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Weekly update on COVID-19 achievements
Date: Week starting Jul 31, 2020
Weekly performance reporting on COVID-19 support
Indicators Baseline
(as on 30th
April)
Past Week’s
Achievement
s*
Cumulative
Achievements
(from start
through COB
Thursday)
Target for
the entire
project
Additional Information
Number of people directly benefited
through USG interventions (e.g.,OPDs,
helplines, chatbots etc.) Note:do not
include mass and social media.
34,093
2585
455233 27,500 -Layered on Pulse
oximetry-1500 (887)
HRP -1000 (1147)
and HBYC-25000
(453199) platform
Number of facility-based health
workers (doctors, nurses, CHOs,
pharmacists, ANMs, MPWs, and
Anganwadi center workers) trained to
prepare for and respond to COVID-19
with USG support. Disaggregated by
RCCE, surveillance, case management,
IPC and/or WASH
3,959 33 6018 1500 -Layered on LaQshya
(4550), NBSU, FPC,
and Safe delivery app
(1468)
Number of community frontline
workers (ASHAss, TB champions,
community volunteers, sanitation
workers, etc.) trained to prepare for
and respond to COVID-19 with USG
support. Disaggregated by, RCCE,
surveillance, case management, IPC
and/or WASH
1,555 106 3509 12,330 -12000 Layered on
FPLMIS (2794)
330 through HRP (715)
Number of facilities supported with
USG resources (including TA,
training, supplies of COVID-19
medicine, ventilators, PPE, etc) and
able to respond COVID-19
300 0 399 122 -Layered on LaQshya
*Please note that these numbers should be consistent with the numbers listed in the narratives below.
Activities:
IPE Global will leverage existing state and district level activities to integrate COVID-19 response measures.
These activities will include:
1. Strengthening infection prevention control and practices at the facility level through self-administered
audits and checklists under LaQshya:
2. Strengthening Universal Precautions at the individual healthcare provider level using self-learning safe
delivery Apps:
3. Daily tracking of cases of Acute Respiratory Infections (ARI) in Health and Wellness Centers and
promoting hand washing practices:
4. Dissemination of available COVID-19 risk-communications and guidelines among healthcare
functionaries and communities:
5. Risk mitigation and action planning
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Key achievements:
Key Activities – Uttarakhand
1. Facilitated Training of Response Officer to be recruited in M&E Cell of NHM for Contacting the
Beneficiaries: As support requested by state government, Vriddhi team coordinated with the MH, TB &
104 project teams to
provide training to
prospective Responding
Officers. The training
session also covers a
session on COVID-19 and
use of Arogya Setu app. A
total of 19 participants were
oriented during the three-
day training facilitated by
resource persons from
MCH Division, TB Cell,
104 & Vriddhi Project.
M&E Control Cell is being
set up to strengthen
Program & Intervention
evaluations. The project
team had earlier provided
technical support in
designing the Pilot & Scale
Up phase based on consultations with the MD-NHM in collaboration with MCH Division. The Scale Up
phase includes the two aspiration districts (Haridwar & US Nagar).
2. Field Activities in Aspirational District Haridwar: Following are the key activities conducted by USAID
Vriddhi team in Aspirational District Haridwar –
▪ Online training on safe delivery app for Staff Nurse posted at CHC Landhora, Block
Narsan: District Technical Officer, USAID Vriddhi team orientated staff nurses on all the
modules of Safe delivery app on 31st July.
▪ On 4th August in SNCU - CRW Hospital Haridwar – DTC USAID Vriddhi team facilitated
handwashing practices for lactating mothers before handling the babies, support in correct
breastfeeding methods and KMC..
▪ Training orientation on
Rad G and IMNCI:
DTO – USAID Vriddhi
team conducted a
training on 5th Aug for
newly Joined MO
(MBBS) and ANM of
PHC Biharinagar to
orient on use of Rad G
device, classification of
Pneumonia, diagnosis &
treatment protocols at
HWC/PHC level. Figure 2: Training orientation on Rad G and IMNCI
Figure 1: Training session for M&E Cell
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Interim LaQshya certification: Innovative approach on resuming work for
LaQshya certification using virtual media – Chhattisgarh
Quality certification of health facilities is one of the core deliverables of USAID Vriddhi (Scaling up
RMNCH+A intervention) project, as promoting Quality is inbuilt feature of all the program interventions.
