Performance Bulletin, August 2012

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1 MINUTES OF THE (10 th ) MONTHLY REVIEW MEETING OF DISTRICT HYDERABAD Monthly Review Meeting (M.R.M) of District, Hyderabad for the Month of August, 2012 was held on 13.09.2012 at meeting Hall of Ex-Zila Nazim Office, Hyderabad. Written invitations to participate were sent to the Administrator/ DCO, the D.H.O, all Focal persons of Vertical Programs, District Population Officer i.e EPI, TB DOTS,MNCH, National Program, Malaria Control, Hepatitis, DHIS & DEWS, representatives WHO, all I/c Medical Officers/ FMOs/LHVs etc. List of Participants: Sr. Names Designation S # Names Designation 1. Mr. Mustafa Kamal Tagar DSM, PPHI 41 Dr. Shazia Zeeshan FMO 2. Dr. Ahmed Ali Talpur A: DHO 42 Dr. Anaila Soomro WMO 3. Dr. Qazi Rasheed Ahmed F.P, DHIS 43 Dr. Mumtaz Rajper FMO 4. Dr. Sono Khan Bhurgri T.H.O Hyd Rural 44 Dr. Neelofer Kazi FMO 5. Dr. M Ayoub Unar Dist: T.B Coor. 45 Dr. Rubina Sheikh SWMO 6. Dr. Naveed Ahmed Eye Specialist 46 Dr. Samira Tebani WMO 7. Dr. Shabum DDO 47 Dr. Yasir MO 8. Dr. Rafique Ahmed MO 48 Dr. Mehwish FMO 9. Dr. Ammnullah Ogahi SMO 49 Dr. Fareeda FMO 10. Dr. Azeem Shah SMO I/C 50 Dr. Shabnum Tunio FMO 11. Dr. A. Rahim Khatian SMO I/C 51 Dr. Liaquat Siyal MO 12. Dr. Raza Muhammad SMO I/C 52 Dr. Farzana Agha WMO 13. Dr. Muqadus Ali MO 53 Dr. Kapil Dev M O HQ 14. Dr. Khadim Hussain SMO / IC 54 Sanjar Kumar Asst. 15. Dr. Khalid Dawich MO I/C 55 Dr. Yasir Ali MO 16. Dr. Iftekhar Ahmed MO 56 Dr. Shahbuddin MO 17. Dr. Abullah Nizamani I/C MO 57 Dr. Naveed Soomro MO 18. Dr. Manzoor Memon I/C MO 58 Dr. Junaid MO 19. Dr. Sohrab Hisbani S M O I/C 59 Dr. Qasim Bhatti MO 20. Dr. Riaz Ahmed SMO I/C 60 Dr. Sameena Rasheed FMO 21. Dr. Ramesh Kumar MO I /C 61 Dr. Sameena Bano FMO 22. Dr. M Qasim Soomro I/C MO 62 Dr. Mehwish Muneer FMO 23. Dr. Abdul Hamid Mangi SMO I/C 63 Dr. Attulah Shahani SMO 24. Dr. Khem Chand SMO I/C 64 Dr. Capr: Nasarullah SMO 25. Dr. Pervez Talpur M O 65 Dr. Saleem Akhter I/C MS 26. Dr. Mehboob Qadir M O I/C 66 Dr. Rai Chand MO 27. Dr. Talib Memon MO 67 Dr. Ashok Kumar MO 28. Dr. M Asif I/C MO 68 Mr. Athar Ali Memon Ex: M&E 29. Dr. Shabana Junejo WMO 69 Mr. Maqsood Ahmed SO 30. Dr. Shahida Din Sonologist 70 Mr. Waseem Jokhio SO 31. Dr. Erij Kamal Abbasi FMO 71 Mr. M Yousuf SO 32. Dr. Sadaf Sheikh FMO 72 Mr.Niaz Hussain Channa Ex:M&E Jamshoro 33. Dr. Aruna Kumari FMO 34. Dr. Abida FMO 35. Dr. Rubina Abro FMO 36. Dr. Jahan Ara FMO 37. Dr. Naila Sheikh FMO 38. Dr. Sadia Pir FMO 39. Dr. Rukhsana Dal Sonologist 40. Dr. Farzana Chachar Sonologist

Transcript of Performance Bulletin, August 2012

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MINUTES OF THE (10th ) MONTHLY REVIEW MEETING

OF DISTRICT HYDERABAD Monthly Review Meeting (M.R.M) of District, Hyderabad for the Month of August, 2012 was held on 13.09.2012 at meeting Hall of Ex-Zila Nazim Office, Hyderabad. Written invitations to participate were sent to the Administrator/ DCO, the D.H.O, all Focal persons of Vertical Programs, District Population Officer i.e EPI, TB DOTS,MNCH, National Program, Malaria Control, Hepatitis, DHIS & DEWS, representatives WHO, all I/c Medical Officers/ FMOs/LHVs etc. List of Participants:

Sr. Names Designation S # Names Designation

1. Mr. Mustafa Kamal Tagar DSM, PPHI 41 Dr. Shazia Zeeshan FMO 2. Dr. Ahmed Ali Talpur A: DHO 42 Dr. Anaila Soomro WMO 3. Dr. Qazi Rasheed Ahmed F.P, DHIS 43 Dr. Mumtaz Rajper FMO 4. Dr. Sono Khan Bhurgri T.H.O Hyd Rural 44 Dr. Neelofer Kazi FMO 5. Dr. M Ayoub Unar Dist: T.B Coor. 45 Dr. Rubina Sheikh SWMO 6. Dr. Naveed Ahmed Eye Specialist 46 Dr. Samira Tebani WMO 7. Dr. Shabum DDO 47 Dr. Yasir MO 8. Dr. Rafique Ahmed MO 48 Dr. Mehwish FMO 9. Dr. Ammnullah Ogahi SMO 49 Dr. Fareeda FMO 10. Dr. Azeem Shah SMO I/C 50 Dr. Shabnum Tunio FMO 11. Dr. A. Rahim Khatian SMO I/C 51 Dr. Liaquat Siyal MO 12. Dr. Raza Muhammad SMO I/C 52 Dr. Farzana Agha WMO 13. Dr. Muqadus Ali MO 53 Dr. Kapil Dev M O HQ 14. Dr. Khadim Hussain SMO / IC 54 Sanjar Kumar Asst. 15. Dr. Khalid Dawich MO I/C 55 Dr. Yasir Ali MO 16. Dr. Iftekhar Ahmed MO 56 Dr. Shahbuddin MO 17. Dr. Abullah Nizamani I/C MO 57 Dr. Naveed Soomro MO 18. Dr. Manzoor Memon I/C MO 58 Dr. Junaid MO 19. Dr. Sohrab Hisbani S M O I/C 59 Dr. Qasim Bhatti MO 20. Dr. Riaz Ahmed SMO I/C 60 Dr. Sameena Rasheed FMO 21. Dr. Ramesh Kumar MO I /C 61 Dr. Sameena Bano FMO 22. Dr. M Qasim Soomro I/C MO 62 Dr. Mehwish Muneer FMO 23. Dr. Abdul Hamid Mangi SMO I/C 63 Dr. Attulah Shahani SMO 24. Dr. Khem Chand SMO I/C 64 Dr. Capr: Nasarullah SMO 25. Dr. Pervez Talpur M O 65 Dr. Saleem Akhter I/C MS 26. Dr. Mehboob Qadir M O I/C 66 Dr. Rai Chand MO 27. Dr. Talib Memon MO 67 Dr. Ashok Kumar MO 28. Dr. M Asif I/C MO 68 Mr. Athar Ali Memon Ex: M&E 29. Dr. Shabana Junejo WMO 69 Mr. Maqsood Ahmed SO 30. Dr. Shahida Din Sonologist 70 Mr. Waseem Jokhio SO 31. Dr. Erij Kamal Abbasi FMO 71 Mr. M Yousuf SO 32. Dr. Sadaf Sheikh FMO 72 Mr.Niaz Hussain Channa Ex:M&E

Jamshoro 33. Dr. Aruna Kumari FMO 34. Dr. Abida FMO 35. Dr. Rubina Abro FMO 36. Dr. Jahan Ara FMO 37. Dr. Naila Sheikh FMO 38. Dr. Sadia Pir FMO 39. Dr. Rukhsana Dal Sonologist 40. Dr. Farzana Chachar Sonologist

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The following could not attend the meeting for the reasons stated against each:-

S # Names Reasons for absence 1 Dr Muhammad Ali Absent 2 Dr Aftab On Leave 3 Dr sadia pir On leave 4 On leave 5 On leave

A. HFs WITH PPHI

RHC: 03 BHUs: 13 MCHCs: 03 Dispensaries: 22

TOTAL: 41

B. Population of the Catchments Area: 385,898

C. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MOs 66 52 14 WMO/FMO 25 10 15 LHVs 29 23 6

MTs/MAs Male

49 40 9 Female Dispensers

D. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

Capacity building session:

Previous Month Total Month under Review Total

Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 1 Clusters of 2 HFs 2

Single HFs 40 Single HFs 39

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 9 Clusters of 2 HFs 9 Single HFs 6 Single HFs 6

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1. Capacity Building Session on Acute Diarrhea And Gastroenteritis in Childhood, By Dr.

Mansoor Saleem Bohra,. a. Clinical Presentation b. How to Evaluate c. Presenting Diagnosis d. Differential Diagnosis

2. Capacity Building Session on Antepartum Haemorrhage Placenta Previa , By Dr. Mehwish Muneer

FMO PPHI.

a. Defination b. Classification c. Clinical Features d. Diagnosis e. Treatment

3. Routine Immunization and role of I/c Medical Officer: (By: Dr. Sono Bhurgri, T.H.O, Rural)

a. Immunization Dozes and Role of NIDs. b. Current status of Immunization coverage through Fix/Mobile and LHW program. c. Issues and Problems. d. How to monitor Work Plan of Vaccinator viz a viz targets.

. F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered to Children at Health Facilities. 2102 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 608 No. of Immunization & Vaccination Administered by out- reach EPI Teams - Total vaccination / immunization for the month of August 2012 2710

2. National Immunization Days (NIDs) for Polio

Dates of NIDs Total Target of coverage Actual coverage Percentage of

coverage

------------------------------------- ---- --------- -----------

3. Other Preventive/Promotional Services

S # Service Number

1 Passive Case Detection (APCD) Slides --

2 Malaria Metro Survey (MMS) Slides 539

3 +ve Slides 37

4 Follow up 0

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH 1. Female Health.

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S. No

NAME OF FMO

NUMBER OF

PATIENT OBSTETRICAL

Total OPD childs

Total OPD

Women& (Childs)

Diagnostic Tests

Women Antenatal 1st Visit Natal

Post Natal

1st visit

PT Total

BS Total

HB Total

1 Dr. Erij Kamal/Sameena 1194 96 0 11 522 1823 37 25 0

2 Dr. Neelofer Kazi 649 31 0 0 318 998 6 15 0

3 Dr. Sadaf Sheikh 1014 45 0 14 543 1616 29 19 0 4 Dr. Sadia Pir 573 9 0 7 222 811 2 5 0 5 Dr. Naila Sheikh 442 15 0 14 134 605 6 12 0

6 Dr. Shabnum Tunio 70 13 12 4 1 100 0 0 0

7 Dr. Sameena 464 28 10 14 0 516 0 0 0

8 Dr. Shazia Zesshan 445 41 3 10 120 619 31 17 49

9

Dr. Rubina Sheikh, Dr. Sameera, Dr. Farzana

1825 82 0 29 616 2552 22 31 0

10

Dr. Mumtaz Soomro, Dr. Aneela Soomro, Dr. Fernaz Andleeb

1945 260 100 210 0 2515 84 226 229

11 Dr Yasmeen 635 55 0 8 993 295 9 8 0

12 Dr. Safia Dr. Shabana 937 58 0 4 1073 74 3 0 0

13 Dr.Fareeda 566 48 0 3 456 1027 4 18 0 14 Dr.Rubina 708 42 0 15 324 1089 16 14 0 15 Dr.Sameera 503 18 0 9 223 753 11 22 3 16 Dr.Jhan Ara 1412 59 0 24 664 2149 16 18 16

17 Dr.Mumtaz khatoon 508 62 0 5 126 701 16 58 0

18 Dr.Mehwish 540 31 0 0 147 718 12 2 3 19 Dr Yasmeen 635 55 0 8 993 295 9 8 0

20 Dr.Aruna Kumari 516 51 0 9 191 767 24 27 10

21 Dr.Abida Ishtiaque 264 93 0 15 231 603 6 0 0

22 Dr.Aqsa Mustaque 172 26 0 2 154 354 2 6 0

Total 5316 437 125 82 5094 8382 107 165 32

During Month under Review 2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 208 2 Deliveries Assisted at Homes 00

3. Lab/ Diagnostic Tests

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S # Test Number 1 Pregnancy Tests 327 2 Blood Sugar Tests 515 3 Hemoglobin Tests 310 4 Ultra Sound Test 1541 5 Other 391

3. Important Discussion on Mother and Child and Reproductive Health during MRM

a. Pre-diagnosis screening of patients for vaccine should be done religiously. b. Where vaccinator are provided under National Program, the duty roster should be signed by I/c

Medical Officer and absence report should immediately be sent to Focal Person. c. Pregnant females should be encouraged for delivery at BHU. d. F.P advice should be part of diagnosis and separate record be maintained. e. Sonologists shall furnish their presentation on the findings, referral and follow up. f. MNCH record and Growth monitoring record should be maintained by FMOs where LHV is not

provided. In all cases, record should be legible, complete and traceable. g. Baby Weighing Scales/ Adult Bath Scales, Hemoglobin Meters and Height Charts have been provided.

Ensure proper usage of the equipments and report of out of order weight machines should be immediately conveyed to I/C MO in writing.

h. Training on Hemoglobin meters have been provided to all Medical and Paramedical Staff for blood tests preferably for pregnant women and same will be repeated for retention.

i. Focal Person (EPI) has declined to provide EPI vaccinators during FMO Days at the places where FMO cover is provided. The Vaccinator at all FMO covered facilities for that day used to bring vaccines in carrier and remarkable increase had been achieved in coverage for TT and BCG vaccines. But, now such matter will thoroughly be discussed with EDO (Health).

3. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number Consultation / Advice 618 Oral Pills 215 IUCDs 11 Injections 200 Others 321

Total 1365

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: 34 Number of Female SGs: 02 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

No. No. of Participants No. No. of

Participants Maqsood Ahmed 3 115 4 138 Wasim Jokhio 3 96 5 156 Yousuf Seelro 5 141 6 167

Total 11 352 15 461

1. School Health Sessions & Community Health Sessions

S. NAME OF FMO Name of Health S.H.SESSION C.H.SESSION

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# Facility No of Session

Child Examined

Child Treated Session Participant

1 Dr. Erij Kamal RHC Hoosri 0 0 0 0 0

2 Dr. Sadaf Sheikh MCHC Jhando Khoso 0 0 0 1 114

3 Dr. Naila Sheikh BHI AMI Qazi 0 0 0 0 0

4 Dr. Shazia Zesshan RHC Tando Qaisar 0 0 0 0 0

5 Dr. Rubina Sheikh,

BHU Sehrish Nagar 0 0 0 0 0 Dr. Sameera, Dr. Farzana

6 DR. Fareeda BHU Massu Bhurgri 0 0 0 1 22 GD Taaj Muhammad Junejo 0 0 0 0 0

Dr. Fareeda 0 0 0 1 22

7 Dr. Rubina Abro

BHU khesana Mori 0 0 0 2 67 GD bheendo sharif 0 0 0 1 45

Dr. Rubina Abro 0 0 0 3 112

8 Dr. Azra Sheikh BHU Hatri 0 0 0 0 0 BHU Darya Beg Mughal 0 0 0 0 0

Dr. Azra Sheikh 0 0 0 0 0

9 Dr. Jahan Ara BHU Bahawal Zaunr 0 0 0 1 45 BHU Jhando Narejo 0 0 0 1 28

Dr. Jahan Ara 0 0 0 2 73

10 Dr. Yasmeen DCD Darhoon Panhwer 0 0 0 0 0 MCHC Jeando Halepoto 0 0 0 0 0

Dr. Yasmeen 0 0 0 1 30

11 Dr. Mumtaz Khatoon

BHU M A B Talpur 0 0 0 1 30 GD Habibullah Memon 0 0 0 1 25

Dr. Mumtaz Khatoon 0 0 0 1 35

12 DR. Mehwish Muneer

BHU Norai Sharif 0 0 0 0 0 BHU Sono Khan Almani 0 0 0 0 0

DR. Mehwish Muneer 0 0 0 0 0

13 Dr. Sameena Rasheed

GD Bheendo Sharif 0 0 0 1 30 GD Mehrab Sonalgi

Dr. Sameena Rasheed 0 0 0 1 30

14 Dr. Aruna Kumari

BHU Moosa Khatian 0 0 0 1 25 GD Arif Khatian 0 0 0 1 30

Dr. Aruna Kumari 0 0 0 2 55 TOTAL 0 0 0 15 461

4. Important Points during Support Group Meetings.

• The CSG members should help in monitoring and facilitation. • I/c Medical Officer has been trained for undertaking necessary day to day equipments/asset repairs on need

basis after seeking administrative approval from DSM- should be regular feature. • Moral support to medical/paramedical staff working at HF.

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• Arranging of awareness sessions at their respective villages • Information sharing to the rest of the villages regarding facilities at HF • Reformation of CSGs and individual roles of the members • Effective local facilitation by CSG members to the hf staff • Developing greenery at HFs by the CSG members • Ownership of the HFs

5. Important Points during SHSs

• To drink clean & safe water and Washing hands after toilet. • Awakening health consciousness in children regarding new aspects of diseases like Dengue Fever, Swine Flue,

Congo Fever etc. • Nutritional awareness to be transferred to mothers through their kids. • Hair trimming clean clothes nails clipping, washing fruit/vegetables before eating.

6. Important Points during CHSs

• Primary health care awareness. • Educate about immunization against infectious disease. • Personal Hygiene and worm infestation/De-worming of children • Prevention from diabetes • Precautions from Malaria and Hepatitis • Importance of family Planning • Importance of Vaccination • Importance of ultrasound • Importance of antenatal and postnatal care

7. Topics for SHSs for the Month

Sr. No. Topics 1 Diarrhea 2 Malaria/Dengue

8 Topics for CHSs for the Month

S # Topics 1 Hepatitis C 2 Hygiene

9. Important Discussion on Community Participation during MRM

• Community Health Sessions are to be planned and held on Sonologist days. • Participation should be ensured through formal contact with LHWs. • Sessions are to be held preferably at Health Facility or at community home duly coordinated and

facilitated by DSU/HF staff. • DSU field staff shall attend 50% of all the CSG meetings conducted during the month. • TORs of CSG must be shared with CSG members in every meeting of CSG. • Formal invitation to the CSG members in meeting • Presiding of the meeting by the CSG members • Participation of notable CSG member in MRM • Effective Mobilization of female CSGs and developing their ownership at H.Facility. • Involvement of notable in solving day to day problems of HFs. • CSG should be held at BHU. • Developing greenery at HFs.

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10. Health Camps: Number Held: Number of Patients: 11. Measures for improvement / provision of Services by other Department / Agencies Sr No Description Recommendation To whom sent Present status I Sanitation Not discussed in this meeting. Normally, a separate Quarterly Review

meeting of Public Representatives and District Government officials/officers/NGOs is being held where such issues are discussed and decisions are taken.

Ii Drainage / sewerage Iii ……… drinking water Iv Prevention of adulteration V Tree Plantation Vi Roads and infrastructure Vii Environmental

Improvement Viii Others

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW 1. OPD*

New patients treated during the month

Old patients treated during the month

Total OPD during the month (New + Old)

65,162 72,26 72,388 2. Maximum OPD**

01 RHC Tando Jam 10,693

02 RHC Hoosri 4714

03 BHU Sehrish Nagar 4018

04 RHC Tando Qaiser 2858

05 MCHC Jhando Khoso 2945 3. Top Five Diseases Treated during School Health Sessions/Camps

S # Diseases No. of Patients

1 ARI 0

2 Allergic Rhnites 0

3 Scabies 0 4 Malaria 0 5 Diarrhea 0

*All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs. . Top Five Diseases During OPD

S # Disease S # Disease 1 Acute URTI 13794 6 Dog Bite 31 2 Malaria 3594 7 3 Scabies 2345 8 4 Diarrhea 4172 9 5 Suspected Viral Hepatitis 143 10

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4. ARV / ASV used during the month

Particulars No. of Patients

Dog bite cases reported 31

ARV Administered ( @ 5 Dozes per patient) 00 ARV Available Doses ( @ 24 dozes/vial) 00 Snake bite cases reported 00 ASV Vaccine Administered 00

ASV Vaccine Available Doses 00 6. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Ch & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Blood Sugar Tests 515

2 Hemoglobin 310 3 X-Rays (if available) 28 4 Ultra Sound 1541 5 Others (Lab Tests) 391

7. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

Hepatitis B 0 0 0 0 0 Hepatitis C 0 0 0 0 0

8. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

0 0 0 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 0 0 0 0 0 0 0 3 4

10. Inverse Referrals

S.No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs 2 0 31 0 16 15 0 0 3 4

G. MONITORING DURING MONTH UNDER REVIEW

1. Monitoring Visits during the month

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DSM Executive Monitoring Other Staff Total

43 84 154 281 2. Important Points/Issues arising from Visits S # Name of HF Issue Action Remarks

01 MCHC JHANDO KHOSO

Building Needs Repair Waiting for Tender

02 GD Bheendo Sharif Building Needs Repair Waiting for Tender

08 GD Arif Khatian Building Needs Repair Waiting for Tender

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for: 30 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

1 BHU Sehrish Nagar Repair of Water connection

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

--------------------------------------- ----------------------------------------- --------------------------------------

* To reflect only non-PPHI Visitors

J- DISCUSSION DURING MRM On Staff Matters:

• All I/c M.Os/FMOs were asked to prepare the base data of that area and set the targets for A.N/P.N, immunization, Deliveries ets. Just reporting the figure does not solve the problems

• Every Medical Officer has to commence a journey to become Health Officer sensitized for all 08 components of Primary Health.

• It was reiterated that already delegated powers for one day leave/short leave to Executive M&E were withdrawn and anybody seeking leave shall have to inform DSM directly.

• All I/c M.Os/FMOs were given Leave formats to discourage sms leaves or hand written applications. • Till DHIS forms are provided by DGHS, HMIS formats are printed to reduce the Photostat costs and same

are being provided to all the I/c MOs before next due date. • Medicine Requisition/DEWS reporting formats were distributed to avoid Photostat cost. • Carbon copies be used for keeping an other copy of Referral Forms • Aprons and Staff Uniforms should be strictly worn during duty hours. • V-phones remain unattended by some facilities. Some V-phone sets remained irreparable despite successive

change of batteries. Requisition for purchase of new sets is moved. • Frequent leaves and late comings should be avoided otherwise explanation calls and deduction of salary may

result for delinquents.

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• The DSM, PPHI Hyderabad requested the in charges of health facilities for their timely submission of HMIS reports, Monthly Medicines Requisition, Referral Cases regarding the TB, Polio Dog Bite, Measles, Diarrhea etc.

• Leaves availed through SMS should be subsequently submitted on prescribed format and got approved otherwise will be treated as absence.

• Late coming/Early going will be marked as “ x” and two such crosses will result in one absence. • All I/c M.Os should counter-sign on Bin Cards and Stock registers at every receiving and usage of stocks. • Waste Disposal pit be properly ditched and regular burning of hospital waste as per protocol must be

observed. • Proper record of ARV ampules be maintained and used ampules be submitted at DSU before issuance of

new stock. • Expiry or near to expiry medicines be separated and disposed as per protocol already circulated.

On Preventive Health:

• All I/c M.Os should ensure checking of temperature chart as well as stock and expiry of vaccines. • Quality of HE sessions not yet improved. S.O should facilitate in arranging most of The CHS in

communities On Curative Health:

• Quality of medicines has improved with clear impact on increased cost of medicines. • Normal Delivery Centers have been opened at 16 facilities of the district. • Rise in OPD and consequent rise in medicine consumption. • Patient coming from farther areas demand for more medicine dosages.

On Mother, Child & Reproductive Health: • Baby Weighing Scales have been provided at all 30 facilities where FMO cover has been provided. • MNCH registers and Growth monitoring registers will be maintained at each facility where FMO cover is

provided. Training has already been provided to all FMOs in this regard. • The registers will be maintained by LHVs wherever provided. Otherwise, FMO will record and maintain. • For NVDs, FMOs should motivate to pregnant ladies for deliveries at BHUs.

Other Matters: • One Pathological laboratory and X-ray unit have been made functional at RHC Tando Qaisar. Now, 02

Pathological Laboratories and 02 X-ray units have started functioning and periodically they have become self sustainable for purchasing diagnosis kits. Planning is in hand for opening up 01 more Pathological Laboratory at RHC hoosri.

• I/c Medical Officers requested not to wait for DSU for minor repairs and to undertake necessary repair in lines with procedures and policies already shared and claim reimbursements.

• Lot of improvements have been brought in newly taken over RHC Tando Jam as (1) X-ray Plant has started functioning, (2) Pathological Laboratory started after purchase of regents and training of Lab. Technician (2) Additional FMO and Dispenser have been provided.

• Night shift at RHC has been started with male doctors in all three shifts and female doctors in morning shift. Full fledge show is to start as soon.

• Date /Time for Next MRM: Tentative Date for next MRM is 11-09-12 Comments on Targets vs Achievements (by DSM)

• It was once again clarified to the medical staff that no contractual employee is allowed for Private Medical Practice.

• Excess medicines available at h.f’s are to be sent back to DSU for supplying at other demanding h.f’s. • DSM conveyed his displeasure to all those FMOs having less number of ante-natal/post natal. • Medical Doctors not conducting school/community sessions were WARNED for the disciplinary action. • DEWS reports don’t reach in time causing embarrassment and delay in reporting. • Pre-Post R&R photos are not found at H.Fs. • Tree Plantation targets.

(Mustafa Kamal Tagar),

District Support Manager,

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PPHI, Hyderabad. Copy for information to:

1) Secretary to Government of Sindh for Health Department, Karachi. 2) Program Director, PSU, PPHI, Karachi. 3) District Coordination Officer, District Government, hyderabad. 4) Director General Health, Directorate of Health Hyderabad. 5) Regional Program Director, Region-I @ Hyderabad 6) DHO Hyderabad.. 7) Incharge Medical Officer(s) all PPHI managed Health Facilities,Hyderabad.

(Mustafa Kamal Tagar), District Support Manager,

PPHI, Hyderabad.

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MINUTES OF THE (12th) MONTHLY REVIEW MEETING OF DISTRICT JAMSHORO

12th Monthly Review Meeting (MRM) of District Jamshoro for the Month of August, 2012 held on 07th September, 2012 at 2PHDC Hall - Jamshoro. Written invitations were sent to the DC, the EDO(H), the EDO(F&P) District Population Welfare Officer and District Incharges of EPI, LHW, T.B Program, Malaria ,DHIS, family planning, District Surveillance Officer WHO and all other National Programs as usual. The list of participants is as follows: List of Participants:

1. Mr. Abdul Shakoor Shekh Regional Program Director RSU-1 @ Hyderabad 2. Mr. Saifullah Abro District Support Manager DSU PPHI Jamshoro 3. Dr. Khalid Memon MO (HQ) PPHI Jamshoro 4. Mr. Niaz Hussain Channa EO(M&E) DSU PPHI Jamshoro 5. Mr. Tarique Ahmed Shaikh Executive F/A DSU 6. Dr. Shahida Shoro FMO BHU Karo Khao / GD Budhapur 7. Dr. Shazia Memon FMO BHU khando / GD Christian

Colony 8. Dr. Rozina Memon FMO BHU KK BAsti 9. Dr. Irum Naz FMO GD Khurshed Colony & BHU Sari 10. Dr. Shah Bano FMO GD Bihar Colony 11. Dr. Khalida FMO LSB+BHU Khanoth 12. Dr. Naseem Junejo FMO GD Akro + BHU Amri 13. Dr. Shaekla Mehtab FMO BHU Lakha / GD Malhdoom

Saharabad 14. Dr. Raheela Naz FMO BHU Wahur / GD Bajara 15. Dr. Sabiha Khaskeli FMO BHU Amri / BHU Garwari 16. Dr. Farzana Arif FMO GD Qubi / GD Mehanda Palarai 17. Dr. Zeba Zardari FMO GD Manjhhu 18. Dr. Anjum Shaikh WMO GD Sindh University 19. Dr. Taqi Soomro MO GD LSB Jamshoro 20. Dr. Aftab Soomro MO BHU Walidad Gabol 21. Dr. M Ramzan MO BHu Bubak 22. Dr Abdul Khalique MO BHU Laki 23. Dr. Premchand MO GD Manhdapalari 24. Dr. Saifullah MO BHU Tajuji 25. Dr. Faraz Hanif Memon MO BHU Lakha 26. Dr. Sultan Ali MO GD Qubi 27. Dr. Irshad Ahmed Nonari MO BHU Thano Ahmed Khan 28. Dr. Suhail Ahmed Soomo MO GD Christian Colony 29. Dr. Zunair Shoro MO GD Budhapur 30. Dr. Zakir Ali MO BHU Garwari 31. Dr. Faisal Channa MO BHU Khuda ki Basti 32. Dr. Mohan Lal MO BHU Karo Khao 33. Dr. Faisal Mehdi Qureshi MO BHU Khanoth / GD Akro 34. Dr. Hafeez Memon MO GD Khursheed Colony 35. Dr. Asan Das MO BHU Mole 36. Dr. Aneel Kumar MO GD Ali Murad Barejo 37. Dr. Nazir Feroz MO GD Bihar Colony 38. Dr. Muzamil MO SHC Dhamach 39. Dr. Shahid Hussain MO BHU Amri

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40. Dr. Ferozuddin MO BHU Talti 41. Dr Amjad Ali Rajpar MO GD Makdoom Saharabad / GD

Manjhu 42. Mr. Ghulam Akabr Disp SHC Thano Arab Khan 43. Mr. Allah Dino SO-/Assistant DSU PPHI Jamshoro 44. Mr. Shahzad Ali SO-/Assistant DSU 45. Mr. Akhtiar Ali Assistant R&R DSU 46. Mr. Nazar Hussain Assistant Accounts DSU 47. Mr. Rashid Shah Attendant DSU 48. Mr. Asif Ali Assistant Store DSU

The following could not attend the meeting for the reasons stated against each:-

1. Dr. Naheed FMO SHC Dhamach C/L 2. Dr. Niisar Ahmed MO Band Maanchar at BHU (Rain Engage

duty) 3. Dr. Ghulam Nabi SMO BHU Wahur at BHU( Rain Engage

duty) 4. DR. Jehanzaib Bhatti MO GD Sindh University 15 Days Leave 5. Dr. Allah Jurio MO GD Bajara at BHU (Rain Engage

duty) 6. Dr. Imamau d din MO BHU Khando C/L 7. Dr. Assar Mal MO BHU Sari at BHU (Rain Engage

duty)

B. HFs WITH PPHI

BHUs: 19 Dispensaries: 16 MCHCs: 00 Others: 00(RHC) TOTAL: 35

B. Population of the Catchments Area: 640303

E. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MOs 35 34 10 24 22 WMO 02 02 00 FMOs - 14 - 14 - LHVs/MW/F. Nurse 20 35 22 13 0

MTs/MAs Male 26 26 7 0

0 Female - - -

Dispensers 11 29 10 19 11

F. CLUSTERS OF HFs WITH ONE MO

Previous Month Total Month under Review Total

Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 02 Clusters of 2 HFs 02

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WITH ONE FMO

E. CAPACITY BUILDING 1. First Session: During MRM

DR Zakir Ali I/C Medical Officer BHU Garwari and Mr. Niaz Hussain Channa (Executive M&E) DSU, Jamshoro highlighted the importance of eDEWS and DHIS Performance Indicators (topic) and focused on the following points:- a) Disease Early Warning System (DEWS) b) Diseases Definitions c) Procedure of Recording and Reporting. d) Days and Time for Recording and Reporting. e) Common errors in Recording and Reporting. f) Performance Indicators of PHC Facility Monthly form.

8. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of Participants

F. REVIEW OF THE PERFORMANCE

(I) PREVENTIVE HEALTHCARE During Month under Review

1. Vaccination / Immunization

No. of Doses of Immunization Administered to Children at Health Facilities. 2272 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 539 No. of Immunization & Vaccination Administered by out- reach EPI Teams - Total vaccination / immunization for the month March 2012 2811

2. National Immunization Days (NIDs) for Polio

Single HFs 28 Single HFs 27

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 08 Clusters of 2 HFs 09 Single HFs 05 Single HFs 06

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Dates of NIDs Target of coverage Actual coverage Percentage of coverage

3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 2 Active Case Detection (ACD) Slides 3 Visits to Check Sanitation (individual house holds + streets) 4 Notices issued against Poor Sanitation 5 Challans sent to Court against Poor Sanitation 6 Patients Nebulized 104

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH During Month under Review

1. Female Health

S # Names of FMOs Ante-Natal Cases Neo-Natal Cases Other OPD Total OPD 1 Dr. Anjum Shaikh 35 737 772 2 Dr. Nighat Naseem 125 713 838 3 Dr. Rozina Memon 135 1002 1137 4 Dr. Naheed Akhtar 28 177 205 5 Dr. Shah Bano 75 2248 2323 6 Dr. Shazia Memon 71 1394 1465 7 Dr. Khalida Buriro 53 1106 1159 8 Dr. Shahida Shoro 82 752 834 9 Dr. Irum Naz 75 2512 2587 10 Dr. Naseem Junejo 68 503 571 11 Dr. Anna Abro On Maternity leave 12 Dr. Shakela Mehtab 66 531 597 12 Dr. Rahella 58 1169 1227 13 Dr. Sabiha Khaskeli 26 405 431 14 Dr. Zeba Zardari 0 150 150

Total 897 13399 14296

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2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 05 2 Deliveries Assisted at Homes 0

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 105 2 Blood Sugar Tests 568 3 Hemoglobin Tests - 4 Ultra Sound Test 50 5 Other 102

9. Important Discussion on Mother and Child and Reproductive Health during MRM

DSM emphasized on creating awareness regarding reducing maternal mortality and morbidity rate in the District. FMOs were advised to increase the Ante and Post natal visits of female patients and guide them for completing TT vaccination course.

10. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number Consultation / Advice 263 Oral Pills 143 IUCDs 01 Injections 86 Others(RC) 46

Total 561

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: 26 Number of Female SGs: -------------- 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups

conducted by him CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of

Participants Shahzad Ali Soomro 03 - 34 2 28 Mujeeb-u-Rehman Shaikh 02 - 18 2 23 Allah Dino Otho 07 - 88 05 77

Total 12 140 9 128 3. School Health Sessions & Community Health Sessions

Sr. No Name of FMO/ MO

CHS School Health Session

No. Part: NO. Examined Treated 1 Dr. Anjum Shaikh 1 14 2 Dr. Nighat Naseem 1 15 4 Dr. Rozina Memon 2 49 5 Dr. Naheed Akhtar 1 34 6 Dr. Shah Bano 1 22 7 Dr. Shazia Memon 2 100

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8 Dr. Khalida Buriro 2 64 9 Dr. Shahida Shoro 2 72 10 Dr. Irum Naz 2 59 11 Dr. Naseem Junejo 2 58

12 Dr. Anna Abro On maternity leave.

13 Dr. Shakela Mehtab 4 109

14 Dr. Rahela 2 45 15 Dr. Sabiha Khaskeli 2 30 16 Dr. Zeba Zardari 0 0

Total 24 671 4. Important Points during Support Group Meeting

• Support in polio eradication campaign • Arrange CHS & SHS in catchment area • Arrange medical camps.

5. Important Points during SHSs • Discussed importance of immunization, personal health & hygiene, nutritional status and other

diseases. 6. Important Points during CHSs

• Importance of breast feeding and maternal health.

7. Topics for SHSs for the Month Sr. No. Topics

1 Immunization 2 Personal Health and hygiene 3 Nutrition 4 Diarrhea (Prevention & Treatment) 5 Malaria

8 Topics for CHSs for the Month

S # Topics 1 Immunization 2 Personal Health and hygiene 3 Nutrition 4 Mother and child health

9. Important Discussion on Community Participation during MRM The schedule of the CSG meetings was shared and finalized with MOs consultation. DSM guided the MOs to arrange the community support groups on mentioned dates in the schedule. Invite and ensure the maximum participation of the members from the CAs of the health facility in the CSG meetings. 10. Health Camps: Number Held: 0 . Number of Patients: 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation No No No Ii Drainage / sewerage No No No Iii ……… drinking water No No No Iv Prevention of adulteration No No No V Tree Plantation No No No Vi Roads and infrastructure No No No

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Vii Environmental Improvement No No No viii Others No No No

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD* New patients treated during

the month Old patients treated during

the month Total OPD during the month

(New + Old) 42,269 1477 43,746

2. Maximum OPD** Minimum OPD**

S # BHF name OPD S # BHF name OPD 01 GD Khurshed Colony 4241 20 BHU Bubak 942 02 GD Bihar Colony 4045 21 BHU Amri 791 03 GD Christian Colony 2844 22 GD Mehenda palari 780 04 BHU Khuda ki basti 2533 23 BHU Laki 755 05 GD Sindh University 2338 24 GD Karchat 747 06 GD LSB Jamshoro Colony 1923 25 BHU Khado Village 734 07 GD Bajara 1562 26 BHU Taung 713 08 BHU Lakha 1542 27 GD Ali Murad Barejo 704 09 BHU Sari 1404 28 BHU Walidad Gabol 690 10 BHU Mole 1404 29 GD Makhdoom Saharabad 689 11 BHU Wahur 1276 30 GD Budhapur 688 12 BHU Karo Khao 1193 31 SHC Dhamach 580 14 BHU Tajuji 1111 32 GD Qubi 567 15 BHU Khanot 1108 33 BHU Garwari 490 16 GD Band Manchar 1102 33 GD Gu Muhammadl Sehtan 483 17 GD Akro 1027 34 BHU Thano Ahmed Khan 469 18 SHC Thano Arib Khan 962 35 GD Manjhoo 365 19 BHU Talti 943

3. Top Five Diseases Treated during School Health Sessions/Camps. 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 ARI 7134 2 Diarrhea 4875 3 Fever(clinical Malaria) 2642 4 Dermatitis 2391 5 Scabies 1699

11. ARV / ASV used during the month

No. of Patients Dog bite cases reported 6 ARV Administered 6 ARV Available Doses 245

S # Diseases No. of Patients 1 ARI 2 Diarrhea 3 Fever(clinical Malaria) 4 Scabies TOTAL

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Snake bite cases reported 7 ASV Vaccine Administered 7 ASV Vaccine Available Doses 30

9. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Pregnancy Tests 105 2 Blood Sugar Tests 568 3 Hemoglobin - 4 X-Rays (if available) 5 Ultra Sound 50 6 Others (please specify) 102

10. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date

Follow up result

Hepatitis B 0 0 0 0 0 Hepatitis C 0 0 0 0 0

8 TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

0 0 0 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 72 46 0 26 0 72 - 3 4

10. Inverse Referrals

S.No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs 2 0 0 0 0 0 0 - 3 4

G. MONITORING DURING MONTH UNDER REVIEW

2. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total 20 22 72 114

2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks

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H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for Weeks: 22 weeks

3. Important Issues raised relating to Medicines, etc. during MRM a. ATS is required by MOs b. One month FP Injection by FMOs

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

1 BHU KK Basti R&R Complete 2 GD Christian Colony R&R Complete 3 GD LSB Jamshoro Colony R&R Complete 4 GD Sindh University R&R Complete 5 BHU Talti R&R Complete 6 BHU Wahur R&R 95% Complete 7 BHU Laki R&R 90% Complete 8 BHU Khanot R&R 95% Complete 9 SHC Dhamach R&R 30% Complete 10 BHU Karo Khaho R&R 90% Complete 11 BHU Bubak R&R Work Stopped 12 BHU Khado R&R Work in progress 13 BHU Garwari R&R Work in progress 14 BHU Lakha R&R Work in progress 15 Gd Qubi R&R Work in progress

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

* To reflect only non-PPHI Visitors.

J- DISCUSSION DURING MRM DSM presented the progress of PPHI and openly discussed the issues related to health facilities

• Regional Program Director emphasized on routine immunization and advised all MOs to take keen interest in this regard.

• FMOs were advised by Mr. Abdul Shakoor, Regional Program Director RSU-1 to increase the number of family planning clients / Ante Natal care and focus on managing/conducting deliveries as according the target against their catchment area population.

• He advised all I/C Medical Officers to ensure the availability of ORS and other supplements to cater the diarrheal disease during rainy season.

• He advised DSU team to ensure the provision of ARV and ASV at scheduled centers.

Date / Time for Next MRM: 8th of October 2012 at 09:30am Comments on Targets v/s Achievements (by DSM) DSM Appreciated the efforts of the MOs and FMOs regarding their working at HFs.

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MINUTES OF THE (45th) MONTHLY REVIEW

MEETING OF DISTRICT MATIARI The Monthly Review Meeting (MRM) of District Matiari for the Month of August, 2012 was held on 11th September, 2012 at DSU PPHI Matiari Office. Written invitations to participate in the meeting were sent to the Deputy Commissioner, the DHO, and District Incharge of EPI, LHW, T.B Program, Malaria, family planning and all other National Programs as usual. The list of participants as follows: List of Participants:

49. Mr. Inam-ur-Raheem Abro District Support Manager DSU PPHI Matiari 50. Mr. Kamran Khan EO(M&E) DSU PPHI Matiari 51. Mr. Imran Qureshi Ex(F/A) DSU PPHI Matiari 52. Mr. Abdul Malik ADPWO District Population Office 53. Dr. Rukhsana Zahid FMO BHU Tahir Hingoro & DCD Dhaloo

Khaskheli 54. Dr. Saeeda Mansoor FMO GD Sher M.Thora & BHU Laloo

Mangwano 55. Dr. Salma Shah I/C Sr.WMO DCD Jumo Shahoke 56. Dr. Safdar Ali Rajpar I/C MO GD Sher M. Thora 57. Dr. Parveen Hafeez FMO MCH/BHU Udero lal Village 58. Dr. M. Ismail Laghari I/C SMO BHU Saeed Khan Laghari 59. Dr. Shuja Muhammad Shah I/C MO GD Shahmeer Ji Wasi & DCD Jumma

Shahook 60. Dr. Sana Hussain FMO BHU A.D Sand & BHU B.K Pathan 61. Dr. Amir Ali Sangrasi I/C MO BHU K.K Nizamani 62. Dr. Sajida Raza FMO BHU K.K.Nizamani & GD Old Saeedabad 63. Dr. Jameela Memon FMO BHU Yousuf Hajano & BHU Bhanothe 64. Dr. Saba Shahnawaz FMO MCH BHU Saeed Khan Laghari 65. Dr. Rumi Ejaz Memon FMO GD Shahmeer Ji Wasi & DCD Pali-Jani 66. Dr. Saran Shakeel FMO GD Punhal Khan Jamali & BHU Ilyas

Abrejo 67. Dr. Tahseen Adeel FMO BHU Mahar Shah & DCD Awal Chachar 68. Dr. Afshan Rafique FMO MCHC BHU Panj Moro 69. Dr. Faisal Shahzad I/C MO BHU Shahmeer Rahu 70. Dr. Ghulam Abbas I/C MO BHU Mahar Shah 71. Dr. Zainab Abro FMO GD Khanothe & GD Rano Bughio 72. Dr. Ghulam Fatima FMO BHU Seerachoo Kaka & BHU S.Rahu 73. Dr. Shazia Shaikh FMO DCD M.M.Khan & DCD Zair Pir 74. Dr. Tasleem Shahzadi FMO BHU N.B Jamali & BHU B.K Jamali 75. Dr. Khuda Dino Memon I/C MO GD Old Saeedabad 76. Dr. Shahid Memon I/C MO BHU Fakir Nooh Hothiani 77. Dr. M. Soomar Memon I/C MO BHU Nabi Bux Jamali 78. Dr. Safina Ahmed Sonologist Taluka Hala 79. Dr. Shakeel Ahmed I/C MO GD Soomar Chand 80. Dr. Shakeel MO BHU Hala Old 81. Dr. Shahzeb Ali Shah I/C MO BHU Panj Moro 82. Dr. Aijaz Ali Memon I/C MO DCD Pali Jani 83. Dr. Parvez Ahmed MO RHC Bhit Shah 84. Dr. Nizamuddin Abro SMO BHU Udero lal Village

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85. Dr. Abdul Sattar Dakhan I/C MO BHU Laloo Mangwano 86. Dr. Toufeeque Ahmed Memon I/C SMO MCHC BHU Sekhat 87. Dr. Abdul Fatah Abro I/C MO BHU Bau Khan Pathan 88. Dr. Fozia Zaheer FMO MCHC BHU Khando 89. Dr. Nadeem Shah I/C MO BHU Bhanothe 90. Dr. Shabana Shah FMO MCH/BHU Sekhat 91. Dr. Amina Bano Sonologist Taluka Matiari 92. Dr. Shazia Atta Sonologist Taluka New Saeedabad 93. Dr. Jamaluddin Ansari I/C MO BHU Yousuf Hajano & DCD Awal

Chachar 94. Dr. Naeem Ahmed Memon I/C MO BHU Khando 95. Dr. Ayaz Ahmed Abrejo I/C SMO BHU Ilyas Abrejo 96. Dr. Anwer Ali Soomro I/C SMO GD Rano Bughio 97. Dr. Muhammad Aizam MO BHU Hala Old 98. Dr. Sache Dino I/C MO DCD Zair Pir 99. Dr. Sahib Dino I/C MO DCD M.M Khan 100. Dr. Waseem Ahmed I/C MO BHU A.D Sand 101. Mr. Rabdino Abid Kazi SO-I/Assistant Taluka Hala 102. Mr. Liaqat Jamali SO-II Taluka Saeedabad 103. Mr. Imran Memon Assistant DSU PPHI Matiari 104. Mr. Abdul Ghaffar Assistant DSU PPHI Matiari 105. Mr. Waqas Anjum Assistant DSU PPHI Matiari 106. Mr. Kirshan Mal Store Manager DSU PPHI Matiari

The following could not attend the meeting for the reasons stated against each:-

C. HFs WITH PPHI BHUs: 13 Dispensaries: 16 MCHCs: 06 Others: 01(RHC)

TOTAL: 36 B. Population of the Catchments Area: 546512

G. STAFF STRENGTH

Sanctioned Posts

Working (govt./PPHI)

Government Employees

PPHI Contract

Vacant (Sanc-Govt)

MOs (Govt) 28 33 12 21 16

MOs (PPHI) 21 WMO/ 3 25 02 23 01 FMO 23 LHVs/MW/F. Nurse 65 47 23 24 18

MTs/MAs Male

22 16 16 0

06 Female - - -

Dispensers 22 22 1 21 0

H. CLUSTERS OF HFs WITH ONE MO

Previous Month Total Month under Review Total

Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs

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WITH ONE FMO

1. GESTATIONAL DIABETES MELLITUS 2. WHAT CAUSES GDM? 3. SCREENING & DIAGNOSIS 4. RISK ASSESSMENT 5. MONITORING 6. 1-MEDICAL NUTRITION THERAPY 7. COMPLICATIONS 8. BREAST FEEDING & DIABETES

• Note: 4 FMOs are engaged at RHC Bhitt Shah ( 2 in Morning and one in evening and night shift

each).

E. CAPACITY BUILDING 1. First Session: During MRM

Dr. Shahzeb Ali Shah, Incharge Medical Officer BHU/MCH Panj Moro, in his lecture on DIABETES IN PREGNANCY on following points: 9. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of

Participants The training of LHVs/ Dispensers is scheduled in next week.

