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Weekly update on COVID-19 achievements

Date: Week starting Aug 14, 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

3376

462412 27,500 -Layered on Pulse

oximetry-1500

(1007)

HRP -1000 (1157)

and HBYC-25000

(460248) 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 55 6110 1500 -Layered on

LaQshya (4603),

NBSU, FPC, and

Safe delivery app

(1507)

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

1,555 126 3723 12,330 -12000 Layered on

FPLMIS (3008)

330 through HRP

(715)

Number of facilities supported with

USG resources (including TA,

training, supplies of COVID-19

medicine, ventilators, PPE, etc) and

able to respond COVID-19

300 0 399 122 -Layered on

LaQshya

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

Activities:

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

These activities will include:

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

audits and checklists under LaQshya:

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

delivery Apps:

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

promoting hand washing practices:

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

functionaries and communities:

5. Risk mitigation and action planning

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Key Activities – Jharkhand

1. Meeting with Mission Director – NHM, Jharkhand USAID Vriddhi state team; Dr Jaya Swarup Mohanty (STA) and Dr Sumant Mishra (Sr Advisor, AD) convened a

meeting on 18th Aug 2020 with Mission Director, NHM on the following points:

Opening of HWCs: Ensuring all the HWCs open during COVID 19, so that services are not hampered.

Program officer in charge of HWCs were instructed to circulate the message to all the CS through a letter, to

keep the HWCs open so the services are provided even during COVID.

New HMIS portal username & password: SPM was to share the read only username and password for

HMIS migrated to the NHP. As per discussion with SDM - NHM, currently they don’t have such provision of

creating user id and password, but they have requested MoHFW to provide the same. They will be sharing it

with USAID Vriddhi state team once they receive the same from MoHFW.

Impact of COVID 19: Impact of Covid-19 on service delivery based on HMIS indicators was shared with

MD. USAID Vriddhi team was instructed to draft a letter to share the HMIS indicators comparison for 2019

& 2020, data of June should be added in the current analysis. This will be done once the username and

password of new portal is received from the state. This letter will be sent to the DCs with action points to improve the indicators.

Issues in LaQshya: Vriddhi team was instructed to enlist issues based on LaQshya separately for Medical

Colleges & District Hospitals and share with Medical Superintendents & Civil Surgeons, respectively and

issue through a letter on his behalf.

2. Meeting for finalization of SoP during COVID times for children residing in Child Care

Institutions in Jharkhand

State Child Health Cell under the chairmanship of Nodal - CH convened a meeting on the 20th August

2020 at RCH Conference hall to finalize the SOP for children residing in Child Care Institutions in

Jharkhand in the perspective of COVID 19 pandemic. The meeting was held keeping in view the recent

infection among children in one of the Child Care Institution (CCI) in Simdega district. Representatives of

USAID VRIDDHI, UNICEF, Save the children, WHO participated in the meeting. Discussion was held on

prevention, testing and treatment of the children residing in the CCIs. It was decided that all the children

would be tested by the Rapid Antigen Test (RAT) and the children found positive would be admitted to the

District COVID Health Care Centers (DCHC) and Dedicated COVID Hospitals (DCH). The detailed SOP

would be prepared by UNICEF team and shared with the participants for final inputs in the next week by 24th

August 2020.

3. Online follow up for handheld FHR monitoring doppler with DH Chaibasa USAID Vriddhi team arranged a meeting with DH Paschimi Singhbhum (Chaibasa Sadar) regarding usage of

handheld FHR Doppler on 20th Aug 2020 using ICT platform. State Technical Consultant USIAD Vriddhi

team facilitated the meeting whereas Labour Room (LR) incharge and other LR staff nurses and District

Technical Consultant attended the meeting.

