 4 kms; Pillayarnatham, 9 kms;
Thodaneri, 19 kms). Sub-centres under Kancharampettai PHC were located at a distance
of 2 – 8 kms (Chatrapatti, 2 kms; Kodimangalam, 6 kms; Thiruppalai, 8 kms_.

The average time taken to reach the farthest village to the sub-centres by public
transport is 38 minutes, and the average time takes to reach sub-centre to PHC is 23
minute, and the sub-centre to CHC is 62 minutes.

44
 The time taken to reach the farthest village to the sub-centre under the
Thummakundu PHC is 20 minutes – 60 minutes, and the sub-centre to PHC is only 30
minutes and the Sub-Centre to CHC varies from 25-120 Kms.
.
In Vikkramangalam PHC the time taken to reach the farthest villages to sub-
centre ranged from 15 – 60 minutes, the time taken to reach the sub-centre to the PHC is
15 –25 minutes, and the time taken to reach the sub-centre to the CHC by public transport
varies from 30 – 60 minutes.

In Samayanallur, the time taken to reach the farthest village to the sub-centre by
public transport for the sub-centre under Koilpapakudi PHC is 15 – 60 minutes, the sub-
centre to PHC is 15 – 45 minutes, and the sub-centre to the CHC is 10 – 90 minutes.

The time taken to reach of the farthest village to the sub-centre in the
Kancharampattai PHC areas is 15 – 45 minutes, sub-centre to PHC is 5 – 30 minutes and
sub – centre to CHC is 45 – 80 minutes (Table S1). ASHA was not appointed in the sub-
centre.

SUB-CETRES IFRASTRUCTURE

Table S2 indicates the availability of infrastructure in sub-centres . Fifty-eight

percent of the sub-centres are functioning in designated government building. In 83
percent of the sub-centre IPHS facility survey was done. Sixty-seven percent of the
facility had labour room. One-third (33 percent) have piped water and regular electricity
supply. Majority (92 percent) of the sub-centres have telephone facilities.

In majority of the sub-centre open drainage (92 percent) is prevailing. Only eight
percent have soak pit. In one-fourth (25 percent) of the sub-centres waste are buried in
pit. In 17 percent incarnation is used for waste disposal. In fifty-eight percent of the
HSC’s waste were thrown in open.

45
 Table S2: Sub Centre Infrastructure

percent
of Sub
Centre
CHC1-Chellampatti CHC2-Samayanallur
having
respectiv
Availability of e facility
Infrastructure in PHC1- PHC2- PHC1- PHC2-
Sub Centres Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
(Yes:1; o:0)

Nedumuthalaikulam

Sakkarappanayakan
Nallaperumalpatty

Kodimangulam
Pillayarnatham
Boothipuram
P.Methupatti

Chatrapathi
Thodaneri
Kannanur

Athalai
1

3
1

Thirupalai
3
Functioning in
designated
government
building 0 1 1 0 1 0 1 1 1 0 0 1 58.3
IPHS Facility
Survey Done 1 1 1 0 1 1 1 1 0 1 1 1 83.3
Labour Room 1 1 1 1 0 0 1 0 0 1 1 1 66.7
Piped water
supply 1 0 1 0 1 0 0 0 0 0 0 1 33.3
Regular
electricity supply 0 0 1 00 0 1 0 0 0 1 0 1 33.3
Telephone 1 1 1 1 1 1 0 1 1 1 1 1 91.7
Type of Sewerage System
Soak Pit 0 0 0 0 1 0 0 0 0 0 0 0 8.3
Connected to
any Sewerage
Line 0 0 0 0 0 0 0 0 0 0 0 0 0
Open Drain 1 1 1 1 - 1 1 1 1 1 1 1 91.7
Waste Disposed
Buried in Pit 0 0 0 0 1 0 1 0 0 1 0 0 25.0
Collected by
Agency 0 0 0 0 0 0 0 0 0 0 0 0 0
Incernation 1 0 1 0 0 0 0 0 0 0 0 0 16.7
Thrown in
Open 0 1 0 1 0 1 0 1 1 0 1 1 58.3

46
 RESIDETIAL STATUS I THE SUB-CETRES

Table S3 explains the residential status of the ANM, i.e., sub-centres with ANM
staying with or away from sub-centre village by distance from sub-centre and reasons for
not staying in sub-centre quarters.

Three-fourth (75 percent) of the sub-centres are having ANM quarters. Only 22
percent of the ANM were staying in the sub-centre. Among those who staged out-side,
one-tenth of the ANM’s were staying with in the sub-centre village. Ninety percent of
the ANM’s were staying out-side of the sub-centre village. Poor security and poor
quality of the quarters (14 present), family related reasons. (14 percent) are the reasons
mentioned by ANM for not staying in sub-centre quarters.

Table S3: Sub Centres with AM staying with or away from SC village by distance
from Sub Centre and reasons for not staying in Sub Centre quarter
Sub Centre
CHC1-Chellampatti CHC2-Samayanallur
PHC1- PHC1- PHC2-
PHC2- Kancharampett
Residential status Thummakundu Vikkramangalam Koilpappakudi i percent of
of AM (Yes:1; Sub
Sakkarappanayakan
Nallaperumalpatty

Nedumuthalaikula

Kodimangulam
Pillayarnatham
o:0) Centres
Boothipuram
P.Methupatti

Thirupalai
Chatrapathi
Thodaneri
Kannanur

Athalai
m
1

3
1

2
3
Sub Centre with
ANM quarter 1 1 1 1 1 1 1 0 0 1 0 1 75.0
Sub Centre with
ANM staying in
SC's quarter 0 0 1 0 0 0 0 0 0 1 0 0 22.2
staying within SC's
village 0 0 0 0 0 0 0 0 0 0 0 1 10.0
staying outside
SC's village 1 1 0 1 1 1 1 1 1 0 1 0 90.0
Reason for AM
not staying in SC
quarter:
Quality of
quarter 1 0 0 1 0 1 0 0 0 0 0 0 42.9
Family related
reasons 0 0 0 0 0 0 0 0 0 0 0 0 14.3
Security reason 0 1 0 1 1 0 0 0 0 0 0 0 42.9

47
 Table 4 explains the staff position in sub-centres. All the sub-centres
(100 percent) have female health workers in position. Forty-two percent of the sub-
centre have male health workers. Additional ANM / Contractual were not appointed.

In all the sub-centres labour room’s are not in use and deliveries were not
conducted (Table S5). The reason for not using labour room includes ANM not staying
in the sub-centers (75 percent), poor condition of the labour room (50 percent), no power
supply/electricity supply (63 percent).

Table S4: Sub Centres with Staff in Position

Sub Centre percent of
Sub
Centres
with
CHC1-Chellampatti CHC2-Samayanallur
specific
staff
Availability of available
Staff (Yes:1; PHC1- PHC1- PHC2-
PHC2-
o:0) Kancharampett
Thummakundu Vikkramangalam Koilpappakudi
i
Sakkarappanayaka
Nallaperumalpatty

Nedumuthalaikula

Kodimangulam
Pillayarnatham
Boothipuram
P.Methupatti

Thirupalai
Chatrapathi
Thodaneri
Kannanur

Athalai
m
1

3
1

2
3

3
n

Health worker
male in position 1 0 0 0 1 0 0 0 1 1 0 1 41.7
Health worker
female in position 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Additional ANM
contractual 0 0 0 0 0 0 0 0 0 0 0 0 0

48
 Table S5: Availability of Labour Room in Sub Centre
Sub Centre
CHC1-Chellampatti CHC2-Samayanallur
PHC1- PHC1- PHC2-
PHC2- Kancharampett
Thummakundu Vikkramangalam Koilpappakudi
i percent
Labour Room
of Sub

Nedumuthalaikulam

Sakkarappanayakan
(Yes:1; o:0)

Nallaperumalpatty

Kodimangulam
Pillayarnatham
Centres

Boothipuram
P.Methupatti

Thirupalai
Chatrapathi
Thodaneri
Kannanur

Athalai
1

3
Labour Room
currently in use 0 0 0 0 0 0 0 0 0 0 0 0 0
Reasons for not
using Labour
Room
ANM not staying 2 1 0 2 1 0 1 1 1 1 1 1 75.0
Poor condition 2 1 0 2 1 0 0 0 1 0 0 1 50.0
No power supply 2 1 0 2 1 0 1 1 0 1 1 0 62.5
No electric
0 0
supply 2 1 2 1 0 1 1 0 1 1 62.5
Other 1 0 1 1 0 1 1 0 1 1 0 1 50.0

Deliveries were not conducted in sub-centre (Table S6A) and the sub-centres have
no arrangement for conducting delivery (Table S6B).

Table S6A: umber of deliveries performed during 2007-08

Sub Centre Average
CHC1-Chellampatti CHC2-Samayanallur delivery
PHC2- conducted per
PHC1- PHC2- PHC1-
Thummakundu Vikkramangalam Koilpappakudi
Kancharampett Sub Centre
i
Sakkarappanayakan
Nallaperumalpatty

Nedumuthalaikula

Kodimangulam
Pillayarnatham
Boothipuram
P.Methupatti

Thirupalai
Chatrapathi
Thodaneri
Kannanur

Athalai
1

2
3

Total deliveries
0 0 0 0 0 0 0 0 0 0 0 0 0
conducted

49
 Table S6B: Sub-Centres with arrangement for deliveries
Sub Centre percent
of Sub
CHC1-Chellampatti CHC2-Samayanallur
Centres
PHC1- PHC1- PHC2-
Kancharampett
PHC2-
Arrangement for Thummakundu Vikkramangalam Koilpappakudi
i
deliveries

Nedumuthalaikulam

Sakkarappanayakan
(Yes:1; o:0)

Nallaperumalpatty

Kodimangulam
Pillayarnatham
Boothipuram
P.Methupatti

Thirupalai
Chatrapathi
Thodaneri
Kannanur

Athalai
1

3
Deliveries conducted at
Sub Centre Itself if
required referred to
higher facility 0 0 0 0 0 0 0 0 0 0 0 0 0
Deliveries not
conducted at Sub
Centre but referred to
higher facility 0 0 0 0 0 0 0 0 0 0 0 0 0
Referred to
Private/NGO facility 0 0 0 0 0 0 0 0 0 0 0 0 0

Table S7A explains the availability of equipments in the selected sub-centres. BP

apparatus, weighing machine and fetoscope (100 percent each) were available in all the
selected sub-centres. Majority of the sub-centres have sterilizer (83 percent). One-
fourth have Cusos speculum (75 percent). One half of the sub-centre have Mucus
extractor (50 percent). Fifty-eight percent have Bag&Mask. In forty-two percent of the
sub-centres Haemoglobine meter is available. In one-third of the sub-centres Height
measuring scale (33 percent) is available. Reagent strip for Urine test and Suction
machine is available in 25 percent of the selected sub-centres.

50
 Table S7 A: Sub Centres with availability of equipments

Sub Centre
CHC1-Chellampatti CHC2-Samayanallur
PHC2- percent
PHC1- PHC2- PHC1- of Sub
Kancharampett
Thummakundu Vikkramangalam Koilpappakudi
Availability of the i Centres
equipments (Yes:1; with

Nedumuthalaikulam

Sakkarappanayakan
Nallaperumalpatty

Kodimangulam
Pillayarnatham
o:0) equipmen

Boothipuram
P.Methupatti

Thirupalai
Chatrapathi
Thodaneri
Kannanur

Athalai
t

3
available

Sterliser 1 1 1 1 1 1 1 0 0 1 1 1 83.3
Haemoglobinometer 0 0 0 0 0 0 1 1 1 1 0 1 41.7
Bag & Mask 0 1 0 0 1 1 1 0 1 0 1 1 58.3
Suction Machine 0 1 1 0 1 0 0 0 0 0 0 0 25.0
Thermometer 1 1 0 0 0 1 1 1 0 0 1 0 50.0
BP Apparatus 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Weighing Machine 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Height Measuring
Scale 1 0 0 0 0 1 1 0 0 1 0 0 33.3
Reagent Strip for
Urine Test 0 1 0 0 0 0 0 0 0 1 1 0 25.0
Cuscos Speculum 0 1 1 1 0 1 1 1 1 0 1 1 75.0
Mucus Extractor 0 1 1 1 1 1 0 0 0 0 1 0 50.0
Fetoscope 1 1 1 1 1 1 1 1 1 1 1 1 100.0

Table S7B shows the percentage of sub-centres with functional equipments. All
the sub-centres have fuctional Thermometer, BP apparatus, Weighing Machine, Reagent
Strips for Urine test, Height Measuring Scale and Fetoscope (100 percent each). In
majority of the selected sub-centre Cusor Speculum (89 percent), Bag & Mask (71
percent) and Mucus Extractor are in functional condition. Haemoglobino meter and
sterilizer are functional in 40 percent and 20 percent of the sub-centres respectively.

