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Gujarat Quarterly Monitoring Visit Report
Quarter 1, April- June 2013
NHSRC
Contents
Map of the District
Executive Summary
Detailed Monitoring Report
Annexures
HMIS Tables for district
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Map of the Porbandar District
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Gujarat Integrated Monitoring Visit Report
Quarter 1, April- June 2013
Executive summary
Purpose: Monitoring &Technical Assistance to districts for planning and implementation of NRHM activities; To assess the status of implementation of free and cashless services for delivery and referral transport for pregnant women and children under JSSK (separate detailed report submitted) .
The integrated monitoring visit for the first quarter of 2013 has covered the better performance district
of Porbandar for three days with visits to the district hospital (DH), one CHC Madhavpur, one 24x7 PHC
at Adityana, one subcentre at Bhade village under Garej PHC . The exit interview checklists for JSSK, User
fees facility checklist, interviews with the district officials and district data from DPMO are analyzed to
examine the existing situation.
Main findings:
DLHS III & HMIS data indicates that District performance is considerably high and much above the state
average in the major maternal health parameters of % ANC Check-up in First Trimester, 3 or More ANC
Check-up (%),Institutional Delivery (%), and Full Immunization (%) and so on. Breastfeeding within 1hour
of birth aspect, which is merely 51.8 percent, requires attention, as it is an important parameter in
neonatal care. Situation of reported maternal deaths (10) is more or less same as last year. Among the
causes of maternal deaths against total reported known causes of maternal deaths, bleeding constitutes
66.7% and 33.3% high fever.
41.2% infant deaths occurred between 24 hrs& under 1 week and 15.4 % deaths occurred within 24 hrs
of deaths and 21.3 % child deaths between one month and under 1 year. Among the known causes of
infant and child deaths against total reported known causes, LBW constitutes to a significant 64% and
Asphyxia 18%.
HR issues: There is a shortage of qualified personnel in the DH such as medical doctors, gynecologists,
specialists, in the class 1 & 2 categories and class 3 staff such as staff nurses, head nurses, and junior
pharmacists etc against sanctioned. As per district data, in CHC too, critical positions of medical
officers and staff nurses are vacant and requires to be filled. In PHCs, all six staff nurses positions, 68
positions of MPW s are vacant. This calls for immediate focus to initiate steps to improvement in HR
situation
Facilities visited: 24x7 PHC Adityana falls short of IPHS norms, without a single staff nurse so far, and
without 6 bedded arrangements in maternity ward. Subcentre, Bhade is housed in a government
building, is well equipped with a delivery room, senior trained ANM, MPW, ASHAs, and all other
equipment including colour coded bins.
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CHC Madhavpur facility needs strengthening on many aspects. Maternity ward/ room is very small could
accommodate two beds though on record there is a sanction for 30 beds.Case load is maternal below
average with 24 normal delivered conducted from April 2012-march 13 and total general OPD of 2485.
No FP operations conducted for the same period.
Blood bank: one government blood bank at the DH, and at the time of the visit there are only 4 units of
blood available. Two other private/NGO banks available in city.Facility has not put in place any system
for regular collection and maintenance of stocks, including a rational system of assessment of the need,
even though there is referral dependence from lower units. NO BSUs at other facilities.
JSY & JSSK: A total of 2466 beneficiaries received the incentives of JSY in the district and total number of
JSSK beneficiaries upto May 2013 are 3411.
Causes of Mortality Heart disease / hypertension related causes constitutes to a predominant 47.2% in
the known causes of deaths against total known causes of deaths 6 years and above
Quality Control: Protocols for bio medical waste management are in place except in CHC Madhavpur.
The state health department has a tie up with an NGO by name “Manavseva Trust” for the biomedical
waste management.
As part of system for monitoring and supervision, checklists are provided to district officials for periodic
assessments.
Display of proper Cityzen charter, RKS list, essential drugs position list, adequate information on JSSK
and breast feeding are needed in all facilities, DH, CHC and 24x7 PHC.
A system /mechanism is needed to be in place for grievance handling and it should be displayed in all
facilities visited.
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Detailed Report
Purpose
Monitoring &Technical Assistance to districts for planning and implementation of NRHM activities
To assess the status of implementation of free and cashless services for delivery and referral transport for pregnant women and children under JSSK
The integrated monitoring visit for the first quarter of 2013 has covered the better performance district of Porbandar for three days with visits to the district hospital, one CHC Madhavpur, one 24x7 PHC at Adityana, one subcentre at Bhade, under PHC Garaj . The exit interview checklists for JSSK, User fees facility checklist, interviews with the district officials and district data from DPMO are analyzed to examine the existing situation. For a macro analysis, HMIS data is utilized.
Profile of the District- Demographic Indicators
Porbandar, acoastal district surrounded by the neighbouring districts of Junagadh, Rajkot and Jamnagar,
has a population of 586,062(as per 2011 census), four Nagarapalikas, 3 Talukas, and 156 villages.It has a
population density 234 persons per sq. km, with a literacy rate of 76.63 %, and a sex ratio of 808females
per 1000 males.
Particulars / Parameters Gujarat Porbandar District
Population - Census - 2011
Persons 6,03,83,628 586,062
Male 31,482,282 300,967
Female 28,901,346 285,095
Population in the Age Group 0-6 - Census - 2011
Persons - 63,620
Male - 33,687
Female - 30,133
Sex Ratio ( No. of Females per 1000 Males)census 2011
811 808
Sex Ratio 0 – 6 years 886 894
IMR (per thousand live births) 44 -
MMR( per one lakh population)SRS 2007-09)
148 -
TFR( census 2011) 2.4 -
CBR( per 1000 population) 21.8
Literacy Rate (%) - Census - 2011
Persons 79.31 76.63
Male 87.23 84.56
Female 70.73 68.32
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Tab 2: Maternal Child Health Indicators2011-12, April 2012- Mar 2013& State
Indicators (DLHS III) Gujarat 2012-13 Porbandar District2011-12
Porbandar April2012-13 March
ANC
ANC Check-up in First Trimester (%)
52.3
76.6 76.6
3 or More ANC Check-up (%) 54.8 71.3 71.3
Deliveries
Institutional Delivery (%) 56.4 68.1 68.1
Home Delivery (%) 42.2 31 31
Home Delivery by SBA (%) 5.2 10.1 10.1
New Born & Post Natal Care
Live Births 96.1 97.9 97.9
PNC within 48 Hours of Delivery (%)
NA 68.2 68.2
Breastfed within 1hourof birth 48 51.8 51.8
Immunization
Full Immunization ((%) 54.8 76.7 76.7
As indicated by the above table, district performance is better and much above the state average in the
major maternal health parameters.In terms of comparativeperformanceof the district, progress
remained the same as the previous year in the major indicators.Breastfeeding within 1hour of birth is
merely 51.8 percent and requires attention, as it is an important parameter in neonatal care.
