HFA District Report - Keich

Health Facility Assessment Balochistan
District Keich
Acknow ledgement
TRF acknowledges the cooperation and support of Contech International Health

Consultants, Lahore who worked on the assignment and authored the report. The final
reports were quality assured by Jennifer Sanchos, HLSP Health Systems Consultants, and
Ms. Pamela Sequeria, M & E Specialist TRF.
Disclaimer
This document is issued for the party which commissioned it and for specific purposes
connected with the above-captioned project only. It should not be relied upon by any other
party or used for any other purpose.
We accept no responsibility for the consequences of this document being relied upon by any
other party, or being used for any other purpose, or containing any error or omission which is
due to an error or omission in data supplied to us by other parties.
June 2012
Table of Contents
List of Tables ................................................................................................................ iv
List of Figures .............................................................................................................. vi
Acronyms .................................................................................................................... vii
Executive Summary ...................................................................................................... 1
Section 1: Introduction ................................................................................................. 3
Survey Objectives ...................................................................................................... 3
Assignment Duration .................................................................................................. 3
Scope Of Hfa ............................................................................................................. 3
Report Organisation ................................................................................................... 4
Section 2: District Information ..................................................................................... 5
Geographical Location ............................................................................................... 5
Administrative Setup .................................................................................................. 6
Demographic Information ........................................................................................... 6
Socioeconomic And Health Indicators ........................................................................ 6
Section 3: Health Facility Assessment Survey Findings............................................ 8
MNCH Services ......................................................................................................... 8
8/6 Preventive MNCH Services At BHU ................................................................ 9
24/7 Basic EmONC Services At RHC.................................................................. 12
24/7 Comprehensive EmONC Services at SHC Hospital .................................... 15
24/7 Basic EmONC Services at THQ Hospital..................................................... 19
Management Basics................................................................................................. 20
Human Resource ................................................................................................ 20
Work Coordination And Supervision .................................................................... 23
Management Information System ........................................................................ 24
Drugs And Supplies ............................................................................................ 26
Fee For Services ................................................................................................. 27
Infection Control .................................................................................................. 29
Death Review ...................................................................................................... 31
Facility Utilisation ..................................................................................................... 31
Well Baby Clinic ....................................................................................................... 34
Donor Contribution ................................................................................................... 34
Clients Perspective .................................................................................................. 35
Procurement Estimates ............................................................................................ 37
ii
Equipment ........................................................................................................... 37
Civil Works .......................................................................................................... 37
Section 4: Key Findings ............................................................................................. 39
Infrastructure ............................................................................................................ 39
Human Resource ..................................................................................................... 39
Equipment ................................................................................................................ 40
Drugs And Supplies ................................................................................................. 40
Support Services ...................................................................................................... 41
Management Basics................................................................................................. 41
Donor Contribution ................................................................................................... 42
Clients Perspective .................................................................................................. 42
Annexes ....................................................................................................................... 43
Annex 1: District Health Department ......................................................................... 44
Annex 2: Input Criteria For MNCH Services .............................................................. 50
Annex 3 A: Status of Surveyed HF Against Minimal Level of Inputs.................... 63
Annex 3 B: List of Items Required .......................................................................... 69
Annex 4: Scope of Civil Works Required .................................................................. 79
iii
List of Tables
Table 1.1: Scope of HFA ................................................................................................ 4
Table 2.1: Demographic profile ....................................................................................... 6
Table 2.2: Population groups .......................................................................................... 6
Table 2.3: Socio-economic and health indicators............................................................ 7
Table 3.1: Status of assessed infrastructure in BHU ..................................................... 10
Table 3.2: Status of MNCH related staff in BHU ........................................................... 10
Table 3.3: Status of functional equipment in BHU......................................................... 11
Table 3.4: Status of drugs and supplies in BHU............................................................ 11
Table 3.5: Status of support services in BHU................................................................ 11
Table 3.6: Status of assessed infrastructurein RHC...................................................... 12
Table 3.7: Status of MNCH related staff in RHC ........................................................... 13
Table 3.8: Status of functional equipment in RHC ........................................................ 14
Table 3.9: Status of drugs and supplies in RHC ........................................................... 14
Table 3.10: Status of support services in RHC ............................................................. 15
Table 3.11: Status of assessed infrastructure in DHQ hospital .................................... 15
Table 3.12: Status of MNCH related staff in DHQ hospital ............................................ 18
Table 3.13: Status of functional equipment in SHC hospital.......................................... 18
Table 3.14: Status of drugs and supplies in SHC hospital ............................................ 19
Table 3.15: Status of support services in SHC hospital ................................................ 19
Table 3.16: Status of HR at SHC hospital ..................................................................... 20
Table 3.17: Status of HR at RHC .................................................................................. 20
Table 3.18: Status of HR at surveyed BHU................................................................... 21
Table 3.19: Reasons of non-availability of HR at RHC.................................................. 22
Table 3.20: Reasons of non-availability of HR on 24/7 basis at SHC hospital ............... 22
Table 3.21: Capacity building of MNCH related staff .................................................... 22
Table 3.22: Status of coordination and supervision ...................................................... 23
Table 3. 25:Status of MIS ............................................................................................. 24
Table 3.24: Reasons for stock out reported by surveyed facilities................................. 26
Table 3.25: Status of fee for service ............................................................................. 28
Table 3.26: Mechanisms of social protection available ................................................. 29
Table 3.27: Status of infection control & waste management practices ........................ 30
Table 3.28: Status of death reviews.............................................................................. 31
Table 3.29: Status of services utilisation ....................................................................... 31
iv
Table 3.30: Average monthly MNCH services provided ................................................ 32

Table 3.31: Average monthly FP services provided ...................................................... 33
Table 3.32: Status of WBC established ........................................................................ 34
Table 3.33: Status of donor contribution ....................................................................... 34
Table 3.34: Clients perspective .................................................................................... 36
Table 3.35: Summary of estimated cost for procurement of equipments & civil works .. 38
Table 2.4: Number of public sector health facilities in the district .................................. 44
Table 2.5: Human resourse in office of DHO ................................................................ 44
Table 2.6: Availability of MNCH services staffing in district Keich ................................. 45
Table 2.7: Financial allocation in district Keich.............................................................. 46
Table 2.8: NMNCHP monitoring indicators (year 2010) ................................................ 47
Table 2.9: Number of facilities with staff provided by the NMNCHP .............................. 48
Table 2.10: Number of staff trained on delivering MNCH services ................................ 49
Table 2.11: Status of CMW training and deployment .................................................... 49
i.
Status of assessed infrastructure in BHU ................................................................ 63
ii. Status of MNCH related staff in BHU ...................................................................... 63

iii. Status of functional equipment in BHU.................................................................... 63
iv. Status of drugs and supplies in BHU ...................................................................... 63
v. Status of support services in BHU........................................................................... 64
i.
Status of assessed infrastructure in RHC ................................................................ 64
ii. Status of MNCH related staff in RHC ..................................................................... 65

iii. Status of functional equipment in RHC ................................................................... 65
iv. Status of drugs and supplies in RHC ...................................................................... 66
v. Status of support services in RHC .......................................................................... 66
i.
Status of assessed infrastructure in SHC hospital ................................................... 66
ii. Status of MNCH related staff in SHC hospital ........................................................ 67

iii. Status of functional equipment in SHC hospital ...................................................... 67
iv. Status of drugs and supplies in SHC hospital ......................................................... 68
v. Status of support services in SHC hospital ............................................................. 68
List of Figures
Figure 1: Map of Keich ................................................................................................... 5
Figure 2: Range of services that signal fully functional MNCH services.......................... 8
Figure 3: Status of management basics ....................................................................... 21
Figure 4: Level of satisfaction with examination and attitude of staff ............................ 37
Figure 5: Availability of medicines and lab services ...................................................... 37
vi
ACRONYMS
ANC
AVD
Antenatal Care
Assisted Vaginal Deliveries
BB technician
BHU
CBA
CEI
Blood Bank Technician

Basic Health Unit
CH
CMW
Civil Hospital
Community Midwives
CWAQ
CDC
Civil Works Assessment Questionnaire

Communicable Disease Control
District Coordination Officer
District Data Collection Teams
DCO
DDCT
Child bearing age

Client Exit Interview
DHO
DHDC
DHIS
DHQH
District Health Officer

District Health Development Centre
DLQ
EDOs
EmONC
ENC
EAQ
EPI
FP & PHC
HF
HFA
District Level Questionnaire

Executive District Officers
Emergency Obstetric and Newborn Care
Emergency Newborn Care
Equipment Assessment Questionnaire
Expanded Programme of Immunisation
Family Planning and Primary Health Care
Health Facilities
Health Facility Assessments
Health Institution Database
Human Immunodeficiency Virus
Health Management Information System
HID
HIV
HMIS
HR
IDI EDOH
IMNCI
IMPAC
JD
LHS
LHV
LHW
MDGs
M&E
MICS
MIS
District Health Information System

District Headquarter Hospital
Human Resource
In-depth Interview of EDO Health
Integrated Management of Neonatal and Childhood Illnesses
Integrated Management of Pregnancy and Childbirth
Job Description
Lady Health Supervisor
Lady Health Visitor
Lady Health Worker
Millennium Development Goals
Monitoring and Evaluation
Multiple Indicator Cluster Survey
Management Information System
vii
MNCH
MO
Maternal, Neonatal and Child Health

Medical Officer
NMNCHP
NVD
National Maternal Newborn and Child Health Programme

Normal Vaginal Deliveries
OBGYN
OPD
OT
PC-1
Obstetrics and Gynaecology

Out Patient Department
Operation Theatre
Planning Commission Proforma 1
PDHS
PNC
PPHI
PSLM
Pakistan Demographic and Health Survey

Post natal care
RHC
SBA
SD&MB
SE
Rural Health Centre

Skilled Birth Attendants
Service Delivery and Management Basics
Socioeconomic
SHC hospitals
SPSS
TA
THQ
TRF
TT
WMO
WBC
Secondary health care

Statistical Package for the Social Sciences
Technical Assistance
Tehsil Headquarter hospital
Technical Resource Facility
Tetanus Toxoid
Women Medical Officer
Well Baby Clinics
Peoples Primary Health care Initiative

Pakistan Social & Living Standards Measurement Survey
viii
District Report - Keich
Executive Summary
Health Facility Assessment 2011 (HFA) is aimed at assessing the availability, functioning,
and quality of health care services in public sector health facilities with a focus on maternal,
new-born and child health services. This report provides the findings of the HFA for each
surveyed health facility in the district. It is baseline information for the district and the
National Maternal New-born and Child Health Programme (NMNCHP), to set performance
benchmarks and realign activities for bridging the gaps existing in Maternal New-born and
Child Health (MNCH) services for achieving the objectives of the programme.
The HFA started in October 2010 and completed in May 2011. Contech accomplished the
assignment in a participatory way by maintaining constant liaison with the entire key
stakeholder. Nineteen (19) health facilities were assessed in District Keich, including 1 DHQ
hospital, 11 RHC and 7 BHU. The BHU were assessed for availability of 8/6 Preventive
MNCH services; RHC were assessed for availability of 24/7 Basic EmONC services; and
DHQ Hospital was assessed for availability of 24/7 Comprehensive EmONC services. An
assessment criterion was formulated to ascertain gaps in availability of inputs1, including
Infrastructure; Human Resource (HR); Drugs and Supplies; Equipment; and Level specific
support services. Summarised HFA findings (detailed findings are given in Section 4) of
HFA, are as follows:
In infrastructure, major gaps existed in availability of labour room at all BHU and 4 RHC,
female ward at RHC Gomazai, RHC Gower Koop and RHC Bal Nigor;LHV residence at
all BHU, 3 RHC
Regarding HR, required number of WMO were not available at all RHC except RHC
Dasht Khudan; required number of LHV were present at 6 RHC; and major gaps were
related to gynaecologist, anaesthetist, anesthesia technician and OT technician at
DHQH
Majority of the required equipment items were not available at the surveyed health
facilities, although complete range of items was not available at any of the facility
Drugs, Supplies, Vaccines and FP commodities were assessed using facility specific list
of tracer items for their availability on the day of survey and stock-out status during last
Optimal level of inputs is proposed in the Planning Commission Proforma 1 (PC-1) of NMNCHP required to
deliver level specific MNCH services; Minimal level of inputs, are bare minimum requirement of the inputs for
delivering level specific MNCH services. More explanation of these inputs has been provided at the start of
Section 3 of the report and contents of the criteria are given in Annexure 1

one month. Majority of the items were available at the RHC and DHQ Hospital, but most
of the required items were not available at the surveyed BHU.The most common reason
for stockout of drugs was poor quantification and delayed supply
Level specific required items for delivery of support services were assessed at the
surveyed health facilities. In District Keich, both DHQH and RHC were provided with
majority of items for delivering support services, however, gaps existed at BHU.
Management basics assessed at the surveyed facilities included availability of job

description and service delivery protocols, work coordination and supervision, MIS, infection
control practices, death reviews of maternal and neonatal deaths, fee for services and
available mechanisms of social protection, and facility utilisation of MNCH services
Majority of the health facilities were conducting regular performance review meetings but
its record was not maintained
Health Management Information System (HMIS) was being practiced in the District Keich
and HMIS tools were available at all surveyed health facilities but not maintained
properly at the surveyed facilities
Major gaps existed in availability of materials for infection control measures
Review of maternal and neonatal deaths was not conducted as death review committee
was not available at any health facility
No Well Baby Clinic established in any of the facilities except at DHQH Keich.
In order to assess the perceptions of the clients, a total of 65 Client Exit Interviews were
conducted in the DHQH and RHC. Clients perspective on quality of care revealed that
majority of the clients were satisfied with the care provided at the public facilities.
Findings of the HFA at all levels revealed significant gaps in the required inputs for provision
of quality MNCH services. This warrants immediate need to bridge these gaps in order to
improve the MNCH services.
Section 1: Introduction
This section includes survey objectives, its scope and duration, and organisation of the
District Report
Survey Objectives
The HFA was aimed at assessing the availability, functioning, and quality of health care
delivery system in the public sector facilities with a focus on maternal, new-born and child
health services.
Specific objectives of the HFA were:
To assess the health facility status and quality of MNCH services (Comprehensive and
Basic EmONC, Preventive MNCH and Family Planning) at district level
To assess clients satisfaction and perception of MNCH services
To provide information for systematic planning for procurement and supply of goods and
commodities (listing the medical equipment and instruments which needs to be replaced
or purchased); and
To update and assess the contributions made by the development partners for improving
MNCH and FP services in the selected districts
Assignment Duration
Estimated duration of the assignment was 7 months. The assignment started in October
2010 and completed in May 2011.
Scope of HFA
The survey included District Headquarter Hospital (DHQH), Tehsil Headquarter Hospital
(THQH), Rural Health Centres (RHC) and 20% of Basic Health Units (BHU) randomly
selected within the district. Selection of the BHU was through geographical stratification on
the basis of proportionate distribution. Client exit interviews were conducted at the surveyed
facilities (10 at DHQH, 5 at each THQH and RHC), excluding BHU. Table 1.1 shows the
number of health facilities in the district and health facilities surveyed.

TABLE 1.1: SCOPE OF HFA
District Keich
Number of Health Facilities by type

DHQH
THQH
RHC
BHU
Total
Number of facilities listed by HID
11
36
48
Number of facilities surveyed
11
19
Report Organisation
HFA District Report has been structured in four sections. While the introduction to the
survey, its scope and methodology is described in Section 1, Section 2 District Information
contains information collected from the District Health Department using DLQ as well as the
secondary data sources and it comprises of demographic, economic and education related
information of the district as well as the organisation of health care delivery system in the
district. This section also includes information about the monitoring indicators of National
MNCH Programme.
Details of the assessment are contained in Section 3 HFA Findings. This section presents
information about NMNCHP analytical framework indicators, status of the MNCH service
availability based on optimal level of inputs including infrastructure, human resource,
equipment, drugs and supplies and availability of support services. Information on
management basics like work coordination, MIS etc., is also contained in this section. The
information presented in this section gives snapshot in time of the surveyed health facilities.
At the end information about the satisfaction and perspective of the clients on the MNCH
services provided at the public sector health facilities. Section 4 comprises of key findings of
HFA at district level.
Section 2: District Information

This section includes district brief, information on demographic, socioeconomic and health
indicators. It also contains information on health resources and NMNCHP indicator compiled
at district level. The data sources of the information are DHO office using District Level
Questionnaire (DLQ) and published documents. The information collected from DHO office
may not match with subsequent tables containing similar information collected from
respective health facilities included in survey.
Geographical Location
District Keich is in the northwest of province Balochistan having 22,539 km2 areas. The
whole population has always been rural. A small portion of the population is residing in urban
areas. The main Baloch tribes in the district are the Gichki, Pogh, Naushervani, Buledai Mir,
Hoth, Khushk, Rais, Rind, Sangur, Lundi, Kattawar, Kalyar, Kaunda, Bizanjo and Darzada.
Tump is very famous tehsil of district Keich, there are so many villages and union council in
Tump after the Turbat tehsil; tump tehsil is beginning from Hothabad village and going end
last border of Iran called Mand. District Kech is connected to adjacent districts and the
provincial capital through a network of roads and rail.
FIGURE 1: MAP OF KEICH
Administrative Setup
Like other districts in the province, district Keich is headed by Deputy Commissioner (DC)
assisting the Divisional Commissioner and is accountable to him. The DC is appointed by
the provincial government from the Federal or Provincial Civil Service.
Demographic Information
TABLE 2.1: DEMOGRAPHIC PROFILE
Indicators
Value
Indicators
Value
Total Population (thousands)
432,569
Urban Population
17%
Population of Tehsil Turbat
205,753
Rural Population
83%
Population of Tehsil Buleda
79,250
Population of Tehsil Dashat
67,866
Population of Tehsil Tump
91,304
Population density (persons

per sq.km)
Sex ratio (number of males
over 100 females) at birth
19
108
S OURCE : HMIS C ELL DHO O FFICE
TABLE 2.2: POPULATION GROUPS
Population
Groups
Standard
Demographic
(%)
Under 1 year
2.70
Under 5 years
13.40
Estimated
population
11,679
57,964
Under 15
years
41.97
181,549
Population
Groups
Women 15-49
years
Married Women
Child Bearing
Age (CBA)
Standard
Demographic
(%)
22.00
Estimated
population
95,165
16.00
69,211
Pregnant women
3.40
Expected Births
2.9
14,707
12,545
S OURCE : PDHS 2006-07
Socioeconomic and Health Indicators

Selected Socio-Economic (SE) and health indicators are given in the table 2.3. The sources
include, Pakistan Demographic and Health Survey (PDHS) 2006-7, Pakistan Social and
Living standards Measurement Survey (PSLM) 2008-09, Immunisation Coverage Evaluation
Survey Pakistan (CES) 2006-7, District EPI Cell.

