pun jab study final

A Study to Review

National Institute of Health and Family WelfareBaba Gang Nath Marg, Munirka, New Delhi - 110067

The Health Care Delivery System Provided by PHSC

PunjabPunjab Health Systems Corporation

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Study to Review The Health Care Delivery System provided by PHSC, Punjab i

Report

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A Study to Review

The Health Care Delivery System

Provided by

Punjab Health Systems Corporation (PHSC), Punjab

National Institute of Health and Family WelfareBaba Gang Nath Marg, Munirka, New Delhi – 110067

Email: [email protected]: www.nihfw.org

2008

List of Abbreviations vi

Preface vii

Acknowledgement viii

Study Team viii

Executive Summary ix

Introduction 1

Objectives of the Punjab Health Systems Corporation Project 1

Rationale 3

Study Objectives 4

Methodology 5

Study Findings 8

Structural and Operational Framework of Punjab Health Systems Corporation (PHSC) 8

Facility Assessment 18

A. District Hospitals 18 B. Sub-divisional Hospitals (SDHs) 35 C. Community Health Centres (CHCs) 50

Views of the Benefi ciaries on Quality of Services 64

1. In-patient Department 64 2. Out-patient Department 74

Evaluation of the Training Institutes 84

Community Voice 91

Views of the Stakeholders 100

• At District Level 100 Deputy Commissioners (D.C) 100 MLA/Elected Representative 102 Civil Surgeons 104 SMO in charge – District Hospitals 106

• At Sub-Division Level 109 MLA/Elected Representative 109 SMO – Sub Divisional Hospitals 110

• At CHC Level 113 Elected Representatives at CHC 113 Senior Medical Offi cers - CHC 114

Observations and Discussion 118

Facility Survey 118 Views of the Benefi ciaries 121 Views of the Community (through FGDs’) 125 Views of the Stakeholders 125

Conclusion and Recommendations 127

CO

NT

EN

TS

iii

List of Tables

1 District Hospitals

1.1 General Profi le and Facility Survey 132

1.2 Facilities Available 136

1.3 Laboratory Facilities 140

1.4 Out-patient Department 141

1.5 Emergency Services 144

1.6 Intensive Care Unit 146

1.7 Clinical Laboratories 147

1.8 Blood Banking Facilities 148

1.9 Radiology and Imaging 149

1.10 Operation Theatre 150

1.11 In-patient Wards 151

1.12 Hospital Medical Stores 153

1.13 Medical Record Department 155

1.14 Hospital Waste Management 156

1.15 Support Services 157

1.16 User Charges 160

1.17 Performance Report 163

1.18 Staff Position 165

1.19 Specialist Position 167

2 Sub Divisional Hospitals


2.2 Availability of Equipment 171



2.5 Emergency Medical Services 178

2.6 Intensive Care Unit 180



2.9 Radiology and Imaging Services 183

2.10 Operation Theatres 185

2.11 In-patient Department 188



2.14 Central Supply Department 194

2.15 Five Year Performance Report 196

2.16 Utilisation of User Charges 198

2.17 Medical Offi cers in Position 201

2.18 Staff Positions 203

3 Community Health Centres


3.2 Equipment available at CHCs 208


3.4 Referral Facilities 210


3.6 Emergency Medical Services 214



3.9 Special Investigations 218

3.10 Operation Theatres 219

3.11 In-patient Department 220



3.14 Hospital Waste Management 224

3.15 Central Supply Department, 225

3.16 Laundry Services 225

3.17 Dietary Services 226

3.18 Medical Offi cers in Position 227

3.19 Five Year Performance Report 229

3.20 Staff Positions 231

3.21 Utilisation of User Charges 233

4 Distribution of Patients in Wards 2365 Admissions in Different Hospitals 2386 User Charges for Services in Various Hospitals 2397 Experience at Facility and Quality of Care 2408 Patient Responses on Quality of Services 2429 Patient Responses on Behaviour of Staff 24410 Availability of Medicines (patients’ responses) 24511 Money Spent (patients’ responses) 24512 Rules and Regulations at Facilities (patients’ responses) 24613 Satisfaction from the Services 246

Study to Review The Health Care Delivery System provided by PHSC, Punjab v

14 Suggestions for Further Improvement 247

15 Distribution of Out-patients 248

16 User Charges for Services (patients’ responses) 250

17 Observations on Facility Profi le (patients’ responses) 251

18 Quality of Services (patient responses) 252

19 Health Manpower (patient responses) 254

20 Waiting Time (patient responses) 255

21 Patients’ Experience (Rating) 256

22 Suggestions for Further Improvement (out patients) 257

23 Responses of Deputy Commissioners 260

24 Responses of MLA/Elected Representatives 261

25 Responses of Civil Surgeons 262

26 Responses of SMOs of District Hospitals 263

27 Responses of Elected Representatives at Sub-division Level 264

28 Responses of SMOs of SDH 265

29 Responses of Elected Representatives at CHC Areas 266

30 Responses of SMOs of CHC 268

vi Study to Review The Health Care Delivery System provided by PHSC, Punjab

List of Abbreviations

ANC Ante Natal Care

ANM Auxiliary Nurse Midwife

ASHA Accredited Social Health Activist

BOR Bed Occupancy Rate

BTR Bed Turnover Rate

CHA Community Health Administration

CHC Community Health Centre

CSSD Central Sterile Supply Department

DC Deputy Commissioner

DD-cum-CS Deputy Director-cum-Civil Surgeon

DH District Hospital

DMC Deputy Medical Commissioner

ECG Electro Cardiogram

FGDs Focus Group Discussions

GDMO General Duty Medical Offi cer

ICU Intensive Care Unit

IPF In-Patient Facilities

LP Lumbar Puncture

MLA Member, Legislative Assembly

MO Medical Offi cer

NHP National Health Programmes

OPD Out-patient Department

OT Operation Theatre

PHC Primary Health Centre

PHSC Punjab Health Systems Corporation

PPS Population Proportionate to Size

RKS Rogi Kalyan Samiti

SDH Sub-divisional Hospital

SHC Subsidiary Health Centre

SMO Senior Medical Offi cer

SP Hospital Special Hospital

VED Vital, Essential, Desirable

Study to Review The Health Care Delivery System provided by PHSC, Punjab vii

The Punjab Health Systems Corporation (PHSC) was created as a non-commercial statutory corporation in 1996 vide Punjab Act no. 6 of 1996, with the purpose to establish, expand, improve and administer curative and preventive services at secondary level health care institutions in the state of Punjab. The corporation has taken over the District Hospitals, Sub-Divisional Hospitals (SDHs) and Community Health Centres (CHCs) along with some rural and urban Medical Institutions. Training Institutes viz. State Institute of Health and Family Welfare (SIHFW), Mohali, and State Institute of Nursing and Paramedical Sciences (SINPS), Badal, Distt. Muktsar and Institute of Mental Health, Amritsar have also been included under PHSC institutions.

The present study was conducted with the aim to review the extent to which the objective of the Health Systems Development Project II focusing on improving the health care delivery at the secondary level of health care has been achieved. It was an exploratory study for situational analysis in order to identify the areas of sub-optimal utilisation and suggest the measures for improvement. The study was conducted through the in-depth review of structural organisational and operational framework of PHSC. The site visits to review at least 50% of the 20 District Hospitals located in the different regions of the state and 26% of 37 SDHs and 10% of the 111 CHCs were made along with two special hospitals (Patiala & Bhatinda) and all the training institutions.

Ten teams each comprising of faculty and research staff from National Institute of Health and Family Welfare (NIHFW) visited each of the 10 selected sample districts of Punjab and collected the data from respective district areas comprising of District Hospital, Sub divisional Hospital and Community Health Centre.

It is hoped that the report of this study will be of considerable help to the State Government and other stakeholders in improving health care delivery system at secondary level of health care.

Prof. Deoki Nandan Director, NIHFW

Preface

Study Team

Team Leader Prof. Deoki Nandan, Director, NIHFW

Amritsar Dr. U. Datta, Reader and Acting Head, Deptt. of Education and TrainingMrs. Rita Dhingra, Research Offi cerMr. G.P. Devrani, Asstt. Research Offi cerDr. B.S. Diwan, PG (CHA) student and Dr. Yashika, PG (CHA) student

Bhatinda Prof. J.K. Das, Head, Deptt. of Epidemiology and MCHAMrs. Reeta Dhingra, Research Offi cerMr. G.P. Devrani, Asstt. Research Offi cerDr. Devinder Megha, PG (CHA) student and Dr. Vartika, PG (CHA) student

Firozpur Dr. Vivek Adhish, Reader, Department of CHAMrs. Vandana Bhattacharya, Research Offi cer Mr. S.S. Mehra, Asstt. Research Offi cerDr. B.S. Diwan, PG (CHA) student and Dr. Jagriti, PG (CHA) student

Gurdaspur Dr. Sanjay Gupta, Reader, Department of CHA and Sub DeanDr. Rachna Agarwal, Asstt. Research Offi cer and Mr. S.P. Singh, Research AssistantDr. Nishant, PG (CHA) student and Dr. Ashu, PG student

Hoshiarpur Dr. V. Adhish, Reader, Department of CHAMrs. Vandana Bhattacharya, Research Offi cerMr. S.S. Mehra, Asstt. Research Offi cerDr. Sonia, PG (CHA) student and Dr. Vijaydeep, PG (CHA) student

Jallandhar Dr. Gyan Singh, Chief Medical Offi cer, Department of CHAMr. S.S. Mehra, Asstt. Research Offi cerMrs. Vaishali, Research AssistantDr. Vartika, PG (CHA) student and Dr. Devendra Megha, PG (CHA) student

Ludhiana Prof. M. Bhattacharya, Head, Department of CHA, and DeanMr. Parimal Pariya, Research Offi cerMr. Ramesh Gandotra, Asstt. Research Offi cerDr. Kumud, PG (CHA) student and Dr. Naveen, PG (CHA) student

Muktsar Dr. Sanjay Gupta, Reader, Department of CHA, and Sub DeanMr. Parimal Pariya, Research Offi cerDr. Rachna Agarwal, Asstt. Research Offi cerDr. Shailender, PG (CHA) student and Dr. Sudha Goel, PG (CHA) student

Sangrur Prof. J.K. Das, Head, Deptt. of Epidemiology and MCHAMrs. Reeta Dhingra, Research Offi cerMr. G.P. Devrani, Asstt. Research Offi cerDr. Rakesh, PG (CHA) student and Dr. Madhu, PG (CHA) student

Tarantaran Prof. J.K. Das, Head, Deptt. of Epidemiology and MCHAMr. J.P. Shivdasani, Research Offi cerMrs. Vinod, Asstt. Research Offi cerDr. Sunil, PG (CHA) student and Dr. Indu, PG (CHA) student

Editorial Team Prof. J.K. Das, Dr. Neera Dhar, Reader, Mr. Jai Shivdasani, RO, Dr. Poonam Khattar, Reader, Department of Education and Training, Dr. Manish Jain, MD, and Ramesh Chand, ARO

Acknowledgement

The leadership and guidance provided by Prof. J.S. Bajaj, Vice Chairman, Punjab State Planning Board, Government of Punjab,

support extended by Health and Family Welfare Department and various stakeholders towards conduction of this study is greatly acknowledged.

Study to Review The Health Care Delivery System provided by PHSC, Punjab ix

Executive Summary

The Punjab Health Systems Corporation (PHSC), has been enacted through “The Punjab Health Systems Corporation Act, 1996 (Punjab Act No. 6 of 1996)”. The ‘Second State Health Systems Development Project’ was started under PHSC in the year 1996, with fi nancial assistance from World Bank, with an objective to upgrade health services at secondary level. This project ended in the year 2002, and since then the Government of Punjab is supervising it through PHSC. Today, PHSC has 166 health institutions throughout the state of Punjab (86 in rural and 80 in urban areas), including District Hospitals, Sub Divisional Hospitals and Community Health Centres. Three Training Institutions viz. State Institute of Health and Family Welfare (SIHFW), Mohali, State institute of Nursing and Paramedical Sciences (SINPS), Badal, and Institute of Mental Health, Amritsar have also been included under PHSC.

The present study is an in-depth review of structural organisation and operational framework of the PHSC, and an assessment of the achievements/success of the Health Systems Development Project in improving health care delivery at secondary health care level. The assessment also meant to bring to light the gaps in delivery of health care services and to provide practical recommendations for further strengthening the system. For the present review, a Review Committee was constituted and it conducted on site visits to 10 District Hospitals, 10 Sub Divisional Hospitals, 11 Community Health Centres, 2 Speciality Hospitals and 3 Training Institutions, which were selected using Population Proportionate Sampling Technique (PPS). Key quantitative information was collected using Facility Survey Checklist, Interview Schedules (for health staff), Exit Interviews of clients, and Interviews with other stakeholders. The information obtained was further triangulated with qualitative observations by conducting Focus Group Discussions with the community. The study was conducted between 15th January 2008 and 5th March 2008.

It was revealed following the study that health facilities under PHSC are well accessible and the buildings and other infrastructure are appropriate. But the cleanliness of facility and surroundings, as well as landscape requires more attention. Some health facilities were not having the required equipment and among those which were having them, there were few where these equipment were either not being used or was non-functional. Shortage of manpower was revealed as a generalised observation in almost all the health facilities, particularly the specialists, laboratory technicians and Class IV employees. This issue was of grave concern in Sub Divisional Hospitals (SDHs) and Community Health Centres (CHCs). Another observation was that there is no separate cadre for GDMOs (General Duty Medical Offi cers) and Specialists, which is leading to poor OPD (Out patient department) services since the specialist doctors have to do emergency duties as well.

Availability of medicines, particularly of the essential medicines was lacking in almost all the health facilities, and patients had to buy it from private medical shops, which was a matter of dissatisfaction among majority of patients as well as community. Health facilities were also found purchasing few essential drugs from the user charges and were not being supplied from State

x Study to Review The Health Care Delivery System provided by PHSC, Punjab

or district level. Besides this although laboratory facilities were available in all the institutions visited, it was observed that they were not able to provide services most of the time due to lack of reagents and equipment. Radiologists and lab technicians were also not available in majority of these institutions. Emergency services were also found grossly compromised, particularly in the sub divisional hospitals, mainly due to staff vacancy and security reasons. Overall the health facilities visited were found defi cient with regard to disaster preparedness, referral linkages, record keeping, store management and in provision of basic facilities like toilets to the visiting clients.

It was observed that majority of clients approaching PHSC institutions were females belonging to poor socio-economic strata of the community. It was revealed that well to do families prefer to visit private doctors, because of better quality and prompt services there as compared to Government facilities. Major reasons for this discontentment were more waiting time due to lack of doctors and other staff, lack of medicines and other investigative facilities and poor behaviour of some of the health staff. Overall experience of respondents at OPDs of the various health institutions was not found to be very satisfactory. This observation was in particular for CHCs and District Hospitals, which require prompt attention.

The community also opined and favoured the observations obtained at the OPD and in-patient departments of the health facilities. Lack of medicines, specialised doctors particularly gynaecologists, lack of diagnostic equipment, investigation facilities, appropriate emergency services, and referrals including ambulance service were major issues raised by the community, which needs to be addressed for improving the acceptability of these services.

In brief, it was revealed from the community, clients and other stakeholders, that the project has succeeded in building the infrastructure. But its further maintenance, its capacity to address the community needs and satisfaction and provision of quality health care services through public health facilities still need to be addressed for better utilisation of the available resources.

Study to Review The Health Care Delivery System provided by PHSC, Punjab 1

Hospital services at secondary level play a vital and complimentary role to the tertiary and primary health care systems and together form a comprehensive district based health care system.

It was observed that in the state of Punjab, District Hospitals, Sub-divisional Hospitals and Community Health Centres were having critical gaps in buildings, equipment, manpower, and skills and were unable to provide basic health care services. With an objective to improve effi ciency and quality of the health care provided at fi rst referral level hospitals, the State Government took an initiative to prepare a proposal for seeking aid from the World Bank.

On the request of the State Government, the World Bank team visited the State in March 1995 to review preparation and pre-appraisal of the proposal for the “Health Systems Development Project-II”. On March 21st, 1996, the International Development Association (IDA) approved credit of SDR 235.5 million (US$350 million equivalent) under the multi-states Health Systems Development Project for implementation in the States of Karnataka, Punjab and West Bengal. The Development Credit Agreement and the Project Agreements were signed on April 18, 1996 on behalf of the Government of India and respective states. Thus, Punjab Health Systems Corporation was incorporated through enactment of Legislative act “The Punjab Health Systems Corporation Act, 1996 (Punjab Act No. 6 of 1996)”.

The Corporation was incorporated through measures by the Government of Punjab to bring more administrative fl exibility for implementation of the ‘Second State Health Systems Development Project’ with World Bank assistance to upgrade Health Services at secondary level.

The Corporation took over 166 Institutions, which included District Hospitals, Sub-Divisional Hospitals and Community Health Centres. 86 Medical Institutions are situated in rural areas and 80 are in urban areas. Two training institutes viz. State Institute of Health and Family Welfare, Mohali and State institute of Nursing and Paramedical Sciences, Badal, Distt. Muktsar have also been constructed and were included under PHSC institutions.

The World Bank sanctioned the Second State Health Systems Development Project of US$106.10 million to upgrade the envisaged areas means clinical, diagnostic and other services provided by community/rural, sub-divisional/taluka/state general and District Hospitals in the State of Punjab.

1.1 Objectives of the Punjab Health Systems Corporation

Project

a) To improve effi ciency in the allocation and use of health resources in the Project States

1.0 Introduction

2 Study to Review The Health Care Delivery System provided by PHSC, Punjab

through policy and institutional development; andb) To improve the performance of the health care system in the Project States through

improvements in the quality, effectiveness and coverage of health services at the fi rst referral level and selective coverage at the primary level, so as to improve the health status of the people, especially the poor, by reducing mortality, morbidity and disability.

As per the suggestions, the Project for revamping the Secondary Level Health Care Services was proposed to help in:• Adding and renovating hospital building at the block, sub-divisional and district

headquarters;• Supplementation of accommodation for essential staff;• Provision of more ambulances and better machinery and equipment;• Increase in body strength at some places;• Additional hospital linen and accessories; • Maintenance funds for building, vehicles, machinery and equipment;• Cleanliness, repair and up-keep of all buildings.

The whole of the State was to be covered through 86 Government Health Centres in the rural areas.

1.2 The Benefi ts to the General Public

a. Free consultation for allb. Free diagnostic analysis, medicines and also treatment like operations, etc. for Yellow Card

holders, Punjab Government Employees, Pensioners, past and present Members of Legislative Assembly, Hon’ble Judges, Freedom Fighters, under trial Prisoners, under emergencies and natural calamities and under National Programmes.

c. Full availability of equipment and chemicals, etc. for diagnostic facilities.


As mentioned above, the Health Systems Development Project started under PHSC in 1996 with fi nancial assistance from World Bank and concluded in the year 2002. Since then Government of Punjab is supervising it through a duly constituted corporation i.e. Punjab Health Systems Corporation (PHSC).

The present study was conducted with the aim of reviewing as to how far the objective of this Project (HSDP II) has been achieved in improving health care delivery at the secondary level of health care. Also to bring to light any lacunae or gaps observed in delivering the health care services to the community. The study is an In-depth review of the Punjab Health System by the Review Committee constituted for the purpose.

2.1 Constitution of Committee

i) Dr. J.S. Bajaj Chairman V.C.Punjab Planning Board

ii) Dr. K.K. Talwar Member Director, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh

iii) Dr. P.K. Dave Member Former Director, All India Institute of

Medical Sciences (AIIMS), New Delhi

iv) Dr. Deoki Nandan Member Director, National Institute of Health and Family Welfare (NIHFW), New Delhi

v) Dr. Shakti Gupta Member Medical Superintendent, AIIMS, New Delhi

vi) Dr. Sukhdev Singh Member Director, Family Welfare, Punjab

vi) Dr. Roshan Sunkaria, IAS Member Managing Director, PHSC Convener Member

viii) Shri Tejveer Singh, IAS Coordinator Special Secretary to Government of Punjab Member Department of Planning

2.0 Rationale


2.2 Terms of Reference

The Committee was to make on site visits and to review at least 50% of the 20 District Hospitals located in different regions of the State, along with a similar inspection of 2 Special Hospitals (Patiala and Bhatinda), as well as of 10% of 37 Sub Divisional Hospitals (SDHs) and 5% of the 111 Community Health Centres (CHCs).

2.3 Study Objectives

i) To conduct an in-depth review of structural organisational and operational framework of Punjab Health System Corporation (PHSC) and to assess the effi ciency and effectiveness of management system so far established.

ii) To conduct site visits to a specifi ed number of District Hospitals, special hospitals, sub divisional hospitals and community health centres and assess the quality and effi ciency of the delivery of health care at each of the health institutions.

iii) To visit the three special Training and Teaching Institutions which are under the management control of PHSC and conduct a short academic review of the physical facilities as well as of the process of education.

iv) To propose requisite remedial measures aimed at optimising a cost-effective and effi cient management of PHSC as well as of hospitals and training institutions under its control and management.

The fi eld work, data collection, analysis, interpretation and report writing was done by National Institute of Health and Family Welfare, New Delhi.


3.1 Type of Study

This was an exploratory study conducted in the state of Punjab with an objective to undertake situational analysis, identify areas of sub optimal functioning and suggest remedial measures.

3.2 Duration of Study

15th January to 5th March 2008.

3.3 Sample Size

1. 50% of 20 District Hospitals (DHs) 10 DHs2. 26% of 37 Sub Divisional Hospitals (SDHs) 10 SDHs3. 10% of 111 Community Health Centres (CHCs) 11 CHCs4. All the Special Hospitals (SHs) 02 SHs5. All the Training Centres (TCs) 03 TCs

Total 36

3.4 Sampling Technique

Selection of the Districts was done by using the Population Proportionate to Size (PPS) Technique. These Districts were selected proportionately from the 3 existing geographical regions i.e. Majha, Doaba and Malwa.

Hence the region wise sample of the Districts drawn was as follows:

Majha

1. Amritsar2. Gurdaspur3. Taran Taran

Doaba

1. Hoshiarpur2. Jalandhar

3.0 Methodology


Malwa

1. Bhatinda2. Ferozpur3. Muktsar4. Sangrur 5. Ludhiana

3.5 Data Collection Tools and Techniques

1) Interview schedule for health functionaries/service providers2) Exit interview schedule for patient satisfaction3) Checklist for Facility Survey4) Questionnaire for trainers 5) Interview schedule for other stakeholders including community

The health functionaries, other stakeholders, sample of benefi ciaries (i.e. patients selected randomly) and facility surveys of health institutions for study were as follows:

3.5.1 At district level

a) District Collector 1x10 = 10 in no.b) Civil Surgeon 1x10 = 10 in no.c) Local MLA/MP 1x10 = 10 in no.d) SMO/MS at District Hospitals 1x10 = 10 in no.e) Indoor patients 10% of the total admitted in hospital or minimum of

10 patientsf) Outdoor patients (OPD) 5% of the OPD attendance or minimum of 20 patientsg) Facility Survey of 1x10 = 10 in no. District Hospitals

3.5.2 At sub-divisional level

a) Local elected representatives at sub-divisional level 1x10 = 10 in no.b) SMOs/MS at Sub-Divisional Hospitals 1x10 = 10 in no.c) Indoor patients 10% of the total admitted in hospital or minimum of

6 patientsd) Outdoor patients (OPD) 5% of the OPD attendance or minimum

of 20 patientse) Facility Survey of 1x10 = 10 in no. Sub-Divisional Hospitalsf) FGD (Male Community Members) 1x10 = 10 in no.


3.5.3 At CHC level

a) Local elected representatives at CHCs 1x11 = 11 in no.b) SMO/MS at CHC 1x11 = 11 in no.c) Indoor patients 10% of the total admitted in hospital or minimum of

3 patientsd) Outdoor patients (OPD) 5% of the OPD attendance or minimum of 10 patientse) Facility Survey of the CHCs 1x11 = 11 in no.f) FGD (female community members) 1x11 = 11 in no.

Due care was taken to select the SDHs and CHCs from the same district from which District Hospital was selected so as to study the referral linkages.

3.5.4 Special hospitals

a) SMO/MS at Special Hospitals 1x2 = 2 in no.b) Indoor patients 10% of the total admitted in hospital or minimum of

10 patientsc) Outdoor patients (OPD) 5% of the OPD attendance or minimum of 20 patients

3.5.5 Training institutes

a) Facility Survey 1x3 = 3 in no.b) Interview of the faculty

3.6 Data Collection Team

10 Teams, each comprising of 1 faculty member, 2 research staff and 2 students from NIHFW visited their respective sample district and collected the above mentioned data from whole of the district area. Training Institutes were also evaluated during these visits.


Following are the study fi ndings as per the terms of reference provided:

4.1 Structural and Operational Framework of Punjab Health

Systems Corporation (PHSC)

A review of structural, organisational and operational framework of Punjab Health Systems Corporation (PHSC) was carried out. The detailed fi ndings are as follows:

The World Bank team on the request of the State Government visited the State in March-95 to review preparation and pre-appraisal of the proposal for the “Health Systems Development Project-II”. Thus, Punjab Health Systems Corporation had been incorporated through enactment of Legislative act “The Punjab Health Systems Corporation Act, 1996 (Punjab Act No. 6 of 1996)’. The Corporation has been incorporated through measures by the State Government of Punjab to bring more administrative fl exibility for implementation with assistance of World Bank to upgrade Health Services at secondary level.

The PHSC was incorporated on October 20, 1995 to establish, expand, improve and administer medical care at secondary level of health care services. The project activities were undertaken by the PHSC and the State Government has ensured that PHSC should function as an autonomous body. For its effective implementation, a Strategic Planning Cell is functioning under the overall supervision of the MD, PHSC-cum-Secretary Health.

Under this project, PHSC had taken over 166 Institutions, which includes District Hospitals, Sub-divisional Hospitals and Community Health Centres. 86 Medical Institutions are situated in rural areas and 80 are in urban areas. Two training institutes viz. State Institute of Health and Family Welfare, Mohali and State Institute of Nursing and Paramedical Sciences, Badal, Distt. Mukatsar have also been constructed and were included under PHSC institutions.

The World Bank sanctioned the Second State Health Systems Development Project of US$106.10 million (approximately Rs. 422 crores) to upgrade the envisaged areas means clinical, diagnostic and other services provided by community/rural, sub-divisional/taluka/state general and District Hospitals in the State of Punjab.

4.0 Study Findings


B

GF

Organogram of Department of Health & Family Welfare

Health & Family Welfare Minister

Parliamentary Secretary Health & Family Welfare

Principal Secretary Health & Family Welfare

Secretary Health cum Managing

Director PHSC

Special Secretary Health

cum Mission Director NRHM cum PD AIDS

Director Health Services

Director Family Welfare

Director (SI)

Secretary Health cum

Commissioner AYUSH

Head of Department Homeopathy

PHSC Jt. Secretary Health

Health-I, II & IV Branches

Under Secretary Health

Health - V, VI & VII

Branches

PSACS

A

C D E

PHSC Punjab Health Systems Corporation

PSACS Punjab State Aids Control Society

SI Social Insurance (ESI)


The major heads under which the funds were provided were Loan Rs. 252.00 crore, Grant Rs. 127.00 crore and Share of the State Government. Rs.43.00 crore.

Break up of the budget was as follows:

Head Rs. in Crore

Civil works for renovation, new construction and extension 174.07

Major/Minor equipment, Surgical Packs and Furniture 66.09

Vehicles and Ambulances 8.49

Medicines, Medical Lab, Supplies 26.51

Information Systems and Computers 11.14

Training and Workshop 12.45

Salaries and Offi ce Expenses 49.66

Price Contingencies 73.47

Total Rs. 421.88

4.2 The Corporation consists of:

(a) The Chairman who shall be the Secretary to the Government of Punjab in the Department of Health and Family Welfare or a distinguished and eminent medical person.

(b) The Vice Chairman of the Punjab Health Systems Corporation is the Secretary Health and Family Welfare and is the overall in charge of the department. He is the Chairman of the Punjab AIDS Control Society, Chairman of SCOVA (RCH Society), TB society and Leprosy Society.

(c) Secretary Health-cum-Managing Director, who shall be an offi cer of the Indian Administrative Service. He assists the Vice chairman of the PHSC in connection with the administrative issues concerning to the PCMS doctors, which include Recruitment, Posting, Transfers, Disciplinary Actions, Service Rules etc. In addition to this, he has also been designated as Head of Department (HOD) of Government Mental Hospital, Amritsar. He is assisted by Superintendents of Health – I and II Branches of the Department and is supported by the Director, General Manager (F&A), Executive Engineers and other Programme Offi cers.

(d) A Board of Directors; and such other employees, as may be determined by the Board of Directors.

4.3 Constitution of Board of Directors

The Board of Directors consisting of the following members namely: -(a) The Secretary to the Government of Punjab in the Department of Finance, (b) The Secretary to the Government of Punjab in the Department of Rural Development and

Panchayats, (c) The Secretary to the Government of Punjab in the Department of Local Government, (d) Representative of the Government of India in the Ministry of Health, (e) The Director of Health Services, Punjab, (f) Six eminent persons as given below nominated by the Government for a period of three

years, (provided that no nominee shall be a member of the Board of Directors for more than


Punjab Health Systems Corporation

Chairman

Vice Chairman-cum-Principal Secretary, Health & Family Welfare

Managing Director

Director cum Principal

S.I.H.F.W. Mohali

Director (Institute of

Mental Health Amritsar)

General Manager (F&A cum

Secy Board)

Executive Engineer (Works)

Principal State Institute (Badal)

Dy Dir. (Admn)

Dy Dir. (P&T)

Asst. Dir. (Admn)

Asst. Dir. (Sur)

Asst. Dir. (HS)

Asst. Dir. (BB)

Asst. Dir (Equip)

EE (C) Jalandhar

AAO

EE (C) Mohali

EE (C) Patiala

AM AuditAMFADMA

Accountants AMFA Assistant Manager (Finance & Accounts)

AAO Assistant Accounts Offi cer

Acct Accountant

Admn Administration

BB Blood Bank

DMA Deputy Manager Accounts

DMC Deputy Medical Commissioner

EE (C) Executive Engineer (Civil)

F & A Finance and Accounts

HMIS Health Management Information Systems

HS Hospital Services

Med Supdt Medical Superintendent

P & T Procurement and Transport

Stat Anyst Statistical Analyst

Sur Surveillance

A


two terms or six years whichever is less): (i) A representative of medical institution of excellence in the country, (ii) Two distinguished experts in professions related to medicine and health, (iii) An experienced professionals in Systems Management or Telecommunication, (iv) The Director of the National Institute of Pharmaceutical Education and Research; and (v) A representative of a reputed industrial house manufacturing pharmaceuticals.

4.4 The Managing Director

• The Managing Director is the Executive Offi cer of the Corporation and he shall implement the decisions of the Board of Directors and shall exercise such other powers and perform such other functions, as may be delegated to him from time by the Broad of Directors.

• The Managing Director exercise general control and supervision over the dispensaries and hospitals in the effective performance of their functions under this Act or the regulations made there under.

• Corporate Level Departments 1. Strategic Planning Cell (SPC) 2. Department of Administration 3. Department of Procurement 4. Engineering Wing 5. Department of Finance and Accounts 6. Computer Cell.

• District Level Management of the Corporation 7. Deputy Medical Commissioner 8. District Health Committee 9. Assistant Medical Commissioner 10. Other medical and Paramedical Staff

• Hospital Level Staff 11. Senior Medical Offi cer 12. Medical Offi cer 13. Other medical and Paramedical Staff

4.5 Functions of the Corporation

In order to ensure the focused approach for management of secondary level health care services, additional programme offi cers in the fi eld of Quality Assurance, HMIS, Waste Management, Surveillance, Referral, Training, IEC, Hospital Services, Blood Bank have been positioned at headquarters level. Separate offi ces were set-up for Deputy Medical Commissioners (DMC). Apart from this, in order to enhance the data collection and analysis capabilities, the offi ce of DMCs have been strengthened by providing manpower in the fi eld of accounts and HMIS which support the hospitals in proper record keeping and monitoring.


The functions of the Corporation are as follows:a) to formulate and implement the schemes for the comprehensive development of the

dispensaries and hospitals;b) to construct and maintain dispensaries and hospitals including cleanliness;c) to implement National Health Programmes as per the directions of the State. The State

Government and Central Government shall make funds available for this purpose;d) to purchase, maintain and allocate quality equipment to various dispensaries and hospitals;e) to procure, stock and distribute drugs, diet, linen and other consumable among the

dispensaries and hospitals;f) to provide services of specialists and super-specialist in various hospitalsg) to enter into collaboration for super specialities with health institutions both within the

country and abroad to provide better medical care;h) to receive donations, funds and the like from the general public and institutions from both

within and outside India;i) to receive grants or contributions which may be made by the Government on such conditions

as it may impose;j) to provide for construction of houses to the employees of the dispensaries and hospitals, and

the maintenance thereof by mobilising resources for fi nancing institutions;k) to plan, construct and maintain commercial complexes, paying wards and providing diagnostic

services and treatment on payment basis and to utilise the receipts for the improvement of the dispensaries and hospitals;

l) to run public utility services and undertake any other activity of commercial nature for the delivery of health care within or without the hospital premises directly or in collaboration with private or voluntary agency on contract basis;

m) to engage specialised agencies or individuals in the relevant disciplines, directly or from external sources for the effi cient conduct of the functions; and

n) to provide immediate treatment in case of emergency and for unaccompanied patients.

4.6 Steps for the betterment of employees

1. Chance of foreign training for all doctors and para-medical staff;2. Substantial training opportunities and fellowships etc. within the country;3. No change in the terms and conditions of the services, establishment matters will remain

wherever they are.

4.6.1 At district headquarter level

There is one Deputy Director cum Civil Surgeon (DD cum CS) in each district and hence a total 20 DD cum CS in Punjab. DD cum CS supports the Directorate of Health Services through taking care of implementation of various National and State Health Programmes, Implementation of Registration of Births and Deaths Act and Prevention of Food Adulteration Act. The Deputy Medical Commissioner (DMC) supports the DD cum CS in the provision of hospital services in the district. The District Health Offi cer assists the DD cum CS in the implementation of the Disease Control Programmes. S/he also supports the Directorate of Family Welfare (DFW) in enforcement of PNDT Act as District Appropriate


District Headquarters

Deputy Director-cum-Civil Surgeon{1 Post at each district}

(Total = 18)

Assistant Civil Surgeon

District Immunisation

Offi cer

District Family Planning Offi cer

Deputy Medical Commissioner

Senior Medical Offi cers ofPHC/SHCs

LHV (Lady Health Visitor)

M+F (Male & Female)

MPHW (Multipurpose Health Worker)

PHC (Primary Health Centres)

SHC (Subsidiary Health Centre)

SMO (Senior Medical Offi cer)

X

District Health Offi cer

1 Primary Health Centre for appropriately (100,000) populationTotal in the State 118SMO - 1 MO - 2 at each PHC

SHC(Subsidiary Health Centre/Dispensary)For 10,000 population each total in the State: 1200

Sub-centre Total with State: 2858+ (5000 population) LHV, Multi-Purpose Supervisor – For a Population of 30,000(MPHW – M+F)

SMO (Hospitals)

Authority and implementation of different schemes in the District under National Family Welfare Programme through District Family Welfare Offi cer and District Immunisation Offi cer.

4.6.2 At block level

The Civil Surgeon is supported by Senior Medical Offi cers, I/c of PHCs and Medical Offi cers I/c of Subsidiary Health Centre (SHC) in implementation of various National and State Health Programmes at grassroot level.

4.6.3 At subsidiary health centre level

The Senior Medical Offi cers are supported by Medical Offi cer I/c SHC for Implementation of different schemes in the SHC area under National Family Welfare Programme through Multipurpose Health Worker (Male and Female). Medical Offi cers I/c are supported by Multipurpose Health Worker (Male/Female) in implementation of (i) Universal Immunisation Programme (DPT, Polio, BCG, Measles and TT for Pregnant mothers). (ii) Maternal & Child Health (Antenatal Check Up, Institutional Delivery & Post Natal Check Up). (iii) Family Planning: Counseling/motivation.


(iv) Management of diarrhoea especially in infants. (v) Health Education: educating the community about the various available services. (vi) Control of Acute Respiratory Infection especially in infants. (vii) Identify the women requiring help for medical termination of pregnancy and refer them to nearest approved institution (viii) Health Survey.

4.6.4 Deputy Medical Commissioner (DMC)

The DMC looks after the hospital services in District Hospitals, Sub Divisional Hospitals, and Block level Community Health Centres, which are headed by Sr. Medical Offi cer or In-charge of the hospital. In two special hospitals, i.e. MKH Patiala and Civil Hospital Jalandhar, there are Medical Superintendents who directly report to headquarters. Apart from this, Principal, State Institute of Nursing and Paramedical Sciences, Badal reports to MD-PHSC through Director cum Principal, State Institute of Health & Family Welfare, Mohali and Director, Institute of Mental Health i.e. Government Mental Hospital, Amritsar reports directly to the Managing Director. Recently the SINPS, Dadal has been handed over to Baba Faridkot University.

4.7 Review of functioning of PHSC

To give more autonomy to the Hospitals, PHSC took the steps like (i) Higher fi nancial powers to hospital in-charge, DMCs and CSs were given; (ii) Full powers were given to hospital incharge for commercial exploitation for support services for revenue raising, outsourcing of sanitation services, maintenance services of equipment and hospital building and condemnation of unserviceable articles; (iii) Clear-cut guidelines were given for the procedures to be adopted for retention and utilisation of user charges; (iv) Direct recommendation for recruitment of critical manpower on contractual terms. This is a very encouraging move. Higher accountability is possible only when more autonomy is given to the institutions.

In more than 50 hospitals and 20 districts headquarters, capacity has been developed for computerised record keeping, which covers records of HMIS, Accounts, OPD/IPD, Blood Banks, and Diagnostic Services. For this purpose, the concerned staff has been trained and computer operators have been provided. In-house capabilities have been developed for commercially negotiating with the private partners for outsourcing. Slowly this capacity is being decentralised for effective implementation. Though computer was provided for computerised record keeping in hospitals/health centres at all levels, but in reality these computers were being used only for the registration purposes and these were not being used for record keeping or generation of HMIS. Only at few of the places, the medical records department was being managed by trained persons.

Computerised HMIS systems were in position and regular data of the hospital activity and effi ciency indicators were supposed to be collected and analysed. This was found to be one of the weakest areas in all most all the hospitals/health centres that were evaluated.

There was hardly any well planned and organised Medical Record Department. Most of the centres were not even fully computerised, as the computers were there in the registration areas only. Even in some places untrained clerical staff manned it. The data so generated were not properly analysed to get the right information (like BOR, Average Length of stay, BTR, Death Rates etc.) required for effective management and to take right policy decisions. For an effective and effi cient Hospital Administrator these are very important tools.


Hence, efforts should be made to strengthen these aspects by planning and organising a good Medical Record Department for hospitals at every level. Also these Medical Record Departments should be Computerised and manned by properly trained and dedicated staff, which will take care of all the required Management Information System used for Hospital Administration.

Overall percentage of the total Government expenditure on health sector increased from 3.54% in FY 94-95 to 4.27% in FY 03-04 (BE). In absolute term, the allocations have increased from Rs. 2057 million in FY 94-95 to Rs. 7117.20 million in FY 03-04 (BE) against the projected level of Rs. 2956 million. The per capita expenditure on Health at current price has increased from Rs.101 in FY 94-95 to Rs.292 in FY 03-04.

Policy as regard to implementation of user charges was placed right from the very beginning. Reports showed the User Charges collections have increased sharply from Rs. 4 million in FY 96-97 to Rs. 125.37 million in FY 03-04. This increase has been established by introducing better collection method and increase in the services offered. Retained user charges are being utilised on defi ned priorities of essential drugs (45%), patient’s facilities (25%), equipment maintenance (15%) and building maintenance (15%). During the study it was observed that in almost all the hospitals at all level about 40-50% of retained revenue from User Charges were used to procure medicines and 20-30% amount on IFP purpose. But utilisation on building maintenance and equipment maintenance were found to be less utilised than its actual allotment.

In the year 1996 & 1998, the State Government recruited 279 & 785 doctors. But since then no new recruitments were made. As a result there were some shortages of doctors in the regular cadre which is having its adverse effect on the overall functioning.

Efforts were made to ensure that core team of specialists to be made available in every hospital. But in reality the availability of all the basic specialists in respective hospitals could not be ensured. Some times it was observed that a Medical Offi cer of one speciality on transfer was replaced by a Medical Offi cer of another speciality or a general duty medical offi cer, because in Punjab, there is only one cadre for Medical Offi cers.

100% equipment as per the norms was supposed to be in position in all the newly commissioned hospitals along with preventive maintenance of the vital equipment to be undertaken through AMCs. But in reality it was found not to be always in place.

Availability of the drugs was to be monitored on monthly basis as a part of the hospital grading exercise. The State Government has continued providing the supplies of the medicines in hospitals. But in practice this was one of the major lacunas on the part of service providers. Most of the places it was told that the hospitals were not getting any regular supply of Drugs from the State, rather, they were told to arrange the same from funds generated through User Charges.

Support services i.e. ambulance maintenance services, sanitation services and general maintenance services had been contracted out as a time gap arrangement. Waste disposal activities were also contracted out. This initiative was a very good move and it was reported that there were some visible improvements. But later on due to some policy decision the regular Class IV employees


working in the peripheral health centres were deployed and contractual staff was removed. As a result, situation of general maintenance services in the hospitals were not one of the best. Main reasons told were absenteeism and unionism.

Comprehensive referral system was to be established by introducing procedures at the primary level, through Out Reach Camps held in the rural and far-fl ung areas and by providing incentives for the referred cases at the higher level institutions.

Referral manual has been prepared containing guidelines that specify ‘what’ ‘when’ and ‘how’ of referral. Colour coded referral cards have been introduced for sub centre level to district level for referring the patients. Training to doctors and paramedics for implementation of referral system was given. Incentive for referred patients (queue jump, exemption of OP/Admission Charges) have been introduced, referral routes have been established and displayed in all the hospitals. Special tie-up has been made at tertiary level facilities for creation of special window for the referred patients. But in practice none of these measures could be observed in exact desired manner. This is a very important aspect for an effective and holistic Health Care delivery system and hence all efforts should be made to further strength it and effectively implement it.

A set of core indicators is being used to grade all the 154 hospitals. External lab quality assurance programme has been introduced. This was found to be a very useful and an effective mechanism for better and quality service output.

Overall, as per the objectives of the PHSC and its policy implementations it was found to be quite cost effective with management effi cient system. All the aspects are properly implemented. Many of these aspects are already mentioned above.

For ensuring better availability of drugs and other consumables in hospitals/health centres at every level the Model of Tamil Nadu Medical Corporation may be followed. As this model is followed by many states with some modifi cation as per their needs.

Referral System needs to made more effective and extreme care needs to be taken to make it two way system and not one way, which was found to be followed in present situation. This was found to be more of Transfer System of patient than of Referral System. In this process the patients will tend to lose their confi dence on the lower centres and as a result these centres will become under utilised. The examples for successful two way Referral Systems which are being followed in India are CGHS, ESIC, Railways, Army, etc. Further, for developing an effective and effi cient system the National Health Scheme (NHS) followed at United Kingdom (UK) may be studied for its implementation.

Efforts should be made to ensure the availability of all the services required for diagnostic and therapeutic processes by applying the modern scientifi c management techniques.

There should be atleast two separate cadres for doctors. One for General Duty and other for the Specialists as it is followed in Central Health Scheme (CHS), ESIC, Railways, Army, etc.


A survey was conducted to assess the existing facilities with respect to various indicators at each health set up.

5.1 District Hospitals

Facility assessment was done in ten District Hospitals selected as sample, which were Amritsar, Bhatinda, Ferozpur, Gurdaspur, Hoshiarpur, Jalandhar, Ludhiana, Muktsar, Sangrur and Taran Taran. Along with these hospitals, two special hospitals were also studied viz. women and child hospital in Patiala and Bhatinda. The general profi le and facility assessment of District Hospitals is given in the Table Section (Refer Table – 1).

5.1.1 Accessibility

All District Hospitals and special hospitals were easily accessible from the railway station and bus stand and well connected with the road. Average distance from the railway station and bus station ranged from one to four kilometres respectively.

5.1.2 Bed strength

Six District Hospitals were 50 to 100 bedded, three were 100 to 200 bedded and one District Hospital of Jalandhar was found to be 300 bedded hospital. Special hospital at Patiala was 154bedded and one at Bhatinda was 50 bedded hospital.

5.1.3 Water supply

Almost all district and special hospitals were having adequate water supply except Bhatinda and Muktsar. Five District Hospitals and two special hospitals were having bore well water supply and four hospitals were having municipal water supply. District hospital, Muktsar was having canal water supply. Water storage capacity was available for one day at 2 District Hospitals and one special hospital, three days at 6 District Hospitals along with Patiala special hospital and two days at the remaining two District Hospitals.

5.1.4 Electricity supply

Electricity supply was found to be regular in most of the district and special hospitals. Only three District Hospitals viz. Amritsar, Muktsar and Taran Taran, were having irregular supplies. However, only one District Hospital was having double phase electric supply, while, rest of the nine District Hospitals and two special hospitals were having three phase electric supply. Back up generator system was available in all the ten District Hospitals and two special hospitals.

5.0 Facility Assessment


5.1.5 Lifts and ramps

Lifts were available in only four District Hospitals out of ten District Hospitals and two special hospitals included in the study. All hospitals were having ramps.

5.1.6 General impression on cleanliness and maintenance of gardens

Six district hospitals (60%) were having good cleanliness and four (40%) were average. Among special hospitals, the cleanliness standard was good in Patiala and average in Bhatinda.

Five District Hospitals (50%) were found to be having good upkeep of garden and rest fi ve were having average landscaping. Among special hospitals, Patiala was found to have good while Bhatinda hospital with average upkeep of garden/landscaping.

5.1.7 Status of Buildings

The status of the buildings in six District Hospitals was good, while it was average in the remaining four District Hospital buildings. Both the special hospitals included in the study were having a good building status.

5.1.8 Signs, roads and lighting

Signage system was poor in Sangrur and average in Ludhiana District Hospitals. Rest of the eight District Hospitals were having good sign post system. Among special hospitals Patiala was having good while Bhatinda was having average sign posting.

Roads and lighting of six District Hospitals were good, three were average and only one hospital (Amritsar) was found to be poor. Both the special hospitals under study were having good roads and lighting.

5.1.9 Public utility facilities

Among all the District Hospitals covered under the study, six had a chemist shop within the premises; majority of District Hospitals (70%) had a canteen as well. Only two District Hospitals did not have Sulabh Shochalaya (Toilet facility) out of 10 District Hospitals. Five District Hospitals had STD/PCO booth within the premises.

Both the special hospitals had a chemist shop, canteen and Sulabh Shochalaya within the hospital premises. Bhatinda Hospital did not have STD/PCO booth in the premises.

5.1.10 Ambulance service

Ambulance facility was available among all the district and special hospitals covered under the study, with the District Hospital in Bhatinda having ten ambulances and rest of the district and special hospitals having one to fi ve ambulances each.


Majority of these ambulances were found to be partially equipped. Only three District Hospitals had fully equipped ambulances. Out of the two special hospitals assessed, only one had a fully equipped ambulance.

5.1.11 Operation Theatres (OT)

Majority of the District Hospitals were having at least one minor OT, except Jalandhar and Muktsar hospitals, which were having four and three minor OTs’ respectively.

Regarding major OTs, two District Hospitals were having one major OT, three District Hospitals were having three major OTs, three District Hospitals had two major OTs and two hospitals were having four major OTs. Patiala special hospital had two major OTs while Bhatinda special hospital had only one major OT.

5.1.12 Dental services

Only the special hospital at Bhatinda, where no Dental Department exists, was without dental services out of the ten District Hospitals and two special hospitals covered under the study.

5.1.13 Maternity services

All the hospitals were having maternity services.

Fig 1: Normal deliveries conducted in District Hospitals (Punjab) in the last five years

0

500

1000

1500

2000

2500

3000

3500

4000

Amritsar

Ferozp

ur

Gurdaspur

Hoshiar

pur

Jalan

dhar

Ludhiana

Muktsar

Patiala

(SH)

Sangrur

Taran tar

an

Bhatinda(S

H)

Districts

No.

of n

orm

al d

eliv

erie

s

1st Yr2nd Yr3rd Yr4th Yr5th Yr


Fig 2: Caesarians done in District Hospitals (Punjab) in the last five years

0

200

400

600

800

1000

1200

1400

1600

Amritsa

r

Ferozp

ur

Gurdas

pur

Hoshiar

pur

Jalan

dhar

Ludhiana

Muktsar

Patiala

(SH)

Sangru

r

Taran ta

ran

Bhatinda(S

H)

Districts

No.

of c

aesa

rians


5.1.14 Mortuary

Out of ten, seven of the District Hospitals (70%) were having a Mortuary whereas two of them did not have post mortem facilities. Both the special hospitals were without Mortuary and post mortem facilities.

5.1.15 Various hospital management committees

Only three District Hospitals were having a drug formulary and hospital antibiotic committee. None of the two special hospitals had a Hospital antibiotic committee, although Patiala special hospital was having a drug formulary committee. All the ten district and two special hospitals were having a store purchase and store verifi cation committee except special hospital at Patiala.

Four District Hospitals were not having a Hospital Infection Control Committee and medical audit/death review committee. Both the special hospitals were without Hospital Infection Control Committee, although Patiala hospital had a medical audit/death review committee.

5.1.16 Drugs and equipment management

Almost all District Hospitals and special hospitals were having dual drug supply. They get drugs and equipment supply from the state and they can also purchase these supplies on their own, utilising the user charge money.


Percentage of drug items which were requested and received were found to be 50 % in four District Hospitals, 40% in one, 60% in one District Hospital and one special hospital, 90% in one District Hospital, 100% in another and only 20% in Patiala special hospital.