F. REVIEW OF THE PERFORMANCE

(I) PREVENTIVE HEALTHCARE During Month under Review

1. Vaccination / Immunization

Clusters of 2 HFs 4 Clusters of 2 HFs 4 Single HFs 27 Single HFs 28

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 14 Clusters of 2 HFs 14 Single HFs 9 Single HFs 11

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No. of Doses of Immunization Administered to Children at Health Facilities. ( Children <12 Months Received 3rd Pentavallent Vaccine &Children <12 Months Received 1st Measles Vaccine & Children <12 Months Received Fully Immunization)

4396

No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 607 No. of Immunization & Vaccination Administered by out- reach EPI Teams - Total vaccination / immunization for the month August 2012 5003

2. National Immunization Days (NIDs) for Polio

Dates of NIDs Target of coverage Actual coverage Percentage of coverage

3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 131 2 Active Case Detection (ACD) Slides 3 Visits to Check Sanitation (individual households + streets) 4 Notices issued against Poor Sanitation 5 Challans sent to Court against Poor Sanitation 6 Patients Nebulizer 488

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health

S # Names of FMOs Ante-Natal Cases Neo-Natal Cases Other OPD Total OPD 1 Dr. Azeema Raza 370 1350 1720 2 Dr. Tasleem 88 1344 1432 3 Dr. Naheed & Dr.Ruqia 727 650 1377 4 Dr. Tahseen Adeel 141 1188 1329 5 Dr. Fozia Zaheer 41 1262 1303 6 Dr. Afshan Rafiq 111 1075 1186 7 Dr. Parveen Hafeez 99 1025 1124 8 Dr. Jameela Memon 111 939 1050 9 Dr. Sajida Raza 192 792 984 10 Dr. Sana Hussain 145 839 984 11 Dr. Salma Shah 90 893 983 12 Dr. Gh.Fatima 95 862 957 13 Dr. Roomi Aijaz 129 801 930 14 Dr. Saba Faiz 124 802 926 15 Dr. Shabana Memon 228 692 920 16 Dr. Saran Shakeel 16 815 831 17 Dr. Zainab Abro 95 584 679 18 Dr. Shazia Shaikh 80 596 676 19 Dr. Rukhsana Zahid 83 584 667 20 Dr. Sumera Naz 52 615 667 21 Dr. Saeeda Memon 84 474 558 22 Dr. Ghulam Sakeena 0 1380 1380 Total 3101 19562 22663

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• The above table shows the OPD of 23 FMOs .The serial # 03 shows the OPD of two FMOs .The remaining two FMOs are working in evening/night shift at RHC Bhitt shah. NO OPD

is conducted in these shifts. 2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 269 2 Deliveries Assisted at Homes 388

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 373 2 Blood Sugar Tests 73 3 Hemoglobin Tests 295 4 Ultra Sound Test 875 5 Other 890

5. Important Discussion on Mother and Child and Reproductive Health during MRM

The DSM appreciated the hard working of FMOs regarding increase of NVDs. The DSM directed FMOs to focus in Data entry specially mainlining of FMOs registers: Maternal Health Register, Family Planning register, PT register. The DSM also directed FMOs to maintain Ultrasound register in HFs. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number 1 Consultation / Advice 1322 2 Oral Pills 811 3 IUCDs 19 4 Injections 16 5 Others(RC) 688 Total 2856

(III) COMMUNITY PARTICIPATION

During Month under Review 1. Number of Male SGs: 36 Number of Female SGs: -------------- 2. Performance of Social Organizers

Names of Social Organizers

Meetings of Support Groups conducted by him CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of

Participants Abid Kazi 15 - 199 21 199 Liaqat Jamali 19 - 211 23 232 Total 36 - 410 44 431

3. School Health Sessions & Community Health Sessions

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Sr. No Name of MO / FMO Community Health Sessions School Health Session

No. Participants NO. Examined Treated 1 Dr. Saran Shakeel 2 45 0 0 0 2 Dr. Tahseen Adeel 2 99 0 0 0 3 Dr. Jamila Memon 2 56 0 0 0 4 Dr. Ghulam Fatima 2 39 0 0 0 5 Dr. Parveen Hafeez 1 41 0 0 0 6 Dr. Salma Shah 1 11 0 0 0 7 Dr. Zainab Abro 2 47 0 0 0 8 Dr. Sajida Raza 2 58 0 0 0 9 Dr. Azeema Raza 1 25 0 0 0 10 Dr. Roomi Aijaz 2 64 0 0 0 11 Dr. Saeeda Mansoor 2 26 0 0 0 12 Dr. Sumera Habib 2 53 0 0 0 13 Dr. Sana Hussain 2 28 0 0 0 14 Dr. Shabana Shah 1 0 0 0 0 15 Dr. Saba Shahnawaz 1 24 0 0 0 16 Dr. Rukhsana Zahid 2 35 0 0 0 17 Dr. Afshan Rafiq 1 50 0 0 0 18 Dr. Fozia Zaheer 1 55 0 0 0 19 Dr. Shazia Shaikh 2 76 0 0 0 20 Dr. Tasleem Shahzadi 2 0 0 0 0 21 Dr. Sachedino Memon 1 19 0 0 0 22 Dr. Muner Ahmed Jamali 2 31 0 0 0 23 Dr. Khuda Dino Memon 1 8 0 0 0 24 Dr. Shahzeb Shah 1 30 0 0 0 25 Dr. Amir Ali Sangrasi 1 16 0 0 0 26 Dr. Ghulam Abbas 1 6 0 0 0 27 Dr. Jamal uddin Ansari 1 28 0 0 0 28 Dr. Faisal Shahzad 1 20 0 0 0 29 Dr. M. Soomar Memon 1 22 0 0 0 30 Dr. Adeel Shahzad 2 12 0 0 0 31 Dr. Anwer Ali Soomro 1 22 0 0 0 32 Dr. Waseem Ahmed 1 23 0 0 0 33 Dr. Shahid Ahmed 1 0 0 0 0 34 Dr. Shakeel Ahmed M 1 22 0 0 0 35 Dr. Abdul Sattar 1 17 0 0 0 36 Dr. Aijaz Ali Memon 1 13 0 0 0 37 Dr. Sahib Dino Memon 1 24 0 0 0 38 Dr. Naeem Ahmed 1 24 0 0 0 39 Dr. M. Ismail Laghari 2 88 0 0 0 40 Dr. Safdar Ali 1 30 0 0 0 41 Dr. Abdul Fatah 1 11 0 0 0 42 Dr. Shuja M. Shah 1 35 0 0 0 43 Dr. Toufeeq Ahmed 1 32 0 0 0 44 Dr. Nizam Abro 1 11 0 0 0

Total 60 1376 0 0 0 4. Important Points during Support Group Meetings. • Disseminating the message of health facilities available at the centers (HFs)

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• Support Groups were made responsible for conduction of School Health Sessions and Community Health session. • Health Facility performances discussed with Support Group. • Sinologist visits have been increased at DCD Pali-Jani on community Support Group request. • Support Group at BHU Nabi Bux Jamali taken the responsibility voluntarily for taking steps for making proper

arrangements of drainage water. • Support Groups were made responsible at BHU Sekhat for plantation. 5. Important Points during SHSs : Due to vacation for summer, the schools were closed. 6. Important Points during CHSs Participators are guided that support EPI team for increasing vaccination in their community. The doctors shared the benefits of timely vaccinations. The DSM and Exe (M&E) participated in CHSs and they discussed the importance of CHSs for developing diseas free socity. They guided community that prevention is better than cure. The Doctors discussed prevention about Skin infections and Malaria. 7. Topics for SHSs for the Month

Sr. No. Topics 1 2 3 4

8 Topics for CHSs for the Month

S # Topics 1 Malaria. 2 Skin infections 3 Personal Health and Hygiene. 4 Benefits of Vaccinations

9. Important Discussion on Community Participation during MRM The schedule of the CSG meetings was shared and finalized with MOs consultation. DSM directed Inc/MOs to make CSG 100% functional, new members may be added. The DSM also guided Inc/MOs that all CHS and SHS held with support of CSG. 10. Health Camps: Number Held: 00 . Number of Patients: 00 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation - - - Ii Drainage / sewerage - - - Iii ……… drinking water - - - Iv Prevention of adulteration - - - V Tree Plantation - - - Vi Roads and infrastructure - - - Vii Environmental Improvement - - - Viii Others - - -

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*

New patients treated during Old patients treated during Total OPD during the month

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the month the month (New + Old) 62,669 4,617 67,286

2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD 1 RHC Bhit Shah 9502 BHU Mahar Shah 915 2 BHU Hala Old 4530 GD Shahmeer JI Wasi 1064 3 BHU Panj Moro 2820 GD Punhal Khan Jamali 1079 4 BHU Sekhat 2718 BHU Yousuf Hajano 1104 5 BHU Udero lal Village 2386 BHU Laloo Mangwano 1111 6 BHU Khando 2293 GD Rano Bughio 1145 7 BHU Saeed Khan Laghari 2202 DC Dispensary Jumo Shahoke 1162 8 DC Dispensary Pali Jani 2201 DC Dispensary Mari Muhammad Khan 1185 9 GD Old Saeedabad 2117 BHU Fakir Nooh Hothiani 1219 10 BHU Shahmeer Rahu 2104 GD Soomar Chand 1257 11 DC Dispensary Awal Chachar 2082 BHU Allah Dino Sand 1265 12 GD Sher Muhammad Thora 2058 BHU Ilyas Abrejo 1411 13 BHU Bhanothe 1902 BHU Bau Khan Pathan 1454 14 DC Dispensary Dhaloo Khaskheli 1746 BHU Tahir Hingoro 1466 15 BHU Karam Khan Nizamani 1710 GD Khanothe 1573 16 BHU Nabi Bux Jamali 1650 BHU Seerachoo Kaka 1592 17 DC Dispensary Zair Pir 1647 BHU Bagho Khan Jamali 1616

3. Top Five Diseases Treated during School Health Sessions/Camps 4. Top Five Diseases during OPD

S # Disease No. of Patients 1 ARI 6327 2 Diarrhea 2102 3 Fever(clinical Malaria) 3548 4 Scabies 2508 5 Asthma 1150

6. ARV / ASV used during the month

No. of Patients Dog bite cases reported 83 ARV Administered 83 ARV Available Doses 987 Snake bite cases reported 00 ASV Vaccine Administered 00 ASV Vaccine Available Doses 05

11. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Diseases No. of Patients 1 2

3 4

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S # Tests Number 1 Pregnancy Tests 632 2 Blood Sugar Tests 397 3 Hemoglobin 694 4 X-Rays (if available) 175 5 Ultra Sound 2008 6 Others (please specify) 1800

12. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date

Follow up result

Hepatitis B 235 22 22 22 Hepatitis C 235 28 28 28

13. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

196 13 101 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 8 3 5 3 3 4

10. Inverse Referrals

S.No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs 2 33 12 0 21 5 28 3 4

G. MONITORING DURING MONTH UNDER REVIEW

4. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total

52 65 110 227 2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks BHU Faqeer Nooh

Hothiani, BHU AD Sand, BHU Khan Pathan

Late arrival of Staff Written explanations have been asked from late staff.

Replies Received.

BHU Khando,GD Soomar Chand

Assists record not updated , medicine

Written explanations have been asked from concern staff.

Replies Received

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record not updated and FMO record did not reconcile with Registers

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for Weeks: 37 weeks

5. Important Issues raised relating to Medicines, etc. during MRM DSM directed MOs and FMOs to avoid multiple and heavy medicines doses. Medicines may be prescribed only need basis. Multidrugtherapy may be avoided

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification

Status / Remarks

1 BHU Laloo Mangwano R&R Work Completed 2 BHU Tahir Hingoro - Completed 3 BHU Udero Lal Village - Completed 4 BHU Khando - Completed 5 BHU Bhanothe - Completed 6 BHU Saeed Khan Laghari - Completed 7 GD Old Saeedabad - Completed 8 GD Sher Muhammad Thora - Completed 9 GD Punhal Khan Jamali - Completed 10 GD Rano Bughio -- Completed 11 GD Soomar Chand -- Completed 12 GD Shahmeer Ji Wasi -- Completed 13 DC Dispensary Jumo Shahoke - Completed 14 DC Dispensary Dhaloo Khaskheli - Completed 15 DC Dispensary Mari Muhammad Khan - Completed 16 BHU Hala Old - Completed 17 BHU Ilyas Abrejo - Completed 18 BHU Mahar Shah - Completed 19 BHU Yousuf Hajano - Completed 20 DC Dispensary Zair Pir - Completed 21 BHU Seerachoo Kaka - Completed 22 BHU Nabi Bux Jamali - Completed 23 BHU Bau Khan Pathan - Completed 24 BHU Karam Khan Nizamani - Completed 25 BHU Panj Moro - Completed 26 BHU Shahmeer Rahu - Completed 27 BHU Bagho Khan Jamali - Completed

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

Nil * To reflect only non-PPHI Visitors.

J- DISCUSSION DURING MRM

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DSM made presentation on Monthly Progress of health facilities and female Medical Officers. He also directed MOs and FMOs to focus in TB patients referred to Taluka Hospitals. He also directed MOs and FMOs to focus in follow up cases. He guided In/MOs about proper filling of DHIs report. Date /Time for Next MRM: 10th of October 2012 at 10:00am Concluding Remarks by Executive Officer (Monitoring and Evaluation) The Executive (M&E) concluded the MRM by sharing last Month observations and Performance of last Month. He shared his expectations as mentioned under:

1. Data Management. 2. Punctuality. 3. CSG Should be 100% functional.

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MINUTES OF THE (50th ) MONTHLY REVIEW MEETING OF DISTRICT TANDO ALLAHYAR

Monthly Review Meeting (MRM) of District, Tando Allahyar for the Month of August , 2012 was held on 14-09-2012 . The following officials participated in the meeting:

Sr # Name Designation 1. Mr. Imran Aziz Siddiqui DSM, Tando Allahyar 2. Mr. Muhammad Asif Executive M&E 3. Dr. Amber Abbas U/S 4. Dr. Amna Sami Shaikh U/S 5. Dr. Noor Jahan FMO 6. Dr. Tooba Abro FMO 7. Dr. Indra FMO 8. Dr. Benish Imran FMO 9. Dr. Quratul Ain FMO

10. Dr. Sumaira Qaimkhani FMO 11. Dr. Samreen FMO 12. Dr. Nazia Jabeen FMO 13. Dr. Samina Naz FMO 14. Dr. Sunita Kumari FMO 15. Dr. Fakhra Qureshi FMO 16. Dr. Shabana Qureshi FMO 17. Dr. Farhana Tahir FMO 18. Dr. Najma FMO 19. Dr. Ambreen memon FMO 20. Dr. Afshan Bhatti FMO 21. Dr. Waseem Ahmed Medical officer 22. Dr. Zahid Hussain Medical officer 23. Dr. Gulzaib Ahmed Medical officer 24. Dr. Hakim Mal Medical officer 25. Dr. Danish Hussain Medical officer 26. Dr. Imam Bux Medical officer 27. Dr. Rehan Yusfani Medical officer 28. Dr. Abdul Razzak Medical officer 29. Dr. Ghulam Rasool Medical officer 30. Dr. Faisal Iqbal Medical officer 31. Dr. Abdul Manan Medical officer 32. Dr. Abdul Hussain Medical officer 33. Dr. Irfan Shah Medical officer 34. Dr. Ariful Hassan Medical officer 35. Dr. Saqib Siddique Medical officer 36. Dr. Hamid Ghousi Medical officer 37. Dr. Allah Warayo Medical officer 38. Dr. Ashok Kumar Medical officer 39. Dr. Rana Muhammad Akhtar Medical officer 40. Dr. Atif Miandad Medical officer 41. Dr. Mazhar Hussain Medical officer

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42. Dr. Naveed Memon Medical officer 43. Dr. Muhammad Amir Qazi Medical officer 44. Dr. Shakeel Ahmed Medical officer 45. Dr. Ali Khan Medical officer 46. Dr. Dharamver Medical officer 47. Dr. Noor Ahmed Pahore Medical officer 48. Dr. Dildar Hussain Mughal Medical officer 49. Dr. Muhammad Ilyas Baig Medical officer 50. Dr. Adil Shamshad Medical officer 51. Dr. Waqar Ahmed Medical officer 52. Dr. Ranu Mal Medical officer 53 Dr. Chatesh Kumar Medical officer 54 Dr. Zubairuddin MO HQ 55 Dr. Ahmed Ali SMO 56 Dr. Lajpat Rai MO

The following could not attend the meeting for the reasons stated against each:-

S # Names/Designation Reasons S # Names/Designation Reasons 1 Dr. Shazia Maternity Leave 2 Dr. Amir Nahyoon On Casual Leave 3 Dr. Aftab Hyder Absent 4

D. HFs WITH PPHI

BHUs: 13 Dispensaries: 32 MCHCs: _______ Others:______

TOTAL: 45 B. Population of the Catchments Area: 375409

I. STAFF STRENGTH

Sr Name of Post HR POSITION

Sanctioned Posts (Govt.) PPHI Govt Total 1 Medical officers 15 36 2 38 2 Female Medical officers - 17 - 17 3 Ultrasound Specialist - 2 - 2 4 Dispensers 21 27 4 31

5 Health Technicians (Male/Female) 26 11 13 24

6 Lady Health Visitors 12 5 7 12

J. CLUSTERS OF HFs WITH ONE MO

Previous Month Total Month under Review Total

Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs 8

Single HFs Single HFs 29

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WITH ONE FMO

CAPACITY BUILDING

1 First Session: During MRM :

(a) Resource person: Dr. Samaria Kaimkhani Topic: Ante Natal Care

Capacity Building of LHVs / Dispensers/other staff members/LHWs During Month under Review

Previous Month Total Month under Review Total

Clusters of more than 5 HFs 2 (U/S) Clusters of 5 HFs 2 (U/S) Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs 14 Single HFs Single HFs 3

Names of the Resource Persons with dates Date Venue Topic No. of

Participants

Dr. Irfan Shah 03-08-2012 BHU Shadyoon ARI 13

Dr.Rana Akhtar 03-09-2012 BHU Allah Rakio Pattan Malaria 07

Dr. Dildar Hussain 01-08-2012 BHU Naseer Khan Leghari T.B 20

Dr. Ahmed Ali Panhwar 01-08-2012 BHU Shahnawaz Muhajir EPI 15

Dr. Lajpat Rai 24-082012 BHU Sultanabad Stand To improve MNCH work 09

Dr. Abdul Razaq Abro 01-08-2012 BHU Dhingano Bozdar Tubarculousis 20

Dr. Rehan Yusfani 02-08-2012 BHU Ditto Kalro Malaria 7

Dr.Arif Hassan Dahri 11-08-2012 GD Darya khan Hingoro Malaria 4

Dr. Faisal Memon 30-08-2012 BHU Tando Soomro Routine Immunization 32-

Dr. Imam bux Unnar

30-08-2012 BHU Kauro Daidano

Heat Stroke 7

17-08-2012 Hepititis E 7

Dr. Naveed Ahmed Memon 25-08-2012 GD Golo halepoto Malaria 5

Dr. Aadil Shamshad 02-08-2012 BHU Sanjar Chang H.E regarding Diarrhea 12

Dr.Ali Khan 01-08-2012 BHU Jhando Mari Assessment of Dehydrations 21

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F. REVIEW OF THE PERFORMANCE

(I) PREVENTIVE HEALTHCARE During Month under Review

1. Vaccination / Immunization

No. of Doses of Immunization Administered to Children at Health Facilities. 2804

Dr. Waseem Ahmed

25-08-2012 GD Hakra Mori Heat Stroke 3

24-08-2012 GD Mail Mori Heat Stroke 5

Dr. Hakeem Mal 17-08-2012 BHU Sultanabad Village Vaccination 16

Dr. Gulzaib Ahmed 07-08-2012 GD Pak Singhar

Dysentry 5

Dr. Abdul Manan Abro 01-08-2012 BHU Bukera Sharif Polio 8

Dr. Farhana Tahir 04-08-2012 BHU sultanabad Village ANC 04

27-08-2012 BHU Sultanabad Stand Environmental Pollution 04

Dr. Nazia Jabeen 31-08-2012 BHU Tando Soomro Immunization 30

Dr. Samreen 03-08-2012 BHU Shahnawaz Importance of ANC 16

Dr. Beenish Imran 17-08-2012 GD Hakra Mori

Epigastric Pain 05

18-08-2012 GD Golo halepoto Vaccination 05

Dr. INDRA

27-08-2012

BHU Ditu kalro HTN 07

30-08-2012 GD Pak Singhar Scabies 04

Dr. Shabana Qureshi 30-08-2012 BHU Shadyoon Diarrhea 06

Dr. Noor Jahan 01-08-2012 BHU Jhando Mari Immunization 20

Dr.Quratul-ain Memon 17-08-2012 GD Darya khan Hingoro SCABIES 04

Dr. Sumaira 30-08-2012 BHU Allah Rakhio Pathan

ANC 09

Dr.Fakhra Qureshi 17-08-2012 GD Saeed Khan RTA 04

29-08-2012 GD Masoo Bozdar T.B 03

Dr.Najma 24-08-2012 BHU Naseer Khan Legh Dengue fever 10

02-08-2012 BHU Sanjar Chang T.B 12

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No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 551 No. of Immunization & Vaccination Administered by out- reach EPI Teams -

2. National Immunization Days (NIDs) for Measles

Dates of NIDs Target of coverage Actual coverage Percentage of coverage

- - - - 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides - 2 Active Case Detection (ACD) Slides 323 3 Visits to Check Sanitation (individual households + streets) - 4 Notices issued against Poor Sanitation - 5 Challans sent to Court against Poor Sanitation - 6 Patients Nebulized 374

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review • Female Health

2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 24 2 Deliveries Assisted at Homes -

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 213 2 Blood Sugar Tests 27

S # Names of FMOs Anti Natal-I

Anti Natal Re-visit Natal Post Natal-I Post Natal

Re-visit other OPD

Total OPD

1 Dr. Noor Jahan 81 23 6 8 0 352 470 2 Dr. Tooba Abro 41 78 0 11 6 563 699 3 Dr. Indra 67 21 3 6 0 411 508 4 Dr. Benish Imran 46 31 0 9 1 578 665 5 Dr. Quratul Ain 34 11 0 2 0 966 1013 6 Dr. Sumaira 45 72 1 4 1 529 652 7 Dr. Samreen 67 33 2 7 3 918 1030 8 Dr. Shazia Parveen 0 0 0 0 0 0 0 9 Dr. Nazia Jabeen 57 51 0 16 5 736 865 10 Dr. Samina (on leave) 0 0 0 0 0 0 0 11 Dr. Sunita Kumari 36 9 0 10 0 795 850 12 Dr. Fakhra Qureshi 26 13 0 0 0 370 409 13 Dr. Shabana 2 16 0 2 0 326 346 14 Dr. Farhana Tahir 81 67 0 4 1 756 909 15 Dr. Najma 84 81 2 18 5 1552 1742 16 Dr. Ambreen 69 14 10 4 0 534 631 17 Dr. Afshan Bhatti 21 13 0 8 1 360 403 TOTAL 757 533 24 109 23 9746 11192

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3 Hemoglobin Tests 118 4 Ultra Sound Test 944 5 Other Nill

7. Important Discussion on Mother and Child and Reproductive Health during MRM

DSM directed the FMOs to ensure immunization of children, pregnant women and child bearing age women and also ensure that they should bring immunization and Ante-Natal card each time they visit HFs. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number 1 Consultation / Advice 618 2 Oral Pills 215 3 IUCDs 11 4 Injections 200 5 Others 321

Total 774

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male Support Group 40: Number of Female 17 SGs: (57 Total ) 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups

conducted by him CHSs/SHSs arranged by him

Male Female No. of Participants No. No. of

Participants Dr. Muhammad Azam 15 175 21 302 Mr. Riaz Hussain 13 145 18 258 Mr. Gandhi 16 184 23 337

Total 44 504 62 897 3. School Health Sessions & Community Health Sessions Sr Names of MO / FMOs/Paramedics Community Health Sessions School Health Sessions

Sessions

Participants

Sessions Children Examined

Children Treated

1 Dr. Noor Jahan 4 65 0 0 0 2 Dr. Tooba Abro 2 41 0 0 0 3 Dr. Indra 2 50 0 0 0 4 Dr. Benish Imran 2 50 1 30 22 5 Dr. Quratul Ain 4 65 0 0 0 6 Dr. Sumaira 2 49 0 0 0 7 Dr. Samreen 2 35 0 0 0 8 Dr. Shazia Parveen(OnLeave) 0 0 0 0 0 9 Dr. Nazia Jabeen 2 33 0 0 0 10 Dr. Samina Naz (ON LEAVE) 0 0 0 0 0 11 Dr. Sunita Kumari 2 19 0 0 0 12 Dr. Fakhra Qureshi 2 32 0 0 0 13 Dr. Shabana qureshi 2 22 0 0 0 14 Dr. Farhana Tahir 2 21 0 0 0

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15 Dr. Najma 2 40 0 0 0 16 Dr. Ambreen 1 25 0 0 0 17 Dr. Afshan Bhatti 2 16 0 0 0 Total 33 563 1 30 22 1 Dr. Waseem Ahmed 2 23 0 0 0 2 Dr. Zahid Hussain 1 9 0 0 0 3 Dr. Gulzaib Ahmed 2 28 0 0 0 4 Dr. Hakim Mal 1 25 0 0 0 5 Dr. Amir Nahyoon 1 10 0 0 0 6 Dr. Danish Hussain 1 11 0 0 0 7 Dr. Imam Bux 2 19 0 0 0 8 Dr. Rehan Yusfani 1 10 1 0 0 9 Dr. Abdul Razzak 1 16 0 0 0

10 Dr. Ghulam Rasool 2 26 0 0 0 11 Dr. Faisal Iqbal 1 15 0 0 0 12 Dr. Abdul Manan 2 25 0 0 0 13 Dr. Abdul Hussain 4 80 0 0 0 14 Dr. Irfan Shah 2 28 0 0 0 15 Dr. Ariful Hassan 4 32 0 0 0 16 Dr. Saqib Siddique 1 10 0 0 0 17 Dr. Allah Warayo 1 20 0 0 0 18 Dr. Hamid Ghousi 1 10 0 0 0 19 Dr. Ashok Kumar 2 27 0 0 0 20 Dr. Shakeel Ahmed 1 17 0 0 0 21 Dr. Rana M Akhtar 1 11 0 0 0 22 DR Muhammad Ilyas 0 0 1 15 1 23 Dr. Atif Miandad 3 39 0 0 0 24 Dr. Naveed Memon 1 13 0 0 0 25 Dr. Aftab Hyder 1 10 0 0 0 26 Dr. Dharamver 2 32 0 0 0 27 Dr. M Amir Qazi 1 10 0 0 0 28 Dr. Mazhar Hussain 1 18 0 0 0 29 Dr. Dildar 1 15 0 0 0 30 Dr. Ali Khan 1 22 0 0 0 31 Dr. Noor Ahmed 2 31 0 0 0 32 Dr. Adil Shamshad 1 12 0 0 0 33 Dr. Waqar Ahmed 2 13 0 0 0 34 Dr. Ahmed Ali 2 53 0 0 0 35 Dr. Laj Pat 0 0 0 0 0 36 Dr.Chatesh Kumar 0 0 0 0 0 37 Dr.Ranu Mal 0 0 0 0 0

TOTAL 52 720 2 15 1 4. Important Points during Support Group Meetings. a. Functioning of X-ray facility at GD Ghani Khan Kaimkhani. b. Electrification issues in newly handed over HFs. c. Urgent necessity of FMO at GDs Sachedino Panhwar, Taj Mori, Mevo Kurkli, Wali Muhammad Dars demanded by the CSG members. 8. Important Points during SHSs 6. Important Points during CHSs Importance of routine vaccination & polio companies Awareness for Family Planning & its importance & benefits Personal Hygiene & prevention from skin infection Awareness & importance of A.N.C & breast feeding Benefits of hygiene Diet in prevention of diseases. Dietary advice during pregnancy

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. Role & importance of T.T vaccination. Oral hygiene & Diarrhea & its Prevention Awareness about how to prevent Gastroenteritis, Viral hepatitis & Skin infection. TB & role of our community in DOTS treatment. Topics for SHSs for the Month AUG

Sr. No. Topics

1 BY M.O I/C Mal Nutrition, Personal Hygiene

2 BY F.M.O Diarrhea

8 Topics for CHSs for the Month AUG

S # Topics 1 BY M.Os I/C:

UTI, Skin infection, Viral hepatitis, DM ,measles , Personal hygiene & health, A.R.I, scabies, polio campaign, Diarrhea & abdominal pain, malaria, routine vaccination, Gastro enteritis, A.R.I, scabies, Polio, malaria, Pneumonia, hygiene Diet

2 BY F.M.Os: T.T vaccination, ,measles, Antenatal care, Family Planning, Diarrhea, HTN, Gastroenteritis, Breast feeding, Skin infection, Health &, Personal hygiene, scabies, Immunization, malaria, anemia in pregnancy.

9. Important Discussion on Community Participation during MRM DSM, DHO and officials raised their concern about polio refusals cases in the District and emphasized the need of community sensitization through CHS, SHS, & CSG meetings. It was also decided that all PPHI HFs will serve as a Fix point during upcoming polio campaign and they will submit their daily reports to nearby BHU in the same UC or DSU Tando Allahyar on the same day. 10. Health Camps: Number Held: Number of Patients: ----------- 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation Ii Drainage / sewerage Iii ……… drinking water Iv Prevention of adulteration V Tree Plantation Vi Roads and infrastructure Vii Environmental

Improvement

viii Others

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW 1. OPD*

New patients treated during the month

Follow up patients treated during the month

Total OPD during the month (New + Follow up)

55179 3366 58545 2. Maximum OPD** Minimum OPD**

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S # BHU OPD BHU OPD 1 Shah Nawaz Muhajir 2590 Kauro Daidano 949

3. Top Five Diseases Treated during School Health Sessions/Camps *All HFs — BHUs and others. 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 Respiratory Disease 7420 2 Gastro Intestinal Disease 7777 3 Dermatological Problems 5679 4 Fever due to other cause 3683 5 Suspected Malaria 2540

9. ARV / ASV used during the month

No. of Patients Dog bite cases reported 170 ARV Administered 150(Vials) ARV Available Doses 858 Snake bite cases reported - ASV Vaccine Administered - ASV Vaccine Available Doses -

14. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Pregnancy Tests 242 2 Blood Sugar Tests 193 3 Hemoglobin 128 4 X-Rays (if available) 0 5 Ultra Sound 944 6 Others (please specify) 435

15. Hepatitis B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

91 132 18 18 - - 16. TUBERCLOSIS

S # Diseases No. of Patients 1 RTI School vacation 2 GIT 3 Dermatological problems 4 Diherraa /Dyse 5 Malaria

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Patients Receiving Treatment

New Cases During the Month Under Diagnosis

38 0 - 9. Referrals

S.No Total Cases Referred To TB DOT Deliveries Others RHCs THQs DHQs

1 217 36 - -

10. Inverse Referrals

S.No Totals Cases Referred from ARV ASV Others RHCs THQs DHQs

1 170 170 - 0 9 0 45

G. MONITORING DURING MONTH UNDER REVIEW

6. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total 45 59 121 225

I. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks

1 GD Usaman Shah Hurri BUILDING INCOMPLETE

MEETING WITH BUILDINGS DEPTT

DO BUILDINGS

VISITED

2 GD MAIL MORI ELECTRIC CITY NOT AVAILABLE

MEETING WITH BUILDINGS DEPTT

DO BUILDINGS

VISITED

3 BHU SANJAR CHANG NEED OF R&R REQUEST RE FOR ESTIMATE RE VISITED

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for ( 28 ) Weeks

II. Important Issues raised relating to Medicines, etc. during MRM • Issues regarding Newly taken over GDs:-

Sr# Name HF ISSUES

1 GD Mehro Khan Lashari Electricity , Fans, meter, drainage system

2 GD Hakra Mori meter, drainage system

3 GD Pak Singhar Electricity , Fans, meter, grill, drainage system, motor

4 GD Mithoo Khaskheli Electricity , Fans, meter, grill, drainage system, motor

5 GD Ghani Khan Kaim Khani Three phase meter connection required, grill, motor

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6 GD Dodo Rind Masonry & plumbing work, motor

7 GD Sobho Rind Electricity , plumbing work, motor

8 GD Ghulam Hussain Lund Electricity , meter, grill, carpenter work, drainage system, motor

9 GD Saleh Arisar Electricity , drainage system, plumbing work, motor

10 GD Sachedino Panhwar Electricity , motor

11 GD Muhammad Hassan Dal drainage system

12 GD Saeed Khan Leghari Electricity , meter, drainage system, motor

13 GD Mashaikh Hoti Carpenter work, meter, grill, drainage system

14 GD Mail Mori Electricity , meter, drainage system, plumbing work

III. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS IV.

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

1 BHU-Allah Rakhio Pathan 100% Completed M.B recorded & Sent to P.S.U. 2 BHU Ditto Kalroo 100% Completed M.B recorded & Sent to P.S.U. 3 GD M Sadiq Memon 100% Completed M.B recorded & Sent to P.S.U. 4 BHU-Jhando Mari 100% Completed M.B recorded & Sent to P.S.U. 5 BHU-Shadyoon 100% Completed M.B recorded & Sent to P.S.U. 6 BHU-Sultanabad stand 100% Completed M.B recorded & Sent to P.S.U. 7 BHU-Sultanabad Village 100% Completed M.B recorded & Sent to P.S.U. 8 GD-Dassori 100% Completed M.B recorded & Sent to P.S.U. 9 B.H.U Bukera Sharif 100% Completed M.B recorded & Sent to P.S.U. 10 B.H.U Kauro Daidaanoo 100% Completed M.B recorded & Sent to P.S.U. 11 B.H.U Tando Soomro 100% Completed M.B recorded & Sent to P.S.U. 12 B.H.U Shahnwaz Muhajir 100% Completed M.B recorded & Sent to P.S.U. 13 BHU-Naseer Khan Leghari 100% Completed M.B recorded & Sent to P.S.U. 14 BHU-Sanjar chang 100% Completed M.B recorded & Sent to P.S.U. 15 GD-Ghulam Khan Sanjrani 100% Completed M.B recorded & Sent to P.S.U. 16 BHU-Dhingano Bozdar 100% Completed M.B recorded & Sent to P.S.U. 17 GD-Ghulam Hussain Khokhar 100% Completed M.B recorded & Sent to P.S.U.

18 Quarter of BHU Shahnawaz Muhajir 100% completed MB needs to be recorded

19 Quarter of BHU Jhando Mari 100% completed MB needs to be recorded 20 Quarter of BHU Bukera 100% completed MB needs to be recorded 21 GD Lal Faqir Behrani 100% completed MB needs to be recorded 22 GD Golo Halepoto 100% completed MB needs to be recorded

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

* To reflect only non-PPHI Visitors.

Health Indicators and performance/target at DSU-PPHI-TAY on quality basis Total Catchment Population of District Tando Allahyar 375409

S.# Description Number Remarks Monthly Achievement %age Targets

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Targets Achieved for Next Month

1 Total Catchment Population 375,409 The popn of villages seeking Facility from

Center

2 Female Catchment Population 180,196 48% of Catchment Population

3 Facility Utilization by all (Total OPD) 750,818 2 visist per person per year 62,568 58,545 94% 62,568

4 Facility Utilization by Female (Total Female OPD) 360,392 2 visist per female per year 30,033 29,914 99% 30,033

5 Pregnant Women 12,764 3.4% of Catchment Population 1,064 1,064

A A.N Check ups (at least 1) 12,764 Equal to # of pregnant women 1,064 757 71% 1,064

B A.N Check ups (at least 2) 25,528 Twice # of pregnant women 2,128 1,290 61% 2,128

6 Deliveries 11,638 3.1% of Catchment Population 45 24 53% 45

7 P.N check ups 11,638 Equal to # of Deliveries 200 132 66% 200 8 F.P clients 60,066 16% of total population 1,000 426 43% 1,000 9 Fully Immunized Children 18770 5% of total population 750 792 106% 750

DISCUSSION DURING MRM

Date /Time for Next MRM: To be decided later

Comments on Targets Achievements (by DSM) Target population and actual coverage in NIDs, SNIDs must be submitted with monthly DHIS report. During NID days all UC focal person / I/C MOs will monitor the field teams and fix points and

report to DSM/DHO/DC on daily basis. Every MO must conduct five minutes meeting with vaccinators at the start of the day and ask him about

performance, progress and targets for the day. MO’s & FMO’s have to be actively involved in NID’s, SNIDs and during NIDs they are bound to ask

every mother and her children for Immunization and prepare a list of children not vaccinated on daily basis and report to DSM /DHO office.

Every MO/FMO shall conduct at least 4 Health sessions/ Capacity Building sessions. Daily expense register should be maintain properly by the Dispenser of the concerned facility and duly verified

by the MO I/C. Every M.O I/C should take initiative to improve their Hf’s Decorum and Medical instruments

functionalization which was pointed out By M& E section during Monitoring visits. Decision taken in the meeting by DSM

• In the CBS/ CHS/SHS conducted by the MOs and FMOs, the topics for this month are as follows 1. Gastro entrities 2. Dengue fever 3. Ante Natal Care 4. Family Planning 5. Proper record keeping of DHIS tools.

• Laboritory and Ambulance Bank a/c are open and will be functional as per policy. • Every MO i/c of HF where EPI centre is functional will bound to their Vaccinator for sending a copy

of their Monthly EPI report to DSU with the stamp and signature of MO i/c. • RPD’s directions in previous MRM regarding eDEWS/ DHIS reconciliation has been done, errors in

reporting of weekly eDews and monthly DHIS has been discussed in meeting in order to improve reporting mechanism and data accuracy.

• Weekly eDews report will send to Exec: M& E/ MO (H.Q) timely.

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• DHIS report submit to DSU every 3rd of month, and must fill the monthly targets and performance of HF s along properly filled sections of DHIS form specially immunization/ family planning services and Maternal and new born health.

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MINUTES OF THE (46th) MONTHLY REVIEW MEETING

OF DISTRICT TANDO MUHAMMAD KHAN Monthly Review Meeting (M.R.M) of District, Tando Muhammad Khan for the Month of August, 2012 was held on 11-09-2012 at meeting Hall of District Government Complex. Written invitations to participate were sent to the Deputy Commissioner, the DHO, the Additional Deputy Commisionar-1, Focal Persons, EPI, TB DOTS, National Program, Malaria Control, Hepatitis, HMIS & DEWS, District Population Welfare Officer, representatives WHO, all I/c Medical Officers/ FMOs etc. List of Participants:

S # Names Designation S # Names Designation 1 Abdul Shakoor Shaikh R.P.D (RSU-I) 41 Dr. Irshad Fareed Siyal FMO-PPHI 2 M. Naeem Khanzada DSM T.M.Khan 42 Dr. Naima Memon FMO-PPHI 3 Dr. M. Ismail Soomro F/P (HMIS) 43 Dr. Sofia Balouch FMO-PPHI 4 Dr. Imtiaz Khowaja MNCH-PPHI 42 Dr. Shazia Qayoom FMO-PPHI 5 Dr. Mir Hassan Turk MO-DG 43 Dr. Sadaf Faraz FMO-PPHI 6 Dr. M. Hussain Notkani MO- DG 44 Dr. Zaid Jamali FMO- PPHI 7 Dr. Makhdom Ali Nawaz MO- DG 45 Dr. Hifza Kinat Shah FMO- PPHI 8 Dr. Shamshad Memon MO-DG 46 Dr. Farzana Malik FMO- PPHI 9 Dr. A.Kareem Leghari MO- DG 47 Joshphine LHV 10 Dr. Dhaloo Mal MO- DG 48 Salma LHV 11 Dr. Mumtaz Bhatti MO- DG 49 Erum Zaffar LHV 12 Dr. Abdul Malik Shaikh MO-PPHI 50 Afshan Rind LHV 13 Dr. Shahbaz Mughal MO-PPHI 51 Sofia LHV 14 Dr. Saddique Khowaja MO-DG 52 Sharjeel Siddique Ex (M&E) 15 Dr. Aamir Khushk MO-PPHI 53 Haji Noor Muhammad S.O 16 Dr. Intekhab Alam MO-PPHI 54 Muhammad Azeem S.O 17 Dr Nizam Soomro MO-PPHI 55 Naveed Khaskheli S.O 18 Dr. Raja M. Ishaque MO-PPHI 56 19 Dr. Ghulam Sarwar MO-PPHI 57 20 Dr. Kashif Faraz Hingoro MO-PPHI 58 21 Dr. Ali Anwar MO-PPHI 59 22 Dr. Sabir Kolachi MO-PPHI 60 23 Dr. Sajan Sawai MO-PPHI 61 24 Dr. Ayoub Memon MO-PPHI 62 25 Dr. Mushtaque Bhurgri MO-PPHI 63 26 Dr. Abdul Rahim Bhurgri MO-PPHI 64 27 Dr. Chatro Mal MO-PPHI 65 28 Dr. Aslam Chana MO-PPHI 66 29 Dr.Ali Raza Jarwar MO-PPHI 67 30 Dr. Muhammad Khalid MO-PPHI 68 31 Dr. Mumtaz Talpur MO-PPHI 69 32 Dr. Ali Raza Shah MO-PPHI 70 33 Dr Ali Raza Jarwar MO-PPHI 71 34 Dr. Ali Muhammad Qurehi MO-PPHI 72 35 Dr. Waheed Abbass MO-PPHI 73 36 74 37 Dr. Rubeena Abbassi FMO-PPHI 75 38 Dr. Shazia Sattar FMO- PPHI 76

The following could not attend the meeting for the reasons stated against each:-

S # Names Reasons for absence 1 Dr. Manoj Kumar On leave 2 Dr. Shazia Dal On Leave 3 Dr. Laila Khowaja On Leave

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E. Fs WITH PPHI RHC: 01 BHUs: 13 Dispensaries: 20 Others: 01

TOTAL: 35 Population of the Catchments Area: 639000

K. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MOs 42 37 11 26 31 WMO 01 01 0 FMOs include sinologist 0 20 0 20 00 LHVs 9 19 8 10 01

MTs/MAs Male

32 41 07 34 25 Female Dispensers

L. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

1. 1st Session: Dr. Imtiaz Khowaja , MNCH Coordinator PPHI on conducted session on MALNUTRITION & MCH and focused on the following points:-

• Introduction • Malnutrition • Social Aspects --- Quick Bullets • Social Measures for Prevention • Six essential qualities are the key to success

2. 2nd _____________________ conducted session on ___________________ and focused on the

following points:- • _______________ • _______________ • ________________ • ________________ • _______________

Previous Month Total Month under Review Total

Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 1 Clusters of 2 HFs 1

Single HFs 33 Single HFs 36

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs 4 Clusters of 3 HFs 2 Clusters of 2 HFs 10 Clusters of 2 HFs 15 Single HFs 0 Single HFs 1

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• _______________

3. 3rd Session : _____________________ Conducted session on _______________ on the following points :-

• • • • •

2. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of Participants

F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered to Children at Health Facilities. 6,865 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 2,832 No. of Immunization & Vaccination Administered by out- reach EPI Teams Total vaccination / immunization for the month August, 2012 9,697

2. National Immunization Days (NIDs) for Polio

Dates of NIDs Total Target of coverage Actual coverage Percentage of

coverage 16th 17th 18th July 97419 115745 119%

3. Other Preventive/Promotional Services

S # Service Number

1 Passive Case Detection (APCD) Slides 542

2 Malaria Metro Survey (MMS) Slides 219

3 +ve Slides 21

4 Follow up 19

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH During Month under Review

2. Female Health

Sr # NAME OF FMO OBSTETRICAL

Total OPD Antenatal Natal Post Natal Total

1 Dr. Mahjabeen 0 0

2 Dr. Shazia Dal 49 0 11 60 1241 3 Dr. Laila Khowaja 63 3 6 72 1482

4 Dr,Shazia Sattar 83 0 1 84 500 5 Dr.Farzana Jarwar 56 0 6 62 740

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6 Dr. Rubina Abbasi 34 0 3 37 455 7 Dr.Irshad Fareed 159 4 19 182 904

8 Dr.Zaid 85 32 22 139 1620 9 Dr. Hifza Kainat Shah 31 0 0 31 1053

10 Dr. Sajida Memon 82 0 16 98 1018 11 Dr. Sofia Baloch 148 9 11 168 751

12 Dr. Rizwana Shah 42 8 5 55 445 13 Dr,Najima Memon 26 0 7 33 717

14 Dr.Farzana Malik 155 5 21 181 1107 15 Dr. Sadaf Faraz 20 0 2 22 759

16 Dr. Sadaf Kolachi 101 0 4 105 678 17 Dr. Naima Memon 60 0 10 70 714

18 Dr. Shazia Qayoom 68 34 32 134 1812 19 Dr. Sanobar 39 10 8 57 598

Total 1,301 105 184 1,590 16,594 2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 90 2 Deliveries Assisted at Homes 00

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 412 2 Blood Sugar Tests 320 3 Hemoglobin Tests 184 4 Ultra Sound Test 490 5 Other 1,585

3. Important Discussion on Mother and Child and Reproductive Health during MRM

• No: of Deliveries has greatly increased at 24 hours MCHCs. Medicine indent has been circulated by PSU

and medicines have been purchased. P.O for tablet cytotec has been supplied at Delivery centers. • Pre-diagnosis screening of patients for vaccine should be done religiously. • Where vaccinator are provided under National Program, the duty roster should be signed by I/c Medical

Officer and absence report should immediately be sent to Focal Person. • Pregnant females should be encouraged for delivery at BHU. • F.P advice should be part of diagnosis and separate record be maintained. • Sonologists shall furnish their presentation on the findings, referral and follow up. • MNCH record and Growth monitoring record should be maintained by FMOs where LHV is not

provided. In all cases, record should be legible, complete and traceable. • Baby Weighing Scales/ Adult Bath Scales, Hemoglobin Meters and Height Charts have been

provided. Ensure proper usage of the equipments and report of out of order weight machines should be immediately conveyed to I/c MO in writing.

• Training on Hemoglobin meters have been provided to all Medical and Paramedical Staff for blood tests preferably for pregnant women and same will be repeated for retention.

• Focal Person (EPI) has declined to provide District Government vaccinators during FMO Days at the places where FMO cover is provided. The Vaccinator at all FMO covered facilities for that day used to bring vaccines in carrier and remarkable increase had been achieved in coverage for TT and BCG vaccines. But, now such matter will thoroughly be discussed with EDO (Health).

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10. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number Consultation / Advice 589 Oral Pills 147 IUCDs 44 Injections 165 Others 72

(III) COMMUNITY PARTICIPATION

During Month under Review

1. Number of Male SGs: 35 Number of Female SGs: 00 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

No. No. of Participants No. No. of

Participants Haji Noor Muhammad 09 142 30 660 Naveed Khaskeli 09 131 28 603 Muhammad Azeem 08 122 32 655

Total 26 395 84 1,918

3. School Health Sessions & Community Health Sessions

Sr # NAME OF FMO SHS No. of

Children examined

No. of Children Treated

CHS Part:

1 Dr. Mahjabeen 2 Dr. Shazia Dal 0 0 0 2 53 3 Dr. Laila Khowaja 0 0 0 4 80 4 Dr,Shazia Sattar 0 0 0 2 31 5 Dr.Farzana Jarwar 0 0 0 4 57 6 Dr. Rubina Abbasi 0 0 0 2 20 7 Dr.Irshad Fareed 0 0 0 3 90 8 Dr.Zaid 0 0 0 2 58 9 Dr. Hifza Kainat Shah 0 0 0 3 56 10 Dr. Sajida Memon 0 0 0 2 86 11 Dr. Sofia Baloch 0 0 0 2 60 12 Dr. Rizwana Shah 0 0 0 1 20 13 Dr,Najima Memon 0 0 0 2 105 14 Dr.Farzana Malik 0 0 0 2 35 15 Dr. Sadaf Faraz 0 0 0 2 35 16 Dr. Sadaf Kolachi 0 0 0 2 44 17 Dr. Naima Memon 0 0 0 1 27 18 Dr. Shazia Qayoom 0 0 0 1 16 19 Dr. Sanober 0 0 0 1 21

Total 0 0 0 38 894

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4. Important Points during Support Group Meetings.