Tab.3 Maternal health-Comparison of district performance of 2012-13 with Previous year
Select Indicators (HMIS) Apr 2012- Mar 2013
Projected April 2012 -Mar13
Last year2011-March 12
Remark
3 ANC checkups against est. pregnancies ( HMIS)
90% 88% 76% Considerable Increase over estimation & last year
Institutional deliveries against est. deliveries
86% 83% 80% Moderate Increase over estimation &overlast year
Reported live births against est. live births
88.8% 86% 83% 5.8 %increase over last year
Fully Immunized against est. live births 90% 90% 93% Decreased by three % points over last year
Reported infant and child deaths 136 139.2 122 Reported deaths increased moderatelyover last year
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Reported maternal deaths 10 10.8 9 Increased by onenumber over last year
New borns breastfed within one hr of birth against reported live births
89% - -
% C. Section against institutional deliveries (public+pvt)
11.8 - - -
Abortion rate against reported pregnancies
3.7% - - -
Based on the above indicators, the overall situation of maternal health is improved over the previous
year. However reported maternal deaths remained same as last year, except that one more death
reported. Analysis of the causes of maternal deaths against total reported maternal deaths for this
period, indicate that ‘40.0% is due to bleeding’, 20% is due to high fever and 40% constitute ‘other
causes’. Among the causes of maternal deaths against total reported known causes of maternal deaths,
bleeding constitutes 66.7% and high fever 33.3%.
HMIS analysis reveals that out of a total of 581 complicated deliveries reportedly managed, 83.3% (484)
are managed and close to 30% of C. Sections (of total reported) are managed by the DH/SDH.
Breast feeding: There is a lot of variation in the data between DLHS III and HMIS with regard to the
‘breastfeeding within the first hour’. The plethora of IEC displayed in the DH facility did not include any
information on the importance of breast-feeding and colostrum in particular. The only women
interviewed at hospital did not initiate breastfeeding within one hr and was neither counseled by the
hospital staff. The same was brought to the notice of the facility authorities. Therefore emphasis is
needed on the importance of breastfeeding to pregnant women in the outreach programs,campaigns
and in many other innovative ways.
Infant and Child mortality: As indicated by the above table,the ‘fully immunized against total estimated
live births’ performance has reduced by 3 percentage points over the previous year. There is slight
increase in the reported infant (122 within one year) and child (14 between 1st year and 5 years) deaths.
41.2% infant deaths occurred between 24 hrs& under 1 week and 15.4 % deaths occurred within 24 hrs
of deaths and 21.3 % child deaths between one month and under 1 year.10.3 % deaths occurred
between 1 year and under 5 years.
Analysis of the causes of infant & child deaths against total reported deaths reveals, a significant 24%
deaths are due to low birth weight (LBW), 7% due to Asphyxia and 4% due to fevers. 62% are in the
category of others. Again in the known causes of infant and child deaths against total reported known
causes, LBW constitutes to a significant 64% and Asphyxia 18%.Cause of LBW correspondingly highlights
the significance of breastfeeding, as one of strategies to address this issue, which requires adequate
advocacy by authorities.
Maternal Death Review (MDR): The district has adopted the multi level MDR process beginning from
the verbal autopsy at Taluk health office to the review by district magistrate with all team.On the day of
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the monitoring visit, scheduled review process was going on, with the district magistrate/ collector
actively engaged in it.
Health care facilities map in the district
Public Health Care Infrastructure in the district includes 1 District Civil Hospital (DH), 4 CHCs, 11 PHCs
and 84 subcentres.
HR situation in the facilities in the district as in 2013
CHC ( 4) PHC (11) DH General
Category of staff sanction filled vacant sanction filled vacant Sanction Filled vacant
MBBS MO 12 4 8 10 8 2 - - -
Ayush MO 1 1 0 - 3 - - - -
Staff Nurse 28 14 14 6 0 6 46 32 14
Head Nurse - - - - - - 11 5 6
XRay tech 4 1 3 - - -
Lab tech 4 2 2 10 5 5 3 1 2
Pharmacist 4 3 1 10 8 2 12 2 10
Ophthalmic Asst 2 1 1 - - - - - -
Female health Worker (FHW)
- - - 84 80 4 - - -
FHSupervisor - - - 10 11 8
MPH S 10 1 9
MPW 84 68 16
Calss 1 category - - - - 18 11 7
Class2 - - - - - - 19 12 7
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HR positions in the facilities in the district include a total of 80 FHW/ANMs, 59 MPW,14 staff
Nurse(CHC), 3 PHC (Ayush) doctors, 8 PHC (MBBS) doctors, 4 CHC (MBBS) doctors and 1 CHC ( Ayush)
doctor.
From the above table, it is evident that there is a shortage of qualified personnel in the DH such as
medical doctors, gynecologists,specialists, in the class 1 & 2 categories and class 3 staff such as staff
nurses, head nurses, and junior pharmacists etc. In CHCS too, critical positions of medical officers and
staff nurses are vacant and requires to be filled. In PHCs, all six staff nurses positions, 68 positions of
MPW s are vacant. This calls for immediate focus to initiate steps to improvement in HR situation.
Facility Readiness: Key Observations:
The visit covered the district hospital at Porbandar, which is housed in two separate Government
buildings, one exclusively for maternity wing. Maternity ward is equipped with OT, laboratory,
pharmacy, SNCU, sonography, colour Doppler units and generator back up.The case load is high
compared to human resources available.
Caseload of DH April 2012- May 2013
Total OPD Total IPD
Gyn USG
NICU/SNCU
196436 16467 4480 317
Waiting halls and OPD exam rooms are available. However arrangement for adequate facilities for of
pregnant and senior citizens, such as washrooms close to OPD, drinking water is required. OPD
management practices are in place such as tokens, registration cards; OPD lists on computer etc.
Crowded Maternity wards are maintained without provision of privacy. Screens are required to be
initiated by the facilities.
Photos: OPD at maternity wing of DH Porbandar. In-Patient ward at Maternity hospital at the DH
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DH: The DH general unit is well equipped with different separate units for male, female, ICUs, male,
female Burn-wards, Ophthalmic, district cell for Non Communicable Diseases (NCD) and a separate wing
(NPCDCS-NPHCE), OPD & IPD, Bloodbank, laboratory, data entry rooms, ART centre with a councilor,
and award for prisoners. Hygiene is maintained well including the washrooms, except in the maternity
wing. Essential drug list is available and registers are updated and maintained in order. Computers are
actively used for various purposes.