Health facilities during COVID-19 have been striving hard to achieve and sustain the LaQshya certifications
status.
With respect to recent guidelines by GoI on LaQshya Interim Certification through virtual tour and verification
of essential list of documents an orientation was convened on 5th August using ICT platform for 5 prioritized
LaQshya facilities namely DH Narayanpur, DH Durg, DH Bijapur, DH Bilaspur and DH Kawardha. Except DH
Bilaspur rest all 4 facilities have already qualified for state certification during assessment held in February and
formal letter release is in process.
The orientation was chaired by Dr Alka Gupta DD-MH, facilitated by ID Vriddhi state team and participants
included state MH consultant, LaQshya nodal officers, Hospital consultants, MOs and nursing staffs of the
respective prioritized facilities.
Vriddhi would be facilitating the process of facility preparedness including completion of necessary
documentation, gathering evidences on quality assurance mechanisms, photographic evidences and would also
facilitate a mock virtual tour by August last week or early September for all the 5 facilities.
Figure 4: Screen shot showing status update of prioritized LaQshya facilities for Interim Certification. There are 7 criteria for Interim certification.
Outcome
• 15 participants across the 5 priority facilities were aware about the process of Interim
certification.
• This innovative approach on interim certification through virtual session is needed to hasten
the process of certification during the current pandemic and resuming LaQshya activity
especially certification.
• Promoting cross learning and rebuilt a momentum for LaQshya certification for the facilities
who were already in their advance stage of certification during pre COVID time
Way Forward
• Vriddhi has been listed as resource person in four facility level Whatsapp groups to support
and fast track the LaQshya certification.
• Technical support and guidance would be rendered in marinating essential list of documents
and conducting a mock virtual tour well before the national assessment.
• Document the process and generate a photo evidence for scaling the lesson learned.
Figure 3: Screen shot showing status update of prioritized LaQshya facilities for Interim Certification. There are 7 criteria for Interim certification.
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Key Activities – Odisha
1. HMIS data analysis shared with state health key decision makers to comprehend the impact of
COVID-19 on delivery of essential services: Vriddhi National team has analyzed the HMIS data for Feb -
May 2019 vs 2020, to get the pattern of essential RMNCH+A service delivery in the state during COVID-
19 pandemic. The Vriddhi Odisha team shared the analysis with the senior health functionaries including
MD-NHM, DFW, Team Leader – State Health System Resource Centre, SPM-NHM, Consultant MH,
Consultant- CH and Consultant RMNHCH+A, NHM Odisha for review and necessary action.
2. Online orientation on
Respectful Maternity Care and
LaQshya mentoring of DHH
Puri: USAID Vriddhi state team
members during a discussion with
the O&G specialist in-charge on
various quality gaps for the
Labour room, strengthening
Respectful Maternity Care (RMC)
emerged as the immediate action
item. A refresher training using
ICT platform was held on 6th Aug
2020 for Hospital Manager,
ADMO medical, staff nurse LR
in-charge and other staff nurses of the facility. A total of 7 participants along with state consultant RMNCH
joined the session. A discussion with the facility team on some key issues related to supplies of
consumables and PPE kits, Supply of birth companion gown, restricted entry of visitors including ASHA
inside the labour room complex, taking appropriate consent in each delivery case as applicable, keeping
medical records confidential, display of posters on RMC near entrance of labour room complex to educate
the pregnant mothers and family were conducted. Allowing birth companion was discussed in detail as a
core component of RMC. It was proposed that women should be oriented on provision of birth companion
during ANC counselling as a part of birth preparedness. The hospital manager proposed that weekly
LaQshya review along with State level mentoring on a fixed day would be helpful. VRIDDI team agreed to
the proposal and offered continuous technical support and distant mentoring as required.