Percentage of patients getting all the prescribed medicines was found to range between 40% to 75% in most of the hospitals, except in Muktsar where it was only 25% and in Hoshiarpur it ranged from 5% to 10% for OPD patients. However, indoor patients in Hoshiarpur District Hospital were found to receive 100% of the prescribed medicines.

Only two District Hospitals were having their own drug formulary. Six District Hospitals and both the special hospitals maintained buffer stock. All the hospitals were having annual maintenance contracts for maintenance of costly equipment and all hospitals maintained a logbook and history sheet for the equipment except two District Hospitals at Sangrur and Taran Taran. Current functional status of all the existing equipment was found to be good at the time of assessment.

5.1.17 Major equipment

Only two District Hospitals at Amritsar and Bhatinda and special hospital at Patiala were not found to have baby incubators. The same were not functional in two out of the remaining District Hospitals having baby incubators.

All the District Hospitals were having functional Boyle’s apparatus with circle absorber. All the hospitals were having a cardiac monitor though it was non functional in two of these District Hospitals. One special hospital did not have dental chairs.

Dosimeter was present only in Taran Taran and one special hospital. ECG facility was available at all the hospitals; however, the same was not functional in Ferozpur hospital. Emergency resuscitation kit was available in all District Hospitals, except at Muktsar District Hospital. The emergency resuscitation kit was not found functional in Ferozpur hospital.

Endoscope was available only in fi ve District Hospitals, although it was non functional in Gurdaspur District Hospital. Endoscope was not available in any of the special hospitals assessed.

All the ten District hospitals were having a functional ophthalmoscope. Out of two special hospitals, it was available only at Bhatinda special hospital.

Four District Hospitals and one special hospital were having a perimeter. Only one District Hospital at Muktsar was not having phototherapy unit. Only Sangrur District Hospital and one special hospital were not having retinoscope. Shortwave diathermy was not present in three District Hospitals and it was found to be non functional in two District Hospitals and one special hospital.Sigmoidoscope was available at six District Hospitals out of ten.

X-ray facility was present in all the hospitals, but ultrasound facility was not present in Sangrur and special hospital, Bhatinda. Slit lamp was available at all District Hospitals, but nowhere at special hospitals.


5.1.18 Referral system

Referral facilities were available in almost all hospitals, though referral manual was not present in half of the District Hospitals and both the special hospitals. Guidelines for referring patients were not available in four District Hospitals and in both the special hospitals. Colour coded referral cards were available only in six District Hospitals and one special hospital at Bhatinda. Feedback mechanism existed only in three District Hospitals.

Transport facilities were provided by all the hospitals. Only one District Hospital and one special hospital was not maintaining records and registers for the same. Incentives for following referral route for patients were provided only in four District Hospitals and one special hospital; they are mainly providing the vehicle for referral.

Five District Hospitals along with special hospital at Bhatinda had a tie-up with other hospitals (both public and private) for diagnostic or referral purposes and most of them were with Government hospitals or Medical colleges except District Hospital at Jalandhar which was having tie-ups with private hospitals also.

Statistical Bulletin was available only in four District Hospitals.

5.1.19 Outreach services and residential area

Three District Hospitals and one special hospital at Bhatinda were having an outreach area and the services provided were mainly related to maternal and child health.

All hospitals were having residential accommodation for the essential staff except at Amritsar and Muktsar. Though residential accommodation was available but still staff members were not getting it. 80% of staff was not getting accommodation in Bhatinda, 70% in Taran Taran, 50% in Hoshiarpur and Ludhiana, 40% in Sangrur and 15 % in Jalandhar. Among special hospitals, 40% of the staff was not getting accommodation in Patiala and 90% in Bhatinda. Ferozpur and Gurdaspur were having full accommodation and all staff members were getting the accommodation.

All hospitals were having a security service. Among them three District Hospitals were having contractual security service and rest were having in-house security service.

Three District Hospitals and one special hospital were having Dharamshala facility.

5.1.20 Out-patient department (OPD)

Reception and registration counter was computerised in nine District Hospitals and in one special hospital at Patiala. It was found to be managed by a clerk in two District Hospitals, staff nurse in one, pharmacist in six and by a computer operator in eight District Hospitals and one special hospital. (See Fig 3)


There were separate registration counters for male, female and senior citizens in most of the hospitals, except in three District Hospitals and one special hospital where only one District Hospital and one special hospital were having a separate registration counter for the staff. Registration registers were properly maintained and entries were made neatly in all hospitals except District Hospital at Muktsar.

In all the hospitals, OPDs were having proper signage and directional signage in every section except at District Hospital Muktsar. Waiting area and sitting arrangement were found to be adequate in all the ten District Hospitals and two special hospitals.

Only one District Hospital at Ludhiana was not having proper drinking water facility and District Hospital at Sangrur was not having separate toilet facility for male and female. Ceiling fans were present in all the hospitals. All doctor’s rooms were having adequate space, proper illumination and the examination tables covered by proper sheets, along with stools for seating the patients. All of them were having examination equipment like BP apparatus, torch, hammer etc.

Minor OT dressing room was present in all the hospitals except at Taran Taran District Hospital. Injection room within the OPD was available in eight district and two special hospitals.

Five District Hospitals and both the special hospitals were having a dispensary/pharmacy with separate counters for male/female/senior citizens/staff.

Fig 3: No. of OPD Patients in District Hospital (Punjab) in last five years

0

50000

100000

150000

200000

250000

300000

Amritsa

r

Bathinda

Ferozp

ur

Gurdas

pur

Hoshiar

pur

Jalan

dhar

Ludhiana

Muktsar

Patiala

(SH)

Sangru

r

Taran ta

ran

Bhatinda(S

H)

Districts

No.

of O

PD p

atie

nts



Laboratory and imaging services were easily accessible from the OPD in all the hospitals. Out of all these hospitals only two District Hospitals were not having central collection centre for laboratory services.

5.1.21 Emergency/casualty services

A separate medical offi cer was found available round the clock for emergency cases at eight District Hospitals out of ten and at one special hospital out of two. Glow sign board display at Emergency service department was observed in seven District Hospitals and one special hospital. Board displaying names of doctors/specialists on call in emergency, was found available in nine District Hospitals and one special hospital.

Emergency wards were attached along with emergency in all hospitals. However, two of these District Hospitals and one special hospital was not having any triage area. Maximum number of observation beds were in Bhatinda, i.e 19 beds, followed by Hoshiarpur with 10 beds. In rest of the hospitals, observation beds ranged from three to eight.

Trolleys and wheel chairs were present in all hospitals except Muktsar. The number varied between one to fi ve.

Fig 4: No. of emergency patients in District Hospitals (Punjab) in the last five years

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

20000

Batinda Ferozpur Gurdaspur Hoshiarpur Jalandhar Sangrur Taran taran Bhatinda(SH)

Districts

No.

ofpa

tient

s


At least one examination room with all basic equipments was present in emergency departments of seven District Hospitals and both the special hospitals assessed. Out of these, one District Hospital and one special hospital had two examination rooms. All the registers including MLR were available in all district and special hospitals assessed. Call book in the prescribed format was not available at two District Hospitals.


Fig 5: Admissions through emergency in District Hospitals (Punjab) in the last five years

0

1000

2000

3000

4000

5000

6000

7000

8000

Bhatinda

Ferozp

ur

Gurdas

pur

Hoshiar

pur

Jalan

dhar

Ludhiana

Muktsar

Sangru

r

Taran tar

an

Bhatinda(S

H)

Districts

No.

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dmis

sion

s th

roug

h em

erge

ncy 1st Yr

2nd Yr3rd Yr4th Yr5th Yr

Waiting area for the attendants, with basic facilities like sitting arrangement, drinking water, toilets etc. were present in emergency department of all hospitals except Taran Taran District Hospital. Public telephone facility was found in only four District Hospitals and one special hospital.

Emergency department of all the hospitals had a retiring room for doctors with toilet facility. All the hospitals were having minor OTs for emergency procedures.

Suffi cient stock of essential and life saving drugs was observed in all the hospitals and all of them were having oxygen cylinders with attachments too.

Separate laboratory services in emergency department was observed in six District Hospitals and both the special hospitals assessed. All the hospitals were having imaging and ambulance services in their emergency departments.

Treatment facilities for dog/snake bite and poisoning were available in emergency departments of eight District Hospitals only. Similarly only seven District Hospitals were having plaster room in their emergency departments. Almost all hospitals were having staff trained in basic life support practices/system except in Gurdaspur and Muktsar District Hospitals.

5.1.22 Disaster management

Only two District Hospitals were having disaster manual and disaster alert code, recall and deployment arrangements. Eight District Hospitals were maintaining a separate drug store for disaster situations.


5.1.23 Intensive care unit (ICU)

Five District Hospitals out of ten were having Intensive Care Unit, while none of the two special hospitals assessed were having this facility. Numbers of beds available in the ICU of these fi ve hospitals were 10 in Jalandhar, 6 each in Bhatinda and Gurdaspur, 5 in Sangrur and 4 in Ludhiana. All of these ICUs were air conditioned with generator support. Regarding separate sanctioned staff in these ICUs, Gurdaspur was having two doctors and three nurses; Ludhiana was having one doctor and two nurses and ICU at other hospitals were without any sanctioned staff. None of these ICUs were having sanctioned technical staff.

5.1.24 Clinical laboratory

Pathology laboratories were present in all District Hospitals and special hospitals assessed except Ferozpur District Hospital. Microbiology laboratories did not exist in Gurdaspur District Hospital and the special hospital at Bhatinda. A qualifi ed pathologist was available in nine District Hospitals and both the special hospitals. A qualifi ed biochemist was present in only three District Hospitals and a qualifi ed microbiologist was present only in one i.e. Jalandhar District Hospital.

All hospitals were having facility for complete urine examination, stool test, blood urea, blood sugar, liver function test, blood grouping and matching test, semen examination and VDRL (Venereal disease research laboratory) test.

Special hospital at Bhatinda was not doing complete blood haemo analysis, while all other District Hospitals and special hospitals were doing it. All hospitals were doing lipid profi le and FNAC (Finel Needle Aspiration Cytology Biopsy) except Bhatinda special hospital and Ferozpur District Hospital. Three District Hospitals were not doing Pap smear.

Biopsies were done only by three District Hospitals and culture and smear examination by only fi ve District Hospitals. Out of ten districts and two special hospitals under study only District Hospital Sangrur was not doing vaginal discharge examination.

Bone marrow examination was done in only three District Hospitals out of ten District Hospitals assessed.

All these laboratories were found following universal precaution procedures and were using protective measures like gown, gloves, masks etc.


All hospitals were collecting specimens centrally except Gurdaspur District Hospital.

All the hospitals were having suffi cient chemicals and reagents and were observing all bio safety measures.

Laboratories of three District Hospitals were not having regular internal quality and external quality control measures.

5.1.25 Blood banking services

Blood banking facility was not available at one District Hospital i.e. Amritsar and both the special hospitals. Among the hospitals with blood bank facility, trained qualifi ed medical offi cers and other staff were present round the clock. All these blood banks were maintaining proper cold chain and refrigerators and doing proper checking and cross matching of blood. Australia antigen, HCV, VDRL, MP and HIV tests were done for every blood bottle of the donor in all these blood banks and efforts were made to collect blood through organising camps. All these blood banks have been renewing the blood banks and HIV licensing as per the rules.

5.1.26 Radiology and imaging services

Round the clock availability of X-ray services/sonography was present in all the District Hospitals assessed during the study.

All hospitals were having a dark room with all facilities. Moreover, only two District Hospitals and one special hospital were using a dosimeter. Seven District Hospitals and special hospital at Patiala were conducting special investigations like IVP, contrast media etc.

Separate register for MLC records was not found to be maintained in three District Hospitals and both the special hospitals. History book and log book of X-ray machines were maintained in all except in Ludhiana District Hospital and Bhatinda special hospital.

5.1.27 Operation theater (OT)

All the hospitals were having major and minor OT. Out of ten, two District Hospitals were having four major OTs each, four were having three major OTs, and one District Hospital and both the special hospitals were having two major OTs each. Rest were having at least one major OT. District hospital Jalandhar was having four minor OTs Muktsar hospital having three and rest of the hospitals having one minor OT each.

Zoning concept was strictly followed in seven District Hospitals out of ten and one special hospital out of two. All the hospitals were having emergency light- generator facility for the OT. Regular disinfection and sterilisation were done in the OT of all hospitals assessed in this study.

Availability of fi re-fi ghting equipments and knowledge to use them were found to be in all OTs except two District Hospitals and one special hospital.


Fig 6: Surgeries performed in District Hospitals (Punjab) in the last five years

0

5000

10000

15000

20000

25000

30000

35000

Amritsa

r

Bhatinda

Ferozp

ur

Gurdas

pur

Hoshiar

pur

Jalan

dhar

Ludhiana

Muktsar

Patiala

(SH)

Sangru

r

Taran ta

ran

Bhatinda(S

H)

Districts

No.

of s

urge

ries


5.1.28 In-patient wards

Almost all the hospitals were having satisfactory cleanliness of wards with adequate housekeeping services except District Hospital Gurdaspur. Wards of hospitals in Hoshiarpur and Gurdaspur were not having adequate and clean toilets and bathrooms.

Only at wards of District Hospital Taran Taran, proper bio medical waste management guidelines for collection and segregation of bio medical waste were not followed, but they were having table top syringe and needle destroyer as in other hospitals.

Wards in all hospitals were having adequate water supply and upkeep of sanitary blocks except Hoshiarpur. Adequate linen on bed was found in all district and special hospitals except in Gurdaspur and Sangrur hospitals. Three District Hospitals viz. Ferozpur, Ludhiana and Muktsar were having doubling of beds or fl oor beds.

Eight District Hospitals and one special hospital were having satisfactory upkeep of cots, mattresses, lockers, linen etc. in the wards. Only one District Hospital was using uniform for the patients.

Regarding availability of necessary equipments in the wards it was observed that nine District Hospitals and one special hospital had functional suction apparatus while in one District Hospital, although it was available but was non-functional. All hospitals were having functional oxygen cylinders with accessories while only six hospitals including one special hospital were having functional venesection/LP/tracheotomy tray. All hospitals were found having functional


emergency light, wheel chairs and stretcher trolleys.

Only two District Hospitals and one special hospital wards were not having stationery, forms and various updated registers.

Two District Hospitals were not found following the concept of progressive patient care. All hospitals were having adequate fans and lights. None of the hospitals assessed were providing diet to the inpatients.

5.1.29 Hospital medical store

Medical store, suitably located with adequate space was found available in eight District Hospitals and one special hospital. In six hospitals including both the special hospitals, staff members of the medical stores were found to have knowledge on material management, system of FIFO, bin cards, lead time, buffer stock etc. and CMO (Chief Medical Offi cer)/MO (Medical Offi cer) were found regularly inspecting the medical store and verifying stock books in all hospitals except Ludhiana and Sangrur. All hospitals were having restriction on entry of unauthorised personnel in the medical store.

Vital and essential drugs were found available in the medical stores of all hospitals under study except Sangrur and Ludhiana. Only fi ve District Hospitals were found up-keeping the expiry date register which was regularly inspected by the Medical offi cer.

Fig 7: No. of In-patients in District Hospitals (Punjab) in the last five years

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

Amritsa

r

Bhatinda

Ferozp

ur

Gurdas

pur

Hoshiar

pur

Jalan

dhar

Ludhiana

Muktsar

Patiala

(SH)

Sangru

r

Taran ta

ran

Bhatinda(S

H)

Districts

No.

of I

n-pa

tient

s



Eight hospitals including both the special hospitals were found making efforts to redistribute large stocks of slow moving drugs or near expiry drugs for its timely utilisation, while only four District Hospitals were having proper arrangements to keep drugs as per ABC/VED category and storage of rubber goods as per guidelines.

Medical stores of all the hospitals, except Taran Taran and Ludhiana, were not taking appropriate steps to prevent pilferage of drugs. All hospitals, except Ludhiana and Amritsar, were found having convenient arrangements of issuing drugs to various wards. Only four District Hospitals were found regularly sending samples to chemical laboratory for checking the standard of drugs.

All hospitals except Ludhiana were circulating list of available drugs to all MOs, OPD and wards as per generic name.

At fi ve District Hospitals and both the special hospitals, the medical store was submitting certifi ed bills to offi ce for release of payment within three days. Auction to clear the empty material from store was done regularly in six hospitals only, including one special hospital.

Availability of fi re-fi ghting equipments and knowledge to use them were found at medical stores of only four hospitals including one special hospital.

Standing drug committees were found in only fi ve District Hospitals, and only two District Hospitals were having a regularly updated hospital drug formulary.

5.1.30 Medical record department

Seven District Hospitals and one special hospital were having a medical record room with enough number of racks. Medical record room was found to be managed by a trained medical record offi cer or technician in 50% of District Hospitals and both the special hospitals.

Case records were maintained as per WHO classifi cation of disease (ICD-X schedule) in only three District Hospitals and one special hospital. All hospitals were found regularly submitting morbidity and mortality reports except in District Hospital of Taran Taran. None of these hospitals were found maintaining the basic hospital utilisation indices like Bed Occupancy Rate, Average Length of Stay, Bed Turnover Interval, Death Rate etc. on a regular basis and in a proper scientifi c way.

All the records were found to be maintained for ten years in fi ve District Hospitals and special hospital at Patiala, fi ve years in two District Hospitals and one special hospital, seven years in Amritsar and fourteen and fi fteen years in Muktsar and Bhatinda District Hospitals respectively. Only three District Hospitals and one special hospital were having back up facility to safe guard these records and only fi ve hospitals including one special hospital were following effective retrieval system.

Medical audit was done at regular intervals in seven hospitals including one special hospital and


regular death audit meetings were held and corrective action was taken in only three District Hospitals and special hospital at Patiala.

5.1.31 Hospital waste management

Adequate number of bins and bags of the required colour codes were available and placed strategically in all patient care areas in all the hospitals except Amritsar District Hospital.

Proper segregation and collection of waste was done with proper packaging and record keeping in almost all hospitals except Amritsar District Hospital. Gurdaspur, Amritsar and Jalandhar hospitals were also found lacking in proper storage facilities of waste.

All hospitals were found following proper transportation of the collected waste. Waste disposal was outsourced in all hospitals assessed except at Sangrur District Hospital.

Six District Hospitals along with both the special hospitals were found following the disposal/recycling methods appropriately for various categories of waste.

5.1.32 Central sterile supply department (CSSD)

Nine District Hospitals and one special hospital at Bhatinda were having CSSD under supervision of trained staff/senior nursing offi cer. Special hospital at Patiala was not having any CSSD. Eight District Hospitals and one special hospital were also having all the required equipments and autoclaves. Physical and chemical quality control measures were followed in seven District Hospitals and special hospital Bhatinda and biological quality control measures were followed in six District Hospitals along with special hospital at Bhatinda.

5.1.33 Laundry services

Out of ten District Hospitals, nine were having in-house laundry services, while this service was found to be outsourced at only one hospital. Both the special hospitals were having mechanised in-house laundry service. At fi ve District Hospitals laundry was of conventional (dhobi) type, while it was mechanised at the remaining fi ve.

Quality of wash and linen was good in seven District Hospitals and both the special hospitals. In rest of the District Hospitals it was average.

5.1.34 Kitchen facility

Kitchen facility was not found available in any of the studied district and special hospitals.

5.1.35 Utilisation of patient care services

Analysis of the last 5 years’ data showed that in all the District Hospital the number of patients


Fig 8: Percent of expenditure of the user charges on Medicine of different District Hospitals (Punjab)

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

Bhatinda Ferozpur Gurdaspur Hoshiarpur Jalandhar Ludhiana Patiala (SH)

Perc

ent c

ost (

Rs)

2003-04 2004-05 2005-06 2006-07 2007-08

Fig 9: Percent of expenditure of the user charges in IPF of different District Hospitals (Punjab)

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00


Perc

ent c

ost (

Rs)

2003-04 2004-05 2005-06 2006-07 2007-08

utilising various medical care facilities including diagnostic and therapeutic, from in-patient and out-door either marginally or steadily increased almost all the District Hospitals.

5.1.36 Utilisation of user charges

Year-wise expenditure of the User Charges made under the following major heads i.e. medicines, improvement of In-patient Facilities (IPF), Building Maintenance and Equipments Maintenance. The expenditure made under the head Medicines was 40% to 50% in most of the District Hospitals except at Ludhiana where it went upto 80% and then came down to 50% over the next 4 years.


Fig 10: Percent of expenditure of the user charges on buildings of different District Hospitals (Punjab)

0

10

20

30

40

50

60

70


Per

cent

cos

t (R

s)

2003-04 2004-05 2005-06 2006-07 2007-08

Fig 11: Percent of expenditure of the user charges on equipments of different District Hospitals (Punjab)

0

2

4

6

8

10

12

14

16

18


Perc

ent c

ost (

Rs)

2003-04 2004-05 2005-06 2006-07 2007-08

Regarding expenditure on IPF head, it was found to be to be around 20% in most of the District Hospitals.

In maintenance of buildings the expenditure was 5% to 10% over the years except for the Special Hospital of Patiala in the fi rst year, which was recorded around 63%.


In most of the District Hospitals, expenditure on medical equipments recorded less than 10% over the years, except at Bhatinda, Ferozpur and Ludhiana where in some years it was more than 10%.

5.2 Sub-divisional Hospitals (SDHs)

Total ten Sub-Divisional Hospitals (SDH) were assessed and facility survey was done as per the pre-structure32d checklist. These Sub-Divisional Hospitals were at Ajnala, Batala, Dasuya, Fazilaka, Jagraon, Maler Kotla, Malout, Nakodar, Patti and Talwandi. The General Profi le and facility survey of Sub- Divisional hospitals is given in the Tables Section (Refer Table – 2.)

5.2.1 Accessibility

All Sub-Divisional Hospitals (SDHs) were easily accessible from the railway station and bus stand and were well connected with the roads.

5.2.2 Water supply

All SDH were having adequate water supply. Seven SDH were having bore well supply, while three of them i.e. Maler Kotla, Malout and Talwandi were having Municipal water supply. One day storage capacity of water was found available at three SDH, while rest seven were having storage capacity of three days.


Electricity supply was found to be regular in six SDHs, while it was irregular in rest of the hospitals. Only one hospital (Fazilaka) was having double phase electric supply, while rest of the nine hospitals were having three phase electric supply. All the hospitals were found having back up generator system except Nakodar Sub-Divisional Hospital.

5.2.4 Availability of lift and ramps

Most of the Sub-Divisional Hospital were single storey buildings. Facility of lifts was available only at Malout Sub-Divisional Hospital. Ramp was available at all hospitals except Batala, Fazilaka and Jagraon.

5.2.5 General impression on cleanliness and maintenance of gardens

Eight hospitals were having good cleanliness whereas it was found average at two hospitals.

Upkeep of garden was found to range from `average to good’ at most of the Sub-Divisional Hospitals except Ajnala and Jagraon.

5.2.6 Signs, roads and lighting

Signage was found good in six Sub-Divisional Hospitals. Rest of the four hospitals were having average sign postings. Roads and lighting of eight hospitals were found good and two average.


5.2.7 Status of buildings

Buildings of eight Sub-Divisional Hospitals were found to be in good condition while at two Sub-Divisional Hospitals (Patti and Talwandi) it was average.


Out of all the Sub-Divisional Hospitals studied, three were having chemist shops, two were having STD/PCO booths, and only one was having a grocery shop and a cycle stand within the hospital premises. Fifty percent (five out of ten) of the Sub-Divisional Hospitals studied were having a functional canteen. Five hospitals were also found to have Sulabh Shochalaya.


Although facility of ambulance services was available at all the Sub-Divisional Hospitals but only three of them, namely Batala, Fazilaka and Maler Kotla were fully equipped. Seven SDH were having two ambulances while another two viz Dasuya and Talwandi were having three ambulances. Ajnala hospital had only one ambulance and that too was found to be only partially equipped.

5.2.10 Dental services

All the Sub-Divisional Hospitals were found providing dental services except one hospital at Fazilaka.

5.2.11 Maternity services

Maternity services were provided at all the Sub-Divisional Hospitals assessed in the present study.

5.2.12 Mortuary services

Mortuary services with cold storage and other preservative facilities were found to be present at seven out of ten Sub-Divisional Hospitals, whereas facilities of post mortem were available at eight hospitals. Fazilaka was the only SDH where although the mortuary services were available, facilities for post mortem were absent.


Only Nakodar and Patti SDH’s were having a drug formulary committee. Nakodar SDH was found to be the only one with a hospital antibiotic committee. Hospital infection control committee was present at Batala, Nakodar and Patti SDH. Store purchase committee was present at all SDH except at Maler Kotla.

Similarly, store inspection committee was present at all SDHs except Maler Kotla and Fazilaka. Five of the ten SDH assessed were found having a Medical Audit/Death Review Committee.



Out of the ten Sub-Divisional Hospitals assessed, fi ve were having a drug formulary. Almost all hospitals were found to have dual drug supply. They get drugs and equipment supply directly from the state and they can also purchase on their own through user charges money. Buffer stock was found to be maintained at all the SDHs, except Ajnala and Patti. Reorder levels were found to be maintained only at Ajnala, Dasuya, Jagraon and Nakodar SDH.

All the SDHs except Ajnala and Patti were found having annual maintenance procedures for costly equipment. Fazilaka, Maler Kotla and Patti SDH were not maintaining log book and history sheet for the equipment. The present status of the existing equipments was found to be average at seven SDHs and good at Batala, Dasuya and Malout SDH.

5.2.15 Major equipment

Six out of the ten Sub-Divisional Hospitals were having baby incubators but the incubator at Fazilaka SDH was not found functional at the time of visit.

Boyle’s apparatus was available and functional at all the SDH except Fazilaka, where it was not functional.

Cardiac monitor was available in all SDHs except Dasuya and Jagraon. The cardiac monitors at Ajnala and Fazilaka SDH were found to be non-functional.

Dental chair was available at all SDHs but it was not functional at Ajnala and Fazilaka.

Dosimeter was available only at Maler Kotla and Malout SDH and out of these it was found functional only at Malout SDH.

ECG machine was available and functional at all the SDHs except Fazilaka.

Emergency resuscitation kit was available and functional at all the SDHs.

Fibre-optic Endoscope was not available at any of the SDH assessed.

Malout was the only Sub-Divisional Hospital without an ophthalmoscope, while rest of the SDH were having a functional ophthalmoscope. Perimeter was available only at Maler Kotla and it was found to be functional. Five of the ten SDHs assessed were having a Retinoscope, which was functional. Slit lamps, which were also in working condition, were present only at fi ve SDHs.

Short wave diathermy (Physiotherapy) unit was available and functional at Fazilaka and Nakodar SDH.


Sigmoidoscopes were present only in two Sub-Divisional Hospitals but these were found to be non-functional.

X-ray facility was available and functional in all Sub-Divisional Hospitals. Ultrasound was present at all SDH except Talwandi. The ultrasound at Patti SDH was not functional.


Referral facilities were available in all SDH but referral manual was present only at six out of ten SDH’s studied. Guidelines for what to refer and when to refer were present at fi ve SDHs whereas guidelines for how to refer were present at six places.

Colour coded referral cards were available at fi ve and feedback mechanism existed at four Sub-Divisional Hospitals. Transport facility was provided by all the SDHs. Maintenance of records and registers was done at all except Talwandi SDH. Incentive for following the referral route in the form of provision of ambulance was available only at Fazilaka SDH.

All the SDHs were found to refer their patients to government/District Hospitals/medical colleges except Nakodar and Talwandi SDH. For diagnostic purposes, fi ve SDHs were found to have a tie-up with other hospitals (both public and private).

Statistical Bulletin was available only in four SDHs and out of them two were also having monthly bulletin and two fortnightly bulletins.

5.2.17 Outreach services

Out-reach area services in the form of MCH camp, Eye camp, Blood donation camp and IEC were found to be available only at Fazilaka, Jagraon, Maler Kotla and Talwandi SDH.

5.2.18 Residential area

Residential accommodation for the essential staff members was available at all SDHs except Ajnala and Jagraon. However, only four of these were having in house security services. Non availability of accommodation at four of these places was more than 50%.

None of the Sub-Divisional Hospitals were found to have the facility of Dharamshalas.

5.2.19 Out-patient department

Reception and registration counters were present in all the Sub-Divisional Hospitals (four were having computerised registration and rest of them manual). These counters were managed by a clerk in one SDH, by MSW in another one, by clerk/MSW in two others and a computer operator in fi ve SDHs. Staff manning these counters was knowledgeable about the OPD procedures.

There were separate registration counters for male, female and staff members at three SDHs. Four SDHs were having a separate registration counter for senior citizens as well. Registration registers were properly maintained and entries were made in all SDHs except at Malout.


In all SDHs, all sections of OPD were having proper signage and directional sign except at Ajnala and Maler Kotla. Waiting area was found to be adequate in six out of ten SDHs and only fi ve SDHs were having proper sitting arrangement.

Drinking water facility, Ceiling fans, Toilet facility, doctor’s chamber with adequate space, examination table with proper sheet, stool for patients to sit and examination equipments (like torch, BP apparatus and hammer etc.) were available in almost all the Sub-Divisional Hospitals. However toilet facility was not available at Nakodar. Examination table with proper sheet was not present at Jagraon SDH. All the hospitals were having adequately illuminated OPDs. Injection room along with facilities to deal with emergency situations was not available at Maler Kotla and Patti SDH. Similarly, Talwandi and Patti SDH were not having Minor OT/Dressing room with all the basic equipments.

Only fi ve Sub-Divisional Hospitals were having dispensaries/pharmacy with separate counters for male/female/senior citizens/staff.

Laboratory and imaging services were easily accessible from the OPD in all the Sub-Divisional Hospitals. All SDHs were having a central collection centre for laboratory services except Maler Kotla SDH.


All the Sub-Divisional Hospitals assessed were found having round the clock emergency services, with almost all the basic facilities.

There was a separate medical offi cer available round the clock for emergency situations in seven Sub-Divisional Hospitals out of ten. Glow sign board displaying emergency service department

Fig 12: No. of OPD Patients in Sub-Divisional Hospitals (Punjab) in the last five years

0

20000

40000

60000

80000

100000

120000

140000

160000

180000

Ajnala

Batala

Dasuya

Fazila

ka

Jagrao

n

Malerko

tka

Malout

Nakodar

Patti

Talwan

di

Sub-divisional Hospitals

No.

of O

PD P

atie

nts



was seen at fi ve SDHs and board displaying doctors/specialists on call in emergency was seen at eight SDHs.

Emergency wards were found attached to the emergency department in all SDHs except Ajnala, with observation bed strengths ranging from 1 to 12. Four of these ten SDHs were not having any triage area. Trolleys and wheel chairs (ranging from 1 to 4 in number) were present in all SDHs.

Examination rooms with all basic equipments and all the registers including MLR were available in emergencies of all SDHs. Emergency department at all SDHs also had a retiring room for doctors with toilet facility except at Malout hospital. Call book in the prescribed format was seen only at four SDHs assessed.

Waiting area for the attendants of the patients with basic facilities like sitting arrangements, drinking water, toilets etc were available in emergency departments of seven SDHs, but public telephone facility was found at only two places.

Five SDHs had Major OT for emergency services whereas treatment room cum minor OT for various emergency procedures was present in emergency departments of all SDHs.

All SDHs were having oxygen cylinders with attachments and suffi cient stock of essential and life saving drugs was available in almost all the SDHs except at Ajnala.

Laboratory, imaging, and ambulance services were available at emergency departments of all the Sub-Divisional Hospitals. All the SDHs were having staff trained in basic life support except at Malout and Talwandi.

Fig 13: Emergency Patients in Sub-Divisional Hospitals (Punjab) in the last five years

0

1000

2000

3000

4000

5000

6000

Ajnala Batala Dasuya Jagraon Malerkotka Malout Nakodar Patti Talwandi


No.

of p

atie

nts



Treatment facilities for dog/snake bite and poisoning were available at emergency departments of eight SDHs (except Patti and Talwandi).


Only three SDHs (viz. Dasuya, Fazilaka and Nakodar) were having Disaster manual and all these three were having disaster alert code, as well as recall and deployment arrangements. Seven SDHs were maintaining a drug store for disaster situation. Plaster room was present at six SDHs.

5.2.22 Intensive care unit (ICU)

ICU was available at only four SDHs viz. Ajnala, Batala, Patti and Talwandi, with the bed strength ranging from 2 to 6 beds. None of these ICUs were found to be air-conditioned and were also not having any back up generator support.

Staff sanctioned specifi cally for ICU was present only at Ajnala Sub-Divisional Hospital (Doctor-1, Nurse-1, Technical staff-1 and class IV-1). Similarly record keeping of the patients was found to be done only at Ajnala SDH.

Oxygen/suction apparatus/compressed air were available at Ajnala, Batala and Talwandi SDH. Defi brillator and ventilator were not available at any of the SDH, whereas ECG machine was available only at Batala SDH. Only Batala and Talwandi SDH were found to have all the life saving vital drugs. Strict aseptic procedures were found to be followed only at the Batala SDH.


A pathology as well as microbiology laboratory was present in half of the Sub-Divisional Hospitals assessed during the study. Qualifi ed pathologists and microbiologists were found present at four of these hospitals respectively. None of the hospitals were having a qualifi ed biochemist.

All Sub-Divisional Hospitals were having facility for complete blood haemogram analysis except Batala and Patti SDHs. Complete urine examination was available at all the Sub-Divisional Hospitals.

Ajnala SDH was found not conducting stool tests whereas Blood Urea and Blood sugar tests were not conducted by Patti SDH. All of the rest SDHs were providing these laboratory facilities.

Facility of liver function test was available at fi ve SDHs, lipid profi le at four, FNAC at one, culture and smear examination at one, semen examination at eight, vaginal discharge examination at two, bone marrow examination at one and other routine tests like HIV/pregnancy tests at six SDHs.

Blood grouping and matching test and VDRL tests were done at all the SDHs. Pap smear and biopsy were not done at any of the SDH.


Six of ten SDHs were found following universal precaution procedures and were using some protective measures like the use of gown, gloves, masks etc. All necessary laboratory chemicals and reagents were available at all SDHs except at Ajnala Sub-Divisional Hospital.

Specimens were collected centrally in all the ten SDHs. All of them were observing the bio-safety measures except Ajnala and Maler Kotla SDH. Regular internal and external quality control measures were found being undertaken by twelve SDHs respectively.


Batala, Dasuya, Fazilaka, Maler kotla, Nakodar and Patti SDH were having the facility of a blood bank. Trained or qualifi ed medical offi cer as Blood Transfusion Offi cer was present at Batala, Dasuya, Fazilaka and Nakodar SDH, while no such offi cer was available at Maler, Kotla and Patti SDH. Round the clock availability of trained staff and services was a feature of all SDHs except Maler Kotla.

All SDHs having blood banks were found following all the procedures like - checking and cross matching of blood by B.T.O; proper maintenance of cold chain and refrigerators; Australia antigen, HCV, VDRL, MP and HIV tests for every blood unit of donor; renewal of blood bank/HIV license as per rules; disposal of HIV positive blood bags and undertaking bio-safety measures and availability of table top syringe and needle destroyer and, colour coded bags. Efforts were made to collect blood through voluntary blood donation camps at fi ve sub divisional hospitals out of the six having a blood bank.

Feedback of transfusion and record maintenance of untoward incidences was found being done at Batala, Dasuya, Maler kotla and Nakodar SDH.

5.2.25 Radiology services

Round the clock availability of X-ray services/sonography was present at six SDHs. However, radiologists were available only at two out of these.

X-ray machines (500/300mA) were available at all the SDHs visited, but they were not found working at Batala and Dasuya SDH. X-ray machines (200/100mA) were available at fi ve SDH and out of these only three were found functional; rest two were pending for condemnation. X-ray machines (moblie/60mA) were available at six SDHs and all of them were in functional status.

All SDH were having a dark room with all the required facilities. Dosimeter was used only at Maler Kotla and Malout SDH and they send these dosimeters regularly to BARC for evaluation. Special investigations like IVP; contrast media etc. were available and conducted at four SDHs.

Separate register for MLC records was found to be maintained at all the SDHs; and all of them except Patti SDH were found maintaining history sheet and log book of X-ray machines.

5.2.26 Operation theatre

Dasuya Sub-Divisional Hospital was having three major operation theatres whereas hospitals at Fazilaka, Malout and Patti were having one major operation theatre each. Rest of the hospitals


were found to have two operation theatres. All the hospitals assessed were having at least one minor operation theatre with the exception of Malout and Nakodar hospitals with two minor operation theatres.

All SDHs were having major and minor OTs, except Jagraon SDH, which was not having a minor OT. Zoning concept in OT was followed at six SDHs.

Fig 13: Normal Deliveries conducted in Sub-Divisional Hospitals (Punjab) in the last five years

0

100

200

300

400

500

600

700

800

900

Ajnala

Batala

Dasuya

Fazila

ka

Jagrao

n

Malerko

tka

Malout

Nakodar

Patti

Talwan

di


No.

of N

orm

al D

eliv

erie

s


Fig 14: Caesarians done in Sub-Divisional Hospitals (Punjab) in the last five years

0

100

200

300

400

500

600

Ajnala Batala Dasuya Fazilaka Jagraon Malerkotka Nakodar Patti Talwandi


No.

of c

aesa

rians



Boyle’s apparatus was available in OT of all the SDHs and the same was found under repair at two of them. Boyle’s apparatus at Ajnala SDH was found pending for condemnation. All the SDH were having hydraulic operation tables. Operation tables at three of these hospitals were found to be under repair and at one for condemnation.

Shadowless lamps were available at all the hospitals. One lamp each at Fazilaka and Maler kotla SDHs were under repair. Fumigation apparatus was available at six SDHs. One out of the two available fumigation apparatus at Jagraon SDH was found to be under repair. Suction apparatus was available at all the SDHs, but one of the two suction apparatus at Patti SDH was under repair. All SDHs were having air conditioned OTs. Electrical cautery was available at all the SDHs. However, it was not functional and under repair at Ajnala, Batala and Jagraon SDH.

Endoscope in the operation theatre was available at Fazilaka SDH only while laryngoscope was available at Batala, Dasuya, Fazilaka, Maler Kotla and Nakodar SDH.

Facility of cardiac monitor was available at six SDHs and that of cardiac defi brillators at two SDHs. Pulse oxymeters were found to be available at all the SDHs except at Batala and Jargaon.

All SDHs were found to maintain OT records, but maintenance of OT postponement records were done only at two SDHs. Emergency light or back up generator facilities to the OTs were available in all SDHs. Availability of fi re-fi ghting equipments and knowledge to use them was found in OTs of fi ve SDHs. Regular disinfection and sterilisation procedures were done at OTs of all sub divisional hospitals.


Almost all SDHs were having satisfactory cleanliness of wards, with adequate housekeeping

Fig 15: Patients admitted in Sub-divisional Hospitals (Punjab) in the last five years

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

Ajnala

Batala

Dasuya

Fazila

ka

Jagrao

n

Malerko

tka

Malout

Nakodar

Patti

Talwan

di


No.

of P

atie

nts



services. All SDHs had adequate and clean toilets and bathrooms and; adequate and proper linen for all the beds except at the Batala SDH.

At Batala and Talwandi SDH, the wards were not found to follow proper bio medical waste management guidelines for collection and segregation of bio medical waste; Talwandi SDH, in addition, was not having table top syringe and needle destroyer, whereas at Ajnala and Batala SDH, although the table top syringe and needle destroyer were available, they were not properly utilised.

Wards in all SDH except Talwandi were having adequate water supply and upkeep of sanitary blocks. None of the SDH had doubling of beds or fl oor beds.

All SDHs under study were having satisfactory upkeep of cots, mattresses, lockers, linen etc. in the wards except at Batala and Malout. Uniform for the patients was found to be used only at Jagraon SDH.

Regarding availability of necessary equipments in the wards, it was observed that all SDHs were having functional suction apparatus except Malout, where it was not available. Oxygen cylinders with accessories were available in functional condition at all SDHs. Functional venesection/LP/tracheotomy tray were available at all SDHs, except Malout, Patti and Talwandi. Eight SDH were having functional emergency light/wheel chairs/stretcher trolley.

All SDHs were found to have adequate stationery, forms and various updated registers, and they were found maintaining various registers and records required in the ward.

Concept of progressive patient care was not followed at Ajnala and Jagraon SDH. All SDHs were having adequate and working fans and lights. Only Malout SDH was providing diet to the inpatients.


Medical stores were found suitably located with adequate space and protection of drugs and non-drug items from pilferage, temperature and humidity at Dasuya, Fazilaka, Jagraon and Nakodar SDH. There was no restriction on entry of unauthorised personnel in the medical store at Maler kotla and Patti SDH. At seven SDHs, staff members of the medical stores had knowledge on material management, system of FIFO, bin cards, lead time, buffer stock etc., while at the remaining three hospitals the staff responsible was not having this knowledge. CMO/MO were found regularly inspecting the medical stores and verifying stock books at all SDHs except Maler Kotla.

Availability of vital and essential drugs was found at medical stores of all SDHs except Ajnala. Up-keep of the expiry date register and its regular inspection by the medical offi cer was observed at six out of the ten SDHs under study.

At seven SDHs, efforts were made to redistribute large stocks of slow moving drugs or near expiry drugs for its timely utilisation, while only four SDHs were having proper arrangements


to keep drugs as per ABC/VED category and storage of rubber goods as per guidelines.

Medical stores of six SDHs were taking appropriate steps to prevent pilferage of drugs, while all SDHs except Ajnala were having convenient arrangements of issuing drugs to various wards. Six out of ten SDHs were regularly sending samples to a chemical laboratory for checking the standard of drugs and to take necessary action thereon.

All SDHs except Maler Kotla were circulating list of available drugs to all MOs, OPDs and wards as per their generic names.

Medical stores of all SDHs except Jagraon, were submitting certifi ed bills to offi ce for release of payment with in three days. Auction to clear the empty material from store was found to be done regularly at only fi ve SDHs.

Availability of fi re-fi ghting equipments and knowledge of staff to use them was found in medical stores of fi ve SDHs.

Standing drug committee and availability of regularly updated hospital drug formulary was found at only fi ve SDHs out of ten.


Only fi ve SDHs were having medical record room with enough number of racks and cup boards. Record keeping in medical record room was manual in all the SDH assessed, except Jagraon where it was computerised. Trained staff comprising medical record offi cer or technician was present at all SDHs, except Maler Kotla. However, in spite of this, the condition of the medical records was not found satisfactory. None of these hospitals were found maintaining some of the basic hospital utilisation indices like Bed Occupancy Rate, Average Length of Stay, Bed Turnover Interval, Death Rate etc. on regular basis and in proper scientifi c way.

Case records were maintained as per WHO classifi cation of disease (ICD-X schedule) at only three SDHs. All SDHs except Patti were regularly submitting their morbidity and mortality reports.

Duration for which the record was maintained ranged from 5 to 10 years. Back up facility to safe guard these records was present at Ajnala, Dasuya, Fazilaka and Malout SDH. Five SDHs were having effective retrieval system. Six SDHs were found holding regular death and medical audit.


Adequate number of bins and bags of required colour codes were found available at all SDH except Talwandi; and these were found placed strategically in all patient care areas at seven out of these SDHs.


Proper segregation, collection of waste with proper packaging and record keeping, proper transportation and storage of waste was seen in almost all SDHs except Talwandi, where proper segregation and collection were lacking and Ajnala, where proper collection, packaging, labelling and record keeping were lacking. All SDHs were having proper storage facility and transportation for the biomedical waste.

Waste disposal was found to be outsourced at all SDHs except Maler Kotla and Malout. Disposal/recycling methods for various waste categories were done at six SDHs. Autoclaves and shredders were not available at Ajnala, Fazilaka and Malout SDH.

5.2.31 Central sterile supply department (CSSD)

All SDHs except Maler kotla and Malout were having CSSD under supervision of trained staff/senior nursing offi cer, and these SDH were having all the required equipments and autoclaves.

Physical and chemical quality control measures were found to be followed at CSSD of seven; whereas biological quality control measures were followed at six SDHs.


Among ten SDHs under study, fi ve were having in house laundry service while the remaining fi ve were found to have outsourced laundry services. Laundry was of conventional (dhobi) type in fi ve SDHs and mechanised in rest of the SDH. Laundry staff was found to be adequate only at four SDHs. Quality of linen as well as quality of wash was good at four SDHs only, while in rest SDHs it was found average.


Kitchen facility was present only at Maler Kotla Sub-Divisional Hospital, with proper and safe arrangement for storage of raw material.

5.2.34 Utilisation of patient care services

Analysis of the last 5 years’ data showed that at all SDHs the number of patients utilising various medical care including diagnostic and treatment from in-patient and outdoor came down in fi rst 2-3 years. But after that, it steadily increased (though at a slower rate) during the recent years.

However, the fi gures for the delivery services were not found very encouraging, during the last 5 years and in almost all the districts, these fi gures fl uctuated on either side. Therefore, it is not only very diffi cult to conclude anything from this data, but it was found very much disturbing, that in some places the numbers have actually come down. One of the reasons may be irregular availability of the gynaecologist and its associated basic facilities in these hospitals.


Fig 16: Percent of expenditure of the user charges in medicine of different Sub-Divisional Hospitals (Punjab)

0

20

40

60

80

100

120

Dasuya Fazilka Ajnala Batala Jagraon Malar Kotla Malout Patti Talwan-di Saboo

Perc

ent c

ost (

Rs)

2003-04 2004-05 2005-06 2006-07 2007-08

Fig 17: Percent of expenditure of the user charges in IPF of different Sub-Divisional Hospitals (Punjab)

0

10

20

30

40

50

60

70

Dasuya Fazilka Ajnala Batala Jagraon Malar Kotla Malout Patti Talwan-di Saboo

Perc

ent c

ost (

Rs)

2003-04 2004-05 2005-06 2006-07 2007-08


Year-wise expenditure of the user charges made under the following major heads i.e. medicines, improvement in-patient’s facilities (IPF), maintenance of buildings and equipments. The expenditure made under the head medicines was 40% to 45% in most of the Sub-Divisional Hospitals except at Ajnala where maximum expenditure made on fi rst 4 years (2002-06) whereas very low during the year 2006-07.


Fig 18: Percent of expenditure of the User charges in building of different Sub-Divisional Hospitals (Punjab)

0

5

10

15

20

25

Dasuya Fazilka Ajnala Batala Jagraon Malar Kotla Malout Patti Talwan-diSaboo

Perc

ent c

ost (

Rs)

2003-04 2004-05 2005-06 2006-07 2007-08

Fig 19: Percent of expenditure of the user charges in equipment of different sub-divisional hospitals (Punjab)

0

5

10

15

20

25

30

35

Dasuya Fazilka Ajnala Batala Jagraon Malar Kotla Malout Patti Talwan-diSaboo

Perc

ent c

ost(R

s)

2003-04 2004-05 2005-06 2006-07 2007-08

Regarding IPF, most of the Sub-Divisional Hospitals utilised 20% to 25% of the user charges over the years.

In maintenance of buildings, majority of the Sub-Divisional Hospitals used less than 15% of the users charges except Fazilka, Batala and Jagraon.

In maintenance of equipment majority of the Sub-Divisional Hospitals spent less than 10% of the user charges over the year, except the hospitals at Ajnala, Jagraon and Talwan-di Saboo where it was more than 10% in some years.


5.3 Community Health Centres (CHCs)

Facility survey was done at total of eleven CHCs as per the pre-structured checklist. These CHCs were Badal, Fatehgarh, Ferozshah, Goniana, Kartarpur, Khemkra, Longowal, Machiwar, Mahilpur, Majitha and Manawala. The general profi le and facility survey of CHCs is given in the Tables Section (Refer Table – 3).

5.3.1 Accessibility

All CHCs assessed were easily accessible from the railway station and bus stand and were well connected with the roads.

5.3.2 Water supply

Almost all CHCs were having adequate water supply except CHC Manawala. Nine CHCs were having bore well supply while two CHCs i.e. Badal and Goniana were with Municipal water supply. Water storage capacity was found to be one day at 4 CHCs, three days at another 4 CHCs and for two days at remaining three CHCs.


Electricity supply was found to be irregular in most of the CHCs and only three CHCs at Kartarpur, Mahilpur and Majitha, were having regular supply to some extent. Only one CHC was with double phase electric supply, while rest of the CHCs were having three phase electric supply. Back up generator system was available at all the eleven CHCs.

5.3.4 General impression on cleanliness and up keep of gardens

Six CHCs maintained good cleanliness while fi ve were found to be average.

Only two CHCs were having good upkeep of the garden and rest were having average landscaping. Only one CHC was found to have poor upkeep of the garden.

5.3.5 Status of Buildings

Regarding status of the building, nine CHCs were in good condition and at two CHCs i.e. Khemkara and Mahilpur, buildings were in average condition.

5.3.6 Sign, roads and lighting

Signage was found poor in Khemkara CHC whereas, it was good at six CHCs. Rest of the CHCs were having average sign posting. Roads and the lighting system were good at seven CHCs, average at three and found poor at one CHC.



Out of all the CHCs studied, none were having a chemist shop or a grocery shop within the premises and only one CHC was having a canteen. Three out of 11 CHCs were having Sulabh Shochalaya.


Ambulance facility was available in all the CHCs studied. Out of these, six CHCs were having at least one ambulance and rest were having two or more ambulances. These ambulances were found to be partially equipped except at two CHCs, where ambulances were well equipped to some extent.

5.3.9 Intensive care unit

None of the CHCs were having intensive care unit; however all the CHCs were found to have round the clock emergency services.

5.3.10 Other services (patient care)

Except two CHCs all were having dental services and all eleven CHCs were having delivery services.

5.3.11 Mortuary

None of the CHCs were having mortuary or post mortem facilities.


Out of eleven, only one CHC was having a drug formulary and hospital antibiotic committee, eight CHCs were having a store purchase and store verifi cation committee, while only three CHCs were having hospital infection control committee and medical audit/death review committee.