• The CSG members should help in monitoring and facilitation. • RHC Rajo Nizamani shall be inaugurated by Federal Minister for Water and Power in the month of November

as R&R work is still left. However, purchase of O.T equipment is in process. • RHC Rajo Nizamani has been made functional for 24 hours with 03 shifts having medical and paramedical

staff. • I/c Medical Officer has been trained for undertaking necessary day to day equipments/asset repairs on need

basis after seeking administrative approval from DSM- should be regular feature. • Moral support to medical/paramedical staff working at HF. • Arranging of awareness sessions at their respective villages • Information sharing to the rest of the villages regarding facilities at HF • Reformation of CSGs and individual roles of the members • Effective local facilitation by CSG members to the hf staff • Developing greenery at HFs by the CSG members • Ownership of the HFs

5. Important Points during SHSs

• To drink clean & safe water and Washing hands after toilet. • Awakening health consciousness in children regarding new aspects of diseases like Dengue Fever, Swine Flue,

Congo Fever etc. • Nutritional awareness to be transferred to mothers through their kids. • Hair trimming clean clothes nails clipping, washing fruit/vegetables before eating.

6. Important Points during CHSs

• Primary health care awareness. • Educate about immunization against infectious disease. • Personal Hygiene and worm infestation. • De-worming of children • Prevention from diabetes • Precautions from Malaria and Hepatitis • Importance of family Planning • Importance of Vaccination • Importance of ultrasound • Importance of antenatal and postnatal care

7. Topics for SHSs for the Month

Sr. No. Topics 1 Diarrhea 2 Malaria/Dengue

8 Topics for CHSs for the Month

S # Topics 1 Diarrhea 2 Malaria/Dengue

9. Important Discussion on Community Participation during MRM

• Community Health Sessions are to be planned and held on Sinologist days. • Participation should be ensured through formal contact with LHWs.

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• Sessions are to be held preferably at Health Facility or at community home duly coordinated and facilitated by DSU/HF staff.

• DSU field staff shall attend 50% of all the CSG meetings conducted during the month. • TORs of CSG must be shared with CSG members in every meeting of CSG. • Formal invitation to the CSG members in meeting • Presiding of the meeting by the CSG members • Participation of notable CSG member in MRM • Effective Mobilization of female CSGs and developing their ownership at H.Facility. • Involvement of notable in solving day to day problems of HFs. • CSG should be held at BHU. • Developing greenery at HFs.

10. Health Camps: Number Held: 00 Fixed and 00 Mobile camps Number of Patients: 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation Not discussed in this meeting. Normally, a separate Quarterly Review

meeting of Public Representatives and District Government officials/officers/NGOs is being held where such issues are discussed and decisions are taken.

Ii Drainage / sewerage Iii ……… drinking water Iv Prevention of adulteration V Tree Plantation Vi Roads and infrastructure Vii Environmental

Improvement Viii Others

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*

New patients treated during

the month Old patients treated during

the month Total OPD during the month (New +

Old)

59,188 2,077 21,265

2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD 01 RHC Rajo Nizamani 5,185 BHU Saeed Mtto 2549 02 MCH Saeed Khan Lund 4,399 BHU Nazar Pur 1,736

141703 MCH Shaikh Bhirkio 3,364 BHU Saeed Pur 1,417 04 BHU Jinhan Soomro 2,972 BHU Wasi Malook Shah 1,352 05 BHU Gh Shah Bagrani 2,719 BHU Seehrani 1,324

3. Top Five Diseases Treated during School Health Sessions/Camps

S # Diseases No. of Patients 1 ARI 62

2 Allergic Rhnites 45 3 Scabies 41 4 Malaria 33 5 Diarrhea 19

*All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs.

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4. Top Five Diseases During OPD

S # Disease S # Disease 1 ARI 6 Suspected Viral Hepatitis 2 Diarrhea 7 Cough more than 2 week 3 Malaria 8 4 Scabies 9 5 Dog Bite 10

11. ARV / ASV used during the month

Particulars No. of Patients

Dog bite cases reported 85

ARV Administered ( @ 5 Dozes per patient) 00 ARV Available Doses ( @ 24 dozes/vial) 00 Snake bite cases reported 00 ASV Vaccine Administered 00

ASV Vaccine Available Doses 65 17. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Ch & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Blood Sugar Tests 320 2 Hemoglobin 184 3 X-Rays (if available) 94 4 Ultra Sound 490 5 Others (Lab Tests) 1,585

18. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

Hepatitis B Hepatitis C

19. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

34 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 34 34 34 3 4

10. Inverse Referrals

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S.No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs 2 34 34 0 0 0 0 34 3 4

G. MONITORING DURING MONTH UNDER REVIEW

7. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total 36 73 167 276

2. Important Points/Issues arising from Visits S # Name of HF Issue Action Remarks

01

02

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for: 30 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

* To reflect only non-PPHI Visitors.

J- DISCUSSION DURING MRM On Staff Matters:

• All I/c M.Os/FMOs were asked to prepare the base data of that area and set the targets for A.N/P.N, immunization, Deliveries ets. Just reporting the figure does not solve the problems

• Every Medical Officer has to commence a journey to become Health Officer sensitized for all 08 components of Primary Health.

• All I/c M.Os/FMOs were given Leave formats to discourage sms leaves or hand written applications. • The DSM, PPHI TM Khan requested the in charges of health facilities for their timely submission of DHIS

reports, Along with self created form for data required for MPR etc. • DSM advised all MO/FMO Submit advance leave application of planed leaves. • DSM advised all Incharge MO share all access medicine with other BHU with the help of monitoring team • All I/c M.Os should counter-sign on Bin Cards and Stock registers at every receiving and usage of stocks.

On Preventive Health:

• All I/c M.Os should ensure checking of temperature chart as well as stock and expiry of vaccines.

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• Quality of HE sessions not yet improved. S.O should facilitate in arranging most of The CHS in communities

On Curative Health: • Quality of medicines has improved with clear impact on increased cost of medicines. • Rise in OPD and consequent rise in medicine consumption. • Patient coming from farther areas demand for more medicine dosages.

On Mother, Child & Reproductive Health: • Baby Weighing Scales have been provided at all 35 facilities where FMO cover has been provided. • New DHIS MNCH registers and Growth monitoring registers will be maintained at each facility where

FMO cover is provided. Training has already been provided to all FMOs in this regard. The DHO office will provide new DHIS register as per requirement.

• The registers will be maintained by LHVs wherever provided. Otherwise, FMO will record and maintain. • For NVDs, FMOs should motivate to pregnant ladies for deliveries at BHUs. • All staff members of BHU Saeed Khan Lund and BHU Shaikh Bhirkyo were appreciated for conducting

55 deliveries during the month . Other Matters:

• One Pathological laboratory has been made functional at BHU Jinhan Soomro. Now, 04 Pathological Laboratories and 03 X-ray units have started functioning and periodically they have become self sustainable for purchasing diagnosis kits.

• I/c Medical Officers requested not to wait for DSU for minor repairs and to undertake necessary repair in lines with procedures and policies already shared and claim reimbursements.

Date /Time for Next MRM: Tentative Date for next MRM is 07-09-2012 Comments on Targets vs Achievements (by DSM)

• MEETING WAS SUCCESSFUL

(M.NAEEM KHANZADA), District Support Manager,

PPHI, Tando Muhammad Khan. Copy for information to:

8) P.S to Syed Naveed Qamar Zaman Shah Sahib, Federal Minister for Water & Power, Govt of Pakistan. 9) Secretary to Government of Sindh for Health Department, Karachi. 10) Program Director, PSU, PPHI, Karachi. 11) Deputy Commissioner, District Tando Muhammad Khan. 12) Director General Health, Directorate of Health Hyderabad. 13) Regional Program Director, Region-I @ Hyderabad. 14) District Health Officer, District T.M Khan. 15) Dr. Wahab, S.O, WHO. 16) Incharge Medical Officer(s) all PPHI managed Health Facilities, T.M Khan.

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MINUTES OF THE (54TH) MONTHLY REVIEW MEETING

OF DISTRICT MIRPURKHAS

Monthly Review Meeting (54th MRM) of District, Mirpurkhas for the Month of August 2012 was held on 14th September, 2012 at Tharparker Gymkhana , Hyderabad Road Mirpurkhas. Written invitations to participate were sent to the DCO, and District In charge of EPI, LHW and all other National Programs as usual but they could not attend the meeting due to their engagements. The list of participants follows:

List of Participants: S. Names Designation S. Names Designation

1 Engr M Juman Thebo DSM,PPHI MPS 2 Dr Neel Kanth MO PPHI 3 Dr. Akhlaq DOH (A& A) 4 Dr A Latif MO PPHI 5 Mr Adil Rasheed Exe(A&A) 6 Dr Nadeem MO PPHI 7 Mr. Shahbaz Ali Memon Exe (M&E) 8 Dr Haroon MO PPHI 9 Mr. Irfan Hyder Shah Exe (M&E) 10 Dr Pardeep MO PPHI 11 Dr. Khan Mohd SMO Govt 12 Dr M Urs MO PPHI 13 Dr Atta Hussain SMO Govt 14 Dr Mukesh MO PPHI 15 Dr Narain SMO Govt 16 Dr Muneer MO PPHI 17 Dr Narain Das MO Govt 18 Dr A Rauf MO PPHI 19 Dr Noor Hasan MO Govt 20 Dr Liaquat Hussain MO PPHI

21 Dr. Tulsi Das SMO Govt 22 Dr Naraindar Sufi MO PPHI 23 Dr Shahid Rizwan MO Govt 24 Dr Ramesh Kumar MO PPHI 25 Dr Arshad Nihal SMO Govt 26 Dr. Rajesh Kumar MO PPHI 27 Dr Farouque MO Govt 28 Dr.Narendar Kumar MO PPHI 29 Dr Rano Mal MO Govt 30 Dr Dileep Kumar MO PPHI 31 Dr Saleh Memon MO Govt 32 Dr Abdul Kabeer MO PPHI 33 Dr Naveen Kumar MO Govt 34 Dr Vishan Das MO PPHI 35 Dr Ashoke Kumar MO Govt 36 Dr Naeem Sheikh MO PPHI 37 Dr Arif Shamim SMO Govt 38 Dr Anis Mari MO PPHI 39 Dr. Farhana Qureshi WMO Govt 40 Dr Attaullah MO PPHI 41 Dr. Sajda Tahir FMO PPHI 42 Dr. Baldev MO PPHI 43 Dr Bushra FMO PPHI 44 Dr Shankar lal MO PPHI 45 Dr Nighat Sultana FMO PPHI 46 Dr. Arif Brohi MO PPHI 47 Dr. Ramila FMO PPHI 48 Dr Munwer MO PPHI 49 Dr Sheerin FMO PPHI 50 Dr Khalid MO PPHI 51 Dr Faria FMO PPHI 52 Dr Saleem MO PPHI 53 Dr Naina Kumari FMO PPHI 54 Dr Ramesh Kumar MO PPHI 55 Dr Hamida Ali FMO PPHI 56 Dr Zulfiquar Ali MO PPHI

57 Dr Aneela Zahoor FMO PPHI 58 Dr. Ramesh Kumar MO PPHI 59 Dr Gulshad FMO PPHI 60 Dr Imran Jarwar MO PPHI 61 Dr Urooj FMO PPHI 62 Dr Pir Nasir Jan MO PPHI 63 Dr Azra Parveen FMO PPHI 64 Dr Chander MO PPHI 65 Dr Sana Ayoub FMO PPHI 66 Dr. Afzal MO PPHI 67 Dr Amna Idrees FMO PPHI 68 Dr A Hameed MO PPHI 69 Dr Mohni FMO PPHI 70 Dr. Saqib Shah MO PPHI 71 Dr Adeela FMO PPHI 72 Dr. Rasheed MO PPHI 73 Dr Saba Ilyas FMO PPHI 74 Dr. Arbab MO PPHI 75 Dr Shaheen FMO PPHI 76 Dr. Mansoor MO PPHI 77 Dr Samreen Shafee FMO PPHI 78 Dr. Ramchand MO PPHI 79 Dr Shazia FMO PPHI 80 Dr. Ghazanfar MO PPHI 81 Dr Saneela FMO PPHI 82 Mumtaz Ali MO PPHI 83 Dr Nargis Naz FMO PPHI 84 Dr Kishore Kella MO PPHI 85 Dr Irum FMO PPHI 86 Dr Moazam MO PPHI 87 Dr Quratulain FMO PPHI 88 Dr. Mehmod-ul-Hassan MO PPHI

89 Dr Noor Nisa FMO PPHI 90 Dr Zahid Hussain MO PPHI

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91 Dr Asma FMO-PPHI 92 Dr Shamsher Mardan MO HQ DSU-MPS 93 Dr. Saeeda FMO PPHI 94 Mr Farhan Rasheed SO DSU-PPHI 95 Dr. Sahira Balooch FMO PPHI 96 Mr Jethanand SO DSU-PPHI 97 Dr. Fahmeeda FMO PPHI 98 Mr Bharji SO DSU-PPHI 99 Dr Shaista FMO PPHI 100 Mr Mohsin SO DSU-PPHI 101 Dr Kiran Kumari FMO PPHI 102 Mr Khair Mohammad SO DSU-PPHI 103 Dr. Kamani FMO PPHI 104 Mr. Faruukh Assistant Accounts 105 Dr Mohd. Siddique MO PPHI 106 Mr Nikhtu HT BHU Sindhri 107 Dr Wishan Das MO PPHI 108 Naresh Asistant Admin

The following could not attend the meeting for the reasons stated against each:-

S # Names/Designation Reasons S # Names/Designation Reasons

1 Dr Yousif Absent 2 Dr Rajni Davi Leave

3 Dr Mohidin Absent 4 Dr Imran Laghari Leave

5 Dr Ghulam Mustafa Leave 6 Dr Salma Absent

7 Dr Allah Ditto Leave 8 Dr. Jan Mohammad Absent

9 Dr Parkash Leave 10 Dr. Nazish Leave

11 Dr Asia Narejo Leave 12 Dr. Vijay Leave

13 Dr Imtiaz Ali Leave 14

F. HFs WITH PPHI BHUs: _______ 38 Dispensaries: _______48 MCHCs: _______10 others: ______2

TOTAL: _______98 B. Population of the Catchments Area: 1681107

M. STAFF STRENGTH

Staff Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MOs 79 71 21 50 58

WMO 04 3 3 0 01 FMOs 00 36 0 36 00 LHVs 08 40 08 32 0

MTs/MAs Male 79 50 50 0 01 Female 28 28 0 Dispensers 14 53 14 39 0

N. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO

Previous Month Total Month under Review Total Clusters of 6 HFs 0 Clusters of 6 HFs 0 Clusters of 5 HFs 0 Clusters of 5 HFs 0 Clusters of 4 HFs 0 Clusters of 4 HFs 0 Clusters of 3 HFs 0 Clusters of 3 HFs 0 Clusters of 2 HFs 11 Clusters of 2 HFs 11

Single HFs 61 Single HFs 60

Previous Month Total Month under Review Total Clusters of 6 HFs 03 Clusters of 6 HFs 03 Clusters of 5 HFs 0 Clusters of 5 HFs 0 Clusters of 4 HFs 0 Clusters of 4 HFs 0 Clusters of 3 HFs 0 Clusters of 3 HFs 0 Clusters of 2 HFs 27 Clusters of 2 HFs 27 Single HFs 07 Single HFs 09

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E. CAPACITY BUILDING

1. First Session: During MRM

Dr. Akhalaq, DOH (M&P Health) in his lecture on ‘Pneumococcal Vaccine’ focused on the following points:-

• Pneumococcal vaccine prevents from pneumonia, meningitis, otitis media and some other diseases caused by pnuemococcai.

• PCV-10 is effective against ten most vulnerable species of pnuemococcai.

• Pneumococcal vaccine can be used with penta but at contra later side at left thigh I/M.

2. Second Session: During MRM

Dr. Narain, I/C MO BHU Hamedpura in his lecture on ‘DHIS Correct Reporting’ focused on the following points:-

• Introduction to DHIS Monthly Reporting Format.

• Review of incorrect & incomplete reports received from health facilities.

• How to fill DHIS Monthly Reporting Format in proper manner.

• Source of data for DHIS Monthly Report.

Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of Participants

F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization No. of Doses of Immunization Administered to Children at Health Facilities & out- reach EPI Teams 17557

No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities & out- reach EPI Teams 3716

No. of Immunization & Vaccination Administered by out- reach EPI Teams -

Total vaccination / immunization for the month ______AUGUST 2012 21273

2. National Immunization Days (NIDs) for Polio

Dates of NIDs Target of coverage Actual coverage Percentage of coverage

16, 17 & 18 July-2012 248116 99% 99%

3. Other Preventive/Promotional Services

S # Service Number

1 Passive Case Detection (PCD) Slides 0

2 Active Case Detection (ACD) Slides 0

3 Visits to Check Sanitation (individual house holds + streets) 0

4 Notices issued against Poor Sanitation 0

5 Challans sent to Court against Poor Sanitation 0

6 Patients Nebulized 262

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(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review

1. Female Health

S. # NAME OF FMO Antenatal Post Natal Total OTHERS Total

1 Dr Faria Atif 116 16 132 128 1129 2 Dr Asia Narejo 39 11 50 50 906 3 Dr Sahira Baloch 48 7 55 91 762 4 Dr Kamni Kumari 96 2 98 0 564 5 Dr Aneela Zahoor 50 7 57 34 621 6 Dr Gulshad 62 15 77 3 691 7 Dr Mohni 51 15 66 21 776 8 Dr Shereen Khan 120 17 137 179 1324 9 Dr Saba Ilyas 76 12 88 95 647 10 Dr Azra Parveen 60 8 68 13 470 11 Dr Adeela 39 5 44 84 450 12 Dr Samreen Shafee 35 5 40 0 843 13 Dr Hamida Ali 45 9 54 179 549 14 Dr Amna Idrees 130 5 135 24 583 15 Dr Kiran Kumari 28 7 35 166 290 16 Dr Nighat Ashraf 32 7 39 216 436 17 Dr Sana Ayoub 20 2 22 122 692 18 Dr Shazia Zulfiqar 69 13 82 55 465 19 Dr Saneela Mughal 40 3 43 158 617 20 Dr. Fahmida Kolachi 69 15 84 119 756 21 Dr Nargis Naz 54 2 56 284 899 22 Dr Naina Kumari 15 0 15 275 691 23 Dr Irum Naz 53 2 55 239 814 24 Dr Bushra Farhin 33 5 38 242 925 25 Dr Shaheen 25 1 26 143 261 26 Dr Urooj 51 4 55 0 623 27 Dr Naziah 0 0 0 0 0 28 Dr Sajida Tahir 178 30 208 0 691 29 Dr Shaista Parveen 25 8 33 283 517 30 Dr Asma Shaikh 285 13 298 204 920 31 Dr Noor Nisa 82 5 87 150 930 32 Dr Saeeda Mari 142 30 172 189 1257 33 LHV Zarina 140 8 148 511 1306 34 Dr Qurat-ul-Ain 225 44 269 243 3074

Total: 2533 333 2866 4500 26479

2. Deliveries Assisted

S # Service Number

1 Deliveries Assisted at HFs 269

2 Deliveries Assisted at Homes 424

3. Lab/ Diagnostic Tests

S # Test Number

1 Pregnancy Tests 451

2 Blood Sugar Tests 769

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3 Hemoglobin Tests 179

4 Ultra Sound Test 1,313

5 Other (X Rays) 37

Total 2,749

Important Discussion on Mother and Child and Reproductive Health during MRM

• Antenatal and postnatal performance shared with the participants. DSM Mirpurkhas requested to pay heed to conducting deliveries at health facility.

Provision of Family Planning Services during the Month

S # Name of the Items / Service Number

1 Consultation / Advice 711

2 Oral Pills 259

3 IUCDs 10

4 Injections 305

5 Others 137

Total 1422

(III) COMMUNITY PARTICIPATION

During Month under Review

1. Number of Male SGs: --------------94 Number of Female SGs: --------------04

2. Performance of Social Organizers

Names of Social Organizers

Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of

Participants

Jethanand 14 0 156 09 412

Farhan 07 0 82 12 394

Mohsin 04 0 53 04 196

Bharji 04 0 38 06 238

Khair Mohammad 09 0 72 08 319

Total 38 0 401 39 1559

3. School Health Sessions & Community Health Sessions

Name Of I/C Community Health Sessions School Health Sessions

CHS Pts SHS Examined Treated Participants

Dr Munwer 1 22 0 0 0 0 Disp. Noor Nabi 1 16 0 0 0 0 Dr Afzal 1 30 0 0 0 0

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Dr Khalid 1 10 0 0 0 0 Dr Zulfikar 1 12 0 0 0 0 Dr Zahid Hussain 1 16 0 0 0 0 Dr A Kabir 1 15 0 0 0 0 Dr Arbab 1 10 0 0 0 0 Dr Khan Mohammad 1 20 0 0 0 0 Dr Abdul Rasheed 1 8 0 0 0 0 Dr Narain 1 32 1 7 6 47 Dr Allah Dito 0 0 0 0 0 0 Dr Haroon 1 8 0 0 0 0 Dr Urs 1 60 1 30 10 40 Dr Arif Shamim 0 0 0 0 0 0 Dr Mukesh 1 35 0 0 0 0 Dr Ramesh 0 0 1 5 5 30 Dr Siddique 1 15 0 0 0 0 Dr. Vijy 0 0 0 0 0 0 Dr Liaquat 1 20 0 0 0 0 Dr Naseem Sultana 0 0 1 5 2 50 Dr Ghazanfar Abbas 1 22 0 0 0 0 Dr Rano Mal 1 35 0 0 0 0 Dr Noor Hussain 0 0 0 0 0 0 Dr Muneer 1 20 1 15 10 60 Dr Wishan 2 46 1 0 0 70 Dr Neel Kanth 1 15 0 0 0 0 Dr Pardip 2 13 0 0 0 0 Dr Parkash 1 17 0 0 0 0 Dr Atta Hussain Shah 1 23 0 0 0 0 Dr A Rauf 1 30 0 0 0 0 Dr A Latif 1 30 1 20 10 30 Dr Salim 1 15 1 15 10 28 Dr Naveen 0 0 1 0 0 40 Dr Kishore 0 0 0 0 0 0 Dr Baldeve 1 23 1 25 15 35 Dr. Dileep 1 16 0 0 0 0 Dr Nadim 1 0 0 0 0 0 Dr Narain 1 17 1 10 3 39 Dr Naeem Sheikh 0 0 0 0 0 0 Disp. Abdul Rehman 1 31 1 2 2 33 Dr Imran Jarwar 3 59 1 12 4 38 Dr. Mansoor 0 0 1 0 0 20 Dr Arif Ali 2 11 0 0 0 0 Dr Ashoke-Kumar 1 27 0 0 0 0 Dr Pir Nasir Jan 3 50 2 23 0 51 Dr Yousif 0 0 0 0 0 0 Dr. Ramchand 1 22 0 0 0 0 Dr Mumtaz 2 38 1 2 2 33 Dr. Ramesh 1 4 0 0 0 0 Dr Arshad Nihal 1 25 0 0 0 0 Dr Mehmood 1 19 0 0 0 0 Dr Rajesh 1 12 1 0 0 30 Dr Ramesh 1 16 0 0 0 0 Dr Abdul Hameed 2 70 0 0 0 0

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Dr Moazam 1 10 0 0 0 0 Dr Imran Laghari 1 32 1 6 4 29 Dr Vishan 1 25 0 0 0 0 Dr. Tulcho 1 21 0 0 0 0 Dr Narainder 2 65 0 0 0 0 Dr Shahid Rizwan 1 25 1 6 1 15 Dr. Imtiaz 1 17 0 0 0 0 Dr Ramesh 1 16 0 0 0 0 Dr. Ghulam Mustafa 1 15 1 10 0 30 Dr Anees 1 21 0 0 0 0 Dr Narainder 1 1 1 9 9 54 Dr Attaullah 1 15 0 0 0 0 Dr Sakib Shah 1 16 0 0 0 0 Dr Chandar Kumar 2 44 0 0 0 0 Dr. Jan Mohammad 0 0 1 20 20 40 Dr Saleh Memon 2 110 0 0 0 0 Dr Mohiddin Shaikh 2 25 0 0 0 0 Dr. Shankar 1 19 0 0 0 0 Dr Faroque 1 10 0 0 0 0 Dr Sajida Tahir 1 15 1 40 20 40 Dr Shaista Parveen 1 20 0 0 0 0 Dr Asma Rasool 1 28 0 0 0 0 Dr Noor Nisa 1 36 0 0 0 0 Dr Saeeda 1 30 0 0 0 0 LHV Zarina 1 36 1 8 4 38 Dr Qurat-ul-Ain 1 56 0 0 0 0 Dr. Fahana Qureshi 1 38 0 0 0 0 Dr Faria Atif 1 20 0 0 0 0 Dr Asia Narejo 2 39 0 0 0 0 Dr Sahira Baloch 1 16 0 0 0 0 Dr Kamni Kumari 1 23 0 0 0 0 Dr Aneela Zahoor 2 35 0 0 0 0 Dr Gulshad 1 15 0 0 0 0 Dr Mohni 1 28 0 0 0 0 Dr Shereen Khan 1 35 0 0 0 0 Dr Saba Ilyas 1 16 0 0 0 0 Dr Azra Parveen 2 30 0 0 0 0 Dr Adeela 2 44 0 0 0 0 Dr Samreen Shafee 1 15 0 0 0 0 Dr Hamida Ali 1 15 0 0 0 0 Dr Amna Idrees 1 30 1 15 12 20 Dr Kiran Kumari 1 18 0 0 0 0 Dr Nighat Ashraf 1 35 0 0 0 0 Dr Sana Ayoub 1 6 0 0 0 0 Dr Shazia 1 15 0 0 0 0 Dr Saneela 1 10 0 0 0 0 Dr. Fahmida Kolachi 2 24 0 0 0 0 Dr Nargis Naz 1 20 0 0 0 0 Dr Naina Kumari 1 12 1 4 1 30 Dr Irum Naz 1 12 1 6 5 32 Dr Bushra Farhin 1 15 0 0 0 0 Dr Shaheen 1 25 0 0 0 0

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Dr Urooj 1 10 1 12 10 46 Dr Naziah 0 0 0 0 0 0

Total 114 2344 29 307 165 1048 4. Important Points during Support Group Meetings.

• Active participation in Polio Campaign

• Laboratory facility be given.

• Ambulance service be given.

• Female staff be provided.

• Ultrsound facility be provided.

5. Important Points during SHSs

• Hands washing and nail cutting & their importance

• Personal Hygiene

• Malaria Fever, causes and its prevention

• Dengue Fever, causes and its prevention

6. Important Points during CHSs

• Malaria, its causes and prevention

• Boils

• ANC & PNC

• Diarrhea, its causes and prevention

Topics for SHSs for this Month

Sr. No. Topics

1 Personal Hygeine

2 Boil Water

3 Water Borne Diseases

4 Importance of Polio Campaign

8 Topics for CHSs for this Month

S # Topics

1 Typhoid

2 Home Made ORS

3 Scabies

4 Dengue Fever

5 Diarrhea

9. Important Discussion on Community Participation during MRM

• Community support group members must be aware of importance of polio campaign.

• CSG members may be helpful to cover refusal & N/A cases in during polio campaign.

10. Health Camps: Number Held: -----------------0 Number of Patients: -----------0

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11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent

Present status

i Sanitation

ii Drainage / sewerage

iii ……… drinking water

iv Prevention of adulteration

v Tree Plantation

vi Roads and infrastructure

vii Environmental Improvement

Viii Others

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*

New patients treated during the month

Old patients treated during the month

Total OPD during the month (New + Old)

106346 2214 108,560

2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD

1 Hameedpura 4334 Sikriyari 729

2 Satellite Town 2319 Ismail Jo Goth 872

3 Makhan Samoon 2223 Abdul Qayoom Khair 904

4 Nawab Colony 2214 Khann 912

5 Kot Mirs 2083 Kangoro 934

3. Top Five Diseases Treated during School Health Sessions/Camps

*All HFs — BHUs and others.

**Reflects OPD at BHUs only — not at other HFs.

4. Top Five Diseases during OPD

S # Diseases No. of Patients

1 ARI 37

2 Diarrhea 21

3 Malaria Fever 18

4 Scabies 12

5 Others 08

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S # Disease No. of Patients

1 ARI 19849

2 Diarrhea 10903

3 Fever (Clinical Malaria) 6662

4 Scabies 5674

5 Dermatitis 4007

ARV / ASV used during the month

Cases No. of Patients

Dog bite cases reported 183

ARV Administered 129

ARV Available Doses 630

Snake bite cases reported 01

ASV Vaccine Administered 0

ASV Vaccine Available Doses 13

20. Lab / Diagnostic Tests: Includes Tests Reported at No.

21. (II) (Mother, Child &Reproductive Health) 3. (Lab / Diagnostic Tests)

S # Tests Number

1 Pregnancy Tests 451

2 Blood Sugar Tests 769

3 Hemoglobin 179

4 X-Rays (if available) 37

5 Ultra Sound 1313

6 Others (please specify) 0

22. B & C SCREENING TESTS

NO ANY SCREENING TEST OF HB & C AVAILABLE AT PPHI HFs.

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

Hepatitis B

Hepatitis C

23. TUBERCLOSIS

Patients

Receiving Treatment New Cases During the Month Under Diagnosis

17 02 02

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9. Referrals

S.No Totals Cases Referred To

1 TB DOT Viral HB Others RHCs THQs DHQs

2 45 12 25 08 14 23 08

10. Inverse Referrals

S.No Totals Cases Referred from

ARV ASV Others RHCs THQs DHQs

1 51 51 0 0 05 01 45

G. MONITORING DURING MONTH UNDER REVIEW

8. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total

30 87 370 487

2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks

No any No any No any No any

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for ……………………… 36 weeks

2. Important Issues raised relating to Medicines, etc. during MRM

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFs

S # Name of HFs Description of Repair /

Maintenance incl. Electrification Status / Remarks

1 BHU Karam Ali Laghari Repair of Furniture & Main Gate Installation Work Done

2 GD Roshanabad Repair of Refrigerator Work Done

3 GD Ahori Repair of Furniture Work Done

4 BHU Malook Pahore Repair of Fans Work Done

5 BHU Kangoro Water Supply Work Done

6 MCH Mirwah Electricity Repair Work Done

7 BHU Makhan Samoon Repair of water motor Work Done

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

* To reflect only non-PPHI Visitors.

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J- DISCUSSION DURING MRM

On Staff Matters:

12. Staff timings must be followed strictly.

13. Monthly reports of all the health facility must reach 2nd of every month.

14. After compilation of reports, reports will be sent to DHO Office on 4th of every month.

15. Popper and accurate reporting of health facility must be ensured.

On Preventive Health:

• Health awareness is an integral part of PPHI Program, in this regard all Incharges are advised to conduct health education sessions on regular basis.

• Performance of MOs and FMOs, regarding health sessions, was scrutinized. Those doctors who did not conduct sessions in August, 2012, were directed to improve their performance and conduct health sessions on regular basis.

• Any of the DSU staff members must participate in these meetings & sessions.

On Curative Health:

• Almost all requirements of health facilities have been completed.

On Mother, Child & Reproductive Health:

• 269 deliveries were conducted at health facilities during the month of August, 2012. DSM Mirpurkhas applauded the performance of FMO.

• Deliveries at HF must be increased, in this regard, FMO should do proper counseling of female patients to motivate them to come at health facility.

Other Matters:

None

Date /Time for Next MRM:

10th October 2012

Major Achievements /Recommendations / Issues:

DSM Mirpurkhas uttered that PPHI Mirpurkhas played a key role during the flood 2011, in which many medical camps (Fixed camps, mobile camps & school camps) were organized by PPHI Mirpurkhas, owing to immediate response, no any out-break of disease was reported in District Mirpurkhas. Keeping in view heavy rain, as predicted by NDMA, PPHI Mirpurkhas has planned to organize medical camps in September, 2012 as well. DSM Mirpurkhas again emphasized on health awareness sessions (integral part of PHC Services) among communities and again directed Medical officers to conduct health sessions in proper manner, those who fail to do so in future, disciplinary action will be action taken against them.

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MINUTES OF THE (51th) MONTHLY REVIEW MEETING

OF DISTRICT BADIN

Monthly Review Meeting (MRM) of District, Badin for the Month of July, 2012 was held on 07-09-2012 at Darbar Hall DCO Office Badin. The EDO (H), Civil surgeon, District Population Welfare Officer, District Incharge of EPI, District Coordinator NP, District Focal Person Malaria, District Focal Person TB and District Officer MNCH Badin were also invited to the meeting. Following participants attend the meeting. List of Participants:

# Names/Designation S # Names/Designation 1 Mr Birj Lal Dossani DSM Badin. 61 DR SAHIB KHOSO 2 Mr. Naveed Abbass Baloch Ex M&E 62 DR SALEEM NOTKANI 3 Mr. Iftikhar Khoso Ex M&E 63 DR SANTOSH KUMAR 4 Dr Amir Ali Khawaja MO HQ 64 DR SARFRAZ AMIR 5 Dr Amir Ali Khawaja MO HQ 65 DR SHAFIQUE AHMED LAGHARI 6 Mr Ali Ahmed SO 66 Dr Soomar Mal 7 Mr. Abdul Razzaque Soomro S.O 67 DR SUNIL KUMAR 8 Lemoon Mal Astt: Admin 68 DR TUFAIUL BHAN 9 Mr. Abdul Razzaque Soomro S.O 69 DR UQEL ABBAS KHAWAJA

10 Mr. Irfan Khan Soomro S.O 70 DR ZAHID HUSSAIN KHAWAJA 11 Mr. Maqsood Arisar S.O 71 Dr Amjad Ali 12 Dr. Aisha Jamil 72 Dr Lalji 13 DR ANITA KHAWAJA FMO 73 Dr Asan Das 14 Dr Kavita Ashok 74 Dr Sunil Kumar Dumbalo 15 DR KHATIJA KAMBRANI FMO 75 Dr Lalji Mal 16 DR Aisha Rahim 76 Dr Asan Das 17 DR SHAHNAZ MUNEER FMO 77 Dr Ashok Kumar Bakho 18 DR NEELOFAR SHAH FMO 78 Dr Kumail Abbas 19 DR RUKHSANA MEMON FMO 79 Dr Kamil Memon 20 DR SAEEDA BANO (Sonologist) 80 Dr Abbas Ali 21 DR SHAZIA RAUF FMO 81 Dr Vishan Das 22 DR TASLEEM KHAWAJA FMO 82 Dr Murad Ali Nizamani 23 Dr Nazi Abbasi FMO 83 Dr Munawar Arain 24 Dr Natasha Soomro FMO 84 Dr Saleem Nizamani 27 Dr Tahseen Pitafi FMO 87 Dr Harchand 28 Dr Nayab FMO 88 Dr Ahmed Khatti 29 Dr Aisha Raheem FMO 89 Dr Haji Khan Nizamani 30 DR RAFFIQUE AHMED BHURGARI 90 Dr Haresh Kumar 31 DR AHMED KHATTI 91 Dr Mohammad Sidique Pahore 32 DR ILYAS LAGHARI 92 Dr Abdul Jabbar Khatti 33 DR MUZAFAR ALI KHAWAJA 93 Dr Ali Mohammed 34 Dr Gulab Kashmiri 94 Dr Khadim 35 Dr Abdul Jabbar Nizamani 95 Dr Dolat 36 DR IQBAL AHMED MEMON 96 Dr Asfgar Soomro 36 DR ABDUL ALI SHAH 96 Dr Shahzad 37 DR ABDUL REHMAN Bhurgri 97 Dr Mukesh Kumar 38 DR ABDUL REHMAN Khatti 98 Dr Saleem Noatkani 39 DR AFAQUE AHMED 99 Dr Amjad Ali

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40 DR AIJAZUDDIN 100 Dr Mohammed Ashraf 41 DR ALTAF BASHEER 101 Mr. Abdul Wahid Pathan N.Q 42 DR AMIR HASSAN MEMON 102 Mr. Allah Dino Memon N.Q 43 DR ASHOK KUMAR (K Q) 103 Mr. Shahzad Ahmed Chand Driver 44 DR ASHOK KUMAR (Bakho Chandio) 104 Mr. Abdul Wahid Pathan N.Q 45 DR CHAIT RAAM 105 Mr. Allah Dino Memon N.Q 46 Dr Ghulam Murtaza Memon 106 Mr. Zakria Bucho Attendent 47 DR GULSHAN KOREJO 107 48 DR HAFEEZULLAH MEMON 108 49 Dr MOHAMMAD HANIF MEMON 109 50 Dr Ibrahim Pinjaro 110 51 DR JAMIL MEMON 111 52 DR JAVED IQBAL QAMBRANI 112 53 DR MEHMOOD MEMON 113 54 DR MOHAMMAD AYOOB PAHOOR 114 55 DR MOHAMMAD RAMZAN SOOMRO 115 56 Dr Ashok Kumar 116 57 DR MOHAN LAL 117 58 Dr Nisar Khawaja 118 59 DR RAZA ALI 119 60 DR SAFIULLAH 120

The following could not attend the meeting for the reasons stated against each:-

S # Names/Designation Reasons S # Names/Designation Reasons

1 Dr Nadeem Bhurgari At HF 2 Dr. Uzma Korejo CL 3 Dr. Imtiaz Ali CL 4 Dr. Shahzad Ali Virk CL 5 Dr Ghulam Nabi Samoon CL 6 Dr Junaid Shah CL 7 Dr Kanwal Sabir CL 8 Dr Fahmeeda Soomro CL

G. HFs WITH PPHI

BHUs: 36 Dispensaries: 66 MCHC: 01 Others: 01 TOTAL: 104

O. STAFF STRENGTH 200

Designation Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MOs 49 79 16 63 32 WMO 0 0 0 FMOs 00 24 0 24 17 LHVs 42 8 8 40 34

MTs/MAs Male

0 0 0 0

0 Female 0 0 0

Dispensers 20 71 17 54 3

P. CLUSTERS OF HFs

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WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

1. First Session: During MRM Dr. Amjad Memon delivered a lecture on “Tuberculoses-TB ”.

F. REVIEW OF THE PERFORMANCE

(I) PREVENTIVE HEALTHCARE During Month under Review

1. Vaccination / Immunization

No. of Doses of Immunization Administered to Children at Health Facilities out- reach EPI Teams. 5692

No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities out- reach EPI Teams. 1072

Total vaccination / immunization for the month August 2012 6764 2. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 219 2 Active Case Detection (ACD) Slides 61 3 Visits to Check Sanitation (individual house holds + streets) 0 4 Notices issued against Poor Sanitation 0 5 Challans sent to Court against Poor Sanitation 0 6 Patients Nebulized 425

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health S # Names of FMOs Ante-Natal Cases Post-Natal Cases Other OPD Total OPD 1 Dr Saima Naz 13 4 252 1189 2 Dr Natasha 31 2 95 534 3 Dr Tasleem Khawaja 47 16 164 1150 4 Dr Neelofar Shah 46 0 152 1390 5 Dr Uzma Korejo 48 0 200 1034 6 Dr Aisha Jamil 40 0 135 818

Previous Month No of Hfs Month under Review Total

Clusters of 6 HFs 0 Clusters of 6 HFs 0 Clusters of 5 HFs 0 Clusters of 5 HFs 0 Clusters of 4 HFs 0 Clusters of 4 HFs 0 Clusters of 3 HFs 0 Clusters of 3 HFs 0 Clusters of 2 HFs 19 Clusters of 2 HFs 19

Single HFs 45 Single HFs 60

Previous Month No of Hfs Month under Review Total

Clusters of 5 HFs 0 Clusters of 5 HFs 0 Clusters of 4 HFs 0 Clusters of 4 HFs 0 Clusters of 3 HFs 0 Clusters of 3 HFs 0 Clusters of 2 HFs 22 Clusters of 2 HFs 22 Single HFs 2 Single HFs 2

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7 Dr Anita Khawaja 32 4 105 798 8 Dr Rukhsana Memon 315 19 454 2418 9 Dr Shazia Rauf 19 0 155 601 10 Dr. Khatija Qambrani 55 2 152 923 11 Dr Kanwal Sabir 25 0 100 409 12 Dr Fahmida Soomro 36 5 14 609 13 Dr Shahnaz Muneer 24 2 20 600 14 Dr Naveen Samoon 15 2 107 401 15 Dr Naz Abbasi 52 0 0 485 16 Dr Nayab Memon 35 0 255 585 17 Dr Tahseen Pitafi 83 1 184 778 18 Dr Aisha Rahim 51 0 245 674

Total 967 57 2,789 15,396 2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 156 2 Deliveries Assisted at Homes 366

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 289 2 Blood Sugar Tests 78 3 Hemoglobin 201 4 Ultra Sound Test 311

Total 879 1. DSM discussed with the participants of MRM in detail regarding;

- EPI, The performance of the vaccinators & weekly targets will be analyzed closely through fortnight and monthly meetings. - Target v/s achievements, DSM sb demonstrated the actual performance of MOs & FMOs through the vindicate facts & figures of targeted OPD against the achievements. He encouraged to all functionaries to achieve the monthly targets by head & shoulder efforts. -Low number of SHS & CHS, DSM sb directed that each MO & FMO should deliver at least two SHS & CHS in a month. Ambulance Running, DSM Sb heartened the all MOs & FMOs to share the Ambulance service to the community through the CHSs & with the regular patients as well.

16. Important Discussion on Mother and Child and Reproductive Health during MRM

j. No: of Deliveries has substantially increased at 24 hours MCHCs. Medicine indent should be standardized.

k. Pre-diagnosis screening of patients for vaccine should be done relugularly. l. Where vaccinators are provided under National Program, the duty roster should be signed by I/c

Medical Officer and absence report should immediately be sent to Focal Person. m. Pregnant females should be encouraged for delivery at BHU. n. F.P advice should be part of diagnosis and separate record be maintained. o. Sinologists shall furnish their presentation on the findings, referral and follow up. p. MNCH record and Growth monitoring record should be maintained by FMOs where LHV is not

provided. In all cases, record should be legible, complete and traceable. q. Baby Weighing Scales/ Adult Bath Scales, Hemoglobin Meters and Height Charts have been provided.

Ensure proper usage of the equipments and report of out of order weight machines should be immediately conveyed to I/c MO in writing.

r. Training on Hemoglobin meters have been provided to all Medical and Paramedical Staff for blood tests preferably for pregnant women and same will be repeated for retention.

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17. Provision of Family Planning Services during the Month

S # Service Provided Number 1 Consultation / Advice 395 2 Oral Pills 172 3 IUCDs 10 4 Injections 156 5 Others 217

Total 950

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male Support Groups: 101 Number of Female Support Groups: 11 2. Performance of Social Organizers

Names of Social Organizers

Meetings of Support Groups conducted

CHSs arranged

Male Female Total No. of Participants No. No. of

Participants Ali Ahmed 05 0 42 7 78 Abdul Razzaque Soomro 12 0 85 18 167 Irfan Khan Soomro 13 0 97 12 128

Total 30 0 224 45 373 3. School & Community Health Sessions S. # NAME OF FMO CHS No. of Part: SHS No. of Chil: Exam: No. of Chil: Treated:

2 Dr.Tasleem Khuwaja 2 95 0 0 0 3 Dr. Saima Naz 2 25 0 0 0 5 Dr. Kaveeta Ashoke 2 33 0 0 0 7 Dr. Neelofer Shah 2 90 0 0 0 8 Dr. Uzma Korejo 2 85 0 0 0 9 Dr. Aisha Jameel 1 12 0 0 0 10 Dr. Fahmida soomro 4 60 0 0 0 11 Dr. Anita Khuwaja 3 60 0 0 0 12 Dr. Shazia Rauf 2 15 0 0 0 13 Dr. Khadija Qambrani 2 19 0 0 0 14 Dr. Kanwal Sabir 2 55 0 0 0 15 Dr. Naveen Samo 2 45 0 0 0 16 Dr. Shahnaz Muneer 1 20 0 0 0 17 Dr. Nitasha 1 8 0 0 0 22 Dr. Naz Abbasi 2 18 0 0 0 23 Dr. Aisha Raheem 2 20 0 0 0

Total 32 660 0 0 0 4. Important Points during Support Group Meetings. • Introduction of PPHI • Ownership of HFs • Health Awareness Sessions for prevention at Community Level • Health Awareness Program at School Level

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• Water and sanitation, Electricity, Cleanliness etc Issues of HFs • Major and Minor Repair & Renovation of HFs • Suggestions for the improvement of HFs

5. Important Points during SHSs Hand washing before and after taking food, and after bath, Nail cutting, wear clean clothes etc.

18. Important Points during CHSs Breast feeding, Antenatal care, Personal Hygiene, Water and sanitation, Communicable Disease, Vaccination

7. Topics for SHS for the Month School were closed due to summer vacations

Sr. No. Topics 1 2 3 4 5

8 Topics for CHS for the Month

S # Topics 1 Prevention of Dengue Fever 2 Hepatitis 3 RTI 4 HIV Aids 5 Brest Feeding 6 ARV

9. Important Discussion on Community Participation during MRM

• Community Health Sessions are to be planned and held on FMO days. • Participation should be ensured through formal contact with LHWs. • Sessions are to be held preferably at Health Facility or at community home duly coordinated and

facilitated by DSU/HF staff. 10. Health Camps: Number Held: 0 11. Measures for improvement / provision of Services by other Department / Agencies No any other Public or Private sector has involved in any regard

Sr No Description Recommendation To whom sent Present status i Sanitation 00 00 00 ii Drainage / sewerage 00 00 00 iii ……… drinking water 00 00 00 iv Prevention of adulteration 00 00 00 v Tree Plantation 00 00 00 vi Roads and infrastructure 00 00 00 vii Environmental Improvement 00 00 00 viii Others 00 00 00

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*

New patients treated during

the month Old patients treated during

the month Total OPD during the month

(New + Old)

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116,413 2,369 118,782 2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD 1 MCHC BADIN 3632

ED M. BACHAL AHMADANI 159

2 BHU SAEEDPUR 2676 DCD MIR MUBARAK @ SIM NALI 230

3 BHU GULAM SHAH MORI 2524 DCD Ramzan Abro 303 4 BHU NABI BUX PANJABI 2348 ED ALLAH BACHAYO 310 5 BHU RAHUKI 2195 DCD SAMAN SARKAR 319

3. Top Five Diseases Treated during School Health Sessions/Camps

4. Top Five Diseases during OPD

S # Disease No. of Patients 1 Acute Respirity Infection 15601

2 Diarrhea / Dysentry 11797

3 Malaria 14053

4 Scabies 4981 5 POU 2588

5. ARV / ASV used during the month

No. of Patients Dog bite cases reported 104 ARV Administered 114 ARV Available Doses 218 Snake bite cases reported 0 ASV Vaccine Administered 0 ASV Vaccine Available Doses 00

24. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Pregnancy Tests 289 2 Blood Sugar Tests 78 3 Hemoglobin 201 4 X-Rays (if available) 0 5 Ultra Sound 311

6 Others (please specify) Malaria 203

S # Diseases No. of Patients 1 Ari 201 2 Fever 289

3 Scabies 108

4 Diarrhea 233 5 Dysentery 0

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25. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

0 0 0 0 0 0

26. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

0 0 0 9. Referrals

S. No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 466 80 89 297 201 67 198

10. Inverse Referrals

S. No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs 2 0 0 4 0 0 4 4

G. MONITORING DURING MONTH UNDER REVIEW

9. Monitoring Visits during the month

DSM ADSM Executive Monitoring Other Staff Total

35 0 73 170 278

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS 1. Medicines available for: 10.06 weeks

10. Important Issues raised relating to Medicines, etc. during MRM/ Submission date of Medicine Requisition Form from 21st to 20th of every month

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS The status of running R & R schemes was reviewed thoroughly during the MRM and doctors were advised to fill the gaps. Moreover, the new 12 schemes of BHUs and GDs were thoroughly discussed. MOs were motivated to get to work in full throttle and complete the work well before the commencement of Third Party Evalution.

