1

Weekly update on COVID-19 achievements

Date: Week starting Aug 21, 2020

Weekly performance reporting on COVID-19 support Indicators Baseline

(as on 30th

April)

Past Week’s

Achievement

s*

Cumulative

Achievements

(from start

through COB

Thursday)

Target for

the entire

project

Additional Information

Number of people directly benefited

through USG interventions

(e.g.,OPDs, helplines, chatbots etc.)

Note:do not include mass and social

media.

34,093

4135

466547 27,500 -Layered on Pulse

oximetry-1500

(1090)

HRP -1000 (1159)

and HBYC-25000

(464298) platform

Number of facility-based health

workers (doctors, nurses, CHOs, pharmacists, ANMs, MPWs, and

Anganwadi center workers) trained

to prepare for and respond to

COVID-19 with USG support.

Disaggregated by RCCE,

surveillance, case management, IPC

and/or WASH

3,959 36 6146 1500 -Layered on LaQshya

(4645), NBSU, FPC,

and Safe delivery app

(1521)

Number of community frontline

workers (ASHAss, TB champions,

community volunteers, sanitation

workers, etc.) trained to prepare for

and respond to COVID-19 with USG support. Disaggregated by, RCCE,

surveillance, case management, IPC

and/or WASH

1,555 102 3825 12,330 -12000 Layered on

FPLMIS (3110)

330 through HRP (715)

Number of facilities supported with

USG resources (including TA,

training, supplies of COVID-19

medicine, ventilators, PPE, etc) and

able to respond COVID-19

300 0 399 122 -Layered on LaQshya

*Please note that these numbers should be consistent with the numbers listed in the narratives below.

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

These activities will include:

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

audits and checklists under LaQshya:

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

delivery Apps:

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

promoting hand washing practices:

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

functionaries and communities:

5. Risk mitigation and action planning

2

Key Activities - Uttarakhand

1. Facilitated state LaQshya assessment at CHC Bhagwanpur during Aug 25-26, 2020

USAID Vriddhi state team facilitated state LaQshya assessment for

CHC Bhagwanpur.

Checked records and documentation, verified SOP, policies,

process mapping, drugs, instruments and BHT at labour room

Verified OSCE Assessment sheets and conducted staff interview on

complicated delivery

Verified Monthly dashboard and indicators of LaQshya

Verified Safe delivery app on staff mobile

2. USAID Vriddhi state team based on HMIS analysis organized a

meeting with Chief Development Officer (CDO) & District Development Officer, Haridwar on Aspirational District program

implementation on 20th August’20 to discuss the Challenges in ANC

& Institutional deliveries at public institution with the objective of

improving essential RMNCHA health services.

3. Support extended to state NMH for Developing SoPs, for

Strengthening 104 Call Centre

USAID Vriddhi team in coordination with State NHM is providing

technical support in developing SoPs for operationalizing the proposed

monitoring and control cell. This novel initiative is being supported for improving essential RMNCHA health services in the state

4. Training CHOs from 4 Health & Wellness Centre on Safe Delivery App

Continuing the SDA orientation for CHOs using ICT platform; Dr Anshika

Puri - HWC Shahpur and Dr Vaishali - HWC Jamalpurkala were trained on

21st August’20 whereas Dr Anjali Bisht - HWC Meethiberi & Dr Rinki -

HWC Salempur were trained on 24th Aug’20 in online sessions facilitated

by Dr Abhisek Nautiyal DTC Haridwar.

Below are the activities done during the online training and all 4 CHOs

completed COVID-19 module.

Orientation & Steps for downloading the app from play store

Orientation on modules including COVID19, videos & practical procedures

Orientation on MY Learning in the app; test Familiar, Proficient & expert

5. SNCU Quality Improvement

USAID Vriddhi state team facilitated SQCI orientation in SNCU, Doon

Medical College. State child health consultant also participated in the

session, Importance and use of SQCI were discussed in detail.