Almost all CHCs were having dual drug supply. They receive drugs and equipment supply through the state and also buy on their own utilising user charge money. Only three CHCs were found to have their own drug formulary. Seven CHCs were maintaining buffer stock, while only four CHCs followed reorder level.

Five CHCs were having annual maintenance contracts for costly equipment, while six CHCs maintained log book and history sheet for the available equipment.

5.3.14 Major equipments

Only one CHC was not having Boyle’s apparatus with circle absorber and two CHCs were lacking the facility of dental chairs.

Emergency resuscitation kit was present at all CHCs except Badal CHC.


Eight CHCs were having ophthalmoscope, but it was found to be non functional at one of these CHCs.

Sigmoidoscope was only present in three CHCs. Other major and minor operation equipment was not found present at CHC Manawala.

X-ray facility was available in all CHC except in one CHC i.e Manawala.


Referral facilities were available in all CHCs except Manawala; however, proper referral manual and guidelines for referring patients were not present in most of the CHCs. Colour coded referral cards were found to be present only at fi ve CHCs and feedback mechanism existed only at CHC Longowal.

Transport facilities were provided by almost all the CHCs except CHC Manawala, as referral facilities were not present here. Only one CHC was not maintaining records and registers other than CHC Manawala.

Seven CHCs were found to have a tie-up with other hospitals (both public and private) for diagnostic or referral purposes and most of them were with government hospitals or medical colleges except CHC Kartarpur, which had a tie-up only with private hospitals.

Statistical bulletins were available only at four CHCs; and out of these three were also having monthly bulletin and one CHC fortnightly bulletin.


5.3.16 Outreach services

Six CHCs were having an outreach area and services provided were mainly maternal and child health.

5.3.17 Residential area

Only one CHC was not having residential accommodation for the essential staff. Besides this, six CHCs mentioned that they were having some sort of security services, which was mainly in house.

None of the CHCs had the facility of dharamshala.

5.3.18 Out-patient department

Reception and registration counter was maintained by a clerk at one CHC, by a staff nurse at three CHCs, by a pharmacist at six CHCs and remaining one CHC was found to be managed by either staff nurse or pharmacist.

Separate registration counters for male, female and freedom fi ghters were available only at two CHCs, while rest of them were having single registration counters. Only one CHC was having separate registration counters for staff and senior citizens. Registers used for registration were properly maintained and entries were found to be made at all CHCs.

At all CHCs, OPDs were having proper signage and directional sign in every section. Waiting area was found to be adequate at ten CHCs, and proper sitting arrangements were available at 9 CHCs.

Fig 20: No. of OPD attendance at CHC hospitals (Punjab) in the last five years

0

10000

20000

30000

40000

50000

60000

70000

80000

Badal

Fate

garh

Fero

jsha

h

Gonia

na

Karta

rpur

Khem

kara

n

Long

wal

Mah

ilpur

Moj

itha

Mac

hiw

ra

Man

awal

a

Community Health Centres

Nu

mb

er

of

OP

D P

ati

en

ts

1st Yr

2nd Yr

3rd Yr

4th Yr

5th Yr


Two CHCs were not having drinking water facility, and three were not having separate toilet facility for male and female. Ceiling fans were present at all eleven CHCs. Doctor’s rooms were having adequate space and proper illumination with examination table covered by proper sheet at all eleven CHCs’. Only one CHC was not having a stool for seating the patient and examination equipments like BP apparatus, torch, hammer etc.

Seven CHCs were having an injection room along with OPD facility, to deal with emergency situation; minor OT/dressing room was present at six CHCs.

Only fi ve CHCs were having dispensaries/pharmacy with separate counters for male/female/senior citizens/staff.

Laboratory and imaging services were easily accessible from OPD at all the CHCs, with only seven CHCs having a central collection centre for laboratory services.


A separate medical offi cer was found to be available round the clock in emergency departments of eight CHCs. Glow sign board displaying ‘emergency service department’ was found only at four CHCs, while board displaying ‘doctors/specialists on call in emergency’ was found at nine CHCs.

Emergency wards were attached along with emergency departments at eight CHCs, with bed strengths ranging from 1 to 6 in number. However, two of these eight CHCs were not having triage area. Observation beds were available at nine CHCs, with beds ranging from one to four in number.

Trolleys and wheel chairs were present at all CHCs, mostly ranging from 1 to 3 in number. Only one CHC had fi ve trolleys/wheel chairs.

Examination rooms with all basic equipments were available in emergency departments of six CHCs and all the registers including MLR were available at nine CHCs. Call book in prescribed format was not found at any of the eleven CHCs.

Waiting area for the attendants of the patients, with basic facilities like sitting arrangement, drinking water, toilets etc. were available at emergency departments of eight CHCs, but public telephone facility was found to be present only at one CHC.

Emergency departments of six CHCs were having a retiring room for doctors with toilet facility. Seven CHCs were having minor OT in emergency department for various emergency procedures.

Suffi cient stock of essential and life saving drugs were available at almost all the CHCs except CHC Khemkar; two CHCs were not having oxygen cylinders with necessary attachments.

Separate laboratory service and imaging service in emergency department was available in seven and eight CHCs respectively. All CHCs were having ambulance services.


Fig 21: No. of emergency patients at CHC Hospitals (Punjab) in the last five years

0

500

1000

1500

2000

2500

3000

Badal Fategarh Ferojshah Goniana Khemkaran Longowal Mahilpur Mojitha ManawalaCommunity Health Centres

No.

of p

atie

nts


Fig 22: Admission through emergency at CHC Hospitals (Punjab) in the last five years

0

100

200

300

400

500

600

700

800

900

Fatehgarh Ferojshah Goniana Kartarpur Khemkaran Longowal Mahilpur Mojitha MachiwaraCommunity Health Centres

No.

of a

dmis

sion

s in

the

Emer

genc

y



Treatment facilities for dog/snake bite and poisoning were available at emergency departments of nine CHCs. Only seven CHCs were having staff trained in basic life support.


Only fi ve CHCs were having a disaster manual, and four CHCs out of them were having disaster alert code, recall and deployment arrangements as well. Five CHCs were found to maintain a drug store for disaster situation.


All CHCs were having facility for complete blood haemogram analysis and complete urine examination.

Two CHCs were not conducting stool test and special tests like blood urea; rest all CHCs’ were providing these services.

Blood sugar test and blood grouping and matching tests were available in all CHCs except one.

Biochemistry laboratory was present at all CHCs with pathology lab only at three CHCs and microbiology lab at four. However, none of the CHCs were having a qualifi ed pathologist, biochemist or microbiologist.

Only three CHCs were not found following universal precaution procedures; laboratories at six CHCs were found having some protective measures like gown, gloves, masks etc. Five CHCs were collecting specimens centrally. Three CHCs’ were not having all the necessary laboratory chemicals and reagents.


None of the CHCs under the study were having blood bank facility.

5.3.23 Radiology services

Round the clock availability of X-ray services/sonography were found available at seven CHCs. However, a radiologist was present only at CHC Ferojshah. All CHCs were having a dark room with all the facilities, but none of the CHCs were using dosimeter or conducting special investigations like IVP, contrast media etc.

Only CHC Longowal was not found maintaining separate register for MLC records. Five CHCs were found maintaining history book and log book of X-ray machines.


5.3.24 Operation theatre (OT)

All the CHCs were having major OT except CHC Ferojshah, and out of these two CHCs were having two major OTs. CHC Goniana, Mahilpur and Khemkaran were not having any minor OTs, while rest of the eight CHCs were having one minor OT each.

Zoning concept in the OT was found to be followed only at three CHCs. All the CHCs were having emergency light-generator facility for OT. All CHCs were maintaining OT records except CHC Manawala. However, maintenance of OT postponement records was done only at three CHCs.

Regular disinfection and sterilisation were found being done in OTs of eight CHCs out of eleven CHCs under this study. Availability of fi re-fi ghting equipments and knowledge to use them were found at OTs of only two CHCs.


All the CHCs, except CHC Badal, were having satisfactory cleanliness of wards with adequate housekeeping services. At nine CHCs wards were found to have adequate and clean toilets and bathrooms.

Wards at only two CHCs were not following proper bio medical waste management guidelines for collection and segregation of bio medical waste, and were not having table top syringe and needle destroyer.

Fig 23: Nornal deliveries conducted at CHC Hospitals (Punjab) in the last five years

0

50

100

150

200

250

Badal

Fatehgarh

Ferojsh

ah

Goniana

Kartarp

ur

Khemka

ran

Longwal

Mahilp

ur

Mojitha

Machiw

ara


No.

of N

orm

al d

eliv

erie

s



Fig 24: Caesarians done at CHC Hospitals (Punjab) in the last five years

0

20

40

60

80

100

120

Fatehgarh Goniana Kartarpur Longowal Mahilpur Mojitha Machiwara


No.

of c

aesa

rians


Wards in eight CHCs were having adequate water supply and upkeep of sanitary blocks with proper and adequate linen on bed. None of the CHCs were found having doubling of beds or fl oor beds.

Nine CHCs were found having satisfactory upkeep of cots, mattresses, lockers, linen etc. in the wards. Only one of the 11 CHCs was having uniforms for the patients.

Regarding availability of necessary equipments in the wards, it was found that six CHCs were having functional suction apparatus, while another CHC which although was having the suction apparatus, but it was non functional. All CHCs were having oxygen cylinders with accessories; however, at two CHCs, they were non-functional. Only three CHCs were having functional venesection/LP/tracheotomy tray. Nine CHCs were found having functional emergency light/wheel chairs/stretcher trolley.


Wards at only two CHCs were not having adequate stationery, forms and various updated registers; however, all were found maintaining various registers and records required in the ward.

All CHCs were having adequate fans and light. None of the CHCs were providing diet to the inpatients.


Medical stores suitably located with adequate space were found at eight CHCs. At seven CHCs, the medical store staff had knowledge on material management, system of FIFO, bin cards, lead time, buffer stock etc. CMO/MO were found to regularly inspect the medical store and verify stock books at all CHCs except CHC Manawala. Eight CHCs were having restriction on entry of unauthorised persons in medical store.

Availability of vital and essential drugs was found at medical stores of eight CHCs, while only fi ve CHCs were up-keeping the expiry date register, which was regularly inspected by a medical offi cer.

Only fi ve CHCs were making efforts to redistribute large stocks of slow moving drugs or near expiry drugs for its timely utilisation. Three CHCs were having proper arrangements to keep drugs as per ABC/VED category and storage of rubber goods as per the guidelines.

0

500

1000

1500

2000

2500

3000

3500

Badal Fatehgarh Ferojshah Goniana Kartarpur Khemkaran Longowal Mahilpur Mojitha Machiwara


Num

ber o

f Inp

atie

nts


Fig 25: No. of patients admitted at CHC Hospitals (PUNJAB) in the last five years


Medical stores of three CHCs were not found to take appropriate steps to prevent pilferage of drugs. All CHCs were having convenient arrangements of issuing drugs to various wards. Only CHC Kartarpur was found to send samples regularly to chemical laboratory for checking standards of drugs.

Eight CHCs were circulating list of available drugs to all MOs, OPD and wards as per their generic names.

Medical store at seven CHCs was submitting certifi ed bills to offi ce for release of payment within three days. Auction to clear the empty material from store was done regularly at only fi ve CHCs.

Availability of fi re-fi ghting equipments and knowledge to use them were found to be in the medical stores of only two CHCs.

Standing drug committee was found to exist only at three CHCs, and only these CHCs were having regularly updated hospital drug formulary.


All eleven CHCs were having medical record room with suffi cient numbers of racks. Record keeping in medical record room was manual in all the CHCs assessed, but at only four CHCs, this was managed by medical record offi cer or technician having some training in medical record keeping. None of these hospitals were found to maintain some of the basic hospital utilisation indices like bed occupancy rate, average length of stay, bed turnover interval, death rate etc. on the regular basis and in proper scientifi c way.

Case records were maintained as per WHO classifi cation of disease (ICD-X schedule) at only two CHCs. However, all eleven CHCs were found regularly submitting morbidity and mortality report except CHC Manawala.

Only two CHCs were having back-up facility to safe guard these records and only four CHCs were found following some kind of retrieval system.


Adequate number of bins and bags of required colour codes were available and placed strategically in all patient care areas in nine out of eleven CHCs included in the study.

Proper segregation and collection of waste was found to be done with proper packaging and record keeping at almost all CHCs except Badal. CHC Fatehgarh and Badal were found lacking in proper transportation of waste. Only four CHCs were having proper storage facility for the biomedical waste.


5.3.29 Central sterile supply department

Only six CHCs were having CSSD under supervision of trained staff/senior nursing offi cer, nine CHCs were having all required equipments and autoclaves. Quality control measures were found to be followed at all six CHCs having CSSD.


Among eleven CHCs under study, six were having in-house laundry services, while remaining fi ve had outsourced it. At all CHCs, laundry was of conventional (dhobi) type. Quality of wash was found good at four CHCs only, while in rest of the CHCs, it was found to be average. Quality of linen was good at six CHCs and average in the remaining fi ve CHCs.


Kitchen facility was not available at any of the CHCs assessed.

5.3.32 Utilisation of Patient care services

At all the CHC hospitals, analysis of last 5 year data, revealed that the number of patients utilising various medical care services, including diagnostics and treatment, from in-patient and outdoor had came down in fi rst 2-3 years. But after that, it has steadily increased during the recent years, though at a slower rate.

However, the fi gures for service delivery were not found very encouraging. For the last 5 years, the fi gures had fl uctuated on either side in almost all the districts. Therefore, not only it is very diffi cult to conclude anything, but is very much disturbing, that in some places the numbers have even come down. One of the reasons may be irregular availability of a gynaecologist and its associated basic facilities in these hospitals.


Year-wise expenditure of the user charges made under the following major heads i.e. medicines, improvement of the in-patient’s facilities (IPF), maintenance of buildings and equipments. The expenditure made under the head medicines was 40% to 50% in most of the community health centre (CHC) except the CHC at Badal, Fatehgarh Churian and Manawala.

Regarding IFP, most of the CHC spent 20% to 30% of the user charges over the years except at Longowal. (See Fig 26 and 27)

The utilisation of User charges in maintenance of buildings at the CHCs under study were observed to be varying very widely in the CHCs, over the years as shown in the graph.

10% to 15% of user charges were found to be used for equipment maintenance in all the CHCs over the years except for Badal, Kartarpur and Mahilpur where it was even less then 5% except in few years. (See Fig 28 and 29)


Fig 26: Percent of expenditure of the user charges in medicine of different CHCs of PHSC (Punjab)

0

10

20

30

40

50

60

70

Badal FatehgarhChurian

Ferojshah Goniana Kartarpur Khemkaran Longowal Mahilpur Majitha Machiwara Manawala

Per

cent

cos

t (R

s)

2003-04 2004 -05 2005-06 2006-07 2007-08

Fig 27: Percent of expenditure of the user charges in IPF of different CHCs of PHSC (Punjab)

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00



Perc

ent c

ost (

Rs)

2003-04 2004 -05 2005-06 2006-07 2007-08


Fig 28: Percentage of expenditure of the user charges in buildings of different CHCs of PHSC (Punjab)

0

5

10

15

20

25

30

35



Perc

ent c

ost (

Rs)

2003-04 2004 -05 2005-06 2006-07 2007-08

Fig 29: Percentage of expenditure of the user charges in equipment of different CHCs of PHSC (Punjab)

0

5

10

15

20

25

30



Perc

ent c

ost (

Rs)

2003-04 2004 -05 2005-06 2006-07 2007-08


6.0 Views of the Benefi ciaries on

Quality of Services

6.1 In-patient Department

A total of 224 respondents were interviewed from various health institutions like CHCs, Sub-divisional hospitals, District hospitals and Special Hospitals of Punjab Health Systems Corporation.

6.1.1 Socio-economic profi le of respondents

• Out of 224 respondents, the services of Punjab Health Systems Corporation were utilised more by females (56.3%) as compared to males (43.8%). When observed separately at the in-patient department of special hospitals, more female patients (90.9%) were found admitted as compared to the males (9.1%). This may be because these hospitals were mainly for women and children. Similarly at Sub-divisional hospitals, more female patients (55.9%) were found admitted as compared to the male patients (44.1%).

• At District hospitals the service utilisation was found to be 55.2% by females as compared to 44.8% by males. But at CHCs, the service utilisation by males was found to be more (65.5%) as compared to the females (34.5%). Utilisation of services by less than 15 years age group was very little (1.3%).

• Half of the respondents (50%) were in the age group of 15-30 years, while 20.1% respondents were in 31-45 years age group. Remaining respondents were above 46 years of age.

Fig 30: Age distribution of in-patients at various health care institutions in Punjab

1.9 0 04.5

43.8

54.4

48.3

68.2

18.1

25

13.8

22.722.9

8.8

24.1

4.5

13.3 11.8 13.8

00

10

20

30

40

50

60

70

80

Dist. Hospital(105) Sub-Divisional(68) CHC(29) SP. Hospital(22)

Perc

enta

ge o

f Pat

ient

s

Less than 15 15-30 31-45 46-60 Above 60


6.1.2 Admission procedure

• 51.3% of the respondents were found to be admitted through emergency, while 48.2% of the admissions were through regular OPD. This indicates that, nearly half of the respondents came for utilisation of PHSC services only in the case of emergency. This might be because they do not have access to other health facilities due to economic reasons and are left with no other alternative except to seek emergency care in these facilities.

• When respondents were asked to rate their experience about the admission procedure at these institutions, 77.7% respondents rated it as being poor while another 12.1% stated that the procedure was average. When this poor rating was assessed specifi cally at different health institutions, it was revealed that 86.2% respondents from CHCs; 80.9% from Sub-divisional hospitals and 77.3% from Special Hospitals had rated the admission procedure as poor. At District hospitals percentage rating was slightly less than the other health institutions (73.3%). This is indicative of the fact that the majority of respondents were not satisfi ed with the admission procedure. (Refer Table 5)

Fig 31: Income distribution of in-patients at various health care institutions in Punjab

39 38.2

55.2

31.8

44.8

39.7

31

22.7

11.4

16.2

6.9

27.3

3.85.9

3.4

13.6

1 03.4 4.5

0

10

20

30

40

50

60

Dist. Hospital (105) Sub-Divisional (68) CHC (29) SP. Hospital (22)

Perc

enta

ge o

f pat

ient

s

Less than 2000 2001-5000 5001-10000 10001-15000 Above 15000

• Literacy level of respondents was low. 35.7% were illiterate and 24.6% were just educated up to primary level. 26.3% respondents were educated upto senior secondary level and 2.2% were graduate and post graduate.

• Economic status of the respondents was low, as monthly income of 40.2% respondents was less than Rs.2000 per month; of 39.3% respondents was between Rs.2000-Rs.5000 per month and only that of 1.3% respondents using PHSC health services was more than Rs. 15000 per month. (Refer Table 4)


6.1.3 User charges

• More than 3/4th of respondents (87.9%) were found to have paid charges for making slip/card; 78.6% for admission and 86.2% for investigations as user charges.

• 69.2% respondents stated that adequacy of information imparted to them by the doctor about their disease and treatment was perceived as adequate; however 24.6% respondents

Fig 32: Opinion of in-patients about admission procedure at various health care

institutions in Punjab

73.3080.90

86.2077.30

0

10

20

30

40

50

60

70

80

90

100


Perc

enta

ge o

f Pat

ient

s

Good Average Poor

10.5011.404.40

11.803.40

10.304.50

18.20

Fig 33: Distribution of in-patients regarding user charges at various health care


96.6

0

20

40

60

80

100

120


Perc

enta

ge o

f Pat

ient

s

Slip/card Admission charges Investigation charges Consultancy charges

87.6 84.8 83.8 85.3

8.6

64.7

10.3

79.3

96.6

10.3

86.490.9

86.4

18.2


said that the information given to them was incomplete. When the issue about the adequacy of information was looked at from the perspective of health-institution, it was found to be highest at CHCs (82.8%), followed by Special Hospitals (77.3%), District Hospital (65.7%) and at last the Sub-Divisional Hospitals (66.2%).

• 54.5% respondents stated that they were informed about the rules and regulations of health institutions, while 44.2% respondents stated that they did not receive any such information. (Refer Table 6)

6.1.4 Experience of respondents at OPD/Emergency

• 17.9% of respondents rated their experience at the emergency/OPD as average for various health care institutions. 1.8% respondents rated their experience as poor and 2.2% respondents preferred not to express their experience regarding services at emergency/OPD.

• When an analysis was done in terms of health facility, it was found that 90.9% respondents at Special Hospitals, 82.4% respondents at Sub-Divisional Hospitals, 75.2% respondents at District Hospitals and 65.5% respondents at CHCs rated their experience as good. Thus, there is a scope of improving the services at CHCs level. (Refer Table 7)

6.1.5 Cleanliness and comfort in the wards

• Out of all respondents, 66.5% rated general cleanliness of wards and beds as good while 44.2% respondents rated it as average. When percentage rating was done separately for different facilities with respect to the in-patient department for general cleanliness, it was found to be rated as good by 95.5% respondents in Special Hospitals, 79.3% respondents in CHCs, 63.3% respondents in Sub-Divisional Hospitals and 64% in District Hospitals.

Fig 34: Opinion of in-patients about general cleanliness of beds/wards at various

health care institutions in Punjab

61 60.3

79.3

95.5

36.2 35.3

20.7

4.52.9 4.4 0 00

20

40

60

80

100

120


Perc

enta

ge o

f Pat

ient

s

Good Average Poor


• 66.5% respondents perceived the cleanliness of bed linen as good and 30.8% respondents perceived it as average. Facility wise 100% of respondents at CHCs, 86.4% at Special Hospitals, 63.2% at Sub-Divisional Hospitals and 60% at the District Hospitals perceived cleanliness of bed linen as good.

Fig 35: Opinion of in-patients about general cleanliness of ward bed-linen at various health care institutions in Punjab

60 63.2

100

86.4

33.327.9

0

13.66.7 8.8

0 00

20

40

60

80

100

120


Perc

enta

ge o

f Pat

ient

s

Good Average Poor

• Among the respondents from different health institutions, 74.1% respondents perceived that the degree of comfort in the ward was good while 30% perceived it as average. When different facilities were compared, it was revealed that respondents perceived comfort better in the wards of CHCs (86.7%) and Special Hospitals (86.4%); as compared to District Hospitals (72.4%) and Sub-Divisional Hospitals (66.2%).

• Overall 79.5% respondents stated that good facilities e.g. lights and fans were available in the wards whereas 18.8% respondents considered these facilities as average. Respondents had perceived these facilities better at the wards of Special Hospitals (90.9%) and CHCs (82.8%), as compared to SDH (77.9%) and District Hospitals (77.1%). (See Fig 25)

• Regarding toilet facilities, overall 47.3% respondents perceived that toilets were clean. However, when assessed facility wise, 63.6% respondents from Special Hospitals, 55.2% from CHCs, 47.1% from Sub-Divisional Hospitals and 41.9% from District Hospitals perceived that toilets in the wards were clean. (Refer Table 8)(See Fig 26)

6.1.6 Behaviour of doctors, nurses and staff during stay in hospitals

• Overall 93.3% respondents stated that the behaviour of the doctors with the patients is good, while 5.8% respondents considered it as average. Remaining 0.9% respondents did not make any comment. When the percentage distribution was seen separately at different


Fig 37: Opinion of in-patients about cleanliness of toilets in wards at various health

care institutions in Punjab

41.947.1

55.2

63.6

38.1

23.5

37.931.8

18.1

27.9

6.901.9 1.5 0

4.5

0

10

20

30

40

50

60

70


Perc

enta

ge o

f Pat

ient

s

Good Average Poor Can't say

facilities, it was found that 95.5% respondents from Special Hospitals, 94.1% from Sub-Divisional Hospitals, 92.4% from District Hospitals and 93.1% patients from CHCs considered the behaviour of doctors as good. This indicates that the overall behaviour of doctors in the health institutions has been good.

• Regarding the behaviour of nurses in the in-patient departments, 80.4% respondents perceived it as good, 17.4% as average, 1.8% as poor and the remaining 0.4% did not comment on their behaviour. Health facility-wise, 87.6% patients from District Hospitals,

Fig 36: Opinion of in-patients about availability of light & fans in wards at various health care institutions in Punjab

77.1 77.982.8

90.9

19 22.117.2

9.13.8 0 0 0

0102030405060708090

100


Perc

enta

ge o

f Pat

ient

s

Good Average Poor


82.8% from CHCs, 81.8% from Special hospitals and 67% respondents from Sub-divisional hospitals considered the behaviour of nurses as good.

• Overall, 74.1% respondents stated that the behaviour of staff members was good in the in-patient department of various health institutions. 19.2% patients considered the behaviour as average, 1.8% considered it poor, while remaining 4.9% respondents did not say anything.

Fig 38: Opinion of in-patients about behaviour of nurses at various health care


87.6

67.6

82.8 81.8

11.4

30.9

6.9

18.2

1 1.56.9

00 03.4

00

10

20

30

40

50

60

70

80

90

100


Perc

enta

ge o

f Pat

ient

s


Fig 39: Opinion of in-patients about behaviour of doctors at various health care


78.1

69.1 69

77.3

18.120.6 20.7

18.2

1 06.9 4.52.9

10.3

3.40

0

10

20

30

40

50

60

70

80

90


Perc

enta

ge o

f Pat

ient

s



• When the respondents were asked about the attitude of nurses at the time of admission, it was revealed that 77.7% respondents considered it good, 19.6% considered it average, 1.3% considered it poor while remaining 1.3% did not comment on this. Facility-wise it was found that 86.4% respondents from Special Hospitals, 80% respondents from District Hospitals, 75.9% from CHCs and 72.1% from Sub-Divisional Hospitals considered the behaviour of nurses as good.

• Regarding behaviour of other staff members, health facility-wise assessment revealed that 78.1% respondents from District Hospitals, 77.3% from Special Hospitals, 69.1% from Sub-Divisional Hospitals and 69% from CHCs stated that the behaviour of other staff members was good.

• The fi ndings revealed that 99.6 % respondents had not paid any money to staff members of the health facility. It was found that none of the respondents from District Hospitals, CHCs and Special Hospitals had to pay any money to staff members of the hospital. However, at the Sub-Divisional Hospital, 1.5% respondents stated that they had paid to the staff members of the hospital. (Refer Table 9)

6.1.7 Availability of diagnostic services

• Out of 224 respondents, 65.6% stated that the facilities e.g. laboratory and radiological investigations were good, 24.1% respondents considered the facilities as average, 1.3% considered them poor and remaining 12.1% respondents did not respond to it.

• When percentage of laboratory and radiological investigation facilities were seen at different health institutions separately, it was revealed that 86.4% respondents of Special Hospitals considered them as good. But in other health facilities such as District Hospitals (65.7%), Sub-Divisional Hospitals (54.4%) and CHCs (51.7%) these percentages were lower than the Special Hospitals. (Refer Table 10)

Fig 40: Opinion of in-patients about availability of Lab. facilities at various health care Institutions in Punjab

65.7

54.451.7

86.4

25.722.1

37.9

4.51 2.9

0 0

7.6

20.6

10.3 9.112.4

8.813.8

31.8

51.4 52.9

72.4

63.6

34.336.8

10.34.51.9 1.5 3.4 0

0

10

20

30

40

50

60

70

80

90

100


Per

cent

age

of P

atie

nts

Good Average Poor Can't say All available Some available None available Can't say


Fig 41: Opinion of in-patients about availability of medicines at various health care


12.48.8

13.8

31.8

51.4 52.9

72.4

63.6

34.3 36.8

10.34.5

1.9 1.5 3.40

0

10

20

30

40

50

60

70

80


Perc

enta

ge o

f Pat

ient

s

All available Some available None available Can't say

6.1.8 Availability of medicines in the In-patient department

• Only 13.4% respondents stated that all the medicines were available, 55.8% stated that some medicines were available and 29% respondents stated that no medicine was available in the ward of the concerned health facility.

• When the percentage was seen separately for the various health institutions, then the comparative availability of medicines was found to be more at Special Hospitals (31.8%) as compared to CHC (13.8%), District hospital (12.4%) and Sub-Divisional Hospitals (8.8%). (Refer Table 10) (See Fig 41)

6.1.9 Money spent on medicines by the respondents

• Out of the total respondents interviewed, 91.1% respondents spent money on medicines while remaining 8.9% respondents did not have to spend any money.

• In different health institutions, the percentage of respondents who spent money on medicines was 100% at Sub-Divisional Hospitals, 93.3% at District Hospitals, 81.8% at Special Hospitals and 69% at CHCs. (Refer Table 11)

6.1.10 Food supply to the patients

• Since, at most of the institutions, food was not supplied from the hospitals, therefore, majority of respondents (80.4%) did not comment on this aspect of the questionnaire.

6.1.11 Quality of care

• 83.0% respondents rated their experience at the reception counter as good, 13.4% rated it as average and 0.4% respondents rated it poor. 2.2% respondents did not comment.


Facility-wise experience of respondents revealed that services were rated well by 90.9% respondents at Special Hospitals, 86.8% at Sub-Divisional Hospitals, 82.9% at the District Hospitals and 69% at the CHCs.

• Out of all, 79.0% respondents stated that the overall quality of treatment was good, 17.0% considered it average, 1.8% stated that the quality of treatment was poor while remaining 2.2% respondents did not comment. When assessed for different facilities, quality of treatment was found to be better at Special Hospitals (95.5%) and District Hospitals (81%) as compared to Sub-Divisional Hospitals (73.5%) and CHCs (72.4%).

6.1.12 Security in the In-patient department

• Nearly half (46.4%) of the respondents from all the health institutions perceived that the security at health facilities was good. This was perceived as average by 17.4%, poor by 17% respondents and 2.2% respondents did not made any comment about their perception on security.

• About half of the respondents at District Hospitals (51.4%) and Special Hospitals (50%) and less than half at CHCs (44.8%) and at Sub-Divisional Hospitals (38.2%) perceived the security as good.

• The above fi ndings suggest that more than half of the respondents did not feel adequately secure in the in-patient department and there is scope to improve security in the health institutions.

6.1.13 Overall satisfaction of the respondents

• Overall, 94.2% respondents of the in-patient department expressed satisfaction and only 5.8% were not satisfi ed with the services of the health institutions.

• When their satisfaction percentage was observed separately for the different health facilities,

Fig 42: Opinion of in-patients about satisfaction on over all services at various health


96.2

86.8

100 100

3.8

13.2

0 00

20

40

60

80

100

120


Perc

enta

ge o

f Pat

ient

s

Yes No


it was revealed that 100% of the patients from in-patient department of CHCs and Special Hospitals, 96.2% patients from District Hospitals and 86.8% from the Sub-Divisional Hospitals were satisfi ed with the services provided. (Refer Table 13)

6.1.14 Suggestions given by the respondents

The major suggestions given by the respondents were as below:

• About 25.5% of the patients were of the view that the medicines should be provided free of cost or atleast on subsidised rates.

• Quality of medicines should be improved; food should be provided, clean toilets, regular visits by the higher authorities to check the facilities of the hospital etc.

• Only 4.2% of the patients were satisfi ed with the services being provided by the hospitals. (Refer Table 14)

6.2 Outpatient Department

A total of 580 respondents were interviewed in the outpatient department of various health institutions like CHCs, Sub-Divisional Hospitals, District Hospitals and Special Hospitals of Punjab Health System Corporation. The following fi ndings have emerged based on the interview of respondents in the outpatient department.

6.2.1 Socio-economic profi le of respondents

• Out of 580 respondents interviewed the services of PHSC were more utilised by females (57.9%) as compared to males (42.1%). When analysed for health facilities it was found that in the outpatient department of Special Hospitals more female respondents (87.2%) utilised

Fig 43: Age distributon of patients attending OPD at various health care institutions in Punjab

5.3 4.41.8

25.5

38.7

34.1

19.3

55.3

30.326.7

37.7

12.8

19.0 20.7

25.4

2.1

6.7

14.1 15.8

4.3

0

10

20

30

40

50

60


Perc

enta

ge o

f Pat

ient

s

Less than 15 15-30 31-45 46-60 Above 60


the services as compared to the male respondants (12.8%). Similarly in District Hospitals, the service utilisation was 59.2% by females as compared to 40.8% by males. But at Sub-Divisional Hospitals and CHCs, the utilisation of services by both males and females was almost same.

• Majority of respondents were in the age group of 15-30 years (35.2%) and 31-45 years (29.5%). • The literacy level of majority of the respondents was found to be low, as 34.8% were illiterate

and 22.4% were just educated up to primary level. (See Fig 44)• Their economic status was also low, as 34.0% respondants’ income was less than Rs.2000 per

month and 37.9% respondents’ income was between Rs.2000-Rs.5000. • This indicates that majority of respondents utilising PHSC were females having poor education

and low income. (Refer Table 15)

6.2.2 User charges

• Majority of the respondents (94.8%) were paying user charges for getting an OPD card and 70% of the respondents were found to have paid for investigation charges. (Refer Table 16)

• The amount of user charge was found to be a token amount of Re.1, which could be the reason for higher proportion of respondents paying for OPD card. (See Fig 45)

6.2.3 General cleanliness

• Out of total 580 respondents, 72.4% rated general cleanliness of OPD as good whereas 25.3% respondents rated it average. When the percentage rating was seen separately at outpatient department of different facilities, the general cleanliness was rated good by 87.2% respondents in Special Hospitals, 73.9% respondents in District Hospitals, 71.1% in Sub-Divisional Hospitals and 64% in CHCs. (See Fig 46)

Fig 44: Educational status of patients attending OPD at various health care institutions in Punjab

28.9

38.5

49.1

25.522.9

25.2

15.8

27.728.2

19.316.7 17

10.6 11.9 11.4

21.3

6.73.7 4.4

8.5

2.8 1.5 2.60

0

10

20

30

40

50

60


Perc

enta

ge o

f Pat

ient

s

Illiterate Primary Secondary Senior Secondary Graduate Above Graduate


Fig 46: Views of patients attending OPD about general cleanliness at various health


73.971.1

64

87.2

22.927.4

34.2

12.8

2.5 0 1.8 00.7 1.5 0 00

102030405060708090

100


Perc

enta

ge o

f Pat

ient

s

Good Average Poor Cannot say

• Overall 77.8% respondents rated the waiting area of OPD as good and 20.3% respondents rated it average. Facility-wise the waiting area of OPD was perceived as good by 93.6% respondents in the Special hospitals, 82.7% in District Hospitals, 77% in Sub-Divisional Hospitals and 59.6% in CHCs.

• Thus, overall rating of general cleanliness of the OPD along with basic facilities was found to be better in the Special Hospitals in comparison to CHCs. (Refer Table 17)

Fig 45: User charges at OPD in various health care institutions in Punjab

94.498.5

93 91.5

6971.9 71.1

68.1

4.6 3.7 3.5

12.8

0

20

40

60

80

100

120


Perc

enta

ge o

f Pat

ient

s

OPD card charges Investigation charges Consultancy charges


Fig 47: Views of patients attending OPD about drinking water facility at various health care institutions in Punjab

88

97

78.1

100

10.93

14

01.1 07.9

00

20

40

60

80

100

120


Perc

enta

ge o

f Pat

ient

s

Yes No Cannot say

6.2.4 Availability of basic facilities

• Overall 75.7% respondents stated that facilities such as light and fan were good where as 18.4% respondents considered these facilities as average. These facilities were perceived to be better at the OPD of Special Hospitals (89.4%), Sub-Divisional Hospitals (83.7%) and District Hospitals (79.2%), as compared to CHCs’ where 51.8% respondents were positive.

• The availability of STD/PCO booth was 43.1% in various health institutions. Health facility-wise, 52.6% Sub-Divisional Hospitals 48.6% District Hospitals, 46.8% Special Hospitals and 16.7% CHCs were having the STD/PCO facility.

• Separate toilets for women were available in 86% of the health facilities. Facility wise separate toilets for women were available at 97.9% Special Hospitals, 88% District Hospitals, 85.9% Sub-Divisional Hospitals and 76.3% of CHCs. This is indicative of the fact that separate toilet facilities need to be made available to the female respondents when more number of females are utilising the OPD services at various institutions.

• Availability of drinking water was 89.1% in various health institutions. The same was 100% at Special Hospitals, 97% at Sub-Divisional Hospitals, 88% at District Hospitals and 78.1% at the CHCs. (See Fig 47)

• Overall availability of screened examination room was found to be 87.2%. However this was 100% at Special Hospitals, while the availability of screened examination room was 88.1% in Sub-Divisional Hospitals, 86.3% in District Hospitals and 83.3% in CHCs. (Refer Table 17)

6.2.5 Adequacy of information about disease and treatment

• Overall 81.4% respondents stated that adequacy of information given to them about their disease and treatment by the doctor was good, while 13.6% respondents stated that the information given was average.


Fig 48: Distribution of OPD patients informed about the diseases and treatment by the treating doctor at various health care institutions in Punjab

85.9

78.571.9

85.1

0.9

12.6

22.8

10.6

1.15.2

1.8 4.32.1 3.7 3.50

0102030405060708090

100


Perc

enta

ge o

f Pat

ient

s


• When the adequacy of information given to respondents about disease and treatment by doctors was assessed facility-wise, it was found that adequacy of information was maximum in District Hospitals (85.9%), followed by Special Hospitals (85.1%), Sub-Divisional Hospitals (78.5%) and CHCs (71.9%) respectively. (Refer Table 18) (See Fig 48)

6.2.6 Availability of medicines

• Out of all the respondents, only 10.3% respondents stated that all medicines were available in the OPD, whereas other respondents (62.8%) stated that not all medicines were available. Rest of the respondents (26.4%) stated that none of the medicines were available in the OPD. (Refer Table 18)

• When the issue was analysed health facility-wise, it was revealed that the availability of all medicines in Sub-Divisional Hospitals and CHCs was 17% and 14% respectively. At other health facilities such as Special Hospitals (8.5%) and District Hospitals (6%) the availability of all medicines was less. (See Fig 49)

6.2.7 Availability of diagnostic facilities

• Most of the respondents stated that the facilities like laboratory and radiological investigations were good (50.7%), whereas 22.1% respondents stated that they were average and 1.95% stated them as poor. (Refer Table 18) (See Fig 50)

6.2.8 Behaviour of staff members

• Overall 56.9% respondents stated that behaviour of staff members was good in the OPD of various institutions. Out of the remaining respondents, 32.4% respondents stated that the


Fig 49: Opinion of patients attending OPD about availability of medicines at various health care institutions in Punjab

6

1714

8.5

54.2

68.172.8 74.5

39.1

14.1 13.2

7

0.7 0.7 0 00

10

20

30

40

50

60

70

80


Perc

enta

ge o

f Pat

ient

s

All available Some available None available No response

Fig 50: Opinion of patients attending OPD about Lab. & radiological facilities at various health care institutions in Punjab

53.951.9

36

63.8

23.2

17

32.5

4.31.4 2.2 3.5

0

21.5

28.9 28.131.9

0

10

20

30

40

50

60

70


Perc

enta

ge o

f Pat

ient

s


overall behaviour of the staff was average, 8.8% respondents did not say anything about their behaviour and 1.9% said that the behaviour was poor. (See Fig 51)

• When the percentage distribution was seen separately for different facilities, it was found that 70.2% respondents of Special Hospitals, 60% respondents of Sub-Divisional


Fig 51: Opinion of patients attending OPD about behaviour of staff at various health care institutions in Punjab

5660

50

70.2

34.530.4

40.4

6.41.8 3 0.9 2.1

7.7 6.7 8.8

21.3

0

10

20

30

40

50

60

70

80


Perc

enta

ge o

f Pat

ient

s


Hospitals, 56% respondents of District Hospitals and 50% respondents of CHCs stated that the behaviour of staff members was good.

• Almost all the respondents (97.1%) said that they did not have to pay any money to the staff members of the hospitals, while 2.9% respondents reported to have paid to staff members of the hospitals. When this was looked for at different health institutions, it was found that 3.2% respondents from District Hospitals, 3% from Sub-Divisional Hospitals, 2.6% from CHCs and 1% from Special Hospitals had paid to staff members at the respective hospitals. (Refer Table 19)

2.9 Availability of doctors, nurses and staff in the OPD

• Overall availability of doctors as stated by the respondents at the health institutions was 94.8%. When respondents were asked about doctor’s behaviour towards them, 91.4% reported the doctor’s behaviour being good.

• When availability of doctors was assessed for different facilities, then 97.9% respondents of Special Hospitals, 95.1% of Sub-Divisional Hospitals, 95.1% of District Hospitals and 89.5% respondents of CHCs stated that doctors were available.

• Overall availability of nurses was confi rmed by 79% of the respondents and 64.5% said that the behaviour of nurses was good towards the patients. Facility wise percentages of the availability of nurses and their good behaviour towards patients were found to be 80.6% & 63% at District Hospitals, 78.1% & 68.4% at CHCs, 77% & 62.2% at Sub-Divisional Hospitals and 76.6% & 70.2% at Special Hospitals respectively. (Refer Table 19) (See Fig 52)


6.2.10 Waiting time

• When respondents were asked about the waiting time at various health facilities, a majority of the respondents (88.7%) stated that they have to wait upto 15 minutes. Rest of the patients stated that they waited longer i.e. 9% for 16-30 minutes and 2.3% for more than 30 minutes.

• At District Hospital, waiting time for 83.6% respondents was up to 15 minutes where as at rest of the facilities more than 91% respondents reported to have got themselves registered in less than 15 minutes (95.7% at Special Hospitals, 95.6% at CHCs and 91.1% at District Hospitals).

• Time spent in waiting for specialist consultation in the OPD was less than 15 minutes for 63.4% respondents. 22.7% respondents stated that they had waited between 16–30 minutes for specialist consultation where as 13.9% waited for more than 30 minutes. When it was seen for different institutions, 79.7% respondents at Sub-Divisional Hospitals, 72% respondents at CHCs, 55.6% respondents at District Hospitals and 46.4% respondents at Special Hospitals waited upto 15 minutes.

• Time spent for getting investigations done at the OPD was found to be less than 15 minutes for 83.6% respondents. Between 9.9% respondents waited for 16–30 minutes for getting the investigations done where as 6.5%% waited for more than 30 minutes. When it was seen for different institutions, 91.1% respondents at Sub-Divisional Hospitals, 86.9% respondents at CHCs, 80.5% respondents at District Hospitals and 78.4% respondents at Special Hospitals waited for up to 15 minutes.

• Waiting time for getting the medicine in the OPD was up to 10 minutes for 80.8% respondents, between 11-20 minutes for 15% respondents and more than 20 minutes for 4.2% respondents. At different health institutions it was up to 10 minutes for 90.4% respondents at CHCs, 86.5% at Special Hospitals, 81% at Sub-Divisional Hospitals and 74% at District Hospitals. (Refer Table 20)

Fig 52: Opinion of patients attending OPD about availabilty of doctors at various health care institutions in Punjab

95.1 97.8

89.5

97.9

4.9 2.2

10.5

2.1

0

20

40

60

80

100

120


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Available Not available


Fig 53: Views of patients attending OPD about waiting area at various health care institutions in Punjab

82.777

59.6

93.6

15.820.7

36.8

6.40.7 0 2.6 00.7 2.2 0.9

10

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2.11 Experience of respondents at OPD

• Out of 580 respondents, 70% rated their experience at OPD as good and 27.4% rated it as being average at the OPD of various health care settings. 1.4% respondents rated their experience as poor and 1.2% respondents did not respond. (See Fig 53)

Fig 54: Rating of patient’s experience attending OPD at various health care institutions in Punjab

71.5 72.6

57

70

26.423.7

39.5

27.4

1.1 0 0.9 1.41.1 0.7 0 1.2

0

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• For different health facilities, it was found that 85.1% respondents at Special Hospitals, 72.6% at Sub-Divisional Hospitals, 71.5% at District Hospitals and 57% at CHCs rated their experience as good. (Refer Table 21) (See Fig 54)


6.2.12 Quality of treatment

• Overall 75.9% respondents rated the quality of treatment in the hospitals as good. Whereas 21% respondents rated quality of treatment as average, 1.4% stated it as poor and 1.7% respondents did not respond.

• When percentage distribution was seen separately at different facilities, it was revealed that 93.6% respondents of Special Hospitals, 78.5% respondents of District Hospitals, 77% respondents of Sub-Divisional Hospitals and 60.5% respondents of CHCs rated their experience as good.

• Overall 77.9% respondents were satisfi ed with the services of various health institutions, whereas 22.1% respondents were not satisfi ed with the services of health institutions. Health facility-wise analysis reveals that 80% respondents of Sub-Divisional Hospitals, 79.8% respondents of CHCs, 78.5% respondents of District Hospitals and 63.8% respondents of Special Hospitals were satisfi ed with the services.

• In the overall rating about the level of cooperation at the reception counter at various institutions, 93.6% respondents rated it as good and 6.4% respondents rated it as average. Health facility-wise, 80% respondents of CHCs, 79.2% respondents of District Hospitals, 77% respondents of Sub-Divisional Hospitals and 70.2% respondents of CHCs, rated the level of cooperation as good. (See Fig 55)

Fig 55: Opinion of patients attending OPD about quality of treatment received at various health care institutions in Punjab

78.5 77

60.5

93.6

18.7 18.5

36

6.41.8 2.2 0 01.1 2.2 3.5

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6.2.13 Suggestions for improvement of services

• Regarding all facilities, 28.3% respondents did not offer any suggestion. 50.5% respondents suggested for free provision of all medicines to everyone, especially to the poor.

• Other suggestions from respondents were; provision of more doctors or specialists (6.4%), cleanliness of OPD and toilets (4.9%) and proper care of respondents and emergency care (3.6%). 2.3% respondents were fully satisfi ed with the services of the out-patient department. (Refer Table 22)


7.1 Introduction

Last two decades have witnessed major shift in the health system and concerns have been expressed regarding health issues, critical to women, children and people in the rural and tribal areas. The health sector being no exception, has very heavily relied upon and included in-built components like systematic training. Training has been used as a planned strategy towards development of human resource for the achievement of total health in the country. The training system helps in continuing the review of current needs of state and national programmes and policies to match with the training personnel at all levels in the health care system. In addition to strengthening the functional performance of human resources, it also caters to aspects like cost containment, quality of care and creation of new categories of health personnel.

However, several lacunae have been identifi ed in the existing training programmes such as:i. Training often does not bear directly on an employee’s offi cial duties.ii. Duplication of training programmes and the same participants receiving training frequently.iii. Lack of written course evaluations with an objective to provide feedback after training while

one has resumed one’s job.

Realising these gaps in the existing health care delivery system it was felt that training institutes would also be evaluated along with the other health service facilities in the state of Punjab during conduction of the study.

Training institutes evaluated were:1. State Institute of Health and Family Welfare, Mohali. 2. State Institute of Nursing and Paramedical Sciences, Badal (in the district of Muktsar).3. Mental Hospital, Amritsar.

7.2 State Institute of Health and Family Welfare (SIHFW),

Mohali

The State Institute of Health and Family Welfare (Kharar) was established under a WB aided project in 1992 after upgrading the Health and Family Welfare Training Centre, Kharar. Now, State Institute of Health and Family Welfare, Phase-VI, Mohali, Punjab, has been established under IPP VII (Year 1997-1999), under World Bank aided project as an apex institute to cater to the training needs of the northern states like Punjab, U.P, Chandigarh, J&K and Haryana. The Institute has been declared as Collaborative Training Institute (CTI, Mohali) with NIHFW, New Delhi being the nodal agency. The institute from Kharar has been shifted to a new campus at Mohali and is made operational with effect from 1st April, 2004 as State Institute of Health and Family Welfare, Phase-VI, Mohali.

7.0 Training Institutes


7.2.1 Objectives

• To develop trained health manpower resources for better delivery of health care services and effective health management.

• To conduct policy relevant and fi eld based research studies on areas relating to population health and family welfare.

• To monitor, supervise and provide technical guidance to regional training centre/School/DTC and NGOs.

• To render advisory and consultancy services to government, and other health related organisations for developing programmes and policies on population and health.

• To provide training to other departments/organisations.

7.2.2 Functions

• To plan, conduct, evaluate and follow up of the training programmes for the health personnel in the region.

• Develop the urban and rural fi eld practice and demonstration areas for providing practical experience to the trainees and utilise the area as fi eld labs.

• To develop a training curriculum.• Conduct simple studies and research, to improve training techniques and tools.• Serve as a technical resource for the region• Plan, conduct and evaluate special health and family welfare campaigns• Provide consultative services on family planning and training to voluntary and allied agencies.• Maintain a close liaison with central training institutions for technical help and guidance.

7.2.3 Major components

1. Training• Professional development course• Basic training for MPHW male• In-service training for medical and para medicals• TOT for key trainers (RCH) trainings

2. Research and evaluation studies in collaboration with medical health and related organisation.3. Service cum training counseling clinics.4. Monitoring and evaluation of the trainings under Health and Family Welfare departments

in the State.5. Computer HMIS.

7.2.4 Trainers of the training institute

This survey was conducted in SIHFW, Mohali. Questions were asked from trainers, considering them as an important stakeholders in this survey. A total of 7 respondents were interviewed. The trainers were mainly medical offi cers and the nursing tutors, having an average experience of 15-20 years of service. The job responsibilities given to them were teaching, planning for ongoing trainings and different administrative responsibilities.


The activities mainly carried out by them were training, administrative, planning, session teaching and sometimes data collection for different research projects.

After the inception of PHSC, there have been special training programmes sponsored to nominate specialists like surgeons, physicians etc. to improve the quality of different training programmes. One of the respondents was of the view that there is not much change; everything is as it is as it was before. Another respondent indicated that there is an improvement in the quality of work, but she could not specifi cally point out the type of quality being referred to. After the inception of PHSC, more emphasis is given to Behaviour Change Communication and on counseling which was not the case earlier.