51
 Table S7 B: Percentage of SCs with functional equipments

Sub Centre percent of

CHC1-Chellampatti CHC2-Samayanallur Sub
PHC1 PHC2 PHC1 PHC2 Centres
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti with
Functional equipments functional

Nedumuthalaikulam

Sakkarappanayakan
Nallaperumalpatty

Kodimangulam
equipment

Pillayarnatham
(Yes:1; o:0)

Boothipuram
P.Methupatti

Thirupalai
Chatrapathi
Thodaneri
Kannanur

Athalai
1

3
Sterliser 0 0 0 0 1 0 0 0 0 1 0 0 20.0
Haemoglobinometer 0 0 0 0 0 0 1 0 0 1 0 0 40.0
Bag & Mask 0 0 0 0 1 1 1 0 1 0 0 1 71.4
Suction Machine 0 0 1 0 1 0 0 0 0 0 0 0 66.7
Thermometer 1 1 0 0 1 1 1 0 0 1 0 100.0
BP Apparatus 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Weighing Machine 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Height Measuring Scale 1 0 0 0 0 1 1 0 0 1 0 0 100.0
Reagent Strips for Urine
Test 0 1 0 0 0 0 0 0 0 1 1 0 100.0
Cuscos Speculum 0 1 1 1 0 1 1 0 1 0 1 1 88.9
Mucus Extractor 0 1 1 0 1 1 0 0 0 0 0 0 66.7
Fetoscope 1 1 1 1 1 1 1 1 1 1 1 1 100.0

In 92 percent of the sub-centres ORS is available. Disposable Gloves, Oral Pills

and Iron / Folic Acid are available in 58 percent of the sub-centres. IUD is available in
fifty percent of the sub-centre. Syrup cotrimoxazole and Syrup paracetamol are available
in 42 percent of the sub-centre. Disposable delivery kit, emergency contraceptive pills,
Tablet Flus Canazode Vagiral, Misoprostal, and Cipro floxacin, vitamin A and pregnancy
test kit are not available in the sub-centers (Table S8).

52
 Table S8: Status of availability of drugs

Sub Centre percent of

CHC1-Chellampatti CHC2-Samayanallur Sub
PHC1 PHC2 PHC1 PHC2 Centres
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti reporting
Type of Drugs
availability

Sakkarappanayaka
Available (Yes:1;

Nallaperumalpatty

Nedumuthalaikula

Kodimangulam
Pillayarnatham
of drug on

Boothipuram
P.Methupatti

Thirupalai
Chatrapathi
o:0)

Thodaneri
Kannanur

Athalai
date of

m
1

3
1

2
3

3
n
survey

Iron/ Folic Acid 0 1 1 0 0 0 1 1 1 1 1 0 58.3

Disposable Delivery
Kit 0 0 0 0 0 0 0 0 0 0 0 0 0
Oral Pills 0 0 0 0 0 1 1 1 1 1 1 1 58.3
Emergency
Contraceptive pills 0 0 0 0 0 0 0 0 0 0 0 0 0
Condoms 0 0 0 0 0 0 1 1 0 1 1 0 33.3
IUD 0 0 1 0 0 0 1 1 1 1 1 0 50.0
ORS 1 1 1 1 1 0 1 1 1 1 1 1 91.7
Tab. Flucanazole
Vaginal 0 0 0 0 0 0 0 0 0 0 0 0 0
Tab. Misoprostal 0 0 0 0 0 0 0 0 0 0 0 0 0
Partograph 0 0 0 0 0 0 0 0 0 1 0 0 8.3
Pregnancy Test Kit 0 0 0 0 0 0 0 0 0 0 0 0 0
Syp Cotrimoxazole 0 0 0 1 1 0 0 1 0 1 1 0 41.7
Syp Paracetamol 0 0 0 1 1 0 0 1 0 1 1 0 41.7
Vi. A 0 0 0 0 0 0 0 0 0 0 0 0 0
Tab Ciprofloxacin 0 0 0 0 0 0 0 0 0 0 0 0 0
Disposable Gloves 0 0 1 0 1 1 1 1 0 1 0 1 58.3

Table S9 explains the availability of specific skits / procedures reported by the sub-
centres. All most all the sub-centres have registers on pregnancy within three months,
reports on 3 ANC visits as per the RCH schedule (1st: 6th month, 2nd : 7th month, 3rd : 9th
month) identification of high risk pregnancies, IUD insertion / removal and immunization
services (100 percent). Eight-three percent of the sub-centre have registers on provision
for TT, IFA etc. In eighty-three percent of the sub-centres ANM were trained on
syndomic treatment of RTI/STI. In eight percent of the sub-centres IUCD insertion being
carried out by using IUDA 380, 17 percent of the sub-centres carried out speciafic
examinations like blood pressures, Hemoglobin and Urine analysis. Regular supply of
IUDS 380 is not reported.

53
 Table S9: Status of Specific Skills and Procedures
Sub Centre percent of
Sub
CHC1-Chellampatti CHC2-Samayanallur Centres
PHC1 PHC2 PHC1 PHC2
reporting
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
Type of Skills/ Procedure availability

Sakkarappanayaka
Nallaperumalpatty

Nedumuthalaikula
of specific

Kodimangulam
(Yes: 1; o: 0)

Pillayarnatham
Boothipuram
P.Methupatti

Thirupalai
Chatrapathi
skills/

Thodaneri
Kannanur

Athalai
procedure

m
1

3
1

2
3

3
n
Register pregnancy within
three month 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Carry out 3 ANC visits as
per the RCH schedule (1st:
6th month, 2nd: 7th month,
3rd: 9th month) 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Carry out specific
examinations like Blood
Pressure, Hemoglobin and
Urine 0 0 0 0 0 0 0 0 1 0 0 1 16.7
Provision of TT, IFA etc. 1 1 0 0 1 1 1 1 1 1 1 1 83.3
Identification of High Risk
Pregnancies 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Is the ANM carrying out
IUCD insertion/ removal 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Is IUCD insertion being
carried out using IUD
A380 1 0 0 0 0 0 0 0 0 0 0 0 8.3
Is the supply of IUD A380
regularly available 0 0 0 0 0 0 0 0 0 0 0 0 0
Has the ANM been trained
on the insertion/ removal
of IUD A380 1 0 0 0 0 0 0 0 0 0 0 0 8.3
Is the ANM trained in
syndromic treatment of
RTI/ STI? 0 1 0 1 1 1 1 1 1 1 1 1 83.3
Immunization services 1 1 1 1 1 1 1 1 1 1 1 1 100.0

Table S10 shows the services out come of the sub-centres based on the last three
months. On an average 25 ANC’s were registered in the selected sub-centres during the
last three months. Among them 18 were registered in 1st trimester. Sixteen were given 3
ANC visit as per the RCH schedule. During 2007-08, 12 IUCD insertions were carried
out. Two neonatal infection were identified and referred. Six pregnancies were referred
and attended by the next higher facility. Three high risk cases were identified.

54
 Table S10: Service Outcome (Based on data for last 3 months)
Sub Centre Average
CHC1-Chellampatti CHC2-Samayanallur per Sub
PHC2- Centre
PHC1- PHC2- PHC1-
Kancharampett
Thummakundu Vikkramangalam Koilpappakudi
i
Indicator

Sakkarappanayakan
Nallaperumalpatty

Nedumuthalaikula

Kodimangulam
Pillayarnatham
Boothipuram
P.Methupatti

Thirupalai
Chatrapathi
Thodaneri
Kannanur

Athalai
m
1

2
1

3
Total ANC registered 23 25 22 27 21 22 8 19 10 33 25 63 25
Out of total ANC,
number registered in 1st
trimester 18 6 16 18 12 22 8 17 7 27 13 48 18
No. given 3 ANC visits
as per the RCH schedule 18 20 17 25 5 6 7 10 11 7 13 50 16
No. of High Risk Cases
identified 4 4 4 3 0 3 2 2 1 6 2 7 3
Deliveries conducted by
ANM at Sub Centre 0 0 0 0 0 0 0 0 0 0 0 1 *
Pregnancies referred and
attended by the next
higher facility 15 13 2 3 2 3 3 13 1 6 8 7 6
No. of neonate
infections identified and
referred 0 0 1 0 0 15 0 1 0 2 0 0 2
No. of IUCD insertions
in 2007-2008 17 21 7 22 2 2 11 12 11 7 16 18 12

Household survey register, antenatal register, family planning register, birth &
death register, immunization register, JSY register, Untied funds register and cash book
were maintained in all the sub-centres. Eighty-three percent of the sub-centres
maintained antenatal register and post natal care registers. Sixty-seven percent
maintained meeting registers (Table S11).

55
 Table S11: Status of Record Maintenance
Sub Centre percent
CHC1-Chellampatti CHC2-Samayanallur of SCs
PHC2- reportin
PHC1- PHC2- PHC1- g
Kancharampett
Thummakundu Vikkramangalam Koilpappakudi
Type of Records i mainten
maintained ance of

Nedumuthalaikulam

Sakkarappanayakan
Nallaperumalpatty

Kodimangulam
Pillayarnatham
(Yes:1; o:0) record

Boothipuram
P.Methupatti

Chatrapathi

Thirupalai
Thodaneri
Kannanur

Athalai
1

2
1

3
Household Survey
Register 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Ante Natal Register 1 1 0 1 1 1 1 1 1 1 1 0 83.3
Eligible Couple Register 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Post Natal Care Register 1 1 0 1 1 1 1 1 1 1 1 0 83.3
Family Planning
Register 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Birth & Death Register 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Immunisation Register 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Meeting Register 0 1 1 0 1 1 1 1 0 0 1 1 66.7
JSY Register 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Untied Funds Register 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Cash Book 1 1 1 1 1 1 1 1 1 1 1 1 100.0

Table S12 A: Status of Awareness of AM about JSY Scheme

AM’s awareness about JSY umber of AMs
Interviewed Reporting
Awareness
Aware about JSY 12 12
Aware about amounts to be given to beneficiaries 12 12
ANM reporting increase in demand for 12 12
Institutional delivery after implementation of JSY
Scheme

Table S12A indicate that all the twelve ANM’s had awareness on JSY and the
amount given to beneficiaries under JSY. All the 12 ANM’s reported that three is an
increase in demand for institutional delivery after implementation of JSY scheme.

56
Table S12 B: Status of procedure under JSY Scheme

percent of AMs according to

AM's awareness about JSY
response
Funds being paid to beneficiaries by
Cash 0
Cheque 100.0
Vouchers 0
Average time taken after birth for JSY payment to
beneficiary
Less than 1 Week……..1 0
1 - 2 Weeks …………..2 0
More than 2 Weeks…...3 100.0
Transport for shifting of cases available from Sub
Centre to PHC/ CHC 66.7
Register available for recording of JSY expenditure 100.0
Total no. of AMs interviewed 12

Table S13A shows that all the ANMs said that funds under JSY scheme was paid
to the beneficiaries by cheque (100 percent). Average time taken after birth for JSY
payment to beneficiary was more than three weeks (100 percent), 67 percent of the
ANMs had aware about transport for shifting of cases available from sub-centre to PHC /
CHC. Register was available for recording of JSY expenditure (100 percent).

Table S13 shows that status of performance of ANM under JSY scheme. During the last
three months on an average 17 cases were registered under JSY scheme and it ranged
from 6-36. Among these 15 were resulted as institutional deliveries with a range of 5-33.
An average amount of Rs.8,142 was disbursed during the last three calendar months for
JSY cases. One hundred and sixty seven home deliveries and 20,050 institutional
deliveries were reported during the last three months and Rupees 1,132 was spent for
transport costs. Home deliveries were reported in Pillayanatham and Thodaneri sub-
centre village.

57
 Table S13: Status of performance of AM under JSY Scheme
Sub Centre Average
per Sub
CHC1-Chellampatti CHC2-Samayanallur Centre
PHC1- PHC2- PHC1- PHC2-
Performance of Thummakundu Vikkramangalam Koilpappakudi Kancharampetti
AM under JSY

Sakkarappanayaka
Nallaperumalpatty

Nedumuthalaikula

Kodimangulam
Pillayarnatham
Scheme

Boothipuram
P.Methupatti

Chatrapathi

Thirupalai
Thodaneri
Kannanur

Athalai
m
1

3
1

n
Total cases of JSY
registered in last 3
calendar months 30 23 36 33 21 11 8 10 12 13 6 6 17
Total number of
JSY cases resulted
in Institutional
deliveries in last 3
months 30 23 16 33 21 11 8 10 5 13 6 6 15
Total cash
disbursed in last 3
calendar months
for JSY cases (Rs.) 1,400 15,100 11,200 7,000 13,300 8,400 10,500 14,700 9,800 - 6,300 - 8,142
Out of total
amount disbursed,
the amount
disbursed on the
following
Home Deliveries
(Rs.) 0 0 0 0 0 0 0 1,500 500 0 0 0 167
Institutional
Deliveries (Rs.) 18,200 19,600 18,200 18,900 38,300 32,900 16,800 18,900 10,500 35,700 7,000 5,600 20,050
Transport Costs
(Rs.) 2,000 800 600 450 0 750 100 500 4,500 2,380 1,200 300 1,132

Status of untied grants in the sub-centre was explained by Table S14. All the 12
sub-centres were received untied grant, reported expenses from untied grant, ANM
having a joint account with the sarpanch / any other GP functionary, maintain registers to
record the decisions taken to spend the untied funds. All the sub-centres have written
record of transactions being carried out on untied funds. Ninety-two percent of the sub-
centres reporting that sarpanch / other reviewed the expenditure of Untied fund.

