monthly review of services - pphi...

1

Monthly Review of Services

April, 2010 People’s Primary Healthcare Initiative

SINDH

2

Foreword

The PPHI Sindh is now providing the health care service through managing first level care facilities in 19 districts of the Province.

The Monthly review meeting is our regular forum to review the performance, discuss the problems and frame the future strategy. It provides a unique opportunity to District Managers and service providers for sitting together and planning for the future upgradation in the service standards. We always make efforts to call all the stakeholders in this meeting including Zila Nazims, District Coordination Officers, District Health Officers and especially focal persons of EPI, TB Control and other vertical programs in order to make it a representative forum for discussing curative as well as preventive aspects of primary healthcare. A compendium of the minutes of Monthly Review Meetings held in 19 districts for the month of April, 2010 are being circulated to give insight into our progress and performance. A brief summary is also attached at the top to give a tabulated and quick insight into our progress. We welcome and expect inputs from your side for future improvement in service delivery at health facilities.

Programme Director PPHI, Sindh Karachi April, 2010

3

TABLE OF CONTENTS

EXECUTIVE SUMMARY…………………………………………………………………………………… (3 ‐ 9) DISTRICT BADIN………………………………………………………………………………………………10 DISTRICT DADU……………………………………………………………………………………………… 24 DISTRICT JACOBABAD……………………………………………………………………………………. 34 DISTRICT KAMBER…………………………………………………………………………………………. 45 DISTRICT KASHMORE…………………………………………………………………………………….. 54 DISTRICT KHAIRPUR………………………………………………………………………………………. 63 DISTRICT LARKANA……………………………………………………………………………………….. 76 DISTRICT MATIARI…………………………………………………………………………………………. 86 DISTRICT MIRPUR KHAS……………………………………………………………………………….. 97 DISTRICT THARPARKAR…………………………………………………………………………………. 108 DISTRICT NAUSHEHROFEROZE………………………………………………………………………. 118 DISTRICT SANGHAR……………………………………………………………………………………….. 125 DISTRICT SHIKARPUR………………………………………………………………………………………136 DISTRICT SUKKUR……………………………………………………………………………………………145 DISTRICT TANDO ALLAHYAR……………………………………………………………………………155 DISTRICT TANDO MUHAMMAD KHAN…………………………………………………………….165 DISTRICT THATTA……………………………………………………………………………………………177 DISTRICT UMERKOT…………………………………………………………………………………………188 DISTRICT GHOTKI……………………………………………………………………………………………..199

4

SUMMARY OF THE MINUTES OF MRMs

1) No. of Districts with PPHI 19

2) HFs with PPHI Sr. # Description Total HFs with PPHI

i) BHUs 859 578

ii) Dispensaries 470 350

iii) MCHCs 36 29

iv) Other HFs 18 13

v) Total 1088 970

3) STAFF STRENGTH

Sr. No

Sanctioned Posts Working Govt.

Employees PPHI

Contract Vacant Posts

1 MOs 882 850 351 499 531

2 W/FMOs 179 346 19 360 160

3 * LHVs 517 345 115 254 402

Male 499 292 191 15 308

4 MTs/MAs

Female 66 79 40 10 26

5 Dispensers 414 577 260 370 154

4) CLUSTERS OF HFs WITH ONE MO

Sr. No

Previous Month Month under

Review Number

1 Clusters of 6 HFs Clusters of 6 HFs



4 Clusters of 3 HFs 10 Clusters of 3 HFs 10

5 Clusters of 2 HFs 45 Clusters of 2 HFs 45

6 Single HFs 702 Single HFs 795

5

5) CLUSTERS OF HFs WITH ONE FMO

Sr. No

Previous Month Month under

Review Number

1 Clusters of 5 HFs 0 Clusters of 5 HFs 5 2 Clusters of 4 HFs 2 Clusters of 4 HFs 2 3 Clusters of 3 HFs 41 Clusters of 3 HFs 28 4 Clusters of 2 HFs 240 Clusters of 2 HFs 244 5 Single HFs 58 Single HFs 56

6) Capacity Building Sessions

Sr. No

Staff Number

1 Capacity Building Session for Doctors 515

2 Capacity Building Session for Paramedics 118

Total 633

7) Vaccination / Immunization Descriptions Number Doses of Immunization Administered in Children at HFs. 110,877

TT vaccines administered to pregnant women at HFs. 58,692

Immunization & Vaccination Administered by outreach EPI Teams 300,144

Total Vaccination / Immunization for the Month 469,713

8) Other Preventive/Promotional Services S # Service / Acitivity Number 1 Passive Case Detection (PCD) Slides 17966 2 Active Case Detection (ACD) Slides 0 3 Visits to Check Sanitation 93 4 Notices issued against Poor Sanitation 22 5 Challans sent to Court against Poor Sanitation 2 6 Blood Sugar Tests 0 7 Patients Nebulized 868

6

9) Mother, Child & Reproductive Health No. of FMOs =

Sr. No

Service Number

1 Ante-Natal Cases 28,820

2 Neo-Natal Cases 1,741

3 Other OPD by FMOs 558,129

Total OPD 588,690

10) Deliveries Assited 1 Deliveries Assisted at HFs 439

2 Deliveries Assisted at Homes 1274

Total 1713

11) Lab /Diagnostic Test (Mother/Reproductive Health Related)

1 Pregnancy Tests 5519

2 Blood Sugar Tests 4703

3 Haemoglobin Tests 489

4 Ultra Sound Tests 14355

Total 25198

12) Provision of Family Planning Services Sr.No Service/ Item Number 1 Consultation/Advice 7,570 2 Oral Pills 31,985 3 IUCDs 1,362 4 Injections 3,927 5 Others 7,475 Total 52,319

7

13) Support Groups

Sr. No

Support Group Number

1 No. of SGs (Male) 903

2 No. of SGs (Female) 87

Total 990

14) Social Organizers & Meetings of SGs

Sr. No

Support Group Number

1 No. of Social Organizers 57

2 Meetings of SGs 427

3 No. of Participants of the meetings 7561

15) Community Health Sessions Number of CHS Number of Participants

1213 30,570

16) School Health Sessions

No. of SHS No. of Children Examined No. of ChildrenTreated

933 21,218 11,177

17) Health Camps

No. of Health Camps arranged No. of Patients Treated

1 913

18) Curative Services

New Patients treated during the month

Old patients treated during the month

Total OPD during the month

1,201,048 34,711 1,235,759

8

19) ARV/ASV

Description Number

No. of Dog bite cases reported 1087

ARV Administered 1198

ARV Available Doses 1894

No. of Snake bite cases reported 85

ASV Vaccine Administered 50

ASV Vaccine Available Doses 268

20) Total Lab/Diagnostic Tests (including Tests reported at section for Mother/Reproductive Health) Sr.No Test No.

1 Pregnancy Test 4346

2 Blood Sugar 4987

3 Haemoglobin 682

4 Ultra Sound 14347

5 X-Rays (if available) 328

6 Others (Please specify) 4778

21) Heapatitis B & C

Sr. No

Screening Test

Performed No. of

PositiveCases No. of Cases Referred

1 Hepatitis B 32 7 7

2 Hepatitis C 14 4 4

Total 46 11 11

22) Tuberclosis

Patients Receiving Treatment

New Cases of the Month Underdiagnosis

1335 422 751

9

23) Other Referrals Cases Referred to

S.

No. Total

TB DOT Deliveries Others RHCs THQs DHQs

1 663 230 10 483 154 131 415

2 - 77 - 0 - - 77

3 - 18 17 1 0 18 0

24) Inverse Referrals

Cases Referred from

S.

No. Total

ARV ASV Others RHCs THQs DHQs

1 70 29 6 10 8 17

2 - - - - - - -

3 - - - - - - -

25) Monitoring Visits

DSM Executive Monitoring Other Staff Total

953 773 3078 5254

26) Repair of HFs

No. oF HFs Repaired /

Rehabilitated 370

10

MINUTES OF THE (24th) MONTHLY REVIEW MEETING OF DISTRICT BADIN

Monthly Review Meeting (MRM) of District, Badin for the Month of April, 2010 was held on 07‐05‐2010 at Memon Community Center Badin. Written invitations to participate were sent to the EDO (H), and The Civil surgeon, the eye specialist civil Hospital, The Child Specialist of Civil Hospital, District Population Welfare Officer, District Incharge of EPI, District coordinator NP, District Focal Person Malaria, and District Focal Person TB. And District Officer MNCH Badin. The list of participants is enclosed.

# Names/Designation S # Names/Designation

1 Mr Fayaz Ahmed Jatoi DSM 52 Dr Harichand / MO

2 Mr Athar Ali ADSM 53 DR Ubedullah Talpur / MO

3 Mr:Sharjeel Siddique Memon Exe M & E 54 Dr Munawar / MO

4 Mr:Allah Nawaz Khatti Exe M&E 55 Dr Abdullah Soomro / Coordinator HMIS

5 Mr Bhagat Singh (Ex F&A) 56 Dr Mohammad Alam Jamali / EPI DFP

6 Dr Abdul Jabar / MOHQ 57 Dr Mohammad Sharif / USI Field Officer

7 Mr Naveed Ali Khawaja So 58 Dr Iftikhar Ahmed / MO

8 Mr Ali Ahmed SO 59 Dr Aijazudin / MO

9 Mr Imran SO 60 Dr Noman Memon / MO

10 Mr Kashif Zaur SO 61 Dr Safullah Abbasi / MO

11 Mr Zubair SO 62 Dr Junaid Shah / MO

12 Mr Aqeel Assistant Accounts 63 Dr Ibrahim Pinjario / MO

13 Mr Kashif Assistant Admn 64 Dr Afaque Bhurgari / MO

14 Mr Abdul Razzaque Store Manager 65 Dr Ameer Ali Khawaja / MO

15 Mr Mashooq ali Khawaja Assistant Store 66 Dr Ashraf Mehran / MO

16 Dr Beenish Bukhari / FMO 67 Dr Shahzad / MO

17 Dr Nazia Khawaja / FMO 68 Dr Haresh Kumar / MO

18 Dr Tasleem Khawaja / FMO 69 Dr Tufail Ahmed Bhan

19 Dr Sakina Jafari / FMO 70 Dr Abubakar Memon / MO

20 Dr Almas Junejo / FMO 71 Dr Saleem Memon / MO

21 Dr Sundas Aslam / FMO 72 Dr M. Ayoob Pahore / MO

22 Dr Neelofer Shah / FMO 73 Dr Danish Siddique / MO

23 Dr Nasreen Hyder /FMO 74 Dr Amir Hassan Memon / MO

24 Dr Aysha Faisal / FMO 75 Dr Javed Iqbal Qambrani / MO

25 Dr Aliya Anjum / FMO 76 Dr Imtiaz Ahmed / MO

26 Dr Saima / FMO 77 Dr M. Saleem Notkani / MO

27 Dr Rashida Parveen / FMO 78 Dr Pardeep Kumar / MO

28 Dr Nusrat Raffique / FMO 79 Dr Hafeezullah MO

29 Dr Nirmala Devi / FMO 80 Dr Ibrahim Jamali / MO

30 Dr Sadia Bukhari / FMO 81 Dr Zahid Hussain Khawaja / MO

31 Dr Shaheda Nizamani ( U/S ) 82 Dr Sahib Khan / MO

32 Dr Darkhshan Hyderi / FMO 83 Dr Santosh Kumar / MO

33 Dr Farzana Arif / FMO 84 Dr Raza Ali / MO

11

34 Dr Anita Siddique / FMO 85 Dr Haji Khan Nizamani / MO

35 Dr Farzana Memon / FMO 86 Dr Muhammad Ramzan / MO

36 Dr Najma Gul / FMO 87 Dr Danish Shams / MO

37 Dr Shahnaz Soomro / FMO 88 Dr Abdul Ali Shah / MO

38 Dr Rabia Shah / FMO 89 Dr Mohammad Jamil Memon / MO

39 Dr Rehana Fayaz / FMO 90 Dr Shafiq Ahmed Laghari / MO

40 Dr Kanwal Sabir / FMO 91 Dr Ghulam Mohammad Memon / MO

41 Dr Anita Khawaja / FMO 92 Dr Gulshan Korejo / MO

42 Dr Aisha Jamil / FMO 93 Dr Mehmood Memon / MO

43 Dr Raffique Bhurgari / MO 94 Dr Altaf Bashir / MO

44 Dr Gulab Kashmiri 95 Dr Manoj Kumar / MO

45 Dr Asadullah / MO 96 Dr Chetram / MO

46 Dr Raffique Memon / MO 97 Dr Ashok / MO

47 Dr Ahmed Khati / MO 98 Dr Uqail Abbas / MO

48 Dr Ilyas Laghari / MO 99 Dr Aftab Alam Pahore / MO

49 Dr Irfan Ashraf 100 Dr Sarfaraz Amir / MO

50 Dr M. Siddique Pahore / MO 101 Dr Ali Nawaz / MO

51 Dr Maqbool Ahmed / MO

The following could not attend the meeting for the reasons stated against each:‐

S # Names/Designation Reason 1 Dr Murad Ali Absent 2 Dr Bheemo Absent 3 Dr Zafarulhaq Sahito Absent 4 Dr Ashok Kumar C/L 5 Dr Mohin Lal C/L 6 Dr Sadaf Sheikh C/L 7 Dr Shahid Abbasi Absent 8 Dr Uzma Korejo Absent 9 Dr Saira Junejo O D 10 Dr Rukhsana Memon O D 11 Dr Fahmida Soomro Absent

A. HFs WITH PPHI

BHUs: 36 Dispensaries: 66 MCHC: 01 Others: 01

TOTAL: 104

C. Population of the Catchment Area: 1430000

12

D. STAFF STRENGTH

Sanctioned

Posts Working Government

Employees PPHI

Contract Vacant

MOs 48 23 23 46 27 W/MOs 00 00 00 32 01 LHV 42 8 8 41 33

Male 00 00 00 00 00 MTs/MAs

Female 00 00 00 00 0 Dispensers 20 17 17 55 03

E. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

1. First Session: During MRM Dr Mohammad Alam Jamali (EPI District Focal Person) in his lecture on EPI topic focused on the following points:‐ He delivered lecture for 40 minutes on EPI. He also focused on the importance of EPI and following topics.

• Vaccine • Vaccine Schedule • General • Consideration About Vaccination • Precaution • Recommendation

Previous Month Month under Review Total at Present

Clusters of 5 HFs Clusters of 5 HFs 00 Clusters of 4 HFs Clusters of 4 HFs 00 Clusters of 3 HFs Clusters of 3 HFs 06 Clusters of 2 HFs Clusters of 2 HFs 15 Single HFs Single HFs 47



13

3. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates

Date

Venue

Topic No. of

Participant

0 0 0 0 0

F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE During Month under Review

1. Vaccination / Immunization

No. of Doses of Immunization Administered in Children at Health Facilities. No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 3090 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams Total vaccination / immunization for the month December

10776

2. National Immunization Days (NIDs) for Polio

Dates of NIDs Target of coverage Actual coverage Percentage of coverage

262728 235636

3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 2 Active Case Detection (ACD) Slides 3 Visits to Check Sanitation (individual house holds + streets) 4 Notices issued against Poor Sanitation 5 Challans sent to Court against Poor Sanitation 6 Patients Nebulized 188

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH During Month under Review

1. Female Health

S # Name of FMO Ante‐Natal

Cases Neo‐ Natal

Cases Other OPD Total OPD

1 Dr Narmila Devi 31 1 669 701

2 DR Rashida Siraj 278 36 627 941

3 Dr Shahnaz Soomro 36 1 520 557

4 Dr Aysha Fasal 86 3 1167 1256

5 Dr Tasleem Khawaja 228 113 785 1125

14

6 Dr Nasreen Hyder 37 0 532 569

7 Dr Rehana Fayaz 59 8 644 701

8 Dr Nazia Khawaja 103 6 667 776

9 Dr Sadaf Sheikh 73 5 1140 1218

10 Dr Sadia Bukhari 64 10 919 993

11 Dr Neelofer Shah 65 7 758 830

12 Dr Sakina Jafari 93 7 1211 1311

13 Dr Sundas Aslam 225 19 547 791

14 Dr Saima Wali 54 5 687 746

15 Dr Rabia Shah 36 15 385 426

16 Dr Uzma Korejo 65 4 929 998

17 Dr Shaheda Din Abbasi 90 50 790 930

18 Dr Farzana Arif 45 18 551 614

19 Dr Aisha Jamil 21 2 652 675

20 Dr Beenish Bukhari 348 15 675 1038

21 Dr Nusrat Raffique 102 2 746 850

22 Dr Najma Gul 40 12 722 774

23 Dr Anita Khawaja 20 4 436 460

24 Dr Kanwal Sabir 98 0 355 453

25 Dr Kvaita Ashok 62 25 581 668

26 Dr Darakhshan Hydri 99 5 741 845

27 Dr Aliya Anjum 50 0 407 457

28 Dr Anita Siddiqi 87 11 166 264

29 Dr Farzana Memon 44 1 419 464

Total 2639 385 19428 22431 2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 51 2 Deliveries Assisted at homes 142

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 681 2 Blood Sugar Tests 434 3 Hemoglobin Tests 387 4 Ultra Sound Test 1206 5 Other 387

15

3. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number Consultation / Advice 689 Oral Pills 408 IUCDs 12 Injections 148 Others (Condoms) 265

Total 1522

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: 101 Number of female SGs: 11

2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups

conducted by him CHSs/SHSs arranged by

him

No. of Assigned HFs

No. No. of Participants

No. No. of

Participants Naved Ali Khawaja 21 14 119 22 308

Ali Ahmed 23 17 136 28 412

Zubair Ahmed Memon 13 8 67 14 128

Mir Imran Ali Talpur 22 11 84 17 136

Kashif Ali Zaur 23 9 78 16 154

Total 102 59 376 97 1138 3. School Health Sessions & Community Health Sessions

Community Health Sessions School Health Sessions S# Names of MO / FMOs/Paramedics

Sessions Participants Sessions Children Examined

Children Treated

1 Dr Narmila Devi 2 70 2 47 10

2 DR Rashida Siraj 2 110 2 38 15

3 Dr Shahnaz Soomro 4 40 2 38 10

4 Dr Aysha Fasal 1 15 1 42 15

5 Dr Tasleem Khawaja 14 234 2 36 21

6 Dr Nasreen Hyder 2 75 2 41 10

7 Dr Rehana Fayaz 2 25 2 42 18

8 Dr Nazia Khawaja 2 120 2 55 20

9 Dr Sadaf Sheikh 2 70 2 54 30

10 Dr Sadia Bukhari 2 125 2 46 22

11 Dr Neelofer Shah 2 62 2 22 13

16

12 Dr Sakina Jafari 2 97 2 55 31

13 Dr Sundas Aslam 2 31 2 25 14

14 Dr Saima Wali 2 42 2 22 12

15 Dr Rabia Shah 1 20 2 20 10

16 Dr Uzma Korejo 3 37 3 17 5

17 Dr Shaheda Din Abbasi 2 83 2 15 10

18 Dr Farzana Arif 2 104 2 20 10

19 Dr Aisha Jamil 2 18 2 27 20

20 Dr Beenish Bukhari 3 94 2 22 14

21 Dr Nusrat Raffique 2 44 2 32 20

22 Dr Najma Gul 2 80 2 32 18

23 Dr Anita Khawaja 2 85 2 65 40

24 Dr Kanwal Sabir 2 75 2 50 35

25 Dr Kvaita Ashok 2 28 2 57 41

26 Dr Darakhshan Hydri 2 64 2 0 0

27 Dr Aliya Anjum 2 20 2 15 10

28 Dr Anita Siddiqi 2 25 2 28 18

29 Dr Farzana Memon 1 22 2 29 21

30 Dr M. Saleem Nizamani / MO 2 42 2 31 19

31 Dr Maqbool Ahmed / MO 2 35 2 34 16

32 Dr Ali Nawaz / MO 2 78 2 26 12

33 Dr Harichand / MO 2 44 2 24 15

34 Dr Bheemo Mal / MO 2 66 2 36 20

35 Dr Iqbal Ahmed Memon / MO 2 40 2 32 20

36 Dr Ibrahim Pinjario / MO 2 38 2 35 18

37 Dr Safeullah Abbasi / MO 1 23 2 19 7

38 Dr Abdul Wahid / MO 1 19 2 21 5

39 Dr M. Jamail Memon / MO 2 61 2 51 25

40 Dr Ameer Ali Khawaja / MO 2 87 2 42 20

41 Dr Ashraf Mehran / MO 2 63 2 38 12

42 Dr Chetram / MO 2 27 2 32 15

43 Dr Ashok Lohana / MO 2 22 2 19 5

44 Dr Mohan Lal / MO 2 87 2 46 20

45 Dr Ghulam Murtaza / MO 2 21 3 36 21

46 Dr Siddique Soomro / MO 2 41 3 56 18

47 Dr Ashok Lohana / MO 2 50 2 42 15

48 Dr Uqail Abbas / MO 2 25 2 50 20

49 Dr Ilyas Laghari / MO 2 38 2 44 14

50 Dr Raffique Memon / MO 1 25 2 57 13

51 Dr Ahmed Khati / MO 2 42 3 35 15

52 Dr Raffique Bhurgari / MO 2 31 2 68 8

53 Dr Amir Hassan Memon / MO 2 37 2 41 22

17

54 Dr Javed Iqbal Qambrani / MO 2 27 2 46 25

55 Dr Imtiaz Ahmed / MO 2 40 2 77 5

56 Dr Sahib Khan / MO 2 39 2 63 14

57 Dr Santosh Kumar / MO 2 27 2 43 12

58 Dr Haji Khan Nizamani / MO 1 28 2 40 20

59 Dr Muhammad Ramzan / MO 2 36 2 35 15

60 Dr Danish Shams / MO 2 29 2 23 20

61 Dr Yousif Nohrio / MO 2 31 2 32 5

62 Dr Abdul Ali Shah / MO 2 42 2 21 16

63 Dr Afaque Bhurgari / MO 1 30 2 34 24

64 Dr M. Saleem Notkani / MO 1 25 2 28 20

65 Dr Junaid Shah / MO 1 33 2 29 26

66 Dr Pardeep Kumar / MO 1 34 2 22 18

67 Dr Ibrahim Jamali / MO 1 22 2 18 12

68 Dr Sarfaraz Amir / MO 1 24 2 16 10

69 Dr Shafique Laghari / MO 1 21 2 24 21

70 Dr Iftikhar Ahmed / MO 2 42 2 20 19

71 Dr Raza Ali / MO 1 24 2 32 32

72 Dr Aijazudin / MO 2 32 3 34 31

73 Dr Zahid Hussain Khawaja / MO 2 33 2 29 24

74 Dr Mehmood Memon / MO 2 49 2 24 22

75 Dr Altaf Bashir / MO 2 41 2 22 10

76 Dr Manoj Kumar / MO 1 35 2 21 15

77 Dr Ghulam Muhammad / MO 1 18 2 19 10

78 Dr Shahzad / MO 1 48 2 24 18

79 Dr Haresh Kumar / MO 1 27 2 40 30

80 Dr Asadullah / MO 1 21 2 26 20

81 Dr Murad Ali / MO 1 35 2 25 22

82 Dr Tufail Ahmed Bhan 2 56 3 66 20

83 Dr Aftab Alam Pahore / MO 1 34 2 27 25

84 Dr Abubakar Memon / MO 1 31 2 24 18

85 Dr Saleem Memon / MO 1 22 2 21 16

86 Dr M. Ayoob Pahore / MO 2 15 2 29 21

87 Dr Danish Siddique / MO 1 23 2 19 17

88 Dr Irfan Ashraf / MO 1 19 2 39 20

89 Dr Hafizullah Memon / MO 1 10 2 24 18

90 Dr Talib Hussain / MO 1 18 2 18 11

91 Dr Ubedullah / MO 1 25 2 22 18

92 Dr Ibrahim Bhoot / MO 1 21 2 20 14

Total 170 4124 189 3083 1602

18

4. Important Points during Support Group Meetings. • Introduction of PPHI • Ownership of HFs • Taulka level CSG meetings • Health Awareness Sessions for prevention at Community Level • Health Awareness Programme at School Level • Water and sanitation, Electricity, Cleanliness etc Issues of HFs • Major and Minor Repair & Renovation of HFs • Suggestions for the improvement of HFs 5. Important Points during SHSs

• Personal Hygiene • Diarrhea • Common Disease • Hand Washing • School Health Camps

6. Important Points during CHSs

• Common Disease • Personal Hygiene • Immunization • Tuberculosis • Family Planning

7. Topics for SHSs for the Month

Sr. No. Topics 1 Scabies 2 Hygiene Condition 3 Common Disease 4 Hand Washing 5 Diarrhea

8 Topics for CHSs for the Month

S # Topics 1 Personal Hygiene 2 Iodized Salt 3 Diarrhea 4 Hepatitis 5 Awareness about Family Planning

19

11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status i Sanitation 00 00 00 ii Drainage / sewerage 00 00 00 iii ……… drinking water 00 00 00

iv Prevention of adulteration

00 00 00

v Tree Plantation 2000 PLANT DO FOREST NO RESPONSE vi Roads and infrastructure 00 00 00 vii Environmental

Improvement 00 00 00

viii Others 00 00 00

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW 1. OPD*

New patients treated during

the month Old patients treated during

the month Total OPD during the month

(New + Old) 105,768 4,530 110,298

2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD 1 BHU Punjab Chak II 2614 BHU ALI MURAD CHANDIO 734 2 BHU Saeed Pur 2588 BHU TURK FARM 909

3 BHU Ghulab Laghari 2519 BHU Mataro Mandhro 911 4 BHU Nabi Bux Punjabi 2131 BHU Haji Nizamuddin 932 5 BHU Wali Mohammd Malkai 1843 BHU Dodo Gishkori 939

3. Top Five Diseases Treated during School Health Sessions/Camps *All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs.

S # Diseases No. of Patients 1 Fever 145

2 Scabies 132 3 Diarrhea 121 4 Asthma / Cough 42 5 Malaria 35

20

4. Top Five Diseases During OPD

S # Disease No. of Patients 1 Acute Rosperity Infection 17419 2 Fever 10652 3 Diarrhea 8801 4 Scabies 6973 5 Dysentery 1152

4. ARV / ASV used during the month

No. of Patients

Dog bite cases reported 51 ARV Administered 51 ARV Available Doses 23 Pts Snake bite cases reported 2


ASV Vaccine Available Doses 25 Pts

6. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Blood Sugar Tests 434 2 Hemoglobin 387 3 X‐Rays (if available) 0 4 Ultra Sound 1206 5 Others (please specify) 387

7. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date

Follow up result

Hepatitis B NA NA NA NA NA Hepatitis C NA NA NA NA NA

8. TUBERCLOSIS


New Cases During the Month

Under Diagnosis

0 0 0 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs

2 78 25 0 53 25 23 30

21

10. Inverse Referrals

S.No Totals Cases Referred from

1 ARV ASV Others RHCs THQs DHQs

2 00 00 00 00 00 00

G. MONITORING DURING MONTH UNDER REVIEW

1. Monitoring Visits during the month

DSM ADSM Executive Monitoring (2) Other Staff Total

60 30 90 228 408

2. Important Points/Issues arising from Visits S # Name of HF Issue Action Remarks 1 BHU Ali

Mohammad Maheri

Record keeping , Referral system Cleanliness Counseling of patients ,Repair & Renovation , Need Of Furniture,

Necessary Instructions issued to Incharge MO

2 GD Sorhadi Record keeping , Referral system Cleanliness Counseling of patients ,Repair & Renovation , Need Of Furniture,


3 GD Mohammad Khan Jarwar

Record keeping, Referral system Cleanliness Counseling of patients, Repair & Renovation, Need Of Furniture, need Sweeper.


4 DCD Ramzan Abro

Record keeping , Referral system Cleanliness Counseling of patients , Need Of Furniture,


5 GD Panhwar Mori

Record keeping , Referral system ,Need Of Furniture, Drinking water problem


H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for: 20.91 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS The status of running R & R schemes was reviewed thoroughly during the MRM and doctors were advised to fill the gaps. Moreover, the new 15 schemes of BHUs were thoroughly discussed. MOs were motivated to get to work in full throttle and complete the work well before the commencement of TPE.

22

S # Name of

HFs Description of Repair / Maintenance

incl. Electrification Status / Remarks

1 BHU Ali Murad Chandio

Tiles, CC Toping, Color, Electricity In Progress

2 BHU Haji Mohammad Boohar

Tiles, Girder T.R Celieng, CC Toping, Color, Electricity

In Progress

3 BHU Abdullah Shah

Tiles, Girder TR Celieng CC Toping, Color, Electricity

In Progress

4 BHU Dadah Tiles, Girder T.R Celieng CC Toping, Color, Electricity, CC path ceiling girder TR.

In Progress

5 BHU Ahmed Rajo Tiles, CC Toping, Color, In Progress

6 BHU Mataro Mandhro


7 BHU Punjab Chak II Tiles, CC Toping, Color, Electricity In Progress

8 BHU Artilary Chak Tiles, CC Toping, Color, Electricity In Progress

9 BHU Behdami Tiles, CC Toping, Color, Electricity In Progress

10 BHU Turk Farm Tiles, CC Toping, Color, Electricity In Progress

11 BHU Khalifo Qasim Tiles, Girder T.iron Celieng CC Toping, Color, Electricity

In Progress

12 BHU Khorwah Tiles, CC Toping, Color, Electricity In Progress

13 BHU Ali Mohammad Maheri


14 BHU Rahooki Tiles, CC Toping, Color, Electricity In Progress

15 BHU Saeed Pur Tiles, CC Toping, Color, Electricity, CC path, RCC Ceiling

In Progress

J‐ DISCUSSION DURING MRM On Staff Matters:

• HIMS Monthly Report • Shortage of Medicine • Training to operate the essential instrument

On Preventive Health: Regarding school health session and community health session mostly topic for preventive were briefly discuss. Scabies, Malaria, Diarrhea and Hygiene etc. On Curative Health: OPD Medicine increase in no of FMO patient. On Mother, Child & Reproductive Health: MCH Centre should increase Number of deliveries. More MCHC center will be opened soon.

23

Other Matters: Hard Allowance, Cheques were distributed among MOs and paramedics. Date /Time for Next MRM: 08‐05‐2010 Comments on Targets vs Achievements (by DSM) Targets vs Achievements: MOs HMIS Reports The target was to send reports in time. Majority of them achieved the targets. Only 20 BRHFs submitted the reports a little late. Health Sessions All doctors were advised to perform as per their job description and conduct as many health education/awareness sessions as possible. All of them conducted sessions quite fruitfully. Punctuality Doctors have become punctual and are attending their HFs in time, despite the fact that they facing numerous hardships in the difficult‐to‐access HFs of District Badin. R & R MOs have started gearing up their efforts for completing R & R schemes at their concerned HFs. Targets vs Achievements: FMOs Ante‐natal care During the month target achieved 2639 cases of antenatal and natal and advised to increase the cases. Deliveries 51 Deliveries are at HFs and MCH Center. FMOs are advised to increase the deliveries. Health Sessions All FMOs were advised to perform as per their job description and conduct as many health education/awareness sessions as possible. All of them conducted sessions quite fruitfully Punctuality FMOs have become punctual and are attending their HFs in time, despite the fact that they facing numerous hardships in the difficult‐to‐access HFs of District Badin. Capacity Building of LHVs 17 capacity building sessions held during the month which is lower side and needs to increase.

24

MINUTES OF THE (17th) MONTHLY REVIEW MEETING

OF DISTRICT DADU

Monthly Review Meeting (MRM) of District, DADU for the Month of April, 2010 was held on 11/05/2010 at Administration Block Civil Hospital Dadu. Written invitations were sent to the DCO, the EDO(H), the EDO(F&P) and District Incharge of EPI, DCO LHW programme and all other National Programs as usual. The list of participants is enclosed.

S # Names/Designation S # Names/Designation

1 Moula Bux Solangi DSM PPHI Dadu

2 Dr Rafique Ahmad Kolachi Civil Surgeon (Civil Hospital)

3 Dr.Zahid Hussain 4 Dr, Abdul Sattar Chandio DMO‐ WHO 5 Dr. Ubed u Rehman Memon DO Public Health 6 Dr. Abdul Rasheed Qureshi THO 7 Dr.Niaz Ahmed jamali District Coordinator DHIS 8 Mr. Taj Mohammad Panhwar DD PWO 9 Abdul Sattar Soomro Exe(F&A) PPHI Dadu 10 Peer Ashfaque Ahmed Exe(M&E) PPHI Dadu 11 Dr Peer Manzoor Ahmad I/c MO 12 Dr. Mohammad Saleh Baloch I/C MO 13 Dr. Bhajan Lal Matlani I/C MO 14 Dr. Ghullmullah Samoo I/C MO 15 Dr. Fayaz Ahmad Panhwar I/c MO 16 Dr. Nizakat Ali Sahar I/C MO 17 Dr. Qamar Din Abbasi I/c MO 18 Dr. Abdul Hakeem Solangi I/c MO 19 Dr. Ashok Kumar I/C MO 20 Dr. Shahnawaz Soomro I/C MO 21 Dr. Mohammad Azam Chandio I/c MO 22 Dr. Imdad Hussain Kalhoro I/C MO 23 Mr. Nazeer Ahmad Lund Dispenser 24 Dr. Mohammad Alam Solangi I/c MO 25 Dr. Ahsan Iqbal I/C MO 26 Dr. Irshad Ali Shah I/C MO 27 Dr. Abdul Sattar Babar I/c MO 28 Dr.Asdullah Lakhiar I/C M.O 29 Dr. Zubair Ahmad Panhwar I/c MO 30 Dr. Abdullah Sameejoi I/C MO 31 Dr. Allah Dino Khoso I/C MO 32 Dr. Azizullah Laghari I/C MO 33 Dr. Syed Lal Shah I/C MO 34 Mr. Ali Raza Jamali I/C Dispenser 35 Dr. Mukhtiar Ahmad Solangi I/C MO 36 Dr. Awais Bughio I/c MO 37 Dr. Zakia Larik FMO 38 Dr. Abdul Hameed Malik I/c MO 39 Dr. Khalid Hussain Laghari I/c MO 40 Dr. Farzana Qureshi FMO 41 Dr.Mehnaz Rasheed Soomro FMO 42 Dr. Jameela Khoso I/c MO 43 Dr. Farzana Naeem Jokhio Sonologist 44 Dr. Aneesa Shaikh FMO 45 Dr. Ameena Bughio FMO 46 Dr. Naheed Akbar FMO 47 Dr. Sabiha Khaskheli FMO 48 Dr. Shabnam Gorar FMO 49 Dr. Farhana Shah FMO 50 Dr.Mumtaz Saeed FMO 51 Dr. Reeta Khushal Das FMO 52 Dr. Afshan Memon FMO 53 Dr. Kalsoom Janweri FMO 54 Dr. Sannaullah Soomro I/C MO 55 Ms. Farzana Ismail FSM 56 Dr. Fareeda Noonari FMO 57 Dr.Naheed Solangi FMO 58 Dr,Rehana Siyal FMO

59 Mr. Feroz Ahmed Memon PAIMAN Representative

60 Mr. Afzal Abro PAIMAN Representative

61 Dr.Nazeer Ahmed Kandhero I/C M.O 62 Dr.Shams‐u‐din I/C M.O 63 Dr.Abdul Karim jamali I/C M.O 64 Mr. Rajib Ali Lund Dispenser 65 Dr.Ahmed Bux Chandio I/C MO 66 Dr.Qaram Ali Shah I/C M.O 67 Dr.Nizam‐u‐din Khoso I/C M.O 68 Abdul Rahim Saryo I/C M.O 69 Hakim Ali Asst:General 70 Syed Abdul Gafar Shah Asst:Admin 71 Naveed Ali SM 72 Dr. Anjum Soomro I/C MO

25

The following could not attend the meeting:‐

S # Names/Designation S # Names/Designation 1 Mr. Altaf Qureshi I/c MO 2 Dr. Altaf Shah Bukhari I/C MO 3 Dr. Rasheed Ahmad Chandio I/c MO 4 Dr. Akhtar Hussain Shaikh I/c MO 5 Dr. Mumtaz Ali Khand I/c MO 6 Dr. Raheela Solangi Sonologist 7 Dr. Fahmeeda Shaikh FMO 8 Dr. Shahmeer Lakhair I/c MO

B. HFs WITH PPHI

BHUs: ___35__ Dispensaries: ___12__ MCHCs: ___01____ Others:______

TOTAL: _48_ B. Population of the Catchments Area:

F. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 40 49 31 18 01 W/FMOs ‐ 22 0 22 04 LHVs 6 33 5 29 16

Male MTs/MAs

Female Dispensers 66 51 23 28 0

G. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO


Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs Single HFs Single HFs 48


Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs 19 Single HFs Single HFs 1 20

26

NOTE: Two Sonologist are working

E. CAPACITY BUILDING 1. First Session: During MRM

Mr./Dr. Naheed Solangi (Resource Person) in his lecture on Obstructive Labour focused on the following points:‐

1. Introduction of Obstructive Labour . 2. Definition Of Obstructive Labour . 3. Types of Obstructive Labour . 4. Sign& Symptom. 5. Diagnosis. 6. Prevention. 7. Treatment.

Second Session: During MRM Dr. Shahnawaz Soomro (M.O) in her lecture on Epilepsy (topic) focused on the following points:‐

Definition of Epilepsy. Causes of Epilepsy Sign& Symptom of Epilepsy Diagnosis. Treatment.



Date

Venue

Topic No. of

Participants Dr.Bhajan Lal 06/04/2010 BHU Phakka Dermatitis 10

Dr.Naheed Solangi 16/04/2010 BHU Khan

Pur Sign of obstructive Labour

08

F. REVIEW OF THE PERFORMANCE

(I) PREVENTIVE HEALTHCARE During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered in Children at Health Facilities. 2268 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 971 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams ‐ Total vaccination / immunization for the month January 2010 3239



26.27.28 257479 293931 114%

27


S # Service Number 1 Passive Case Detection (PCD) Slides 12989 2 Active Case Detection (ACD) Slides ‐ 3 Visits to Check Sanitation (individual house holds + streets) ‐ 4 Notices issued against Poor Sanitation ‐ 5 Challans sent to Court against Poor Sanitation ‐ 6 Patients Nebulized 71

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health

Deliveries Assisted 2. Deliveries


S # Names of FMOs Ante‐Natal Cases

Neo‐Natal Cases

Other OPD Total OPD

1 Dr. Jameela Khoso 155 0 647 802 2 Dr. Fahmida Shaikh 31 3 417 451 3 Dr.Aneesa Shaikh 29 3 579 611 4 Dr.Reeta Khushal Das 186 37 1365 1588 5 Dr.Naheed Akbar 119 1 865 985 6 Dr.Mehnaz Soomro 7 Dr.Shabnam Niaz 184 30 732 946 8 Dr.Rubeena Tahir 122 0 468 590 9 Dr.Farzana Quershi 60 11 697 768 10 Dr.Nargis Memon 11 Dr.Mumtaz Shaikh 22 4 284 310 12 Dr.Rehana Siyal 101 8 385 494 13 Dr.Sana Hussain Chandio 14 Dr.Afshan Memon 169 2 750 921 15 Dr.Ameena Bhughio 97 24 1114 1235 16 Dr.Farhana Shah 11 60 948 1019 17 Dr.Zakia Larik 23 3 567 593 18 Dr.Sabiha Khaskheli 81 3 1418 1502 19 Dr.Bachul Solangi 3 8 860 871 20 Dr.Naheed Solangi 32 1 803 836 21 Dr.Qalsoom Janweri 23 1 909 933 22 Dr.Farida Noonari 81 0 393 474

28


S # Test Number 1 Pregnancy Tests 136 2 Blood Sugar Tests 133 3 Hemoglobin Tests 4 Ultra Sound Test 585 5 Other

4. Important Discussion on Mother and Child and Reproductive Health during MRM

The MOs and FMOs demanded that supply of the injectable Antibiotics and Multi vitamin suspension. Increase quantity of peads: medicine especially in suspension form.