Display: Citizens charter is displayed only at the general DH building and not at the separate unit of
maternity wing.Display of RKS/HDS members, essential drug list stock position, adequate JSSK
information,grievance handling mechanism, information on breastfeeding are required. IEC display
should be kept at a strategic, place where patients can notice and find it convenient to read on.
NICU/ SNCUs at DH:There is a SNCU in the DH and a full time pediatrician and a staff nurse available. It
has 4 units out of which one is not functional /condemned. There are no infants/patients in the SNCU at
the time of visit. As mentioned already caseload for the entire year is only 317.
Utilization is low and needs to be improved.
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24x7 Maternity home (PHC)Adityana: Upgraded as 24x7 PHC ,operates in a government building with a
MO and a Ayush doctor.
Case load: It caters to an average case load-a total OPD (April 2012- March 2013) of 11074; 73 deliveries
(of which 16 are night deliveries).
The PHC falls short of IPHSnorms. There is not a single staff nurse from the beginning and deliveries are
conducted by a Dai stationed at residential quarters and the local senior FHW. The maternity ward has
only 2 beds instead of required 6 beds. The single maternity room with 2 beds is used for multi
purposes of meetings etc. a birth waiting room is initiated recently.
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Registers and Data maintenance arewell in order. Stock lists are available. Display of proper Cityzen
charter, RKS list, essential drugs position list, adequate information on JSSK and breast feeding are
needed.
Needed interventions: Recruitment of at least one staff nurse and provision for full fledgedsix
maternity beddedward are important actions.
Madhavpur CHC and Bhadesubcentre:
Sub-centre Bhade is housed in a government building, is well equipped with a delivery room, and all
other equipment including colour coded bins. It has all the trained, senior staff and ASHAs attached to
it. Per month an average 2 o 3 deliveries take place. Lab technician from the nearest PHC visits the SC on
schedules for conducting blood exam for ANCs, in addition to the blood exam kits that are maintained
there. It carries an ANC OPD for all 6 days and 2 days particularly are allotted for national programs.
Subcentre has some IEC material but requires adequate information on breast feeding and JSSK.
Photograph- subcentre.
CHC Madhavpur is also housed in a government building and converted froma PHC to CHC in
Feb 2012. At the time of visit the regular medical officer was reportedly on leave and another medical
officer TB in charge is posted that day. There Is one staff nurse. the CHC is not equipped in general , for
example, without any arrangements for patient waiting( patients were observed as waiting on the exit
cantilever, waiting for OPD), no display of information on any important aspects including citizen
charter, RKS, drug list, grievance handling mechanism, and JSSK ( one banner washurridly hung, loosely
to tube lights).
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Maternity ward room is very small could accommodate two beds though on record there is a sanction
for 30 beds. It has a baby warmer, with one common wash room provision. Labour room is so tiny that
baby warmer had to be located in the injection room of the nurse, did not have colour coded bins.
Proper arrangements are required for the maternity room. Laboratory technician is trained in HIV
testing and no register is maintained for ANC tests particularly for HB tests count record.
Case load is maternal below average with 24 normal delivered conducted from April 2012-march 13 and
total general OPD of 2485. No FP operations conducted for the same period.
CHC has no BSU. It is mentioned that in case blood transfusion is required patient is referred to the DH,
which is 70 km far away.
CHC Madhavpur, delivery room without colour bins. Baby warmer in the injection room
RKS & VHNCs in the district
RKS data in the district& state
Porbandar Gujarat
RKS status PHCs CHCS PHCs CHCs
Facilities functional 11 4 1156 300
RKS formed 10 4 1146 299
RK S not formed 1 10 1
RKS registered 10 3 1136 297
Not registered - 1 8 2
The district hospital has the new hospital development society formed. However details of the society
or RKs and its members have not been on display in any of the facilities visited. There are a Total of 148
VHSCs as on April 2012.
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ASHAs
State has a total of 31780 ASHAs in position and Porbandar district has 276 ASHAs and all have
completed 5th module training. 12 of them completed fourth round of 6th& 7th module in the district. In
the state 18438 completed fourth round of 6th& 7th module.
Blood Bank:
There is only a government blood bank at the DH and at the time of the visit there are only 4 units of
blood available. There are 2 NGO/ private blood bankslocated in the city covering the district, from
which blood supply is sought if& when required. However it is revealed during interviews with the
authorities, facility has not put in place any system for regularcollection andmaintenance of stocks,
including a rational system of assessment of the need. The physical infrastructure of the blood bank is
maintained well at DH.
None of the facilities visited such as CHC, 24X7 PHC have any BSUs. It is repeatedly revealed during
discussions with doctors/ officials/ paramedical staff in the visited facilities, that any slightest sign of
criticality or requiring blood transfusion, case is essentially referred to the DH in Porbandar. There is
only one referral ambulance for each facility in general, which can crop up the issue of availability in
time for critical cases.
This clearly indicates the high dependence from all quarters of district on the DH even for blood
transfusion, calls for creating self-sufficiency of the CHCs, &allied facilities for maintaining BSUs and
simple blood transfusion services.
Required intervention: Systems to be put in place at DH to maintain adequate supply of blood, based on
a rational assessment of needs. BSUs are to be initiated in facilities on the basis of assessment and make
them self-sufficient.
JSY& JSSK
A total of 2466 beneficiaries received the incentives of JSY in the district (upto may 2013). As per
analysis of HMIS, 10.99% of JSY paid against reported Home deliveries and19.05% JSY paid against
reported public institutional deliveries.
It is revealed during the course of exit interviews of JSSK, that many women (for first and second child)
did not receive the JSY benefit, though they belonged to the Below Poverty Line (BPL) category, as they
did not possess the statutory document.
Needed intervention: As a social determinant of health this aspect is highly significant which is related
to mothers nutrition support during pregnancy.
Convergence with other relevant department may be called for. Strategies are needed to be initiated
through RKS and HDS (as they often consist of members from political bodies) to address this issue.
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JSSK REPORT 2012-13 & 2013-14 march (Source: DPMU, Porbandar)
Year Free Drugs Free Diagnostic
Free Diet Free B.T. Drop Back
2012-13 10979 6171 2900 73 916
Target for 2013-14 1900 1801 4154 73 910
2013-14 2610 424 511 43 398
Per.% 137.37 23.54 12.30 58.90 43.74
Total number of JSSK beneficiaries upto May 2013 were 3411.
