An Assessment of High Delivery Load Facilities under the Dakshata Program

Abstract

IntroductionGoal 3 of Sustainable Development Goals (SDGs) which include the older version of Millenium Development Goals (MDGs) maternal health (MDG-5) and child health and survival (MDG-4) are prime focused themes under the National Health Mission (NHM) of Government of India (GoI) [1]. Reduction in the maternal mortality of the country to achieve SDG goal is far away. On the further analysis, there has been a significant change with steady decline found in Infant Mortality Rate (IMR) in last decade, while Early Neonatal Mortality Rate (ENMR) and Perinatal Mortality Rate (PNMR) remained steady since last decade [2].Considering the fact that institutional deliveries raised significantly up to 73% across India after implementing Janani Suraksha Yojana (JSY) scheme, the major proportion of maternal mortality (44%) and neonatal mortality (40%) is still high on the period around child birth [2]. The majority of causes of maternal and newborn mortality are preventable through appropriate care to mother and newborn at the time of birth despite of having many strategies like Reproductive Maternal Neonatal Child and Adolescent Health (RMNCH+A). With the objective of improving the quality of care during child birth, GoI institutionalized 21 days training program of Skill Birth Attendance (SBA) for in-services Auxillary Nurse Midwives (ANMs) and staff nurses but results were not as according to expectations [2]. Subsequently, GoI introduced "Dakshata" which means adroitness, to improve intra partum and immediate post partum care with the training competency based and focusing on the highest impact practices during child birth, specifically shorter in duration for 3 days, post training follows up with support component by rolling out safe child birth checklist for doctors, staff nurses and ANMs The present investigation is an attempt to the assess the available infrastructure and services in the labor room, i.e., intra partum AbstractGoal 3 of the Sustainable Development Goals which use to be United Nations Millenium Development Goals (Goals 4 and 5) had focused on child survival and maternal health. These are the focused theme of the Government of India's public health programs under National Health Mission. It was Dakshata Program initiated in 2016 by GoI in 31 districts of the populous state of India, i.e., Uttar Pradesh. The investigation was carried out for these districts for the 124 high delivery load facilities selected from Health Management Information System data 2015-16. The random observations were undertaken for 2½ months (15 Sep -30 Nov 2016). The quality of the services was assessed using indicators in form of human resource, infrastructure, availability of drugs and trays, staff practices and knowledge and documentation processes. It was observed that human resource was inadequate for the investigated facilities. Despite of designated delivery rooms in all districts, the infrastructural setup was in poor state. The availability of the drugs and trays was in worst state. The labor room staff hardly follow...