S # Name of the Items / Service Number 1 Consultation / Advice 277 2 Oral Pills 200 (Cycle) 3 IUCDs 00 4 Injection (Norigest) 100 5 Inj:Depo 100 5 Others (Condoms) 300

Total


1. Number of Male SGs: ‐‐‐‐‐‐‐46‐‐‐‐‐‐‐‐‐‐‐ Number of female SGs: ‐‐‐‐‐‐‐‐01‐‐‐‐ 2. Performance of Social Organizers


conducted by him CHSs/SHSs arranged by him

No. No. of

Participants No.

No. of Participants

Abdul Hafeez Bhatti 6 12x6=72 10 20x10=200 Arif Iqbal Channa 4 13x4=52 09 18x9=162 Ms. Farzana Ismail 4 16x4=64 16 32x16=512

Total 16 188 35 874 3. School Health Sessions & Community Health Sessions

Community Health Sessions School Health Sessions Names of MO /

FMOs/Paramedics Sessions Participants Sessions

Children Examined

Children Treated

Dr. Fahmida Shaikh 0 0 0 0 0 Dr.Aneesa Shaikh 2 30 2 13 0 Dr.Reeta Khushal Das 2 120 2 130 80 Dr.Naheed Akbar 2 76 2 135 10 Dr.Mehnaz Soomro 0 0 0 0 0 Dr.Shabnam Niaz 2 54 2 26 14

29

Dr.Rubeena Tahir 2 85 2 60 16 Dr.Farzana Quershi 2 27 2 25 25 Dr.Nargis Memon 2 42 1 54 30 Dr.Mumtaz Shaikh 2 12 1 40 10 Dr.Rehana Siyal 2 85 2 190 90 Dr.Afshan Memon 2 104 1 32 2 Dr.Ameena Bhughio 2 45 2 25 15 Dr.Sabiha Khaskheli 2 36 2 318 0 Dr.Sana hussain Chandio Dr.Zakia Larik 2 24 2 25 25 Dr.Farhana Shah 2 40 2 15 4 Dr.Bachul Solangi 2 115 2 100 100 Dr.Jameela Khoso 2 40 2 83 30 Dr.Naheed 2 28 2 55 10 Dr.Qalsoom Janweri 2 25 2 25 6 Dr.Fareeda Noonari 1 16 2 220 220

Totals 37 1031 35 1571 687

4. Important Points during Support Group Meetings. a) They demanded increase supply of ARVs and ASVs. b) CSG demanded that the Ultrasound facility may be provided at uncovered areas. c) CSG members demanded that health facilities may be repaired. 5. Important Points during SHSs a d)Prevention of Scabies b)Precaution of Acute respiratory Infection. c)Increase awareness regarding the prevention of Swine Flu. d)Prevention of Malaria. 6. Important Points during CHSs c)Awareness regarding Breast feeding. d)Awareness regarding advantages of FP methods c) Female community health session conducted in which FMO discuss about Reproductive health. d)Prevention of Respiratory infection in Newborns. . 7. Topics for SHSs for the Month

Sr. No. Topics 1 Preventive measurements of Respiratory disease 2 Prevention of Diarrhea 3 Scabies 4 Malaria 5 Personal Hygienic


S # Topics 1 Prevention of Acute respiratory Infection in new borns 2 Advantages of Injectable Contraceptives 3 Malaria 4 Advantages of boiled water

30

9. Important Discussion on Community Participation during MRM The DSM urged the MOs and FMOs to conduct regular monthly meetings with community support group and send a copy of minutes of the meeting to DSU for record purpose. He further directed to hold community health meetings and keep record of the same. 10. Health Camps: Number Held: NIL. Number of Patients: 00 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status

i Sanitation ‐ ‐ ‐ ii Drainage / sewerage ‐ ‐ ‐ iii Drinking water ‐ ‐ ‐ iv Prevention of

adulteration ‐ ‐ ‐

v Tree Plantation ‐ ‐ vi Roads and infrastructure ‐ ‐ ‐ vii Environmental

Improvement ‐ ‐ ‐

viii Others ‐ ‐ ‐


New patients treated during the month


Total OPD during the month (New + Old)

73627 157 73784


S # BHU OPD BHU OPD 1 BHU Aghamani 4430 BHU Dougar 705 2 BHU Wahi Pandh 3184 BHU Qasbo 780

3 BHU Allahyarani 2907 GD Mounder Jamali 804 3. Top Five Diseases Treated during School Health Sessions/Camps

S # Diseases No. of Patients 1 Respiratory Disease 189 2 GIT(Diarrhea) 115

3 Scabies 105 4 Malaria 75 5 Enteric Fever 20

31


S # Disease No. of Patients 1 Respiratory Disease 13196 2 GIT 6033 3 Malaria 5127 4 Scabies 4079 5 Dermatitis 2772


No. of Patients

Dog bite cases reported 83

ARV Administered ‐

ARV (Intramuscular) 30

ARV Available Doses(Intramuscular) 50 Snake bite cases reported 0 ASV Vaccine Administered 0

ASV Vaccine Available Doses 20 9. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health) 3. (Lab / Diagnostic Tests)

S # Tests Number 1 Blood Sugar Tests 133 2 Haemoglobin ‐ 3 X‐Rays (if available) ‐ 4 Ultra Sound 585 5 Others (please specify) ‐






Follow up result

Hepatitis B ‐

‐ ‐ ‐ ‐

Hepatitis C ‐

‐ ‐ ‐ ‐

11. TUBERCLOSIS



Under Diagnosis

88 7 0

32




35 60 150 245 2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks

1 BHU Boriri M.O demanded repair of BHU

Papers signed for opening of Account

The account has been opened.

2 BHU Butt Serai M.O demanded some minor repair

Work will start soon

3 BHU Dhani Bux Bughio

MO demanded the start of R & R

The order has been placed for material


1. Medicines available for: ……37.73…………………. Weeks 2. Important Issues raised relating to Medicines, etc. during MRM Few Doctors pointed out that the quality of medicine may be improved and also increase the quantity of medicine. The DSM apprised the medical officers that 10 items of medicine were procured from multinational companies and rest of the items are also of good quality and efficacious. I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of

HFs Description of Repair /

Maintenance incl. Electrification Status / Remarks

1 BHU Aminani Completed MB recorded Completed

2 BHU Ibrahim Panhwar Completed MB recorded Completed 3 BHU Phulji Station Work in progress 4 BHU Pyaro Goath Completed

5 BHU Kolachi Completed

6 BHU Allahyarani Completed

7 BHU Khanpur Completed MB recorded Completed

8 BHU Makhdoom Bilawal Completed MB recorded Completed

9 BHU Bahawalpur Completed

10 BHU Gozo

11 BHU Betto Completed

12 BHU Kamal Khan Lund Completed

13 BHU Phakka Work in progress

14 BHU Samtani Work in progress

15 BHU Qazi Arif Work in progress

16 BHU Boriri Work in progress

17 BHU Thallo Work in progress

33

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

DCO Dadu BHU Allahyarani Appraised the quality work of R & R and the Role of MO I/c

* To reflect only non‐PPHI Visitors.


• Regularly updating of records. • Regularity and punctuality. • To take security measure during the driving, while coming to the HFs.

On Preventive Health:

• The DSM emphasize the regular CHS, SHC. • Keeping the view the swine flue, the awareness of this disease was on top priority. • Properly wastages of Disposables. • Role on awareness rising about vaccination and NIDs and it was shared with the forum that DSU‐PPHI

Dadu has appointed the 07 vaccinator for said purpose. On Curative Health:

• Properly usage of Glucometers, Nabulizer Machine and BP apparatus. • The DSM emphasize on the properly examination of Infants, female and old age patients.

On Mother, Child & Reproductive Health:

• Timely vaccination of TT vaccine. • The DSM appreciate the increase in NVDs • Ensure the fully participation in NIDs.

Other Matters: The DSM stressed upon furnishing the record of inverse cases of tuber couloses. Date /Time for Next MRM: On 8th June 2010 at 10 am. Comments on Targets vs Achievements (by DSM)

• Regular Supply of Medicines • Provided ARVs / ASVs • Established Greenery and Plantation • Maintaince of HFs Record • Arranged School Health Session/Community Health Session • Established link with Community Support Group and meeting there.

34

MINUTES OF THE 21st MONTHLY REVIEW MEETING DISTRICT JACOBABAD

The Twenty First Monthly Review Meeting of DSU‐PPHI, Jacobabad for the month of April, 2010 was held at Conference Hall, Zila Nazim Office Jafferabad Jacobabad on Tuesday 11th May, 2010 at 10:00 am. The invitations were sent to the DCO, EDO (H), DPWO, District Coordinator UNFPA, District Coordinator National Program for Family Planning and Primary Healthcare, District Coordinator, EPI, District Coordinator, TB‐DOTS program, District Coordinator, HMIS, DPO Marie Stopes Society, MOs/FMOs and Dispensers of the respective BHUs/GDs/MCHCs. The following participants attended the meeting;

S# Name of the Participant Designation

01 Ghulam Ali Soomro District Support Manager PPHI‐Jacobabad 02 Dr. Deedar Ali Jamali Executive District Officer Health Jacobabad 03 Mrs. Razia Awan Assistant District Coordinator National Program 04 Dr. Santosh Kumar DSO, UNICEF

05 Dr. Saluchna Mumtani I/C RHS (A) Population Welfare Dept: JCD

06 Hafeez‐u‐llah Sarki DSV, EPI, Jacobabad

07 Ghulam Murtaza Noonari District Coordinator (FALAH) Jacobabad 08 Ghulam Rabbani IFO Marie Stopes Society JCD

09 Inam Illahi Waggan Executive Officer‐Monitoring and Evaluation

10 Marghoob Ahmed Bhatti Executive Officer‐Account and Admin

11 Dr. Abdul Jabbar Thaheem Medical Officer Head Quarter

12 Dr. Abdul Ghaffar Babar I/C MO BHU Mohammed Pur Odho

13 Dr. Abdul Rab Bhatti I/C MO BHU Mola Dad 14 Dr Lutufullah Channa I/C MO BHU Pyaro Khoso 15 Dr. Sajjad Ahmed Buriro I/C MO BHU G M Jakhrani 16 Dr. Veer Bhan I/C MO BHU Bahadur Pur 17 Dr. Rano Mal Mandhan I/C MO BHU Baxan Pahore 18 Dr. Aziz Ahmed Soomro I/C MO BHU Uddi 19 Dr. Muzaffer Ali Khaskheli I/C MO BHU Hashmatabad 20 Dr. Irfan Ali Khoso I/C MO BHU Bangul

21 Dr. Ghulam Mohammad Dashti I/C MO BHU Karim Bux 22 Dr. Zafar Ali Tunio I/C MO BHU Bahoo Khoso 23 Dr. Ghulam Mohammed Talani I/C MO BHU Madad Pur 24 Dr. Ihtisham‐ul‐Haq Soomro I/C MO GD Shabirabad 25 Dr. Shafique Ahmed Brohi I/C MO BHU A R Suhendro 26 Dr. Tara Chand Talreja I/C MO GD Adam Khan Panhwar 27 Dr. Shahzad Ahmed Mangi I/C MO GD Imam Bux Kehar 28 Dr. Naeem Ahmed Sarki I/C MO GD Naseer Khan Bhangar 29 Dr. Mohammed Panah Brohi I/C MO BHU Dodapur

30 Dr Azizullah Talani I/C MO GD Police Head Quarter 31 Dr. Raheel Ahmed Khoso I/C MO BHU Mubarkpur

35

32 Dr. Inayatullah Dayo I/C MO BHU Sheranpur 33 Dr. Kishore Kumar I/C MO GD Hindu Panchaiyat 34 Dr. Saifullah Bhutto I/C MO BHU Pyaro Khoso 35 Dr. Shokat Ali Soomro I/C MO GD Juma Khan Dasti 36 Dr. Baqa Mohammed Panhwer I/C MO BHU Bungalow Sayedan 37 Dr. Habib‐u‐Rehman Jakhrani I/C MO BHU Azizabad 38 Dr. Wahid Bux Lighari I/C MO BHU Noor Mohammed Pathan

39 Dr. Sajjad Ahmed Soomro I/C MO GD Abad

40 Dr. Muhammed Azim Shah I/C MO BHU Jumo Dakhan 41 Dr. Fozia Khoso I/C FMO MCH Center Jafferabad 42 Dr. Farzana Khoso FMO MCH Center Jafferabad 43 Dr. Saeeda Solangi FMO MCH Center Jafferabad 44 Dr Sheerin Soomro FMO Cluster IV (BHU Bunglow Sayedan, GD Abad) 45 Dr. Haseena Daudpoto FMO Cluster 1 (BHU Bangul, BHU Udi, BHU A.R Suhendro)

46 Dr. Rukaya Abro

FMO Cluster II (BHU Suhno Khan Rind, BHU Noor Mohammed Pathan)

47 Dr. Aruna Kumari

FMO Cluster III (GD Juma Khan Dasti, GD Adam Khan Panhwar)

48 Dr. Naila Majid Soomro FMO Cluster V ( MCHC Thull, BHU Mubarakpur) 49 Dr. Zahida Qureshi FMO GD Police Head Quarter 50 Shahab‐u‐Din Sahto Store Manager DSU‐PPHI‐JCD

51 Asif Ali Waggan Store Assistant DSU‐PPHI‐JCD

52 Ghullam Hussain Soomro Assistant Accounts DSU‐PPHI‐JCD

53 Bhai Khan Khemtio Social Mobilizer‐2 DSU‐PPHI‐JCD

54 Mohammad Tahir Social Mobilizer‐1 DSU‐PPHI‐JCD 55 Wahd Bux Bhayo Assistant Admin DSU PPHI Jacobabad


C. HFs WITH PPHI

BHUs: 24 Dispensaries: 06 MCHCs: 02 Others: 03

TOTAL: 35 B. Population of the Catchment Area: 569,472

S# Name of Official Designation Reason

01 Dr. Kashif Ali Pahore I/C MO BHU Joungal Went for Mother’s checkup to Larkana

02 Dr. Abdul Fatah Khoso I/C MO BHU Bachro On Leave 03 Dr. Abdul Waheed Pathan I/C MO GD District Jail Jacobabad Hearing at Court

04 Meer Jawed Hussain Talpur District Population Welfare Officer Jacobabad

Meeting at Karachi

05 Dr. Wajid Ali Bhutto District Coordinator, TB‐DOTS/ District Coordinator, HMIS

Meeting at Karachi

36

H. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 35 35 9 25 2 W/FMOs 14 7 1 8 5 LHVs 19 2 1 1 17

Male 9 7 7 0 2 MTs/MAs


I. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO E. CAPACITY BUILDING

1. First Session: During MRM

Dr. Azizullah Talani (Resource Person) in his Lecture on (Safe Blood Transfusion) program focused on the following points:‐

1. History of Blood Transfusion. 2. First Successful Transfusion. 3. Early Successes. 4. Methods of Safe Blood Transfusion. 5. Counseling Methodology. 6. Complications.


Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs Single HFs 35 Single HFs 35


Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs 1 Clusters of 3 HFs 2

Clusters of 2 HFs 3 Clusters of 2 HFs 3

Single HFs 2 Single HFs 2

37

2. Second Session: During MRM……………..



Date

Venue

Topic No. of

Participants Dr. Mehmood Riaz Dr. Abdul Hakeem

12 to 17th April

Distt: Govt: Library

Family Planning

10


(I) PREVENTIVE HEALTHCARE During Month under Review


No. of Doses of Immunization Administered in Children at Health Facilities. 2,973 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 1,159 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams 6,772 Total vaccination / immunization for the month of April, 10 10,904



26,27,28th April, 2010 198,356 190,576 96%


S # Service Number 1 Passive Case Detection (PCD) Slides N/A 2 Active Case Detection (ACD) Slides ‐‐‐ 3 Visits to Check Sanitation (individual house holds + streets) ‐‐‐ 4 Notices issued against Poor Sanitation ‐‐‐ 5 Challans sent to Court against Poor Sanitation ‐‐‐ 6 Patients Nebulized ‐‐‐

38


1. Female Health

2. Deliveries Assisted





1). The DSM discussed that our main objective of posting of female skilled staff i.e FMOs, LHV and Midwives is to reduce the maximum deaths during pregnancy adding that it was only possible if maximum number of births are attended by our female staff. He showed bit satisfaction that now deliveries were attended at the level of BHUs which was hitherto not perceived before PPHI. He however, said that only 41 deliveries were attended by PPHI skilled staff during the month of April, 2010. 2). He showed concern over the situation that about 30% pregnant women were having enema. He stressed upon the FMOs that all pregnant women visiting the HFs must be registered in the Mother Health Register. The medicines required to control the anemia were available at BHUs. FMOs are required to issue Mother Health Cards to pregnant mothers and guide them to visit them at least 4 times during pregnancies.


Neo‐Natal Cases

Other OPD Total OPD

01 DR AROONA KUMARI 26 00 381 407 02 DR. RUQAYA ABRO 33 02 1101 1136 03 DR HASEENA DAUDPOTO 77 23 547 647 04 DR. SHEERIN SOOMRO 53 05 1163 1221 05 DR. NAILA MAJID SOOMRO 23 01 1098 1121 06 DR. SAEEDA SOLANGI 42 12 2032 2086 07 DR. FARZANA KHOSO 87 08 2671 2766 08 DR. FARIDA ZAHID 27 00 871 898

Total 368 51 9864 10282

39


S # Name of the Items / Service Number Consultation / Advice 309 Oral Pills 76 (Cycles) IUCDs 09 Injections 542 Others 216

Total 1,152


1. Number of Male SGs: 28 Number of female SGs: 00 2. Performance of Social Organizers



No. No. of

Participants No.

No. of Participants

Bhai Khan Khemtio 8 122 18 346

Tahir Lashari 6 89 11 213



FMOs/Paramedics Sessions Participants Sessions Children Examined

Children Treated

Dr. Shokat Ali Soomro 3 43 2 24 6 Dr. Ghulam Mohammed Dasti 2 24 2 38 18 Dr. M Azim Shah 1 16 1 21 9 Dr. Rano Mal 2 26 1 38 18 Dr. Naeem Saki 2 33 1 42 14 Dr. Habib Rehman Khoso 1 22 1 28 9 Dr. Zafar Ali Tunio 1 24 1 29 14 Dr. Kashif Pahore 1 28 1 22 6 Dr. Sheerin Soomro 1 20 2 41 17 Dr. Shahzad Mangi 1 19 1 16 8 Dr. Inayatullah Dayo 1 22 0 0 0 Dr. Habib Jakhrani 2 28 1 17 9 Dr. Aruna Kumari 1 25 0 0 0 Dr. Hasina Daudpoto 2 42 2 36 18 Dr. Ihtisham Soomro 1 19 0 0 0 Dr. Rukia Abro 3 45 0 0 0

Total 25 436 16 352 146 4. Important Points during Support Group Meetings.

• Purpose of formation of CSG • Role of CSG members’ vis‐à‐vis BHU activities.

40

• Importance of vaccination for children and women of Child bearing Age. • Participation in R&R work. • Ownership of HFs.

5. Important Points during SHSs

• Primary health care awareness. • Importance of Hand washing against infectious disease. • Health education. • Prevention of Diarrhea/Scabies.


• Primary health care awareness. • Awareness about importance of immunization against infectious disease. • Health education. • Prevention of Diarrhea/Scabies.


Sr. No. Topics 1 Importance of Hand washing 2 Primary health care awareness 3 Prevention of Diarrhea/Scabies 4 Health education


S # Topics 1 Primary health care awareness 2 Importance of family Planning 3 importance of immunization against infectious disease 4 Health education/ importance of nutrition

9. Important Discussion on Community Participation during MRM N/A 10. Health Camps: Number Held: 00. Number of Patients: 00. 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No

Description Recommendation To whom sent Present status

i Sanitation ii Drainage / sewerage iii …… drinking water iv Prevention of adulteration v Tree Plantation vi Roads and infrastructure vii Environmental

Improvement

viii Others Electrification SE HESCO Pending

41





(New + Old)

48,962 621 49,583


S # BHU OPD BHU OPD

1 BHU Joungal 3078 BHU G M Jakhrani 530

4 BHU Karim Bux 2335 BHU Mouladad 747

2 BHU Noor M Pathan 2002 BHU Piaro khoso 852

3 BHU Dodapur 1817 BHU Jumo Dakhan 930

5 BHU Bahadurpur 1804 BHU A R Suhindro 1035 3. Top Five Diseases Treated during School Health Sessions/Camps 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 Acute Respiratory Infections 7305 2 Scabies 5437 3 Fever (Clinical Malaria) 4165 4 Diarrhea 3605 5 Cough 612


No. of Patients Dog bite cases reported 93 ARV Administered IM (5 doses) ARV Available Doses 90

Snake bite cases reported 00



S # Diseases No. of Patients 1 Acute Respiratory Infections 2 Fever (Clinical Malaria)

3 Scabies

4 Cough

5 Cough

42



S # Tests Number 1 Blood Sugar Tests 450 2 Haemoglobin 52 3 X‐Rays (if available) 14 4 Ultra Sound 150 5 Others (MP/TB) 143






Follow up result

Hepatitis B 00 00 00 00 00

Hepatitis C 0 0 0 0 0

14. TUBERCLOSIS



Under Diagnosis

51 13 This is in valid column 9. Referrals

S.No Totals Cases Referred To

1 TB DOT Deliveries Others RHCs THQs DHQs

2 42 27 03 12 13 11 18




2 07 10 0 0 05 01 04




43 31 78 152

43

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS 1. Medicines available for: 12 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM MOs demanded for supply of Ventolin Solution, Ceiling Fans, Furniture & Equipments.

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of

HFs

Description of Repair / Maintenance incl. Electrification

Status / Remarks

01 BHU Uddi 98% 02 BHU Bangul 100%

03 BHU Jumo Dakhan 100%

04 BHU Joungal 98%

05 BHU Suhno Khan Rind 100%

06 BHU Bungalow Sayedan 100% 07 BHU Madad Pur 99% 08 BHU Bachro 95%

09 BHU Karim Bux 100%

10 BHU Azizabad 98%

11 BHU G M Jakhrani 75%

12 BHU Moladad 90%%

13 BHU Sheranpur 100%

14 BHU Md; Pur Odho 98%

15 BHU Mubarakpur 99% 16 MCHC Jafferabad 98%



Team of U/T CSS Officers BHU Bungalow Sayedan

Appreciated the performance of PPHI and availability of medicines

District & Session Judge Jacobabad

District Jail Dispensary Appreciated the availability of

medicines * To reflect only non‐PPHI Visitors.

J‐ DISCUSSION DURING MRM

DSM welcomed all the participants and specially thanked to the EDO (H) Jacobabad. He appreciated the support given to the programme by the DCO and EDO Health. He also thanked to incharge of various vertical programmes for their joint contribution towards improvement of health services in the District. He requested the ADC of National Programme to refer the cases of deliveries and D&Cs to MCHC Jacobabad where evening shift had been started. He appreciated all the M.Os for their work which was being appreciated all levels in the District. DSM further stressed upon all the participants about the importance of Data reporting adding that they need to learn about all instruments of HMIS. He called upon all I/C MOs to bring the details of cases so referred to various Diagnostic centres so that feedback upon such referrals could be discussed in next MRM. He informed

44

participants about establishment of Taluka wise focal centers for administration of ARV vaccine. EDO (H) suggested that BHU Jumo Dakhan and BHU Doda pur should also be the focal centers for ARV. On Mother, Child & Reproductive Health: DSM focused on immunization and TT vaccine and directed all the MOs and FMOs for the close liaison with the field teams of polio and EPI. He also emphasized that all the women age between 15‐49 and children under the age of 2 years should be verified and cleared by vaccination staff before giving any treatment so that the maximum number of children and the mothers can be immunized/ vaccinated. The use of contraceptive should be promoted among the community through health sessions. Date /Time for Next MRM: 08th or 09th June, 2010 will be the tentative dates. Comments on Targets vs Achievements (by DSM) DSM shared the progress and achievements of the program at the district. A detailed discussion held on the progress of the previous month and OPD of each Health Facility highlighted. DSM conducted an open session with participants on the issues faced by them at RHF level. EDO (H) praised the Cooperation & working of PPHI‐JCD.

45

MINUTES OF THE MONTHLY REVIEW MEETING OF DISTRICT: KAMBER‐SHAHDADKOT @ KAMBER

Monthly Review Meeting (MRM) of District, Kamber‐Shahdadkot for the Month of April, 2010 was held on 07‐05‐2010 at DSU‐PPHI District Kamber‐Shahdadkot. Written invitations to participate were sent to the DCO, the EDO (H), the EDO (F&P) and DPO, District Officer WHO, DPWO Kamber‐Shahdadkot, I/C TB Dot Program Kamber‐Shahdadkot as usual. The participants of the meeting were as under:‐

S # Names/Designation S # Names/Designation 1 Mr Riaz Ali Abbasi DSM 2 Mr Abdul Rahim Junejo Ex A/A 3 Mr Imtiaz Ali Kalhoro Ex (M&E) 4 Dr Subhan Lakho (MO) 5 Mr Mumtaz Ali Shaikh DDO EDO (H) Office 6 Mr Dhani Bux Makol (Dawasaz) 7 Dr Hosh Mohammad (MO) 8 Dr Khalid Buriro (MO) 9 Dr Abdul Karim (MO) 10 Dr Noor Mohammad Memon (MO) 11 Dr Attaullah Phulphoto (MO) 12 Dr Abdul Ghaffar Chandio (MO) 13 Dr Mehboob Ali Chandio (M.O) 14 Dr Aziz Ahmed Soomro 15 Dr Umbreen Bhutto (FMO) 16 Dr Tahira Memon (FMO) 17 Dr Noor Khatoon (FMO) 18 Dr. Shabana Tunio (FMO) 19 Dr Surya Lashari (FMO) 20 Dr Farzana Soomro (FMO) 21 Dr Fozia Soomro (FMO) 22 Dr Rehana Chandio (FMO) 23 Dr Nadeem Akhtar 24 Dr Farah Abasi (FMO) 25 Dr Itrat Fatima (FMO) 26 Dr Bashir Ahmed Brohi 27 Dr Mansoor Depar (MO) 28 Dr Rehana Tunio (FMO) 29 Dr Hiranand (MO) 30 Dr Sanaullah Wagan (MO) 31 Dr Lal Mohammad Junejo 32 Dr Munwar Chandio (MO) 33 Dr Zahida Keheri (FMO) 34 Dr Khalid Shaikh (MO) 35 Dr Nadeem Akhtar Sheikh (MO) 36 Dr Ameer Ali (MO) 37 Dr Hafeezullah Leghari 38 Dr Samina Shah (FMO) 39 Dr. Shahnawaz (MO) 40 Dr Aziz Ahmed Soomro (MO) 41 Dr Sunil Kumar (MO) 42 Dr Najamuddin Shaikh (MO) 42 Dr Mansoor Ali Depar (MO) 43 Mr Najamuddin Hakro (Malaria Supdt) 44 Dr Parkash Lal (MO) 45 Dr Abdul Manan Shaikh (MO)

All the MOs / WMOs / FMOs attended the meeting, except the following, for reasons mentioned against each:

S # Names Reasons for absence 1 Dr Ghulam Abbas Without Intimation 2 Dr Mehvish Qureshi ‐do‐ 3 Dr Aijaz Channa ‐do‐

D. HFs WITH PPHI


TOTAL: 27

46

J. Population of the Catchment Area: 1,375,398

K. STAFF STRENGTH

Sanctioned

Posts Working

Government Employees

PPHI Contract

Vacant

MOs 24 25 11 15 03 W/FMOs 02 15 02 15 01 LHVs 26 12 10 08 14

Male ‐ ‐ ‐ ‐ ‐ MTs/MAs

Female ‐ ‐ ‐ ‐ ‐ Dispensers 03 21 03 18 ‐

L. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO

E.

CAPACITY BUILDING

1. First Session: During MRM Dr. Sanaullah Waggan, in his lecture on “Malaria” reporting, focused on the following points:‐

Introduction Types of Malaria Clinical Features Cure/Treatment

2. Second Session: During MRM

Dr Zahida Keheri, in her lecture on “U.T.I” focused on following points:

Definittion Types of U.T.I Clinical features Investigation

Previous Month Month under Review Clusters of 5 HFs ‐ Clusters of 5 HFs ‐ Clusters of 4 HFs ‐ Clusters of 4 HFs ‐ Clusters of 3 HFs ‐ Clusters of 3 HFs ‐ Clusters of 2 HFs Clusters of 2 HFs ‐


Previous Month Month under Review

Clusters of 5 HFs ‐ Clusters of 5 HFs ‐ Clusters of 4 HFs ‐ Clusters of 4 HFs ‐ Clusters of 3 HFs ‐ Clusters of 3 HFs ‐ Clusters of 2 HFs 12 Clusters of 2 HFs 12


47



No. of Doses of Immunization Administered in Children at Health Facilities. 5236 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 1733 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams ‐ Total vaccination / immunization for the month April, 2010 6969



26/04/2010 to 28/04/2010 233852 287139 99 % 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides ‐ 2 Active Case Detection (ACD) Slides ‐ 3 Visits to Check Sanitation ‐ 4 Notices issued against Poor Sanitation ‐ 5 Challans sent to Court against Poor Sanitation ‐ 6 Patients Nebulized ‐



S # Names of FMOs Ante‐Natal Cases Neo‐Natal Cases Other OPD Total OPD

1 Dr. Suraya Lashari 45 1 1534 1580 2 Dr. Tahira Memon 78 3 998 1079

3 Dr. Zahida Kaheri 81 0 1350 1431

4 Dr. Itrat Fatima Jokhio 26 19 1228 1273 5 Dr. Shabana Tunio 107 3 1852 1962

6 Dr. Noor Khatoon Panhwar 40 5 1158 1203

7 Dr. Samina Begum Shah 120 0 1204 1324

8 Dr.Rehana Chandio 330 15 2875 3220

9 Dr. Farzana Bano Soomro 0 0 445 445

10 Dr. Almas Mehboob 28 0 913 941

11 Dr. Mehwish Qureshi 72 5 1219 1296

12 Dr. Fozia Soomro 124 0 1930 2054

13 Dr. Farah Abasi 14 0 722 786

14 Dr.Ambreen Bhutto 339 8 344 691 15 Dr.Reehana Tunio 270 20 639 929

Total 1674 79 18411 20214

48


S # Service Number 1 Deliveries Assisted at HFs 36 2 Deliveries Assisted at homes ‐


S # Test Number 1 Pregnancy Tests 298 2 Blood Sugar Tests 215 3 Hemoglobin Tests ‐ 4 Ultra Sound Test 382

10. Important Discussion on Mother and Child and Reproductive Health during MRM On mother and child and reproductive health, DSM laid great emphasis on MOs, especially FMOs to properly attend such cases and advise clients to facilitate them for proper treatment.

11. Provision of Family Planning Services

S # Name of the Items / Service Number 01 Consultation / Advice Nil 02 Oral Pills Nil 03 IUCDs Nil 04 Injections Nil 05 Others (Disp Syringes) Nil

Total Nil



Names of Social Organizers Meetings of Support Groups conducted

by him/No of Participants CHSs/SHSs arranged by him /No of participants

Mr Imran Ahmed leghari 7 140 18 270 Mr Riaz Ahmed Tunio 9 180 12 180

Total 15 320 30 450

49

3. School Health Sessions & Community Health Sessions


FMOs/Paramedics Sessions

Participants

Sessions Children Examined

Children Treated

Dr. Suraya Lashari 2 45 2 30 13 Dr. Tahira Memon 3 68 1 20 12 Dr. Zahida Kaheri 3 61 1 10 6 Dr. Itrat Fatima Jokhio 3 58 0 0 0 Dr. Shabana Tunio 2 24 2 24 15 Dr. Noor Khatoon Panhwar 3 45 0 0 0 Dr. Samina Begum Shah 2 38 2 27 12 Dr. Rehana Chandio 4 0 ‐ ‐ ‐ Dr. Farzana Bano Soomro 2 36 2 22 9 Dr. Almas Mehboob 2 31 1 16 8 Dr. Mehwish Qureshi 2 34 2 23 13 Dr. Fozia Soomro 2 38 1 15 8 Dr. Farah Abbasi 2 38 2 20 8 Dr.Reehana Tunio 2 35 0 0 0 Dr.Ambreen Bhutto 3 65 1 15 8 Total 33 616 17 204 115

4. Important Points during Support Group Meetings.

1. Supply of ARV 2. To cope with the water problem 3. Functioning of EPI centers 4. Repair & Renovation of HFs


1. To create awareness in children how to maintain cleanliness. 2. To create awareness in children to maintain physical fitness 3. To create awareness in children about different diseases.


1. To create awareness in community to keep environment healthy. 2. Counseling to pregnant women and advise on family planning 3. To create awareness in community about prevelant disease in the area.


Sr. No. Topics 1 Cough 2 Scabies 3 Nutrition 4 Malaria

50


S # Topics 1 U.T.I 2 Atonic Uterus 3 Abortion 4 Typhoid fever

9. Important Discussion on Community Participation during MRM

1. Supply of ARV 2. R&R of HFs

10. Health Camps: Number Held: 0 . Number of Patients: 0 11. Measures for Improvement/provision of services by other Department/agencies:

Sr No Description Recommendation To whom sent Present status I Sanitation Nil Nil Ii Drainage / sewerage Nil Nil Iii ……… drinking water Nil Nil Iv Prevention of

adulteration Nil Nil

V Tree Plantation Vi Roads and infrastructure Nil Nil Vii Environmental

Improvement Nil Nil

Viii Others Nil Nil

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW (V)

1. Supply of medicines 2. Proper attendance of staff at HFs

1. OPD*




(New + Old)

57033 ‐

57033


S # BHU OPD BHU OPD 1 Bhambo Khan Chandio 3863 Khairpur Jooso 971 2 Arzi Bhutto 2589 Chakyani 1126

3 Gazi Khan Khuhawar 2560 Aitbar Khan Chandio

1282

4 Kot Ghulam Shah 2404 Khandu 1423 5 Khuda Bux Wahocho 2287 Ghulam Ali Magsi 1539

51

3. Top Five Diseases Treated during School Health Sessions/Camps

S No Disease 1 Malaria 2 ARI 3 Scabies 4 Diarrhea 5 Fever


S # Disease 1 Scabies 2 ARI 3 Fever 4 Diaherra 5 Dysentery


No. of Dog bite cases reported 46 ARV Administered 46 ARV Available Doses 17 No. of Snake bite cases reported ‐ ASV Vaccine Administered ‐ ASV Vaccine Available Doses ‐

15. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) 3 (Mother, Child & Reproductive Health)

S # Tests Number 1 Blood Sugar Tests 215 2 Hemoglobin ‐ 3 X‐Rays (if available) ‐ 4 Ultra Sound 382 5 Others (please specify) 2261

16. B & C Screening Tests




Hepatitis B ‐ ‐ ‐ Hepatitis C ‐ ‐ ‐

17. Tuberculosis

Patients Receiving

Treatment New Cases During the

Month Under Diagnosis

53 9 ‐

52

9. Referrals

Cases Referred To S.No Totals

TB DOT Deliveries Others RHCs THQs DHQs 1 ‐ ‐ ‐ ‐ ‐ ‐ 2 ‐ ‐ ‐ ‐ ‐ ‐ ‐


Cases Referred from

S.No Totals ARV ASV Others RHCs THQs DHQs

1 ‐ ‐ ‐ ‐ ‐ ‐ ‐ 2




44 51 101 196


1. Medicines available for: 18 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM. 3. Availability of essential medicines at HFs.


S # Name of

HFs


Status / Remarks

01

BHU Ziauddin Isran Work Completed MB Recorded

02 BHU Datu Teewna ‐do‐ ‐do‐ 03 BHU Ghazi Khan Khuhawar ‐do‐ ‐do‐ 04 BHU Aitbar Khan Chandio ‐do‐ ‐do‐ 05 BHU Bhambo Khan Chandio ‐do‐ ‐do‐‐ 06 BHU Mohammad Ali Gurmani ‐do‐ ‐do‐ 07 BHU Gathar ‐do‐ MB not recorded 08 BHU Thori Bajar ‐do‐ ‐do‐ 09 BHU Chakyani ‐do‐ MB recorded. 10 BHU Kot Ghulam Shah ‐do‐ MB Recorded 11 BHU Behram ‐do‐ MB not recorded. 12 BHU Lalu Raunk ‐do‐ MB recorded 13 BHU Ghogaro ‐do‐ MB Recorded 14 BHU Thoof Chosool ‐do‐ MB not recorded

53

15 BHU Arzi Bhutto ‐do‐ ‐ 16 BHU Ghulam Ali Magsi ‐do‐ ‐ 17 BHU Deera 50 % completed. Work in progress 18 BHU Khandu 10 % work completed ‐do‐ 19 BHU Wadho Kalhoro 50 % work completed ‐d0‐ 20 BHU Gaji Khuhawar 10 % work completed ‐do‐ 21 BHU Khuda Bux Wahocho T.S received Ten per cent issued 22 Unani Shafa khana Gul Buriro T.S received ‐do‐

J‐ DISCUSSION DURING MRM On Staff Matters: Regularity / Punctuality of staff at HFs came under discussion. On Preventive Health:

1. Conduct of proper CHSs / SHSs 2. Proper functioning of EPI centres 3. To properly check outreach staff of HFs

On Curative Health:

1. Supply of medicines at HFs, specially essential drugs. 2. Proper treatment of patients


1. To properly attend all the anti netal & Neo natal cases. 1. Counseling to pregnant women for proper treatment.

Other Matters: 1. I/C FMO Dr Rehana Chandio of MCH Nasirabad carried out delivery of Mst. Tahmina w/o Nawaz Ali Jalbani of

boy baby weighing (5 kg) , vide OPD NO.1128 dated 21‐04‐2010 2. FMO Dr Farzana Soomro at MCH Shahdadkot carried out delivery of a women who gave birth to 3 children,

during the month of April, 2010. Date /Time for Next MRM: 08 June, 2010. 09.00 am Comments on Targets vs. Achievements (by DSM)

R&R work of 4 ongoing HFs completed. Work on remaining HFs started.

54

MINUTES OF THE (17th) MONTHLY REVIEW MEETING OF DISTRICT_KASHMORE @ KANDHKOT

Monthly Review Meeting (MRM) of District, Kashmore @ KandhKot for the Month of April 2010 was held on 07‐05‐2010 at 10:00am at District Government Complex KandhKot. Written invitations to participate were sent to the District Administrator/DCO, the EDO(H), the EDO(F&P) and District Incharge of EPI, LHW, T.B DOTs and all other National Programs as usual. The list of participants is enclosed.


