1

Weekly update on COVID-19 achievements

Date: Week starting Jul 31, 2020

Weekly performance reporting on COVID-19 support

Indicators Baseline

(as on 30th

April)

Past Week’s

Achievement

s*

Cumulative

Achievements

(from start

through COB

Thursday)

Target for

the entire

project

Additional Information

Number of people directly benefited

through USG interventions (e.g.,OPDs,

helplines, chatbots etc.) Note:do not

include mass and social media.

34,093

2585

455233 27,500 -Layered on Pulse

oximetry-1500 (887)

HRP -1000 (1147)

and HBYC-25000

(453199) platform

Number of facility-based health

workers (doctors, nurses, CHOs,

pharmacists, ANMs, MPWs, and

Anganwadi center workers) trained to

prepare for and respond to COVID-19

with USG support. Disaggregated by

RCCE, surveillance, case management,

IPC and/or WASH

3,959 33 6018 1500 -Layered on LaQshya

(4550), NBSU, FPC,

and Safe delivery app

(1468)

Number of community frontline

workers (ASHAss, TB champions,

community volunteers, sanitation

workers, etc.) trained to prepare for

and respond to COVID-19 with USG

support. Disaggregated by, RCCE,

surveillance, case management, IPC

and/or WASH

1,555 106 3509 12,330 -12000 Layered on

FPLMIS (2794)

330 through HRP (715)

Number of facilities supported with

USG resources (including TA,

training, supplies of COVID-19

medicine, ventilators, PPE, etc) and

able to respond COVID-19

300 0 399 122 -Layered on LaQshya

*Please note that these numbers should be consistent with the numbers listed in the narratives below.

Activities:

IPE Global will leverage existing state and district level activities to integrate COVID-19 response measures.

These activities will include:

1. Strengthening infection prevention control and practices at the facility level through self-administered

audits and checklists under LaQshya:

2. Strengthening Universal Precautions at the individual healthcare provider level using self-learning safe

delivery Apps:

3. Daily tracking of cases of Acute Respiratory Infections (ARI) in Health and Wellness Centers and

promoting hand washing practices:

4. Dissemination of available COVID-19 risk-communications and guidelines among healthcare

functionaries and communities:

5. Risk mitigation and action planning

2

Key achievements:

Key Activities – Uttarakhand

1. Facilitated Training of Response Officer to be recruited in M&E Cell of NHM for Contacting the

Beneficiaries: As support requested by state government, Vriddhi team coordinated with the MH, TB &

104 project teams to

provide training to

prospective Responding

Officers. The training

session also covers a

session on COVID-19 and

use of Arogya Setu app. A

total of 19 participants were

oriented during the three-

day training facilitated by

resource persons from

MCH Division, TB Cell,

104 & Vriddhi Project.

M&E Control Cell is being

set up to strengthen

Program & Intervention

evaluations. The project

team had earlier provided

technical support in

designing the Pilot & Scale

Up phase based on consultations with the MD-NHM in collaboration with MCH Division. The Scale Up

phase includes the two aspiration districts (Haridwar & US Nagar).

2. Field Activities in Aspirational District Haridwar: Following are the key activities conducted by USAID

Vriddhi team in Aspirational District Haridwar –

▪ Online training on safe delivery app for Staff Nurse posted at CHC Landhora, Block

Narsan: District Technical Officer, USAID Vriddhi team orientated staff nurses on all the

modules of Safe delivery app on 31st July.

▪ On 4th August in SNCU - CRW Hospital Haridwar – DTC USAID Vriddhi team facilitated

handwashing practices for lactating mothers before handling the babies, support in correct

breastfeeding methods and KMC..

▪ Training orientation on

Rad G and IMNCI:

DTO – USAID Vriddhi

team conducted a

training on 5th Aug for

newly Joined MO

(MBBS) and ANM of

PHC Biharinagar to

orient on use of Rad G

device, classification of

Pneumonia, diagnosis &

treatment protocols at

HWC/PHC level. Figure 2: Training orientation on Rad G and IMNCI

Figure 1: Training session for M&E Cell

3

Interim LaQshya certification: Innovative approach on resuming work for

LaQshya certification using virtual media – Chhattisgarh

Quality certification of health facilities is one of the core deliverables of USAID Vriddhi (Scaling up

RMNCH+A intervention) project, as promoting Quality is inbuilt feature of all the program interventions.