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Following points were discussed:

Issues regarding FHR monitoring

device was discussed. Facility team

requested replacement for the

dysfunctional device (not giving

sound). The LR staffs said that they

are now very comfortable using the

device and it is being very helpful in

regular FHR monitoring activities. Regarding data collected, it is

observed that covid-19 has no or

minor effect on the FHR monitoring

as the number of mothers monitored

for more than once for FHR remains

almost same.

4. SQCI Orientation

USAID Vriddhi team oriented and handholded Ms. Rajbir Kaur, State MCH consultant, NHM Jharkhand

on SQCI excel tool, on how to generate SQCI using SNCU portal data at USAID Building, Namkum Ranchi on

19th Aug 2020. The MCH consultant generated the SQCI by downloading latest data from SNCU portal for all

SNCUs of Jharkhand.

5. HBYC review of district Simdega on 14th Aug 2020 and Lohardaga on 18th Aug

USAID Vriddhi team facilitated HBYC review meeting of Simdega district on 14th Aug and Lohardaga district on

18th Aug using ICT platform. Total 13 BTTs, 13 Sahiya Saathis and 2 STTs from 7 blocks of Simdega districts

and 34 logins including 1 STT, 14 BTTs and 20 Sahiya Sathis from Lohardaga district participated in the meeting.

Whereas respective DPCs of the two districts along with DTC facilitated the review meetings.

Below mentioned topics were

discussed during the meeting:

Activities to be conducted

during HBYC home visit

and Line listing of

beneficiaries

Activities to be conducted

after training of Sahiya

Activities during

Supportive supervision by

Sahiya Saathi and BTT

Availability of logistics.

Monthly Reporting in form 1,2,3,4

6. 3rd

batch of NBSU review, Jharkhand on 14th Aug 2020

State Child Health Cell, Jharkhand in coordination with USAID Vriddhi Online review of NBSUs of Jharkhand

organized third batch of NBSU reviews on 14th Aug 2020 using ICT platform. A total of 44 logins were recorded

during the training session consisting of participants from 14 NBSUs; CS, DPM, MoIC, NBSU Incharge, BPM,

BDM and Staff Nurses along with USAID Vriddhi State team. Dr.Ajit Prasad; Nodal Officer – Child Health Cell

and Ms Rajbir Kaur; MCH consultant facilitated the training session.

Figure 2: Dr Anil Prabhanjan, DTC (HBYC), USAID-Vriddhi facilitating during online review on HBYC of Lohardaga district

Figure 1: LR staffs DH Chaibasa, West Singhbhum participating in online meeting on FHR monitoring (MOYO)

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Following points were discussed in the meeting:

• Availability of space

• Status of HR ( MO and Staff Nurses )

• Availability of equipment and instruments

• Status of admission both in-patients and out-patients

• Monthly reporting status

• Initiative taken to make NBSU fully functional after the FBNC review meeting

by Child health division

• Utilization of financial allocation by NBSUs

• Any other issue

Key Activities - Uttarakhand

1. Facilitated state LaQshya assessment: Following activities facilitated for state LaQshya assessment of CHC Bahadrabad on 19th August-

Check all record and documentation of Labour room and NBSU

Verified OSCE Assessment sheets

Staff interviewed on Complicated delivery

Verified drugs, instruments and BHT at labour room

Verified Monthly dashboard and indicators of

LaQshay

Verified Safe delivery app on staff mobile, SOP and

policies of labour room and Process mapping of

labour room

2. Meeting with CMO Haridwar on

Aspirational District program progress:

USAID Vriddhi team convened a meeting with CMO

Haridwar on 18th Aug to discuss each NITI Aayog

indicator their status and below mentioned focus areas: -

ANC Coverage: 1st trimester registration of pregnant

women, 4 or more ANC checkups & severe Anaemia

treatment

Newborn health - % of babies Breastfeeding within

one hour & low birth weight babies

Health infrastructure: Health and wellness center

progress report

LaQshya certification: Progress report of SDH

Roorkee, CHC Bhadrabad & Bhagwanpur on

LaQshya.