All the respondents have done many training programmes over the years like on disaster management, capacity building, RCH, counseling skills, integrated course for NRHM, adolescent and reproductive health, fi rst aid course, workshop on community participation etc. It indicates that trainers are given relevant training, which is of importance to keep them updated with the new emerging trends. They can apply this while conducting different training sessions.

Almost all the respondents were positive about the need of more training in the areas like leadership, management.

Skills of Trainers: Faculty of training institute were asked basic information regarding organisation of trainings.• When asked about the concept of systems approach to training, all the seven respondents

could not speak about it. Though few responded that it should be based on needs assessment followed by a systematic approach to training.

• The response on pre-requisites for preparation of training calendar, the respondents most of them reported as training load, availability of resources (man, money and material) and availability of venue.

• According to the respondents the training methods used for skill development are hands on training, demonstrations, powerpoint presentations, group discussion and role-play.

The above analysis shows that the trainers have fairly good knowledge about the organisation of training programmes.

Common complaints of trainees attending training programmes:

When asked about the nature of complaints by the trainees who attended the training programmes, some of the common complaints were:

Shortage of faculty members, duration of the lectures being very long, quality of food is not very good, and poor hostel facilities.

The quality of training programmes is usually assessed by the trainers from pre and post evaluation, participant’s evaluation report and through informal communication with the participants.


The procedure for the preparation of training report includes compiling data and taking feedback from the participants.

The impact evaluation is not done in the institute, however, according to one of respondent, reaction feedback (immediate) from the participants is taken on completion of training programme..

Some programmes which are proposed to be started shortly are on NRHM, BCC, HISM, Leadership and Disaster Management.

Changes required in the existing training structures: Opinion of the respondents was taken to identify the changes required in the existing training structure for the staff in their district.

• Guidelines for organising training programmes should be more clear and freely available• More class rooms are required• Training calendar should be spread uniformly throughout the year• There should be more training programmes for the nursing personnel

7.3 State Institute of Nursing and Paramedical Sciences,

Badal (in the district of Muktsar)

The State Institute of Nursing and Paramedical Sciences was established in the year 2001 at Badal in the district of Muktsar. The main objective of this training institute was to have a good quality training institute available in the rural area of Punjab which can teach and train the candidates from the rural community. It was till recently under the Punjab Health Systems Corporation and has now been transferred to Baba Faridkot University.

7.3.1 Major courses being offered

1. BSc. (Nursing)- a four year full time course with a capacity of 50 admissions (recently started)2. General Nursing & Midwifery course- Three and a half years with a capacity of 50 admissions3. Diploma in Radiography- a two year course with a capacity of 10 admissions4. Diploma in Medical Laboratory Technology- a two year course with a capacity of 20 admissions.

7.3.2 Practical training of students

The practical training of a student is done in a number of hospitals on a rotational basis. The hospitals are:a. Civil hospital Badal- not very suitable as daily attendance is very lowb. Civil hospital Bhatinda- good daily attendancec. Women and Children Hospital Bhatinda- around 70-80, attendanced. Civil hospital Malout- daily attendance of around 50e. Mata Kaushalya hospital Patiala- around 200 daily attendancef. Institute of Mental Health, Amritsarg. Rajindra Hospital and Medical college Patiala


h. Baba Faridkot (GGS Medical college) for Radiographyi. Sub Centre Singhewala under PHC Lumbi for Community Health Nursing

7.3.3 Fees structure

The fee structure is as follows:For BSc Nursing the annual fees is Rs. 43,500/-For GNM course the annual fees I Rs. 41,500/-For DMRT and DMLT courses, the annual fees is Rs. 17,000/-

7.3.4 Salient features

1. The intake in the BSc (Nursing) and GNM courses is very good and generally the fi fty seats allocated are fi lled up with very few drop outs during the academic year.

2. The Diploma in Radiography has generally 50-60% occupancy. This year there are only two students enrolled against 10 seats.

3. The Diploma in Medical Lab Technology does not attract enough number of students- in this batch there is only one student against 20 seats.

4. There is shortage of faculty. 10 out of the required 18 nursing tutor posts are fi lled up. Further there are only 2 MSc. qualifi ed nurses (including the Principal) for training the BSc. Nursing students.

5. As there is no hospital within the premises and for all practical purposes the civil hospital Badal has very few patients, it is diffi cult for the students to go for training to Bhatinda and other places. The students have to commute to and fro to Bhatinda as the hostel facilities are not there. This suggests that there is a need of a hostel for the nursing students which will help in cutting down on the commuting time and promote better learning.

6. The eligibility criteria for DMLT course needs to be re-looked at. Punjab technical University is admitting Arts students too.

7. There is lot of dissatisfaction amongst the staff as regards the pay scales. Further as many of the tutors are on contract, they are not able to deliver their best.

8. There is a need for atleast one staff bus for the employees and one more bus for the students as the public transport system is not functioning well.

9. There is also requirement for a full time student counsellor and one health offi cer.10. Upgradation of the library with more books, journal and computers with internet connectivity

is a must.11. Modern AV aids are required- especially LCD projector12. Funds for repair and maintenance of the hostel are needed as many repairs and renovations

are pending13. The institute was more comfortable under the PHSC as regards funds and sanctions for different

tasks. It is facing more problems after being transferred to the Baba Faridkot University.


7.4 Mental Hospital, Amritsar

This hospital is catering to services of psychiatric patients from Punjab and other states. All the available staff has the expertise in psychiatric and related areas. Training programme of nurses in care of psychiatric patients is also being organised by the hospital. There is a capacity of 350 students for the training programme with a fee structure of Rs. 1500 per student for 1 month training. This is one of the sources of income for the hospital. By virtue of this training programme being organised for the nursing categories, the institute may be considered as one of the potential training institutes. However, before considering that, the following points may be taken into account.

• The faculty of the institute is tuned to the psychiatric care services and due to shortage of them; it would be very diffi cult for them to carry out other training activities.

• The institute does not have any professional trainer or faculty who has been trained in Training Technology. Furthermore, their experiences were not matched with the primary health care service delivery.

• Hence, in the context of declaring a training institute for primary health care service delivery, Institute will have to depend totally on external resource persons.

• In lieu of the above context, a major part of the training budget might be utilised in the payment of honorarium to the guest faculty. In addition to this, training programmes would likely be earning source for the institute and it will enhance the training budget more.

• The institute does not have established hostel with mess facilities. Dharamshala for the attendants of in-patients is being used as hostel for the trainee, nurses and kitchen for the patients was being used for the food for them on adhoc basis.

• As the ongoing in-service training was limited to the psychiatric ward only, institute has not developed any Field Practice Demonstration Area (FPDA), which is essential for Primary Health Care Skill training.

• On the other side, the Director of the institute, a retired Principal from Medical College, has vast experience and good networking with the health system in Punjab. Furthermore, all the teaching aids space for the training programme is available in the institute.

A summarised SWOT analysis is being projected below:

7.5 SWOT analysis of training institutes

Variable State Institute of Health and Family Welfare, Mohali

State Institute of Nursing and Paramedical Sciences, Badal (in the district of Muktsar)

Mental Hospital, Amritsar

Strength Well designed complex spread over 5 Acers of land having

• Teaching Block• Hostel Block• Administration Block• Residential Block

Well designed complex having • A vast Teaching Block• Two Hostel Blocks• Administration Block• Residential Block

• Suffi cient infrastructure.• Had experiences in the conduction of Nursing training• Availability of training and teaching aids


Variable State Institute of Health and Family Welfare, Mohali

State Institute of Nursing and Paramedical Sciences, Badal (in the district of Muktsar)

Mental Hospital, Amritsar

Well equipped• Auditorium• Lecture Halls• Seminar Room• Committee Room• Computer Lab• Demonstration Room• Library

Well Furnished• 64 Hostel Rooms• Guest House• Recreation Room• Common Room• Mess• Gym

Operational• Two Buses

Well equipped• Auditorium• Lecture Halls• Seminar Room• Committee Room• Demonstration Room

Modestly Furnished

Hostel Rooms

• Common Room

• Mess (run as a cooperative mess with contractual staff)

Operational• Three Buses- one 52 seater, one32 seater, one an 18 seater,One Tata Sumo

• Availability of class rooms.• Availability of transport facilities for fi eld visit.• Availability of library

Generating income through hostel charges.

Weakness • Very limited faculty.• Consultant posts are vacant• No full time director.• Too much dependence on external funding training programmes

• Staff shortage.

• Only experience in nursing training

• Library has adequate space. It does not have enough books. There are only 797 books and 13 nursing journals available. Seven types of health related journals are also available.

There is no internet connectivity in the library and no facilities for the students to browse the internet.

1. Only experience of Psychiatric training, no experience of other training methodology.2. Very limited faculty and that too psychiatric specialist.3. No proper hostel or mess facilities.

Opportunities • Very good linkages with Punjab Health System Corporation having the facilities in the same premises.

• Established linkages with NIHFW and other central training institute

• Good political support 1. On going mess facilities for patients, may be used for trainees.2. Existing dharamshala may be used as hostel.

Director of the institute is a very much known personality in the health fi eld and having good network which may help in the mobilisation of trainer.

Threats • Depends upon Punjab Health System Corporation.

No apparent threat 1. Funds for the training may be used in the hospital services for the psychiatric patients.


For listening to the community voice, focus group discussions (FGDs) were conducted to take care of qualitative dimensions. Ten (10) FGDs among the females were undertaken in nearby villages of community health centres and 10 FGDs among the males were conducted in nearby villages of sub divisional hospitals. Let us read and understand their issues.

8.1 Observations among Male Groups

8.1.1 Accessibility to health care facility:

a) Health care facility availed by villagers

• Local people are interested in availing the government facilities. However due to various reasons most of them are not utilising these facilities.

• People of low socio-economic group are utilising the government facilities due to their very little paying capacities. These are the people who primarily try to avail the services. The people belonging to lower–middle group and above, generally utilise private facilities as per their paying capacities.

• Few Sub-divisional hospital’s /CHCs attract large number of patients, even from the far off places, only because of the good administration and services offered by the hospital in-charge.

b) Reasons for non-utilisation of Government health facilities

Varied reasons emerged following the discussions in different districts. Following are the few common reasons from all the districts:

• If the distance of the health facility is more, then local people tend to utilise private facility only.

“Anay janay may he to sara kharcha ho jana hai, Time waste hoga who alag. Isliye hum to pas ke doctor ke pas he chaley jatey hain”.

• People are primarily unhappy with the fact that they have to spend the money for availing health services.

“Private mein jayen ya serkari mein, kharcha to dono mein he karna hai, Private vale doctor per to hum jor bhi dal sakte hain”.

8.0 Community Voice


“Sui se le kar glucose, davaiyan, injection sab bahar se he khareedna padta hai”.

• In most of the emergency departments, 24 hour services are not available due to non-availability of staff. Therefore people prefer to go to the private hospitals/nursing homes only.

“aise jaedah hai jadon police case hove, emergency which to koi sahuliat nahin hai”.

• Availability of the doctor in the hospital/CHC is not sure.

“Asain doron jaidai doctor ravey na ravey, sanu to kuch pata nahin,”.

(Once we reach most of the time doctor is on leave or gone for some meeting or other commitment, our whole day is gone and even the money).

• Majority mentioned that the government doctors prefer to see the patients in their private settings, charging heavy consultation fees. Besides specifi c investigations, like ultrasound etc. are required to be done from outside private centres.

c) Distance from home and connectivity from the road

• Majority pointed out that distance is an important factor, but if all the facilities are available with good doctors, people would prefer to utilise those health facilities, e.g. Dasua Sub-Divisional Hospital is known to be good so far as deliveries are concerned. People from far off places utilise the services available there.

• There are places where the hospitals/health centres are near the villages or in the residential area, but people still do not utilise the services and go to private hospitals/nursing homes which are far away.

• Many of the groups commented - “as the same doctors give good treatment in private nursing homes, so we go there only”.

d) Transport facilities and cost of travel

• Sub-divisional hospitals are generally situated near the main roads, which are well connected with the local transport as well. Travel cost depends on the economic status of the family and for the poor patients it is a cause of concern.

‘Panchayat aur local loki madad kar den dey , chanda ekthda ker key de den de”.

(Villagers help their native people by contributing money for the medical expenses etc.)

e) Services:

• The services in the hospital are on payment basis. One group said that they need to buy everything needed during hospitalisation or otherwise. As outpatient also, majority of them have to purchase the medicines from outside.


“We can only save the visiting fees of the doctor otherwise there is no difference in going to either Government or Pvt. Facilities.

8.1.2 Availability of the facilities in the hospital

a) Waiting time in OPD

• Majority commented that waiting time in OPD depends on the number of the patients. If the doctor is available and fewer patients are there. It takes 20-25 minutes.

• Whereas if the number of the patients is more, than it may take even 2-3 hours. As far as timings of the OPD are concerned, all of them feel it is convenient for them.

b) Availability of the doctors

• Different opinions emerged. Most of them agreed that availability of the staff is there, but there is a scarcity of the staff.

• The participants also put forth that the availability of the doctors /staff etc. depends on the administrator of that place.

“Bade doctor sakht jadon honge sab changa chalta hey”.

c) Availability of the medicines

• All emphasised on the non-availability of the medicines. Whatever the patient needs while hospitalisation or in OPD, they are asked to buy. Very few people mentioned that for economically weaker section some medicines are given from the hospital.

“sarkari aspatalan bich to asan garib loki e jaedah hai, davaiyan kuch bhi nahi dende”

‘Why should we go to the Government hospitals, as only visiting the doctor is not going to help, we need to buy the medicines also “Local private doctors give the medicines also within the Fees”.

d) Availability of the laboratory and radiological services

• All were unhappy with the functioning of the laboratory and radiological services.

• It was pointed out that in case of emergency, there are great diffi culties in availing any of these facilities. They were of the opinion that at few of the places, machines/equipment are either not in working condition or the technician is not available.

“If it is only the availability, ‘yes’, it is available but if we talk about the functioning aspect, it is questionable”.


“Whole day goes off only for one investigation to be done”. Again they were required to collect the report from the lab and then visit the doctor.

8.1.3 Behaviour of health care providers towards patients

• Most expressed happiness with the doctors’ behaviour.

• Few refl ected that doctor’s behaviour is more prompt and appropriate when they visit the same doctors in their clinics.

• It emerged that the staff does not ask for any money for any reason.

• They are at times cooperative.

8.1.4 Outreach services offered by Government facility

• Most pointed out that though ANMs exists in the area, but they are not conducting group meetings. Home visits were also very less.

• ANC is not a regular agenda. Women themselves go to the hospital to get registered.

• Few of the respondents said that ANM is active and take due care of the pregnant women.

• Visits of the ANM/ASHA are actually restricted to specifi c areas.

• These workers are more centred to areas near their residence. The far off villages are not taken care off. As such there is no coverage for family planning services.

• No medicines have been distributed by the ANM since 4-5 years.

• Iron and folic acid tablets are also not available with them. Only hospitals provide these medicines for 3-5 days to each pregnant women.

8.1.5 Coverage

• Remote areas are not being served. People are forced to utilise private services, sometimes with the same government doctor of the hospital in their private clinics.

• Most emphasised that health facilities are not fully equipped. They need to go to the other specialised hospitals/referrals to avail some of the facilities.

8.1.6 Satisfaction with the services provided by the Government

health facility

• Responses were varied among different groups. In the Sub-divisional hospital areas, which are running fi ne due to good administration, people are somewhat satisfi ed with it. Whereas those, where there is bad administration like no doctors on duty or shortage of doctors, people are not at all happy with them.


• They feel that government has invested so much in the infrastructure for the betterment of the general public, but the ultimate purpose has not been achieved.

8.2 Observations among the Female Groups

8.2.1 Accessibility to health care facility

a) Health care facility availed by villagers

• Women primarily want to avail the government facilities. This is either due to their positive experiences in the past or those of the friends/relatives.

• Most of the women said that for delivery they primarily feel safe in going to the government hospital but due to various reasons most of them actually are not utilising these facilities. Women from the villages need to travel long distances, as CHCs are not situated in the villages but near the main roads.

• Various groups with single voice stated that delivery occurs most of time during odd hours or in emergency, and for that, one could not depend on the present health system. They added that doctors are not available and for the reasons not known to them, they refer the patient to either private hospital or to the District Hospital.

“Wahan hota hi kon hay”.‘asan to aes lai privaton e jainda hega”

• For this reason they go to either private or to the District Hospital. Few of the women also added that the government doctors, who are practicing privately also provide good treatment in their nursing homes, and so it is better to go to them.

• Parishad CHCs are more popular in some of the areas as compared to the PHSC’s CHCs.

b) Reasons for non-utilisation of Government health facilities

• Most of the rural women visit the CHCs for their reproductive health problems.

• Most of the places gynaecologists are not available.

• If the distance of the health facility is more, the local people utilise private facility only. “For delivery we cannot take any chances” was the version of most of the respondents.

• People were found unhappy because they have to spend the money for availing health services. They were of the opinion that at least delivery facility should be provided by the Government free of cost.

“Madam suin se ley kar glucose, davaina, injection sab bahar se he khareedna padta hai”. “Serkari aspatal witch to sab kokh hi milna chaida hay”


• At night time nobody can think of going to the CHC for any emergency as hardly anybody would be available there. People prefer to go the private hospitals /nursing homes only. It was commented that in general, these government health service providers provide no emergency facilities.

• Availability of the doctor in the hospital/CHC is not very sure.

• Laboratory testing, ultrasound etc. are required to be done from private centres. At many places, women groups stated that these centres are also in someway or other related to the government hospital doctors. Most commented that the government doctors prefer to see the patient in their private settings charging consultation fees..

c) Distance from home and connectivity from the road

• Although distance is an important factor, but if good doctors are available at health facilities, people will most likely utilise these health facilities.

• Most of the rural women visit Parishad CHC, as it provides the services. The nearby CHCs under PHSCs with 6 doctors are not being visited.

• At places, where the CHC are nearby the villages or even in the residential area, people still do not utilise the services and rather go to private hospitals/nursing homes which are situated at distance. “The same doctors give good treatment in private nursing homes, so we go there only’.

d) Transport facilities and cost of travel

• CHCs are found to be mainly situated near the main roads but away from many villages. These roads are however, well connected with the local transport also. Still the paying capacity for the cost of travel depends on the economic status of the family, which is a matter of concern for the poor patients.

• Those who cannot afford to bear these costs prefer to call for TBAs for conducting the delivery, irrespective of the fact whether she is trained or untrained.

e) Services

• It was stated that they have to purchase everything needed during hospitalisation or otherwise. Even as outpatients, majority of the medicines have to be purchased from outside.

8.2.2 Availability of the facilities in the hospital

a) Waiting time at OPD

• Waiting time in OPD depends on the number of the patients. If doctor is available and few patients are there it only takes 20-25 minutes. Whereas if the number of the patients is more, than it may take even 5-6 hours. As far as timings of the OPD are concerned, all of them felt it is convenient for them.


• Few opined that if a gynaecologist is there, women will feel comfortable in going to them and would not even mind the waiting time. Very few deliveries are being conducted at the CHCs.

b) Availability of the doctors

• Different members were having different opinions on this issue. Though most of them agreed that availability of the doctors is there but there are also some places where there is scarcity of the staff. Few of the women added that if doctor is from the same area, there are chances that they will be available.

c) Availability of the medicines

• Almost all mentioned about the non-availability of the medicines. Whatever the patient needed whether as in-patients or as out-patients, they are being asked to buy almost everything. Even for the delivery, everything is to be purchased. No medicines are being provided from the hospitals. Very few people mentioned that for economically weaker sections, some medicines are given from the hospital.

c) Availability of the laboratory and radiological investigation

• All were not very happy with the functioning of the laboratory and radiological investigations. The respondents pointed out the fact that in emergency, it becomes a great problem in availing any of these facilities. Few respondents opined that it is diffi cult for a pregnant woman to collect the report from the lab and then visit the doctor.

• It was revealed that at few of the places, machines/equipments are either not in working condition or else the technician is not available.

“If it is only the availability ‘Yes’, it is available but if we talk about the functioning aspect, it is questionable”.

“Whole day goes off only for one test to be done”

8.2.3 Behaviour of health care providers towards patients

• In general, members experienced happiness with the general doctors. But few commented that gynaecologists are available only sometimes.

• It was refl ected that the doctors’ behaviour is more prompt and appropriate when they go to visit the same doctors in their private clinics as compared to government facility.

• Behaviour of the nursing staff was reported to be good. It was also mentioned that the staff did not ask for any money for any reason and that they are at times cooperative.


8.2.4 Outreach services offered by Government facility

• Though ANM is available but home visits are very less.

• No health related discussion takes place ever.

“ab to sub jante hai kya achha hai kya kharab”

• All were happy about the pulse polio. However, ANC is not a regular agenda. Women generally go by themselves to the hospital to get registered.

• Families were found to be well aware about the institutional deliveries. Few stated that ANM is active and takes due care of the pregnant women.

• Visits of ANM/ASHA is generally restricted to specifi c area. It was stated that they are more centred towards their residential area.

• Far off villages are not taken care of. Some women commented that as such there is hardly any coverage for family planning services. They use contraceptives, based on whatever information they get from various sources.

• No medicines are distributed by the ANM. Iron and folic acid tablets are also not available with them. CHCs provide these medicines for 3-5 days to each pregnant women.

• Women who go to the private doctors get prescription for iron and folic acid tablets and they purchase it. The people from poor background only visit the hospitals for delivery and that also was when local dais tell them that about some problem during home delivery.

8.2.5 Coverage

• Remote areas are not being properly served. People are forced to utilise private services sometimes with the same government doctor of the hospital in their private clinics.

The centres are like “ujada chaman, wahan kon jayga”.

• Health facilities are not fully equipped. They need to go to the other specialised hospitals/ referrals.

8.2.6 Satisfaction with the services provided by the Government health

facility

• Most were not satisfi ed with the government facilities.

• Very few of them commented that services are fi ne to an extent but almost all women were of the opinion that the services need improvement.


8.2.7 Suggestions for improvements

• There should be improvement in basic facilities in hospitals including cleanliness, recruitment of the staff, specialised doctors, drinking water arrangement, toilets on all the fl oors and wards, electricity (lighting arrangement), generator, water tank, timely repair of accessories and machines etc.

• Medicines should be provided by the hospital. If not possible, at least the BPL families should get the facility. For the other patients, subsidised medicines can also be a good option.

• In emergency delivery cases, at least hospital should provide everything.

• Provision for laboratory and ultrasound, especially in emergency, should be in perfect condition.

• On call doctors should be arranged for emergency departments.

• Fee for the investigations should be subsidised.

• Community oriented programmes e.g. Camps, health Melas, health education etc. should be organised especially in far-fl ung areas.

• Local community participation should be enhanced for utilisation of health services. Mahila Mandals should be strengthened.

• Emergency departments, ambulances should be arranged at very minimum rates. For transport of delivery cases, there should be no charge.

• Doctor on emergency duty should be available for 24 hours.

• The private practice of the Government doctors should be stopped.

• Every village should have a trained dai and a lady doctor.


Interviews were conducted with senior administrators and other stakeholders to get their views on the functioning of the health system. The fi ndings of interviews as per facility are given below:

9.1 At District Level

9.1.1 Deputy Commissioners (DC)

Out of the 10 districts visited in Punjab for evaluation of the health System, the Deputy Commissioners (DC) of only 9 districts could be interviewed as the DC of Hoshiarpur district was not available at the time the study team visited the district. All the DCs interviewed had less than 2 years of service as D.C.

The revelations from these interviews are as follows: (Refer Table 23)

9.1.1.1 Overall functioning

• Out of the total 9 DCs interviewed from the various districts visited, DCs of 50% districts reported that the overall functioning of health facilities in their district is good, while 30% reported average (mainly due to shortage of staff) and 20% reported poor and gave lack of doctors as one reason for poor functioning.

• Regarding availability of staff, 60% DCs admitted shortage of staff, while 30% of the DCs could not say anything defi nitely on this matter. DCs of district Muktsar, Sangrur and Gurdaspur felt that the decrease in utilisation of health services by the community is mainly due to the shortage of staff particularly the specialists viz., gynaecologist, orthopedician and eye-specialist.

• Shortage of O.T staff at most places was reported by DC, Muktsar. He also reported that cancer is a big problem in Muktsar and no focus has been given to that.

• It was emphasised mostly that the general cleanliness is not good and needs further improvement. Maternity services in most of the District Hospitals also need improvement. Long waiting time was also reported as a big problem in the delivery of services (Sangrur District).

• Besides this, lack of staff, lack of supervision to ensure punctuality and to check absenteeism, improper monitoring systems as well as negative interference (on non-health issues) were reported as other constraints in the delivery of services.

9.1.1.2 Extent of fulfi lment of community needs

• Regarding the extent of fulfi lment of health needs of the community, 40% of the DCs stated that it is being partially fulfi lled (upto 50%) while 40% DCs stated that large extent of

9. Views of the Stakeholders


community needs are being fulfi lled (upto 80%). Remaining 10% DCs did not have any conclusive comment on this issue.

• Regarding the perceived barriers among facilities in utilising public health services, 30% felt that availability and accessibility are a barrier mainly for CHCs. 20% felt that there are some barriers in terms of utilisation and acceptability of services. Remaining 50% DCs felt that there are no barriers for the availability, accessibility, utilisation and acceptability at services at District hospitals, but for Sub-divisional hospitals and CHCs it requires further improvement.

9.1.1.3 Referral services

• According to 40% DCs non availability and not fully equipped ambulance are a problem, 30% DCs opined that referral services are satisfactory in their districts and the remaining 20% DCs had no idea about this.

9.1.1.4 Knowledge of RKS (Rogi Kalyan Samiti)

• More than 60% of DCs were found to have knowledge of RKS while rest were unaware. 10% DCs told about BPL cards being given to poor patients for free treatment.

9.1.1.5 Fund fl ow

• Regarding the fund fl ow it was felt by 30% DCs that there is no problem with respect to the fund fl ow, 20% stated that it is not through DC. Other 10% DCs stated that funds are not adequate and another 10% felt that the funds are not being fully utilised. 20% did not have any comment regarding the funds fl ow. It was suggested that funds should be given for the purchase of C.T. Scan and MRI. Medical Insurance for poor and economically backward people should be introduced at state level.

9.1.1.6 Manpower management

• About 40% DCs reported good levels of motivation amongst their staff, 20% reported low to very low motivation level, over load of work and low salaries being the main reasons for low motivation. 30% DCs did not give any comments. Frequent transfers were also opined as one of the main reasons for low motivation level.

9.1.1.7 Constraints in delivery of services

• About 30% of the D.C felt that lack of staff is a major constraint in the delivery of health care services. 10% felt that lack of supervision, absenteeism, lack of punctuality, lack of funds, lack of super specialists, lack of facilities and high load of work are some other constraints in the delivery of quality health care services.

9.1.1.8 Suggestions

The following suggestions were given by DCs:• More infrastructure facilities and equipments should be provided.• Salary of doctors should be increased otherwise they will go for private practice.• More contractual employees should be placed – especially class IV and lab technician.


• PPP model need to be introduced.• Telemedicine should be promoted.• Performance linked appraisal should be there.• Number and quality of drugs need to be increased and improved.• Paid wards should be started.• Transport services should be improved.• Health insurance should be done for poor patients.• Cleanliness should be emphasised upon.

9.1.2 MLA/Elected Representative

A total of 10 districts were visited in Punjab for evaluation of the health system and elected representatives of all these districts were interviewed. Elected representatives of 60% districts had a length of service of more than 2 years and 30% had 1 – 1.5 yrs. of service. (Refer Table 24)


• About 50% reported that the overall functioning of health facilities in their district is good, while 10% reported it as average and 20% reported as poor (mainly the CHCs). Remaining 20% did not give any comments.

• The overall services of hospitals were reported to be satisfactory by 40%, 20% reported as average and 10% reported them bad mainly due to poor gynaecological facility. No comments were received from 30% of the representatives.

• MLA of Jalandhar opined that for improving the functioning of the hospitals, the Sub-Divisional Hospitals should be upgraded to 100 beds, since the load of patients is more in these hospitals.

9.1.2.2 OPD services

• With regard to the availability of staff it was felt by 20% of MLAs that the adequate staff is available in the District Hospitals, however, it was felt by 70% of them that there is shortage of doctors in most of the hospitals.

• With regard to the availability of medicines in OPD, 60% stated that medicines are available but are not suffi cient as per the requirement, 40% felt that the medicines are not at all available. They felt the need and suggested that the costly medicines, which the people purchase from outside should be provided at subsidised rates by the District Hospital.

• With regard to the waiting time, 60% of the elected representatives felt that the waiting time is not much (<30 minutes), while 30% of them felt that it could range anywhere from 1-3 hours.

• With regard to cleanliness, 70% felt that the District Hospitals are maintaining good and/or satisfactory level of cleanliness while 20% felt that the cleanliness is not good.


• Regarding the extent of fulfi lment of health needs of the community, 40% gave a satisfactory response that the health needs are being fulfi lled for >60% of the community. 50% of them


reported low levels of community needs fulfi lment (30 – 50%) and that mostly poor people are the only ones using it.

9.1.2.4 Behaviour of staff

• 60% of the elected representatives felt that the overall behaviour of health staff is good/satisfactory while the rest 20% felt that it is not satisfactory.

• It was stated that the behaviour of nurses and class IV in particular is rude towards the patients. No conclusive comments were given by 20% of the elected representatives.


• Regarding the ambulance services, 40% reported that there are good services while the other 40% said that the ambulance services are either not available or wherever available are not functioning well. 20% did not give any comments.

• When asked to rate the services in a government hospital as compared to Private/NGO/Charitable hospital, it was stated that government doctors are better qualifi ed than private, but in odd hours and emergency and due to non-availability of the doctors, they have to go to private facilities.

• Otherwise government services are better. One of the MLA stated that private facilities are better but one needs to pay for that. They stressed on more number of ambulances to be made available and further increase in IEC activity at government hospitals.

9.1.2.6 RKS and poor patients’ treatment

• About 40% of the elected representatives were having the knowledge of RKS while the other 30% had no knowledge and 30% did not give any comments.

• With regard to free treatment of poor patients, 20% stated that free treatment is being given to poor while 30% said that no free treatment is being provided to the poor. 20% said that treatment for poor is being provided from Red Cross fund or from NGOs. 30% did not give any comments which might be due to lack of knowledge.

9.1.2.7 Perceived barriers

• When asked about the perceived barriers, the responses received were as follows: Regarding availability, 20% felt that less availability of medicines and ambulance service is a barrier. One serious issue which was reported from Civil Hospital Firozpur was that anti-rabies vaccine is not available and with an increase in the number of street dogs, it is becoming diffi cult to tackle the situation.

• With regard to the accessibility, 80% felt that there is no barrier, rather, health facilities upto CHCs are easily accessible, whereas 20% felt that referral service is a barrier as this requires money.

• Regarding utilisation, 20% of the elected representatives felt that it is not low, while 40% felt that the scarcity of medicines is a barrier and 20% felt that utilisation is low mainly due to lack of diagnostic equipments and laboratory facilities in CHCs.

• With regard to the acceptability, 20% felt that it is a barrier in CHCs only and 10% felt that non-availability of equipments is a barrier.


9.1.2.8 Suggestions

• Most elected representatives suggested that more equipment for diagnostic facility (i.e. C.T. Scan, MRI) should be made available for poor patients.

• More number of ambulances should be made available.• They advocated sanction of vehicle for SMO for fi eld visits. • Extra water facility should be provided. • Security guards should be recruited at health facilities. • They suggested increasing plantation in and around hospital complex.• Night and emergency services should be improved and more doctors should be made available.• The hospital should be upgraded from 50 to 100 beds to adequately meet the patient load.• A Generator with greater capacity and power should be installed to improve functioning.• Technicians for ultrasound must be recruited.

9.1.3 Civil Surgeons

Civil Surgeons of all 10 districts of Punjab included in the assessment for evaluation of the Health System were interviewed. (Refer Table 25)


• CHCs: � Civil surgeons of 40% district stated that overall functioning of health facilities in their

district is good, while 40% reported poor service condition of CHCs and 20% reported over utilisation of OPD.

� Problem with indoor facilities was reported by 10%. Main problem reported by civil surgeons was shortage of staff especially at CHCs.

� Regarding bed occupancy, 60% Civil Surgeons stated bed occupancy in the range of 40-60% in their CHCs, 20% reported between 10-20% and 20% were not able to provide any exact fi gure.

• Sub-Divisional hospitals: � 70% Civil Surgeons stated bed occupancy in their districts in the range of 70-100%

in Sub divisional hospitals, 20% Civil Surgeons stated bed occupancy as 50%, while remaining 10% did not give any comments.

• District hospitals: � 70% civil surgeons stated bed occupancy in the range of 70-100% in the District

Hospitals and 20% reported bed occupancy of 50%. No comments were given by 10% civil surgeons.


• Regarding the extent of fulfi lment of the health needs of the community, 50% civil surgeons gave a satisfactory response, while 40% reported average level of fulfi llment of community and 10% reported that the needs are not being fulfi lled at all.


• Most of the civil surgeons opined that the health services are not being fully utilised by the community because of the following main reasons:� Lack of specialists� Shortage of technical staff� Non-availability of medicines

• It was stated by most of the civil surgeons that the patients had to spend money on laboratory and radiological investigations. Some civil surgeons also felt that lack of infrastructure for building is also one of the constraints in utilisation of services by the community.

• It was also stated that due to the shortage/non-availability of staff, patients had to wait for considerable time for receiving consultation from specialists/doctors, for getting medicines and getting investigations done.

• Civil surgeons were of the view that patients of well off families are not availing their health care facilities because of poor cleanliness, lack of privacy for admitted patients, inferior quality of nursing care and low client satisfaction level.

• It was stated by civil surgeons that one of the constraints in delivery of health services is due to non-staying doctors at the health facility, which again is due to lack of good accommodation facility and irregular supply of electricity.

• Civil surgeon of Taran Taran district felt that there is a need to improve the obstetrics & gynaecology services in these facilities.

9.1.3.3 Availability of medicines

• Only 20% civil surgeons stated that medicines are available in OPD while 80% of them reported that the medicines are lacking.

• With regard to the waiting time, 50% civil surgeons felt that it is not much, while another 50% felt that the waiting time is long.

• About 40% civil surgeons stated that cleanliness is not good in their hospitals, while 50% reported it to range from good to average and only 10% felt that it is of very good standard.


• 80% civil surgeons felt that the overall behaviour of health staff is in range of good to satisfactory while the rest 20% felt that it needs improvement.

• Regarding referral services it was stated by 30% civil surgeons that there is no problem while 50% reported that there is shortage of ambulances and drivers at some places.

9.1.3.5 Funds fl ow

• It was stated by 40% of the Civil Surgeons that there is no problem regarding the fund fl ow. 30% of them reported that funds are not being provided and they are managing only through the user charges.

• 10% civil surgeons stated that there is a slight delay in getting the funds and the remaining 10% said that funds are available only under NRHM (National Rural Health Mission).



• About 30% of civil surgeons reported low levels of motivation amongst their staff, 40% reported good motivation level and 20% reported average levels of motivation.

• For improving the motivational level among staff members, they laid importance on increasing the salary of staff, constructing the residential quarters, giving desired place of posting of job, incentives for good workers and reducing mismatch with specialist and GDMO regarding place of posting.


• Regarding availability, 20% civil surgeons felt that lack of manpower in SDH and CHC is a barrier while other 70% reported no barriers in availability of services.

• Regarding accessibility, 10% felt that it is a barrier especially for the CHC while the other 70% did not report any barriers.

• 30% civil surgeons felt that the utilisation of services at CHCs is low by the community, 10% felt that short supply of medicines is a barrier in effective utilisation, while the rest 40% felt that there are no barriers as such with regard to utilisation.

• Regarding acceptability, 30% civil surgeons felt that there are barriers with regard to CHC while 50% reported no barriers. No conclusive comments were received from 20% civil surgeons.

• According to most of the civil surgeons interviewed, the areas which require attention are cleanliness of toilets, proper working condition of certain equipments, IEC activity among community, fi lling up of vacant posts of Class IV, sweepers, ambulances for the hospital, increase in allotment of funds and staff for O.T and pharmacists.

9.1.4 SMO (Senior Medical Offi cers) In-charge of District Hospitals

Senior Medical Offi cers In-charge of all District Hospitals from 10 districts visited were interviewed. It was observed that out of the 10 District Hospital SMOs interviewed, 50% had their length of service for less than 2 years while other 50% had more than 2 yrs. of service in their respective District Hospitals. (Refer Table 26)


• Regarding the staff strength of OPD, 20% SMOs felt that the staff strength is adequate, while 60% felt that there is shortage of nursing staff, Paramedics, Class IV, and radiologists. 20% felt shortage of specialists especially paediatricians in their OPDs. Staff of OPD is overworked in opinion of some SMOs.

• SMOs of all districts stated that the OPD timings are adequate and the quality of treatment provided from OPD is also quite good.

• Bed occupancy was estimated 100% in 30% of the hospitals, more than 70% in 40% of the hospitals and less than 70% in 20% hospitals as stated by the SMOs.

• 60 % SMOs stated that poor patients are being provided with free medicines. 30% SMOs stated that very few medicines are actually available (mainly the 5 basic medicines i.e. Antibiotics, B-Complex, Paracetamol, Ibuprofen & Metronidazole).


9.1.4.2 Services provided

• In opinion of the SMOs, patients are spending money mainly on the transport, medicines and lab investigations.

• No dietary service is available in any of the District hospitals but it was revealed that at 10% of the hospitals only one meal is being provided to them free of charge by Voluntary organisations.

• While most SMOs were of the opinion that their services are up to 80% at par with the private sector, some were of the opinion that private sector is giving better services. However, most of the SMOs felt that they are giving best services and value for money particularly to the poor patients.

9.1.4.3 National Health Programmes (NHP)

• About 80% of the SMOs were having information regarding various National Health Programmes. However, 10% SMOs stated that this information is not available under PHSC.

9.1.4.4 Fund fl ow and RKS

• About 40% SMOs stated no problem in fund fl ow in their hospitals. But 30% SMOs (viz; Tarantaran, Jalandhar and Hoshiarpur) stated that no funds are being provided and they are managing from User Charges alone; 10% SMOs reported shortage of funds while another 10% (i.e., Sangrur) stated that SMO has got no role in this regard.

• While 80% SMOs were found to be aware of the Rogi Kalyan Samiti, 20% were not sure about its functioning, since they have been recently constituted. They reported that there are some problems in constitution of the committee and conducting the regular meetings.

• It was revealed that money is mostly being used for infrastructure development, e.g. building etc.

• At some places, free dentures, dental check-ups and Cataract Operation are being done for poor patients.

• All the SMOs stated that efforts are being made to provide medicines to all, but due to non-availability of medicines, some medicines are to be purchased through user charges (e.g. vital and life saving drugs).

9.1.4.5 Extent of community needs fulfi lment

• Regarding the extent of fulfi lment of health needs of the community, 50% SMOs felt that they are able to fulfi l up to 100% needs; while 30% stated that they are mainly catering to the needs of the poor.

• The community was found to be utilising OPD facility to its maximum.

9.1.4.6 In-patient services

• It was stated by SMOs that at some places (20%) there is shortage of nursing staff and junior doctors, with nurse to bed ratio ranging from 1:20–1:40. 50% SMOs stated that nurse to bed ratio is adequate, in the range 1:2 to 1:6.

• Doctor/Bed ratio also showed a lot of variation.


• It was revealed that job of cleanliness is given on contract in more than 50% of health facilities. It was also commented by SMOs that at many places drinking water is not being treated and is supplied for usage as such.

9.1.4.7 Manpower management and other services

• 90% SMOs stated that they have a system of performance appraisal in their hospitals. The problem of confl icts between the staff and patients was not found to be a big issue in most of the hospitals.

• Regarding Emergency services, SMOs stated that they run for 24 hours a day with Specialists and Surgeons available on call. One doctor is always present for night duty. Emergency supply of drugs is ensured and Lab. Technician is also available on call during emergency.

9.1.4.8 Community participation and manpower management

• Regarding community participation, it was revealed that at some places food is being provided by Voluntary Organisations and at others there are NGOs and charitable organisations that are providing medicines and blankets other than food.

• At most places no barriers/challenges are being faced for effective community participation, whereas at one place (Amritsar) some political interference was found leading to some administrative problems, like transfer of staff etc.

• SMOs were found to adopt a variety of methods for monitoring and effective supervision e.g. ACRs, Daily rounds, monthly meetings, surprise checks, checking of medicine registers, feed backs etc.

• Some SMOs also stated that they undertake efforts for reducing the stress levels of the staff by counselling them, appreciating them, motivating, following appraisal system, by directly talking and by obliging the person. To increase motivation level, doctors are also being sent outside to receive trainings.

• Bio-medical waste management was found to be undertaken in most (90%) of the District Hospitals; however 10% of them reported shortage of bags.

9.1.4.9 Perceived barriers to avail health facilities

• Regarding the perceived barriers for availability of health services, 20% SMOs felt that there is lack of information and shortage of staff which is a barrier while the rest 60% did not felt that any barrier existed.

• Regarding accessibility, 20% SMOs felt that shortage of medicines and lack of staff is a barrier. • 60% the SMOs opined that there is no perceived barrier for ‘Utilisation’, while 20% felt that shortage

of facilities and lack of information is a barrier in effective utilisation of health services. • Regarding acceptability of health facilities only 10% reported these as barriers.


9.2 At Sub-division Level

9.2.1 MLA/Elected Representative–Sub Divisional Hospital

Elected representatives of 9 out of 10 districts were interviewed at SDH level. Elected representative of Amritsar district was not available for interview. Elected representatives of 70% districts had more than 2 years of length of service while 20% had less than 2 yrs. of service. (Refer Table 27)


• About 30% of elected representatives reported that the overall functioning of health facilities in their district is good, while 50% reported it as satisfactory and 10% as poor (mainly at CHCs).

• The overall services of hospitals were reported to be in ranges from good to satisfactory by 70% of them, while 20% reported them as not very good.


• With regard to the availability of staff, 40% of elected representatives stated that the staff was available at the Sub Divisional hospitals, whereas 50% felt that there is shortage of doctors/specialists in the hospitals.

• Regarding availability of medicines in the OPD, only 20% stated that medicines are available, while 60% stated that suffi cient medicines are not available so as to meet the requirement. 10% stated that most of the time no medicines are available.

• They opined that, all the medicines which the people purchase from outside should be provided from the hospital itself.

• Regarding the waiting time, 40% of the representatives stated that the waiting time is not much, while 50% of them stated that it is long and it depends on the number of patients and availability of doctors.

• Regarding cleanliness in OPD, 30% felt that the Sub Divisional Hospitals are maintaining good level of cleanliness, while 30% stated that it is of average level. Rest 30% representatives felt that the cleanliness is not good.

9.2.1.3 Extent of fulfi lment of community needs:

• In response to this question, 50% of them gave a good response, with the health needs being fulfi lled for more than 75% of the community. 10% stated that only average level of need fulfi lment is being achieved. Remaining 20% reported low levels of community needs fulfi lment (20 – 40%) and mentioned that the services are being mostly utilised by poor people.


• Regarding behaviour of staff in Sub Divisional hospitals, 40% elected representatives felt that the overall behaviour ranges from good to satisfactory. 40% felt that it varies and reported the behaviour of staff as average while 10% reported that the behaviour is not good. It was stated that the behaviour of Nurses and class IV in particular is not good.



• Regarding the Ambulance services, 40% stated that the services are available and satisfactory, while another 40% stated that the ambulance services are either not available or wherever available, these are on payment basis.

9.2.1.6 RKS and treatment of poor patients

• About 40% of the elected representatives were having the knowledge of RKS, while another 50% were having no knowledge about it.

• Regarding free treatment of poor patients, 60% stated that these facilities are providing free treatment to poor, while 20% stated that no free treatment is being given to the poor patients.


When asked about the perceived barriers the responses were as follows:

• Regarding the availability, 20% felt that less availability of medicines and equipments is a barrier, while 70% perceived that availability as such is no barrier.

• With regard to the accessibility, all of them opined that there is no barrier. • 70% of the elected representatives also felt that there is no perceived barrier for utilisation,

while 20% stated that it is a barrier due to non-availability of USG machine and other diagnostic facilities.

• Regarding acceptability, 80% elected representatives stated that it is no barrier, while 10% felt that the acceptability of health services by community is low.

9.2.1.8 Suggestions

• Most of the elected representatives suggested that more equipment for diagnostic facility (i.e. C.T.Scan, MRI) should be made available for poor patients.

• They advocated sanction of vehicle for SMO for fi eld visits. • Extra water facility should be provided; and security guards must be recruited to ensure patient

security. They even suggested increasing plantation in and around hospital complex.• Technician for Ultrasound must be recruited.• Medicines should be available in good quantity• There should be a Blood bank at these health facilities • More staff, medicines, funds and ambulances should be made available.

9.2.2 SMO – Sub Divisional Hospitals

Senior Medical Offi cers of all Sub divisional hospitals included in the study were interviewed. It was found that out of SMOs of 10 Sub divisional hospitals, 80% had their length of service less than 2 yrs. and 10% had more than 2 yrs. of service in their respective Sub divisional hospitals.(Refer Table 28)



• Regarding the OPD Services, 50% SMOs felt that the staff strength is adequate, while other 50% stated that it is poor due to shortage of Class IV employees and specialist doctors.

• Bed occupancy was stated as 85-100% in 50% of the hospitals, while the rest 40% SMOs’ reported 40-70% bed occupancy.

• Poor patients were being given free medicines in opinion of 60% of the SMOs, while in other 30% hospitals, only some of the medicines are available as free.

9.2.2.2 National Health Programmes (NHP)

• Most of the SMOs (70%) were having information regarding various National Health Programmes, but at few facilities (30%) information regarding malaria and STD programmes were not available.


• Regarding the extent of fulfi lment of health needs of the community, 20% of the SMOs felt that they are able to fulfi l 100% of health related needs; while other 30% stated this level of fulfi lment upto 75% and rest 30% upto 50%.

• 10 % of the SMOs opined that health needs of the community are fulfi lled to high level by the OPD; however, this is comparatively lower for in patient departments.

9.2.2.4 In-patient department

• It was found that Nurse to bed ratio in most (80%) hospitals was in the range 1:3 to 1:5, while at 10% of the hospital (Ludhiana) this ratio was 1:12.

• Doctor/Bed ratio was found to be of range 1:3 to 1:6 at 50% of the hospitals, while it is in the range of 1:7 to 1:10 at 30% hospitals. For the rest 20% the ratio was not specifi ed.

• Dietary services are not organised in the hospitals and this is mostly managed by patient’s attendants.

• Level of cleanliness was opined to be good at 20% of the hospitals, average level at 30% and poor at 10% of the hospitals.

• 20% of the SMOs reported shortage of staff and 10% reported that they had recruited the staff on contract basis.

9.2.2.5 RKS and fund fl ow

• While 60% SMOs were aware of the Rogi Kalyan Samiti, its exact status and functioning was not known to 10% of them and 20% reported that RKS is not functioning in their hospitals.

• 60% SMOs reported no problem of fund fl ow in their respective hospitals, while 20% of them (Tarantaran and Jalandhar) reported that no funds are being provided to them.

• SMO of Amritsar Sub-Divisional Hospital stated that they are managing only from the user charges.


9.2.2.6 Manpower management and other services

• Most of the SMOs (70%) stated that they have a system of performance appraisal in their hospitals, which included benchmarking for doctors and ACRs. 10% stated they do not have any appraisal system, while 10% said that they have their own personal perception.

• Almost all (90%) hospitals were having Emergency services running 24 hours a day with specialists and surgeons available on call, in the opinion of SMOs. They stated that at least one doctor is always present for night duty.

• Only major constraint brought out following interview with SMOs was that of the non- availability of doctors.

• Bio-medical waste management was found being followed at most (80%) of the Sub divisional hospitals, however, 20% SMOs reported shortage of disposal bags.

9.2.2.7 Perceived barriers to avail health services

Responses received regarding the perceived barriers are as follows:

• Regarding availability, 30% SMOs stated that there is lack of specialists and doctors, which are barriers at their hospitals, 10% SMOs stated lack of medicines and staff as a barrier. Rest 40% SMOs stated that no barrier exist in terms of availability.

• Regarding accessibility, 70% SMOs felt that it is no barrier, while the other 30% did not comment on this aspect.

• 10% of the SMOs felt that lack of infrastructure and behaviour of staff are being perceived as barriers for the utilisation of services, while 70% stated that it is not a perceived barrier. Rest 20% did not give any comment on this.

• With regard to the acceptability, it was felt by 70% SMOs that it is not a barrier and no comments were received from the rest 30% of the respondents.

9.2.2.8 Suggestions

• Vacant staff positions should be fi lled up.• Regular training for the staff should be provided.• Repair and maintenance of staff quarters should be done.• Manpower shortage, especially of gynaecologists, radiologists and Class IV employees should

be looked into.• Fully equipped ambulance and CT scan service should be provided.• Private wards should be created at these health facilities.• There should be provision of seminar room in these facilities.• SMOs should be given authority to cut down on non-performing staff.• Security services should be provided on contract basis to ensure security.• Costly equipments should have annual maintenance contracts.• More and regular supply of medicines should be ensured.• Awareness generation regarding available services should be done through the media.


9.3 At CHC Level

9.3.1 Elected Representatives

Elected representatives were interviewed for assessment of the functioning of CHCs in their respective areas, in all districts included in the study.. Out of the total 10 districts visited, elected representatives of 90% districts had more than 2 years of length of service while remaining 10% had less than 2 years of service. (Refer Table 29)


• When asked about the functioning of CHCs in their districts, about 50% of them reported that the overall functioning of CHCs in their area is good, while 20% stated that it is getting better now and 20% reported that the functioning of CHCs is not good, mainly because the doctors are not available as they were going for private practice.

• The overall services of CHCs were opined as good by 30% of them, 60% reported the services as average and 10% reported them as ‘not good’.