Key Activities – Haryana
1. Visit to Padheni for NQAS Review assessment
(5th Aug 2020): Visit was done by District
Technical Consultant USAID - Vriddhi team
visited PHC Padheni for preparation of annual
review. The National NQAS certified facilities are
mandated to have an annual review. This annual
review is due for PHC Padheni which was
certified last year. The participants were MO,
LMO, ANM, SN, Pharmacist, Lab Technician and
MPW. Discussion regarding the NQAS review
assessment was done with the team which is
scheduled for 10th August’20. Discussion
regarding the LaQshya checklist and gaps were
done with the facility. QI team Padheni will work
on filling the gaps to ensure that the certification
criteria are maintained.
Figure 5: NQAS review assessment meeting at Padheni
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2. Mentoring Visit to Health and Wellness
Centre, Dhulawat (5th Aug 2020) : District
Technical Consultant USAID - Vriddhi team
visited HWC Dhulawat to review and
management of RAD G data along with CHO
Dhulawat. Discussion regarding low footfall
of patient due to COVID-19 pandemic was
done and it was suggested to inform ASHAs
and ANMs to disseminate the message in the
community regarding availability of services
in HWC Dhulawat. COVID-19 precautions to
be taken and sustained were discussed with
CHO.
Key Activities – Himachal Pradesh
1. Technical support to two LaQshya Facilities:
▪ Technical support was provided to RH Reckongpeo (LaQshya facility), district Kinnaur on 4 th August
using ICT platform was for preparation of LaQshya incentive claim forms from NHSRC & apply for the
same. The facility will apply for incentive to NHSRC for LaQshya incentive as both LR & OT of facility
are national LaQshya certified
▪ Technical support was provided to CH Sundarnagar (LaQshya facility), district Mandi, on 5th Aug’20
using ICT platform for preparation of gap filling documents to be submitted to state and further to
NHSRC. The facility received conditionality certification for LR and was asked by NHSRC to submit
gap filled for complete certification. After technical support facility submitted the documents to state to
approve and further share with NHSRC for national certification process.
2. Meeting with MH division NHM on 6th Aug 2020: Meeting with MH division NHM was held on 6th
Aug 2020 and following points were discussed: -
▪ The presentation and graph prepared by NTSU on impact of COVID 19 was discussed for maternal
health indicators.
▪ LaQshya MIS reports from all LaQshya facilities was discussed and was decided to give feedback to
LaQshya facilities with technical support from SRU-HP.
3. Meeting with CH division NHM on 6th Aug 2020: Meeting with CH division NHM was held on 6th Aug
2020 and following points were discussed: -
▪ The presentation and graph prepared by NTSU on impact of COVID 19 was discussed for Child health
indicators with CH division.
▪ Advocacy and follow up for use of new COVID 19 PFC videos in all SNCUs of HP
▪ Follow up for use of SQCI in all SNCUs review by state.
Figure 6: DTO conducting discussion with CHO at HWC Dhulawat
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Technical Support to the health department of Punjab in development of
draft MMR strategy – Punjab
MMR of Punjab is 129 in SRS 2016-18 which has been increased by 7 points from 2015-17, while MMRs of
surrounding states are either decreasing or stable. In this regard, to flatten the curve of MMR in Punjab, a
meeting was organized
by the Additional Chief
Secretary (ACS) of
department of health and
family welfare with the
department of heads of
WCD and MER on July
31, 2020 at RCHC in
Chandigarh.
USAID Vriddhi Project
provided technical
support to the health
department to prepare
draft of MMR strategy,
PowerPoint based on
Maternal Death
Analysis. Vriddhi team
also participated in
discussion along with the
other stakeholders.