Both OPD and IPD services are free of cost in all facilities visited. Blood services are provided free of
cost. Drugs, Diagnostics and diet are provided free of cost in all the facilities visited.
75 percent of the exit interview respondents mentioned that they used their own personal transport
such as rickshaws, vans and train incurring OOP expenses. The 75 percent of those who used rickshaws
as transport, the reported out-of- pocket expenses range is Rs 15 to100/- and Rs.100 to 400/- for those
used vans.The woman delivered in the 24x7 PHC mentioned that they used facility ambulance to reach.
ARSH
At the DH the ARSH clinic is reported as initiatedonly 3 days prior to the visit. There is no separate
counselor.
NRC
There is no NRC in the district.
ART Centre
Separate ART centre is available with a trained councilor. Out of a total of 21,774 tested for HIV, there is
0.3% positive for HIV and are on ART drugs.
Immunization
HMIS analysis shows, the ‘fully immunized against total estimated live births’ is 90 %( o-11 months) and
between April to march2013, drop out from BCG to DPT3 is minus 4% and same for drop out from BCG
to Measles.Though overall district performance is substantive, it has reduced by 3 percentage points
over the previous year.
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Family Planning:
As per HMIS analysis, between April to March, of the total 1885 sterilizations, there 100% female
sterilization(1879) and male sterilization are only 6.
FP Performance (April 2012- May 2013) source: DPMU
Category District Target
District Achievement
% Achievement
State achievement % (upto march 2013)
Sterilizations 2388 2259 94.59 83.81
Copper T 4081 4295 95 89.9
Oral Pills 1722 2135 123 53.6 (equivalent users)
Condoms 6098 4161 68.23 39.83 (equivalent users)
There is found to be variation between the HMIS figures and the DPMU figures, which are on higher
side. However, analysis of HMIS( upto march2013) indicated, of the total FP method users42% is the
reported IUD users,; 15% is OCP users; and 21% Limiting method users. As 0.3 % is male sterilization
figure of the total reported sterilizations, focus is required to work out gender sensitization strategies
for the promotion of Male sterilization in the district.
As per HMIs analysis, 11% “limiting” and 44% “ spacing” unmet need met by reported family planning
methods during the period April 12 –march 13.
Mortality - Communicable diseases:
HMIs analysis of major cause group of mortality indicates that 20.9 % fall in the category of
Communicable, maternal & perinatal diseases; 35.1 in Non Communicable disease category; 8.2 % in
Injuries and 35.8% in the category of ‘others’.
Predominantly, 32% deaths are owing to heart disease/ hypertension related; 6% is due to suicide and
4.8 % is due to respiratory diseases ( other than TB) against the total reported deaths 6years & above (
during 2012 April-march 13). Again, Heart disease / hypertension related causes constitutes to a
predominant 47.2% in the known causes of deaths against total known causes of deaths 6 years and
above. This certainly calls for special emphasis in adopting preventive and curative strategies to address
this. The NCD cell created has a major role.
Performance in other National Programs:
In the blindness control Program a total of 8827 patients were operated for cataract and 8827 were
provided Intraocular lens (IOL) implantations (Up to May 2013).
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School Health:
A total of 2066 school children were detected and provided with Refractive errors and 3271 were
provided with free glasses during 2012 April to may 2013.
NVBDCP, Waterborne disease control:
Total number of patients treated under this program during april 2012-May 2013
Diarrhea Decentry Viral hepatitis
Enteric fever
14363 329 20 261
Malaria achievements:
Upto June 2012 Blood Sample Collection is 42672, Positive Case load is 167, PF 11
Total Dengue Cases 172, Positive 29; Mosquito Net Distributed 8941
June 2013 Ending Blood Sample Collection 42869, Positive Cases 115, PF 5
Total Dengue Case June Ending 57, Positive10.
RNTCP:
Progress during2012-2013 march
Sl Activity Target Achievement
1 New Sputum Positive Cases
340 377
2 New Sputum Positive Detection Rate
56 Per Lakh Per Year
63.22
3 Sputum Conversion Rate
> 90%
90.7%
4 Cure Rate
>85%
91.4%
5 Defaulter Rate
<5%
3.5%
6 Death Rate
<4% 3.2%
7 Failure Rate
<3% 1.0%
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Program management
The district program management unit is housed in the district health office. There is a district program
coordinator and a regional coordinator who is the in-charge for 3-4 districts in the region, including
Porbandar.
System in place: For monitoring and supervision checklists are provided to district officials for
Immunization aspect and other aspects and inspection report formats for facilities. Filled in checklists
are supposed to send with feedback to concerned THO( Taluk Health Officer) and PHC MOs with the
signature of the CDMO for action to be taken by THO & PHC MO. The later are expected to send action
taken report within 7 days to the CDHO. In addition to this there are monthly review meetings.
Quality Control:
Infection Control- Biomedical waste management:
Protocols for bio medical waste management are in place. The state health department has a tie up with
an NGO by name “Manavseva Trust” for the biomedical waste management. Colour coded bins are
available and maintained in critical places such as OT, labs etc. in the DH and the 24x7 Adityana PHC.
CHC madhavpur did not maintain them.
Colour coded bins at delivery room at DH
Grievance handling mechanism
There is no system /mechanism in place for grievance handling at any facility visited.
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Annexure: Key Findings of last PRC Report
Monitoring&Evaluation of Program Implementation Plan 2012-13 Gujarat PRC, Vadodara - August 2012
Summary
PIP evaluation study was conducted in the high focus district of Narmada and Non-high focus district of
Vadodara. In each district, I district hospital, 2 CHCs (1 FRU and 1non-FRU), 2 PHCs as well as 3 Sub
centres under each PHC were selected for the study. In addition to the above, at Vadodara, the hospital
attached to the medical college and 2 urban health centres were also covered.
Findings: The mandatory disclosures are not displayed on the state NRHM website. The JSSK is not yet
implemented in total in Narmada district, though JSSK benefits are provided to the women under one or
other scheme at Baroda, except uniform pick up, drop-back and free diet to the attendant at all
facilities. The JSY guidelines are being followed in identifying beneficiaries and making payments in both
the districts.
Adolescent health program, the school health component is implemented according to the guidelines
while the same cannot be said for the other two aspects viz., MHS and WIFS.
All the service delivery points especially those below district level at Vadodara are not yet operational in
terms of eithermanpower or infrastructure/ equipment to provide safe delivery and ensure child
survival. In Narmada, one of the delivery points including the district hospital are fully operational to
provide mandated services. This is mainly due to lack of trained staff or essential infrastructure /
equipment.
