Table 1. Government district health facility framework and description of facilities in the context of PSBI management.
| Sl. no | Name of the Facility/ Institution | Expected strength of health personnel | Type of care provided | Population covered | Number of health facilities in the study area | Number of health personnel in position during the study period for neonatal care |
|---|---|---|---|---|---|---|
| 1 | Accredited Social Health Activist (ASHA) | Sanctioned positions for the area-172 | Social mobilizer for promoting maternal and child health: ante-natal care; deliveries; immunization and sickness identification, counseling, door-to-door surveys for specific service recipients | @One ASHA for approximately 1000 rural population | Working from home | 172 |
| 2 | Sub-Centre (SC) | 1. Two ANMs one male multi-purpose health worker (MPW) | Lower most health service delivery facility; provides basic antenatal care, immunization and treatment for minor illnesses | 3000–5000 | 18 | ANM: 29 Male Multi Purpose Health worker -3 |
| 3 | Primary Health Centre (PHC) | 1. Two qualified doctors (1-allopathic-MBBS and 1- Ayush Traditional medicine physician) One staff nurse 2. One ANM Other staff not directly involved with neonatal care: 1 pharmacist; 1 health educator and 2 health assistants |
PHC- first port of call to a qualified public sector doctor in rural areas for the sick and those who directly report or referred from Sub-Centres (5–6 SC fall under each PHC) for curative, preventive and promotive health care. 4–6 Bedded facility | 20000–30000 | 3 |
PHC 1: Nagaljaat Medical Officer: 0 Nurse: 1 ANM: 2 PHC 2: Kot Medical Officer: 2 Nurse: 0 ANM:1 PHC 3: Uttawar Medical Officer: 2 Nurse: 0 ANM:1 |
| 4 | Community Health Centre (CHC) | 1. Five medical specialists (i.e., general surgeon, physician, gynecologist, anesthetist and pediatrician) 2. Four general duty officers (1 dental surgeon, 3 general medical officers 3. Twenty one paramedical and support other staff. |
First referral unit for SCs and PHCs; Facilities with one operation theater, X-ray machine, labour room and laboratory. Provides facilities for 24X7 obstetric care and specialist consultations Beds: 20–30 |
80000–120000 | 3 |
CHC 1: Aurangabad Specialist: 0 Medical Officers: 4 Nurse: 1 ANM: 3 CHC 2: Hodal Specialist: 0 Medical Officers: 4 Nurse: 4 ANM: 4 CHC 3: Hathin Specialist: 0 Medical Officers: 5 Nurse: 4 ANM: 2 |
| 5 | District Hospital (DH) | Palwal district hospital is a 200 bedded hospital. The district hospital has 1. Thirty seven specialists (including 3 paediatricians) 2. One hundred and thirty two paramedical staffs (including 90 Staff nurse) |
District Hospital is secondary referral level facility and provides comprehensive secondary health care services to the population in the district. District Hospital is expected to deliver Essential (Minimum Assured Services) and Desirable (which we should aspire to achieve) package of services. The services include OPD, indoor and emergency service. In addition, basic specialty services, newborn care, psychiatric services, physical medicine and rehabilitation services, accident and trauma services, dialysis services and anti-retroviral therapy. | Average population of a district varies between 15 to 30 million Palwal district hospital covers a population of 1 million |
1 |
Palwal Civil Hospital Paediatrician:3 Medical officers:6 Nurse: 6 A deputy Chief Medical Officer [Deputy-CMO] supervised ANMs and ASHA coordinators [supervisors for ASHAs] Health administration in the district managed by Chief Medical Officer’s Office |
| 6 | Special Newborn Care Unit (SNCU) | Managed by an adequately trained pediatrician, doctors, staff nurses and support staff to provide 24x7 services. As per MOHFW, the expected staff strength for a SNCU should be 1. One doctor per 4 beds 2. One nurse per 1.5 beds (Palwal SNCU should have 5 doctors and 12 nurses) |
A SNCU is established at the district hospital and sub-district hospitals to provide care for sick newborns, i.e., all type of neonatal care except assisted ventilation and major surgeries. It is a separate unit close to the labour room with 12 or more beds. Palwal DH- SNCU has 18 beds to manage sick newborns |
>3000 to 20000 annual delivery at district /sub-district level | 1 | Same as mentioned in row 5 under the district hospital |