Salient Points
• Rationalization of
staff; ensure availability
of MOs and specialists
• Advocacy to reduce
the number of home
deliveries
• Cesarean Section: during the night, overall rate against total number of deliveries should be reviewed
• Engagement of partners in Maternal Death Surveillance, reporting and data analysis
• Mandatory Hospital Stay; till 48 hours in the hospital after delivery
• Ensure engagement of education and WCD Department to fight against Anemia
Participants
Government of Punjab: ✓ Chief Secretary of the Government of Punjab, Addition Chief Secretary,
Department of Health and Family Welfare , Additional Chief Secretary, Woman and Child Development , Additional Chief Secretary, Medical Education and Research Department of Health and Family Welfare
• Dr Avneet, Director Health Services (DHS), Dr Prabhadeep Kaur, Director Family Welfare (DFW), Dr Inderdeep Kaur, Program Officer, MCH Division, Dr Diksha, Assistant Program Officer (APO), MCH Division Department of Women and Child Department (WCD)
• Additional Chief Secretary
Department of Medical Education and Research
• Additional Chief Secretary USAID supported Vriddhi Project
• Dr Nidhi Chaudhary, Regional Technical Advisor (RTA) for Punjab, Haryana, and Himachal
• Dr Shailendra Singh Tomar, State Technical Advisor for Punjab
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Key Activities – Jharkhand
1. Safe Delivery App study: 2nd Follow up online facilitation / mentoring with Hazaribagh
The second online facilitation/ mentoring for
the SDA study with intervention facilities of
district Hazaribagh (CHC Bishnugarh, CHC
Ichak and CHC Keredari) was conducted on
31st July 2020. District Technical Consultant
USIAD Vriddhi project facilitated the
mentoring in the presence of State Technical
Officer. Staff nurses / ANM from 3 facilities
who are enrolled in the study attended the
training. There were total 13 logins including
the facilitators.
2. LaQshya Activity Support (31st July to 6th August 2020)
District Hospital Ranchi:
DTC USAID Vriddhi team convened a telephonic follow up meeting (online review held on 27 th July) with LR
& OT staffs of district hospital Ranchi to support preparation of LaQshya gap finding report and action plan.
Recently the facility has conducted internal assessment of LR & OT and the state had reviewed the facility based
on the internal assessment report through review meeting held on 27th July using ICT platform. The facility; DH
Ranchi was instructed to prepare an action plan to mitigating the gaps.
Also, there is long standing requirement for the facility to increase space for LR as the case load has increased in
last 1 year. So the facility has identified few places to shift the LR and utilize the existing space to increase area
for postpartum patients and triage. DTC has helped the facility to finalize the locations/ space for shifting of labor
room. Identification of space for triage area and extra space for post-natal mothers were also discussed and
preliminary identified.
Medical College & Hospital (MCH) Dumka:
Dumka MCH was reviewed through online meeting on 14th July by the state. A follow meeting was facilitated
by DTC USAId Vriddhi team and chaired by HoD – ObG with faculty members, residents, medical officers,
Hospital Manager and staff nurses of OBG department. To discuss regarding Section G, LR gaps and SOP. It
was decided that a revised SOP will be prepared and shared with the state.
Figure 7: DTC USAID Vriddhi, facilitating training
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Activities at other facilities
DH Sahebganj - DTC conducted a telephonic discussion with DPM Sahebganj on shifting of LR.
DH Pakur and CHC Maheshpur - Discussion was held CS Pakur on status of printing and display of RMC
posters in LRs of DH Maheshpur & CHC Pakur.
DH Latehar - Data entry has been started in all registers as per LaQshya guideline. Out of 40, 31 new registers
used in LR at DH- Latehar.
MCH Palamu, DH Chatra and RH Simaria (Chatra) - DTC facilitated discussion with respective LR incharge on
interim LaQshya certification of the facilities and strengthening of documentation such as preparation of
departmental standard operating procedures (SOP).
DH Garhwa - DTC provided techno managerial support in development of departmental SOP with the help of
Ex DPM and also supported for procurement of consumables.
DH Ramgarh - DTC has facilitated a discussion with hospital manager and LR / MoT Staff Nurse incharge
regarding departmental checklist filling, audit reports filling and gap closures of LR and MoT
Rolling out of FPLMIS to ASHA level in Ramgarh district of Jharkhand
ASHA is considered as depot holder at community for essential services which includes family planning
commodities. The final stage of streamlining the FP commodities supply is FPLMIS rolled out at ASHA level.