None of the sub-centres included in the study have two ANMS. Only one out of 6 PHCs approved as
24X7 at Narmada is functioning, and with only one Medical officer.
At Baroda, training of ASHA s in modules 6 & 7 is ongoing whereas in Narmada 80% ASHA workers are
trained in module 6&7.
The present evaluation during the first quarter has brought to light the fact that due to delay in receiving
the grant from the state for the quarter, the district authorities were only able to carry out routine
activities and not any of the activities/ programs planned under the current PIP.
Strengths:AYUSH practitioners have been co-located in the CHCs / PHCs
Pregnant women visiting the health facilities are screened for anemia and free treatment provided if
necessary. JSY guidelines are being followed in identifying beneficiaries and making payments.
ARSH and school health program is being implemented as per the guidelines.
___________________
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HMIS
National Health Systems Resource Center
HMIS Analysis – Gujarat –
Porbandar - Apr’12 – mar’13
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Note for Information Users
This data analysis is primarily presented to facilitate the use of this information by District level
Programme Managers. They are in a better position to interpret this information in context and act on
it. Even what are apparently data of poor quality or errors can be useful if the nature of error is
understood. However those not sensitized to the data quality issues and those trying to use this for
policy or journalistic purposes will find serious limitations – especially due to incomplete reporting of
private sector data and poor quality of death reporting. Also please note that interpretation of
information will differ with choice of denominator. We should be familiar with choice of denominator in
use. Do consult HMIS Training Manual 2 for further understanding of these issues. Data is also analyzed
and presented so as to help districts, find data errors and correct them. Only when data is converted
into information and used, do many errors become apparent. Some states are likely to notice data entry
errors & change their data- for which reason also, care should be taken when quoting from this source.
We would advise you to check with state government and take permission before quoting from this.
Executive Director
National Health Systems Resource Centre
May 2013
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Gujarat - District - Porbandar
State Statistics - Gujarat District Statistics - Porbandar
Population - Census - 2011
Person 60,383,628 Indicators DLHSIII
Male 31,482,282 ANC
Female 28,901,346 ANC Check-up in first trimester 76.6
Sex Ratio ( No. of Females per1000 males)
Census - 2011 811 3 or more ANC Check-up 71.3
Sex Ratio 0 - 6 years Census - 2011 886 Atleast 1 TT received 86.5
MMR ( per 100,000 live births)
SRS - 2011
148 100 IFA Tablets 46
CBR ( per 1000 population) 21.8 Deliveries
CDR ( per 1000 population) 6.7 Institutional Delivery 68.1
IMR 44 Home Delivery 31
Neo- natal Mortality Rate Home Delivery by SBA 10.1
Under Five Mortality Rate New born & post natal care
District Statistics - Porbandar Still Birth 0
Population - Census - 2011
Person 586,062 Live Birth 97.9
Male 300,967 Breastfed within 1 hour of birth 51.8
Female 285,095 PNC within 48 hrs of delivery 68.2
Population in the age group 0-6 - Census - 2011
Person 63,820 Immunisation
Male 33,687 BCG 97
Female 30,133 DPT3 90.8
Sex Ratio ( No. of Females per1000 males) 808 Measeles 86.7
Sex Ratio 0 - 6 years 894 Full immunisation 76.7
Literacy Rate - Census - 2011
Person 76.63 Unmet need for Family Planning
Male 84.56 Spacing 6.2
Female 68.32 Limiting 10
% Decadal Growth Rate 9.17 Total 16.2
Population Density per Sq.K.m 255
Infrastructure - District Statistics - Porbandar
SC
RHS - March - 2011
85
PHCs 10
CHCs 3
22
Gujarat-Porbandar- Key Performance Indicators -Apr'12 to Mar'13
ANM Related
% ANC Registration in First Trimester against Reported ANC registration
78% % PNC visits within 48 hours and 14 days against total deliveries
91%
% Three ANC check ups against estimated pregancies.
90% % DPT3 immunisation against Estimated Live Births
91%
% Hypertension in pregnancy- detected against ANC Reported
1.0% % Measles Immunization against Estimated Live Births
90%
% Severe anaemia (Hb<7) treated gainst Reported ANC registration
0.8% % Full immunisation against Estimated Live Births
90%
ASHA Related
% Newborns weighed at birth against Estimated live Births
88% JSY Paid to ASHA as % of reported Institutional deliveries
0%
% of Newborns having weighed less than 2.5 kg against newborns weighed
7% % ASHAs present during immunisation Sessions
75%
% Newborns visited within 24 hrs of Home deliveries
58%
Facility Related
OPD per 1000 population 668
% C- Section against Institutional Deliveries 11.8%
IPD per 1000 population 27
Abortion Rate against Reported pregnancies 3.7%
Major surgeries per lakh population. 35
Total sterilisation done per 1000 eligible couples.
19
Institutional deliveries against estimated deliveries.
86% Total IUD inserted per 1000 eligible couples 37.84
Institutional deliveries against Reported deliveries.