S # Name of HFs

Description of Repair / Maintenance incl.

Electrification

Status / Remarks

1 GD Seerani Tiles, CC Toping, Plaster, Plinth protection, Colour, Electricity

30% Completed Estimate Sent for Revise

2 BHU Haji Mohammad Boohar

Tiles, Girder T.R, Plaster, Roof Topping, Plinth protection, Colour, Electricity

60% Completed Estimate Sent for Revise

3 BHU Abdullah Shah Tiles, Girder T.R, Plaster, Roof Topping, Plinth protection, Color, Electricity

65 % Completed

4 BHU Dadah Tiles, Girder T.R, Plaster, CC Toping, Roof Topping, Plinth 100% Completed

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protection, Colour, Electricity, Girder TR. Plinth Protection

5 BHU Ahmed Rajo Tiles, CC Toping, Plaster, Roof Topping Color, Plinth Protection 100% Completed

6 BHU Mataro Mandhro

Tiles, CC Toping, Plaster, Roof Topping, Color, Electricity , Plinth Protection

100 % Completed

7 GD Beero Lanjwani Tiles, CC Toping, Plaster, Color, Roof Topping, Electricity , Plinth Protection

100 % Completed for Revise

8 BHU Artilary Chak

Tiles, CC Toping, Plaster, Roof Topping, Electricity , Plinth Protection, Tiles, Colour, Electricity

80 % Completed

9 BHU Khalifo Qasim Tiles, Girder T.iron, Plaster, CC Toping, Color, Electricity, Plinth Protection Tiles, CC Toping,

100 % Completed

10 BHU Ali Mohammad Maheri

Tiles, CC Toping, Plaster, Color, Roof Topping, Plinth Protection 100 % Completed

11 BHU Rahooki Tiles, CC Toping, Plaster, Color, Roof Topping, Plinth Protection 100 % Completed Sent for Revise

12 BHU Saeed Pur Tiles, CC Toping, Plaster, Color, Roof Topping, Electricity , Plinth Protection, CC Roof

Completed

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

* To reflect only non-PPHI Visitors.

J- DISCUSSION DURING MRM Staff Matters:

• Basic issues of HFs & Doctors • Irregularity of eDEWS Report • Follow-up of TB referral cases • OPD ratio and per patient cast • Discussed on FMO Performance including Vaccination, Antenatal, Natal, Post Natal Pregnancy and family

Planning • DHIs Monthly Report • Self analyses of HFs by MOs & FMOs • Ownership • Discipline in PPHI

Preventive Health:

Regarding school health session and community health session mostly topic for preventive measures including Scabies, Malaria, Diarrhea and Hygiene etc were discussed. Curative Health:

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Issues relating to Mother, Child & Reproductive Health: More focus on Mother- Child health care. Effort is to be made for institutional birth instead of deliveries at home. More MCHCs center will be opened soon. Other Matters: Date /Time for Next MRM: 10-10-2012, Time 10: 00 am Comments on Targets vs Achievements (by DSM) Targets vs Achievements: MOs Monitoring Mechanism DHIs Reports Health Sessions Punctuality Doctors have become punctual and are attending their HFs in time, despite the fact that they facing numerous hardships in the difficult-to-access HFs of District Badin. Targets vs Achievements: FMOs Ante-natal care During the month target achieved 1849 cases of antenatal and natal and advised to increase the cases. Family Planning Service FMO’s have improved on the count of Family Planning clientele. Health Sessions All FMOs and MOs were advised to perform as per their job description and conduct as many health education/awareness sessions as possible. A total of 166 Health Session’s were conducted majority of FMO’s have done well. Punctuality FMOs have become punctual and are attending their HFs in time, despite the fact that they facing numerous hardships in the difficult-to-access HFs of District Badin. Capacity Building of LHVs Things are improving consistently in Badin. Hopefully, we will be achieving the targets set by PSU in near future Inshallah.

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MINUTES OF THE 59th MONTHLY REVIEW MEETING OF DISTRICT THARPARKAR @ MITHI

Monthly Review Meeting (MRM) of District, Tharparkar for the Month of August, 2012 was held on September 17th, 2012 at Karoonjhar Hall Mithi. Written invitations to participate were sent to Deputy Commissioner Tharparkar, The DHO (H), District Population welfare officer and District Incharge of EPI, Secondary Care Doctors, M/S of THQs, Surveillance officer, WHO Team and all other National Programs as usual. The list of participants given below: List of Participants:

S # Names Designation

1 Raiz Ahmed Jakhrani District Support Manager Tharparkar 2 Dr. Abdul Sattar Chandio Public Health Specialist PSU Karachi 3 Dr. Bhansi Focal Person National Progrmme (DHO) Mithi 4 Dr. Nasrullah Thebo SO DEWS WHO 5 Mohammad Arif Executive Officer (M&E)

6 Dr. Jeewat Rai MO H.Q 7 Dr. Bhamero Gen: Surgeon DHQ Mithi 10 Dr. Bheem Raj Dental Surgeon 11 Dr. Salma Gynaecologist THQ Nangarparkar 12 Dr. Serwan Kumar (BHU Chelhar) Senior Medical Officer 13 Dr. Pirbhu Lal Medical Officer 14 Dr. Saleem Rahimoo Medical Officer 15 Dr. Shahid Medical Officer 16 Dr. Ishtiaq Shah Medical Officer 17 Dr. Lajpat Rai Medical Officer 18 Dr. Nehchal Das Medical Officer 19 Dr. Adu Mal Medical Officer 20 Dr. Nand Lal Medical Officer 21 Dr. Muhammad Misri Medical Officer 22 Dr. Madan Lal Medical Officer 23 Dr. Mahesh Kumar Medical Officer 24 Dr. Dechand Medical Officer 25 Dr. Lachman Medical Officer 26 Dr. Parkash Medical Officer 27 Dr. Ashok (BHU Wakrio) Medical Officer 28 Dr. Bheru Lal Medical Officer 29 Dr. Dileep Kumar (BHU PABOHAR) Medical Officer 30 Dr. Moolchand Medical Officer 31 Dr. Mukesh Kumar Medical Officer 32 Dr., Serwan Kumar (BHU Arokhi) Medical Officer 33 Dr. Suneel Medical Officer 34 Dr. Amanullah Medical Officer 35 Dr. Vijay Kumar Medical Officer 36 Dr. Sundeep Kumar Medical Officer 37 Dr. Ashok Kumar (Cluster) Medical Officer 38 Dr. Sajjad Rahimon Medical Officer 39 Dr. Vikram Kumar Medical Officer 40 Dr. Gotam Medical Officer 41 Dr. Shagufta Shah Female Medical Officer 42 Dr. Lata kumari Female Medical Officer 43 Dr. Meena Kumari Female Medical Officer 44 Dr. Asma Karam Baloch Female Medical Officer 45 Dr. Janta Kumari Female Medical Officer 46 Dr. Jai Mala Female Medical Officer (THQ Diplo) 47 Mrs. Najma LHV THQ Diplo 48 Mrs. Rehana LHV BHU Kaloi

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49 Mr. Soortoji HT 50 Mr. Chandan Kumar HT 51 Mr. Mohammad Hashim HT 52 Mr. Mohammad Mohisin HT 53 Mr. Saindad HT 54 Mr. Abdul Aziz HT 55 Mr. Dheno Mal HT 56 Mr. Moroo Mal HT 57 Mr. Amir Bux HT 58 Mr. Pirbhu Lal M.T 59 Mr. Lachman Singh HT 60 Mr. Gomoo Mal HT 61 Mr. Shahab Din HT 62 Muhammad Rahim HT 63 Mr. Ab: Hadi HT 64 Mr. Abdul Qadir Social Organizer 65 Mr. Muqeem Ahmed Social Organizer 66 Mr. Allah Rakhyo Admin Asstt: 67 Mr. Raheel Aziz Account Asstt: 68 Mr. Muneesh Asstt: 69 Mr. Chaman Lal Asstt:

The following could not attend the meeting for the reasons stated against each: S # Names Designation Place of Posting Reason

1 Dr.Chander Kumar Gen Surgeon THQ Nangarparkar Un Known 2 Dr. Santosh Kumar Medical Officer Culster Un Known 3 Dr. Mir Imran Talpur Medical Officer BHU Kaloi Alternate Duty

A. HFs WITH PPHI

BHUs: 31 Dispensaries: 18 MCHCs: Others: 0

TOTAL: 49

B. Population of the Catchments Area: 819,804/= C. Staff Strength

Staff Sanct: Posts

(Govt) Working

Govt: Employees

PPHI Contract

Vacant Sanctioned (Govt.)

Remarks

Mos 52 34 07 27 18 FMOs 0 07 0 07 0 WMOs 0 0 0 0 0

MTs/MAs Male

0 0 0 0 -

Female 0 0 0 0 0

LHVs 47 3

1 2 44

Dispensers: 55

14 7 7 0

HTs: 39

18 28 02

D. Clusters: CLUSTERS OF HFs

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WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING:

1. First Session: Dr. Sundeep Kumar (Medical Officer BHU Kot Arbab Mir Mohd.) conducted Session on History & Importance of Immunization. 2. Second Session: Dr. Dileep Kumar (I/C Medical Officer BHU Pabohar), conducted session on Routine Immunization. 3. Dr. Abdul Sattar Chandio (Public Health Specialist PSU Karachi) conducted session on DHIS.

Capacity Building of LHVs / Dispensers during month under Review:

Names of the Resource Persons with dates

Date Venue Topic No. of Participants

F. REVIEW OF THE PERFORMANCE:

Executive Officer (M&E) Mr. Arif Abbasi Presented DSU Progress for the Month of August-12. (I) PREVENTIVE HEALTHCARE

During Month under Review 1.Vaccination / Immunization

2. National Immunization Days (NIDs) for Polio:

Dates of NIDs Target of coverage Actual coverage

Percentage of coverage

Note: According to 3rd Party Evaluation percentage of coverage 98%. 3. Other Preventive/Promotional Services:

S # Service Number 1 Passive Case Detection (PCD) Slides (NEGATIVE) 2,174 2 Active Case Detection (ACD) Slides (FALCIPARIUM) 128 3 Active Case Detection (ACD) Slides (VIVAX) 311

Previous Month Total Month under Review Total

Clusters of 6 HFs 0 Clusters of 6 HFs 0 Clusters of 5 HFs 0 Clusters of 5 HFs 0 Clusters of 4 HFs 0 Clusters of 4 HFs 0 Clusters of 3 HFs 04 Clusters of 3 HFs 04 Clusters of 2 HFs 02 Clusters of 2 HFs 02 Single HFs 28 Single HFs 28

Previous Month Total Month under Review Total

Clusters of 5 HFs 0 Clusters of 5 HFs 0 Clusters of 4 HFs 0 Clusters of 4 HFs 0 Clusters of 3 HFs 06 Clusters of 3 HFs 06 Clusters of 2 HFs 1 Clusters of 2 HFs 1 Single HFs 0 Single HFs 0

Children < 12 months received 3rd Pentavalent vaccine 2,079 Children < 12 months received 1st Measles Vaccine 1,584 Children < 12 fully immunized 1,370 Pregnant women received TT-2 Vaccine 1,851

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4 Active Case Detection (ACD) Slides (MIXED) 0 5 Visits to Check Sanitation (individual house holds + streets) 0 6 Notices issued against Poor Sanitation 0 7 Challans sent to Court against Poor Sanitation 0 8 Patients Nebulized 05

MOTHER, CHILD & REPRODUCTIVE HEALTH:

(During the month under Review) I. Female Health:

2. Deliveries Assisted

3. Lab/ Diagnostic Tests (by MO & FMOs)

5. Important Discussion on Mother and Child and Reproductive Health during MRM

The FMO were directed to keep record of Mother and Child Health in the facilities, improve the family planning Programme by giving medicine and aware about family planning methods.

6. Provision of Family Planning Services during the Month: S # Name of the Items / Service Number 1 Consultation / Advice 408 2 Oral Pills 3,846 3 IUCDs 0 4 Injections 141 5 Others 77

Total 4,472 (III) COMMUNITY PARTICIPATION:

During Month under Review 1. Number of Male CSGs: - 49- Number of female CSGs: 3 2. Performance of M&E Section:

Names Meetings of Support Groups

conducted CHSs /SHSs arranged

No. No. of Participants No. No. of Participants Mohammad Arif Ex: Officer (M&E) 8 128 4 89

S.# Name of FMO ANC cases Natal Post Natal Other OPD Total OPD 1 Dr. Meena 116 2 37 372 1040 2 Dr. Shagufta Shah 82 2 47 135 588 3 Dr. Asma Karam 79 1 10 36 412 4 Dr. Lata 112 1 25 234 526 5 Dr. Janta 67 2 26 130 567 6 Dr. Jaimala 37 1 4 25 207 Grand Total 493 9 149 932 3,340

S # Service Number 1 Deliveries Assisted at HFs 17 2 Deliveries Assisted at homes 60

Total Deliveries 77

S # Test Number 1 Pregnancy Tests 172 2 Blood Sugar Tests 627 3 Hemoglobin Tests 81 4 Ultra Sound Test 352 5 Other(Malaria/RDT) 29

Grand Total 1,261

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Muqeem Ahmed 6 91 4 83 Abdul Qadir 8 115 5 76 Total 22 434 13 248

Important Points during Support Group Meetings:

1. Need of Hand pumps 2. Repair of Roof b/c water leakage the Roof. 3. Availability of Female doctors.

4. School Health Sessions & Community Health Sessions SHSs/CHSs conducted By MOs/FMOs/HTs for the month of Aug-2012

S# Name

Community Support Group

Meetings Community Health

Sessions School Health Session

Session Participant Session Participant Session Pax Children

Examined Children Treated

1 Dr. Meena NA 4 84 2 Dr.Janta NA 4 71 3 Dr.Shagufta Shah NA 4 155 4 Dr.Asma Karam NA 4 50 5 Dr.Lata Kumari NA 4 131 6 Dr. Jaimala NA 2 86 7 Dr.Saleem 1 12 4 152 8 Dr.Shahid 1 14 2 25 9 Dr.Dechand 1 7 4 77

10 Dr. Ashok Kumar (Culster) 2 19 4 83 2 78 15 5

11 Dr.Dileep Sonaro 1 13 4 108 12 Dr.Dileep Kumar 1 11 4 42 13 Dr . Parkash 1 2 4 134 14 Dr.Gotam 1 4 4 70 15 Dr.Amanullah 1 10 4 94 16 Dr.Adu Mal 1 10 4 86 17 Dr.Mahesh Kumar 1 9 4 55 18 Dr.Bheroo Lal 1 8 4 55 19 Dr. Madan Lal 1 6 4 139 20 Dr.Perwaiz Sajjad 1 17 1 15 21 Dr.Lachman 1 5 4 85 22 Dr. Lajpat Rai 1 20 4 87 23 Dr.Vijay Kumar 1 12 4 32 24 Dr.Nand lal 1 8 4 56 25 Dr.Santosh Kumar 2 20 4 50

26 Dr.Sarwan Kumar Chelhar 1 7 4 69

27 Dr.Mir Imran/Nechal 0 0 2 27

28 Dr.Molchand 1 8 3 37 29 Dr.Ishtiaque Shah 1 4 4 155

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30 Dr.Pirbhu Lal 1 13 3 117 31 Dr.Misri 1 6 4 72 32 Dr.Mukesh Kumar 1 5 4 39 33 Dr.Suneel Kumar 1 10 4 70 34 Dr Ashok(Wakrio) 1 8 4 94 35 Dr Sajjad 1 9 3 30 36 Dr Vikram 1 3 4 36

37 Dr Sundeep Kumar 1 7 4 108

38 Dr

Sarwan(Arokhi) 1 10 4 69 39 HT Chander 1 8 4 97 40 HT Abdul Aziz 1 20 4 146 41 HT Hashim 1 20 2 46 42 HT Mohsin 1 18 4 100 2 63 15 15

43 HT Muhammad Raheem 0 0 3 40

44 HT Bheesham Kumar 1 20 4 54

45 HT Pirbhu Lal 1 6 2 26 46 HT Amir Bux 1 12 4 91 2 42 13 5 47 HT Dhino 1 7 4 30 48 HT Mooro Mal 1 10 4 120 49 HT Abdul Hadi 1 0 2 43 50 HT Shahbdin 1 10 2 35

51 HT Saindad Samejo 1 10 2 14

52 HT Chandan Singh 0 0 4 70 2 15 0 0

53 HT Bhoopal Singh 1 14 4 97 Grand Total 46 452 189 3954 8 198 43 25

4. Important Points during Health Sessions: 1. Importance of Immunization 5. Topics for CHS for the Month

S # Topics 1 IMMUNIZATION

2 3

4 6. Important Discussion on Community Participation during MRM: Honorable DSM directed to all I/C MOs that regularly conduct the CSG meetings and get support of CSG in different RHF level activities & be alert for the out break etc. 10. Health Camps (TENT FIX CAMP): Number Held: 01 Number of Patients: - 162 11. Measures for Improvement / provision of Services by other Department / Agencies S. No Description Recommendation To whom sent Present status

I Sanitation - - - II Drainage / sewerage - - - III Drinking water - - - IV Prevention of adulteration

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(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW: 1. OPD*

New patients treated during

the month Old patients treated during

the month Total OPD during the month (New +

Old 47,953 1,348 49,301

2. Maximum OPD** Minimum OPD** S # BHU OPD BHU OPD

1 BHU KALOI 2784 GD WAGHO BAJEER 392 2 BHU DANO

DHANDHAL 2315 BHU AROKHI 455

3 BHU KOT ARBAB M.M 2168 BHU CHACHI MOORA 466 4 BHU CHELHAR 2095 GD M SUTHAR 493

5 BHU BHAKUO 1636 GD PEELU 580 3. Top Five Diseases Treated during School Health Sessions/Camps: *All HFs — BHUs and others.

**Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases during OPD:

S # Disease No. of Patients 1 ARI 14,961

2 OTHER COMMUNICABLE DISEASE 18,002

3 GASTRO INTESTINAL 5,990 4 SCABIES/SKIN 2,570

5 URINARY TRACT INFACTION 963

5. ARV / ASV used during the month:

Detail No. of Patients

Dog bite cases reported 15

ARV Administered 77 ARV Available Doses (DSU) Snake bite cases reported 20 ASV Vaccine Administered 27

ASV Vaccine Available Doses(DSU) 119 Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother Child & Reproductive Health.

V Tree Plantation - - - VI Roads and infrastructure - - - VII Environmental

Improvement - - -

VIII Others - - -

S # Diseases No. of Patients 1 ARI 9

2 Fever 6 3 Ear/Eye Problems 4 4 Cough 3 5 Scabies 3

Total 25

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3. (Lab / Diagnostic Tests)

S # Tests Number 1 Blood Sugar Tests 627 2 Hemoglobin 81 3 X-Rays (if available) 0 4 Ultra Sound 352 5 Others 29

Total 1,089 B & C SCREENING TESTS:

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred up-to date

Follow up

result Hepatitis B 0 0 0 0 0 Hepatitis C 0 0 0 0 0

8. TUBERCLOSIS Patients Receiving Treatment New Cases During the

Month Under Diagnosis

0 0 0 9. Referrals

S.No

Totals

Cases Referred To TB DOT Deliveries Others RHCs THQs DHQ

1 25 0 0 25 03 15 07

10. Inverse Referrals

S.No

Totals

Cases Referred from

ARV ASV Others RHCs THQs DHQs

1 0 0 0 0 0 0 0

G. MONITORING DURING MONTH UNDER REVIEW

1. Monitoring Visits during the month DSM Executive officer (M&E) Other Staff Total

27 25 111 163 2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 1 BHU M.Gechu Electricity, approach road,

main gate, and boundary wall destroy due to heavy rain

Contact to Line Deptt: by Admin & resolve electricity problem, Assign to Regional Engineer for verification and estimate of the damages

2 BHU Mithrio Bhatti Roof Repair Regional Engineer verified and preparing Technical Sanction, after approval work will be start.

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for: 45 Weeks 2. Important Issues raised relating to Medicines etc. during MRM: No any issue was discussed in the MRM. I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

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S # Name of HFs

Description of Repair / Maintenance incl.

Electrification

Status / Remarks

1 BHU Virawah Work Completed MB Sent to PSU 2 BHU Dano Dhandhal Work Completed MB Sent to PSU 3 BHU Malanhore vena Work Completed MB Sent to PSU 4 BHU Chelhar Work Completed MB Sent to PSU 5 BHU Kantio Work Completed MB Sent to PSU 6 BHU Wahori Work Completed MB Sent to PSU 7 BHU Mubarak Rind Work Completed MB Sent to PSU 8 BHU Verijhap Work Completed MB Sent to PSU 9 BHU Pabhuar Work Completed MB Sent to PSU 10 BHU KG Shah Work Completed MB Sent to PSU 11 BHU Warkio Work Completed MB Sent to PSU 12 BHU Chanida Work Completed MB Sent to PSU 13 BHU Kolhi Ji Veri Work Completed MB Sent to PSU 14 BHU Kaloi Work Completed MB Sent to PSU 15 BHU Hirar Deda Work Completed MB Sent to PSU 16 BHU Jadam Jhanjhi Work Completed MB Sent to PSU 17 GD Kehri Work Completed MB Sent to PSU 18 GD Jado Joyo Work Completed MB Sent to PSU 19 GD Jogi Mari Work Completed MB is complete 20 GD Bhagisal Work Completed MB is completed 21 GD Peelu Work Completed MB is completed 22 GD Dalan Jo Tar Work Completed MB is completed 23 BHU Amrio Work Completed MB is completed 24 BHU Bhakuo Work Completed 100% work is done 25 BHU Doonjh Work Completed 100% work is done 26 BHU M.Bhatti Work Completed 100% work is done 27 BHU Arokhi Work Completed MB is completed 28 BHU Kankio Work Completed 100 % work done 29 BHU Khetlari Work Completed 100% work done 30 BHU Choopni Work Completed 100% work done 31 BHU Kot Arbab Work Completed 100% work done 32 BHU Khario Fazal Work Completed 100% work done

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited

Overall Comments

• To reflect only non-PPHI Visitor:

J- DISCUSSION DURING MRM: On Staff Matters: 1. The Government Employees were directed to inform the DSM before performing any assignment by EDO Health Office. 2. All In charges of Health Facilities must be inform to the DSU PPHI before giving joining to any newly Appointed staff & directed to all no employee will relieve without permission of District Support Manager. 3. All In charges should be submitted their Monthly Progress Reports before third of the month. 4. All staff under the administration of PPHI district Mithi should be professional, be punctual and bring improvement in Primary Healthcare Services and improver their ownership. 5. 6. Appreciation Certificates issued to Dr. Dileep Sonaro I/C MO BHU Pabohar & Dr. Sarwan Kumar Senior Medical Officer BHU Chelhar for best performance in the last month August 2012.

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7. DSM has strictly directed to all staff that should be avoid to protocol any visitor, if any one will visit then you must be busy their activity. On Preventive Health:

1. Honorable Public Health Specialist Dr. Abdul Sattar Chandio has appreciated the progress of DSU Mithi and suggested to revise the catchment area population targets of PPHI Health Facilities which were not suitable.

2. All Doctors have been directed that to conduct regular Health awareness Sessions in the community and Schools as we can prevent the souls of Thar from different diseases.

3. Directed to all must be capture the emergency cases, Health Sessions, Deliveries etc. 4. During any visit by any PPHI official including DSM or any other organization, they must remain there work,

no need of protocol. 5. Directed to all must be sent DEWS Report every Saturday before 3.00 PM Sharp.

On Curative Health: The Medical and Paramedical Staff has advised to give three days medicine to the patients. In any center there is shortage of medicine the information should be reached to DSU PPHI at least three days in advance. On Mother, Child & Reproductive Health: Directed to the FMOs for regular Health Sessions, motivation and counseling to Community for the importance of deliveries at BHUs and also appreciated their progress which is satisfactory from previous. Other Matters: Directed to all participants be punctual, bring discipline and all reports must be reach before 5TH of the every month. Date /Time for Next MRM: 06-10-2012 10: 00 AM Comments on Targets vs. Achievements (DSM): Honorable DSM warmly welcome to Public Health Specialist Dr. Abdul Sattar Chandio & Dr. Bhansi Focal Person National Program Health department for being participation, then suggested to all Medic & Paramedic staff that we all are working for the betterment of people, so we should perform our duty honestly with regularly and punctuality and directed to all improve your progress, every Incharge should be call staff meeting and collect, verify the data then fill DHIS carefully before the reporting of DSU office & also directed to all FMO that improve Female Planning Services & Maternal Health Services.

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MINUTES OF THE 46th MONTHLY REVIEW MEETING

OF DISTRICT_SANGHAR

Monthly Review Meeting (MRM) of District, Sanghar for the Month of August 2012 held on September 11th , 2012 at DSU office; Sanghar. Written invitations to participates were sent to the District Coordination Officer, the DHO, EDO (F&P), in charge WHO, District Sanghar and District Incharge of EPI, LHW and all other National Programs as usual. The list of participants is enclosed.

Attendance sheet Sr. # Name & Designation Sr.

# Name & Designation

1 Mr.Abdul Rasool Golo DSM DSU,Sgr 58 Dr. Rasool Bux I/C M.O

2 Mr. Ghulam Murtaza Executive (M&E), DSU-Sgr 59 Mr. Ghulam

Mohammad I/C Senior Disp

3 Mr.Mushtaque Ali Executive (M&E), DSU-Sgr 60 Dr. Muhammad Zakir I/C PPHI, M.O

4 Dr.Deedar Hassan M.O (HQ) 61 Dr. Muhammad Saeed I/C PPHI, M.O 5 Dr. Irfan Ali I/C PPHI, M.O 62 Dr. S. Atta ul Mustafa I/C PPHI, M.O 6 Dr. Syed Tarique Ali I/C PPHI, M.O 63 Dr. Jetha Nand I/C PPHI, M.O 7 Dr. Abdul Waheed I/C PPHI, M.O 64 Dr. Hathi Singh I/C PPHI, M.O 8 Dr. Abdul Jabbar I/C PPHI, M.O 65 Dr. Bashir Ahmed I/C M.O 9 Dr. Bashir Ahmed I/C PPHI, M.O 66 Dr. Naeem Ashraf I/C PPHI, M.O 10 Dr. Pitamber Das I/C PPHI, M.O 67 Dr. Jai Ram I/C PPHI, M.O 11 Dr. Shaman Das I/C PPHI, M.O 68 Dr. Shah Saud I/C M.O 12 Dr. Ghulam Abbas I/C M.O 69 Dr. Ghulam Sarwer I/C PPHI, M.O 13 Dr. Manzoor Ahmed I/C PPHI, M.O 70 Dr. Santosh Kumar I/C PPHI, M.O 14 Dr. Abul Qadir I/C PPHI, M.O 71 Dr. Abdul Hameed I/C PPHI, M.O 15 Dr. Haque Nawaz I/C PPHI, M.O 72 Dr. Fouzia Sonologist 16 Dr. Mahesh Kumar I/C M.O 73 Dr. Amna Hayat F.M.O 17 Dr. Mohammad Sharif I/C PPHI, M.O 74 Dr. Asma Jabeen F.M.O 18 Dr. Muhammad Rafique I/C M.O 75 Dr. Asma Malik F.M.O 19 Dr. Talib Hussain I/C PPHI, M.O 76 Dr. Farzana Parveen F.M.O 20 Dr. Ghulam Hyder I/C PPHI, M.O 77 Dr. Hamida F.M.O 21 Dr. Mahesh Kumar I/C PPHI, M.O 78 Dr. Jai Shree F.M.O 22 Dr. Ghulam Mustafa I/C PPHI, M.O 79 Dr. Mahreen F.M.O 23 Dr. Mohan I/C PPHI, M.O 80 Dr. Nusrat Jameel F.M.O

24 Dr. Ali Bahar Rind I/C S.M.O 81 Dr. Qamar-Un-Nisa Shumila F.M.O

25 Dr. Aftab Ahmed I/C PPHI, M.O 82 Dr. Rizwana Channar F.M.O 26 Dr. Arjan Kumar I/C M.O 83 Dr. Rizwana Shaheen F.M.O 27 Dr. Moula Bux I/C M.O 84 Dr. Ruqayya Chandio F.M.O 28 Dr. Muhammad Aslam I/C PPHI, M.O 85 Dr. Rukhsana F.M.O 29 Dr. Shahid Hussain I/C PPHI, M.O 86 Dr. Sadaf F.M.O 30 Dr. Muhammad Yaqoob I/C M.O 87 Dr. Samina Bhatti F.M.O 31 Dr. Mouhammd Yousif I/C PPHI, M.O 88 Dr. Satti Jeewat F.M.O 32 Dr. Altaf Hussain I/C PPHI, M.O 89 Dr. Shamim Begum F.M.O

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89

33 Dr. Gobind Ram I/C PPHI, M.O 90 Dr. Shazia Sharif Zardari F.M.O

34 Dr. Dilshad Ali Khan I/C PPHI, M.O 91 Dr. Shumail Naz F.M.O 35 Dr. Shafique Ur Rehman I/C PPHI, M.O 92 Dr. Wajiha F.M.O 36 Dr. Syed Turab Ali Shah I/C PPHI, M.O 93 Dr. Zulekha Pari F.M.O 37 Dr. Muhammad Haroon I/C PPHI, M.O 94 Dr. Rizwana Khokhar F.M.O 38 Dr. Asif Pervaiz I/C M.O 95 Dr. Tasleem Akhtar F.M.O 39 Dr. Qamar-ul-Hassan I/C PPHI, M.O 96 Dr. Zohra Bibi F.M.O 40 Dr. Bhagwan Das I/C PPHI, M.O 97 Dr. Nusrat F.M.O 41 Dr. Molla Bux I/C PPHI,M.O 98 Dr. Hira Naz F.M.O 42 Dr. Muhammad Farooque I/C PPHI, M.O 99 Dr. Rahima Memon F.M.O 43 Dr. Jewat Ram I/C PPHI, M.O 100 Dr. Qurat-Ul-Ain F.M.O 44 Dr. Kishwar Das I/C PPHI, M.O 101 Dr Fozia Soomro F.M.O 45 Dr. Muhammad Aslam I/C PPHI, M.O 102 Dr.Shumaila Khan F.M.O 46 Dr. Anwar Adil I/C M.O 103 Mr. Imtiaz Ali Store Manager 47 Dr. Jawaher Lal I/C PPHI, M.O 104 Mr. Sultan Ali Social Organizer 48 Dr. Aijaz Baig I/C PPHI, M.O 105 Mr. Abdul Ghaffar Social Organizer 49 Dr. Nand Lal I/C PPHI, M.O 106 Mr. Muhammad Faisal Social Organizer 50 Dr. Aftab Ali I/C PPHI, M.O 107 Mr. Shahid Social Organizer 51 Dr. Aftab Ali I/C PPHI, M.O 108 Mr. Shabeer Ahmed Asst. Admin 52 Dr. Kirpal Das I/C PPHI, M.O 109 Mr. Asif Ali Arain ASM 53 Dr. Taj Mohammad I/C PPHI, M.O 110 Mr. Muhammad Essa Med. Handler 54 Dr. Rafique Ahmed I/C M.O 111 Mr. Muhammad Asif Attendant 55 Dr. Israr Ahmed I/C M.O 112 Mr. Qaim Ali Attendant 56 Dr. Persram I/C PPHI, M.O 113 Mr. Abdul Rasheed Med. Handler 61 Dr Amana Fatma FMO

The following could not attend the meeting for the reasons stated against each:-

Name & Designation Reason Dr. Israr Ahmed I/C S.M.O

ABSENT

Dr. Amil Khan I/C M.O Dr. Ahsan Gohar I/C M.O Dr Narain Das I/C M.O Dr. Muhammad Ramzan I/C M.O Dr. Qurban Ali I/C M.O

Dr. Faiz Muhammad I/C M.O

A. HFs WITH PPHI

BHUs: 58 Dispensaries: 32 MCHCs: (4 functioning in BHU) Others: 01 TOTAL: 91 B. Population of the Catchments Area: 1446257 C. STAFF STRENGTH

Sanctioned Working Government PPHI Vacant

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Posts Employees Contract (Sanc-Govt)

MOs 136 81 23 58 55

W/FMOs 49 32 2 30 -

LHVs 144 56 12 44 67

MTs/MAs

Male 104 32 32 0 72

Female 0 07 07 0 -07

Dispensers 126 89 24 41 61

D. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

1. First Session: During MRM Following persons addressed in MRM.

Capacity Building of LHVs / Dispensers During Month under Review Names of the Resource Persons with dates

Date

Venue Topic No. of

Participants

F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered in Children at Health Facilities. 6013 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 781

No. of Immunization & Vaccination Administered by out- reach EPI Teams 32020 Total vaccination / immunization for the month JULY 2012. 6950

Previous Month Month under Review Total at Present

Clusters of 6 HFs - Clusters of 6 HFs -

Clusters of 5 HFs - Clusters of 5 HFs -

Clusters of 4 HFs - Clusters of 4 HFs -

Clusters of 3 HFs - Clusters of 3 HFs -

Clusters of 2 HFs 03 Clusters of 2 HFs 07

Single HFs 77 Single HFs 74

Previous Month Month under Review Total at Present Clusters of 5 HFs - Clusters of 5 HFs - Clusters of 4 HFs - Clusters of 4 HFs - Clusters of 3 HFs - Clusters of 3 HFs - Clusters of 2 HFs 22 Clusters of 2 HFs 29 Single HFs 08 Single HFs 03

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3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 2 Active Case Detection (ACD) Slides - 3 Visits to Check Sanitation (individual house holds + streets) - 4 Notices issued against Poor Sanitation - 5 Challans sent to Court against Poor Sanitation - 6 Patients Nebulized 547

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health

S # Names of FMOs Ante-Natal Cases Neo-Natal Cases Other OPD Total OPD

1 Ruqia Chandio 21 0 81 567 2 Farzana Ishtiaque 18 0 31 631 3 Samina Bhatti 28 1 63 485 4 Shazia Shareef 44 0 129 539 5 Asma 55 0 81 638 6 Hira Naz 41 0 80 875 7 Nusrat Dilshad 23 3 96 840 8 Shumaila Naz 28 3 79 551 9 Mehreen 41 0 86 591 10 Wajiha Anwar 75 0 25 802 11 Tasleem Aziz 141 13 77 1003 12 Rizwana Chanar 100 2 155 993 13 Nusrat Rani 17 0 29 703 14 Asma Jabeen 11 0 161 550 15 Hameeda Zardari 22 2 62 1257 16 Jai Shiree 45 0 103 955 17 Qamar-un-Nisa Shumaila 43 3 113 851 18 Zohra 46 0 136 745 19 Sadaf Choudry 37 0 35 557 20 Amna Hayat 55 0 89 533 21 Shamim Begam 595 22 Zulikha Pari 32 2 48 713 23 Amna Fatima 426 24 Rukhsana Babar 76 0 58 1061 25 Fozia Soomro 167 1 24 677 26 Shumaila Khan 36 0 67 319 27 Rizwana Khokhar 45 5 24 774 28 Satti Jeevat 21 26 896

26 2 39 Rizwana Shaheen 44 1 88 411 Rahema Memon 45 0 131 1289 Qurat-ul-Ain 479 18 0 31

Deliveries Assisted

S # Service Number

1 Deliveries Assisted at HFs 116

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2 Deliveries Assisted at homes 557

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 835 2 Blood Sugar Tests 464 3 Hemoglobin Tests 124 4 Ultra Sound Test 585 5 Other (Malaria/HBs/HCv) 1034

7. Important Discussion on Mother and Child and Reproductive Health during MRM

During the MRM DSM deeply discussed on the progress of Mother and child and reproductive health and DSM was not satisfied the performance of the different Health facilities regarding the topic, and he also mentioned to improve all the indicators regarding standard demographical charts requirement which is provided to individual each health facility. Further dsm insisted to all FMOs to motivate female patients to visit their respective health facility for ANC checkup and deliveries.

8. Provision of Family Planning Services during the Month S # Name of the Items / Service Number

1 Consultation / Advice 731 2 Oral Pills 371 3 IUCDs 19 4 Injections 365 5 Condom 11

Total 1497 1. Number of Male SGs: --------------87 Number of Female SGs: -------------01 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him

CHSs / SHSs arranged by him

No. No. of Participants No. No. of

Participants Mr. Sultan Ali 7 7 2 2 Mr. Abdul Ghaffar(s.o H.Q) Mr. Faisal 2 2 3 3 Mr.Nadeem Mr.Shahid 6 6 2 2

Total 3. School Health Sessions & Community Health Sessions

S # Name of Medical Officer Community Health Sessions Male Female

1 DR Haroon 2 123 0

2 Dr Hameeda 1 5 30

3 Dr Ghulam Abbas 1 17 0

4 Dr Ali bahar Rind 1 16 10

5 Dr Sadaf Choudhary 1 0 16

6 Dr Abdul Jabbar Sanjrani 1 12 23

7 Dr Asrar(BN) 1 20 19

8 Dr. Samina Bhatti 2 0 32

9 DR Jai Ram Das (DCD Ali Mohd Tahim) 2 23 17

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10 Dr Shumaila khan 1 2 15

11 Dr Rizwana Khokhar 1 0 25

12 Dr Mola Bux Lakho 1 59 0

13 Dr Aslam BHU Rahim Abad 2 64 0

14 Dr Waheed 1 12 0

15 Dr. Amna Fatma 2 0 40

16 Dr. Shumaila Naz 1 0 38

17 Dr Manzoor Rind 1 6 12

18 Dr. Ghulam Hyder (BHU H.H.H) 1 33 0

19 Dr Jewat 1 47 34

20 Dr. Asif 1 25 5

21 Dr. Israr Ahmed 0 0 0

22 Dr. Rizwana shaheen 1 0 8

23 Dr. ASMA Malik 1 0 55

24 Dr. Farooque(mhm) 1 30 0

25 Dr. Anwer adil 1 12 35

26 Dr. Ghulam Sarwar 2 60 50

27 Dr. Tarque ali shah 2 27 0

28 Dr. Aslam (BHU Kamil Keerio) 0 0 0

29 Dr. Yaqoob umrani 1 42 38

30 DR Satti jewat 2 16 51

31 Dr. Nusrat rani 1 0 51

32 Dr. Mehreen 1 0 23

33 Dr. Amna Hayat 2 12 54

34 Dr. Ramzan Wassan 1 38 0

35 Dr. Farzana 1 0 103

36 Dr. Rukhsana Babar 0 0 0

37 Dr. jettha nand 0 0 0

38 Dr. Shamim 1 12 30

39 Dr. Tasleem Aziz 1 0 50

40 Dr. Muhammad Sharif 2 81 0

41 Dr. Abdul Hameed 1 12 9

42 Dr. Asma Jabeen 2 0 53

43 Dr. Aftab Ahmed 1 15 10

44 Dr. Dilshad 2 18 9

45 Dr. Zulekha Pari 1 0 50

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46 Dr. Turab Ali Shah 1 25 0

47 Dr. Wajiha Anwar 1 0 20

48 Dr. Rukiya 1 0 34

49 Dr. Nusrat Jameel 2 0 22

50 Dr. Jay Shiri 2 0 46

51 Dr. Rizwana Channar 1 13 43

52 Dr. Aijaz Beg 1 43 28

53 Dr. JayRam Das (GD Ghundan) 1 8 12

54 Dr. Babar 1 30 18

55 Dr. Bhagwandas 1 29 45

56 Dr. Shafiqurehman 1 20 11

57 Dr. Qamrunissa Shumaila 2 0 48

58 Dr. Qamrulhassan 0 0 0

59 Dr. Fozia Soomro 2 0 37

60 Dr. Naeem Ashraf 1 27 16

61 Dr. Attaul Mustafa 1 34 0

62 Dr. Bashir Ahmed (GD S.F.Mahar) 2 28 14

63 Dr. Kishwar Dass 1 27 0

64 Dr. Bashir Ahmed (Bassi) 1 66 37

65 Dr. Hira 1 0 20

66 Dr. Shazia Sharif 1 0 15

67 Dr. Mehdi Hassan 1 22 0

68 Dr. Zohra 1 0 10

69 Dr. Rasool Bux 1 10 5

70 Dr. Taj Muhammad 2 20 21

71 DR Muzafar Hussain 2 20 25

72 DR Muhammad Yousif 1 20 0

73 DR Rafique Ahmed (Adam Bhambhro) 2 45 0

74 DR Haq Nawaz Jatoi 1 6 22

75 DR Gobindram 3 60 33

76 DR Mahesh Kumar BHU Dhaliyar 1 0 22

77 DR Mahesh Kumar BHU HAMZO 1 26 0

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DARS

78 DR Arjun 1 6 8

79 DR Pitambar 1 15 0

80 DR Shamandas 1 12 10

81 DR Nanad Lal 1 23 0

82 DR Santosh Kumar 0 0 0

83 DR Kirpal 1 39 0

84 DR Moula Bux (Kamil Hingoro) 0 0 0

85 DR Ghulam Mustafa 1 23 0

86 DR Mohammad Zakir 1 34 0

87 DR Mohammad Aslam(Rahimabad) 1 28 0

Total 102 1598 1617

9. Important Points during Support Group Meetings.

Various important points have been discussed in different community support groups meetings conducted by DSM,M&E and SOs. A .at the head jamarao, community appreciated the efforts of PPHI and they emphasized more attention to this BHU as there had been no CSG before this one, conducted by dsm himself .it was first meeting at BHU since takeover of pphi in the district. b. in the BHU preetamabad also first time CSG was conducted by DSM himself in which it first time motivation to the com;;munity who promised to purchase water cooler for bhu and a generator.they requested for sinologist as well , who has been appointed as per cluster. c. in bhu Kamil Kerio, some local miscreants wanted to occupy premises of the health facility, after complain of m.o incharge, DSM himself visited and conducted CSG , in which all the csg members were made aware about the interests of the health facility. They assured that they would protect the interests of health facility

5. Important Points during SHSs Schools closed due to summer vacations 6. Important Points during CHSs

1. Counseling on Family Planning among families. 2. Advantages of neat and cleanliness. 3. Preventive aspects of Hepatitis B&C,malaria nad dengi due to rainy seasons

7. Topics for SHSs for the Month

Sr. No. Summer vacation Topics 8 Topics for CHSs for the Month

S # Topics 1 Family Planning 2 Importance of Breast Feeding 3 Identification of T.B Patents

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9. Important Discussion on Community Participation during MRM The DSM emphasized that all the MOs and FMOs should motivate community of the local area of the health facility and do counseling with them so that they should be active participants in the health facility activities for the betterment and welfare of the health facility and local people of the health facility as well. Further dsm emphasized for the active involvement of incharge m.o in the repair and renovation of the health facilities where R&R is going for the quality work and immediate completion of the work. apart from major repair work dsm insisted on the active participation of m.os to manage their respective medicine stores and dispensaries at health facility as any non technical visitor can appreciate the display of medicine if he/she visited. Dsm further more vowed to visit in order to ensure whether the decisions have been implemented at all the health facilities. 10. Health Camps: 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status i Sanitation - - - ii Drainage / sewerage - - - iii ……… drinking water - - - iv Prevention of adulteration - - - v Tree Plantation - - - vi Roads and infrastructure - - - vii Environmental Improvement - - - viii Others - - -

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*

New patients treated during the month

Old patients treated during the month

Total OPD during the month (New + Old)

119807 1877 121684

2. Maximum OPD** Minimum OPD** S # BHU OPD BHU OPD

1 BHU Rukan Burira 3524 BHU Landhi 2913

3. Top Five Diseases Treated during School Health Sessions/Camps *All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 ARI 14921

4 Facility of Anti Natal care at heath centers 5 Management of / prevention of Malaria 6 Importance of immunization

S # Diseases No. of Patients 1 Allergy 2 Scabies 3 Dandruff 4 Abdominal pain 5 Head ache

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2 Malaria 11855 3 SKIN DISEASES 8072 4 GIT 5360 5 UIT 1145

5. ARV / ASV used during the month

No. of Patients Dog bite cases reported 178

ARV Administered (667 doses Intra Dermal) ARV Available Doses (567 Vials) Snake bite cases reported 0 ASV Vaccine Administered 0 ASV Vaccine Available Doses 53

27. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health) 3. (Lab / Diagnostic Tests)

S # Tests Number 1 Blood Sugar Tests 464 2 Haemoglobin 124 3 X-Rays (if available) 175 4 Ultra Sound 585 5 Others (Malaria/HBs/HCv/PT) 1034

28. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date

Follow up result

Hepatitis B 74 7 - Hepatitis C 78 13 -

8. TUBERCLOSIS

Patients Receiving Treatment New Cases During the Month

Under Diagnosis

14 8 9. Referrals

S.No Totals Cases Referred To

1 114 TB DOT Deliveries Others RHCs THQs DHQs

At serial number (9), the data required is not mentioned DHIS formate. 10. Inverse Referrals

S. No Totals Cases Referred from

1 ARV ASV Others RHCs THQs DHQs

2 49 0 5 44

3

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4

G. MONITORING DURING MONTH UNDER REVIEW 1. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total

46 62 124 232

2. Important Points/Issues arising from Visits S # Name of HF Issue Action Remarks

01

GD Furniture need repair and polished All furniture get repaired by I/ C mo

02

BHU Rahim Abad Furniture need repair and polished All furniture get repaired by I/ C mo

03 BHU Soomar Wassan Water Pump was required on urgent basis

Provided Water Pump

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for: 32 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair /

Maintenance incl. Electrification

Status / Remarks

1

GD Daloor Mori Purchased new wire for H.F the old wire was not working properly

2

Inspections / Visits of PPHI HFs Visitors* Health Facilities Visited Overall Comments

* To reflect only non-PPHI Visitors. I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

1 GD Rawtiani Repair and maintenance of main building

including water supply, drainage, electricity, coloring etc. Completed

2 BHU Tando Mitha Khan ---do--- Completed 3 BHU Rukan Burera ---do--- Completed 4 BHU Chotyarion ---do--- Completed 5 BHU Pritam abad ---do--- Completed 6 BHU Malook Junejo ---do--- Completed

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7 BHU Landhi ---do--- Completed

8 BHU Golo Pir ---do--- Completed 9 BHU Moheb Ali Junejo ---do--- Completed 10 DCD Loon Khan ---do--- Completed 11 DCD Bobi Town ---do--- Completed 12 BHU Jia Abad ---do--- Completed

13 BHU Perumal ---do--- Completed 14 BHU Khairo Kaloi ---do--- Completed 15 DCD Ali Muhammad Thaheem ---do--- Completed 16 BHU Bago Wadadani ---do--- Completed 17 BHU Karim Dino Wassan ---do--- Completed 18 BHU M.K Rind ---do--- Completed 19 BHU Yameen Hingoro ---do--- Completed 20 BHU Bilawal Hingoro ---do--- Completed 21 BHU Khai ---do--- Completed 22 BHU Gider Aahpan ---do--- Completed 23 BHU Soomar Wassan ---do--- Completed 24 G D Ghundan ---do--- Completed 25 BHU Bassi ---do--- Completed 26 BHU Malook Maher ---do--- Completed 27 BHU Rahimabad ---do--- Completed 28 G.D USAMN NIZAMANI ---do--- Completed 29 G.D Juma Village ---do--- Completed 30 G.D Soomar Faqeer Maher ---do--- Completed 31 G.D Bakir Nizamani ---do--- completed

32 G.D NASSER KHAN JALALANI ---do--- completed

33 BHU MAROOF DAHRI ---do--- Completed 34 BHU MEER HASSAN MARI ---do--- Completed

35 G.D DIN MOHD KAKEPOTO ---do--- Work in Progress

36 G.D DALOOR MORI ---do--- Completed 37 BHU QAZI JUMAN DAHRI ---do--- Completed

38 G.D SACHY DINO WARYAH ---do--- Completed

39 BHU ALI MARDAN JAMALI ---do--- Work in Progress

40 BHU PERO FAQEER SHORO ---do--- Completed

41 BHU MULLAN HURMAT ---do--- Completed 42 BHU JEANDO RIND ---do--- Completed 43 BHU MAHER ALI TALPUR ---do--- Completed 44 BHU LUNDO ---do--- Completed 45 DCD MULLAN MAKHAN ---do--- Completed 46 BHU AWADH ---do--- Completed

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47 BHU HAMZO HAMZO DARS ---do--- Work in Progress

48 BHU BHIT BHAITI ---do--- completed

49 BHU DHANI PARTO RAJPAR ---do--- Completed

50 BHU ABDULLAH SANGHRASI Work in Progress

51 BHU CHAMANDAS Completed 52 BHU Chack 8 Work in Progress

J- DISCUSSION DURING MRM

On Staff Matters: 1. It was informed to keep a record of referral / inverse referral record. 2. The District Support Manager assured all the participants that; PPHI will provide full support and cooperation

in all matters of Incharge of Health facilities. 3. The DSM, PPHI Sanghar once again in this MRM reminded all the in charges of health facilities for their

timely submission of HMIS reports, Monthly Medicines Requisition On Preventive Health:

1. The District Support Manager ensured all the participants that PPHI will extend its full support and cooperation in all vertical Programs related from health.