• Regarding the availability of staff it was stated by 70% of the elected representatives that the staff is available in the CHCs, however, 30% of them opined that there is shortage of doctors in most places, especially of the gynaecologist.

• With regard to the availability of medicines in OPD, 50% felt that medicines are available, however rest 50% stated that the medicines are either less or only partly available. They also stated that, all the medicines should be provided at the CHC.

• Regarding the waiting time, 70% of the representatives felt that the waiting time is not much (<30 minutes), while 30% of them felt that it is long.

• With regard to cleanliness, 80% stated that the CHCs are maintaining satisfactory/good level of cleanliness; while 10% felt that the level of cleanliness is bad (Hoshiarpur) and 10% felt that this needs improvement (Muktasar).


• In response to this question, 40% stated that the needs are being fulfi lled to a large extent; another 30% felt that only 50% of the health needs are being fulfi lled and the rest 30% felt that only 10% of the community health needs are being fulfi lled and only medico legal cases generally go to CHCs.


• Regarding behaviour of staff in CHCs, 70% elected representatives felt that the overall behaviour is good and the rest 30% felt that it is not good.

• It was commented upon that the behaviour of nurses in particular is bad.



• Regarding Ambulance services at CHCs, 30% stated that the services are available, while 60% stated that the ambulance services are either not available or only partially available.

• It was stated by the elected representatives that in the emergency situation they utilise the untied funds available with Panchayats to hire a vehicle.

9.3.1.6 RKS and poor patients’ treatment

• About 40% of the elected representatives were found to have knowledge of RKS, while the other 50% were having no knowledge and 10% did not comment on this issue.

• Regarding free treatment of poor patients, only 20% said that they are being given free treatment, while majority of them (60%) said that no free treatment is being offered to the poor. 20% were not able to give any conclusive comments.


Regarding perceived barriers to avail health facilities the views of elected representatives were as follows:

• Regarding the availability, 40% of them felt that less availability of medicines and absence of doctors is a perceived barrier, 10% felt that far off location is a barrier, while the rest 50% opined that there are no perceived barriers in terms of availability.

• Regarding accessibility, 10% felt that referral services are a barrier since these referral facilities are located very far, while 90% stated that there no barriers.

• 40% felt that scarcity of medicines and less availability of doctors is a barrier in utilisation of services available CHCs, while the other 60% reported no barrier.

• With regard to the Acceptability, it was felt by 40% that it is a barrier in CHCs due to restricted or lack of quality facilities, no barriers were reported by the other 60%.

9.3.2 Senior Medical Offi cers – CHC

• A total of 11 Senior Medical Offi cers from 11 CHCs were interviewed in 10 districts visited in Punjab for evaluation of the Health System. One SMO from each of the sampled district CHC and 2 from Amritsar were interviewed. It was found that out of 11 SMOs interviewed, 80% had their length of service as more than 2 yrs. while rest 30% had more than 2 yrs. of service at their respective CHCs’. (Refer Table 30)


• Regarding the OPD Services, only 30% stated that the staff strength is adequate; while the other 70% felt opined there is shortage of staff.


• Bed occupancy rate was found to be between 10-20% in 60% of the CHCs, 30-50% in 20% of the CHC and 100% at only one CHC (Bhatinda).

• Poor patients were being given free medicines in the opinion of 90% of the SMOs interviewed; while 10% stated that they are providing only few medicines and the remaining 10% SMOs did not comment on this.

9.3.2.2 RKS and National Health Programmes

• About 80% SMOs were aware of the Rogi Kalyan Samiti. Though some initiatives had already been taken in other areas, but it found not functioning/not formed in 30% of the CHCs due to various administrative reasons.

• About 40% of the SMOs were having information regarding various National Health Programmes, while 50% stated that not all information is available to them (i.e., Malaria, T.B and STD). Rest 20% SMOs did not give any comments in this regard.


• 20% SMOs felt that they are able to fulfi l upto 90-100% needs of the community; 20% stated they are able to fulfi l 70-80% of the health needs, 20% stated satisfactory level of needs fulfi lment, 20% reported that the CHCs are under-utilised and no defi nite comments were obtained from remaining 20% of the SMOs.

9.3.2.4 In-patient department (IPD)

• With regard to the IPD Services it was found that Nurse to bed ratio in about 20% CHCs was about 1:10, another 40% CHCs had this ratio between 1:3 –and 1:7, while CHC at Ferozpur reported this ratio as 1:1.2.

• CHC Jalandhar reported shortage of staff. No conclusive comments were received from 30% of the SMOs on issue of services in in-patient departments.

• Doctor/Bed ratio at 20% of the CHCs was between 1:2 and 1:4 and at the other 40% CHC sit was in the range of 1:5 to 1:7.

• Doctor-bed ratio was 1:30 at Manawala CHC in Amritsar. • Staff shortage was reported form Jalandhar; Sangrur CHC reported high i.e., 1:15 doctor/bed

ratio. • Level of cleanliness was opined as good by 30% of the SMOs and as average by 70%. 10%

SMOs stated that level of cleanliness is not up to the mark.

9.3.2.5 Fund fl ow

• While 50% SMOs reported no problem of fund fl ow in their respective CHCs, 10% of them reported that no funds are being provided to them. Rest 40% SMOs stated that this is being handled by civil surgeons.



• About 90% of the SMOs stated that they have a system of performance appraisal by means of ACRs in their CHCs, which also includes laying down benchmarking indicators for doctors and medical offi cers.

• 20% SMOs stated that they are doing appraisals through records and meetings as well as through appreciation letters, other than ACRs.

9.3.2.7 Other services

• About 90% SMOs stated about availability of emergency services running 24 hours a day, with specialists and surgeons being available on call. Only 10% said that there is shortage of staff but still somehow they are providing services.

• Doctors were mostly available on call. 10% stated that they take help from mini PHCs. • Bio-medical waste management was being followed in opinion of 90% of the SMOs, rest SMOs

did not provide any conclusive information regarding this aspect.


• Regarding the availability of services, 30% SMOs felt that there is lack of doctors and shortage of staff, which is a barrier, while the rest 30% did not feel any barrier existed.

• With regard to the Accessibility, only 10% stated that diffi culties are there as CHC is in a border area while 60% reported no problem.

• Regarding utilisation of services at CHC, 60% of the SMOs felt that due to lack of funds, non-availability of specialists, shortage of drugs, poor investigation facilities and poor quality of services, there is low utilisation.

• With regard to the acceptability, it was felt by 20% SMOs that it is low due to less number of doctors, while 40% did not perceive this as a barrier.

9.3.2.9 Suggestions

The following suggestions were made:• Regular Investigation and X-ray facility should be made available even after 3 p.m., so that

patients do not suffer.• Essential drugs should be adequately available.• Bed linen should be provided in adequate quantity. Laundry unit should be made available

in CHC.• Services should be made accountable to general public/community.• Assured career plan should be developed for all cadres comparable to bench marks.• Manpower must be provided in places where it is lacking. Vacant posts should be fi lled. The

available services can be improved a lot by providing a gynaecologist, paediatrician and dentists in the CHCs’.

• Medicines should be supplied and ‘border area’ allowances also be given where the CHC is located near the border.


• Doctors and staff should be provided good accommodation facility at par with their status.• CHCs should be provided with uninterrupted supply of electricity.• There should be AMC for all equipments.• Computer operators should be provided.• Junior Engineer should visit CHCs twice a month. • Availability of Diesel for generator should be ensured at all times.• User charges should be increased according to rising infl ation, as patients are ready to pay

for quality services.


10.1 Facility Survey

Based on the analysis of quantitative and qualitative data, the following

observations are drawn forth:

10.1.1 Infrastructure

a) Almost all the hospitals under study were easily accessible from the Bus Stop and nearest Railway Station and easily approachable by a motorable road.

b) The building and general infrastructure for all the health care facilities were found to be reasonably well constructed. But as most of them are newly constructed, this infrastructure needs proper maintenance so that its life can be prolonged.

c) Most of the hospitals were not found to be equipped with the required equipments. In some hospitals, equipment was there but there was mismatch as some were found to be either not in use and some were reported to be out of order.

d) The surrounding of these health care facilities was not found in good condition. Almost every health facility required paying serious attention towards this aspect.

e) The cleanliness of the hospital premises was not up to the mark.

10.1.2 Human resources

a) Almost all the hospitals under study have vacant posts including post of Doctors and Support Staff.

b) The doctors posted in these hospitals are from one single cadre. There is no separate cadre for GDMO and Specialists. As a result, particularly in CHCs and Sub Divisional Hospitals, the Specialists were also doing night duties/emergency duties and hence were not available for regular OPDs.

c) Doctors including specialists in the hospitals under study were supposed to perform other duties like, the VIP duties, attend court cases and remain involved in various public health activities and health fairs. If regular GDMO would have been available, these duties could well be undertaken by GDMOs.

d) There is an acute shortage of Radiologist, Anaesthetists, Paediatrician and Gynaecologist in almost all the hospitals, particularly in Sub Divisional Hospitals and CHCs.

e) There is also an acute shortage of the support staff, particularly the Technical staff in Sub Divisional Hospitals and CHCs.

f) Frequent transfers of the doctors has also been refl ected as a cause of concern and problems in these hospitals. For example, in case where a doctor of one speciality is transferred, he is most likely to be replaced by doctor of another speciality. This disrupts the services of hospital for that particular speciality and patients suffer on this account.

10.0 Observations and Discussion



a) It was observed in all the hospitals and reported by almost everybody that medicines are not available in adequate quantity.

b) The patients were found to purchase the medicines from outside.c) Though there is a provision of supply from the State and District level, but in practice

most of these centres reported that they are asked to buy the medicines from the User Charges fund.

d) It was also observed that purchasing medicines from User Charges fund have become a routine practice in almost every hospital/health centre under study.

10.1.4 Laboratory and diagnostic services

a) Though the laboratories and diagnostic services were available in all the hospitals assessed, but functioning of the labs was not reported to be up to the mark.

b) The patients are forced to get the tests done from outside laboratory services due to lack of reagents and equipments..

c) Regarding the radiological services, X-ray Units were found to be non-functional due to erratic electric supply and non-availability of fi lms.

d) Moreover, Radiologists were also not available in all the hospitals.

10.1.5 Emergency and maternity services

a) Emergency and Maternity services found to be worst effected mainly in Sub Divisional Hospitals and CHCs. Main reason for this was non-availability of the doctors for Emergency and Maternity services.

b) Even Nursing staff was not feeling comfortable to do the duty in the night and odd hours due to security reasons, as other staff and people are not available during night hours.

c) It was revealed that due to non-availability of the staff and other facilities, the patients have to return back from the facility. As a result, the community is losing confi dence in the hospitals. This is one reason of low utilisation of health facilities and also for this trend to down further.

10.1.6 Disaster preparedness

a) None of the hospitals, including District Hospitals were found to be properly prepared to deal with any Disaster situation.

b) None of the hospitals including District Hospitals were having any well-prepared Disaster Action Plan. Nor they are having any disaster drill or any disaster manual.

10.1.7 Referral linkages

a) Though on paper all these hospitals are having a well laid down referral system but in practice this is not very meticulously followed.


b) Mostly the patients are transferred from the lower health centre to the higher centre without any feedback loop.

c) No guidelines are available at the facilities for “whom to refer”, “how to refer” “when to refer” and “where to refer”.

10.1.8 Medical records

An analysis of all medical records revealed the following:

a) None of the hospitals were having a properly planned and organised Medical Record Department.

b) All the data and statistics from Medical records were found to be maintained manually. None of the Medical Record Departments were found to be computerised.

c) Most of the case-sheets kept in the Medical Record Departments were found to be incomplete and mostly not maintained as per any defi nite standard indexing/procedure.

10.1.9 Stores management

a) The Medical Store management was not found to be very organised, and following the modern techniques of store management.

b) In almost all the hospitals, only few medicines could be found in the medical stores of health facilities.

c) The record maintenance of the stores was not found to be in proper order and they were not maintaining any “Buffer Stock” or calculating the “Reorder Level”.

d) The scientifi c ‘Inventory Control Techniques’ were not practiced in any of the stores visited and the staff was also not having much knowledge about these techniques.

10.1.10 Diet services

a) None of the hospitals were providing regular diet to their in-patients, except in one Sub-divisional hospital (Meler Kotla).

b) It has been suggested that if the patients are provided diet from the hospitals, this would be highly appreciated.

10.1.11 Basic facilities

a) The relatives of the patients, particularly those who are coming from distant places, were not having any proper place to stay (Dharmshala) and were having no access to other facilities like toilet, kitchen etc. As a result they were found loitering all over the places in and around the hospital.

b) Similarly, the basic facilities like toilets, particularly separate toilets for ladies were not available in every OPD.

c) These facilities must also have other services like STD booths, canteen and subsidised chemist shop.

d) Residential accommodation available was not found to be fully utilised, mostly due to poor maintenance of residential accommodation.


10.1.12 Rogi Kalyan Samiti

a) Though on papers Rogi Kalyan Samitis existed in all the hospitals, but due to their internal administrative problems and non fulfi lment of the required pre-requisites, these Samitis were found to be non functional or yet to be made functional in almost all the hospitals.

b) Funds under these Samitis were found to be un-utilised in all these hospitals.

10.2 Views of the Benefi ciaries

A total of 580 respondents were interviewed in the outpatient department and 224 respondents from inpatient departments of various health institutions like CHCs, Sub-divisional hospitals, District hospitals and two Special Hospitals of Punjab Health System Corporation to obtain their opinion about the available health services.

10.2.1 Socio-economic dimension of the respondents

a) Majority of respondents utilising PHSC were females having poor education and low income in age group of 15-30 years.

10.2.2 User charges

a) Majority of the respondents were paying user charges for getting OPD card and for getting investigations done. More than 3/4th of respondents were paying the charges for making slip/card required for admission.

10.2.3 Admission procedure

a) 77.7% of the respondents were not satisfi ed with the admission procedures and 86.2% of respondents at CHC and 81% at sub divisional hospitals rated it poor.

b) Only half of the respondents were informed about rules and regulation of these health facilities regarding admission procedures.

10.2.4 General cleanliness and comfort in wards

a) Overall ratings of general cleanliness of the OPD along with basic facilities were found to be better in the Special Hospitals and the same was comparatively lower in the CHCs.

b) According to the fi ndings, 66.5% rated general cleanliness of wards and beds as good whereas 44.2% respondents rated it average. 66.5% respondents had perceived the cleanliness of bed linen as good, while 30.8% respondents perceived it average.

c) There is a need to improve the general cleanliness and cleanliness of linen in Sub-divisional hospitals and District hospitals.

d) Out of various health institutions 74.1% respondents perceived that the level of comfort in the wards was good but 30% perceived comfort as average, with better comfort in CHCs and special hospitals.


e) Only 47.3% respondents perceived that toilets were clean. This was further low in case of District Hospitals and Sub divisional hospitals.

10.2.5 Availability of basic facilities

a) Facilities like fan and lights were found to be good according to 75.7% of respondents in OPD and 79.5% for inpatients. These facilities were not up to the mark in OPD of CHCs, although it was good in wards of CHC.

b) District hospitals need improvement for both outpatients and inpatients services. STD/PCO booths were not present in 57% of health institutions and only 16.7% of CHCs were having STD/PCO booths out of these health institutions.

c) 14% of health institutions were not having a separate toilet facility which was 23.7% in case of CHCs. 11% of health institutions were lacking in drinking water facilities and again CHCs were lacking more in context of this facility. Separate toilet facilities need to be made available to the female respondents, particularly when more number of females are utilising the services of the OPD of various institutions. 16.7% of CHCs were not having screens in the examination room.

10.2.6 Adequacy of information about disease and treatment

a) Among OPD patients, 81.4% said that adequacy of information given to them about their disease and treatment by doctor was good. 69.2% inpatients reported the adequacy of information as good. In the case of OPD, information given was least in CHCs as compared to other institutions, but on the contrary, CHCs were found better in case of inpatient services.


a) Only 10.3% respondents stated that all medicines are available in the OPD and 26.4% stated that none of the medicines are available in the OPD. When the percentage was seen separately in the various health institutions than the availability of medicines was more in Sub-divisional hospitals and least in District hospitals.

b) In case of Inpatient department, only 13.4% respondents stated that all the medicines are available and 29% respondents stated that none of the medicine were available in the wards. When the percentage was seen separately in the various health institutions then availability of medicines was found to be more in Special hospitals and least in Sub-divisional hospitals.

c) Among the in-patients, 91.1% respondents were found to have spent money on medicines and in case of different health institutions, the percentage of respondents who spent money on medicines was as high as 100% at Sub-divisional hospitals and up to 69% at CHCs.

10.2.8 Availability of diagnostic facilities

a) Out of all respondents interviewed at OPD, 50.7% stated that the facilities like laboratory and radiological investigations are good. In case of inpatients, 65.6% stated that the facilities such as laboratory and radiological investigations are good.


10.2.9 Availability and behaviour of doctors, nurses and staff

a) Overall availability of doctors as stated by the respondents at the health institutions was 94.8% and when respondents were asked about doctor’s behaviour towards them, 91.4% respondents from OPD and 93.3% from in patient departments stated that doctor’s behaviour is good.

b) Availability and behaviour of staff was found to be similar in case of specialists. When percentage availability of doctors and specialists were seen separately, then it was found lower in case of CHCs and District Hospitals among all the institutions.

c) Availability and behaviour of nurses was not found to be as good as in case of doctors. Availability of nurses was found to be 79% and good behaviour of nurses in OPD as 64.5%. On the other hand 80.4% nurse’s behaviour was good in the in-patient department of various health institutions with lowest in Sub-Divisional Hospitals (67%).

d) Overall 56.9% staff member’s behaviour was perceived as good by the respondents in the OPD of various institutions, which was 74% in case of in-patient services.

e) Behaviour of staff was rated lowest in CHCs as compared to other health institutions. In case of OPD 2.9% respondents had to pay to staff members of the hospitals other than user fees for getting services.

10.2.10 Waiting time in OPD

a) Time spent in waiting for specialist consultation in the OPD was less than 15 minutes for 63.4% respondents and more than 30 minutes for other 13.9%. In case of investigations, 83.6% respondents were found to have waited for 15 minutes and 6.5%% for more than 30 minutes.

b) Waiting time for getting the medicine in the OPD was up to 10 minutes for 80.8% respondents. Patients at District Hospitals and special hospitals were found to have waited for more time period.

10.2.11 Security in the in-patient department

a) Only 46.4% respondents of all the health institutions perceived that the security at these facilities is good, whereas 17% respondents perceived it poor.

b) It means that more than half of the respondents did not feel adequately secure in the in-patient department. Security in the health institutions needs to be improved with more focus on CHCs and sub divisional hospitals.

10.2.12 Quality of care

a) Overall 75.9% of OPD and 79% of in-patient respondents rated the quality of treatment in the hospitals as good. CHCs and Sub-Divisional Hospitals were rated low in quality in comparison to the other institutions.

b) Overall 77.9% respondents in OPD were satisfi ed with the services of various health institutions. However, only 2.3% respondents were fully satisfi ed with the services of the out-patient department. 22.1% respondents were not satisfi ed with the services available at the health institutions. 94.2% respondents of the in-patient department were satisfi ed and


only 5.8% were not satisfi ed with the services of the health institutions. c) Overall rating about the cooperation at the reception counter of the various institutions was

found to be good, but CHCs need to have improvement in this regard.d) 70% respondents rated their experience at OPD as good and this proportion is only 57% at

CHCs. This indicates that services at CHCs need overall improvement.

10.2.13 To sum up

a) Majority of respondents utilising PHSC were females having poor education and low income levels.

b) Patients approach mainly PHSC for utilisation of emergency services. This may be because at that time they do not have access to other health facilities and they have no other alternative left due to economic reasons.

c) General cleanliness and cleanliness of linen in Sub-Divisional Hospitals and District Hospitals need to be improved.

d) Overall behaviour of doctors, nurses and other staff members in the health institutions was stated to be good by majority of the respondents. Only a minor proportion of them rated it unsatisfactory.

e) Majority of the respondents stated that the medicines are not available, and that they have to buy it from market, as advised by doctors.

f) More than half of the respondents did not feel adequately secure in the in-patient department. Security in the health institutions needs to be improved.

g) Availability of basic facilities, in general, was not very satisfactory in all type of health institutions and particularly in District Hospitals and CHCs. These include: � Availability of STD/PCO booth, � Better toilet facilities and mainly separate toilets for women in all types of health

institutions, � Availability of safe drinking water, � Availability of screen in the examination room.

h) Behaviour of staff members in the OPDs was not rated to be satisfactory by majority of the respondents.

i) A good percentage of respondents stated that availability of doctors, nurses and staff in the OPDs is good, except at CHCs. However, the fi nding on the similar issue in the community was very different. Rather this was reported to be as one of the major issues underlying low utilisation of health services provided by PHSC.

j) The facilities like laboratory and radiological investigations were not rated to be satisfactory by majority of the respondents as most of the time these facilities are not available. Because of this, patients are forced to go to private facilities to get the required investigations done.

k) Overall experience of respondents at OPDs of the various health institutions under study was not found to be very satisfactory. This observation holds true in particular for CHCs and District hospitals and needs further attention.

l) A good percentage of respondents felt that the quality of treatment in the hospitals needs to be improved, mainly in the CHCs, as these are in the rural areas and mostly the community was not having any other alternative option for health care.


10.3 Views of the Community based on Focus Group

Discussions

The following observations are noted based on focus group discussion in the community:

a) General administration of the hospital needs rectifi cation. This includes cleanliness, recruitment of the staff, doctors with specialties, drinking water arrangement, toilets on all the fl oors & wards, electricity (lightening arrangement), generator, water tank, timely repair of accessories and machines etc.

b) All necessary medicines should be provided by the hospital. If not possible, at least the BPL families should get this facility. For the other patients subsidised medicines can also be a good option.

c) At least in the emergency situation hospital should provide every facility like diagnostic services or medicines.

d) Provision for laboratory and ultrasound should also be in perfect situation.e) Surgeons can be arranged for emergencies on call.f) Fee for the diagnostic tests should also be subsidised.g) There is a need to organise community campaigns such as camps, health melas, health

education etc. especially in far-fl ung areas.h) Local community participation should be enhanced for utilisation of health services.i) For strengthening emergency services, ambulances need to be arranged at very minimum rates.j) Doctor on emergency duty should be available for 24 hours a day.k) The private practice of the Government doctors should be stopped.l) Every village should have a trained dai and a lady doctor.m) It was desired that at least delivery facility for pregnant women should be provided by the

government free of cost.n) If all the facilities with the good doctors were available people would prefer to utilise those

health facilitieso) It was observed in the discussion that the parishad CHCs were more popular in the areas as

compared to the PHSCs/CHCs.

10.4 Views of other Stakeholders

The view of the other stakeholders is as given below:i) More infrastructure facilities and equipments need to be provided.ii) Salaries of doctors are not very lucrative as a result they go for private practice.iii) More contractual employees are required – especially class IV and lab technicians.iv) Public Private Partnership model needs to be introduced.v) Telemedicine should be promoted.vi) Performance linked appraisal should be adopted.vii) Number and quality of drugs need to be increased and improved for increasing acceptance

of the services.viii) Paid wards should be started.


ix) Transport services should be improved.x) Health insurance should be made available for poor patients.xi) Cleanliness should be emphasised.xii) More equipment for diagnostic facility (i.e. CT Scan, MRI) should be made available for

poor patients. xiii) More number of ambulances should be made available.xiv) A separate vehicle should be made available for SMO for fi eld visits. xv) Extra water facility and clean, treated water should be provided. xvi) Security guards must be recruited to improve security of in patients. xvii) Plantation in and around hospital complex should be increased.xviii) Night and emergency services should be improved and more doctors should be made

available.xix) The 50 bedded hospitals need to be upgraded to 100 beds to meet the community needs.xx) Generators with more power and capacity should be made available to improve functioning,

as frequent power failure is a perpetual problem in many areas.xxi) Technician for Ultrasound must be recruited.xxii) Vacant staff positions should be fi lled up.xxiii) Regular training should be provided to the staff.xxiv) Repair and maintenance of staff quarters should be done.xxv) Manpower shortage especially that of radiologist, anaesthetist, paediatrician and

gynaecologist and obstetrician, along with class IV employees, should be seriously looked into.

xxvi) Fully equipped ambulance and CT scan should be provided.xxvii) There should be provision of a seminar room.xxviii) Facility in charge should be given authority to cut down on non-performing staff.xxix) Security services should be provided on contract.xxx) Costly equipments should have AMC.xxxi) Awareness of services should be done through media.


Based on above quantitative, qualitative and triangulation of data, the following

recommendations are proposed:

11.1 Human Resource

a) An assessment may be done for the State of Punjab to fi nd out the staff position for all categories of health workers including doctors.

b) An exercise to fi nd out the strength of the sanctioned and vacant posts needs to be undertaken.

c) Urgent efforts may be made to fi ll up the vacant positions.d) Two separate cadres for the doctors i.e. one for GDMOs and one for specialists instead of

having only one single cadre of Medical Offi cers should be created.e) Category wise GIS mapping of all types of human resources including Medical offi cers and

various Specialists for all the Health Institutions may be done for the entire state. By this exercise, a clear picture will emerge regarding the exact availability against the requirement of each category of health personnel.

f) It is suggested that PHSC may take policy decisions whereby all the doctors are paid a basic minimum salary so as to motivate them to work at government health facilities.

g) This exercise will help in planning and recruitment of the required specialists and GDMOs.h) Moreover based on the norms of IPHS, posts for GDMOs and other essential categories of

specialists may be created and fi lled up. i) Availability of basic specialists in the respective health centres will surely build up the

confi dence among the community and hence result in increased utilisation of services. j) Separate administrative cadre may be developed for the administrative posts of district,

sub-division and CHCs so that a full time and well qualifi ed/trained doctor can be assigned to these jobs. A specialist may not be given this responsibility by virtue of his/her seniority as this effects his clinical practice in the hospital.

k) As reported, the salaries of the doctors under PHSC were not at par with the private sector and this could be one of the reasons for high attrition rate among the doctors.

l) Performance based incentives may be considered not only for retaining the existing specialists, but also State may explore the possibility of involvement of private practitioners under public private partnership as per market rate. This exercise can be done under human resource innovation which is one of the components in NRHM. A similar performance assessment system was already in practice i.e. ‘Bench Marking’. Also, by this method, it may be easier to retain the specialist category of radiology, anaesthesia, paediatric, gynaecology etc.

11.0 Conclusion and Recommen-


11.2 Availability of Drugs

a) At all the health care institutions, the benefi ciaries reported to have expectations that the medicines, particularly the vital ones, should be provided by the health centre. Moreover, it becomes a moral obligation for the authorities to provide at least the vital and essential medicines.

b) Hence, the availability of these medicines specially the vital and essential ones should be necessary in all health facilities..

c) Therefore it is recommended that every health centre should prepare the list of medicines (drug formulary) to be used at that centre and the same to be sent to their concerned authorities for procurement/indent.

d) At the State level, these lists of drugs, coming from various types of health facilities through their respective district headquarters to be compiled and a common list to be prepared.

e) By applying scientifi c Inventory Control Techniques of ABC and VED analysis, they should fi nd out the list of all the vital and essential drugs and the costlier one (which shall not be more than 20% of the total procured drugs).

f) These medicines should be procured through state level and distributed to the districts for onwards supply.

g) Alternatively the state may fi x up the rate contract of each item after following the laid down procurement procedures for drug items and supply this information with the required authority letter to the respective districts so that they can directly procure these medicines from the suppliers at the rate fi xed by the state.

h) In this way, the state headquarters need not to worry about their budget and every district health centre and below will be procuring these medicines by using funds of Rogi Kalyan Samitis or user charges.

i) By this partial de-centralised procurement, the availability of the medicines will defi nitely improve and quality of the medicines can also be ensured.

j) Every hospital/health centre should have proper antibiotic policy and standard treatment guidelines.

k) There should be regular practice of prescription audit.

11.3 Community Education and Community Rights

Regarding Health Facilities

a) Every hospital/health centre should clearly display the citizen charter and the name, designation and telephone numbers of the concerned offi cers to whom they can approach at the time of any dispute or complaint.

b) The benefi ciaries should also be informed about the routine procedures they are expected to follow in that health centre and their rights.

11.4 Cleanliness

a) Special efforts should be taken to maintain the cleanliness of the hospital. CHCs should focus more on this so that it is at par with basic required standards.


b) The general up keep of surroundings of the hospital should also be maintained properly. For this reason, special efforts should be taken for regular repair, maintenance and landscaping.

c) The toilets should be kept clean and the drainage system in particular to be fl ushed routinely at regular intervals. Drainage system should be regularly cleaned and monitored.

d) For the support staff a training capsule having role and responsibilities\ including basics of hygiene and sanitation, preventive and promotive health care, motivation, attitudinal changes, services available in the health facility may be developed and continuing exercise should be regularly undertaken.

e) For house keeping and sanitation, the services may be out sourced and may be given to the professional organisation like sulabh etc.

f) A separate toilet for the females should be there in the OPDs of every hospital/health centre.

11.5 Diagnostic Facilities

a) Efforts should be made to ensure that all the required reagents and equipments in the laboratories are available.

b) For those special investigations, which are not carried out in the respective centres, the authorities should tie up with the private laboratories at pre-negotiated fi xed rates.

c) With these arrangements, the benefi ciaries can be referred to these laboratories and they will not end up paying a higher price.

d) Even for the poor patients, respective health centre may pay their charges from the funds available from user charges/Rogi Kalyan Samitis.

11.6 Medical Record Department

a) For any good administration, the correct and timely information is very important. This information can only be made available, if the respective data is generated in outpatient and In-door facilities. Hence, to have proper information, every hospital needs to have a well planned and organised medical record department. The information in medical records, helps hospital administrator to monitor the utilisation pattern of their respective hospital and to help them to take required necessary decision for improvement. The following observations are made in this regard:

• All the case sheets and medical records pertaining to patient care is required to be maintained following some standard indexing system so that in future, retrieval becomes easy.

• Every hospital should come out with the routine statistical bulletin, which should include some of the important Hospital Utilisation Indices like bed occupancy rate, average length of stay, bed turnover interval, gross and net death rate etc.

11.7 Emergency Services

a) Due to paucity of doctors and other support staff in various hospitals, the emergency services are not functioning properly. This creates a problem for the community


(especially for the poor population) who are forced to go to the private sector for availing emergency services.

b) This calls for taking into account, that the emergency services are taken very seriously and action needs to be taken immediately.

c) To start with, doctors may be posted in these hospitals, particularly at sub divisional hospital and CHC, exclusively to run emergency services.

11.8 Maternity Services

a) Emergency obstetric services: Non-availability of satisfactory obstetric services is another major drawback in the system. The community is compelled to seek care from the private sector due to the non availability of emergency obstetric services in the public sector.

b) Main reasons found out for this was non-availability of gynaecology and obstetrics specialists. c) Hence efforts should be made to ensure that every hospital upto CHC level has atleast one

gynaecologist with all required facilities.d) A model of public private partnership like the one followed in Gujarat (Chiranjeevi scheme)

may be looked into for strengthening the maternity services.

11.9 Other Aspects

a) Admission procedures need improvement with more focus on CHC and sub divisional hospitals. Rules and regulations of health institutions should be properly informed to the patients.

b) Cleanliness of linen in Sub-Divisional Hospitals and District Hospitals needs to be improved.

c) STD/PCO booth to be installed for convenience of the patients and relatives as per IPHS standards and NRHM.

d) CHCs were lacking in many facilities and PHSC should look into this matter immediately to provide quality service to rural people.

e) Inpatients should also be provided by adequate information regarding disease and treatment.f) The inclination of community to use private services is due to ensured availability of the

services including holidays, at night, clean environment and at a time convenient to the people in the community.

g) Hence to increase the utilisation of the facilities, evening OPDs may be started. h) On the experimental basis, it may be made as pay clinics, with the choice of the patient to

select the doctor. A good share of the earning (say about 60-70%) from these pay clinics may be paid to the doctors.

i) The amount paid to the doctors as honorarium may be in consonance to the number of patients they are attending.

j) Proper and well maintained residential accommodation for doctors and other staff may be provided at all levels of health centres.

k) Security in the health institutions needs to be improved with more focus on CHCs and sub divisional hospitals.


l) Every Hospital should have a hospital infection control committee.m) There should be a regular grand clinical rounds for all the health centres i.e. CHCs and above.

This should be attended by all the doctors.

Hence, to sum up, the utilisation of health care services will defi nitely improve if along with the availability of doctors and required specialists, the medicines (at least the vital ones), basic laboratory and radiological investigations are made available.

Further, the emergency services and the delivery services could be improved and made available round the clock for the satisfaction of the community. This would result in increased utilisation of the facilities provided by PHSC.


Tab

le 1

.1. G

en

era

l P

rofi

le a

nd

Fa

cilit

y S

urv

ey o

f D

istr

ict

Ho

sp

itals Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Acce

ssib

ility

to

Railw

ay/

Bus

Stat

ion

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s

Dist

ance

fro

m R

ail S

tati

on

km2

33

23

32

31

12

3

Dist

ance

fro

m B

us S

tati

on

km1

12

11

34

21

13

1

All W

eath

er R

oads

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Bed

Stre

ngth

5010

020

060

100

-300

-200

100

164-

100

5060

Sour

ce o

f W

ater

Sup

ply

Mun

icip

al

supp

lyBo

re w

ell

Bore

wel

lBo

re w

ell

Bore

wel

lM

unic

ipal

su

pply

Mun

icip

al

supp

lyCa

nal

wat

erBo

re w

ell

Mun

icip

al

supp

lyBo

re w

ell

Bore

wel

l

Wat

er S

uppl

y (Q

uant

ity)

Adeq

uate

Inad

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teIn

adeq

uate

Adeq

uate

Adeq

uate

Adeq

uate

Adeq

uate

Wat

er S

uppl

y (s

tora

ge

capa

city

ava

ilabl

e fo

r no

. of

day

s)

11

33

23

23

33

31

Elec

tric

ity

(sup

ply)

Irre

gula

rRe

gula

rRe

gula

rRe

gula

rRe

gula

rRe

gula

rRe

gula

rIr

regu

lar

Regu

lar

Regu

lar

Irre

gula

rRe

gula

r

Elec

tric

ity

(pha

se)

Phas

e-th

ree

Phas

e-th

ree

Phas

e-th

ree

Phas

e-th

ree

Phas

e-th

ree

Phas

e-th

ree

Phas

e-th

ree

Phas

e-th

ree

Phas

e-th

ree

Phas

e-th

ree

Phas

e-do

uble

Phas

e-th

ree

Elec

tric

ity

(Bac

kup

Gene

rato

r /U

PS A

vaila

ble

)Av

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

e

If m

ore

than

one

sto

rey

build

ing

(Lif

t Av

aila

ble)

Yes

Yes

NoNo

NoYe

sNo

NoNo

Yes

NoNo

If m

ore

than

one

sto

rey

build

ing

(Ram

p Av

aila

ble

)Ye

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Gene

ral I

mpr

essi

on-

up

keep

of

gard

enGo

odAv

erag

eGo

odAv

erag

eGo

odGo

odAv

erag

eGo

odGo

odAv

erag

eAv

erag

eAv

erag

e

Gene

ral I

mpr

essi

on-

clea

nlin

ess

Good

Aver

age

Good

Good

Good

Good

Aver

age

Good

Good

Aver

age

Aver

age

Aver

age

Gene

ral I

mpr

essi

on-

sign

po

stin

gGo

odGo

odGo

odGo

odGo

odGo

odAv

erag

eGo

odGo

odpo

orGo

odAv

erag

e

Gene

ral I

mpr

essi

on-

road

s an

d lig

htin

gPo

orGo

odGo

odGo

odGo

odGo

odAv

erag

eGo

odGo

odAv

erag

eAv

erag

eGo

od

(Con

td..

.)


Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Gene

ral I

mpr

essi

on-

Stat

e of

Bui

ldin

gGo

odAv

erag

eGo

odGo

odGo

odGo

odAv

erag

eGo

odGo

odAv

erag

eAv

erag

eGo

od

Any

Publ

ic U

tilit

y Se

rvic

e av

aila

ble

in H

ospi

tal

Prem

ises

NoGo

odNo

NoNo

NoNo

Good

NoNo

NoGo

od

Any

publ

ic U

tilit

y Se

rvic

e Av

aila

ble

in H

ospi

tal

Prem

ises

-Che

mis

t

Yes

Yes

NoYe

sNo

NoYe

sYe

sYe

sYe

s No

Yes

Any

Publ

ic U

tilit

y Se

rvic

e av

aila

ble

in

Hos

pita

l Pre

mis

es-S

ulab

h Sa

ucha

laya

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Yes

Any

Publ

ic U

tilit

y Se

rvic

e Av

aila

ble

in H

ospi

tal

Prem

ises

-Can

teen

NoYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

NoYe

s

Any

Publ

ic U

tilit

y Se

rvic

e Av

aila

ble

in H

ospi

tal

Prem

ises

-STD

/PCO

boo

th

NoNo

Yes

Yes

Yes

Yes

Yes

NoYe

sNo

NoNo

Ambu

lanc

e Se

rvic

esYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Ambu

lanc

e Se

rvic

es if

av

aila

ble

Part

ially

Eq

uipp

edFu

lly

Equi

pped

Fully

Eq

uipp

edPa

rtia

lly

Equi

pped

Part

ially

Eq

uipp

edPa

rtia

lly

Equi

pped

Part

ially

Eq

uipp

edPa

rtia

lly

Equi

pped

Fully

Eq

uipp

edPa

rtia

lly

Equi

pped

Fully

Eq

uipp

edPa

rtia

lly

Equi

pped

Tota

l Num

ber

of V

ehic

les

(Nos

.)1

105

34

43

21

32

1

No.

of O

pera

tion

The

atre

s-

Min

or (

Nos.

)1

11

11

41

31

11

1

No.

of O

pera

tion

The

atre

s-

Maj

or (

Nos.

)4

31

23

42

32

12

1

ICU

typ

esYe

sYe

sNo

Yes

NoYe

sYe

sNo

NoYe

sNo

No

ICU

no.

of

beds

86

NA6

NA10

4NA

NA5

NANA

(Con

td..

.)


Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Emer

genc

y Se

rvic

esRo

und

the

Cloc

kRo

und

the

Cloc

kRo

und

the

Cloc

kRo

und

the

Cloc

kRo

und

the

Cloc

kRo

und

the

Cloc

kRo

und

the

Cloc

kRo

und

the

Cloc

kRe

stric

ted

Roun

d th

e Cl

ock

Roun

d th

e Cl

ock

Roun

d th

e Cl

ock

Dent

al S

ervi

ces

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Deliv

ery

Serv

ices

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Faci

litie

s fo

r Po

st-m

orte

mNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoNo

Yes

No

Mor

tuar

y se

rvic

es w

ith

cold

sto

rage

& o

ther

pr

eser

vati

ve f

acili

ties

av

aila

ble.

NoYe

sYe

sNo

Yes

Yes

Yes

Yes

NoNo

Yes

No

Drug

for

mul

ary

com

mit

tee

NoNo

NoYe

sNo

Yes

NoNo

Yes

NoYe

sNo

Hos

pita

l Ant

ibio

tic

com

mit

tee

NoNo

NoYe

sYe

sNo

NoNo

NoNo

Yes

No

Hos

pita

l Inf

ecti

on C

ontr

ol

Com

mit

tee.

Yes

NoNo

Yes

Yes

Yes

NoYe

sNo

NoYe

sNo

Stor

e Pu

rcha

se C

omm

itte

eYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Stor

e ve

rifi c

atio

n Co

mm

itte

eYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Med

ical

Aud

it/

Deat

h Re

view

Com

mit

tee

Yes

NoYe

sNo

Yes

Yes

Yes

NoYe

sYe

sNo

No

Syst

em o

f Su

pply

of

Drug

it

ems

thro

ugh

Push

Push

Pull

Pull

Push

Pull

Push

Push

Pull

Push

Push

Pull

% o

f Dr

ug it

ems

aske

d fo

r is

sup

plie

d50

6050

9010

040

5020

5060

% o

f pa

tien

ts g

etti

ng a

ll th

e m

edic

ines

pre

scri

bed

5040

5070

100-

indo

or

5-10

-OPD

4025

7550

70

Is t

he d

rug

form

ular

y av

aila

ble

NoNo

NoNo

Yes

Yes

NoNo

NoNo

NoNo

Is b

uffe

r st

ock

mai

ntai

ned

Yes

Yes

Yes

NoYe

sYe

sYe

sNo

Yes

NoNo

Yes

(Con

td..

.)


Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Annu

al m

aint

enan

ce

proc

edur

e fo

r co

stly

Eq

uipm

ents

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Log

book

/ H

isto

ry s

heet

m

aint

aine

d fo

r th

e Eq

uipm

ents

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoNo

Yes

Pres

ent

stat

us/s

itua

tion

s of

the

exi

stin

g Eq

uipm

ents

:

Good

Good

Good

Good

Good

Good

Good

Good

Good

Good

Good

Good


Tab

le 1

.2 Facilit

ies A

vailab

le a

t D

istr

ict

Ho

sp

itals

Nam

e of

the

Dis

tric

t

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Baby

Inc

ubat

ors

NoNo

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

s

Baby

Inc

ubat

ors

NANA

Non

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Non

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

Func

tion

alFu

ncti

onal

Boyl

es A

ppar

atus

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Boyl

es A

ppar

atus

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

al

Card

iac

Mon

itor

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Card

iac

Mon

itor

Non

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Non

Func

tion

alFu

ncti

onal

Func

tion

al

Dent

al C

hair

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Dent

al C

hair

Non

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

N

Dosi

met

erNo

NoNo

NoNo

NoNo

NoNo

NoYe

sYe

s

Dosi

met

erNA

NANA

NANA

NANA

NANA

NAFu

ncti

onal

Func

tion

al

ECG

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

ECG

Func

tion

alNo

n Fu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

al

Emer

genc

y Re

susc

itat

ion

Kit

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s

Emer

genc

y Re

susc

itat

ion

Kit

Func

tion

alNo

n Fu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

al

Endo

scop

e

(fi b

er o

ptic

)

NoNo

Yes

Yes

Yes

Yes

Yes

NoNo

NoNo

No

Endo

scop

e(fi b

er o

ptic

)NA

NAFu

ncti

onal

Non

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NANA

NANA

NA

Opht

halm

o-sc

opes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Opht

halm

o-sc

opes

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NA

(Con

td..

.)


Nam

e of

the

Dis

tric

t

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Peri

met

erNo

NoNo

Yes

Yes

Yes

Yes

NoYe

sNo

NoNo

Peri

met

erNA

NANA

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NANA

NA

Phot

o Th

erap

y Un

itYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Phot

o Th

erap

y Un

itFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alNA

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Reti

nosc

ope

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sNo

Reti

nosc

ope

Func

tion

alNo

n Fu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

NA

Shor

t W

ave

Diat

herm

y (P

hysi

o th

erap

y)No

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Yes

Shor

t W

ave

Diat

herm

y (P

hysi

o th

erap

y)NA

Non

Func

tion

alNo

n Fu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

Func

tion

alNA

Non

Func

tion

al

Sigm

oido

scop

esNo

Yes

Yes

Yes

Yes

Yes

NoNo

NoYe

sNo

Sigm

oido

scop

esNA

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alNA

NANA

Func

tion

alNA

Slit

lam

p

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Slit

lam

pFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

Func

tion

alNA

Ult

ra s

ound

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sNo

Ult

ra s

ound

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

NA

X ra

yYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

X ra

yFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Othe

r M

ajor

and

Min

or

Oper

atio

n eq

uipm

ents

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Othe

r M

ajor

and

Min

or

Oper

atio

n eq

uipm

ents

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Any

Refe

rral

Sys

tem

in

plac

eYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

(Con

td..

.)


Nam

e of

the

Dis

tric

t

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Refe

rral

man

ual a

vaila

ble

NoNo

Yes

Yes

Yes

Yes

Yes

NoNo

NoNo

No

Guid

elin

es f

or-

Wha

t to

re

fer

NoNo

Yes

Yes

NoYe

sYe

sYe

sNo

Yes

NoNo

Guid

elin

es-W

hen

to r

efer

NoNo

Yes

Yes

NoYe

sYe

sYe

sNo

Yes

NoNo

Guid

elin

es-

How

to

refe

rNo

NoYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

NoNo

Colo

ur c

oded

ref

erra

l car

ds

avai

labl

eNo

Yes

Yes

Yes

NoYe

sYe

sYe

sNo

NoNo

Yes

Feed

-bac

k M

echa

nism

ex

isti

ng:

NoNo

NoNo

Yes

Yes

Yes

NoNo

NoNo

No

Tran

spor

t fa

cilit

y pr

ovid

ed:

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Mai

nten

ance

of

reco

rds/

regi

ster

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Ince

ntiv

e fo

r fo

llow

ing

refe

rral

rou

teNo

NoYe

sNo

NoYe

sYe

sNo

NoNo

Yes

Yes

If Y

es,

wha

tNA

NAVe

hicl

e pr

ovid

edNA

NAVe

hicl

e pr

ovid

edNo

pro

per

Answ

erNA

NANA

No p

rope

r An

swer

No A

nsw

er

Proc

edur

e fo

llow

ed f

or

refe

rral

:H

ighe

r Ce

ntre

NoM

edic

al

Colle

geCo

lour

cod

ed

card

-Med

ical

co

llege

Vehi

cle

prov

ide

to

Med

ical

Co

llege

Vehi

cle

wit

h co

lour

ca

rd

Hig

her

Cent

reW

ith

refe

rral

ca

rd

PGI

Chan

diga

rhRe

fer

to

Pati

ala

Refe

r to

M

edic

al

Colle

ge

Not

Serv

e

Tie-

up w

ith

othe

r ho

spit

al

(bot

h pu

blic

and

pvt

) fo

r di

agno

stic

NoYe

sYe

sNo

NoYe

sYe

sNo

NoNo

Yes

Yes

Hos

pita

l has

a t

ie-u

p w

ith:

(M

edic

al C

olle

ge/

othe

r go

vern

men

t/ p

vt.

inst

itut

ions

)

None

Othe

r Go

vern

men

t H

ospi

tals

Med

ical

Co

llege

Med

ical

Co

llege

&

Oth

er

Gove

rnm

ent

Hos

pita

ls

None

Priv

ate

Hos

pita

lsPv

t.

Hos

pita

lsNo

neNo

neNo

ne1

2

Does

the

Hos

pita

l hav

e an

y Ou

trea

ch A

rea

NoYe

sYe

sNo

NoNo

Yes

NoNo

NoNo

Yes

(Con

td..

.)


Nam

e of

the

Dis

tric

t

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Stat

isti

cal B

ulle

tin:

Avai

labl

eNo

t Av

aila

ble

Not

Avai

labl

eNo

t Av

aila

ble

Avai

labl

eNo

t Av

aila

ble

Not

Avai

labl

eNo

t Av

aila

ble

Avai

labl

eNo

t Av

aila

ble

Not

Avai

labl

e

Avai

labi

lity

of d

hara

msh

ala

NoYe

sNo

NoNo

Yes

NoNo

NoYe

sNo

Yes

Avai

labi

lity

of r

esid

enti

al

acco

mm

odat

ion

for

the

esse

ntia

l

NoYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

if a

vaila

ble,

wha

t %

is n

ot

gett

ing

acco

mm

odat

ion

(In

% )

NA80

00

5015

50NA

4040

7090

Secu

rity

arr

ange

men

t:Co

ntra

-ct

ual

In h

ouse

In h

ouse

In h

ouse

In h

ouse

Cont

ract

ual

Cont

ract

ual

NAIn

hou

seIn

hou

seIn

hou

seIn

hou

se


Tab

le 1

.3 Lab

ora

tory

Tests

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Com

plet

e Bl

ood

Hae

mog

ram

An

alys

is

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Com

plet

e U

rine

Ex

amin

atio

nYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

stoo

l tes

tYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Bloo

d ur

eaYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Bloo

d su

gar

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Live

r fu

ncti

on t

est

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Lipi

d pr

ofi le

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

PAP

smea

rYe

sYe

sNo

NoYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

FNAC

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Bloo

d Gr

oupi

ng

and

Mat

chin

g te

stYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Biop

sy t

est

NoNo

NoNo

Yes

Yes

NoNo

NoYe

sNo

No

Cult

ure

and

smea

r ex

amin

atio

nYe

sNo

NoNo

Yes

Yes

NoYe

sNo

NoYe

sNo

Sem

en E

xam

inat

ion

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Vagi

nal d

isch

arge

ex

amin

atio

nYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Bone

Mar

row

Ex

amin

atio

nNo

NoNo

Yes

NoYe

sNo

Yes

NoNo

NoNo

VDRL

tes

tYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Othe

r ro

utin

e te

sts.

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

NoYe

s


Tab

le 1

.4 O

ut

Pati

en

t D

ep

art

men

t

Out

Pati

ent

Depa

rtm

ent

Nam

e of

the

Dis

tric

tTo

tal

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Rece

ptio

n &

Re

gist

rati

on

Coun

ter

(man

ual/

co

mpu

teri

sed)

Man

ual

Com

pute

rise

dCo

mpu

teri

sed

Com

pute

rise

dCo

mpu

teri

sed

Com

pute

rise

dM

anua

lCo

mpu

teri

sed

Com

pute

rise

dCo

mpu

teri

sed

Com

pute

rise

dM

anua

l3

Man

aged

by

cler

kNo

NoNo

NoNo

NoNo

Yes

NoYe

sNo

No2

Man

aged

by

MSW

NoNo

NoNo

NoNo

NoNo

NoNo

NoNo

10

Man

aged

by

staf

f nu

rse

NoNo

NoNo

NoNo

NoNo

NoYe

sNo

No1

Man

aged

by

com

pute

r op

erat

orNo

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sNo

9

Know

ledg

eabl

e ab

out

the

OPD

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

12

Sepa

rate

regi

stra

tion

fo

r m

ale

Yes

Yes

Yes

Yes

NoYe

sNo

NoYe

sYe

sYe

sNo

8

Sepa

rate

regi

stra

tion

fo

r fe

mal

eYe

sYe

sYe

sYe

sNo

Yes

NoNo

Yes

Yes

Yes

No8

Sepa

rate

regi

stra

tion

fo

r se

nior

cit

izen

sYe

sYe

sYe

sNo

Yes

Yes

Yes

NoYe

sYe

sNo

No8

Sepa

rate

regi

stra

tion

fo

r st

aff

NoNo

Yes

NoNo

NoNo

NoYe

sNo

NoNo

2

Regi

stra

tion

re

gist

ers

are

prop

erly

mai

ntai

ned

and

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s11

(Con

td..