TABLE 2.3: SOCIO-ECONOMIC AND HEALTH INDICATORS
Indicators
District Specific figures
Value
Indicators
Value
PSLM 2008-09
Literacy rate
52%
Malnutrition*
Women
Children
Income per Capita*
Provincial figures
PDHS 2006-07
86 (DHO)
Infant Mortality Rate (IMR)
49 per 1000 live births
Under 5 Mortality Rate (U5MR)
59 per 1000 live births
% children<12 months fully

immunised
Maternal Mortality Ratio
79.2 (CES)
785 per
100,000 live
births
* Data Not Available
Section 3: Health Facility Assessment Survey

Findings
MNCH Services
The packages of MNCH services assessed include Preventive MNCH services at BHU,
Basic EmONC services at RHC and Comprehensive EmONC services at THQ and DHQ
hospitals2. The range of MNCH services are given below.
FIGURE 2: RANGE OF SERVICES THAT SIGNAL FULLY FUNCTIONAL MNCH SERVICES
BHU: Facility
available for
8/6 Preventive
MNCH Services
Antenatal checkup
Lab (Anemia,
Malaria, pregnancy
test, urine test for
sugar & Protein)
Normal delivery
Family planning
services (at least 3
methods)
TT immunisation
EPI vaccination
Growth monitoring
Nutrition counseling
HR (at least one
LHV or Doctor)
RHC: Facility
available for
24/7 Basic EmONC

Services
Parenteral
antibiotics
Parenteral oxytocic
drugs
Parenteral
anticonvulsants for
pregnancy induced
convulsions (due to
hypertension)
Manual removal of
placenta
Removal of
retained products
Assisted vaginal
delivery (vacuum
extraction, forceps)
Newborn
resuscitation
+
Post abortion care
HR (skilled female
providers-WMO
and LHV), and
Preventive MNCH
DHQ/THQ
Hospitals: Facility
available for
24/7
Comprehensive
EmONC services
Surgery (C-section)
Blood transfusion
Newborn care
(resuscitation &
incubator)
+
Gynaecological
care
Comprehensive
family planning
services including
sterilisation
HR (skilled staff for
conducting, Csection, blood
transfusion and
anaesthesia),
and
Preventive MNCH
and Basic EmONC
NMNCHP PC -1

Functional capacity of health facilities were assessed against 5 specified inputs, which
include:
1. Infrastructure
2. Human Resource
3. Drugs and Supplies
4. Equipment
5. Level specific support services
Health facilities assessment findings are presented against two levels of inputs including:
1. Optimal level of Inputs are those proposed in the PC-1 of the National MNCH
Programme, required to make a health facility fully functional for provision of level
specific package of MNCH services.
Optimal level of inputs provides a strategic norm upon which gaps are identified and
up-gradation are proposed for improving accessibility of quality MNCH services
through development and implementation of an integrated and sustainable MNCH
programme at all levels of the health care delivery system.
2. Minimal level of Inputs, which are bare minimum requirement of the inputs, required for
delivering the package specific MNCH services at the health facilities. Findings related
to minimal level of inputs are given as Annex 2.
Following tables present the status of assessed facilities for availability of the optimal
level of inputs
8/6 Preventive MNCH Services at BHU

BHU operating within District Keich were assessed for provision of Preventive MNCH
services available for 8 hours a day, 6 days a week (8/6). Seven BHU were assessed for
availability of optimal level of inputs as summarised in Tables 3.1 - 3.5 by individual BHU.

TABLE 3.1: STATUS OF ASSESSED INFRASTRUCTURE IN BHU
Status of building components at Surveyed BHU

Infrastructure
Status
OPD
1. Consultation
area
2. Examination
area
3. Hand washing
LHV Room
1. Consultation
area
2. Examination
area
3. Hand washing
Labour room
1. Delivery room
2. Scrub area
3. Patient wash
room
Residence
Doctor
Residence
LHV
BHU
Dastuk*
BHU
Gawak
BHU
Kohad
BHU
Balgather
BHU
Gokdan
BHU
Drachkoo
BHU
Kunchity*
A
F
A
F
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
A
F
A
F
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
F
A
F
A
F
A
F
A
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
Y
N
N
N
N
N
N
N
Y
*THE BHU DASHAT, AND BHU KUNCHITY ARE AFFECTED BY FLOOD.
Doctor or LHV is required for provision of Preventive MNCH Services.Status of assessed

BHU for availability of Human Resource (HR) (both regular posted and provided by
NMNCHP),against the required number mentioned in PC-1 of NMNCHP is presented below:
TABLE 3.2: STATUS OF MNCH RELATED STAFF IN BHU
Number of MNCH related staff available at each BHU

Staff
categories
Required
number
BHU
Dastuk
BHU
Gawak
BHU
Kohad
BHU
Balgather
BHU
Gokdan
BHU
Drachkoo
BHU
Kunchity
WMO
LHV
Equipment items (general items, equipment for OPD and LHV room) for BHU are listed in
PC-1 of NMNCHP. Status of functional quantity of these items at assessed BHU is
presented below:
10

TABLE 3.3: STATUS OF FUNCTIONAL EQUIPMENT IN BHU
Equipment
Total
Items
required
at each
BHU
General items
Number of functional equipment items available at each surveyed

BHU
BHU
Dastuk
BHU
Gawak
BHU
Kohad
BHU
Balgather
BHU
Gokdan
BHU
Drachkoo
BHU
Kunchity
OPD
14
LHV Room
12
List of essential drugs and supplies for MNCH services is contained in PC-1 of NMNCHP.
Tracer items were selected from the list (Annex 1) for assessing their availability at surveyed
facilities. Status of surveyed BHU regarding available quantity of tracer items is presented
below:
Total Items
required at
each BHU
TABLE 3.4: STATUS OF DRUGS AND SUPPLIES IN BHU
BHU
Dastuk
BHU
Gawak
BHU
Kohad
BHU
Balgather
BHU
Gokdan
BHU
Drachkoo
BHU
Kunchity
Drugs
12
10
11
10
Vaccines
FP
Commodities
Item groups
Supplies
Number of items available at each surveyed BHU
Facility for basic laboratory tests (test strips and HR) was assessed at surveyed BHU and
their status is presented below
TABLE 3.5: STATUS OF SUPPORT SERVICES IN BHU
Support
services
Total
Items
required at
each BHU
BHU
Dastuk
BHU
Gawak
BHU
Kohad
BHU
Balgather
BHU
Gokdan
BHU
Drachkoo
BHU
Kunchity
Basic lab
tests
11
24/7 Basic EmONC Services at RHC

RHC operating within District Keich were assessed for provision of Basic EmONC services
available for 24 hours a day, 7 days a week (24/7). Eleven RHC were assessed for
availability of optimal level of inputs as summarised in Tables 3.6 - 3.10 by individual RHC.
Infrastructure of the RHC has been assessed for availability of OPD, indoor ward, LHV room,
labour room and clinical laboratory as service provision areas and residences for
accommodation of required staff. Service provision areas have been assessed as single
room having facilities like consultation, examination and hand washing etc., as contained in
table below. Findings are presented as status of building components available and
functional:
TABLE 3.6: STATUS OF ASSESSED INFRASTRUCTURE IN RHC
Status of building components at each RHC
Infrastructure
Status
RHC Buleda
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower
Koop
RHC Kalatak
RHC
Nasirabad
RHC Pidark
RHC Bal
Nigore*
RHC Khudan
RHC Zaring
Bag
OPD
1. Consultation
area
2. Examination
area
A
F
A
F
A
F
A
F
A
N
N
N
N
Y
N
Y
N
Y
N
N
N
N
N
N
N
N
N
N
N
N
N
Y
Y
Y
N
Y
N
N
N
N
Y
Y
Y
N
Y
N
N
N
N
N
N
N
N
N
N
N
N
N
Y
N
Y
N
N
Y
Y
N
N
Y
Y
Y
N
Y
N
N
N
N
Y
N
Y
Y
Y
N
N
N
N
N
N
N
N
N
N
N
N
N
Y
Y
Y
N
Y
N
N
N
N
Y
N
Y
N
Y
A
F
A
F
A
N
N
Y
N
Y
N
N
N
N
Y
N
N
Y
N
Y
N
N
Y
N
Y
N
N
N
N
N
N
N
N
N
Y
N
N
Y
Y
Y
N
N
Y
Y
Y
N
N
N
N
N
N
N
Y
Y
Y
Y
N
Y
Y
Y
A
F
A
F
A
N
N
Y
N
Y
N
N
Y
N
Y
N
N
Y
Y
Y
N
N
Y
Y
Y
N
N
N
N
Y
N
N
Y
Y
N
N
N
Y
Y
N
N
N
Y
Y
N
N
N
N
N
Y
N
N
Y
N
N
Y
N
Y
Y
Y
3. Hand
washing
Female ward
1. Patient area
2. Patient wash
room
Labour room
1. Delivery
room
2. Scrub area
3. Patient wash
room
Clinical lab.
1. Laboratory
room
2. Working area
3. Pt. wash
room
LHV Room
1. Consultation
area
12

RHC
Nasirabad
RHC Pidark
RHC Bal
Nigore*
RHC Khudan
RHC Zaring
Bag
Residence
LHV
RHC Kalatak
Residence
Doctor
RHC Gower
Koop
3. Hand
washing
RHC Tump
A
F
A
F
A
F
A
F
RHC Mand
2. Examination
area
RHC Gomazai
Status
RHC Buleda
Infrastructure
Y
Y
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
Y
N
Y
Y
N
N
N
N
Y
N
Y
N
N
N
N
N
Y
Y
N
N
N
N
N
N
N
N
Y
N
N
N
N
N
Y
N
Y
N
N
N
N
N
N
N
N
N
N
N
N
N
Y
N
Y
N
N
N
N
N
Y
N
Y
N
N
N
N
N
Y
N
Y
N
*THE RHC BAL NIGORE IS AFFECTED BY FLOOD
PC-1 of NMNCHP contains category and number of staff required for Basic EmONC
services. Status of RHC for availability of HR (both regular posted and provided by
NMNCHP), against required numbers is presented in table below:
TABLE 3.7: STATUS OF MNCH RELATED STAFF IN RHC
Staff
categories
Required number at
each RHC
RHC Buleda
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower Koop
RHC Kalatak
RHC Nasirabad
RHC Pidark
RHC Bal Nigore
RHC Khudan
RHC Zaring Bag
Number of MNCH related staff available at each RHC
WMO
LHV
Lab
technician
OT
technician
Ambulance
driver
Equipment items for various service components at RHC are listed in PC-1 of NMNCHP.
Status of functional quantity of these items at RHC, is presented in the table below:
13

TABLE 3.8: STATUS OF FUNCTIONAL EQUIPMENT IN RHC
WMO OPD
15
10
10
10
10
Labour
room
19
12
10
16
LHV Room
10
RHC Zaring
Bag
RHC Khudan
RHC Bal
Nigore
RHC Pidark
RHC Tump
RHC
Nasirabad
RHC Mand
General
items
Female
ward
RHC Kalatak
RHC Gomazai
Equipment
RHC Gower
Koop
RHC Buleda
Total Items
required at each
RHC
Number of functional equipment items available at each RHC
facilities. Status of surveyed RHC regarding available quantity of tracer items is presented
below:
TABLE 3.9: STATUS OF DRUGS AND SUPPLIES IN RHC
Item groups
Total Items
required at each
RHC
RHC Buleda
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower
Koop
RHC Kalatak
RHC Nasirabad
RHC Pidark
RHC Bal Nigore
RHC Khudan
RHC Zaring Bag
Number of items available at each RHC
Supplies
Drugs
18
11
10
12
13
13
14
15
14
15
13
11
Vaccines
FP
Commodities
Facility for support services including basic laboratory tests (space, test strips and HR) and
ambulanceservices (functional vehicle and driver) was assessed at surveyed RHC.
Availability status of these services at RHC is presented below:
14

TABLE 3.10: STATUS OF SUPPORT SERVICES IN RHC
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower Koop
RHC Kalatak
RHC Nasirabad
RHC Pidark
RHC Bal Nigore
RHC Khudan
RHC Zaring Bag
Basic lab
tests
Ambulance
service
RHC Buleda
Total Items required

at each RHC
Support
services
24/7 Comprehensive EmONC Services at SHC Hospital

DHQ Hospital operating within District Keich was assessed for provision of Comprehensive
EmONC services available for 24 hours a day, 7 days a week (24/7). DHQ Hospital was
assessed for availability of optimal level of inputs as summarised in Tables 3.11 - 3.15.
Infrastructure of the DHQ hospital has been assessed for availability of OPD, indoor wards,
LHV room, labour room, operation theatre, paediatric nursery, blood bank, ultrasound room
and clinical laboratory as service provision areas and residences for accommodation of
required staff. Service provision areas have been assessed for availability of essential space
in respective areas e.g., consultation area, examination area and hand washing in OPD;
patient area, nursing station, store rooms and attached washrooms in indoor wards, etc., as
contained in table below. Findings are presented as status of building components available
and functional:
TABLE 3.11: STATUS OF ASSESSED INFRASTRUCTURE IN DHQ HOSPITAL
Infrastructure
Status
Availability of building components

DHQH Keich
OPD:
1. Consultation area
2. Examination area
3. Privacy of examination area
4. Hand washing
Female ward:
1. Patient area
2. Nursing station
F
A
F
A
F
A
F
A
Y
Y
Y
N
N
N
N
Y
F
A
F
Y
Y
Y
15
3. Patient wash room

4. Store for general items
5. Store for equipment
Labour room:
1. Delivery room
2. Preparation /stage room
3. Scrub area
4. Staff duty room
6. Staff wash room
8. Store for equip.
Operation theatre:
1. Patient preparation room
2. Operating room
3. Recovery room
4. Scrub area
5. Sterilisation area
6. Doctors room
7. Support staff duty room
9. Store for equipment

10. Attached washroom for staff
Paediatrics ward:
1. Patient area
2. Nursing station
3. Store for general
items/drugs or equip.
Paediatric nursery:
A
F
A
F
A
F
A
Y
Y
N
N
N
N
Y
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
Y
Y
Y
Y
Y
N
N
Y
Y
Y
Y
N
N
N
N
N
N
Y
Y
N
N
Y
Y
N
N
Y
Y
N
N
N
N
N
N
N
N
Y
Y
Y
Y
N
N
Y
N
Y
16

1. Patient area
F
A
F
A
F
A
F
A
Y
N
N
N
N
N
N
Y
F
A
F
A
F
A
F
A
F
A
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
Y
Y
Y
N
N
N
N
Y
Y
Y
Y
Y
Y
N
N
N
N
Y
Residence:
Gynaecologist
Residence:
Anaesthetist
Residence:
Paediatrician
Residence:
WMO
Residence:
LHV
Residence:
Nurses
2. Nursing station
3. Store for general
items/drugs or equip.
4. Change room/area
Clinical lab.:
1. Laboratory room
2. Working area
3. Doctors duty room
4. Store for general reagents or
equip.
5. Attached wash room
Blood bank:
1. Blood collection room
2. Working area
3. Staff duty room
4. Store for general reagents or
equip.
5. Attached wash room
LHV Room:
2. Examination area
3. Privacy for examination
4. Hand washing facility
Ultrasound room:
Examination area
17
Residence
Lab technician
Residence:
BB technician
Residence:
Anaesthesia technician
PC-1 of NMNCHP contains category and number of staff required for Comprehensive
EmONC services. Status of DHQ hospital for availability of HR (both regular posted and
provided by NMNCHP), against required numbers is presented in table below:
TABLE 3.12: STATUS OF MNCH RELATED STAFF IN DHQ HOSPITAL
Staff categories
Availability of MNCH related staff at SHC Hospital

DHQH Keich
Required number
Available number
Gynaecologist
Anaesthetist
Paediatrician
WMO
OT technician
BB technician
Lab technician
Nurses
20
LHV
Ambulance drivers
Equipment items for various service components at DHQ hospital are listed in PC-1 of
NMNCHP. Status of functional quantity of these items at SHC hospitals, is presented in the
table below:
TABLE 3.13: STATUS OF FUNCTIONAL EQUIPMENT IN SHC HOSPITAL
Staff categories
Number of functional equipment at
General items
Total required Items

4
DHQH Keich
3
Female ward
OPD
Paediatric nursery
19
12
13
14
9
11
18

Paediatric ward
Labour room
10
24
8
18
Operation theatre
Clinical laboratory
31
5
23
2
facilities. Status of DHQ hospital regarding available quantity of tracer items is presented in
the table below:
TABLE 3.14: STATUS OF DRUGS AND SUPPLIES IN SHC HOSPITAL
Item groups
Number of items available at