2. On Curative Health: 1. On Mother, Child & Reproductive Health:

Efforts relating to establishment of more MCH centers will be taken. Other Matters:

Date /Time for Next MRM: The Monthly Review Meeting for all the In Charges of Health Facilities shall be held on 9th of coming month.

Comments on Targets vs. Achievements (by DSM) TARGETS ACHIEVEMENTS NEGATIVE:

DISTRICT SUPPORT MANAGER CC to:

• Programme Director, PSU-PPHI-Sindh, Karachi. • Regional Programme Director, RSU-II, PPHI, Mirpurkhas. • All Participants. • Master File.

DISTRICT SUPPORT MANAGER

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MINUTES OF THE (44th) MONTHLY REVIEW MEETING

OF DISTRICT UMERKOT Monthly Review Meeting (MRM) of District, Umerkot for the Month of August, 2012 was held on 14th September, 2012 at Darbar Hall, DC Office, Umerkot. Written invitations to participate were sent to the DC, the DHO, the DO (F&P), D.O Population Welfare Department, District In charge, National Program, EPI, HANDS, TRDP, AWARE, Sami Foundation, Medical officers & Female Medical Officers as usual. The list of participants is as follows: List of Participants:

Sr. Names Designation Sr. Names Designation

1 Ashique Hussain Chandio DSM PPHI U.K 28 Dr. Mohan Bhoopani MO PPHI

2 Dr Fareed Ahmed Focal Person EPI 29 Dr Devi das MO PPHI

3 Sheelai Rai HANDS 30 Dr Malook Oad MO PPHI

4 Bharat Lal HANDS 31 Dr Ashok Kumar MO PPHI

5 Dr Mahboob Ali Samejo E.O (M &E) 32 Dr Mansoor Ali Shah MO PPHI

6 Mohammad Yousif E.O (F & A) 33 Dr Nasrullah MO PPHI

7 Dr Talib Mangrio MO Govt 34 Dr Mohan Lal MO PPHI

8 Dr Chetan Malhi MO Govt 35 Dr Nadir Ali MO PPHI

9 Dr Ghansham Das MO Govt 36 Dr Bahadur Singh MO PPHI

10 Dr Eassar Das MO Govt 37 Dr Ghandi Lal MO PPHI

11 Dr Nand Lal MO Govt 38 Dr Chetan Kolhi MO PPHI

12 Dr Qazi Samejo MO Govt 39 Dr. Mukesh Kumar MO PPHI

13 Dr Jeevraj MO Govt 40 Dr Kanji Mal MO PPHI

14 Dr Khushal Das MO Govt 41 Dr Gomoon Mal MO PPHI

15 Dr M Naeem MO Govt 42 Dr Bhawani Shanker MO PPHI

16 Dr Vijay Kumar MO PPHI 43 Dr Shazia FMO PPHI

17 Dr Teekam Das MO PPHI 44 Dr Naheed Akhtar FMO PPHI

18 Dr Santosh Kumar MO PPHI 45 Dr Devi Jagdesh FMO PPHI

19 Dr Mohammad Yousif MO PPHI 46 Dr Tahreem FMO PPHI

20 Dr Dalpat Rai MO PPHI 47 Dr Rana Shah FMO PPHI

21 Dr Naresh Kumar MO PPHI 48 Dr Hussna Bhatti FMO PPHI

22 Dr Parshotam MO PPHI 49 Chetan Dev Store Manager

23 Dr Jai Parkash MO PPHI 50 Dileep Kumar S.O

24 Dr Vasdev MO PPHI 51 Abdul Rehman S.O

25 Dr Sibghatullah MO PPHI 52 Mohmmad Usman S.O

26 Dr Shanker Malhi MO PPHI 53 Zulfiqar Ali Asst:

27 Dr. Gobind Ram MO PPHI The following could not attend the meeting for the reasons stated against each:-

S # Names/Designation Reasons S # Names/Designation Reasons 1 Nill 2 Nill

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H. HFs WITH PPHI

BHUs: 30 Dispensaries: 11 MCHCs: 01 Others: 0 TOTAL: 42

B. Population of the Catchments Area: 622,536

Q. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) Mos 43 36 08 28 35 WMO 0 0 0 FMOs 01 06 0 06 01 LHVs 31 43 30 13 13

MTs/MAs Male

64 31 31 0

37 Female 0 0 0

Dispensers 2 27 0 27 2

R. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

4. Sessions: During MRM

1st Session: -------- conducted session on ---- and focused on the following points:

19. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of

Participants

F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review

1. Vaccination / Immunization

Previous Month Total Month under Review Total

Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 05 Clusters of 2 HFs 05

Single HFs 31 Single HFs 31

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 05 Clusters of 2 HFs 05 Single HFs 01 Single HFs 01

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No. of Doses of Immunization Administered to Children at Health Facilities. 3661 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 1136 No. of Immunization & Vaccination Administered by out- reach EPI Teams ---- Total vaccination / immunization for the month August 2012

2. National Immunization Days (`s) for Polio

Dates of NIDs Target of coverage Actual coverage Percentage of coverage

3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 00 2 Active Case Detection (ACD) Slides 00 3 Visits to Check Sanitation (individual households + streets) -- 4 Notices issued against Poor Sanitation -- 5 Challans sent to Court against Poor Sanitation -- 6 Patients Nebulized --

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health

2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 109 2 Deliveries Assisted at Homes 00

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 249 2 Blood Sugar Tests 332 3 Hemoglobin Tests 193 4 Ultra Sound Test 0 5 Other (Sputum) 07

20. Important Discussion on Mother and Child and Reproductive Health during MRM

S # Names of FMOs Ante-Natal Cases

Neo-Natal Cases Other OPD Total OPD

1 Dr. Husna Bhatti 78 7 662 747 2 Dr Naheed Akhtar 61 33 597 691 3 Dr Devi Jagdesh 407 20 1420 1847 5 Dr Tahreem 18 15 311 344 6 Dr Rana Shah 139 37 1224 1400 7 Dr Shazia Rahoo 38 12 634 684

Total 741 124 4848 5713

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It was unanimously agree up that PHC services revolve around the mother & child healthcare. It was reiterated that all possible efforts would be taken to improve delivery in this area.

Provision of Family Planning Services during the Month

S # Name of the Items / Service Number

1 Consultation / Advice 361 2 Oral Pills 3 IUCDs 4 Injections 5 Others

Total 361

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: 41 Number of Female SGs: 06 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of

Participants Dileep Kumar 05 70 05 75 Abdul Rehman 05 80 05 70 Mohammad Usman 04 65 05 68

Total 14 215 15 213

5. School Health Sessions & Community Health Sessions

Names of MO / FMOs/Paramedics

Community Health Session School Health Session

Session Participants Session Children

Examined Treated Dr Bahadur Singh 1 19 0 0 0 Dr Mukesh Kumar 1 16 0 0 0 Dr Easar Das 2 40 0 0 0 Dr Sabightullah 0 0 0 0 0 Dr Chetan Kolhi 1 28 0 0 0 Dr Gomoon 1 20 0 0 0 Dr Shanker 1 11 0 0 0 Dr Khushahal Das 1 26 0 0 0 Dr Talib Mangrio 1 30 0 0 0 Dr Chetan Kumar 2 38 0 0 0 Dr Parshotam Das 1 18 0 0 0 Dr Vijay Kumar 1 15 0 0 0 Dr Nandlal 1 30 0 0 0 Dr Qazi Samejo 1 30 0 0 0 Dr Gobind Ram, 1 14 0 0 0 Dr Ghansham 1 10 0 0 0 Dr Vasdev 1 29 0 0 0 Dr Chetan 0 0 0 0 0 Dr Bhawani Shanker 1 20 0 0 0 Dr Dalpat Rai 1 24 0 0 0

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Dr Nasrullah 1 11 0 0 0 Dr Jeev raj 1 26 0 0 0 Dr Gobind Ram, 1 13 0 0 0 Dr Naresh Kumar 2 19 0 0 0 Dr Gomoon 1 23 0 0 0 Dr Teekam Das 1 11 0 0 0 Dr Gandhi 1 30 0 0 0 Dr Jai Parkash 1 4 0 0 0 Dr Naeem 1 9 0 0 0 Dr Kanji 1 28 0 0 0 Dr Sabightullah 0 0 0 0 0 Dr Mohan Bhoopani 1 5 0 0 0 Dr Santosh Kumar 1 7 0 0 0 Dr Ashok Kumar 1 20 0 0 0 Dr Mansoor Shah 1 22 0 0 0 Dr Devidas 1 12 0 0 0 Dr Nadir Ali 0 0 0 0 0 Dr Malook Oad 1 8 0 0 0 Dr M Yousif 1 23 0 0 0 Dr Mohan Rathore 1 9 0 0 0 Dr Mansoor Shah 1 20 0 0 0 Hussna 1 11 0 0 0 Dr Naheed Akhtar 1 16 0 0 0 Dr Tahreem 4 76 0 0 0 Dr Rana Shah 2 26 0 0 0 Dr Devi Jagdesh 1 18 0 0 0 Dr Shazia 1 21 0 0 0

51 886 0 0 0 4. Important Points during Support Group Meetings.

• FMO, LHV & Dai needed • Vaccinator & Pathology Laboratory required • Ultra Sound facility be provided • Progress of Health Facility

5. Important Points during CHSs

• Skin Disease • Malaria Prevention • Diarrhea Prevention • Water Diseases • Breast feeding is important for newly born baby. • Importance of EPI

21. Topics for SHSs for the Month

Sr. No. Topics

1 8 Topics for CHSs for the Month

S # Topics 1 Scabies 2 ARI 3 Measles 4 Polio

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9. Important Discussion on Community Participation during MRM 10. Health Camps: Number Held: 0 Number of Patients: 0 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation ----- ----- ----- Ii Drainage / sewerage ----- ----- ----- Iii ……… drinking water ----- ----- ----- Iv Prevention of adulteration ----- ----- ----- V Tree Plantation ----- ----- ----- Vi Roads and infrastructure ----- ----- ----- Vii Environmental

Improvement ----- ----- -----

Viii Others ----- ----- -----

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW 1. OPD*

New patients treated during

the month Old patients treated during

the month Total OPD during the month

(New + Old) 53337 2241 55578

2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD

1 BHU Shadi Palli 3673 BHU Siddique Abro 540

2 BHU G N Shah 3092 BHU M Hassan 593

3 BHU M Jo Par 3086 BHU Mir Din Mohamad 613

4 BHU Rana Jagir 2355 BHU Dilawar H Shah 621

5 GD Shewani 2209 GD Hurabad 660

3. Top Five Diseases Treated during School Health Sessions/Camps *All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 ARI

2 Fever

3 Diarrhea 4 Pneumonia

5 Scabies

S # Diseases No. of Patients 1

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22. ARV / ASV used during the month

No. of Patients Dog bite cases reported 41 ARV Administered 41 ARV Available Doses 161 (Patients) Snake bite cases reported 00 ASV Vaccine Administered 00 ASV Vaccine Available Doses 00

29. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Pregnancy Tests 249 2 Blood Sugar Tests 331 3 Hemoglobin 193 4 X-Rays (if available) 0 5 Ultra Sound 0 6 Sputum 7 7 Others (Lab test) 1447

30. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

Hepatitis B N/A N/A N/A N/A N/A Hepatitis C N/A N/A N/A N/A N/A

31. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

46 01 00 9. Referrals

Sr. Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 0 0 00 0 0 0 0

10. Inverse Referrals

Sr. Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs 2 00 00 0 0 00 00 00

G. MONITORING DURING MONTH UNDER REVIEW

11. Monitoring Visits during the month

DSM ADSM/ Executive Monitoring Other Staff Total

37 42 115 194

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2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 1

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for 43 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

• Monthly medicine supplied at all the health Facilities • Health facility wise, monthly medicine consumption and per patients cost were shared with doctors.

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification

Status / Remarks

1 BHU Rana Jagir Tiles Work, Colour, Repair, Carpenter, Plumbering & Electrification Complete

2 BHU Aahori Farm Tiles Work, Co lour, Repair, Carpenter, Pulmbering & Electrification Complete

3 BHU Kharoro Syed Tiles Work, Co lour, Repair, Carpenter & Pulmbering Complete

4 BHU Moula Bux Rajar Tiles Work, Co lour, Repair, Carpenter, Pulmbering & Electrification Complete

5 MCH Umerkot Tiles Work, Co lour, Repair, Carpenter, Pulmbering & Electrification Complete

6 BHU Digu Co lour, Repair, Carpenter & Pulmbering Complete

7 BHU Samaro Road Co lour, Repair, Carpenter & Pulmbering Complete

8 BHU Kunri Memon Tile work, Co lour, Repair, Carpenter, Pulmbering & Electrification Complete

9 BHU Sanwan Rajar Tile work, Co lour, Repair, Carpenter & Pulmbering Complete

10 BHU Pir Sarhandi Tile work, Co lour, Repair, Carpenter, Pulmbering & Electrification Complete

11 BHU Faqir Ali Bux Halepoto Tile work, Co lour, Repair, Carpenter & Pulmbering Complete

12 GD Muzafer Hussain Shah Tile work, Co lour, Repair, Carpenter & Pulmbering Complete

13 GD Amin Rajar Tile work, Co lour, Repair, Carpenter & Pulmbering Complete

14 BHU Nabisar Thar Tile work, Co lour, Repair, Carpenter & Pulmbering Complete

15 BHU Fateh M.Rajar Tile work, Co lour, Repair, Carpenter & Pulmbering Complete

16 BHU Toban Veri Tile work, Co lour, Repair, Carpenter &n Pulmbering Complete

17 BHU Haji Pir Shah Tile work, Co lour, Repair, Carpenter & Pulmbering Complete

18 BHU Siddique Abro New Roof, Co lour, Repair, Carpenter & Pulmbering Complete

19 BHU Saleh Bhanbhro Co lour, Repair, Carpenter & Pulmbering Complete

20 BHU Mehinry Jo Par Work started Tile work, Co lour, Repair, Carpenter & Pulmbering Complete

21 BHU Abdul Hakim Aresar Repair, Tile work, Plumbering & Colour Complete

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22 BHU Nawaz Ali Shah Repair, Tile work, Plumbering & Colour Complete 23 BHU Mohd. Hussain Gujrati Repair, Plumbering & Colour Complete 24 GD Sajan Khan Chandio Repair, Tile work, Plumbering & Colour Complete 25 G.D Moosa Jan Sarhandi Repair, Tile work, Plumbering & Colour Complete 26 BHU Araro Bhurgri Repair, Tile work, Plumbering & Colour Complete

27 BHU Dilawar Hussain Shah Co lour, Repair, Carpenter, Pulmbering & Electrification Complete

28 GD Noor Mohammad Mangrio Colour, Repair, Tile, Carpenter & Pulmbering. Complete

29 GD Ismail Nohri Colour, Repair, Tile, Carpenter & Pulmbering & Electrification Complete

30 BHU Darelo Colour, Repair, Tile, Carpenter & Pulmbering & Electrification Complete

31 BHU Padheri Farm Colour, Repair, Tile, Carpenter & Pulmbering & Electrification Complete

32 GD Maghan Khan Chandio Tiles Work, Colour, Repair, Carpenter & Plumbering complete

33 BHU Talhi Tiles Work, Colour, Repair, Carpenter & Plumbering complete

34 BHU Okraro Chanio New Roof, Co lour, Repair, Carpenter & Pulmbering Incomplete

35 BHU Mir Din Mohd New Roof, Co lour, Repair, Carpenter & Pulmbering Incomplete

36 BHU Ghulam Nabi Shah Tiles Work, Colour, Repair, Carpenter & Plumbering Revised

37 BHU Shadi Pali New Roof, Co lour, Repair, Carpenter & Pulmbering Revised

38 GD Ahmedabad In Progress Revised Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

------- ------- ------- * To reflect only non-PPHI Visitors.

J- DISCUSSION DURING MRM On Staff Matters:

• Health Facilities Timings should be followed strictly. On Preventive Health:

• School Health Sessions, Community Health Sessions & CSG meetings will continuously be monitored by Monitoring staff.

On Curative Health: • The chair emphasized the importance the presence of the doctor at the health facility which will ensure the

provision of curative service in the true sense of the word. • Mother, Child & Reproductive Health: • It was shared with the participants that inclusion of quite a few female technical staff has further strengthened

the human resource present at the health facility for provision of healthcare services to the female segment of the population .moreover, conversion of three health facilities into the 24 hour running MCHCs has also started picking the pace towards alleviating the sufferings of female folk.

Other Matters: Date /Time for Next MRM: October 10, 2012 at 10:00 am Comments on Targets vs. Achievements (by DSM)

• R & R work of one more health facilities will be completed soon.

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MINUTES OF THE (48th) MONTHLY REVIEW MEETING

OF DISTRICT LARKANA Monthly Review Meeting (MRM) of PPHI, District Larkana for the month of August, 2012 was held on 12th September, 2012 at hotel Asia In, Larkana. Written invitations to participate were sent to the DCO, EDO (H), EDO (F&P), Distt. Population Welfare Officer, WHO representative, Dy.Dir. Malaria and District In charges of EPI, LHW and all other National Programs. The list of participants is as follows: List of Participants:

S # Names/Designation S # Names/Designation

1 Mr. Ghulam Abbas Detho, RPD, RSU III Larkana 2 Mr. Abdul Hafeez Mahesar, DSM- Lrk

3 Dr. Amanullah Soomro,Asstt:Prf: ZMBBMU Larkan 4 Mr. Ashfique Hyder, ADPTO./ TPWO

5 Dr. Saima Hameed Shaikh, WMO, Shaikh Zaid Women Hospital Larkana 6 Mr.Hamadullah Soomro, EX (F&P)

7 Mr. Asadullah Chang Exe. M&E 8 Mr. Gada Hussain Chachar, SO I. 9 Mr. Amir Ali, Asstt: Store 10 Mr. Sarfraz Ahmed Asstt: F&A 11 Mr. Khalid Hussain, SO. II 12 Mr. Farhan Ahmed, Asstt: Admin 13 Dr. M. Younis khuhro, MO 14 Mr. Mohammad Ali, SO III 15 Dr. Abdul Matab Jatoi, MO 16 Dr. Farman Ali Abro , MO 17 Dr. Attahullah Jagirani, MO 18 Dr. Mumtaz Ali Bhutto, MO 19 Dr. Ashok Kumar 20 Dr. M.Hanif Dhamraho, MO 21 Dr. Asadullah Gopang, MO 22 Dr. Ahsanullah Bugti, MO 23 Dr. S Baleegh Din Rashidi, MO 24 Dr. Bashir Ahmed Wagan, MO 25 Dr. Baqa Muhammad 26 Dr. Abdul Razaque Rahujo, MO 27 Dr. M. Afzal Odho, MO 28 Dr. Badar Din Channo, MO 29 Dr. M.Hanif Mashori , MO 30 Dr. Ganesh Lal , MO 31 Dr.Mahesh Kumar , MO 32 Dr. Zafar Ali Tunio, MO 33 Dr. M.Ali shaikh, MO 34 Dr. Aijaz Ali sheikh, MO 35 Dr. Raj Kumar , MO 36 Hakeem Razakat Ali, MO 37 Dr. Khuda Bux Soom, MO 38 Dr. Altaf Khokhar , MO 39 Dr. Abdullah Arijo, MO 40 Dr. Nabi Dino Bludi, MO 41 Dr. Nisar Kandhro, MO 43 Dr. Tarique Altaf Jatoi, MO 44 Dr. Abdul Aziz Siyal, MO 45 Dr. Shamsdin Sohu, MO 46 Dr. Abdul Rehman Shaikh, MO 47 Dr. Amanullah Abro , MO 48 Dr. Muzafar Ali Bhutto , MO 49 Dr. Mushtaque Ahmed , MO 50 Dr. Maqsood Wadho, MO 51 Dr. M.Aslam Soomro , MO 52 Dr. Zafar Ali Morio, MO 53 Dr. Rahim Bux Soomro, MO 54 Dr.M Yousif Shaikh, MO 55 Dr. Afroz Memon , FMO 56 Dr. Zakir Khoso. MO 57 Dr. Kashifa Ayaz, FMO 58 Dr. Dur-e- Najaf , FMO 59 Dr. Bilqees Khokhar , FMO 60 Dr. Qurtlain Soomro , FMO 61 Dr. Zaib Nisa Bhutto, FMO 62 Dr. Shazia Ambreen , FMO 63 Dr. Rozina Shah , FMO 64 Dr. Sanam Asia , FMO 65 Dr. Musrat Sandano, FMO 66 Dr. Shazia Rehman , FMO 67 Dr. Farzana Balouch, FMO 68 Dr. Seeema kousar , FMO 69 Dr. Jawahar Sheeraz, FMO 70 Dr. Nusrat Wagan,FMO 71 Dr. Aziz Akhtar, FMO 72 Dr. Asma Abbasi, FMO 73 Dr. Aneeta Raj, FMO 74 Dr. Khadeja Makkiah, FMO 75 Dr. Noor JAhan , Sonologist 76 Mst. Rani, LHV 77 Dr. Farzana Shaikh, FMO 78 Mst. Humera parveen, LHV 79 Mst. Feroza , LHV 80 Mst. Saima Maryam, LHV 81 Mst. Sumera Kanwal, LHV 82 Mst.Sajida Bhutto, LHV 83 Mst. Shazia Khuhro, LHV 84 Mst. Zahisa Magsi, LHV 85 Mst. Naveeda Abbasi, LHV

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86 Mst. Bashiran Chandio, LHV 87 Mst. Tasleem, LHV 88 Mst.Afroz Sandelo, LHV 89 Mst. Saima Syed, LHV 90 Mst. Razia, LHV 91 Mst. SaniaMughal, LHV 92 Mst. Asma Shaikh, LHV 93 Mst. Mehtab Mangi, LHV 94 Mst. Fozia, LHV 95 Mst. Rehana Siyal, LHV 96 Mst. Samina Bhutto, LHV 97

The following could not attend the meeting for the reasons stated against each:-

S # Names/Designation Reasons S # Names/Designation Reasons 1 Dr. Altaf Hussain Abro, MO Absent 2 Dr. Sabeen Naz, FMO 3 Dr. Mukhtiar Channo, MO On training 4 Dr. Farzana Tunio, FMO C/l 5 Abdul Ghani Noonari Absent 6 Mst. Noor Shaheen , LHV 7 Mst. Rashida Solangi, LHV Absent 8 Mst. Zubida Mugheri, LHV Absent 9 Mr. Mazhar Abbasi, Disp Absent 10 Mst. Nafees Fatima, LHV Absent 11 Mst. Roohi Banoo, LHV C/l 12 Mst. Benazir Junejo, LHV Absent 13 Mst. Yasmeen Shaikh, LHV Absent 14 Mst. Rehana Brohi, LHV Absent 15 Mst. Shahida Lashari, LHV Absent 16

I. HFs WITH PPHI

BHUs: 27 Dispensaries: 19 MCHCs: 00 Others: 01

TOTAL: 47 B. Population of the Catchments Area:

S # Name of Health Facility Population 1 BHU SAJAN SANGI 32,034 2 BHU AKIL 21,300 3 BHU SHAH ABAD 33,280 4 BHU BEERO CHANDIO 26,500 5 BHU MASOODERO 15,200 6 BHU KHAN WAH 20,000 7 BHU IZAT JI WANDH 7,836 8 BHU LASHARI 24,000 9 BHU WARIS DINO MACHI 9,484

10 BHU JUMO AGHAM 15,000 11 BHU PATHAN 29,000 12 BHU NEW GUD 45,000 13 BHU BAKHAR KARIRA 12,710 14 BHU SONO JATOI 55,000 15 BHU KOTHI 30,000 16 BHU PIR BUX BHUTTO 24,800 17 BHU SAIDUDERO 12,250 18 BHU WASAYO BHUTTO 9,135 19 BHU VEEHAR 30,000 20 BHU KARANI 31,000 21 BHU MAD BAHOO 26,355 22 BHU DHAMRAH 38,341 23 BHU HAJI DHADHRO 5,000 24 BHU FATEHPUR 15,000

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25 BHU MOEN JO DARO 34,713 26 BHU SEEHAR 23,316 27 BHU USMAN KALHORO 23,119 28 GD RASHID WAGAN 23,418 29 GD BAQAPUR 14,000 30 GD KANGA 17,409 31 GD AGHANI 12,240 32 GD DODO SANHERI 5,000 33 GD AREEJA 10,000 34 GD PANJODERO 25,200 35 GD ABAD BHUTTO 4,666 36 GD KOT BHUTTO 10,500 37 GD KETI MUMTAZ 2,000 38 GD SHAHANI 3,080 39 GD KHAIRODERO 10,000 40 GD MEHAR BURIRO 4,300 41 GD GUJHAR 4,078 42 GD LAL BUX SHAIKH 34,731 43 GD TATRI 41,500 44 GD MANGRIA 18,000 45 GD HESSAB CHANDIO 30,000 46 GD BAHMAN 1,550 47 GD MAHOTA 18,155

Total: 9,39,200

S. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MOs 52 47 15 32 37

WMO 00 00 0 00 00 FMOs 28 23 0 23 5 LHVs 42 37 11 26 31

MTs/MAs Male

33 9 9 0

24 Female 0 0 0

Dispensers 52 52 42 28 25 10

T. CLUSTERS OF HFs WITH ONE MO

Previous Month Total Month under Review Total

Clusters of 6 HFs 0 Clusters of 6 HFs 0 Clusters of 5 HFs 0 Clusters of 5 HFs 0 Clusters of 4 HFs 0 Clusters of 4 HFs 0 Clusters of 3 HFs 0 Clusters of 3 HFs 0 Clusters of 2 HFs 0 Clusters of 2 HFs 0

Single HFs 46 Single HFs 46

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WITH ONE FMO

E. CAPACITY BUILDING 1. Second Session: During MRM

Dr. Rafia Baloch, Asstt: Professor Gynae/Obs Dept: Shaikh Zaid Women Hospital, delivered lecture on “Hypertension in Pregnancy”:

Dr. Amanullah Abbasi, Asstt: Professor, Urology Deptt: SMBBMU, delivered lecture on “BPH”.

After the session he invited the participants for open discussion, which was very productive. E. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered to Children at Health Facilities. 747 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 234 No. of Immunization & Vaccination Administered by the out- reach EPI Teams 00 Total vaccination / immunization for the month of May 990

2. National Immunization Days (NIDs) for Polio

Dates of NIDs Target of coverage Actual coverage

Percentage of coverage

Nil Nil Nil Nil 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides -- 2 Active Case Detection (ACD) Slides -- 3 Visits to Check Sanitation (individual house holds + streets) -- 4 Notices issued against Poor Sanitation -- 5 Challans sent to Court against Poor Sanitation -- 6 Patients Nebulized --

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health

S.No Name of FMOs Antenatal Post Natal Other Total OPD

1 Dr. Rozina Shah 61 12 718 746

2 Dr. Farzana Balouch 239 17 529 256

3 Dr. Sabeen Naz 237 15 285 472

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 16 Clusters of 2 HFs 16 Single HFs 07 Single HFs 07

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4 DR. Qurtlain Soomro 138 42 1785 1965

5 Dr. Asma Abbasi 70 23 825 918

6 Dr. Shazia Abbasi 141 28 1216 1385

7 Dr. Shazia Rehman 22 8 546 576

8 Dr. Zaib Nisa Bhutto 12 3 495 510

9 Dr. Aziz Akhtar 110 46 623 779

10 Dr. Dur-e - Najaf 56 5 912 973

11 Dr. Bilqees Khokhar 44 6 592 642

12 Dr. Farzana Shaikh 44 7 1121 1172

13 Dr. Sanam Asia 109 25 1321 1455

14 Dr. Aneeta Raj 40 20 840 900

15 Dr. AfrozMemon 62 15 842 919

16 Dr. Seema Kousar 27 00 808 835

17 Dr. Musrat Nazir 138 10 700 1683

18 Dr. Jawahar Sheeraz 50 32 769 851

19 Dr. Khadeja Makkiah 69 25 542 636

20 Dr. nusrat Wagan 74 28 863 965

21 Dr. Farzana Tunio 78 32 890 1000

22 Dr. Kashifa Ayaz 54 13 897 964

23 Dr. Ruksana Bughio 148 93 1545 1790

Total: 2023 505 19664 22392 2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 118 2 Deliveries Assisted at Homes 00

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 532 2 Blood Sugar Tests 1247 3 Hemoglobin Tests 342 4 Ultra Sound Test 3356 5 Other (Malaria) 0

23. Important Discussion on Mother and Child and Reproductive Health during MRM

Discussions were carried out by the participants with the guest speakers. 24. Provision of Family Planning Services during the Month

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S # Name of the Items / Service Number 1 Consultation / Advice 630 2 Oral Pills 0 3 IUCDs 20 4 Injections 240 5 Others (Condoms) 1060

Total 1950

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: 47 Number of Female SGs: 00 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of

Participants Mr. Gada Hussain Chachar 02 0 65 01 50 Mr. Khalid Hussain Abro 02 0 55 01 46

Mohammad Ali 01 0 35 01 55 Total 05 0 155 03 151

2. School Health Sessions & Community Health Sessions

S.No NAME OF FMOs/MOs

Community Health Session School Health Session

NO: SESSIO

N

TOTAL PARTICIPA

NTS

TOTAL OPD/ TREATMENT

NO: SESSIO

N

TOTAL PARTICIPANTS

TOTAL OPD/TREATMENT

1 Dr. Aijaz Ali shaikh 2 35 10 0 0 0 2 Dr. Sabeen Naz 2 38 0 0 0 0 3 Dr. Farman ali Abro 2 108 90 0 0 0 4 Dr. Farzana Tunio 4 83 50 0 0 0 5 Dr. Abdullah Arijo 2 35 15 0 0 0 6 Dr. M.Hanif Dhamraho 2 23 5 0 0 0 7 Dr. Raj Kumar 2 106 89 0 0 0 8 Dr. Nisar Kandhro 2 51 7 0 0 0 9 Dr. Muzafar Ali 2 15 7 0 0 0 10 Dr. Baqa Muhammad 2 37 0 0 0 0 11 Dr. Mumtaz Ali Bhutto 2 45 14 0 0 0 12 Dr. Mushtaque Ali 1 30 10 0 0 0 13 Dr. Seema Kousar 3 26 10 0 0 0 14 Dr. Khuda Bux Soomro 2 13 0 0 0 0 15 Dr. M.Yousif Shaikh 2 21 18 0 0 0 16 Dr. Kashifa Ayaz 2 66 50 0 0 0 17 Dr. Tarique Altaf 2 61 53 0 0 0 18 Dr.Ruksana Bughio 2 58 22 0 0 0

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19 Dr. Maqsood Ahmed 2 20 5 0 0 0 20 Dr. Abdul Rehman 2 41 20 0 0 0 21 Dr. Shazia Rehman 2 41 20 0 0 0 22 Dr. Ashok Kumar 2 32 10 0 0 0 23 Dr. Baleeg DinRashidi 2 29 19 0 0 0 24 Dr. Mahesh Kumar 2 90 11 0 0 0 25 Dr. Zaib Nisa Bhutto 2 60 50 0 0 0 26 Dr. Jawahar Sheeraz 3 50 30 0 0 0 27 Dr. Afroz Memon 4 118 40 0 0 0 28 Dr. Musrat Nazir 2 18 10 0 0 0 29 Dr. Aneeta Raj 2 140 50 0 0 0 30 Dr. Zakir Khoso 2 245 142 0 0 0 31 Dr. Asma Abbasi 2 56 15 0 0 0 32 Dr. Zafar Ali Tunio 2 26 2 0 0 0 33 Dr. Rozina Shah 2 65 30 0 0 0 34 Dr. Ahsanullah Bugti 2 56 33 0 0 0 35 Dr. Shamsdin Sohu 2 50 35 0 0 0 36 Dr. Nusrat Wagan 4 80 55 0 0 0 37 Dr. Bilqees Khokhar 2 11 2 0 0 0 38 Dr. Qurtlain Soomro 2 35 35 0 0 0 39 Dr. A.Matab Jatoi 2 35 15 0 0 0 40 Dr. Sanam Asia 4 280 210 0 0 0 41 Dr. Shazia Abbasi 0 121 120 0 0 0 42 Dr. Farzana Balouch 2 62 20 0 0 0 43 Dr. Khadeja Makkiah 2 52 0 0 0 0 44 Dr. Dur-e-Najaf 2 110 102 0 0 0 45 Dr. M.Aslam Soomro 2 40 20 0 0 0 46 Dr. Aziz Akhtar 2 105 50 0 0 0 47 Dr. Mukhtiar channo 3 250 80 0 0 0 Total 102 3169 1681 00 00 00

4. Important Points during Support Group Meetings.

• Check the Attendance of the staff of health facility. • Polio Campaign discussed • Diagnostic Laboratory • Medicine quality and quantity. • EPI Coverage were discussed • Ultra sound facility days • FMO days at HFs also discussed • Security and ownership of community. • Demanded of Ambulance.

25. Important Points during CHSs • Dysfunctional Uterine Bleeding DUB • Scabies • Rabies virus Tuberculosis • Antenatal Care

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• Pelvic Inflammatory Diseases • Importance of Vaccinations • Conjunctivitis (Red Eye) • Low Birth weight Newborn • Family Planning • Diet in Pregnancy • U/S Examination During Pregnancy • Lactating Mother • Postpartum Hemorrhage. • Urine Tract Infection • Vomiting • Anemia • Intestinal Tuberculosis • Constipation • Vomiting • Cough • Acute Diarrhea • Influenza Virus • Nutrition • Respiratory trait Infection and Asthma • Personal Hygiene. • Pneumonia • Malaria.

8 Topics for CHSs for the Month of August 12

S.No Topics

1 Dysfunctional Uterine Bleeding DUB 2 Scabies 3 Rabies virus Tuberculosis

4 Antenatal Care 5 Pelvic Inflammatory Diseases

6 Importance of Vaccinations

7 Conjunctivitis (Red Eye)

8 Low Birth weight Newborn

9 Family Planning

10 Diet in Pregnancy

11 U/S Examination During Pregnancy

12 Lactating Mother

13 Postpartum Hemorrhage

14 Urine Tract Infection

15 Vomiting 16 Anemia 17 Intestinal Tuberculosis 18 Constipation

19 Vomiting

20 Cough

21 Acute Diarrhea 22 Influenza Virus

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23 Nutrition

24 Respiratory trait Infection and Asthma

25 Personal Hygiene

26 Pneumonia

27 Malaria 9. Important Discussion on Community Participation during MRM

• Most of the Participants acknowledged PPHI role to provide basic health facilities in rural areas for poor community at free of cost.

• Community participation through community support groups also the role model of PPHI. • Repair and Renovation of Health facilities and other facilities provided at Health facilities by PPHI also

appreciated by participants.

10. Health Camps: Number Held: 00. Number of Patients: 00. 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation N/A N/A N/A Ii Drainage / sewerage N/A N/A N/A Iii ……… drinking water N/A N/A N/A Iv Prevention of adulteration N/A N/A N/A V Tree Plantation N/A N/A N/A Vi Roads and infrastructure N/A N/A N/A Vii Environmental Improvement N/A N/A N/A Viii Others N/A N/A N/A

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*

New patients treated during

the month Old patients treated during

the month Total OPD during the month

(New + Old) 107878 107878

2. Maximum OPD** Minimum OPD**

S # BHU/GD OPD BHU/GD OPD 1 BHU Sono Jatoi 4022 GD Keti Mumtaz 870 2 BHU Dhamrah 3828 GD Areeja 951

3 BHU Pir Bux Bhutto 3350 BHU Sajan Sangi 1048 4 USK/GD Mahota 3092 BHU Bakhar Karira 1343 5 BHU Beero Chandio 2955 GDMangria 1436

3. Top Five Diseases Treated during School Health Sessions/Camps *All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs.

S # Diseases No. of Patients 1 Scabies 00 2 Malaria 00

3 ARI 00

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4. Top Five Diseases during OPD

S # Disease No. of Patients

1 Fever (Clinical Malaria) 15707

2 Acute Respiratory Infections 11841

3 Scabies 10513 4 Diarrhea 15340 5 Dysentery 326

3. ARV / ASV used during the month

No. of Patients Dog bite cases reported 118 ARV Administered 188 ARV Available Doses 451 Snake bite cases reported 00 ASV Vaccine Administered 00 ASV Vaccine Available Doses 00

32. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Pregnancy Tests 532 2 Blood Sugar Tests 1247 3 Hemoglobin 342 4 X-Rays (if available) 3356 5 Ultra Sound 0 6 Others (Malaria) 0

33. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred up to date Follow up result

Hepatitis B 00 00 00 00 00 Hepatitis C 00 00 00 00 00

8. TUBERCLOSIS

Patients

Receiving Treatment New Cases During the

Month Under Diagnosis

00 0 00 9. REFERRALS

S# Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 No No No No No No No 3 No No No No No No No 4 No No No No No No No

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10. Inverse Referrals

S No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs 2 No No No No No No No 3 No No No No No No No

G. MONITORING DURING MONTH UNDER REVIEW

1. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total

51 49 156 256 2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 1 N/A N/A N/A N/A 2 N/A N/A N/A N/A 3 N/A N/A N/A N/A 4 N/A N/A N/A N/A

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for 38 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

1 00 00 00 Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

N/A

N/A N/A

N/A

N/A N/A

* To reflect only non-PPHI Visitors.

J- DISCUSSION DURING MRM On Staff Matters:

• All the staff members of BRHF’ were once again reminded to observe timings in their health facilities. • Always wear aprons/ uniforms which have been already provided. • Observe/ ensure cleanliness in their health facilities. • Maintenance of proper record keeping • Ensure availability of all essential medicines.

• Ensure availability of instruments in working condition.

• Submitted DHIS reports timely.

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• Submitted Medicine position/Stock position timely.

On Preventive Health:

• All the Medical Officers/ Female Medical Officers were informed that Family Planning material / medicine are available in abundant quantity and they should promote its usage.

• It was also requested that ensure availability of T. B DOTS medicine and wherever there is shortage, inform DSU immediately.

On Curative Health: All the Medical Officers were informed that there is sufficient stock of medicines available in DSU store and they should report immediately for any kind of shortage On Mother, Child & Reproductive Health: N/A Other Matters: Matters regarding supply of medicines, repair of buildings, provision of uniforms, and other items were also discussed during the monthly meeting. Date /Time for Next MRM:

Next MRM will be held on first week of October, 2012 Comments on Targets vs Achievements (by DSM) All the targets/goals and assignments from time to time are being achieved for successful continuation of this program and for the satisfaction of the community.

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MINUTES OF THE (48th) MONTHLY REVIEW MEETING OF DISTRICT KAMBER-SHAHDADKOT

Monthly Review Meeting (MRM) of District, Kamber-Shahdadkot for the Month of August , 2012 was held on 15 September, 2012 at Sapna inn hotel larkana . Written invitations to participate were sent to the DCO, the EDO(H), the EDO(F&P) and District Incharge of EPI, Surveillance Officer WHO, T.B Dot Programme, EDO (Education), and all other National Programs as usual. The list of participants follows:

S.No. Name of Officer’s 1 Mr Habibul Rehman Jamot (DSM Kamber Shahdadkot) 2 Mr Abdul Latif Malik (Executive M&E) 3 Mr Abdul Raheem Junejo (Executive F&A) 4 Dr Mumtaz Sheikh ( Deuty DHO Kamber) 5 Dr Farzana Soomro ( BHU Aitbar Khan Chandio/ BHU Chakiyani) 6 Dr Freeda Sheikh ( WMO MCH Shahdadkot) 7 Dr Nadeem Akhtar Sheikh ( GD Chhajjra) 8 Dr Zahida Keheri (FMO BHU Khairpur Jooso & BHU Ghogaro) 9 Dr Surya Lashari (BHU Ghazi Khan Khuhawar & BHU Thoof Chosool) 10 Dr Khalid Hussain Sheikh ( BHU Thori Bijar) 11 Dr Abdul Karim Memon(BHU Ziaudin Isran) 12 Dr Fozia Soomro (FMO BHU Arzi Bhutto) 13 Dr Safia Jamali (FMO BHU Deera & Wadho Kalhoro) 14 Akhtar Hussain Burirro ( H.T BHU Gathar) 15 Dr Reehana Chandio (FMO MCH Nasirabad) 16 Dr Shahid Nabi Shah (BHU Thoof Chusool 17 Dr Tahira Memon (BHU Gathar & GD Chajjra) 18 Dr Najamuddin Shaikh (I/C M.O MCHC Shahdadkot) 19 Dr Samina Shah (FMO BHU Lalu Raunk & BHU Thori Bijar 20 Dr Noor Mohammad Memon 21 Dr Heema (BHU Aitbar Khan Chandio/BHU Chakiyani) 22 Dr Ameer Rahojo (I/C BHU Khuda Bux Wahoocho) 23 Dr Ambreen Bhutto ( BHU Bambho Khan Chandio / BHU Ghulam Ali Magsi) 24 Mr Riaz Ahmed Tunio (S.O) 25 Mr Imran Ahmed Laghari (S.O) 26 Dr Ravi Kumar ( GD Abdul Wahab Khoso) 27 Dr Shamshad Begum Wagan ( BHU Khuda Bux Wahoocho/ BHU Datu Teewna) 28 Dr Nisar Ahmed Mugheri ( BHU Mohammad Ali Gurhmani) 29 Dr Barkat Makool (BHU Kot Ghulam Shah) 30 Dr Munwar Chandio ( BHU Googharo) 31 Dr Ghaulam Farid Khuhawar( BHU Khandu) 32 Dr Suneel Kumar ( BHU Aitbar Khan Chandio) 33 Dr Parkash Lal Advani ( BHU Chakiyani) 34 Dr Abdul Manan Sheikh (BHU Wadho Kalhoro) 35 Dr Noor Khatoon (BHU Deera/BHU Wadho Kalhoro) 36 Dr Mansoor Depar ( BHU Gaji Khuhawar) 37 Dr Allah Bux Soomro(BHU ARZI BHU Arzi Bhutto) 38 Dr Khalid Hussain Burirro( BHU Gazi Khan Khuhawar) 39 Dr Subhan Ali Lakho ( BHU Hamal) 40 Dr Hiranand (BHU Ghulam Ali Magsi)

The following could not attend the meeting for the reasons stated against each:- S # Names/Designation Reasons Concerned Health Facility 01 Dr Hakimzadi On Leave MCH Shahdadkot 02 Dr Ghulam Shabir Wagan Absent BHU Lalu Raounk

J. HFs WITH PPHI

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TOTAL: 27 BHUs: 22 Dispensaries: 02 MCHCs: 02 Others: 01 B. Population of the Catchments Area: 1375398

U. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MO 24 24 8 16 W/FMOs 01 15 2 13 2 LHVs 26 14 9 05 12

MTs/MAs Male

- - - -

- Female - - -

Dispensers 03 25 05 20 -

V. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO

E.

CAPACITY BUILDING 1. First Session: During MRM . Review Performance Of all health facilities 1 Dr Koro Mal given a lecture on the Topic ( Typhoid Fever) F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered to Children at Health Facilities. 5596 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 886 No. of Immunization & Vaccination Administered by out- reach EPI Teams _ Total vaccination / immunization for the month ---------------- 6482

2. National Immunization Days (NIDs) for Polio

Dates of NIDs Target of coverage Actual coverage Percentage of coverage

Previous Month Total Month under Review Total

Clusters of 6 HFs - Clusters of 6 HFs - Clusters of 5 HFs - Clusters of 5 HFs - Clusters of 4 HFs - Clusters of 4 HFs - Clusters of 3 HFs - Clusters of 3 HFs - Clusters of 2 HFs - Clusters of 2 HFs -

Single HFs 23 Single HFs 23

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 10 Clusters of 2 HFs 10 Single HFs 05 Single HFs 05

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16/7/2012 TO 18/7/2012 233852 287139 99 % 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides Nil 2 Active Case Detection (ACD) Slides Nil 3 Visits to Check Sanitation (individual house holds + streets) - 4 Notices issued against Poor Sanitation - 5 Challans sent to Court against Poor Sanitation - 6 Patients Nebulized 181

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health 2.

Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 114 2 Deliveries Assisted at Homes -

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 391 2 Blood Sugar Tests 235 3 Hemoglobin Tests 40 4 Ultra Sound Test 0 5 Other 8662

26. Important Discussion on Mother and Child and Reproductive Health during MRM DSM stressed on all MOs, especially FMOs to provide better services to the people for mother and reproductive health.

27. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number Consultation / Advice 277

S # Names of FMOs Ante-Natal Cases

Neo-Natal Cases

Other OPD Total OPD

01 Dr Samina Shah 127 5 2509 2641 02 Dr Tahira Memon 80 6 1930 2016 03 Dr Umbrin Bhutto 164 12 2770 2946 04 Dr Surya Lashari 33 2 2000 2035 05 Dr Fozia Soomro 75 0 788 863 06 Dr Noor Khatoon 62 5 1383 1450 07 Dr Rehana Chandio 337 37 5117 5491 08 Dr Safia Jamali 100 0 2627 2727 09 Dr Farzana Soomro 4 0 385 389 10 Dr Zahida Khaeri 44 0 1586 1630 11 Dr Shamshad Begum 49 0 1538 1587 12 Dr Hakimzadi 0 0 0 0 13 Dr Reehana Tunio 65 15 3429 3509 14 Dr Heema 143 8 371 522 15 Dr Fareeda Sheikh 275 15 335 625 TOTAL 1558 105 26768 28431

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Oral Pills 102 IUCDs 0 Injections 170 Others 360

Total 909

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: 27 Number of Female SGs: 01 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of Participants Mr Imran Ahmed Leghari 11 0 174 29 307 Mr Riaz Ahmed Tunio 9 0 148 24 284

Total 20 0 322 53 591 3. School Health Sessions & Community Health Sessions

Names of MO / FMOs/Paramedics

Community Health Sessions School Health Sessions

Sessions Participants Sessions Children Examined

Children Treated

Dr Samina Shah 2 28 - - _ Dr Tahira Memon 4 63 - - _ Dr Umbrin Bhutto 2 41 - - _ Dr Surya Lashari 4 69 - - _ Dr Fozia Soomro 4 66 - - _ Dr Noor Khatoon 0 0 - - _ Dr Safia Jamali 4 71 - - _ Dr Zahida Kaheri 4 61 - --- _ Dr Shamshad Begum 4 74 - -- _ Dr Farzana Soomro 4 64 - --- _ Dr Rehana Tunio 3 54 - - _ Dr Rehana Chandio 4 69 - - _ Dr Heema 2 31 - - _ Dr Khalid Sheikh 01 21 - - _ Dr Abdul Karim 2 26 - - _ Dr Nadim Akhtar 1 18 - - _ Dr Subhan Lakho 1 17 - - - Dr Heeranand 2 26 - - _ Dr Barkat Makool 1 19 - - _ Dr Ghulam Fareed 1 18 - - _ Dr Bashir Ahmed Brohi 1 23 - - _ Dr Munwar Chandio 1 15 - - _ Dr Khalid Buriro 1 16 - - _ Dr Ravi Kumar 1 19 - - _ Dr Sanaullah Wagan 1 14 - - _ Dr Ameer Rahojo 2 28 - - _ Dr Suneel Kumar 1 16 - - _ Dr Shahid Nabi Shah 1 17 - - _ Dr Mansoor Depar 1 19 - - _ Dr Nisar Ahmed Mugheri 2 28 - - - Dr Allah Bux Soomro 2 29 - - _ Dr Parkash 1 14 - - _

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Dr Shabir Ahmed Wagan 1 18 - - _ Dr Abdul Manan Sheikh 1 14 - - _ Totals 67 1096 - - _

4. Important Points during Support Group Meetings. 1. Electricity problem 2. Supply of ARV 3. Supply of medicines

5. Important Points during SHSs

1. 2. 3.