Health facilities during COVID-19 have been striving hard to achieve and sustain the LaQshya certifications

status.

With respect to recent guidelines by GoI on LaQshya Interim Certification through virtual tour and verification

of essential list of documents an orientation was convened on 5th August using ICT platform for 5 prioritized

LaQshya facilities namely DH Narayanpur, DH Durg, DH Bijapur, DH Bilaspur and DH Kawardha. Except DH

Bilaspur rest all 4 facilities have already qualified for state certification during assessment held in February and

formal letter release is in process.

The orientation was chaired by Dr Alka Gupta DD-MH, facilitated by ID Vriddhi state team and participants

included state MH consultant, LaQshya nodal officers, Hospital consultants, MOs and nursing staffs of the

respective prioritized facilities.

Vriddhi would be facilitating the process of facility preparedness including completion of necessary

documentation, gathering evidences on quality assurance mechanisms, photographic evidences and would also

facilitate a mock virtual tour by August last week or early September for all the 5 facilities.

Figure 4: Screen shot showing status update of prioritized LaQshya facilities for Interim Certification. There are 7 criteria for Interim certification.

Outcome

• 15 participants across the 5 priority facilities were aware about the process of Interim

certification.

• This innovative approach on interim certification through virtual session is needed to hasten

the process of certification during the current pandemic and resuming LaQshya activity

especially certification.

• Promoting cross learning and rebuilt a momentum for LaQshya certification for the facilities

who were already in their advance stage of certification during pre COVID time

Way Forward

• Vriddhi has been listed as resource person in four facility level Whatsapp groups to support

and fast track the LaQshya certification.

• Technical support and guidance would be rendered in marinating essential list of documents

and conducting a mock virtual tour well before the national assessment.

• Document the process and generate a photo evidence for scaling the lesson learned.

Figure 3: Screen shot showing status update of prioritized LaQshya facilities for Interim Certification. There are 7 criteria for Interim certification.

4

Key Activities – Odisha

1. HMIS data analysis shared with state health key decision makers to comprehend the impact of

COVID-19 on delivery of essential services: Vriddhi National team has analyzed the HMIS data for Feb -

May 2019 vs 2020, to get the pattern of essential RMNCH+A service delivery in the state during COVID-

19 pandemic. The Vriddhi Odisha team shared the analysis with the senior health functionaries including

MD-NHM, DFW, Team Leader – State Health System Resource Centre, SPM-NHM, Consultant MH,

Consultant- CH and Consultant RMNHCH+A, NHM Odisha for review and necessary action.

2. Online orientation on

Respectful Maternity Care and

LaQshya mentoring of DHH

Puri: USAID Vriddhi state team

members during a discussion with

the O&G specialist in-charge on

various quality gaps for the

Labour room, strengthening

Respectful Maternity Care (RMC)

emerged as the immediate action

item. A refresher training using

ICT platform was held on 6th Aug

2020 for Hospital Manager,

ADMO medical, staff nurse LR

in-charge and other staff nurses of the facility. A total of 7 participants along with state consultant RMNCH

joined the session. A discussion with the facility team on some key issues related to supplies of

consumables and PPE kits, Supply of birth companion gown, restricted entry of visitors including ASHA

inside the labour room complex, taking appropriate consent in each delivery case as applicable, keeping

medical records confidential, display of posters on RMC near entrance of labour room complex to educate

the pregnant mothers and family were conducted. Allowing birth companion was discussed in detail as a

core component of RMC. It was proposed that women should be oriented on provision of birth companion

during ANC counselling as a part of birth preparedness. The hospital manager proposed that weekly

LaQshya review along with State level mentoring on a fixed day would be helpful. VRIDDI team agreed to

the proposal and offered continuous technical support and distant mentoring as required.