58
 Eight percent of the untied grant was spent on purchase of drugs. Fifty percent
each for arranging transport and paying of power / telephone bills and sixty-seven percent
was spent for other purposes like white wash and maintenance etc.,
Table S14: Status of Untied Grants
Sub Centre perce
CHC1-Chellampatti CHC2-Samayanallur nt of
PHC1- PHC2- PHC1- PHC2- Sub
Thummakundu Vikkramangalam Koilpappakudi Kancharampetti Centr
es
Status of Untied Grants (Yes:1;

Sakkarappanayakan
Nallaperumalpatt

Kodimangulam
Pillayarnatham
Nedumuthalaikula
Boothipuram
P.Methupatti

Chatrapathi
o:0)

Thirupalai
Thodaneri
Kannanur

Athalai
m
1

3
1

3
y
Sub Centre received Untied Grant 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Sub Centre reported expenditure
from Untied Grant 1 1 1 1 1 1 1 1 1 1 1 1 100.0
ANM having a joint account with
the Sarpanch/ any other GP
functionary 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Sub Centre reporting maintenance
of register to record the decisions
taken to spend this amount 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Sub Centre reporting written
record of transactions being
carried out on Untied funds 1 1 1 1 1 1 1 1 1 1 1 1 100.0
Sub Centre reporting that
Sarpanch/ others ever reviewed
the expenditure records 1 1 1 0 1 1 1 1 1 1 1 1 91.7

59
 CHAPTER – 6

HOUSEHOLD CHARACTERISTICS

CHARACTERISTICS OF THE RESPODETS

Two-fifth (40 percent) of the respondent were below 30 years. One-fourth (25
percent) were 30 – 39 years old. The percentage of respondents above 40 years accounts
35 percent of the sample population, i.e., 16 percent were in 40 –49 years, ten percent
belongs to 50 –59 years. Only nine percent were 60 or more years. Majority of the
respondents were female (87 percent). One-third of the study population is illiterate.
One-fourth (25 percent) of them completed 1 – 5 years of schooling and 24 present
completed 5 – 9 years of schooling. Only 17 percent had 10 or more years of schooling.
Currently married constitute a major proportion of the study population (86 percent).

Table H1. Characteristics of the respondents

Percent distribution of respondents by background characteristics
Characteristics of the respondents Percent
Age
< 30 years 40.8
30-39 years 24.3
40-49 years 15.7
50-59 years 10.2
60 years or more 9.1
Sex
Male 12.6
Female 87.4
Years of Schooling
IIiterate 33.9
1-5 Years 24.1
5-9 years 25.4
10 years of more 16.6
Marital status
Unamrried 3.3
Currently Married 85.8
Divorced/Separated 0.8
Widowed 10.1
Total number of respondents 1,200

Table H2 explains the characteristics of the selected households. A higher

proportion of the households belongs to OBC (66 percent) and the remaining were SC
(34 percent). All most all the households belongs to Hindus (99 percent).

60
Table H2. Characteristics of the household
Percent distribution of household by their background characteristics
Characteristics of the household Percent
Social category
SC 34.2
ST -
OBC 65.8
Others 0.1
Religion
Hindu 98.7
Muslim 0.4
Christian 0.9
Sikhs -
Other -

Households having BPL status 8.8

Household living in pucca house 30.8
Households with electricity 93.7
Households with toilet facility 12.8
Households with piped water supply 24.4
Households using LPG/Biogas for cooking 17.8
Household with own agricultural land/cultivating any agricultural land 32.0
Households own a colour / B&W television 83.8
Households have a mobile phone 38.2
Households with low standard of living index 33.7
percent of children born in Health Institutions during last 5 years
Total number of respondents 1,200

Nine percent of the households have BPL status. Thirty-one percent of were
living in pucca house. Ninety-four percent of the houses were electrified. Thirteen
percent had toilet facility. Twenty-four percent of the households had piped water
supply. Eighteen percent of the households using LPG / Biogas for cooking. Thirty-two
percent of the households had own agriculture land. Eighty-four percent of the
households owned a colour / B&W television. Thirty-eight percent have a mobile phone.
Thirty-four households were belongs to low standard of living index.

Table H3 explains the percentage distribution of households by their waste

disposal, stagnation of waste water and mosquito breeding around the house and the
system of medicine preferred by them. Nine-eight percent of the households thrown out
the waste in the open. Only one percent burnt the wastages. There is no difference in
waste disposal between the households located in sub-centres, head quarter village and
households located in other villages. In five-five percent of the households, the
interviewer observed that wastewater is stagnated around the house. More number
households located in sub-centre head quarter villages (58 present) were surrounded by

61
waste water than villages away from sub-centre. In all the households mosquito breeding
was observed in the stagnated water (100 percent). All most all the households preferred
allopathic system of medicine (100 percent).

Table H3: Percent distribution of households by their waste disposal, stagnation of

waste water and mosquito breeding around the house and system of medicine
preferred by them

Waste disposal, stagnation of waste water Households

Households
and mosquito breeding and system of located in Sub
located in other All
medicine preferred Centre HQ
village
Village
Method of waste disposal by the household
Thrown in the open 98.0 97.0 97.5
Buried in a pit 0.5 1.3 0.9
Burnt 1.3 1.5 1.4
Other 0.2 0.2 0.2
Stagnation of waste water around the household
(Stagnation of waste water observed by the
interviewer ) 57.8 52.8 55.3
Instance of mosquito breeding in the stagnant
water ( among the households where stagnation of
water is observed) 99.4 99.7 99.5
System of medicine preferred:
( Multiple answer )
Allopathic 99.7 100.0 99.8
Ayurveda 0.2 0.2 0.2
Yoga and Naturopathy 0 0.2 0.1
Unani 0 0 0
Siddha 0.5 0.2 0.3
Homeopathy 0.5 0 0.3
Traditional healing 0.7 0.2 0.4
Any other 0 0 0
None 0 0 0
Total umber of Households 600 600 1,200

Information about availability of health worker, health facilities and transport

used to take serious patients to the health facility is explained in table H4. Almost all the
respondents in the selected households heard about ANM. Nineteen percent heard about
male health worker. More number of respondent in the sub-centre head quarter villages
(24 percent) were heard about male health worker than respondent belongs to non-sub-
centre village (18 percent). Only twenty-three percent of the respondents says that health
worker visited to their home in the last one months, this percentage is more in households
located in sub-centre head quarter village (28 percent) than in other village (19 percent).
Twenty-eight percent of the respondents says that health worker is available whenever

62
they need. Availability of health worker at the time of need is more in sub-centre head
quarter village (35 percent) than in other villages (21 percent).
Table H 4. Percent distribution of household respondents by their information
about availability of health worker, health facilities and transport used to take
serious patients
Households
Households
Information about health worker and health located in Sub
located in All
facilities Centre HQ
other village
Village
Availability of health workers
Heard about ANM 100.0 99.2 99.6
Heard about male health worker 23.7 13.2 18.4
Visited by a Health Worker in last one month 27.8 18.8 23.3
Health worker available when need 34.7 20.3 27.5
Available health facility to the households, when
required (multiple responses)
RMP 2.8 2.5 2.7
Private clinic / NGO 39.3 38.8 39.1
Sub Centre 17.5 1.5 9.5
PHC 69.5 72.7 71.1
CHC 9.8 14.5 12.2
Other 38.3 48.8 43.6
Facilities for which serious patients are taken,
when required ( multiple response)
RMP / Private Clinic 28.5 27.5 28.0
NGO hospital Clinic 2.5 2.2 2.3
PHC 33.8 33.3 33.6
CHC 6.3 6.0 6.2
District / Sub Divisional Hospital 82.3 86.7 84.5
Other 3.5 1.0 2.3
Mode of transport used to take serious patients,
when required ( multiple responses)

Bus 5.8 3.0 4.4

Private vehicle 92.8 96.7 94.8
Ambulance 1.5 0.2 0.8
Other 0 0.3 0.2
Total number of household respondents 600 600 1,200

For majority of the respondent PHC (71 percent) is the available health facility to
their households, for 39 percent private clinic/NGO is easily available. Twelve percent
said CHC is the available facility for them. Forty-four percent depending on other
facility. Sub-center is the available health facility for one-tenth of the households (10
percent), the percentage informed about availability of sub-centers were more in head
quarters village (18 percent) than households located in other villages (2 percent).

Majority of the serious patient are taken to district / sub divisional hospital (85
percent) when required. Thirty-four percent were taken to PHC and 28 percent to RMP /

63
 Private clinic. Private vehicle (95 percent) is the main mode of transport used to take
serious patients followed by bus (4 percent).

Table 5. Percent distribution of household respondents by their knowledge about

RHM, ASHA and her activities, VHD, VHSC and JSY
Households Household
located in s located in
RHM,ASHA and JSY
Sub Centre other
All
HQ Village village
Heard of RHM 95.0 93.0 94.0
If heard of RHM, Source of information about RHM (multiple
responses)
ASHA NA NA NA
Radio/television 37.7 30.3 34.0
Newspaper 4.4 2.7 3.5
Panchayat 0.7 0.5 0.6
Community member 29.5 27.4 28.5
Other 63.5 69.2 66.3
Heard about ASHA NA NA NA
ASHA and her activities, VHD and VHSC NA NA NA
ASHA carries a kit NA NA NA
ASHA provides common medicine free of cost NA NA NA
ASHA held discussion about hand washing NA NA NA
ASHA held discussion about construction of household toilets NA NA NA
ASHA held discussion about safe drinking water NA NA NA
Village Health and Nutrition Day being organized in the village 3.2 2.7 2.9
Presence of village health and Sanitation Committee in the
village 18.5 1.8 10.2
Frequency of Village Health and utrition Day
Weekly - - -
Monthly 36.8 62.5 48.6
Quarterly 15.8 6.3 11.4
Annual 47.4 31.3 40.0
Aware about the JSY scheme 97.3 97.2 97.3
If aware about JSY, source of information about the JSY (multiple
options)
Radio / Television 23.6 20.1 21.9
Pamphlets 0.9 0.3 0.6
Hoardings at SC / PHC etc 6.5 3.4 5.0
ASHA worker NA NA NA
Anganwadi Centre / Worker 6.2 9.8 8.0
ANM 64.2 57.8 61.0
Doctor 0.3 0.3 0.3
Gram Panchayat 0.9 0.5 0.7
NGOs / SHGs 3.1 2.2 2.7
Others 46.1 58.5 52.3
Household beneficiary of JSY scheme 16.8 12.0 14.4
Total number of household respondents 584 583 1,167
NA- Not Applicable
Table 5 shows the respondents knowledge about NRHM, VHND, VHSC and
JSY. Ninety-four percent of the respondents heard about NRHM. Radio / television (34
percent), community Member (29 percent) were the sources of information for NRHM.

64
Only three percent of the respondents known about the village health and nutrition day
organized in the village. Only ten percent were aware about the presence of village
health and sanitation committee in the village. Awareness of village health and sanitation
committed is more in households located in sub-centres village (19 percent) than in other
villages (2 percent).

Knowledge about the frequency of village health and nutrition day was less.
Forty-nine percent of the respondent said that village health and nutrition day was
celebrated by weekly. Forty percent said it is quarterly. Eleven percent said frequency of
village health and nutrition day was monthly.

Ninety-seven percent of the respondents had awareness about JSY scheme the
main source of awareness is ANM (61 percent) followed by radio / television (22
percent), Anganwadi centre / worker (8 percent), Hoarding at SC / PHC at (5 percent)
and NGO’s / SHG’s (3 percent). Fifty-two percent heard through other source. Among
them 14 percent were beneficiaries of JSY scheme, and the percentage of beneficiaries is
17 percent in sub-centres head quarter village and 12 percent in other village.

REGISTRATIO OF JSY BEEFICIARIES

Table H7 explains the timing, person, and place of registration for JSY scheme.
Majority (90 percent) of the women heard about JSY during pregnancy. Only ten percent
heard before being pregnant. Eighty-eight percent of the beneficiaries got registered for
JSY scheme in the 5th month or later. Nine percent registered in the 3rd month of
pregnancy. The percentage of women registered in the 2nd and 4th month of pregnancy
were one and two percent respectively. ANM (92 percent) is main person who registered
the beneficiary for JSY scheme. The contribution of LHV (5 percent) and Anganwadi
worker (2 percent) is less.

65
Table H6. Percent distribution of JSY beneficiaries by their background characteristics
Characteristics of JSY beneficiaries Percent
Age
< 20 years 5.4
20-24 years 55.4
25-29 years 31.5
30-34 years 6.0
35-39 years 1.8
40-44 years -
45-49 years -
Parity
0 -
1 0.6
2 31.0
3 & 3+ 68.5
Social category
SC 46.4
ST -
OBC 53.6
Others -
Religion of the household
Hindu 99.4
Muslim -
Christian 0.6
Sikhs -
Other -
SLI of the household
Low 34.5
Medium 44.0
High 21.4
BPL household 9.5
Place of last delivery (delivery previous to this delivery)
Household 1.2
Health Institution 98.8
Total number of JSY beneficiaries interviewed 168

PHC (60 percent) is the place where most of the beneficiaries registered for JSY
scheme followed by sub- centre (26 percent) and anganwadi centre (13 present).