In Jharkhand after achieving 92% indent & rollout of FPLMIS up to Subcenter & PHCs level, the next step
initiated is the training of ASHAs on the FPLMIS as rolling out strategy. For this 4 blocks; Gola, Mandu,
Patratu & Sadar of Ramgarh district has been selected for pilot, Block Trainer Team (BTT) has been identified
as nodal for supervising the trainings and keep
record of indent by ASHAs.
Training for two blocks Patratu on 1st August &
Sadar on 5th August has been conducted using ICT
platform with 11 ASHA facilitators as participant
in each session. The training ids were created
without password so that ASHA Facilitators can
easily log into the training session. Before the
training user ids & passwords for individual
ASHA Facilitators were shared with the
respective BTTs, so that they can provide support
for the training.
FPLMIS consultant facilitated the training session
and the participants were made to learn how to log
in the FP-LMIS App. They were further oriented on the method of viewing the stocks, raising the indents,
viewing the indents, stock update which are major tasks to be completed by the ASHAs. In the training it was
also finalized that these trained ASHA Facilitators will further train and facilitate indent by the ASHAs working
under them during the cluster meetings conducted twice in a month.
During the FPLMIS training ASHA Facilitators prepared the plan for training of ASHAs during the cluster
meeting. It was also ensured that during the cluster meeting State Consultant and BTT would handhold over
phone/online in case there is any difficulty being faced by ASHA Facilitator. After the FPLMIS training two
cluster meetings were conducted by two ASHA facilitators under Patratu block in which a total of 15 ASHAs
indented the FP commodities using FPLMIS app.
Figure 8: ASHA facilitator training ASHA under them on FPLMIS during cluster meeting of Patratu block, Ramgarh district
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Activity: Monitoring of ARI Cases
Vriddhi team from National level is regularly tracking ARI cases from 19 Health and Wellness centers. Total 23
cases of ARI screened in this week and 2 cases were diagnosed as pneumonia.
Chart 1: Daily incidences of ARI cases (31st Jul to 6th Aug 20)
Chart 2: Weekly Incidences of ARI Cases
3
1
0 0
6
4
9
0 0 0 0 0
1 1
31-Jul 1-Aug 2-Aug 3-Aug 4-Aug 5-Aug 6-Aug
Total Screened Pneumonia cases
0
20
40
60
80
100
120
140
27
Mar
-2 A
pr
W-1
W-2
W-3
W-4
W-1
W-2
W-3
W-4
W-5
W-1
W-2
W-3
W-4
W-1
W-2
W-3
W-4
31
Ju
l - 6
Au
g
Mar Apr May Jun Jul Aug
Total Screened Pneumonia cases Severe pneumonia Referred
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Effects of COVID-19 on RMNCH+A, TB, HIV and other essential health
services in project geography:
Impact on RMNCH services in project states
Services in all states are opening in areas outside the containment zones and there is focus on resumption of
essential RMNCH services. However, on account of the recent spurt in COVID cases in states such as
Jharkhand, Odisha, Uttarakhand, services are once again disrupted. Inputs obtained from project states on status
of RMNCH services is as follows -
Outreach services
Antenatal Care
services
PMSMA is being organized in all districts as per GoI guidelines and Use of e
sanjeevani for consults has been rolled out. VHSND are being held as per GoI
guidelines And Line listing of HRP is being done.
In Jharkhand Due to NHM strike the ANC services have been hampered this week
wherever contractual NHM staff nurses and ANMs are posted.
In Chhattisgarh ANC outreach services have been withheld since late March and
only facility-based ANC services is being provided.
Home visits Integrated surveillance being undertaken by FLWs across states. ASHAs are doing
COVID related screening in the community and undertaking integrated surveillance
for active case finding for TB, screening for NCD, surveillance and sensitization for
NDD and IDCM with postnatal visits in Haryana, Jharkhand, Odisha and Punjab
Routine
Immunization
RI in VHSNDs are functioning beyond containment and buffer zone as per GoI
guidelines maintaining social distancing in states
However, in Jharkhand Due to NHM strike the ANC services have been hampered
this week wherever contractual NHM staff nurses and ANMs are posted.
