Chief minister's health initiative for attainment and realization of Mdgs (CHARM)

24/7 EmONC Services at Selected Health Facilities Monthly Report of Health Facility
Reporting Month Facility Name A-1
Catchment Population Registered Pregnant Women

June

Year

2011

BHU Talokar

District Name Facility Type (Comp/Basic)

Khushab

Basic

Facility Profile & Progress indicators

Registered FP Clients Total OPD Total Admissions EmONC Admissions

60

20

943
Number of High Risk Number of women who cases women who came for 4th Identified came for 3rd or during ANC Visit subsequent ANC ANC Visit

A-2
Total Number of Antenatal women who Consultatio came for 1st ANC ns Visit

Antenatal Checkups
Women who got HB Tested during ANC

Number of women who came for 2nd ANC Visit

69

20

24

16

A-3

Complications Identified
PPH Sepsis

Complications Referred
Eclampsia / Pre clampsia PPH Sepsis

USG Eclampsia / Pre Performed clampsia

0 Abortions

A -4
Total Deliveries Deliveries in Morning Shift

Delivery & Outcomes of Deliveries

Deliveries in Night Shift Spontaneous Missed Abortions/ Abortions Miscarriage Post Abortion care

Deliveries
Deliveries in Evening Shift

2
Normal Vaginal Deliveries

2 Mode of Delivery
Assisted Delivery C- Sections

0 Mortality
Maternal Death Newborn Death

0 0 Post Natal Consultations

Total Post Complication Natal s Referred Consultati after PNC on

0 A-5
From LHWs to BEmONC Facility

0 Referrals
From BasicTo CEmONC Facility High Risk Cases Referred

24
Referred for Csection to CEmONC General Referrals

Total EmONC Referrals

B.
Designatio n PGRs Gyne PGRs Anaesthsia WMO OTA Lab Assistant
BT Assist

Human Resources & Remunerations

Comprehensive EmONC
Sanctioned Filled

Comprehensive & Basic EmONC

Designation LHV Midwife Aya Sanitory Workers Ward Cleaners Chowkidar Drivers Sanctioned 1 1 0 1 1 1 0 Filled 1 1 0 1 1 1 0 Vacant 0 0 0 0 0 0 0

C
Old (Follow up cases) 20 Newly Registered Cases

General Case Load Family Planning Clients

Condoms Pills Injectibles IUCD

GBV
GBV cases reported

8
Condoms Pills

10
Injectibles IUCD

0
Permanent GBV cases referred

20
Fever Gastro

2
ARI

3
Wound/ Injury STI

0
Others

Caseload
Scabies

D
Condoms 100
Contraceptive Pills

Medicines, Equipment & Supplies and MISC Stock Position

Injections 10 Antipyretic Cough Syrup IUCD 0 Newborn Kits 0 Kits Requirement Qty Required

20

Antibiotics Anti histamine

Kit # / Item Clean Electrolyte Delivery Kit Newborn Kit Hygeine Kit

Hygiene, Newborn and Clean Delivery Kits

Newborn Kits distributed CDK Distributed CDK Used At Facility Hygiene Kits distributed

Please list the Medicines, Equipment and Supplies Needed for EmONC services

Issues and Recommendations

Referrals
Ambulance Availability Number of Ambulance Trips

Name of Incharge

Designation

Contact Number

Signature/Stamp

INSTRUCTIONS
1. Please enter the complete facility name & whether the facility is serving as a basic of comprehensive EmONC Center 2. Please mention the total number of EmONC Admissions (Not outdoor cases) in section A 3. In the section on ANC, please mention separately the total number of ANCs conducted during the month, the number of women who came for their first, second, third and subsequent ANC 4. In the section on ANC, please mention only those high risk pregnancies which were identified during the ANC. DO NOT include complications at the time of delivery or during post natal period. 5. In section A-3 please mention the number of complications identified and complications referred, disaggregated by nature of complication 6. In section A-5, regarding referrals, please mention separately the number of referrals made by the LHWs to the BEmONC facility, from Basic to Comprehensive, the number of high risk cases referred, number of patients referred for C sections and overall referrals made by the facility. Total EmONC Referrals should include only those that are referred from basic to comprehensive facility for any reasons (high risk, elective C/S, etc.) 7. In the section for family planning please mention separately the number of newly registered cases and the number of followup cases. Do not include follow up cases in the number of newly registerd cases. 8. In the section for supply of kits, please mention the amount of kits required. For RH Kits, please mention the Kit number and quantity required.