.)


Out

Pati

ent

Depa

rtm

ent

Nam

e of

the

Dis

tric

tTo

tal

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

All s

ecti

ons

of

the

OPD

havi

ng

prop

er s

igna

ge a

nd

dire

ctio

nal s

ign

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

s10

Wai

ting

are

a is

ad

equa

teYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s12

Prop

er s

itti

ng

arra

ngem

ent

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

12

Drin

king

wat

er

faci

lity

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

s11

Ceili

ng F

ans

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

12

Toile

t fa

cilit

yYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

11

Doct

or’s

Cham

bers

ar

e ha

ving

ade

quat

e sp

ace

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

12

Exam

inat

ion

tabl

e w

ith

prop

er s

heet

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

12

Stoo

l for

the

pat

ient

to

sit

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

12

Exam

inat

ion

equi

pmen

ts (

like

BP a

ppar

atus

Tor

ch,

ham

mer

, et

c.)

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

12

Adeq

uate

ill

umin

atio

nYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s12

Inje

ctio

n Ro

om

alon

g w

ith

faci

litie

s an

d to

dea

l wit

h Em

erge

ncy

situ

atio

n

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sNo

Yes

10

(Con

td..

.)


Out

Pati

ent

Depa

rtm

ent

Nam

e of

the

Dis

tric

tTo

tal

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Min

or O

T /

Dres

sing

Ro

om w

ith

all t

he

basi

c Eq

uipm

ents

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

s11

Disp

ensa

ries

/ Ph

arm

acy

wit

h se

para

te c

ount

ers

for

mal

e/fe

mal

e/se

nior

cit

izen

NoYe

sYe

sYe

sNo

NoYe

sNo

Yes

Yes

NoYe

s8

Labo

rato

ry &

Im

agin

g Se

rvic

es

easi

ly a

cces

sibl

e

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

12

Cent

ral C

olle

ctio

n Ce

ntre

for

La

bora

tory

Ser

vice

s

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

10


Tab

le 1

.5 E

merg

en

cy M

ed

ical S

erv

ices (

Casu

alt

y)

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

EMER

GENC

Y M

EDIC

AL

SERV

ICES

(CA

SUAL

TY)

Sepa

rate

Med

ical

Of

fi cer

(s)

avai

labl

e ro

und

the

cloc

k

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

sNo

Yes

No

Boar

d di

spla

ying

on

call

doct

ors/

spec

ialis

t an

d ot

her

staf

f on

dut

y

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoNo

Yes

Yes

Glow

sig

n bo

ard

indi

cati

ng ‘E

mer

genc

y Se

rvic

es D

epar

tmen

t’

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

NoNo

Emer

genc

y W

ard

atta

ched

to

Emer

genc

y De

part

men

t

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Tria

ge a

rea

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sNo

Yes

NoYe

s

Obse

rvat

ion

Beds

(fi l

l nu

mbe

r, fo

r No

fi ll

00)

319

37

108

43

45

36

Trol

leys

(fi l

l num

ber,

for

No fi

ll 00

)4

33

35

52

02

23

2

Whe

el c

hair

s (fi

ll

num

ber,

for

No fi

ll 00

)2

21

14

52

01

22

1

Exam

inat

ion

room

s (fi

ll

num

ber,

for

No fi

ll 00

)0

01

12

11

01

11

2

All t

he r

egis

ters

in

clud

ing

MLR

ava

ilabl

e fo

r pr

oper

reg

.

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Reti

ring

roo

m w

ith

toile

ts f

or t

he d

octo

rsYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Call

book

in p

resc

ribe

d fo

rmat

ava

ilabl

eYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

NoYe

s

(Con

td..

.)


Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Wai

ting

are

a fo

r th

e at

tend

ants

of

the

pati

ents

wit

h th

e ba

sic

Faci

litie

s lik

e si

ttin

g ar

rang

emen

ts, dr

inki

ng

wat

er,

toile

t et

c.

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

s

Publ

ic t

elep

hone

av

aila

ble

Yes

NoNo

Yes

Yes

Yes

NoNo

NoNo

NoYe

s

Trea

tmen

t ro

om-c

um-

min

or O

TYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Maj

or O

TYe

sYe

sNo

NoYe

sYe

sNo

NoYe

sYe

sNo

Yes

Suffi

cien

t st

ock

of

esse

ntia

l and

life

sav

ing

drug

s

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Oxyg

en c

ylin

ders

wit

h at

tach

men

tsYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Labo

rato

ry s

ervi

ces

Yes

NoNo

Yes

Yes

Yes

Yes

NoYe

sNo

Yes

Yes

Radi

olog

y Se

rvic

esYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Ambu

lanc

e se

rvic

esYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Staf

f tr

aine

d in

BLS

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Trea

tmen

t fa

cilit

ies

for

Dog/

sna

ke b

ite

&

Pois

onin

g

Yes

Yes

Yes

Yes

Yes

Yes

NoNo

NoYe

sYe

sNo

Avai

labi

lity

of D

isas

ter

man

ual

NoNo

NoNo

Yes

Yes

NoNo

NoNo

NoNo

Disa

ster

Ale

rt C

ode,

re

call

& d

eplo

ymen

tNo

NoNo

NoYe

sYe

sNo

NoNo

NoNo

No

Mai

nten

ance

of

dedi

cate

d Dr

ug s

tore

for

di

sast

er s

itua

tion

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sNo

Yes

NoNo

Plas

ter

Room

Yes

Yes

Yes

Yes

NoYe

sNo

Yes

NoYe

sNo

No


Tab

le 1

.6 In

ten

siv

e C

are

Un

it (

ICU

)

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Inte

nsiv

e Ca

re U

nit

(ICU

)No

Yes

NoYe

sNo

Yes

Yes

NoNo

Yes

NoNo

Tota

l num

ber

of b

eds

avai

labl

e:NA

6NA

6NA

104

NANA

5NA

NA

Air-

cond

itio

ned

ICU

wit

h ge

nera

tor

supp

ort

NAYe

sNA

Yes

NAYe

sYe

sNA

NAYe

sNA

NA

Staf

f sa

ncti

oned

for

the

ICU

- no

. of

doc

tors

NA0

NA2

NA0

1NA

NA0

NANA

Staf

f sa

ncti

oned

for

the

ICU

- no

. of

nur

ses

NA0

NA3

NA0

2NA

NA0

NANA

Staf

f sa

ncti

oned

for

the

ICU

- no

. of

tec

hnic

al s

taff

NA0

NA0

NA0

0NA

NA0

NANA


Tab

le 1

.7 C

lin

ical Lab

ora

tori

es

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Type

of

labo

rato

ries-

pa

thol

ogy

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Type

of

labo

rato

ries-

m

icro

biol

ogy

Yes

Yes

NoNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Qual

ifi ed

-Pat

holo

gist

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Qual

ifi ed

-Bio

chem

ist

NoNo

NoNo

Yes

Yes

Yes

NoNo

NoNo

No

Qual

ifi ed

-Mic

ro b

iolo

gist

NoNo

NoNo

NoYe

sNo

NoNo

NoNo

No

Follo

win

g th

e Un

iver

sal

Prec

auti

on P

roce

dure

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Usin

g Pr

otec

tive

Mea

sure

s i.e

. gl

oves

/gow

ns/m

asks

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Spec

imen

Col

lect

ion

done

Ce

ntra

llyYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Avai

labi

lity

of a

ll th

e Ch

emic

als

and

Reag

ents

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Obse

rvin

g al

l the

Bio

-sa

fety

mea

sure

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Accu

racy

of

the

Repo

rts

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

s

Regu

lar

Inte

rnal

Qua

lity

Cont

rol M

easu

res

Unde

rtak

en

NoYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

NoYe

s

Regu

lar

Exte

rnal

Qua

lity

Cont

rol M

easu

res

Unde

rtak

en

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Yes

Yes

NoYe

s


Tab

le 1

.8 B

loo

d B

an

kin

g F

acilit

ies

Amri

tsar

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

BLOO

D BA

NK (

If N

o bl

ood

bank

fi ll

“8”

for

sect

ion

E)No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Trai

ned

or Q

ualifi

ed

Med

ical

Offi

cer

Post

ed a

s B.

T.O.

NAYe

sYe

sYe

sYe

sYe

sYe

sYe

sNA

Yes

Yes

NA

Roun

d th

e Cl

ock

Avai

labi

lity

of T

rain

ed S

taff

an

d Se

rvic

es

NAYe

sYe

sYe

sYe

sYe

sYe

sYe

sNA

Yes

Yes

NA

Chec

king

& C

ross

Mat

chin

g by

B.T

.O.

NAYe

sYe

sYe

sYe

sYe

sYe

sYe

sNA

Yes

Yes

NA

Prop

er M

aint

enan

ce o

f Co

ld

Chai

n an

d Re

frig

erat

ors

NAYe

sYe

sYe

sYe

sYe

sYe

sYe

sNA

Yes

Yes

NA

Aust

ralia

ant

igen

, H

CV,

VDRL

, M

.P.

and

HIV

tes

ts

done

for

Eve

ry B

lood

Bo

ttle

of

dono

r.

NAYe

sYe

sYe

sYe

sYe

sYe

sYe

sNA

Yes

Yes

NA

Effo

rts

mad

e to

Col

lect

Bl

ood

thro

ugh

Volu

ntar

y Or

gani

sati

on C

amps

NAYe

sYe

sYe

sYe

sYe

sYe

sYe

sNA

Yes

Yes

NA

Rene

wal

of

Bloo

d Ba

nk/

HIV

Lic

ense

as

per

Rule

sNA

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NAYe

sYe

sNA


Tab

le 1

.9 R

ad

iolo

gy &

Im

ag

ing

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

as p

urH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Avai

labi

lity

of t

he D

ark

Room

w

ith

all F

acili

ties

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Use

of D

osim

eter

and

the

y Re

gula

rly s

ent

to B

ARC

NoNo

NoNo

NoNo

NoYe

sNo

NoYe

sYe

s

Spec

ial I

nves

tiga

tion

like

IVP

, Co

ntra

st M

edia

etc

.No

NoNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Roun

d th

e cl

ock

avai

labi

lity

of

X-ra

y se

rvic

es/

Sono

grap

hyYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

No

Sepa

rate

Reg

iste

r fo

r M

LC

Reco

rds

Yes

NoYe

sNo

Yes

Yes

Yes

Yes

NoNo

Yes

No

Mai

nten

ance

of

His

tory

Bo

ok a

nd L

og b

ook

of X

-ray

M

achi

nes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sNo


Tab

le 1

.10 O

pera

tio

n T

heatr

e

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

No.

of O

pera

tion

s Th

eatr

es-

maj

or4

31

23

43

32

11

2

No.

of O

pera

tion

s Th

eatr

es-

min

or1

11

11

41

31

11

1

Zoni

ng c

once

pts

stric

tly

follo

wed

NoYe

sYe

sNo

Yes

Yes

Yes

Yes

NoNo

Yes

Yes

Emer

genc

y lig

ht o

r ge

nera

tor

faci

litie

s pr

ovid

ed t

o O.

T.

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Avai

labi

lity

of fi

re

fi ght

ing

equi

pmen

ts a

nd

know

ledg

e to

use

the

m

NoNo

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Regu

lar

disi

nfec

tion

s &

st

erili

sati

on p

roce

dure

s do

ne a

t O.

T.

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes


Tab

le 1

.11 In

-pati

en

ts W

ard

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Sati

sfac

tory

cle

anlin

ess

of

the

war

ds w

ith

adeq

uate

ho

use

keep

ing

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Colo

ur c

odes

of

Yello

w,

Blue

, Re

d, W

hite

bin

&

Blue

tra

nspa

rent

PPF

for

w

aste

col

lect

ion

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

s

Tabl

e to

p sy

ring

e &

nee

dle

dest

roye

rYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Prop

er U

tilis

atio

nYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Adeq

uate

wat

er s

uppl

y an

d up

kee

p of

san

itar

y bl

ocks

.Ye

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Adeq

uate

& C

lean

Toi

lets

an

d Ba

thro

oms

Yes

Yes

Yes

NoNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

All t

he b

eds

are

havi

ng

prop

er &

ade

quat

e lin

enYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

s

Floo

r be

ds/d

oubl

ing

of

beds

in t

he w

ards

NoNo

Yes

NoNo

NoYe

sYe

sNo

NoNo

No

if Y

es,

Anal

yse

the

Reas

onNA

NARa

re c

ases

of

Gas

tro

&

Pead

.

NANA

NANA

NANA

NA

Sati

sfac

tory

up

Keep

of

cots

, m

attr

esse

s, b

edsi

de

lock

ers,

line

n

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

sNo

Yes

No

Use

of H

ospi

tal U

nifo

rms

by a

ll Pa

tien

tsNo

NoNo

NoNo

NoNo

Yes

NoNo

NoNo

Avai

labi

lity

and

Func

tion

ing

of S

ucti

on

appa

ratu

s (E

lect

ric &

Foo

t Op

erat

ed)

Avai

labl

eNo

t Av

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eNo

t Av

aila

ble

(Con

td..

.)


Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

If a

vaila

ble

(Fun

ctio

nal/

No

t)Fu

ncti

onal

NAFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alNo

t Fu

ncti

onal

NA

Avai

labi

lity

and

func

tion

ing

of o

xyge

n cy

linde

r w

ith

acce

ssor

ies

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eav

aila

ble

If a

vaila

ble

(fun

ctio

nal)

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Avai

labi

lity

and

func

tion

ing

of v

enes

ecti

on t

ray,

LP,

tr

ache

otom

y tr

ay.

Avai

labl

eNo

t Av

aila

ble

Avai

labl

eNo

t Av

aila

ble

Not

Avai

labl

eAv

aila

ble

Not

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Not

Avai

labl

eNo

t Av

aila

ble

If a

vaila

ble

(fun

ctio

nal)

Func

tion

alNA

Func

tion

alNA

NAFu

ncti

onal

NAFu

ncti

onal

Func

tion

alFu

ncti

onal

NANA

Avai

labi

lity

and

func

tion

ing

of e

mer

genc

y lig

ht,

whe

el

chai

r, tr

olle

y

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

If a

vaila

ble

(fun

ctio

nal)

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Stat

ione

ries,

for

ms,

upt

o da

te v

ario

us r

egis

ters

etc

.Ye

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

NoNo

Yes

Conc

ept

of p

rogr

essi

ve

pati

ent

care

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sNo

Yes

Adeq

uacy

and

wor

king

of

fans

and

ligh

tsYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Sati

sfac

tory

ava

ilabi

lity

of

diet

,No

NoOw

n ar

rang

emen

tNo

Yes

NoNo

NoNo

NoNo

Yes

Qual

ity

of c

are

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Mai

nten

ance

of

vario

us

regi

ster

s, r

ecor

ds,

etc.

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

s


Tab

le 1

.12 H

osp

ital M

ed

ical S

tore

s

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Med

ical

sto

re s

uita

bly

loca

ted

wit

h ad

equa

te s

pace

and

pr

otec

tion

of

drug

s an

d no

n-dr

ugs

item

s fr

om p

ilfer

age,

te

mpe

ratu

re,

hum

idit

y

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sNo

Rest

ricti

on o

n en

try

for

unau

thor

ised

per

sonn

el’s

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Staf

f kn

owle

dgea

ble

in m

ater

ials

m

anag

emen

tYe

sNo

Yes

NoYe

sYe

sNo

Yes

NoNo

Yes

Insp

ecti

on o

f st

ores

by

the

Civi

l Su

rgeo

n /

M.O

. I/

c at

reg

ular

in

terv

al t

o ve

rify

sto

ck b

ooks

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

s

Avai

labi

lity

of V

ital

, es

sent

ial

drug

s in

suf

fi cie

nt Q

uant

ity

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

s

Upk

eep

of e

xpir

y da

te r

egis

ter

and

its

regu

lar

insp

ecti

on b

y M

O I/

c

Yes

Yes

Yes

NoYe

sYe

sNo

NoNo

NoNo

Effo

rts

mad

e to

red

istr

ibut

e la

rge

stoc

k of

slo

w m

ovin

g dr

ugs

or n

ear

expi

ry f

or it

s ut

ilisa

tion

.

NoYe

sYe

sNo

Yes

Yes

Yes

Yes

NoYe

sYe

s

Prop

er a

rran

gem

ents

to

keep

the

dr

ugs

as p

er A

BC/V

ED c

ateg

ory

and

stor

age

of r

ubbe

r go

ods

as

per

guid

elin

es

Yes

NoYe

sNo

Yes

Yes

NoNo

NoNo

No

Appr

opria

te s

teps

tak

en t

o pr

even

t pi

lfera

ge o

fYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

A co

nven

ient

arr

ange

men

t of

is

suin

g dr

ugs

to v

ario

usNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

(Con

td..

.)


Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Regu

lar

send

ing

of s

ampl

es t

o ch

emic

al la

bora

tory

to

chec

k it

as

per

spe

cifi c

atio

n an

d st

anda

rd

& a

ctio

n ta

ken

ther

eon

NoNo

Yes

NoYe

sYe

sYe

sNo

NoNo

No

Circ

ulat

ion

of li

sts

of a

vaila

ble

drug

s to

all

the

MOs

, OP

D&

war

ds a

s pe

r ge

neric

nam

es

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Subm

issi

on o

f ce

rtifi

ed b

ills

to

offi c

e fo

r re

leas

e of

pay

men

ts

wit

hin

thre

e da

ys.

Yes

Yes

Yes

NoYe

sYe

sNo

Yes

NoNo

Yes

Auct

ion

to c

lear

the

em

pty

mat

eria

l fro

m s

tore

don

e re

gula

rly.

NoYe

sNo

NoYe

sYe

sYe

sNo

Yes

NoYe

s

Avai

labi

lity

of F

ire F

ight

ing

equi

pmen

ts a

nd k

now

ledg

e of

st

aff

to o

pera

te it

NoNo

NoNo

Yes

Yes

NoYe

sNo

Yes

No

Avai

labi

lity

of r

egul

arly

upd

ated

H

ospi

tal D

rug

Form

ular

yNo

Yes

NoNo

NoYe

sNo

NoNo

NoNo

Exis

tenc

e of

sta

ndin

g Dr

ug

Com

mit

tee

Yes

Yes

NoNo

Yes

Yes

NoNo

NoYe

sNo


Tab

le 1

.13

M

ed

ical R

eco

rd D

ep

art

men

t

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

as

pur

Hos

hiar

pur

Jala

ndha

rLu

dhia

naM

ukts

arSH

Pat

iala

Sang

rur

Tara

n Ta

ran

SH

Bhat

inda

Avai

labi

lity

of M

edic

al R

ecor

d Ro

om w

ith

enou

gh n

umbe

r of

ra

cks

NoYe

sYe

sYe

sYe

sYe

sNo

Yes

NoYe

sNo

Yes

Med

ical

rec

ord

NoNo

NoNo

Yes

NoNo

NoNo

NoNo

No

Is it

man

aged

by

a tr

aine

d m

edic

al r

ecor

d of

fi cer

/

tech

nici

an o

r

NoYe

sYe

sNo

Yes

NoNo

Yes

Yes

NoYe

sYe

s

Case

rec

ord

is m

aint

aine

d as

per

W

HO

clas

sifi c

atio

n of

dis

ease

s (I

CD-X

)

NoNo

NoNo

Yes

Yes

Yes

NoNo

NoYe

s

Regu

lar

subm

issi

on o

f th

e m

orbi

dity

, m

orta

lity

repo

rts

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

s

For

wha

t du

rati

on a

ll th

e re

cord

s be

ing

mai

ntai

ned

(In

year

s)7

1510

105

510

1410

1010

5

Is t

he b

acku

p fa

cilit

y av

aila

ble

to s

afeg

uard

the

se r

ecor

dsNo

NoYe

sNo

Yes

No b

acku

pNo

Man

ual

Yes

Yes

NoNo

Wha

t is

the

eff

ecti

ve r

etrie

val

syst

em f

ollo

wed

by

this

hos

pita

lNo

new

&

old

crno

.,

alph

a in

dex

As p

er

adm

issi

on

No.

& y

ear

wis

e

Adm

issi

on

No.,

bu

ndle

of

100

Com

pute

rNo

NoYe

sNo

NoNo

Regu

lar

deat

h au

dit

mee

ting

s he

ld &

min

utes

of

mee

ting

Yes

NoYe

sNo

Yes

NoNo

NoYe

sNo

NoNo

Med

ical

aud

it d

one

at r

egul

ar

inte

rval

Yes

Yes

Yes

NoYe

sYe

sNo

Yes

Yes

NoNo

No


Tab

le 1

.14 H

osp

ital W

aste

Man

ag

em

en

t

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Are

the

adeq

uate

num

ber

of

bins

and

the

bag

s of

req

uire

dNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Are

thes

e pl

aced

str

ateg

ical

ly

in a

ll pa

tien

t ca

re a

reas

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Segr

egat

ion

of d

iffe

rent

ca

tego

ries

of w

aste

s do

ne a

t th

e

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Colle

ctio

n of

was

te,

pack

agin

g, la

belli

ng,

reco

rd

keep

ing

done

in s

cien

tifi c

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Prop

er t

rans

port

atio

n of

the

w

aste

so

colle

cted

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Stor

age

faci

litie

s an

d du

rati

onNo

Yes

Yes

NoYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Disp

osal

/ re

cycl

ing

met

hods

fo

r va

rious

cat

egor

ies

ofNo

Yes

NoYe

sYe

sNo

Yes

NoYe

sYe

sYe

sYe

s

Whe

ther

was

te d

ispo

sal i

s ou

tsou

rced

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

s


Tab

le 1

.15 S

UP

PO

RT

SE

RV

ICE

S

Cen

tral S

teri

le S

up

ply

Dep

art

men

t

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Unde

r th

e Su

perv

isio

n of

a

Trai

ned

Tech

nica

l Sta

ff/

Seni

or N

ursi

ng O

ffi ce

r

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NAYe

sNo

Yes

Hav

ing

all t

he r

equi

red

equi

pmen

ts &

Aut

ocla

ves

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sNA

Yes

NoYe

s

Qual

ity

cont

rol m

easu

res

are

stric

tly

follo

wed

-ph

ysic

alYe

sNo

Yes

NoYe

sYe

sYe

sYe

sNA

Yes

NoYe

s

Qual

ity

cont

rol m

easu

res

are

stric

tly

follo

wed

- ch

emic

alYe

sYe

sYe

sNo

Yes

Yes

Yes

NoNA

Yes

NAYe

s

Qual

ity

cont

rol m

easu

res

are

stric

tly

follo

wed

- bi

olog

ical

Yes

NoYe

sNo

Yes

Yes

Yes

NoNA

Yes

NAYe

s


Lau

nd

ry S

erv

ices

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Laun

dry

Serv

ices

(M

echa

nise

d/

conv

enti

onal

)

Conv

enti

onal

Mec

hani

sed

Conv

enti

onal

Mec

hani

sed

Mec

hani

sed

Mec

hani

sed

Mec

hani

sed

conv

enti

onal

Mec

hani

sed

Conv

enti

onal

Conv

enti

onal

Mec

hani

sed

Laun

dry

Serv

ices

-sta

ff(A

dequ

ate)

Adeq

uate

Adeq

uate

Adeq

uate

Adeq

uate

Adeq

uate

Adeq

uate

Not

Adeq

uate

Not

Adeq

uate

Adeq

uate

Not

Adeq

uate

Adeq

uate

Adeq

uate

Qual

ity

of

was

hGo

odAv

erag

eGo

odGo

odGo

odGo

odAv

erag

eGo

odGo

odAv

erag

eGo

odGo

od

Qual

ity

of

linen

Good

Good

Good

Aver

age

Good

Good

Aver

age

Good

Good

Aver

age

Good

Good


Die

tary

Serv

ices

Nam

e of

the

Dis

tric

t

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Prop

er &

saf

e ar

rang

emen

t fo

r st

orag

e of

raw

mat

eria

lsNo

NANA

NANA

NANA

NANA

NANA

NA

Mea

sure

s fo

r Pe

st &

Rod

ent

cont

rol

NoNA

NANA

NANA

NANA

NANA

NANA

Sani

tati

on a

nd h

ygie

ne o

f th

e co

okin

g ar

ea p

rope

rly

mai

ntai

ned

NoNA

NANA

NANA

NANA

NANA

NANA

Regu

lar

heal

th c

heck

-up

for

food

han

dler

sNo

NANA

NANA

NANA

NANA

NANA

NA

Avai

labi

lity

of m

oder

n co

okin

g eq

uipm

ents

NoNA

NANA

NANA

NANA

NANA

NANA

Avai

labi

lity

of p

rope

rly

mai

ntai

ned

reco

rds

&

regi

ster

s

NoNA

NANA

NANA

NANA

NANA

NANA

Diet

ser

vice

und

er t

he

supe

rvis

ion

of a

qua

lifi e

d Di

etic

ian

NoNA

NANA

NANA

NANA

NANA

NANA


Tab

le 1

.16 U

ser

Ch

arg

es in

Dif

fere

nt

Dis

tric

t H

osp

itals

Nam

e of

Di

stri

ct

Hos

pita

l

Year

sTo

tal I

ncom

e (C

olle

ctio

n)To

tal

Expe

ndit

ure

Deta

iled

Expe

ndit

ure

Med

icin

eI.

F.P.

Build

ings

Equi

pmen

tER

F A/

cSa

lary

to

Cont

ract

ual

Staf

f

Rogi

Kal

yan

Sam

iti

Amri

tsar

2003

-04

1900

185

2004

-05

2374

199

2005

-06

2741

536

2006

-07

3050

132

2007

-08

3301

463

Tota

l13

3675

15

Bati

nda

2003

-04

5138

784

6517

634

2944

683

1611

906

3193

0631

9306

--

-

2004

-05

5045

995

4323

803

2249

330

9849

0824

1353

2413

53-

4889

59-

2005

-06

6313

724

5711

847

2386

983

1310

739

5370

0747

1309

5386

0446

7205

-

2006

-07

6162

264

6209

016

2193

207

1485

296

3459

7710

4595

863

6396

5021

82-

2007

-08

5290

741

4718

401

1653

431

9439

8846

9782

7902

7251

2474

3484

54-

Tota

l27

9515

0827

4807

0111

4276

3463

3683

733

5375

828

6819

816

8747

418

0680

0-

Fero

zpur

2003

-04

2179

219

2129

219

8741

4343

5635

2913

8129

1381

-23

6679

-

2004

-05

2840

423

2840

423

1162

196

6456

6438

7398

3873

98-

2577

67-

2005

-06

2908

548

4673

865

2908

548

6343

5038

0910

3809

10-

3691

47-

2006

-07

3074

681

3074

681

1186

566

6592

0339

5522

3955

22-

4378

68-

2007

-08

3275

538

3275

538

1312

560

7292

0143

7521

4375

21-

3587

35-

Tota

l14

2784

0914

2784

0974

4401

331

0405

318

9273

218

9273

2-

1660

196

-

Gurd

aspu

r

2003

-04

3875

328

2586

302

1290

006

7548

2820

8792

1755

4800

0015

7128

0000

2004

-05

4889

763

3229

772

1480

509

8202

6944

0287

2971

0100

0019

1606

0000

2005

-06

5213

162

3365

249

1610

770

6594

3743

3148

1456

7727

9392

2366

2500

00

2006

-07

6519

411

4482

801

2061

622

8662

3666

6745

2758

8236

4511

2478

0500

00

2007

-08

NA38

8227

317

1231

476

1250

3659

0526

1018

4461

2623

5660

1000

00

Tota

l20

4976

6417

5463

9781

5522

138

6222

021

1487

711

5522

610

9002

910

6882

410

0000

(Con

td..

.)


Nam

e of

Di

stri

ct

Hos

pita

l

Year

sTo

tal I

ncom

e (C

olle

ctio

n)To

tal

Expe

ndit

ure

Deta

iled

Expe

ndit

ure

Med

icin

eI.

F.P.

Build

ings

Equi

pmen

tER

F A/

cSa

lary

to

Cont

ract

ual

Staf

f

Rogi

Kal

yan

Sam

iti

Hos

hiar

pur

2003

-04

2004

-05

2005

-06

2006

-07

2007

-08

5826

166

6027

980

2404

437

1399

160

6118

8252

7801

6194

7546

5225

-

Tota

l58

2616

660

2798

024

0443

713

9916

061

1882

5278

0161

9475

4652

25-

Jala

ndha

r

2003

-04

2004

-05

2005

-06

9419

098

9630

442

4747

258

2315

901

9670

0033

5006

5127

1475

2563

-

2006

-07

1349

9437

1072

4214

5622

143

2127

532

7559

4446

0244

1194

458

5638

93-

2007

-08

1541

6929

1585

8716

6393

457

3189

803

1056

121

1355

608

3234

468

6292

59-

Tota

l38

3355

464

3621

3372

1676

2858

7633

236

2779

065

2150

858

4941

640

1945

715

-

Ludh

iana

2003

-04

3101

683

3777

674

2643

851

5214

4033

5221

1299

08-

1472

54-

2004

-05

3803

090

3607

862

2948

549

3347

3758

076

2058

13-

6068

7-

2005

-06

4544

871

4573

092

3326

884

5246

3018

9417

1678

3011

5586

2487

45-

2006

-07

4811

096

3183

321

1976

830

3496

6123

7645

4191

8559

9608

7206

8-

2007

-08

5024

987

3864

421

2007

813

7705

1179

6861

2892

3633

138

4580

-

Tota

l21

2857

2719

0063

7012

9039

2727

0097

916

1722

012

1197

274

8332

5332

54-

Muk

tsar

2003

-04

2004

-05

2005

-06

2006

-07

2007

-08

Tota

l

(Con

td..

.)


Nam

e of

Di

stri

ct

Hos

pita

l

Year

sTo

tal I

ncom

e (C

olle

ctio

n)To

tal

Expe

ndit

ure

Deta

iled

Expe

ndit

ure

Med

icin

eI.

F.P.

Build

ings

Equi

pmen

tER

F A/

cSa

lary

to

Cont

ract

ual

Staf

f

Rogi

Kal

yan

Sam

iti

Pati

ala

(Sp.

H

ospi

tal)

2003

-04

6030

396

4212

300

8040

5043

3198

2674

019

5234

9-

2486

84-

2004

-05

4575

8115

1368

779

6653

3010

8642

819

4795

8-

3251

71-

2005

-06

5476

548

2529

041

1201

486

4896

7988

679

8539

734

2852

3209

48-

2006

-07

6887

658

3027

748

1499

017

3710

0913

7009

1153

5547

7461

4278

97-

2007

-08

Tota

l18

8521

8311

2827

7643

0120

615

9497

229

4252

630

1059

8203

1313

2270

0-

Sang

rur

2003

-04

3188

235

2011

939

--

--

--

-

2004

-05

4054

724

2072

265

--

--

--

-

2005

-06

4687

936

3129

318

--

--

--

-

2006

-07

4454

628

3777

499

--

--

--

-

2007

-08

4745

583

4782

224

--

--

--

-

Tota

l21

1311

0615

7732

45-

--

--

--

Tara

n Ta

ran

2003

-08

Not

Avai

labl

e Du

e to

For

mat

ion

of N

ew D

istr

ict

Sp. H

ospi

tal

Bhat

inda

2003

-04

9517

9698

2268

5045

91-

--

--

-

2004

-05

1133

336

5619

0721

6541

2304

1957

573

5737

4-

--

2005

-06

1431

652

1062

972

4233

7633

8376

1569

6243

467

1007

91-

-

2006

-07

1541

913

1160

399

5812

0519

9501

8726

916

2740

1189

5910

725

-

2007

-08

1223

898

9678

3650

0471

1397

8870

660

1190

3912

2744

1513

4-

Tota

l62

8259

547

3538

222

2618

411

3092

544

5485

5644

3534

2494

2585

9-


Tab

le 1

.17

P

erf

orm

an

ce R

ep

ort

of

Dis

tric

t H

osp

ital

Perf

orm

ance

(An

nual

)N

ame

of t

he D

istr

ict

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

OPD

atte

ndan

ce

last

5 y

ears

1st Y

r68

726

1709

3611

2815

1152

4718

9243

--

9696

112

3171

1439

4988

942

4775

3

2nd Y

r10

4203

1780

8310

0355

1340

421

5921

--

9559

114

8476

1517

4311

2667

5473

3

3rd Y

r10

9836

1936

8788

901

1609

5423

5353

1698

9117

6891

1068

4116

2196

1582

6812

0134

6172

5

4th Y

r12

5668

2211

8795

306

1831

9624

2693

2226

6918

2811

1343

3518

8125

2014

8112

6646

6256

5

5th Y

r13

9137

2202

1710

4298

1764

3223

1386

1568

2715

6942

9371

316

2518

1742

5912

1578

6795

5

1st Y

r20

4162

9368

0591

8410

188

--

3149

6093

1016

544

9123

61

2nd Y

r33

7070

5363

1494

6712

476

--

3149

6093

1016

544

9123

61

3rd Y

r43

7190

4560

7210

713

1317

012

538

1024

940

6988

0211

492

4804

4518

4th Y

r52

7198

0861

4611

564

1321

916

054

1024

138

8110

495

1232

348

6849

06

5th Y

r78

5310

657

6340

1200

412

731

5106

8366

3956

1152

213

051

4728

5958

No.

of

Surg

erie

s do

ne1st

Yr

1330

3567

1110

339

25-

--

1708

3355

5751

2114

859

2nd Y

r29

3036

6510

113

4177

9214

--

3071

3977

9072

2490

2197

3rd Y

r94

3871

0985

1665

9612

217

2508

113

607

4403

4201

8590

3845

2554

4th Y

r98

8560

8982

3463

2511

494

2930

113

304

4201

8652

8223

5056

2033

5th Y

r10

819

6965

9095

6272

1097

327

245

1359

629

4410

619

8642

5181

3442

No.

of

Emer

genc

ies

1st Y

r-

4543

2596

4621

--

--

0$53

5321

4734

5

2nd Y

r-

4983

3167

4715

1302

2-

--

0$62

4125

7994

1

3rd Y

r-

4689

2735

5396

1343

813

385

--

0$58

0225

9097

7

4th Y

r-

7370

3626

5570

1508

318

073

--

0$64

2226

1411

76

5th Y

r-

6496

4735

5973

1549

025

41-

-0$

7140

3059

1792

No.

of

adm

issi

ons

thro

ugh

emer

genc

y

1st Y

r-

3580

1317

4687

--

-10

430$

2817

2016

345

2nd Y

r-

3328

1610

4822

6905

--

1514

0$34

1922

0494

1

3rd Y

r-

3631

2171

4919

6708

4596

3275

1814

0$32

8820

1597

7

4th Y

r-

3461

1525

4925

6989

6647

4295

1902

0$39

2420

1711

76

5th Y

r-

4229

1495

5594

6523

1891

3039

1912

0$50

5519

2217

92

(Con

td..

.)


Perf

orm

ance

(An

nual

)N

ame

of t

he D

istr

ict

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

No.

of

med

ico-

lega

l cas

es1st

Yr

1350

-11

8154

4-

-95

4256

10$

1016

-0$

2nd Y

r27

3712

8210

1065

461

2-

9734

701

0$75

219

20$

3rd Y

r23

6396

210

8572

167

019

9810

116

666

0$58

042

10$

4th Y

r25

9315

7513

4374

195

115

7012

168

903

0$90

953

50$

5th Y

r27

3311

6713

4470

189

616

0514

049

908

0$81

550

90$

No.

of

post

-mor

tum

done

1st Y

r-

392

173

186

--

1439

-0$

123

186

0$

2nd Y

r-

460

233

203

294

-14

35-

0$10

419

00$

3rd Y

r-

524

180

223

258

644

1492

-0$

8520

10$

4th Y

r-

580

158

279

293

827

1731

-0$

110

910$

5th Y

r-

610

184

270

375

790

1703

-0$

192

950$

No.

of

norm

al

deliv

erie

s co

nduc

ted

1st Y

r15

80*

268

578

--

-60

1966

1058

258

331

2nd Y

r23

70*

310

595

577

--

7624

5214

5725

961

0

3rd Y

r27

20*

520

567

781

476

222

185

2802

1477

234

558

4th Y

r40

90*

296

577

742

737

298

265

3268

1177

152

811

5th Y

r45

70*

317

615

554

738

196

301

3671

1557

9210

14

No

of C

aesa

rean

do

ne1st

Yr

114

0*25

541

4-

--

3057

153

020

512

4

2nd Y

r22

10*

308

514

350

--

2185

271

416

230

5

3rd Y

r31

20*

269

483

460

314

164

4911

2353

123

037

8

4th Y

r39

20*

291

463

387

379

147

4012

4151

913

733

3

5th Y

r32

40*

367

653

376

362

196

3114

0947

010

128

1

* Al

l del

iver

ies

wer

e co

nduc

ted

at S

peci

al h

ospi

tal B

hati

nda

$ Th

ere

was

no

regu

lar

emer

genc

y de

part

men

t. T

here

wer

e sp

ecia

l hos

pita

ls f

or w

omen

and

chi

ld.


Tab

le 1

.18

S

taff

Po

sit

ion

of

Dis

tric

t H

osp

ital

Nam

e of

Pos

tPo

siti

on o

f Po

stN

ame

of t

he D

istr

ict

Hos

pita

l

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

M.S

.Sa

ncti

oned

--

--

-1

--

1-

--

Vaca

nt-

--

--

--

--

--

-

S.M

.O.

In-p

osit

ion

--

--

-1

--

1-

--

Sanc

tion

ed2

11

12

4-

12

2-

1

Vaca

nt1

--

--

--

1-

1-

1

Doct

ors

G.D.

M.O

.

In-p

osit

ion

11

11

24

--

21

--

Sanc

tion

ed27

69

118

448

134

5-

-

Vaca

nt2

11

3-

24

3-

1-

-

Doct

ors

Spec

ialis

tIn

-pos

itio

n25

58

88

424

10

(Adh

oc-1

)4

4-

-

Sanc

tion

ed-

1211

820

3425

-29

1913

17

Vaca

nt-

-4

-2

-5

-2

4-

1

Nurs

ing

Staf

fIn

-pos

itio

n-

157

818

3426

-27

1513

16

Sanc

tion

ed40

3327

2840

110

4511

5427

1238

Vaca

nt4

73

--

107

38

1-

18

Adho

c-

--

-8

--

--

--

-

Tech

nici

anIn

-pos

itio

n36

2624

2840

100

38+1

1(*)

846

2612

20

Sanc

tion

ed-

1614

1610

449

34

47

2

Vaca

nt-

41

--

4-

2-

1-

1

Adho

c/co

n-

--

--

-3

con.

--

--

-

Adm

inis

trat

ive

Staf

fIn

-pos

itio

n35

1213

1610

409

14

37

1

Sanc

tion

ed-

99

713

2010

21

102

9

Vaca

nt-

-1

--

22

--

--

2

(Con

td..

.)


Nam

e of

Pos

tPo

siti

on o

f Po

stN

ame

of t

he D

istr

ict

Hos

pita

l

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH P

atia

laSa

ngru

rTa

ran

Tara

nSH

Bh

atin

da

Clas

s-IV

In-p

osit

ion

-9

87

1318

4+1

(*)

+5($

)2

110

27

Sanc

tion

ed-

7166

6780

110

7432

101

7126

28

Vaca

nt-

22

19-

--

-22

1-

1

Othe

rsIn

-pos

itio

n-

6964

4880

110

36+3

8($)

3279

7026

29+6

(*)

Sanc

tion

ed2

96

6-

858

738

--

7

Vaca

nt-

36

--

182

211

--

3

In-p

osit

ion

96

-6

-67

10+4

(*).

527

--

4

* Pl

aced

on

Depu

tati

on$

Gone

on

depu

tati

on t

o ot

her

dist

ricts

/pla

ces


Tab

le 1

.19 P

osit

ion

of

Sp

ecia

list

in D

istr

ict

Ho

sp

ital

Nam

e of

Sp

ecia

lity

Degr

eeN

ame

of t

he D

istr

ict

Hos

pita

l

Amri

tsar

Bhat

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

SH

Pati

ala

Sang

rur

Tara

n Ta

ran

SH

Bhat

inda

Med

icin

eM

.D.

21

12

52

11

12

11

Surg

ery

Gyna

ecol

ogis

t &

Ob

stet

ricia

n

M.S

21

21

35

31

12

11

M.D

.2

11

22

43

-3

11

3

Paed

iatr

icM

BBS

--

--

--

--

--

--

M.D

.2

1-

12

33

-2

21

2

Dipl

oma

--

--

--

-1

--

--

Opth

amol

ogy

M.D

.-

1-

12

-3

11

11

1

ENT

M.D

.-

--

22

22

1-

11

1

Orth

o.M

.S1

21

11

Derm

atol

ogy

M.D

.-

1-

-2

22

11

11

1

Psyc

hiat

ric

Anae

sthe

sia

M.D

.-

--

-1

2-

-1

-1

-

M.D

.-

1-

12

53

1-

11

2

Bloo

d Ba

nkDi

plom

a-

--

--

--

-1

--

-

M.D

.-

--

-1

11

1-

1-

-

MBB

S-

1-

--

--

--

--

-

Path

olog

yM

.D.

-1

-1

12

11

11

-1

Bioc

hem

istr

yM

.D.

--

--

11

--

--

-

Mic

ro-B

iolo

gyM

.D.

--

--

-1

--

--

--

Radi

olog

y

Dent

al

M.D

.-

1-

-2

21

--

-1

-

B.D.

S.-

1-

13

21

-1

11

1

MBB

S-

--

--

--

1-

--

-


Tab

le 2.1

Gen

era

l P

rofi

le &

Facilit

y S

urv

ey o

f S

ub

-Div

isio

nal H

osp

itals

Gene

ral P

rofi l

e of

Hos

pita

lsN

ame

of t

he S

ub-D

ivis

iona

l Hos

pita

ls

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kotl

aM

alou

tN

akod

arPa

tti

Talw

andi

Acce

ssib

ility

to

Railw

ay/B

us S

tati

onYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Wat

er S

uppl

yBo

re w

ell

Bore

wel

lBo

re w

ell

Bore

wel

lBo

re w

ell

Mun

icip

al

supp

lyM

unic

ipal

su

pply

Bore

wel

lBo

re w

ell

Mun

icip

al

supp

ly

Wat

er S

uppl

yAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

te

Wat

er S

uppl

y1

day

1 da

y1

day

3 da

ys3

days

3 da

ys3

days

3 da

ys3

days

3 da

ys

Elec

tric

ity

Regu

lar

Irre

gula

r su

pply

Regu

lar

Irre

gula

r su

pply

Irre

gula

r su

pply

Regu

lar

Regu

lar

Regu

lar

Regu

lar

Irre

gula

r su

pply

Elec

tric

ity-

Phas

eTh

ree

Thre

eTh

ree

Doub

leTh

ree

Thre

eTh

ree

Thre

eTh

ree

Thre

e

Elec

tric

ity-

Back

up

(Gen

erat

or/U

PS)

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eNo

t Av

aila

ble

Avai

labl

eAv

aila

ble

Avai

labi

lity

of li

ftNo

t Av

aila

ble

Not

Avai

labl

eNo

t Av

aila

ble

Not

Avai

labl

eNo

t Av

aila

ble

Not

Avai

labl

eAv

aila

ble

Not

Avai

labl

eNo

t Av

aila

ble

Not

Avai

labl

e

Avai

labi

lity

of r

amp

Avai

labl

eNo

t Av

aila

ble

Avai

labl

eNo

t Av

aila

ble

Not

Avai

labl

eAv

aila

ble

Avai

labl

eNo

t Av

aila

ble

Avai

labl

eAv

aila

ble

General Impression

• U

p ke

ep o

f ga

rden

• Cl

eanl

ines

s

• Si

gn p

osti

ng

• Ro

ads

and

light

• St

ate

of b

uild

ing

Poor

Aver

age

Good

Good

Poor

Good

NAGo

odAv

erag

eAv

erag

e

Good

Good

Good

Good

Good

Good

Good

Good

Aver

age

Aver

age

Aver

age

Good

Good

Good

Good

Aver

age

Good

Good

Aver

age

Aver

age

Aver

age

Good

Good

Good

Good

Good

Good

Good

Aver

age

Good

Good

Good

Good

Good

Good

Good

Good

Good

Aver

age

Aver

age

Any public utility service available in hospital premises

• Ch

emis

tNo

NoNo

Yes

Yes

NoNo

Yes

NoNo

• Su

labh

sau

chal

aya

Yes

Yes

NoYe

sNo

Yes

Yes

NoNo

No

• Ca

ntee

nNo

Yes

Yes

Yes

Yes

NoNo

NoYe

sNo

• Gr

ocer

y sh

ops

NoYe

sNo

NoNo

NoNo

NoNo

No

• ST

D/PC

O bo

oth

NoYe

sNo

Yes

NoNo

NoNo

NoNo

• Ot

her

-cyc

le s

tand

Yes

NoNo

NoNo

NoNo

NoNo

No (Con

td..

.)


Gene

ral P

rofi l

e of

Hos

pita

lsN

ame

of t

he S

ub-D

ivis

iona

l Hos

pita

ls

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kotl

aM

alou

tN

akod

arPa

tti

Talw

andi

Ambu

lanc

e Se

rvic

es

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Part

ially

Eq

uipp

edFu

lly

Equi

pped

Part

ially

Eq

uipp

edFu

lly

Equi

pped

Part

ially

Eq

uipp

edFu

lly

Equi

pped

Part

ially

Eq

uipp

edPa

rtia

lly

Equi

pped

Part

ially

Eq

uipp

edPa

rtia

lly

Equi

pped

Tota

l num

ber

of v

ehic

les

12

32

22

22

23

No.

of

oper

atio

n th

eatr

es

Min

or1

11

11

12

21

1

Maj

or2

23

12

21

21

2

ICU

typ

esGe

nera

lGe

nera

lNo

Gene

ral

NoNo

NoNo

Gene

ral

Gene

ral

ICU

no.

of

beds

25

NANI

LNA

NANA

NA4

6

Emer

genc

y Se

rvic

esRo

und

the

cloc

kRo

und

the

cloc

kRo

und

the

cloc

kRo

und

the

cloc

kRo

und

the

cloc

kRo

und

the

cloc

kRo

und

the

cloc

kRo

und

the

cloc

kRo

und

the

cloc

kRo

und

the

cloc

k

Dent

al S

ervi

ces

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

s

Deliv

ery

Serv

ices

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Faci

litie

s fo

r Po

st-m

orte

mYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

No

Mor

tuar

y se

rvic

es w

ith

cold

sto

rage

&

oth

er p

rese

rvat

ive

faci

litie

s av

aila

ble.

NoYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

No

Drug

for

mul

ary

com

mit

tee

NoNo

NoNo

NoNo

NoYe

sYe

sNo

Hos

pita

l Ant

ibio

tic

com

mit

tee

NoNo

NoNo

NoNo

NoYe

sNo

No

Hos

pita

l Inf

ecti

on C

ontr

ol

Com

mit

tee.

NoYe

sNo

NoNo

NoNo

Yes

Yes

No

Stor

e Pu

rcha

se C

omm

itte

eYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Stor

e ve

rifi c

atio

n Co

mm

itte

eYe

sYe

sYe

sNo

Yes

NoYe

sYe

sYe

sYe

s

Med

ical

Aud

it/

Deat

h Re

view

Co

mm

itte

eYe

sNo

Yes

NoNo

NoYe

sYe

sYe

sNo

Is t

he d

rug

form

ular

y av

aila

ble

Yes

NoYe

sNo

Yes

NoYe

sYe

sNo

No (Con

td..

.)


Gene

ral P

rofi l

e of

Hos

pita

lsN

ame

of t

he S

ub-D

ivis

iona

l Hos

pita

ls

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kotl

aM

alou

tN

akod

arPa

tti

Talw

andi

Syst

em o

f su

pply

of

drug

item

s th

roug

hPu

shPu

llPu

shPu

llPu

shPu

shPu

ll &

Pus

hPu

llPu

shPu

sh

Is b

uffe

r st

ock

mai

ntai

ned

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Reor

der

leve

l mai

ntai

ned

Yes

NoYe

sNo

Yes

NoNo

Yes

NoNo

Annu

al m

aint

enan

ce p

roce

dure

for

co

stly

Equ

ipm

ents

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Log

book

/ H

isto

ry s

heet

mai

ntai

ned

for

the

Equi

pmen

tsYe

sYe

sYe

sNo

Yes

NoYe

sYe

sNo

Yes

Pres

ent

stat

us/s

itua

tion

s of

the

ex

isti

ng E

quip

men

ts:

Aver

age

Good

Good

Aver

age

Aver

age

Aver

age

Good

Aver

age

Aver

age

Aver

age


Tab

le 2

.2 A

vailab

ilit

y o

f eq

uip

men

t

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Baby

Inc

ubat

ors

Yes

Yes

Yes

Yes

NoYe

sNo

Yes

NoNo

Func

tion

alFu

ncti

onal

Func

tion

alNo

n Fu

ncti

onal

NAFu

ncti

onal

NAFu

ncti

onal

NANA

Boyl

es A

ppar

atus

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Func

tion

alFu

ncti

onal

Func

tion

alNo

n Fu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Card

iac

Mon

itor

Yes

Yes

NoYe

sNo

Yes

Yes

Yes

Yes

Yes

Non

Func

tion

alFu

ncti

onal

Func

tion

alNo

n Fu

ncti

onal

NAFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Dent

al C

hair

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Non

Func

tion

alFu

ncti

onal

Func

tion

alNo

n Fu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Dosi

met

er

NoNo

NoNo

NoYe

sYe

sNo

NoNo

NANA

NANA

NANo

n Fu

ncti

onal

Func

tion

alNA

NANA

ECG

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

s

Func

tion

alFu

ncti

onal

Func

tion

alNA

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Emer

genc

y Re

susc

itat

ion

Kit

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Endo

scop

e (fi

ber

opt

ic)

NoNo

NoNo

NoNo

NoNo

NoNo

NANA

NANA

NANA

NANA

NANA

Opht

halm

osco

pes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

s

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

Func

tion

alFu

ncti

onal

Peri

met

erNo

NoNo

NoNo

Yes

NoNo

NoNo

NANA

NANA

NAFu

ncti

onal

NANA

NANA

Phot

o Th

erap

y Un

itYe

sYe

sYe

sYe

sNo

NoNo

Yes

NoNo

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NANA

NAFu

ncti

onal

NANA

(Con

td..