DHQH Keich
Total Items
Supplies
Drugs
Vaccines
FP Commodities
21
5
7
14
5
5
Facility for support services including laboratory tests (space, test strips and HR), blood
transfusion services (space, supplies and HR), ambulanceservices (functional vehicle and
driver), operation theatre (space, drugs and supplies, equipment items and HR) was
assessed at surveyed DHQ hospital. Availability status of these services at SHC hospitals is
presented below:
TABLE 3.15: STATUS OF SUPPORT SERVICES IN SHC HOSPITAL
Item groups
Total Items
Number of items available at

DHQH Keich
Basic laboratory tests
17
15
Blood transfusion
Ambulance services
Radiology services
Operation theatre
62
35
24/7 Basic EmONC Services at THQ Hospital

There is no THQH in this District.
19
Management Basics
Findings related to facility management basics are presented below:
Human Resource
Information about sanctioned and filled posts of MNCH related staff was collected from the
surveyed facilities; and their status is presented in table 3.16 - 3.18. Filled status of staff
categories presented in following tables, include regular posting only, as reported by the
respective facility on the day of survey.
TABLE 3.16: STATUS OF HR AT SHC HOSPITAL
Status of HR at SHC Hospital
Staff
DHQH Keich
Gynaecologist
Sanctioned
1
Filled
1
Anaesthetist
Paediatrician
WMO
OT technician
BB technician
Lab technician
Nurses
14
LHV
Ambulance drivers
TABLE 3.17: STATUS OF HR AT RHC
Number of posts sanctioned and filled at each RHC
S
1
F
0
S
1
F
0
S
0
F
0
S
1
F
0
S
1
F
0
S
1
F
0
S
0
F
0
S
1
F
2
S
1
F
0
RHC Bal
Nigore
RHC Mand
Lab
technician
RHC
Gomazai
WMO
RHC Zaring
Bag
F
0
RHC
Khudan
RHC
Nasirabad
S
0
RHC Pidark
RHC
Kalatak
F
0
RHC Tump
RHC Gower
Koop
RHC Buleda
S
1
Staff
20
Nurse
LHV
Ambulance
drivers
TABLE 3.18: STATUS OF HR AT SURVEYED BHU
Number of posts filled at BHU

Staff
BHU
Dashat
BHU
Gawak
BHU
Kohad
BHU
Balgather
BHU
Gokdan
BHU
Drachkoo
BHU
Kunchity
WMO/MO
LHV
Availability
ity of job descriptions,
descriptions service delivery protocols and staff as per duty roster was
assessed and their findings are presented in the Figure 3.
FIGURE 3: STATUS OF MANAGEMENT BASICS
12
11
Total number
10
Availability of MNCH related job

descriptions (JDs)
8
7
Presence of duty staff
Availability of MNCH service

delivery protocols
4
3
2
Displayed MNCH service delivery

protocols
1 1
0 0 0
DHQH
0 0
0 0 0
0
RHCs
BHUs
Reasons for non-availability

availability of staff on 24/7 basis at RHC and SHC are provided in Table
3.19 and 3.20.
21

TABLE 3.19: REASONS OF NON-AVAILABILITY OF HR AT RHC
Reasons of non-availability
Status in RHC
LHV
5
1
0
0
WMO
0
0
0
0
Residence not available

Residence damaged
Security reasons
Lack of basic amenities
Ambulance Driver
0
0
0
0
TABLE 3.20: REASONS OF NON-AVAILABILITY OF HR ON 24/7 BASIS AT SHC HOSPITAL
Status of DHQ Hospital

Anaesthetist
Paediatrician
Blood Bank
Technician
Laboratory
Technician
WMO
LHV
Residence not available

Residence damaged
Security reasons
Lack of basic amenities
Gynaecologist
Reasons of non-availability
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Health facilities having staffed trained for providing MNCH services is presented in the Table
3.21.
TABLE 3.21: CAPACITY BUILDING OF MNCH RELATED STAFF
MNCH related training conducted
Health
Facility
EmONC
ENC
IMNCI
IMPAC
FP
surgical
FP
counselling
Client
centeredness
DHQH Keich
RHC Buleda
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower
Koop
RHC Kalatak
RHC
Nasirabad
RHC Pidark
Y
22
Health
Facility
MNCH related training conducted

FP
counselling
Client
centeredness
BHU Gawak
BHU Kohad
BHU
Balgather
BHU Gokdan
BHU
Drachkoo
BHU Kunchity
EmONC
ENC
IMNCI
IMPAC
BHU Dashat
RHC Bal
Nigore
RHC Dasht
Khudan
RHC Zaring
Bag
FP
surgical
Work Coordination and Supervision

Health facilities in the district were assessed for work coordination and supervisory activities,
including facility staff meetings, participation of facility in charges in district level meetings
and conduction of supervisory visits and feedbacks by district health managers. Findings of
each surveyed health facility are presented in Table 3.22.
TABLE 3.22: STATUS OF COORDINATION AND SUPERVISION

Health Facility
Regular facility PRM*

Meeting
held
Record
maintained
DHQH Keich
RHC Buleda
RHC Gomazai
Monthly Supervisory Visit

Participation in
district PRM*
Facility
visited
Facility received
visit feedback
RHC Mand
RHC Tump
RHC Gower Koop
RHC Kalatak
RHC Nasirabad
RHC Pidark
Y
23

Regular facility PRM*
Health Facility
Meeting
held
Record
maintained
RHC Bal Nigore
RHC Dasht Khudan
RHC Zaring Bag
Monthly Supervisory Visit

Participation in
district PRM*
Facility
visited
Facility received
visit feedback
BHU Dashat
BHU Gawak
BHU Kohad
BHU Balgather
BHU Gokdan
BHU Drachkoo
BHU Kunchity
* PRM=Performance Review Meeting
Management Information S ystem

District Keich was practicing Health Management Information System (HMIS). Surveyed
facilities were assessed for availability and maintenance of HMIS tools and their findings are
presented in Table 3.23.
TABLE 3. 1: STATUS OF MIS
Status of MIS Tools
Medicine Stock
register
Daily expense register
HMIS monthly report
TB register
Disease Early Warning

System
DEWS chart
Growth Monitoring
Register
RHC Buleda
RHC
Gomazai
RHC Mand
RHC Tump
Meeting register
EPI register
Family Planning
register
Child health register
Birth register
Mother health register
OPD register
OPD ticket
DHQH Keich
Health
Facility
MIS Tools Available
24

Status of MIS Tools
OPD ticket
OPD register
Birth register
Family Planning
register
EPI register
Meeting register
Medicine Stock
register
HMIS monthly report
TB register

System
DEWS chart
Growth Monitoring
Register
RHC Gower
Koop
RHC Kalatak
RHC
Nasirabad
RHC Pidark
Health
Facility
RHC Bal
Nigore
RHC Dasht
Khudan
RHC Zaring
Bag
BHU Dashat
BHU Gawak
BHU Kohad
BHU
Balgather
BHU Gokdan
BHU
Drachkoo
BHU Kunchity
MIS Tools Maintained

DHQH Keich
RHC Buleda
RHC
Gomazai
RHC Mand
RHC Tump
RHC Gower
Koop
RHC Kalatak
RHC
Nasirabad
RHC Pidark
N
25

Status of MIS Tools
OPD register
Birth register
Family Planning
register
EPI register
Meeting register
Medicine Stock
register
HMIS monthly report
TB register

System
DEWS chart
BHU Dashat
BHU Gawak
BHU Kohad
BHU
Balgather
BHU Gokdan
BHU
Drachkoo
BHU Kunchity
Growth Monitoring
Register
OPD ticket
RHC Bal
Nigore
RHC Dasht
Khudan
RHC Zaring
Bag
Health
Facility
Drugs and Supplies

Availability of drugs and supplies has been described under individual MNCH service
packages. The reasons of their non-availability were identified at the surveyed facilities and
presented in the Table 3.24.
TABLE 3.24: REASONS FOR STOCK OUT REPORTED BY SURVEYED FACILITIES
Reasons for stock out

Poor quantification
Delayed demand
submission
Unavailability of
buffer stock
Lack of storage
capacity
Delayed supply
Under supply
No procurement
powers
Insufficient budget
Lack of cold-chain
DHQH Keich
RHC Buleda
RHC Gomazai
Health facilities
citing stock out
26

Reasons for stock out
Poor quantification
Delayed demand
submission
Unavailability of
buffer stock
Lack of storage
capacity
Delayed supply
Under supply
No procurement
powers
Insufficient budget
Lack of cold-chain
RHC Mand
RHC Tump
RHC Gower Koop
RHC Kalatak
RHC Nasirabad
RHC Pidark
RHC Bal Nigore
RHC Dasht Khudan
RHC Zaring Bag
BHU Dashat
BHU Gawak
BHU Kohad
BHU Balgather
BHU Gokdan
BHU Drachkoo
BHU Kunchity
Health facilities
citing stock out
Fee for Services

Fee for MNCH services and availability of social protection mechanisms for the poor were
assessed at surveyed facilities and their findings are presented in Table 3.25 and 3.26.
27

TABLE 3.25: STATUS OF FEE FOR SERVICE
Services provided free of cost

OPD
Indoor
OPD X-rays
OPD Medicines
Admission fee
Ward bed
Inpatient Laboratory
Inpatient Ultrasound
Inpatient X-rays
RHC Buleda
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower Koop
RHC Kalatak
RHC Nasirabad
RHC Pidark
RHC Bal Nigore
RHC Dasht
Khudan
Ambulance services
OPD Ultrasound
Inpatient medicines
OPD Laboratory
Blood grouping &

cross matching
OPD Ticket
DHQH Keich
RHC Zaring Bag
BHU Dashat
BHU Gawak
BHU Kohad
BHU Balgather
BHU Gokdan
BHU Drachkoo
BHU Kunchity
Health facilities
where service are
charged
28

TABLE 3.26: MECHANISMS OF SOCIAL PROTECTION AVAILABLE
Social Protection Mechanism

Health Facilities with available
Social Protection
Bait-ul Maal
Zakat
Patient Welfare
Society
DHQH Keich
RHC Buleda
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower Koop
RHC Kalatak
RHC Nasirabad
RHC Pidark
RHC Bal Nigore
RHC Dasht Khudan
RHC Zaring Bag
BHU Dashat
BHU Gawak
BHU Kohad
BHU Balgather
BHU Gokdan
BHU Drachkoo
Infection Control
Health facilities were assessed for practices of infection control and waste management, and
availability of related material. Findings of individual surveyed facilities are presented in table
3.27.
29

TABLE 3.27: STATUS OF INFECTION CONTROL & WASTE MANAGEMENT PRACTICES
Availability of Materials
RHC Buleda
RHC Gomazai
RHC Mand
RHC Bal Nigore
RHC Dasht
Khudan
RHC Zaring Bag
BHU Dashat
BHU Gawak
BHU Kohad
BHU Balgather
BHU Gokdan
BHU Drachkoo
Waste segregation
Hep B Vaccination of Staff
Disinfection of service
provision area
Hand washing practices of

HCP
Functional Incinerators
Waste treatment equipment
Disposal through Municipal

Arrangement
Personal protection materials
Disposal through Throwingaway
Waste collection materials
Disposal of waste through

burning
Waste management plan
DHQH Keich
Infection Control Practices
RHC Tump
RHC Gower
Koop
RHC Kalatak
RHC Nasirabad
RHC Pidark
Health facilities
30
Death Review
Findings related to availability and functioning of death review committees are presented in
the Table 3.28.
TABLE 3.28: STATUS OF DEATH REVIEWS
Status of Death Review

Death
Review
Committee
Available
Annual
Number
Reviewed by
committee
Annual
Number
Reviewed by
committee
DHQ Keich
RHC Buleda
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower Koop
RHC Kalatak
RHC Nasirabad
RHC Pidark
RHC Bal Nigore
RHC Dasht Khudan
Health Facility
Maternal Deaths
Neonatal Deaths
Facility Utilisation
Findings of services utilisation at surveyed facilities are given as monthly aggregate from
July to December 2010, annual utilisation of year 2010 and facility-wise average monthly
utilisation are presented in Tables 3.29, 3.30 and 3.31.
TABLE 3.29: STATUS OF SERVICES UTILISATION
July
Aug
Sep
Oct
Nov
Dec
Annual
utilisation
(2010)
1st Antenatal Care visits (ANC-1)
351
323
241
231
237
266
3,611
Normal vaginal deliveries
236
300
254
257
231
246
2,548
Assisted vaginal deliveries
C-sections
23
14
13
18
23
216
Monthly utilisation (July to December 2010)

Type of service
31
July
Aug
Sep
Oct
Nov
Dec
Annual
utilisation
(2010)
1st Postnatal Care visits (PNC-1)
106
146
149
192
99
105
1,320
Pregnant women given TT2

vaccine
563
524
532
542
484
441
6,802
FP services
208
165
167
197
92
172
1,829
1,607
1,380
1,826
1,661
1,330
1,175
18,222
943
827
893
765
784
791
9,466
Monthly utilisation (July to December 2010)

Type of service
Diarrhoea/Dysentery cases
treated (< 5 years of age)
Pneumonia cases treated
(< 5 years of age)
TABLE 3.30: AVERAGE MONTHLY MNCH SERVICES PROVIDED
Average Monthly Utilisation

Health
Facility
TT2
Diarrhoea/
Dysentery
(in <5 yr)
Pneumonia
(in <5 yr)
24
137
23
63
112
31
45
19
28
39
30
31
13
51
280
44
47
47
23
144
85
27
15
110
53
113
41
31
14
21
77
42
16
61
14
36
10
16
14
11
10
30
24
BHU Gawak
38
10
BHU Kohad
37
27
57
24
26
NVD
Assisted
VD
C
Section
PNC 1
111
144
17
28
10
RHC Mand
RHC Tump
DHQH
Keich
RHC
Buleda
RHC
Gomazai
RHC Gower
Koop
RHC
Kalatak
RHC
Nasirabad
RHC Pidark
RHC Bal
Nigore
RHC Dasht
Khudan
RHC Zaring
Bag
BHU
Dashat
BHU
Balgather
BHU
Gokdan
ANC 1
32

BHU
Drachkoo
BHU
Kunchity
23
63
28
10
112
31
45
TABLE 3.31: AVERAGE MONTHLY FP SERVICES PROVIDED
Average Monthly Utilisation of FP Services

Health
Facility
COC
POP
DPMA
Neten
Condoms
IUCDs
Implants
Surgical (Tubal
Ligation Vasectomy)
DHQH
Keich
39
64
14
RHC Buleda
RHC
Gomazai
RHC Mand
13
RHC Tump
11
10
BHU Dashat
BHU Gawak
BHU Kohad
RHC Gower
Koop
RHC
Kalatak
RHC
Nasirabad
RHC Pidark
RHC Bal
Nigore
RHC Dasht
Khudan
RHC Zaring
Bag
BHU
0
0
0
0
0
0
0
Balgather
BHU
0
0
0
0
0
0
0
Gokdan
BHU
0
0
0
0
0
0
0
Drachkoo
BHU
1
0
8
0
0
0
0
Kunchity
KEY: COC=Combined Oral Contraceptive, POP=Progesterone-Only Pills, DPMA=Depot
Medroxyprogesterone Acetate, Net-en=norethisterone enanthate, IUCDs=Intrauterine Contraceptive
Devices
33
Well Baby Clinic

Surveyed health facilities were assessed for established Well Baby Clinic (WBC) and its
findings are presented in Table 3.32.
TABLE 3.32: STATUS OF WBC ESTABLISHED
Name of health facility
WBC Established
Name of health facility
WBC Established
DHQ Keich
RHC Dasht Khudan
RHC Buleda
RHC Zaring Bag
RHC Gomazai
BHU Dashat
RHC Mand
BHU Gawak
RHC Tump
BHU Kohad
RHC Gower Koop
BHU Balgather
RHC Kalatak
BHU Gokdan
RHC Nasirabad
BHU Drachkoo
RHC Pidark
BHU Kunchity
RHC Bal Nigore
Donor Contribution
Donor Contribution during last three years was assessed regarding human resource,
infrastructure, equipment including ambulances, and drugs and supplies and findings are
presented in Table 3.33.
TABLE 3.33: STATUS OF DONOR CONTRIBUTION
Donor Contribution
Human Resource
Drugs and
Supplies
Capacity building
Staff Incentive
Construction of
new building
Renovation of
existing building
Provision of new
equipment
Provision of new
vehicle/
ambulance
Provision of
Medicines
Provision of
Consumables
DHQ Keich
Equipment
Provision of key
staff
Health Facilities
Infrastructure
34

Donor Contribution
Human Resource
Infrastructure
Equipment
Drugs and
Supplies
Provision of key
staff
Capacity building
Staff Incentive
Construction of
new building
Renovation of
existing building
Provision of new
equipment
Provision of new
vehicle/
ambulance
Provision of
Medicines
Provision of
Consumables
RHC Buleda
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower Koop
RHC Kalatak
RHC Nasirabad
RHC Pidark
RHC Bal Nigore
RHC Dasht Khudan
RHC Zaring Bag
BHU Dashat
BHU Gawak
BHU Kohad
BHU Balgather
BHU Gokdan
BHU Drachkoo
BHU Kunchity
Health Facilities
Clients Perspective
Client Exit Interviews (CEI) was conducted within the scope of the HFA Survey to assess
clients perspective on provided services. Findings of these interviews were analysed for
assessing their perspective on access, quality and preference for health care and are
presented in Table 3.34 and Figures 4 and 5.
35

TABLE 3.34: CLIENTS PERSPECTIVE
No of interviewed clients (Total: 65)