Chief minister's health initiative for attainment and realization of Mdgs (CHARM)

24/7 EmONC Services at Selected Health Facilities Monthly Report of Health Facility
Reporting Month Facility Name A-1
Catchment Population Registered Pregnant Women

June

Year

2011

BHU Daewal

District Name Facility Type (Comp/Basic)

Khoshab

Basic

Facility Profile & Progress indicators

Registered FP Clients Total OPD Total Admissions EmONC Admissions

17510

135

14

1715

13

13

A-2
Total Number of Antenatal women who Consultatio came for 1st ANC ns Visit

Antenatal Checkups
Number of High Risk Number of women who cases women who came for 4th Identified came for 3rd or during ANC Visit subsequent ANC ANC Visit Women who got HB Tested during ANC

Number of women who came for 2nd ANC Visit

135

56

79

45

A-3

Complications Identified
PPH Sepsis

Complications Referred
Eclampsia / Pre clampsia PPH Sepsis

USG Eclampsia / Pre Performed clampsia

0 Abortions

A -4
Total Deliveries Deliveries in Morning Shift

Delivery & Outcomes of Deliveries

Deliveries in Night Shift Spontaneous Missed Abortions/ Abortions Miscarriage Post Abortion care

Deliveries
Deliveries in Evening Shift

13
Normal Vaginal Deliveries

12 Mode of Delivery
Assisted Delivery C- Sections

0 Mortality
Maternal Death Newborn Death

0 0 Post Natal Consultations

Total Post Complication Natal s Referred Consultati after PNC on

13

0 A-5
From LHWs to BEmONC Facility

0 Referrals
From BasicTo CEmONC Facility High Risk Cases Referred

10
Referred for Csection to CEmONC General Referrals

Total EmONC Referrals

B.
Designatio n PGRs Gyne PGRs Anaesthsia WMO OTA Lab Assistant
BT Assist

Human Resources & Remunerations

Comprehensive EmONC
Sanctioned Filled

Comprehensive & Basic EmONC

Designation LHV Midwife Aya Sanitory Workers Ward Cleaners Chowkidar Drivers Sanctioned Filled Vacant 0 0 0 0 0 0 0

C
Old (Follow up cases) 2 Newly Registered Cases

General Case Load Family Planning Clients

Condoms Pills Injectibles IUCD

GBV
GBV cases reported

1
Condoms Pills Injectibles

1
IUCD Permanent GBV cases referred

12
Fever Gastro

12
ARI

5
Wound/ Injury STI

5
Others

Caseload
Scabies

D
Condoms
Contraceptive Pills

Medicines, Equipment & Supplies and MISC Stock Position

Injections IUCD Newborn Kits Kits Requirement Qty Required

Antibiotics Anti histamine

Antipyretic

Cough Syrup

Kit # / Item Clean Electrolyte Delivery Kit Newborn Kit Hygeine Kit

Hygiene, Newborn and Clean Delivery Kits

Newborn Kits distributed CDK Distributed CDK Used At Facility Hygiene Kits distributed

Please list the Medicines, Equipment and Supplies Needed for EmONC services

Issues and Recommendations

Referrals
Ambulance Availability Number of Ambulance Trips

Name of Incharge

Designation

Contact Number

Signature/Stamp

INSTRUCTIONS
1. Please enter the complete facility name & whether the facility is serving as a basic of comprehensive EmONC Center 2. Please mention the total number of EmONC Admissions (Not outdoor cases) in section A 3. In the section on ANC, please mention separately the total number of ANCs conducted during the month, the number of women who came for their first, second, third and subsequent ANC 4. In the section on ANC, please mention only those high risk pregnancies which were identified during the ANC. DO NOT include complications at the time of delivery or during post natal period. 5. In section A-3 please mention the number of complications identified and complications referred, disaggregated by nature of complication 6. In section A-5, regarding referrals, please mention separately the number of referrals made by the LHWs to the BEmONC facility, from Basic to Comprehensive, the number of high risk cases referred, number of patients referred for C sections and overall referrals made by the facility. Total EmONC Referrals should include only those that are referred from basic to comprehensive facility for any reasons (high risk, elective C/S, etc.) 7. In the section for family planning please mention separately the number of newly registered cases and the number of followup cases. Do not include follow up cases in the number of newly registerd cases. 8. In the section for supply of kits, please mention the amount of kits required. For RH Kits, please mention the Kit number and quantity required.