Key Activities – Haryana

1. Visit to Padheni for NQAS Review assessment

(5th Aug 2020): Visit was done by District

Technical Consultant USAID - Vriddhi team

visited PHC Padheni for preparation of annual

review. The National NQAS certified facilities are

mandated to have an annual review. This annual

review is due for PHC Padheni which was

certified last year. The participants were MO,

LMO, ANM, SN, Pharmacist, Lab Technician and

MPW. Discussion regarding the NQAS review

assessment was done with the team which is

scheduled for 10th August’20. Discussion

regarding the LaQshya checklist and gaps were

done with the facility. QI team Padheni will work

on filling the gaps to ensure that the certification

criteria are maintained.

Figure 5: NQAS review assessment meeting at Padheni

5

2. Mentoring Visit to Health and Wellness

Centre, Dhulawat (5th Aug 2020) : District

Technical Consultant USAID - Vriddhi team

visited HWC Dhulawat to review and

management of RAD G data along with CHO

Dhulawat. Discussion regarding low footfall

of patient due to COVID-19 pandemic was

done and it was suggested to inform ASHAs

and ANMs to disseminate the message in the

community regarding availability of services

in HWC Dhulawat. COVID-19 precautions to

be taken and sustained were discussed with

CHO.

Key Activities – Himachal Pradesh

1. Technical support to two LaQshya Facilities:

▪ Technical support was provided to RH Reckongpeo (LaQshya facility), district Kinnaur on 4 th August

using ICT platform was for preparation of LaQshya incentive claim forms from NHSRC & apply for the

same. The facility will apply for incentive to NHSRC for LaQshya incentive as both LR & OT of facility

are national LaQshya certified

▪ Technical support was provided to CH Sundarnagar (LaQshya facility), district Mandi, on 5th Aug’20

using ICT platform for preparation of gap filling documents to be submitted to state and further to

NHSRC. The facility received conditionality certification for LR and was asked by NHSRC to submit

gap filled for complete certification. After technical support facility submitted the documents to state to

approve and further share with NHSRC for national certification process.

2. Meeting with MH division NHM on 6th Aug 2020: Meeting with MH division NHM was held on 6th

Aug 2020 and following points were discussed: -

▪ The presentation and graph prepared by NTSU on impact of COVID 19 was discussed for maternal

health indicators.

▪ LaQshya MIS reports from all LaQshya facilities was discussed and was decided to give feedback to

LaQshya facilities with technical support from SRU-HP.

3. Meeting with CH division NHM on 6th Aug 2020: Meeting with CH division NHM was held on 6th Aug

2020 and following points were discussed: -

▪ The presentation and graph prepared by NTSU on impact of COVID 19 was discussed for Child health

indicators with CH division.

▪ Advocacy and follow up for use of new COVID 19 PFC videos in all SNCUs of HP

▪ Follow up for use of SQCI in all SNCUs review by state.

Figure 6: DTO conducting discussion with CHO at HWC Dhulawat

6

Technical Support to the health department of Punjab in development of

draft MMR strategy – Punjab

MMR of Punjab is 129 in SRS 2016-18 which has been increased by 7 points from 2015-17, while MMRs of

surrounding states are either decreasing or stable. In this regard, to flatten the curve of MMR in Punjab, a

meeting was organized

by the Additional Chief

Secretary (ACS) of

department of health and

family welfare with the

department of heads of

WCD and MER on July

31, 2020 at RCHC in

Chandigarh.

USAID Vriddhi Project

provided technical

support to the health

department to prepare

draft of MMR strategy,

PowerPoint based on

Maternal Death

Analysis. Vriddhi team

also participated in

discussion along with the

other stakeholders.