DHQH
RHC
Less than 30 minutes
46
30 minutes to 1 hour
More than 1 hour
Walk
Personal transport
42
Public transport
Less than 10 minutes
16
10 minutes to 20 minutes
31
20 minutes to 30 minutes
0
3
Time to reach facility
Means of transport
Waiting time at facility
More than 30 minutes
5
3
Fee for services

10
Public HF
10
54
Private sector
Close to home
29
Good quality
17
Staff attitude
Affordability
Lack of choice
Very satisfied
20
Satisfied
34
Not satisfied
Paid fee for services

Health Education Material
Received Education Material
Preference for healthcare
Reasons for visiting public HF
Overall satisfaction
36
FIGURE 4: LEVEL OF SATISFACTION WITH EXAMINATION AND ATTITUDE OF STAFF
Communication
40
Attitude of other staff
39
55
61
Very satisfied
Attitude of care provider
39
61
Satisfied
Not satisfied
Clinical Examination
35
0%
65
20%
40%
20
60%
80%
100%
FIGURE 5: AVAILABILITY OF MEDICINES AND LAB SERVICES
Lab services
62
38
0
Received (all)
Received (some)
Medicines
60
0%
20%
30
40%
60%
80%
10
Not received
100%
Procurement Estimates
Equipment
Based on the information collected, procurement needs for provision of required equipment
have been identified for individual surveyed facilities to strengthen MNCH services.
Summary of estimated cost for procurement of required equipment is given below. List of
required equipment for each surveyed facility is presented as Annex 3 A and details about
cost estimates for individual facilities is given in Annex 3 B.
Civil Works
A yardstick has been used for assessing the scope of civil works of various MNCH related
building components (Annex
Annex 1).
1) Identified scope of work to complete the infrastructure
37

needs of the individual surveyed facilities is presented in Annex 4. Summary of estimated
cost for
38

execution of civil works including repair and maintenance, renovation and new construction
of missing facilities; is given in table below and details about cost estimates for individual
facilities is given in Annex 4.
TABLE 3.35: SUMMARY OF ESTIMATED COST FOR PROCUREMENT OF EQUIPMENTS & CIVIL
WORKS
Procurement
Estimated Cost (PKR in Millions)

DHQH
RHC
BHU
Total
Equipment
8.4
71
4.5
84
Civil Works
20
124
37
181
39
Section 4: Key Findings

In district Keich, total of 19 health facilities were assessed including 7 BHU, 11 RHC, and 1
DHQH. The BHU were assessed for availability of 8/6 Preventive MNCH services; RHC
were assessed for availability of 24/7 Basic EmONC services; and DHQ Hospital was
assessed for availability of 24/7 Comprehensive EmONC services.
The key findings have been presented based on the availability of specified inputs including,
Infrastructure, Human Resource, Equipment, Drugs and Supplies, and Support services.
Status of each input has been described at one place for all levels. This is followed by key
findings on Management basics, Donor contribution and Clients perspective on the quality of
MNCH services.
Infrastructure
At BHU, OPD was available at all the BHU while labour rooms were not available at all
BHU; LHV residences were available only at BHU Drachkoo and Kunchity but none of
these were in good condition
OPD was available at all eleven RHC while female ward was not present at 3 RHC i.e.,
RHC Gomazai, RHC Gower Koop and RHC Bal Nigore. Labour room was not available
at 4 RHC, clinical laboratory was not available at RHC Gower Koop and RHC Bal Nigore.
WMO residence was available at 7 RHC but was in good condition at RHC Gower Koop
OPD,female ward, Delivery room,Operating Theater,Paediatric ward and Paediatrc

Nursery,clinical
laboratory
and
blood
bankand
also
USG
room
were
at
DHQH.Residences for gynaecologist,paediatrician and anaesthetist were available but

were not in good condition.
Human Resource
All required staff was available at all BHU except at BHU Dashat and BHU Balgather,
where no staff was available
Required number of WMO were available only at RHC Dasht Khudan out of 11 RHC;
while required number of LHV were available at 5 RHC; Laboratory technicians were
available at 9 RHC; while OT technicians were available at 6 RHC. Ambulance drivers
were available only at 5 RHC
40
Required number of Paediatrician were present at DHQH. OTand Anaesthesia

techncians were not available at DHQH
Staff residence not being available was the most common reason for non-availability of
staff round the clock at RHC
Staff at DHQH received training on FP counselling, FP surgical, IMNCI and EmONC;staff

at BHU Gokdan received training on IMPAC while all RHC and BHU except BHU
Gokdan received training on client centredness only
Equipment
The complete set of required equipment items was not available at any of the surveyed
facilities
General equipment items were not available at any of the surveyed BHU. LHV room
equipment was not available atBHU Balgather, BHU Drachkoo and BHU Kunchity out of
7 BHU
General equipment items were not available at all RHC. All required female ward
equipment items were not available at 5 RHC. WMO equipment items were not available
at 4 RHC. Labour room equipment items was not available at 6 RHC; while LHV room
equipment items were not available at 3 RHC
Drugs and Supplies
The complete list of tracer drugs and family planning were not available at any of the
surveyed facilities
All the required vaccines were not available at any of the BHUexcept BHU Gokdan while
FP commodities were alsonot available at anyBHU except BHU Kohad
The complete range of vaccines was available at 8 RHC.FP commodities were absent at
3 RHC namely RHC Gomazai, RHC Gower Koop and RHC Pidark.The complete range
of supplies was available at 3 RHC namely RHC Mand, RHC Nasirabad and RHC
Khudan
Complete range of vaccines and supplies were available at DHQH
The most common reason for stockout of drugs was poor quantification and delayed
supply
41
Support Services
The complete range of required inputs for delivery of support services was not available
at most of the surveyed facilities
Inputs required for provision of basic laboratory tests were not available at BHU Dastuk
and BHU Balgather
All required inputs for provision of ambulance services were not present at 7 RHC
Blood transfusion and ambulance services were available at DHQH Keich
Management Basics
Management basics assessed at the surveyed facilities included availability of job
description and service delivery protocols, work coordination and supervision, MIS, infection
control practices, death reviews of maternal and neonatal deaths, fee for services and
available mechanisms of social protection, and facility utilisation of MNCH services.
Eight out of nineteen health facilities were conducting regular performance review
meetings but its record was maintained at only 5 of the surveyed facilities. Eight facility
in-charges reported regular participation in district level performance review meetings
Majority of the facilities reported supervisory visits of district health managers and its
feedback was also received at most of the facilities
Health Management Information System (HMIS) was being practiced in district Keich.
Regarding HMIS tools, complete range of tools was not available except at DHQH,
specifically non-availability of TB Register,child health register and DEWS chart
Social protection mechanisms for the poor was found only at DHQH in the form of Bait ul
Mal
Complete range of inputs required for infection control practices were deficient at all the
surveyed facilities. Out of 19 facilities, 3 reported availability of waste management plan
but materials for waste collection, personal protection and waste treatment were not
available at any of the facility
Death review committee was not available for review of maternal and neonatal deaths at
any of the surveyed facilities.
42
Donor Contribution
Donor contribution for supporting delivery of MNCH was assessed at the surveyed facilities
for provision of human resource, infrastructure, equipment, drugs and supplies. In the
district, no facility reported any such contribution.
Clients Perspective
Client exit interviews were conducted to assess clients perspective about their satisfaction
with the services utilised at the facility. Total of 65 interviews were conducted in the district
and findings concluded that 35% of the clients were very satisfied and 63% were satisfied
with the availed services.
43
Annexes
44
Annex 1: District Health Department

Public sector district health system consists of Secondary Health Care (DHQH) and Primary
Health Care (RHC, BHU) facilities. DHO acts as head of the district health department,
under supervision of DC.
Health Resources
Health facilities (Public sector)
Public sector facilities providing MNCH services are given in table below:
TABLE 2.4: NUMBER OF PUBLIC SECTOR HEALTH FACILITIES IN THE DISTRICT
Type
Number
Bed strength
Teaching hospitals
DHQ Hospital
90
THQ Hospital
RHC
11
98
BHU
36
Govt. Rural Dispensaries
43
MNCH Centres
Sub Health Centres
S OURCE : HMIS C ELL , DHO OFFICE
Human Resource DHO Office

Table 2.5 summarises the HR situation at the DHO Office.
TABLE 2.5: HUMAN RESOURCE IN OFFICE OF DHO
Name of Post
Sanctioned
Filled
% Filled
District Officer Health
100
Deputy District Officer Health
100
District Coordinator National Program for FP & PHC
100
District Coordinator EPI Surveillance
100
District Coordinator NMNCHP
100
District Sanitary Inspector
100
CDC Officer
100
CDC Inspector
Drug Inspector
100
District Superintendent Vaccination
100
45
Name of Post
Sanctioned
Filled
% Filled
Assistant Superintendent Vaccination
100
Tehsil Sanitary Inspector
Inspector Vaccination
Total
13
13
100
S OURCE : DHO OFFICE
MNCH staff in District Keich

Table 2.6 summarises the status of MNCH staffing in health facilities including DHQH, RHC
and BHU in the district. The information was collected from DHO office during survey.
This information may not match with subsequent tables containing similar information on
human resource (HR) collected from respective surveyed health facilities (No. 3.7, 3.12,
3.16, 3.17, 3.18).
TABLE 2.6: AVAILABILITY OF MNCH SERVICES STAFFING IN DISTRICT KEICH
Sanctioned
Filled posts
R= Regular,
C= On Contract
Filled
Gynaecologist
100
Paediatrician
100
Anaesthetist
Radiologist
Pathologist
60
12
75
O.T. Technician
33
Anaesthesia
Technician
17
LHV
18
14
78
Posts
Women Medical
Officers (WMO)
Medical Officers
(MOs)
Blood Transfusion
Officers
Blood Bank
Technician
Nurses
% Filled
DHQH=1
THQH=0
RHC=11
BHU=36
46
Sanctioned
Filled posts
R= Regular,
C= On Contract
Filled
10*
10
100
X-ray Technician
Dispenser
10
90
Vaccinators
10
50
100
Posts
Lady Health
Workers (LHW)
Laboratory
Technician
% Filled
Ambulance
2
2
Drivers
* LHW ARE COMMUNITY BASED
DHQH=1
THQH=0
RHC=11
BHU=36
S OURCE : HMIS C ELL , DHO OFFICE,
Financial Allocations
Budgetary allocations and expenditures over the last three years for the district (in PKR
Million) are presented in table 2.7; allocations mentioned below are lump sum as provided by
DHO office.
TABLE 2.7: FINANCIAL ALLOCATION IN DISTRICT KEICH
District
Health
Budget
2007-08
2008-09
2009-10
Allocation
Expenditure
Allocation
Expenditure
Allocation
Expenditure
NonDevelopment
93.1
92.7
14.2
12.4
139
134
Development
93.1
92.7
14.2
12.4
139
134
Total
S OURCE : DHO OFFICE
Donor Contribution
Information about donor contribution for MNCH services was asked from DHO office in terms
of financial input. It was reported that donor contribution was not provided to this district.
During survey, information about donor inputs on surveyed health facilities was also
collected, and findings were the same.
47
NMNCH Programme Indicators

Information on NMNCHP indicators is being compiled at office of DHO and this information
has been gathered on the sets of indicators, which is reproduced as such in following
tables. It is important to note that services utilisation data reported by district office take into
account utilisation of all public sector facilities in the district.
This information may not match with subsequent tables containing information on drugs and
supplies (Table No. 3.4, 3.9, 3.14 and 3.24) and C-sections (No. 3.29) collected from
respective health facilities included in survey.
TABLE 2.8: NMNCHP MONITORING INDICATORS (YEAR 2010)
Services Management
Number of district monthly performance review meetings held during last year
Number of facilities with stock-out of FP commodities
60
Number of facilities stock outs of essential EmONC drugs
Support Services
Number of facilities with laboratory services available
11
Number of facilities with blood transfusion services available
Service Utilisation
Antenatal care coverage
9371
Percentage of children <12 months fully vaccinated
86%
TT-2 coverage
18663
Number of deliveries at health facilities
3147
Number of live births at health facilities
Postnatal coverage
1179
Number of family planning visits (by type of modern method)at health facilities
3479
Number of Caesarean Sections at Comprehensive EmONC facilities
202
Morbidity and Mortality (at public health facilities)

Number of maternal deaths
Number of neonatal deaths
Number of diarrhoea / dysentery in <5 years age group
30786
Number of pneumonia in <5 years age group
37222
Lady Health Workers (NP FP&PHC)

Number of new pregnant mothers registered
5360
Number of SBA deliveries reported
1764
Number of maternal deaths reported

Number of modern FP methods users
Number of infant deaths reported
0
7967
2
48
Community Mid-Wives (NMNCHP)

Number of first antenatal care visits (ANC 1)
372
Number of ANC revisits
348
Number of TT 2 given
348
Number of deliveries
1208
Number of post natal visits
816
Number of family planning visits (both new and follow-up)
8248
Number of FP commodities provided
996
Number of maternal complications referred
110
Number of neonates referred
70
Number of clean/safe delivery kits used
Stock out of clean/safe delivery kits
Stock out of FP commodities
Number of pregnant women referred by LHW
1042
Number of maternal deaths
Number of neonatal deaths
S OURCE : HMIS C ELL , MNCH C ELL , EPI C ELL , MIS NP FOR FP&PHC-DHO O FFICE
- DATA Not Available
Provision of Staff by the NMNCHP

The NMNCHP is supposed to provide supporting human resource at target health facilities,
including specialists, doctors and paramedics. The programme is currently under
implementation and number of facilities having staff provided by the NMNCHP is given in the
table 2.9
TABLE 2. 9: NUMBER OF FACILITIES WITH STAFF PROVIDED BY THE NMNCHP
Staff Cadre
Number of Health facilities

DHQH
THQH
RHC
BHU
Gynaecologist
-*
Anaesthetist
Paediatrician/Neonatologist
WMO
OT technician
BB technician
Lab technician
Nurses
LHV
Ambulance drivers
S OURCE : MNCH C ELL DHO O FFICE

49
MNCH Staff Trainings

Part of the mandate of the Programme is to build capacity of MNCH related staff through
conducting skill development trainings of the staff in standards of service provision,
counselling techniques and client centeredness. Information about trainings of MNCH staff is
presented in the table 2.10. It is important to note here that this information collected from
district office may not match with similar information contained in Table No. 3.21 collected
from the surveyed facilities.
TABLE 2.10: NUMBER OF STAFF TRAINED ON DELIVERING MNCH SERVICES
Category of
staff
Number of staff trained (during last three years)

EmONC
ENC
IMNCI
IMPAC
FP
Surgical
FP
Counselling
Client
centeredness
Gynaecologist
Paediatrician
Anaesthetics
WMO
15
MO
OT Technician
Nurse
LHV
42
CMW Training and Deployment

Part of the mandate of the Programme is to train and deploy CMW for improving community
based MNCH services. Information collected from district NMNCH cell related to the CMW
training and deployment is presented in the table 2.11.
TABLE 2.11: STATUS OF CMW TRAINING AND DEPLOYMENT
Training and Deployment of Community Mid-Wives (NMNCHP)

Number of selected CMW verified for their residential status
35
Number of CMW with completed training
35
Number of CMW deployed by NMNCHP
30
Number of CMW Schools where renovation/ construction completed
CMW Manual/Books available (Number of sets)
50
CMW training equipment/models available (Number)
37
Number of CMW sponsored/supported by partners

50
Annex 2: Input Criteria for MNCH services

A. Civil w orks criteria
CIVIL WORKS SCOPE FOR BHU
OPTIMAL ITEMS
2. Examination area
3. Hand washing facilities
2. Scrub area
3. Functional attached wash room for patient
Ob/Gyn OPD or LHV room

Labour room
1. Delivery room
WMO or LHV residence
1. Available
2. Good condition
MINIMAL ITEMS
Available
LHV Room
CIVIL WORKS SCOPE FOR RHC

OPTIMAL ITEMS
2. Examination area
Ob/Gyn OPD
Ob/Gyn ward
1. Patient area
Labour room
1. Delivery room
Clinical laboratory
1. Laboratory room
LHV room
2. Functional attached wash room

2. Scrub area
3. Functional attached wash room for patient
2. Working area
3. Functional attached washroom
2. Examination area
1. Available
2. Good condition
1. Available
2. Good condition
MINIMAL ITEMS
Available
Available
Available
Available
1. Available
2. Good condition
1. Available
2. Good condition
WMO residence
LHV residence
Ob/Gyn OPD
Ob/Gyn ward
Labour room
LHV room
WMO residence
LHV residence
CIVIL WORKS SCOPE FOR DHQH & THQH
Ob/Gyn OPD
Ob/Gyn ward
1. Patient area
2. Nursing station
Labour room
1. Delivery room
2. Preparation/ stage room
3. Scrub area
4. Staff duty room
Operation theatre
OPTIMAL ITEMS
2. Examination area
3. Store for General items/drugs, or
5.
6.
7.
8.
Store for General items/drugs,

Store for Equipment
Functional attached wash room for patient
Functional attached wash room for staff
5. Sterilisation area
51

1.
2.
3.
4.
Patient preparation room

Operating room
Recovery room
Scrub area
Paediatric ward
1. Patient area
2. Nursing station
Paediatric nursery
1. Patient area
2. Nursing station
Clinical laboratory
1. Laboratory room
2. Working area
Blood bank
1. Blood collection room
2. Working area
LHV room
2. Examination area
Ultrasound room
Gynaecologist residence
Anaesthetist residence
Paediatrician residence
WMO residence
LHV residence
Nurse residence
Lab technician residence
BB technician residence
Anaesthesia technician residence
6.
7.
8.
9.
10.
3. Store for General items/drugs, or equip