1 Mr. Aijaz Ali Agha DSM, DSU Kashmore

2 Mr.Naveed Akhtar Siyal Executive Officer (M&E), DSU Kashmore

3 Mr. Naeem Ahmed Channa Executive Officer (A/A), DSU Kashmore

3 Mr. Ayaz Hussain Pathan Assistant (A/A ), DSU Kashmore

4 Mr. Mehmood Ali Roongho Sub‐ Engr. 5 Mr.Israr Ahmed Malik SM DSU Kashmore 6 Mr. Jamal‐ul‐Din, SM DSU Kashmore 7 Mr. Khalid Hussian SM, DSU Kashmore

8 Mr. Ghulam Muhamad Shaikh Assistant Admin / Computer/ General

9 Dr. Zain Mailk MO PPHI

10 Dr. Mansoor Ahmed Channa MO PPHI 11 Dr. Irshad Ahmed MO PPHI 12 Dr. Mohammad Ishaque Malik MO PPHI 13 Dr. Hafizullah Bahlkani MO PPHI 14 Dr. Mansoor Malik MO PPHI 15 Dr. Shagufta Gull MO PPHI 16 Dr. Mohammad Saleem Khoso MO PPHI 17 Dr. Rehana Qadir FMO PPHI 18 Dr. Basheer Ahmed MO PPHI 19 Dr. Mohammad Yasir MO PPHI 20 Dr. Zulifqar Soomro MO PPHI 21 Dr. Aftab Ahmed Soomro MO PPHI 22 Dr. M Bashart Mangi MO PPHI 23 Dr. Mushtaq Soomro MO Govt 24 Dr. Zubair Soomro 25 Dr. Maqbool Ahmed MO Govt 26 Dr.Rukhsana Baloch FMO PPHI 27 Dr. Misbah Ambreen Shaikh FMO PPHI 28 Dr. Aneel Kumar MO PPHI 29 Dr Shumaila Rasool FMO PPHI 30 Dr. Noor‐u‐Din MO Govt 31 Ms. Naik Bakhat Khoso LHV PPHI 32 Dr. Mumtaz Malik FMO PPHI 33 Mr. Abdul Khalique MT PPHI 34 Dr. Sumeera Soomro FMO PPHI 35 Mr. Abdul Samand Hyder MT 36 Dr. Pir Bux Kalwar MO Govt 37 Mr. Shams u Din Khoso MT PPHI 38 Mr. Rabnawaz MT 39 Mr. Badar‐u‐ Din Hyder MT 40 Dr. Shushela Mihindar 41 Mr. Mohammad Hanif MT Govt 42 Dr. Ayaz Hussain MNCH (WHO) 43 Dr. Nirmal Rep EDO Health 44 Dr. Naseem Liaqat FMO Govt 45 Dr. Waris Bhutto FMO PPHI 46 Dr. Faiq Ali Bijarani FMO PPHI 47 Dr. Fozia Faiq Ali FMO PPHI 48 Dr. Barath Lal Dist: TB Programme 49 Dr. Farzana Baloch FMO PPHI Larkana 50 Dr. Gulab‐u‐Din MO PPHI 50 Dr. M. Idress MO (H/Q)


S # Names Reasons for absence 1 Dr. Ghulam Murtza Silerro PPHI C/L

E. HFs WITH PPHI


TOTAL: 40

55

B. Population of the Catchment Area: 8, 11777

M. STAFF STRENGTH

Sanctioned Posts


PPHI Contract

Vacant

DG PPHI DG PPHI

MOs 32 30 6 24 26 6 W/FMOs 07 22 3 8 4 14 LHVs 7 14 0 3 7 11 MTs/MAs 14 14 26 6 Dispensers

48 21 2 6 4 0

N. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO


1. First Session: During MRM Dr. Aijaz Ali Agha “DSM”

Dr. Aijaz Ali Agha DSM PPHI, Kashmore first of all introduced himself and gave a power point presentation

on eight principles of primary Healthcare. Doctor Sb started his presentation with following definition and briefed the audience about many important points of Primary Healthcare .He presented following definition of Primary Healthcare "Primary Health Care is essential health care based on practical, scientifically sound and socially acceptable methods and technology, made universally accessible to individuals and families in the community through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self‐reliance and self‐determination. The participant Male and Female Doctors asked questions and the session remain very interesting

Previous Month Month under Review Total at Present Clusters of 6 HFs Clusters of 6 HFs No Clusters of 5 HFs Clusters of 5 HFs No Clusters of 4 HFs Clusters of 4 HFs No Clusters of 3 HFs Clusters of 3 HFs No Clusters of 2 HFs 5 Clusters of 2 HFs 6 Single HFs 22 Single HFs 20

Previous Month Month under Review Total at Present Clusters of 5 HFs Clusters of 5 HFs No Clusters of 4 HFs Clusters of 4 HFs No Clusters of 3 HFs 3 Clusters of 3 HFs 2 Clusters of 2 HFs 2 Clusters of 2 HFs 4 Single HFs 4 Single HFs 4

56

Second Session: During MRM Dr. Noor Din Dr. Noor Din Daud potao I/C MO BHU Dari and District Focal Person of HIMS and EPI delivered. A message ful lecture on tools of HIMS. He taught new MOs and FMOs how to fill HIMS report .An interesting session was endeded with remarks of Dr. Maqbool Ahmed Baglani, Dr. Veena Dara, Dr. Bisharat Mangi and Dr. Nirmal Kumar of EDO (H) office. 2. Third Session: During MRM Dr. Farzana Baloch For the first time a guest speaker was called from DSU larkana Dr. Farzana Baloch FMO, PPHI larkna was specially called in capacity Building session. She delivered lecture on Birth Asphyxia. All participates listened her patiently and appreciated her a lot. After lecture and during lecture young MOs and FMOs asked questions and whole session remained interactive. 3. Fourth Session: During MRM Dr. Bhart Lal Dr. Bhart Lal District Coordinator TB Dots Programme stressed on I/C MOs to strengthen referral system by sending patients at diagnostic centers. We have made all facilities available at RHCs, THQs and some BHUs also staff has been trained and necessary material and equipments have also been provided. During Session it was decided that a new TB Diagnostic centre will be established at BHU Khewali DSM, PPHI assured the District coordinator TB Programme to provide all possible martial support for establishment of TB centre at BHU Kewali. F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered in Children at Health Facilities. ‐‐‐ No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. ‐‐‐ No. of Immunization & Vaccination Administered by out‐ reach EPI Teams ‐‐‐‐ Total vaccination / immunization for the month February ‐‐‐‐‐



26 ‐27 & 28 April 2010 145,560 2,00611 156% 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides No 2 Active Case Detection (ACD) Slides No 3 Visits to Check Sanitation (individual house holds + streets) No 4 Notices issued against Poor Sanitation No 5 Challans sent to Court against Poor Sanitation No 6 Patients Nebulized No

57


1. Female Health


S # Service Number 1 Deliveries Assisted at HFs 23 2 Deliveries Assisted at homes No


S # Test Number 1 Pregnancy Tests 219 2 Blood Sugar Tests 109 3 Hemoglobin Tests No 4 Ultra Sound Test 393 5 Other No

13. Important Discussion MRM

Executive Officer (M&E) Naveed Akhtar introduced new DSM Dr. Aijaz Ali Agha to all participants and all participants introduced them to new DSM some doctors raised their problems and DSM Sb listened them and assured them quick redressal. He asked the MOs of all BRHF’s to come forward and join hands with PPHI Monitoring Team and make their BRHF’s up to mark. He said that we have purchased all required equipments, furniture items and other necessary martial which is needed at BRHF’s. He asked all MOs to collect all missing items or submit requests and our team will supply at earliest. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number Consultation / Advice 98 Oral Pills 322 IUCDs 900 Injections 100 Others 130

Total 1550


Neo‐Natal Cases

Other OPD Total OPD

1 Dr.Veena Darra 275 10 100 1632 2 Dr.Naseem Liquat 100 5 238 1161 3 Dr.Mumtaz Malik 11 0 0 450 4 Dr.Sumeera Soomro 265 0 0 1198 5 Dr.MisbahAmbreen Shaikh 121 7 121 519 6 Dr.Sajda Gul 0 0 0 0 7 Dr.Rukhsana Baloch 40 4 48 458 8 Dr. Fozia Faiq Ali 16 9 0 367

58




conducted by him CHSs/ SHSs arranged by him

No. No. of Participants No. No. of Participants

Mr. Jaml‐u‐Din 19 300 45 409

Mr. Khalid Ahmed Langha 12 290 38 397

Mr. Israr Ahmed Malik 10 220 35 417




Children Treated

Dr.Sajida Gul 0 0 0 0 0 Dr. Misbah Ambreen 2 58 0 No No Dr. Basharat Mangi 2 89 3 34 12 Dr.Irshad Langh 2 52 3 31 15 Dr. Mohammad Saleem Khoso 2 60 3 25 12 Dr.Mushfaq Soomro 2 50 2 34 08 Dr.Jawhar Lal 2 72 1 20 15 Dr.Mansoor Channo 2 55 2 32 7 Dr.Abdul Ghafoor Soomro 2 57 2 43 15 Dr. Zain Malik 2 60 2 32 10 Dr.Mohammad Ishaq Malik 2 52 2 34 17 Dr.Mansoor Malik 2 58 2 25 10 Dr.Zulfiqar Soomro 2 64 2 34 15 Dr. Hafizullah Banglani 2 70 2 32 18 Dr. Faiq Ali Bijrani 1 68 2 35 22 Dr.Maqbool Ahmed 2 55 1 41 23 Dr. M Muqeem Khoso 2 88 2 34 14 Dr. Basheer Ahmed 2 90 2 23 12 Dr. Yasir Ahmed 2 72 2 22 13 Dr. Aneel Kumar 1 52 2 28 12 Dr. Mumtaz Malik 2 60 2 25 6 Dr. Fozia Faiq Ali 2 88 0 22 6 Dr. Pir Bux Kalwar 2 65 0 25 7 Dr. Noor‐u‐Din 2 50 2 41 0 Dr. Aftab Ahmed 2 64 3 24 12 Dr. Ghulam murtza 2 52 2 18 15 Dr. Naseem Liaqat 2 60 0 0 0

59

Dr. Susheela Mendar 2 54 0 0 0 Dr. Veena Dara 1 79 0 0 0 Dr. Ruksana Baloch 2 74 2 37 10 Dr. Jabbar Malik 2 65 2 45 20 Dr. Waris Bhutto 1 45 2 43 32 Dr. Gulab‐u‐ Din 2 69 3 54 22 Dr. Javeed Ali Sundrani 1 81 2 43 30 Total 61 2128 57 936 410

4. Important Points during Support Group Meetings. Some members of CSGs also participated in the meeting and stress was laid on their role in R&R work. Community was specially requested to take keen interest in R&R work, by providing labour and procurement of material at economical rates. 5. Important Points during SHSs The children were lectured regarding their personal health and Hygiene. Use the dustbins at their homes and schools. They were told about the health facilities available at the nearest health facility. The use of vegetables and fruits was also focused. 6. Important Points during CHSs Participants were guided that during the polio campaign they should cooperate with the teams and support in vaccination and immunization process at their villages. They were guided regarding their personal health and Hygiene. Doctors shared the facilities available at the nearest health facility to that community. The use of vegetables and fruits was also focused. 7. Topics for SHSs for the Month

Sr. No. Topics 1 Health & Hygiene 2 Scabies 3 Immunization 4 Diarhea 5 Water born diseases 6 Malaria 7 T.B


S # Topics 1 Health & Hygiene 2 Scabies 3 Immunization 4 Diarhea 5 Advantages of Family planning 6 Malaria, its causes, effects , and remedies 7 T.B

9. Important Discussion on Community Participation during MRM It was decided that CHS/SHS will be conduct frequently to mobilize community regarding health issues. 10. Health Camps: No any Health Camps were arranged

60


Sr No Description Recommendation To whom sent Present status i Sanitation No No No ii Drainage / sewerage iii ……… drinking water No No No iv Prevention of

adulteration

v Tree Plantation No No No vi Roads and infrastructure vii Environmental

Improvement No No No

viii Others No No No





36404 ‐

32867


S # BHU OPD BHU OPD 1

MCHC Kashmore 2358

GD‐ Mushtaque Bijarani 70 2

3. Top Five Diseases Treated during School Health Sessions/Camps 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 Scabies 11754 2 Diarrhea 2451 3 Anemia 34 4 Malaria 5487 5 ARI 25

S # Diseases No. of Patients 1 Scabies 705

2 Diarrhea 541

3 Anemia 74 4 Malaria 854 5 ARI 54

61


No. of Patients Dog bite cases reported 67 ARV Administered 10 ARV Available Doses 160 Snake bite cases reported 9





S # Tests Number 1 Blood Sugar Tests 109 2 Hemoglobin 0 3 X‐Rays (if available) No 4 Ultra Sound 393 5 Others (please specify) No






Follow up result

Hepatitis B

No No No

No No

Hepatitis C

No No No

No No

20. TUBERCLOSIS



Under Diagnosis

No No No




40 76 136 252


1. Medicines available for: 86 Weeks

62


S # Name of



1 MCHC Kashmore Completed 2 BHU Sher Muhammad Bijarani Completed 3 BHU Pir Jan Bajkani Completed 4 GD Ghous Bux Bangwar Completed 5 GD Kashmore Colony‐I Completed 6 GD Nasrullah Bijarani Completed 7 BHU Gullanpur Completed 8 GD Mehrab Mazari Completed 9 BHU Khewali Completed 10 BHU Dari Completed 11 GD Sardaroo Khoso Completed

12 BHU Sardarbabad

Completed

Revised Scheme approved and work has been started to be complete very soon

13 BHU M.K Mazari Completed 14 BHU Diyani Completed 15 BHU Badani Completed 16 BHU Din Muhammad Kosh Completed 17 MCHC Kandhkot Work not started

J‐ DISCUSSION DURING MRM Date /Time for Next MRM: June 08, 2010, 11.00 am Comments on Targets vs Achievements (by DSM) DSM presented presentation on over all Progress for the month of April, particularly focused per patient cost and emphasis to control per patient cost. He also told the participants Repair and renovation of four BHUs Namely BHU Abdul Qadir Bhayo BHU Saeed Khan Rind , BHU Ghulam Sarwar Sarki BHU Jahan Khan Bangwar has been completed and R&R work at 7 more BHUs is in progress and hopefully will be completed by the end of May 2010. He also told that more Male and female Medical officers will be appointed to enhance medical cover at all BHUs. Further he also assured the participants to solve their all problems at earliest. Meeting ended with vote of thanks to and from chair.

63

MINUTES OF THE 29th MONTHLY REVIEW MEETING OF DISTRICT KHAIRPUR

Monthly Review Meeting (MRM) of District, Khairpur for the Month of April, 2010 was held on 7 April, 2010 at Naz Pilot Secondary School Khairpur. Written invitations to participate were sent to the DCO, the EDO (H), the EDO(F&P), EDO(CDD), District Population Welfare Officer, Taluka Health Officer(s) (all), District Coordinator National Program Khairpur, District Focal Person EPI, District Focal Person TB, District Coordinator, Malaria Control Program, NMO (WHO), District Coordinator PAIMAN, and District Coordinator JSI, PAIMAN as usual. The list of participants is enclosed.

S. No.

Name Designation S. No.

Name Designation

1 Mr. Maqsood Ahmed Baloch DSM 52 Dr Zafar Hussain MO / IC 2 Dr. M.Baqar Yousif DSO 53 Dr. Ghulam Murtaza Rajar MO / IC 3 Mr. Abdul Sattar Dy. D.O 54 Dr. Ghulam Haider Phul MO / IC 4 Ghulam Hussain Sales Officer 55 Dr. Parvez Iqbal Shaikh MO / IC 5 Mr. Riaz Dogar Asstt. Prof. 56 Dr. Khalique Dino MO / IC 6 Dr. Aman ullah D.S.C 57 Dr. Ghulam Murtaza Bugti MO / IC 7 Dr. Ghulam Muhammad DDSO 58 Dr. Ghulam Mustafa Shaikh MO / IC 8 Dr. Zulfiqar Dharejo R.Coordinator 59 Dr. Ghulam Rasool MO / IC 9 Mr. Javed Ahmed Memon Dy. DPWO 60 Dr. Rafique Ahmed MO / IC 10 Mr. Abid Ali Shah Member, CDC 61 Dr. Ihsan solangi MO / IC 11 Mr. Muhammad Ilyas Sahto EO (M&E) 62 Dr. Javed Memon MO / IC 12 Mr. Safdar Ali Bhatti EO (M&E) 63 Dr. Javeed Soomro MO / IC 13 Mr. Athar Khalique Shar Exe‐ F&A 64 Dr. M. Juman Sahito MO / IC 14 Dr. Asif Hussain Khaskheli MO(HQ) 65 Dr. Kamran Rasool MO / IC 15 Mr. Abid Ali Shah Member, CDC 67 Dr. Karam Abbas MO / IC 16 Mr. Muhammad Ibrahim SO 68 Dr. Khalid Memon MO / IC 17 Mr. Akhtar Khaskheli SO 69 Dr. Khalid Sahito MO / IC 18 Mr. Abdul Rehman Shar SO 70 Dr. Khalid Javed Awan MO / IC 19 Mr. Ayaz Meerani SO 71 Dr. M. Aslam Baloch MO / IC 20 Dr. Abdul Hameed shaikh MO / IC 72 Dr. Mir Iqbal Talpur MO / IC 21 Dr. Muhmmad Azam MO / IC 73 Dr. Mir Sarfraz Ali Talpur MO / IC 22 Dr. Abdul Qayoom Memon MO / IC 74 Dr. Muhamad Panah MO / IC 23 Dr. Abdul Munam Shar MO / IC 75 Dr. Habibullah MO / IC 24 Dr Suhail Ahmed Memon MO / IC 76 Dr. Ghulam Safdar Lakho MO / IC 25 Dr. Abdul Karim MO / IC 77 Dr. Mohammad Ramzan MO / IC 26 Dr. Ali Muhammad MO / IC 78 Dr. Nazeer Ahmed MO / IC 27 Dr. Ghulam Asghar MO / IC 79 Dr. Nizam uddin Bozdar MO / IC 28 Dr. Aijaz Ali Solangi MO / IC 80 Dr. Nazeer Ahmed Shaikh MO / IC 29 Dr. Abdul Qadir MO / IC 81 Dr. Niaz Hussain Palh MO / IC 30 Dr. Asif Ali Khaskheli MO / IC 82 Dr. Niaz Wassan MO / IC 31 Dr. Abdul Rasheed Abasi MO / IC 83 Dr. Noor Ahmed Banbhan MO / IC 32 Dr. Abdul Rouf Shaikh MO / IC 84 Dr. Noor Din Abro MO / IC 33 Dr. Abdul Waheed Abassi MO / IC 85 Dr. Munir Ahmed MO / IC 34 Dr. Akhter Ali Khuhro MO / IC 86 Dr. Rab Dino MO / IC 35 Dr. Abdul Razaque Chang MO / IC 87 Dr. Rahim Bux Rind MO / IC

64

36 Dr. Ali Sher Metlo MO / IC 88 Dr. Ramesh Kumar MO / IC 37 Dr. Anwar Illahi Sahito MO / IC 89 Dr. Kundan Dass MO / IC 38 Dr. Atta Hussain Nareejo MO / IC 90 Dr. Safiullah Memon MO / IC 39 Dr. Atta Muhammad Memon MO / IC 91 Dr. Saifullah Bughti MO / IC 40 Dr. Ayaz Ali Mirani MO / IC 92 Dr. Sayed Hashim Ali Shah MO / IC 41 Dr. Ayaz Ali Chandio MO / IC 93 Dr. Seed Ahmed MO / IC 42 Dr. Ghulam Murtaza Shar MO / IC 94 Dr. Shafique Ahmed MO / IC 43 Dr. Nek Muhammad MO / IC 95 Dr. Zafar Hussain MO / IC 44 Dr. Bagh Ali Bozdar MO / IC 96 Dr. Washo Mal MO / IC 45 Dr. Falak Sher Sahto MO / IC 97 Dr.Waris Kubar MO / IC 46 Dr. Farhan Ahmed MO / IC 98 Dr. Shafiq Rehman MO / IC 47 Dr. Abdul Ahad Mahesar MO / IC 99 Dr. Ehsanullah Channa MO / IC 48 Dr. Fayaz Memon MO / IC 100 Dr. Sheeraz Ali MO / IC 49 Dr. Gada Hussain MO / IC 101 Dr. Gulam Murtaza Rajper MO / IC 50 Dr. G.Mujtaba Memon MO / IC 102 Dr. Lal Bux Rajper MO / IC 51 Dr. G.Shabbir Mirani MO / IC 103 Dr. Ghulam Shabir Rajper MO / IC

S. No.

Name Designation S. No.

Name Designation

1 Farzana Khatoon Kanhar FMO 19 Roshan Begum FMO 2 Ghazala Lashari FMO 20 Rozeena Soomro FMO 3 Hameeda Rajper FMO 21 Shazia Shaikh FMO 4 Irshad Begam FMO 22 Rubeena Begam FMO 5 Khadija Soomro FMO 23 Rukhsna Soho FMO 6 Lal Khatoon FMO 24 Saba Memon FMO 7 Maryam Shaikh FMO 25 Dr. Samina Chana FMO 8 Nadia Sharaf Danwar FMO 26 Samina Shaikh FMO 9 Naseem Dhareejo FMO 27 Sanobar Soomro FMO 10 Khadija Soomro FMO 28 Shabiran Mari FMO 11 Naseema Imtiaz FMO 29 Shabnum Phull FMO 12 Nusrat Memon FMO 30 Shamshad FMO 13 Nusrat Wassan FMO 31 Firdous Ara FMO 14 Rehana Zulfikar FMO 32 Tanveer Fatima FMO 15 Zainab Bozdar FMO 33 Zeenat‐u‐Nisa FMO 16 Aisha Kango FMO 34 Asifa Khuwaja FMO 17 Fakhrunisa Bhambhro FMO 35 Fazana Keerio FMO 18 Naheed Akhtar FMO 36 Naila Soomro FMO


S # Names Reasons for absence 1 Dr. Ali Qasim Jaffiri Absent without information‐Explanation Issued 2 Dr. Adul Shakoor Absent without information‐Explanation Issued 3 Dr. Ayaz Shaikh Absent without information‐Explanation Issued 4 Dr. Azhar Din Arejo Absent without information‐Explanation Issued 5 Dr. Ghulam Ali Absent without information‐Explanation Issued 6 Dr. Ghulam Hussain Absent without information‐Explanation Issued 7 Dr. Hakim Ali Solangi Absent without information‐Explanation Issued 8 Dr. Nazeer Ahmed Shaikh Absent without information‐Explanation Issued

65

9 Dr. Ghulam Akbar Absent without information‐Explanation Issued 10 Dr. Sanaullah Bherejo Absent without information‐Explanation Issued 11 Dr. Mumtaz Ali Wassan Absent without information‐Explanation Issued 12 Dr. Muhammad Fazal Ahmed Absent without information‐Explanation Issued 13 Dr. M Ali Sikandar Absent without information‐Explanation Issued 14 Dr. Mumtaz Shaikh Absent without information‐Explanation Issued 15 Dr. Arif Ali Absent without information‐Explanation Issued 16 Dr. Syed Ashique Ali Absent without information‐Explanation Issued 17 Dr. Asma Shaikh Absent without information‐Explanation Issued 18 Dr. Farzana Keerio Absent without information‐Explanation Issued 19 Dr. Ghazala Absent without information‐Explanation Issued 20 Dr. Samina Shaikh Absent without information‐Explanation Issued 21 Dr. Sanobar Absent without information‐Explanation Issued 22 Dr. Shabnam Absent without information‐Explanation Issued 23 Dr. Naheed Absent without information‐Explanation Issued 24 Dr. Naseema Absent without information‐Explanation Issued 25 Dr. Reena Absent without information‐Explanation Issued 26 Dr. Zahida Soomro Absent without information‐Explanation Issued 27 Dr. Zainab Absent without information‐Explanation Issued

F. HFs WITH PPHI


TOTAL: 104 B. Population of the Catchment Area:

O. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 100 27 73 W/FMOs 49 3 46 LHVs 33 11 21

Male ‐‐ ‐‐‐ ‐‐ MTs/MAs

Female ‐‐ ‐‐ ‐‐ Dispensers 143 115 28

P. CLUSTERS OF HFs

WITH ONE MO


Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs Single HFs 95 Single HFs 95

66

WITH ONE FMO


Mr./Dr. Ghulam Muhamad Shaikh (DO.DHIS)in his lecture on Proper Use Of DHIS Material focused on the following points:‐

Importance of Data - Use of DHIS Performa - Common errors in DHIS Performa - Introduction of new charts - Analysis of Data - Data collection 2. Second Session: During MRM Mr./Dr. Baqar Jatoi Focal Person for EPI, District Khairpur in his lecture Importance of EPI and Role of PPHI focused on the following points:‐ - EPI and Immunization in Khairpur - Reporting from BHU side - Role of PPHI in routine immunization - Responsibilities of I/C of BRHF - EPI current situation in Sindh and Khairpur



Date

Venue

Topic No. of

Participants

Dr. Kalsoom Azad Lashari 29‐04‐2010 Zila Council Hall ANC & PNC 22

F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered in Children at Health Facilities.

2068

No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities.

1241

No. of Immunization & Vaccination Administered by out‐ reach EPI Teams

Not Available

Total vaccination / immunization for the month April 2010

3309


Clusters of 5 HFs Clusters of 5 HFs 0 Clusters of 4 HFs 1 Clusters of 4 HFs 1 Clusters of 3 HFs 13 Clusters of 3 HFs 8 Clusters of 2 HFs 24 Clusters of 2 HFs 30 Single HFs 5 Single HFs 1

67



19,20,21 100% NA 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides NA 2 Active Case Detection (ACD) Slides NA 3 Visits to Check Sanitation (individual house holds + streets) NA 4 Notices issued against Poor Sanitation NA 5 Challans sent to Court against Poor Sanitation NA 6 Patients Nebulized NA




Neo‐Natal Cases

Other OPD

Total OPD

1 Dr. Asma Shaikh 09 0 526 535 2 Dr. Shabnaum Phull 8 0 277 285 3 Dr. Afsheen 34 0 984 1021 4 Dr. Nusrat Memon 27 2 862 891 5 Dr. Samina Shaikh 21 6 670 518 6 Dr. Rehana Zulifqar 12 4 501 686 7 Dr. Khadija Zulfqar 38 0 1347 1385 8 Dr. Lal Khatoon 99 18 809 926 9 Dr. Nadia Sharaf 25 0 908 933 10 Dr. Naila Soomro 42 0 742 784 11 Dr. Farzana Kanhar 122 59 878 1045 12 Dr. Rozina Soomro 42 0 537 579 13 Dr. Sanobar Soomro 40 0 624 664 14 Dr. Maryam Shaikh 34 1 765 800 15 Dr. Saba Memon 22 0 461 483 16 Dr. Roshan Begum 51 0 959 1010 17 Dr. Sobia Memon 24 0 687 711 18 Dr. Naseema Imtiaz 48 0 1676 1724 19 Dr Aalia 23 0 20 Dr. Naseem Dharejo 121 4 1048 1169 21 Dr. Samana Syal 3 0 107 110 22 Dr. Shamshad 22 30 1292 1314 23 Dr. Zeenat U Nisa 35 0 969 1004 24 Dr. Naheed On leave 25 Dr. Farzana Keerio 31 0 810 841

68

26 Dr. Tanweer Fatima 45 0 379 424 27 Dr. Rukhsana Sohu 28 Dr. Gazala Lashari 112 30 688 830 30 Dr. Zenab Bozdar 51 20 856 927 31 Dr. Nusrat Wassan 32 Dr. Irshad Begum 103 7 1702 1812 33 Dr. Shabiran Mari 15 0 556 571 34 Dr. Rubina Begum 32 0 408 440 35 Dr. Hamida Rajpar 33 1 1095 1129 36 Dr. Fakhur u Nisa 880 23 747 1650 37 Dr. Reena Kumari 507 7 293 807 38 Dr. Shazia Qayyum 0 0 0 0 39 Dr Samina Channa 334 5 74 40 Dr Hamida Rajar




15. Important Discussion on Mother and Child and Reproductive Health during MRM It was shared Family Planning material still not provided and the same will be delivered to HFs as soon as received at DSU from the department, and at MCHC and Maternity Home gynae related medicines should be provided and family planning martial in adequate number. 16. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number 1 Consultation / Advice 855 2 Oral Pills 24612 3 IUCDs 0 4 Injections 498 Others 4982

Total 30947

S # Test Number

1 Pregnancy Tests. 688 2 Blood Sugar Tests. 474 3 Hemoglobin Tests. 0 4 Ultra Sound Test. 2589 5 Other. 0

69


1. Number of Male CSGs: 95 Number of female SGs: 00 2. Performance of Social Organizers



No. No. of

Participants No.

No. of Participants

Sanaulla Mangi 11 98 0 0 Muhammad Ibraheem 8 70 0 0 Abudul Rahman 9 88 0 0 Akhtar Hussain 9 92 0 0 Ayaz Hussain Mirani 10 105 0 0 Muhammad Ilyas Tumrani 7 65 0 0


Community Health Sessions School Health Sessions S No.

Names of MO / FMOs/

Paramedics Sessions Participants Sessions

Children Examined

Children Treated

1 Dr. Asma Shaikh 3 23 1 10 8 2 Dr. Shabnaum Phull 2 30 1 10 5 3 Dr. Afsheen 0 0 0 0 0 4 Dr. Nusrat Memon 2 35 1 5 5 5 Dr. Samina Shaikh 0 0 0 0 0 6 Dr. Rehana Zulifqar 1 20 1 16 0 7 Dr. Khadija 3 7 1 6 0 8 Dr. Lal Khatoon 2 22 2 38 0 9 Dr. Nadia Sharaf 3 61 0 0 0 10 Dr. Naila Soomro 0 0 0 0 0 11 Dr. Farzana Kanhar 1 20 1 200 41 12 Dr Rozina Soomro 4 47 1 10 0 13 Dr Sanobar Soomro 3 33 1 20 7 14 Dr Maryam Shaikh 3 61 1 0 0 15 Dr Saba Memon 2 23 1 14 10 16 Dr Roshan Begum 3 48 1 14 0 17 Dr Sobia Memon 2 24 2 36 5 18 Dr Naseema Imtiaz 3 63 1 0 0 19 Dr. Samina Channa 0 0 0 0 0 20 Dr Naseem Dharejo 4 73 1 37 7 21 Dr Samana Syal 3 22 1 16 0 22 Dr Shamshad 2 35 1 3 0 23 Dr Zeenat U Nisa 3 37 1 12 6 24 Dr Naheed 2 31 1 7 0 25 Dr Farzana Keerio 2 40 1 3 0 26 Dr Tanweer Fatima 0 0 0 0 0 27 Dr Gazala Lashari 3 128 1 20 0

70

28 Dr Nusrat Wassan 3 32 1 0 0 29 Dr Zenab Bozdar 2 17 1 13 0 30 Dr Irshad Begum 3 33 1 10 10 31 Dr Shabiran Mari 3 32 1 20 2 32 Dr Rubina Begum 3 45 1 40 0 33 Dr Hamida Rajpar‐I 3 51 0 0 0 34 Dr Hamida Rajper‐II 0 0 0 0 0 35 Dr Rukhsana Sohu 1 7 1 6 2 36 Dr Fakhur u Nisa 3 44 1 8 0 37 Dr. Reena Kumari 0 0 0 0 0 38 Dr. Shazia Qayyum 0 0 0 0 0 39 Dr. Reeta 0 0 0 0 0 40 Dr. Suneeta 0 0 0 0 0 41 Dr. Rukhsana Malik 2 27 2 21 15 42 Dr. Aalia 0 0 0 0 0 43 Dr. Aasifa 1 25 0 0 0 44 Dr. Aisha Kango 0 0 0 0 0 Total 89 1396 33 599 134


- Shortage of Family Planning Medicines at BRHFs. - Postings of Chokidars andSanitary Workers of locality - Repair and Renovation of BRHFs - Shortage of ARV at BRHFs.


- Female Medical Officer(s) shared with he students and teachers about the preventive measures of local diseases and also shared the signs and symptoms of different diseases.


- Medical Officers andFemale Medical Officer(s) shared the preventive measures to be taken inside the house and village to prevent themselves from different diseases.

- They Shared the signs and symptoms of different diseases and guided them to take the treatment at its earlier stage


Sr. No. Topics 1 Diarrha 2 Malaria 3 Skin Diseases 4 ARI


S # Topics 1 Malaria 2 ARI 3 Blood Pressure

71

9. Important Discussion on Community Participation during MRM - Holding of regular Community Support Groups and low attendance at meeting at BRHFs - Involvement of community in BRHFs issues and R&R. - Support from community member in holding Community Health Sessions and SHS. - Holding of Taluka Level Community Support Groups Meetings

10. Health Camps: Number Held: Nil Number of Patients: Nil 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation NIL Ii Drainage / sewerage NIL iii ……… drinking water NIL Iv Prevention of

adulteration NIL

V Tree Plantation NIL Vi Roads and infrastructure NIL vii Environmental

Improvement NIL

viii Others NIL





(New + Old) 151516 4143 155659


S # BHU OPD BHU OPD 1 BHU Akri 3381 BHU Pir Bux Gaho 618 2 BHU Rahooja 3378 BHU Tajjal Sharif 639

3 BHU Hindyari 3087 BHU Tando Mir Karam Khan 737 4 BHU Machyoon Wada 2914 BHU Kathore 826 5 BHU Kolab Jeal 2883 BHU Khaush Kher Muhammad 919


S # Diseases No. of Patients 1 Skin Diseases 37 2 Diarrhea 33 3 ARI 32 4 Malaria 26 5 Dental Care 6

72


S # Disease No. of Patients 1 ARI 23187 2 Scabies 14678 3 Fever (Clinical Malaria) 17147 4 Fever for other causes 11974 5 Diahrea 8306


No. of Patients



ARV Available Doses 552 vials Snake bite cases reported 10 ASV Vaccine Administered 21

ASV Vaccine Available Doses 15 22. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)


S # Tests Number 1 Blood Sugar Tests 476 2 Hemoglobin 56 3 X‐Rays (if available) Nil 4 Ultra Sound 2589 5 Others (please specify) 688(P.T)






Follow up

result Hepatitis B NA Hepatitis C NA

24. TUBERCLOSIS



Under Diagnosis

93 Nil 18 9. Referrals



13 6 77 28 53 15

73


S.No Totals Cases Referred from ARV ASV Others RHCs THQs DHQs

1 0 0 0 0 0 0 0




68 71 346 485 2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 01 BHU Khalifo Huryah Delay in R&R Dr was issued explanation

02 GD Auteri Theft of Fans CSG meetings called, community

assured of return


1. Medicines available for: 14 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

- Supply of medicine after office hours and shaort supply - Submission of timely medicine requisitions by Incharge Medical Officer. - Supply of Gynee Medicines at MCHS and Haternity Homes


S # Name of HFs


Status / Remarks

01 BHUSadarJi Bhatyoon 100%

02 BHU Kot Mir Muh: 100% 03 BHU Therhi 100% 04 BHU Long Fakir 100%

05 GDAllah Bux Katohar 100%

06 BHU Jiskani 100%

07 BHU Nawab Wassan 100%

08 BHU Rahooja 100%

09 BHU Bahar Larik 100%

10 BHU GD Nihal Khan 100%

11 GD Ali Hyder Jalbani 100%

12 GD Siming 100%

13 BHU Gagri 100%

74

14 BHU Babar Wada 100%

15 BHU Pir Mangio 100%

16 GD Razi Goth 100%

17 Gd Mitho Maree 100%

18 BHU Bago Daro 100%

19 GD Manghi Khan Katohar 100%

20 GD Murad Gopang 100%

21 BHU New Goth Sahito 100%

22 BHU Amir Ali Shah 100%

23 BHU Manghan wari 100%

24 BHU Bhelar wada 100%

25 BHU Dhoro 100%

26 BHU Mithri 100%

27 BHU Tando Masti 100%

28 BHU Dubi 100%

29 BHU Tando Nazar ali 100%

30 BHU Layari 100%

31 BHU Kolab Jial 100% 32 BHU Kharrah 100% 33 BHU Tarko 100%

34 GD Deparja 100%

35 BHU Sami 100%

36 BHU Hindyari 75%

37 BHU Imam Bux Palh 90% 38 BHU Bago Maitlo 80% 39 BHU Machayoon Wada 100%

40 GD sutiayaro 100%

41 BHU Mehasar Wada 95%

42 GD Gabar Metilo 100%

43 BHU Kabir khan Siyal 95%

44 BHU Hadal Shah 95%

45 BHU Khalifo Hurya 75%

46 MCHC Chowndiko 80%

47 GD Talpur Wada 80%

48 BHU Rukrani 60%

49 BHU Razal Memon 95%

50 GD Mangho Fakir Shar 60%

51 BHU Karam Ali Lashari 75%

52 BHU Jan Muhammad Wandyar 80%

75


- Excess leave of staff. - Over and under staffing at BRHFs - Absence in MRM - Submission of Requisition of Medicines and Submission of report to DSU in time.


- Conduction of community and school health sessions. - Active Participation and Cooperation with other National Program Staff.

On Curative Health:

- Medicine supply according to requisition. On Mother, Child & Reproductive Health:

- Shortage of Family Planning Material, DSM informed that requisition has been sent to Family Welfare Department and same would be supplied as soon as received.

- DSM informed that orders are placed for purchased of equipments and furniture for Labor rooms to be established at BHUs and same are still not supplied to DSU.

- HCHC will be converted into 24 hours. Other Matters:

- Issues pertaining to timely submission of HMIS Reports - Maintenance of Record and fictionalization of public toilets. - Fixing of Boards / Charts at BRHFs at proper place provided by PPHI.

Date /Time for Next MRM: To be fixed Comments on Targets vs. Achievements (by DSM) DSM gave detailed presentation to the audience. He informed them that at all HFs of district MOs are posted which makes 100% coverage, where as, 44 FMOs are posted in a cluster of 1 HF/2 HF( 95% coverage). Additionally, 02 Sonologists are providing free ultra sound facilities at 24 HFs. The medicine was supplied to all HFs in the reporting month. The total OPD of the district for the reporting month was 1,55,659. Out of 95 notified CSGs, the meetings were held at 54 HFs. A total of 89 community health sessions and 33 school health sessions were conducted in the reporting month. An effective coordination was ensured with focal persons of all vertical programmes. The purchase orders have been placed for procurement of furniture and equipment. As for as R&R work is concerned, 38 schemes have been completed and 18 schemes are in progress.

76

MINUTES OF THE (22nd) MONTHLY REVIEW MEETING

OF DISTRICT_LARKANA

Monthly Review Meeting (MRM) of District, Larkana for the Month of April , 2010 was held on 11‐05‐2010 at Hotel Sapna Inn, Larkana. Written invitations to participate were sent to the DCO, the EDO (H), the EDO (F&P) and District Incharge of EPI, National Program and all other as usual. The list of participants is enclosed. The following persons participated in MRM.