6. Important Points during CHSs

1. Awareness in community about prevalent diseases. 2. Counseling to pregnant women. 3. Awareness in community how to protect from heat & sun stroke.

7. Topics for SHSs for the Month

Sr. No. Topics 1 Malaria 2 Cough 3 Hygiene 4 Fever

8 Topics for CHSs for the Month

S # Topics 1 Dengu Fever 2 Meningitis 3 Viginal discharge 4 Tuber Closes

9. Important Discussion on Community Participation during MRM

Community to help at centers for tree plantation etc. 10. Health Camps: Nil 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status i Sanitation Nil Nil ii Drainage / sewerage Nil Nil iii Drinking water Nil Nil iv Prevention of adulteration Nil Nil v Tree Plantation Nil Nil vi Roads and infrastructure Nil Nil vii Environmental Improvement Nil Nil viii Others Nil Nil

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*

New patients treated during the month

Old patients treated during the month

Total OPD during the month (New + Old)

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78210 713 78923 2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD 1 Lalu Rounk 10040 Hamal 1276 2 Bambho khan chandio 4940 Chakiyani 1443 3 Mohammad Ali Gurhmani 3723 Aitbar Khan Chandio 1543 4 Deera 3556 Arzi Bhutto 1765 5 Gazi Khan Khuhawar 3438 Gathar 1812

3. Top Five Diseases Treated during School Health Sessions/Camps *All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 A.R.I 8673 2 Scabies 6863 3 Fever clinical Malaria 6113 4 Diarrhea 3941

28. ARV / ASV used during the month

No. of Patients Dog bite cases reported 93 ARV Administered 93 ARV Available Doses 72 Snake bite cases reported Nil ASV Vaccine Administered Nil ASV Vaccine Available Doses 08

34. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests) S # Tests Number 1 Pregnancy Tests 391 2 Blood Sugar Tests 235 3 Haemoglobin 40 4 X-Rays (if available) _ 5 Ultra Sound _ 6 Others (please specify) 8662 9328

35. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date

Follow up result

S # Diseases No. of Patients 1 Fever (Clinical Malaria 1441 2 A.R.I 1213

3 Scabies 975 4 Diaherrea 413

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Hepatitis B Nil - Nil Nil - Hepatitis C Nil - Nil Nil -

36. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

34 _ - 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 16 - - - - 16 3 4

10. Inverse Referrals

S.No

Totals Cases Referred from ARV ASV Others RHCs THQs DHQs

1 Nil Nil Nil Nil Nil Nil Nil 2 3

G. MONITORING DURING MONTH UNDER REVIEW

12. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total

34 32 102 168 2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 01 N/A N/A N/A N/A 02 N/A N/A N/A N/A 03 N/A N/A N/A N/A 04 N/A N/A N/A N/A

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for 37 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM As such no issue was discussed.

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

01 BHU Khairpur Jooso Work completed MB recorded 02 BHU Datu Teewna -do- -do- 03 BHU Ghazi Khan Khuhawar -do- -do- 04 BHU Aitbar Khan Chandio -do- -do- 05 BHU Gathar -do- -do- 06 BHU Bhambo Khan Chandio -do- -do- 07 BHU Mohammad Ali Gurmani -do- -do-

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08 BHU Thori Bijar -do- -do- 09 BHU Chakyani -do- -do- 10 BHU Kot Ghulam Shah -do- -do- 11 BHU Behram d-o- -do- 12 BHU Lalu Raunk -do- -do- 13 BHU Ghogharo -do- -do- 14 BHU Ghulam Ali Magsi -do- -do- 15 BHU Arzi Bhutto -do- -do- 16 BHU Thoof Chosool -do- -do- 17 BHU Deera -do- MB recorded 18 BHU Wadho Kalhoro -do- MB recorded 19 BHU Khuda Bux Wahocho -do- MB recorded 20 BHU Gaji Khuhawar -do- MB recorded 21 BHU Khandu -do- MB recorded 22 Unani Shifakhana Gul Buriro work completed MB recorded

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

- - -

* To reflect only non-PPHI Visitors.

J- DISCUSSION DURING MRM On Staff Matters: I On the puctualty of staff at health facility.. On Preventive Health: It was decided to conduct more and more CHSs and utilize the services of vaccinators and outreach staff in order to prevent diseases, and to establish rapport in all the national programs. On Curative Health: 1. To run OPDs properly at all HFs. 2. To properly provide the services to the people. 3. To ensure availability of essential medicines at HFs On Mother, Child & Reproductive Health: FMOs as well MOs were asked by the DSM to properly attend all the ante-natal & neo-natal cases. Other Matters: Date /Time for Next MRM: 10_10_2012 @ 09.30 am Comments on Targets vs Achievements (by DSM) 1. R&R Target of all the HFs / schemes completed.

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MINUTES OF THE 50th MONTHLY REVIEW MEETING

OF DISTRICT KHAIRPUR

Monthly Review Meeting of District Khairpur for the Month of August-2012 was held on 19,20 and 22nd September 2012 at DHDC Hall Khairpur Mir’s. Written invitations to participants were sent to the Deputy Commisioner, the DHO, the DO (F&P), DO(CDD), District Population Welfare Officer, Civil Surgeon DHQ-Khairpur, Taluka Health Officer(s) (all), District Coordinator National Program Khairpur, District Focal Person EPI, District Focal Person TB, District Coordinator, Malaria Control Program and NMO (WHO) as usual. The list of participants is enclosed.

S No Name of In-charge Designation S No Name of In-charge Designatio

n 1 Abdul Ahad Mahesar MO 59 Asghar Arain M.O

2 Ab. Karim Shaikh M.O 60 Raja Ikram M.O

3 Ab. Qadir Shaikh M.O 61 Dharampal .M.O

4 Ab. Qayoom Memon M.O 62 Waqar Ahmed M.O

5 Ab. Rauf Shaikh M.O 63 Gh. Murtaza Lakho M.O

6 Ahsan Solangi M.O 64 Ghayoor Abbas M.O

7 Akhtar Khuhro M.O 65 Mukhtyar wassan M.O

8 Ali Mohd Bhanbhro M.O 66 M. Afzal M.O

9 Ali Sher Maitlo M.O 67 Mehtab Phull M.O

10 Anwar Sahto M.O 68 Asad Ghumro M.O

11 Atta Hussain Narejo M.O 69 Maqsood Ahmed Bozdar M.O

12 Atta Mohd Memon M.O 70 Safiullah Mahesar M.O 13 Ayaz Chandio M.O 71 Irshad Sahto M.O 14 Ayaz Mirani M.O 72 Gada Husain Bhutto M.O 15 Ayaz Shaikh M.O 73 Majeed Memon M.O 16 Azhar Arejo M.O 74 Mukesh Kumar M.O 17 Bashir Khuhro M.O 75 Gobind Ram M.O 18 Falak Sher Sahto M.O 76 Pardeep Kumar M.O 19 Fayaz Memon M.O 77 Arif Hussain M.O 20 Akbar Kanhar M.O 78 Imtiaz Maitlo M.O 21 Gh. Hussain Bhellar M.O 79 Ayub Jogi M.O 22 G. Mujtaba Memon M.O 80 Narain Mal M.O 23 G.Mujtaba Rajper M.O 81 Khalid Kalhoro M.O 24 Gh. Murtaza Bugti M.O 82 Abdullah Al Asad M.O 25 Gh. Mustafa Shaikh M.O 83 Shahid Hussain M.O 26 Gh. Murtaza Rajar M.O 84 Rosho Mal M.O 27 Safdar Lakho M.O 85 Khalid Bashir M.O 28 Javed Memon M.O 86 Ahmed Ali Kanhar M.O 29 Javed Soomro M.O 87 Majeed Kanhar M.O 30 Kamran Rasool M.O 88 M. Malik Soomro M.O 31 Karam Abbas M.O 89 Nadeem Abbas M.O 32 Khalid Memon M.O 90 Mohsin Mangrio M.O 33 Khalique Dino Wassan M.O 91 Kamal Bozdar M.O 34 Kher Mohammad Rajper M.O 92 Mast Ali M.O 35 Sarfraz Talpur M.O 93 Nisar Soomro M.O 36 M. Ali lund M.O 94 Abdul Rehman Memon S.M.O 37 Aslam Baloch M.O 95 Sarwar Shaikh S.M.O 38 Azam Ghambir M.O 96 Majid Mangi S.M.O

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39 Juman Sahto M.O 97 Qadam Jamro S.M.O 40 M. Panah M.O 98 Jabar Lashari S.M.O 41 Mumtaz Shaikh M.O 99 Hassan Shaikh S.M.O 42 Mumtaz Wassan M.O 100 Gh. Rasool S.M.O 43 Nek Mohammad Memon M.O 101 Bashir Narejo S.M.O 44 Niaz Wasan M.O 102 Israr Ahmed M.O 45 Noor Bhanbhan M.O 103 Hakim Solangi S.M.O 46 Parvez IQBAL M.O 104 Kalash Pati S.M.O 47 Rab Dino Rajper M.O 105 M. Shareef S.M.O 48 Saeed Ahmed Ansari M.O 106 Noor Din Abro S.M.O 49 Saifullah Bugti M.O 107 Ramesh Kumar S.M.O 50 Sanaullah Bharejo M.O 108 Kundan Das S.M.O 51 Safique Memon M.O 109 Mir Iqbal S.M.O 52 Sheraz Phulpoto M.O 110 Niaz Ali S.M.O 53 Sohail Memon .M.O 111 Waris Kubar S.M.O 54 Waheed Kalhoro M.O 112 Hakeem Kubar S.M.O 55 Washoo Mal .M.O 113 Qaisar Bozdar S.M.O 56 Nizam Bozdar .M.O 114 Hashim Shah S.M.O 57 Kher Mohd Shah .M.O 115 Bagh Ali S.M.O 58 Razaque Chang .M.O 116 Abdul Shakoor S.M.O 117 Iftkhar Ahmed S.M.O

Following Medical Officers remained absent from Monthly Review Meeting

Dr. Suhail Ahmed Memon

1 Ab. Munam Shar M.O 14 M. Sidique M.O 2 Ab. Qayoom Solangi M.O 15 Ajmal Ghumro M.O 3 Gh. Hyder Phull M.O 16 Mushtaque Phull M.O 4 Muneer Ahemd Lund (Late) M.O 17 Arif Hussain Shahani M.O 5 Rasheed joyo M.O 18 M. Rafique M.O 6 Muhkum Din Bozdar M.O 19 Taj Mohd Shaikh M.O 7 M. Nawaz M.O 20 Ab. Rasheed Abbasi M.O 8 Rahim Bux Rind M.O 21 Ab. Qadeer Memon M.O 9 Hameed Shaikh M.O 22 Nizam Burdi M.O 10 Gada Soomro M.O 23 Gh. Hyder Wasan M.O 11 Ramzan Langah M.O 24 Ahsan Channa .M.O

List of Female Medical Officers attended Monthly Review meeting Dr Asadullah Ghumro

S No Name of Female Medical Officer

Designation S No Name of Female Medical Offcer Designatio

n 1 Nusrat Wassan FMO 30 Madiha Rehman FMO 2 Asma Shaikh FMO 31 Sanobar Soomro FMO 3 Naila Soomro FMO 32 Marium Shaikh FMO 4 Rozina Soomro FMO 33 Meharunisa FMO 5 Samina Shaikh FMO 34 Fakharunisa FMO 6 Naheed Memon FMO 35 Afsheen FMO

7 Naseem Dharejo FMO 36 Farzana Kanhar FMO

8 Irshad Rajper FMO 37 Shabiran Mari FMO 9 Sangita Washo FMO 38 Shahida Mangrio FMO 10 Sobia Memon FMO 39 Abida Memon FMO

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11 Zainab Bozdar FMO 40 Suneeta Dharampal FMO 12 Khadija Soomro FMO 41 Rukhsana Sohu FMO 13 Aliya Nazir FMO 42 Sanam Shaikh FMO 14 Rehana Zulifqar FMO 43 Nadia Sharaf FMO 15 Rubina Rajper FMO 44 Hameeda Rajper (Sn) FMO 16 Lal Khatoon FMO 45 Shamshad Shaikh FMO 17 Nusrat Memon FMO 46 Zeenat memon FMO 18 Zahida Soomro FMO 47 Roshan Waqar FMO 19 Asia Bhatti FMO 48 Aisha Baloch FMO 20 Shazia Shaikh FMO 49 Rukhsana Mailto FMO 21 Rabia Sangi FMO 50 Reeta FMO 22 Sangita Mukesh FMO 51 Samina Channa FMO 23 Afshan Shaikh FMO 52 Tahira SONOL 24 Rizwana Andleep SONOL 53 Reshma FMO 25 Shafiat Rehman FMO 54 Suneeta Bozdar FMO 26 Afshan Bhanbhro FMO 55 Abida Kanhar FMO 27 Jamila Jabar FMO 56 Hameeda Rajper (Jr) SONOL 28 Rozina Lakho SONOL 57 Pukhraj Panhwar SONOL 29 Sadaf Rajib FMO

Following Female Medical Officers remained absent from Monthly Review meeting

Mohsin Ali

S. No Name of Female Medical Officer

Designation S. No Name of Female Medical Officer Designatio

n 1 Reena FMO 6 Sajida Rajar FMO 2 Nazia Noor FMO 7 Rukhsana Shaikh FMO 3 Ghazala Lashari FMO 8 Farida sangri FMO 4 Firdous Ara FMO 9 Sabnam Phull FMO 5 Sadaf Raheel FMO 10 Ghazala Ghumro FMO

List of DSU Staff attended the monthly review meeting

01 Mr.Ammanat Ali Shar DSM 09 Mr. Akhtar Hussain Khaskhlei S.O 02 Mr.Riaz Ahmed Rahoojo ADSM 10 Mr. Mohsin Mehboob Bhatti S.O 03 Mr.Aijaz Phull EO(M&E) 11 Mr. Abdul Rahman Shar S.O 04 Dr.Khalid Mahmood MO(HQ) 12 Mr. M Ibrahim Chandio S.O 05 Mr.Asif Kalwar EO(M&E) 13 Mr. Junaid Jonejo Assistant 06 Mr. Bhai Khan Khemtio S.O 14 Mr. Bisharat Hussain Assistant 07 Mr. Kaleem Ullah, Khilji S.O 15 Mr. Saleem Mangi Assistant 08 Mr. Asif Thebo SM

K. HFs WITH PPHI

BHUs: 82 Dispensaries: 45 MCHCs: 09 Others: 14 TOTAL: 150 B. Population of the Catchments Area:

W. STAFF STRENGTH

Sanctioned Posts

Working Government Employees

PPHI Contract Vacant

Mos 150 60 104

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WMOs(Govt) 05 05 0 --- FMO 59 0 59 07 Sonologist 06 - 06 1 LHVs 73 11 80 --- MTs/MAs

Male --- --- --- ---

Female --- --- --- --- Dispensers 152 112 50 ---

X. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

1. First Session: During MRM

Names of the Resource Persons with dates

Date

Venue Topic No. of

Participants

Capacity Building of LHVs / Dispensers during Month under Review Names of the Resource Persons with dates

Date

Venue Topic No. of

Participants

F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered in Children at Health Facilities. 9590 NO. of TT Vaccines provided to pregnant/child bearing age women @HFs. 2398 No. of Immunization & Vaccination Administered by out- reach EPI Teams 0 Total vaccination / immunization for the month of August-2012 11988

2. National Immunization Days (NIDs) for Polio

Previous Month Total at Present Month under Review Total at Present Clusters of 6 HFs 00 Clusters of 6 HFs 00 Clusters of 5 HFs 00 Clusters of 5 HFs 00 Clusters of 4 HFs 00 Clusters of 4 HFs 00 Clusters of 3 HFs 00 Clusters of 3 HFs 00 Clusters of 2 HFs 09 Clusters of 2 HFs 10

Single HFs 130 Single HFs 130

Previous Month Total at Present Month under Review Total at Present Clusters of 5 HFs 00 Clusters of 5 HFs 00 Clusters of 4 HFs 00 Clusters of 4 HFs 00 Clusters of 3 HFs 00 Clusters of 3 HFs 00 Clusters of 2 HFs 47 Clusters of 2 HFs 47

Single HFs 10 Single HFs 09

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Dates of NIDs Target of coverage Actual coverage Percentage of coverage

August-2012 100% NA 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides NA 2 Active Case Detection (ACD) Slides NA 3 Visits to Check Sanitation (individual house holds + streets) NA 4 Notices issued against Poor Sanitation NA 5 Challans sent to Court against Poor Sanitation NA 6 Patients Nebulized NA

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S # Names of FMOs Ante-Natal Cases

Neo-Natal Cases

Other OPD Total OPD

01 Dr: Nusrat Wassan 200 13 987 1200 02 Dr: Asma Shaikh 49 0 1295 1344 03 Dr: Madiha Rahman 102 0 533 635 04 Dr: Sanober Soomro 37 0 644 681

05 Dr: Rena Kumari 559 10 408 977

06 Dr: Rozina Soomro 88 0 1271 1359

07 Dr: Naila Soomro 0 0 0 0

08 Dr: Samina Shaikh 70 0 750 820

09 Dr: Naheed Akhtar 42 0 822 864

10 Dr: Naseem Dharejo 49 0 995 1044

11 Dr: Ghazala Lashari 60 0 1092 1152

12 Dr: Firdos Ara 0 0 0 0

13 Dr: Irshad Rajper 109 5 828 942

14 Dr: Hameeda Rajper Sr 105 11 1584 1700

15 Dr: Sobia Fayaz Memon 48 0 827 875

16 Dr: Zainab Bozdar 109 9 1453 1571

17 Dr: Marium Shaikh 164 0 1455 1619

18 Dr: Mehrunisa 75 0 868 943

19 Dr: Fakhrunisa 900 53 1354 2307

20 Dr: Afsheen Khamisani ICU

21 Dr: Farzana Kanhar 108 9 588 705

22 Dr: Shabiran Mari 31 9 632 672

23 Dr: Sadaf Raheel 0 0 0 0 24 Dr: Shahida Parveen 138 47 949 1134 25 Dr: Abida Memon 39 0 582 621 26 Dr: Suneeta Dharmpal 75 0 1485 1560

27 Dr: Rukhsana Sohu 360 4 334 698

28 Dr: Khadija Soomro 40 0 875 915

29 Dr: Aliya Nazir 100 2 559 661

30 Dr: Reehana Zulfiqar 11 4 731 746

31 Dr: Rukhsana Maitlo 176 0 0 0

32 Dr Tahira Sonologist

33 Dr: Nadia Sharaf 75 0 897 972

34 Dr: Hameeda Rajper (Jr) Sonologist

35 Dr Reshman 30 0 530 560

36 Dr Sajida Parveen 0 0 0 0

37 Dr: Rubina Rajper 43 0 757 800

38 Dr: Sanam Shaikh 11 0 492 503

39 Dr. Afshan Bhambhro 50 5 154 209

40 Dr: Lal Khatoon Red Crescent Unit

41 Dr: Nusrat Memon 60 1 732 793

42 Dr: Nazia Noor 0 0 0 0

43 Dr: Shamshad Shaikh 37 0 988 1025

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(II )MOTHER, CHILD & REPRODUCTIVE HEALTH During Month under Review

1. Female Health 2. Deliveries Assisted

S # Service Number

44 Dr: Zeenat Memon 45 0 923 968

45 Dr: Roshan Waqar 39 0 530 569 46 Dr: Zahida Soomro Sonologist 47 Dr: Asia Bhatti 15 3 722 740

48 Dr: Aisha Balouch 109 6 758 873

49 Dr: Shabnam Phull Neonatal Ward

50 Dr: Reeta SMBB Poly Clinic (Sonologist)

51 Dr: Samina Channa 0 0 0 0

52 Dr: Abida Kanhar 69 0 895 964

53 Dr: Rabia Sangi 34 0 807 841

54 Dr: Sangeeta Mukesh 60 0 828 888

55 Dr: Afshan Shaikh 30 1 537 568

56 Dr:Rozina Lakho Sonologist

57 Dr:Rizwana Andleep Sonologist

58 Dr: Shazia Shaikh 45 0 611 656

59 Dr Sangeeta Washoo 106 0 509 615

60 Dr. Sunita Bozdar 68 0 580 648

61 Dr. Shafiat Rehman 51 0 381 432

62 Dr. Jameela Jabbar 104 4 499 607

63 Dr. Sadaf Rajab 15 0 554 569

64 Dr. Pukhraj Sonologist

65 Dr. Anjuman Ara 200 01 1259 1460

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1 Deliveries Assisted at HFs 112 2 Deliveries Assisted at homes 0

3. Lab/ Diagnostic Tests

10. Important Discussion on Mother and Child and Reproductive Health during MRM It was informed by DSM that since Family Planing material is being supplied to HFs. The FMOs were also directed to pay more attention over vaccination of children and women and provide family planning advice. Provision of Family Planning Services during the Month

S # Name of the Items / Service August 1 Consultation / Advice 1660 2 Oral Pills 592 3 IUCDs 69 4 Injections 618 05 Others 1811

Total 4750

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male CSGs: 120 Number of female SGs: 0 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him CHSs/SHSs arranged by him

No. No. of Participants No. No. of

Participants

Bhai Khan 4 25 3 23

Muhammad Ibrahim 3 28 2 26

Akhtar Hussain 5 34 3 29

Abdul Rehman 2 26 2 26

Kaleemullah Khilji 4 31 3 34

Mohsin Ali 4 22 3 37

Ammanulah Keerio 2 21 2 25

Total 24 187 18 200

3. School Health Sessions & Community Health Sessions

S No.

Names of MO /

FMOs/Paramedics

Community Health Sessions School Health Sessions

Sessions

Participants

Sessions Children Examined

Children Treated

01 Dr: Nusrat Wassan 4 90 0 0 0 02 Dr: Asma Shaikh 4 45 0 0 0 03 Dr: Sanober Soomro 4 66 0 0 0 04 Dr: Madiha Rahman 3 46 0 0 0 05 Dr: Rena Kumari 0 0 0 0 0

S # Name of Test Number 1 Pregnancy Tests. 888 2 Blood Sugar Tests. 1048 3 Haemoglobin Tests. 1797 4 Ultra Sound Test. 4382 5 Other. 1445

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06 Dr: Rozina Soomro 3 35 0 0 0 07 Dr: Naila Soomro 2 45 0 0 0 08 Dr: Samina Shaikh 4 80 0 0 0 10 Dr: Naheed Akhtar 4 26 0 0 0 11 Dr: Naseem Dharejo 3 32 0 0 0 12 Dr: Ghazala Lashari 4 32 0 0 0 13 Dr: Firdos Ara 0 0 0 0 0 14 Dr: Irshad Rajper 4 59 0 0 0 15 Dr: Hameeda Rajper (Sn) 4 52 0 0 0 16 Dr: Sobia Fayaz Memon 4 38 0 0 0 17 Dr: Zainab Bozdar 4 43 0 0 0 18 Dr: Marium Shaikh 4 71 0 0 0 19 Dr: Mehrunisa 4 58 0 0 0 20 Dr: Fakhrunisa Bhambhro 4 64 0 0 0

21 Dr: Afsheen Khamisani Red Crescent Unit 22 Dr: Farzana Kanhar 3 34 0 0 0 23 Dr: Shabiran Mari 4 39 0 0 0 24 Dr: Sana Raheel 0 0 0 0 0 25 Dr: Shahida Mangrio 4 46 0 0 0

26 Dr: Abida Memon 4 32 0 0 0

27 Dr: Suneeta Dharmpal 4 43 0 0 0 28 Dr: Rukhsana Sohu 4 56 0 0 0 29 Dr: Khadija Soomro 4 57 0 0 0 30 Dr: Aliya Nazir 4 72 0 0 0 31 Dr: Rehana Zulfiqar 4 50 0 0 0 32 Dr: Rukhsana Maitlo 4 57 0 0 0 33 Dr Tahira Sonologist 34 Dr: Nadia Sharaf 4 52 0 0 0 35 Dr: Hameeda Rajper (JN) Sonologist 36 Dr Reshman 4 65 0 0 0 37 Dr Sajida Parveen 0 0 0 0 0 38 Dr: Rubina Rajper 4 72 0 0 0 39 Dr. Sanam Shaikh 2 22 0 0 0 40 Dr. Afshan Bhambhro 2 39 0 0 0 41 Dr: Nazia Noor 0 0 0 0 0 42 Dr: Lal Khatoon Red Crescent Unit 43 Dr: Nusrat Memon 2 27 0 0 0 44 Dr: Shamshad Shaikh 4 77 0 0 0 45 Dr: Zeenat Memon 4 51 0 0 0 46 Dr: Roshan Waqar 4 59 0 0 0 47 Dr: Zahida Soomro Sonologist 48 Dr: Asia Bhatti 3 52 0 0 0 50 Dr: Aisha Balouch 4 50 0 0 0 52 Dr: Shabnam Phull Neonatal Ward 53 Dr: Reeta SMBB Polyclinic 55 Dr: Samina Channa 2 33 0 0 0 56 Dr: Rabia Sangi 2 28 0 0 0 57 Dr: Sangeeta Washoo 4 48 0 0 0 58 Dr: Afshan Shaikh 4 53 0 0 0 59 Dr: Rozina Lakho Sonologist 60 Dr: Rizwana Andleep Sonologist 61 Dr. Shazia Shaikh 4 55 0 0 0 62 Dr. Sangeeta Mukesh 4 36 0 0 0 63 Dr. Jameela Jabbar Shaikh 4 34 0 0 0 64 Dr. Sadaf Rajab 2 20 0 0 0

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65 Dr. Abida Kanhar 3 55 0 0 0 66 Dr. Pukhraj Sonologist 67 Dr. Anjuman Ara 2 70 0 0 0

4. Important Points during SHSs

- FMOs should provide the knowledge about the causes and preventive measures of most common diseases to the students and teachers. Female Medical Officer(s) also informed about preventive measures for diseases and also shared the signs and symptoms and prevention measures of different diseases and treat the affected.

5. Important Points during CHSs - Medical Officers and Female Medical Officer(s) provide information for the preventive measures to be

taken inside the house and village for prevention of different diseases. - They inform about signs and symptoms of different diseases and provide guidelines for treatment.

6. Topics for SHSs for the Month S No. SUMMER VACCATION 1 2 3

7 Topics for CHSs for the Month S # Topics 1 Scabies 2 Malnutrition 3 Hypertansion

8. Important Discussion on Community Participation during MRM - Holding of regular Community Support Groups Meetings. - Involvement of Active community members in BRHFs issues and in R&R and problems faced by BRHFs. - Support from community member in holding Community Health Sessions and SHS & their participation.. - All Male & Female Medical Officers were instructed to keep HF neat & clean & plantation.

9. Health Camps: Number Held: 0 Number of Patients: 10. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation NIL Ii Drainage / sewerage NIL Iii Drinking water NIL Iv Prevention of adulteration NIL V Tree Plantation NIL Vi Roads and infrastructure NIL Vii Environmental Improvement NIL Viii Others NIL

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD* New patients treated during the month

Old patients treated during the month

Total OPD during the month (New + Old)

243,510 6,545 250,055 2. Maximum OPD** Minimum OPD**

S # BRHF OPD BRHF OPD 1 SMBB Polyclinic 6659 BHU Pir Bux Gaho 506 2 BHU Khuhra 5511 GD SALU 588 3 NMC Chondko 5258 DCD Sulemanaradin 620 4 BHU Bozdar Wada 5049 GD Rab Rakhio 621 5 BHU Drib Meher Shah 4025 BHU Tajjal 633

3. Top Five Diseases Treated during School Health Sessio ns/Camps

S # Diseases No. of Patients

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*All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 Malaria 28552 2 ARI 28056 3 Skin Disea 25778 4 Diarrhea 23587 5 Fever(due to other causes) 18664

37. ARV / ASV used during the month No. of Patients

Dog Bite cases Reported 541 ARV Administered 342 Vials ARV Available Doses 492Vials Snake Bite cases Reported 37 ASV Vaccine Administered 26 Vials ASV Vaccine Available Doses 0 Vials

38. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health) (Lab / Diagnostic Tests)

S # Tests Number 1 Blood Sugar Tests 1048 2 Hemoglobin 1797 3 X-Rays (if available) 25 4 Ultra Sound 4382 5 Others (Malaria+Lab Test) 2308

B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred up to date

Follow up result

Hepatitis B NA Hepatitis C NA

8. TUBERCLOSIS Patients

Receiving Treatment New Cases During the

Month Under Diagnosis

0 9. Referrals

S. No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs

10. Inverse Referrals S.No Totals Cases Referred from

ARV ASV Others RHCs THQs DHQs

1 SUMMER VACCATION

2 3 4 5

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G. MONITORING DURING MONTH UNDER REVIEW 1. Monitoring Visits during the month

DSM ADSM Executive Monitoring Other Staff Total 58 38 52 320 468

2. Important Points/Issues arising from Visits S # Name of HF Issue Action Remarks

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

2. Important Issues raised relating to Medicines, etc. during MRM

• Late Submission of medicine requisitions DHIS, FMO Reports, Dews Reports by Medical Officer and Female Medical Officers

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS S # Name of

HFs Description of Repair /

Maintenance incl. Electrification Status / Remarks

01 BHU Dhoro 100%

02 BHU Dubi 100% 03 BHU Hindyari 100% 04 BHU Kabir Khan Siyal 100% 05 BHU Kharrah 100%

06 BHU Tarko 100%

07 GD Deparja 100% 08 GD Mangho Fakir Shar 100%

09 GD Sutyaro 100%

10 BHU Bachal Bhambhro 100%

11 BHU Khalifo Huryah 98%

12 BHU New Goth Sahito 100%

13 BHU Sami 100%

14 BHU Rukrani 100%

15 BHU Bhelar wada 100%

16 BHU Razal Memon 100%

17 BHU Gadeji 100%

18 BHU Kathore 100%

19 BHU Bachal Bhambhro (Nara) 100%

20 BHU Sikanadr Abad 100%

21 MCHC Choondiko 100%

22 BHU Layari 100%

23 BHU Mithri 100%

24 GD Fateh pur 100%

25 BHU Amir Ali Shah 100%

26 BHU Arab Solangi 100%

27 BHU Jiskani 100%

28 GD Murad Gopang 100%

29 BHU Nawab Khan Wassan 100%

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30 BHU Imam Bux Palh 100%

31 BHU Jan M Wandiar 100% 32 BHU Hashim Shah Jagir 100% 33 BHU Karam Ali Khan Lashari 100% 34 BHU Babar wada 100%

35 BHU Bago daro 100%

36 GD Talpur wada 100%

37 BHU Hadal Shah 100% 38 BHU Kot Mir Muhammad 100% 39 BHU Sadarji Bhatyoon 100% 40 BHU Rahooja 100%

41 BHU Mahesar wada 100%

42 BHU Manghanwari 95%

43 BHU Bahar Larik 100%

44 BHU Kolab Jial 100%

45 GD Ali Hyder Jalbani 100%

46 BHU Thehri 100%

47 BHU Babarloi 100%

48 GD Mitho Mari 100%

49 BHU Machyoon wada 100%

50 BHU Pir Mangio 100%

51 BHU Bago Maitlo 100%

52 BHU Tando Masti 100%

53 BHU Gagri 95%

54 BHU Lal Bux Mangi 100%

55 BHU Long Fakir 100%

56 GD Allah Bux Katohar 100%

57 GD Manjhi Khan Katohar 100%

58 GD Siming 100%

59 BHU Tando Nazar Ali 100%

60 GD Razi Goth 100%

61 GD Gabar Maitlo 100%

62 GD Nihal Khan 100%

63 BHU Ripri 100%

64 GD Arab Phull 100%

65 BHU M Ramzan Mullo 100%

66 BHU Araro 100%

67 BHU Bhango Behan 100%

68 BHU Zafarabad 100%

69 BHU Ubhri 100%

70 BHU Tando Mir Ali 100%

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71 BHU Phori Chadio 100%

72 BHU Jado Wahan 100%

73 BHU Razidero 30%

74 GD Shah Ali Jamro 75%

75 BHU Pir Hayat Shah 40%

76 GD Imdad Ali Sahito 95%

77 BHU Tando Mir Karam 95%

78 BHU Sagyoon 75%

79 BHU Tajjal Sharif 90%

80 BHU Pir Bux Gaho 50%

81 BHU Hussain Abad 90%

82 GD Kandhar 75%

83 BHU Ahmed Pur 100%

84 BHU Drib Mahar Shah 60%

85 BHU Piryaloi 100%

86 BHU Phat 100%

87 GD Akan Behan 75%

88 BHU Sadi Lower 98%

89 GD Fakir M Lakho 80%

90 BHU Akri 70%

91 BHU Ghulam Nabi Rajper 20%

92 BHU Bozdar Wada 100%

93 BHU Setharja 100%

94 GD Imdad Ali Shar 10%

95 GD Abu Zaibi 65%

96 BHU Kumb 90%

97 BHU Rahooja II 40%

Inspections / Visits of PPHI HFs Visitors* Health Facilities Visited Overall Comments

* To reflect only non-PPHI Visitors. Date /Time for Next MRM: 10th of October 2012/ 9:00am Comments by DSM MOs were emphasized to fill DHIS Reports properly.They made correctionsin DHIS Reports from Jan 2012 to August 2012,they were strongly suggested to fill reports properly and submit within due time .Some HFs have no building at all. Improvement is needed in order to extend coverage of FMO in hard areas of Nara, Faizganj.

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MINUTES OF THE (43 rd) MONTHLY REVIEW MEETING

OF DISTRICT_DADU Monthly Review Meeting (MRM) of District, DADU for the Month of August, 2012 was held on 12/ 09/2012 at DC Darbar Hall Dadu. Written invitations to participate were sent to the DC, the DO(H), the DO(F&P) and District Incharge of EPI, LHW and all other National Programs as usual. The list of participants follows: List of Participants S # Names/Designation S # Names/Designation

1 Mr. Moula Bux Solangi DSM PPHI Dadu 2 Dr. Abdul Razaque Junejo

DO (Admn) DHO (H) Office

3 Peer Ashfaque Ahmad Executive (M&E) 4 Mr. Abdul Sattar Soomro

Executive (F&A)

5 Dr. Sohail Ahmad Channar SO, WHO Dadu 6 Dr. Nizam u Din Abro

MO I/c BHU Moundar

7 Dr. Bashir Ahmad Channa MO I/c BHU Makhdoom Bilawal 8 Dr. Bhajan Lal Matlani

MO I/c BHU Phakka

9 Mr. Mohammad Aslam Soomro H.T BHU Phulji Station 10 Dr. Sanaullah Soomro

I/c BHU Aminani

11 Dr. Sayed Lal Shah I/c MO BHU Sita Village 12 Dr. Abdul Kareem Jamali

MO I/c BHU Samtani

13 Dr. Fayaz Ahmad Panhwar I/c MO BHU Ibrahim Panhwar 14 Dr. Altaf Hussain Shah

MO I/c BHU Purano Dero

15 Dr. Akbar Ali Panhwar I/c MO BHU Piaro Goth 16 Dr. Altaf Hussain Qureshi

MO I/c GD Jatt Shahdad

17 Dr. Ghullmullah Samoo I/C MO BHU Patt 18 Dr. Deedar Hussain Abbasi

I/c MO BHU Fareed Abad

19 Dr. Allah Dino Khoso I/c MO GD Nawab jo Patt 20 Dr. Nizakat Ali Sahar

MO I/c BHU Thareri Mohabat

21 Dr. Mumataz Ali Khand I/c MO BHU Chorr 22 Dr. Ammanullah Chandio

MO I/c BHU Saeedpur

23 Dr. Mujahid Saand I/c MO GD Gul Mohammad Jatoi 24 Dr. Mohammad Naeem Mahesar

I/c BHU Aghamani

25 Dr. Karam Yousif Outho MO I/c BHU Dhani Bux Bughio 26 Dr. Hidayatullah Chandio

MO I/c GD Qadir Bux Rind

27 Dr. Ihsan Iqbal Thebani MO I/c BHU Baid 28 Dr. Imdad Hussain Kalhoro

I/c MO BHU Burera

29 Dr. Mohammad Waseem Arain I/c MO BHU Haji Khan 30 Dr. Rasheed Ahmad Chandio

I/c MO BHU Thallo

31 Dr. Manzoor Ahmad Sario MO I/c BHU Qasboo 32 Dr. Assadullah Lakhair

MO I/c BHU Essa Kahn Thebo

33 Dr, Awais Ahmad Bughio I/c MO GD Mureed Babar 34 Dr. Abdul Raheem Saryo

MO I/c MCH Khanpur

35 Dr. Qamarudin Abbasi MO I/c GD Peer Gaji Shah 36 Dr. Irshad Ahmad Shah

I/C MO BHU Boriri

37 Dr. Mohammad Nawaz Arain Disp GD Sijawal Khan Alkhani 38 Dr. Akram Ali Soomro

I/c MO BHU Dougar

39 Dr. Abdullah Sameejo I/C MO BHU Bahawalpur 40 Dr. Shamas Din Kalhoro

I/c MO GD Gul Mohammad Chandio

41 Ali Raza Jamali I/C Dispenser GD Moundar khan Jamali 42 Dr. Khalid Hussain Laghari

I/c MO BHU Allahyarani

43 Dr. Shabnam Niaz Gorar FEMALE MEDICAL OFFICER 44 Dr. Altaf Ahmed Lund

I/c BHU Kamal Khan Lund

45 Dr. Naheed Akbar Janwari FEMALE MEDICAL OFFICER 46 Mr. Mohammad Khan Rustamani

Dispenser GD Murad Khan Jamali

47 Dr. Afshan Memon FEMALE MEDICAL OFFICER 48 Dr. Dost Mohammad Bughio

GD. K.B.Chakkar Khan Shahani 49 Dr. Mehnaz Saeed Soomro 50 Dr. Kalsoom Janwary

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Female Medical Officer Female Medical Officer

51 Dr. Zakia Larik FEMALE MEDICAL OFFICER 52 Dr. Farzana Qureshi

Female Medical Officer

53 Dr. Naheed Shaikh FEMALE MEDICAL OFFICER 54 Dr. Ameena Bughio

FEMALE MEDICAL OFFICER

55 Dr. Adeela Soodhar Sonologist 56 Dr. Rehana Joyo

FEMALE MEDICAL OFFICER

57 Dr. Farhana Shah Female Medical Officer 58 Dr. Fareeda Noonari

Female Medical Officer

59 Dr. Farzana Jokhio FEMALE MEDICAL OFFICER 60 Dr. Abida Dawach

FEMALE MEDICAL OFFICER

61 Dr. Uzma Soomro FEMALE MEDICAL OFFICER 62 Dr. Jameela Khoso

FEMALE MEDICAL OFFICER

63 Dr. Shoaib Qazi MO (HQ) 64 Mr. Abdul Hafeez Bhatti

Social Mobilizer

65 Mr. Hakim Ali Jatoi Social Mobilizer 66 Mansoor Ali Panhwar

Social Mobilizer

67 Syed Abdul Gaffar Shah Assistant Admin 68 Abid Ali Jatoi

Assistant Accounts

69 Ghulam Rabbani Panhwar Store Incharge

The following could not attend the meeting for the reasons stated against each:-

S # Names/Designation Reasons S # Names/Designation Reasons

1 Dr. Nazeer Ahmad Kandhro MO I/c BHU Kolachi

CL 2 Dr. Akhtar Hussain Shaikh I/c MO BHU Qazi Arif

CL

3 Mr. Allahwarayo Khoso I/c GD Paryo Jamali CL 4 Dr. Ashok Kumar

I/c MO BHU Butt Serai CL

5 Dr. Mohammad Azam Chandio I/c BHU Gozo

Sick Leave 6

Dr. Zubair Ahmad Panhwar I/c MO BHU Wahi Pandhi

CL

7 Dr. Fahmeeda Shaikh Female Medical Officer CL 8 Dr. Shams Din Jokhio

I/c MO BHU Betto CL

L. HFs WITH PPHI

BHUs: 35 Dispensaries: 12 MCHCs: 02 Others:______ TOTAL: 49

B. Population of the Catchments Area: 699342 Y. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MOs 49 42 17 25 32 WMO FMOs - 17 0 17 07 LHVs 9 36 9 27 20

MTs/Mas Male

- - - -

- Female - - - Dispensers/HT 78 59 28 31 0

Z. CLUSTERS OF HFs

WITH ONE MO

Previous Month Total Month under Review Total

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WITH ONE FMO

NOTE: One Sonologist is working

E. CAPACITY BUILDING 1. First Session: During MRM

Dr.Abida Dawach (FMO),MCH Khudabad in her lecture focused on HEPATITS on the following points:- • HEPATITS • DEFINATION

a) Anatomy of Liver b) Physiology of Liver

• PHYSIOLOGY OF LIVER • Protein Synthesis • Storage • Excretion • Causes Of Viral Hepatitis • Acute Hepatitis • Chronic Hepatitis • Hepatitis A • Symptoms: • Physical Examination: • Investigation: • TREATMENT • PREVENTION : • HEPATITS A in PREGNANCY : • HEPAPTIS B VIRUS.

2. Second Session: During MRM Dr. Bashir Ahmad Channa (MO), BHU Makhdoom Bilawal in his lecture focused on Haemorrhoids on the following points:-

• Definition • External Haemorrhoid • Internal Hemorrhoid • Grades: • Aetiology: • Clinical features • Investigations • Complications • Treatment Non-surgical • Prevention

Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs

Single HFs 44 Single HFs 42

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 14 Clusters of 2 HFs 13 Single HFs 4 Single HFs 4

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29. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of Participants

-- -- -- -- -- -- -- -- -- --

F. REVIEW OF THE PERFORMANCE

(I) PREVENTIVE HEALTHCARE During Month under Review

1. Vaccination / Immunization No. of Doses of Immunization Administered to Children at Health Facilities. 5434 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 1763 No. of Immunization & Vaccination Administered by out- reach EPI Teams - Total vaccination / immunization for the month July 2012 7197

2. National Immunization Days (NIDs)

Dates of NIDs Target of coverage Actual coverage Percentage of coverage

---- ---- ---- ---- 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 2255 2 Active Case Detection (ACD) Slides - 3 Visits to Check Sanitation (individual house holds + streets) - 4 Notices issued against Poor Sanitation - 5 Challans sent to Court against Poor Sanitation - 6 Patients Nebulized -

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health

S # Names of FMOs Ante-Natal Cases Neo-Natal Cases Other OPD Total 1 Dr. Abida Dawach 132 17 701 850 2 Dr.Afshan Memon 60 4 493 557 3 Dr.Ameena Bughio 210 22 514 746 4 Dr Fahmeda Shaikh 114 6 660 780 5 Dr.Fareeda Noonari 71 4 322 397 6 Dr.Farhana Shah 235 19 676 930 7 Dr Farzana Jokhio 229 8 498 735 8 Dr.Farzana Quershi 39 2 342 383 9 Dr Jamila Khoso 116 5 308 429 10 DR. Kalsoom Janwari 156 9 452 617 11 Dr.Mehnaz Soomro 61 4 388 453 12 Dr.Naheed Akbar 139 12 463 614 13 Dr. Naheed Shaikh 36 2 662 700 14 Dr. Rehana Joyo 95 6 809 910 15 Dr.Shabnam Niaz 77 7 407 491 16 Dr. Uzma Soomro 97 5 281 383 17 Dr.Zakia Larik 54 4 414 472

TOTAL 1921 136 8390 10447 Deliveries Assisted

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S # Service Number 1 Deliveries Assisted at HFs 47 2 Deliveries Assisted at Homes 3

3. Lab/ Diagnostic Tests

30. Important Discussion on Mother and Child and Reproductive Health during MRM The MOs and FMOs demanded that supply of the Tables Ponstan, Paracetamol, Brufen and Amoxil Drops. Increase quantity of peads: medicine especially in suspension form and Tablet forms.

31. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number 1 Consultation / Advice 1006 2 Oral Pills 585 3 IUCDs 13 4 Injections Depo 174 5 Injection Noregest 8 6 Others (Condoms) 262

Total 2048

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: ------47------------ Number of Female SGs: -------02------- 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of

Participants Mr.Abdul Hafeez Bhatti 57 3x19=57 7 7x20=140 Mr.Hakim Ali Jatoi 54 3x18=54 8 8x18=144

Mr.Mansoor Ali Panhwar 60 3x20=60 5

5x18=90

Total 171 171 20 374

2. School Health Sessions & Community Health Sessions

Names of MO / FMOs / Paramedics

Community Health Sessions School Health Sessions

Sessions Participants

Sessions Children Examined

Children Treated

Dr. Altaf Lund 2 49 Dr. Akbar Panhwar 2 31 Dr. Allahdino Khoso 2 56

S # Test Number 1 Pregnancy Tests 76 2 Blood Sugar Tests 27 3 Hemoglobin Tests 136 4 Ultra Sound Test 1499 5 Other 794

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Dr. Ammanullah Chandio 2 32 VACCATION Dr. Ashok Kumar 2 60

Dr. Awais Ahmad Bughio 2 34 Dr. Bhajan Lal 2 36 Dr. Bashir Ahmad Channa 2 30 Dr. Deedar Ali Abbasi 2 46 Dr. Dost Mohammad Bughio 2 40 Dr. Fayaz Ahmad Panhwar 2 24 Dr. Hidyatullah Chandio 2 24 Dr. Irshad Ahmad Shah 2 69 Dr. Khalid Hussain Laghari 2 47 Dr. Manzoor Ahmad Saryo 2 38 Dr. Mohammad Akram Soomro 2 19 Dr. Mohammad Azam Chandio 2 36 Dr. Mohammad Naeem Mahessar 2 30 Dr. Mujahid Hussain Saand 1 23 Dr. Nizakat Ali Sahar 2 30 Dr. Nizam u Din Abro 2 25 Dr. Qamar Din Kalhoro 1 22 Dr. Shams Din Kalhoro 2 14 Dr. Sayed Lal Shah 2 41 Dr. Abida Dawach 2 29 Dr.Afshan Memon 4 88 Dr.Ameena Bughio 4 132 Dr Fahmeda Shaikh 4 120 Dr.Fareeda Noonari 4 104 Dr.Farhana Shah 4 110 Dr Farzana Jokhio 4 120 Dr.Farzana Quershi 2 75 Dr Jamila Khoso 2 60 DR. Kalsoom Janwari 4 98 Dr.Mehnaz Soomro 4 92 Dr.Naheed Akbar 4 114 Dr. Naheed Shaikh 4 67 Dr. Rehana Joyo 2 24 Dr.Shabnam Niaz 4 80 Dr Uzma Soomro 4 68 Dr.Zakia Larik 4 58

Totals 106 2295

4. Important Points during Support Group Meetings. a) CSG demanded that the Ultrasound facility may be provided at uncovered areas. b) CSG members demanded that health facilities may be repaired. 5. Important Points during SHSs A) Prevention of Scabbies b) Prevention of Diarrhea c) Increase awareness regarding the prevention of Malaria. d) Precaution of Acute respiratory Infection. 6. Important Points during CHSs c Prevention of Diarrhea b) Prevention of Polymylitis c) Prevention of Family Planning d) Prevention of Maleria 7. Topics for SHSs for the Month

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Sr. No. Topics

1 Malaria 2 Health & Hygine 3 Typhoid 4 Sun Stroke 5 Cholera

8 Topics for CHSs for the Month

S # Topics 1 Polio 2 Diarrhoea 3 Dermatitus 4 Family Planning

9. Important Discussion on Community Participation during MRM

The DSM urged the MOs and FMOs to conduct regular monthly meetings with CSG/ CHS/ SHS and send a copy of minutes of the meeting to DSU for record purpose. He further directed keep record of the same and focus on the staff regularity and punctuality. 10. Health Camps: Number Held: 00. Number of Patients: 00 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation - - - Ii Drainage / sewerage - - - Iii ……… drinking water - - - Iv Prevention of adulteration - - - V Tree Plantation - - - Vi Roads and infrastructure - - - Vii Environmental Improvement - - - Viii Others - - -

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD* New patients treated during

the month Old patients treated during

the month Total OPD during the month

(New + Old) 82826 697 82826

2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD 1 BHU Wahi Pandhi 4577 GD Mureed

Babar 791

2 BHU Betto 2884 BHU Chrr 802 3 BHU Allahyarani 2695 GD Sijawal

Khan Alkhani 926

3. Top Five Diseases Treated during School Health Sessions/Camps *All HFs — BHUs and

S # Diseases No. of Patients 1 Respiratory Disease - 2 DIARRHOEA - 3 SCABBIES - 4 MALARIA - 5 EYE INFECTION -

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others. **Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 ARI 11653

2 DIARRHOEA / DYSENTERY 10064

3 SKIN DISEASE 10273 4 SUSPECTED MALARIA 6555 5 EYE/ENT 1442

32. ARV / ASV used during the month

No. of Patients Dog bite cases reported 139 ARV Administered 100 ARV Available Doses 626 Snake bite cases reported 0 ASV Vaccine Administered 0 ASV Vaccine Available Doses 10

39. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Pregnancy Tests 471 2 Blood Sugar Tests 151 3 Haemoglobin 136 4 X-Rays (if available) 0 5 Ultra Sound 1499 6 Others (please specify) 275

40. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

Hepatitis B 75 5 - - - Hepatitis C 73 5 - - -

41. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

52 7 53 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 - - - - - - 3 - - - - - - 4 - - - - - -

10. Inverse Referrals

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S.No Totals Cases Referred from

1 ARV ASV Others RHCs THQs DHQs 2 - - - - - - 3 - - - - - - 4 - - - - - -

G. MONITORING DURING MONTH UNDER REVIEW

13. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total

48 54 78 78 2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 1 BHU Fareed Abad MO demanded repair of Fans Repair has been done

2 BHU Burera MO demanded demanded repair of furniture Work is in process

3 BHU Aminani MO demanded repair of Motor Repair has been done

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for ……………… Weeks 2. Important Issues raised relating to Medicines, etc. during MRM Few Doctors pointed out that the quality of medicine may be improved and also increase the quantity of medicine. The DSM apprised the medical officers that 10 items of medicine were procured from multinational companies and rest of the items are also of good quality and efficacious.

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

1 BHU Aminani Completed MB recorded Completed 2 BHU Ibrahim Panhwar Completed MB recorded Completed 3 BHU Khanpur Completed MB recorded Completed 4 BHU Makhdoom Bilawal Completed MB recorded Completed 5 BHU Pyaro Goth Completed MB recorded Completed 6 BHU Kolachi Completed MB recorded Completed 7 BHU Allahyarani Completed MB recorded Completed 8 BHU Bahawalpur Completed MB recorded Completed 9 BHU Gozo Completed MB recorded Completed 10 BHU Betto Completed MB recorded Completed 11 BHU Kamal Khan Lund Completed MB recorded Completed 12 BHU Phakka Completed MB recorded Completed 13 BHU Samtani Completed MB recorded Completed 14 BHU Qazi Arif Completed MB recorded Completed 15 BHU Boriri Completed MB recorded Completed 16 BHU Thallo Completed MB recorded Completed 17 BHU Haji Khan Completed MB recorded Completed 18 BHU Thareri Mohabat Completed MB recorded Completed 19 BHU Moundar Completed MB recorded Completed 20 BHU Dhani Bux Bughio Completed MB recorded Completed 21 BHU Phulji Station Completed MB recorded Completed

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22 GD G.Mohammad Chandio Completed MB recorded Completed 23 BHU Sita Village Work Completed Completed 24 BHU Essa Khan Thebo Completed MB recorded Completed 25 BHU Burera Completed MB recorded Completed 26 BHU Wahi Pandhi Work Completed Completed 27 BHU Baid Work Completed Completed 28 BHU Patt Work Completed Completed 29 GD Nawab jo Patt (Tender) Work Completed Completed 30 BHU Aghamani (Tender) Work Completed Completed 31 BHU Fareed Abad Revised estimate has been sent to PSU 32 Bhu Purano Dero Work in progress 70% 33 GD Jatt Shahdad Work in progress 90% 34 GD K. B. Chakkar Khan Work in progress 70% 35 BHU Dogar (Tender) Work in progress 90% 36 BHU Chorr (Tender) Work in progress 40%

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments ---- ---- ----

* To reflect only non-PPHI Visitors.

J- DISCUSSION DURING MRM On Staff Matters:

• Involve of PPHI staff in NIDs . • Regularity and punctuality. • HF Record updated.

On Preventive Health: • The DSM emphasizes the regular CSG Meetings and CHS Meeting. • Keeping the view the Polio Drops, the awareness of this disease was on top priority. • Establish the Wastage Pitch. • Role on awareness rising about vaccination and it was shared with the forum that DSU-PPHI Dadu has

appointed the 10 vaccinator for said purpose. On Curative Health:

• Properly usage of laboratory machine, Pregnancy strips, Nabulizer Machine and Glucometer strips. • The DSM emphasize on the properly Keeping Record and HF cleanliness.

On Mother, Child & Reproductive Health: • Female Deliveries. • The DSM appreciate the increase in Vaccination. • Ensure the fully participation in NIDs

Other Matters: The DSM stressed upon furnishing the record of inverse cases of HB / HC. Date /Time for Next MRM: Date /Time for Next MRM: On 09 October at 10:00 am. Comments on Targets vs Achievements (by DSM)

• Repair of the HFs. • Provided ARVs / ASVs • Provided Water Connection at HFs • Maintaince of HFs Record • Regularity and Punctuality of Staff • Established link with Community Support Group and meeting there and tell them about PPHI and there

Services at HFs.

MOULA BUX SOLANGI DISTRICT SUPPORT MANAGER

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MINUTES OF THE (52nd) MONTHLY REVIEW MEETING

OF DISTRICT NAUSHEHRO FEROZE 52nd Monthly Review Meeting (MRM) of District, Naushehro Feroze for the Month of August-2012 was held on 12th-September-2012 at DC-Committee room NF. Written invitations to participants were sent to the DC, the DO (H), the DO (F&P) and District Incharge of EPI, notable of CSG members and Incharge of all other National Programs as usual. The list of participants is as follows: List of Participants: (Enclosed as annex.) The following could not attend the meeting for the reasons stated against each:- S # Names/Designation Reasons S # Names/Designation Reasons

1 Dr Gulam Sarwar Shah Polio meeting 2 Dr Gulam Abbas Leave

3 Dr Rafiq Ahmed Mangrio Polio meeting 4 Dr A. Hafeez Mangi Leave

5 Dr Shahid Hussain Rajper Leave 6 Dr Hafizullah Memon Leave 7 Dr Hafiz Akhter Leave 8 Dr Mubin Rajput Leave

M. HFs WITH PPHI

BHUs: 46 Dispensaries: 3 MCHCs: Others: ______ TOTAL: 49 B. Population of the Catchments Area: 856,442

AA. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MOs 51 48 23 23 28 WMO 2 02 00 FMOs 00 29 00 29 00 LHVs 3 00 00 23 3

MTs/MAs Male

71 4 4 00

65 Female 2 2 00

Dispensers/Vacci: 4 64 34 30 00 BB. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

Previous Month Total Month under Review Total

Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 02 Clusters of 2 HFs 02

Single HFs 44 Single HFs 44

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 17 Clusters of 2 HFs 17 Single HFs 11 Single HFs 11

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1. First Session: During MRM

i. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of

Participants N/A

F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered to Children at Health Facilities. 5193 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 824 No. of Immunization & Vaccination Administered by out- reach EPI Teams - Total vaccination / immunization for the month 6017

2. National Immunization Days (NIDs) for Polio

Dates of NIDs Target of coverage Actual coverage Percentage of coverage

NIDs not held during the month of August 2012.

3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides - 2 Active Case Detection (ACD) Slides - 3 Visits to Check Sanitation (individual house holds + streets) - 4 Notices issued against Poor Sanitation - 5 Challans sent to Court against Poor Sanitation - 6 Patients Nebulized 612

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health

NAME OF FMO Neo-Natal Post-Natal Other OPD Total OPD Dr. Asma Memon 3 5 65 853 Dr. Aneesa Sahito 4 7 306 881 Dr. AQeela Qureshi 5 6 59 715 Dr. Arfeen Korai 3 1 81 1090 Dr. Fozia Abbassi 6 4 307 1372 Dr. Ghulam Qubra Buriro' 5 1 221 1122 Dr. Ghulam Zaineb 14 8 210 1358 Dr. Khoula Naz 3 7 201 645 Dr. Marya Khaskheli 6 15 222 1939 Dr. Shaista Qurban 2 5 75 872 Dr. Naseem Khatoon Rajper 5 1 73 609 Dr. Nusrat Parween 2 0 175 711 Dr. Nuzhat Anwar 6 9 57 747 Dr. Ruqaya Samo 5 6 43 887

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Dr. Sadia Shah 4 1 243 778 Dr. Kainat 3 0 180 812 Dr. Safia Memon 7 4 95 1385 Dr. Salma Amjad 5 6 73 732 Dr. Shamsunisa 3 1 51 590 Dr. Shehnaz Begum 3 5 61 710 Dr. Rehana Sardar 2 15 14 800 Dr. Sughra Badar 6 48 20 1459 Dr. Tabbasum Buriro' 6 2 159 787 Dr. Usha 2 35 35 396 Dr. Shahzadi Sarwat 3 7 153 909 Dr. Azra 5 0 434 1515 Dr. Zareena Noonari 6 45 98 1538

2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 36 D&C 05 2 Deliveries Assisted at Homes 602

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 469 2 Blood Sugar Tests 500 3 Hemoglobin Tests 543 4 Ultra Sound Test 1813 5 Other -

33. Important Discussion on Mother and Child and Reproductive Health during MRM 34. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number Consultation / Advice 683 Oral Pills 449 IUCDs 85 Injections 335 Others-Condoms 1800

Total 3,352 (III) COMMUNITY PARTICIPATION

During Month under Review

1. Number of Male SGs: 48 Number of Female SGs: 48 2. Performance of Social Organizers

Names of Social Organizers

Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

Male Female Total No. of Participants No: No: of Participants

Zubair Ahmed Memon-SM1 9 0 147 5 279 Zia-ur-Rehman Mastoi-SM2 7 0 96 4 209 Waheed Bhatti- SM3 12 0 199 7 344 Munawar Kaleri- SM4 6 0 105 6 299

Total 34 0 547 22 1131 3. School Health Sessions & Community Health Sessions

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Names of MO / FMOs/Paramedics

Community Health Sessions School Health Sessions

Sessions Participants Sessions Children Examined

Children Treated

All MOs and FMOs 74 1719 00 00 00

Totals 74 1719 00 00 00

4. Important Points during Support Group Meetings.

• Involvement of CSG members in polio campaign • Increasing mobility of Ambulance at MCHCs • Owner ship of the HF and the assets like ambulance by CSG members • Presiding of the meeting by CSG members emphasized. • Highlighted the role of CSG members during Polio Campaign • Coverage of PPHI- EPI centers and working of the new appointed EPI vaccinators • Facility of the different Tests at MCHCs • Encouraging support group members to help during NIDs. • Floating the message of PPHI service to the people of respective catchment area. • Arranging of awareness sessions at their respective villages • Developing greenery at HFs

5. Important Points during SHSs

Due to summer vacations SHS not held.

6. Important Points during CHSs

• Dangerous Effects of unhygienic food • Importance of TT vaccine • Personal hygene • Importance of BCG vaccine • Measures to get rid from scabies

7. Topics for SHSs for the Month

Sr. No. Topics 1 Summer Vacations 2 3 4 5

8 Topics for CHSs for the Month

S # Topics 1 Dangerous effects of unhygienic food 2 Importance of BCG , Penta and Measle vaccine 3 TT vaccine 4 Personal hygene

9. Important Discussion on Community Participation during MRM

• Sensitization to CSG members about family planning stressed

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• Role of CSG members in Polio Campaign • Monthly meeting with CSG members and proper updating of the minutes • Establishment of greenery at all HFs • Formal invitation to the CSG members for monthly meeting • Effective Mobilization of female CSGs and developing their ownership @ hf. • Community mobilization area should be strengthened.

10. Health Camps: Nil. 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status i Sanitation ii Drainage / sewerage iii ……… drinking water iv Prevention of adulteration v Tree Plantation vi Roads and infrastructure vii Environmental Improvement viii Others

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*

New patients treated during the month

Follow-up patients treated during the

month

Total OPD during the month (New+Old+Ultrasonologist)

83,275 1,525 86,613 2. Maximum OPD** Minimum OPD**

S# Name of BHU OPD Name of BHU OPD 1 BHU Bhirya Road 4893 Gul Muhammad Jatoi 951 2 BHU Phull 3433 Mehmood Chandio 916 3 BHU Kundha Khahi 3131 Kandhar 901 4 BHU Jiando Rajper 3075 Fazul Sahito 869 5 BHU Lakha Road 3073 Ali Muhammad Phariro 629

3. Top Five Diseases Treated during School Health Sessions/Camps

S # Diseases No. of Patients

1 Summer vacation

2

3

4

5 Total *All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases during OPD

S # Disease No. of Patients 1 Suspected Malaria 11686 2 ARI 9958 3 Diarrhea 7799

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4 Dermatitis 4963 5 Scabies 4513

7. ARV / ASV used during the month

Names No. of Patients

Dog bite cases reported 270 ARV vial used/ Administered 83 ARV Available Ampules 380 Snake bite cases reported 0 ASV Vaccine Administered 0 ASV Vaccine Available Doses 3

42. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Pregnancy Tests 469 2 Blood Sugar Tests 500 3 Hemoglobin Tests 543 4 X-Rays (if available) 2 Units 09 5 Ultra Sound 1813 6 Others (please specify) -

43. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

Hepatitis B 0 0 0 - - Hepatitis C 3 2 2 2 Nil-

44. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

00 13 - 9. Referrals

S.No Totals Cases Referred To

TB DOT Deliveries Others RHCs THQs DHQs 1 13 13 0 0 8 3 2 2 3

10. Inverse Referrals

S.No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs 2 3 4

G. MONITORING DURING MONTH UNDER REVIEW

14. Monitoring Visits during the month DSM Executive Monitoring Other Staff Total

20 49 155 224

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2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 01 N/A N/A N/A N/A

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for 38 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

1

Repair and Renovation work of all assigned HFs have been completed satisfactorily.

Inspections / Visits of PPHI HFs Visitors* Health Facilities Visited Overall Comments

N/A N/A N/A

* To reflect only non-PPHI Visitors. J- DISCUSSION DURING MRM

On Staff Matters: • Trend of short leave must come to an end • Getting proper history of patients • Wearing of aprons by all staff members • Proper timing and facilitation of patients • Regularity and punctuality of the staff • Proper updating and reconciliation of the record especially stock and daily expense register • Daily visit of the MO and FMO of the medicine store • Medicine management

On Preventive Health: • Holding awareness sessions in schools and colleges of catchment area • Waste disposal pit must be properly used • Getting proper history of the patients • Arranging of quality CHS and SHS • Agenda of the sessions must be with planning and in simple language. • Cleanliness of the HFs on regular basis.

On Curative Health: • Efficient use of Medicine at HF • Lab: tests at HFs • Medicine must be properly managed • Proper record also maintained and reconciled • Least use of injections • House keeping of the HFs is must. • X-Ray and Ultrasound facility

On Mother, Child & Reproductive Health: Other Matters: Date /Time for Next MRM: Next 53rd MRM shall be held on 9th October-2012 at 9:30 am. Comments on Targets vs Achievements (by DSM)

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MINUTES OF THE (48th) MONTHLY REVIEW MEETING

OF DISTRICT SUKKUR Monthly Review Meeting (MRM) of District, Sukkur for the Month of August, 2012 was held on 06th September, 2012 at Circuit House Sukkur. Written invitations to participate were sent to the DC, the EDO(H), the RPD RSU IV, the District Incharges of all vertical programs (EPI, TB Dots, LHWs, and all other National Programs as usual, DPWO, DHCSO-UNICEF & DSO WHO. The list of participants follows: List of Participants S # Names/Designation S # Names/Designation

1 Mr. Ghulam Ali Soomro (RPD RSU IV) 37 Dr. Musarat Qureshi 2 Dr. Abdul Sattar Chandio PHS PSU Karachi) 38 Dr. Ghulam Zuhra 3 Mr. Nasimuddin Mirani DSM Sukkur 39 Dr. Shahid Shahani 4 Mr. Syed Haider Ali Shah EO (M&E) 40 Dr. Aneela Haseeja 5 Ms Shazia Rasool EO (F&A) 41 Dr. Suneel Kumar 6 Dr. Mumtaz Ahmed Bullo 42 Dr. Kaneez Fatima 7 Dr. Ghulam Murtaza Jatoi 43 Dr. Rasool Bux Shah 8 Dr. Abdul Aziz Sheikh 44 Mr. Faisal Sheikh Assistant Admin 9 Dr. Abdul Wahab 45 Mr. Zubair Ahmed SOII 10 Dr. Muhammad Javed 46 Dr. Abida Gilani 11 Dr. Muhammad Hussan Indhar 47 Dr. Abdul Waheed Simair 12 Dr. Ahsanullah Dayo 48 Dr. Zaib-u-Nisa Qazi 13 Dr. Abdul Sami Sheikh 49 Dr. Najma Shah 14 Dr. Ali Gul Shah 50 Dr. Abdul Ghaffar Khoso 15 Dr. Farzana Talpur 51 Dr. Mohmmad Naqi 16 Dr. Bashir Ahmed Chachar 52 Dr. Farzana chachar 17 Dr. Sanam Qazi 53 Dr. ShaziaAmir 18 Dr. Khurram Hayat 54 Dr. Mushtaque Mahar 19 Dr. Ghulam Rasool 55 Dr. Abdul Hakeem Faisal 20 Dr. Noor Ahmed Soomro 56 Dr. Abida Simair 21 Dr. Girdhari Mal 57 Mr. Javed Ahmed Abro DSM Shikarpur 22 Dr. Tahir Hussain Abbassi 58 23 Dr. Munawar Kalwar 59 24 Dr. Ghulam Qadir 60 25 Dr. Zahid Mahar 61 26 Dr. Salahuddin Shah 62 27 Dr. Nusrat Dharejo 63 28 Dr. Nadeem Ahmed 64 29 Dr. Ghulam Muhammad 65 30 Dr. Saifullah Qureshi 66 31 Dr. Afshan Soomro 67 32 Dr. Shazia Memon 68 33 Dr. Amanullah 69 34 Dr.Shazia Mangi 70 35 Dr. Zakia Mahar 71 36 Dr. Shaista Mahar 72

The following could not attend the meeting for the reasons stated against each:-

S # Names/Designation Reasons S # Names/Designation Reasons 1 Dr. Mir Parwaiz Leave 3 Dr. Jalees Fatima Relieved 2 Dr. Rizwana Malik Maternity leave 4 5 Dr. Farzana Chachar Maternity leave 6

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7 Dr. Abida Simair Leave N. HFs WITH PPHI

BHUs: ___26____ Dispensaries: ___7____ MCHCs: ___1____ Others:__1____

TOTAL: ___35____ B. Population of the Catchments Area:

CC. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MOs 31 35 10 23 8 WMO 0 0 0 FMOs 22 18 0 18 4 LHVs 27 27 14 11 9

MTs/MAs Male 2 2 2 0

0 Female 0 0 0

Dispensers/HT 52 54 37 17 0

DD. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

35. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of Participants

NIL Presentation on EPI Presented By: Dr. Abdul Aziz Shaik Review of DHIS reports Presented By: Dr. Abdul Sattar Chandio PHS PSU Karachi F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

Previous Month Total Month under Review Total

Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs

Single HFs 34 Single HFs 34

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 11 Clusters of 2 HFs 11 Single HFs 8 Single HFs 8

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During Month under Review 1. Vaccination / Immunization

Descriptions Number

Doses of Immunization Administered to Children at HFs. 2106 TT vaccines administered to pregnant women at HFs. 1195 Immunization & Vaccination Administered by out- reach EPI Teams 7085 Total Vaccination / Immunization for the Month August 2012 10386

2. National Immunization Days (NIDs) for Polio

Dates of NIDs Target of coverage Actual coverage Percentage of coverage

0 0 0 0

3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 0 2 Active Case Detection (ACD) Slides 0 3 Visits to Check Sanitation (individual households + streets) 0 4 Notices issued against Poor Sanitation 0 5 Challans sent to Court against Poor Sanitation 0 6 Patients Nebulizer 350

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health S # Names of FMOs Ante-Natal Cases Neo-Natal Cases Other OPD Total OPD

1 Dr. Kaneez Fatima 278 8 1309 1595 2 Dr. Nusrat Dharejo 356 12 373 741 3 Dr. Najma Shah 416 6 1182 1604 4 Dr. Shazia Mangi 133 7 1272 1412 5 Dr. Shazia Aamir 214 5 2111 2330 6 Dr. Abida Simair 333 6 1731 2070 7 Dr. Zaibunisa 58 8 791 857 8 Dr. Shaista Mahar 187 1 998 1186 9 Dr. Jalees Fatima 112 0 842 954

10 Dr. Afshan Soomro 229 14 981 1224 11 Dr. Sanam Qazi 123 1 846 970 12 Dr. Anila Hasija 116 1 1515 1632 13 Dr. Farzana Chachar 28 0 620 648 14 Dr. Ghulam Zuhra 378 25 541 944 15 Dr. Rizwana 0 0 0 0 16 Dr. Zakia Mahar 180 1 790 971 17 Dr. Farzana Naz 84 1 776 861

Total 3225 96 16678 19999

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2: Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 103 2 Deliveries Assisted at Homes 87

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 443 2 Blood Sugar Tests 831 3 Hemoglobin Tests 305 4 Ultra Sound Test 2084 5 Other 0

36. Important Discussion on Mother and Child and Reproductive Health during MRM No new thing was discussed on this issue.

37. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number Consultation / Advice 446 Oral Pills 212 IUCDs 18 Injections 247 Others 193

Total 1116 8

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: -----34------------- Number of Female SGs: ----02---------- 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of

Participants DSM 1 0 10 0/0 0/0 Syed Haider Ali Shah EO M&E 4 0 63 0/0 0/0 Zubair Ahmed 1 0 12 0/0 0/0 Asif Nazeer jointly with EO (M&E) 0 0 0 0/0 0/0

Total 6 0 85 0/0 0/0 3. School Health Sessions & Community Health Sessions

Names of MO / FMOs/Paramedics

Community Health Sessions School Health Sessions

Sessions Participants Sessions Children Examined

Children Treated

Dr. Afshan Shahid 1 22 0 0 0 Dr. Nusrat Dharejo 2 86 0 0 0 Dr. Kaneez Fatima 2 51 0 0 0 Dr. Ghulam Zuhra 2 35 0 0 0 Dr. Shazia Mangi 2 57 0 0 0 Dr. Najma Shah 2 85 0 0 0

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Dr. Shazia Amir 2 40 0 0 0 Dr. Zaibunisa 1 16 0 0 0 Dr. Abida Simair 2 90 0 0 0 Dr. Anila Hasija 2 50 0 0 0 Dr. Sanam Qazi 2 39 0 0 0 Dr. Zakia Mahar 2 25 0 0 0 Dr. Shaista Mahar 2 32 0 0 0 Dr. Farzana Naz 1 25 0 0 0 Dr. Girdhari 2 40 0 0 0 Dr. Shahid Hafeez 2 44 0 0 0 Dr. Zahid Mahar 2 64 0 0 0 Dr. Bashir Ahmed 1 40 0 0 0 Dr. Ghulam Rasool 2 30 0 0 0 Dr. Salahuddin Shah 2 83 0 0 0 Dr. Ahsan Dayo 2 34 0 0 0 Dr. Mumtaz Bullo 1 22 0 0 0 Dr. Abdul Aziz Sheikh 1 21 0 0 0 Dr. Ali Gul Shah 2 18 0 0 0 Dr. Abdul Wahab 1 23 0 0 0 Dr. Munwar Kalwar 2 58 0 0 0 Dr. Abdul Waheed 1 15 0 0 0 Dr. Khuram Hayat 1 18 0 0 0 Dr. Ghulam Qadir 1 15 0 0 0 Dr. Tahir Abbasi 2 36 0 0 0 Dr. Noor Ahmed 1 11 0 0 0 Dr. Ghulam Muhammad 2 30 0 0 0 Dr. Mushtaq Mahar 2 25 0 0 0 Dr. Faisal Qazi 1 13 0 0 0 Dr. Ghulam Murtaza 1 16 0 0 0 Dr. Javeed Baloch 2 22 0 0 0 Dr. Nadeem Mangi 2 17 0 0 0 Dr. Sunil Kumar 1 12 0 0 0

Total 62 1360 0 0 0 4. Important Points during Support Group Meetings. In Community Support group Meetings, it was suggested by community members that both MOs & FMOs should conduct joint health sessions. It was planned that during next month all MOs and FMOs will conduct sessions in the catchments areas of their respective facilities. (The plan has been circulated by DSU) 5. Important Points during SHSs In school health sessions the focus of all doctors was on Diarrhea & suspected malaria. They advised children to take care of both fatal diseases during upcoming month of September. 6. Important Points during CHSs The Doctors imparted prevention measures against Diarrheal and Malarial disease to participants. The way to avoid outbreak of both diseases 7. Topics for SHSs for the Month

Sr. No. Topics 1 • ARI Infections & its prevention. 2 • Diarrhea types & its prevention 3 • Health Awareness and its importance 4 • Quakes & its effects on society

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5 • Obstetric problems and its complications. 6 • Skin infection & its prevention (Scabies).

8 Topics for CHSs for the Month

S # Topics 1 • ARI Infections & its prevention. 2 • Diarrhea types & its prevention 3 • Health Awareness and its importance 4 • Quakes & its effects on society 5 • Obstetric problems and its complications. 6 • Skin infection & its prevention (Scabies). 7 • Poliomyelitis its complication & preventions. 8 • Vaccination & its importance. 9 • Malaria its complications& its prevention. 10 • Heat Stroke and its prevention.

9. Important Discussion on Community Participation during MRM We should take all possible measures to sensitize community to own our program 10. Health Camps: Number Held: -----------------. Number of Patients: -----------. 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation N/A N/A N/A Ii Drainage / sewerage N/A N/A N/A Iii ……… drinking water N/A N/A N/A Iv Prevention of adulteration N/A N/A N/A V Tree Plantation N/A N/A N/A Vi Roads and infrastructure N/A N/A N/A Vii Environmental Improvement N/A N/A N/A Viii Others N/A N/A N/A

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIE

1. OPD*

New patients treated during the month

Old patients treated during the month

Total OPD during the month (New + Old)

84187 4130 88317 2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD 1 BHU Dadloi 6863 GD Village Sehta 1004 2 BHU Newpind 6816 GD Faiz M Jatoi 1329 3 BHU Qasimpur 5230 GD Riazabad 1353 4 BHU Cheechro 3810 BHU Lutuf Ali Jagirani 1600 5 BHU Patni 3656 BHU Kandri 1601

3. Top Five Diseases Treated during School Health Sessions/Camps

S # Diseases No. of Patients 1 ARI 0

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*All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases during OPD

S # Disease No. of Patients 1 URTI 11573 2 Skin Diseases 7956 3 Diarrhea 6941 4 Susp: Malaria 2651

38. ARV / ASV used during the month

No. of Patients Dog bite cases reported 135 ARV Administered 135 ARV Available Doses at DSU 105 Snake bite cases reported 1 ASV Vaccine Administered 1 ASV Vaccine Available Doses 3

45. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests) S # Tests Number 1 Pregnancy Tests 443 2 Blood Sugar Tests 831 3 Hemoglobin 305 4 X-Rays (if available) 12 5 Ultra Sound 2084 6 Others (please specify) 0

46. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

Hepatitis B 0 0 0 0 0 Hepatitis C 0 0 0 0 0

47. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

90 64 70 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs/HF THQs DHQs 2 83 11 0 72 4 35 44

2 Suspected Malaria 0 3 Diarrhea 0 4 Scabies 0

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3 4

S.No Totals Cases Referred from

1 ARV ASV Others RHCs/HF THQs DHQs 2 94 83 0 11 29 17 48 3 4

G. MONITORING DURING MONTH UNDER REVIEW

15. Monitoring Visits during the month

DSM EX: M&E Other Staff Total 37 55 72 164

2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks Nil Nil Nil Nil

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for …………59……………. Weeks 2. Important Issues raised relating to Anti-Malarial Medicines, etc. during MRM We have approached Dr Habib Focal Person Malaria Crash Program for provision of Anti-malarial & RDT kits to DSU for on ward distribution among all facilities.

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

1 BHU Patni 100% Completed

2 BHU New pind 100% Completed

3 BHU Salehpat 100% Completed

4 BHU Qasimpur 100% Completed 5 BHU Arore 100% Completed 6 BHU Nouraja 100% Completed 7 BHU Dadloi 100% Completed 8 BHU Dubar 100% Completed 9 BHU Hingoro 100% Completed 10 BHU Tando Thatti 100% Completed 11 BHU Gagro 100% Completed 12 BHU Darawhan 100% Completed 13 BHU Kandowahan 100% Completed 14 BHU Sultan pur 100% Completed 15 GD Mubarkpur 100% Completed 16 BHU Cheechro 100% Completed 17 BHU Haji Khan Chachar 100% Completed

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18 BHU Thikratho 100% Completed 19 GD Naseerabad 100% Completed 20 BHU Nirch 100% Completed 21 BHU Abad 100% Completed 22 BHU Faqeerabad 100% Completed 23 BHU Thariri 100% Completed 24 BHU Lutaf Ali Jagrani 100% Completed 25 BHU Hussain Kalwar 100% Completed 26 BHU Samo Chachar 100% Completed 27 BHU Dodanko 100% Completed 28 BHU Kandri 100% Completed 29 GD Ali Wahan 100% Completed 30 GD Riazabad 100% Completed 31 GD Village Sehta 100% Completed

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

* To reflect only non-PPHI Visitors.

J- DISCUSSION DURING MRM On Staff Matters:

• Low Rate of TB Suspected Cases & its referral to Diagnose Centre • Most of the Female Doctors are not focusing on Vaccination • Reporting formats are not properly checked & filled by FMOs • Suspected Cases of TB not mentioned in DHIS Report • Sonologist are not given reports to patients. • The F.M.Os always doing calculation mistakes in their reports. • CHS & SHS ratio are not up to the mark. • CSG Meetings must be conducted at all Health Facilities. • Weekly Vaccination report are not submitted at DSU • Performance column not filled by various health facility • DHIS report must be filled by IC MO & then Counter sign on it

On Preventive Health:

• Punctuality and performance of all vaccinators August be monitored strictly as special direction received from worthy Program Director.

• Report of Immunization (EPI) was submitted on weekly bases by I/C MO at DSU Sukkur for further submission to PSU.

On Curative Health:

• The RTI was the top diagnostic diseases for the month of August and it may be further increase in next month so more medicine of ARI will be provided to the HFs.

On Mother, Child & Reproductive Health: Total 103 NVDs were conducted by PPHI staff during the month of August 2012. The contraceptive material is Available, so family planning cases must be increased. Other Matters: Date /Time for Next MRM: 10/10/2012 Comments on Targets vs Achievements (by DSM) Target for the Month of September

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Installation of 2 Gas connections at MCHC Salehpat & Qasimpur Sangi (Pano-Akil), push doctors for more family planning services to visiting clients & impart paramedics trainings for use of DHIS Tools.. Achievement for the Month of August

We place our special attention on UCs which were declared below 95% in PCM during last month’s SNID by placing female teams, replaced area incharges and sweeped all poor pockets of three UCs Tarai (Saleh Pat Taluka), Arrore (Rohri Taluka) & Rahuja (New Sukkur Taluka). Besides we have made alert all MOs to keep the roofs of their respective HFs clean owing to monsoon rains. Delivered medicine in bulk qty at all HFs to contain likely out break in our district.

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MINUTES OF THE 28th MONTHLY REVIEW MEETING OF DISTRICT Ghotki@Mirpur Mathelo.

Monthly Review Meeting of District, Ghotki@MirpurMathelo for the Month of August, 2012 was held on 7th SEP- 2012 at DC Committee Hall Mirpur Mathelo. Written invitations to participate were sent to the DC, the DHO, and District Incharge of EPI, LHW and all other National Programs as usual. The list of participants follows: List of Participants:

S # Names/Designation Designation S # Names/Designation Designation

1 Dr . Riaz A. Memon Project Director 33 Dr:Samina shaikh SONOLOGIST 2 Mr.Ghulam Ali soomro RPD 34 Dr. yasmeen FMO 3 Mr. Danish Afzal DSM 35 Dr. Amna Khokhar FMO 4 Dr. Abdul Sattar Chandio Public Health Specialist 36 Dr. Salma FMO 5 Mr. Malik Gh: Mustafa Provincial Engineer 37 Dr. Afsana FMO 6 Mr. Sanaullah Mangi Ex:M&E 38 Dr. Rahat Shakeel FMO 7 Mr. Ahsan Masood Executive (F&A) 39 Dr Suresh Kumar Sonologist 8 Dr. Mukesh Kumar ENT Specl: 40 Dr. Ropa FMO 9 Dr. Parshotam MO 41 Dr. Yaqoob Mahar MO 10 Dr. Moiz-u-Din MO 42 Dr sadia Nisar FMO 11 Dr. Parshootam Dental Surgeon 43 Dr Hina Mumtaz FMO 12 Dr. Zakir hussain Cardiologist 44 Dr. Rabia Raheem FMO 13 Dr. Imtiaz Hussain Gen. Surgeon 45 Dr Nazim Shah MO 14 Dr. Zulfiqar Shah MO 46 Dr. Touquer Ahmed MO 15 Dr Altaf Hussain Dental Sergeon 47 Dr. Nisar Ahmed MO 16 Dr. Abdul Latif MO 45 Dr. Rashida Shaikh FMO 17 Dr. Amar Lal MO 46 Dr Nusrat Noor FMO 18 Dr. Asif Hakeem MO 47 Dr. Mumtaz Ahmed Pediatrician 19 Dr. Amanullah MO 48 Dr. Atiya Zafar FMO 20 Dr. Ghulam Rasool MO 49 Dr. Asma Qadeer FMO 21 Dr. Imtiaz Hussain MO 50 Dr. Ab: Qadeer Shaikh MO 22 Dr. Irfan Ahmed Orthopedic Surgeon 51 Dr. Imran Hussain MO 23 Dr. Shankar MO 52 Dr Ghulam Mujtaba MO 24 Dr. Majid Rahim MO 53 Dr. Nand Lal Child Specl: 25 Dr. Ahsan Ali MO 54 Dr Sanaullah MO 26 Dr. Qadir bux General Surgeon 55 Dr. Raj Kumar Anesthetist 27 Dr. Muhammad Akbar Sr. RMO 56 Dr. Qarat ul ain Gynecologist 28 Dr. Nazir Ahmed MO 29 Dr Shah pasand MO 30 Dr. Ghulam Sarwar MO 31 Dr. Manooj Kumar MO

All the MOs / WMOs / FMOs attended the meeting, except the following, for reasons mentioned against each:

S # Names/Designation Reasons for absence 1 Deena Nath MO 2 Dr. Suneel Kumar MO 3 Dr. Ali Muhammad Anesthetist 4 Dr. Shazia Shakeel Dentist 5 Dr. Sameena Asif Sonologist

A. HFs WITH PPHI BHUs: 31 Dispensaries: 10 RHC: 03 DCDs: 7

TOTAL: 51 B. Population of the Catchment Area: 666535 EE. STAFF STRENGTH

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Sanctioned Posts

As per PPHI

Working Government Employees

PPHI Contract Vacant

MOs 31 44 25 1 24 20 W/FMOs 1 25 11 0 11 14 LHVs 13 16 22 5 9 7 MTs/HTs 43 22 41 31 14 8 Dispensers 5 0 5 5 0 0

FF. CLUSTERS OF HFs

WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

1. First Session: During MRM

Nil 2. Second Session: During MRM Nil

39. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of Participants

Nil Nil Nil Nil Nil

F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered to Children at Health Facilities. 2542 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 1910 No. of Immunization & Vaccination Administered by out- reach EPI Teams 2218 Total vaccination / immunization for the month August -2012 4126

2. National Immunization Days (NIDs) for Polio

Previous Month Month under Review Total at Present Clusters of 6 HFs Clusters of 6 HFs - Clusters of 5 HFs Clusters of 5 HFs - Clusters of 4 HFs Clusters of 4 HFs - Clusters of 3 HFs Clusters of 3 HFs 1 Clusters of 2 HFs 01 Clusters of 2 HFs 4 Single HFs 28 Single HFs 20

Previous Month Month under Review Total at Present

Clusters of 5 HFs ( Ultrasound) Clusters of 6 HFs - Clusters of 4 HFs - Clusters of 4 HFs - Clusters of 3 HFs - Clusters of 3 HFs - Clusters of 2 HFs 9 Clusters of 2 HFs 7 Single HFs 1 Single HFs 4

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Dates of NIDs Target of coverage Actual coverage Percentage of coverage

- - - - 3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 274 2 Active Case Detection (ACD) Slides 7 3 Visits to Check Sanitation (individual house holds + streets) 0 4 Notices issued against Poor Sanitation - 5 Challans sent to Court against Poor Sanitation - 6 Patients Nebulized 249

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health

2.Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 43 2 Deliveries Assisted at Homes 0

3. Lab/ Diagnostic Tests

S # Test Number

1 Pregnancy Tests 155 2 Blood Sugar Tests 522 3 Hemoglobin Tests 132 4 Ultra Sound Test 1221 5 Other 40

40. Important Discussion on Mother and Child and Reproductive Health during MRM

Nil

41. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number

S # Names of FMOs Ante-Natal Cases

Neo-Natal Cases

Other OPD Total OPD

1 Dr. Roopa 28 0 922 950 2 Dr. Rashida Shaikh 305 13 689 1007 3 Dr. Afsana Zulfikar 205 0 802 1007 4 Dr. Atia Zafar 28 0 982 1010 5 Dr. Sadia Nisar 231 12 724 967 6 Dr. Salma Qureshi 186 5 754 945 7 Dr. Yasmeen 65 1 495 561 8 Dr. Amna Khokhar 28 2 548 518 9 Dr Nusarat Noor 19 0 461 480 10 Dr. Hina Mumtaz 239 9 1142 1390 11 Sr. Rahat Shakeel 179 1 450 630

Total 1513 43 7969 9467

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1 Consultation / Advice 339 2 Oral Pills 173 3 IUCDs 1 4 Injections 202 5 Others -

Total 715

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: 5 Number of Female SGs: 0 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of

Participants M.usman 01 10 0

Total 0

2. School Health Sessions & Community Health Sessions S # Name of Medical

Officer CHS SHS

CSG

No.

of

Mee

tings

Part

icip

ants

No.

of

sess

ion

Part

icip

ants

Exa

min

ed

Trea

ted

1 Dr. Abdul Latif Naich

1 18 0 0 0 0 1

2 Dr. Ahsan Ali

1 12 0 0 0 0 0

3

Dr. Amanullah Khan Mahar

1 35 0 0 0 0 1

4 Dr. Amar Lal

1 23 0 0 0 0 0

5 Dr. Asif Hakeem

2 38 0 0 0 0 0

6 Dr. Bashir Ahmed Bhutto

2 0 0 0 0 2

7 Dr. Fasihuddin Gujar 0 0 0 0 0 0 0

8 Dr. Gh: Rasool

2 31 0 0 0 0 0

9 Dr. Gh: Sarwar Mahar 1 35 0 0 0 0 0

10 Dr. Ghulam Mujtab

2 44 0 0 0 0 0

11 Dr. Imran Hussain 2 62 0 0 0 0 0

12 Dr. Imtiaz Ahmed 1 21 0 0 0 0 0

13 Dr. Majid Rahim

1 7 0 0 0 0 0

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S # Name of FMO

CHS SHS

No.

of

Mee

ting

s

Part

icip

ant

s

No.

of

sess

ion

Part

icip

ant

s

Exm

ine

d

Trea

ted

1 Dr. Afsana Zulfikar 2 62 0 0 0 0

2 Dr. Amna Khokhar 3 75 0 0 0 0

3 Dr. Atia Zafar 1 25 0 0 0 0

4 Dr. Hina Mumtaz 2 35 0 0 0 0

5 Dr. Nusrat Noor 1 9 0 0 0 0

6 Dr. Rahat Shakeel 2 75 0 0 0 0

7 Dr. Rashida Shiakh 0 0 0 0 0 0

8 Dr. Roopa 4 56 0 0 0 0

9 Dr. Sadia Nisar Memon 1 15 0 0 0 0

10 Dr. Salma Qureshi 4 50 0 0 0 0

11 Dr. Yasmeen 0 0 0 0 0 0

4. Important Points during Support Group Meetings. Nil 5. Important Points during SHSs Nil 6. Important Points during CHSs Nil 7. Topics for SHSs for the Month

Sr. No. Topics 1 2 3

8 Topics for CHSs for the Month

S # Topics 1 Antenatal and post natal care 2 Hepatitis 3 Scabies

9. Important Discussion on Community Participation during MRM Nil 10. Health Camps: Number Held: Nil . Number of Patients: Nil.

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11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status i Sanitation Nil Nil Nil ii Drainage / sewerage Nil Nil Nil iii ……… drinking water Nil Nil Nil iv Prevention of adulteration Nil Nil Nil v Tree Plantation Nil Nil Nil vi Roads and infrastructure Nil Nil Nil vii Environmental Improvement Nil Nil Nil viii Others Nil Nil Nil

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW 1. OPD*

New patients treated during

the month Old patients treated during

the month Total OPD during the month

(New + Old) 74686 2927 77613

2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD 1 BBHU Umar Daho 4767 BHU M.Y Mahar 296 2 RHC Qadir Pur 3238 GD M.pur 581 3 BHU Adil pur 3172 GD.Abul Garhi 836 4 BHU Dad laghari 2961 DCD Dari 655 5 BHU Rountti 2966 GD Changlani 713

3. Top Five Diseases Treated during School Health Sessions/Camps *All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 ARI 8707

2 Fever due to other causes 6934

3 Susp: Maleria 5193 4 Scabies 4705 5 Dermatits 4081

42. ARV / ASV used during the month

No. of Patients Dog bite cases reported 82 ARV Administered 0 ARV Available Doses 0 Snake bite cases reported 1 ASV Vaccine Administered 0

S # Diseases No. of Patients

1 Nil Nil

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ASV Vaccine Available Doses 0 48. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Pregnancy Tests 155 2 Blood Sugar Tests 522 3 Haemoglobin 132 4 X-Rays (if available) 0 5 Ultra Sound 1221 6 Others (please specify) 40

49. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

Hepatitis B Nil Nil Nil Nil Nil Hepatitis C Nil Nil Nil Nil Nil

50. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

20 3 3 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 344 22 - 322 - 241 103

10. Inverse Referrals

S.No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs 2 29 32 - 3 - 5 32

G. MONITORING DURING MONTH UNDER REVIEW

16. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total

15 29 133 177 2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 1 Nil Nil Nil Nil

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for 15 Weeks

17. Important Issues raised relating to Medicines, etc. during MRM DSM discussed with all MOs regarding medicine consumption and control on misuse of medicine.

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I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

1 BHU Qadirpur R&R 100%

2 BHU Umer Deho R&R 100%

3 BHU Bago Bhutto R&R 100% 4 BHU Dad Laghari R&R 100% 5 BHU Soi Sharief R&R 100% 6 BHU Kamo Shaheed R&R 100% 7 BHU Ali Mahar R&R 100% 8 BHU Ayoub Lakhan R&R 100% 9 BHU Hussain Beli R&R 100% 10 BHU Syed Pur R&R 100% 11 BHU Jahanpur Sharief R&R 100% 12 BHU Saleh Mahar R&R 100% 13 BHU Noor Abad R&R 100% 14 BHU Ahmed Ali Pitafi R&R 100% 15 BHU Darwaish Naich R&R 100% 16 BHU Taj M.Ruk R&R 100% 17 GD M.Pur R&R 100% 18 GD Changlani R&R 100% 19 GD Khadwari R&R 100% 20 BHU Ghulam Hyder Leghari R&R 100% 21 GD Hayat Pitafi R&R 100% 22 BHU Lohi R&R 100% 23 GD Qazi Badal R&R 100% 24 GD SIjawal Dhaundhu R&R 100% 25 BHU Abdul Sattar R&R 100% 26 BHU Haso Daho R&R 100% 27 BHU Raunti R&R 100% 28 BHU Sanghri R&R 100% 29 GD Chak Shahbaz Pur R&R 100% 30 GD Pir Jo Goth R&R 95% 31 BHU Bago Daho R&R 50% 32 BHU Gh: Hussain Leghari R&R 5%

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

- - -

J- DISCUSSION DURING MRM

Honourable Programe Director emphasies that improve Antinatal coverage , Family planning and routine immunization .

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Discussed over error in DHIS reports and presentation by Dr. Abdul Sattar chandio that how to fill the DHIS reports in proper way.

Discussed over CSG Formation and hand outs regarding CSG formation provided to all particepents.