Figure 1: Dr Abhishek Nautiyal, DTC Haridwar - Facilitated LaQshya assessment at CHC Bhagwanpur from Aug 25-26

Figure 2: Dr Anshika Puri showing completion status of COVID-19 module on Safe Delivery App

3

6. Development of HMIS Based Dashboard: USAID Vriddhi state team developed HMIS

dashboard to prioritize areas for focussed

advocacy and action especially to address the

impact of Covid-19 on delivery of RMNCH+A

Services. The data trends were also discussed with

the State Team from MCH on Thursday. The

dashboard will be shared with the State Officials in

the coming week with additional refinements.

Figure 4: Snapshot of Dashboard

Figure 3: Online orientation

4

Activities: Jharkhand

1. Online orientation of Hospital Managers and other District Hospital staffs on District Hospital

Quality of Care Index (DQCI), 24th August 2020

USAID Vriddhi state team organized an orientation of Hospital Managers, Data entry operators and staffs of all

23 District Hospitals of Jharkhand on 24th Aug 2020 using ICT platform. The orientation was facilitated by the

state maternal health cell and USAID Vriddhi state team. State Nodal officer in-charge for Maternal Health, Dr

Deepawali gave opening remarks whereas session on overall DQCI process flow and mechanism for

implementation was facilitated by STA and STOs, USAID Vriddhi team. The data sources (New HMIS portal,

SQCI data and Enquiry based format) and indicators required for DQCI dashboard generation using the DQCI

tool was explained by Associate Manager, M&E - USAID Vriddhi. This orientation was one of the final steps of

institutionalization of DQCI in the state NHM system post which the District Hospitals will be able to self-generate

the DQCI quarterly dashboards and it can be used at both state and district level for effective monitoring of District

Hospitals.

2. LaQshya online walkthrough for OT, DH Khunti, 24th August 2020

USAID Vriddhi team arranged a walkthrough of DH Khunti using ICT platform to take update of the present

situation of OT, which is undergoing renovation. The objective of the walkthrough was to help the facility identify

appropriate places within the pre-identified OT complex for setting up various rooms, zones and areas. From the

facility the hospital manager conducted the walkthrough. From the state nodal officer maternal health guided the

session. State maternal health consultant and DTC VRIDDHI also joined online. STO VRIDDHI facilitated the

process of the walkthrough.

During the process following discussions were done:

Demarcation of protective

zone, clean zone, sterile zone

was identified

Appropriate location and

route for the disposal for

biomedical waste was

finalized

Doctor’s changing area,

scrub area, hand washing

area, sterilization area, doctor and sister duty rooms

were also identified

Location for Pre op and post

op rooms were also

suggested

3. LaQshya interim certification review for facilities

USAID Vriddhi state team organized review meetings with facilities using ICT platform to review the preparatory

status of LaQshya interim certification activities. From the facilities Deputy Superintendent, medical Officer,

Hospital Manager in-charge, LR & OT sister in-charge and DTC of VRIDDHI project were present. State nodal

officer maternal health chaired the meetings where as state MH consultant and STO VRIDDHI coordinated the

meetings.

Details of the LaQshya Interim Certification Review Meetings held during the week:-

Sl No Facility Date

1 DH Bokaro 25th August

2 DH Godda 26th August

3 DH Ramgarh 27th August

5

A walkthrough of the facilities were conducted using ICT platform. Discussions were based on the walkthrough

and the documents send by the facilities. The following points were discussed:

4. Follow up Meeting with MD, NHM on suggestions provided in meeting dated 18th Aug:

STA and Sr Advisor (Aspirational Districts) UAID Vriddhi state team conducted a meeting with MD, NHM

on 27th Aug 2020 regarding suggestions from MD to the Vriddhi team in the previous meeting dated 18th

Aug 2020.

Key achievements:

Directives issued to districts on LaQshya; distinctly for Medical Colleges & District Hospitals with

information to Deputy Commissioners for taking corrective actions based on feedback from the state

team for LaQshya certification.

