RCH- ARSH Program (2010-11)

Reporting formats from Civil Surgeons office to State Office, NRHM

Name of District : GONDIA Reporting Format

MONTH - MAY. 2011

District Hospital Gondia

a)Availabilityofseparate(designated)space If Yes, location of the space Ifno,whichspaceisbeingusedfortheclinics b) Fixed timings / days -

2010-11
Yes Near OPD

May-11
District Name Gondia

Information regarding ARSH Clinic

Tuesday 11.00am To 2.00 pm Yes Yes

c) Availability of essential furniture provided for the clinics.(Pl. give details) d) Provisions made for maintaining confidentiality/ privacy. (Pl. give details)

e) Name of Medical Officer designated for the clinics (Nodal Officer) with qualification & Dr.Ajay Ghormare, Dr. D.P. Pardhi training status under ARSH. f) Name of another Medical Officer who will look after the clinic in the absence of first No Medical Officer with qualification & training status under ARSH. g) Whether Waiting area, sitting arrangements, drinking water & clean toilet facilities Yes available. (give details) h) IEC material available. (give details) i) Whether Health exhibition is available at the clinic site. j)SeparatestaffdesignatedforARSHClinic
Yes Yes Yes

Names & designations of staff assigned for clinic or staff given additional duties- Names with Mr. Sanjay Bisen (cons.), Mrs.Chhabu Kanere (Staff Nur.) designation & original duties.
Mrs. Ashvini Dehare(Staff Nur.) Yes Yes Mr. Sanjay Bisen (cons.) sep. 2009 1st

k) Whether Appropriate sign board displayed.(Maitree Clinic ) l) Whether counselor appointed at district hospital for ARSH clinics. m) If yes give name and date of joining.

n) Involvement of counselors working in ICTC at Sub District/ Rural/ Hospitals in ARSH No activities - ( Mention details). o) Provision of essential laboratory / other investigations.( give details ) p) Involvement of educational institutions at District HQ. q) Formation of Adolescent Health Committee. ( Bring the orders reg. the committee )
Using Services of DH lab. No Yes Nil

r) Dates of committee meetings held so far. ( Bring the minutes of last meeting )

Womans Hospital Gondia

2010-11

Information regarding ARSH Clinic a)Availabilityofseparate(designated)space If Yes, location of the space Ifno,whichspaceisbeingusedfortheclinics b) Fixed timings / days c) Availability of essential furniture provided for the clinics.(Pl. give details) d) Provisions made for maintaining confidentiality/ privacy. (Pl. give details) Yes

May-11 District Name Gondia Near OPD

Thursday At 1.00am To 3.00 pm Yes (Table-1,Chair-4 ) Yes

e) Name of Medical Officer designated for the clinics (Nodal Officer) with qualification & training status Dr.Asha Agrawal(MBBS,Gyne) under ARSH. f) Name of another Medical Officer who will look after the clinic in the absence of first Medical Officer with Dr.Sanjay Dodke(MBBS,Pead) qualification & training status under ARSH. g) Whether Waiting area, sitting arrangements, drinking water & clean toilet facilities available. (give Yes details) h) IEC material available. (give details) i) Whether Health exhibition is available at the clinic site. j)SeparatestaffdesignatedforARSHClinic Yes NO Yes

Names & designations of staff assigned for clinic or staff given additional duties- Names with designation & Mr. Sanjay Bisen (cons.), Mrs.Vishranti Lonare (Staff Nur.) original duties. k) Whether Appropriate sign board displayed.(Maitree Clinic ) l) Whether counselor appointed at district hospital for ARSH clinics. m) If yes give name and date of joining. n) Involvement of counselors working in ICTC at Sub District/ Rural/ Hospitals in ARSH activities Mention details). o) Provision of essential laboratory / other investigations.( give details ) p) Involvement of educational institutions at District HQ. q) Formation of Adolescent Health Committee. ( Bring the orders reg. the committee ) Yes Yes Mr. Sanjay Bisen (cons.) sep. 2009 ( No 1st

Using Services of BGW lab. No Not Format Nil

r) Dates of committee meetings held so far. ( Bring the minutes of last meeting )

Sub District Hospital Tirora 2010-11

Information regarding ARSH Clinic

May-11 District Name Gondia Yes Near OPD

a)Availabilityofseparate(designated)space If Yes, location of the space Ifno,whichspaceisbeingusedfortheclinics b) Fixed timings / days c) Availability of essential furniture provided for the clinics.(Pl. give details) d) Provisions made for maintaining confidentiality/ privacy. (Pl. give details)