Discussed over the data accuracy and EPI coverage

Expected Date for Next MRM: 10th oct -2012 Comments on Targets vs Achievements (by DSM)

Nil

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MINUTES OF THE (47th) MONTHLY REVIEW MEETING

OF DISTRICT JACOBABAD Monthly Review Meeting (MRM) of District, Jacobabad for the Month of August 2012 was held on 07th September 2012, at Zila Nazim council Hall Jacobabad. Written invitations were sent to the DC, DHO, DPWO, DSO (WHO), SO (DEWS)-WHO, SO UNICEF), and District In charge of EPI, LHW, Distt Coordinator, TB DOTS, HMIS and all other National Programs as usual. The list of participants follows: List of Participants:

1. Mr. Zulfiqrar Ali Langah District Support Manager Jacobabad 2. Dr. Deedar Hussain Jamali DHO Jacobabad 3. Dr. Wajid Hussain Bhutto District Coordinator TB Dots 4. Mr. Tahir Ali Lashari E.O (M&E) 5. Mr.Muhammad Iqrar Veesar S.M DSU Jcd. 6. Mr.Haq Nawaz Lashari S.M DSU Jcd. 7. Mr. Noor Muhammad Bhangar S.M DSU Jcd. 8. Dr.Abdul Jabar Thahim M.O H/Q DSU Jcd. 9. Dr.Sajjad Ahmed Burriro I/C M.O G.M Jakhrani 10. Dr.Habib ul Rehman Khoso I/C M.O Abdullah Lashari 11. Dr.Shoukat Ali Soomro I/C M.O Jumo Dasti 12. Dr.Ghulam Mohammad Talani I/C M.O Madadpur 13. Dr.Kishor Kumar M.O MCHC Jafferabad,Jcd 14. Muhammad Ishaque Malik I/C M.O Mouladad 15. Dr.Mohammad Aslam Abbasi M.O Noor Mohammad Pathan 16. Dr.Ghulam Mohammad Dasti I/C M.O Karim Bux Khoso 17. Dr.Nusrat Soomro FMO Welfare Dispensary Ahmed Mian Soomro 18. Dr.Fozia Khoso FMO MCHC Jaffarabad 19. Dr.Farzana Khoso FMO MCHC Jaffarabad 20. Dr.Naila Soomro FMO GD Abad / BHU Mubarakpur 21. Dr. Farida Qureshi FMO GD Police Head Quarter 22. Dr. Rukkaya Abro FMO BHU N.M Pathan / BHU S.K Rind 23. Dr. Shazia Jamali FMO Welfare Disp Ahmed Mian Soomro 24. Dr. Sheerin Soomro FMO GD Adam Khan 25. Dr. Saima Patujo FMO BHU Madadpur / BHU Bahadurpur 26. Dr. Saeeda Solangi FMO MCHC Jaffarabad 27. Dr. Resham Naseer Soomro FMO BHU Abdullah Lashari/ GD Jumo Dasti 28. Dr. Fazalullah Brohi I/C M.O Muhammad Pur Odho 29. Dr. Aziz Ahmed Soomro I/C M.O BHU Udi 30. Dr. Muzafar Khaskheli I/C M.O BHU Hashmatabad 31. Dr. Naeem Ahmed Sarki I/C M.O GD Naseer Khan Bhangar 32. Dr. Zulfiqar Ali Golo M.O BHU Bachro 33. Dr. Abdul Fattah Khoso ` I/C M.O BHU Bachro 34. Dr. Abdul Ghafar Babar I/C M.O Dodapur 35. Dr. Baqa Muhammad Panhwar I/C M.O Banlow Syedan 36. Dr. Kashif Ali Pahore I/C M.O BHU Joungal 37. Dr. Nabi Bux Soomro GD Imam Bux Kehar 38. Dr. Azizullah Talani I/C M.O GD Police H/Q 39. Dr. Inayatullah Dayo I/C M.O BHU Sheranpur 40. Dr. Safiullah Bhutto I/C M.O BHU Mubarakpur

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41. Dr. Ihtasham ul Haq I/C M.O BHU A.R Suhendero 42. Dr. Zafar Ali Pathan I/C M.O GD Abad 43. Dr. Ashok Kumar Sangitiani I/C M.O BHU Karim Bux Khoso 44. Dr. Amar Lal M.O BHU Karim Bux 45. Dr. Irfan Ahmed Khoso I/C M.O BHU Bangul 46. Dr. Kishore Kumar M.O MCHC Jaffarabad 47. Dr. Saeed Ahmed Odhano I/C M.O DCD Abdul Rasool Khoso 48. Dr. Abdul Basit Pahore Medical Officer BHU Buxan Pahore 49. Dr. Muhammad Azim Shah I/C Medical Officer BHU Jumo Dakhan 50. Mr. Nadeem Ahmed Dispenser BHU Bahoo Khoso 51. Mr. Ghulam Hyder Brohi Dispenser BHU Piyaro Khoso 52. Mr.Ghulam Hussain Assistant Accounts 53. Mr. Mehmood Ali Roongho Sub-Engineer PPHI 54. Mr.Shehryar Abro Assistant/Computer Operator 55. Mr.Shuhab Ali Sehto Store Manager 56. Mr.Asif Ali Assistant Store Manager 57. Mr.Abdul Wahid Bhayo Assistant Admin

The following could not attend the meeting for the reasons stated against each:-

S # Names/Designation Reasons S # Names/Designation Reasons 1 Dr. Aqeela Ghaffar LWP 2 Dr. Abdul Ghaffar Rind C.L 3 4 5

O. HFs WITH PPHI

BHUs: __24____ Govt Dispensaries: ___09____ MCHCs: ___01____ Others:__ 03 TOTAL: __37__

B. Population of the Catchments Area: 723,473 GG. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) Mos 42 38 7 31 4 WMO 0 0 0 0 FMOs 20 14 1 13 6 LHVs 20 02 1 1 18

MTs/MAs Male 09 07 07 0

02 Female 0 0 0 0

Dispensers 65 58 28 29 8

HH. CLUSTERS OF HFs WITH ONE MO

Previous Month Total Month under Review Total

Clusters of 6 HFs 0 Clusters of 6 HFs 0 Clusters of 5 HFs 0 Clusters of 5 HFs 0 Clusters of 4 HFs 0 Clusters of 4 HFs 0 Clusters of 3 HFs 0 Clusters of 3 HFs 0 Clusters of 2 HFs 0 Clusters of 2 HFs 0

Single HFs 37 Single HFs 37

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WITH ONE FMO

E. CAPACITY BUILDING

1. First Session: During MRM

2. Second Session: During MRM

43. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of Participants

0 0 0

F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered to Children at Health Facilities. (Only 3rd Penta valent & Measles) 1345

No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 665 No. of Immunization & Vaccination Administered by out- reach EPI Teams – (Govt Vaccinators do not submit their performance report at HF / DSU) -

Total vaccination / immunization for the month 2010 2. National Immunization Days (NIDs) for Polio

Dates of NIDs Target of coverage Actual coverage Percentage of coverage

3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides 0 2 Active Case Detection (ACD) Slides 0 3 Visits to Check Sanitation (individual house holds + streets) 0 4 Notices issued against Poor Sanitation 0 5 Challans sent to Court against Poor Sanitation 0 6 Patients Nebulized 0

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs 01 Clusters of 3 HFs 01 Clusters of 2 HFs 05 Clusters of 2 HFs 05 Single HFs 08 Single HFs 08

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1. Female Health

S.No Name of FMO Ante Natal

Cases Natal Cases

Other OPD

Total OPD

1 Dr. Farida Zahid 258 12 1470 1740

2 Dr. Saeeda Solangi 118 13 1407 1538

3 Dr. Farzana Khoso 161 8 1197 1366

4 Dr. Asya Solangi 186 18 1130 1334

5 Dr. Shazia Rasheed 276 15 1018 1309

6 Dr. Haseena Jaan 156 3 734 893

7 Dr. Shireen Soomro 44 6 787 837

8 Dr. Naila Soomro 67 1 686 754

9 Dr. Rukkaya Abro 58 2 680 740

10 Dr. Saima Patujo 24 0 704 728

11 Dr. Resham Naseer 25 0 360 385

12 Dr.Nusrat Soomro 0 4 Evening shift

13 DR. AQEELA GHAFFAR on Leave

14 DR. FOUZIA KHOSO WORKING AS SONOLOGIST

TOTAL 1373 82 10173 11624 2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 177 2 Deliveries Assisted at Homes 18

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 274 2 Blood Sugar Tests 172 3 Hemoglobin Tests 53 4 Ultra Sound Test 1543 5 Other 863

44. Important Discussion on Mother and Child and Reproductive Health during MRM

Following points were discussed:

• Deliveries & D&Cs (during the month) conducted by FMOs / LHVs / CMWs-name wise evaluation.

• Contraceptive clients-FMO wise. • School Health Sessions / Community Health Sessions. • Ultrasounds examinations by FMOs.

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45. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number Consultation / Advice 512 Oral Pills (clients) 119 IUCDs 14 Injections 142 Others 2

Total 789

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: ------37--------- Number of Female SGs: -------------- 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of

Participants Muhammad Iqrar Veesar 03 0 61 31 419 Haq Nawaz Lashari 03 0 54 38 896 Noor Muhammad Bhangar 02 0 36 18 332

Total 07 0 151 87 1647 3. School Health Sessions & Community Health Sessions

S.No Name of M.O / F.M.O CHS SHS

Sessions Participants Sessions Children Examined

Children Treated

1 Dr. G.M Dasti 5 52 0 0 0 2 Dr. Tara Chand 4 38 0 0 0 3 Dr. Veer Bhan 4 42 0 0 0 4 Dr. Jai Chand 3 47 0 0 0 5 Dr. Amar Lal 3 42 0 0 0 6 Dr. Naeem Ahmed Sarki 2 43 0 0 0 7 Dr. Ashok Kumar Sangitiani 2 44 0 0 0 8 Dr. Fazalullah Brohi 2 21 0 0 0 9 Dr. Resham Naseer 2 18 0 0 0 10 Dr. Inayatullah Dayo 2 46 0 0 0 11 Dr. Baqa Muhammad 2 42 0 0 0 12 Dr. Ghulam Muhammad Talani 2 54 0 0 0 13 Dr. Nabi Bux Soomro 2 78 0 0 0 14 Dr. Ishaque Malik 2 41 0 0 0 15 Dr. Rukkaya 2 24 0 0 0 16 Dr. Saeeda 2 52 0 0 0 17 Dr. Farzana 2 26 0 0 0 18 Dr. Asya 2 43 0 0 0 19 Dr. Shazia Jamali 2 45 0 0 0 20 Dr. Saima 2 74 0 0 0

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21 Dr. Shoakat Soomro 2 42 0 0 0 22 Dr. Sajjad Buriro 2 9 0 0 0 23 Dr. Abdul Fattah Khoso 2 46 0 0 0 24 Dr. Nusrat Soomro 2 13 0 0 0 25 Dr. Safiullah 2 31 0 0 0 26 Dr. Kishore Kumar 2 41 0 0 0 27 Dr. Zafar pathan 2 65 0 0 0 28 Dr. Kashif Pahore 2 46 0 0 0 29 Dr. Sheerin Soomro 2 33 0 0 0 30 Dr. Abdul Ghaffar Babbar 2 47 0 0 0 31 Dr. Ihtasham ul Haq 2 22 0 0 0 32 Dr. Veer Singh 1 15 0 0 0 33 Dr. Zulfiqar Golo 1 12 0 0 0 34 Dr. Haseena Jaan 1 19 0 0 0 35 Dr. Habib Jakhrani 1 24 0 0 0 36 Dr. Irfan Khoso 1 28 0 0 0 37 Dr. Vijay 1 16 0 0 0 38 Dr. Naila Soomro 1 16 0 0 0 39 Dr. Azizullah Talani 1 39 0 0 0 40 Dr. Aziz Ahmed 1 14 0 0 0 41 Dr. Saeed Odhano 1 22 0 0 0 42 Dr. Muzaffar Khaskheli 1 35 0 0 0 43 Dr. Rano Mal 1 37 0 0 0 44 Dr. Abdul Basit 1 32 0 0 0 45 Dr. Habib Khoso 1 24 0 0 0 46 Dr. Azim Shah 1 16 0 0 0 47 Dr. Farida 1 31 0 0 0

Total 87 1647 0 0 0 4. Important Points during Support Group Meetings.

• Progress Review of R/R work where it was in progress. • Importance of community Health Sessions in catchment areas of the H.F. • Participation of CSG members during special Polio campaign. • Importance of immunization of children.

5. Important Points during SHSs

• Importance of Immunization • Diarrhea • Malaria

6. Important Points during CHSs

• Importance of Immunization • Diarrhea • Malaria

7. Topics for SHSs for the Month

Sr. No. Topics

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1 Diarrhea 2 Malaria 3 Importance of Immunization 4 5

8 Topics for CHSs for the Month

S # Topics 1 Diarrhea 2 Malaria 3 Importance of Immunization 4 5

9. Important Discussion on Community Participation during MRM 10. Health Camps: Number Held: --------0--------. Number of Patients: ------0-----. 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation Ii Drainage / sewerage Iii ……… drinking water Iv Prevention of adulteration V Tree Plantation Vi Roads and infrastructure Vii Environmental Improvement Viii Others

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*

New patients treated during

the month Old patients treated during

the month Total OPD during the month

(New + Old) 70146 2648 72794

2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD 1 MCH Jaffarabad 8488 BHU GM Jakhrani 636 2 Welf Dispensary AMS 6059 BHU NK Bhangar 653 3 GD Police Dispensary 4127 GD Shabirabad 762 4 BHU Joungal 4112 BHU Uddi 843

3. Top Five Diseases Treated during School Health Sessions/Camps

S # Diseases No. of Patients 1. Scabies 651 2. ARI 617 3. Malaria 101 4. Unexplained fever 98 5. Fever (Clinical Malaria) 7

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*All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 Scabbies 10305

2 ARI 8130

3 Fever (Clinical Malaria) 6576

4 Diarrhea 4092 5 Cough 114

46. ARV / ASV used during the month

No. of Patients Dog bite cases reported 239 ARV Administered (vials) 147 ARV Available Doses 788 Snake bite cases reported 0 ASV Vaccine Administered 0 ASV Vaccine Available Doses 19

51. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Pregnancy Tests 272 2 Blood Sugar Tests 172 3 Hemoglobin 53 4 X-Rays (if available) 06 5 Ultra Sound 1543

6 Others (please specify) Malaria-ICT / Microscopic 420

52. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

Hepatitis B 157 05 05 66 0 Hepatitis C 149 35 35 363 0

53. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

9. Referrals

S.No Totals Cases Referred To TB DOT Deliveries Others BHU/RHCs THQs DHQs

1 2 3

10. Inverse Referrals

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S.No Totals Cases Referred from ARV ASV Others RHCs THQs DHQs

1 76 76 0 0 4 6 66 2 3

G. MONITORING DURING MONTH UNDER REVIEW

18. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total

42 48 71 161 2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 1 2 3

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for …14.3…. Weeks

19. Important Issues raised relating to Medicines, etc. during MRM

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFs

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

1 2 3

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

* To reflect only non-PPHI Visitors.

J- DISCUSSION DURING MRM

• OPD BHU wise. Comparison of OPDs of Aug in corresponding years ie 2006, 2007, 2008, 2009, 2010, 2011 & 2012.

• ARV cases during the month. • Various tests during the month under review i.e Blood sugar, malaria, pregnancy test,

hemoglobin test HBs HCV etc. • Ultrasounds cases / X-Ray cases.

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• EPI-performance BHU wise. Issues relating to cold chain maintenance. Shortage of BCG at EPI centers throughout the month.

• TB referrals during the month. • Monthly progress of FMOs, deliveries, D&Cs, FP cases, ANC registrations etc. • School Health Sessions / Community Health Sessions. • Community Support Group meetings. • Repair & renovation of BHUs. • Contraceptive material. • Increase in NVDs

On Mother, Child & Reproductive Health: Date /Time for Next MRM: 6th October, 2012 will be the tentative dates. Comments on Targets vs Achievements (by DSM)

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MINUTES OF THE (44rd) MONTHLY REVIEW MEETING

OF DISTRICT KASHMORE Monthly Review Meeting (MRM) of District, Kashmore @ Kandhkot for the Month of August-2012 was held on 07th September, 2012 at District Complexl Kandhkot. Written invitations to participate in the MRM were sent to the Deputy Commissioner Kashmore, Additional Deputy Commissioner-1 Kashmore, the DHO (Health) and District In charge of EPI, LHW and all other National Programs including MOs, FMOs, and othrs relevant I/Cs of BRHFs of PPHI. List of Participants:

S # Names/Designation Designation S # Names/Designation Designation 1 Mr. Munawar Ali Mithani DC Kashmore 27 Mr. Badar-u-din M.T 2 Mr. Abdul Ghaffar Surahio DSM Kashmore

28 Mr. Ali Jan Bahalkani Mr. Qutub-u-din Hyder Mr. Javed Ahmed Khoso

Vaccinator M.T

Vaccinator

3 Dr. Nirmal Chilmanani Focal Person DHIS

4 Abdul Razaque Junejo

EO M&E

5 Abdul Waheed Soomro

EO F/A 29 Mr. Ghulam Sarwar

Khoso Vaccinator

6 Jahangir Khan Store Manager 30 Dr. Vijay Kumar Chawila MO

7 Dr. Mansoor Malik Dr. Irshad Ahmed Langah

MO MO

31 Mr. Ghulam Sarwar Chachar Vaccinator

32 Mr. Abdul Ghani Bapar M.T 8 Dr. Abdul Ghafoor MO 33 Mr. Mohammad Bachal M.T 9 Dr. Aftab Ahmed MO 34 Mr. Nazeer Ahmed M.T 10 Dr. Aneel Kumar MO 35 Dr. Yougesh Kumar MO 11 D. Shishpal Das MO 36 Dr. Asadullah Noonari MO 12 Mr.Abdul Khalique Malik M.T 37 Mr. Imran Khan M.T 13 Mr. Shamas Din Khoso M.T 38 Mr. Abdul Bais M.T 14 Mr. Israr Ahmed SO 39 Miss Naik Bakht LHV 15 Mr. Abdul Ghani SO 40 Miss Farzana Midwife 16 Rafique Ahmed Khoso SO 41 Dr. Mumtaz Malik FMO 17 Dr. Gulab din Bijarani MO 42 Miss Farzana Lashari Midwife 18 Dr. Zulfiqar Ali Soomro MO 43 Dr. Sumera Soomro FMO

19 Mr. Abdul Razaque M.T 44

20 Dr. Javed Ahmed Sundrani MO 45

21 Mr. Qamar Zaman Astt:admin 46

22 Dr. Hafeezullah Banglani MO 47

23 Dr. M.Saleem Khoso MO 48

24 Mr. Waqar Ahmed M.T

25 Mr. Gulsher Ahmed M.T

26 Mr. Ghulam Yaseen Vaccinator The following could not attend the meeting for the reasons stated against each:-

S # Names/Designation Reasons 1 Dr. Yougesh Kumar On leave 2 Dr. Anwar Ali Buriro On Leave 3 Mr. Naveed Ahmed Domko (M.T) Absent 4 Dr. Rukhsana Baloach On Leave 5 Dr. Shagufta Noonari (FMO) On Leave

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P. HFs WITH PPHI

BHUs: 21 Dispensaries: 16 MCHCs: 1 Others: 1 TOTAL: 39

B. Population of the Catchments Area: Approximately One Million II. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MOs 25 18 0 18 07 WMOs 04 0 0 0 04 FMOs 17 4 0 4 13 LHVs 8 5 0 5 3

MTs/MAs/Dispenser Male

50 49 25 23

02 Female

JJ. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

1. First Session: During MRM Deputy Commissioner Kashmore @ Kandhkot shared his experiences about the last polio campaign and appreciated the performance, commitment of PPHI team who actively steered the whole campaign. PPHI monitoring team and Doctors also expressed their experience, reservations.

2. Second Session: During MRM DSM Kashmore has welcomed to all participants and discussed issues, decisions taken in last MRM. 47. Third Session: During MRM

Executive (M&E) Kashmore have addressed to all participants and also thanks to all participants in MRM.

48. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of

Participants - - - - - - - - - - - - - - -

Previous Month Total Month under Review Total

Clusters of 6 HFs 0 Clusters of 6 HFs 0 Clusters of 5 HFs 0 Clusters of 5 HFs 0 Clusters of 4 HFs 0 Clusters of 4 HFs 0 Clusters of 3 HFs 0 Clusters of 3 HFs 0 Clusters of 2 HFs 10 Clusters of 2 HFs 11

Single HFs 7 Single HFs 7

Previous Month Total Month under Review Total

Clusters of 5 HFs 0 Clusters of 5 HFs 0 Clusters of 4 HFs 0 Clusters of 4 HFs 0 Clusters of 3 HFs 0 Clusters of 3 HFs 0 Clusters of 2 HFs 1 Clusters of 2 HFs 1 Single HFs 1 Single HFs 2 On Leave 1 On Leave 1

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F. REVIEW OF THE PERFORMANCE (I) PREVENTIVE HEALTHCARE

During Month under Review 1. Vaccination / Immunization

No. of Doses of Immunization Administered to Children at Health Facilities. 539 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 87 No. of Immunization & Vaccination Administered by out- reach EPI Teams 842 Total vaccination / immunization for the month May- 2012 1468

(II) MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health

Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 09 2 Deliveries Assisted at Homes 0

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 77 2 Blood Sugar Tests 126 3 Hemoglobin Tests 06 4 Ultra Sound Test 0 5 Other 59

49. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number 1 Consultation / Advice 25 2 Oral Pills 2 3 IUCDs 0 4 Injections 3 5 Others 10

Total 40

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: --------39-------- Number of Female SGs: --------00---- 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of

Participants

S # Names of FMOs Ante-Natal Cases Neo-Natal Cases Other OPD Total OPD

1 Dr. Mumtaz Malik 95 3 320 418 2 Dr. Rukhsana 56 3 651 710

Total 151 6 971 1128

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Abdul Ghaffar Surahio 12 0 264 0/0 0/0 Abdul Razaque Junejo 02 0 30 1/6 0/0 Abdul Ghani Panhyar 04 0 77 0/0 0/0 Muhammad Rafique Khoso 06 0 133 0/0 0/0 Israr Malik 04 0 82 1/6 0/0

Total 28 0 586 2/12 0/0 CGS meetings conducted by SOs lacked effectiveness and coherence; they were warned to conduct session more interactively and with specific time line 3. School Health Sessions & Community Health Sessions

Names of MO /

FMOs/Paramedics

Community Health Sessions School Health Sessions S.no

Sessions Participants Sessions Children Examined

Children Treated

1 Dr. Javed Ahmed 4 95 0 0 0 2 DR GULAB U DIN 4 108 0 0 0 3 DR ABDUL GHAFOOR 4 112 0 0 0 4 DR SALEEM KHOSO 4 76 0 0 0 5 DR AFTAB SOOMRO 4 120 0 0 0 6 Dr. Anwar Ali 1 22 0 0 0 7 Dr. Asadullah 4 105 0 0 0 8 Dr. Mansoor Malik 2 24 0 0 0 9 DR ZULFIQAR 4 36 0 0 0 10 Dr. Nazeer Ahmed Shah 4 52 0 0 0 11 DR IRSHAD LANGHA 4 88 0 0 0 12 Dr. Shishpal Das 4 46 0 0 0 13 DR ANEEL 3 22 0 0 0 14 Dr HAFEEZULLAH 4 68 0 0 0 15 Dr. Yougesh Kumar 4 45 0 0 0 16 Dr. Mumtaz Malik 3 63 0 0 0 17 DR. Rukhsana 4 65 0 0 0 18 MT SHAMAS KHOSO 2 38 0 0 0 19 M.T Waqar 2 26 0 0 0 20 Abdul Ghani (M.T) 2 56 0 0 0 21 Abdul Razaque (M.T) 2 31 0 0 0 22 Badar din (M.T) 0 0 0 0 0 23 M.T Abdul Khalique 0 0 0 0 0 24 Dr. Hazoor Bux 0 0 0 0 0 25 Dr. Vijay 0 0 0 0 0 26 Dr. Shagufta Gul 0 0 0 0 0 27 M.T M.Bux 0 0 0 0 0 28 Qutub din (M.T) 0 0 0 0 0 29 Gulsher (M.T) 0 0 0 0 0 30 M.T Naveed Ahmed 0 0 0 0 0 31 M.T M.Bachal 0 0 0 0 0

Total 69 1298 0 0 0 Important Decisions during MRM.

• Every I/C MO/M.T should send leave application of last month of all employees with monthly reports to DSU Office.

• Three days leave can be granted by I/C MO/M.T of BRHF employee. • Every I/C MO/ M.T should maintained medicine record from 2007 and compile all delivery chalans of

medicine year wise in file. • FMOs should increased ANC and PNC.

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• Every I/C MO/ M.T should utilized maximum Syp: Zinc sulphate. • I/C should visit EPI center before sitting of his chair and every child should be stamped from EPI. • I/C MO/M.T should send daily OPD to concerned SO. • I/C MO should possess key of main medical store with him. • I/C should maintain DHIS record and submit on 2nd of every calendar month. • I/C MO/ FMO/ M.T should increase routine immunization at their catchment of Health Facility. • I/C MO/ M.T should maintain leave record, Personal Files of staff (PPHI, Govt) and other relevant record at

Health Facility. • I/C MO should write OPD register at his own. • I/C MO should conduct Two (02) Community Health Session and Two (02) every month; Advance schedule

should be submitted to DSU on 1st of every calendar month. • I/C MO should send EPI (Monthly) reports on prescribed format at the end of every month. • FMO should emphasize upon the increase of delivery at Basic Health Facility.

4. Important Points during Support Group Meetings. The following issues were discussed during the support Group Meetings:

• EPI centre facility • Repair and Renovation work. • Staff shortage at health facilities • Female Staff appointed at health facilities

5. Important Points during SHS’s

• Gastro enteritis • Dengue Fever • Diahhorea • Malaria

6. Important Points during CHS’s • Antenatal Checkup • RTI • Boil Water • Prevention of Scabies • Personal Hygiene

7. Topics for SHSs for the Month

Sr. No. Topics 1 • Gastro Intitus 2 • Dengue Fever 3 • Diahhorea 4 • Malaria 5 • Hygiene (Personal Domestic Food, environmental)

8 Topics for CHSs for the Month

S # Topics 1 • Gastro Intitus 2 • Dengue Fever 3 • Diahhorea 4 • Malaria 5 • Hygiene (Personal Domestic Food, environmental)

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9. Important Discussion on Community Participation during MRM

• Realizing community of the responsibility to feel ownership of their health facility. • Effective communication with the PPHI staff, cooperating with the monitoring staff and with the staff of

health facility and responding to the various initiatives introduced by the PPHI for the betterment of the health facility and its functioning.

• To impart feelings of ownership to the community, it was decided to make useful interaction and communication through social organizers and MOs.

• It was also discussed to invite some CSG members to MRM to make them abreast of PPHI role in primary health care and also to have an interaction on larger scale to address general issues.

• Various methods were discussed to make community more interested in the maintenance of their HF through frequent visits and close interaction with the Doctors.

• It was also decided to apprise community through CSG meetings about the recent trends in primary health care and various tools/methods to promote healthy habits which ultimately would lead to healthy society.

• Apprising community of the various interventions being made by the PPHI and the difference made in the functioning of the HFs after the PPHI takeover.

10. Health Camps: Number Held: ----------0-------. Number of Patients: ----00------. 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status I Sanitation - - - Ii Drainage / sewerage - - - Iii ……… drinking water - - - Iv Prevention of adulteration - - - V Tree Plantation - - - Vi Roads and infrastructure - - - Vii Environmental Improvement - - - Viii Others - - -

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*

New patients treated during

the month Old patients treated during

the month Total OPD during the month

(New + Old) 32604 1466 34070

2. Maximum OPD** Minimum OPD** S # BHU OPD BHU OPD 1 GD Sardaroo Khoso 2402 BHU Rasaldar 438 2 BHU Dari 1871 GD Nasrullah 356 3 GD Kashmore Colony 1635 GD Jam Sunharo 336 4 BHU D.M.Kosh 1523 GD Mushtaque Bijarani 257 5 MCHC Kashmore (M) 1480 GD Mando Khan 256

3. Top Five Diseases Treated during School Health Sessions/Camps *All HFs — BHUs and others.

S # Diseases No. of Patients 1 ARI 0 2 Fever (clinical Malaria) 0

3 Diarrhea 0 4 Scabies 0 5 Dysentery 0

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**Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases During OPD

S # Disease No. of Patients 1 Scabies/Skin 3015 2 Diahhorea 2484 3 ARI 2373 4 Malaria 2285 5 Pneumonia 848

50. ARV / ASV used during the month

No. of Patients Dog bite cases reported 121 ARV Administered 115 ARV Available Doses 152 vials Snake bite cases reported 0 ASV Vaccine Administered 0 ASV Vaccine Available Doses 0

54. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests)

S # Tests Number 1 Pregnancy Tests 77 2 Blood Sugar Tests 126 3 Hemoglobin 06 4 X-Rays (if available) 0 5 Ultra Sound 0 6 Others (please specify) MP Test 59

55. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

Hepatitis B - - - - - Hepatitis C - - - - -

56. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

2 3 3 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs/HF THQs DHQs 2 9 0 9 0 9 0 0 3 - - - - - - - 4 - - - - - - -

10. Inverse Referrals

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S.No Totals Cases Referred from 1 ARV ASV Others RHCs/HF THQs DHQs 2 121 121 0 0 121 0 0 3 - - - - - - - 4 - - - - - - -

G. MONITORING DURING MONTH UNDER REVIEW

20. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total

57 18 179 254 2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 1 GD Kashmore Colony Sanitation 2 GD 27 mile Need Repair Building of HF Done 3 GD Azim Golo Need Repair Building of HF Done 3 BHU Sardarabad Hand pump Done 4 GD Mehrab Mazari Boundary Wall In process 5 BHU Malguzar Suhryani Boundary Wall In process 6 GD Hafeezullah Repair and Renovation In progress 7 GD Elahi Bux Khoso Repair and Renovation In process 8 BHU Dari Boundry Wall Done 9 BHU Zorgarh Boundry wall In process

Action:- Sanitation work would be completed before the next MRM at 9 HFs. Approval has been sought from

the program director to do sanitation work. Similarly R & R work would be given priority as soon as PC-1 stage of that HFs reached.

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for …………102……………. Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

• Non clearance of DTL of some items • Extra Supply of Capsule Amoxicillin and Syrup Calpol • Shortage of essential items • Shortage of Equipments (B.P Apparatus, Thermometer, Stethoscope, baby weight scale, Nebulizer, etc. • Proper maintenance of store at Health facility • Shortage of FMO and LHVs.

REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFS

S # Name of HFs Description of Repair / Maintenance incl. Electrification

Status / Remarks

1 MCHC Kashmore Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification. Completed

2 BHU Sher Muhammad Bijarani Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

3 BHU Pir Jan Bajkani Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

4 GD Ghous Bux Bangwar Tiles Work, Co lour, Repair, Carpenter, Completed

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Plumbering, Electrification.

5 GD Kashmore Colony-I Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

6 GD Nasrullah Bijarani Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

7 BHU Gullanpur Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

8 GD Mehrab Mazari Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

9 BHU Khewali Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

10 BHU Dari Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

11 GD Sardaroo Khoso Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

12 BHU Sardarbabad Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

13 BHU M.K Mazari Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

14 BHU Diyani Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

15 BHU Badani Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

16 BHU Din Muhammad Kosh Tiles Work, Co lour, Repair, Carpenter, Plumbering, Electrification.

Completed

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

- - -

- - -

J- DISCUSSION DURING MRM On Staff Matters: YES On Preventive Health: YES On Curative Health: YES On Mother, Child & Reproductive Health: YES Other Matters: YES Date /Time for Next MRM: 10th Oct- 2012, 10:00 am Comments on Targets v/s Achievements (by DSM)

• OPD challan fee and its timely deposit. • Doctor’s responsibility to prepare medicine indent by themselves. • Stock register and proper store maintenance of store data. • Hard area allowance • Proper store keeping • Attendance/absenteeism

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• Importance of MRM in the overall working of PPHI • Realizing staff of the importance of their attachment with an institution like PPHI, a motivated and

functional organization in the health sector unlike the dormant public sector. • Emphasis on community session and school sessions

Though the shortage of FMOs is chronically an old issue but its importance cannot be overemphasized. After making all out efforts to recruit and attract new lady doctors for the HFs of DSU Kashmore and experiencing little success in this endeavor, now we are shifting our emphasis to the recruitment of Staff nurses, LHVs/Midwives, so we could provide primary services to the poor women of the area as MCH issue is of very important nature and cannot be ignored anymore owing to the want of FMOs. We are having acute shortage of funds as we are intervening warmly in the provision of primary health care to all the people of community, but our share of total health budget is mere 16 %, while we are managing 85 % of total district health facilities. Paucity of funds always is a great hurdle in the execution of ours progressive approach to upgrade community health. I hope sanity will prevail and people who are at the helm of affairs, especially at the ministry of finance, will realize the services being provided by the PPHI in the remote and backward areas of the district where public health sector never imagined and intended to reach out.

(Abdul Ghaffar Surahio) District Support Manager

Cc: 1. Secretary to Sindh, Health Department Karachi for his kind information, 2. Program Director, PPHI, Sindh, Karachi. 3. Regional Program Director, RSU III Larkana. 4. Director General (Health), Hyderabad. 5. Deputy Commissioner Kashmore @ Kandhkot. 6. District Health Officer Kashmore @ Kandhkot. 7. District Population Welfare Officer, Kashmore @ Kandhkot. 8. DHCSO UNICEF, Kashmore @ Kandhkot. 9. District Coordinator National Program, Kashmore @ Kandhkot. 10. District Project Manager, Marrie Stopes Society, Kashmore @ Kandhkot. 11. All I/C MOs/ FMOs/ M.Ts of BRHF under the management of PPHI Kashmore @ Kandhkot.

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MINUTES OF MONTHLY REVIEW MEETING (35th)

OF DISTRICT SHIKARPUR Monthly Review Meeting (MRM) of District, Shikarpur for the Month of August, 2012 was held on 22nd Septmber, 2012 at DC Office (Darbar Hall) Shikarpur. Written invitations for participation were sent to the DC, DHO, DO (R), DO(F&P) and District In charge of EPI, District Coordinator National Program District Officer Population Welfare and representative of WHO. The participants list is given below. S # Names/Designation S # Names/Designation 1 Mr. Javed Ahmed Abro DSM 2 Dr. Khursheed Qazi DHO Shikarpur 3 Mr. Mohammad Ramzan Ex: M&E 4 Dr. Zubair Soomro SO WHO 5 Dr. Akhtar Memon MO 6 Mr. Zia Ahmed Jalbani Ex (F&A) 7 Dr. Rahim Bux Bhutto MO 8 Mr. Tariq Hussain Mahar SO 9 Dr. Sahib Khan Brohi MO 10 Dr. Abdul Hafeez Jakhro MO 11 Dr. Israr Daudpoto MO 12 Dr. Waseem Lohar MO 13 Dr. Naeem Ahmed Pathan MO 14 Dr. Tanveer Memon Sonologist 15 Dr. Imdad Ali Mahar MO 16 Dr. Zulfiqar Mahar MO 17 Dr. Saiqa Soomro FMO 18 Dr. Shahjahan Malik MO 19 Dr. Tahmina Memon FMO 20 Dr. Maida Siddiqi FMO 21 Dr. Hafeezullah Shah MO 22 Dr. Saima Hajano FMO 23 Dr. Anmanullah Soomro MO 24 Mr. Khalil Ahmed Sohu SO 25 Dr. Latif Dino MO 26 Dr. Allah Bux Sanjrani MO 27 Dr. Deepa Dileep FMO 28 Mr. Salahuddin Soomro A/A 29 Dr. Faiza Kanwal FMO 30 Dr. Antonia Maria FMO 31 Dr. Waqar Ahmed Mangi S Manager 32 Dr. Saifullah Mahar SMO 33 Mr. Himayatullah Naich Ex: Construction 34 Dr. Fozia Bano FMO 35 Dr. Marvi Qazi FMO 36 Dr. Ghulam Murtaza MO 37 Mr. Mohammad Shujah HR Assistant 38 Dr. Naseema Mangi FMO 39 Mr. Farhan Shaikh A/A 40 Dr. Rifat Khalil FMO 41 Dr. Athar Hussain Shah MO (HQ) 42 Dr. Manzoor Channa MO 43 Dr. Imran Shaikh MO 44 Dr. Nisar Ahmed Brohi MO 45 Mr. Mohammad Azeem Vaccinator 46 Mr. Mohammad Bachal Vaccinator 47 Mr. Abdullah Vaccinator 48 Mr. Abdul Sattar Vaccinator 49 Mr. Asif Ali Vaccinator 50 Mr. Ameer Bux Vaccinator 51 Mr. Nazir Ahmed Vaccinator 52 Mr. Din Mohammad Vaccinator 53 Mr. Farooque Brohi Vaccinator 54 Mr. Ali Asgar Mahar Vaccinator

Q. HFs WITH PPHI

BHUs: 18 Dispensaries: 07 MCHCs: ___01___ others: ___Nil___ TOTAL: ___26____

B. Population of the Catchments Area: KK. STAFF STRENGTH

Sanctioned Posts (Govt.) Working Government

Employees PPHI

Contract Vacant

(Sanc-Govt) MOs 29 25 10 15 4

WMO 0 0 0 FMOs 18 13 0 13 5 LHVs 19 14 2 14 3

MTs/MAs Male

15 - - -

0 Female 15 7 8

Dispensers 10 10 4 6 0

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LL. CLUSTERS OF HFs WITH ONE MO

WITH ONE FMO

E. CAPACITY BUILDING

1. First Session: IMPROVEMENT OF HEALTH CARE SERVICES AT HF

Mr. Javed Ahmed Abro, DSM PPHI DSU Shikarpur briefly discussed the achievement and reviewed the performance of Health Facility, MOs and FMOs. DSM also directed MOs and FMOs to achieve their targets according to catchment area population by providing routine immunization/measles day and best health care services in their respective areas. He apprised FMOs on increasing deliveries upto 93 and also focused on reduced antenatal visit. He also took notice on low coverage of routine immunization, TT vaccinations and Family Planning Advices. With this all MOs have requested to complete their register correctly as huge problems found in their DHIS reports.

2. Second Session: Case Definition DEWS. The case definition was discussed thoroughly and WHO Survelience Officer DR. Zubair Soomro given brief training of the case definition as some Dr. were reporting in DEWS but not verifiable in their register. ikarpur.

. 51. Capacity Building of LHVs / Dispensers During Month under Review

Names of the Resource Persons with dates Date Venue Topic No. of Participants

NA

F. REVIEW OF THE PERFORMANCE

(I) PREVENTIVE HEALTHCARE During Month under Review

1. Vaccination / Immunization No. of Doses of Immunization Administered to Children at Health Facilities. 4140 No. of TT vaccines provided to pregnant / Child Bearing Age Women at Health Facilities. 1242 No. of Immunization & Vaccination Administered by out- reach EPI Teams 0 Total vaccination / immunization for the month 5382

Previous Month Total Month under Review Total

Clusters of 6 HFs Clusters of 6 HFs Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs Clusters of 2 HFs

Single HFs 26 Single HFs 26

Previous Month Total Month under Review Total

Clusters of 5 HFs Clusters of 5 HFs Clusters of 4 HFs Clusters of 4 HFs Clusters of 3 HFs Clusters of 3 HFs Clusters of 2 HFs 6 Clusters of 2 HFs 6 Single HFs 5 5

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2. National Immunization Days (NIDs) for Polio

Dates of NIDs Target of coverage Actual coverage Percentage of coverage

N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

3. Other Preventive/Promotional Services

S # Service Number 1 Passive Case Detection (PCD) Slides N/A 2 Active Case Detection (ACD) Slides N/A

3 Visits to Check Sanitation (individual house holds + streets) 7 4 Notices issued against Poor Sanitation N/A 5 Challans sent to Court against Poor Sanitation N/A 6 Patients Nebolizer N/A

MOTHER, CHILD & REPRODUCTIVE HEALTH

During Month under Review 1. Female Health

2. Deliveries Assisted

S # Service Number 1 Deliveries Assisted at HFs 93 2 Deliveries Assisted at Homes 159

3. Lab/ Diagnostic Tests

S # Test Number 1 Pregnancy Tests 283 2 Blood Sugar Tests 848 3 Hemoglobin Tests 329 4 Ultra Sound Test 1114 5 Other (MP) & (Nebulizer) 286

52. Important Discussion on Mother and Child and Reproductive Health during MRM

FMOs were directed to improve their working in mother and child health care and reproductive health by DSM. He observed that while it is matter of pride that BHUs and GDs under administrative control of PPHI are

S # Names of FMOs Ante-Natal Cases

Neo-Natal Cases

Other OPD Total OPD

1 Dr. Saima Hajano 186 2 3509 3713 2 Dr. Deepa Dileep 122 4 1841 1987 3 Dr. Tahmina 153 12 1793 1973 4 Dr. Faiza Kanwal 277 37 1504 1859 5 Dr. Fozia Bano 176 10 1610 1828 6 Dr. Maida Siddiqi 115 7 1516 1657 7 Dr. Antonia Maria 201 13 1349 1578 8 Dr. Saiqa Soomro 87 3 1187 1306 9 Dr. Naseema Mangi 97 2 931 1041 10 Dr. Marvi Kazi 109 0 766 882 12 Dr. Riffat Khalil 116 3 693 826

Total 1724 93 17475 19667

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providing services continuously at such far flung areas of the district but a lot of work remains to be done. FMOs can extend antenatal and postnatal cover by educating visiting women of its importance.

53. Provision of Family Planning Services during the Month

S # Name of the Items / Service Number 1 Consultation / Advice 342 2 Oral Pills 132 3 IUCDs 6 4 Injections 156 5 Others 7

Total 738

(III) COMMUNITY PARTICIPATION During Month under Review

1. Number of Male SGs: ------26------------ Number of Female SGs: -----Nil--------- 2. Performance of Social Organizers

Names of Social Organizers Meetings of Support Groups conducted by him

CHSs/SHSs arranged by him

Male Female Total No. of Participants No. No. of

Participants Mr. Tariq Hussain Mahar 1 N/A 15 32 599 Mr. Khalil Ahmed Sohu 4 N/A 69 28 581

Total 5 84 60 1180

3. School Health Sessions & Community Health Sessions

Names of MO / FMOs/Paramedics

Community Health Sessions School Health Sessions

Sessions Participants Sessions Children Examined

Children Treated

Dr. Saiqa Soomro 2 16 0 0 0 Dr. Saima Hajano 2 18 0 0 0 Dr. Faiza Kanwal 2 10 0 0 0 Dr. Tahmina 2 19 0 0 0 Dr. Marvi Qazi 2 38 0 0 0 Dr. Fozia Bano 2 32 0 0 0 Dr. Naseema 2 35 0 0 0 Dr. Deepa Dileep 2 32 0 0 0 Dr. Antonia Maria 2 21 0 0 0 Dr. Rafat Khalil 0 0 0 0 0 Dr. Maida Siddiqi 2 23 0 0 0 Dr. Athar Hussain Shah 1 14 0 0 0 Dr. Fida Soomro 1 12 0 0 0 Dr. Shahjan Malik 2 25 0 0 0 Dr. Akhatar Mohammad 1 18 0 0 0 Dr. Allah Bux Sanjrani 2 26 0 0 0 Dr. Saifullah Mahar 1 13 0 0 0 Dr. Waseem Lohar 2 18 0 0 0 Dr. Fayyaz Lohar 0 0 0 0 0 Dr. Zulifqar Mahar 2 28 0 0 0 Dr. Rahim Bux Bhutto 2 18 0 0 0 Dr. Nadar Ali Pahnwar 1 13 0 0 0 Dr. Majid Soomro 1 13 0 0 0

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Dr. Murtaza Seelro 2 18 0 0 0 Dr. Fida Hussain 1 11 0 0 0 Dr. Sahib Khan Brohi 1 8 0 0 0 4. Important Points during Support Group Meetings. CSG Member requested for 24 hours service of Health Facility with ambulance service. They also want screening of Hepatitis at the Health Facility. 5. Important Points during SHSs

Curative from the diseases due to monsoon rains and flood. 6. Important Points during CHSs

Community members demanded the free camp of Hepatitis and ATS Vaccination due to RTA.

7. Topics for SHSs for the Month

Sr. No. Topics 1 Chest infection 2 Skin Infection 3 Malaria 4 Mal Nutrition

8 Topics for CHSs for the Month

S # Topics 1 Post Natal Visits & its importance 2 Skin Infection 3 Malaria 4 EPI & Routine Immunization

9. Important Discussion on Community Participation during MRM 10. Health Camps: Number Held: ---------------. Number of Patients: ------------. 11. Measures for improvement / provision of Services by other Department / Agencies

Sr No Description Recommendation To whom sent Present status i Sanitation 0 0 0 ii Drainage / sewerage 0 0 0 iii ……… drinking water 0 0 0 iv Prevention of adulteration 0 0 0 v Tree Plantation 0 0 0 vi Roads and infrastructure 0 0 0 vii Environmental Improvement 0 0 0 viii Others 0 0 0

(IV) CURATIVE SERVICES DURING THE MONTH UNDER REVIEW

1. OPD*

New patients treated during the month

Old patients treated during the month

Total OPD during the month (New + Old)

61,314 3536 64850

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2. Maximum OPD** Minimum OPD**

S # BHU OPD BHU OPD 1 BHU Wazirabad 5590 BHU Rustam 2962

2 BHU Jahan Khan 4652 BHU Jhalli Kalwari 2465 3 BHU Jamra 3753 BHUNapirabad 2733

3. Top Five Diseases Treated during School Health Sessions/Camps *All HFs — BHUs and others. **Reflects OPD at BHUs only — not at other HFs. 4. Top Five Diseases during OPD

S # Disease No. of Patients 1 ARI 10123

2 Sussp: Malaria 5002 3 Diarrhea 4886 4 Skin Infection 3511 5 Dysentery 751

5. ARV / ASV used during the month

No. of Patients Dog bite cases reported 51 ARV Administered 41 ARV Available Doses 239 Snake bite cases reported 2 ASV Vaccine Administered 1 ASV Vaccine Available Doses 11

57. Lab / Diagnostic Tests: Includes Tests Reported at No. (II) (Mother, Child & Reproductive Health)

3. (Lab / Diagnostic Tests) S # Tests Number 1 Pregnancy Tests 283 2 Blood Sugar Tests 848 3 Hemoglobin 329 4 X-Rays (if available) 1114 5 Ultra Sound 0 6 Others (please specify) 286

58. B & C SCREENING TESTS

Screening No. of Tests Performed

No. of cases found positive

No. of cases referred for treatment

Total referred upto date Follow up result

Hepatitis B 0 0 0 0 0 Hepatitis C 0 0 0 0 0

S # Diseases No. of Patients 1 Chest infection 0

2 Skin Infection 0

3 Malaria 0

4 Mal Nutrition 0

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59. TUBERCLOSIS

Patients Receiving Treatment

New Cases During the Month Under Diagnosis

68 12 5 9. Referrals

S.No Totals Cases Referred To 1 TB DOT Deliveries Others RHCs THQs DHQs 2 35 35 0 0 15 12 8 3 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0

10. Inverse Referrals

S.No Totals Cases Referred from 1 ARV ASV Others RHCs THQs DHQs 2 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0

G. MONITORING DURING MONTH UNDER REVIEW

21. Monitoring Visits during the month

DSM Executive Monitoring Other Staff Total

29 38 68 135 2. Important Points/Issues arising from Visits

S # Name of HF Issue Action Remarks 1 - - - - 2 - - - -

H. AVAILABILITY OF MEDICINES/MEDICAL MATERIALS

1. Medicines available for 16 Weeks 2. Important Issues raised relating to Medicines, etc. during MRM

I. REPAIR / MAINTENANCE / ELECTRIFICATION OF / AT HFs

S # Name of HFs Description of Repair / Maintenance incl. Electrification Status / Remarks

1 BHU Nabi Shah Waggan 99% Work in progress 2 GD Khadim Hussain Jatoi 90% Work in progress 3 BHU Mehmood Panhwar 60% Work in progress

Inspections / Visits of PPHI HFs

Visitors* Health Facilities Visited Overall Comments

- - -

- - -

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* To reflect only non-PPHI Visitors.

J- DISCUSSION DURING MRM Punctuality: DSM asked MOs & FMOs to ensure punctuality of the time during the HF working hours in the interest of the patients. On Preventive Health: Family Planning and Routine Immunization discussed and focused in August 2012. On Curative Health: Skin Infection, Dehydration and antenatal visits. On Mother, Child & Reproductive Health: Other Matters: Followups of Measles vaccination directives as received from PD EPI. Date /Time for Next MRM: 10th October 2012 Comments on Targets vs Achievements (by DSM) R&R work completion within given deadline DSM directed the Executive Construction, MOs, M&E & SO concerned to ensure early start R&R work at BHU Mahmood Panhwar & early completion of R&R work at BHU Nabi Shah Wagan, GD Khadim Hussain Jatoi.

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