Directives issued to Medical colleges for providing NHM program services (Maternal Health, Child

health and Family planning services) in all 6 Medical colleges.

Directives issued to districts for NBSU operationalization and gap fulfillment based on feedback

provided

District Hospital Bokaro

Overall cleanliness of the

post op room and OT area to

be improved

Extra oxygen cylinder or

oxygen concentrator to be

placed in LR

Instruction manuals to be

placed with radiant warmer

and other equipment

The legs of all the tables and

trolleys are to be painted as

rust has settled on them

Remove all non-functional

equipment from OT (eg.

Non-functional Boyles’

apparatus)

Floor of post op room in the LR area to cleaned/ matted/

tiled

Placement of shoe rack

outside protective zone

Increase sitting arrangement

to at least 30 in the waiting

area

JSSK entitlement wall

paintings to include benefits extended to infants

Increase number of delivery

trays to 16 as per MNH toolkit delivery norm

Clean toilet in the LR,

instrument processing area in

District Hospital Gudda

As the OT is not prepared review for LR is done only

The facility to prepare the OT for certification process as they are

doing for the LR

JSSK entitlement to be displayed at hospital gate

Toilet for LR beneficiaries to be earmarked inside the LR area

Demarcation of restricted areas (zoning) to be done

Provision for Point of Care tests i.e. RBS, HIV, Proteinuria and

Hb to be available at LR for 24 hours testing facility

Patients to be provided gowns in LR

Case sheets to be with patient all the time. (Case sheets are sent

to lab with blood sample, for investigation purpose investigation

slip is to be used)

Increase instruments used in delivery trays so that 20 delivery

trays can be prepared. (Based on case load of 20/ day)

Temperature charting of refrigerator and LR to be done

General clinical knowledge is satisfactory but repeat OSCE for

improving knowledge and skill of all nursing staffs

Arrange training for housekeeping staffs on hand washing, spill

management and waste disposal

Arrange re training on usage of fire extinguisher. Fire exit to be

marked properly in red

Assign one Lady Medical Officer as LR in-charge.

The facility to send action plan based on patient satisfaction

6

Activity: Chhattisgarh

Inclusion of COVID module during FPC sessions in SNCUs: USAID Vriddhi state team with continuous advocacy at state level has

successfully initiated use of COVID related videos during FPC

sessions in the district SNCUs. The two modules namely Session 1 A

and 4 A have been introduced by the Deputy Director Child health

(Directorate Health Services, Chhattisgarh) for educating parents on

COVID prevention across the 23 SNCUs.

COVID module has been shared in state SNCU WhatsApp group by

DD-CH and Vriddhi has been assigned to provide High resolution

media to SNCU and monitor the usage during regular FPC sessions. Prioritized facilities in Aspirational districts are being contacted for

downloading the COVID Video and process of initiating discussion

with families.

An official letter from DD-CH is in process for signing.

Documentation efforts would be initiated to capture the success story

and learnings.

Activity: Haryana

1. LaQshya Mentoring visit to SHKMGMC, Nalhar: USAID Vriddhi state team facilitated a Visit to

SHKGMC, Nalhar on 25th Aug. Professors, HOD Gynecology, and 2 Assistant Professors participated in

the visit. The mentoring visit was specifically to discuss Quality Management under LaQshya in Nalhar

Medical College.

Major points discussed were:-

The Quality circle notification and process to be functional for the Labour room and Maternity

Operation Theatre.

Documentation of QI meetings.

Smart Quality objectives, mission, values, Quality policy and objectives with the staff.

Quality Improvement methodology and tools like PDCA, 5S, Fishbone analysis and process mapping

should be incorporated.

QI team will document the tools used and share with DTO Vriddhi after 10 days.