Figure 5: Dr Abhishek Nautiyal – DTC Haridwar discussing with CMO Haridwar on Aspirational District Program

Figure 3: Participants from NBSU Nagaruntari, Garhwa

Figure 4: DTO during facilitation of LaQshya Assessment

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3. USAID Vriddhi state team extended support to State Quality Cell for

online orientation of Staff on Virtual Certification, in preparation of

agenda and Power Point Presentation.

4. Training on Safe Delivery App:

USAID Vriddhi team conducted a training on safe delivery app for

staff/medical officer posted at HWC Kotamuradnagar & HWC Khalateela,

Bahadrabad Block of District Haridwar on 14th August and for medical

officer (Ayush) posted at HWC Panjenhedi, block Bahadrabad & HWC

Bhagwanpur Chandenpur, block Narsan on 18th August using ICT platform.

Activity: Inauguration of Delivery Points at Aspirational District Mewat -

Haryana

Deputy Commissioner Mr Pankaj, inaugurated new Delivery points at PHC Marora and Bichor. Civil Surgeon,

Deputy Civil Surgeon, CMO, DPM, SMO, MO, SN, Pharmacist, LT and MPW participated in the Inaugural

ceremony. The 2 PHCs are situated on inter-district/inter-state borders and have high home deliveries in their

catchment area. PHC Bichor covers a population of 40000 with 1300 deliveries including 700 home deliveries

each year. PHC Marorora has a catchment population of over 1 lakh 4000 deliveries including 1500 home

deliveries.

DTO Vriddhi team facilitated the identification of new delivery points for reducing home deliveries, planning and

organization of the LR complexes in both PHCs. Infrastructure, equipment and lay outs were planned as per the

Labour Room standardization and requirements under LaQshya. Referral transport for the PHCs were arranged.

Multiple mentoring visits jointly along with district officials were conducted for making the delivery points

functional.

Figure 7: Inauguration of Delivery Point at PHC Bichor by the Deputy Commissioner

Figure 6: Dr Priyanka (CHO), HWC Panjenhedi, Block Bahadrabad

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Figure 8: Inauguration of Delivery point at PHC Marora

Key Activities: Himachal Pradesh

1. LaQshya Review/Quality circle meeting conducted on Dated 18 Aug 2020 at RH

Solan:

USAID Vriddhi state team conducted a LaQshya Review

/Quality Circle meeting on 18th Aug at RH Solan to

discuss the current status of RH Solan under LaQshya.

Total 12 participants from RH Solan and MH consultant –

NHM attended the meeting. As the facility is state certified

and National assessment was done on 29 and 30 January

2020 and as per national assessment report LR and OT did

not qualify for LaQshya certification. The major gaps

according to national team was discussed and gap closure

plan along with timeline were discussed.

Figure 9: Meeting Photograph

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2. Review Meeting on LaQshay Programme for Quality of Labour Room and OT at

MGMSC Khaneri USAID Vriddhi state team convened a meeting on

LaQshay Programme for Quality Circles of Labour

Room and OT at MGMSC Khaneri on 19th Aug

using ICT platform under the chairmanship of Dr.

Hari Ram Thakur, District Health Officer. The

meeting was attended by 15 participants from MGMS

Khanneri along with Ms. Priyanka Chauhan,

Consultant MH-NHM and Dr. Akanksha Sood,

Consultant, Quality Assurance from State.

3. Orientation of doctors, ward sister, staff nurses on SDA on 18 Aug 2020 of RH Solan

and 19th Aug 2020 of MGMSC Khanneri.

- Orientation on Safe delivery app for 4 doctors, 2 ward sisters, and 4 staff nurses of RH Solan was conducted

on 18th Aug 2020.

- Orientation on Safe delivery app for 3 doctors, 1 Matron, 1 ward sisters, 4 staff nurses and 1 OTA of

MGMSC Khanneri was conducted on 19th Aug 2020.