99%
23
Gujarat-Porbandar- Summary -Apr'12 to Mar'13
ANC
ANC Registration against Expected Pregnancies
95% TT2/ Booster given to Pregnant women against ANC Registration
93%
3 ANC Check ups against ANC Registrations 94% 100 IFA Tablets given to Pregnant women against ANC Registration
90%
Deliveries
Reported Deliveries against Expected Deliveries
87.2% Home Deliveries( SBA& Non SBA) against Estimated Deliveries
0.7%
Institutional Deliveries against Estimated Deliveries
86.5% Home Deliveries( SBA& Non SBA) against Reported Deliveries
0.8%
Institutional Deliveries against Reported Deliveries
99.2% C Section Deliveries against Institutional Deliveries( Pvt& Pub)
11.8%
Births & Neonates Care
Live Births Reported against Estimated Live Births
88.8% Newborns weighed against Reported Live Births
99%
Still Births against reported 1000 live Births 7.7
Newborns weighed less than 2.5 kgs against newborns weighed
7%
Sex Ratio at Birth 898
Newborns breastfed within one hr of Birth against Reported live Births
89%
Child Immunisation( 0 to 11 mnths)
Measles given against Expected Live Births 90% Measles given against Reported Live Births
102%
Fully Immunised Children against Expected Live Births
90% Fully Immunised Children against Reported Live Births
102%
Required numbers of VHNDs per thousand population in 12 mnths
7,158 Immunisation Sessions held as percentage of required VHNDs
63%
Family Planning & Abortions
24
Family Planning Methods Users( Sterilisations(Male &Female)+IUD+ Condom pieces/72 + OCP Cycles/13)
9,129
Total Sterilisations ( Male & Female) 1,885
MTP up to 12 weeks 85
Abortion (spontaneous/induced) 413
MTP more than 12 weeks 1
Abortion Rate against Expected pregnancies
3.6%
Demographic Denominators - Gujarat-Porbandar
IMR of the state - Gujarat-Porbandar
CBR - Gujarat-Porbandar
Total Population
Expected Pregnancies Apr'12 to Mar'13
Expected Deliveries Apr'12 to Mar'13
Eligible Couple ( 17% of total population)
Source SRS -2011 SRS -2011 Projectd population for 2012
Derived Derived Derived
41 21.3 596,517 13,976 12,966 101,408
Gujarat-Porbandar- Deliveries - Apr'12 to Mar'13
Total Population 596,517 Expected Deliveries - Apr'12 to Mar'13 12,966
Home SBA Home Non SBA Institutional ( Pub&Pvt) Total Deliveries Reported Unreported Deliveries
18 73 11,211 11,302 1,664
Home SBA % Home Non SBA% Institutional % Total Deliveries Reported % Unreported Deliveries %
0% 1% 86% 87% 13%
25
Gujarat-Porbandar- C sections & Complicated Deliveries Apr'12 to Mar'13
Home Non SBA 1%
Institutional 86%
Unreported Deliveries 13%
Gujarat-Porbandar- Home ( SBA & Non SBA) & Institutional Deliveries against Expected Deliveries - Apr'12 to Mar'13
Home SBA 0.2%
Home Non SBA 0.6%
Institutional (Pub) 35.9%
Institutional (Pvt) 63.3%
Gujarat-Porbandar- Home ( SBA & Non SBA) & Institutional Deliveries against Reported Deliveries - Apr'12 to Mar'13
26
Institutional Deliveries (Public) Institutional Deliveries (Pvt) Total Institutional deliveries
Total Deliveries 4,053 7,158 11,211
C Section 394 932 1,326
C Section% 9.7% 13.0% 11.8%
Complicated Pregnancies attended
581 - 581
Complicated Pregnancies attended %
14.3% 0.0% 5.2%
Gujarat-Porbandar- Facility wise %ge of C sections & Complicated Deliveries Apr'12 to Mar'13
PHC CHC SDH/DH
Other State owned institution
Private Facilities
Total
Complicated deliveries managed ( Reported)
- 97 484 - - 581
Complicated deliveries managed as %ge of total reported
0.0% 16.7% 83.3% 0.0% 0.0%
C Section (reported ) - - 394 - 932 1,326
C Section as percentage of total reported
0.0% 0.0% 29.7% 0.0% 70.3%
Gujarat-Porbandar- Complicated Pregnancies & Deliveries Treated - Apr'12 to Mar'13
C- section % 11.8%
Complicated Pregnancies attended %
5.2%
Normal deliveries % 83.0%
Gujarat-Porbandar- C-Section, Complicated & Normal Deliveries against Reported Institutional Deliveries ( Pvt. & Public) Apr'12 to Mar'13
27
Reported Deliveries 11,302
Complicated Pregnancies attended
Complicated Pregnancies Rate
C - Section Deliveries
PNC Maternal Complications
Abortions Still Births
581 4.2% 1,326 26 413 87
Complicated Deliveries Treated with No Of Eclampsia cases Treated
No Of severe anemia cases treated IV Antibiotics
IV antihypertensive/Magsulph injection
IV Oxytocis Blood Transfusion
109 2 50 30 7 103
Gujarat-Porbandar - JSY Paid to Mothers as % of reported deliveries - Apr'12 to Mar'13
Deliveries JSY Paid to mothers
%age JSY paid against reported deliveries
Home 91 10 10.99%
Institutional (Public) 4,053 772 19.05%
Institutional ( Accredited - Pvt ) 7,158 649 9.07%
Stay for less than 48 hrs after delivery
38%
Stay for more than 48 hrs after delivery
62%
Gujarat-Porbandar- Stay duration as percentage of Reported Institutional Deliveries - Apr'12 to Mar'13
28
Gujarat-Porbandar- Management of Complications (Reflecting Quality of ANC )against Reported ANC Registration- Apr'12 to Mar'13
Reported %age against reported ANC Registration
Hypertensive cases detected at institution 135 1.0%
Eclampsia cases managed during delivery 7 0.1%
ANC women having Hb level<11 4046 30.3%
ANC women having severe anaemia (Hb<7) treated at institution
103 0.8%
11%
19%
9%
0%
5%
10%
15%
20%
25%
Home Institutional (Public) Institutional (Pvt)
Gujarat-Porbandar -JSY Paid to Mothers as % of reported deliveries - Apr'12 to Mar'13
13,976 13,344
10,344
2,051
12,572
9,640
12,437 11,990
-
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
ExpectedPregnancies -
Apr'12 toMar'13
Total ANCRegistration
ANCRegistrationwithin firsttrimester
ANCregistration for
JSY
3 ANC checkups
TT1 TT2 or Booster 100 IFA tabletsgiven
Gujarat-Porbandar-ANC Services - Apr'12 to Mar'13
29
1.0% 0.1%
30.3%
0.8%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