Activity: Odisha

1. Meeting with Director Family Welfare, Government of Odisha on MMD pulse oximeter pilot

intervention in Kandhmal district:

USAID Vriddhi team conducted a meeting with Dr. Bijay Kumar Panigrahi, Director Family Welfare, Dr. Pratibha

Pradhan, Joint Director CH and Ms. Anindita Pattnaik, Consultant CH, Department of Health, Government of

Odisha on 26th Aug’20 to update on multimodal pulse oximeter pilot intervention in Kandhamal district.

Intervention progress till date was shared in terms of diagnosis of Pneumonia and severe Pneumonia among under

five children using the Pulse Oximeter device. Detail product specifications and different features of the device

was also shared with DFW. The DFW was interested in the display feature of the device with the respiratory rate

count and mentioned that it would be convenient for mid- level service provider at HWC to screen patients for

pneumonia with the device. This meeting was organized to facilitate procurement by the state.

1. LaQshya orientation conducted for Bhadrak district:

Figure 5: FPC COVID Module being demonstrated at SNCU Narayanpur one of the Aspirational districts.

7

USAID Vriddhi team in collaboration with district NHM and DMRCH Bhadrak conducted LaQshya programme

orientation on 26th Aug’20 using ICT platform. Ms. Somyashree Mohapatra - Consultant MH, NHM Odisha, Dr.

Muralidhara Padhi - ADMO Medical, Ms. Satrupa Mishra - Hospital Manager, DHH Bhadrak, Ms. Sarita

Mohaptra - DPM, Mr. Jitendra Biswal – DPMU, DMRCH Bhadrak, LR and OT staff from DHH Bhadrak joined

the orientation. The participants were briefed about the LaQshya program and different activities to be undertaken

by the facility team to get the certification. The Hospital Manager was suggested to immediately form the quality

circle and once again do the baseline assessment as the baseline was done long back and many indicators might

have changed by now.

Major points discussed were:

Core components of the LaQshya programme, quality improvement cycles, labour room standardization.

Common gaps observed during mentoring visits and elaborate guidance on how to expedite the LaQshya

implementation in the prioritized health facilities.

Role of district coaching team, facility quality circle, convergent action between functionaries and team spirit

were emphasized.

Details on LaQshya incentive structure and LaQshya Monthly MIS data update process in the LaQshya web

portal was also informed.

At the end of the session, district team committed to take up the LaQshya programme on priority basis and share

the assessment score with VRIDDHI team at the earliest. The key documents essential for LaQshya

implementation were shared with the DPMU team immediately after the orientation session.

2. Online orientation on Safe delivery application for the DAKSH trainees:

USAID Vriddhi state team conducted SDA orientation session for the 47th Batch of DAKSH trainees using ICT

platform. All the service providers were oriented on

how to use the Safe Delivery App and how to

continue learning the key technical skills related to

safe birthing practices by using different learning

modules. The orientation on Safe Delivery App was

primarily focused on the COVID-19 and infection

prevention modules. Vriddhi team members

addressed queries of service providers on benefits of

using SDA learning modules. During the session,

the facility team was also briefed on infection

control practices in maternity units especially in

labour room and OT of the facility. All staff nurses

were suggested to complete the self-assessment in

the COVID-19 module as soon as possible keeping in view the importance of COVID-19 prevention at the health

facility set up.

Activity: Himachal Pradesh

1. Meeting with MH & CH Division for COVID impact on RMNCH Services:

HMIS data till June 2020 for RMNCHA indicators were analyzed to assess the impact of COVID 19 on RMNCHA

services. The data was discussed and shared with MH & CH division during the meeting conducted on 26th

Aug’20.

2. Child health review meeting through VC chaired by Special secretary/MD-NHM:

USAID Vriddhi team in collaboration with state NHM organized a State Child Health review meeting on 27th

Aug 2020 using ICT platform. The review meeting was chaired by Special secretary/MD-NHM and CMO,

Medical officer health, District program officer CH and pediatrician from all 12 districts of Himachal Pradesh

participated virtually in the meeting. SRU HP technically supported for inclusion of SQCI for reviews of SNCUs.