66
Table H7. Timing, person place of registration for JSY scheme
Timing, place of registration for JSY card scheme and JSY card Percent
Timing of hearing about JSY scheme
Before being pregnant 9.8
During pregnancy 90.2
Stage of pregnancy when beneficiary got registered for JSY scheme
1st month 0
2nd month 0.8
3rd month 9.2
4th month 2.3
5th month or later 87.8
Person who registered the beneficiary for JSY scheme
Doctor 0.6
LHV 5.4
ANM / FHW 91.7
Anganwadi worker 2.4
ASHA worker 0
Others 0
Place where the beneficiary was registered for JSY scheme
District/Sub-DIstrict Hospital 0.0
Community Health Centre 0.0
PHC 60.1
Sub-Centre 26.2
Anganwadi Centre 13.1
Pvt. Hosp. accredited by the Govt. 0
At home 0.6
Other places 0
Total number of JSY beneficiaries 168

JSY Card
Table H8 detailed the receipt of JSY card, role of ASHA in getting JSY card and
difficulties faced by the beneficiaries in getting the JSY card. Five percent of the
beneficiaries received JSY card. Beneficiaries were not facing any difficulty in getting
JSY cars.
Table H8. Receipt of JSY card, role of ASHA in getting JSY card and difficulties
faced by the beneficiary in getting the JSY card
JSY Card Percent
JSY card received by the beneficiary 4.8
ASHA worker helped the beneficiary in getting JSY card NA
Beneficiary faced difficulty in procuring JSY card 0
If faced difficulty, type of difficulties faced by beneficiary (multiple options)
Cards were not available 0
Formalities for making card were too cumbersome 0
Was asked to pay money for the card 0
Other difficulties 0
Total number of JSY beneficiaries 168
In Tamil Nadu ASHA was not appointed. Information on micro birth planning
such as date of expected delivery (83 percent), date of next checkup (85 percent), place of
next checkup (70 percent), place of delivery (56 percent) and place of referral, if

67
complications arise (11 percent) were given to the beneficiaries by the doctor / ANM
during antenatal check-up (Table H9).
able H 9. Role of ASHA during the pregnancy of the beneficiaries

Role of ASHA during the pregnancy of the beneficiaries Percent

ASHA worker provided specific help during pregnancy for the following
(multiple options) 0
Beneficiary received advice from ASHA 0
Diet
Danger signs 0
Delivery Care 0
Breastfeeding 0
Newborn care 0
Family Planning 0
Not applicable (ASHA not appointed in the village) 100.0
Information given to the beneficiary ( Micro Birth Planning) during
antenatal period by doctor / AM / ASHA (multiple options)
Date of next check-up 85.1
Place of next check-up 70.2
Date of expected delivery 83.3
Place of delivery 56.0
Place of referral, if complications arise 11.3
Total number of JSY beneficiaries 168

Table H10 denotes the place of delivery and reason for opting institutional
delivery. One-half of the deliveries took place in district / sub-district hospital
(52 percent) followed by PHC (29 percent), private hospital (11 percent) community
health centre (5 percent) and home (3 percent).
Table H 10. Place of delivery and reason for opting institutional delivery
Place of delivery and reason for opting institutional delivery Percent
Place of delivery
District / Sub-District Hospital 52.1
Community Health Centre 4.8
PHC 28.7
Sub-Centre -
Trust / NGO Hospital -
Private Hospital 10.8
Private Hospital accredited by the Govertment 0.6
At home 3.0
Reasons for opting Institutional Delivery ( multiple reasons)
Money available under JSY scheme 3.7
Better access to institutional delivery 10.5
Better care for mother and new born child 89.5
Services in the area 4.9
Support provided by ASHA NA
Availability of transport assistance -
Previous child was born in an institutions 18.5
Other 1.2
Total number of JSY beneficiaries 162
Note: NA-Not applicable

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 Better care for mother and new born child (90 percent) is the main reason for
opting institutional delivery. The reasons such as previous child was born in institution
(19 percent), better access to institutional delivery (11 percent), services with in the area
(5 percent), money available under JSY (4 present ) were the reasons mentioned by the
JSY beneficiaries, for opting institutional deliveries (Table H 10).

Table H 11. Transport of the beneficiaries to reach the Health Institution

Process of Transport Percent
Received referral slip from ASHA / health personnel to access delivery services 2.5
Faced difficulty in reaching Health Institution 5.6
If faced difficulty, type of difficulties faced in reaching the Health institution by the
beneficiaries (multiple options)
It was late in the night 22.2
Did not have insufficient money 0
Transport was not immediately available 77.8
Male members in the household were not present 11.1
ASHA was not readily available NA
Others 0
Average distance to the ultimate place of delivery from the beneficiary residence (in kms) 10.7
Mode of transport used by the beneficiary to reach the ultimate place of delivery
Government Ambulance 0.6
Private Vehicle 80.9
Vehicle arranged by Local Health Committee 0
Others 18.5
Persons facilitated in arranging the transport
ASHA 0
ANM 1.3
Village Health Committee 0
Others 98.8
Beneficiary had money to pay for the transport services 97.5
Average amount spent on transport (in Rs.) 0
Average amount of transport assistance received under JSY scheme by the beneficiary (in
Rs.) 164.7
Cases where amount spent on transport is more than the amount
Received
Person accompanied the beneficiary to the health institution
ASHA NA
Relatives 98.1
Mother / Mother-in-Law -
Husband -
ANM / health Worker -
Others 1.9
Total number of JSY beneficiaries 162
ote:A-ot applicable

Three percent of the women received referral slip from health personnel to access
delivery services. Six percent faced difficulty in reaching health institution. The
difficulties faced by the beneficiaries is the non availability of transport (78 percent), and
absence of male members in the households (11 percent) and other reasons such as it was

69
late in the night (22.2 percent) was also reported. The average distance to the ultimate
place of delivery from the beneficiaries residence is 11 kms. Private vehicle (81 percent)
is the mode of transport used by the beneficiary to reach the ultimate place of delivery.
Village health committee (99 percent) facilitating the arrangements for transport. Ninety-
eight percent of the beneficiaries had money to pay for the transport services. The
average amount of transport assistance received under JSY scheme by the beneficiaries is
Rs.165. Ninety-eight percent of the beneficiaries were accompanied by their relatives to
the health institution (Table H11).

Table H12 explains the waiting time at the health facility, type of delivery, amount spent
at the health facility and satisfaction regarding services available in the health facility.
Average waiting time at the facility until some one attend the beneficiaries is nine
minutes. More than three-fourth of the beneficiaries (78 percent) had normal delivery.
Two-fifth were caesarean section delivery (20 percent) and only two percent were
assisted (Forceps, Vacuum) delivery. Average number days spent in the facility till
discharge was four. Thirty-six percent of the beneficiaries said they paid at the health
centre. An average amount Rs.2,667 was paid at the health centre. Ninety-seven percent
of the beneficiaries were satisfied about the services available in the health centre. Rude
behaviour of the staff was the only reason for the dissatisfaction of the services provided
in the health centres. Only five home deliveries were reported (Table H13).
Table H 12. Waiting time at the health facility, type of delivery, amount spent at the
health facility and satisfaction regarding services available in the health facility
Waiting time, type of delivery and satisfaction regarding services Percent
Average waiting time at the facility until someone attended the beneficiary (in
minutes) 8.6
Type of delivery ( Percent )
Normal 78.4
Assisted (Forceps, Vacuum) 1.9
Caesarean 19.8
Average number of days spent in the facility till discharge 4
Percent beneficiary who have to pay at the health centre 36.4
Average amount paid at the health centre (Rs.) 2667
Satisfaction regarding the services available in the health center (Percent)
Satisfied 95.7
Somewhat satisfied 3.7
Not satisfied 0.6
Reason for non satisfied with the services in the health center (Percent)
Staff was rude 100.0
Facility was not clean -
Poor quality of services -
Others -
Total number of JSY beneficiaries 162

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Table H13. Reason for the JSY beneficiary to opt home delivery, in spite of cash
incentives being available under the JSY
Reason for the beneficiary to opt home delivery Percent
Reasons for home delivery (multiple options)
Home delivery is more convenient 20.0
Fear of stitches / caesarean -
Indifferent behaviour of medical / paramedical staff -
Cultural / social reasons -
Transport not being available -
Can't afford -
Others 80.0
Total number of JSY beneficiaries under Home Delivery 5

Table H.14 Cash incentive received by the beneficary under JSY scheme
Case incentive Percent
Beneficiary received cash incentive under JSY scheme 68.9
Total number of JSY beneficiaries 167
Average amount received by beneficiary as cash incentive 698.3
Received the cash incentive
In one go 100.0
In 2-3 installments -
Timing of the receipt of the cash incentive by beneficiary
At the time of registration -
At the time of antenatal check up -
Much before the delivery -
Within a week before the EDD 0.9
Immediately after the delivery -
Within a week after the delivery 3.5
Much later 95.7
Not received yet -
Do not know/ Husband knows -
Other -
Person who delivered the cash incentive to the beneficiary
Doctor 8.7
LHV 17.4
ANM/FHW 73.0
Anganwadi worker 0.9
ASHA worker -
Other -
Place where the cash incentive received by the beneficiary
District/Sub-District Hospital 0.9
Community Health Centre 13.0
PHC 70.4
Sub-Centre 11.3
Anganwadi Centre 2.6
Private Hospital accredited by the Government -
At home 1.7
Other place -
Faced difficulty in getting incentive money 5.2
If faced difficulty, type of difficulty faced by the beneficiary
Was asked to pay the bribe 83.3
Was paid by cheque / draft 16.7
Others -
Total number of JSY beneficiaries 6

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Table H14 explains the cash incentive received by the beneficiary under JSY scheme.
Sixty-nine percent of the beneficiaries received cash incentive under JSY scheme. An
average amount of Rs.698 was received by the beneficiary as cash incentive under JSY
scheme, and the amount is received in one go.

Majority of the women received the cash long time after the delivery (96 percent).
ANM / FHW delivered the cash incentive to the beneficiary (73 percent), followed by
LHV (17 percent) and doctor (9 percent). The cash incentive was received by the
beneficiary at the PHC (70 percent), CHC (13 percent), sub-centre (11 percent) and
anganwadi centre (3 percent). Five percent of the beneficiaries feported difficulty in
getting incentive money. The difficulties faced by the beneficiaries is bribe (83 percent)
and the cash was paid by cheque / draft (17 percent).

During the last six months, sixty-five percent of the households in the selected
villages availed health services in Government health facility (Table H15). There is not
much variation between households located in the sub-centre village (64 percent) and
other villages (65 percent).

Table H 15. Utilization of government health facility in last 6 months

Households located Households
Utilization of government health
in Sub Centre HQ located in other All
facility
Village village
Percent of household who availed health
services in government health facility in
last 6 months 64.2 65.0 64.6
Total number of households 600 600 1,200

Table H16 explains the characteristics of the respondents who have availed the
services in Government health facility in last six months. Two-fifth of the respondents
were in the age group of 20-29 years (40 percent) and one-fifth (21 percent) were 30-39
years. Majority of the users (65 percent) were less than 40 years. Females constitute the
major proportion of users (88 percent). Non-literate (36 percent) and respondent with 1-5
years of education (23 percent) and 6-9 years (27 percent) were the main users of
Government health facility. Currently married (86 percent) were the prime users of
Government health facility. Other backward caste (61 percent) were the prime users of
Government health facility followed by scheduled caste (39 percent). One-tenth of the

72
users were BPL households (10 percent). Medium (44 percent) and low SLI (37 percent)
households were mainly used Government health facility than high SLI (19 percent)
households.

Table H. 16 Characteristics of the respondents who have availed the services in

government health facility in last 6 months
Characteristics of the respondent Percent
Age
<16 years -
16-19 years 3.7
20-29 years 40.1
30-39 years 21.0
40-49 years 14.2
50-59 years 10.5
60 years or more 10.5
Sex
Male 12.3
Female 87.7
Years of schooling completed
Illiterate 36.1
1-5 years 23.4
6-9 years 26.8
10+ years 13.7
Marital status
Unmarried 3.0
Currently married 85.9
Divorced/Separated 0.5
Widowed 10.6
Social category of the household
SC 38.7
ST -
OBC 61.2
Others 0.1
Religion of the household
Hindu 98.5
Muslim 0.4
Christian 1.2
Sikhs -
Other -
BPL Household 10.2
Standard of Living Index of the household
Low SLI 37.2
Medium SLI 44.3
High SLI 18.6
Total respondents who have availed the services in government
health facility in last 6 months 775

Table H17 denotes the type of health facility visited, purpose of visit and client
satisfaction regarding behaviour of health worker, privacy and availability of medicines.
Fifty-five percent of the respondent availed the services at the PHC, and 38 percent

73
utilized district / sub-district hospitals. Services availed at CHC (5 percent) and sub-
centre (3 percent) is very meager.
Table H.17 Type of health facility visited, purpose visit and client satisfaction
regarding behaviour of health worker, privacy and availability medicines
Type of health facility visited, purpose visit and client satisfaction Percent
Type of health facility where service availed
District/ Sub district hospital 37.8
CHC 4.5
PHC 54.7
Sub Centre 3.0
AYUSH -
Purpose of visit to health facility
Treatment of minor ailment 67.0
ANC care 5.4
Child care 14.6
Immunisation 2.5
Other 10.6
Behaviour of staff at health facility
Courteous 88.6
Causal/Indifferent 11.0
Insulting/Derogatory 0.4
Listening of complaints by Doctor/staff
Listened to complaints 84.0
Somewhat listened 14.6
Not listened 1.4
Cannot say -
Women patient were treated in privacy
Yes 89.5
No 6.2
Don’t know 4.3
Patients with chronic disease get regular medicines from health facility
Yes 91.0
No 2.5
Don’t know 6.6
Private practice of the doctors during and after the duty hours
Yes 9.4
No 29.7
Don’t know 60.9
Satisfied with overall services and staff of Govt Health Facility
Satisfied 77.9
Somewhat satisfied 19.4
Not satisfied 2.7
Satisfied with the behaviour of staff at Govt. Health Facility
Satisfied 77.8
Somewhat satisfied 19.5
Not satisfied 2.7
Total respondents who have availed the services in government health
facility in last 6 months 775

Treatment for minor ailment (67 percent) is the main purpose to visit to the health
facility followed by child care (15 percent), ANC care (5 percent) and immunization (3
percent).