Salient Points

• Rationalization of

staff; ensure availability

of MOs and specialists

• Advocacy to reduce

the number of home

deliveries

• Cesarean Section: during the night, overall rate against total number of deliveries should be reviewed

• Engagement of partners in Maternal Death Surveillance, reporting and data analysis

• Mandatory Hospital Stay; till 48 hours in the hospital after delivery

• Ensure engagement of education and WCD Department to fight against Anemia

Participants

Government of Punjab: ✓ Chief Secretary of the Government of Punjab, Addition Chief Secretary,

Department of Health and Family Welfare , Additional Chief Secretary, Woman and Child Development , Additional Chief Secretary, Medical Education and Research Department of Health and Family Welfare

• Dr Avneet, Director Health Services (DHS), Dr Prabhadeep Kaur, Director Family Welfare (DFW), Dr Inderdeep Kaur, Program Officer, MCH Division, Dr Diksha, Assistant Program Officer (APO), MCH Division Department of Women and Child Department (WCD)

• Additional Chief Secretary

Department of Medical Education and Research

• Additional Chief Secretary USAID supported Vriddhi Project

• Dr Nidhi Chaudhary, Regional Technical Advisor (RTA) for Punjab, Haryana, and Himachal

• Dr Shailendra Singh Tomar, State Technical Advisor for Punjab

7

Key Activities – Jharkhand

1. Safe Delivery App study: 2nd Follow up online facilitation / mentoring with Hazaribagh

The second online facilitation/ mentoring for

the SDA study with intervention facilities of

district Hazaribagh (CHC Bishnugarh, CHC

Ichak and CHC Keredari) was conducted on

31st July 2020. District Technical Consultant

USIAD Vriddhi project facilitated the

mentoring in the presence of State Technical

Officer. Staff nurses / ANM from 3 facilities

who are enrolled in the study attended the

training. There were total 13 logins including

the facilitators.

2. LaQshya Activity Support (31st July to 6th August 2020)

District Hospital Ranchi:

DTC USAID Vriddhi team convened a telephonic follow up meeting (online review held on 27 th July) with LR

& OT staffs of district hospital Ranchi to support preparation of LaQshya gap finding report and action plan.

Recently the facility has conducted internal assessment of LR & OT and the state had reviewed the facility based

on the internal assessment report through review meeting held on 27th July using ICT platform. The facility; DH

Ranchi was instructed to prepare an action plan to mitigating the gaps.

Also, there is long standing requirement for the facility to increase space for LR as the case load has increased in

last 1 year. So the facility has identified few places to shift the LR and utilize the existing space to increase area

for postpartum patients and triage. DTC has helped the facility to finalize the locations/ space for shifting of labor

room. Identification of space for triage area and extra space for post-natal mothers were also discussed and

preliminary identified.

Medical College & Hospital (MCH) Dumka:

Dumka MCH was reviewed through online meeting on 14th July by the state. A follow meeting was facilitated

by DTC USAId Vriddhi team and chaired by HoD – ObG with faculty members, residents, medical officers,

Hospital Manager and staff nurses of OBG department. To discuss regarding Section G, LR gaps and SOP. It

was decided that a revised SOP will be prepared and shared with the state.

Figure 7: DTC USAID Vriddhi, facilitating training

8

Activities at other facilities

DH Sahebganj - DTC conducted a telephonic discussion with DPM Sahebganj on shifting of LR.

DH Pakur and CHC Maheshpur - Discussion was held CS Pakur on status of printing and display of RMC

posters in LRs of DH Maheshpur & CHC Pakur.

DH Latehar - Data entry has been started in all registers as per LaQshya guideline. Out of 40, 31 new registers

used in LR at DH- Latehar.

MCH Palamu, DH Chatra and RH Simaria (Chatra) - DTC facilitated discussion with respective LR incharge on

interim LaQshya certification of the facilities and strengthening of documentation such as preparation of

departmental standard operating procedures (SOP).

DH Garhwa - DTC provided techno managerial support in development of departmental SOP with the help of

Ex DPM and also supported for procurement of consumables.

DH Ramgarh - DTC has facilitated a discussion with hospital manager and LR / MoT Staff Nurse incharge

regarding departmental checklist filling, audit reports filling and gap closures of LR and MoT

Rolling out of FPLMIS to ASHA level in Ramgarh district of Jharkhand

ASHA is considered as depot holder at community for essential services which includes family planning

commodities. The final stage of streamlining the FP commodities supply is FPLMIS rolled out at ASHA level.