3. Store for General items/drugs, or equip
4. Change room
3.
4.
5.
3.
4.
5.
Anaesthetist residence
Paediatrician residence
WMO residence
Lab technician residence
Doctors duty room

Store for chemical / reagents, or equip
Functional attached washroom
Staff duty room
Store for equipment / reagents

Examination area
Available
Good condition
Available
Good condition
Available
Good condition
Available
Good condition
Available
Good condition
Available
Good condition
Available
Good condition
Available
Good condition
Available
Good condition
MINIMAL ITEMS
Ob/Gyn OPD
Ob/Gyn ward
Labour room
Operation theatre
Paediatric ward
Clinical laboratory
Gynaecologist residence
Doctors room
Support staff duty room
Store for General items/drugs, or equip.
Store of equipment
Functional attached washroom for staff
Available
Available
Available
Available
Available
Available
Available
Good condition
Available
Good condition
Available
Good condition
Available
Good condition
Available
Good condition
52
B. Human Resource criteria

HUMAN RESOURCE FOR PREVENTIVE
EmONC
OPTIMAL HR FOR BHU
Category
Number
MO, or
1
LHV
1
MINIMAL HR FOR BHU
MO, or
1
LHV
1
-
HUMAN RESOURCE FOR 24/7 Basic EmONC

OPTIMAL HR FOR RHC
Category
Number
WMO
2
OT technician
1
Lab technician
1
LHV
2
Ambulance driver
1
MINIMAL HR FOR RHC
WMO
1
Lab technician
1
LHV
1
-
HUMAN RESOURCE FOR 24/7 Comprehensive EmONC

OPTIMAL HR FOR DHQH
OPTIMAL HR FOR THQH
Category
Number
Gynaecologist
2
Anaesthetist
2
Paediatrician
2
WMO
6
OT technician
4
BB technician
4
Lab technician
3
4
Nurses
20
LHV
4
Ambulance drivers
4
MINIMAL HR FOR DHQH
Gynaecologist
1
Anaesthetist
1
Paediatrician
1
WMO
4
OT technician
1
Lab technician
1
Nurses
6
LHV
1
Category
Number
Gynaecologist
1
Anaesthetist
1
Paediatrician
1
WMO
4
OT technician
4
BB technician
4
Lab technician
2
4
Nurses
12
LHV
4
Ambulance drivers
4
MINIMAL HR FOR THQH
Gynaecologist
1
Anaesthetist
1
Paediatrician
1
WMO
2
OT technician
1
Lab technician
1
Nurses
4
LHV
1
53
C. Equipment criteria
General hospital equipment

1. Electric water cooler
OPD / WMO office
1. Office / plain chairs
2. Examination couch
3. Office tables with drawer
4. Steel almirah large
5. Patient stool
6. Weight machine adult
EQUIPMENT FOR BHU

OPTIMAL ITEMS
2. Water filter
3. Incinerator
7. Weight machine infant
8. Height measuring board
9. Height measuring device
10. B.P Apparatus mercury-desk type
11. Foetal stethoscope
12. Steam inhaler
13. Nebuliser
14. Examination lamp
Lady health visitor's room

1. Weight scale Adult
2. Weight scale Infant
5. Disposable syringe cutter
6. D & C instruments set
1.
2.
3.
4.
5.
7.
8.
9.
10.
11.
12.
P.V. Examination light

Examination couch
Office chairs
Office tables with drawer
Patient stool
Steel almirah large
MINIMAL ITEMS
Office chairs
B.P Apparatus mercury-desk type
Foetal stethoscope
Weight scale Adult
EQUIPMENT FOR RHC

OPTIMAL ITEMS
General Hospital
1. Ambulance
Female ward items
1. Fowler bed (Iron)
2. Attendant's bench
3. Bed side locker
4. Overhead food trolley
OPD / WMO Office
1. Office chairs
2. Plain chairs
6. Patient stool
Labour room
1. UPS power supply system (2000W)
2. Suction machine electric
3. Infant weight machine
5. Electric instrument steriliser 12"x6"
6. Jar for forceps
7. Spring type dressing forceps (ss)
8. Sim's Speculum right angle, small
9. Sim's Speculum right angle, medium
3. Water filter
4. Incinerator
5.
6.
7.
8.
9.
8.
9.
10.
11.
12.
13.
14.
15.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
6.
7.
8.
Dust Bin Stainless Steel

Screen folding complete
Baby Cot
Stethoscope
Weight machine infant
Height measuring board
Height measuring device
Foetal stethoscope
Steam inhaler
Nebuliser
Examination lamp
Sim's Speculum right angle, large
Sponge forceps
Long straight artery forceps
Uterine sound
Vulsellum forceps
Scissors dissecting blunt pointed
Artery forceps
Blunt-ended scissors
D & C instruments set
Infant ambo bag
Examination couch
Office chairs
54

5. P.V. Examination light
EQUIPMENT FOR RHC

OPTIMAL ITEMS
9. Patient Stool
MINIMAL ITEMS
2.
3.
4.
5.
6.
Female ward items

1. Fowler bed (Iron)
OPD / WMO office
1. Office chairs
Labour room
3. Sponge forceps
4. Uterine sound
1. Office chairs

Stethoscope
Foetal stethoscope
5.
6.
7.
8.
Vulsellum forceps
Artery forceps
4.
5.
6.
7.
Weight scale Infant

Examination couch
EQUIPMENT FOR DHQ HOSPITAL

OPTIMAL ITEMS
General hospital
3. Desktop computer with monitor and
1. Ambulance
accessories
2. Defibrillator
Gynae/Obs. Ward items
10. Scissors curved 5 inch
1. Cabinet Instrument large
11. Scissors sharp 5 inch straight
2. Fowler bed (Iron )
12. Chital forceps
13. Kidney tray s.s 10 inch
4. Bed side locker
14. Jar for forceps
5. Screen folding complete
15. Infusion / drip stands
16. Foetal monitor (foetal Doppler desk type)
7. Artery forceps 7 inch
17. Infant B.P apparatus
8. B P Apparatus mercury Desk type
9. Dissecting forceps plain 7 inch
19. Baby cot
6. Stethoscope adult size
OPD / Gynaecologists Office
7. B.P apparatus desktop type
8. Office chair
9. Office table with drawers
10. Patient stool
4. Ultrasound machine
11. Patient waiting bench
5. Examination lamp
6. Phototherapy unit
Paediatric nursery
7. Baby warmer
1. Air ways 2 size
8. Infant B.P apparatus (Cuff 2.5 cm)
2. Infant ambo bag
9. Room thermometer
3. Infant laryngoscope set
10. Baby cot
4. Suction apparatus: electrically
11. Steam inhaler
operated
12. Oxygen cylinder complete with trolley
5. Infant Incubators
Paediatric ward
6. Emergency medicine trolley
1. Suction machine
7. Patient's attendant bench
3. Stethoscope Paediatric Littman type
9. Bed side locker s.s top
4. Nebuliser
Labour room
13. Artery forceps
14. Blunt-ended scissors
55

EQUIPMENT FOR DHQ HOSPITAL
OPTIMAL ITEMS
15. Episiotomy instruments set complete
3. Jar for forceps
16. D&C instruments set complete
17. Delivery forceps set
18. Infant ambo bag
19. Portable Light rechargeable batteries
7. Sim's Speculum right angle, large
20. Sterilising drum
8. Sponge Forceps
21. Vacuum extractor
9. Long straight artery forceps
22. Delivery table
10. Uterine sound
11. Vulsellum forceps
12. Scissors dissecting blunt pointed
Operation theatre
17. Surgical knife handle # 3
1. Needle holder
2. Stitch scissors
19. Abdominal retractors, double-ended
3. Dissecting forceps, toothed
(Richardson)
4. Sim's speculum large
20. Curved operating scissors, blunt pointed
5. Sim's speculum medium
(Mayo), 17 cm
6. Vacuum extractor
21. Straight operating scissors, blunt pointed
7. Obstetric forceps
(Mayo), 17 cm
8. Rectangular instrument tray lids
22. Aesthetic face masks (3 sizes)
9. Towel clips
23. Anaesthesia Machine
10. Sponge forceps, 22.5 cm
24. Laryngoscopes
11. Straight artery forceps, 16 cm
25. X-Ray illuminator
12. Uterine homeostasis forceps, 20 cm
26. Gynae Instrument set
13. Hysterectomy forceps, straight, 22.5
27. General Instrument set
cm
28. Adult ambo bag and mask
14. Mosquito forceps, 12.5 cm
15. Tissue forceps, 19 cm
30. Myomectomy screw
16. Needle holder, straight, 17.5 cm
31. Air conditioners
Laboratory
3. Counter (hand tally differential)
1. Spin machine
4. Steel Elmira large
2. Chemistry analyser
5. Lab cabinet
MINIMAL ITEMS
Gynae/Obs. ward items
4. B.P apparatus desktop type
5. Office chair
2. Examination lamp
6. Office table with drawers
3. Stethoscope adult size
Paediatric nursery
4. Suction apparatus: electrically operated
1. Air ways 2 size
2. Infant ambo bag
Paediatric ward
2. Nebuliser
Labour room
6. Uterine sound
9. D&C instruments set complete
10. Delivery forceps set
5. Sponge forceps
11. Delivery table
Operation theatre
1. Anaesthesia machine
2. Laryngoscopes
56

EQUIPMENT FOR THQ HOSPITAL
OPTIMAL ITEMS
General hospital
3. Desktop computer with monitor and
1. Ambulance
accessories
2. Defibrillator
10. Scissors curved 5 inch
1. Cabinet Instrument large
11. Scissors sharp 5 inch straight
12. Chital forceps
13. Kidney tray s.s 10 inch
4. Bed side locker
14. Jar for forceps
16. Foetal monitor (foetal Doppler desk type)
7. Artery forceps 7 inch
17. Infant B.P apparatus
9. Dissecting forceps plain 7 inch
19. Baby cot
4. Ultrasound machine
5. Examination lamp
Paediatric nursery
7. Baby warmer
1. Air ways 2 size
2. Infant ambo bag
9. Room thermometer
10. Baby cot
4. Suction apparatus: electrically
11. Steam inhaler
operated
Paediatric ward
6. Emergency medicine trolley
1. Suction machine
7. Patient's attendant bench
9. Bed side locker s.s top
4. Nebuliser
Labour room
10. Uterine sound
12. Scissors dissecting blunt pointed
3. Jar for forceps
13. Artery forceps
14. Blunt-ended scissors
16. Infant ambo bag
17. Portable Light rechargeable batteries
8. Sponge Forceps
18. Sterilising Drum
9. Long straight artery forceps
19. Vacuum Extractor
Operation theatre
1. Needle holder
2. Stitch scissors
19. Abdominal retractors, double-ended
3. Dissecting forceps, toothed
(Richardson)
4. Sim's speculum large
20. Curved operating scissors, blunt pointed
5. Sim's speculum medium
(Mayo), 17 cm
6. Vacuum extractor
21. Straight operating scissors, blunt pointed
7. Obstetric forceps
(Mayo), 17 cm
8. Rectangular instrument tray lids
22. Aesthetic face masks (3 sizes)
9. Towel clips
23. Anaesthesia Machine
10. Sponge forceps, 22.5 cm
24. Laryngoscopes
11. Straight artery forceps, 16 cm
25. X-Ray illuminator
12. Uterine homeostasis forceps, 20 cm
13. Hysterectomy forceps, straight, 22.5
27. General Instrument set
cm
28. Adult ambo bag and mask
14. Mosquito forceps, 12.5 cm
15. Tissue forceps, 19 cm
30. Myomectomy screw
16. Needle holder, straight, 17.5 cm
31. Air conditioners
Laboratory
3. Counter (hand tally differential)
57
1. Spin Machine
2. Chemistry analyser
EQUIPMENT FOR THQ HOSPITAL

OPTIMAL ITEMS
4. Steel Elmira large
5. Lab cabinet
MINIMAL ITEMS

Paediatric nursery
1. Air ways 2 size
2. Infant ambo bag
Paediatric ward
2. Nebuliser
Labour room
Operation theatre
1. Anaesthesia machine
2. Laryngoscopes
2. Examination lamp
4. Suction apparatus: electrically operated
4.
5.
6.
7.
Sponge Forceps
Uterine sound
Vulsellum forceps
Episiotomy instruments set complete

D. Drugs and supplies criteria

DRUG & SUPPLIES FOR BHU
OPTIMAL ITEMS
Supplies
4. Reagents/ strips for routine lab tests
1. Gloves
5. Surgical Spirit
2. Clean / Safe delivery kit
6. Oral Rehydration Salt ORS
3. Disposable/ Auto disable Syringes
Tracer Drugs
7. Tetracycline Ointment
1. Cap Amoxicillin
8. Injection Oxytocin
2. Syrup Amoxicillin
9. IV Solutions
3. Tablet Metronidazole
10. Syp. Salbutamol
4. Syrup Metronidazole
11. Syp. Chloroquine
5. Tablet iron
12. Syp. Zinc Sulphate
6. Tablet folic acid
Vaccines
3. Penta-valent
1. BCG
4. Measles
2. OPV
5. TT
FP Commodities
4. IUCDs
1. Condoms
5. Injection DMPA
2. COC
6. Injection Net-En
3. POP
MINIMAL ITEMS
Supplies
1. Tablet iron
Tracer Drugs
Vaccines
3. Penta-valent
1. BCG
4. Measles
2. OPV
5. TT
FP Commodities (any three)
3. COC or POP
1. Condoms
4. Injection DMPA or Net-En
2. IUCDs
58

DRUG / SUPPLIES FOR RHC
OPTIMAL ITEMS
Supplies
1. Gloves
Tracer Drugs
1. Injection Dexamethasone
2. Injection Adrenaline
3. Injection Atropine
4. Injection Ampicillin
5. Cap Amoxicillin
9. Tablet iron
Vaccines
1. BCG
2. OPV
FP Commodities
1. Condoms
2. COC
3. POP
Supplies
Tracer Drugs
Vaccines
1. BCG
2. OPV
1. Condoms
2. IUCDs

5. Surgical Spirit
10.
11.
12.
13.
14.
15.
16.
17.
18.
Tablet folic acid

Tetracycline Ointment
Injection Oxytocin
Injection Magnesium sulphate
IV Solutions
Syp. Salbutamol
Syp. Chloroquine
Syp. Zinc Sulphate
Injection Diclofenac Sodium
3.
4.
5.
4.
5.
6.
Penta-valent
Measles
TT
IUCDs
Injection DMPA
Injection Net-En
MINIMAL ITEMS
3. Injection Magnesium sulphate
3. Penta-valent
4. Measles
5. TT
3. COC or POP
4. Injection DMPA or Net-En
DRUG / SUPPLIES FOR DHQH & THQH

OPTIMAL ITEMS
Supplies
5. Screening Kits for Hep B,C & HIV
1. Gloves
6. Blood grouping reagents
7. Blood bags with transfusion sets
8. Surgical Spirit
Tracer Drugs
14. IV Solutions
15. Syp. Salbutamol
5. Cap Amoxicillin
18. Injection Diclofenac Sodium
19. Injection Thiopentone Sodium
9. Tablet iron
20. Injection Neostigmine
21. Injection Propofol
Vaccines
3. Penta-valent
1. BCG
4. Measles
2. OPV
5. TT
FP Commodities
4. IUCDs
1. Condoms
5. Injection DMPA
2. COC
6. Injection Net-En
59

3. POP
7. Implants
MINIMAL ITEMS
Supplies
1. Gloves
Tracer Drugs
Vaccines
1. BCG
2. OPV
1. Condoms
2. IUCDs

5.
6.
7.
8.
9.
3.
4.
5.
3.
4.
5.
Injection Oxytocin
Injection Magnesium sulphate
Injection Thiopentone Sodium
Injection Neostigmine
Injection Propofol
Penta-valent
Measles
TT
COC or POP
Injection DMPA or Net-En
Implants
E. Support Service Criteria

SUPPORT SERVICES FOR BHU
SUPPORT SERVICES FOR RHC
OPTIMAL CRITERIA
Basic lab tests
1. Doctor or LHV
2. Reagents and strips
OPTIMAL CRITERIA
Basic lab tests
1. Space
2. Doctor or LHV or Lab Technician
Ambulance services
1. Functional ambulance
2. Ambulance driver
MINIMAL CRITERIA FOR BHU

Basic lab tests
1. Doctor or LHV
MINIMAL CRITERIA FOR RHC

Basic lab tests
1. Space
2. Doctor or LHV or Lab Technician
SUPPORT SERVICE CRITERIA FOR SHC HOSPITALS

OPTIMAL CRITERIA
Basic lab tests
1. Space
2. Laboratory technician
Blood transfusion services
1. BB Technician or Lab Technician
Radiology services
1. Space
Operation theatre services
1. Space
2. Anaesthetist
3. OT Technician
Ambulance services

4. Laboratory Equipment
2. Screening strips for Hep B, C & HIV
2. Ultrasound equipment
4. Anaesthesia Technician
5. OT equipment
6. Drugs and supplies
2. Ambulance driver
MINIMAL CRITERIA
Basic lab tests
1. Space
Blood transfusion services
2. Lab Technician
2. Screening strips for Hep B, C & HIV
60

1. Laboratory or BB Technician
Radiology services
1. Space
Operation theatre services
1. Space
2. Anaesthetist or Anaesthesia Technician
2. Ultrasound equipment
3. OT equipment
4. Drugs and supplies
F. Infection Control & Waste Management Criteria