Key Activities - Odisha

1. Online orientation on Safe Delivery App for

DAKSH participants of 46th batch DAKSH

training organized by skill lab capital

hospital, Cuttack: On 18th Aug 2020, an online orientation for the 10

service providers deployed in 9 health facilities, as the

first session of the 46th batch DAKSH training was

organized by Skill Lab, Capital Hospital

Bhubaneshwar. USAID Vriddhi team oriented the

participants on use and benefits of the smart phone

based Safe Delivery App and how it helps develop the

key skills related to safe delivery practices. Participants

were briefed that continuous use of SDA for learning would help improving the OSCE score of the staffs which

is a pre-requisite for LaQshya certification. The providers were suggested to achieve expert level achievement

in all modules of SDA and prioritize the COVID-19 and infection control module to finish within the DAKSH

training duration. It was briefed that after getting expert level achievement in all modules, the provider can

appear for self-assessment to get the SDA champion certificate. A follow up session was planned for all

participants after DAKSH training, to understand the provider experience of learning through SDA and

mentoring support as required.

2. Online LaQshya review SDH Banki, Cuttack district:

Figure 10: LaQshya review meeting of MGMS Khanneri

Figure 11: Dr Anil during orientation

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USAID Vriddhi team in

coordination with

Assistant Manager GKS,

Cuttack conducted an

online review for LaQshya

progress in SDH Banki on

19th Aug 2020 using ICT

platform. A total of 9

participants including

State consultant

RMNCHA, DMRCH,

Assistant Manager GKS,

Superintendent, Junior

hospital manager, Staff

nurses LR and OT in-

charges from SDH Banki,

O & G specialist and other

staff nurses LR and OT joined the online review meeting. The discussion was carried out w.r.t. the latest internal

LaQshya assessment done by the health facility as well as the time bound action plan shared by VRIDDHI team

with the facility. Gaps identified during latest internal assessment and possible solutions were discussed in

detail. It was suggested that the facility team will fix definite timelines for each action point along with a nodal

person responsible to take up the actions. It

was observed that few staff trainings such as

training on Quality assurance, ALS and CPR,

disaster preparedness etc are yet to be

conducted to fulfill LaQshya requirement.

An online training on quality tools will be

conducted in the following week.

Promoting usage of Safe Delivery App (SDA) among SN posted in SNCU for

improving knowledge on Newborn Health - Chhattisgarh

State of Chhattisgarh has registered a negative growth in Neonatal Mortality rate (NMR) in SRS 2018 and rose 3

points from 26 (SRS 2017) to 29. USAID-Vriddhi project has been supporting the state in strengthening newborn

care services through multifaceted approaches. During Covid it has become increasingly important to address the

gaps in newborn care through technology driven initiatives to be able to reach the audiences remotely. From the

success of SDA in the state, advocacy with Deputy Director Child Health (DD-CH) has been done to emphasize

on importance of SDA and to increase the reach of SDA and introduce it in the SNCUs. For enhancing the

capacity of MOs and nursing staff on newborn care knowledge and skills through modules on LBW, Newborn

resuscitation, Newborn management as well as precautions to be taken during Covid pandemic through newly

added Covid module in the app.

Figure 12: Vriddhi Odisha team orienting the DAKSH training participants on use of Safe Delivery App

Figure 13: The progress against the last time bound action plan was discussed with the SDH Banki team during the LaQshya review

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DD-CH has been oriented on SDA and facilitated with downloading and installation of the app.

Advocacy for promotion of SDA in the upcoming state level online training on Newborn resuscitation practices has

been done and release of directive from the state to districts on introduction of SDA across SNCUs has been

facilitated.

SDA will contribute to build capacity of more than

300 SN and 60 SNCU nodal officers on newborn

care and care during Covid pandemic along with

ensuring availability of essential commodities

related to Newborn care and resuscitation in

SNCUs.

Way forward

Follow up would be held with SNCU in

aspirational districts for improving the usage of

SDA.