In Jharkhand after achieving 92% indent & rollout of FPLMIS up to Subcenter & PHCs level, the next step

initiated is the training of ASHAs on the FPLMIS as rolling out strategy. For this 4 blocks; Gola, Mandu,

Patratu & Sadar of Ramgarh district has been selected for pilot, Block Trainer Team (BTT) has been identified

as nodal for supervising the trainings and keep

record of indent by ASHAs.

Training for two blocks Patratu on 1st August &

Sadar on 5th August has been conducted using ICT

platform with 11 ASHA facilitators as participant

in each session. The training ids were created

without password so that ASHA Facilitators can

easily log into the training session. Before the

training user ids & passwords for individual

ASHA Facilitators were shared with the

respective BTTs, so that they can provide support

for the training.

FPLMIS consultant facilitated the training session

and the participants were made to learn how to log

in the FP-LMIS App. They were further oriented on the method of viewing the stocks, raising the indents,

viewing the indents, stock update which are major tasks to be completed by the ASHAs. In the training it was

also finalized that these trained ASHA Facilitators will further train and facilitate indent by the ASHAs working

under them during the cluster meetings conducted twice in a month.

During the FPLMIS training ASHA Facilitators prepared the plan for training of ASHAs during the cluster

meeting. It was also ensured that during the cluster meeting State Consultant and BTT would handhold over

phone/online in case there is any difficulty being faced by ASHA Facilitator. After the FPLMIS training two

cluster meetings were conducted by two ASHA facilitators under Patratu block in which a total of 15 ASHAs

indented the FP commodities using FPLMIS app.

Figure 8: ASHA facilitator training ASHA under them on FPLMIS during cluster meeting of Patratu block, Ramgarh district

9

Activity: Monitoring of ARI Cases

Vriddhi team from National level is regularly tracking ARI cases from 19 Health and Wellness centers. Total 23

cases of ARI screened in this week and 2 cases were diagnosed as pneumonia.

Chart 1: Daily incidences of ARI cases (31st Jul to 6th Aug 20)

Chart 2: Weekly Incidences of ARI Cases

3

1

0 0

6

4

9

0 0 0 0 0

1 1

31-Jul 1-Aug 2-Aug 3-Aug 4-Aug 5-Aug 6-Aug

Total Screened Pneumonia cases

0

20

40

60

80

100

120

140

27

Mar

-2 A

pr

W-1

W-2

W-3

W-4

W-1

W-2

W-3

W-4

W-5

W-1

W-2

W-3

W-4

W-1

W-2

W-3

W-4

31

Ju

l - 6

Au

g

Mar Apr May Jun Jul Aug

Total Screened Pneumonia cases Severe pneumonia Referred

10

Effects of COVID-19 on RMNCH+A, TB, HIV and other essential health

services in project geography:

Impact on RMNCH services in project states

Services in all states are opening in areas outside the containment zones and there is focus on resumption of

essential RMNCH services. However, on account of the recent spurt in COVID cases in states such as

Jharkhand, Odisha, Uttarakhand, services are once again disrupted. Inputs obtained from project states on status

of RMNCH services is as follows -

Outreach services

Antenatal Care

services

PMSMA is being organized in all districts as per GoI guidelines and Use of e

sanjeevani for consults has been rolled out. VHSND are being held as per GoI

guidelines And Line listing of HRP is being done.

In Jharkhand Due to NHM strike the ANC services have been hampered this week

wherever contractual NHM staff nurses and ANMs are posted.

In Chhattisgarh ANC outreach services have been withheld since late March and

only facility-based ANC services is being provided.

Home visits Integrated surveillance being undertaken by FLWs across states. ASHAs are doing

COVID related screening in the community and undertaking integrated surveillance

for active case finding for TB, screening for NCD, surveillance and sensitization for

NDD and IDCM with postnatal visits in Haryana, Jharkhand, Odisha and Punjab

Routine

Immunization

RI in VHSNDs are functioning beyond containment and buffer zone as per GoI

guidelines maintaining social distancing in states

However, in Jharkhand Due to NHM strike the ANC services have been hampered

this week wherever contractual NHM staff nurses and ANMs are posted.