1 Mr. Mustafa Kamal Tagar DSM 2 Dr. Zulfiqar Ali Laghari District Officer: MNCH Program Larkana District.

3 Dr. Erum Majid Shaikh Asstt: Professor, Shaikh Zaid Women Hospital Larkana.

4 Mr. Javed Ali Hullio EO (M&E)

5 Mr. Habibullah Shaikh EO (F&A) 6 Mr. Gada Hussain Chachar SO I 7 Mr. Khalid Hussain SO II 8 Mr. Mumtaz Ali Tunio EO (C ) 9 Dr. M. Younis Khuhro, MO 10 Dr. Abdul Matab Jatoi, MO 11 Dr. Abdul Sami Siddiqui, MO 12 Dr. Ashok Kumar, MO 13 Dr. Pirbh Das, MO 14 Dr. Jamil Ahmed Brohi, MO 15 Dr. Attaullah Jagirani, MO 16 Dr. Khuda Bux Soomro, MO 17 Dr. Mahesh Kumar, MO 18 Dr. Imdad Hussain Lashari, MO 19 Dr. M. Ali Shaikh, MO 20 Dr. Ghulam Asghar Abro, MO 21 Dr. Gur Dino Mal, MO 22 Dr. M. Hashim Bughio, MO 23 Dr. Haresh Kumar, MO 24 Dr. Raj Kumar, MO 25 Dr. Altaf Hussain Abro, MO 26 Dr. Altaf Hussain Khokhar, MO 27 Dr. Abdul Rab Sangi, MO 28 Dr. Sumeet Kumar, MO 29 Dr. Farman Ali Abro,MO 30 Dr. Zakir Hussain Khoso, Mo 31 Dr. Sajid Shafique, MO 32 Dr. Amanullah Abro, MO 33 Dr. M. Afzal Odho, MO 34 Dr. M. Aslam Soomro, MO 35 Dr. Nisar Ahmed Seelro, MO 36 Dr. Noshad Soomro, MO 37 Dr. Bashir Ahmed Wagan,MO 38 Dr. Allah Dino Tunio, MO 39 Dr. Rahim Bux Soomro, MO 40 Dr. Zafarullah Morio, MO 41 Dr. M. Hanif Dhamrah, MO 42 Dr. M. Aslam Shaikh 43 Dr. Abdul Razaque Rahujo, MO 44 Dr. M Yousif Shaikh, MO 45 Dr. Jai Kumar, MO 46 Dr. Badar Din Channa, MO 47 Dr. M. Yahya Channo, MO 48 Dr. Ganesh Lal, MO 49 Dr. Tarique Hussain Soomro , MO 50 Moin Din Chandio, Hakeem 51 Dr. Kashifa Ayaz, FMO 52 Dr.Ambar Nisa Soomro, FMO 53 Dr. Farzana Shaikh, FMO 54 Dr. Afroz Memon,FMO 55 Dr. Farzana Baloch, FMO 56 Dr. Daina Ahuja, FMO 57 Dr. Dur‐e‐Najaf, FMO 58 Dr. Nazia Wali, FMO 59 Dr. Nirmala Oad, FMO 60 Dr. Waheeda Abbasi, FMO 61 Dr. Sanam Asia, FMO 62 Dr. Nusrat Wagan,FMO 63 Dr. Naseem Gulzar,FMO 64 Dr. Ambar Altaf Soomro, FMO 65 Dr. Qurtlain Soomro, FMO 66 Dr. Shazia Ambreen, FMO 67 Dr. Zaib Nisa Bhutto, FMO 68 Dr. Lubna Adnan, FMO 69 Dr. Salma Soomro, FMO 70 Dr. Farzana Tunio, FMO 71 Dr. Seema Shaikh, FMO 72 Dr. Qamar Nisa Soomro,FMO 73 Dr. Musrat Nazeer, FMO 74 Dr. Noor Jahan Abbassi , FMO 75 Mst. Abida Parveen Lashari, LHV 76 Mst. Noor Shaheen, LHV

77

77 Mst. Zule Huma, LHV 78 Mst. Humera, LHV 79 Mst. Afroz Begum, LHV 80 Mst. Abida Parveen, LHV 81 Mst. Rozina Brohi, LHV, 82 Mst. Razia Begum, LHV 83 Mst. Feroza,LHV 84 Mst. Habiba Bughio,LHV 85 Mst. Basira Chandio, LHV 86 Mst. Irshad Panhwar, LHV 87 Mst. Saeeda Tagar, LHV 88 Mst. Asia Bano, LHV 89 Mst. Asma Shaikh, LHV 90 Mst. Sumera Kanwal, LHV 91 Ms. Samina Kanwal, LHV 92 Mst. Yasmeen Shaikh, LHV 93 Mst. Rehana Brohi, LHV 94 Mst. Saeeda Sartaj Aghani, LHV 95 Mst. Waheeda Mahoto, LHV 96


S # Names/Designation S # Names/Designation 01 Dr. Ayaz Hussain Soomro 02 Dr. Haseena Shaikh, Sonologist 03 Dr. Baqa Muhammad Kalhoro 04 Dr. Abdul Aziz Siyal , MO 05 Mst. Sabra Bhutto, LHV 06 Mst. Husna Bhutto, LHV 07 Mst. Abida Parveen Abro 08 Mst. Seema Daudpota, LHV

G. HFs WITH PPHI


TOTAL: 47

Q. Population of the Catchment Area: 9,39,200

R. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 52 49 25 27 27 W/FMOs 28 25 00 25 28 LHVs 42 30 05 25 37

Male 33 09 09 00 24 MTs/MAs


S. CLUSTERS OF HFs WITH ONE MO


Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs 01 Single HFs 45 Single HFs 45

78

WITH ONE FMO

E. CAPACITY BUILDING 1. First Session: During MRM Dr. Kashifa Ayaz, Female Medical Officer, PPHI. Delivered a wonderful lecture on “Vaginal Bleeding in Early Pregrency”, she asked all participants about Vaginal Bleeding in Early Pregrency was very well. Lecture was highly appreciated by FMOs & LHVs. 2. Second Session: During MRM Dr. Muhammad Afzal Odho, Medical Officer, PPHI Larkana. Delivered a comprehensive lecture on “Acute MI”, He highlighted the signs and symptoms of Acute MI. 3. Third Session: During MRM Dr. Zulfiqar Ali Laghari, District Officer MNCH Programme Larkana delivered an excellent lecture on “MNCH Strategies” He also assure all kind of possible cooperation in any kind of support needed by PPHI in the benefit of poor people.

4. Fourth Session: During MRM. Dr. Erum Majid Shaikh, Assistant Professor Gynea, Shaikh Zaid Women Hospital Larkana delivered a comprehensive lecture on “ Disfunctional Utrine Bleeding” She also assure all kind of possible cooperation in any kind of support needed by PPHI in the benefit of poor people.



Date

Venue

Topic No. of

Participants

No separate session for LHVs / Disp:. Was held during the month. However both the cadres attended the MRM, and shared their experiences with the guest speakers and lecturers.




No. of Doses of Immunization Administered in Children at Health Facilities. No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. No. of Immunization & Vaccination Administered by out‐ reach EPI Teams Total vaccination / immunization for the month _________


Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 20 Clusters of 2 HFs 20 Single HFs 03 Single HFs 03

79



26, 27, 28 April : 2010 Did Not Received from

EDO Health


S # Service Number 1 Passive Case Detection (PCD) Slides No 2 Active Case Detection (ACD) Slides No 3 Visits to Check Sanitation (individual house holds + streets) No 4 Notices issued against Poor Sanitation No 5 Challans sent to Court against Poor Sanitation No 6 Patients Nebulized No



S # Name of FMOs Ante‐Natal Cases Neo‐Natal Cases Other OPD Total OPD 1 Dr. Lubna Adnan 131 03 1296 1430 2 Dr. Seema Shaikh 244 07 389 640 3 Dr. Farzana Tunio 21 00 589 610 4 Dr. Daina Ahuja 12 05 548 565 5 Dr. Afroz Memon 103 02 1522 1627 6 Dr. Farzana Shaikh 126 00 929 1055 7 Dr. Farzana Baloch 39 01 1144 1184 8 Dr. Ambar Altaf Soomro 78 07 900 985 9 Dr. Nirmla Oad 102 02 735 839 10 Dr. Musrat Nazeer 225 05 116 346 11 Dr. Sanam Asia 80 01 570 651 12 Dr. Kashifa Ayaz 75 00 514 589 13 Dr. Zaib Nisa Bhutto 40 01 358 399 14 Dr. Shazia Abbasi 72 01 734 807 15 Dr. Nazia Wali 30 00 1011 1041 16 Dr. Naseem Gulzar 45 00 565 610 17 Dr. Dure‐e‐ Najaf 77 00 878 955 18 Dr. Qurtulain Soomro 82 00 405 487 19 Dr. Waheeda Abbasi 55 01 436 492 20 Dr. Amber Soomro 46 00 1209 1255 21 Dr. Qamar Nisa Soomro 35 55 648 738 22 Dr. Nusrat Wagan 119 00 664 783 23 Dr. Salma Soomro 45 03 952 1000 Total 1882/= 94/= 17112/= 19088/= 2. Deliveries Assisted


80




S # Name of the Items / Service Number Consultation / Advice 515 Oral Pills 100 Strips IUCDs 27 Injections 120 Others (Condoms) 00

Total 762/=






No. No. of

Participants No.

No. of Participants

Gada Hussain 09 130 05 210

Khalid Hussain 09 145 04 102

Total 18 275 09 312 3.School Health Sessions & Community Health Sessions



Children Treated

Dr. Farzana Baloch 02 41 02 89 70

Dr. Daina Ahuja 02 85 02 98 80 Dr. Lubna Adnan 02 72 02 130 18 Dr. Seema Shaikh 00 00 03 53 30 Dr. Farzana Tunio 02 33 02 29 15 Dr. Sanam Asia 02 110 02 41 07 Dr. Farzana Shaikh 03 140 01 45 15 Dr. Salma Soomro 02 33 02 68 20 Dr. Nirmala Oad 02 220 02 110 35

81

Dr. Afroz Memon 02 80 02 60 55 Dr. Naseem Gulzar 02 42 02 00 00 Dr. Nisar Seelro 02 40 02 45 15 Dr. Ambar Altaf Soomro 02 110 02 110 50 Dr. Ambar Nisa Soomro 03 192 01 60 22 Dr. Zaib‐u‐Nisa Bhutto 02 90 02 60 43 Dr. Shazia Ambreen Abbasi

02 85 02 64 55

Dr. Nazia Wali 04 60 02 110 35 Dr. Qurtlain Soomro 01 15 02 50 47 Dr. Dure‐e‐Najaf 02 15 02 30 20 Dr. Waheeda Abbasi 02 50 02 80 40 Dr. Kashifa Ayaz 02 79 02 67 50 Dr. Qamar Nisa Soomro 04 43 00 00 00 Dr. Nusrat Wagan 02 45 02 40 30

Totals 52 1733 40 1381 747 4. Important Points during Support Group Meetings.

• Community demand increase in quantity of medicine. • FMO cover round the week. • Immediate repair work, where it has not been started. • EPI cover at all facilities.


• Personal Hygiene. • Scabies. • Cholera. • Malaria. • Cleanliness


• Anti Natal care and Post Natal care. • Scabies (causes, effects, remedies) • Birth Spacing. (Usage of contraceptives.)


Sr. No. Topics 1 Scabies 2 Personal Hygiene 3 Acute flaccid paralysis (Polio) 4 Malaria


S # Topics 1 Antenatal Care 2 Pneumonia 3 Family Planning 4 Skin Diseases

82


• Almost all the guest speakers appreciated PPHI initiative of giving active role to community in matters of BRHFs

• The trend of CSG meetings was highly appreciated. • Formation of Project Management Committee to look after R&R work was also admired.

10. Health Camps: Number Held: 00 Number of Patients: 00 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status i Sanitation ii Drainage / sewerage iii ……… drinking water iv Prevention of adulteration v Tree Plantation Request for plants Distt. Forest

Officer Received

vi Roads and infrastructure vii Environmental Improvement viii Others

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*




100625 0

100625


S # BHU OPD BHU OPD 1 BHU Pir Bux Bhutto 4405 GD Ketty Mumtaz 805 2 USK Mahotta 3552 GD Bahman 1070

3 BHU New Gud 3211 BHU Izat Ji Wandh 1064 4 GD Hessab Chandio 2882 BHU Wasayo Bhutto 1109 5 BHU Mad Bahu 2616 BHU Izat Ji Wandh 1270


S # Diseases No. of Patients 1 Skin Disease 4227

2 RTI 3303 3 GIT 1886

4 Malaria 1187

5 Enteric Fever 614

83


S # Disease No. of Patients 1 A.R.I 12258 2 Fever (Clinical Malaria) 11556 3 Scabies 4724 4 Dysentery 1846 5 Acute Diarrhea 680







S # Tests Number 1 Blood Sugar Tests 144 2 Haemoglobin 00 3 X‐Rays (if available) ‐‐‐ 4 Ultra Sound 1320 5 Others (please specify) Pregnancy test 566






Follow up result

Hepatitis B No No No No No Hepatitis C No No No No No

27. TUBERCULOSIS



Under Diagnosis

No No No 9. Referrals

S.No Totals Cases Referred To 1 No TB DOT Deliveries Others RHCs THQs DHQs 2 17 17 No No 03 08 06

84



1 No ARV ASV Others RHCs THQs DHQs

2 No No No No No No No




65 42 (S.O I) 54 (S.O II) 48

209

2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 01 BHU Karani Electric Transformer

Installed Work done Work in Progress

02 BHU Bakhar Karira

New PVC wire Installed & started Electricity

Work done R&R work in process.

03 BHU Veehar R&R work in process TS approved/received R&R work in process 04 GD Mangria Electricity required No electricity

available in that area Matter will be taken up with Distt. Govt.

05 BHU Mad Bahu New PVC wire Installed & started Electricity

Work done


1. Medicines available for: 22 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

• Inj: Gentamycin available in store but DTL is awaited. • Tab: Frusimide available in store but DTL is awaited. • Tab: Vitamin B Complex available in store but DTL is awaited.


S # Name of HFs


Status / Remarks

1 BHU Karani Electric Transformer Installed Work completed 2 BHU Bakhar Karira New PVC wire Installed & started Electricity Work completed 3 BHU Mad Bahu New PVC wire Installed & started Electricity Work completed

85


On Staff Matters:

• All the staff members of BRHF’ were once again reminded to observe timings in their health facilities. • Always wear aprons/ uniforms which have been already provided. • Observe/ ensure cleanliness in their health facilities. • Maintenance of proper record. • Ensure availability of all essential medicines.


• All the Medical Officers/ Female Medical Officers were informed that Family Planning material / medicine are available in abundant quantity and they should promote its usage.

• It was also requested that ensure availability of T. B DOTS medicine and wherever there is shortage, inform DSU immediately.

On Curative Health: All the Medical Officers were informed that there is sufficient stock of medicines available in DSU store and they should report immediately for any kind of shortage Other Matters: Matters regarding supply of medicines, repair of buildings, provision of uniforms, and other items were also discussed during the monthly meeting. Date /Time for Next MRM: first week of June 2010. Comments on Targets vs. Achievements (by DSM) All the targets/goals and assignments from time to time are being achieved to the satisfaction of the superiors

86

MINUTES OF THE 17th MONTHLY REVIEW MEETING OF DISTRICT MATIARI

Monthly Review Meeting (MRM) of District, Matiari for the Month of April 2010, held on 6th of May, 2010 at Meeting Hall at EDO(Edu.) Matiari. Written invitations to the participate were sent to the DCO, the EDO(H), the EDO(F&P) and District Incharges of EPI, LHW and all other National Programs as usual. The list of participants is enclosed.

S # Names/Designation S # Names/Designation 1 Mr.Inam‐ur‐Raheem Abro DSM 28 Dr.Ghulam Rasool Incharge EPI

2 Dr.Ghulam Rasool, DMS Taluka Hospital Matiari

29 Mr.Niaz H.Channa Executive M&E

3 Mr.Imran Qureshi Executive F/A 30 Mr.Saleem Khandhro Eng. Construction

4 Dr.Mushtaq Ahmed Memon I/C MO DCD Awal Chachar

31 Dr.Allah Bux Arbab I/C SMO GD Khanothe

5 Dr.Asqhar Qadir Memon I/C MO BHU Hala Old

32 Dr.Ajiaz Ali Memon I/C MO GD Shahmeer Ji Wasi

6 Dr.Amir Ali Sangrasi I/C MO BHU Yousuf Hajano

33 Dr.Shamsuddin Memon I/C MO BHU Mahar Shah

7 Dr.Ghulam Hussain Memon I/C MO BHU Seerachoo Kaka

34 Dr.Muhammad Ismail Hingoro I/C MO DCD Dhaloo Khaskheli

8 Dr.Shuja Muhammad Shah I/C MO DCD Pali Jani

35 Dr.Naeem Ahmed Memon I/C BHU Udero Lal Village

9 Dr.Abdul Hussain Soomro I/C MO GD Sher Muhammad Thora

36 Dr.Khalid Saghir I/C MO BHU Allah Dino Sand

10 Dr.Asif Zaffar Abro I/C MO DCD Zair Pir 37 Dr.Safdar Rajpar I/C MO BHU Fakir Nooh Hothiani

11 Dr.Abdul Wali I/C MO BHU Tahir Hingoro 38 Dr.Shakeel Arshad I/C MO GD Soomar Chand

12 Dr.Nusrat memon I/C MO BHU Bau Khan Pathan

39 Dr.M.Soomar Ahmed Memon I/C MO BHU Bhanothe

13 Dr.Aftab Ali Shah I/C MO GD Punhal Khan Jamali

40 Dr.Shahzeb Ali Shah I/C MO BHU Panj Moro

14 Dr.Zaheeruddin Memon I/C MO BHU Khando

41 Dr.Saran Shakeel FMO MCHC Panj Moro

15 Dr.Afshan Rafique FMO PPHI 42 Dr.Zainab Abro FMO PPHI

16 Dr.Ruqia Ali FMO PPHI 43 Dr.Fozia Zaheer FMO PPHI

17 Dr.Sajida Raza FMO PPHI 44 Dr.Romi Aijaz Memon FMO PPHI

18 Dr.Saba Faiz FMO PPHI 45 Dr.Safeena Ahmed Sonologist

19 Dr.Parveen Hafeez FMO PPHI 46 Dr.Rukhsana Zahid FMO PPHI

20 Dr.Shabana Ahmed FMO PPHI 47 Dr.Tahmina Naseem FMO PPHI

21 Dr.Ameena Memon 48 Sonologist PPHI

22 Dr.Shahnaz Altaf FMO PPHI 49 Dr.Ghulam Fatima FMO PPHI

87

23 Mr.Abid Ali SM‐1/Assistant 50 Mr.Imtiaz Ali Memon SM‐2

24 Mr.Liaqat Jamali SM‐3 51 Mr.Kirshan Mal Store Manager

25 Mr.Bakhtiar Khatak Assistant 52 Mr.Imran Memon Assistant

26 Mujeeb‐ur‐Rehman Attendant 53 Naeem Ahmed Medicine Handler

27 Shamussuddin Chachar Attendant


S # Names Reasons for absence 1 Dr. Syed Hassan Murad Shah (EDO‐H) On Polio Meeting

H. HFs WITH PPHI


TOTAL: 36

I. Population of the Catchment Area:

S.No Variable Population Percentage %

1 Total Population 642095 ‐‐‐‐‐ 2 Rural Pop. 508540 79.21% 3 Urban Pop. 133555 20.79% 4 Growth rate ‐‐‐‐‐‐‐‐ 2.02% 5 Male 324704 50.57% 6 Female 317391 49.43% 7 Under‐ 15Year 283163 44.09% 8 Above 15 year 358932 55.90%

T. STAFF STRENGTH

Name of Posts Sanctioned Posts Working Government Employees

PPHI Contract

Vacant

MOs 28 33 24 13 4

W/FMOs 3 22 2 20 01

LHVs/Midwives ‐ ‐ ‐ 14 ‐

Male 21 19 16 03 05 MTs/Mas

Female 23 13 12 1 11

Dispensers 1 36 01 35 ‐

88

U. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO


1. First Session: During MRM Dr. Ghulam Rasool, DMS Taluka Hospital Matiari delivered lecture on Seasonal Diseases. Focused on the following points:‐ 1. Malaria 2. Diarrhea 3. Asthma 4. scabies 2. Second Session: During MRM Dr. Zaheeruddin Memon , I/C MO BHU Khando delivered lecture on How to Operate Hemoglobin Meter? Focused on the following points:‐

1. Operating Hemoglobin Meter

F. REVIEW OF THE PERFORMANCE (I)PREVENTIVE HEALTHCARE During Month under Review


No. of Doses of Immunization Administered in Children at Health Facilities. 7909 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 3800 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams Total vaccination / immunization for the month April 2010 11709


Clusters of 5 HFs Clusters of 5 HFs





Previous Month Month under Review Total at Present Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 15 Clusters of 2 HFs 15 Single HFs 5 Single HFs 5

20 20

89



12th, 13th & 14th 106745 124891.7 117% 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 2 Active Case Detection (ACD) Slides 3 Visits to Check Sanitation (individual house holds + streets) 4 Notices issued against Poor Sanitation 5 Challans sent to Court against Poor Sanitation 6 Patients Nebulized


1. Female Health

‐


Neo‐Natal Cases

Other OPD Total OPD

1 Dr.Afshah Rafiq 33 ‐ 980 1013

2 Dr.Azeema Raza 608 ‐ 1175 1290

3 Dr.Azra Shakoor 282 ‐ 891 1173

4 Dr.Fozia Zaheer 215 ‐ 1464 1679

5 Dr.Gh.Fatima 94 ‐ 1809 1903

6 Dr.Noushaba 233 ‐ 2022 2255

7 Dr.Parveen Hafeez 82 ‐ 604 686

8 Dr.Roomi Aijaz 77 ‐ 952 1029

9 Dr.Rukhsana Zahid 92 ‐ 672 764

10 Dr.Ruqia Ali Memon 324 ‐ 1877 2201

11 Dr.Saba Faiz 156 ‐ 1058 1214

12 Dr.Sajida Raza 177 1156 1333

13 Dr.Saran Shakeel 109 844 953

14 Dr.Shabana 51 1313 1364

15 Dr.Shahnaz Altaf 95 1136 1231

16 Dr.Tahmina Naseem 115 1230 1345

17 Dr.Zainab Abro 76 747 823

Total 2102 19930 23665

90

2‐. Deliveries Assisted

S # Service Number

1 Deliveries Assisted at HFs 26

2 Deliveries Assisted at homes 199 3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 393 2 Blood Sugar Tests 167 3 Hemoglobin Tests ‐ 4 Ultra Sound Test 1246 5 Other ‐



S # Name of the Items / Service Number 1 Consultation / Advice 501 2 Oral Pills 1525 3 IUCDs 236 4 Injections 580 5 Others 330

Total 3172


1. Number of Male SGs: 34 Number of female SGs: ‐‐‐‐‐‐‐‐‐‐‐‐‐‐




No. No. of

Participants No.

No. of Participants

Abid Kazi 2 35 9 358 Imtiaz Ali 09 187 10 659 Liaqat Jamali 12 275 13 700

Total 23 497 32 1717

91


Community Health Session School Health Session Sr.No Name of FMO

No. Participants NO. Examined Treated

1 Dr.Afshan Rafique 2 54 2

2 Dr.Rukhsana Zahid 2 63 2

3 Dr.Parveen Hafeez 2 51 2 67 63

4 Dr.Sajida Raza 2 50 2

5 Dr.Noushaba 2 103 1

6 Dr.Azra Shakoor Shaikh 2 79 2 21 7

7 Dr.Tahmina Naseem 2 89 2

8 Dr.Zainab Abro 2 59 2 56 56

9 Dr.Fozia Zaheer 2 73 2

10 Dr.Ghulam Fatima 2 71 2

11 Dr.Saran Shakeel 1 20 1 50 50

12 Dr.Saba Faiz 2 63 2

13 Dr.Shahnaz Altaf 2 71 2 101 83

14 Dr.Shabana 1 13 1 12 3

15 Dr.Azima Raza 1 45 1

16 Dr.Romi Aijaz 2 27 2 113 113

17 Dr.Anwar Ali Soomro 1 20 1 20 9

18 Dr.Soomar Memon 1 58 1 60 60

19 Dr.Allah Bux Arbab 1 16 1 13 13

20 Dr.Asghar Qadir 1 14 1 25 7

21 Dr.Abdul Hussain Soomro

1 31 1

22 Dr.Shuja M. Shah 1 25 1

23 Dr.Yar M. Gahoti 1 22 1 10 6

24 Dr.Aftab Ali Shah 1 15 1

25 Dr.Aijaz Ali Memon 1 38 1 16 12

26 Dr.Shakeel Arshad 1 7 1

92

27 Dr.Mushtaq Ali Memon 1 12 1

28 Dr.Noordin Jamali 1 53 1 71 39

29 Dr.Toufeeque Ahmed 1 0 1

30 Dr.Munir Ahmed Jamali 1 45 1

31 Dr.M.Ismail Hingoro 1 0 1

32 Dr.Zaheeruddin 1 10 1

33 Dr.Shahzeb Ali Shah 1 40 1 39 39

34 Dr.Abdul Sattar 1 15 1 9 9

35 Dr.Abdul Wali 1 25 1

36 Dr.Asif Zaffar 1 20 1 25 10

37 Dr.Safdar Rajpar 1 15 1 13 13

38 Dr.M.Ismail Laghari 1 42 1 38 38

39 Dr.Nusrat Memon 1 8 1 23 3

40 Dr.Naeem Ahmed Memon

1 22 1 7 7

41 Dr.Qadir Bux Dahri 1 30 1

42 Dr.Shamsuddin Memon 1 20 1

43 Dr.Khalid Saghir 1 31 1

45 Dr.Amir Ali Sangrasi 1 29 1 9 9

46 Dr.Parvez Ahmed 1 9 1

Total 58 1603 57 798 649


• Dissemination the message of facilities available at HFs. • Role of the community support group in vaccination and polio campaigns. • Role of the community support group for the arrangements of school health sessions. • Role of the community support group for the arrangements of Community health sessions for male and

female participants. • Support of the community during the R&R work. • Support of the community groups for plantation. • Increasing the number of members in each community meeting while inviting the social people of the

catchments area of the facility. 5. Important Points during SHSs

• Immunization • Personal Health and hygiene • Nutrition • Use of fruits and vegetables in daily life

93


Participants were guided that during the polio campaign they should cooperate with the teams and support in vaccination and immunization process at their villages or Muhallas. They were guided regarding their personal health and Hygiene. Doctors shared the facilities available at the nearest health facility to that community. The use of vegetables and fruits was also focused. 7. Topics for SHSs for the Month

Sr. No. Topics 1 Immunization 2 Personal Health and hygiene 3 Nutrition 4 Mother and child health


S # Topics 1 Immunization 2 Personal Health and hygiene 3 Nutrition 4 Mother and child health

9. Important Discussion on Community Participation during MRM The schedule of the CSG meetings was shared and finalized with MOs consultation. DSM guided the MOs to arrange the community support groups on mentioned dates in the schedule. Invite and ensure the maximum participation of the members in the CSG meetings. The avg. number of participants in the CSG meetings as per MOs information during the last month was 14 out of avg. of 25. The DSM guided the MOs to increase the number of the participants and invite the new members from the CAs of the health facility. 10. Health Camps: Number Held: ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐. Number of Patients: ‐‐‐‐‐‐‐‐‐‐‐. 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No

Description Recommendation To whom sent

Present status

I Sanitation No No No Ii Drainage / sewerage No No No Iii ……… drinking water No No No Iv Prevention of adulteration No No No V Tree Plantation No No No Vi Roads and infrastructure No No No Vii Environmental Improvement No No No viii Others No No No


1. OPD*




70,114 4,984 75,098

94


S # BHU OPD BHU OPD 1 RHC Bhit Shah 7492 BHU Mahar Shah 1968 2 BHU Hala Old 6045 DC Dispensary Zair Pir 1956 3 DC Dispensary Awal Chachar 3035 BHU Nabi Bux Jamali 1920 4 BHU Allah Dino Sand 2756 GD Rano Bughio 1906 5 BHU Khando 2697 DC Dispensary Pali Jani 1902 6 BHU Seerachoo Kaka 2607 BHU Saeed Khan Laghari 1851 7 BHU Udero lal Village 2456 BHU Bhanothe 1850 8 BHU Karam Khan Nizamani 2450 BHU Shahmeer Rahu 1839 9 BHU Sekhat 2445 GD Soomar Chand 1773 10 GD Shahmeer JI Wasi 2182 BHU Fakir Nooh Hothiani 1726 11 GD Sher Muhammad Thora 2170 BHU Panj Moro 1713 12 DC Dispensary Jumo Shahoke 2147 BHU Bagho Khan Jamali 1673 13 GD Old Saeedabad 2145 BHU Bau Khan Pathan 1569 14 GD Punhal Khan Jamali 2128 BHU Laloo Mangwano 1434 15 DC Dispensary Dhaloo Khaskheli 2093 BHU Ilyas Abrejo 1344 16 GD Khanothe 2079 BHU Yousuf Hajano 1223 17 BHU Tahir Hingoro 2077 DC Dispensary Mari Muhammad Khan 1203


S # Disease 1 Malaria 2 ARI 3 Scabies 4 Typhoid 5 Asthama/Cough


No. of Patients


ARV Administered 28

ARV Available Doses 0 Snake bite cases reported ‐ ASV Vaccine Administered ‐

ASV Vaccine Available Doses ‐

S # Diseases

1 Malaria 2 ARI 3 Scabies 4 Typhoid 5 Asthama/Cough

95



S # Tests Number

1 Blood Sugar Tests 112

2 Hemoglobin 74 3 X‐Rays (if available) 206 4 Ultra Sound ‐ 5 Others (please specify) ‐






Follow up result

Hepatitis B 178 03 03 ‐ Hepatitis C 180 16 16 ‐

30. TUBERCLOSIS

Patients Recei ving Treatment New Cases During the Month Under Diagnosis

38 24 22

G. MONITORING DURING MONTH UNDER REVIEW 1. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total 35 35 150 220


1. Medicines available for: 35 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair /


1 BHU Laloo Mangwano Repair & Renovation of building Completed 2 BHU Udero Lal Village ‐ Completed 3 BHU Tahir Hingoro ‐ Completed 4 BHU Saeed Khan Laghari ‐ Completed 5 BHU Khando ‐ Completed 6 BHU Bhanothe ‐ Completed 7 GD Soomar Chand ‐ Completed 8 GD Shahmeer Ji Wasi ‐ Completed

96

9 GD Sher Muhammad Thora ‐ Completed 10 DCD Jumo Shahoke ‐ Completed 11 DCD Mari Muhammad Khan ‐ Completed 12 GD Rano Bughio ‐ Completed 13 GD Punhal Khan Jamali ‐ Completed 14 DCD Dhaloo Khaskheli ‐ Completed 15 GD Old Saeedabad ‐ Completed 16 BHU Panj Moro ‐ Completed 17 BHU Nabi Bux Jamali ‐ Completed 18 DCD Zair Pir ‐ Completed

Date /Time for Next MRM: 5th of June 2010 at 10:00am Comments on Targets vs Achievements (by DSM) DSM appreciated the incharge MOs regarding their efforts for the better health services provision at the HFs. He added that there is always room for the betterment thus we should even work harder to facilitate the poor peoples of the rural areas.

97

MINUTES OF THE (27th) MONTHLY REVIEW MEETING OF DISTRICT_ MIRPURKHAS

Monthly Review Meeting (27th MRM) of District, Mirpurkhas for the Month of APRIL, 2010 was held on 6‐5‐2010 at City Hotel, Baldiya Complex Mirpurkhas. Written invitations were sent to the DCO, the EDO(H), the EDO(F&P) and District In charge of EPI, LHW and all other National Programs as usual and District In charge MNCH Programme but they could not attend the meeting due to their engagements. The list of participants is enclosed.

S # Names Designation S # Names Designation 1 Mr Huzoor Bux RPD, Mirpurkhas 63 Dr Shehla Yasir FMO 2 Mr Birjlal Dossani DSM 64 Dr Adeela FMO 3 Mr Ajaz Ali DO Education 65 Dr Sheerin Khan FMO 4 Dr Hanif Baloch DO Health 66 Dr Rajni Davi FMO 5 Mr Aziz Daudpota DO Finance 67 Dr. Salma Khan FMO 6 Dr Mohd Sharif USI Field officer 68 Dr Quratul Ain FMO 7 Dr Alam Azad In charge WHO 69 Dr Sajida Tahir FMO 8 Dr Khalid Memon DDO RCH 70 Dr Amna Idrees FMO ‐PPHI 9 Dr Javed ADSM Khairpur 71 Dr Sumaira FMO‐PPHI 10 Dr Naseer Ahemd InchargeTB Dot 72 Dr. Abdul Rahim MO PPHI Mps 11 Dr.Mehboob Ali ADSM PPHI 73 Dr Anis Mari MO PPHI Mps 12 Mr Taj Mohd Exe(A&A) 74 Dr Rasheed Ali MO PPHI Mps 13 Dr. Khan Mohd SMO Govt 75 Dr Mehmood Hasan MO‐PPHI 14 Dr Atta Hussain SMO Govt 76 Dr Ghazanfar Abbas MO‐PPHI 15 Dr Ghulam Mustafa SMO Govt 77 Dr Mumtaz Ali MO‐PPHI‐MPS 16 Dr Ghulam Mustafa MO Govt 78 Dr Nadim MO‐PPHI‐MPS 17 Dr Arshad Nihal SMO Govt 79 Dr Afzal Laghari MO‐PPHI‐MPS 18 Dr. G R Soomro SMO Govt 80 Dr. Parkash MO‐PPHI‐MPS 19 Dr Shahid Rizwan SMO Govt 81 Dr Javed Hussain MO PPHI 20 Dr. Bhawani SMO Govt 82 Dr Wishan Das MO PPHI 21 Dr Tulsi Ram SMO Govt 83 Dr Vishan Das MO‐PPHI‐MPS 22 Dr. Allah Dito SMO Govt 84 Dr. Neel Kanth MO‐PPHI‐MPS 23 Dr Shamas SMO Govt 85 Dr Kishore MO‐PPHI‐MPS 24 Dr Safdar Ali SMO Govt 86 Dr Haresh Kumar MO‐PPHI‐MPS

25 Dr. Qasim Ali SMO Govt 87 Dr Attaullah MO‐PPHI‐MPS 26 Dr. Yousuf SMO Khan 88 Dr. Pardeep Kumar MO‐PPHI‐MPS 27 Dr Rano Mal SMO Govt 89 Dr Chandar Parkash MO‐PPHI‐MPS 28 Dr Narain Das SMO Govt 90 Dr Ashoke‐Kumar MO‐PPHI‐MPS 29 Dr. Narain MO Govt 91 Dr Naeem Sheikh MO‐PPHI‐MPS 30 Dr. Faroque Ahmed M‐O Govt 92 Dr Moazam MO‐PPHI‐MPS 31 Dr. Arif Shamim M.O Govt 93 Dr Dheeraj Kumar MO‐PPHI‐MPS 32 Dr. Captain M. Ismail M.O Govt 94 Dr Saqib Kazmi MO‐PPHI‐MPS 33 Dr. Noor Hassan M.O Govt 95 Dr Kashif Khan MO PPHI Mps 34 Dr Ashoke Kumar MO Govt 96 Dr Zahid Hussain MO PPHI Mps 35 Dr Saleh Memon MO Govt 97 Dr. Imran Laghari MO‐PPHI‐MPS 36 Dr. Farhana Qureshi SWMO Govt 98 Dr. Yousuf Magsi MO‐PPHI‐MPS 37 Dr Tahira WMO Govt 99 Dr Dileep Kumar MO PPHI Mps 38 Dr Aneela Zahoor FMO‐PPHI 100 Dr. Naresh MO PPHI Mps 39 Dr Sanila FMO‐PPHI 101 Dr Aneel Kumar MO‐PPHI 40 Dr Shaista Parveen FMO I/C 102 Dr Rajesh Kumar MO‐PPHI 41 Dr Hamida Ali FMO‐PPHI 103 Dr. Rajesh MO PPHI Mps 42 Dr. Sadia Shaikh I/C FMO 104 Dr Mohammad Uris MO PPHI Mps

98

43 Dr. Kiran Kumari FMO‐PPHI 105 Dr Ghansham MO PPHI Mps 44 Dr. Kamni FMO 106 Dr Naraindar MO‐PPHI‐MPS 45 Dr Hina Karim U/S FMO‐PPHI 107 Dr Naraindar Kumar MO‐PPHI‐MPS 46 Dr. Faiza Aleem I/C FMO 108 Dr Ramesh Kumar MO‐PPHI‐MPS 47 Dr. Saeeda Mari I/C FMO 109 Dr. Ramesh MO‐PPHI 48 Dr. Asma Shaikh I/C FMO 110 Dr Baldeve Kumar MO‐PPHI 49 Dr Sumreen Shafi FMO‐PPHI 111 Dr Saleem MO PPHI 50 Dr. Samina Naz FMO‐PPHI 112 Dr Suresh Kumar MO PPHI 51 Dr. Azra Parveen FMO‐PPHI 113 Dr Tahir Imran MO PPHI 52 Dr Sana Ayub FMO‐PPHI 114 Dr Zulfiquar Ali MO PPHI 53 Dr Mohni FMO‐PPHI 115 Dr Shankar lal MO PPHI 54 Dr Nighat Ashraf FMO‐PPHI 116 Dr Shahbaz MO PPHI 55 Dr. Sahira Baloch FMO‐PPHI 117 Dr Naeem Sheikh MO PPHI 56 Dr. Asia Karim FMO‐PPHI 118 Altaf Hussain Exe M&E MPS 57 Dr Faria Atif FMO‐PPHI 119 Jethanand DSU‐PPHI 58 Dr Gulshad FMO‐PPHI 120 Naresh Kumar DSU‐PPHI 59 Dr Ramila Davi FMO‐PPHI 121 Aamir Ali DSU‐PPHI 60 Dr Shazia FMO‐PPHI 122 Farhan Rasheed DSU‐PPHI 61 Dr Bushra Farhin FMO‐PPHI 123 Mohsin DSU‐PPHI 62 Dr Aisha Mughal FMO 124 Abdul Hafeez Store Manager


S. Names/Designation Reasons 1 Dr Mushraf Aziz‐ SMO Leave 2 Dr Naseem Sultana‐WMO Leave 3 Dr Saima Mari‐FMO Maternity Leave

J.HFs WITH PPHI

BHUs: 38 Dispensaries: 48 MCHCs: 10 Others: 2 USK

TOTAL: 98 B. Population of the Catchment Area: 1681107

V. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 146 71 25 49 75 W/FMOs 62 39 03 36 23 LHVs 63 39 8 31 24

Male 55 55 0 0 MTs/MAs

Female 24 24 0 0 Dispensers 46 31 6 25 15

99

W. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO


Dr. Ghulam Akbar (Resource Person) in his lecture on " Integrated Management of Childhood Ilness " (topic) focused on the following points:‐

Causes Symptoms Precautions Treatment

2. Second Session: During MRM Dr. Javed (Resource Person) in his lecture on TPE and focused on the following points:‐

a. Questioner about third party evaluation. b. Requirements of Third party Evaluation




No. of Doses of Immunization Administered in Children at Health Facilities. 16458No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 7852No. of Immunization & Vaccination Administered by out‐ reach EPI Teams Total vaccination / immunization for the month _________APRIL‐2010 24310



19/20/21 ‐04‐2010 223110 90%



Previous Month Month under Review Total at Present Clusters of 5 HFs Clusters of 5 HFs 3 Clusters of 4 HFs Clusters of 4 HFs 0 Clusters of 3 HFs Clusters of 3 HFs 0 Clusters of 2 HFs Clusters of 2 HFs 26 Single HFs Single HFs 9

100


S # Service Number 1 Passive Case Detection (PCD) Slides 0 2 Active Case Detection (ACD) Slides 0 3 Visits to Check Sanitation (individual house holds + streets) 0 4 Notices issued against Poor Sanitation 0 5 Challans sent to Court against Poor Sanitation 0 6 Patients Nebulized 12



S # Names of FMOs Ante‐Natal Cases Neo‐Natal Cases Other OPD Total OPD 1 Dr. Faria 46 8 806 878 2 Dr.Shella Yasir 190 0 900 1010 3 Dr. Kamni 177 0 1026 1129 4 Dr.Sahira Baloch 136 6 360 481 5 Dr. Aasia Narejo 39 0 780 819 6 Dr. Ramila Davi 175 25 547 794 7 Dr Samina Naz 97 65 890 1084 8 Dr Gulshad Baloch 0 30 568 608 9 Dr Sana Ayoub 93 1 780 858 10 Dr Mohni 149 0 960 1025 11 Dr Aneela Zahoor 40 20 1000 1083 12 Dr Kiran Kumari 98 0 735 836 13 Dr Bushra Farhin 0 30 716 746 14 Dr Sheerin Khan 92 2 708 811 15 Dr Azra Parveen 37 0 660 724 16 Dr Aisha Mughal 45 0 564 537 17 Dr Nighat Ashraf 90 0 580 688 18 Dr Sumaira 140 0 495 658 19 Dr Adeela 15 2 729 825 20 Dr Hamida Ali 46 0 754 847 21 Dr Samreen Shafee 32 29 810 879 22 Dr Shaista Parveen 14 1 1025 1040 23 Dr Saeeda 40 5 1520 1624 24 Dr Sajida 110 10 1040 1160 25 Dr Asma Rasool 310 0 1204 1524 26 Dr Saima 0 0 0 0 27 Dr Sadia 200 0 1400 1600 28 Dr Quraut‐ulAin 115 25 3000 3283 29 Dr Faiza Aleem 155 22 1089 1190 30 Dr Sanila 96 0 917 1102 31 Dr Amna Idrees 100 0 1027 1127 Total 2877 477 27590 30970

101






S # Name of the Items / Service Number Consultation / Advice 1005 Oral Pills 880 IUCDs Injections 200 Others

Total 3500


1. Number of Male SGs: ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐78 Number of female SGs: ‐‐‐‐‐‐‐‐‐‐‐‐‐‐04 2. Performance of Social Organizers



No. No. of

Participants No.