ASSESSMENT CRITERIA
Infection Control Hand washing
1. Hand washing basin with running water
3. Towel
2. Soap
4. Gloves
Personal Protection Materials
1. Face masks
4. Gowns
2. Safety goggles
5. Industrials boots
3. Heavy duty leather gloves
Waste collection materials
1. Safety boxes
2. Colour-coded plastic bags
Waste treatment equipment
1. Autoclave for waste treatment
2. Autoclave test strips
Disinfection of service provision areas
1. Cleaning materials
2. Chemical disinfectant
G. Input Criteria for Basic EmONC services at THQ Hospital

G.1 Civil works
OPD
Female Ward
1. Patient area
Labour Room
1. Delivery room
Clinical Laboratory
1. Laboratory room
LHV Room
WMO residence
LHV residence
CIVIL WORKS SCOPE

2. Examination area
2.
3.
2.
3.
2.
3.
Scrub area
Functional attached wash room for patient
Working area
Examination area
Hand washing facilities
Available
Good condition
Available
Good condition
61

G.2 Human Resource
HUMAN RESOURCE
Category
Number
WMO
OT technician
Lab technician
LHV
Ambulance drivers
1
1
2
1
G. 3 Equipment
EQUIPMENT
General hospital
1. Ambulance
Female ward
3. Bed side locker
OPD
Labour room
3. Jar for forceps

6. Baby cot
3. Examination lamp
8.
9.
10.
11.
12.
13.
14.
Sponge Forceps
Long straight artery forceps
Uterine sound
Vulsellum forceps
Artery forceps
G.4 Drugs and Supplies

DRUG / SUPPLIES
Supplies
1. Gloves
9. Tablet iron
Tracer Drugs
14. IV Solutions
5. Cap Amoxicillin
15. Syp. Salbutamol
18. Injection Diclofenac Sodium
Vaccines
3. Penta-valent
1. BCG
4. Measles
2. OPV
5. TT
FP Commodities
4. IUCDs
1. Condoms
5. Injection DMPA
2. COC
6. Injection Net-En
3. POP
62

G.5 Support Services
SUPPORT SERVICE
Laboratory services
1. Basic Laboratory tests
Ambulance services
2. Ambulance driver
63
A nnex 3 A: Status of Surveyed HF against Minimal
Level of Inputs
A. Status of BHU
i.
STATUS OF ASSESSED INFRASTRUCTURE IN BHU

Status of building components at Surveyed BHU
Infrastructure
BHU
Dashat
BHU
Gawak
BHU
Kohad
BHU
Balgather
BHU
Gokdan
BHU
Drachkoo
BHU
Kunchity
LHV Room Available
LHV Room Functional
ii.
STATUS OF MNCH RELATED STAFF IN BHU

Availability of MNCH related staff at surveyed BHU
Staff
categories
Required
Number
WMO or
LHV
iii.
BHU
Dashat
BHU
Gawak
BHU
Kohad
BHU
Balgather
BHU
Gokdan
BHU
Drachkoo
BHU
Kunchity
STATUS OF FUNCTIONAL EQUIPMENT IN BHU

Availability of functional equipment items at surveyed BHU
Equipment
Total
Items
Assessed
items
10
iv.
Item groups
Supplies*
Drugs*
Vaccines
FP
Commodities
BHU
Dashat
BHU
Gawak
BHU
Kohad
BHU
Balgather
BHU
Gokdan
BHU
Drachkoo
BHU
Kunchity
STATUS OF DRUGS AND SUPPLIES IN BHU

Total
Items
required
at each
BHU
3
2
5
4

BHU
Dashat
BHU
Gawak
BHU
Kohad
BHU
Balgather
BHU
Gokdan
BHU
Drachkoo
BHU
Kunchity
1
2
0
1
2
0
2
2
0
1
2
0
1
2
1
1
0
0
1
1
0
* Tracer items were selected for assessment from list provided in the PC-1 NMNCHP
64

v.
STATUS OF SUPPORT SERVICES IN BHU
Support
services
Total
Items
required
at each
BHU
Basic lab
tests*

BHU
Dashat
BHU
Gawak
BHU
Kohad
BHU
Balgather
BHU
Gokdan
BHU
Drachkoo
BHU
Kunchity
*Include facility for tests of pregnancy, haemoglobin, urine for protein and sugar, and malaria.
B. 24/7 Basic EmONC Services at RHC

i.
STATUS OF ASSESSED INFRASTRUCTURE IN RHC
6. Pt. wash room

LHV room
5. Examination area
6. Hand washing
Residence
Doctor
RHC Zaring
Bag
5. Working area
RHC Dasht
Khudan
Clinical lab.
4. Laboratory room
RHC Bal
Nigore
RHC Pidark
5. Scrub area
RHC
Nasirabad
Labour room
4. Delivery room
RHC Kalatak
RHC Gower
Koop
Female ward
3. Patient area
RHC Tump
6. Hand washing
RHC Mand
5. Examination area
RHC Gomazai
OPD
RHC Buleda
Infrastructure
Status
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
A
F
Y
Y
Y
N
Y
Y
Y
Y
N
N
N
N
Y
Y
Y
N
Y
Y
Y
Y
N
N
N
N
Y
Y
Y
N
Y
Y
Y
Y
N
N
N
N
Y
N
N
N
N
N
Y
Y
N
N
N
N
Y
N
N
N
N
N
Y
Y
N
N
N
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
N
Y
Y
Y
N
Y
N
Y
Y
Y
Y
Y
N
Y
Y
Y
N
Y
N
Y
Y
Y
Y
Y
N
Y
Y
N
N
N
N
Y
N
Y
Y
N
N
Y
Y
N
N
N
N
Y
N
Y
Y
N
N
Y
Y
N
N
N
N
Y
Y
Y
N
N
N
N
N
N
N
Y
N
Y
Y
Y
N
N
N
N
N
N
N
Y
N
Y
Y
Y
N
N
N
Y
Y
Y
Y
Y
N
N
N
Y
N
Y
N
Y
Y
Y
Y
Y
N
N
N
Y
N
Y
N
Y
Y
Y
Y
Y
N
Y
Y
Y
N
Y
N
N
N
N
N
N
N
Y
Y
Y
N
Y
N
N
N
N
N
N
N
Y
Y
Y
N
Y
N
Y
Y
N
N
N
N
Y
N
Y
N
Y
N
Y
Y
N
N
N
N
Y
N
Y
N
Y
N
Y
Y
N
N
N
N
Y
Y
Y
Y
Y
Y
N
N
Y
N
Y
N
Y
Y
Y
Y
Y
Y
N
N
Y
N
Y
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
N
Y
N
Y
N
Y
N
Y
N
Y
Y
Y
N
Y
N
Y
N
Y
N
Y
N
Y
Y
Y
N
Y
N
65
RHC Mand
RHC Tump
RHC Gower
Koop
RHC Kalatak
RHC
Nasirabad
RHC Pidark
RHC Bal
Nigore
RHC Dasht
Khudan
RHC Zaring
Bag
ii.
RHC Gomazai
Residence
LHV
RHC Buleda
Infrastructure
Status
A
F
Y
Y
Y
N
Y
Y
Y
Y
Y
N
N
N
N
N
N
N
Y
N
N
N
Y
N
STATUS OF MNCH RELATED STAFF IN RHC
Number of MNCH related staff available at each RHC

Staff
categories
Required
number
at each
RHC
RHC Buleda
RHC
Gomazai
RHC Mand
RHC Tump
RHC Gower
Koop
RHC Kalatak
RHC
Nasirabad
RHC Pidark
RHC Bal
Nigore
RHC Dasht
Khudan
RHC Zaring
Bag
WMO
LHV
Lab
technician
iii.
STATUS OF FUNCTIONAL EQUIPMENT IN RHC
Equipment
RHC Buleda
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower
Koop
RHC Kalatak
RHC
Nasirabad
RHC Pidark
RHC Bal
Nigore
RHC Dasht
Khudan
RHC Zaring
Bag
Number of functional equipment items available at each RHC
Total
Items
required
at each
RHC
Female
ward
WMO OPD
Labour
room
LHV Room
66

iv.
STATUS OF DRUGS AND SUPPLIES IN RHC
Item groups
Total Items
required at
each RHC
RHC Buleda
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower Koop
RHC Kalatak
RHC Nasirabad
RHC Pidark
RHC Bal Nigore
RHC Dasht Khudan
RHC Zaring Bag
Supplies*
Drugs*
Vaccines
FP
Commodities
v.
RHC Gomazai
RHC Mand
RHC Tump
RHC Gower
Koop
RHC Kalatak
RHC
Nasirabad
RHC Pidark
RHC Bal
Nigore
RHC Dasht
Khudan
RHC Zaring
Bag
Total
Items
required
at each
RHC
RHC Buleda
Support
services
STATUS OF SUPPORT SERVICES IN RHC
Basic lab
tests*
Ambulance
service
C. 24/7Comprehensive EmONC Services at SHC Hospital

i.
STATUS OF ASSESSED INFRASTRUCTURE IN SHC HOSPITAL
Infrastructure
Status
Availability of building components

DHQH Keich
OPD
Female ward
Labour room
Operation theatre
Paediatrics ward
F
A
F
A
Y
Y
Y
N
67

F
A
F
A
N
N
N
Y
Residence:
Anaesthetist
Residence:
Paediatrician
Residence:
WMO
Residence
Lab Technician
LHV Room
Residence:
Gynaecologist
ii.
STATUS OF MNCH RELATED STAFF IN SHC HOSPITAL
Staff categories
Availability of MNCH related staff at

DHQH Keich
Required number
Available number
Gynaecologist
Anaesthetist
Paediatrician
WMO
OT technician
Lab technician
Nurses
LHV
iii.
STATUS OF FUNCTIONAL EQUIPMENT IN SHC HOSPITAL
Equipment
Availability of functional equipment items

Total Items
DHQH Keich
Female ward
OPD
Paediatric nursery
Paediatric ward
Labour room
11
10
Operation theatre
3
68

iv.
STATUS OF DRUGS AND SUPPLIES IN SHC HOSPITAL
Item Groups
Total Items
Availability of Items at
DHQH Keich
Supplies*
Drugs*
Vaccines
FP Commodities
v.
STATUS OF SUPPORT SERVICES IN SHC HOSPITAL
Item groups
Total Items
Availability of functional equipment

at SHC
DHQH Keich
Basic laboratory tests*
Blood transfusion
Ambulance services
Radiology services
Operation theatre
16
11
69
Annex 3 B: List of Items Required

Each item is assessed against the standard quantity in different assessed components of the
service provision areas. Standard quantity of same item may vary in each component.
Annexed tables include aggregate quantity of each item in all the surveyed components.
Therefore, table may show requirement of an item despite having same aggregate quantity
in respect of standard, available and functional, as explained in the following table. Annexed
tables shows the aggregate quantities of each assessed item, therefore, requirement may
arise even the overall standard quantity is available and functional in the facility.
Quantity of an item
Component
STD*
AVL*
FUNC*
RQRD*
OPD
Ward
Aggregate
* STD: Standard, AVL: Available, FUNC: Functional, RQRD: Required
A. List of items required for DHQ Hospital in District Keich

DHQ Hospital, Keich - Balochistan
Items name
Abdominal retractors, double-ended
(Richardson)
Adult ambo bag and mask
Air conditioner (Split) 1.5 Ton (with heating
system)
Air ways 2 size
Ambulance
Anaesthesia machine $
Anaesthetic face masks (3 sizes)
Artery forceps 7"
Attendant's bench
Auto-clave for treatment of hospital waste
B P Apparatus mercury Desk type
Baby cot
Baby warmer
Bed side locker s.s top
C.T.G. machine
Cabinet Instrument large
Chemistry analyser
Chital forceps
Counter (hand tally differential)
Curved operating scissors, blunt pointed (Mayo),
17 cm
Item Quantities
Standard
Available
Functional
Required
12
10
10
1
1
2
2
8
30
1
4
21
2
60
6
1
2
1
2
2
0
3
2
2
4
0
1
2
11
1
22
1
1
0
3
1
1
0
3
2
2
2
0
1
2
11
1
22
1
1
0
3
1
1
1
0
0
0
6
30
0
2
10
1
38
5
0
2
0
1
1
10
5
70

Defibrillator
Delivery forceps set
Delivery table
Desktop computer with monitor and accessories
Dissecting forceps plain 7"
Dissecting forceps, toothed
Dust bin stainless steel
ECG machine
Electric instrument steriliser 12"x6"
Electric water cooler
Emergency medicine trolley
Episiotomy instruments set complete
Examination couch
Foetal monitor (foetal Doppler desk type)
Foetal stethoscope
Fowler bed (Iron)
General Instrument set
Glucometer
Gynae Instrument set
Haematology analyser
Hysterectomy forceps, straight, 22.5 cm
Incinerator 50kg
Infant ambo bag
Infant B.P apparatus (Cuff 2.5 cm)
Infant laryngoscope set
Infant weight machine
Infusion / drip stands
Infusion pump
Jar for forceps
Kidney tray s.s 10"
Lab Cabinet
Lab Incubator
Laryngoscopes set (Adult)
LaserJet Printer
Long straight artery forceps 10"
Mosquito forceps, 12.5 cm
Myomectomy screw
Nebuliser
Needle holder, straight, 17.5 cm
Needle holder, straight, 8"
Obstetric forceps
Office Chair
Office Tables with drawer
Ophthalmoscope
Overhead food trolley
Oxygen cylinder complete with trolley &
regulator
Patient Stool
Patient waiting bench
Patient's attendant bench
Phototherapy unit
Portable Light e rechargeable batteries (OT)
Power Generator 50 Kva (Diesel)
Pulse oximeter
Rectangular instrument tray e lids
Refrigerator 10 cuft
Room thermometer
Scissors curved 5"
1
1
2
4
2
4
30
1
2
2
1
4
2
1
4
60
1
2
2
1
18
1
2
5
1
5
18
2
4
2
2
5
4
4
3
36
2
2
12
4
2
2
2
1
30
0
2
4
3
1
10
2
0
1
5
3
2
1
0
2
33
10
0
4
0
4
1
2
0
1
2
12
0
2
1
0
11
1
1
0
10
0
3
0
10
0
1
1
0
2
0
2
4
3
1
10
2
0
1
5
3
2
1
0
2
30
10
0
2
0
2
1
2
0
1
2
12
0
2
1
0
11
1
1
0
10
0
2
0
5
0
1
1
0
2
1
0
0
1
1
0
28
1
1
0
0
2
1
1
2
30
0
2
0
1
16
0
0
5
0
3
6
2
2
1
2
0
3
3
3
26
2
1
12
0
2
1
1
1
28
3
2
2
30
1
1
1
3
3
3
1
2
3
1
1
0
0
3
2
3
0
5
5
1
1
0
1
1
0
0
3
2
3
0
5
5
1
1
0
2
1
2
30
0
0
0
3
0
1
0
1
3
71