74
 Eighty-nine percent of the client said the behaviour of staff at health facility is
courteous and for 11 percent their behaviour is causal / in different. According to 84
percent of the clients doctors / staff listened their complaints, and for 15 percent doctor /
staff listened their clients complaints some what. Ninety percent of the women patient
were treated in privacy. Ninety-one percent of the patients with chronic disease get
regular medicines from the Government health facility.
Table H.18 User fees and extra charges
Type of health facility visited, purpose visit and client
satisfaction Percent
Type of health facility where service availed
District/ Sub district hospital 37.8
CHC 4.5
PHC 54.7
Sub Centre 3.0
AYUSH -
Purpose of visit to health facility
Treatment of minor ailment 67.0
ANC care 5.4
Child care 14.6
Immunisation 2.5
Other 10.6
Behaviour of staff at health facility
Courteous 88.6
Causal/Indifferent 11.0
Insulting/Derogatory 0.4
Listening of complaints by Doctor/staff
Listened to complaints 84.0
Somewhat listened 14.6
Not listened 1.4
Cannot say -
Women patient were treated in privacy
Yes 89.5
No 6.2
Don’t know 4.3
Patients with chronic disease get regular medicines from health facility
Yes 91.0
No 2.5
Don’t know 6.6
Private practice of the doctors during and after the duty hours
Yes 9.4
No 29.7
Don’t know 60.9
Satisfied with overall services and staff of Govt Health Facility
Satisfied 77.9
Somewhat satisfied 19.4
Not satisfied 2.7
Satisfied with the behaviour of staff at Govt. Health Facility
Satisfied 77.8
Somewhat satisfied 19.5
Not satisfied 2.7
Total respondents who have availed the services in government health
facility in last 6 months 775

75
 According to 30 percent of the clients doctors were not doing private practice
during and after the duty hours, and 10 percent of the clients said doctors doing private
practice. Sixty-one percent were not known about the private practice of the doctors
during and after duty hours.

Seventy-eight percent of the clients were satisfied with the over all services and
staff of government health facility. Seventy-eight percent of the clients were satisfied
with the behaviour of staff at government health facility and 25 percent of the clients
were somewhat satisfied.

According to ninety-eight percent of the respondents users feel was not charged
from the users. The users fee was charged for ultrasound (4 percent), X-ray
(12 percent), and registration and lab services (6 percent each) (Table H18). Equal
opinion exist on feel on subsidized services, difficulties in getting subsidized/free
services and RKS facilitated the paper work for BPL patients were prevailed
(Table H19).
Table H19. Services for the BPL patients
BPL Patents Percent
BPL patients provided free / subsidized services
Yes -
No 50.0
Don’t know 50.0
BPL patients faced difficulty in getting free / subsidized services
Yes -
No 50.0
Don’t know 50.0
RKS facilitated the paperwork for BPL patients
Yes -
No 50.0
Don’t know 50.0
Total BPL respondents who have availed the services in government
health facility in last 6 months 2

Table H20, shows the outbreak of selected diseases (malaria, Gastroenteritis,

Jaundice and other diseases) in the respondents area in the last six months. During the
last six month out break of malaria is not reported. Measles (13 percent), gastroenteritis
(2 percent), Jaundice (6 percent) and other diseases such as Denque (1 percent) were
reported.

76
 Table H21 explains the preventive and curative actions to be taken for selected
diseases (diarrhea, high fever, persistent cough, loose motion, and breathing problem for
a child). Use of safe food and water (60 percent), hand washing (49 percent), use of
covered containers (21 percent) and proper disposal of garbage (9 percent) were the
actions taken in the selected households for prevention of diarrhea reported by the
respondents. Seventeen percent were not knowing the preventive measures of diarrhea.

Table H 20. Outbreak of selected diseases (Malaria, Gastroenteritis, Jaundice and

other Diseases) in the respondents’ area in the last six months
Outbreak of diseases Percent
Outbreak of Malaria in last six months
Yes 0.4
No 98.4
Donot know 1.2
Outbreak of Measles in last six months
Yes 13.4
No 86.1
Donot know 0.5
Outbreak of Gastroenteritis in last six months
Yes 1.5
No 95.6
Don’t know 2.9
Outbreak of Jaundice in last six months
Yes 6.3
No 93.2
Don’t know 0.5
Outbreak of Any Other disease in last six months
Yes 1.3
No 92.8
Don’t know 6.0
Total number of household respondents 1,200

Approaching the nearest Government health facility (83 percent), or registered

medical practitioner (43 percent), (43 percent) was the actions taken if a family member
has high fever. If a family member has a persistent cough for more than two-weeks, the
action to be taken includes, approaching the nearest government health facility (83
percent), taken to the RMP (38 percent) and sputum testing (5 percent), Home remedies
(15 percent) were also reported.

For loose motions lasting for more than 24 hours, the immediate action taken was
referred to the nearest Government health facility (80 percent), start giving ORS (35
percent), taken to RMP (34 percent) and home remedy (19 percent).

77
 When a child in the family has persistent cough and breathing problems. Like
other diseases, they were taken to the nearest government health facility (83 percent) or
taken to RMP (35 percent). Home remedy (5 percent) was also reported.

Table H 21. Action to be taken for selected diseases (diarrhoea, high fever, persistent cough,
loose motion, persistent cough and breathing problem for a child )
Action to be taken for selected diseases (Multiple responses) Percent
Prevention of diarrhoea
Hand washing 49.3
Use of safe food and water 59.9
Use of covered container 20.9
Proper disposal of garbage 9.4
other 0.8
Don't know 17.2
Action to be taken if a family member has a high fever
Blood test for malaria 2.0
Taken to RMP 42.8
Taken to nearest govt health facility 82.8
Consult ASHA -
Try home remedies 5.3
Other 9.1
Don't know -
Action to be taken if a family member has a persistent cough for more than
two weeks
Taken for sputum testing 4.6
Taken to the RMP 38.1
Taken to nearest govt health facility 82.8
Consult ASHA 0.2
Try home remedies 14.5
Other 7.1
Don't know -
Action to be taken if a family member has loose motions lasting for more
than 24 hours
Stop giving oral fluids/food etc 0.6
Start giving ORS 35.1
Taken to RMP 34.4
Taken to nearest govt health facility 80.1
Consult ASHA -
Try home remedies 19.3
Other 7.1
Don't know -
Action to be taken if a child in the family has persistent cough and
breathing problems
Try home remedies 5.3
Taken to the RMP 35.3
Taken to the nearest govt. health facility 82.7
Consult ASHA 0.2
Other 1.6
Don't know -
Total number of household respondents 1,200

Table H22 explains the respondents awareness about spacing methods and ideal
gab between 1st and 2nd child. Ninety-nine percent of the respondent had awareness

78
about family planning methods. According to 57 percent of the women the ideal gab
between first and second child was 3 or more years for 40 percent it was 2 years. Only
four percent said about one year gab between first and second child.

Table H 22. Awareness about spacing methods and ideal gap between 1st and 2nd child
Awareness about spacing methods and ideal gap between children Percent
Aware of family planning methods 98.5
Ideal gap between first and second child
1 year 3.6
2 year 39.9
3 and more year 56.5
Methods available for spacing
IUD 75.0
Oral Pills 28.6
Nirodh / Condom 23.9
Any other 4.3
Don't know 11.1
Total number of household respondents 1,182

Three-fourth of the respondents known about IUD (75 percent) and 29 percent aware of
Oral pills. Twenty-four percent known of Nirodh / Condom.

AWAREESS ABOUT MODES OF GETTIG AIDS, SOURCE OF

IFORMATIO AD AWAREESS ABOUT VCTC

Ninety-five percent of the respondents heard about HIV/AIDS. More than 93

percent said unsafe sexual contact is the mode of getting HIV/AIDS followed by sharing
needles (67 percent) and blood transfusion (46 percent). Awareness on other modes of
transmission such as mother to child (10 percent), sneezing (4 percent) is very less.

Television (80 percent) is the main source of information on HIV/AIDS followed

by health worker (33 percent) and radio (20 percent). The contribution of posters (6
percent) and news papers (79 percent) in making awareness is very less.

Fifty-eight percent of the respondents had awareness on HIV/AIDS by the

nearest counseling centre / VCTC centres. Among them, 48 percent reported the near by
location of HIV/AIDS counseling centre / VCTC centre is PHC (48 percent), district
hospital (34 percent) sub-district hospital (9 percent) and CHC (5 percent).

79
Table H23. Awareness about modes of getting AIDS, source of information about
AIDS and awareness about VCTC
AIDS and VCTC Percent
Heard about HIV/AIDS 94.9
Awareness about modes of getting HIV/AIDS (out of respondents
who have heard of AIDS)
Unsafe Sexual contact 92.5
Blood transfusion 45.6
Sharing needles/syringes 66.5
From mother to child 9.5
Shaking hands 1.1
Sneezing 2.3
Insect bite 3.6
Kissing 0.4
Other 3.0
Source of information on HIV/AIDS (out of respondents who have
heard of AIDS)
Radio 19.8
TV 80.2
Health workers 32.8
Posters 6.0
News papers 7.9
Other 24.0
Aware about HIV/AIDS counseling center / VCTC nearby (out of
respondents who have heard of AIDS) 57.8
Respondents by reported location of HIV / AIDS counseling center /
VCTC (out of respondents who are aware about HIV/AIDS
counseling center / VCTC nearby )
PHC 48.3
CHC 4.9
District Hospital 34.2
Sub District Hospital 9.4
Private Hospital 1.7
Other 1.5
Total number of household respondents 658

80
 Chapter - 7
GRAM PACHAYAT

Twelve Gram Panchayats were covered in Madurai districts. Table A1 explains

the states of Gram Panchayat covered. Total population covered by a Gram Panchayat is
3, 394, and among them nearly one fourth (777) were Scheduled caste. Total number of
households covered by a Gram Panchayat was 958, among them nearly are one-fourth
(229) were SC households. Total number of BPL families covered by a gram panchayat
was 302, among them nearly one- half (142) belongs to Scheduled Caste (Table A1).
Table A1: Status of Gram Panchayats Covered
Status of Gram Panchayat Covered Value
A. umber of Gram Panchayats covered in the district 12
B. Population of the Gram Panchayat covered
Scheduled Caste 776.8
Scheduled Tribe -
Total 3,394.4
C. Average number of Households in the Gram Panchayat covered
Scheduled Caste 229.4
Scheduled Tribe -
Total 958.4
D. Average number of BPL families in the Gram Panchayat covered
Scheduled Caste 142.3
Scheduled Tribe -
Total 302.4

Table A2 indicates the level of awareness on NRHM activities and involvement

of Gram Panchayat in NRHM activities. Majority of Gram Panchayat (831) reporting
regular availability of ANM. Three-fourth of the gram panchayat reporting about timely
services provided by sub-centre to the patients and their role in conducting finalizing IEC
Programme. All the Gram panchayat (100 percent) reporting about existence of VHSC in
their panchayat and they all received untied fund, they had awareness about the benefit
under JSY scheme, and reporting about improvements in the area due to NRHM. Eighty-
three percent of the Gram Panchayat reporting regular meeting of VHSC, and thirty-three
percent reporting about village health plan prepared by VHSC.

Due to NRHM in 58 percent of the Gram Panchayats said funds were available
for maintenance of Sub-Centre. Three-fourth (75 percent) of gram panchayats reported
that funds are available under JSY. Seventeen percent of the Gram Panchayats used

81
NRHM funds to avail better facilities available at CHC/ PHC for referral patients and
another 17 percent used it for transporting the patients.

Table A2: Level of awareness and involvement of Gram Panchayats

Level of awareness and involvement of Gram Panchayats Percent
A1. Percentage of Gram Panchayat reporting regular availability of
ANM 83.3
A2. Percentage of Gram Panchayat reporting awareness about ANM
tour plan
B. Percentage of Gram Panchayat reporting timely services provided
by Sub Centre to the patients 75.0
C. Percentage of Gram Panchayat reporting role of Gram Panchayat in
Conducting / finalizing IEC programme in Gram Panchayat 75.0
D. Percentage of Gram Panchayat reporting existence of VHSC in their
Gram Panchayat 100.0
E. Percentage of Gram Panchayat reporting regular meetings of VHSC 83.3
F. Percentage of Gram Panchayat reporting Village Health Plan been
prepared by VHSC 33.3
G. Percentage of Gram Panchayat reporting that VHSC has received
any Untied Fund 100.0
H. Percentage of Gram Panchayat reporting ASHA worker in position -
I. Percentage of Gram Panchayat reporting awareness of the benefits
under JSY scheme 100.0
J. Percentage of Gram Panchayat reporting that NRHM brought about
any improvement in their area 100.0
K. Percentage of Gram Panchayat reporting conduct of IEC activities
during last 6 months -
L. Distribution of Gram Panchayat covered by type improvement
reported due to NRHM
Funds available for maintenance of Sub Centres 58.3
Community support is available as ASHA worker -
Funds/facilities are available under JSY 75.0
Better facilities are available for CHCs / PHCs for referred patients 16.7
Transport facilities are available 16.7
Other -
M. Distribution of Gram Panchayats by type of difficulties faced in
Implementing programme activities under NRHM
Funds not available in time 83.3
Decision making with the community leaders is difficult 8.3
ASHA has not been adequately trained -
Adequate facility for institutional deliveries are not available 16.7
Other -
N. Distribution of Gram Panchayats by kind of support required to
enable them in implement the programme more effectively
More funds are required for maintenance / effective functioning 91.7
Gram Panchayat should be given direct control over funds 50.0
More training is to be arranged for ASHA and Community members -
Any other 8.3

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 Difficulties such as funds not available in time (83 percent) inadequate facility for
institutional deliveries (17 percent) and difficulties decision making with the community
leader (8 percent) are mentioned by the Grampanchayats in implementing programme
activities under NRHM at the Panchayat level.