No. of Participants

Jetanand 17 105 2 28 Farhan Rasheed 6 58 4 42 Amir Panhwar 6 48 2 16 Mohsin 7 62 2 26

Total 36 273 10 112

102




Children Examined

Children Treated

Dr Shaista Parveen 1 10 0 0 0 Dr Farhana Qureshi 1 15 1 6 4 Dr Sanila 1 12 0 0 0 Dr Sajida Tahir 0 0 1 0 0 Dr Asma Rasool 1 11 0 0 0 Dr Faiza Aleem 1 30 1 30 30 Dr Saeeda 1 30 1 20 20 Dr Sadia 1 20 0 0 0 Dr Quratulain 1 112 0 0 0 Dr Saima 0 0 0 0 0 Dr. Faria 0 0 0 0 0 Dr.Shella Yasir 1 16 1 0 0 Dr. Kamni 1 35 1 12 12 Dr.Sahira Baloch 0 0 0 0 0 Dr. Aasia Narejo 1 28 1 6 4 Dr. Ramila Davi 1 75 1 50 15 Dr Samina Naz 1 17 1 2 2 Dr Gulshad Baloch 1 8 1 2 2 Dr Sana Ayoub 1 10 0 0 0 Dr Mohni 1 28 1 7 5 Dr Aneela Zahoor 1 15 1 24 7 Dr Kiran Kumari 1 25 1 10 5 Dr Bushra Farhin 1 20 1 15 15 Dr Sheerin Khan 1 25 1 12 0 Dr Azra Parveen 1 39 1 15 8 Dr Aisha Mughal 1 27 0 0 0 Dr Nighat Ashraf 1 30 1 20 10 Dr Sumaira 1 20 1 40 5 Dr Adeela 1 14 1 4 2 Dr Hamida Ali 1 15 1 14 4 Dr Samreen Shafee 0 0 0 0 Dr Ramesh 1 13 1 7 7 Dr Safdar Ali 1 15 1 0 0 Dr Saqib Kazmi 1 10 1 0 0 Dr Narain 1 17 1 3 1 Dr Zahid Hussain 1 12 1 5 4 Dr Aneel 1 38 1 0 0 Dr A Kabir 1 20 1 17 15 Dr Abdul Rasheed 1 20 1 10 5 Dr Narain 1 33 1 7 5 Dr Haresh Kumar 0 0 0 0 0 Dr Uris 1 20 1 12 12 Dr Rajesh 1 40 1 7 7 Dr Tahir Imran 1 12 1 5 2 Dr Yousif 0 0 0 0 0 Dr Qasim Ali 0 0 0 0 0 Dr Rano Mal 1 30 1 25 25

103

Dr Ghansham Das 1 55 1 5 3 Dr Ghazanfar Abbas 1 55 1 5 3 Dr Neel Kanth 1 23 1 0 0 Dr Nadim 1 15 1 17 15 Dr Parkash 1 20 1 25 5 Dr Saleem 1 18 1 14 7 Dr Shamas 1 13 1 2 2 Dr Ghualm Mustafa 0 0 0 0 0 Dr Baldeve 1 31 1 20 6 Dr Pardeep 1 10 1 25 20 Dr Ashoke‐Kumar 1 20 1 7 3 Dr Arshad Nihal 1 30 1 0 0 Dr Mumtaz 2 35 2 10 7 Dr Anis Mari 1 13 1 2 2 Dr Mehmoodulhasan 1 24 1 32 4 Dr Naresh Kumar 2 18 2 18 13 Dr Ramesh 1 10 1 0 0 Dr Moazam 1 7 1 0 0 Dr Abdul Rahim 1 30 1 20 10 Dr Imran 1 10 1 10 10 Dr Wishan 1 30 1 5 5 Dr Yousif 1 17 1 179 18 Dr Naraindar 1 25 1 30 30 Dr Shahid Rizwan 1 25 1 25 25 Dr Dileep 1 20 1 3 3 Dr Kashif Khan 1 18 1 5 5 Dr Dheeraj 1 10 1 10 10 Dr Naraindar 1 17 1 12 12 Dr Atta Shah 1 10 1 0 0 Dr Chandar Parkash 2 41 2 8 4 Dr Kishor Kumar 1 10 1 16 4 Dr Saleh Memon 1 20 1 7 7 Dr Suresh 1 19 1 17 9 Dr Farouque 1 8 1 7 5 Dr Wishan 1 10 2 55 55 76 1684 71 978 535


• Over all cleanliness at each HFs • Repair Work of HFs • Disease prevention • Lawn maintaining at HFs


• Preventions of different Diseases • Precautions from different Diseases • Take Health and hygiene conditions • Norms of cleanliness

104


• Preventions of different Diseases • Precautions from different Diseases • Use of ORS • Preventions of Dengue Fever • Viral Hepatitis • Treatment of Scabies


Sr. No. Topics Topics 1 Viral Hepatitis Cardiac Disease, 2 Malaria Dengue Fever, 3 Malnutrition Eye Disease 4 Gastro Intuits Viral Hepatitis , 5 Hyper Tension Diarrhea


S # Topics Topics

1 Breast Feeding, First Aid, 2 Post Natal Care Communicable Disease 3 Health and Hygiene, Hygiene and Scabies 4 ARI, Tuberculoses 5 Immunization Family Planning

9. Important Discussion on Community Participation during MRM DSM informed to the all MOs/FMOs that all MOs must held CSG meeting on regular monthly basis and DSU staff

will attend these meetings 10. Health Camps: Number Held: ‐‐‐‐‐0‐. Number of Patients: ‐‐‐‐‐‐‐‐‐ 0 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status i Sanitation No any No any ii Drainage / sewerage No any No any iii ……… drinking water No any No any iv Prevention of

adulteration No any No any

v Tree Plantation No any No any vi Roads and infrastructure No any No any vii Environmental

Improvement No any No any

viii Others No any No any

105


1. OPD*




(New + Old)

114005 1,825 115,832


S # BHU OPD BHU OPD 1 Hameedpura 4166 Fakir Faiz M Bilalani 796 2 St Town 2063 Doulat Laghari 846 3 Girhore Sharif 2057 Fazal Bhanbro 901 4 Patoyoon 1919 Jhuluri 993 5 Nawab Colony 1888 Usman Junejo 1012

3. Top Five Diseases Treated during School Health Sessions/Camps 4. Top Five Diseases during OPD

S # Disease No. of Patients 1 ARI 22870 2 Diarrhea 9438 3 Fever (Clinical Malaria) 6553 4 Scabies 6317 5 Dysentery 1676


No. of Patients Dog bite cases reported 36 ARV Administered 100 ARV Available Doses 100 Snake bite cases reported 0 ASV Vaccine Administered 14 ASV Vaccine Available Doses 14

S # Diseases No. of Patients

1 ARI 375

2 Diarrhea 226

3 Fever 200 4 Scabies 184 5 Malaria 158

106

31. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health) 3. (Lab / Diagnostic Tests)


NO ANY SCREENING TEST OF HB & C AVAILABLE AT PPHI HFs





Follow up result

Hepatitis B

Hepatitis C

32. TUBERCLOSIS



Under Diagnosis

10 42 89 9. Referrals


1 TB DOT Deliveries Others HB +ve

RHCs THQs DHQs

2 109 89 0 20 50 30 29



1 ARV ASV Others RHCs THQs DHQs 2



DSM ADSM Executive Monitoring

Other Staff Total

71 182 150 473 876

107

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS 1. Medicines available for: ………………………. 20 Weeks I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of



1 Bhu Girhore Sharif Cement and other material

purchased 40 % work completed

2 MCH Jhudo Out Side Coloring continued 90 % work completed 3 BHU Karm Laghari Colour continued. 20 % work completed 4 BHU Patoyoon Colour continued. 50 % work completed 5 BHU Kot Mir Jan Mohd Colour continued. 60% 6 BHU F Faiz M Billalani Out Side Coloring continued 50% 7 BHU Fakir Bashir Laghari Colour continued. 50% 8 BHU Lalchand Bunglow Material purchased 20% 9 BHU Malook Pahore Material purchased 20% 10 BHU Khadim Ali Shah Colour continued. 70% 11 GD M Hasan Mari Coloring continued 80% 12 GD Dajhero Mori Material purchased 50% 13 GD Ahori Material purchased 30%

J‐ DISCUSSION DURING MRM Date /Time for Next MRM: 3rd June 2010 on Tuesday. Address by Regional Programme Director: Regional Programme Director, Mr. Huzoor Bux Laghari appreciated the performance of all Medical Officers for their dedicated work as he remembered the date 16th May 2007, when PPHI took control of 98 health facilities in district Mirpurkhas. At that time situation was confused, staff was not available, the appointed staff remained absent, medicine was not available and the condition of buildings was dangerous. But, now the situation is completely changed. Medical Officers are appointed at all Health Facilities, Lady Doctors are available at all HFs. All staff has been appointed. Medicines are supplied regularly and repair work of majority of dangerous buidings has been completed. Address by Dr. Hanif Baloch: DO (Health) Dr. Hanif Balouch also appreciated the work of PPHI in Mirpurkhas as he seconded the speech of RPD by saying that the condition of health facilities in district Mirpurkhas in 2007 was not satisfactorily. But due to the hard work of PPHI team, they have shaped the health facilities in their original color.

108

MINUTES OF THE MONTHLY REVIEW MEETING DISTRICT THARPARKAR@MITHI

Monthly Review Meeting (MRM) of District, Tharparkar for the Month of April, 2010 was held on 6‐5‐2010 at Karoonjher Hall Mithi. Written invitations to participate were sent to the District Administrator, the EDO (H), the EDO(F&P) and District Incharge of EPI, District Information Officer, Secondary Care Doctors, Medical Superintendents,LHW and all other National Programs . The list of participants is enclosed. The following could not attend the meeting for the reasons stated against each:‐

S.# NAME OF DOCTOR PLACE OF POSTING REASON ACTION TAKEN 1 Surgeon Chander THQ Nagarparkar Unknown Explanation issued 2 Dr. Kuldeep BHU Kaloi Unknown Explanation issued 3 Dr. Meena Kumari BHU Kaloi Unknown Explanation issued 4 Dr.Ghulam Muhiudin BHU Mithi Gecho Unknown Explanation Issued 5 Dr. Sahibdino DHQ Mithi Personal Leave Informed to DSU

The following attended the meeting:

S # Names/Designation S # Names/Designation 1 Mr. Khalid Abbsi, DSM PPHI Mithi 41 Dr. Shagufta Shah 2 Dr. Nasrullah Thebo, Executive(M&E) 42 Dr. Rizwana Sajad 3 Mr. Tarique Sheikh, Executive(A&A) 43 Miss Amna, Staff Nurse 4 Dr. Bhamar Lal, Surgeon DHQ Mithi 44 Dr. Parwaiz Sajjad 5 Eng: Teerath Executive(M&E) 45 Mr. Chandan Singh 6 Dr. Parkash, Anesthetist, THQ N.Parkar 46 Mr. Pirbhu Lal 7 Dr. Heearnand, Anesthetist THQ N. Parkar 47 Dr. Sayed Ishtiaque Ali Shah 8 Dr. Allah Warayo,MO S.Rind 48 Dr. Satram Das 9 Dr. Santosh Kumar 49 Mr. Aslam Rind 10 Dr. Dileep Kumar 50 Mr. Anopo 11 Dr. Sarwan Kumar 51 Dr. Dileep Kumar 12 Dr. Moolchand 52 Dr. Pirbhu Lal 13 Dr. Mir Imran 53 Dr. Dechand 14 Mr. Sanwan 54 Mr. Rajesh Kumar 15 Dr. Adu Mal 55 Mr. Chnadan Singh 16 Ms Samina 56 Mr. Dheenu Mal 17 Dr. Amanullah 57 Ms. Susheela 18 Dr. Mahesh Kumar 58 Ms. Samina 19 Dr. Sarwan Kumar 69 Dr. Asma Karam 20 Dr. Gotam 60 Dr. Latta Kumari 21 Dr. Parkash 61 Sazaan Rind 22 Dr. Peetamber 62 Shazia Naz 23 Mr. Ladoo Mal 63 Dr Manak Lal 24 Dr. Ashok Kumar 64 Dr. Heeranand 25 Rai Khanghar 65 Mrs. Naseeran 26 Mr. M.Afzal 66 Mr. Bheru Lal 27 Dr. Lachman Das 67 Ms. Amna Sindhu 28 Dr. Mukesh Kumar 68 Mr. Gomoon Mal 29 Saroopoji 69 Mr Mohsan 30 Mr. Sawan 70 Mr.Sunil Kumar 31 Dr. Allah Warayo

109

32 Dr. M. Saleem 33 Mr. Jhando Khan 34 Mr. Irshad Janjhi 35 Mr Mohammad Raheem 36 Mr Mumtaz Ali Dars 37 Mr. Allah Rakhio 38 Mr. Jawed SO 39 Mr. Tayab Store Manager 40 Mr. Chaman Lal

K. HFs WITH PPHI

BHUs: __31 __ Dispensaries: ____18___ MCHCs: ___0____ Others:___0___

TOTAL: ____49___ B. Population of the Catchment Area: 910193

X. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 53 41 17 24 8 FMOs 0 6 0 6 0 LHVs 47 4 2 2 43

Male ‐ 0 0 0 ‐ MTs/MAs Female ‐ 0 0 0 ‐ Dispensers 0 8 3 5 0 HTs 30 48 28 18 2

Y. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO

Previous Month Month under Review Clusters of 5 HFs Clusters of 5 HFs 0 Clusters of 4 HFs Clusters of 4 HFs 0 Clusters of 3 HFs Clusters of 3 HFs 4 Clusters of 2 HFs Clusters of 2 HFs 2


Clusters of 5 HFs 0 Clusters of 5 HFs 0 0 Clusters of 4 HFs 1 Clusters of 5 HFs 1 1 Clusters of 3 HFs 5 Clusters of 5 HFs 5 5 Clusters of 2 HFs 0 Clusters of 5 HFs 0 0 Clusters of 1 HFs 0 Clusters of 5 HFs 0 0

110

E. CAPACITY BUILDING 1. First Session: During MRM Dr. Bhamarlal presented the case study of a female a patient of vesicle Fistula, focused on following points:

1. Signs & Symptoms of fistula 2. Investigations 3. General measures 4. General treatment 5. Specific treatment : Surgery

In his session he advised all MOs, FMOs, and HTs to refer this type of patient to surgeon. In his second on Malaria, Dr. Parkash talked on he discussed on definition, signs and symptoms and investigations of Malaria.



Date

Venue

Topic No. of

Participants

Dr. Parkash 6‐5‐2010 DSU Record

Keeping 46





26, 27, 28 221553 204243 92% 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 0 2 Active Case Detection (ACD) Slides 0 3 Visits to Check Sanitation (individual house holds + streets) 0 4 Notices issued against Poor Sanitation 02 5 Challans sent to Court against Poor Sanitation 0 6 Patients Nebulized 0

No. of Doses of Immunization Administered in Children at Health Facilities. 4753 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 1915 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams Total vaccination / immunization for the month April 2010 204243

111


During Month under Review 1. Female Health 2. Deliveries Assisted


24. Important Discussion on Mother and Child and Reproductive Health during MRM All FMOs were advised to conduct regular meetings with Female support groups because CS Group female members were support the FMOs in conduction of meeting, health sessions and in reproductive Health problems resolving matters.



Total 680

S.# Name of FMO ANC cases Neo natal Other OPD Total OPD 1 Dr. Meena 116 0 1691 1807 2 Dr. Shagufta 75 0 520 595 3 Dr. Asma 291 0 325 616 4 Dr.Janta 46 0 511 557 5 Dr. Rizwana 30 10 380 420 6 Dr. Lata 55 0 309 364


S # Test Number 1 Pregnancy Tests 122 2 Blood Sugar Tests 48 3 Hemoglobin Tests 25 4 Ultra Sound Test 118

112

(III) COMMUNITY PARTICIPATION 1. Number of Male SGs: ‐ 49‐ Number of female SGs: 3




No. No. of Participants No. No. of Participants Mumtaz Ali 18 365 6 410 Jawed Ahmed 12 254 7 325 Ghulam Mustafa 10 237 5 266 Total 40 856 18 1001


Community Health Sessions School Health Sessions Names of MO / FMOs/Paramedics


Children Treated

Dr. Janta Kumari 3 48 1 4 0 Dr. Shugufta Shah 3 42 1 3 1 Dr. Asma Karam 3 88 1 5 2 Dr. Rizwana 2 46 1 6 6 Dr. Lata Kumari 3 78 1 4 2 Dr. Meena Kumari 3 58 1 3 3 Dr. Dileep Kumar 3 45 1 8 5 Dr. Dileep Soni 3 66 1 6 4 Dr. Suneel Kumar 2 55 1 8 7 Dr. Sarwan Kumar 3 82 1 2 5 Dr. Mool chand 3 78 1 2 3 Dr. Mir Imran 3 85 1 2 2 Dr. Satram Das 3 60 1 2 2 Dr. Perwaiz Sajjad 2 83 1 2 1 Dr. Ishtiaque Ali 3 77 1 2 1 Dr. Dechand 3 82 1 2 2 Dr. Santosh Kumar 3 78 1 2 2 Dr. Pirkash Kumar 3 87 1 2 2 Dr. Ashok Kumar 3 50 1 3 2 Dr. Amanullah 3 63 1 3 2 Dr. Gotam 3 60 1 2 2 Dr. Lachman 3 65 1 2 2 Dr. Saleem 3 60 1 2 2 Dr. Adu Mal 3 75 1 3 2 Dr. Mahesh 3 82 1 4 2 Dr. Gh. Mohihuddin 3 62 1 2 3 Dr. Manak Lal 2 54 1 3 2 Dr. Mukesh 3 63 1 4 3 Dr. Allah Warayo 3 58 1 3 3 Dr. Shahid 3 48 1 2 1 Dr. Peetamber 3 62 1 3 1 Dr. Madan 2 62 1 2 1

113

Dr. M. Hasan 2 55 1 2 1 Dr.Bheru 2 52 1 1 2 Dr. Naseer 1 22 0 0 0 Dr. Sarwan 3 90 1 3 1 Dr. Nehchal 3 68 1 4 2 Dr. Misree 3 76 1 2 2


1. Repair of RHFs by TRDP 2. Provision of Electricity to RHFs

3. Provision of third generation antibiotics 5 . Cleanliness of RHFs. 6. Functioning of EPI facility. 7. Functioning of EPI Centers by PPHI 8. Maintenance of record at all RHFs


1. Diarrhea 2. Tuberculosis 3. Malnutrition 4. Skin and Eye diseases 5. Malaria


1. Personal Hygiene 2. Hazards of Supari, Ghutka chewing 3. Anti natal care 4. Hepatitis B & C


Sr. No. Topics 1 First Aid 2 Hepatitis B& C 3 Eye/ Ear diseases 4 Balance Diet 5 Dental Care/ Oral Hygiene


S # Topics 1 Personal Hygiene 2 Skin and eye/ear disease 3 Anti Natal Care 4 Hazards of Tobacco smoking, chewing of supari and ghutka

Important Discussion on Community Participation during MRM It was again in discussed in the MRM, and MOs suggested that in next MRMs one CSG Members may participate in the MRM as he shares the progress and problems of BHUs

9. Health Camps: Number Held: 09 Number of Patients: ‐‐‐2433

114





the month Total OPD during the month (New +

Old)

41279 705

41984


S # BHU OPD BHU OPD 1 BHU Veerawah 2294 BHU Chanida 143

2 BHU Chelhar 2217 GD Dalan Jo Tar 168

3 BHU Kot Arbab 1589 BHU Chachi Moora 220


S # Disease No. of Patients 1 ARI 9913 2 Fever 3342 3 Diarrhea 2128 4 Scabies 790 5 Dysentery 482

Sr No Description Recommendation To whom sent Present status i Sanitation ‐ ii Drainage / sewerage ‐ iii Drinking water ‐ iv Prevention of

adulteration ‐

v Tree Plantation For provision of Plants DO Forest He provided 500 plants vi Roads and infrastructure ‐ vii Environmental

Improvement ‐

viii Others ‐

S # Diseases No. of Patients 1 ARI 28 2 Fever 20 3 Diarrhea 16 4 Eye /Ear infections 23

115


Detail No. of Patients Dog bite cases reported 09 ARV Administered 09 ARV Available Doses 31 Snake bite cases reported 07 ASV Vaccine Administered 14

ASV Vaccine Available Doses 60 Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)


S # Tests Number 1 Blood Sugar Tests 150 2 Hemoglobin 12 3 X‐Rays (if available) 28 4 Ultra Sound 110 5 Others (Malaria test) 451

B & C SCREENING TESTS





Follow up result

Hepatitis B 0 0 0 0 0 Hepatitis C 0 0 0 0 0

8. TUBERCLOSIS

Patients Receiving Treatment New Cases During the

Month Under Diagnosis

10 0 0 9. Referrals



2 0 0 16 6 8 2




37 41 88

166

116


S # Name of HF Issue Action Remarks 1 BHU M. Bhatti Repair of Hand Pump TRDP will install the H. Pump

2 GD Giryancho Repair of Building TRDP has started the work 3 GD Jhirmrio Repair of Building TRDP has started the work 4 BHU Choopni Building repair TS is received from PSU 8 Kaloi Repair of X‐ray Machine Parts are sent to Hyderabad for

repair.

9. BHU Khario Fazal Repair / FMO Eng is preparing TE

10. BHU Samo Rind Repair of the building TRDP is going to conduct the repair work.

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS 1. Medicines available for: 12 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM Participants were informed that this time DSU PPHI is providing 17 Multinational items to the BHUs, participants showed satisfaction over the medicine supplied by the PPHI, The doctors also advised for provision of third generation antibiotics especially in injection form to treat the children for acute pneumonia and other infected cases doctors also suggested for the provision of Xylocaine injection to RHFs which is needed in stitching . I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of



1 BHU Virawah Work Completed MB Sent to PSU 2 BHU Dano Dhandhal Work Completed MB Sent to PSU 3 BHU Malan hor vena Work Completed MB Sent to PSU 4 BHU Chelhar Work Completed MB Sent to PSU 5 BHU Kantio Work Completed MB Sent to PSU 6 BHU Wahori Work Completed MB Sent to PSU 7 BHU Mubarak Rind Work Completed MB Sent to PSU 8 BHU Veerijhap Work Completed MB Sent to PSU 9 BHU Pabhuar Work Completed MB Sent to PSU 10 BHU KG Shah Work Completed MB Sent to PSU 11 BHU Warkio Work Completed MB Sent to PSU 12 BHU Chanida Work Completed MB Sent to PSU 13 BHU Kolhi Ji Veri Work Completed MB Sent to PSU 14 BHU Kaloi Work Completed MB Sent to PSU 15 BHU Hirar Deda Work Completed MB Sent to PSU 16 BHU Jadam Jhanjhi Work Completed MB Sent to PSU 17 GD Kehri Work Completed MB Sent to PSU 18 GD Jado Joyo Work Completed MB Sent to PSU 19 GD Jogi Mari Work Completed MB is complete 20 GD Bhagisal Work Completed MB is completed 21 GD Peelu Work in progress MB is completed 22 GD Dalan Jo Tar Work Completed MB is completed 23 BHU Amrio Work in progress 95% physical work 24 BHU Bhakuo Work in progress 90% work is done

117

25 BHU Doonjh Work in progress 90% work is done 26 BHU M.Bhatti Work in progress 90% work is done 27 BHU Arokhi Work in progress 100 % work is done 28 BHU Kankio Work in progress 10% work is done

J‐ DISCUSSION DURING MRM On Staff Matters: DSM said that he has powers to approve 3 days leave to a employee, for long leave govt: employee will got leave by EDO Health. On Preventive Health: All MOs/ FMOs to conduct the health sessions regularly as we prevent the peoples from diseases; he also insisted that there should be maximum participation in health sessions as the message reach to maximum peoples. On Curative Health: MOs suggested for the availability of Injection Xylocaine, Xylocaine gel which are required in stitching and in catheterization of the patient.. On Mother, Child & Reproductive Health: DSM said to FMOS that they maintain the record regarding MCH, were also advised to conduct health sessions specially convey the women for delivery at BHUs and for TT Vaccine and routine vaccination. They were also advised to give family planning advices to mothers. FMOs were also directed to regularly conduct the female CSG meetings and the meeting agenda should be about MCH and reproductive health. Repair of Nonfunctioning Cold Chains. Provision of Hard Area Allowance to all facilities of Tharparkar by PPHI. Electrification of the facilities is of great importance. Date /Time for Next MRM: 5‐6‐2010 10: AM Comments on Targets vs Achievements (by DSM) The DSU has achieved targets, DSU is trying to achieve target regarding Repair and Renovation work, he said that we all should work for poor peoples of the area; he also said that we are working for 24 hrs MCH Centers. The meeting was ended with the vote of thanks to all participants.

118

MINUTES OF THE 25th MONTHLY REVIEW MEETING

OF DISTRICT NAUSHEHRO FEROZE

Monthly Review Meeting (MRM) of District, Naushehro Feroze for the Month of April2010 was held on 05th May ‐2010 at District Government Committee Room. Written invitations to participate were sent to the DCO, the EDO (H), the EDO (F&P) and District Incharge of EPI, LHW/LHVs and all other National Programs as usual. The list of participants is enclosed. The following could not attend the meeting for the reasons stated against each:‐

L. HFs WITH PPHI

BHUs: 45 Dispensaries: 02 MCHCs: 01 Others: N/A

TOTAL: 48 B. Population of the Catchment Area: 848,442

Z. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 51 51 38 13 13 W/FMOs 3 26 2 24 1 LHVs 3 15 1 14 2

Male 71 4 4 0 67 MTs/MAs

Female 0 3 3 0 0 Dispensers/Vaccinators 4 61 38 23 38

AA. CLUSTERS OF HFs

WITH ONE MO

S# Names/Designation S# Names/Designation

01 Mr. Zulfiqar Ali Shah‐ DCO‐Naushehor Feroze – Busy in meeting

02 Dr. Aqeela Qureshi on Leave

03 Dr. Abdul Ghaffar Wighio‐ BHU Palano was on leave 04 Dr. Liaqat Ali Chang on Training 05 Dr. Rafeeque Ahmed Mangrio on Training 06 Dr Shafi Mohammad on Training 07 Dr Aftab Ahmed Siyal on Training 08 Dr. Shehzado Tariq Hussain on Training 09 Dr Zulfiqar Solangi on Training 10 Dr Ghazanfer Pirzado on Training




119

WITH ONE FMO


1. First Session: During MRM Dr Ghullam Akbar Kanher conducted session on priority diseases. Following points discussed in detail:‐

• Diphtheria, ARI, Diarrhea, Measles and other priority diseases.



Date

Venue

Topic No. of

Participants

Dr Zakia Samoo 5 May DCO Hall WHO Protocols, Anti‐natal care, Normal labor and management.

14




No. of Doses of Immunization Administered in Children at Health Facilities. 13,295 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 3,346 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams N/A Total vaccination / immunization for the month 16,641



26‐28 April 2010 223,927 254109 113% 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides NA 2 Active Case Detection (ACD) Slides NA 3 Visits to Check Sanitation (individual house holds + streets) 67 4 Notices issued against Poor Sanitation 22 5 Challans sent to Court against Poor Sanitation NA 6 Patients Nebulized 55



120


During Month under Review

Names of FMOs Ante‐Natal

Cases Neo‐Natal Cases

Other OPD Total OPD

Dr. Afsheen Sehar 67 0 96 831

Dr. Amber Kehro 94 22 8 774

Dr. Aqeela 61 1 167 463

Dr. Fozia Abbassi 55 4 199 828

Dr. Ghulam Zaineb 59 0 228 1036

Dr. Khuola Naz 28 2 265 441

Dr. Mumtaz Khatoon Rajper 34 0 86 1098

Dr. Naima Batool 154 1 127 1141

Dr. Naseem Rajper 0 0 304 698

Dr. Nusrat Parween 50 0 234 785

Dr. Nuzhat Anwar 177 5 105 891

Dr. Rukaya Samo 26 0 127 796

Dr. Safia Memon 63 3 85 888

Dr. Sajida Parween 128 8 146 1202

Dr. Salma Amjad 30 2 115 833

Dr. Shaista Umrani 17 1 49 979

Dr. Shazia Shaikh 74 1 277 1244

Dr. Sughra Badar 144 37 47 1476

Dr. Tabbasum Buriro 56 7 310 1148 Dr. Usha 70 0 73 1128 Dr. Zakia Samo 21 56 16 1635 Dr. Zareena 33 2 211 1126


S # Service Number 1 Deliveries Assisted at HFs 12 2 Deliveries Assisted at homes N/A



121


S # Name of the Items / Service Number 01 Consultation / Advice 267 02 Oral Pills 940 03 IUCDs 94 04 Injections 376 05 Others Disposable Syringes 376

Total 2053


1. Number of Male SGs: 47 Number of Female SGs: 33 2. Performance of Social Organizers

Meetings of Support Groups conducted by him CHSs/SHSs arranged by him Names of Social Organizers No. No. of Participants No. No. of Participants

Zubair Ahmed Memon 14 252 Zia‐ur‐Rehman Mastoi 12 216

CHS ‐88 3891

Zaffar Ali Khushk 13 234 Total 39 702

SHS‐ 71 4824


Community Health Sessions School Health Sessions Names of MO / FMOs/Paramedics Sessions Participants Sessions Children Examined Children Treated

All MOs/FMOs/Paramedics 88 3891 71 4824 1015 Totals 88 3891 71 4824 1015


a. Ownership of BHU and speed up of the R and R work b. Availability of ARV & ASV at each HFs c. Provision of medicines of Multinational companies d. R and R work follow ups e. Maximum coverage of Ultrasound


• Primary health care guidelines discussed • Balanced Diet • Scabies • Personal Hygiene


• Precautions of Hepatitis • Signs and symptoms of Scabies • Effective cleanliness of Homes & Streets • Importance of Vaccination during Polio Camp • Health Education

122


Sr. No. Topics 1 Personal Hygiene 2 Primary Health Cover 3 Scabies 4 Malaria


S # Topics 1 Anti natal /Natal care 2 Importance of Family Planning 3 Hepatitis (B&C) 4 Importance of Vaccination


• Mobilization of female CSGs and developing ownership among male CSG members. • Involvement of notable in R and R work • CHS preferably held at Otaqs of notables so that maximum participation may be made. • Topics for CHS and SHS will be followed with letter and spirit • Participation of notables in the CSGs re‐enforced.


S# Description Recommendation To whom sent Present status i Sanitation NA NA ii Drainage / Sewerage NA NA iii ……… drinking water NA NA iv Prevention of adulteration NA NA v Tree Plantation NA NA vi Roads and infrastructure NA NA vii Environmental Improvement NA NA viii Others


1. OPD*




74032 2074 76106

2. Maximum OPD** Minimum OPD** S # BHU OPD BHU OPD 1 BHU Phull 3219 BHU Masur Ji Wai 10062 BHU Lakha Road 3127 GD Koaro Memon 9843 BHU Bhirya Road 2875 BHU Diloo Shah 9504 GD Faiz Mohd: Rajper 2674 BHU Mehmood Chandio 8525 BHU Qamardin Chandio 2659 MCHC Lutfullah Pahnwar 729

123

4. Top Five Diseases during OPD



No. of Patients



ARV Available Doses 00 Snake bite cases reported 00 ASV Vaccine Administered 00

ASV Vaccine Available Doses 00 33. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests) 34. SCREENING TESTS





Follow up result

Hepatitis B N/A N/A N/A N/A N/A Hepatitis C N/A N/A N/A N/A N/A

35. TUBERCLOSIS


New Cases During the Month Under Diagnosis

09 18 00




48 51 104 203

S # Tests Number 1 Blood Sugar Tests 448 2 Hemoglobin Tests 0 3 X‐Rays (if available) Nil 4 Ultra Sound 1133 5 Others (please specify) 0

124


1. Medicines available for: 30‐Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

• No any issue related to medicine • Medicine is provided in abundance quantity.


S # Name of HFs Description of Repair / Maintenance incl. Electrification

Status / Remarks

01 BHU Soomar Channar Repair and Electrification 100% 02 BHU Khanwahan Repair and Electrification 95% 03 BHU Bazidpur Repair and Electrification 80% 04 BHU Kamil Rajper Repair 80% 05 BHU Mohbat Dero Jatoi Repair and Electrification 78% 06 BHU Ali Sher Chang Repair 60% 07 BHU Tunia Baqa Shah Repair 70% 08 BHU Fatoo Balal Repair 10% 09 BHU Chaheen Suleman Repair 10% 10 BHU Qamardin Chandio Repair 10% 11 BHU Kot Ghulam Shah Repair 10%

12 BHU Dangaja Repair 10% 13 GD Faiz Mohammed Rajper Repair 10%


On Staff Matters:

• Regularity and punctuality of the staff • Proper updating and reconciliation of the record • Wearing of aprons and uniforms


• More Sessions should be held in elementary schools and community. • Arranging of quality health session re‐ emphasized • Agenda of the sessions must be with planning and in simple language. • Cleanliness of the HFs on regular basis.

On Curative Health:

• Medicine must be properly managed • Proper record also maintained and reconciled • Yearly record must be separated and kept in proper way. • X‐Ray and Ultrasound facility

Date /Time for Next MRM: On 8th June 2010 at 10:30 am. Comments on Targets vs. Achievements (by DSM)

• Thorough the efforts of the all staff working at HFs the over all performance have been qualitatively improved and we are very near to achieve our set targets.

125

MINUTES OF THE (16TH) MONTHLY REVIEW MEETING

OF DISTRICT_SANGHAR

Monthly Review Meeting (MRM) of District, Sanghar for the Month of April 2010 was held on 04.05.2010 at DSU‐PPHI‐Office, Sanghar located at New OPD Block, Civil Hospital Sanghar. Written invitations to participate were sent to the District Coordination Officer, the EDO(H), the EDO(F&P) and District Incharge of EPI, LHW and all other National Programs as usual. The list of participants is enclosed.

S# Name / Designation S# Name / Designation 1 Mr. Rasool Bux Sameho DCO, Sanghar 33 Mr. Imtiaz Ahmed Store Manager

2 Mr. Abdul Ghaffar Surahio

DSM, Sanghar 34 Dr. Asim Rasool I/C PPHI, M.O

3 Dr. Mushtaque Ahmed Memon

EDOH, Sanghar 35 Dr. Khalid Hussain Leghari

M.O (H.Q)

4 Mr. Shoukat Ali Wassan D.O (Admin & Finance), Sanghar

36 Dr. Rasool Bux I/C M.O

5 Dr. Capt Muhammad Farooque Awan

Civil Hospital, Sanghar

37 Dr. Muhammad Zakir I/C PPHI, M.O

6 Mr. Gul Muhammad Bhurgri

Executive (F&A) 38 Dr. Muhammad Yousif I/C PPHI, M.O

7 Mr. Mumtaz Ali Leghari Executive (M&E) 39 Dr. Muhammad Aslam I/C Dispenser

8 Dr. Abdul Rehman Laghari M.O, Civil Hospital Sanghar

40 Mr. Mushtaque Ali Social Mobilizer

9 Mr. Muhamamd Iqbal M.S Malaria, Sanghar

41 Dr. Taj Muhammad I/C PPHI, M.O

10 Dr. Sher Muhammad SMO 42 Dr. Dilshad Ali Khan I/C PPHI, M.O 11 Dr. Aftab Ahmed SMO 43 Dr. Ashfaque Ahmed I/C S.M.O 12 Dr. Gul Hassan Dahri I/C M.O, PPHI 44 Dr. Syed Turab Ali Shah I/C PPHI, M.O 13 Dr. Muhammad Farooque I/C M.O PPHI 45 Dr. Muhammad Haroon I/C PPHI, M.O 14 Dr. Syed Tarique Ali Rizvi I/C M.O PPHI 46 Dr. Anwer Adil Ansari I/C M.O, PPHI 15 Dr. Waheed Ali I/C M.O PPHI 47 Dr. Bhagwan Das I/C PPHI, M.O 16 Dr. Abdul Jabbar Sanjrani I/C M.O PPHI 48 Dr. Ahsan Gohar I/C M.O 17 Dr. Bashir Ahmed I/C M.O PPHI 49 Dr. Ashfaque Ali I/C M.O 18 Dr. Israr Ahmed I/C M.O 50 Dr. Irfan Ali I/C PPHI, M.O 19 Dr. Shaman Das I/C M.O PPHI 51 Dr. Mehdi Hassan I/C PPHI, M.O 20 Dr. Allah Jurrio IC/ M.O 52 Dr. Jewat Ram I/C PPHI, M.O 21 Dr. Asrar Ahmed I/C M.O 53 Dr. Narain Das I/C M.O 22 Dr. Deedar Hassan I/C M.O, PPHI 54 Dr. Muhammad Ramzan I/C M.O 23 Dr. Haque Nawaz I/C PPHI, M.O 55 Dr. Rafique Ahmed I/C PPHI, M.O 24 Dr. Mahesh Kumar I/C M.O 56 Dr. Faiz Muhammad I/C M.O

25 Dr. Muhammad Sharif I/C PPHI, M.O 57 Dr. Syed Qamar ul Hassan

I/C PPHI, M.O

26 Dr. Rafique Ahmed I/C M.O 58 Dr. Jayram Das I/C PPHI, M.O 27 Dr. Saeed Nasim I/C PPHI, M.O 59 Dr. Nand Lal I/C PPHI, M.O

28 Dr. Ghulam Hyder I/C M.O, PPHI 60 Dr. Muhammad Farooque

I/C M.O

29 Dr. Sardar Ahmed I/C M.O 61 Dr. Kanya Lal I/C PPHI, M.O 30 Dr. Muhammad Azhar I/C M.O, PPHI 62 Dr. Kishwer das I/C PPHI, M.O 31 Dr. Ali Bahar Rind I/C S.M.O 63 Dr. Tanveer Ahmed I/C PPHI, M.O

126

32 Dr. Aftab Ahmed I/C PPHI, M.O 64 Dr. Muhammad Mujtaba I/C PPHI, M.O 65 Dr. Atta ul Mustafa I/C PPHI, M.O 88 Dr Tasleem Aziz F.M.O 66 Dr. Bashir Ahmed I/C M.O 89 Dr Zulekha Pari F.M.O 67 Dr. Paras Ram I/C PPHI, M.O 90 Dr. Sanober Hussain FMO 68 Dr. Ghulam Murtaza I/C PPHI, M.O 91 Dr Rizwana Channar F.M.O 69 Dr. Jetha Nand I/C PPHI, M.O 92 Dr Rizwana Khokhar F.M.O 70 Dr.Gul Afshan Sonologist 93 Dr. Safeena Mughal F.M.O 71 Dr. Hina Shabir Sonologist 94 Dr Saima Jabeen F.M.O 72 Dr Abida F.M.O 95 Dr. Samina Bhatti F.M.O 73 Dr Aisha Dastagir F.M.O 96 Dr Satti Jeevat F.M.O 74 Dr Amna Fatima F.M.O 97 Dr. Moona FMO 75 Dr Amna Hayat F.M.O 98 Dr. Shaista F.M.O 76 Dr Asma Jabeen F.M.O 99 Dr. Sadaf Chaudhry 77 Dr. Asma Malik F.M.O 100 Dr. Irfana Irum Memon FMO 78 Dr. Ruqia Chandio FMO 101 Mr. Sultan Ali Dharejo Social Mobilizer

79 Dr. Ghazala Rashid F.M.O 102

Mr. Muhammad Faisal Community Mobilizer

80 Dr Hameeda Zardari F.M.O 103

Mr. Abdul Ghaffar Community Mobilizer

81 Dr Jai Shree F.M.O 104

Mr. Asif Ali Arain Asst. Store Manager

82 Dr Mehreen F.M.O 105 Mr. Syed Imdad Ali Shah Asst Accounts 83 Dr Nusrat Jameel F.M.O 106 Mr. Ali Asghar Medicine Handler 84 Dr Shamim Begam F.M.O 107 Mr. Hidayatullah Medicine Handler 85 Dr Sumera Bano F.M.O 108 Mr. Qaim Ali Attendant 86 Dr Shazia Zeshan F.M.O 109 Mr. Muhammad Asif 87 Dr.Sonia Rani F.M.O 110


S # Names/Designation S # Names/Designation 1 Dr. Gobind Ram, I/C M.O 9 Dr. Allah Warayo Bozdar , I/C M.O 2 Dr. Abdul Aziz, I/C SMO 10 Dr. Haresh Kumar, I/C MO. PPHI 3 Dr. Amil Khan, I/C M.O 11 Dr. jawaher Lal, I/C M.O, PPHI 4 Dr. Dileep Kumar, I/C M.O 12 Dr. Arjan Kumar, I/C M.O 5 Dr. Shah Saood Marri, I/C M.O 13 Dr. Muhammad Yaqoob Dahiri, I/C M.O 6 Dr. Akmal Baig, I/C M.O 14 Dr. Mahesh Kumar, I/C M.O, PPHI 7 Dr. Ratan Kumar, I/C M.O, PPHI 15 Dr. Mir Muhammad Dahiri, I/C M.O 8 Dr. Muhammad saeed, I/C M.O, PPHI 16 Mr. Ghulam Rasool, Dawasaaz

M. HFs WITH PPHI

BHUs: 58 Dispensaries: 33 MCHCs: 0 1 Others: 01

TOTAL: 93

127

STAFF STRENGTH

Sanctioned

Posts Working


PPHI Contract

Vacant

MOs 77 76 30 48 0 W/FMOs 34 34 2 33 3 LHVs 77 62 17 45 02

Male 32 32 0 0 MTs/MAs

Female 10 10 0 0 Dispensers

107 65 30 35 0

BB. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO


Following persons addressed in MRM.