Scissors sharp 5" straight
Shredder 500 litre
Sim's speculum large
Sim's speculum medium
Sim's Speculum right angle, medium
Sim's Speculum right angle, small
Spin Machine (centrifuge)
Sponge forceps, 22.5 cm
Spring type dressing forceps (ss)
Steam inhaler
Steel Almirah large
Sterilising Drum
Stethoscope adult size
Stethoscope Paediatric Littman type
Stitch scissors
Straight artery forceps, 16 cm
Straight operating scissors, blunt pointed
(Mayo), 17 cm
Suction apparatus: electrically operated
Surgical knife handle # 3
Surgical knife handle # 4
Tissue forceps, 19 cm
Towel clips
Ultrasound machine
UPS for computer
UPS power supply system (2000W)
Uterine homeostasis forceps, 20 cm
Uterine sound
Vacuum extractor
Vulsellum forceps
Water distillation unit
Water filter
Weight machine adult
X-Ray illuminator
Total quantities
2
10
1
4
4
3
3
3
1
7
2
4
2
4
2
4
4
36
1
5
1
2
0
0
1
1
4
12
2
1
0
6
1
4
5
30
1
5
0
2
0
0
1
1
4
12
2
1
0
6
1
4
0
25
1
5
1
2
4
3
2
2
0
0
0
3
2
0
1
0
4
11
4
3
3
36
36
1
4
4
18
2
2
3
1
2
2
1
766
5
5
3
8
10
0
0
0
4
0
2
1
0
1
2
0
373
5
5
3
8
10
0
0
0
4
0
2
1
0
1
2
0
340
0
0
0
28
26
1
4
4
14
2
0
2
1
1
0
1
487
72
B. List of items required for RHC in District Keich
FUNC
RQRD
AVL
FUNC
RQRD
AVL
FUNC
RQRD
RHC Dasht
Khudan, Keich
Balochistan
AVL
Ambulance
Artery forceps 7"
Attendant's bench
Baby Cot
Clean Delivery Kits
Disposable syringe cutter
Electric Water Cooler
Examination Couch
Foetal stethoscope
Fowler bed (Iron)
Incinerator 50kg
Infant ambo bag
Jar for forceps
Nebuliser
Office Chair
Office Tables with drawer
Patient stool
Plain chairs
Steam inhaler
Steel Almirah large
Suction apparatus: electrically
operated
Uterine sound
Vulsellum forceps
Water filter
Total
RHC Buleda,
Keich Balochistan
Standard Quantity
Items name
RHC Bal
Nigore, Keich
- Balochistan
1
4
20
2
4
20
2
100
2
1
20
1
1
2
2
20
1
2
2
1
1
3
1
2
1
6
2
20
2
2
2
2
2
2
2
2
2
2
1
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
4
20
2
4
20
2
100
2
1
20
1
1
2
2
20
1
2
2
1
1
3
1
2
1
6
2
20
2
2
2
2
2
2
2
2
2
2
1
2
1
1
1
2
1
1
2
1
1
1
1
0
0
0
2
1
4
0
0
0
1
1
3
0
0
1
2
2
0
1
3
4
1
1
2
1
1
2
0
0
1
1
0
1
2
1
1
2
1
1
1
1
0
0
0
2
1
2
0
0
0
0
1
3
0
0
1
2
2
0
1
3
3
1
1
2
1
1
1
0
0
1
1
1
3
18
1
3
18
1
99
1
0
20
1
1
0
1
18
1
2
2
1
0
0
1
2
0
4
0
20
1
0
0
1
1
0
1
1
1
2
1
1
0
1
2
0
2
0
0
0
3
0
0
0
0
0
1
1
0
0
0
0
0
0
2
1
0
0
1
1
0
0
1
2
2
0
0
0
0
0
2
0
1
1
0
2
0
2
0
0
0
3
0
0
0
0
0
1
1
0
0
0
0
0
0
2
1
0
0
1
1
0
0
1
2
2
0
0
0
0
0
1
0
1
1
1
2
20
0
4
20
2
97
2
1
20
1
1
1
1
20
1
2
2
1
1
1
0
2
1
5
1
20
2
1
0
0
2
2
2
2
2
1
1
1
0
1
2
2
1
2
277
0
0
0
0
0
0
0
0
0
0
0
0
1
2
2
1
2
277
0
0
0
0
2
50
0
0
0
0
2
44
1
2
2
1
0
235
0
0
0
0
1
25
0
0
0
0
1
23
1
2
2
1
1
254
Item
Quantities
Item Quantities
Item Quantities
73
FUNC
RQRD
AVL
FUNC
RQRD
AVL
FUNC
RQRD
RHC Kalatak,
Keich Balochistan
AVL
Ambulance
Artery forceps 7"
Attendant's bench
Baby Cot
Clean Delivery Kits
Electric Water Cooler
Examination Couch
Foetal stethoscope
Fowler bed (Iron)
Incinerator 50kg
Infant ambo bag
Jar for forceps
Nebuliser
Office chair
Patient stool
Plain chairs
Steam inhaler
Steel Almirah large
operated
Uterine sound
Vulsellum forceps
Water filter
Total
RHC Gower
Koop, Keich
- Balochistan
Item
Quantities
Standard Quantity
Items name
RHC Gomazai,
Keich Balochistan
1
4
20
2
4
20
2
100
2
1
20
1
1
2
2
20
1
2
2
1
1
3
1
2
1
6
2
20
2
2
2
2
2
2
2
2
2
2
1
2
1
0
0
0
1
0
0
0
0
0
1
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
1
1
0
0
1
4
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
1
1
0
0
1
2
0
0
0
0
0
0
0
0
0
0
1
4
20
1
4
20
2
100
2
0
20
1
1
1
1
20
1
2
2
1
1
3
1
2
1
5
1
20
2
1
0
2
2
2
2
2
2
2
1
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
1
0
0
0
0
0
0
0
0
0
1
0
1
4
20
2
4
20
2
100
2
1
20
1
1
1
2
20
1
2
2
1
1
3
1
2
1
5
1
20
2
1
2
2
2
2
2
2
2
2
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
1
1
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
1
0
0
1
0
0
0
0
0
0
0
0
0
1
0
1
4
20
2
4
20
2
100
2
1
20
1
1
2
2
20
1
2
2
1
1
2
1
2
1
5
1
20
2
1
2
2
2
2
2
2
2
2
1
1
1
1
2
2
1
2
277
0
0
0
0
1
12
0
0
0
0
1
10
1
2
2
1
1
267
0
0
0
0
1
6
0
0
0
0
1
6
1
2
2
1
1
271
0
0
0
0
0
6
0
0
0
0
0
5
1
2
2
1
2
272
Item Quantities
Item Quantities
74
Standard Quantity
RQRD
AVL
FUNC
RQRD
Item
Quantities
FUNC
Item Quantities
AVL
Item Quantities
RQRD
RHC Pidark,
Keich
Balochistan
FUNC
Ambulance
Artery forceps 7"
Attendant's bench
Baby Cot
Clean delivery kits
Examination couch
Foetal stethoscope
Fowler bed (Iron)
Incinerator 50kg
Infant ambo bag
Jar for forceps
Nebuliser
Office chair
Patient stool
Plain chairs
Sim's Speculum right angle,
medium
Steam inhaler
Steel Almirah large
operated
Uterine sound
Vulsellum forceps
Water filter
Total
RHC
Naseerabad,
Keich Balochistan
AVL
Items name
RHC Mand,
Keich Balochistan
1
4
20
2
4
20
2
100
2
1
20
1
1
2
2
20
1
2
2
1
1
3
1
2
1
6
2
20
2
2
2
2
2
2
1
2
7
2
1
14
1
0
1
1
2
0
0
2
2
14
1
0
0
0
0
3
0
1
0
2
2
0
0
2
10
0
1
2
0
2
7
2
1
10
1
0
1
1
2
0
0
2
2
9
1
0
0
0
0
3
0
1
0
2
2
0
0
2
6
0
1
1
1
2
13
0
3
10
1
100
1
0
18
1
1
0
0
11
0
2
2
1
1
0
1
1
1
4
0
20
2
0
0
2
1
1
1
0
0
1
1
5
0
0
0
1
1
0
0
2
0
5
0
0
0
0
0
2
0
0
1
2
2
0
0
2
3
0
1
0
0
0
0
1
1
4
0
0
0
1
1
0
0
2
0
5
0
0
0
0
0
2
0
0
1
2
2
0
0
2
3
0
1
0
1
4
20
1
3
16
2
100
2
0
19
1
1
0
2
15
1
2
2
1
1
1
1
2
0
4
0
20
2
0
0
2
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
1
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
1
1
0
0
1
0
0
0
0
1
4
20
2
4
20
2
100
2
1
20
1
1
1
2
20
1
2
2
1
1
2
1
2
1
5
1
20
2
1
2
2
2
2
2
2
2
1
2
1
0
1
1
0
2
1
0
1
1
0
2
1
2
1
1
1
0
0
0
0
0
0
1
1
0
0
0
0
1
1
2
2
2
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
2
2
2
1
2
1
1
2
2
1
2
277
0
0
0
0
2
82
0
0
0
0
2
67
1
2
2
1
0
214
0
0
0
0
2
34
0
0
0
0
2
32
1
2
2
1
0
246
0
0
0
0
1
6
0
0
0
0
1
6
1
2
2
1
1
271
75
Items name
Ambulance
Artery forceps 7"
Attendant's bench
B P Apparatus mercury Desk
type
Baby Cot
Clean delivery kits
Electric instrument steriliser
12"x6"
Examination couch
Foetal stethoscope
Fowler bed (Iron)
Incinerator 50kg
Infant ambo bag
Jar for forceps
Nebuliser
Office chair
Patient stool
Plain chairs
Scissors dissecting blunt
pointed
large
medium
small
Spring type dressing forceps
(ss)
Steam inhaler
Steel Almirah large
operated
UPS power supply system
(2000W)
RHC Tump, Keich Balochistan
RHC Zaring, Keich Balochistan
Item Quantities
Item Quantities
Standard
Quantity
AVL
FUNC
RQRD
AVL
FUNC
RQRD
1
4
20
1
2
12
0
1
12
1
3
8
0
10
0
0
10
0
1
0
20
4
20
2
100
2
1
20
0
20
1
1
1
0
0
0
16
1
1
1
0
0
4
4
1
99
1
1
20
0
3
6
0
2
1
0
0
3
5
0
2
1
0
4
17
0
100
0
0
20
1
2
2
20
1
2
2
1
1
3
1
2
1
6
2
20
2
2
2
0
1
1
20
1
0
0
0
0
2
0
2
0
1
1
0
0
1
0
0
1
1
12
1
0
0
0
0
2
0
1
0
1
1
0
0
1
0
1
1
1
8
0
2
2
1
1
1
1
1
1
5
1
20
2
1
2
0
2
1
2
0
0
0
0
1
3
1
4
0
2
2
0
0
2
6
0
2
1
2
0
0
0
0
1
3
1
4
0
2
2
0
0
2
4
1
0
1
18
1
2
2
1
0
0
0
0
1
4
0
20
2
0
0
1
2
1
0
2
1
0
2
1
1
0
0
0
3
0
0
3
0
1
0
1
1
76

Uterine sound
Vulsellum forceps
Water filter
Total
2
2
1
2
277
0
0
0
2
77
0
0
0
2
62
2
2
1
0
215
0
3
0
2
76
0
3
0
2
73
2
0
1
0
225
C. List of items required for surve yed BHU in District Keich

BHU Dashat,
Keich Balochistan
Item Quantities
BHU Drachkoo,
Keich Balochistan
Item Quantities
AVL
FUNC
RQRD
AVL
FUNC
RQRD
AVL
FUNC
RQRD

type
Clean delivery kits
Examination couch
Foetal stethoscope
Incinerator 50kg
Nebuliser
Office chair
Patient stool
Plain chairs
Steam inhaler
Steel Almirah large
Water filter
Total
Standard Quantity
Items name
BHU Balgather,
Keich Balochistan
Item Quantities
50
1
1
1
2
1
2
2
1
2
1
4
2
2
2
4
1
2
1
2
85
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
1
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
1
3
50
1
1
1
2
1
2
2
1
2
1
4
2
2
2
4
1
1
1
1
83
0
0
1
0
1
0
0
0
0
0
0
1
1
0
0
0
0
2
0
0
6
0
0
1
0
1
0
0
0
0
0
0
1
1
0
0
0
0
2
0
0
6
50
1
0
1
1
1
2
2
1
2
1
3
1
2
2
4
1
0
1
2
79
0
0
0
0
1
0
0
0
0
0
0
0
1
0
1
5
0
1
0
1
11
0
0
0
0
1
0
0
0
0
0
0
0
1
0
1
4
0
1
0
1
10
50
1
1
1
1
1
2
2
1
2
1
4
1
2
1
0
1
1
1
1
75
77
RQRD
AVL
FUNC
RQRD
AVL
FUNC
RQRD

Clean delivery kits
Examination couch
Foetal stethoscope
Incinerator 50kg
Nebuliser
Office chair
Patient stool
Plain chairs
Steam inhaler
Steel Almirah large
Water filter
Total
BHU Kohad,
Keich Balochistan
Item Quantities
FUNC
Items name
BHU Gokdan,
Keich Balochistan
Item Quantities
AVL

type
Clean delivery kits
Examination couch
Foetal stethoscope
Incinerator 50kg
Nebuliser
Office chair
Patient stool
Plain chairs
Steam inhaler
Steel Almirah large
Water filter
Total
Standard Quantity
Items name
BHU Gawak,
Keich Balochistan
Item Quantities
50
1
1
1
2
1
2
2
1
2
1
4
2
2
2
4
1
2
1
2
85
1
1
1
0
1
0
0
0
0
1
0
1
1
0
1
0
0
3
0
2
13
1
1
1
0
1
0
0
0
0
1
0
1
1
0
1
0
0
3
0
2
13
49
0
0
1
1
1
2
2
1
1
1
3
1
2
1
4
1
0
1
0
73
0
1
1
0
2
0
0
0
0
0
0
2
2
0
3
7
0
4
0
1
24
0
1
1
0
2
0
0
0
0
0
0
2
2
0
3
5
0
3
0
1
21
50
0
0
1
0
1
2
2
1
2
1
2
0
2
0
0
1
0
1
1
67
1
1
1
0
2
0
0
0
0
0
1
3
2
0
2
4
1
4
0
1
24
1
1
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
3
0
1
8
49
0
0
1
1
1
2
2
1
2
1
4
2
2
2
4
1
1
1
1
79
Standard Quantity
1
50
1
1
1
2
1
2
2
1
2
1
4
2
2
2
4
1
2
1
2
85
BHU Kunchity, Keich Balochistan

Item Quantities
AVL
FUNC
RQRD
1
1
0
0
0
50
0
0
1
0
0
1
0
0
1
0
0
2
0
0
1
0
0
2
0
0
2
0
0
1
0
0
2
0
0
1
1
1
3
1
1
1
0
0
2
1
1
1
3
3
1
0
0
1
1
1
1
0
0
1
0
0
2
8
8
77
78
D. Estimated cost of required equipment at surve yed facilities

Health facility
Estimated cost (in PKR)
Health facility
DHQH Keich
8,445,893
RHC Tump
6,059,728
RHC Bal Nigore
6,686,534
RHC Zaring Bag
6,438,318
RHC Buleda
6,024,998
BHU Balgather
699,071
RHC Dasht Khudan
6,593,632
BHU Dashat
660,650
RHC Gomazai
6,640,075
BHU Drachkoo
650,314
RHC Gower Koop
6,642,343
BHU Gawak
641,452
RHC Kalatak
6,643,838
BHU Gokdan
597,364
RHC Mand
6,135,486
BHU Kohad
685,873
RHC Nasirabad
6,247,903
BHU Kunchity
659,284
RHC Pidark
6,652,118
79
Annex 4: Scope of Civil Works Required

A. Scope of civil w orks required at SHC Hospital
Rough cost Estimate for improvement/Renovation
DHQH Keich
Description
Covered Unit
Qty
Area
Boundary wall
Repair of boundary wall
Hospital
Main building
Repair
Restoration of brick work
Restoration of roof tiles
Restoration of plaster work
Restoration of floor
Restoration of distempering
Restoration of Almirah
Restoration of doors/windows
Tile work in bathrooms
Restoration toilets
Restoration of electric components
Residence
Repair
Restoration toilets
New construction
Total
Without new construction
Amount
Sft
4,950
115
Cft
Sft
Sft
Sft
Sft
Sft
Sft
648
1,553
6,961
3,257
43,002
180
587
10
17,858
10,379
120
84
20
60
10
500
500
40,000
60
60
Sft
Rft
3,906
420
115
1,500
449,190
630,000
Sft
Rft
Rft
1,275
186
417
60
350
350
76,500
65,188
145,863
Rft
Rft
60
110
350
350
21,000
38,500
Sft
2,200
9,429,200
Sft
Sft
Sft
Sft
2,790
1,204
14,588
779
4
4,802
4,802
-
20
60
10
500
40,000
60
60
2,200
55,800
72,240
145,880
389,500
160,000
288,120
288,120
3,960,000
569,250
37145
Compound walls
Repair of compound walls ( 4 1/2 " )
Construction of new compound walls ( 9 " Thick )
External development
Repair
Internal roads (Tuff Pavers)
Sewerage system ( 9 " dia ) including manholes
Water supply system ( 3" Dia)
New construction
Sewerage system ( 9 " dia )
New construction
Rate
4286
77,715
130,410
139,220
195,405
430,020
90,000
293,500
400,000
1,071,490
622,725
16464
1800
Sft
20,234,835
6,845,635
80
B. Scope of civil w orks required at surve yed RHC

RHC Buleda District Keich
Description
Covered
Unit
Qty
Rate
Area
Boundary wall
Sft
1,610
115
Hospital
Main building
Repair
Restoration toilets
185,150
7500
Sft
Sft
Sft
Sft
Sft
Sft
113
718
671
7,018
12
178
4
7,031
1,875
84
20
60
10
500
500
40,000
60
60
9,450
14,362
40,260
70,176
6,000
89,000
160,000
421,875
112,500
Rft
130
1,500
195,000
Sft
Rft
450
55
60
350
27,000
19,250
Rft
229
350
79,975
Sft
Rft
Rft
1,080
60
93
60
350
350
64,800
21,000
32,550
2416
Sft
2,200
5,315,200
3250
Sft
2,200
7,150,000
Compound walls
Construction of new compound walls (
9 " Thick )
Repair
Approach road
Sewerage system ( 9 " dia ) including
manholes
New construction
New construction
Amount
Residence
New construction
Total
14,013,548
1,548,348
81

RHC Gomazai District Keich
Description
Covered Unit
Qty
Rate
Area
Boundary wall
Sft
6,600
115
Hospital
Main building
Repair
Restoration toilets
759,000
930
Sft
Sft
Sft
Sft
Sft
116
836
96
1,672
72
1
930
465
84
20
60
10
500
40,000
60
60
9,723
16,720
5,775
16,720
36,000
40,000
55,800
27,900
Rft
660
1,500
990,000
Sft
Rft
195
10
60
350
11,700
3,500
Rft
45
350
15,750
Sft
Rft
Rft
1,500
140
225
60
350
350
90,000
49,000
78,750
3560
Sft
2,200
7,832,000
3375
Sft
2,200
7,425,000
Compound walls
9 " Thick )
Repair
Approach road
manholes
New construction
New construction
Amount
Residence
New construction
Total
17,463,338
2,206,338
82

RHC Mand District Keich
Description
Covered Unit
Qty
Rate
Area
Boundary wall
Sft
19,800
115
Hospital
Main building
Repair
Restoration toilets
Residence
Repair
Restoration toilets
New construction
2,277,000
7104
Compound walls
9 " Thick )
Repair
Approach road
manholes
New construction
New construction
Amount
2476
Sft
Sft
Sft
Sft
Sft
483
3,300
483
7,172
139
3
4,144
3,552
84
20
60
10
500
40,000
60
60
40,530
66,000
28,950
71,720
69,500
120,000
248,640
213,120
Sft
Rft
700
300
115
1,500
80,500
450,000
Sft
Rft
300
110
60
350
18,000
38,500
Rft
299
350
104,563
Rft
Rft
70
120
350
350
24,500
42,000
Sft
2,200
5,447,200
Sft
Sft
Sft
Sft
Sft
568
1,496
568
2,992
376
3
1,563
1,250
84
20
60
10
500
40,000
60
60
47,712
29,920
34,080
29,920
188,000
120,000
93,750
75,000
Sft
2,200
2,200,000
2500
1000
Total
12,159,105
4,511,905
83