More funds for maintaining/ ffective functioning (92 percent) and direct control
of Gram Panchayat over funds are the supports required by the gram panchayats to enable
them in implementing the NRHM programme more effectively.

83
 Chapter - 8
I-PATIET FACILITIES (IPD)

Majority of the inpatients belongs to 20-29 years (81 percent). A small proportion
were less than 20 years (9 percent). Rural (95 percent), female (93 percent) and currently
married (90 percent) constitute the major part of the inpatients. Forty-eight percent of the
in-patient were from PHC, 35 percent belongs to CHC and 17 percent were from district
hospitals.
Table 1: Background characteristics of the in-patients
Background Characteristics of the In-Patients Percent
Age
< 20 years 8.6
20-29 years 81.0
30-39 years 1.7
40-49 years 1.7
50-59 years -
60 years or more 6.9
Sex
Male 6.9
Female 93.1
Marital status
Unmarried 5.2
Currently married 89.7
Divorced/Separated -
Widowed 5.2
Residence
Rural 94.8
Urban 5.2
Type of Health Facility
District Hospital 17.2
CHC 34.5
PHC 48.3
Total In-patients interviewed 58

Table 2 explains the purpose of the admission in the health institution. Most of
the inpatients were admitted in the hospitals for delivery (69 percent), followed by family
planning surgery 14 percent) and minor illness (10 percent). Majority (96 percent) of the
inpatients in the PHC were admitted for delivery. In the CHC’s 45 percent of the
patients were admitted for delivery followed by Family Planning Surgery (40 percent)
and minor illness(15 percent). Delivery (40 percent) and minor illness (30 percent) were
main purpose of inpatients admission in the Government Hospital.

84
Table 2: Purpose of the admission in the Health Institution
Purpose of admission Type of Health Facility (Percent)
in the Health District
Institution Hospital CHC PHC All
Minor illness 30.0 15.0 - 10.3
FP surgery - 40.0 - 13.8
Delivery 40.0 45.0 96.4 69.0
Cataract surgery - - - -
Child admitted - - - -
Other 30.0 - 3.6 6.9
Total In-patients
interviewed 10 20 28 58

Table 3 explained the average waiting time of the in-patients in the health facility.
Patients were waiting more for doctor’s call (105 minutes) and doctor’s examination
(104 minutes) compare to discharge (36 minutes), getting services (17 minutes),
registration (13 minutes) and admission to ward (15 minutes). Patients wait more time for
doctor’s call and doctor’s examination (16 minutes each) in the PHC compare to the CHC
(70 minutes and 68 minutes respectively) and Districts hospital (20 minutes and 18
minutes respectively). Average waiting time for registration (23 minutes), admission to
ward (29 minutes), getting services (36 minutes) and to get discharge (66 minutes) were
more in District hospital compare to CHC and PHC.
Table 3: Waiting time
Average waiting time (in minutes)
Average waiting time for: Type of Health Facility
District
Hospital CHC PHC All
Registration 23.0 12.5 9.8 13.0
Doctor's call 20.0 69.7 160.9 105.2
Doctor's examination 17.5 68.0 160.5 104.0
Admission to ward 29.0 8.8 14.1 14.8
Getting services 36.0 10.8 13.8 16.6
To get discharged 66.0 29.3 30.2 36.0
Total In-patients interviewed 10 20 28 58

Table 4 explains the patients satisfaction regarding waiting time. Seventy percent
of the in-patients opinioned that waiting time for registration, doctor’s call and doctor’ s
examination were appropriate, and for 30 percent their weighting time for doctors call
and examination is too short. For 50 percent of the patients waiting time to get
discharged is too long in the district hospitals.

85
Table 4: Satisfaction regarding waiting time
A.
Type of Facility District Hospital
Satisfaction (percent of patients)
Waiting time for
Too Long Appropriate Too Short Can’t Say
Registration 10 70 20 -
Doctor’s call - 70 30 -
Doctor’s examination - 70 30 -
Admission to ward 10 50 40 -
Getting services 20 50 30 -
To get discharged 50 50 - -
Total In-patients interviewed 10 10 10 -
B.
Type of Facility CHC
Satisfaction (percent of patients)
Waiting time for:
Too Long Appropriate Too Short Can’t Say
Registration 10 80 10 -
Doctor’s call 25 60 15 -
Doctor’s examination 25 65 10 -
Admission to ward - 85 15 -
Getting services - 85 15 -
To get discharged 30 60 10 -
Total In-patients interviewed 20 20 20 -
C.
Type of Facility PHC
Satisfaction (percent of patients)
Waiting time for:
Too Long Appropriate Too Short Can’t Say
Registration - 82.1 17.9 -
Doctor’s call 35.7 60.7 3.6 -
Doctor’s examination 35.7 60.7 3.6 -
Admission to ward 10.7 75.0 14.3 -
Getting services 7.1 82.1 10.7 -
To get discharged 32.1 64.3 3.6 -
Total In-patients interviewed 28 28 28 -
D.
Type of Facility All
Satisfaction (percent of patients)
Waiting time for:
Too Long Appropriate Too Short Can’t Say
Registration 5.2 79.3 15.5 -
Doctor’s call 25.9 62.1 12.1 -
Doctor’s examination 25.9 63.8 10.3 -
Admission to ward 6.9 74.1 19.0 -
Getting services 6.9 77.6 15.5 -
To get discharged 34.5 60.3 5.2 -
Total In-patients interviewed 58 58 58 -

In the CHC’s waiting time for registration (80 percent), admission to ward and
getting services (85 percent). Doctor’s call (60 percent) were appropriate. According to

86
10percent of the inpatients waiting time for registration is too long, for 25 percent waiting
time to doctor’s call and doctor’s examination is too long. Thirty percent viewed that in
the CHC waiting time for discharge is too long.

While considering PHC’s the waiting time for registration and getting services
(82 percent), admission to ward (75 percent) doctor’s call and examination (61 percent)
and to get discharged (64 percent) were appropriate. Thirty-six percent viewed in the
PHC’s waiting time for doctor’s call, examination (26 percent) and to get discharged (35
percent) were too long.

Overall, majority of the inpatients opinioned that waiting time for registration
(79 percent), getting services (78 percent), admission to ward (74 percent), doctor’s
examination (64 percent), doctor’s call (62 percent) and to get discharged (60 percent)
were appropriate. Twenty-six percent of the inpatients viewed waiting time for doctor’s
call and doctor’s examination are too long. For thirty-five percent waiting time to get
discharged was too long.

BEHAVIOUR OF STAFF:

Table 5 explains the behaviour of the staff with the inpatients in the Government
health facilities. Almost all the inpatients (97 percent) said doctor greet them in a
friendly manner. For sixty-seven percent of the inpatients the behaviour of the doctor is
good, and twenty-four percent said doctors behaviour is reasonable. Behaviour of nurse
in the Government health facilities were good (72 percent) and reasonable (24 percent).
Behaviour of technical people with the inpatients is also mentioned as good (76 percent)
and reasonable, and the same attitude prevails among the behaviour of counter clerk (96
percent) also.

According to fifteen percent of the inpatients (CHC 10 percent; PHC 25 percent)

unique /innovative measures has to be taken to improve the behaviour of staff. Sixty-
three percent of the inpatients has no idea (District hospital 90 percent; CHC 65 percent
and PHC 54 percent) about the unique / innovative measure taken to improve the
behaviour of the staff (Table 6).

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Table 5: Bahaviour of Staff
Staff Behaviour Type of Health Facility (Percent)
District Hospital CHC PHC All
Doctor greet in a friendly manner
Yes 90.0 95.0 100.0 96.6
Somewhat 10.0 5.0 - 3.4
No - - - -
Behaviour of Doctor
Rude 10.0 - - 1.7
Reasonable 10.0 25.0 28.6 24.1
Good 80.0 70.0 60.7 67.2
Very kind - 5.0 10.7 6.9
Behaviour of urse
Rude 10.0 - - 1.7
Reasonable 10.0 30.0 25.0 24.1
Good 80.0 70.0 71.4 72.4
Very kind - - 3.6 1.7
Behaviour of Technical Staff
Rude - - - -
Reasonable 11.1 44.4 - 23.8
Good 88.9 55.6 100.0 76.2
Very kind - - - -
Behaviour of Ayah
Negligent 10.0 - - 1.8
Arrogant - - - -
Indifferent 10.0 5.3 - 3.5
Good 80.0 94.7 100.0 94.7
Behaviour of Ward Boys
Negligent 12.5 - - 6.7
Arrogant - - - -
Indifferent - - - -
Good 87.5 100.0 100.0 93.3
Behaviour of Counter Clerk
Negligent - - - -
Arrogant - - - -
Indifferent 10.0 5.3 - 3.6
Good 90.0 94.7 100.0 96.4
Total of In-patients interviewed 10 20 28 58
Table 6: Unique/ innovative measure taken to improve the staff behaviour
Percent
Staff Behaviour
Type of Health Facility
District Hospital CHC PHC All
Unique/innovative measure
taken to improve the staff
behaviour 10 20 28 58
Yes - 10.0 25.0 15.5
No 10.0 25.0 21.4 20.7
Don't know 90.0 65.0 53.6 63.8
Total In-patients interviewed 10 20 28 58

88
Table 7: Privacy
Percent
Privacy Type of Health Facility
District
Hospital CHC PHC All
Patients reporting presence of
privacy at the place of
examination 100.0 100.0 100.0 100.0
Total no. of in-patients
interviewed 10 20 28 58

All the inpatients (100 percent) reported about presence of privacy at the place of
examination in all the health facilities (table 7).

Table 8 : Patient-Doctor/ Provider Communication

Percent
Patient-Doctor/ Provider Communication Type of Health Facility
District
Hospital CHC PHC All
Doctor listened to description of ailment
patiently
Yes, somewhat 30.0 5.0 10.7 12.1
Yes, always 70.0 95.0 89.3 87.9
No - - - -
Doctor allowed to ask question
Yes, somewhat 40.0 10.0 28.6 24.1
Yes, always 60.0 90.0 71.4 75.9
No - - - -
Doctor responded to question
Yes, somewhat 40.0 - 10.7 12.1
Yes, always 60.0 100.0 89.3 87.9
No - - - -
Doctor discussed about ailment 60.0 75.0 57.1 63.8
Doctor talked about the recovery 90.0 95.0 100.0 96.6
Doctor gave 'other advice' 90.0 95.0 82.1 87.9
Total In-patients interviewed 10 20 28 58

Table 8 denotes the patient –doctor / provider communication in the government

health facilities. Eighty-eight percent of the inpatients said doctors always listened the
description of ailment patiently, the percentage varies from 70 percent in the District
hospital to 95 percent in the CHC. Seventy-six percent of the inpatients said doctor
always allowed them to ask questions. This percentage varies from 60 percent in District
hospitals to 90 percent CHC. Eighty-eight percent of the inpatients says that doctors

89
always responded to their questions, the response of the doctors to patients question was
more in CHC(100 percent) compare to PHC (89 percent) and District hospital (60
percent). Sixty-four percent of the inpatients said doctor discussed with them about their
ailment and it varies from 57 percent in PHC to 75 percent in CHC.

Ninety-seven percent of the inpatients accept that doctor talked about their
recovery. Overall eighty-eight percent of the inpatients said doctor gave other advice to
the inpatients. This was reported more in CHC (95 percent) compare to District hospital
(90 percent) and PHC (82 percent).

Table 9 indicates the cleanliness of the Government health facilities. In district

hospital patients uniform was changed once in a day (100 percent). Floor and toilet/
bathrooms were cleaned once a day (90 percent each). Bed sheets were changed less than
once a day (70 percent).

Table 9: Cleanliness of the facility

A.
Type of Facility District Hospital
Percent of In-patient
Floor Toilet/Bathroom Changing Changing
Frequency of cleaning
Patient’s Bed
Uniform Sheets
Thrice a day - - - -
Twice a day 10.0 10.0 - 10.0
Once a day 90.0 90.0 100.0 20.0
Less than once a day - - - 70.0
Total number of in- 10 10 10 10
patients interviewed

B.
Type of Facility CHC
Percent of In-patient
Floor Toilet/Bathroom Changing Changing
Frequency of cleaning
Patient’s Bed
Uniform Sheets
Thrice a day 5.0 5.0 - -
Twice a day 60.0 55.0 20.0 5.0
Once a day 35.0 40.0 80.0 40.0
Less than once a day - - - 55.0
Total number of in- 20 20 20 20
patients interviewed

90
C.
Type of Facility PHC
Percent of In-patient
Floor Toilet/Bathroom Changing Changing
Frequency of cleaning
Patient’s Bed
Uniform Sheets
Thrice a day 17.9 10.7 3.6 -
Twice a day 64.3 39.3 17.9 14.3
Once a day 10.7 46.4 78.6 53.6
Less than once a day 7.1 3.6 - 32.1
Total number of in- 28 28 28 28
patients interviewed

D.
Type of Facility All
Percent of In-patient
Floor Toilet/ Changing Changing
Frequency of cleaning
Bathroom Patient’s Bed
Uniform Sheets
Thrice a day 10.3 6.9 1.7 -
Twice a day 53.4 39.7 15.5 10.3
Once a day 32.8 51.7 82.8 43.1
Less than once a day 3.4 1.7 - 46.6
Total number of in-patients 58 58 58 58
interviewed

In the CHC, Floor was cleaned twice a day (60 percent) and toilet / Bath rooms
(55 percent) were cleaned twice a days (55 percent) and patients uniform was changed
once in a day (80 percent). Bed sheets (55 percent) were changed less than once a day.