Discussion on SDA during upcoming online

state level training on newborn resuscitation

practices.

Review Meeting cum Refresher Training on FPLMIS - Mizoram

During Covid 19 to ensure availability of commodities at sub centre level, orientation of ANM of Champhai

district on FPLMIS app was conducted on 19th Aug using ICT platform. A total of 20 participants including store

in charge of PHC, CHC and UPHC officials participated in the online training. During the training a review of

FPLMIS performance was also done along with resolving the issues being faced in the portal. A presentation on

Stock management, online indenting and stock status along with hands on training to all ANM were given with

respect to how to indent, how to update stock and how to issue to client.

This training was facilitated by state consultant and Team Coordinator.

Figure 15: Snapshot of online meeting of Champhai district

Figure 14: State directive issued on promoting usage of Safe delivery App by services provider posted at SNCU

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Activity: LaQshya Planning Meeting - Punjab

USAID Vriddhi team convened a planning meeting with MCH division of state health department, Punjab on 20th

August 2020. Dr. Inderdeep; PO- MCH, Dr. Diksha; APO – MCH and Dr. Jagdeep; APO – MCH participated in

the meeting. Salient points of this meetings are mentioned below;

1. AD Ferozepur

Date for LaQshya follow finalized - September 24-25, 2020

During this meeting Maternal Death Review (MDR) will also be done

2. Identified health facilities for state level LaQshya Assessment, following 3 facilities were identified for this

purpose.

Amritsar: BABA Bakala

Kapurthala: SDH Phagwada

Patiala: SDH Rajpura

Activity: Monitoring of ARI Cases

Vriddhi team from National level is regularly tracking ARI cases from 19 Health and Wellness centers. Total 48

cases of ARI screened in this week and 7 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

6

0 0

911

13

9

10 0 0

32

1

0

5

10

15

14-Aug 15-Aug 16-Aug 17-Aug 18-Aug 19-Aug 20-Aug

Total Screened Pneumonia cases

0

20

40

60

80

100

120

140Total Screened Pneumonia cases

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Impact on RMNCH services in project states

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

essential RMNCH services. Spurt in COVID cases in states such as Jharkhand, Odisha, Uttarakhand, have

resulted in services getting disrupted in pockets.

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.

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

Routine

Immunization

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

guidelines maintaining social distancing

HBYC services ASHAs are making home visits along with COVID screening during home visits

outside buffer zone.

HBYC is operational in only one district of HP, AD Chamba.

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

methods (Condoms & Pills) are being provided to beneficiaries. However, FP Commodities are not available in adequate quantity in block and district

of Haridwar. FPLMIS is not implemented here.

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.

There is a decline in deliveries seen at CHCs in Haridwar district consequent to spurt

in covid19 cases in community.

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

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Admission to SNCU SNCUs are fully functional and providing services. In Jharkhand SNCU (Rajmahal) remains closed as is converted to COVID ICU, SNCU Gumla has been closed from 19th -21st August due to fumigation activities. 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. In MP, Guidelines has been issued to perform sterilization on Fixed day, following COVID protocols with a maximum of 10 cases in a single day in a facility. PPIUCD & Injectables services are continued.

Figure 16: PMSMA organized in Kandhamal AD, Odisha

Figure 17: PMSMA Day in Baleswar, Odisha

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Figure 18: PNC ward at newly inaugurated Delivery point PHC Bichor, Mewat, Haryana

Figure 19: KMC is given in SNCU Chamba, Himachal Pradesh

Figure 20: Figures Showing mothers were counselled on Brest feeding through demonstrating FPC video, And a hand holding is being provided to a mother on establishing correct positioning and attachment for Brest feeding at SNCU Kabirdham. Photo curtesy SN Ms Mamta

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Figure 21: FPC Session being conducted in SNCU Chamba, Himachal Pradesh

Figure 22: Nesting being given to LBW at SNCU Nahan, Himachal Pradesh