HBYC services ASHAs are making home visits along with COVID screening. In Jharkhand,

Supportive supervision of Sahiya has now resumed. And ASHAs conducting HBYC

home visits outside buffer zone.

In Chhattisgarh, ASHA home visitation is ongoing.

HBYC is operational in only one district of HP, AD Chamba. Home visits by ASHA

are being done as per HBNC in remaining districts of state.

In Haridwar district, ASHAs are doing HBNC Visits regularly however, HBYC

Program has not been streamlined properly in the district.

Family Planning Home Delivery of Contraceptives by ASHAs is ongoing in all states and all

temporary methods (Condoms & Pills) are being provided to beneficiaries.

Facility services

ANC services In all states facility level ANC services are being provided on walk in basis using

staggered approach* and following physical distancing norms. Non-COVID PW

being transferred in non-COVID vehicles only is being ensured

Institutional

deliveries

All states have identified facilities both COVID and Non COVID for provision of

institutional deliveries and services remain uninterrupted.

Newborn care Birth doses continue uninterrupted, as does promotion of Breast-feeding practices

with early initiation of breast feeding and Kangaroo Mother Care.

Immunization

services

are being provided at facilities, for walk-in beneficiaries. Daily immunization for all

PW & Children at DH & SDH has been resumed in Haridwar district

11

Admission to SNCU SNCU are fully functional and providing services.

In Odisha, Due to COVID-19 positive cases found in the facility, two DHH including

SNCU services which were temporarily closed last week have resumed services this

week.

In Jharkhand SNCU (Rajmahal) remains closed as is converted to COVID ICU. The

SNCUs of Hazaribagh, Pakur, Dumka, Godda, Simdega, Chaibasa, closed from 4th

August 2020 due to NHM strike.

SNCU Ghatshila closed from 6th August 2020. SNCU Gumla is open but they are

not admitting any sick newborns as the MTC staff have been posted here during the

strike.

In Himachal Pradesh one SNCU at Medical college Nerchowk Mandi, is not

functioning as facility is a dedicated COVID Hospital.

NBSU services are functional

Family Planning

services

Now with increase in cases temporary closure of facilities is common and affecting

services in Odisha.

In Jharkhand, few CHCs have been converted to COVID center due to which FP

services especially sterilization have been hampered.

Punjab has seen a drop in PPIUCD and IUCD numbers.

In MP, Guideline has been issued to perform sterilization on Fixed day services,

following COVID protocols and maximum of 10 cases can only be performed in a

single day in a facility. PPIUCD & Injectables services are continued.

FP services such as sterilization and IUCD/PPIUCD are hampered due to full lock

down in Mizoram

*Staggered approach- Where adequate seating for beneficiaries and caregivers with physical distancing is

ensured

Figure 9: DTC provided telephonic support in planning for shifting DH Ranchi Labor room to the PNC ward.

12

Figure 11: LR & OT staff of DH Ranchi, Jharkhand during preparation of gaps finding report, DTC USAID Vriddhi supported Telephonically in this activity

Figure 12: Beneficiaries watching FPC 2nd session video at SNCU SDH Ghatshila, East Singhbhum - Jharkhand

Figure 10: Chhattisgarh - All the SN posted in DH Korba have become safe delivery app champion. This is first time when entire facility became champion. DH Narayanpur DH Kanker and many more such facilities are very near to achieve this accolade.

13

Figure 13: Handwashing Training for Lactating Mother in SNCU Haridwar , Uttarakhand

Figure 16: Punjab - Health and Wellness Center Shakoor at District Ferozepur, CHO is screening child for pneumonia

Figure 17: Staff nurse at DH Mohali is facilitating FPC session while SNCU In-charge is observing FPC session

Figure 14: Nesting and phototherapy of newborn in SNCU Giridih, Jharkhand (02 Aug 2020)

Figure 15: Nesting and phototherapy of newborn in SNCU Giridih, Jharkhand (02 Aug 2020)