Hypertensive cases detectedat institution
Eclampsia cases managedduring delivery
ANC women having Hblevel<11
ANC women having severeanaemia (Hb<7) treated at
institution
Gujarat-Porbandar- Management of Complications (Reflecting Quality of ANC )against Reported ANC Registration- Apr'12 to Mar'13
96% 91%
0%
20%
40%
60%
80%
100%
120%
PNC within 48 hours after deliveries PNC between 48 hours and 14 days of Deliveries
Gujarat-Porbandar- Post Natal Check up against Reported deliveries -Apr'12 to Mar'13
30
Gujarat-Porbandar - Births - Apr'12 to Mar'13
Live Birth - Males Live Birth - females Live Birth - Total Still Births Sex Ratio at birth Still Birth per 1000 live births ( reported)
5,942 5,336 11,278 87 898 7.7
12,706
11,278 11,140
812
10,043
-
2,000
4,000
6,000
8,000
10,000
12,000
14,000
Estimated Live Births -Apr'12 to Mar'13
Reported Live Birth -Apr'12 to Mar'13
Newborns weighed atbirth
Number of Newbornshaving weight less than
2.5 kg
Newborns breast fedwithin 1 hour
Gujarat-Porbandar-Births - Apr'12 to Mar'13
87% 91% 91% 90% 90%
0%
20%
40%
60%
80%
100%
BCG % DPT3% OPV3% Measles % Fully Immunised %
Gujarat-Porbandar-Immunisation ( 0 to 11mnths) Against Estimated Live Births- Apr'12 to Mar'13
31
Gujarat-Porbandar- Adverse Event Following Immunisation(AEFI) - Apr'12 to Mar'13
Abscess 1
Death -
Others 5
Gujarat-Porbandar- Immunisation - Dropouts - Apr'12 to Mar'13
Dropout from BCG to DPT3 Dropout from BCG to Measles Dropout from DPT3 to Measles
-4% -4% 0%
Gujarat-Porbandar - Abortions - Apr'12 to Mar'13
MTP Less than 12 weeks
MTP More than 12 weeks
Abortions (spontaneous/Induced)
Abortions in Pvt Facilities
Abortion Rate against expected pregnancies
98% 102% 102% 102% 102%
0%
20%
40%
60%
80%
100%
120%
BCG % DPT3% OPV3% Measles % Fully Immunised %
Gujarat-Porbandar-Immunisation ( 0 to 11mnths) Against Reported Live Births- Apr'12 to Mar'13
4,528 4,512
3,379
-
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
5,000
Immunisation sessions planned Immunisation sessions Held Sessions where ASHAs were present
Gujarat-Porbandar-Immunisation Sessions- Apr'12 to Mar'13
32
85 1 413 - 3.6%
Gujarat-Porbandar - RTI Cases - Apr'12 to Mar'13
Total OPD Total RTI/STI cases - Male
Total RTI/STI cases - Female
Total RTI/STI cases RTI/STI cases as %ge of Total OPD
Number of wet mount tests conducted
398,766 - - - 0.000% -
Gujarat-Porbandar-Sterilisations - Apr'12 to Mar'13
Reported %age of Reported Sterilisation
Total Sterilisation 1,885
NSV 6 0%
Laparoscopic 1,879 100%
MiniLap - 0%
Post Partum - 0%
Male Sterilisation 6 0%
Female Sterilisation 1,879 100%
MTP less than 12 weeks 17.03%
MTP more than 12 weeks 0.20%
Abortion (spontaneous/induced)
82.77%
Gujarat-Porbandar-Abortions - Apr'12 to Mar'13
33
Gujarat-Porbandar-FP Methods - Apr'12 to Mar'13
Reported %age of All Reported FP Methods
Total Reported FP Method (All types) Users 9,129
-
Sterilisations 1,885
21%
IUD 3,837
42%
Condom Users 2,027
22%
OCP Users 1,380
15%
Limiting Methods 1,885
21%
Spacing Methods 7,244
79%
Gujarat-Porbandar- Facility wise % of Sterilisations& IUDs - Apr'12 to Mar'13
Subcenter PHC CHC SDH/DH Other State owned institution
Private Facilities
NSV as % of total reported 0.0% 0.0% 100.0% 0.0% 0.0%
Laparoscopic as % of total reported
0.0% 9.4% 70.6% 0.0% 20.0%
MiniLap as % of total reported
Post Partum as % of total reported
IUD inserted as % of total reported
84.1% 0.0% 0.2% 12.4% 0.0% 3.3%
Sterilisations 21%
IUD 42%
Condom Users 22%
OCP Users 15%
Gujarat-Porbandar- Distribution of Family Planning Methods against Total Reported -Apr'12 to Mar'13
34
Gujarat-Porbandar- Unmet need ( DLHSIII) met by reported FP Methods - Apr'12 to Mar'13
Estimated total Eligible Couples ( 17% of population)
101,407.93
Eligible Couples for unmet need- Calculated Using DLHSIII Unmet need - Gujarat-Porbandar
Total reported FP Users - HMIS - Apr'12 to Mar'13
Unmet need met by Reported Family Planning Methods - Apr'12 to Mar'13
Unmet Needs Total
16.2 16,428 9,129 56%
Limiting 10 10,141 1,885 11%
Spacing 6.2 6,287 7,244 44%
Gujarat-Porbandar- Service Delivery - Apr'12 to Mar'13
Total OPD Total IPD
Operation major (General and spinal anaesthesia)
Operation minor (No or local anaesthesia)
AYUSH Dental Procedures
Adolescent counselling services
398,766 16,246 208 1,176 4,186 231 1
OPD Visit Per 1000 Population
IPD per 1000 population
Operation major (General and spinal anaesthesia) per 100000 Population
Operation minor (No or local anaesthesia)as %ge of OPD
AYUSH as %ge of OPD
Dental Procedures as %ge of OPD
Adolescent counselling services as %ge of OPD
668.5 27.2 34.9 0.3% 1.0% 0.06% 0.0%
Gujarat-Porbandar- Childhood Disease - Vaccine Preventable -Apr'12 to Mar'13
Diphtheria Pertussis Tetanus Neonatorum
Tetanus others Polio Measles
0 0 1 0 0 4
Gujarat-Porbandar-Childhood Disease - Others - Apr'12 to Mar'13
Diarrhoea and dehydration Malaria Number admitted with Respiratory Infections
540 42 215
35
Gujarat-Porbandar- Lab Services - Apr'12 to Mar'13
Total Population Total HB tested Total HIV tested Total VDRL Tested
Total Widal Test Conducted
Blood Smear Examined
596,517 41,161 21,774 4,439 2,839 44,054
Total OPD HB test conducted as %age of OPD
HB<7gm as %age of HB tested
HIV test conducted as %age of OPD
HIV positive as %age of HIV tested
VDRL test conducted as %age of OPD
Widal test conducted as %age of OPD
Blood Smear Examined as % of Population
398,766 10.3% 1.8% 5.5% 0.3% 1.1% 0.71% 7.39%
36
Gujarat-Porbandar - Mortality Data - Apr'12 to Mar'13
Gujarat-Porbandar - Mortality - Major Causes Group - Apr'12 to Mar'13
Death Groups Cause-wise deaths included in the group Reported deaths
Communicable Disease , Maternal & Perinatal