.)


Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Reti

nosc

ope

NoYe

sYe

sFu

ncti

onal

NoYe

sNo

NoYe

sNo

NAFu

ncti

onal

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

NANA

Func

tion

alNA

Shor

t W

ave

Diat

herm

y (P

hysi

o th

erap

y)

NoNo

NoYe

sNo

NoNo

Yes

NoNo

NANA

NAFu

ncti

onal

NANA

NAFu

ncti

onal

NANA

Sigm

oido

scop

esNo

Yes

NoNo

NoNo

Yes

NoNo

No

NANo

n Fu

ncti

onal

NANA

NANA

Non

Func

tion

alNA

NANA

Slit

lam

pNo

Yes

NoYe

sNo

Yes

NoYe

sYe

sNo

NAFu

ncti

onal

NAFu

ncti

onal

NAFu

ncti

onal

Non

Func

tion

alFu

ncti

onal

Func

tion

alNA

Ult

ra s

ound

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Non

Func

tion

alNA

X ra

yYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Othe

r M

ajor

and

Min

or

Oper

atio

n eq

uipm

ents

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal


Tab

le 2

.3 Lab

ora

tory

Facilit

ies A

vailab

le a

t S

ub

-Div

isio

nal H

osp

itals

Labo

rato

ry T

ests

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Com

plet

e Bl

ood

Hae

mog

ram

An

alys

isYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

s

Com

plet

e U

rine

Exa

min

atio

nYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Stoo

l tes

tNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Bloo

d ur

eaYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Bloo

d su

gar

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

s

Live

r fu

ncti

on t

est

NoYe

sYe

sNo

NoYe

sNo

Yes

NoYe

s

Lipi

d pr

ofi le

NoNo

Yes

Yes

NoNo

NoYe

sNo

Yes

PAP

smea

rNo

NoNo

NoNo

NoNo

NoNo

No

FNAC

NoNo

NoYe

sNo

NoNo

NoNo

No

Bloo

d Gr

oupi

ng a

nd

Mat

chin

g te

stYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Biop

sy t

est

NoNo

NoNo

NoNo

NoNo

NoNo

Cult

ure

and

smea

r ex

amin

atio

nNo

NoNo

NoNo

NoNo

Yes

NoNo

Sem

en E

xam

inat

ion

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoNo

Vagi

nal d

isch

arge

ex

amin

atio

nNo

NoNo

NoNo

Yes

NoYe

sNo

No

Bone

Mar

row

Exa

min

atio

nNo

Yes

NoNo

NoNo

NoNo

NoNo

VDRL

tes

tYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Othe

r ro

utin

e te

sts.

H

IV/P

regn

ancy

Tes

tYe

sYe

sNo

Yes

Yes

NoYe

sNo

NoYe

s

(Con

td..

.)


Labo

rato

ry T

ests

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Any

Refe

rral

Sys

tem

in p

lace

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Refe

rral

man

ual a

vaila

ble

Yes

Yes

Yes

Yes

Yes

NoNo

Yes

NoNo

Guid

elin

es f

or-

Wha

t to

ref

erYe

sYe

sNo

Yes

Yes

NoNA

Yes

NANo

Guid

elin

es-W

hen

to r

efer

Yes

Yes

NoYe

sYe

sNo

NAYe

sNA

No

Guid

elin

es-

How

to

refe

rYe

sYe

sYe

sYe

sYe

sNo

NAYe

sNA

No

Colo

ur c

oded

ref

erra

l car

ds

avai

labl

eNo

Yes

NoYe

sNo

NoNo

Yes

Yes

Yes

Feed

-bac

k M

echa

nism

ex

isti

ng:

NoYe

sNo

Yes

NoYe

sNo

Yes

NoNo

Tran

spor

t fa

cilit

y pr

ovid

ed:

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Mai

nten

ance

of

reco

rds/

regi

ster

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Ince

ntiv

e fo

r fo

llow

ing

refe

rral

rou

teNo

NoNo

Yes

NoNo

NoYe

sNo

No

if Y

es w

hat

NANA

NAAm

bula

nce

Prov

ided

NANA

NANo

Wai

ting

For

Pati

ent

NANA

Proc

edur

e fo

llow

ed f

or

refe

rral

:Go

vern

men

t.

Hos

pita

lsGo

vern

men

t.

Hos

pita

lsDi

stt.

H

ospi

tals

Med

ical

Co

llege

Gove

rnm

ent.

H

ospi

tals

Gove

rnm

ent.

H

ospi

tals

Dist

t.

Hos

pita

lsNo

neGo

vern

men

t.

Hos

pita

lsNo

ne

Tie-

up w

ith

othe

r ho

spit

al

(bot

h pu

blic

and

pri

vate

) fo

r di

agno

stic

NoNo

NoYe

sYe

sNo

NoYe

sYe

sYe

s

Hos

pita

l has

a t

ie-u

p w

ith:

None

Med

ical

Co

llege

None

Med

ical

Co

llege

Med

ical

Co

llege

Othe

r Go

vern

men

t.

Hos

pita

ls

None

None

Med

ical

Co

llege

Othe

r Go

vern

men

t.

Hos

pita

ls

Does

the

Hos

pita

l hav

e an

y Ou

trea

ch A

rea

NoNo

NoYe

sYe

sYe

sNo

NoNo

Yes

If Y

es,

wha

t se

rvic

es a

re

prov

ided

NANA

NAEy

e ca

mp,

IE

CM

CH,

Eye

cam

p

Bloo

d Co

ll.

Cam

p,

Eye

cam

p

NANA

NAM

CH (Con

td..

.)


Labo

rato

ry T

ests

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Stat

isti

cal B

ulle

tin

Yes

NoNo

Yes

NoYe

sNo

Yes

NoNo

Mon

thly

NANA

Fort

nigh

tly

NAFo

rtni

ghtl

yNA

Mon

thly

NANA

Avai

labi

lity

of D

hara

msh

ala

NoNo

NoNo

NoNo

NoNo

NoNo

Avai

labi

lity

of r

esid

enti

al

acco

mm

odat

ion

for

the

esse

ntia

l sta

ff

NoYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

If a

vaila

ble,

Wha

t %

is n

ot

Gett

ing

Acco

mm

odat

ion

NA00

90%

25%

NA70

%25

%`2

5%50

%65

%

Secu

rity

Arr

ange

men

t:No

NAIn

hou

seIn

hou

seNo

In h

ouse

NoNo

In h

ouse

No


Tab

le 2.4

O

ut

Pati

en

t D

ep

art

men

t at

Su

b-D

ivis

ion

al H

osp

itals

Out

Pati

ent

Depa

rtm

ent

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Rece

ptio

n &

Reg

istr

atio

n Co

unte

rM

anua

lCo

mpu

teri

sed

Com

pute

rise

dM

anua

lM

anua

lCo

mpu

teri

sed

Com

pute

rise

dM

anua

lM

anua

lM

anua

l

Man

aged

by

cler

kNo

NoNo

Yes

Yes

Yes

NoNo

Yes

No

Man

aged

by

MSW

Yes

NoNo

Yes

Yes

NoNo

NoNo

No

Man

aged

by

staf

f nu

rse

NoNo

NoNo

NoNo

NoNo

NoNo

Man

aged

by

com

pute

r op

erat

orNo

Yes

Yes

NoNo

Yes

Yes

Yes

NoNo

Know

ledg

eabl

e ab

out

the

OPD

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Sepa

rate

reg

istr

atio

n fo

r m

ale

Yes

Yes

NoNo

NoYe

sNo

NoNo

No

Sepa

rate

reg

istr

atio

n fo

r fe

mal

eYe

sYe

sNo

NoNo

Yes

NoNo

NoNo

Sepa

rate

reg

istr

atio

n fo

r se

nior

cit

izen

sYe

sYe

sYe

sNo

NoYe

sNo

NoNo

No

Sepa

rate

reg

istr

atio

n fo

r st

aff

Yes

Yes

NoNo

NoYe

sNo

NoNo

No

regi

stra

tion

reg

iste

rs a

re p

rope

rly

mai

ntai

ned

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

s

All s

ecti

ons

of t

he O

PD h

avin

g pr

oper

si

gnag

e an

d di

rect

iona

l sig

nNo

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s

Wai

ting

are

a is

ade

quat

eYe

sNo

Yes

Yes

Yes

Yes

NoNo

Yes

No

Prop

er s

itti

ng a

rran

gem

ent

Yes

NoYe

sYe

sYe

sYe

sNo

NoNo

No

Drin

king

wat

er f

acili

tyYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Ceili

ng F

ans

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Toile

t fa

cilit

yYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Doct

or’s

Cham

bers

are

hav

ing

adeq

uate

sp

ace

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Exam

inat

ion

tabl

e w

ith

prop

er s

heet

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

s

Stoo

l for

the

pat

ient

to

sit

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Exam

inat

ion

equi

pmen

ts (

like

BP

appa

ratu

s To

rch,

ham

mer

, et

c.)

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

(Con

td..

.)


Out

Pati

ent

Depa

rtm

ent

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Adeq

uate

Illu

min

atio

nYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Inje

ctio

n Ro

om a

long

wit

h fa

cilit

ies

and

to d

eal w

ith

Emer

genc

y si

tuat

ion

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Yes

Min

or O

T/ D

ress

ing

Room

wit

h al

l the

ba

sic

Equi

pmen

tsYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

No

Disp

ensa

ries/

Pha

rmac

y w

ith

sepa

rate

co

unte

rs f

or m

ale/

fem

ale/

seni

or c

itiz

enNo

Yes

Yes

NoNo

NoYe

sYe

sNo

Yes

Labo

rato

ry &

Im

agin

g Se

rvic

es e

asily

ac

cess

ible

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Cent

ral C

olle

ctio

n Ce

ntre

for

Lab

orat

ory

Serv

ices

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s


Tab

le 2.5

E

merg

en

cy M

ed

ical S

erv

ices (

Casu

alt

y)

at

Su

b-D

ivis

ion

al H

osp

itals

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Sepa

rate

Med

ical

Offi

cer(

s) a

vaila

ble

roun

d th

e cl

ock

Yes

NoYe

sYe

sYe

sYe

sNo

Yes

NoYe

s

Boar

d di

spla

ying

on

call

doct

ors/

spec

ialis

t an

d ot

her

staf

f on

dut

yYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

No

Glow

sig

n bo

ard

indi

cati

ng

‘Em

erge

ncy

Serv

ices

Dep

artm

ent’

NoYe

sYe

sYe

sYe

sNo

NoYe

sNo

No

Emer

genc

y W

ard

atta

ched

to

Emer

genc

y De

part

men

tNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Tria

ge a

rea

Yes

NoYe

sYe

sYe

sNo

Yes

Yes

NoNo

Obse

rvat

ion

Beds

(fi l

l num

ber,

for

No

fi ll 0

0)02

0412

0403

0407

0501

06

Trol

leys

(fi l

l num

ber,

for

No fi

ll 00

)4

22

41

24

21

1

Whe

el c

hair

s (fi

ll n

umbe

r, fo

r No

fi ll

00)

0401

0203

0103

0202

0001

Exam

inat

ion

room

s (fi

ll n

umbe

r, fo

r No

fi ll

00)

0101

0102

0101

0101

0102

All t

he R

egis

ters

incl

udin

g M

LR

avai

labl

e fo

r Pr

oper

Reg

.Ye

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Reti

ring

roo

m w

ith

toile

ts f

or t

he

doct

ors

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

s

Call

book

in p

resc

ribe

d fo

rmat

av

aila

ble

NoYe

sYe

sNo

Yes

NoNo

Yes

NoNo

Wai

ting

are

a fo

r th

e at

tend

ants

of

the

pati

ents

wit

h th

e ba

sic

Faci

litie

s lik

e si

ttin

g ar

rang

emen

ts,

drin

king

w

ater

, to

ilet

etc.

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sNo

No

Publ

ic t

elep

hone

ava

ilabl

eNo

Yes

NoYe

sNo

NoNo

NoNo

No

Trea

tmen

t ro

om-c

um-m

inor

OT

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

(Con

td..

.)


Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Maj

or O

TYe

sNo

NoYe

sNo

Yes

Yes

Yes

NoNo

Suffi

cien

t st

ock

of E

ssen

tial

and

Lif

e Sa

ving

Dru

gsNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Oxyg

en C

ylin

ders

wit

h At

tach

men

tsYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Labo

rato

ry S

ervi

ces

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Radi

olog

y Se

rvic

esYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Ambu

lanc

e Se

rvic

esYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Staf

f Tr

aine

d in

BLS

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Trea

tmen

t Fa

cilit

ies

for

Dog/

Snak

e Bi

te &

Poi

soni

ngYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

No

Avai

labi

lity

of D

isas

ter

Man

ual

NoNo

Yes

Yes

NoNo

NoYe

sNo

No

Disa

ster

Ale

rt C

ode,

Rec

all &

De

ploy

men

tNo

NoYe

sYe

sNo

NoYe

sYe

sNo

No

Mai

nten

ance

of

Dedi

cate

d Dr

ug s

tore

fo

r Di

sast

er S

itua

tion

NoYe

sYe

sYe

sYe

sNo

Yes

Yes

NoYe

s

Plas

ter

Room

Yes

Yes

Yes

Yes

NoYe

sNo

Yes

NoNo


Tab

le 2

.6 In

ten

siv

e C

are

Un

it a

t S

ub

-Div

isio

nal H

osp

itals

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Ava

ilabi

lity

of I

CUYe

sYe

sNo

NoNo

NoNo

NoYe

sYe

s

Tota

l num

ber

of b

eds

avai

labl

e:02

05NA

NANA

NANA

NA04

06

Air-

cond

itio

ned

ICU

wit

h Ge

nera

tor

Supp

ort

NoNo

NANA

NANA

NANA

NoNo

Staf

f sa

ncti

oned

for

the

ICU

- no

. of

Do

ctor

s01

00NA

NANA

NANA

NA00

00

Staf

f sa

ncti

oned

for

the

ICU

- no

. of

Nu

rses

0100

NANA

NANA

NANA

0000

Staf

f Sa

ncti

oned

for

the

ICU

- no

. of

Te

chni

cal S

taff

0100

NANA

NANA

NANA

0000

Staf

f sa

ncti

oned

for

the

ICU

- no

. of

Cl

ass

IV01

00NA

NANA

NANA

NA00

00

Reco

rd K

eepi

ng o

f th

e Pa

tien

tsYe

sNo

NANA

NANA

NANA

No00

Avai

labi

lity

of o

xyge

n/ s

ucti

on

appa

ratu

s/ c

ompr

esse

d ai

rYe

sYe

sNA

NANA

NANA

NANo

Yes

Defi b

rilla

tor

NoNo

NANA

NANA

NANA

NoNo

ECG

mac

hine

NoYe

sNA

NANA

NANA

NANo

No

Vent

ilato

rNo

NoNA

NANA

NANA

NANo

No

All t

he li

fe s

avin

g Vi

tal d

rugs

NoYe

sNA

NANA

NANA

NANo

Yes

Stric

t as

epti

c pr

oced

ures

are

fol

low

edNo

Yes

NANA

NANA

NANA

NoNo


Tab

le 2.7

C

lin

ical Lab

ora

tori

es a

t S

ub

-Div

isio

nal H

osp

itals

Clin

ical

Lab

orat

orie

sN

ame

of t

he S

ub-D

ivis

iona

l Hos

pita

ls

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Type

of

Labo

rato

ries-

Pat

holo

gyYe

sYe

sNo

Yes

NoNo

NoYe

sNo

Yes

Type

of

Labo

rato

ries-

Mic

robi

olog

yYe

sNo

NoNo

Yes

Yes

NoYe

sNo

Yes

Qual

ifi ed

- Pa

thol

ogis

tNo

Yes

NoYe

sNo

NoNo

Yes

NoNo

Qual

ifi ed

- Bi

oche

mis

tNo

NoNo

NoNo

NoNo

NoNo

No

Qual

ifi ed

- M

icro

Bio

logi

stNo

NoNo

NoNo

NoNo

Yes

NoNo

Follo

win

g th

e Un

iver

sal P

reca

utio

n Pr

oced

ures

NoYe

sYe

sYe

sNo

Yes

NoYe

sYe

sNo

Usin

g Pr

otec

tive

Mea

sure

s i.e

. gl

oves

/go

wns

/mas

ksYe

sNo

Yes

Yes

NoYe

sNo

Yes

Yes

No

Spec

imen

Col

lect

ion

done

Cen

tral

lyYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Avai

labi

lity

of a

ll th

e Ch

emic

als

and

Reag

ents

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Obse

rvin

g al

l the

bio

-saf

ety

mea

sure

sNo

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s

Accu

racy

of

Repo

rts

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

s

Regu

lar

Inte

rnal

Qua

lity

Cont

rol

Mea

sure

s Un

dert

aken

NoYe

sYe

sYe

sNo

Yes

NoYe

sNo

No

Regu

lar

Exte

rnal

Qua

lity

Cont

rol

Mea

sure

s Un

dert

aken

NoYe

sYe

sNo

Yes

Yes

Yes

Yes

NoYe

s


Tab

le 2.8

B

loo

d B

an

kin

g F

acilit

ies

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

BLOO

D BA

NK (

If N

o bl

ood

bank

fi ll

“8”

for

sect

ion

E)No

Yes

Yes

Yes

NAYe

sNA

Yes

Yes

Trai

ned

or q

ualifi

ed

med

ical

offi

cer

post

ed a

s B.

T.O.

NAYe

sYe

sYe

sNA

NoNA

Yes

NoNA

Roun

d th

e cl

ock

avai

labi

lity

of t

rain

ed

staf

f an

d se

rvic

esNA

Yes

Yes

Yes

NANo

NAYe

sYe

sNA

Chec

king

& c

ross

mat

chin

g by

B.T

.O.

NAYe

sYe

sYe

sNA

Yes

NAYe

sYe

sNA

Prop

er m

aint

enan

ce o

f co

ld c

hain

and

re

frig

erat

ors

NAYe

sYe

sYe

sNA

Yes

NAYe

sYe

sNA

Aust

ralia

ant

igen

, H

CV,

VDRL

, M

.P.

and

HIV

tes

ts d

one

for

Ever

y bl

ood

bott

le o

f do

nor.

NAYe

sYe

sYe

sNA

Yes

NAYe

sYe

sNA

Effo

rts

mad

e to

col

lect

blo

od t

hrou

gh

Volu

ntar

y Or

gani

sati

on C

amps

NAYe

sYe

sYe

sNA

NoNA

Yes

Yes

NA

Rene

wal

of

bloo

d ba

nk/H

IV L

icen

se a

s pe

r Ru

les

NAYe

sYe

sYe

sNA

Yes

NAYe

sYe

sNA

Disp

osal

of

HIV

Pos

itiv

e Bl

ood

Bags

&

bio-

safe

ty m

easu

res

unde

rtak

enNA

Yes

Yes

Yes

NAYe

sNA

Yes

Yes

NA

Avai

labi

lity

of T

able

Top

Syr

inge

&

need

le d

estr

oyer

and

Col

our

Code

d Ba

gsNA

Yes

Yes

Yes

NAYe

sNA

Yes

Yes

NA

Feed

back

of

Tran

sfus

ion,

and

Rec

ord

mai

nten

ance

of

unto

war

d in

cide

nces

NAYe

sYe

sNo

NAYe

sNA

Yes

NoNA


Tab

le 2.9

R

ad

iolo

gy a

nd

Im

ag

ing

Serv

ices a

t S

ub

-Div

isio

nal H

osp

itals

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Rad

iolo

gist

ava

ilabl

eNo

NoNo

NoYe

sNo

NoYe

sNo

No

X-ra

y M

achi

nes

Mob

ile C

-arm

- To

tal N

o.

Avai

labl

e0

01

11

00

11

0

X-ra

y M

achi

nes

Mob

ile C

-arm

Wor

king

Co

ndit

ion

00

01

10

01

10

X-ra

y M

achi

nes

Mob

ile C

-arm

Und

er

Repa

irs

00

00

00

00

00

X-ra

y M

achi

nes

Mob

ile C

-arm

Pen

ding

for

Co

ndem

nati

on0

00

00

00

00

0

X-ra

y M

achi

nes

500/

300

mA

Tota

l No.

Av

aila

ble

11

21

12

11

01

X-ra

y M

achi

nes

500/

300

mA

Wor

king

10

01

12

11

01

X-ra

y M

achi

nes

500/

300

mA

Unde

r Re

pair

s0

00

00

00

00

0

X-ra

y M

achi

nes

500/

300

mA

Pe

ndin

g fo

r Co

ndem

nati

on0

00

00

00

00

0

X-ra

y M

achi

nes

200/

100

mA

Tota

l No.

Av

aila

ble

10

01

00

10

12

X-ra

y M

achi

nes

200/

100

mA

Wor

king

Co

ndit

ion

10

01

00

00

02

X-ra

y M

achi

nes

200/

100

mA

Unde

r Re

pair

s0

00

00

00

00

0

X-ra

y M

achi

nes

200

/ 10

0 m

A Pe

ndin

g fo

r Co

ndem

nati

on0

00

00

01

01

0

X-ra

y M

achi

nes

Mob

ile /

60

mA

Tota

l No.

Av

aila

ble

11

01

11

10

00

X-ra

y M

achi

nes

Mob

ile /

60

mA

Wor

king

Co

ndit

ion

11

01

11

10

00

(Con

td..

.)


Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

X-ra

y M

achi

nes

Mob

ile /

60

mA

Unde

r Re

pair

s0

00

00

00

00

0

X-ra

y M

achi

nes

Mob

ile /

60

mA

Pend

ing

for

Cond

emna

tion

00

00

00

00

00

Avai

labi

lity

of t

he d

ark

room

wit

h al

l fa

cilit

ies

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Use

of d

osim

eter

and

the

y re

gula

rly s

ent

to B

ARC

NoNo

NoNo

NoYe

sYe

sNo

NoNo

Spec

ial i

nves

tiga

tion

s lik

e IV

P, c

ontr

ast

med

ia e

tc.

NoNo

Yes

Yes

Yes

Yes

NoNo

NoNo

Roun

d th

e cl

ock

avai

labi

lity

of X

-ray

se

rvic

es/S

onog

raph

yNo

Yes

NoYe

sYe

sNo

Yes

Yes

NoYe

s

Sepa

rate

reg

iste

r fo

r M

LC r

ecor

dsYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s


Tab

le 2.1

0 O

pera

tio

n T

heatr

es A

t S

ub

-Div

isio

nal H

osp

itals

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

No.

of O

pera

tion

Th

eatr

esM

ajor

22

31

22

12

12

Min

or1

11

10

11

21

1

Zoni

ng c

once

pts

stric

tly

follo

wed

NoNo

Yes

Yes

Yes

NoYe

sYe

sNo

Yes

Boyles Apparatus

Tota

l No.

Ava

ilabl

e1

23

21

11

21

1

Unde

r Re

pair

00

01

00

10

00

Pend

ing

for

Cond

emna

tion

10

00

00

00

00

Hydraulic Operation

Table

Tota

l No.

Ava

ilabl

e2

42

12

22

22

3

Unde

r Re

pair

s0

20

00

12

00

0

Pend

ing

for

Cond

emna

tion

00

00

00

10

00

Shadow less lamp

Tota

l No.

Ava

ilabl

e1

23

22

21

42

2

Unde

r Re

pair

s0

00

10

10

00

0

Pend

ing

for

Cond

emna

tion

00

00

00

00

00

Fumigation apparatus

Tota

l No.

Ava

ilabl

e1

01

12

10

00

1

Unde

r Re

pair

s0

NA0

01

00

00

0

Pend

ing

for

Cond

emna

tion

0NA

00

00

00

00

Suction Apparatus

Tota

l No.

Ava

ilabl

e3

22

23

21

62

3

Unde

r Re

pair

s0

00

00

00

01

0

Pend

ing

for

Cond

emna

tion

00

00

00

00

00

Air conditioner

Tota

l No.

Ava

ilabl

e2

26

13

12

32

3

Unde

r Re

pair

s0

00

00

00

00

0

Pend

ing

for

Cond

emna

tion

00

00

00

00

00

(Con

td..

.)


Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Electric cautery

Tota

l No.

Ava

ilabl

e1

11

12

11

11

1

Unde

r Re

pair

s1

10

01

00

00

0

Pend

ing

for

Cond

emna

tion

00

00

00

00

00

Endoscope

Tota

l No.

Ava

ilabl

e0

00

10

00

00

0

Unde

r Re

pair

s0

00

00

00

00

0

Pend

ing

for

Cond

emna

tion

00

00

00

00

00

Laparo-scope

Tota

l No.

Ava

ilabl

e0

11

10

10

10

0

Unde

r Re

pair

s0

00

00

00

00

0

Pend

ing

for

Cond

emna

tion

00

00

00

00

00

Cardiac monitor

Tota

l No.

Ava

ilabl

e0

10

11

11

00

1

Unde

r Re

pair

s1

00

00

00

00

0

Pend

ing

for

Cond

emna

tion

00

00

00

00

00

Cardiac defi brillators

Tota

l No.

Ava

ilabl

e1

00

00

00

10

0

Unde

r Re

pair

s0

00

00

00

00

0

Pend

ing

for

Cond

emna

tion

00

00

00

00

00

Pulse oxymeter

Tota

l No.

Ava

ilabl

e1

22

11

01

10

1

Unde

r Re

pair

s0

10

01

00

00

0

Pend

ing

for

Cond

emna

tion

00

00

00

00

00

Portable mobile x ray

machine

Tota

l No.

Ava

ilabl

e1

01

11

30

10

0

Unde

r Re

pair

s0

00

00

00

00

0

Pend

ing

for

Cond

emna

tion

00

00

00

00

00

(Con

td..

.)


Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Up-

to-d

ate

mai

nten

ance

of

O.T.

rec

ords

lik

e O.

T. r

egis

ters

, em

erge

ncy

O.T.

, M

onth

ly a

bstr

act

disc

iplin

e w

ise,

m

ajor

/min

or e

tc

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Mai

nten

ance

of

oper

atio

n po

stpo

nem

ent

regi

ster

NoYe

sNo

Yes

NoNo

NoNo

NoNo

Emer

genc

y lig

ht o

r ge

nera

tor

faci

litie

s pr

ovid

ed t

o O.

T.Ye

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Avai

labi

lity

of fi

re fi

ghti

ng e

quip

men

ts

and

know

ledg

e to

use

the

mNo

NoYe

sYe

sYe

sYe

sNo

NoYe

sNo

Regu

lar

disi

nfec

tion

s &

ste

rilis

atio

n pr

oced

ures

don

e at

O.T

.Ye

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s


Tab

le 2

.11

In

Pati

en

t W

ard

s a

t S

ub

-Div

isio

nal H

osp

itals

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Sati

sfac

tory

cle

anlin

ess

of t

he w

ards

wit

h ad

equa

te h

ouse

kee

ping

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Colo

ur c

odes

of

Yello

w, B

lue,

Red

, W

hite

bi

n &

Blu

e tr

ansp

aren

t PP

F fo

r w

aste

co

llect

ion

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Tabl

e to

p sy

ring

e &

nee

dle

dest

roye

rYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Prop

er u

tilis

atio

nNo

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Adeq

uate

wat

er s

uppl

y an

d up

kee

p of

sa

nita

ry b

lock

s.Ye

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Adeq

uate

& c

lean

Toi

lets

and

Bat

hroo

ms

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

All t

he b

eds

are

havi

ng p

rope

r &

ade

quat

e lin

enYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Floo

r be

ds/d

oubl

ing

of b

eds

in t

he w

ards

NoNo

NoNo

NoNo

NoNo

NoNo

if Y

es,

anal

yse

the

reas

onNA

NANA

NANA

NANA

NANA

NA

Sati

sfac

tory

up

keep

of

cots

, m

attr

esse

s,

beds

ide

lock

ers,

line

nYe

sNo

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

s

Use

of h

ospi

tal u

nifo

rms

by a

ll pa

tien

tsNo

NoNo

NoYe

sNo

NoNo

NoNo

Avai

labi

lity

and

func

tion

ing

of s

ucti

on

appa

ratu

s (

elec

tric

& f

oot

oper

ated

)Av

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eNo

t Av

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

e

If A

vaila

ble

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Not

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Avai

labi

lity

and

func

tion

ing

of o

ygen

cy

linde

r w

ith

acce

ssor

ies

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

If a

vaila

ble

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Avai

labi

lity

and

func

tion

ing

of

vene

sect

ion

tray

, LP

, tr

ache

osto

my

tray

.Av

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eNo

t Av

aila

ble

Avai

labl

eNo

t Av

aila

ble

Not

Avai

labl

e

If a

vaila

ble

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

NANA

(Con

td..

.)


Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Avai

labi

lity

and

func

tion

ing

of e

mer

genc

y lig

ht,

whe

el c

hair,

tro

lley

Avai

labl

eNo

t Av

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Not

Avai

labl

eAv

aila

ble

If a

vaila

ble

Func

tion

alNA

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

Stat

ione

ries,

for

ms,

upt

o da

te v

ario

us

regi

ster

s et

c.Ye

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Conc

ept

of p

rogr

essi

ve p

atie

nt c

are

NoYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Adeq

uacy

and

wor

king

of

fans

and

ligh

tsYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Sati

sfac

tory

ava

ilabi

lity

of d

iet,

NANA

NoNo

NoNo

Yes

NoNo

No

Qual

ity

of c

are

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Yes

Mai

nten

ance

of

vario

us r

egis

ters

, re

cord

s,

etc.

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes


Tab

le 2.1

2 H

osp

ital M

ed

ical S

tore

s a

t S

ub

-Div

isio

nal H

osp

itals N

ame

of t

he S

ub-D

ivis

iona

l Hos

pita

ls

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Med

ical

sto

re s

uita

bly

loca

ted

wit

h ad

equa

te s

pace

and

pro

tect

ion

of d

rugs

an

d no

n-dr

ugs

item

s fr

om p

ilfer

age,

te

mpe

ratu

re,

hum

idit

y

NoNo

Yes

Yes

Yes

NoNo

Yes

NoNo

Rest

ricti

on o

n en

try

for

unau

thor

ised

pe

rson

nel’s

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Yes

Staf

f kn

owle

dgea

ble

in m

ater

ials

m

anag

emen

tNo

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Insp

ecti

on o

f st

ores

by

the

Civi

l Sur

geon

/ M

.O.

I/c

at r

egul

ar in

terv

al t

o ve

rify

sto

ck

book

s

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s

Avai

labi

lity

of V

ital

, es

sent

ial d

rugs

in

suffi

cien

t Qu

anti

tyNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Upk

eep

of e

xpir

y da

te r

egis

ter

and

its

regu

lar

insp

ecti

on b

y M

O I/

cNo

Yes

NoYe

sYe

sNo

Yes

Yes

NoYe

s

Effo

rts

mad

e to

red

istr

ibut

e la

rge

stoc

k of

sl

ow m

ovin

g dr

ugs

or n

ear

expi

ry f

or it

s ut

ilisa

tion

.

NoYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Prop

er a

rran

gem

ents

to

keep

the

dru

gs

as p

er A

BC/V

ED c

ateg

ory

and

stor

age

of

rubb

er g

oods

as

per

guid

elin

es

NoNo

Yes

Yes

Yes

NoNo

Yes

NoNo

Appr

opria

te s

teps

tak

en t

o pr

even

t pi

lfera

ge o

fNo

Yes

Yes

NoYe

sNo

Yes

Yes

NoYe

s

A co

nven

ient

arr

ange

men

t of

issu

ing

drug

s to

var

ious

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Regu

lar

send

ing

of s

ampl

es t

o ch

emic

al

labo

rato

ry t

o ch

eck

it a

s pe

r sp

ecifi

cati

on

and

stan

dard

& a

ctio

n ta

ken

ther

eon

NoYe

sYe

sYe

sNo

Yes

Yes

Yes

NoNo

(Con

td..

.)


Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Circ

ulat

ion

of li

sts

of a

vaila

ble

drug

s to

al

l the

MOs

, OP

D& w

ards

as

per

gene

ric

nam

es

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s

Subm

issi

on o

f ce

rtifi

ed b

ills

to o

ffi ce

for

re

leas

e of

pay

men

ts w

ithi

n th

ree

days

.Ye

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Auct

ion

to c

lear

the

em

pty

mat

eria

l fro

m

stor

e do

ne r

egul

arly

.No

NoYe

sYe

sNo

Yes

NoYe

sYe

sNo

Avai

labi

lity

of F

ire F

ight

ing

equi

pmen

ts

and

know

ledg

e of

sta

ff t

o op

erat

e it

NoNo

Yes

NoYe

sYe

sYe

sNo

Yes

No

Avai

labi

lity

of r

egul

arly

upd

ated

Hos

pita

l Dr

ug F

orm

ular

yNo

NoYe

sYe

sYe

sNo

Yes

Yes

NoNo

Exis

tenc

e of

sta

ndin

g Dr

ug C

omm

itte

eNo

Yes

Yes

NoYe

sNo

NoYe

sYe

sNo


Tab

le 2.1

3 M

ed

ical R

eco

rds D

ep

art

men

t at

Su

b-D

ivis

ion

al H

osp

itals

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Avai

labi

lity

of m

edic

al r

oom

w

ith

enou

gh n

o. o

f ra

cks

and

cup-

boar

d et

c.

Yes

Yes

Yes

Yes

Yes

NoNo

NoNo

No

Med

ical

rec

ord

Man

ual

Man

ual

Man

ual

Man

ual

Com

pute

rise

dM

anua

lM

anua

lM

anua

lM

anua

lM

anua

l

Is it

man

aged

by

a tr

aine

d m

edic

al r

ecor

d of

fi cer

/ te

chni

cian

or

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s

Case

rec

ord

is m

aint

aine

d as

per

WH

O cl

assi

fi cat

ion

of

dise

ases

(IC

D-X)

NoYe

sYe

sYe

sNo

NoNo

NoNo

No

Regu

lar

subm

issi

on o

f th

e m

orbi

dity

, m

orta

lity

repo

rts

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

s

Dura

tion

for

all

the

reco

rds

bein

g m

aint

aine

d (I

n ye

ars)

5 yr

s.9

yrs.

5 yr

s.10

yrs

.No

t Av

aila

ble

6 yr

s.10

yrs

.5

yrs.

Not

Avai

labl

e8

yrs

Is t

he b

acku

p fa

cilit

y av

aila

ble

to s

afeg

uard

the

se r

ecor

dsYe

sNo

Yes

Yes

NoNo

Yes

NoNo

No

Is t

he e

ffec

tive

ret

rieva

l sy

stem

fol

low

ed b

y th

is

hosp

ital

NoNo

Com

pute

rise

dYe

sNo

BLS

In-p

atie

nt

no.

NoNo

Corr

espo

nden

ce

Regu

lar

deat

h au

dit

mee

ting

s he

ld &

min

utes

of

mee

ting

Yes

NoYe

sYe

sYe

sNo

Yes

Yes

NoNo

Med

ical

aud

it d

one

at r

egul

ar

inte

rval

Yes

NoYe

sYe

sYe

sYe

sNo

Yes

NoNo

Are

the

adeq

uate

num

ber

of

bins

and

the

bag

s of

req

uire

dYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Are

thes

e pl

aced

str

ateg

ical

ly

in a

ll pa

tien

t ca

re a

reas

NoNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

(Con

td..

.)


Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Segr

egat

ion

of d

iffe

rent

ca

tego

ries

of w

aste

s do

ne a

t th

e

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Colle

ctio

n of

was

te,

pack

agin

g,

labe

lling

, re

cord

kee

ping

don

e in

sci

enti

fi c

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Prop

er t

rans

port

atio

n of

the

w

aste

so

colle

cted

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Stor

age

faci

litie

s an

d du

rati

onYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Disp

osal

/ re

cycl

ing

met

hods

for

va

rious

cat

egor

ies

of W

aste

NoYe

sYe

sYe

sNo

Yes

NoYe

sNo

Yes

Avai

labi

lity

of a

utoc

lave

s,

shre

dder

sNo

Yes

Yes

NoYe

sYe

sNo

Yes

Yes

Yes

Whe

ther

was

te d

ispo

sal i

s ou

tsou

rced

Ye

sYe

sYe

sYe

sYe

sNo

NoYe

sYe

sYe

s


Tab

le 2.1

4 C

en

tral S

up

ply

Dep

art

men

t at

Su

b-D

ivis

ion

al H

osp

itals

Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Unde

r th

e su

perv

isio

n of

a t

rain

ed

tech

nica

l sta

ff/

seni

or n

ursi

ng

offi c

er

Yes

Yes

Yes

Yes

Yes

NoNo

Yes

Yes

Yes

Hav

ing

all t

he r

equi

red

equi

pmen

ts

& A

utoc

lave

sYe

sYe

sYe

sYe

sYe

sNo

NoYe

sYe

sYe

s

Qual

ity

cont

rol m

easu

res

are

stric

tly

follo

wed

-ph

ysic

alNo

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Qual

ity

cont

rol m

easu

res

are

stric

tly

follo

wed

- ch

emic

alNo

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Qual

ity

cont

rol m

easu

res

are

stric

tly

follo

wed

- bi

olog

ical

NoYe

sYe

sNo

Yes

Yes

NoYe

sYe

sNo

Laun

dry

Serv

ices

In h

ouse

In h

ouse

In h

ouse

Out

sour

ced

In h

ouse

Out

sour

ced

Out

sour

ced

In h

ouse

Out

sour

ced

Out

sour

ced

Laun

dry

Serv

ices

Conv

enti

onal

Mec

hani

sed

Mec

hani

sed

Conv

enti

onal

Mec

hani

sed

Conv

enti

onal

Mec

hani

sed

Mec

hani

sed

Conv

enti

onal

Conv

enti

onal

Laun

dry

Serv

ices

- st

aff

Not

adeq

uate

Not

adeq

uate

Adeq

uate

Adeq

uate

Not

adeq

uate

Not

adeq

uate

Not

adeq

uate

Not

adeq

uate

Adeq

uate

Adeq

uate

Qual

ity

of w

ash

Aver

age

Aver

age

Good

Good

Good

Aver

age

Good

Aver

age

Aver

age

Aver

age

Qual

ity

of li

nen

Aver

age

Aver

age

Good

Good

Good

Aver

age

Good

Aver

age

Aver

age

Aver

age

Diet

ary

Serv

ices

(If

no

diet

ary

serv

ices

fi ll

“8”)

Ade

quat

e sp

ace

for

kitc

hen

NANA

NANA

NAYe

sNA

NANA

NA

Prop

er &

saf

e ar

rang

emen

t fo

r st

orag

e of

raw

mat

eria

lsNA

NANA

NANA

Yes

NANA

NANA

Mea

sure

s fo

r Pe

st &

Rod

ent

cont

rol

NANA

NANA

NANA

NANA

NANA

Sani

tati

on a

nd h

ygie

ne o

f th

e co

okin

g ar

ea p

rope

rly m

aint

aine

dNA

NANA

NANA

NoNA

NANA

NA

(Con

td..

.)


Nam

e of

the

Sub

-Div

isio

nal H

ospi

tals

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

aler

Kot

laM

alou

tN

akod

arPa

tti

Talw

andi

Regu

lar

heal

th c

heck

-up

for

food

ha

ndle

rsNA

NANA

NANA

NoNA

NANA

NA

Avai

labi

lity

of m

oder

n co

okin

g eq

uipm

ents

NANA

NANA

NANo

NANA

NANA

Avai

labi

lity

of p

rope

rly m

aint

aine

d re

cord

s &

reg

iste

rsNA

NANA

NANA

NoNA

NANA

NA

Diet

ser

vice

und

er t

he s

uper

visi

on o

f a

qual

ifi ed

Die

tici

anNA

NANA

NANA

NoNA

NANA

NA


Tab

le 2

.15 Fiv

e Y

ears

Perf

orm

an

ce R

ep

ort

of

Su

b-d

ivis

ion

al H

osp

itals

Perf

orm

ance

(Ann

ual)

Nam

e of

the

Sub

-Div

isio

n ho

spit

al

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

alar

kot

laM

alou

tN

akod

arPa

tti

Talw

andi

OPD

Atte

ndan

ce la

st

5 ye

ars

1st Y

r80

500

8787

783

843

-74

417

1321

4493

452

1078

4613

2857

5589

6

2nd Y

r79

500

1238

5387

245

-83

174

1399

5489

208

NA12

9245

5776

2

3rd Y

r78

300

1189

5190

957

7185

191

738

1458

1688

343

NA12

5296

4387

8

4th Y

r81

000

9488

992

177

7673

411

4972

1566

2282

641

1072

4612

4884

5566

7

5th Y

r 72

000

1106

3393

716

8357

614

0825

1651

3380

273

1538

7712

2326

5705

0

In-p

atie

nt A

dmit

ted

1st Y

r28

1059

3242

97-

3593

6062

1882

3697

4525

1554

2nd Y

r27

2960

6651

23-

4340

7370

2022

-38

7115

63

3rd Y

r29

1560

2556

1039

9746

8084

7724

80-

3620

985

4th Y

r26

7057

2362

6542

2150

1286

3128

0853

1530

0117

28

5th Y

r 27

5063

4876

5348

6752

4092

4228

8245

1327

7119

11

No.

of

Surg

erie

s do

ne

1st Y

r34

1925

7318

90-

3045

1925

931

4196

1939

853

2nd Y

r33

3545

2152

12-

5847

4647

649

-34

3276

6

3rd Y

r38

4048

0382

3377

762

0865

1910

87-

5220

508

4th Y

r38

5341

7674

4224

0460

0210

474

1567

5891

4832

1282

5th Y

r 35

2440

1194

1629

2661

7984

5641

4159

7741

1514

18

No.

of

Emer

genc

ies

1st Y

r14

7042

5725

81-

2956

3991

1627

2083

1303

617

2nd Y

r13

9041

8928

63-

2305

4264

1997

-14

0553

1

3rd Y

r12

2039

8430

72-

3432

4610

2104

-12

4839

2

4th Y

r14

1040

8635

12-

4111

4260

2039

2352

2267

745

5th Y

r 15

2437

7745

22-

4144

4984

2351

2463

1479

943

No.

of

adm

issi

ons

thro

ugh

emer

genc

y

1st Y

r14

7033

8419

90-

1271

2915

1013

1230

1303

405

2nd Y

r13

9029

3822

80-

1540

3582

1271

-14

1047

9

3rd Y

r12

2023

8424

5221

3916

9037

5813

95-

1486

392

4th Y

r14

1026

0726

9623

8019

2535

4912

0316

1813

4973

9

5th Y

r 15

2425

9935

4527

9620

4635

9614

8418

7215

2579

5

(Con

td..

.)


Perf

orm

ance

(Ann

ual)

Nam

e of

the

Sub

-Div

isio

n ho

spit

al

Ajna

laBa

tala

Dasu

yaFa

zilk

aJa

grao

nM

alar

kot

laM

alou

tN

akod

arPa

tti

Talw

andi

No.

of

Med

ico-

lega

l ca

ses

1st Y

rNe

w

Hos

pita

ls85

015

0-

625

-39

0NA

502

NA

2nd Y

rNA

870

154

-88

360

944

4NA

484

234

3rd Y

rNA

880

180

1120

740

635

445

NA48

923

7

4th Y

rNA

902

229

1445

934

790

321

NA47

141

7

5th Y

r NA

900

318

1711

838

-41

726

246

736

3

No.

of

post

-mor

tem

Do

ne

1st Y

rNA

118

150

-12

512

676

8513

70

2nd Y

rNA

126

150

-10

198

89-

141

0

3rd Y

rNA

136

148

137

119

9091

-12

10

4th Y

rNA

178

149

151

129

118

110

210

151

0

5th Y

r NA

159

160

129

169

103

223

108

0

No.

of

norm

al

deliv

erie

s co

nduc

ted

1st Y

r91

244

427

-17

586

-11

104

9

2nd Y

r85

333

516

-14

706

9-

133

7

3rd Y

r77

313

574

198

2779

810

-23

925

4th Y

r82

270

677

9044

848

3914

037

493

5th Y

r 45

214

724

138

141

8819

236

511

7

No.

of

Caes

aria

n do

ne

1st Y

r12

026

115

2-

6256

2752

0

2nd Y

r12

532

128

2-

9911

6-

100

0

3rd Y

r15

246

135

676

9614

7-

265

0

4th Y

r13

728

641

364

6220

750

269

3

5th Y

r 36

230

556

9310

573

344

4


Tab

le 2.1

6 U

tilisati

on

of

user

Ch

arg

es in

dif

fere

nt

Su

b-d

ivis

ion

al H

osp

itals

SDH

Year

sTo

tal I

ncom

e (C

olle

ctio

n)To

tal

Expe

ndit

ure

Deta

iled

Expe

ndit

ure

Rogi

Kal

yan

Sam

iti

Med

icin

eI.

F.P.

Build

ings

Equi

pmen

tER

F A/

cSa

lary

to

Cont

ract

ual

Staf

f

Ajna

la

2002

-03

6278

561

842

3445

015

9042

1500

9950

--

2003

-04

6883

198

998

8621

065

9361

95-

--

2004

-05

1288

8718

6126

1123

6552

071

1734

043

50-

-

2005

-06

6431

062

204

1408

716

1050

50-

-

2006

-07

6714

031

069

765

1545

018

2576

76-

5353

Tota

l 4,

42,3

452,

95,9

941,

04,1

4328

,470

27,0

26-

5.35

3

Bata

la

2003

-04

2856

930

1455

379

7095

5441

2825

6578

3-

2133

89

2004

-05

2501

043

1254

498

7496

4232

3472

4432

3-

1291

08

2005

-06

2564

636

1359

199

7979

7947

256

3816

820

1324

1207

10

2006

-07

2591

846

9858

2175

1368

4557

2622

5669

5786

911

5393

2007

-08

2781

007

1208

331

6356

9751

3302

3079

53-

1157

24

Tota

l 1,

32,9

5,46

262

,63,

228

36,4

4,24

017

,52,

581

6,81

,896

2,59

,193

6,94

,324

Dasu

ya

2003

Jan

to

Dec

1937

123

1906

015

9496

3048

1342

1177

0820

4455

_15

2880

2004

2569

442

2118

990

9992

9951

7145

2399

9113

6185

_22

6370

2005

2724

788

2560

358

1138

910

6248

3925

6041

2104

2914

0035

1841

04

2006

3236

033

3824

239

1019

279

1737

364

2462

7040

0142

2194

1220

1772

2007

3555

379

2944

546

1007

892

8046

2836

1026

2627

5752

4273

1761

77

Tota

l 1,

40,2

2,76

51,

33,5

4,14

851

,15,

010

41,6

5,30

012

,21,

036

12,1

3,96

88,

83,7

209,

41,3

03

Fazi

lka

2003

NANA

NANA

NANA

__

2004

1498

695

2109

466

1331

367

5114

2416

8746

9792

9_

_

2005

1526

801

1643

986

8247

5136

8495

3186

4713

2093

__

2006

-07

1417

432

1184

084

5922

1532

3291

2201

2548

453

__

2007

-08

1713

121

1405

856

6282

6942

3310

2276

5712

6620

__

Tota

l 61

,56,

049

63,4

3,39

233

,76,

602

16,2

6,52

09,

35,1

754,

05,0

95-

-

(Con

td..

.)


SDH

Year

sTo

tal I

ncom

e (C

olle

ctio

n)To

tal

Expe

ndit

ure

Deta

iled

Expe

ndit

ure

Rogi

Kal

yan

Sam

iti

Med

icin

eI.

F.P.

Build

ings

Equi

pmen

tER

F A/

cSa

lary

to

Cont

ract

ual

Staf

f

Jagr

aon

2003

-04

7673

8481

6526

1895

5347

9142

1273

5820

473

--

2004

-05

1280

104

1171

531

5390

2633

2573

1319

2716

8005

--

2005

-06

1526

969

1166

907

4646

1431

8339

1253

4913

0561

1128

4215

202

2006

-07

1586

933

1089

631

3852

5535

4189

1709

9517

9192

1632

2111

520

2007

-08

1949

779

1224

822

5037

0231

9985

1920

5420

9081

1787

44-

Tota

l 71

,11,

169

54,6

9,41

720

,82,

150

18,0

4,22

87,

47,6

837,

07,3

124,

54,8

0726

,722

Mal

ar

Kotl

a

2003

-04

2401

730

1845

039

8612

8149

6054

5865

892

452

_33

6599

2004

-05

2911

828

2913

691

1341

339

7001

8472

985

2339

49_

5652

34

2005

-06

3074

958

2643

327

1290

855

6509

5723

4480

2148

23_

2522

12

2006

-07

3843

699

3096

277

1544

136

8653

8389

337

1876

15_

4098

06

2007

-08

3431

073

3232

796

1894

129

7682

8397

998

2692

02_

2031

84

Tota

l 1,

56,6

3,28

81,

37,3

1,13

069

,31,

740

34,8

0,86

15,

53,4

589,

98,0

41-

17,6

7,03

5

Mal

out

2002

-03

8830

8478

6189

2596

1017

7339

7449

729

124

024

5619

2003

-04

1170

491

9064

1442

7686

1245

3759

033

3252

50

2626

33

2004

-05

1218

956

1045

483

4977

8984

062

6344

368

380

033

1809

2005

-06

1485

141

1543

708

2021

5951

9310

1593

4314

6260

051

6636

2006

-07

1643

569

1194

926

2691

9929

6156

2655

664

820

1611

2437

7071

2007

-08

1785

796

1229

213

3148

7624

6211

5972

197

408

1746

1133

6386

Tota

l 81

,87,

037

67,0

5,93

319

,71,

319

14,4

7,61

54,

42,5

934,

38,5

173,

35,7

3520

,70,

154

Nak

odar

2002

-03

9843

1974

8091

--

--

--

2003

-04

1088

831

1217

550

--

--

--

2004

-05

1564

222

1747

670

--

--

--

2005

-06

1919

253

1658

387

--

--

--

2006

-07

1178

820

9932

77-

--

--

-

2007

-08

Tota

l67

,35,

445

63,6

4,97

5

(Con

td..

