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Daily update on COVID-19 activities

Date: May 21st, 2020

Daily performance reporting on COVID-19 support

Indicators Baseline (as on start date)

Yesterday’s Achievement

Cumulative Achievements (till Yesterday)

Target for the entire project

Additional Information

Number of people

reached/contacted/benefited (e.g. test, treatment, risk

communication, counselling, other

services, helpline, daily OPD etc.)

NA 2097

54,848

27500 -Layered on Pulse

oximetry-1500

(316)

HRP -1000 (1017)

and HBYC-25000

(53,515) platform

Number of health workers trained (e.g. identify and treat COVID-19,

infection control, risk

communication, counselling, etc.)

NA 32

4667 1500 -Layered on

LaQshya (3,790),

NBSU, FPC, and

Safe delivery app

(877)

Number of frontline workers reached

with risk communication materials (e.g. ASHA, AWW, Sanitation workers, Tele workers, TB

champions, etc.)

NA 45

2341 12330 -12000 Layered

on FPLMIS (1626)

330 through HRP

(715)

Number of facilities supported by

USG resources and ready to respond COVID-19

NA - 399 122 -Layered on

LaQshya

1. Background:

IPE Global will leverage existing state and district level activities to integrate COVID-19 response measures.

These activities will include:

1. Strengthening infection prevention control and practices at the facility level through self-administered

audits and checklists under LaQshya:

2. Strengthening Universal Precautions at the individual healthcare provider level using self-learning safe

delivery Apps:

3. Daily tracking of cases of Acute Respiratory Infections (ARI) in Health and Wellness Centers and

promoting hand washing practices:

4. Dissemination of available COVID-19 risk-communications and guidelines among healthcare

functionaries and communities:

5. Risk mitigation and action planning

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2. Activity 1:

• Vriddhi Support to State during Covid 19 Pandemic - Haryana

• Monitoring of ARI cases from 19 Health and Wellness Centres

Activity-1: Vriddhi Support to State during Covid 19 Pandemic – Haryana

Support to State NHM

Vriddhi has been working closely with State NHM especially the Maternal and Child Health division and has

been providing technical support as and when required. The technical support provided has been for policy and

program changes in view of COVID 19 and also for resuming RMNCH+A services and LaQshya Quality

Initiatives during COVID-19 Pandemic. With concurrent advocacy below mentioned actions have been

integrated:

• For facility preparedness in non COVID facilities,

MH division has issued letter to districts to identify

isolation rooms for labour, delivery and recovery in

case suspect case comes late in labour and cannot be

referred

• Testing guidelines for pregnant women as per ICMR

were shared by MH division

• Letter regarding Infection prevention and BMW

management were shared with all districts and

delivery points

• MD has issued letter regarding essential services

continuation during COVID 19

• Aarogya Setu app – Use and its guidelines were shared on all state Whatsapp groups. In addition, MD had

issued a letter.

Vriddhi project activities

• Infection prevention guidelines and job aids for

practices and documentation were shared with all 48

LaQshya facilities.

• In Aspirational District, weekly Obstetric drills and

neonatal drills are being done at 21 delivery points for

enhancing skills to manage complications. Vriddhi is

supporting conducting these drills.

• Family participatory Care – COVID prevention

guidelines were shared with 24 SNCUs and

implemented. All mothers are asked to wear masks,

practice hand hygiene and social distancing in the

Figure 1: COVID LDR Isolation room in CHC Punhana

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SNCUs. COVID 19 guidelines and infection prevention modules were shared on Whatsapp group that

includes SNCUs of all districts.

Figure 2: FPC – Mothers using mask and social distancing in SNCU during FPC

• Pneumonia Management using multimodal Pulse Oximeter – 2

Community Health Officers in both HWCs in Mewat where the piloting is

being done, were given infection prevention training. The HWCs have

initiated practicing hand washing for clients at the entrance, patients are

asked to use face cover and regular disinfection of RAD G is being

practiced.

• NBSUs in Aspirational district - Telephonic follow up and physical

supportive supervision visits have been done in 3 NBSUs in Mewat. The

staff were oriented on Infection prevention in the context of COVID 19.

Online Training on Infection Prevention

The District Technical Consultant, Mewat has been providing Infection prevention trainings to labour room staff.

The trainings use standardised presentation, donning doffing video, and poster and facility readiness presentation.