The main issues discussed were rational admission index of SNCU Hamirpur and SNCU Khaneri, rational use of

antibiotics, low birth weight admission and mortality in good weight babies in SNCU Chamba. Low birth weight

admission index and optimal bed utilization index were also discussed.

Figure 6: DAKSH trainees being oriented on SDA by the Odisha Vriddhi team

8

Activity: Punjab

Process of transferring the ownership of DHQC and SQCI to State Health Department:

MD NHM Punjab has approved the scaling up of District Hospital Quality Care (DHQC) Index in all the districts

of Punjab. Till June 2020 USAID Vriddhi team has been generating dashboards for both the DHQC and SNCU

Quality Care Index (SQCI) and were shared with the State Health Department on regular basis and further to the

districts of Punjab including aspirational Districts.

During the week Vriddhi state team held a discussion with M&E cell - NHM to finalize the process of transition.

It will be done in 2 phases, first for aspirational districts and then for non-aspirational districts. As an outcome of

the discussion, an online orientation for the Data Entry Operators (DEOs), Monitoring Evaluation Officers

(MEOs), and District Program Managers (DPMs) of Aspirational district is planned on September 01, 2020. The

same cadres of non-aspirational districts will also be trained through similar online orientation which will be

scheduled later.

Activity: FPLMIS

Online Review cum Training on FPLMIS for Pharmacist, ANM & ASHA, Arunachal Pradesh

USAID Vriddhi FPLMIS team conducted a review cum training session on FPLMIS on 25 Aug 20 with

Pharmacist, ANM & ASHA of Upper Siang district of Arunachal Pradesh using ICT platform. The

objective of the meeting was to orient ANM, HWO, Pharmacist & BCM on FPLMIS, progress review

of FPLMIS and share the COVID19 related information and precautions. In total 38 participants were

present in the meeting, state FPLMIS consultant - Ms. Shamina Khatoon facilitated the session,

whereas state and district level officials; Deputy Director MCH, District ASHA Nodal officer, DDM and

DCM participated in the meeting.

The meeting was conducted in two parts, in the first half FPLMIS training for ASHA, ANM, BCM, HWO

& Pharmacist were conducted whereas in the second half FPLMIS progress review was conducted. In

the training participants were trained on app, codes of FP commodities for SMS, how to indent &

update the stock through mobile app & SMS. A discussion on performance of indicators of FPLMIS,

stock out at DWH & BWH and training status was also conducted. The outcome of the training was

as follows:

Activity: Monitoring of ARI Cases

Vriddhi team from National level is regularly tracking ARI cases from 19 Health and Wellness centers. Total 83

cases of ARI screened in this week and 10 cases were diagnosed as pneumonia.

CHC PHC SC ASHA

Indenting 4 2 15 12 Issue Against indent 17 7 Stock Update 9 5

9

Chart 1: Daily incidences of ARI cases (21st to 27th Aug 20)

Chart 2: Weekly Incidences of ARI Cases

Impact on RMNCH services in project states

Services in all states have opened up in areas outside the containment zones and there is focus on resumption of

essential RMNCH services. Spurt in COVID cases in states such as Jharkhand, Odisha, Uttarakhand, have

resulted in services getting disrupted in pockets.

In Odisha, The COVID-19 positive cases have shown a sharp increase. Nine staff from the Directorate of Health

services and two from NHM Odisha have tested positive. The NHM and Directorate are now operating on a

roster basis.

68

0

21

25

9

14

1 20 0

5

02

0

5

10

15

20

25

30

21-Aug 22-Aug 23-Aug 24-Aug 25-Aug 26-Aug 27-Aug

Total Screened Pneumonia cases

0

20

40

60

80

100

120

140Total Screened Pneumonia cases Severe pneumonia Referred

10

Inputs obtained from project states on status of RMNCH services is as follows -

Outreach services

Antenatal Care

services

PMSMA is being organized as per GoI guidelines in Odisha, Jharkhand, Haryana,

Punjab, HP & Uttarakhand. States are actively following up with the districts for

ensuring social distancing and prior line listing of beneficiaries for PMSMA day

Use of e Sanjeevani for consults has been rolled out. VHSND are being held as per

GoI guidelines And Line listing of HRP is being done.