Wednesday At 1.00am To 3.00 pm Yes (Table-1,Chair-4 Almari-1 ) Yes

e) Name of Medical Officer designated for the clinics (Nodal Officer) with qualification & Dr.Rekha Ramteke (MBBS) training status under ARSH. f) Name of another Medical Officer who will look after the clinic in the absence of first Dr.Sachin Bansod (MBBS) Medical Officer with qualification & training status under ARSH. g) Whether Waiting area, sitting arrangements, drinking water & clean toilet facilities Yes available. (give details) h) IEC material available. (give details) i) Whether Health exhibition is available at the clinic site. j)SeparatestaffdesignatedforARSHClinic Names & designations of staff assigned for clinic or staff given additional duties- Names with designation & original duties. k) Whether Appropriate sign board displayed.(Maitree Clinic ) l) Whether counselor appointed at district hospital for ARSH clinics. m) If yes give name and date of joining.
Yes Yes Yes Mr. Sanjay Bisen (cons.), Mrs.Priti Katre (Staff Nur.) Yes Yes Mr. Sanjay Bisen (cons.) sep. 2009 1st

n) Involvement of counselors working in ICTC at Sub District/ Rural/ Hospitals in ARSH No activities - ( Mention details). o) Provision of essential laboratory / other investigations.( give details ) p) Involvement of educational institutions at District HQ. q) Formation of Adolescent Health Committee. ( Bring the orders reg. the committee )
Using Services of SDH lab. No Yes Nil

r) Dates of committee meetings held so far. ( Bring the minutes of last meeting )

Rural Hospital Deori 2010-11

Information regarding ARSH Clinic

May-11 District Name Gondia Yes Near OPD

a)Availabilityofseparate(designated)space If Yes, location of the space Ifno,whichspaceisbeingusedfortheclinics b) Fixed timings / days c) Availability of essential furniture provided for the clinics.(Pl. give details) d) Provisions made for maintaining confidentiality/ privacy. (Pl. give details)

Friday 2.00pm To 4.00 pm Yes Yes

e) Name of Medical Officer designated for the clinics (Nodal Officer) with qualification & Dr.Dipak Dhumankhede training status under ARSH. f) Name of another Medical Officer who will look after the clinic in the absence of first Dr.P.Nikhade Medical Officer with qualification & training status under ARSH. g) Whether Waiting area, sitting arrangements, drinking water & clean toilet facilities Yes available. (give details) Yes h) IEC material available. (give details) i) Whether Health exhibition is available at the clinic site. j)SeparatestaffdesignatedforARSHClinic
Yes Yes

Names & designations of staff assigned for clinic or staff given additional duties- Names with Mr.Pramod Kadmkar (ICTC cons.), Smita Dhale designation & original duties.
(Staff Nur.) Yes Yes

k) Whether Appropriate sign board displayed.(Maitree Clinic ) l) Whether counselor appointed at district hospital for ARSH clinics. m) If yes give name and date of joining.

n) Involvement of counselors working in ICTC at Sub District/ Rural/ Hospitals in ARSH Yes activities - ( Mention details). o) Provision of essential laboratory / other investigations.( give details ) p) Involvement of educational institutions at District HQ. q) Formation of Adolescent Health Committee. ( Bring the orders reg. the committee )
Using Services of RH lab. Yes Yes 1/17/2011

r) Dates of committee meetings held so far. ( Bring the minutes of last meeting )

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Name of District Hospital,Gondia

Month-MAY - 2011

Month wise attendance at ARSH clinic during 2010-11

Sr. Particulars No. 1 Attended clinic on their own 2 Referred 3 Total 4 Married 5 Unmarried 6 Services provided i Ante natal Male 10 0 10 2 8 0 0 0 0 0 0 0 0 5 0 0 10 7 0 During Month Female Total 10 0 10 3 7 0 0 0 0 3 0 0 7 6 0 0 10 4 0 20 0 20 5 15 0 0 0 0 3 0 0 7 11 0 0 20 11 2 Male 42 13 55 12 43 0 0 0 0 2 0 8 0 8 0 0 30 19 2 Progressive Female Total 35 12 44 9 35 0 0 0 0 10 0 3 14 9 0 0 23 12 0 77 25 99 21 78 0 0 0 0 12 0 11 14 17 0 0 53 31 2

ii ECP and counseling iii TT iv IFA and counseling v Counseling for MTP vi Treatment of RTI / STI vii Menstrual problem viii Counseling for sex problem & scholastic problems ix Violence x Screening of Goiter, sickle cell xi Counseling for life skills, social xii skills Contraceptives 7 Referred to DH / WH

Name of WH : Bai Gangabai W.H. Gondia

Month-MAY- 2011

Month wise attendance at ARSH clinic during 2010-11

Sr. No. Particulars During Month Male Female Total 3 0 3 0 3 0 0 0 0 0 0 0 0 0 0 0 3 3 0 8 0 8 0 8 0 0 0 0 3 0 0 4 1 0 0 8 2 0 11 0 11 0 11 0 0 0 0 3 0 0 4 1 0 0 11 5 0 Male 164 22 186 12 174 0 0 0 0 18 0 3 0 3 0 0 11 5 0 Progressive Female Total 444 41 485 15 470 0 0 0 0 40 0 2 19 8 0 1 33 10 0 608 63 671 27 644 0 0 0 0 58 0 5 19 11 0 1 44 15 0