Chief minister's health initiative for attainment and realization of Mdgs (CHARM)

24/7 EmONC Services at Selected Health Facilities Monthly Report of Health Facility
Reporting Month Facility Name A-1
Catchment Population Registered Pregnant Women

June

Year

2011

BHU Sandral

District Name Facility Type (Comp/Basic)

Khushab

Basic

Facility Profile & Progress indicators

Registered FP Clients Total OPD Total Admissions EmONC Admissions

A-2
Total Number of Antenatal women who Consultatio came for 1st ANC ns Visit

Antenatal Checkups
Number of High Risk Number of women who cases women who came for 4th Identified came for 3rd or during ANC Visit subsequent ANC ANC Visit Women who got HB Tested during ANC

Number of women who came for 2nd ANC Visit

A-3

Complications Identified
PPH Sepsis

Complications Referred
Eclampsia / Pre clampsia PPH Sepsis

USG Eclampsia / Pre Performed clampsia

A -4
Total Deliveries Deliveries in Morning Shift

Delivery & Outcomes of Deliveries

Abortions
Deliveries in Night Shift Spontaneous Missed Abortions/ Abortions Miscarriage Post Abortion care

Deliveries
Deliveries in Evening Shift

Mode of Delivery
Normal Vaginal Deliveries Assisted Delivery C- Sections

Mortality
Maternal Death Newborn Death

Post Natal Consultations

Total Post Complication Natal s Referred Consultati after PNC on

A-5
Total EmONC Referrals From LHWs to BEmONC Facility

Referrals
From BasicTo CEmONC Facility High Risk Cases Referred Referred for Csection to CEmONC General Referrals

B.
Designatio n PGRs Gyne PGRs Anaesthsia WMO OTA Lab Assistant
BT Assist

Human Resources & Remunerations

Comprehensive EmONC
Sanctioned Filled

Comprehensive & Basic EmONC

Designation LHV Midwife Aya Sanitory Workers Ward Cleaners Chowkidar Drivers Sanctioned Filled Vacant 0 0 0 0 0 0 0

C
Old (Follow up cases) Newly Registered Cases

General Case Load Family Planning Clients

Condoms Pills Injectibles IUCD

GBV
GBV cases reported

Condoms

Pills

Injectibles

IUCD

Permanent

GBV cases referred

Caseload
Fever Gastro ARI Scabies Wound/ Injury STI Others

D
Condoms
Contraceptive Pills

Medicines, Equipment & Supplies and MISC Stock Position

Injections IUCD Newborn Kits Kits Requirement Qty Required

Antibiotics Anti histamine

Antipyretic

Cough Syrup

Kit # / Item Clean Electrolyte Delivery Kit Newborn Kit Hygeine Kit

Hygiene, Newborn and Clean Delivery Kits

Newborn Kits distributed CDK Distributed CDK Used At Facility Hygiene Kits distributed

Please list the Medicines, Equipment and Supplies Needed for EmONC services

Issues and Recommendations

Referrals
Ambulance Availability Number of Ambulance Trips

Name of Incharge

Designation

Contact Number

Signature/Stamp

INSTRUCTIONS
1. Please enter the complete facility name & whether the facility is serving as a basic of comprehensive EmONC Center 2. Please mention the total number of EmONC Admissions (Not outdoor cases) in section A 3. In the section on ANC, please mention separately the total number of ANCs conducted during the month, the number of women who came for their first, second, third and subsequent ANC 4. In the section on ANC, please mention only those high risk pregnancies which were identified during the ANC. DO NOT include complications at the time of delivery or during post natal period. 5. In section A-3 please mention the number of complications identified and complications referred, disaggregated by nature of complication 6. In section A-5, regarding referrals, please mention separately the number of referrals made by the LHWs to the BEmONC facility, from Basic to Comprehensive, the number of high risk cases referred, number of patients referred for C sections and overall referrals made by the facility. Total EmONC Referrals should include only those that are referred from basic to comprehensive facility for any reasons (high risk, elective C/S, etc.) 7. In the section for family planning please mention separately the number of newly registered cases and the number of followup cases. Do not include follow up cases in the number of newly registerd cases. 8. In the section for supply of kits, please mention the amount of kits required. For RH Kits, please mention the Kit number and quantity required.