S # Name of

Resource Person Designation Speech Detail

01 Mr. Rasool Bux Samejo

District Coordination Officer, Sanghar

Progress of PPHI in District Sanghar, Distribution of Hard Area Allowance, V‐Phone Sets, Rechargeable Torch for Medical Officer and Watchman of BRHFs were also distributed by the Honourable Chief Guest DCO, Sanghar.

02 Mr. Abdul Ghaffar Surahio

District Support Manager

Welcome Address, progress f PPHI achieved for the month of April 2010

03 Dr. Mushtaque Ahmed Memon

Executive District Officer (Health)

Coordination with PPHI

04 Dr. Abdul Rehman Laghari

Medical Officer, Civil Hospital, Sanghar

lecture on Hepatitis C

Previous Month Month under Review Total at Present Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 04 Clusters of 2 HFs 03 Single HFs 42 Single HFs 45

Previous Month Month under Review Total at Present Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs 03 Clusters of 3 HFs 02 Clusters of 2 HFs 22 Clusters of 2 HFs 26 Single HFs 01 Single HFs 02

128



No. of Doses of Immunization Administered in Children at Health Facilities. 5945 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 3024 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams 21836 Total vaccination / immunization for the month _________ 30805



26 to 28 April 2010 269,894 355018 131.53% 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 4327 2 Active Case Detection (ACD) Slides ‐ 3 Visits to Check Sanitation (individual house holds + streets) ‐ 4 Notices issued against Poor Sanitation ‐ 5 Challans sent to Court against Poor Sanitation ‐ 6 Patients Nebulized ‐



S # Names of FMOs Ante‐Natal

Cases Neo‐Natal Cases

Other OPD Total OPD

1 Dr.Satti jeevat 78 10 9 852 2 DR.Saima 209 12 461 1275 3 Dr.Sumera Bano 251 62 68 1818 4 Dr.Aisha 101 5 218 657 5 Dr.Amna Hayat 98 4 373 762 6 Dr. Abida 263 2 260 702 7 Dr.Mehreen 228 7 172 969 8 Dr.Amna Fatima 45 0 110 611 9 Dr.Shamim Begam 103 0 204 706 10 Dr.Rizwana Chanar 51 15 120 757 11 Dr.Sadaf 154 29 122 924 12 Dr.Zulekha Pari 189 7 155 897 13 Dr.Jai Shree 41 0 192 2220 14 Dr.Tasleem Aziz 42 0 328 699 15 Dr.Hameeda 15 2 217 756 16 Dr,Shazia Zeshan 141 3 180 509 17 Dr.Asma Jabeen 27 0 244 739 18 Dr.Nusrat Jameel 49 5 211 881

129

19 Dr.Safeena Mughal 28 4 36 351 20 Dr.Sonia Rani 26 7 159 613 21 Dr.Rukia Chandio 23 8 239 572 22 Dr.Fozia Soomro 123 9 245 876 23 Dr.Rizwana Khokhar 23 0 167 846 24 Dr.Samena Bhatti 23 2 121 563 25 Dr.Ghazala Rashid 162 4 167 877 26 Dr.Asma Malik 235 4 1778 8502 27 Dr.Snober Hussain 138 6 426 1514 28 Dr.Irfana Iram 6 2 1 86 29 Dr.Moona 8 4 176 323 30 Dr.Shaista 7 6 136 409

Deliveries Assisted



S # Test Number 1 Pregnancy Tests 365 2 Blood Sugar Tests 133 3 Hemoglobin Tests ‐ 4 Ultra Sound Test 1145 5 Other 1102


S # Name of the Items / Service Number Consultation / Advice 184 Oral Pills 262 IUCDs 31 Injections 286 Condom 49

Total 920 2. Performance of Social Organizers

Names of SO Meetings of Support Groups conducted by him CHSs / SHSs arranged by him No. No. of Participants No. No. of Participants

Mr. Sultan Ali

Mr. Mushtaque

Mr. Abdul Ghaffar

Mr. Faisal

Total * No support group meeting conducted, no S.H.S/Community health session was conducted due to all S.O,s were engaged in R & R work.

130


Community Health Sessions School Health Sessions Names of MO / FMOs/Paramedics Sessions Participants Sessions

Children Examined

Children Treated

Dr.Satti jeevat 2 83 2 55 0 DR.Saima 2 68 2 12 5 Dr.Sumera Bano 3 130 1 30 15 Dr.Aisha 2 56 2 50 15 Dr.Amna Hayat 2 60 2 60 25 Dr. Abida 1 20 1 40 32 Dr.Mehreen 2 78 2 19 15 Dr.Amna Fatima 2 60 2 25 25 Dr.Shamim Begam 2 45 1 0 0 Dr.Rizwana Chanar 2 21 2 48 0 Dr.Sadaf 2 45 0 0 Dr.Zulekha Pari 2 30 1 0 0 Dr.Jai Shree 2 65 1 21 5 Dr.Tasleem Aziz 2 40 2 10 10 Dr.Hameeda 2 57 2 80 0 Dr,Shazia Zeshan 2 49 2 20 15 Dr.Asma Jabeen 2 69 2 0 0 Dr.Nusrat Jameel 1 14 1 10 2 Dr.Safeena Mughal 2 37 2 90 0 Dr.Sonia Rani 2 67 2 0 0 Dr.Rukia Chandio 1 23 1 0 0 Dr.Fozia Soomro 2 60 0 0 Dr.Rizwana Khokhar 4 26 0 0 Dr.Samena Bhatti 2 36 0 0 0 Dr.Ghazala Rashid 1 32 2 62 0 Dr.Asma Malik 1 135 1 40 0 Dr.Snober Hussain 1 44 1 30 20 Dr.Irfana Iram 0 0 0 0 0 Dr.Moona 0 0 0 0 0 Dr.Shaista 0 0 0 0 0 Total 51 1450 37 702 184


1. The District Support Manager told the participants regarding important role of participation of in R&R schemes of an active Community Support Group members.

2. To put extra care for female staff i.e FMO, LHV. 3. Ownership of their health facility. 4. To cater the free facilitation of FMO \ ultrasound services provided by PPHI, Sanghar. 5. Important Points during SHSs

1. Preventive measure from Swain Flue. 2. Hand Washing 3. Using Safe and boiled drinking water. 4. Diarrhea diseases in children.

131


1. Counseling on Family Planning among families. 2. Advantages of neat and clean. 3. Preventive aspects of Hepatitis B&C. 4. Preventive Measures from Swain Flue.


Sr. No. Topics 1 Safe drinking water 2 Hand Washing 3 Personal Hygiene 4 Importance of Child health 5 Self Medication Practice 6 Importance of exercises


9. Important Discussion on Community Participation during MRM The DSM emphasized these health facilities are made to benefit public and public is the owner of that health facility. 10. Health Camps:

• 02 Health camps arranged by PPHI Sanghar at GD Saeedahoo located at Acchro Thar, Taluka Khipro, District Sanghar Number of Patients: ‐‐‐357 ‐‐‐‐‐


Sr No Description Recommendation To whom sent Present status i Sanitation ‐ ‐ ‐ ii Drainage / sewerage ‐ ‐ ‐ iii ……… drinking water ‐ ‐ ‐ iv Prevention of adulteration ‐ ‐ ‐ v Tree Plantation ‐ ‐ ‐

S # Topics 1 Prevention from hepatitis B and C 2 Injection safety 3 Identification of T.B Patents 4 Facility of Anti Natal care at heath centers 5 Importance of Child health 6 Importance of Breast Feeding 7 Management / prevention of skin diseases 8 Management of / prevention of Malaria 9 Importance of immunization 10 Management of / prevention of worm infestation 11 Family Planning 12 Safe Blood transfusion 13 Management / prevention of Jaundice

132

vi Roads and infrastructure ‐ ‐ ‐ vii Environmental Improvement ‐ ‐ ‐ viii Others ‐ ‐ ‐


1. OPD*





S # BHU OPD BHU OPD 1 Malook Junejo 3341 Amul Wassan 577


S # Disease No. of Patients 1 ARI 19872 2 Maleria 15561 3 Diarrhea 11933 4 Scabies 8410 5 Dyentry 1390


No. of Patients


ARV Administered 49 ARV Available Doses 54 Snake bite cases reported 0


ASV Vaccine Available Doses

S # Diseases No. of Patients 1 Allergy

2 Scabies

3 Dandruff 4 Abdominal pain 5 Head ache

133



S # Tests Number 1 Blood Sugar Tests 315 2 Haemoglobin 0 3 X‐Rays (if available) 4 Ultra Sound 1145 5 Others (please specify)






Follow up

result Hepatitis B 32 7 7 39 ‐ Hepatitis C 14 04 04 43 ‐

38. TUBERCLOSIS

Patients Receiving Treatment New Cases During the Month

Under Diagnosis

524 215 510




81 62 159 302

2. Important Points/Issues arising from Visits S # Name of HF Issue Action Remarks

01 All Health facilities

Soft boards Done

02

All health facilities Shortage of Furniture Purchase Orders have been placed

03 All Health facilities Material for School Health Literature In Process 04 All Health facilities Material regarding FMO, Ultrasound

Facility Days, Free Consultation, Availability of ARV / ASV, Health messages etc

All necessary material has been supplied



134

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS S # Name of HFs Description of Repair / Maintenance


1 GD Rawtiani Repair and maintenance of main

building including water supply, drainage, electricity, coloring etc.

Completed

2 BHU Rukan Burera ‐‐‐do‐‐‐ Completed 3 BHU Chotyarion ‐‐‐do‐‐‐ Completed 4 BHU Pritam abad ‐‐‐do‐‐‐ Work in process 5 BHU Malook Junejo ‐‐‐do‐‐‐ Completed 6 BHU Landhi ‐‐‐do‐‐‐ Completed 7 BHU Golo Pir ‐‐‐do‐‐‐ Work in process 8 BHU Moheb Ali Junejo ‐‐‐do‐‐‐ Completed 9 DCD Loon Khan ‐‐‐do‐‐‐ Completed 10 DCD Bobi Town ‐‐‐do‐‐‐ Completed 11 BHU Jia Abad ‐‐‐do‐‐‐ Completed 12 BHU Perumal ‐‐‐do‐‐‐ Completed 13 BHU Khairo Kaloi ‐‐‐do‐‐‐ Work in process

14 DCD Ali Muhammad Thaheem

‐‐‐do‐‐‐ Work in process

15 BHU Bago Wadadani ‐‐‐do‐‐‐ Work in process 16 BHU Karim Dino Wassan ‐‐‐do‐‐‐ Work in process 17 BHU M.K Rind ‐‐‐do‐‐‐ Work in process 18 BHU Yamin Hingorjo ‐‐‐do‐‐‐ Work in process 19 BHU Bilawal Hingorjo ‐‐‐do‐‐‐ Work in process 20 BHU Khahi ‐‐‐do‐‐‐ Work in process 21 BHU Gider Ahpan ‐‐‐do‐‐‐ Work in process 22 BHU Soomer Wassan ‐‐‐do‐‐‐ Work in process

23 BHU Malook Mahar ‐‐‐do‐‐‐ Bank Account in process

24 GD Ghundan ‐‐‐do‐‐‐ Work in process 25 BHU Rahim Abad ‐‐‐do‐‐‐ Work in process

26 DCD Mula Makhan

‐‐‐do‐‐‐ Work not Started due to non opening of Bank Account ,because MO CNIC is expired .

27 BHU Basi ‐‐‐do‐‐‐ Work in process



Mr.Rasool Bux Samejo D.C.O Sanghar BHU Hathungo Satisfied

Mr.Rasool Bux Samejo D.C.O Sanghar BHU Khadro Satisfied


135


On Staff Matters:

1. The DSM emphasized to all participants to ensure the availability of staff at their health facilities. 2. The District Support Manager ensured all the participants that; PPHI will provide full support and

cooperation in all matters of Incharge of Health facilities. 3. The DSM, PPHI Sanghar once again in this MRM reminded all the in charges of health facilities for their

timely submission of HMIS reports, Monthly Medicines Requisition, Referral Cases regarding the TB, Polio Dog Bite, Measles, Diarrhea etc.


1. The District Support Manager ensured all the participants that PPHI will extend its full support and cooperation in all vertical Programs i.e EPI, Measle, Malaria, TB Dot, Hepatitis B&C etc.

2. He further told the participants that PPHI will take extra pain to cover and support our national campaigns EPI, NIDs, Measles etc. he ensured honourable guests that, they will never found PPHI backward in national campaigns.

On Curative Health:

1. The DSM told the participants that PPHI is trying its level best in order to make the system fully functional and increase the volume of medicines and make sure the availability of other necessary medical equipments, furniture.

On Mother, Child & Reproductive Health: No such discussion took place in the MRM. MCH Inauguration Ceremony of MCH Khadro Briefed at MRM Other Matters:

1. The DSM requested all the I/C ‘s of H.Fs to submit their reimbursement claims if any. Date /Time for Next MRM: The Monthly Review Meeting for all the In Charges of Health Facilities shall be held on 1st week of every month.

Comments on Targets vs. Achievements (by DSM) TARGETS 1. For M.Os preparation of Third Party Evaluation 2. For FMOs Deliveries, & Antenatal care, Arranging School and Community Health Sessions. ACHIEVEMENTS So far the majority of M.Os has achieved the targets regarding

1. Cleanliness of HFs. 2. Punctuality of Staff 3. Store Management 4. Waste Management 5. Overall Behavior of staff has improved with visitors and patients. 6. Record Keeping

136

MINUTES OF THE (8th) MONTHLY REVIEW MEETING OF DISTRICT SUPPORT UNIT SHIKARPUR

Monthly Review Meeting (MRM) of District, Shikarpur for the Month of April, 2010 was held on 07/05/2010 at the District Administrator Secretariat, DSU, PPHI Shikarpur. The participants of the meeting were as under:‐ S # Names/Designation S # Names/Designation 1 Mr. Tariq Aziz Kolachi – DSM 2 Dr. Athar Hussain Shah MO/HQ 3 Dr. Manzoor Ahmed Channa ‐ MO 4 Dr. Allah Bux Sanjrani 5 Dr. Javed Shaikh‐I/c MO 6 Dr. Niaz Soomro – MO 7 Mr. Waqar Ahmed Mangi Store Manager 8 Mr. Shamsuddin Bhutto (Dispenser) 9 Dr.Aijaz Hussain – SMO 10 Dr. Waseem Lohar – MO 11 Dr. Nadir Ali‐ I/c MO 12 Asif Ali Shar Exe: F&A 13 Dr.Satyapal – MO 14 Dr. Shabeer Ahmed‐DDO‐H 15 Dr.Kishore Kumar 16 Dr.Naresh Kumar 17 Dr. Abdul Rauf Memon‐T.B Coordtr 18 Dr. Maida Siddiqi‐FMO 19 Dr. Naila Khoso‐DBO 20 Dr. Saima Hajano‐FMO 21 Dr. Zulfiqar Mahar‐ I/c MO 22 Dr.Deepak Kumar 23 Syed Munwar Shah 24 Dr. Cap: Masood Badvi MS Taluka Lakhi Hospital 25 Dr. Saiqa Soomro‐FMO 26 Tariq Hussain Mahar‐SO 27 Dr.Tanveer Khatoon‐FMO 28 Himayatullah Naich‐Sub Engineer 29 Dr. Salma Mahar‐FMO 30 Khalil Ahmed Sohu‐SO 31 Dr. Sabhagi‐FMO 32 A Ghani Napar 33 Safdar Hussain Memon 34 Dr.Masood Shaikh 35 Tanveer Ahmed Khoharo Asstt: Accounts 36 Dr.Ram Chand 37 Dr.Abdul Qudoos Soomro


S # Names/Designation Reasons for absence 01 Dr. Irshad Katpar (M.O) Absent From Duty

N. HFs WITH PPHI

BHUs: 09 Dispensaries: 05 MCHCs: Nil Others: Nil


CC. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 11 15 12 3 ‐ W/FMOs 0 7 ‐ 7 ‐ LHVs 3 5 5 ‐ 8

Male ‐ ‐ ‐ ‐ ‐ MTs/MAs Female ‐ ‐ ‐ ‐ ‐ Dispensers ‐ 5 2 3 ‐

137

DD. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO


1. First Session: During MRM Dr. Nadar Panhwar (I/C MO) in his Lecture on topic Polio Program ; He presented on the slides about the running polio rounds and its importance . 2. 2nd Session: During MRM Dr.Athar Hussain Shah Mo/HQ PPHI DSU Shikarpur during his capacity building session on the subject HMIS informed the participants about the information of HMIS report in due time .



Date

Venue

Topic No. of

Participants Dr. Nadar Panhwar 5/4/2010 BHU Hamayoon Family planning & EPI 23 Dr. Aijaz Soomro 10/4/2010 BHU Abdoo Family planning & EPI 26 Dr. Masood Shaikh 16/4/2010 BHU Haji Khwasti Family planning & EPI 17

Dr. Jawed Shaikh 22/4/2010 BHU Jahan Khan Family planning & EPI 18



No. of Doses of Immunization Administered in Children at Health Facilities. 3693 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 591 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams 0

Total vaccination / immunization for the month December 2009 4284


Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs Single HFs Single HFs 14

Previous Month Month under Review Total at Present Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs 07 Single HFs Single HFs

138



N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A


S # Service Number 1 Passive Case Detection (PCD) Slides N/A 2 Active Case Detection (ACD) Slides N/A 3 Visits to Check Sanitation (individual house holds + streets) 26 4 Notices issued against Poor Sanitation N/A 5 Challans sent to Court against Poor Sanitation N/A 6 Patients Nebulized N/A






S # Test Number 1 Pregnancy Tests 515 2 Blood Sugar Tests 877 3 Hemoglobin Tests N/A 4 Ultra Sound Test N/A


Neo‐Natal Cases

Other OPD Total OPD

1 Dr.Saiqa 51 0 1671 1722 2 Dr.Sabhagi 63 0 1223 1286 3 Dr.Saima Hajano 69 0 2749 2818 4 Dr.Saima Mughal 56 0 1314 1370 5 Dr.Salma 75 0 1427 1502 6 Dr.Tanveer 80 0 3162 3242 7 Dr.Maida 77 1 2167 2245

Total 471 1 13713 14185

139


Deliveries at HFs came under discussion. FMOs were emphasized by the DSM to attend all the neo‐natal and ante‐natal cases properly and carry out maximum number of deliveries. 32. Provision of Family Planning Services during the Month


Total 551


1. Number of Male SGs: 13 Number of female SGs: N/A 2. Performance of Social Organizers



No. No. of

Participants No.

No. of Participants

Mr. Tarique Hussain Mahar 6 138 36 1152

Mr. Khalil Ahmed Sohu 7 168 38 1301




Children Treated

Dr. Saiqa Soomro 2 43 2 49 18 Dr. Sabhagi 2 69 2 53 20

Dr.Saima Hajano 2 73 2 56 17 Dr. Saima Mughal 2 51 2 48 19 Dr. Salma Mahar 2 53 2 49 17 Dr. Tanveer Khatoon 2 50 2 52 18 Dr. Maida Siddiqi 2 59 2 56 18 Dr. Athar Hussain Shah 2 63 2 60 15

Dr. Aijaz Soomro 2 54 2 48 17 Dr. Sajjad Badvi 2 57 2 53 16 Dr. Naiz Ahmed Soomro 2 44 2 47 19 Dr. Allah Bux Sanjrani 2 49 2 54 18 Dr. Saifullah Mahar 2 58 2 52 16

140

Dr. Naresh Kumar 0 0 0 0 0 Dr. Waseem Lohar 2 60 2 59 13 Dr.Satya pal 2 65 2 68 17

Dr. Zulifqar Mahar 2 59 2 57 19 Dr. Manzoor Channa 2 48 2 46 18 Dr. Jawed Ali Shaikh 2 37 2 73 20 Dr. Nadar Ali Pahnwar 2 44 2 42 17 Dr. Masood Ahmed Shaikh 0 0 2 49 12


5. Supply of medicine 6. Regularity / punctuality of staff 7. Identification of problems at HFs faced by staff 8. Demand by community for appointment of FMOs at single HFs 9. Provision of intra‐muscular injection instead of 14 doses

5. Important Points during SHSs 4. Awareness among students about cleanliness & different diseases 5. Co‐operation sought from teachers to spread health awareness in community.

6. Important Points during CHSs 4. Stress on health consciousness 5. Education about prevention from different diseases 6. Support of MOs/FMOs to community in providing free treatment at HFs


Sr. No. Topics 1 Malaria 2 Scabies 3 Chest infection 4 Mal Nutrition


S # Topics 1 Nutrition 2 Scabies 3 Malaria 4 PID

9. Important Discussion on Community Participation during MRM Provision of free ultra sound facility at each facility. 10. Health Camps: Number Held: ‐‐‐‐‐‐NIL‐‐‐‐‐. Number of Patients: ‐‐‐‐‐Nil‐‐‐‐‐.

141


Sr No Description Recommendation To whom sent Present status i Sanitation N/A N/A N/A ii Drainage / sewerage N/A N/A N/A iii ……… drinking water N/A N/A N/A iv Prevention of

adulteration N/A N/A N/A

v Tree Plantation N/A N/A N/A vi Roads and infrastructure N/A N/A N/A vii Environmental

Improvement N/A N/A N/A

viii Others N/A N/A N/A (IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW 1. OPD*




(New + Old) 27046

5489

32535


S # BHU OPD BHU OPD 1 BHU Jamra 3100 GD New Lalyoon 1990 2 BHU Wzirabad 4512 GD Bhirkan 2664

3 BHU Rustam 3533 Darwesh Kakepota 2268 4 BHU Hamayoon 1790 BHU Haji Khawasti Brohi 1476 5 BHU Abdu 3470 BHU Jahan Khan 2944 6 BHU Soomar Goth 1705 GD M Hayat Junejo 3391 7 GD Chodhio Sadhayo 2002 GD Boriri 455


S # Diseases No. of Patients 1 ARI 175 2 Scabies 98 3 Malaria 22

4 Diarrhea 19 5 Flue 03

142


S # Disease No. of Patients 1 ARI 9211 2 Malaria 1522 3 Scabies 6428 4 Diarrhea 2531 5 Dysentery 1032







S # Tests Number 1 Blood Sugar Tests 877 2 Hemoglobin N/A 3 X‐Rays (if available) N/A 4 Ultra Sound N/A 5 HBs , Hcv @ Camp N/A






Follow up result

Hepatitis B N/A N/A N/A N/A N/A Hepatitis C N/A N/A N/A N/A N/A

41. TUBERCLOSIS



Under Diagnosis

279 43 N/A 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 N/A N/A N/A N/A N/A N/A N/A

143


S.No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs 2 N/A N/A N/A N/A N/A N/A N/A




98 N/A 138 236


S # Name of HF Issue Action Remarks GD Chodhio

Sadhayo MO Resigned DSM posted new I/C MO Dr.Naresh Kumar

@ HF. ‐

BHU‐Boriri Non Functional GD Boriri was reopened after posting MO,FMO and necessary repair work of the

HF.

‐


1. Medicines available for: 8 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM Demand for ARV/ASV, Hemoglobin Meter, Gluco meter, Nebulizer, Stitching material etc Raised by doctors and DSM agreed and allowed to make these items available soon. I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of



1 BHU Jahan Khan 100% ‐ 2 BHU Soomar Goth 100% ‐ 3 BHU‐Wazir Abad 100% 4 BHU H K Brohi 100% ‐



EDO Health Shikarpur

BHU Jahan Khan, BHU Wazirabad, Haji Khawasti, GD Muhammad

Hayat, Soomar Goth

Satisfied and advised staff of HF’s to improve their services to poor & needy patients of

the adjoining areas. * To reflect only non‐PPHI Visitors.

144


On Staff Matters: Appointment and posting of staff at different HFs came under discuss. On Preventive Health:

4. Opening of new stationary EPI centers. 5. Conduct of proper CHSs /SHSs 6. Checking of out reach staff properly by the MOs.

On Curative Health:

3. Suggestions by FMOs/MOs to arrange free medical camps On Mother, Child & Reproductive Health:

2. FMOs to attend all the mother‐child health related cases. 3. FMOs to attend maximum number of deliveries at HFs.

Other Matters: No any important matter came under discussion. Date /Time for Next MRM: 10/06/2010 – 10:00am Comments on Targets vs Achievements (by DSM)

1. Reopening of GD Boriri were MO & FMO Appointed Medicine were given M&R work is required @ HF. 2. 13 CSGs forums formed @ HFs new furniture provided @ HFs. 3. R&R work is completed at BHU Jahan Khan, Soomar Goth,Wazir Abad, Haji Khawasti ,R&R work 65%

completed at BHU Abdoo, 50% GD New Lalyoon . 4. FMOs kit, Stationary, Petty articles, Medicine instruments provided to HFs. 5. ARV, ASV and Required Medicine is supplied at HF’s. 6. Provision of ARV I / M. 7. Provision of Ultra sound facility @ each HF. Where as Ultra sound machine already purchased. 8. Provision of refrigerators @ HF’s where required 9. Purchase of selling fans and repair of the fans @ each HF

145

MINUTES OF THE MONTHLY REVIEW MEETING

OF DISTRICT_SUKKUR

Monthly Review Meeting (MRM) of District, Sukkur for the Month of April, 2010 was held on 06‐05‐2010 at DSU office Sukkur. Written invitations to participate were sent to the DCO, the EDO(H), the EDO(F&P) and District Incharge of EPI, LHW and all other National Programs as usual. The list of participants is enclosed.

S # Names/Designation S # Names/Designation 1 Dr. Najeeb‐ur‐Rehman Chachar DSM Sukkur 27 Mr. Aijaz Ali Phul Executive (M&E)

2 Mr. Raza Muhammad Dandan DSV EPI Sukkur

28 Mr. Buland Shah Malaria Focal Person

3 Mr. Zia Jalbani Executive (F/A) 29 Dr. Fiza Ahsan 4 Dr. Muhammad Hassan Indhar 30 Dr. Saifullah Qurashi 5 Dr. M. Javeed Balouch 31 Dr. Farzana Ubaid Shaikh 6 Dr. Salahudin Shah 32 Dr. Nadia Jabeen 7 Dr. Mushtaque Mahar 33 Dr. Nizam‐u‐din Shah 8 Dr. Arshad Qazi. 34 Dr. Roomana 9 Dr. Mumtaz Ali Bullo 35 Dr. Zaib‐u‐Nisa Qazi 10 Dr.Abdul Wahab 36 Dr. Faisal Qazi 11 Dr.Ali Gul Shah 37 Dr.Shazia Mangi 12 Dr. Mir Parveez 38 Dr.Nusrat Dharejo 13 Dr.Noor Ahmed Soomro 39 Dr.Sharmeen Bano 14 Dr.Illahi Bux Domki 40 Dr.Farheen Fatima 15 Dr.Nadeem Mangi 41 Dr.Jalees Fatima 16 Dr. Gridhari Lal 42 Dr.Kaneez Fatima 17 Dr. Khadim Hussain 43 Dr.Roomana Shah 18 Dr.Sunnel Kumar 44 Dr.Rizwana Parveen 19 Dr.Ghulam Murtaza Jatoi 45 Dr.Najma Shah 20 Dr. Ihsanullah Dayoo 46 Dr.Abida Gillani 21 Dr.Abdul Sami Sheikh 47 Dr.Abida Simair 22 Dr.Tahir Abbasi 48 Dr.Raheela Gohar 23 Dr.Khuram Hayat 49 Dr.Shahista Dahar 24 Dr.Ghulam Mohammad Soomro 50 Dr. Ghulam Qadir Shaikh 25 Dr.Ghulam Rasool Sheikh 51 Dr. Ghulam Nabi Soomro 26 Dr. Abdul Aziz Shaikh 52 Dr. Ali Gul Shah


S # Names/Designation Reasons for absence 1 Dr. Niaz Kalhoro C/L 2 Dr. Abdul Waheed Simair C/L 3 Dr. Rasool Bux Shah Absent

O. HFs WITH PPHI


TOTAL: 35

146

B. Population of the Catchment Area: 1,243,360

EE. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 31 34 16 18 W/FMOs 0 18 1 17 0

Female 27 19 8 11 8 LHVs

Male ‐ 5 5 ‐ ‐ Male 29 36 24 12 ‐ HTs/MTs

Female ‐ ‐ ‐ ‐ ‐ Dispensers 2 2 2 ‐ ‐

FF. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO E. CAPACITY BUILDING

1ST SESSION TOPIC: Integrated Management of Childhood Illnesses. RESOURCE PERSON: Dr. Obaid Raheem Usmani. MAIN POINTS:

Background. Strategy. IMCI Strive to do. Objective. Rationale of IMCI. Improves Family and Community Practices. Improves Health Workers Skills. Improves Health Systems. Simple Clinical Signs. Prevention. Treatment.

Previous Month Month under Review Total at Present Clusters of 6 HFs ‐ Clusters of 6 HFs ‐ Clusters of 5 HFs ‐ Clusters of 5 HFs Clusters of 4 HFs ‐ Clusters of 4 HFs Clusters of 3 HFs ‐ Clusters of 3 HFs Clusters of 2 HFs ‐ Clusters of 2 HFs Single HFs 33 Single HFs 34


Clusters of 5 HFs ‐ Clusters of 5 HFs ‐ Clusters of 4 HFs ‐ Clusters of 4 HFs ‐ Clusters of 3 HFs ‐ Clusters of 3 HFs ‐ Clusters of 2 HFs 13 Clusters of 2 HFs 13 Single HFs 4 Single HFs 4

147

2nd SESSION TOPIC: Acute Respiratory Infection in Children RESOURCE PERSON: Dr. Bahawal‐u‐Din Jamro (Child Specialist) MAIN POINTS:

Sign & Symptoms. Examination. Investigation. Treatment.

3rd SESSION TOPIC: ANTENANTAL CARE. RESOURCE PERSON: Dr. Fiza Ahsan Siddique (FMO PPHI) MAIN POINTS:

Definition. Aims of ANC. Schedule of Visits. Investigation.

4th SESSION TOPIC: Orientation for Male Medical Officers RESOURCE PERSON: Dr. Najeeb‐ur‐Rehman (DSM Sukkur) MAIN POINTS:

Five Diseases Managed at BHU that spread by faeco‐oral route. Common causes of haemoptysis. Discuss the given case history and respond.



No. of Doses of Immunization Administered in Children at Health Facilities. 1395 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 802 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams 2722 Total vaccination / immunization for the month April‐2010 4919



26th to 28th April‐2010 217459 235576 108%

148


S # Service Number 1 Passive Case Detection (PCD) Slides ‐ 2 Active Case Detection (ACD) Slides ‐ 3 Visits to Check Sanitation (individual house holds + streets) ‐ 4 Notices issued against Poor Sanitation ‐ 5 Challans sent to Court against Poor Sanitation ‐ 6 Patients Nebulized 85




S # Service Number 1 Deliveries/D&Cs Assisted at HFs 28 2 Deliveries Assisted at homes 0




Neo‐Natal Cases

Other OPD Total OPD

1 Dr. Nusrat 245 1 401 647 2 Dr. Aneela 183 2 1825 2010 3 Dr. Raheela 223 3 594 820 4 Dr. Shazia Mangi 172 0 891 1063 5 Dr. Najma Shah 187 3 2371 2561 6 Dr. Sharmeen 224 22 1628 1874 7 Dr. Kaneez Fatima 313 7 1202 1522 8 Dr. Zaib‐u‐Nisa 100 6 872 978 9 Dr. Shazia Amir 161 1 2163 2325 10 Dr. Rizwana 83 0 942 1025 11 Dr. Farhana 148 3 1100 1251 12 Dr. Jalees Fatima 143 0 445 588 13 Dr. Nadia Jabeen 80 0 459 539 14 Dr. Abida Parveen 72 0 540 612 15 Dr. Fiza Sharaf 0 0 0 0 16 Dr. Shahista Dahar 39 0 667 706 17 Dr. NZakia Mahar 0 0 0 0 18 Dr. Roomana Shah 0 0 0 0 Total 2373 48 16100 18521

149

33. Important Discussion on Mother and Child and Reproductive Health during MRM Sonologist cover may be increased for improved reproductive health services.



Total 677



Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him Names of Social Organizers


Mr. Aijaz Ali Phul EO(M&E) 13 272 ‐ ‐

Mr. Abdul Razaque SO‐II ‐ ‐ 7/2 172/107

Mr. Asif Nazeer SO‐I ‐ ‐ 6/3 212/109

Total 13 272 13/5 384/216 3. School Health Sessions & Community Health Sessions

Community Health Sessions School Health Sessions Names of MO / FMOs/Paramedics Sessions Participants Sessions Children Examined Children Treated

Dr. Nusrat 2 79 1 40 4 Dr. Aneela 3 91 1 28 28 Dr. Raheela 5 169 1 23 23 Dr. Shazia Mangi 3 60 1 7 0 Dr. Najma Shah 1 10 0 0 0 Dr. Sharmeen 3 71 1 34 11 Dr. Kaneez Fatima 3 70 1 20 8 Dr. Zaib‐u‐Nisa 0 0 0 0 0 Dr. Shazia Amir 4 90 0 0 0 Dr. Rizwana 3 150 1 20 20 Dr. Farhana 2 35 1 7 2 Dr. Roomana 0 0 0 0 0 Dr. Abida Parveen 1 19 1 18 6 Dr. Fiza Sharaf 0 0 0 0 0 Dr. Shaista Dahar 2 12 1 20 10 Dr. Nadia Jabeen 0 0 1 10 5 Dr. Zahid Mahar 1 10 1 18 18

Total 33 864 12 245 135

150

4. Important Points during Support Group Meetings. 1. Members demanded for Injections. 2. Medicine for deliveries. 3. Labour room instruments. 4. Female staff required. 5. Shortage of furniture. 5. Important Points during SHSs

6. Awareness among students about cleanliness & different diseases 7. Awareness about preventive from Scabies. 8. Hands washing. 9. Creating health consciousness

5. Co‐operation sought from teachers to spread health awareness in community 6. Important Points during CHSs

8. Stress on health consciousness 9. Education about prevention from different diseases 10. Information from health hazards of different diseases 11. Support of MOs/FMOs to community in providing free treatment at HFs


Sr. No. Topics 1 Measels 2 Scabies 3 Malaria 4 Amoebic Dysentry


S # Topics 1 Aneema 2 Importance of ANC 3 Diarrhoea 4 Swine flue

10. Health Camps: Number Held: 01. Number of Patients: 913. (Hepatitis B Vaccine) 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation Nil Nil Nil Ii Drainage / sewerage Nil Nil Nil Iii ……… drinking water Nil Nil Nil Iv Prevention of adulteration Nil Nil Nil V Tree Plantation Nil Nil Nil Vi Roads and infrastructure Nil Nil Nil Vii Environmental

Improvement Nil Nil Nil

Viii Others Nil Nil Nil

151


1. OPD*




76915 3727 80642 2. Maximum OPD** Minimum OPD** S # BHU OPD BHU OPD

1 BHU Dadilo 5290 GD Samo Cahcahr 1318 2 BHU Newpind 5170 GD Village Sehta 1297 3 BHU Qasimpur 4864 GD Riazabad 1214 4 BHU Tando Thatti 4376 BHU Dubar 887 5 BHU Nauraja 3674 GD FM Jatoi 523


S # Disease No. of Patients 1 Suspected Malaria 6485 2 Scabies 10827 3 Diarrhoea 6790 4 ARI 9398 5 Fever 7680


S # Diseases No. of Patients 1 Influenza ‐ 2 ARI ‐ 3 Fever ‐ 4 Eye Infection ‐ 5 Scabies ‐

No. of Patients

Dog bite cases reported 94 ARV Administered 143 ARV Available Doses 355 Snake bite cases reported 0



152

6. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health) 3. (Lab / Diagnostic Tests)


7 B & C SCREENING TESTS




No. of patients vaccinated

Follow up

result Hepatitis B ‐ ‐ ‐ ‐ ‐ Hepatitis C ‐ ‐ ‐ ‐ ‐

8. TUBERCLOSIS

Patients Receiving Treatment New Cases During the Month Under Diagnosis

83 28 66

9. Referrals


33 22 1 10 11 6 16


S.No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs

25 19 0 6 5 7 13




29 77 117 223


1. Medicines available for: 47 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM Shortage of Injections and Local Purchase items.

153


S # Name of HFs


Status/Remarks

1 BHU Patni 100% 2 BHU New pind 100% 3 BHU Salehpat 100% 4 BHU Qasimpur 100% 5 BHU Arore 100% 6 BHU Nouraja 100% 7 BHU Dadloi 100% 8 BHU Dubar 100% 9 BHU Hingoro 100% 10 BHU Tando Thatti 100% 11 BHU Gagro 100% 12 BHU Darawhan 100% 13 BHU Kandowahan 100% 14 BHU Sultan pur 100% 15 GD Mubarkpur 100% 16 BHU Cheechro 100% 17 BHU Haji Khan Chachar 100% 18 BHU Thikratho 100% 19 GD Naseerabad 100% 20 BHU Nirch 100% 21 BHU Abad 100% 22 BHU Faqeerabad 100% 23 BHU Thariri 100% 24 BHU Lutaf Ali Jagrani 100% 25 BHU Hussain Kalwar 100% 26 BHU Samo Chachar 100% 27 BHU Dodanko 100% 28 BHU Kandri 100% 29 GD Ali Wahan 100% 30 GD Riazabad 100%


• New PPHI staff has been appointed and there is no shortage of staff at any facility. • One more Ultrasound Specialist Female appointed. • Regularity and punctuality of the staff must be ensured. If there are any habitual late comers or

absentees report must be sent to DSU immediately. There must be monthly staff meetings. On Preventive Health:

• The trained vaccinators have been posted at the newly established vaccination centers. • There must be conducting of community and School Health Sessions and reports must be submitted

on given format.

154

On Curative Health: • T.B DOTS Medicine availability shall be ensured at all BRHFs and expired T.B DOTS medicine shall be

reported to this office. Requisitions must be sent for the TB medicine. • Any out break of influenza or another disease may be reported immediately and taken seriously.


• Ante‐Natal & Post‐Natal patients’ number has increased considerably. • Number of D&C and Deliveries may be increased at the BRHFs where LHVs have been posted and

delivery rooms have been established. • Shortage of essential medicine items like stitching material, Diazepam Tabs, liquid Paraffin and

Kleen Enema was reported by FMOs, which will be covered by means of local purchase. Date /Time for Next MRM: 08‐06‐2010 Comments on Targets vs Achievements (by DSM)

• Repair & Renovation work has been completed at all the facilities of the district. • Ten new vaccination centers have been established and vaccinators have been posted and Refrigerators

also provided. • The shortage of staff has been covered at all BRHFs. • Shortages of indictable have been covered by means of local purchase.