However, In Chhattisgarh, PMSMA has not been held since March 2020.

In Mewat district of Haryana Footfall is low at PMSMA, this is attributed to the fact that pregnant women have apprehension as COVID Antibody testing is being done

for all coming for ANC.

Home visits Integrated surveillance being undertaken by FLWs across states. ASHAs are doing

COVID related screening in the community and undertaking integrated surveillance

for active case finding for TB, screening for NCD, surveillance and sensitization for

NDD and IDCM

In Chhattisgarh though, ASHA home visitation is ongoing, HBNC home visits have

reduced by 13% as compared to last year Apr-May

Routine

Immunization

RI in VHSNDs are functioning beyond containment and buffer zone as per GoI

guidelines maintaining social distancing

HBYC services ASHAs are making home visits along with COVID screening during home visits

outside buffer zone.

HBYC is operational in only one district of HP, AD Chamba. HBYC home visits not yet started in Chattisgarh, as trainings have not been

completed.

Family Planning Home Delivery of Contraceptives by ASHAs is ongoing in all states and all

temporary methods (Condoms & Pills) are being provided to beneficiaries.

However, FP Commodities are not available in adequate quantity in district of

Haridwar. FPLMIS is not implemented here.

In MP, A new initiative under KILL Corona Abhiyaan have started from 16th Aug

20, in which ANM & ASHA will be involved in survey/screening. Instructions has

been issued to distribute FP commodities during home visits.

Facility services

ANC services In all states facility level ANC services are being provided on walk in basis using

staggered approach* and following physical distancing norms. Non-COVID PW

being transferred in non-COVID vehicles only is being ensured

Institutional

deliveries

All states have identified facilities both COVID and Non COVID for provision of

institutional deliveries and services remain uninterrupted. In Odisha, DHH Kendrapara was shut down as a large number of staff in the facility were found

positive.

Blood Banks are functioning.

Newborn care Birth doses continue uninterrupted, as does promotion of Breast-feeding practices

with early initiation of breast feeding and Kangaroo Mother Care.

Immunization

services

are being provided at facilities, for walk-in beneficiaries. Daily immunization for all

PW & Children at DH & SDH has been resumed in Haridwar district

11

Admission to SNCU SNCUs are fully functional and providing services.

In Jharkhand SNCU (Rajmahal) remains closed as is converted to COVID ICU.

In Himachal Pradesh one SNCU at Medical college Nerchowk Mandi, is not

functioning as facility is a dedicated COVID Hospital.

In Odisha, SNCU at DHH Kendrapara was shut down as a large number of staff in

the facility were found positive. NBSU services are functional

Family Planning

services

Now with increase in cases temporary closure of facilities is common and affecting

services. Last week DHH Kendrapara in Odisha, was shut down as a large number

of staff in the facility were found positive.

In Jharkhand, Sterilization and IUCD/PPIUCD services ongoing but not in full pace.

For suspected cases, first COVID test need to be done.Few CHC has been converted to COVID center due to which FP services especially sterilization have been

hampered.

IUCD/PPIUCD services are available in all designated health facilities in states.

Antara services are available at facility level

Sterilization services not still started in Arunachal Pradesh, Meghalaya, Tripura

Additional visual support:

Figure 7: FPC session attended by caregivers at Aspirational District, Moga, Punjab

12

Figure 8: Staff Nurse delivering FPC session to caregivers at DH Barnala, Punjab

Figure 9: ARI screening at HW Partan, Hazaribagh, Jharkhand

13

Figure 10: DTO during State LaQshya assessment at CHC Bhagwanpur, Haridwar, Uttarakhand

Figure 11: Haryana - DTO during Review of records at NBSU Nuh with Staff Nurses