HBYC services ASHAs are making home visits along with COVID screening. In Jharkhand,
Supportive supervision of Sahiya has now resumed. And ASHAs conducting HBYC
home visits outside buffer zone.
In Chhattisgarh, ASHA home visitation is ongoing.
HBYC is operational in only one district of HP, AD Chamba. Home visits by ASHA
are being done as per HBNC in remaining districts of state.
In Haridwar district, ASHAs are doing HBNC Visits regularly however, HBYC
Program has not been streamlined properly in the district.
Family Planning Home Delivery of Contraceptives by ASHAs is ongoing in all states and all
temporary methods (Condoms & Pills) are being provided to beneficiaries.
Facility services
ANC services In all states facility level ANC services are being provided on walk in basis using
staggered approach* and following physical distancing norms. Non-COVID PW
being transferred in non-COVID vehicles only is being ensured
Institutional
deliveries
All states have identified facilities both COVID and Non COVID for provision of
institutional deliveries and services remain uninterrupted.
Newborn care Birth doses continue uninterrupted, as does promotion of Breast-feeding practices
with early initiation of breast feeding and Kangaroo Mother Care.
Immunization
services
are being provided at facilities, for walk-in beneficiaries. Daily immunization for all
PW & Children at DH & SDH has been resumed in Haridwar district
11
Admission to SNCU SNCU are fully functional and providing services.
In Odisha, Due to COVID-19 positive cases found in the facility, two DHH including
SNCU services which were temporarily closed last week have resumed services this
week.
In Jharkhand SNCU (Rajmahal) remains closed as is converted to COVID ICU. The
SNCUs of Hazaribagh, Pakur, Dumka, Godda, Simdega, Chaibasa, closed from 4th
August 2020 due to NHM strike.
SNCU Ghatshila closed from 6th August 2020. SNCU Gumla is open but they are
not admitting any sick newborns as the MTC staff have been posted here during the
strike.
In Himachal Pradesh one SNCU at Medical college Nerchowk Mandi, is not
functioning as facility is a dedicated COVID Hospital.
NBSU services are functional
Family Planning
services
Now with increase in cases temporary closure of facilities is common and affecting
services in Odisha.
In Jharkhand, few CHCs have been converted to COVID center due to which FP
services especially sterilization have been hampered.
Punjab has seen a drop in PPIUCD and IUCD numbers.
In MP, Guideline has been issued to perform sterilization on Fixed day services,
following COVID protocols and maximum of 10 cases can only be performed in a
single day in a facility. PPIUCD & Injectables services are continued.
FP services such as sterilization and IUCD/PPIUCD are hampered due to full lock
down in Mizoram
*Staggered approach- Where adequate seating for beneficiaries and caregivers with physical distancing is
ensured
Figure 9: DTC provided telephonic support in planning for shifting DH Ranchi Labor room to the PNC ward.
12
Figure 11: LR & OT staff of DH Ranchi, Jharkhand during preparation of gaps finding report, DTC USAID Vriddhi supported Telephonically in this activity
Figure 12: Beneficiaries watching FPC 2nd session video at SNCU SDH Ghatshila, East Singhbhum - Jharkhand
Figure 10: Chhattisgarh - All the SN posted in DH Korba have become safe delivery app champion. This is first time when entire facility became champion. DH Narayanpur DH Kanker and many more such facilities are very near to achieve this accolade.
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Figure 13: Handwashing Training for Lactating Mother in SNCU Haridwar , Uttarakhand
Figure 16: Punjab - Health and Wellness Center Shakoor at District Ferozepur, CHO is screening child for pneumonia
Figure 17: Staff nurse at DH Mohali is facilitating FPC session while SNCU In-charge is observing FPC session
Figure 14: Nesting and phototherapy of newborn in SNCU Giridih, Jharkhand (02 Aug 2020)
Figure 15: Nesting and phototherapy of newborn in SNCU Giridih, Jharkhand (02 Aug 2020)
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