In the PHC floor was cleaned twice a day (64 percent), toilet / Both room (46
percent) were cleaned once in a day, patients uniform (7 percent) and Bed sheet
(54percent) were changed once a day.

According to the inpatients of the Government health facilities, floor was cleaned
twice a day (53 percent), toilet / Bath room (52 percent) were cleaned once in a day and
patients uniform (83 percent) was changed once a day and bed sheets were changed less
than once a day (47 percent).

Table 10 explains the satisfaction of patients regarding cleanliness of the

Government health facilities. In the district hospital, 40 percent of the inpatients were
satisfied with the floor cleaning and toilet / Both room cleaning, 60 percent satisfied with

91
 the changing of patients uniform and 30 percent with changing of bed sheets. Seventy
percent of the inpatients were not satisfied with the changing of bed sheets.

In the CHC’s percentage of inpatients satisfied regarding the cleaning of floor

was 80 percent. Sixty percent satisfied with the toilet / Both room, and the percentage of
inpatients had had satisfaction on changing patients uniform and bed sheets were 45
percent and 35 percent respectively. Fifty-five percent of the inpatients were not satisfied
with changing of bed sheets.

Table 10: Satisfaction of patients regarding cleanliness of the facility

A.
Type of Facility District Hospital
Satisfaction (percent of in-patients) Total
number of
Satisfaction regarding Somewhat
Satisfied ot satisfied in-patients
satisfied
interviewed
Floor cleaning 40.0 60.0 - 10
Toilet/Bathroom cleaning 40.0 50.0 10.0 10
Changing patient’s uniform 60.0 40.0 - 10
Changing bed-sheets 30.0 - 70.0 10

B.
Type of Facility CHC
Satisfaction (percent of in-patients) Total
number of
Satisfaction regarding Somewhat
Satisfied ot satisfied in-patients
satisfied
interviewed
Floor cleaning 80.0 20.0 - 20
Toilet/Bathroom cleaning 60.0 30.0 10.0 20
Changing patient’s uniform 45.0 55.0 - 20
Changing bed-sheets 35.0 10.0 55.0 20

C.
Type of Facility PHC
Satisfaction (percent of in-patients) Total
number of
Satisfaction regarding Somewhat
Satisfied ot satisfied in-patients
satisfied
interviewed
Floor cleaning 82.1 3.6 14.3 28
Toilet/Bathroom cleaning 71.4 7.1 21.4 28
Changing patient’s uniform 82.1 17.9 - 28
Changing bed-sheets 53.6 14.3 32.1 28

92
 D.
Type of Facility All
Satisfaction (percent of in-patients) Total
number of
Satisfaction regarding Somewhat
Satisfied ot satisfied in-patients
satisfied
interviewed
Floor cleaning 74.1 19.0 6.9 58
Toilet/Bathroom cleaning 62.1 22.4 15.5 58
Changing patient’s uniform 65.5 34.5 - 58
Changing bed-sheets 43.1 10.3 46.6 58

In the PHC’s majority of the inpatients were satisfied with the floor cleaning (82
percent), toilet / Both room cleaning (71 percent), changing patients uniform 982 percent)
and changing of bed sheets (54 percent). Nearly one-third (32 percent) were not satisfied
with changing of bed sheets, and one-fifth (21 percent) were not satisfied with the
cleanliness of the toilet / Both room and 14 percent were not satisfied with floor cleaning.

Overall, 74 percent inpatients were satisfied with cleanliness of floor, 62 percent

satisfied with toilet / both room, 66 percent satisfied with changing patient’s uniform.
But 47 percent were not satisfied regarding changing of bed sheets and seven percent
were unsatisfied with cleaning bathroom and floor.

Table 11 denotes the crowding in various Government health facilities. Almost

all the inpatients reported that immediately they avail cot (95 percent). The percentage
varies from 89 percent in the PHC to 100 percent in the District hospital and CHC.
Ninety-five percent of the inpatients avail the cot/ bed till the time of discharge. This
percentage varies from 90 percent in the District hospital to 95 percent in CHC and 96
percent in PHC.

Two-fifth (40 percent) of the inpatients in the Government health facilities

reported about adequate space in the ward and 17 percent reported about inadequate
space in the ward. Thirty percent of the inpatients of District Hospital, 36 percent of
inpatients form PHC and 50 percent of inpatients form CHC reported about adequate
space in the ward. This percentage varies form 5 percent in CHC, 20 percent and 25
percent respectively in District Hospital and PHC respectively. Forty-five percent of the
inpatients were satisfied with the ward arrangements. Only 5 percent were not satisfied

93
with ward arrangements. Two percent of inpatients satisfied with ward arrangements
were 55 percent, 43 percent and 30 percent in CHC, PHC and DH respectively. Forty-
two percent of the inpatients reported about adequate space in IPD. This percentage
varies from 30 in DH to 55 in CHC.

Table 11: Crowding in the facility

Percent
Type of Health Facility (Percent)
Crowding in the facility
District
Hospital CHC PHC All
Availability of cot
Immediately 100.0 100.0 89.3 94.8
Not immediately but
same day - - 3.6 1.7
Next day - - 3.6 1.7
After more than a day - - 3.6 1.7
Availability of cot/bed till the
time of discharge
Yes 90.0 95.0 96.4 94.8
No 10.0 5.0 3.6 5.2
Adequacy of space in the ward
Not adequate 20.0 5.0 25.0 17.2
Somewhat adequate 50.0 45.0 39.3 43.1
Adequate 30.0 50.0 35.7 39.7
Satisfaction with the ward
arrangement
Not satisfied 10.0 - 7.1 5.2
Somewhat satisfied 60.0 45.0 50.0 50.0
Satisfied 30.0 55.0 42.9 44.8
Adequacy of space in IPD
Not adequate 10.0 - 28.6 15.5
Somewhat adequate 60.0 45.0 35.7 43.1
Adequate 30.0 55.0 35.7 41.4
Lot of noise in the ward
Yes
No
Total no. of in-patients
interviewed 10 20 28 58

Table12 explains the amenities provided by the hospital. Medical shop

(Pharmacy) is available in all the Government health facilities. All the inpatients are
satisfied with the pharmacy. Thirty percent of the inpatients in the district hospital
reporting about availability of accommodation for relatives in the district hospital, and

94
 among them one-third (33 percent) were satisfied with this facility. Television, canteen,
telephone and Ambulance were not available in the Government head quarter’s hospital.
Television (90 percent) and telephone (60 percent) were available in CHC’s. The
percentage of inpatients satisfied with the amenities was 72 percent and 92 percent
respectively. Television and telephone were available in the PHC. Majority of the
inpatients were satisfied with this facilities.
Table 12: Amenities provided by the hospital
A.
Type of Facility District Hospital
percent of Total percent of in-patients Total number of in-
in-patients number of reporting Satisfaction patients interviewed
Amenities
reporting in-patients among those who that who said that the
Availability interviewed the amenity is available amenity is available
Television - 10 - 10
Canteen - 10 - 10
Medical shop 100.0 10 100.0 10
Telephone - 10 - 10
Accommodation 30.0 10 33.3 10
for relatives
Ambulance - 10 - 10
B.
Type of Facility CHC
percent of Total percent of in-patients Total number of in-
in-patients number of reporting Satisfaction patients interviewed
Amenities
reporting in-patients among those who that who said that the
Availability interviewed the amenity is available amenity is available
Television 90.0 20 72.2 20
Canteen - 20 - 20
Medical shop 100.0 20 100.0 20
Telephone 60.0 20 91.7 20
Accommodation 45.0 20 100.0 20
for relatives
Ambulance - 20 - 20
C.
Type of Facility PHC
percent of Total percent of in-patients Total number of in-
in-patients number of reporting Satisfaction patients interviewed
Amenities
reporting in-patients among those who that who said that the
Availability interviewed the amenity is available amenity is available
Television 89.3 28 92.0 28
Canteen 3.6 28 100.0 28
Medical shop 100.0 28 100.0 28
Telephone 92.9 28 100.0 28
Accommodation 71.4 28 65.0 28
for relatives
Ambulance - 28 - 28

95
 D.
Type of Facility All
percent of Total percent of in-patients Total number of in-
in-patients number of reporting Satisfaction patients interviewed
Amenities
reporting in-patients among those who that who said that the
Availability interviewed the amenity is available amenity is available
Television 74.1 58 83.7 58
Canteen 1.7 58 100.0 58
Medical shop 100.0 58 100.0 58
Telephone 65.5 58 97.4 58
Accommodation 55.2 58 71.9 58
for relatives
Ambulance - 58 - 58

Table 13: Continuity of treatment

Type of Health Facility (Percent)
Continuity of treatment District
Hospital CHC PHC All
Overall satisfaction on visiting
to facility
Dissatisfied 10.0 - - 1.7
Somewhat satisfied 20.0 20.0 28.6 24.1
Satisfied 70.0 80.0 71.4 74.1
Reason of dissatisfaction
Lack of facilities 100.0 - - 100.0
Bad experience with
doctor - - - -
Poor quality of
services - - - -
Charges are
exorbitant - - - -
Other - - - -
Visit again to the facility (if fell
sick)
Yes 90.0 100.0 100.0 98.3
No 10.0 - - 1.7
May come/unsure - - - -
Recommend this hospital to
other
Yes 100.0 100.0 100.0 100.0
No - - - -
Total no. of in-patients
interviewed 10 20 28 58

As reported by the inpatients (89 percent), medical shop (100 percent), telephone
(93 percent) and accommodation for relatives (71 percent) were the amenities available in

96
the PHC. The percentage of inpatients (100 percent) satisfied with television and
accommodation for relatives was 92 percent and 65 percent respectively.

Television was available in 74 percent of the facilities and 84 percent of the

inpatients were satisfied with this. Sixty-six percent of the facilities have telephone and
97 percent of the inpatients were satisfied with this. Fifty-five percent of the inpatient
reported about accommodation for relatives and 72 percent were satisfied.

Table 13 explains the continuity of treatment in the government health facilities.

Overall 74 percent of the inpatient were satisfied about visiting to the government
facilities (District Hospital 70 percent ; CHC 80 percent; PHC 71 percent). Only two
percent had dissatisfaction on visiting the hospital i.e., only in District hospital (10
percent). The main reason for dissatisfaction is lack of facilities (100 percent). Ninety-
eight percent of the inpatients said they will visit again to the facility if they fell sick and
all the inpatients said they will recommend this hospital to others (100 percent).

97
 Chapter - 9
OUTPATIET (OPD)

Table 1 explains the background characteristics of the out patients. Forty–eight percent of
the out patient were in the age group of 20-29 years. Sixteen percent belongs to 40-49
years and 14 percent were 60 years or more. Majority of the outpatient were female (73
percent) and currently married (70 percent). All most all the outpatients belongs to rural
(97 percent). Fifty seven percent of the outpatient were from PHC, 29 percent were from
CHC and 14 percent from district hospital.
Table 1:Background characteristics of the out-patients
Background Characteristics of the Out-Patients Percent
Age
< 20 years 7.1
20-29 years 45.7
30-39 years 10.0
40-49 years 7.1
50-59 years 15.7
60 years or more 14.3
Sex
Male 27.1
Female 72.9
Marital status
Unmarried 15.7
Currently married 70.0
Divorced/Separated -
Widowed 14.3
Residence
Rural 97.1
Urban 2.9
Type of Health Facility
District Hospital 14.3
CHC 28.6
PHC 57.1
Total no. of out-patients interviewed 70

Table 2 explains the purpose of visit to the health institution. Overall 47 percent of the
out patient visit to the health facility for minor illness (District Hospital 80 percent; CHC,
35 percent, PHC 45 percent). Twenty-three patients visited for children’s illness, (District
Hospital 20 percent; CHC 25 percent, PHC 23 percent) and 13 percent visited for
antenatal care (CHC 10 Percent and PHC 18 percent).

98
Table 2: Purpose of visit to the Health Institution
Percent
Purpose of visit in the Type of Health Facility
Health Institution District
Hospital CHC PHC All
Minor illness 80.0 35.0 45.0 47.1
FP services - - - -
Antenatal care - 10.0 17.5 12.9
PNC - - - -
Eye checkup - - - -
MDT-DOTs - - - -
Child illness 20.0 25.0 22.5 22.9
Other - 30.0 15.0 17.1
Total out-patients
interviewed 10 20 40 70

Table 3 explains about the waiting time in the Government hospitals. In the
district hospitals, average, waiting time as reported by out patients was 14 minutes for
doctors examination, 12 minutes for registration, nine minutes and 10 minutes for getting
injection and medicines respectively.

In the CHC, average waiting time for registration (22 minutes), doctors examination
(19 minutes), injection (13 minutes), getting medicines (15 minutes) and dressing
(5 minutes) is less than 30 minutes.