155

MINUTES OF THE (23th ) MONTHLY REVIEW MEETING OF DISTRICT TANDO ALLAHYAR

Monthly Review Meeting (MRM) of District, Tando Allahyar for the Month of April, 2010 was held on 11/05/2010

at 12:00 pm. Written invitations to participate were sent to the DCO, the EDO(H), the EDO(W&S) and District Incharge of EPI & TB DOTs, and all other National Programs as usual. The following participated:

Sr Name of Participant Designation

1 Dr. Abdul Jaleel Bachani EDO (H), Tando Allahyar

2 Mr. Saifullah Abro DSM‐PPHI‐Tando Allahyar

3 Dr. Karim Bux Burdi DO (Health department)

4 Dr. Waseem Shaikh Distt Focal person for LHWs Program

5 Dr. Anwer Qadir memon Distt Focal person for EPI Program

6 Dr. Arif Soomro Distt Incharge TB DOTS

7 Mr. Ali Nawaz DDO Building

8 Mr. Saeed Ahmed Sub Engineer (Buildings)

9 Mr. Mudassir Ahmed Nizamani Executive (A&A)

10 Dr. Junaid Gul Memon Executive (M&E)

11 Dr. Ghulam Nabi Brohi Medical officer

12 Dr. Lajpat Medical officer

13 Dr. Ahmed Ali Panhwar Medical officer

14 Dr. Amir Bux Mughal Medical officer

15 Dr. Noor Jahan FMO

16 Dr. Waheeda Memon FMO

17 Dr. Naheed Qureshi FMO

18 Dr. Tooba Abro FMO

19 Dr. Ambar Abbas U/S Specialist

20 Dr. Rukhsana Dal U/S Specialist

21 Dr. Quratul Ain FMO

22 Dr. Benish Imran FMO

23 Dr. Rubina FMO

24 Dr. Sarwar Khatoon FMO

25 Dr. Quratul Ain FMO

26 Dr. Atif Miandad MO

27 Dr. Wajid MO

28 Dr. Waseem MO

29 Dr. Zahid MO

30 Dr. Ashok Kumar MO

31 Dr. Abdul Hussain MO

32 Dr. Gulzaib Ahmed MO

33 Dr. Hakim Mal MO

34 Dr. Amir Nahyoon MO

35 Dr. Noor Ahmed MO

36 Dr. Danish Hussain MO

156

37 Dr. Imam Bux MO

38 Dr. Rehan Ali Yusfani MO

39 Dr. Abdul Razzaque MO

40 Dr. Saqib Siddique MO

41 Dr. Faisal Memon MO

42 Dr. Ghulam Rasool MO

43 Dr. Abdul Manan MO


S # Names/Designation

1 DCO Tando Allahyar Engaged in a meeting at Karachi Dr. Abdul Karim Thebo Medical officer, On leave

2 Dr.Indra FMO, On leave 3 Dr. Fawzia FMO, On leave

P. HFs WITH PPHI

BHUs: 13 Dispensaries: 17 MCHCs: _______ Others:______


GG. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 16 23 5 18 01 W/FMOs 0 12 12 02 LHVs 0 9 7 2

Male 12 12 Nil Nil MTs/MAs

Female

15 3 3 Nil Nil Dispensers 21 4 18

HH. CLUSTERS OF HFs WITH ONE MO


Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs 7 Single HFs Single HFs 16

157

WITH ONE FMO

II. CAPACITY BUILDING 1. First Session: During MRM

Training of Haemoglobin meter usage imparted by Mr. Ghulam Mustafa, HT, BHU Sultanabad village

11. Second Session: During MRM Monthly Progress Report presented by Dr. Junaid Gul Memon

12. Third Session: During MRM

Capacity building session conducted by Dr. Arif Soomro, Distt Incharge TB DOTS : Topic “TB DOTS PROGRAM AND IMPORTANCE OF REFERALL SYSTEM OF TB CASES”

13. Capacity Building of LHVs / Dispensers During Month under Review Names of the Resource Persons with dates

Date Venue Topic No. of

Participants

Dr. Waheeda 02/04/2010 BHU Kauro Daidano EPI, Routine Vaccination

20

Dr. Rubina 15/04/2010 30/04/2010

BHU Ditto BHU ARP

EPI, TT Vaccination

14

Dr. Quratul Ain 01/04/2010 BHU Shadyoon Hepatitis 15 Dr. Benish 26/04/2010 GD Missan Ante Natal Care 3 Dr. Tooba 16/04/2010 BHU Dhingano Ante Natal Care 14

Dr. Sarwar Khatoon 12/04/2010 BHU S. Village TT Vaccination 8 F. REVIEW OF THE PERFORMANCE


1. Vaccination / Immunization No. of Doses of Immunization Administered in Children at Health Facilities. 8697 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 2067 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams Total vaccination / immunization for the month March, 2010 10764


Clusters of 5 HFs Clusters of 5 HFs 2 Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs 10 Single HFs Single HFs

158



19‐24/04/2010 ‐ ‐ ‐ 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides ‐ 2 Active Case Detection (ACD) Slides ‐ 3 Visits to Check Sanitation (individual house holds + streets) ‐ 4 Notices issued against Poor Sanitation ‐ 5 Challans sent to Court against Poor Sanitation ‐ 6 Patients Nebulized 245






S # Test Number 1 Pregnancy Tests 199 2 Blood Sugar Tests 377 3 Hemoglobin Tests ‐ 4 Ultra Sound Test 744 5 Other 100

S # Names of FMOs Ante‐Natal Cases Neo‐Natal Cases Other OPD Total OPD 1 Dr. Waheeda 151 929 1080 2 Dr. Noor Jahan 159 853 1012 3 Dr. Indra 66 2 903 969 4 Dr. Tooba 221 1 1024 1245 5 Dr. Naheed 82 895 977 6 Dr. Benish 113 969 1082 7 Dr. Fawzia 107 838 945 8 Dr. Rubina 132 872 1004 9 Dr. Sarwar Khatoon 118 1 606 724 10 Dr. Quratul‐Ain 104 1012 1116 TOTAL 1253 4 8901 10154

159


Camps of Tubal Ligation by NGOs 36. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number 1 Consultation / Advice 140 2 Oral Pills 136 3 IUCDs 9 4 Injections 215 5 Others (Condoms) 137

Total 637

S(III) COMMUNITY PARTICIPATION During Month under Review



Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

Names of Social Organizers No.

No. of Participants

No. No. of

Participants Dr. Azam 11 197 23 397

Riaz Hussain 9 117 15 242

Ahmed Ali 10 237 19 332

Total 30 551 57 971


Community Health Sessions School Health Sessions

Names of MO /


Children Examined

Children Treated

1 Dr,Waheeda 4 68 2 106 7 2 Dr. Noor Jahan 3 55 1 175 123 3 Dr. Indra 1 31 2 19 8 4 Dr. Tooba 3 65 2 104 8 5 Dr. Naheed 4 27 4 100 23 6 Dr. Benish 3 90 3 184 146 7 Dr. Fawzia 2 33 2 49 9 8 Dr. Rubina 2 18 2 85 5 9 Dr. Sarwar Khatoon 3 31 2 30 3 10 Dr. Quratul Ain 3 36 3 17 11 11 Dr. Ahmed Ali 1 21 1 8 3 12 Dr. Amir Bux 1 9 1 30 5 13 Dr. Lajpat 1 14 1 15 17 14 Dr. Abdul Karim 0 0 0 0 0

160

15 Dr. Ghulam Nabi Brohi 1 26 2 55 33 16 Dr. Noor Ahmed Phore 2 28 2 65 54 17 Dr. Wajid 2 33 2 25 16 18 Dr. Waseem 1 12 2 8 5 19 Dr. Zahid 2 30 2 35 13 20 Dr. Atif Miandad 2 24 1 7 2 21 Dr. Ashok Kumar 2 33 1 7 7 22 Dr. Abdul Manan 1 14 1 10 223 23 Dr. Gulzaib Ahmed 2 32 2 40 2624 24 Dr. Hakim Mal 1 25 1 10 5 25 Dr. Amir Nahyoon 2 22 2 53 13 26 Dr. Ghulam Rasool 1 14 1 30 10 27 Dr. Danish Hussain 1 14 1 17 12 28 Dr. Imam Bux 2 40 1 7 2 29 Dr. Rehan Yusfani 1 25 1 20 7 30 Dr. Abdul Razzak 1 18 1 15 8 31 Dr. Saqib Siddique 1 6 1 30 20 32 Dr. Faisal Iqbal 1 10 1 12 4 33 Dr. Abdul Hussain 1 18 1 40 30


Performance of MO/FMO and other staff working in concerned health facilities Provision of ultrasound facility where not available, camps for Hepatitis B&C screening, extension of BHU timings, TPE, establishment of TB DOTS centre at BHU‐Bukera and Tando Soomro, , Greenery/Plantation at HFs., upcoming NID’s of Polio and Maternal and Neo Natal tetanus.

5.Important Points during SHSs

General cleanliness, tooth brushing, scabies, IDD Cough, Polio, Immunization, Oral hygiene , Nutrition, Heat stroke Malaria, Hepatitis, food and nutrition , ARI, Hazards of chewing tobacco


Ante Natal care, Post natal care, Immunization, IDD Polio, Scabies, weaning, family planning Neo Natal care, Dental care, Hepatitis Malaria, prevention from cold, Hazards of chewing tobacco, ARI, Nutrition, Heat strokes, RTI, Gastro, Preparation of ORS at home.


Sr. No. Topics 1 General cleanliness, tooth brushing, scabies, IDD 2 Cough, Polio, Immunization, Oral hygiene 3 Malaria, Hepatitis, food and nutrition , ARI, Hazards of chewing tobacco

161


S # Topics 1 Ante Natal care, Post natal care, Immunization, IDD 2 Polio, Scabies, weaning, family planning 3 Neo Natal care, Dental care, Hepatitis 4 Malaria, prevention from cold, Hazards of chewing tobacco, ARI

9. Important Discussion on Community Participation during MRM 10. Health Camps: Number Held: . Number of Patients: 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation Ii Drainage / sewerage Iii ……… drinking water Iv Prevention of

adulteration

V Tree Plantation Greener BHU DO (Forest), TAY In process Vi Roads and infrastructure Vii Environmental

Improvement

Viii Others





(New + Old) 45527 3164 48691


S # BHU OPD BHU OPD 1 BHU‐Sanjarchang 3356 BHU‐NKL 1246


S # Diseases No. of Patients 1 GIT 754 2 Skin 607

3 RTI 546

4 ENT 149 5 Malaria 90

162


S # Disease No. of Patients 1 ARI 4404 2 Diarrhea 3549 3 Fever 2065 4 Scabies 1934 5 Dysentery 319