RHC Tump District Keich
Description
Covered Unit
Qty
Rate
Area
Boundary wall
Sft
5,400
115
Hospital
Main building
Repair
Restoration toilets
Residence
Repair
Restoration toilets
New construction
621,000
6344
Compound walls
Construction of new compound walls ( 9
" Thick )
Repair
manholes
New construction
Approach road
New construction
Amount
2500
Sft
Sft
Sft
Sft
Sft
495
1,315
495
7,392
139
2
2,643
3,172
84
20
60
10
500
40,000
60
60
41,601
26,290
29,715
73,920
69,500
80,000
158,600
190,320
Sft
Rft
753
300
115
1,500
86,538
450,000
Rft
93
350
32,550
Rft
209
350
73,238
Sft
Sft
Rft
Rft
9,600
2,550
65
110
60
60
350
350
576,000
153,000
22,750
38,500
Sft
2,200
5,500,000
Sft
Sft
Sft
Sft
Sft
555
1,474
555
2,948
374
2
1,225
1,531
84
20
60
10
500
40,000
60
60
46,620
29,480
33,300
29,480
187,000
80,000
73,500
91,875
Sft
2,200
2,200,000
2450
1000
Total
10,994,776
3,294,776
84

RHC Gower Koop District Keich
Description
Covered Unit
Qty
Rate
Area
Boundary wall
Construction of new boundary wall ( 9 "
Rft
900
1,500
Thick )
Hospital
Main building
Repair
Residence
Repair
Restoration toilets
New construction
1,350,000
762
Compound walls
" Thick )
Repair
New construction
Approach road
New construction
Amount
3900
Cft
Sft
Sft
Sft
Sft
Sft
206
74
550
148
1,100
52
762
120
84
20
60
10
500
60
24,750
6,216
11,000
8,880
11,000
26,000
45,720
Sft
Rft
844
580
115
1,500
97,003
870,000
Sft
Sft
Rft
Rft
#######
3,000
115
230
60
60
350
350
32,400,000
180,000
40,250
80,500
Sft
2,200
8,580,000
Sft
Sft
Sft
Sft
Sft
Sft
302
1,680
302
1,680
24
196
2
1,210
1,210
84
20
60
10
500
500
40,000
60
60
25,389
33,600
18,135
16,800
12,000
98,000
80,000
72,600
72,600
Sft
2,200
5,940,000
1210
2700
Total
50,100,443
35,580,443
85

RHC Kalatak District Keich
Description
Covered Unit
Qty
Rate
Area
Boundary wall
Sft
4,032
115
Hospital
Main building
Repair
Restoration toilets
Residence
Repair
Restoration toilets
New construction
463,680
4038
Compound walls
" Thick )
Repair
manholes
New construction
Approach road
New construction
Amount
2784
Sft
Sft
Sft
Sft
Sft
280
1,133
390
4,532
59
1
4,038
1,683
84
20
60
10
500
40,000
60
60
23,520
22,660
23,400
45,320
29,500
40,000
242,280
100,950
Sft
Rft
665
410
115
1,500
76,475
615,000
Rft
63
350
22,138
Rft
224
350
78,225
Sft
Sft
Rft
Rft
1,800
2,250
80
120
60
60
350
350
108,000
135,000
28,000
42,000
Sft
2,200
6,124,800
Cft
Sft
Sft
Sft
Sft
Sft
Sft
470
400
1,254
400
2,508
36
338
1
836
1,114
120
84
20
60
10
500
500
40,000
60
60
56,430
33,600
25,080
24,000
25,080
18,000
169,000
40,000
50,130
66,840
Sft
2,200
4,400,000
2228
2000
Total
13,129,108
2,604,308
86

RHC Nasirabad District Keich
Description
Covered Unit
Qty
Rate
Area
Boundary wall
Sft
7,800
115
Hospital
Main building
Repair
Restoration toilets
Residence
Repair
Restoration toilets
New construction
897,000
3630
Compound walls
9 " Thick )
Repair
manholes
New construction
Approach road
New construction
Amount
2616
Sft
Sft
Sft
Sft
Sft
Sft
468
1,761
468
7,980
12
159
2
2,723
2,017
84
20
60
10
500
500
40,000
60
60
39,291
35,220
28,065
79,800
6,000
79,500
80,000
163,350
121,000
Sft
Rft
1,831
140
115
1,500
210,508
210,000
Rft
100
350
35,000
Rft
208
350
72,713
Sft
Sft
Rft
Rft
42,000
5,400
40
60
60
60
350
350
2,520,000
324,000
14,000
21,000
Sft
2,200
5,755,200
Cft
Sft
Sft
Sft
Sft
Sft
Sft
995
1,545
4,248
1,210
5,304
72
531
4
2,910
4,365
120
84
20
60
10
500
500
40,000
60
60
119,340
129,780
84,960
72,600
53,040
36,000
265,600
160,000
174,600
261,900
Sft
2,200
1,100,000
4365
500
Total
13,149,466
6,294,266
87

RHC Pidark District Keich
Description
Covered Unit
Qty
Rate
Area
Boundary wall
Rft
500
1,500
Thick )
Hospital
Main building
Repair
Restoration toilets
750,000
8736
Sft
Sft
Sft
204
10,311
151
2,184
2,184
60
10
500
60
60
12,213
103,111
75,500
131,040
131,040
Rft
530
1,500
795,000
Rft
65
350
22,750
Rft
140
350
49,000
Sft
Rft
Rft
4,200
350
480
60
350
350
252,000
122,500
168,000
1576
Sft
2,200
3,467,200
3250
Sft
2,200
7,150,000
Compound walls
9 " Thick )
Repair
manholes
New construction
Approach road
New construction
Amount
Residence
New construction
Total
13,229,354
2,612,154
88

RHC Bal Nigore District Keich
Description
Covered Unit
Qty
Rate
Area
Boundary wall
Rft
900
1,500
Thick )
Hospital
Main building
Repair
Residence
Repair
Restoration toilets
New construction
1,350,000
762
Compound walls
Repair
manholes
New construction
Approach road
New construction
Amount
4149
Sft
Sft
Sft
Sft
Sft
58
506
58
1,012
13
762
84
20
60
10
500
60
4,872
10,120
3,480
10,120
6,500
45,720
Sft
1,852
115
212,923
Rft
102
350
35,700
Rft
209
350
73,150
Sft
Sft
Rft
Rft
360
1,800
40
60
60
60
350
350
21,600
108,000
14,000
21,000
Sft
2,200
9,127,800
Sft
Sft
Sft
Sft
1,029
2,058
4,796
386
5
3,439
3,752
84
60
10
500
40,000
60
60
86,436
123,480
47,960
193,000
200,000
206,360
225,120
Sft
2,200
1,320,000
3752
600
Total
13,529,841
3,082,041
89

RHC Dasht Khudan District Keich
Description
Covered Unit
Qty
Rate
Area
Boundary wall
Sft
1,620
115
Hospital
Main building
Repair
Restoration toilets
Residence
Repair
RCC roof
Restoration toilets
New construction
186,300
4697
Compound walls
Repair
manholes
New construction
Approach road
New construction
Amount
3088
Sft
Sft
Sft
Sft
Sft
Sft
565
2,162
467
7,208
12
136
3
4,697
4,362
84
20
60
10
500
500
40,000
60
60
47,477
43,238
28,032
72,075
6,000
68,000
120,000
281,820
261,690
Sft
1,236
115
142,083
Rft
44
350
15,225
Rft
63
350
22,050
Sft
Sft
Rft
Rft
3,000
840
166
200
60
60
350
350
180,000
50,400
58,100
70,000
Sft
2,200
6,793,600
Sft
Sft
Sft
Sft
Sft
Sft
338
263
1,749
436
3,564
220
3
2,122
2,122
84
400
20
60
10
500
40,000
60
60
28,392
105,300
34,986
26,130
35,635
110,000
120,000
127,305
127,305
Sft
2,200
1,452,000
2829
660
Total
10,613,142
2,367,542
90

RHC Zaring Bag District Keich
Description
Covered
Unit
Qty
Rate
Area
Boundary wall
Sft
2,250
115
Hospital
Main building
Repair
Restoration toilets
Residence
Repair
Restoration toilets
New construction
258,750
8200
Compound walls
Construction of new compound
Walls ( 9 " Thick )
Repair
Approach road
including manholes
New construction
Amount
1136
Sft
Sft
14,683
133
1
2,563
2,050
10
500
40,000
60
60
146,832
66,500
40,000
153,750
123,000
Sft
Rft
613
50
115
1,500
70,438
75,000
Sft
Sft
Rft
2,400
1,750
68
60
60
350
144,000
105,000
23,625
Rft
425
350
148,750
Sft
2,200
2,499,200
Sft
Sft
4,048
270
5
1,411
706
10
500
40,000
60
60
40,480
135,000
200,000
84,660
42,330
Sft
2,200
1,100,000
2822
500
Total
5,457,315
1,858,115
91
C. Scope of civil w orks required at surve yed BHU

BHU Dashat District Keich
Description
Covered
Unit
Qty
Rate
Area
Boundary wall
Construction of new boundary wall ( 9
Rft
120
1,500
" Thick )
Hospital
Main building
Repair
180,000
922
Sft
Sft
Sft
Sft
Sft
81
572
81
1,144
34
461
84
20
60
10
500
60
6,783
11,440
4,845
11,440
17,000
27,660
Rft
50
1,500
75,000
Sft
Rft
540
15
60
350
32,400
5,250
Rft
53
350
18,375
2209
Sft
2,200
4,859,800
1350
Sft
2,200
2,970,000
Compound walls
Construction of new compound walls
( 9 " Thick )
Repair
Approach road
manholes
New construction
Amount
Residence
New construction
Total
8,219,993
390,193

BHU Gawak District Keich
Description
Covered
Unit
Qty
Rate
Area
Boundary wall
Rft
150
1,500
" Thick )
Hospital
Main building
Repair
Compound walls
Amount
225,000
922
Sft
Sft
Sft
Sft
Sft
81
572
81
1,144
34
461
84
20
60
10
500
60
6,783
11,440
4,845
11,440
17,000
27,660
92

Construction of new compound walls
( 9 " Thick )
Repair
Approach road
manholes
New construction
Rft
50
1,500
75,000
Sft
Rft
540
30
60
350
32,400
10,500
Rft
83
350
28,875
1471
Sft
2,200
3,236,200
1200
Sft
2,200
2,640,000
Residence
New construction
Total
6,327,143
450,943

BHU Kohad District Keich
Description
Covered
Unit
Qty
Rate
Area
Boundary wall
Rft
130
1,500
" Thick )
Hospital
Main building
Repair
195,000
922
Sft
Sft
1,183
26
461
10
500
60
11,832
13,000
27,660
Rft
50
1,500
75,000
Rft
15
350
5,250
Rft
120
350
42,000
1501
Sft
2,200
3,302,200
1200
Sft
2,200
2,640,000
Compound walls
9 " Thick )
Repair
manholes
New construction
Amount
Residence
New construction
Total
6,311,942
369,742
93

BHU Balgather District Keich
Description
Covered
Unit
Qty
Rate
Area
Boundary wall
Rft
130
1,500
" Thick )
Hospital
Main building
Repair
195,000
922
Sft
Sft
Sft
77
1,100
40
461
60
10
500
60
4,605
11,000
20,000
27,660
Rft
50
1,500
75,000
Sft
Rft
240
15
60
350
14,400
5,250
Rft
30
350
10,500
1587
Sft
2,200
3,491,400
1200
Sft
2,200
2,640,000
Compound walls
9 " Thick )
Repair
Approach road
manholes
New construction
Amount
Residence
New construction
Total
6,494,815
363,415

BHU Gokdan District Keich
Description
Covered
Unit
Qty
Rate
Area
Boundary wall
Rft
440
1,500
" Thick )
Hospital
Main building
Repair
RCC roof
New construction
Approach road
Amount
660,000
1400
Cft
Sft
Sft
Sft
Sft
Sft
1,073
420
1,430
420
1,430
25
1,400
120
400
20
60
10
500
60
128,700
168,000
28,600
25,200
14,300
12,500
84,000
Sft
Sft
36,600
600
60
60
2,196,000
36,000
94

New construction
612
Rft
Rft
30
40
350
350
10,500
14,000
Sft
2,200
1,346,400
Total
4,724,200
3,377,800

BHU Drachkoo District Keich
Description
Covered
Unit
Qty
Rate
Area
Boundary wall
Sft
858
115
Hospital
Main building
Repair
Restoration toilets
Residence
Repair
Restoration toilets
New construction
98,670
922
Compound walls
New construction
Approach road
New construction
Amount
860
Sft
Sft
Sft
Sft
Sft
73
272
73
1,090
20
1
922
922
84
20
60
10
500
40,000
60
60
6,111
5,448
4,365
10,896
10,000
40,000
55,320
55,320
Sft
1,316
115
151,340
Sft
Sft
Rft
Rft
720
480
80
40
60
60
350
350
43,200
28,800
28,000
14,000
Sft
2,200
1,892,000
Sft
Sft
Sft
Sft
1,262
181
1,262
52
1
744
744
20
60
10
500
40,000
60
60
25,242
10,858
12,621
26,000
40,000
44,640
44,640
Sft
2,200
744
Total
2,647,470
755,470
95

BHU Kunchity District Keich
Description
Covered
Unit
Qty
Rate
Area
Boundary wall
Sft
0
115
Rft
25
1,500
" Thick )
Hospital
Main building
Repair
Restoration toilets
Residence
Repair
Restoration toilets
New construction
4
37,500
922
Compound walls
New construction
Approach road
New construction
Amount
536
Sft
Sft
Sft
Sft
267
71
1,070
20
1
922
922
20
60
10
500
40,000
60
60
5,348
4,275
10,696
10,000
40,000
55,320
55,320
Sft
256
115
29,383
Sft
Sft
Rft
Rft
5,400
240
45
35
60
60
350
350
324,000
14,400
15,750
12,250
Sft
2,200
1,179,200
Sft
Sft
Sft
Sft
Sft
169
905
169
1,206
188
1
676
676
84
20
60
10
500
40,000
60
60
14,196
18,096
10,140
12,064
94,000
40,000
40,560
40,560
Sft
2,200
676
Total
2,063,062
883,862
96
D. Estimated cost for execution of civil w orks at surve yed

facilities
Health facility
Health facility
DHQH Keich
20,234,835
RHC Tump
10,994,776
RHC Bal Nigore
13,529,841
RHC Zaring Bag
5,457,315
RHC Buleda
14,013,548
BHU Balgather
6,494,815
RHC Dasht Khudan
10,613,142
BHU Dashat
8,219,993
RHC Gomazai
17,463,338
BHU Drachkoo
2,647,470
RHC Gower Koop
50,100,443
BHU Gawak
6,327,143
RHC Kalatak
13,129,108
BHU Gokdan
4,724,200
RHC Mand
12,159,105
BHU Kohad
6,311,942
RHC Nasirabad
13,149,466
BHU Kunchity
2,063,062
RHC Pidark
13,229,354
97
TRF is funded by UKaid from the Dep

epartment for International Development and AusAID
ID, and managed by HLSP

HFA District Report - Keich

Enviado por

Dados do documento

Direitos autorais

Formatos disponíveis

Compartilhar este documento

Compartilhar ou incorporar documento

Opções de compartilhamento

Você considera este documento útil?

Este conteúdo é inapropriado?

Direitos autorais:

Formatos disponíveis

HFA District Report - Keich

Enviado por

Direitos autorais:

Formatos disponíveis

Health Facility Assessment Balochistan

TRF acknowledges the cooperation and support of Contech International Health

Table 3.30: Average monthly MNCH services provided ................................................ 32

Status of assessed infrastructure in BHU ................................................................ 63

ii. Status of MNCH related staff in BHU ...................................................................... 63

Status of assessed infrastructure in RHC ................................................................ 64

ii. Status of MNCH related staff in RHC ..................................................................... 65

Status of assessed infrastructure in SHC hospital ................................................... 66

ii. Status of MNCH related staff in SHC hospital ........................................................ 67

Blood Bank Technician

Civil Works Assessment Questionnaire

Child bearing age

District Health Officer

District Level Questionnaire

District Health Information System

Maternal, Neonatal and Child Health

National Maternal Newborn and Child Health Programme

Obstetrics and Gynaecology

Pakistan Demographic and Health Survey

Rural Health Centre

Secondary health care

Peoples Primary Health care Initiative

District Report - Keich

District Report - Keich

Management basics assessed at the surveyed facilities included availability of job

Major gaps existed in availability of materials for infection control measures

District Report - Keich

To assess clients satisfaction and perception of MNCH services

District Report - Keich

Number of Health Facilities by type

Number of facilities listed by HID

Number of facilities surveyed

District Report - Keich

Section 2: District Information

District Report - Keich

Total Population (thousands)

Population of Tehsil Turbat

Population of Tehsil Buleda

Population of Tehsil Dashat

Population of Tehsil Tump

Population density (persons

S OURCE : HMIS C ELL DHO O FFICE

TABLE 2.2: POPULATION GROUPS

S OURCE : PDHS 2006-07

Socioeconomic and Health Indicators

District Report - Keich

Income per Capita*

Infant Mortality Rate (IMR)

49 per 1000 live births

Under 5 Mortality Rate (U5MR)

59 per 1000 live births

% children<12 months fully

Maternal Mortality Ratio

* Data Not Available

District Report - Keich

Section 3: Health Facility Assessment Survey

24/7 Basic EmONC

District Report - Keich

8/6 Preventive MNCH Services at BHU

District Report - Keich

Status of building components at Surveyed BHU

*THE BHU DASHAT, AND BHU KUNCHITY ARE AFFECTED BY FLOOD.

Doctor or LHV is required for provision of Preventive MNCH Services.Status of assessed

Number of MNCH related staff available at each BHU