In the PHCs average waiting for registration and doctors examination was 21 minute and
23 minute respectively. Waiting time for injection, getting medicine and dressing was 15
minutes, 16 minutes and 5 minutes respectively.
Table 3: Waiting time
A.
Type of Facility District Hospital
o. of patients Average waiting
Average waiting time for:
availed the service time (in minutes)
Registration 10 11.5
Doctor’s examination 10 13.5
Injection 9 9.4
Getting medicines 10 9.5
Dressing - -
Paying bill - -
Total time taken for OPD services

99
B.
Type of Facility CHC
o. of patients Average waiting
Average waiting time for:
availed the service time (in minutes)
Registration 20 22.1
Doctor’s examination 20 19.3
Injection 8 12.5
Getting medicines 19 14.9
Dressing 1 5.0
Paying bill - -
Total time taken for OPD services

C.
Type of Facility PHC
o. of patients Average waiting
Average waiting time for:
availed the service time (in minutes)
Registration 40 21.1
Doctor’s examination 40 23.3
Injection 28 14.8
Getting medicines 39 16.3
Dressing 1 5.0
Paying bill - -
Total time taken for OPD services

D.
Type of Facility All
o. of patients Average waiting
Average waiting time for:
availed the service time (in minutes)
Registration 70 20.0
Doctor’s examination 70 20.7
Injection 45 13.3
Getting medicines 68 14.9
Dressing 2 5.0
Paying bill - -
Total time taken for OPD services

Overall, in the Government health facilities average waiting time taken for registration in
the OPD was 20 minutes and doctors call is 21 minutes. The average time taken for
injection and getting medicines was 13 minutes and 15 minutes respectively.

Table 4 explains the satisfaction regarding waiting time. All the OPD patients viewed that
waiting time for registration, doctor’s examination, injection and getting medicines
(100 percent) is appropriate.

100
Table 4: Satisfaction regarding waiting time
A.
Type of Facility District Hospital
o. of patients Satisfaction
Waiting time for: availed the (percent of patients)
service Too Long Appropriate Too Short Can’t Say
Registration 10 - 100.0 - -
Doctor’s examination 10 - 100.0 - -
Injection 10 - 100.0 - -
Getting medicines 10 - 100.0 - -
Dressing 10 - - - -
Paying bill 10 - - - -

B.
Type of Facility CHC
o. of patients Satisfaction
Waiting time for: availed the (percent of patients)
service Too Long Appropriate Too Short Can’t Say
Registration 20 35.0 30.0 35.0 -
Doctor’s examination 20 25.0 55.0 20.0 -
Injection 20 - 75.0 25.0 -
Getting medicines 20 26.3 31.6 42.1 -
Dressing 20 - 100.0 - -
Paying bill 20 - - - -

C.
Type of Facility PHC
o. of patients Satisfaction
Waiting time for: availed the (percent of patients)
service Too Long Appropriate Too Short Can’t Say
Registration 40 17.5 67.5 15.0 -
Doctor’s examination 40 27.5 62.5 10.0 -
Injection 40 14.3 71.4 14.3 -
Getting medicines 40 17.9 69.2 12.8 -
Dressing 40 - 100.0 - -
Paying bill 40 - - -

D.
Type of Facility All
o. of patients Satisfaction
Waiting time for: availed the (percent of patients)
service Too Long Appropriate Too Short Can’t Say
Registration 70 20.0 61.4 18.6 -
Doctor’s examination 70 22.9 65.7 11.4 -
Injection 70 8.9 77.8 13.3 -
Getting medicines 70 17.6 63.2 19.1 -
Dressing 70 - 100.0 - -
Paying bill 70 - - - -

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 In the CHCs, 30 percent of the patient felt that waiting time for registration is
appropriate (30 percent), 35 percent felt it was too long and for 35 percent it was too
short. According to 55 percent of the out patient waiting time for doctors examination
was appropriate and for 25 percent it was too long and it was too short for 20 percent of
OPD patients. According to three fourth of the outpatient waiting time for injection was
appropriate and for 25 percent it was too short. As reported by the out patients the time
for getting medicines was appropriate for 32 percent, too long for 26 percent and 42
percent for too short.

In the PHCs majority of the out patients felt that waiting time for registration (68
percent), doctor’s examination (63 percent), injection (71 percent), getting medicines (69
percent) and dressing (100 percent) was appropriate.

Overall higher proportion of the out patients felt that waiting time for registration
(61 percent), doctor’s examination (66 percent), injection (78 percent), getting medicines
(63 percent) and dressing (100 percent) was appropriate.

Table 5 explains the behaviour of staff with the patient in the government health
facilities. Majority of the out patient opinioned that in the District Hospitals the doctors
greets the patient in friendly manner (70 percent) behaviour of doctor was reasonable
(100 percent), good behaviour of nursing staff (90 percent) and dispenser (100 percent).
The same situation exists in the CHCs and PHCs also. Over all 77 percent of the out
patients opinioned that doctor greet them friendly (CHC 75 percent; PHC 80 percent),
behaviour of doctor is reasonable (CHC 80 percent; PHC 76 Percent), Good behaviour of
nursing staff (CHC 75 percent; PHC 98 percent), and good behavior of dispenser (CHC
80 percent; PHC 95 percent).

All the out patients (94 percent) reported about privacy at the place of
examination, in the District Hospital (100 per cent), CHC (95 percent), PHC (93 percent).
(Table 6).

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Table 5: Behaviour of staff
Type of Health Facility
Staff Behaviour
District Hospital CHC PHC All
Doctor greet in a friendly
manner
Not friendly 20.0 - 5.0 5.7
Yes, somewhat 10.0 25.0 15.0 17.1
Yes 70.0 75.0 80.0 77.1
Behaviour of Doctor
Rude - - - -
Reasonable - 10.0 10.0 8.6
Good 100.0 80.0 77.5 81.4
Very kind - 10.0 12.5 10.0
Behaviour of ursing Staff
Rude - 5.0 - 1.4
Reasonable 10.0 15.0 2.5 7.1
Good 90.0 75.0 97.5 90.0
Very kind - 5.0 - 1.4
Behaviour of Dispenser
Rude - 5.0 - 1.4
Reasonable - 10.0 2.5 4.3
Good 100.0 80.0 95.0 91.4
Very kind - 5.0 2.5 2.9
Behaviour of Technician
Rude - - - -
Reasonable - 10.0 2.5 4.3
Good - - 20.0 11.4
Very kind - 5.0 - 1.4
Total out-patients interviewed 10 20 40 70

Table 6: Privacy
Type of Health Facility (Percent)
Privacy
District
Hospital CHC PHC All
Patients reporting presence of
privacy at the place of
examination 100.0 95.0 92.5 94.3
Total out-patients interviewed 10 20 40 70

Table 7 denotes the patient-doctor /provider communication according to the

outpatients. Fifty-six percent of the out patients viewed, doctors always listened to
description of ailment patiently, allowed to ask questions (53 percent), always allowed to
respond to questions (50 percent), discussed about the ailment with the patient (77
percent) and gave other advice (69 percent).

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Table 7: Patient-Doctor/Provider Communication
Percent
Type of Health Facility (Percent)
Patient-Doctor Communication
District
CHC PHC All
Hospital
Doctor listened to description of
ailment patiently
Yes, somewhat 30.0 65.0 37.5 44.3
Yes, always 70.0 35.0 62.5 55.7
No - - - -
Doctor allowed to ask questions
Yes, somewhat 10.0 55.0 42.5 41.4
Yes, always 60.0 45.0 55.0 52.9
No 30.0 - 2.5 5.7
Doctor responded to questions
Yes, somewhat 10.0 60.0 42.5 42.9
Yes, always 50.0 40.0 55.0 50.0
No 40.0 - 2.5 7.1
Doctor discussed about the
ailment
Yes 50.0 85.0 80.0 77.1
No 50.0 15.0 20.0 22.9
Doctor talked about the recovery
Yes 30.0 90.0 80.0 75.7
No 70.0 10.0 20.0 24.3
Doctor gave 'other advice'
Yes 30.0 70.0 77.5 68.6
No 70.0 30.0 22.5 31.4
Total out-patients interviewed 10 20 40 70

Table 8 explains the satisfaction of OPD patients regarding cleanliness of the

facility. All most all the patients were satisfied with the cleanliness of OPD room,
examination room, dispensary (90 percent each), injection room (80 percent) and
laboratory (100 percent).
Table 8: Satisfaction of OPD patients regarding cleanliness of the facility

A.
Type of Facility District Hospital
Cleanliness (percent of patients)
o. of patients
Satisfaction regarding Partially
availed the service ot Clean Clean
Clean
OPD Room 10 - 10.0 90.0
Examination Room 10 - 10.0 90.0
Dispensary 10 - 10.0 90.0
Laboratory 10 - - 10.0
Injection Room 10 - 10.0 80.0
Dressing Room 10 - -

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B.
Type of Facility CHC
Cleanliness (percent of patients)
o. of patients
Satisfaction regarding Partially
availed the service ot Clean Clean
Clean
OPD Room 20 - 5.0 95.0
Examination Room 20 - 5.0 95.0
Dispensary 20 - 5.0 90.0
Laboratory 20 - - 10.0
Injection Room 20 - 5.0 35.0
Dressing Room 20 - 5.0 5.0

C.
Type of Facility PHC
Cleanliness (percent of patients)
o. of patients
Satisfaction regarding Partially
availed the service ot Clean Clean
Clean
OPD Room 40 - 12.5 37.5
Examination Room 40 - 7.7 92.3
Dispensary 40 - 5.4 94.9
Laboratory 40 - - 2.5
Injection Room 40 - 5.0 65.0
Dressing Room 40 - - 10.0

D.
Type of Facility All
Cleanliness (percent of patients)
o. of patients
Satisfaction regarding Partially
availed the service ot Clean Clean
Clean
OPD Room 70 - 10.0 90.0
Examination Room 70 - 7.2 92.8
Dispensary 70 - 5.8 92.8
Laboratory 70 - - 5.7
Injection Room 70 - 5.7 58.6
Dressing Room 70 - 1.4 7.1

In the CHCs also almost all the out patient were satisfied with the cleanliness of
OPD room, examination room (95 percent each), dispensary (90 percent), laboratory
(100 percent), injection room (95 percent).

Examination room (92 percent) dispensary (95 percent) and injection room (65
percent), OPD room (88 percent) were clean in the PHCs. Overall according to 90
percent of the outpatient OPD room was clean, for 93 percent examination room and
dispensary were clean. Fifty nine percent viewed that injection room was clean.

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 Table 9 viewed the satisfaction of OPD patient regarding crowding in the facility.
According to out patient in the District Hospitals, OPD room, examination rooms,
dispensary were reported about crowded at some extent (70 percent) and 60 percent
reported about crowd in the injection room. The percentage of the patients satisfied with
adequate crowd was 35 percent, OPD room (37 percent), examination room (30 percent),
dispensary.

Table 9: Satisfaction of OPD patients regarding crowding in the facility

A.
Type of Facility District Hospital
Crowding (percent of patients)
o. of patients
Satisfaction regarding ot Somewhat
availed the service Adequate
Adequate Adequate
OPD Room 10 - 70.0 30.0
Examination Room 10 - 70.0 30.0
Dispensary 10 - 70.0 30.0
Laboratory 10 - - 10.0
Injection Room 10 - 60.0 30.0
Dressing Room 10 - - -

B.
Type of Facility CHC
Crowding (percent of patients)
o. of patients
Satisfaction regarding ot Somewhat
availed the service Adequate
Adequate Adequate
OPD Room 20 35.0 30.0 35.0
Examination Room 20 15.5 47.4 36.8
Dispensary 20 20.0 45.0 30.0
Laboratory 20 - 5.0 5.0
Injection Room 20 10.0 25.0 5.0
Dressing Room 20 - 5.0 5.0

C.
Type of Facility PHC
Crowding (percent of patients)
o. of patients
Satisfaction regarding ot Somewhat
availed the service Adequate
Adequate Adequate
OPD Room 40 15.0 65.0 20.0
Examination Room 40 - 74.4 25.6
Dispensary 40 - 72.5 25.0
Laboratory 40 - - 2.5
Injection Room 40 7.5 40.0 22.5
Dressing Room 40 - 10.0 -

106
 D.
Type of Facility All
Crowding (percent of patients)
o. of patients
Satisfaction regarding ot Somewhat
availed the service Adequate
Adequate Adequate
OPD Room 70 18.6 55.7 25.7
Examination Room 70 4.4 66.2 29.4
Dispensary 70 5.7 64.3 27.1
Laboratory 70 - 1.4 4.3
Injection Room 70 7.1 38.6 18.6
Dressing Room 70 - 7.1 1.4

In the PHCs also OPD room (65 percent), examination room (74 percent),
dispensary (73 percent) and injection room were some what crowded.
Table 10 explains the out patient view about the continuity of the treatment in the
Government health facility. Sixty-seven percent of the outpatients were fully satisfied
with their visit to the Government health facility (District Hospital 60 percent; CHC 65
percent; PHC 70 percent). All most all the patients (99 percent) viewed that they will visit
again to the facility if they fell sick and also they recommend this hospitals to others.

Table 10: Continuity of treatment

Percent
Continuity of treatment
Type of Health Facility
Continuity of treatment District Hospital CHC PHC Total
Satisfaction with the visit to the
health facility
Dissatisfied - - - -
Somewhat satisfied 40.0 35.0 30.0 32.9
Satisfied 60.0 65.0 70.0 67.1
Reason of dissatisfaction, if
dissatisfied
Lack of facilities - - - -
Bad experience with the doctors - - - -
Poor quality of services - - - -
Charges are exorbitant - - - -
Other - - - -
Visit again to the facility (if fell
sick)
Yes 100.0 100.0 97.5 98.6
No - - 2.5 1.4
May come / unsure - - - -
Recommend this hospital to
others
Yes 100.0 100.0 97.5 98.6
No - - 2.5 1.4
Total out-patients interviewed 10 20 40 70

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