No. of Patients


ARV Administered 175 (vials of IM)

````ARV Available Doses 155 Snake bite cases reported 1

ASV Vaccine Administered ‐




S # Tests Number 1 Blood Sugar Tests 377 2 Hemoglobin ‐ 3 X‐Rays (if available) ‐ 4 Ultra Sound 744 5 Others (please specify) 100






Follow up result

Hepatitis B Hepatitis C

44. TUBERCLOSIS



Under Diagnosis

47 21 9. Referrals

S.No Totals Cases Referred To TB DOT Deliveries Others RHCs THQs DHQs

279 24 0 255 279

163




27 55 155 237


1. Medicines available for 35.6 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

• Medicines like Tab: Para, Cimitidine, , Inj: CPM, Hydrocortisone creams, Inj: Lincomycin, Gentamycin, are required in more quantities at health facilities

• Germinal cream and Hydergen par oxide are demanded by Incharge MOs • Doctors thanked the team of PPHI for providing Amoxil drops, Panadol drops, Tab: Cimitidine, Tab:

Omeprozale. Ethylated spirit, Haemoglobin meter.


S # Name of



1 BHU‐Allah Rakhio Pathan 100% Completed M.B recorded & Sent to P.S.U. 2 BHU Ditto Kalroo 100% Completed M.B recorded & Sent to P.S.U. 3 GD M Sadiq Memon 100% Completed M.B recorded & Sent to P.S.U. 4 BHU‐Jhando Mari 100% Completed M.B recorded & Sent to P.S.U. 5 BHU‐Shadyoon 100% Completed M.B recorded & Sent to P.S.U. 6 BHU‐Sultanabad stand 100% Completed M.B recorded & Sent to P.S.U. 7 BHU‐Sultanabad Village 100% Completed M.B recorded & Sent to P.S.U. 8 GD‐Dassori 100% Completed M.B recorded & Sent to P.S.U. 9 B.H.U Bukera Sharif 100% Completed M.B recorded & Sent to P.S.U. 10 B.H.U Kauro Daidaanoo 100% Completed M.B recorded & Sent to P.S.U. 11 B.H.U Tando Soomro 100% Completed M.B recorded & Sent to P.S.U. 12 B.H.U Shahnwaz Muhajir 100% Completed M.B recorded & Sent to P.S.U. 13 BHU‐Naseer Khan Leghari 100% Completed M.B recorded & Sent to P.S.U. 14 BHU‐Sanjar chang 100% Completed M.B recorded & Sent to P.S.U. 15 GD‐Ghulam Khan Sanjrani 100% Completed M.B recorded & Sent to P.S.U. 16 BHU‐Dhingano Bozdar 100% Completed M.B recorded & Sent to P.S.U. 17 GD‐Ghulam Hussain

Khokhar 100% Completed M.B recorded & Sent to P.S.U.


On Staff Matters:

• Proper HR management at BHU level • Monitoring of NIDs and other Program by Incharge MO • Record keeping • Monthly reports discrepancies • Poor performance of Government vaccinators

164


• Participation of PPHI staff in Polio Campaign and Mother & Child Health week • Absence of vaccinators and non submission of EPI report.

On Curative Health:

• Excessive/unnecessary medicines be not dispensed. • Proper disposal of syringes after use.

Date /Time for Next MRM: 07/06/2010 Comments on Targets vs Achievements (by DSM)

Every MO is given instructions to conduct at least 2 Health sessions. MO’s & FMO’s have to be actively involved in NID’s and during NIDs they are bound to ask every child for Immunization.

Target population and actual coverage in NIDs must be submitted with monthly HMIS report. Every MO must conduct five minutes meeting with vaccinators at the start of the day and ask him about performance, progress and targets for the day.

165

MINUTES OF THE (19th) MONTHLY REVIEW MEETING OF DISTRICT TANDO MUHAMMAD KHAN_

Monthly Review Meeting (M.R.M) of District, Tando Muhammad Khan for the Month of April, 2010 was

held on 11.05.2010 at meeting Hall of District Government Complex. Written invitations to participate were sent to the Zila Nazim, the DCO, the EDO(H), the EDO (Education), the EDO(Revenue), the EDO(F&P), Focal Persons, EPI, TB DOTS, National Program, Malaria Control, Hepatitis, HMIS & DEWS, District Population Welfare Officer, representatives Bridge Consultants, DTW, Marie Stoops Society, all incharge Medical Officers/ FMOs/LHVs etc. The list of participants is enclosed.

S # Names Designation S # Names Designation 1 Dr. Kazim Raza Shah EDO (H) 39 Dr. Liaqat Siyal MO‐PPHI 2 Dr. A.Rasheed Tareen F /P Hepatitis 40 Dr. Sofia Baloch FMO‐PPHI 3 Dr. A.Hafeez Pasha F/ P TB Dots 41 Dr. Shazia Sattar FMO‐PPHI 4 Dr. Ghajjan Mastoi D.O Admin 42 Dr. Rizwana Shah FMO‐PPHI 5 Dr. Bashir Ali Memon F/P EDO (H) 43 Dr. Sadaf Kolachi FMO‐PPHI 6 Dr. Roomana DDO (N.P) 44 Dr. Sajida Memon FMO‐PPHI 7 Dr. M. Ismail Soomro F/P (HMIS) 45 Dr. Shaheen Abid Syed FMO‐PPHI 8 Abdul Shakoor Shaikh DSM TMKhan 46 Dr. Farzana Jarwar FMO‐PPHI 9 Dr Talib Hussain Arain SMO‐DG 47 Dr. Ambreen FMO‐PPHI 10 Dr.Mumtaz Bhatti MO‐DG 48 Dr. Raheela Maqsood FMO‐PPHI 11 Dr. Shamshad Abbas MO‐DG 49 Dr. Naima Memon Sonologist 12 Dr.Shakeel Qureshi MO‐DG 50 Dr. Sadaf Sabir Sonologist 13 Dr.Mir Hassan Turk MO‐DG 51 Samina LHV 14 Dr Dhaloo Mal MO‐DG 52 Muneer A Bhatti A.O Z.N 15 Dr.Narendar Kumar MO‐DG 53 Haji Noor Muhammad S.O 16 Dr.Wahid Bux MO‐DG 54 Shahbaz Ali Memon S.O 17 Dr.Sadique Ali MO‐DG 55 Khalil Ahmed Memon S.O 18 Dr. Abdul Qayoom M.O DG 56 Atif Ali Ex‐A&A 19 Dr. A.Kareem Leghari M.O DG 57 Salman Chang S.O 20 Dr. Mangan Khan M.O DG 58 Naveed Khaskheli S.O 21 Dr. Ali Raza Jarwar MO‐PPHI 59 Pardeep Kumar Asst A&A 22 Dr. Aamir Khushk MO‐PPHI 60 Razia Sultan LHS DHQ 23 Dr Chatromal MO‐PPHI 61 Farhat Parveen LHV 24 Dr Mushtaque Bhurgri MO‐PPHI 62 Yasmeen Gul LHV 25 Dr. Asghar Talpur MO‐PPHI 63 Arsheen Hameed LHV 26 Dr. Ali M.Qureshi MO‐PPHI 64 Josphine LHV 27 Dr.Amir Ali Khuwaja MO‐PPHI 65 Ghazala LHV 28 Dr. M.Ali Memon MO‐PPHI 66 29 Dr Nizam Soomro MO‐PPHI 67 30 Dr. Aslam Rustamani MO‐PPHI 68 31 Dr. Sohrab Kolachi MO‐PPHI 69 32 Dr. Abdul Jalil Buledi MO‐PPHI 70 33 Dr. Abdul Rasheed MO‐PPHI 71 34 Dr. Mumtaz Talpur MO‐PPHI 72 35 Dr. Ayoub Memon MO‐PPHI 73 36 Dr. Intekhab Alam MO‐PPHI 74 37 Dr. Manoj Kumar MO‐PPHI 75 38 Dr. M.Qasim Bhatti MO‐PPHI 76

166

Q. HFs WITH PPHI


TOTAL: 32

JJ. Population of the Catchments Area: 611,863

KK. STAFF STRENGTH

Working Government

Employees PPHI Contract

Vacant

Mos 31 12 19 00 W/FMOs 13 00 13 01 LHVs 09 05 03 03 MTs/Mas 06 06 00 17 Dispensers 25 00 25 00

LL. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING 1. First Session: HMIS/DEWS reporting

Dr. Muhammad Ismail Soomro, Focal Person HMIS, (Resource Person) in his session on HMIS/DEWS reoporting focused on the following points:‐

• Importance of Reporting in Decision making. • Types of common errors in District Reporting. • Importance of Stock out days record. • Reconciliation from Abstract Registers.


Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 01 Clusters of 2 HFs 01



Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs 06 Clusters of 3 HFs 06 Clusters of 2 HFs 06 Clusters of 2 HFs 06


167

• Importance of Monthly & Yearly Numbers. • Ante‐natal/Post natal and Growth monitoring data. • Correction of errors in current month reporting.

2. Second Session: Checklist for EPI activities.

Dr. Ali Bux Mallah, Focal Person, EPI , (Resource Person) in his lecture on EPI focused on the following points:‐

• Role of I/c Medical Officer for checking and scheduling outreach activities. • Logistics, Record Keeping and Planning. • Cold Chain (CC) status. • Immunization coverage. • Monitoring of Vaccination activity. • Upkeep of vaccines in Ice liners/Refrigerator chambers.




6,540


2,440


11,735

Total vaccination / immunization for the month March, 2010

20,715


Dates of NIDs Total Target of

coverage Actual coverage

Percentage of coverage

26th ‐27th ‐ 28th April 106,118 110,568 104% 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 650 2 Malaria Metro Survey (MMS) Slides 165 3 +ve Slides 12 4 Follow up 12

168


1. Female Health




S # Test Number 1 Pregnancy Tests 271 2 Blood Sugar Tests 215 3 Hemoglobin Tests 00 4 Ultra Sound Test 1,016 5 Total 1,502


a. MNCH week was celebrated w.e.f 05th‐10th April, 2010. Everybody participated at Facility level. Whereas, DSM participated in District Walk with EDO (Health). Subsequent letter was issued to all I/c M.Os/FMOs for Health Education Session on related topics.

b. As deliveries at BHUs/DCDs have become a routine practice, related reporting and monitoring material may be provided so that patient monitoring can be improved. Training on formats is also scheduled in the 1st week of May, 2010.

c. All Lady Health Supervisors of the district and National Program Coordinator, Dr. Roomana appreciated the efforts taken after last meeting and showed satisfaction on improvement level in (1) increase Ante‐natal patients (2) Increasing Sonograms (3) Increasing Follow up of patients (4) Improving participation in Health Education Session (5) Reducing MMR.

d. On FMO day, MO should share the diagnosis load of children and females with vague symptoms

Sr. Name of FMO Antenatal Natal Post Natal

Total Others Total

1 Dr,Sofia Baloch 125 2 7 134 565 1,217

2 Dr,Shazia Sattar 258 ‐ 2 260 284 954

3 Dr.Razia Khowaja 84 ‐ 3 87 347 1,005

4 Dr.Rizwana Shah 115 1 1 117 131 1,232

5 Dr,Sadaf Kolachi 65 ‐ ‐ 65 169 815

6 Dr.Farzana Jarwar 85 ‐ 7 92 315 1,044

7 Dr,Ambreen Memon 51 ‐ 3 54 448 955

8 Dr.Irshad Fareed 250 7 17 274 13 1,732

9 Dr.Raheela Bilal 138 1 8 147 37 540

10 Dr,Shaheen Abid 27 ‐ 5 32 198 673

11 Dr,Laila Khowaja 64 ‐ 11 75 191 983

12 Dr. Sajida Memon 165 3 3 171 360 2,135

13 Dr,Beenish Abid 136 ‐ 8 144 266 1,395

TOTAL 1,563 14 75 1,652 3,324 14,680

169

so that patient load on FMO can be reduced and quality time can be given for the desired objectives.

e. Pregnant females should be encouraged for delivery at BHU. f. F.P advice should be part of diagnosis. g. MNCH record and Growth monitoring record should be maintained by FMOs where LHV is not

provided. In all cases, record should be legible, complete and traceable. h. Baby Weighing Scales/ Adult Bath Scales, Hemoglobin Meters and Height Charts have been

provided. Ensure proper usage of the equipments and report of out of order weight machines should be immediately conveyed to I/c MO in writing.

i. Training on Hemoglobin meters have been provided to all Medical and Paramedical Staff for blood tests preferably for Pregnant women and same will be repeated for retention.

j. E.D.O (Health) has issued the letter to all vaccinators along with changed duty roster on the FMO Days at the places where FMO cover is provided. The Vaccinator at all FMO covered facilities for that day bring vaccines in carrier and remarkable increase has been achieved in coverage for TT and BCG vaccines.


S # Name of the Items / Service Number 01 Consultation / Advice 561

02 Oral Pills 1,832 tab:/ 58 cycles

03 IUCDs 00

04 Injections 56

05 Others 271

(III) COMMUNITY PARTICIPATION

During Month under Review 1. Number of Male SGs: 32 Number of female SGs: 00




No. No. of

Participants No.

No. of Participants

Shahbaz Ali Memon 7 105 15 398

Haji Noor Muhammad 7 115 13 395

Naveed Khaskeli 8 132 14 380

Total 22 352 44 1,173

170




Children Treated

Dr,Sofia Baloch 02 30 01 10 5 Dr,Shazia Sattar 02 68 00 00 00 Dr.Razia Khowaja 02 60 2 50 30 Dr.Rizwana Shah 03 61 1 10 2 Dr,Sadaf Kolachi 00 00 00 00 00 Dr.Farzana Jarwar 02 40 01 16 00 Dr,Ambreen Memon 03 100 02 00 00 Dr.Irshad Fareed 04 144 00 00 00 Dr.Raheela Bilal 04 129 01 04 04 Dr,Shaheen Abid 03 95 01 12 07 Dr,Laila Khowaja 03 86 02 35 33 Dr.Sajida Memon 02 150 01 32 21 Dr. Benish Abid 01 21 01 20 06

Total:‐ 31 984 13 189 108 4. Important Points during Support Group Meetings.

• Inauguration of Health Facilities have been conducted at 02 HFs and community support groups not only participated and shared with full vigor but also offered refreshment and seating arrangements on their own expenses.

• District level Support Group convention is to be organized at District Headquarters. • I/c Medical Officer has been trained for undertaking necessary day to day equipments/asset repairs on

need basis after seeking administrative approval from DSM‐ should be regular feature. • Moral support to medical/paramedical staff working at HF. • Training of CSGs is being conducted in liaison with NGO network namely “Strengthening Participatory

Organizations” through Aghaz Social Welfare Association. • Community Interviews have also been conducted by Aghaz Social Welfare Association.

5. Important Points during SHSs • Letters have been written to EDO (Education) for earmarking 25 schools to be adopted by PPHI. No

response has yet been received till date. • New Plan for School Health Screening camps shared with EDO (Health) and all MOs/FMOs • Need of Training on students screening for Health related problems. • To drink clean & safe water and Washing hands after toilet. • Awakening health consciousness in children regarding new disease patterns. • Nutritional awareness to be transferred to mothers. • Hair trimming, clean clothes, nails clipping, washing fruit/vegetables before eating.


• Primary health care awareness. • Educate about immunization against infectious disease. • Personal Hygiene and worm infestation.

171


Sr. No. Topics 1 Diarrhea and Dehydration


S # Topics 1 U.T.I 2 Diarrhea and Dehydration


• Community Health Sessions are to be planned and held on Sonologist days. • Participation should be ensured through formal contact with LHWs. • Sessions are to be held preferably at Health Facility or at community home duly coordinated and

facilitated by DSU/HF staff. 10. Health Camps: Number Held: 00 ‐. Number of Patients: 00 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation Ii Drainage / sewerage Iii ……… drinking water Iv Prevention of adulteration V Tree Plantation Vi Roads and infrastructure Vii Environmental

Improvement Viii Others

Not discussed in this meeting. Normally, a separate Quarterly Review meeting of Public Representatives and District Government officials/officers/NGOs is being held where such issues are discussed and decisions are taken.


1. OPD*




48,411 530 48,411


S # BHU OPD BHU OPD 1 BHU Shaih Bhirkio 3,323 BHU Seehrani 1,158 2 BHU Saeed Khan Lund 3,164 BHU Nazar Pur 1,309 3 BHU Jinhan Soomro 2,790 BHU Saeed Matto 1,553 4 BHU Gh Shah Bagrani 2,584 BHU Saeed Pur 1,573 5 BHU Mullkatiar 2,013 BHU Nago Shah 1,789

172


S # Diseases No. of Patients

1 Malaria

2 ARI

3 Diarrhea 4 Scabies 5 Allergic Rhnites

4. Top Ten Diseases During OPD

S # Disease S # Disease 1 ARI 6 Skin Infection(Fungal) 2 Scabies 7 Dog Bite 3 Malaria 8 Chronic Cough 4 Diarrhea 9 Asthma 5 Personal Hygiene 10 Arthritis


Particulars No. of Patients Dog bite cases reported 29 ARV Administered ( @14 Dozes per patient) 110 ARV Available Doses ( @ 24 dozes/vial) 60 Snake bite cases reported 00




S # Tests Number 1 Blood Sugar Tests 271 2 Haemoglobin 00 3 X‐Rays (if available) 00 4 Ultra Sound 1,016 5 Others (please specify) 00


Chief Minister Program

Sr Detail HCV HBV HDV Total 01 No: of Patients Registered of this month 75 3 00 78 02 Total No of Patients registered for treatment

(since the program started ) 860 30 00 890

03 Total No of Patients under treatment 339 23 00 362 04 Total No: of patients completed treatment 494 00 00 494 05 No: of defaulter patients 01 00 00 01 06 No of non responder patients 04 00 00 04

173

48. TUBERCLOSIS

Suspected Cases 107 Total Registered Cases 43 Smear +ve Cases 15

Smear ‐ve Cases 12 Others (+ve Cases) 00 Others (‐ve Cases) 09 Transfer inn cases 00 Extra Pulmonary Cases 07 Relapse Cases 02 Treatment Default 00 Treatment Failure 01

9. Referrals



2 77 77

MONITORING DURING MONTH UNDER REVIEW 1. Monitoring Visits during the month


40 00 116 156


S # Name of HF Issue Action Remarks 01 DCD Haji Karim

Dino Siyal Vaccinator not visiting the facility as per instructions of EDO (Health)

Talked to Focal Person, the matter resolved.

02 BHU Mullakatyar

Refrigerator out of order Dispatched to DSU for repair.

03 BHU Mullakatyar

Water Pipes are rusted and electricity of whole village disconnected

Partially resolved.

04 BHU G.S Baghrani

Electric Fans Matter under consideration.

05 BHU Nango Shah

Un‐availability of LHV Appointment process initiated

06 DCD A.Raheem Katyar

Electric Motor out of order Matter sent for repair under warranty

07 USK Digh Mori Unavailability of Dispenser Asghar H.T transferred.

174

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS 1. Medicines available for: 44 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

• Issues found with medicine consumption at H.F • Facility‐wise Medicine consumption report was shared with all I/c MOs.


S # Name of HF Issue Action Taken Remarks

1 BHU Dadoon Dismantled building R&R work in progress 2 DCD Soomar

Leghari Functionalizing Wash rooms and Electricity connection and Electric Fans needed.

Purchase orders for PVC and fans placed.

3 DCD Lakhat No sanitary fitting, Examination coach requires repair

Resolved

4 DCD Asgharabad No Building/Furniture New building approved by District Government and repair work started.

5 Mohbat bhurgri No Building/Furniture New building approved by Federal Minister

6 DCD Abdul Raheem Katyar

Dismantled building R&R work in progress

7 BHU Mullakatyar

Dysfunctional Water lines and electricity

I/c M.O guided to initiate the process of getting the services functionalized in liaison with Social Organizer.


• Samples for PPHI Service Cards was discussed and same is to be finalized. • Pay Slip System should be introduced. • Test/Interview dates for new hiring were done on 10th April, 2010. • EDO (Agriculutre) provided free of cost Tree saples which are planted at 32 HFs. Every I/c M.O should

furnish request if required. • Carbon copies be used for keeping an other copy of Referral Forms • Aprons and Staff Uniforms should be strictly worn during duty hours. • V‐phones remain unattended by some facilities. • The DSM, PPHI TM Khan requested the in charges of health facilities for their timely submission of HMIS

reports, Monthly Medicines Requisition, Referral Cases regarding the TB, Polio Dog Bite, Measles, Diarrhea etc.

• Leaves availed through SMS should be subsequently submitted on prescribed format and got approved otherwise will be treated as absence.

• Late coming/Early going will be marked as “ x” and two such crosses will result in one absence.

175


• Quality of HE sessions not yet improved. S.O should facilitate in arranging most of The CHS in communities

• After completion of training of 03 Vaccinators, PPHI EPI Centers are running. Another batch of Vaccinator is to be sent for remaining 03 EPI Centers.

On Curative Health:

• Quality of medicines has improved with clear impact on cost of medicines. • Normal Delivery Centers are to be opened at 15 facilities of the district. • Rise in OPD and consequent rise in medicine consumption. • Patient coming from farther areas demand for more medicine dosages.


• Baby Weighing Scales have been provided at all 30 facilities where FMO cover has been provided. • MNCH registers and Growth monitoring registers will be maintained at each facility where FMO cover

is provided. Training has already been provided to all FMOs in this regard. • The registers will be maintained by LHVs wherever provided. Otherwise, FMO will record and

maintain. • For NVDs, FMOs should motivate to pregnant ladies for deliveries at BHUs. • Dr. Irshad Fareed Siyal, LHV Josephine, Dispenser Abdul Razaq Lund, CSG members and I/c M.O

Saeed Khan Lund were appreciated on managing maximum number of deliveries in the district. Other Matters:

• Chairman District Zakat Committee participated in meeting and disclosed about the availability of Rs. 26,000/‐ each against 12 BHUs under Zakat Head of Account for 06 months.

• As per Policy guidelines and joint discussion in House, following modus Operandi is to be adopted. o Joint Bank Account needs to be opened by I/c M.O and Dispenser/CSG member etc. o Already signed Zakat Forms shall be provided to all BHUs. o Discretion of assessing the poor patients lie with I/c Medical Officer. o I/c Medical Officer shall make an understanding with nearing Medical Store after verifying his

registration and availability of valid License (Not expired). o The outdoor patients prescription limit is Rs. 500/‐ and Indoor Patient limit is R.s 2,000/‐. o The medicine, if not available at BHU shall be prescribed and patient sent to Medical Store. o Ensure by calling back the patients that quality/quantity of medicine has been provided. o Payment to Medical Store on monthly basis through bank. o Maintaining Record of Patients at H.F.

• Both the proposed MCH centers are to be inaugurated by Federal Minister by the end of May, 2010. • I/c Medical Officers requested not to wait for DSU for minor repairs and to undertake necessary repair in

lines with procedures and policies already shared and claim reimbursements. Date /Time for Next MRM: Tentative Date for next MRM is 04.06.2010 Comments on Targets vs Achievements (by DSM)

• DSM appreciated the efforts for efficient service delivery at all Health outlets. • DSM conveyed his displeasure to all those FMOs having less number of ante‐natal. • TPE targets have been shared and quantified. I/c M.Os and field teams directed to give more inputs to

bring facilities at par with international standards. • 02 Pathological Laboratories and 02 X‐ray Plants are made functional during May, 2010.

176

• Complaint/Suggestion Box is to be provided to Every H.F • Pre‐Post R&R pics are not found at H.Fs. • 15 Labor rooms are to be made functional by the end of May, 2010. • E.D.O (Health) appreciated the efforts and referred that PPHI and District Health Department are in best

cooperation and coordination for the improvement in Health Service Delivery throughout the district and wish to continue in same manner.

177

MINUTES OF THE 18th MONTHLY REVIEW MEETING OF DISTRICT THATTA_

Monthly Review Meeting (MRM) of District, THATTA for the Month of APRIL, 2010 was held on MAY 11, 2010 at 10:00 AM. Written invitations to participate were sent to the DCO, the EDO (H), and District Incharge of EPI, LHW and all other National Programs as usual. The list of participants is enclosed. S #

Names/Designation S #

Names/Designation

1 Mr Nasimuddin Mirani/DSM‐Thatta 2 Dr Arifa Tahirani/EDO‐Health,Thatta 3 Dr Ghulam Qadir Sheikh THO,Thatta 4 Dr Wasdev/Dist.TB Coordinator,Thatta

5 Dr Maqbool Memon/DCO,National Programme. 6 Dr Mumtaz Brohi, Epidemiologist CM Hepatites Programe.

7 Dr Ghulam Sarwar DTHO(P),Thatta 8 Mr Akhlaque Ahmed/WHO‐Representative.

9 Mr Hassan Ali Memon/Ex M&E Thatta. 10Dr Ghulam Sarwer ,Monitoring Officer,CM Hepatites Programe

11 Dr Shafi Memon/MO‐ BHU Gujjo 12 Mr Asim Soomro/Ex.F&A 13 Dr Akhtar Ali shah /MO BHU MK Rind 14 Dr Muzaffar Shah/MO‐BHU NMThaheem 15 Dr Attaullah /MO BHU Gariwah 16 Dr Abdul Aleem/MO BHU Jokhio village. 17 Dr Ahsan Khawaja/MO BHU Buhara 18 Dr Kamlesh kumar/MO BHU Ghulamullah. 19 Dr Habib Khawaja/MO BHU Dhandari. 20 Dr Anwar Khawaja/MO BHU Gail Mori. 21 Dr Jamal Memon/MO BHU Ghorabari 22 Dr Din Mohd Memon/MO BHU Sajanwari 23 Dr Muhammad Amin /MO BHU Pir Jo Goth 24 Dr A.Ghani Soomro /MO BHU Garho. 25 Dr Asif Behrani/MO BHU Jhimpir 26 Dr Gulzar Uqaili/MO BHU Aacher Jakhro 27 Dr Qayoom Jakhro/MO HQ. 28 Dr Zeeshan Shah/MO BHU Jhangri 29 Dr A.Rasheed Memon/MO BHU T.H Shah 30 Dr Aijaz Gandro/MO BHU Ali Bahar 31 Dr Anwar Memon/MO BHU Bello 32 Dr A.Qadir Narejo/MO BHU Chatochand. 33 Dr Parkash /MO BHU Khair Bux Leghari 34 Dr Jai Kumar/MO BHU Banno&Rahoot 35 Dr Gul Mohd Memon/MO BHU Laiqpur&AMG 36 Dr khan Mohd/MO BHU Muzaffar Leghari 37 Dr Qasim Kawaja/MO BHU DK soho 38 Dr Ameet Kumar/MO BHU Jhoke sharif. 39 Dr Naimatullah Khawaja/MO BHU Mureed Jarejo 40 Dr Moosa Kharik/MO BHU Shahnawaz Leghari 41 Dr Nisar A.Memon/MO BHU Nodo Baran 42 Dr Jameel Soomro/MO BHU Jaar. 43 Dr Kishore Kumar/MO BHU Begna Mori 44 Dr Khalid Ali Mallah/MO BHU GM Baran 45 Dr Nisar Khawaja/MO BHU Raj Malik 46 Dr Ali Mohd Memon/MO BHU Boohar&Kothi. 47 Dr Narain Das/MO BHU GM Shah 48 Dr Sajid Kehar/MO BHU Raj Sheikh Bachal 49 Dr Sadhu Ram/MO BHU Mureed Khoso 50 Dr Abdul Hussain Shah/MO GD Aresor.

51 Dr Aslam Parihary/MO BHU Goongani&Jeand Zangejo

52 Dr Chander Bhan/MO BHU Jungo Jalbani

53 Dr Shaheen karnani/FMO 54 Dr Jaffar Almani/MO BHU Ladiyoon. 55 Dr Marvi Shah/FMO 56 Dr Hakima Palijo./FMO 57 Dr Umm‐e‐Kulsoom/FMO 58 Dr Farah Rafique/Sonologist. 59 Dr Zuhra Abbasi/FMO 60 Dr Nasreen Waheed/FMO. 61 Dr Zareen Kehar/FMO 62 Dr Rubina Khokhar/FMO 63 Dr Saba Fatima/FMO 64 Dr Rukhsana Leghari/FMO 65 Dr Zuhra Kiran/FMO 66 Dr Devi Sadho/FMO 67 Dr Munzareen Shah/FMO 68 Dr Ghazala/FMO 69 Dr Umera Jabeen/FMO 70 Dr Medhraj/Store Manager‐Thatta 71 Dr Farhana Memon/FMO. 72 Mr Ghulam Mustafa/SM‐I 73 Dr Abdul Karim Khawaja/MO BHU HM Sodho 74 Mr Lutuf Shah/SM‐II 75 Dr M.Umer Memon/MO BHU Kot Alamo 76 Dr Jamshed /Dental Surgeon,BHU Dhabeji. 77 Dr Murtaza Khumbati/MO BHU S.Qadir Dino 78 Mr Basheer Mirani/SM‐III

178



1 Mr Manzoor Shaikh (DCO Thatta) Another meeting

2 Dr Jameel Memon/MO BHU Dhabeji ABSENT

3 Dr Tahmina Memon FMO(Leave) 4 Dr Shahida Farooqui FMO (Study leave) 5 Dr Shaheen Brohi /FMO (Leave) 6 Dr Rabia Memon/FMO (Maternity Leave)

B. HFs WITH PPH


TOTAL: 51

B. Population of the Catchment Area: 1.746 million

MM. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 51 48 14 34 2

FMOs 25 23 01 22 2

LHVs 51 21 18 07 26 51 69 49 20 01 MTs/MAs

51 28 28 0 26 Dispensers 03 02 02 0 01

NN. CLUSTERS OF HFs

WITH ONE MO

Shah

79 Dr Gul Mohd Memon/MO BHU Laiqpur 80Dr Aftab Ahmed khatti/MO BHU Marho Bula Khan.

81 Dr M.Ibrahim /MO BHU Kandra. 82


Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs 03

179

WITH ONE FMO


Dr Mumtaz Ali Brohi, Epidemiologist Chief Minister’s Hepatitis Programme during his session on“HEPATITES” focused on following points:‐

• What is Liver? • Functions of Liver. • Liver Damages. • What is Hepatites? • Types of Hepatites. • Mode of Transmission B,C & D. • Preventive Measures.




No. of Doses of Immunization Administered in Children at Health Facilities. 6426 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 10215 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams 9634 Total vaccination / immunization for the month APRIL 2010 26275



Was held on April 26‐28 2010. 220,380 253,437 115% 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides N/A 2 Active Case Detection (ACD) Slides N/A 3 Visits to Check Sanitation (individual house holds + streets) N/A 4 Notices issued against Poor Sanitation N/A 5 Challans sent to Court against Poor Sanitation N/A 6 Patients Nebulized 224


Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs 02 Clusters of 2 HFs Clusters of 2 HFs 20 Single HFs Single HFs 01 (DG)

180


1. Female Health




S # Test Number 1 Pregnancy Tests 363 2 Blood Sugar Tests 104 3 Hemoglobin Tests 0 4 Ultra Sound Test 258 5 Other (Malaria) 1234

40. Important Discussion on Mother and Child and Reproductive Health during MRM:

• It was emphasized that we have to reduce maternal mortality rate (MMR) & Infant Mortality rate (IMR) and increase CPR (contraceptive prevalence rate).


Post‐Natal Cases

Other OPD Total OPD

1 Dr. Ishwari Bai 35 0 658 693 2 Dr Shahida Farooqi On leave 3 Dr. Munazrin Shah 44 12 691 747 4 Dr. Zuhra Abbasi 67 11 1009 1087 5 Dr Naseem banno 24 02 545 571 6 Dr Nasreen Waheed 129 05 840 974 7 Dr Farhana Memon 43 10 581 634 8 Dr Devi sadho 32 07 669 708 9 Dr Hakeema Palijo 59 03 606 668 10 Dr Ruksana Leghari 61 4 796 861 11 Dr Zareen kehar 185 0 1135 1320 12 Dr Shaheen Brohi 248 10 1114 1372 13 Dr Rubeena khokhar 62 4 803 869 14 Dr Tehmina Memon 175 27 1017 1219 15 Dr Umme Kulsoom 122 05 554 681 16 Dr Umera jabeen 123 07 774 904 17 Dr Saba Fatima 10 09 860 879 18 Dr Shaheen Karnai 14 15 111 140 19 Dr Ghazala 26 06 207 439 20 Dr Fouzia Gaho 23 03 163 189 21 Dr Zuhra kiran On Leave

181



Total 1621






Mr. Ghulam Mustafa

Mr. Lutif Shah

Mr.Basheer Ahmed Total


Community Health Sessions School Health Sessions

Names of MO / FMOs/Paramedics Sessions Participants Sessions

Children Examined

Children Treated

Dr Shaheen karnani 01 10 0 0 0 Dr. Munazrin Shah 02 44 02 42 04 Dr. Zuhra Abbasi 02 60 02 85 26 Dr Naseem Banno 02 34 02 76 28 Dr Nasreen Waheed 02 35 02 35 19 Dr Farhana Memon 02 42 03 22 11 Dr Devi sadho 02 73 01 62 22 Dr Hakeema Palijo 02 22 02 42 15 Dr Ruksana Leghari 02 50 02 45 30 Dr Zareen kehar 01 08 02 19 09 Dr Shaheen Brohi 02 58 02 65 18 Dr Rubeena khokhar 03 22 02 38 15 Dr Tahmina Memon 0 0 01 25 10 Dr Umme Kulsoom 02 23 02 145 13 Dr Umera jabeen 02 35 01 21 0 Dr Zuhra kiran 02 65 0 0 0 Dr Ghazala 0 0 02 35 08

182


• Repair and Renovation • Schedule of Sonologist • Quality of medicine • Vaccination • Ownership of BHU • Regular community meetings • Co‐ordination between BHU and DSU staff • Visit of CSG members at BHU • Shortage of furniture and equipments. • Progress of Health facility. • Health issues of catchment area.

43. Important Points during SHSs : a. Diarrhea. b. Vaccination c. Personal Hygiene. d. Scabies. e. Infection prevention. f. Benefits of Nets. g. Hepatitis Important Points during CHSs : h. Family Planning i. Vaccination j. Personal Hygiene. k. Scabies. l. Antenatal care.


Sr. No. Topics 1 Diarrhea 2 Scabies 3 Malaria 4 Importance of vaccination. 5. Use of Iodine salt.


S # Topics 1 Malaria 2 Anemia 3 Personal Hygiene 4 Hepatites 5 Family Planning

183


• To Conduct regular CSG meetings • Active Participation of CSG members • Change / Replace inactive members of CSG • Develop Ownership of BHUs among community • Cooperation for arranging SHS & CHS. • Active Participation of CSG members in polio campaign

10. Health Camps: Number Held: 0. Number of Patients: 0. 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status i Sanitation ii Drainage / sewerage TMA should help with it TMO Awaiting from

TMO iii ……… drinking water TMA should help with it TMO Awaiting from

TMO iv Prevention of

adulteration N/A

v Tree Plantation EDO Agri help in tree plantation

DO Forest Action awaited

vi Roads and infrastructure Acess Rds net work at various facilities

DCO Action Awaited

vii Environmental Improvement

viii Others New Electric connection at BHUs & replacement of non‐functional meters

SDO Hessco Thatta

Action awaited





(New + Old) 59015 1178 60193


S # BHU OPD BHU OPD 1 Chatochand 3250 Jangri 379

2 Gariwah 2386 Raj Malik 407 3 Bello 2383 Muzaffar Leghari 476

4 Gujjo 2357 Jeand Zangejo 575 5 Gail Mori 2293

184


S # Disease No. of Patients 1 ARI 10930 2 Diarrhea 4414 3 Clinical Malaria 3859 4 Scabies 4459 5 Cough more than 02 wks 818


No. of Patients



ARV Available Doses 105

Snake bite cases reported 03





S # Tests Number 1 Blood Sugar Tests 104 2 Haemoglobin 0 3 X‐Rays (if available) 0 4 Ultra Sound 258 5 Others (please specify) 1234 (Malaria)

50. B & C SCREENING TESTS N/A





Follow up

result

Hepatitis B

Hepatitis C

S # Diseases No. of Patients 1 RTI 1340

2 Dermatological problems 967

3 GIT 951 4 Malaria 443 5 ENT 336

185

51. TUBERCLOSIS



Under Diagnosis

04 0 37

9. Referrals


2 38 37 0 01(Hpatites) 35 0 03




2 18 17 01 0 18 0 0




39 67 212 318


S # Name of HF Issue Action Remarks 1 BHU Ghilamullah Dangerous condition of

building Survey done.Will start R&R work very soon.

3 BHU Qadirdino shah EPI fridge out of order. Fridge taken for repair. 4 BHU Bello Electricity problem. Letter written to HESCO

officials for connection.

5 BHU Jhoke sharif Water supply problem. Survey done by P.E.

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS 1. Medicines available for: 14 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

• No any issue related to medicine was raised during MRM.

186


S # Name of



01 BHU Achar Jakhro Completed MB recorded

02 BHU Gujjo Completed Already Completed 03 BHU NM Thaeem Completed Already completed 04 BHU Jokhio Village Completed Already completed 05 BHU Ali Bahar Completed MB Recorded 06 BHU Chato Chand 100% MB recorded 07 BHU Haji M. Sodho 95% Work in Progress 08 BHU Dhabeji 95% Work in Progress 09 BHU Ghari Wah 85% Work in Progress 10 BHU Garho 40% Work in Progress 11 BHU Ghorbari 25% Work in progress


Visitors* Health Facilities Visited Overall Comments 1. Dr Rasool Bux Magsi,DO(H) BHU Buhara Satisfied

2. Mr Fida Shoro,Mukhtiarkar thatta BHU Ali Bahar Appreciated the work.

3.D.D.O(R),Sujawal,Mukhtiarkar BHU Syed Qadirdino Shah Satisfied

4.D.D.O(R),Jati,DO(H) BHU Begna Mori Satisfied

5.D.D.O(R) BHU Nodo Baran Satisfied



On Staff Matters: • Regularity & punctuality of staff. • Maintenance of all records. • Doctors & paramedical staff should wear apron during working hours. • Maintenances of leave record of HF staff at BHUs/GD. • Maintenance of V‐phone at health facilities.


• Conduct health sessions on regular basis and include topics of seasonal disease. • Arranging of quality/genuine health sessions.

On Curative Health: • MOs & FMOs with low OPD were directed to increase liaison with community and make regular CSG

meetings. On Mother, Child & Reproductive Health: During MRM it was emphasized that all female medical officers should concentrate more on mother and child health, besides their general OPD they should focus on ANC/PNC, normal delivery cases and also make counseling of patients. Make public family planning services to the clients.

187

Date /Time for Next MRM: The tentative date for next MRM is 06.06.2010 Comments on Targets vs Achievements (by DSM) This was 18th Monthly Review Meeting held on 11th of this month wherein Dr Mumtaz Brohi & Dr Sarwar Rajput belongs to Provincial Hepatitis program participated and delivered very meaningful and informative talk. He also offered provision of vaccination to all health providers particularly Male Medical Officers & Female Medical Officers, We try our level best to invite such persons in future too. Our HFs are located very far however we have made available MOs at 48 facilities and FMO cover at 46 facilities while Sonologist visits 10 facilities. We are trying our level best to make our services more meaningful for the poor people of Thatta particularly female.

188

MINUTES OF THE (17th) MONTHLY REVIEW MEETING OF DISTRICT_UMERKOT

Monthly Review Meeting (MRM) of District Umerkot for the Month of April, 2010 was held on 11th May 2010 at Darbar Hall DCO secretariat Umerkot. Written invitations to participate were sent to the DCO, the EDO (H), the EDO (F&P), District In charge of EPI, HANDS, TRDP, Sami Foundation, medical Officers & Female Medical Officers as usual. The list of participants is enclosed.

S # Names/Designation Designation S # Names/Designation Designation

1 Capt. Dr. Fazal Illahi EDO(H) 35 Dr Syed Mansoor Ali Shah MO PPHI 2 Ashiq Hussainn Chandio DSM PPHI U.K 36 Dr. Gobind Ram MO PPHI 3 Asadullah Asst EDO(H) 37 Dr. Ghansham Das MO PPHI 4 Dr. Fareed Ahmed F.P EPI Umarkot 38 Dr Dalpat Rai MO PPHI 5 Dr. Soomar Bhayon D.O Health 39 Dr Parshotam MO PPHI 6 Dr.Mohd Murad DDO Govt 40 Dr Ashoke Kumar MO PPHI 7 Sayed Irfan Hyder Shah Ex (M & E) 41 Dr Madan Rathi MO PPHI 8 Dhanesh Kumar Ex F & A 42 Dr Devi das MO PPHI 9 Zulifqar Laghari E.O Const PPHI 43 Dr Mohan Lal MO PPHI 10 Dr. Asad Ishaque MO H.Q 44 DR Wahid Kolachi MO PPHI

11 Dr. Jawed Ahmed Bhutto DO MNCH‐WHO Umerkot

45 Dr. Zulifqar MO Talhi

12 Nand Lal Malhi SO TRDP 46 Dr Vasdev MO PPHI

13 Dr. Abdul Sattar Mangrio DFP & WFP 47 Dr Khalid Mangrio MO PPHI

14 Dr. Bhagwano MS Umerkot 48 Dr Malook Oad MO PPHI

15 Dr. Dull‐e‐Shahwar Asst Manager Green Star

49 Dr.Chetan das MO PPHI

16 Munawer Ali Green Star 50 Dr Bahadur Singh MO PPHI 17 Imaran Ali Green Star 51 Dr Naresh Kumar MO PPHI 18 Rab Dino Soomro PWD 52 Dr. Mohan Lal Bhopani MO PPHI 19 Nasreeb Khoso ADCN.P 53 Dr Ghandi Lal MO PPHI 20 Dr.Khushal Das MO Govt 54 Dr. Salik Soomro MO PPHI 21 Dr .Qazi Samejo MO Govt 55 Dr. Mohammad Ali MO PPHI 22 Dr.Eassar Das MO Govt 56 Dr. Rafique Halipoto MO PPHI 23 Dr Bhag chand MO Govt 57 Dr. Mohd Naeem MO PPHI 24 Dr. Mtharam MO Govt 58 Dr. Husna Bhati FMO PPHI 25 Dr Sarwan Kumar MO Govt 59 Dr. Shazia Asif Rahoo FMO PPHI 26 Dr.Chetan Mal MO Govt 60 Dr. Naheed Akhtar FMO PPHI 27 Dr.Nand Lal Dewani MO Govt 61 Dr. Devi Jagdesh FMO PPHI 28 Dr. Yaqoob Malwani MO Govt 62 Dr. Anila Rawal FMO PPHI 29 Dr. Nazar Ali MO Govt 63 Dr. Saima Ali FMO PPHI 30 Dr.Jeev Raj MO Govt 64 Dr. Paras Bibi FMO PPHI 31 Dr.Shankar MO Govt 65 Ghulam Murtaza Laghari Asst: M&E 32 Dr. Talib Mangrio MO Govt 66 Hosh Muhammad Asst: Admin 33 Dr. Amin Bhatti MO Govt 67 Feroz Ali Maher Asst R & R 34 Dr. Ghansham Das MO Govt

189


S # Names/Designation Reasons for absence 1 Dr Mohan V Tilwani ‐ MO Govt Sick Leave 2 Dr. Nasrullah – MO PPHI Sick Leave

A. HFs WITH PPHI


TOTAL: 42

B. Population of the Catchment Area: 622,536

OO. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 41 38 15 23 26 W/FMOs 1 7 0 7 1 LHVs 31 29 8 21 23

Male 64 31 31 0 33 MTs/MAs Female ‐ ‐ ‐ ‐ ‐ Dispensers 2 22 0 22 2

PP. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO


Clusters of 6 HFs Clusters of 6 HFs ‐ Clusters of 5 HFs Clusters of 5 HFs ‐ Clusters of 4 HFs Clusters of 4 HFs ‐ Clusters of 3 HFs Clusters of 3 HFs ‐ Clusters of 2 HFs Clusters of 2 HFs 1 Single HFs Single HFs 37


Clusters of 5 HFs Clusters of 5 HFs ‐ Clusters of 4 HFs Clusters of 4 HFs ‐ Clusters of 3 HFs Clusters of 3 HFs 1 Clusters of 2 HFs Clusters of 2 HFs 5 Single HFs Single HFs 1

190


Dr. Asad, MO Head Quarter PPHI, gave a lecture on “Seasonal Diseases in summer in Umerkot District”. In this lecture he threw light on following important points;

• Seasonal Diseases and its various types • Typhoid & Diarrhea are the two major seasonal diseases • Causes of Seasonal Diseases • What types of Preventive measures can be taken to make ourselves safe from these diseases. • Signs, symptoms & causes of Typhoid & diarrhea. • Is PPHI providing enough assistance to cure and prevent from seasonal diseases?

14. Second Session: During MRM The second sessions during MRM was conducted by Dr. Serwan, MO Smaro Road.

He discussed Scabies disease in his lecture. Some of the important points of his lecture are mentioned below; • Define Scabies • Causes of Scabies • Signs & Symptoms of Scabies • Preventive & Curative measures to be safe from scabies




No. of Doses of Immunization Administered in Children at Health Facilities. 11405 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 10256 No. of Immunization & Vaccination Administered by out‐ reach EPI Teams 0 Total vaccination / immunization for the month March 2010 21661



April 26,27 & 28 2010 166032 171311 103 % 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides ‐ 2 Active Case Detection (ACD) Slides ‐ 3 Visits to Check Sanitation (individual house holds + streets) ‐ 4 Notices issued against Poor Sanitation ‐ 5 Challans sent to Court against Poor Sanitation ‐ 6 Patients Nebulized ‐

191



S # Name of FMO Anti‐Natal Neo‐Natal Other OPD Total OPD 1 Dr. Husna 159 62 230 1473 2 Dr. Shazia 283 61 35 1024 3 Dr. Paras 41 7 27 702 4 Dr. Devi 288 74 225 2903 5 Dr. Saima 199 53 35 645 6 Dr. Naheed 36 56 3 605 7 Dr. Anila 26 09 42 380

Total 1032 322 597 7732 2. Deliveries Assisted




44. Important Discussion on Mother and Child and Reproductive Health during MRM Dr. Jawed Ahmed Bhutto, district MNCH officer WHO, Umerkot, presented the overview of Maternal Neonatal Child Health (MNCH) Project. He uttered that MNCH being implemented by Govt. of Sindh, had been funded by 47 countries and 7 donor agencies. Now this project is started in 10 districts of Sindh including Umerkot. He further said that he had visited BHU Faqeer Abdullah & Shadi Pali. He said that PPHI was working nicely in district Umerkot. Apart from this following points were discussed as well;

• More & more birth cases that are occurred in catchment area must be registered. • LHS & LHW will have to cooperate with MOs, FMOs & LHVs. • Monitoring of LHS will be ensured.



Total 372

192


1. Number of Male SGs: ‐‐‐‐‐‐‐41‐‐‐‐‐‐‐‐‐‐‐ Number of female SGs: ‐‐‐‐‐6‐‐‐‐‐‐‐‐‐ 2. Performance of Social Organizers



No. No. of

Participants No.

No. of Participants

Ghulam Murtaza 8 69 12 265

Dileep Kumar 4 43 10 227

Khair Mohammad 4 79 5 115




Children Treated

Dr Qazi Samejo 2 60 1 0 0 Dr Yaqoob Mehrani 0 0 0 0 0 Dr Madhan Rathi 2 40 1 0 0 Dr Bahadur Singh 2 33 1 0 0 Dr Sarwan Kumar 2 45 1 0 0 Dr Jeevraj 0 0 0 0 0 Dr Ghansham Das 2 38 1 0 0 Dr Nand Lal 2 55 1 0 0 Dr Chetan Mal 2 33 0 0 0 Dr Talib Mangrio 1 25 1 0 0 Dr Vasdev 2 59 1 23 16 Dr Easer Das 1 30 2 30 0 Dr Malook Oad 2 41 1 10 5 Dr Shanker Lal 2 30 1 48 0 Dr Nasurullah 2 46 1 0 0 Dr A Wahid Kolachi 1 30 1 0 0 Dr Metharam 0 0 0 0 0 Dr Parshotam 2 50 1 11 6 Dr Dilpat Rai 1 17 2 0 0 Dr Ashok kumar 2 45 1 10 5 Dr Devidas 2 28 1 26 3 Dr Mohen Bhoopani 1 21 1 8 8 Dr Gandhi Lal 1 18 1 9 8 Dr Gobind Ram 2 26 1 4 0 Dr Chetan 2 43 1 0 0 Dr Mansoor Ali Shah 1 14 1 0 0

193

Dr Naresh Kumar 2 21 1 0 0 Dr Khalid Mangrio 2 40 1 21 0 Dr. Allah Warayo 0 0 0 0 0 Dr Bhagchand 2 34 1 3 3 Dr Amin Bhati 0 0 0 0 0 Dr Mohammad Ali 2 20 1 0 0 Dr Mohan Lal 2 36 1 0 0 Dr Khushal Das 2 60 1 28 20 Dr Mohan Tilwani 1 30 2 20 20 Dr Naeem 2 20 1 8 0 Dr Zulifqar 0 0 0 0 0 Dr Saliq 1 17 0 0 0 Dr. Rafiq 0 0 0 0 0 Dr Saima 2 52 1 6 6 Dr Paras Bibi 2 36 1 0 0 Dr Hussna Bhati 2 35 0 0 0 Dr Shazia Rahoo 1 38 1 0 0 Dr Naheed Akhtar 2 33 1 19 2 Dr Devi Jagdeesh 1 30 1 50 50 Dr. Anila 1 30 0 0 0


The following issues were discussed during the support Group Meetings: • Water Problem • Electricity Problem • Repair and Renovation work • Female Staff Required • Moral support to medical/paramedical staff working at HF. • To develop sense of ownership among community support groups. • A few HFs are using the illegal electricity connections but this matter will be resolved very soon. • HFs, where safe water is available, will be provided water coolers.

46. Important Points during SHSs a. Personal Hygiene is very essential to prevent ourselves from the diseases such as diarrhea, eye‐ear

infections, scabies etc. b. Quantity and quality of school health sessions be increased. c. School Health Sessions are very fruitful in a sense that a child is a good message deliverer because he/she

conveys his/her message to entire family. d. Immunization is important to prevent from the diseases. e. To drink clean & safe water and Washing hands after toilet.

6. Important Points during CHSs The following points came under discussion during community health sessions:

• Clean and boiled water should be used for drinking and cooking. • In dehydration, ORS or mixture (made of salt and sugar) must be utilized. • Malaria cases are increased because of unhygienic conditions. • Most of the diseases occurred owing to use of contaminated water.

194


Sr. No. Topics 1 Malaria 2 Diarrhea 3 Personal Hygiene 4 Measles 5 Personal Hygiene


S # Topics 1 Pneumonia 2 Scabies 3 Hepatitis 4 Eye infection


• By the support of LHW, community participation could be increased specially of female health sessions. • DSM will himself participate and monitor the Health Sessions. • Social Organizers can also play a vital role and can also provide good assistance to organize community

health sessions in better fashion.

10. Health Camps: Number Held: ‐‐‐‐‐‐‐‐0‐‐‐‐‐‐‐‐‐. Number of Patients: ‐‐‐‐‐‐0‐‐‐‐‐. 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status i Sanitation ‐ ‐ ‐ ii Drainage / sewerage ‐ ‐ ‐ iii ……… drinking water ‐ ‐ ‐ iv Prevention of

adulteration ‐ ‐ ‐

v Tree Plantation ‐ ‐ ‐ vi Roads and infrastructure ‐ ‐ vii Environmental

Improvement ‐ ‐ ‐

viii Others ‐ ‐ ‐





(New + Old)

49545

1315

50860

195


S # BHU OPD BHU OPD 1 BHU Shadi Palli 3025 BHU Muhammad Hassan Gujrati 483 2 MCH Umer Kot 2903 BHU Mir Din Muhammad 533

3 BHU Ghulam Nabi Shah 2398 GD Ismail Noohri 651 4 GD Syed Muzafar Shah 2156 GD Hurabad 656 5 BHU Rana Jagir 2089 BHU Faqeer Ali Bux Halepoto 676




No. of Patients


ARV Administered 0

ARV Available Doses 54 Amp Snake bite cases reported 2


ASV Vaccine Available Doses 9 vaccines



S # Tests Number 1 Blood Sugar Tests 49 2 Haemoglobin 0 3 X‐Rays (if available) 0 4 Ultra Sound 0 5 Others (please specify) 0

S # Diseases No. of Patients 1 ARI 37 2 Fever 28

3 Diarrhea 17

4 Skin Diseases 08 5 Eye 05

196






Follow up result

Hepatitis B 0

0 0 0 0

Hepatitis C 0

0 0 0 0

54. TUBERCLOSIS



Under Diagnosis

03 02 0 9. Referrals



2 13 13 0 40 18 15 20


S.No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs

2 0 0 0 0 0 0 0




54 52 165 271


S # Name of HF Issue Action Remarks 1 BHU Digu Electric Motor Repaired Water available @ BHU Digu 2 BHU Mohd Hassan Water Issue Pipe line fixing Water is now available

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS 1. Medicines available for: 46.79 Weeks

197

2. Important Issues raised relating to Medicines, etc. during MRM • After the completion of presentation on the theme of scabies, some doctors raised the complaint that

more advanced medicine for the scabies should be provided. Doctors demanded more benzene derivative to cure the disease. DSM asked the senior doctors to send him the list of required medicine for scabies that can be effective.


S # Name of HFs Description of Repair / Maintenance incl.

Electrification Status / Remarks

1

BHU Ghulam Nabi Shah Tiles Work, Color, Repair, Carpenter, Pulmbering,

Complete

2

BHU Rana Jagir Tiles Work, Co lour, Repair, Carpenter, Pulmbering, Electrification.

Complete

3 BHU Aahori Farm Tiles Work, Co lour, Repair, Carpenter, Pulmbering, Electrification.

Complete

4 BHU Kharoro Syed Tiles Work, Co lour, Repair, Carpenter, Pulmbering,

Complete

5 BHU Moula Bux Rajar Tiles Work, Co lour, Repair, Carpenter, Pulmbering, Electrification.

Complete

6 MCH Umerkot Tiles Work, Co lour, Repair, Carpenter, Pulmbering, Electrification.

Complete

7 BHU Digu Co lour, Repair, Carpenter, Pulmbering, Complete 8 BHU Samaro Road Co lour, Repair, Carpenter, Pulmbering, Complete

9 BHU Kunri Memon Tile work, Co lour, Repair, Carpenter, Pulmbering, Electrification

Complete

10 BHU Sanwan Rajar Tile work, Co lour, Repair, Carpenter, Pulmbering,

Complete

11 BHU Pir Sarhandi Tile work, Co lour, Repair, Carpenter, Pulmbering, Electrification

Complete

12 BHU Faqir Ali Bux Halepoto

Tile work, Co lour, Repair, Carpainter, Pulmbering

Complete

13 GD Muzafer Hussain Shah Physicaly work is completed Complete 14 GD Amin Rajar 95 % work is completed Incomplete 15 BHU Nabi sar Thar 95% work is completed Incomplete 16 BHU Fateh M.Rajar 90 % work is completed Incomplete 17 BHU Toban Veri 90 % work is completed Incomplete 18 BHU Sidique Abro Work in Progress Incomplete 19 BHU Haji Pir Shah Work in Progress Incomplete 20 BHU Nawaz Ali Shah Work in Progress Incomplete 21 BHU Saleh Bhanbhro Work in Progress Incomplete 22 BHU Mehinry Jo Par Work started Incomplete 23 BHU Abdul Hakim Areesar Work in Progress Incomplete

24 BHU Mohd. Hussain Gujrati

Work in Progress Incomplete

25 BHU Shadi Pali Work in Progress Incomplete 26 GD Sajan Khan Chandio Work in Progress Incomplete 27 G.D Moosa Jan Sarhandi Work started Incomplete

198



UN Team visited the health Facilities

BHU Mandri Jopar, Okrarao Chanio

Appreciated the work done by PPHI

District Officer MNCH, WHO Umerkot

BHU Shadi Palli & Faqir Abdullah ‐Do‐


J ‐ DISCUSSION DURING MRM On Staff Matters:

• Punctuality of Time should be maintained. • Hard Area Allowance was distributed. • Decision was made that two short leave will be calculated as one leave and if any staff member comes

late thrice in a month, his/her salary will be deducted. • V‐phones remain unattended by some health facilities. • New doctors & Lady Health Visitors have been appointed to fulfill the deficiency of staff. • A letter will be sent to all LHS to make sure their full cooperation.


• Quality & quantity of community & school health sessions must be increased in this regard social organizers have to play their part.

• Vaccinations are not being provided by EDO (H). • Slides will be provided to record the malaria cases.

On Curative Health:

• Some of the organizations are holding the medical camps in district Umerkot where tubeligation are being conducted without screening of blood. Such organization will be banned because of conducting such illegitimate activities.

• HTs will be provided a training to operate Hemoglobin meter in better manner. On Mother, Child & Reproductive Health:

• It was recommended by few doctors that a corner should be made at every BHU where women must be taught to make ORS.

• Number of Natal & neo natal case should to some extent be increased in this regard women medical officers, Lady Health visitors & midwife have to encourage the patients.

Other Matters: No any important matter came under discussion. Expected Date for Next MRM: 10th June 2010 Comments on Targets vs Achievements (by DSM)

• MOs, FMOs & LHVs, & Assistant have been appointed. • Medicine has been provided to all the Health Facilities. • R & R work is going nicely the work of 13 health facilities is completed while the work of remaining 14

health facilities is in progress.

199

MINUTES OF THE (1st) MONTHLY REVIEW MEETING OF DISTRICT_Ghotki

Monthly Review Meeting (MRM) of District Ghotki for the Month of April, 2010 was held on 14th May 2010 at Meeting Hall DCO Complex Mirpur Mathelo. Written invitations to participate were sent to the DCO, the EDO (H), In charge of EPI, and other officials of health department, medical Officers & Female Medical Officers as usual. The list of participants is enclosed. Attendance of Participants:

S # Names/Designation Designation S # Names/Designation Designation

1 Dr. Abdul Rauf kalwar DO (Health) 21 Dr. Rabia Raheem FMO PPHI 2 Dr. Altaf Soomro In Charge (HMIS) 22 Dr. Sadaf Malhan FMO PPHI 3 Mr. Hamza Shafqaat DSM 23 Dr. Hafiza Lakhan FMO PPHI 4 Ahsna Masood Ex. A/A 24 Dr. Salma Qureshi FMO PPHI 5 Nazir A. Laghari Ex. M&E 25 Dr. Samina Asif FMO PPHI 6 Dr. Vijai Kumar MO Govt 26 Dr. Rasheeda Shaikh FMO PPHI 7 Dr. Sarvanand MO Govt 27 Muhammad Sharif HT 8 Dr. Ashok Kumar MO Govt 28 Muhammad Tayyab HT 9 Dr. Abdul Ghaffar MO Govt 29 Sikandar Ali HT 10 Dr. Muhammad Hassan MO Govt 30 Shabir Anwar HT 11 Dr. Bashir Ahmed MO Govt 31 Abdul Salam Disp 12 Dr. Imtiaz Hussain MO PPHI 32 Muhammad Suleman HT 13 Dr. Aijaz Ali MO PPHI 33 Ladhoram HT

14 Dr. Aijaz Ali Pitafi MO PPHI 34 Shamas Din HT

15 Dr. Nisar Ahmed MO PPHI 35 Muhammad Rafique HT 16 Dr. Umesh Lal MO PPHI 36 Asadullah HT 17 Dr. Ranjeet Kumar MO PPHI 37 Adnan Chandio Assistant 18 Dr. Srichand MO PPHI 38 Muhammad Ahmed Assistant 19 Dr. Abdul Rasheed MO PPHI 39 Dr. Rahim Gadani Assistan 20 Dr. Asif Hakeem MO PPHI 40 Shahjahan Assistant

41 Faique Karhoro Assistant Store


S # Names/Designation Reasons for absence

1 Dr Parshotam (MO‐PPHI) Sick Leave 2 Dr. Tarique Gujjar – MO Govt Polio Training 3 Dr. Tooqeer Soomro (MO‐PPHI) Casual Leave 4 Dr. Rozina (FMO‐PPHI) Casual Leave Dr. Ghulam Sughra (FMO‐PPHI) Casual Leave

200

A. HFs WITH PPHI

BHUs: 25 Dispensaries: 08 MCHCs: 01 RHC: 03 Others: 1

TOTAL: 38

B. Population of the Catchment Area: 506635

QQ. STAFF STRENGTH

Sanctioned


Employees PPHI

Contract Vacant

MOs 33 20 8 12 13 W/FMOs 1 8 0 8 1 LHVs 34 6 2 4 28

Male 34 36 36 0 0 MTs/MAs Female ‐ ‐ ‐ ‐ ‐ Dispensers 0 1 1 0 0

RR. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO


Clusters of 6 HFs Clusters of 6 HFs ‐ Clusters of 5 HFs Clusters of 5 HFs ‐ Clusters of 4 HFs Clusters of 4 HFs ‐ Clusters of 3 HFs Clusters of 3 HFs ‐ Clusters of 2 HFs Clusters of 2 HFs ‐ Single HFs Single HFs 20 20


Clusters of 5 HFs Clusters of 5 HFs ‐ Clusters of 4 HFs Clusters of 4 HFs ‐ Clusters of 3 HFs Clusters of 3 HFs ‐ Clusters of 2 HFs Clusters of 2 HFs 8 Single HFs Single HFs ‐ 8

201





11816


4190


0

Total vaccination / immunization for the month April 2010

16006



April 26,27 & 28 2010 283959 295332

104 %


During Month under Review

1. Female Health

# Name of FMO Anti‐Natal Neo‐Natal Other OPD Total OPD

1 Dr. Rabia 50 0 50 425

2 Dr. Sadaf 29 8 137 676

3 Dr. Hafiza 46 7 184 869

4 Dr. Salma 24 7 6 955

5 Dr. Samina 98 2 246 1226

6 Dr. Rasheeda 37 18 20 517

7 Dr. Rozina 13 0 161 530

8 Dr. Sughra 7 0 82 182

Total 304 42 886 5380

202


Mr. Hamza Shafqaat DSM PPHI Ghotki shares with all participants about the focus of PPHI on Mother and Child Health. PPHI will arrange facility of normal deliveries at HF’s where FMO works. So a labour room will set at HF level and all services will be free of cost. The all participants appreciates the efforts of PPHI and asked that PPHI DSU Ghotki should immediately provides the pregnancy strips to all FMOs as they starts pregnancy tests at HFs. It was also shared that PPHI will also provides family planning medicine at all HFs free.


S # Name of the Items / Service Number

1 Consultation / Advice 129 2 Oral Pills ‐ 3 IUCDs ‐ 4 Injections ‐ 5 Others ‐

Total 129


1. Number of Male SGs: ‐‐‐‐‐‐‐24‐‐‐‐‐‐‐‐‐‐‐ Number of female SGs: ‐‐‐‐‐1‐‐‐‐‐‐‐‐‐




No. No. of

Participants No.

No. of Participants

Dr. Rahim 0 0 1 23

Shahjahan Malhan 0 0 8 163

Total 0 0 9 186



Sessions

Participants

Sessions Children Examined

Children Treated

Dr. Vijai Kumar 0 0 0 0 0 Dr. Sarvanand 0 0 0 0 0 Dr. Ashok Kumar 0 0 0 0 0 Dr. Abdul Ghaffar 0 0 0 0 0 Dr.Muhammad Hassan 0 0 0 0 0 Dr. Bashir Ahmed 0 0 0 0 0 Dr. Tarique Gujjar 0 0 0 0 0 Dr. Imtiaz Hussain 0 0 0 0 0 Dr. Aijaz Ali 0 0 0 0 0

203

Dr. Aijaz Ali Pitafi 1 18 0 0 0 Dr. Nisar Ahmed 0 0 0 0 0 Dr. Umesh Lal 2 54 1 23 23 Dr. Ranjeet Kumar 1 8 1 23 23 Dr. Srichand 1 14 0 0 0 Dr. Abdul Rasheed 0 0 0 0 0 Dr. Asif Hakeem 0 0 0 0 0 Dr. Nazir Malik 1 11 0 0 0 Dr. Partosham 0 0 0 0 0 Dr. Tooqeer Soomro 0 0 0 0 0 Dr. Rabia Raheem 1 11 1 2 2 Dr. Sadaf Malhan 0 0 0 0 0 Dr. Hafiza Lakhan 0 0 0 0 0 Dr. Salma Qureshi 0 0 2 15 15 Dr. Samina Asif 1 30 0 0 0 Dr. Rasheeda Shaikh 1 21 1 8 8 Dr. Rozina 1 17 0 0 0 Dr. Ghulam Sughra 1 16 0 0 0


Only Support Groups were formed during the month. Formal meetings with CSG will be conducted in May 2010. 50. Important Points during SHSs Personal Hygiene, Hepatitis, and Malaria were major topics during the school sessions. It was very first experience of MO and FMOs about Health Education. MOs/FMO’s has eager to conduct School Health sessions regularly

6. Important Points during CHSs Hepatitis, Scabies, and malaria were common topics. Total 11 community health sessions were conducted for the month of April 2010.


Sr. No. Topics 1 Diarrhea 2 Personal Hygiene 3 Malaria


S # Topics

1 Hepatitis

2 Scabies

3 Malaria

204


• DSM Shared that PPHI DSU Ghotki Monitoring team has formed 25 CSG in April 2010 and remaining CSG will be formed in May and meetings with CSG will be conducted in May 2010.

10. Health Camps: Number Held: ‐‐‐‐‐‐‐‐0‐‐‐‐‐‐‐‐‐. Number of Patients: ‐‐‐‐‐‐0‐‐‐‐‐.


1. OPD*




(New + Old)

19130

405

19535


S # BHU OPD BHU OPD

1 GD Sijawal Dhandhu 1310 BHU Kamoon Shaheed 153

2 BHU Ayoub Lakhan 1294 BHU Sono Pitafi 164

3 BHU Hussain Beli 971 BHU Lohi 183

4 BHU Sangri 878 GD Abul Ji Garhi 189

5 BHU Umar daho 834 BHU Ghulam Hyder

Laghari 192


S # Diseases No. of Patients 1 ARI 10 2 Fever 23

3 Diarrhea 19

4 Cough 08 5 RTI 05

205

4. Top Five Diseases during OPD S # Disease No. of Patients 1 ARI 3795 2 Fever 3335 3 Diarrhea 1234 4 Scabies 1067 5 Dysentery 690


No. of Patients


ARV Administered 0

ARV Available Doses 0 Snake bite cases reported 0






42 251


S # Name of HF Issue Action Remarks

1 BHU Sangri Medicine Leakage Relieved the HT after

formal inquiry

2 BHU Soi Sharif Wrong prescription

and Nephew of HT run

the OPD illegally

Relieve the HT after

formal inquiry



2. Important Issues raised relating to Medicines, etc. during MRM

• Most participants shared that there is acute need of medicine of scabies, asthama, and RTI. DSM shared that we are arranging the medicine from other DSU’s of Sindh. The all required items will be supplied till to June 10, 2010.

206


S # Name of

HFs


Status / Remarks

1

BHU Bago Bhutto TS send to PSU for approval ‐

2

BHU Umar Daho

TS send to PSU for approval

‐

3 BHU Qadirpur TS send to PSU for approval



UN Team and DCO visited the health Facilities

BHU Garhi Chakar, Noor Abad, Ahmed Pitafi, Dad Laghari,

Qadirpur, and GD hayat Pitafi

Appreciated the initiatives of PPHI and recommended the

more efforts.


J ‐ DISCUSSION DURING MRM

On Staff Matters:

• Punctuality of staff is improved.

• A few staff members are continuously absent from their duties.

• The explanation callas to 23 most irregular employees including Medical Officer were issued.

• New doctors & Lady Health Visitors have been appointed to fulfill the deficiency of staff.

• The necessary transfers of staff were made to ensure the punctuality and performance.


• 6 School Health Sessions were conducted in first month which put very positive impact over the teachers and students of schools. Many participating children were educated about the preventive measures of harmful diseases.

• 11 Community Health sessions were conducted in the first month. Most sessions were conducted with females.

207

On Curative Health:

• The all handed over HFs are made functional and 12 MO, 8 FMO, and 4 LHVs are hired to provide quality primary healthcare services in rural areas of district Ghotki. The over all 100% OPD increased in very first month of PPHI interventions. The necessary medicines and HMIS material were provided to all handed over HFs. Respected EDO Health also appreciated the efforts of PPHI which have improved the primary heathcare services in very first month of its operations.


• The all participating Doctors recommended that PPHI DSU Ghotki should provide the pregnancy strips, and Homglobin meters to FMOs as they provide the quality health services to the poorer women of rural areas.

Other Matters:

No important matter came under discussion.

Expected Date for Next MRM: 10th June 2010

Comments on Targets vs Achievements (by DSM)

• PPHI DSU Ghotki team is endeavoring to complete their tasks in very short span of time. In this regard the cooperation and support of all staff of HFs is required.

• New MOs, FMOs, and LHVs are hired to fill the vacant posts. • The necessary medicines will be arranged from other DSUs and will provide to all health facilities as soon

as possible. • The R&R work will be started in the month of may 2010. So technical sanctions of three centers are send

to PSU for approval. • The center wise need of Human resource, Equipment, and furniture is collected and will soon supply to all

centers.

monthly review of services - pphi...

Documents