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Group-1

Dr. Akhtar
Dr. Farrukh
Dr. Khalid
Dr. Nazish
Dr. Rehan
Dr. Sumaida
Dr. Tehseen
Dr. Waseem
Introduction
If the health care system is to serve the
community, there must be a good fit between
community health needs and health system.

Objectives
To determine the extent to which the
services are oriented towards needs.
To determine what systems are in
place to adequately manage and
support the services.
Problem solving approach
Contents
Availability of specific
Health Programs

Health Facility
Management

Health Facility
Physical Inventory

Health Facility
Activities

Health Facility
Morbidity Conditions
BHU Bhukkar Social Security Hospital
Population Coverage 11,000 persons 199,000 persons
Availability of Services General curative General curative services,
services, Antenatal Antenatal care, Delivery
care, Delivery care, care, Postnatal care, EPI,
Postnatal care, EPI, Family planning
Family planning
Active Outreach for Midwifery, Health Feeding program,
education, Family Nutritional rehabilitation,
planning, Antenatal Nutritional surveillance,
and Postnatal care and Curative care, Surgical care,
Curative care Obstetric and
Gynaecological care
Inpatient Curative Not Available Available
Services
Specific Preventive and Available Available
Health Promotive
Services
Specific Organization TBA Training, Program Transport system, drug
Adequacy Of Staff (<75% denotes absentism)
BHU Bhukkar Social Security
Hospital
Proportion of staff physically 25% Not available
present

Training and Supervision


Score
BHU Bhukkar Social Security
Hospital
On job training and supportive 6/8 (Adequate) 7/8 (Adequate)
supervision
Adequacy of treatment 5/8 (Adequate) 8/8 (Adequate)
guideline
Management and Organization
BHU Bhukkar Social Security Hospital
Adequacy of 0/7 (InAdequate) 7/10 (Adequate)
transport facilities.
Drug Management Drug received from Drug received from
district office Central Medical Store
(InAdequate) (Adequate)
Planning and 4/6 (Good job 6/7 (Good job
Management organization and organization and
planning) planning)
Finance Total Budget: Information Total Budget:
not available. (incharge 101,072,900
was not aware of financial Salaries: 70,987,000
requirements. Drugs: 13,000,000
Repair: 430,000
(Hospital is self sufficient
with respect to running
cost.
Health Information 12/20 (Record well 22/24 (Adequate record
BHU Bhukkar Social Security
Hospital
Status of building 2/7 (Largely InAdequate 19/23 (Adequate
physical facilities) physical infrastructure)

Status of furniture and 7/13 (InAdequate 21/25 (Very well


utensils availability) equipped and
maintained facility)
Status of equipment 14/29 (InAdequate 101/101 (Very well
and instruments Availability) equipped and
maintained facility)
Lab Equipment NA 23/23 (Adequate lab
equipement)
Status of drugs and 10/23 (InAdequate) 31/31 (Adequate)
sundries in OPD
Outpatient Load (visits per person to OPD per year)
BHU Bhukkar Social Security Hospital
0.837 Visits (gross underutilization 0.44 Visits (gross underutilization of
of services) services)

MCH Activities
BHU Bhukkar Social Security Hospital

No. of antinatal visits 0.412 ( <1 means 0.93 (population is


per pregnancy. population is under under served)
served)
No. of preschool 26 ( <50 means under 10 (population is under
children seen per utilization of services) served)
population unit per
month.
Outreach
BHU BhukkarSocial Security
Hospital
Percentage of home deliveries none none
carried out by BHU staff
Health education talks given in Zero Data Unavailable
community
%age of beds for pre-school children 12%

%age of beds for maternity care 19%


Record keeping Good Management & Organization
12 recent pre-school children GE, ARI, Fever, IDDM, Anemia, GB
admissions Syndrome, malaria
Average duration of stay of pre- 3 days (Efficient use of facility)
school children
12 recent maternity admissions Pregnancy induced hypertension,
anemia, UTI, Preterm labor,
Miscarriages, Fibriod uterus, Elective
C-Section
12 recent school-age Vomiting, ARI, GE, Thalassemia, Asthma,
children admissions Hepatitis, Fits
Average duration of stay 3 days
12 recent adult admissionsDM, COPD, CLD, Acute hepatitis, HTN, CVA,
CRF, PUO, Anxiety
Average duration of stay 4 days
Daily theatre utilization 3 operations per day
rate
%age of operations carried 7%
out on pre-school children

C-Section rate 50%


Morbid conditions encountered in OPD,
Services
BHU Bhukkar Social Security
Hospital
Pre-School GESTRO, ARI, Dysentery, GESTRO, ARI, Dysentery,
Children Fever (clinical malaria), Scabies
Scabies
School Age ARI, Diarrhea, Dysentery, Diarrhea, URTI, Malaria,
Scabies, Malaria Enteric Fever, Acute
hepatitis
Women Arthritis, APD, Anxiety, Fever, Arthritis,
ARI, Fever Hypertension, Obstetric
conditions
Men ARI, APD, Hypertension, Hypertension, IHD, TIA,
Minor injuries CLD, Acute hepatitis
Sanitation
Water supply
Prevalence of infectious diseases
Inadequate physical, human and
financial resources
Unavailability of evening and night
services
Unavailability of sanctioned items
Underutilization of services
Poor immunization coverage
Inefficient management of resources
Focus on preventive rather than curative
services
Target the improvement of PHC facilities
Ensure sufficient allocation as well as
distribution of financial resources
Inter sectoral collaboration
Community participation
Ensure job satisfaction of working staff
(human resource management)
Thank You