1 Attended clinic on their own 2 Referred 3 Total 4 Married 5 Unmarried 6 Services provided i Ante natal

ii ECP and counseling iii TT iv IFA and counseling v Counseling for MTP vi Treatment of RTI / STI vii Menstrual problem viii Counseling for sex problem & scholastic problems ix Violence x Screening of Goiter, sickle cell xi Counseling for life skills, social skills xii Contraceptives 7 Referred to DH / WH

Name of SDH : Tirora

Month-MAY- 2011

Month wise attendance at ARSH clinic during 2010-11

Sr. Particulars No. 1 Attended clinic on their own 2 Referred 3 Total 4 Married 5 Unmarried 6 Services provided i Ante natal During Month Male Female Total 6 3 9 0 9 0 0 0 0 0 0 0 0 0 0 0 9 5 0 4 2 6 0 6 0 0 0 0 6 0 0 5 0 0 0 6 2 0 10 5 15 0 15 0 0 0 0 6 0 0 5 0 0 0 15 7 0 Male 193 17 210 6 204 0 0 0 0 7 0 10 0 8 0 0 19 13 0 Progressive Female Total 155 20 175 1 174 0 0 0 0 21 0 5 12 12 0 0 21 8 0 348 37 385 7 378 0 0 0 0 28 0 15 12 20 0 0 40 21 0

ii ECP and counseling iii TT iv IFA and counseling v Counseling for MTP vi Treatment of RTI / STI vii Menstrual problem viii Counseling for sex problem & scholastic problems ix Violence x Screening of Goiter, sickle cell xi Counseling for life skills, social skills xii Contraceptives 7 Referred to DH / WH

Rural Hospital Deori

Month-MAY- 2011

Month wise attendance at ARSH clinic during 2010-11

Sr. Particulars No. 1 Attended clinic on their own 2 Referred 3 Total 4 Married 5 Unmarried 6 Services provided i Ante natal ii ECP and counseling iii TT iv IFA and counseling v Counseling for MTP vi Treatment of RTI / STI vii Menstrual problem viii Counseling for sex problem & scholastic problems ix Violence x Screening of Goiter, sickle cell xi Counseling for life skills, social skills xii Contraceptives 7 Referred to DH / WH Male 6 0 6 0 6 0 0 0 0 2 0 3 0 0 0 0 6 2 0 During Month Female Total 7 13 0 7 0 7 0 0 0 0 4 0 2 5 0 0 0 7 2 0 0 13 0 13 0 0 0 0 6 0 5 5 0 0 0 13 4 0 Male 42 0 42 0 42 0 0 0 0 11 0 8 0 0 0 0 30 9 0 Progressive Female Total 81 123 0 81 0 81 0 0 0 0 21 0 8 18 0 0 0 50 17 0 0 123 0 123 0 0 0 0 32 0 16 18 0 0 0 80 26 0

Outreach Activities during 2009-10

Sr. No. 1 Activity Date organized 11/12/2009 No. of participants 60
Dist- Gondia Venue

Co-ordinating agency

Issues discussed

Youth melava

Z.P. Gondia

ARSH, HIV-AIDS

Outreach Activities during 2009-10

Sr. No. Activity Date organized 11/11/2009 Sub Distirct Hospital Tirora Distirct:- Gondia No. of Co-coordinating Venue Issues discussed participant agency 60 SDH Tirora ARSH, HIV-AIDS

1 Youth Melava

Outreach Activities during 2010-11

Sr. No. 1 2 3 4 Activity Youth Melava Camp Camp Youth Melava Date No. of organized participant 2/23/2010 50 2/24/2010 35 3/10/2010 31 3/20/2010 100 Sub Distirct Hospital Tirora Distirct:- Gondia Co-coordinating Venue Issues discussed agency ARSH, HIV-AIDS Gandhi Vidhalaya Tirora ARSH, HIV-AIDS SDH Tirora ARSH, HIV-AIDS SDH Tirora ARSH, HIV-AIDS Sahid Mishra Vidhalaya Tirora

Outreach Activities during 2010-11

Dist- Gondia

Sr. No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14

Activity Information Information Information Information Information Information Information Information Information Information Information Information Information Information

Date organized 7/23/2010 8/16/2010 9/14/2010 9/20/2010 10/13/2010 10/16/2010 6/12/201 12/9/2010 12/13/2010 12/26/2010 1/3/2011 1/8/2011 1/25/2011 1/27/2011

Venue No. of participants 35 High School Dhapewada

Co-ordinating agency

Issues discussed ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS ARSH, HIV-AIDS

30 30 40 35 34 25 23 30 27 20 25 25 22

High School Bhanpur Govt. Ashram School Gondia Sant. Gyaneshwar Ashram School, Pandharabodi Rajiv Gandhi College Of Socialwork, Gondia Sarshwati Jr. College Gondia Adasi Tanda High School Adasi Bhanpur High School Bhanpur Rastriya Madhyamik Vidhyalay Savari Shreram High School Khamari Hindal Madhamik School Mundipar Shriram Vidhalaya Kamari Z.P. Varith High School Banathar G.E. S. High School Kamtha