These trainings are done telephonically/ online zoom

platform/face to face. The trainings have been

provided in small groups, facility wise. Till date 82

nurses have been trained from 21 delivery points in

the aspirational district, Mewat.

Figure 3: Hand washing Facility at HWC for patients

Figure 4: Online IPC training

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Using COVID module in Safe Delivery App for capacity building

of LR staff

WhatsApp platform and telephonic/online training platform were used to

promote the use of COVID module and attaining expert level by staff nurses.

The staff nurses have been sharing their expert level attainment in COVID

module on the WhatsApp group of the Aspirational district. Till date we have

104 staff nurses who have attained expert level in the COVID module.

Aspirational District level support for COVID

• Readiness in District Hospital and establishing a COVID Isolation

ward in DH Mandikhera

The DTC Mewat worked closely with the COVID Nodal Officer in

Mandikhera to plan and implement the following:

Changes in Main Hospital

1. Handwashing facility fully equipped including hand washing posters at

the entrance of COVID OPD and IPD for patients/relatives and for

main OPD too

2. Markings for social distancing in registration counter for queuing.

3. IEC display in hospital

4. Supporting in implementation on social distancing in maternity wards.

5. Advised LR staff to organise handwashing sessions in maternity

wards with patients and family members in each shift.

Changes supported in Isolation Ward

• Identification of Isolation ward with male and female wards and nursing station

• Unidirectional flow of patients with separate entry and exit

• Separate space for donning and doffing of PPE in Isolation ward

• Shower area constructed for staff at the exit of ward

• Ensuring availability and arrangement of all requirements in the ward – Oxygen, Suction, Crash cart, BMW

bins

• Ensuring Infection prevention protocols are in place and implemented

• Labelling of all areas and IEC

Participants share their Covid-19 Module expert level

Figure 5: Participants share their Covid-19 Module expert level

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• Advised all 21 delivery points LR staff (167) to organise hand washing sessions in ANC/PNC ward for

patients and family and awareness regarding social distancing to be practices at home also after discharge.

Sessions being done in DH Mandikhera, CHC Nuh, CHC Punhana and CHC Firozpur Jhirka.

• Planning management of persons under investigation being brought for testing after community

screening – As per guidance from MOHFW and state, the district formed 24 screening teams for door to

door community screening of families for any history of contact or influenza like illness symptoms. Those

community members found to have a positive history have been labelled as Persons Under Investigation

(PUIs).

On 15th April 20, PUIs were being brought to DH for testing and there were issues of mixing of non COVID

patients and PUIs. In addition, since many busses arrived at the same time there was overcrowding in the

testing area, long waiting time and no arrangement for PUIs waiting in the hospital. Based on the assessment

at the site, the team decided to implement the following actions. The main consideration was to segregate the

PUIs and other non COVID patients visiting the DH for non COVID care.

a. Demarcation and cordoning off the area to avoid mixing of non-covid patients and those PUIs

coming for COVID testing following community screening.

b. The screening teams to co-ordinate telephonically with DH for arrival time of the PUIs for testing

so as to avoid overcrowding and long waiting.

c. Amenities for PUIs –

i. On day 1, seating in the bus and benches in shaded area ensuring social distancing

ii. Thereafter, tents and chairs were arranged for temporary waiting area

maintaining social distancing

iii. Masks to be given to PUIs who do not have a face cover. This was started on day

1 itself.

Figure 6: Isolation Ward established in DH Mandikhera

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iv. Drinking water to be made available

v. Dustbins were made available

d. Restricting number of PUIs entering the area for testing – PUIs were taken in batches of 5-6 so as

to avoid crowding inside the designated testing area in the DH.

Activity -2: Monitoring of ARI Cases

Vriddhi team from National level is regularly tracking ARI cases from 19 Health and Wellness centers.

Yesterday, 12 cases of ARI screened and 3 cases were diagnosed as pneumonia.

Chart 1: Daily incidences of ARI cases

3. Include any Govt. Order, if any, related to COVID-19:

05

101520253035

Total Screened Pneumonia cases Severe pneumonia Referred

7

4. Include any photo (good quality), if any, related to activities:

Figure 7: ARI Screening at HWC Partan, Hazaribagh, Jharkhand

Figure 8: ARI Screening at HWC Rangelbera, West Singhbhum, Jharkhand