Maternal & Perinatal, Diarrhoea, Tuberculosis, Respiratory (excluding TB), Malaria, Other Fever related, HIV/AIDS
239
Non communicable disease Heart Disease/ Hypertension, Neurological including Stroke
401
Injuries Trauma, Accidents, Burns, Suicide, Animal Bites 94
37
Others Other known acute diseases, Other known chronic diseases, Other diseases (Causes not known)
409
Gujarat-Porbandar- Still Births, Neonatal , Infant ,Under 5 and Maternal Deaths - Apr'12 to Mar'13
Live Births - Reported Live Births -Estimated Still Births Early Neonatal deaths
11,278 12,706 87 77
Late Neonatal Deaths Infant Death Under 5 Child Deaths Maternal Deaths
Communicable Disease , Maternal & Perinatal
20.9%
Non communicable disease 35.1%
Injuries 8.2%
Others 35.8%
Gujarat-Porbandar - Mortality - Major Causes Group -Apr'12 to Mar'13
38
16 122 136 10
Gujarat-Porbandar- Still Birth Rate, Perinatal,Neonatal& Infant Mortality Rates - Apr'12 to Mar'13
Against Reported Live Births( 1000)
Against Estimated Live Births ( 1000)
Reported Still Birth 7.71 6.85
Reported Perinatal Mortality 14.54 13
Reported Neonatal Mortality 8.25 7.32
Reported Infant Mortality 10.82 9.60
Reported Under 5 Child Deaths 12.1 10.70
Reported Maternal Deaths 88.67 78.70
Gujarat-Porbandar - Infant & Child Deaths - Apr'12 to Mar'13
Infant Deaths within 24 hrs of birth
Infant Deaths between 24hrs & under 1 week
Infant Deaths between 1 week & under 1 month
Child Deaths between 1 month & under 1 year
Total Infant Deaths
Child Deaths between 1yr & under 5years
Total Deaths
Total Reported 21 56 16 29 122 14 136
% against total deaths
15.4% 41.2% 11.8% 21.3% 89.7% 10.3%
39
Gujarat-Porbandar- Causes of Infant & Child Deaths - Apr'12 to Mar'13 - Total Deaths - 115
Sepsis Asphyxia LBW
Up to 1 Weeks of Birth
Between 1 week & 4 weeks of birth
Total Up to 1 Weeks of Birth
Between 1 week & 4 weeks of birth
Total Up to 1 Weeks of Birth
Between 1 week & 4 weeks of birth
Total
1 1 2 7 1 8 23 5 28
Pneumonia Diarrhoea Fever related
Between 1 month and 11 months
Between 1 year & 5 years
Total Between 1 month and 11 months
Between 1 year & 5 years
Total Between 1 month and 11 months
Between 1 year & 5 years
Total
1 0 1 0 0 0 4 1 5
Measels Others ( For age upto 4 weks of Birth) Others( For age from 1 month to 5 yrs)
Between 1 month and 11 months
Between 1 year & 5 years
Total Up to 1 Weeks of Birth
Between 1 week & 4 weeks of birth
Total Between 1 month and 11 months
Between 1 year & 5 years
Total
- - - 25 9 34 24 13 37
Infant Deaths within 24 hrs of birth
15.4%
Infant Deaths between 24hrs & under 1 week
41.2%
Infant Deaths between 1 week & under 1 month
11.8%
Child Deaths between 1 month & under 1 year
21.3%
Child Deaths between 1yr& under 5years
10.3%
Infant & Child Deaths against reported Infant & Child deaths - Gujarat-Porbandar-Apr'12 to Mar'13
40
Sepsis 2%
Asphyxia 7%
LBW 24%
Pneumonia 1%
Fever related 4% Others
62%
Gujarat-Porbandar - Causes of Infant & Child Deaths against total reported infant & child deaths-Apr'12 to Mar'13
41
Gujarat-PorbandarMaternal Deaths & Causes-Apr'12 to Mar'13
Causes Reported % against total reported
% against total reported known causes
Abortion - 0.0% 0.0%
Obstructed/prolonged labour
- 0.0% 0.0%
Severe hypertension/fits - 0.0% 0.0%
Bleeding 4 40.0% 66.7%
High Fever 2 20.0% 33.3%
Other Causes 4 40.0%
Total 10
Sepsis 5%
Asphyxia 18%
LBW 64%
Pneumonia 2%
Fever related 11%
Gujarat-Porbandar - Known Causes of Infant & Child Deaths against total reported known causes of infant & child deaths -Apr'12 to Mar'13
42
Gujarat-Porbandar - Causes of deaths above 6 yrs of age-Apr'12 to Mar'13
6-14 yrs 15-55 yrs. Above 55yrs Total
Diarrhoeal Diseases - 4 - 4
Tuberculosis - 12 14 26
Respiratory Diseases (Other than TB)
- 6 38 44
Bleeding 40.0%
High Fever 20.0%
Other Causes 40.0%
Gujarat-Porbandar - Causes of Maternal Deaths against total reported maternal deaths-Apr'12 to Mar'13
Bleeding 66.7%
High Fever 33.3%
Gujarat-Porbandar - Known Causes of Maternal Death against total reported Known Causes of maternal deaths -Apr'12 to Mar'13
43
Malaria - 1 - 1
Other fever Related 3 12 23 38
HIV/AIDS - 2 4 6
Heart Disease/ Hypertension related
2 81 208 291
Neurological Disease including strokes
1 8 28 37
Trauma/Accidents/ Burn Cases
3 20 6 29
Suicide - 44 11 55
Animal Bites & Stings 2 6 2 10
Known Acute Disease - 6 34 40
Known Chronic Disease 1 6 28 35
Causes not known 1 17 276 294
Total Deaths 13 225 672 910
44
Diarrhoeal Diseases 0.6%
Tuberculosis 4.2%
Respiratory Diseases (Other than TB)
7.1%
Malaria 0.2% Other fever Related
6.2%
HIV/AIDS 1.0%
Heart Disease/ Hypertension related
47.2%
Neurological Disease including strokes
6.0%
Trauma/Accidents/ Burn Cases 4.7%
Suicide 8.9%
Animal Bites & Stings 1.6%
Known Acute Disease 6.5%
Known Chronic Disease 5.7%
Gujarat-Porbandar - Known causes of deaths 6 yrs & above against total reported Known causes of deaths 6 yrs & above - Apr'12 to Mar'13
45
National Health System Resource Centre National Rural Health Mission, Ministry of Health & Family Welfare Government of India NIHFW Campus Baba Gangnath Marg, Munirka New Delhi- 110067 Email: [email protected] Website: www.nhsrcindia.org
Diarrhoeal Diseases 0.4%
Tuberculosis 2.9%
Respiratory Diseases (Other than TB)
4.8%
Malaria 0.1%
Other fever Related 4.2%
HIV/AIDS 0.7%
Heart Disease/ Hypertension related
32.0% Neurological Disease including strokes
4.1% Trauma/Accidents/ Burn Cases 3.2%
Suicide 6.0%
Animal Bites & Stings 1.1%
Known Acute Disease 4.4%
Known Chronic Disease 3.8%
Causes not known 32.3%
Gujarat-Porbandar - Cause of deaths 6 yrs & above against total reported deaths 6 yrs & above - Apr'12 to Mar'13
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