.)


SDH

Year

sTo

tal I

ncom

e (C

olle

ctio

n)To

tal

Expe

ndit

ure

Deta

iled

Expe

ndit

ure

Rogi

Kal

yan

Sam

iti

Med

icin

eI.

F.P.

Build

ings

Equi

pmen

tER

F A/

cSa

lary

to

Cont

ract

ual

Staf

f

Patt

i

2003

1447

955

1664

515

6828

5644

0026

1344

1124

0122

_16

7100

2004

1664

189

1821

980

8132

0659

0521

1286

2114

5632

_14

4000

2005

1941

864

4010

536

1020

627

6007

3222

1555

8175

8_

1440

00

2006

1895

881

3840

986

1111

049

5263

8653

579

1179

34_

1361

57

2007

2132

756

2234

989

9271

0839

6859

1342

7564

0747

_13

6000

Tota

l 90

,82,

645

1,35

,73,

006

45,5

4,84

625

,54,

524

6,72

,441

12,2

6,19

3-

7,27

,257

Talw

an D

e Sa

boo

2003

-04

3784

6137

0944

1559

8013

7884

3619

940

881

--

2004

-05

3204

3929

9001

9347

284

821

3511

235

671

-49

925

2005

-06

3927

5140

2239

1393

5510

0269

3114

827

951

9455

9406

1

2006

-07

5641

2252

4283

1566

1312

2462

6741

073

995

1725

786

546

1000

00

2007

-08

4759

7446

5776

1889

3111

5123

6974

151

674

7632

3267

510

0000

Tota

l 21

,31,

747

20,6

2,24

37,

34,3

515,

60,5

592,

39,6

102,

30,1

7234

,344

2,63

,207

2,00

,000


Tab

le 2.1

7 M

ed

ical O

ffi c

ers

in

Po

sit

ion

Nam

e of

Pos

tPo

stAj

nala

Bata

laDa

suya

Fazi

lka

Jagr

aon

Mal

er k

otla

Mal

aout

Nak

odar

Path

iTa

lwan

diTo

tal

Med

icin

e

M.D

.1

22

12

12

23

-16

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

--

1-

-1

Surg

ery

M.D

.1

12

12

11

12

113

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

--

--

--

OBG

M.D

.1

11

-1

2-

11

19

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

--

--

--

Paed

iatr

ics

M.D

.2

-1

-1

--

--

-4

Dipl

oma

-1

-1

--

--

--

2

MBB

S-

--

--

--

--

--

ENT

M.D

.1

11

12

1-

11

-9

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

--

--

--

Orth

opae

dics

M.D

.2

11

-1

--

11

-7

Dipl

oma

-1

-1

--

--

--

2

MBB

S-

--

--

--

--

--

Derm

atol

ogis

t

M.D

.1

1-

11

-1

1-

-6

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

--

--

--

Psyc

hiat

ry

M.D

.-

--

--

-1

--

-1

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

--

--

--

(Con

td..

.)


Nam

e of

Pos

tPo

stAj

nala

Bata

laDa

suya

Fazi

lka

Jagr

aon

Mal

er k

otla

Mal

aout

Nak

odar

Path

iTa

lwan

diTo

tal

Anae

sthe

sia

M.D

.1

11

2-

--

11

-7

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

--

--

--

Bloo

d Ba

nk

M.D

.-

1-

--

1-

1-

-3

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

--

--

--

Path

olog

y

M.D

.-

--

1-

1-

1-

-3

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

--

--

--

Bio-

chem

istr

y

MD/

MSc

--

--

--

--

--

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

--

--

--

Mic

robi

olog

y

MD/

MSc

--

--

-1

-1

--

2

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

--

--

--

Radi

olog

y

M.D

.-

11

-1

--

--

-3

Dipl

oma

--

--

--

--

--

-

MBB

S-

--

--

-1

--

-1

Dent

alBD

S1

11

11

11

11

110

Dipl

oma

--

--

--

--

--

-


Tab

le 2.1

8 P

resen

t S

taff

Po

sit

ion

of

Su

b-D

ivis

ion

al H

osp

itals

Un

der

PH

SC

Nam

e of

Pos

tPo

stAj

nala

Bata

laDa

suya

Fazi

lka

Jagr

aon

Mal

ar k

otla

Mal

out

Nak

odar

Patt

iTa

lwan

di

SMO

Sanc

tion

11

11

-1

11

11

Vaca

nt-

1-

--

--

--

-

Ad h

ock

--

--

--

--

--

Tota

l in

posi

tion

11

(offi

ce)

11

-1

11

1-

Med

ical

Offi

cer

(G

DMO

& Sp

ecia

lists

)

Sanc

tion

1421

2114

1410

1313

1211

Vaca

nt1

32

31

-6

-1

7

Ad h

ock

--

--

--

--

--

Tota

l in

posi

tion

1318

1911

1310

713

114

Nur

sing

Sta

ff

Sanc

tion

1214

2524

1624

1112

1310

Vaca

nt-

--

7-

23

3-

2

Ad h

ock

-12

(con

t.)

7-

--

--

-

Tota

l10

+2($

)14

1217

1622

+2 (

depu

.)*

89

138

Tech

nici

an

Sanc

tion

43

92

54

23

3-

Vaca

nt-

-1

--

--

--

-

Ad h

ock

--

1-

--

--

--

Tota

l in

posi

tion

2+2(

*)3

82

54

23

3-

Adm

inis

trat

ive

staf

f

Sanc

tion

25

31

27

12

35

Vaca

nt-

--

--

--

--

-

Ad h

ock

--

--

--

--

--

Tota

l in

posi

tion

25

31

27

12

35

Driv

er

Sanc

tion

35

2-

-3

--

22

Vaca

nt-

--

--

--

--

-

Ad h

ock

-3

--

--

2-

--

Tota

l in

posi

tion

2+1(

*)2

2-

-3

--

22


Nam

e of

Pos

tPo

stAj

nala

Bata

laDa

suya

Fazi

lka

Jagr

aon

Mal

ar k

otla

Mal

out

Nak

odar

Patt

iTa

lwan

di

Clas

s IV

Sanc

tion

2332

3030

2847

726

1921

Vaca

nt2

97

73

9-

7-

1

Ad h

ock

--

--

--

--

--

Tota

l in

posi

tion

19+2

(*)

2323

2325

387

1919

20

Othe

rs

Sanc

tion

153

57

--

42

25-

Vaca

nt-

--

--

-1

--

-

Ad h

ock

-1

--

--

--

--

Tota

l in

posi

tion

152

57

--

32

25-

• On

dep

utat

ion

plac

ed in

the

SDH

$ Go

ne d

eput

atio

n in

oth

er p

lace

s/ou

tsid

e SD

H


(Con

td..

.)

Tab

le 3.1

G

en

era

l P

rofi

le &

Facil

ity S

urv

ey o

f C

HC

s U

nd

er

PH

SC

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Acce

ssib

ility

to

Railw

ay/B

us

Stat

ion

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Wat

er S

uppl

yM

unic

ipal

Bore

wel

lBo

re w

ell

Mun

icip

alBo

re w

ell

Bore

wel

lBo

re w

ell

Bore

wel

lBo

re w

ell

Bore

wel

lBo

re w

ell

Avai

labi

lity

of w

ater

Ad

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teAd

equa

teIn

adeq

uate

Stor

age

capa

city

of

Wat

er

Supp

lyTh

ree

day

One

day

Thre

e da

yTh

ree

day

Thre

e da

yTw

o da

yTw

o da

yOn

e da

yTw

o da

yOn

e da

yOn

e da

y

Elec

tric

ity

-Ir

regu

lar

Irre

gula

rIr

regu

lar

Irre

gula

rRe

gula

rIr

regu

lar

Irre

gula

rIr

regu

lar

Regu

lar

Regu

lar

Irre

gula

r

Phas

e of

Ele

ctric

ity

Thre

eTh

ree

Doub

leTh

ree

Thre

eTh

ree

Thre

eTh

ree

Thre

eTh

ree

Thre

e

Back

up G

ener

ator

/ U

PSAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labi

lity

of li

ft

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eNo

t w

orki

ngNo

t av

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Ram

p fa

cilit

y Av

aila

ble

Avai

labl

eNo

t av

aila

ble

Avai

labl

eAv

aila

ble

Not

avai

labl

eAv

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Avai

labl

eAv

aila

ble

Gene

ral I

mpr

essi

on -

Up

keep

of

gar

den

Aver

age

Aver

age

Good

Not

Appl

icab

leGo

odAv

erag

eAv

erag

eAv

erag

ePo

orAv

erag

eAv

erag

e

Clea

nlin

ess

Good

Aver

age

Good

Aver

age

Good

Aver

age

Good

Good

Aver

age

Good

Aver

age

Sign

pos

ting

Good

Aver

age

Good

Good

Good

Poor

Aver

age

Good

Aver

age

Good

Aver

age

Road

s &

ligh

ting

Good

Aver

age

Good

Good

Good

Aver

age

Good

Good

Good

Poor

Aver

age

Stat

e of

bui

ldin

gGo

odGo

odGo

odGo

odGo

odAv

erag

eGo

odGo

odAv

erag

eGo

odGo

od

Any

publ

ic u

tilit

y se

rvic

e av

aila

ble

in h

ospi

tal

prem

ises

che

mis

tNo

NoNo

NoNo

NoNo

NoNo

NoNo

Sula

bh S

ocha

laya

NoYe

sNo

NoNo

NoYe

sNo

NoYe

sNo

Rest

aura

nts/

can

teen

NoNo

Yes

NoNo

NoNo

NoNo

NoNo

Groc

ery

shop

sNo

NoNo

NoNo

NoNo

NoNo

NoNo


Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Ambu

lanc

e Se

rvic

esAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

If A

vaila

ble

Part

ially

eq

uipp

edPa

rtia

lly

equi

pped

Fully

eq

uipp

edPa

rtia

llyeq

uipp

edPa

rtia

lly

equi

pped

Part

ially

eq

uipp

edFu

lly

equi

pped

Part

ially

eq

uipp

edPa

rtia

lly

equi

pped

Part

ially

eq

uipp

edPa

rtia

lly

equi

pped

Tota

l No.

of

Vehi

cles

21

41

32

11

31

1

No.

of O

pera

tion

The

atre

s-M

inor

11

10

10

11

01

1

No.

of O

pera

tion

The

atre

s

-Maj

or2

10

21

11

12

11

Inte

nsiv

e Ca

re U

nits

NoNo

NoNo

NoNo

NoNo

NoNo

No

No.

of b

eds

in I

CUNA

NANA

NANA

NANA

NANA

NANA

Emer

genc

y Se

rvic

es

Roun

d th

e cl

ock

Roun

d th

e cl

ock

Roun

d th

e cl

ock

Roun

d th

e cl

ock

Roun

d th

e cl

ock

Roun

d th

e cl

ock

Roun

d th

e cl

ock

Roun

d th

e cl

ock

Roun

d th

e cl

ock

Roun

d th

e cl

ock

Roun

d th

e cl

ock

Dent

al S

ervi

ces

Yes

Yes

NoYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Deliv

ery

Serv

ices

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Faci

litie

s fo

r Po

st-m

orte

mNo

NoNo

NoNo

NoNo

NoNo

NoNo

Mor

tuar

y se

rvic

es w

ith

cold

st

orag

e &

oth

er p

rese

rvat

ive

faci

litie

s av

aila

ble

NoNo

NoNo

NoNo

NoNo

NoNo

No

Vario

us m

anag

emen

t co

mm

itte

es,

Drug

for

mul

ary

com

mit

tee

NoNo

NoNo

Yes

NoNo

NoNo

NoNo

Hos

pita

l Ant

ibio

tic

com

mit

tee

NoNo

NoNo

Yes

NoNo

NoNo

NoNo

Hos

pita

l Inf

ecti

on C

ontr

ol

Com

mit

tee

NoNo

NoYe

sNo

Yes

NoNo

NoYe

sNo

Stor

e Pu

rcha

se C

omm

itte

eYe

sYe

sNo

Yes

Yes

Yes

NoYe

sYe

sYe

sNo

Stor

e ve

rifi c

atio

n Co

mm

itte

eYe

sYe

sNo

Yes

Yes

Yes

NoYe

sNo

Yes

Yes

(Con

td..

.)


Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Med

ical

Aud

it/

Deat

h Re

view

Co

mm

itte

eYe

sNo

NoNo

NoYe

sNo

NoNo

NoYe

s

Syst

em o

f Su

pply

of

Drug

it

ems

thro

ugh

Pull

Pull

Pull

Push

Push

Push

Pull

Push

Pull

Pull

&

Push

Push

Is t

he d

rug

form

ular

y av

aila

ble

NoNo

NoNo

Yes

NoYe

sNo

Yes

NoNo

Is b

uffe

r st

ock

mai

ntai

ned

Yes

Yes

NoYe

sYe

sNo

Yes

Yes

Yes

NoNo

Is R

eord

er le

vel m

aint

aine

dNo

NoNo

Yes

Yes

NoNo

Yes

Yes

NoNo

Annu

al m

aint

enan

ce p

roce

dure

fo

r co

stly

Equ

ipm

ents

Yes

NoNo

Yes

NoNo

Yes

Yes

NoYe

sNo

Log

book

/ H

isto

ry s

heet

m

aint

aine

d fo

r th

e Eq

uipm

ents

NoNo

NoYe

sYe

sYe

sYe

sYe

sNo

Yes

No


Tab

le 3.2

E

qu

ipm

en

t availab

le a

t C

HC

s

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Boyl

es a

ppar

atus

wit

h ci

rcle

ab

sorb

erYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

al

Dent

al c

hair

NoYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

NAFu

ncti

onal

NAFu

ncti

onal

Non

Func

tion

alNo

n Fu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

al

Emer

genc

y Re

susc

itat

ion

Kit

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Not

appl

icab

leFu

ncti

onal

Func

tion

alFu

ncti

onal

Non-

func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

al

Opht

halm

osco

pes

NoYe

sYe

sYe

sNo

Yes

Yes

Yes

NoYe

sYe

s

Not

appl

icab

leNo

n -

Func

tion

alFu

ncti

onal

Func

tion

alNA

Func

tion

alFu

ncti

onal

Func

tion

alNA

Func

tion

alFu

ncti

onal

Sigm

oido

scop

esNo

Yes

NoYe

sNo

NoNo

NoNo

Yes

No

NAFu

ncti

onal

NAFu

ncti

onal

Not

appl

icab

leNA

NANA

NAFu

ncti

onal

NA

X-Ra

yYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Func

tion

alFu

ncti

onal

Func

tion

alNo

t ap

plic

able

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

al

Othe

r M

ajor

and

Min

or

Oper

atio

n eq

uipm

ents

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

NA


Tab

le 3

.3 Lab

ora

tory

tests

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Com

plet

e U

rine

Exa

min

atio

nYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Stoo

l Tes

tNo

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sYe

s

Spec

ial T

est

Like

:-bl

ood

urea

Yes

NoYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Bloo

d Su

gar

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Bloo

d Gr

oupi

ng a

nd

Mat

chin

g te

stYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Man

y ot

her

rout

ine

test

s.Ye

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s


Tab

le 3

.4

Refe

rral Facilit

ies

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Any

Refe

rral

Sys

tem

in

plac

eYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Refe

rral

man

ual a

vaila

ble

NAYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

No

Guid

elin

es g

iven

reg

ardi

ng:

Wha

t to

ref

erNo

Yes

Yes

NoYe

sNA

Yes

Yes

Yes

Yes

No

Whe

n to

ref

erNo

Yes

Yes

NoYe

sNA

Yes

Yes

Yes

Yes

No

How

to

refe

rNo

Yes

Yes

NoYe

sNA

Yes

Yes

Yes

Yes

No

Colo

ur c

oded

ref

erra

l car

ds

avai

labl

eNo

Yes

NoYe

sYe

sNA

Yes

NoNo

Yes

No

Feed

-bac

k M

echa

nism

ex

isti

ngNo

NoNo

NoNo

NoYe

sNo

NoNo

No

Tran

spor

t fa

cilit

y pr

ovid

edYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Mai

nten

ance

of

reco

rds/

regi

ster

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

No

Ince

ntiv

e fo

r fo

llow

ing

refe

rral

rou

teNo

NoYe

sNo

Yes

Yes

NoYe

sNo

Yes

No

Proc

edur

e fo

llow

ed f

or

refe

rral

*No

Yes

Yes

Don’

t kn

owDo

n’t

know

Yes

Yes

Yes

Yes

Yes

No

Tie-

up w

ith

othe

r ho

spit

al

(bot

h pu

blic

and

pri

vate

) fo

r di

agno

stic

or

refe

rral

pu

rpos

es

NoNo

NoYe

sYe

sYe

sYe

sYe

sYe

sNo

Yes

Hos

pita

l has

a t

ie-u

p w

ith

NANA

NAOt

her

Pvt.

H

ospi

tals

Med

ical

Co

llege

&

Othe

r Ot

her

Othe

r M

edic

al

Colle

geOt

her

(Con

td..

.)


Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

If A

vaila

ble

NANA

NANA

Mon

thly

NAM

onth

lyNA

Fort

nigh

tly

Mon

thly

NA

Does

the

Hos

pita

l hav

e an

y Ou

trea

ch A

rea

Yes

NoNo

Yes

Yes

Yes

Yes

Yes

NoNo

No

If y

es,

wha

t se

rvic

es a

re

prov

ided

MCH

NANA

MCH

MCH

Nat

. he

alth

pr

og.

Hea

lth

Ed.

MCH

MCH

MCH

NANA

NA

Avai

labi

lity

of D

hara

msh

ala

NoNo

NoNo

NoNo

NoNo

NoNo

No

Avai

labi

lity

of r

esid

enti

al

acco

mm

odat

ion

for

the

esse

ntia

l sta

ff w

ith

in t

he

cam

pus

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Secu

rity

arr

ange

men

tNo

In-h

ouse

In-h

ouse

NoNo

In-h

ouse

In-h

ouse

NoNo

In-h

ouse

In-h

ouse


Tab

le 3

.5 O

utp

ati

en

t D

ep

art

men

t

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

MSW

NoNo

NoNo

NoNo

NoNo

NoNo

No

Staf

f Nu

rse

NoYe

sYe

sNo

NoNo

NoNo

Yes

Yes

No

Phar

mac

ist

NoYe

sNo

Yes

Yes

Yes

Yes

Yes

NoNo

Yes

Know

ledg

eabl

e ab

out

the

OPD

(by

obse

rvat

ion)

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Sepa

rate

reg

istr

atio

n fo

r M

ale

NoNo

NoNo

NoNo

Yes

Yes

NoNo

No

Fem

ale

NoNo

NoNo

NoNo

Yes

Yes

NoNo

No

Free

dom

fi gh

ters

NoNo

NoNo

NoNo

Yes

Yes

NoNo

No

Seni

or c

itiz

ens

NoNo

NoNo

NoNo

NoYe

sNo

NoNo

Staf

fNo

NoNo

NoNo

NoYe

sNo

NoNo

No

The

regi

stra

tion

reg

iste

rs

are

prop

erly

mai

ntai

ned

and

entr

ies

are

mad

e ne

atly

Yes

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

All s

ecti

ons

of t

he O

PD

havi

ng p

rope

r si

gnag

e an

d di

rect

iona

l sig

n

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Wai

ting

are

a is

ade

quat

eYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Prop

er s

itti

ng a

rran

gem

ent

Yes

NoYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Drin

king

wat

er f

acili

tyNo

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Ceili

ng F

ans

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Toile

t fa

cilit

y(Se

para

te f

or

Mal

e an

d Fe

mal

e)No

Yes

Yes

Yes

Yes

NoYe

sNo

Yes

Yes

Yes

Doct

or’s

Cham

bers

are

hav

ing

adeq

uate

spa

ceYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

(Con

td..

.)


Desc

ript

ion

of

faci

litie

sN

ame

of t

he C

HC

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Exam

inat

ion

tabl

e w

ith

prop

er s

heet

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Stoo

l for

the

pat

ient

to

sit

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Exam

inat

ion

equi

pmen

ts

(lik

e BP

app

arat

us

Torc

h, h

amm

er,

etc.

)

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Adeq

uate

illu

min

atio

nYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Inje

ctio

n Ro

om a

long

w

ith

faci

litie

s an

d to

de

al w

ith

Emer

genc

y si

tuat

ion

NoYe

sYe

sNo

Yes

Yes

NoYe

sYe

sYe

sNo

Min

or O

T /

Dres

sing

Ro

om w

ith

all t

he b

asic

Eq

uipm

ents

Yes

NoYe

sNo

NoYe

sYe

sYe

sNo

Yes

No

Disp

ensa

ries

/ Ph

arm

acy

wit

h se

para

te c

ount

ers

for

mal

e/fe

mal

e/se

nior

ci

tize

n/st

aff

Yes

NoNo

NoNo

Yes

NoYe

sYe

sNo

Yes

Labo

rato

ry &

Im

agin

g Se

rvic

es e

asily

ac

cess

ible

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Cent

ral C

olle

ctio

n Ce

ntre

fo

r La

bora

tory

Ser

vice

sNo

NoYe

sYe

sYe

sNo

NoYe

sYe

sYe

sYe

s


Tab

le 3

.6 E

merg

en

cy (

Casu

alt

y)

Serv

ices a

t C

HC

s

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Boar

d di

spla

ying

on

call

doct

ors/

spec

ialis

t an

d ot

her

staf

f on

dut

yYe

sYe

sYe

sNo

Yes

Yes

NoYe

sYe

sYe

sYe

s

Glow

sig

n bo

ard

indi

cati

ng

‘Em

erge

ncy

Serv

ices

Dep

artm

ent’

NoYe

sYe

sNo

Yes

NoNo

NoYe

sNo

No

Emer

genc

y W

ard

atta

ched

to

Emer

genc

y De

part

men

tYe

sNo

Yes

NoYe

sYe

sNo

Yes

Yes

Yes

Yes

If Y

es,

the

no.

of b

eds

Tria

ge a

rea

2NA

2NA

16

Not

men

tion

ed1

2No

t m

enti

oned

3

Yes

NoYe

sNo

Yes

NoNo

Yes

Yes

Yes

No

Obse

rvat

ion

Beds

If Y

es,

No.

of b

eds

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sNo

21

14

Not

men

tion

ed6

NA2

2No

t m

enti

oned

NA

Trol

leys

and

Whe

el c

hair

s av

aila

ble

If y

es,

exac

t No

.Ye

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

23

21

12

13

35

2

Exam

inat

ion

room

s w

ith

all b

asic

eq

uipm

ents

NoNo

Yes

NoYe

sYe

sNo

Yes

NoYe

sYe

s

All t

he r

egis

ters

incl

udin

g M

LR

avai

labl

e fo

r pr

oper

reg

istr

atio

nYe

sYe

sYe

sNo

Yes

Yes

NoYe

sYe

sYe

sYe

s

Reti

ring

roo

m w

ith

toile

ts f

or t

he

doct

ors

NoNo

Yes

NoYe

sNo

Yes

Yes

NoYe

sYe

s

Call

book

in p

resc

ribe

d fo

rmat

av

aila

ble

NoNo

NoNo

NoNo

NoNo

Yes

NoNo

(Con

td..

.)


Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Wai

ting

are

a fo

r th

e at

tend

ants

of

pati

ents

wit

h th

e ba

sic

faci

litie

s lik

e si

ttin

g ar

rang

e-m

ents

, dr

inki

ng

wat

er,

toile

t et

c

Yes

NoYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

No

Publ

ic t

elep

hone

ava

ilabl

eYe

sNo

NoNo

NoNo

NoNo

NoNo

No

Trea

tmen

t ro

om-c

um-m

inor

OT

NoYe

sYe

sNo

Yes

NoYe

sYe

sNo

Yes

Yes

Maj

or O

TYe

sNo

NoNo

Yes

NoYe

sYe

sNo

Yes

No

Suffi

cien

t st

ock

of e

ssen

tial

an

d lif

e sa

ving

dru

gsYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Oxyg

en c

ylin

ders

wit

h at

tach

men

tsYe

sNo

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Labo

rato

ry s

ervi

ces

NoNo

Yes

NoYe

sNo

Yes

Yes

Yes

Yes

Yes

Radi

olog

y Se

rvic

esYe

sNo

Yes

NoYe

sNo

Yes

Yes

Yes

Yes

Yes

Ambu

lanc

e se

rvic

esYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Staf

f tr

aine

d in

BLS

NoNo

Yes

NoYe

sNo

Yes

Yes

Yes

Yes

Yes

Trea

tmen

t fa

cilit

ies

for

Dog/

sn

ake

bite

& P

oiso

ning

NoYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Avai

labi

lity

of D

isas

ter

Man

ual

NoNo

Yes

Yes

Yes

NoNo

Yes

Yes

NoNo

Disa

ster

Ale

rt C

ode,

rec

all &

de

ploy

men

tNo

NoYe

sYe

sNo

NoNo

Yes

Yes

NoNo

Mai

nten

ance

of

dedi

cate

d dr

ug s

tore

for

dis

aste

r si

tuat

ion

NoNo

Yes

Yes

Yes

NoNo

Yes

Yes

NoNo


Tab

le 3

.7 C

lin

ical Lab

ora

tori

es a

t C

HC

s

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Type

of

labo

rato

ries

Bioc

hem

istr

yYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Path

olog

yNo

NoNo

Yes

Yes

NoNo

NoNo

Yes

No

Mic

robi

olog

yNo

NoNo

Yes

NoNo

Yes

Yes

NoYe

sNo

Qual

ifi ed

Pat

holo

gist

av

aila

ble

NoNo

NoNo

NoNo

NoNo

NoNo

No

Bioc

hem

ist

avai

labl

eNo

NoNo

NoNo

NoNo

NoNo

NoNo

Mic

robi

olog

ist

avai

labl

eNo

NoNo

NoNo

NoNo

NoNo

NoNo

Follo

win

g th

e un

iver

sal

prec

auti

on p

roce

dure

sNo

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

sNo

Usin

g pr

otec

tive

mea

sure

s i.e

. gl

oves

/gow

ns/m

asks

NoNo

NoYe

sYe

sNo

Yes

Yes

Yes

Yes

No

Spec

imen

col

lect

ion

done

ce

ntra

llyNo

NoYe

sYe

sYe

sNo

NoYe

sYe

sYe

sNo

Avai

labi

lity

of a

ll th

e ch

emic

als

and

reag

ents

Yes

Yes

NoNo

Yes

Yes

Yes

Yes

Yes

Yes

No

Obse

rvin

g al

l the

bio

-saf

ety

mea

sure

sNo

NoYe

sYe

sYe

sNo

NoYe

sYe

sYe

sNo

Reg

ular

Inte

rnal

Qua

lity

cont

rol m

easu

res

unde

rtake

n

No

No

Yes

Yes

Yes

No

No

No

Yes

No

No

Reg

ular

Ext

erna

l Qua

lity

cont

rol m

easu

res

unde

rtake

n

No

No

Yes

Yes

Yes

No

No

No

No

No

No

(Con

td..

.)


Tab

le 3

.8 B

loo

d B

an

kin

g F

acilit

ies

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Avai

labi

lity

of B

lood

Ban

k

NoNo

NoNo

NoNo

NoNo

NoNo

No

Trai

ned

or q

ualifi

ed

med

ical

of

fi cer

pos

ted

as B

.T.O

.NA

NANA

NANA

NANA

NANA

NANA

Roun

d th

e cl

ock

avai

labi

lity

of t

rain

ed s

taff

and

ser

vice

sNA

NANA

NANA

NANA

NANA

NA

Chec

king

& c

ross

mat

chin

g by

B.T

.ONA

NANA

NANA

NANA

NANA

NANA

Prop

er m

aint

enan

ce o

f co

ld

chai

n an

d re

frig

erat

ors

NANA

NANA

NANA

NANA

NANA

NA

Aust

ralia

ant

igen

, H

CV,

VDRL

, M

.P.

and

HIV

tes

ts d

one

for

Ever

y bl

ood

bott

le o

f do

nor.

NANA

NANA

NANA

NANA

NANA

NA

Effo

rts

mad

e to

col

lect

bl

ood

thro

ugh

Volu

ntar

y Or

gani

sati

on C

amps

NANA

NANA

NANA

NANA

NANA

NA

Rene

wal

of

bloo

d ba

nk/H

IV

Lice

nse

as p

er R

ules

NANA

NANA

NANA

NANA

NANA

NA

Disp

osal

of

HIV

pos

itiv

e bl

ood

bags

& b

io-s

afet

y m

easu

res

unde

rtak

en.

NANA

NANA

NANA

NANA

NANA

Avai

labi

lity

of T

able

Top

Sy

ring

e &

nee

dle

dest

roye

r an

d co

lour

cod

ed b

ags

NANA

NANA

NANA

NANA

NANA

NA

Feed

bac

k of

tra

nsfu

sion

, an

d re

cord

mai

nten

ance

of

unto

war

d in

cide

nces

NANA

NANA

NANA

NANA

NANA

NA

Radi

olog

ist

avai

labi

lity

NoNo

Yes

NoNo

NoNo

NoNo

NoNo

Avai

labi

lity

of t

he d

ark

room

w

ith

all f

acili

ties

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Use

of d

osim

eter

and

the

y re

gula

rly s

ent

to B

ARC

NoNo

NoNo

NoNo

NoNo

NoNo

Yes


Tab

le 3

.9 S

pecia

l In

vesti

gati

on

s a

t C

HC

s

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Spec

ial i

nves

tiga

tion

s lik

e IV

P, c

ontr

ast

med

ia e

tcNo

NoNo

NoNo

NoNo

NoNo

NoNo

Roun

d th

e cl

ock

avai

labi

lity

of X

-ray

ser

vice

s/

Sono

grap

hy

Yes

Yes

NoYe

sNo

NoYe

sYe

sNo

Yes

Yes

Sepa

rate

reg

iste

r fo

r M

LC

reco

rds

Yes

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s

Mai

nten

ance

of

hist

ory

book

and

log

book

of

X-ra

y m

achi

nes

Yes

NoNo

Yes

NoYe

sYe

sYe

sNo

NoNo


Tab

le 3

.10

O

pera

tio

n T

heatr

es a

t C

HC

s’

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

No.

of m

ajor

OT

11

02

11

11

21

1

No.

of m

inor

OT

11

10

10

11

01

1

Zoni

ng C

once

pt S

tric

tly

Follo

wed

NoNo

NoYe

sNo

NoNo

Yes

Yes

NoNo

Mai

nten

ance

of

OT r

ecor

dsYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sNo

Mai

nten

ance

of

OT

post

pone

men

t re

cord

sNo

NoNo

NoNo

Yes

NoYe

sYe

sNo

No

Emer

genc

y lig

ht-g

ener

ator

fa

cilit

y fo

r OT

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Avai

labi

lity

of fi

re fi

ghti

ng

equi

pmen

t &

kno

wle

dge

to

use

them

NoNo

NoNo

NoNo

Yes

NoNo

NoYe

s

Regu

lar

disi

nfec

tion

&

ster

ilisa

tion

don

e at

OT

Yes

NoYe

sNo

Yes

Yes

Yes

Yes

Yes

Yes

No


Tab

le 3

.11 In

pati

en

t w

ard

s a

t C

HC

s

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Sati

sfac

tory

cle

anlin

ess

of w

ards

w

ith

adeq

uate

hou

se k

eepi

ngNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Colo

ur c

odes

of

yello

w,

blue

,red

,whi

te b

in &

blu

e tr

ansp

aren

t PP

F fo

r w

aste

co

llect

ion,

tab

le t

op s

yrin

ge &

ne

edle

des

troy

er&

uti

lisat

ion

NoYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Adeq

uate

wat

er s

uppl

y an

d up

keep

of

san

itar

y bl

ocks

NoYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

No

Adeq

uate

and

cle

an t

oile

ts a

nd

bath

room

sNo

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Prop

er a

nd a

dequ

ate

linen

on

beds

NoYe

sNo

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s

Floo

r be

ds/d

oubl

ing

of b

eds

invo

lved

NoNo

NoNo

NoNo

NoNo

NoNo

No

Sati

sfac

tory

upk

eep

of c

ots,

m

attr

esse

s, lo

cker

s, li

nen

etc.

NoYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Use

of h

ospi

tal u

nifo

rms

by

pati

ents

NoNo

NoNo

NoNo

NoYe

sNo

NoNo

Avai

labi

lity

and

func

tion

ing

of

suct

ion

appa

ratu

sNo

t av

aila

ble

Avai

labl

eNo

t av

aila

ble

Avai

labl

eAv

aila

ble

Not

avai

labl

eAv

aila

ble

Avai

labl

eNo

t av

aila

ble

Avai

labl

eAv

aila

ble

Cond

itio

n on

ava

ilabi

lity

Not

avai

labl

eNo

n Fu

ncti

onal

NAFu

ncti

onal

Func

tion

alNA

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

Func

tion

al

Avai

labi

lity

and

func

tion

ing

of

oxyg

en c

ylin

ders

wit

h ac

cess

orie

sAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Cond

itio

n on

ava

ilabi

lity

Func

tion

alFu

ncti

onal

Non

func

tion

alFu

ncti

onal

Func

tion

alNo

n fu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

al

(Con

td..

.)


Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Avai

labi

lity

and

func

tion

ing

of v

enes

ecti

on/

LP/

trac

heos

tom

y tr

ay

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eAv

aila

ble

Avai

labl

eNo

t av

aila

ble

Not

avai

labl

eAv

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

e

Cond

itio

n on

ava

ilabi

lity

NANA

NAFu

ncti

onal

Func

tion

alNA

NAFu

ncti

onal

NANA

NA

Avai

labi

lity

and

func

tion

ing

of e

mer

genc

y lig

ht /

whe

el

chai

rs/s

tret

cher

tro

lley

Avai

labl

eAv

aila

ble

Not

avai

labl

eAv

aila

ble

Avai

labl

eNo

t av

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

eAv

aila

ble

Avai

labl

e

Cond

itio

n on

ava

ilabi

lity

Func

tion

alFu

ncti

onal

NAFu

ncti

onal

Func

tion

alNA

Func

tion

alFu

ncti

onal

Func

tion

alFu

ncti

onal

Func

tion

al

Stat

ione

ries,

for

ms

and

vario

us u

pdat

ed r

egis

ters

etc

.Ye

sYe

sNo

Yes

Yes

Yes

NoYe

sYe

sYe

sYe

s

Conc

ept

of p

rogr

essi

ve

pati

ent

care

NoYe

sYe

sYe

sYe

sNo

NoNo

Yes

NoYe

s

Adeq

uacy

and

wor

king

of

fans

an

d lig

hts

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Sati

sfac

tory

ava

ilabi

lity

of

diet

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

e

Qual

ity

of c

are

NoYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

NoNo

Mai

nten

ance

of

vario

us

regi

ster

s, r

ecor

ds,

etc.

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes


Tab

le 3

.12 H

osp

ital M

ed

ical S

tore

s a

t C

HC

s

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

rest

ricti

on o

n en

tery

for

un

auth

oris

ed p

erso

nnel

sYe

sYe

sYe

sYe

sYe

sNo

NoYe

sNo

Yes

Yes

Staf

f kn

owle

dge

on m

ater

ial

man

agem

ent,

sys

tem

of

FIFO

,bin

ca

rds,

lead

tim

e, b

uffe

r st

ock

reor

der

leve

l

NoNo

Yes

Yes

Yes

Yes

Yes

NoYe

sYe

sNo

Avai

labi

lity

of v

ital

,ess

enti

al d

rugs

in

suf

fi cie

nt q

uant

ity

Yes

Yes

NoYe

sYe

sNo

Yes

Yes

Yes

Yes

No

Upk

eep

of e

xpir

y da

te r

egis

ter

and

its

regu

lar

insp

ecti

on b

y M

O i/

cNo

NoYe

sNo

Yes

Yes

NoYe

sYe

sNo

No

Effo

rts

mad

e to

red

istr

ibut

e la

rge

stoc

ks o

f sl

ow m

ovin

g dr

ugs

or n

ear

expi

ry f

or it

s ut

ilisa

tion

NoNo

Yes

Yes

Yes

NoNo

Yes

Yes

NoNo

Prop

er a

rran

gem

ents

to

keep

dru

gs

as p

er A

BC/V

ED c

ateg

ory

and

stor

age

of r

ubbe

r go

ods

as p

er

guid

elin

es

NoNo

NoYe

sYe

sNo

NoNo

Yes

NoNo

Appr

opria

te s

teps

tak

en t

o pr

even

t pi

lfera

ge o

r dr

ugs

NoYe

sYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

No

Conv

enie

nt a

rran

gem

ent

of is

suin

g dr

ugs

to v

ario

us w

ards

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Regu

lar

send

ing

of s

ampl

es t

o ch

emic

al la

bora

tory

for

che

ckin

g st

anda

rds

of d

rugs

NoNo

NoNo

Yes

NoNo

NoNo

NoNo

Circ

ulat

ion

of li

st o

f av

aila

ble

drug

s to

all

MOs

, OP

D& w

ards

as

per

gene

ric n

ame

Yes

Yes

NoYe

sYe

sYe

sNo

Yes

Yes

Yes

No

Subm

issi

on o

f ce

rtifi

ed b

ills

to

offi c

e fo

r re

leas

e of

pay

men

ts w

ith

in t

hree

day

s

NoYe

sYe

sYe

sYe

sNo

NoYe

sYe

sYe

sNo

Auct

ion

to c

lear

the

em

pty

mat

eria

l fr

om s

tore

don

e re

gula

rlyYe

sNo

NoYe

sYe

sNo

NoNo

Yes

NoYe

s

Avai

labi

lity

of fi

re fi

ghti

ng

equi

pmen

t &

kno

wle

dge

to u

se t

hem

Yes

NoNo

NoNo

NoYe

sNo

NoNo

No

Avai

labi

lity

of r

egul

arly

upd

ated

ho

spit

al d

rug

form

ular

yNo

NoYe

sNo

Yes

NoNo

NoYe

sNo

No

Exis

tenc

e of

sta

ndin

g dr

ug

com

mit

tee

Yes

NoNo

Yes

Yes

NoNo

NoNo

NoNo


Tab

le 3

.13 M

ed

ical R

eco

rd D

ep

art

men

t at

CH

Cs’

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Avai

labi

lity

of m

edic

al r

ecor

d ro

om w

ith

enou

gh n

o. o

f ra

cks

etc.

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Is t

he m

edic

al r

ecor

d co

mpu

teri

sed

or m

anua

lM

anua

lM

anua

lM

anua

lM

anua

lM

anua

lM

anua

lM

anua

lM

anua

lM

anua

lM

anua

lM

anua

l

Is it

man

aged

by

trai

ned

med

ical

re

cord

offi

cer/

tech

nici

an &

su

perv

isio

n pr

ovid

ed b

y M

Oi/c

Yes

NoYe

sNo

NoNo

NoYe

sNo

Yes

No

Case

rec

ord

is m

aint

aine

d as

per

W

HO

clas

sifi c

atio

n of

dis

ease

s (I

CD-X

)

NoNo

NoNo

NoNo

NoYe

sYe

sNo

No

Regu

lar

subm

issi

on o

f m

orbi

dity

, m

orta

lity

repo

rts

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Is t

he b

acku

p fa

cilit

y ke

pt t

o sa

fe g

uard

the

se r

ecor

dsNo

NoYe

sNo

NoNo

NoNo

Yes

NoNo

Is t

he e

ffec

tive

ret

rieva

l sys

tem

fo

llow

edYe

sNo

NoNo

NoNo

Yes

NoYe

sNo

Yes

Regu

lar

deat

h au

dit

mee

ting

he

ld/m

inut

es o

r m

eeti

ng

reco

rded

/ co

rrec

tive

act

ion

take

n

Yes

NoNo

NoYe

sNo

NoYe

sNo

NoNo

Med

ical

aud

it d

one

at r

egul

ar

inte

rval

Yes

Yes

NoYe

sYe

sYe

sYe

sNo

Yes

NoNo


Tab

le 3

.14 H

osp

ital W

aste

Man

ag

em

en

t at

CH

Cs

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Adeq

uate

no.

of

bins

and

ba

gs o

f re

quire

d co

lour

cod

es

are

avai

labl

e

NoYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Are

thes

e pl

aced

str

ateg

ical

ly

in a

ll pa

tien

t ca

re a

reas

NoYe

sYe

sYe

sYe

sNo

Yes

Yes

Yes

Yes

Yes

Segr

egat

ion

of d

iffe

rent

ca

tego

ries

of w

aste

don

e at

po

int

of g

ener

atio

n

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Colle

ctio

n of

was

te,

pack

agin

g, la

belin

g, r

ecor

d ke

epin

g do

ne in

sci

enti

fi c

way

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Prop

er t

rans

port

atio

n of

w

aste

col

lect

edNo

NoYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Stor

age

faci

lity

and

dura

tion

NoYe

sNo

Yes

NoYe

sYe

sNo

NoNo

No

Disp

osal

/ re

cycl

ing

met

hods

fo

r va

rious

cat

egor

ies

of

was

te

NoNo

NoYe

sNo

NoYe

sYe

sYe

sNo

No

Avai

labi

lity

of a

utoc

lave

, sh

redd

ers

, inc

iner

ator

s et

c.

No

No

No

Yes

Yes

Yes

Yes

Yes

No

No

Yes


Tab

le 3

.15

C

en

tral S

teri

le S

up

ply

Dep

art

men

t at

CH

Cs

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

CS

SD

(und

er s

uper

visi

on

of tr

aine

d st

aff/

seni

or

nurs

ing

offi c

er

No

No

Yes

Yes

No

No

Yes

Yes

No

Yes

Yes

Hav

ing

all t

he re

quire

d eq

uipm

ents

& a

utoc

lave

sYe

sN

oYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Qua

lity

cont

rol m

easu

res

are

stric

tly fo

llow

edN

oN

oYe

sYe

sYe

sYe

sN

oYe

sYe

sN

oYe

s

Tab

le 3

.16 Lau

nd

ry S

erv

ices a

t C

HC

s

Desc

ript

ion

of f

acili

ties

Nam

e of

the

CH

C

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Laun

dry

serv

ices

if in

-hou

se

In-h

ouse

In-h

ouse

In-h

ouse

In-h

ouse

In-h

ouse

Outs

ourc

edOu

tsou

rced

Outs

ourc

edOu

tsou

rced

Outs

ourc

edIn

-hou

se

Conv

enti

onal

(d

hobi

)Co

nven

tion

al

(dho

bi)

Conv

enti

onal

(d

hobi

)Co

nven

tion

al

(dho

bi)

Conv

en-

tion

al (

dhob

i)Co

nven

-ti

onal

(dh

obi)

Conv

en-

tion

al (

dhob

i)Co

nven

tion

al (

dhob

i)Co

nven

tion

al

(dho

bi)

Conv

enti

onal

(d

hobi

)Co

nven

tio

nal

(dho

bi)

Laun

dry

staf

fNo

t ad

equa

teNo

t ad

equa

teNo

t ad

equa

teAd

equa

teAd

equa

teNA

NANA

NANA

Adeq

uate

Qual

ity

of w

ash

Aver

age

Aver

age

Aver

age

Good

Good

Aver

age

Aver

age

Good

Aver

age

Good

Aver

age

Qual

ity

of li

nen

Aver

age

Aver

age

Aver

age

Good

Good

Aver

age

Aver

age

Good

Good

Good

Good


Tab

le 3

.17 D

ieta

ry S

erv

ices

Desc

ript

ion

of

faci

litie

sN

ame

of t

he C

HC

Bada

lFa

tehg

arh

Fero

zsha

hGo

nian

aKa

rtar

pur

Khem

kara

nLo

ngow

alM

achi

war

aM

ahilp

urM

ajit

haM

anaw

ala

Avai

labi

lity

of

kitc

hen

Faci

lity

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

eNo

t av

aila

ble

Not

avai

labl

e

Prop

er a

nd s

afe

arra

ngem

ent

for

stor

age

of r

aw

mat

eria

l

NANA

NANA

NANA

NANA

NANA

NA

Mea

sure

s fo

r pe

st

and

rode

nt c

ontr

olNA

NANA

NANA

NANA

NANA

NANA

Sani

tati

on a

nd

hygi

ene

of t

he

cook

ing

area

pr

oper

ly m

aint

aine

d

NANA

NANA

NANA

NANA

NANA

NA

Regu

lar

heal

th

chec

kup

for

food

ha

ndle

rs

NANA

NANA

NANA

NANA

NANA

NA

Avai

labi

lity

of

mod

ern

cook

ing

equi

pmen

ts

NANA

NANA

NANA

NANA

NANA

NA

Avai

labi

lity

of

prop

erly

mai

ntai

ned

reco

rds

& r

egis

ters

NANA

NANA

NANA

NANA

NANA

NA

Diet

ser

vice

und

er

the

supe

rvis

ion

of a

qu

alifi

ed d

ieti

tian

NANA

NANA

NANA

NANA

NANA

NA


Tab

le 3

.18 M

ed

ical O

ffi c

ers

in

Po

sit

ion

Nam

e of

Pos

tPo

stN

ame

of C

HC

Bada

lFa

tega

rhFe

roz

shah

Goni

ana

Kart

arpu

rKh

emKa

ran

Long

o w

alM

achi

-W

ara

Mah

il-Pu

rM

ajit

haM

ana-

wal

aTo

tal

Med

icin

e

M.D

.-

1-

1-

11

1-

41

10

Dipl

oma

1-

--

--

--

--

-1

MBB

S-

-1

--

--

1-

-2

4

Surg

ery

M.S

.1

11

11

1-

1-

--

7

Dipl

oma

--

--

--

--

--

--

MBB

S-

--

--

--

--

--

-

OBG

M.S

.-

--

--

1-

-1

--

2

Dipl

oma

--

--

--

--

--

--

MBB

S-

--

--

--

--

--

-

Pedi

atric

s

M.D

.-

11

--

--

--

-1

3

Dipl

oma

--

--

--

--

--

--

MBB

S-

--

--

--

--

--

-

ENT

M.S

.-

--

-1

--

-1

--

2

Dipl

oma

--

--

--

--

--

--

MBB

S-

--

--

--

--

--

-

Orth

oped

ics

M.S

.-

--

--

--

--

--

-

Dipl

oma

1-

--

--

--

--

-1

MBB

S-

--

--

--

--

--

-

Derm

atol

ogis

t

M.D

.-

--

--

--

--

--

-

Dipl

oma

--

--

--

--

--

--

MBB

S-

--

--

--

--

--

-

Psyc

hiat

ry

M.D

.-

--

--

--

--

--

-

Dipl

oma

--

--

--

--

--

--

MBB

S-

--

--

--

--

--

-

(Con

td..

.)


Nam

e of

Pos

tPo

stN

ame

of C

HC

Bada

lFa

tega

rhFe

roz

shah

Goni

ana

Kart

arpu

rKh

emKa

ran

Long

o w

alM

achi

-W

ara

Mah

il-Pu

rM

ajit

haM

ana-

wal

aTo

tal

Anae

sthe

sia

M.D

.1

1-

--

--

1-

--

3

Dipl

oma

--

--

--

--

--

--

MBB

S-

--

--

--

--

--

-

Bloo

d Ba

nk

M.D

.-

--

--

--

--

--

-

Dipl

oma

--

--

--

--

--

--

MBB

S-

--

--

--

--

--

-

Path

olog

y

M.D

.-

--

--

--

--

--

-

Dipl

oma

--

--

--

--

--

--

MBB

S-

--

--

--

--

--

-

Bio-

chem

istr

y

MD/

MSc

--

--

--

--

--

--

Dipl

oma

--

--

--

--

--

--

MBB

S-

--

--

--

--

--

-

Mic

robi

olog

y

MD/

MSc

--

--

--

--

--

--

Dipl

oma

--

--

--

--

--

--

MBB

S-

--

--

--

--

--

-

Radi

olog

y

M.D

.-

--

--

--

-1

--

1

Dipl

oma

--

--

--

--

--

--

MBB

S1

--

--

--

--

--

1

Dent

alBD

S-

1-

-1

1-

1-

11

6

MBB

S1

--

1-

--

--

--

2


Tab

le 3

.19 Fiv

e Y

ears

Perf

orm

an

ce R

ep

ort

of

CH

C H

osp

itals

(P

un

jab

)

Perf

orm

ance

(An

nual

)N

ame

of t

he C

HC

Bada

lFa

tega

rhFe

roz

shah

Goni

ana

Kart

arpu

rKh

emKa

ran

Long

o w

alM

achi

-W

ara

Mah

il-Pu

rM

ajit

haM

ana-

wal

a

OPD

atte

ndan

ce

last

5 y

ear

1st Y

r30

492.

3767

386

8841

371

5915

2-

1779

728

788

2036

144

498

1968

3

2nd Y

r17

531

3920

913

792

4424

968

949

-13

504

3474

826

459

4140

621

263

3rd Y

r15

594

4705

210

804

3501

356

222

2100

814

038

3516

624

531

5157

820

980

4th Y

r18

881

5271

099

4047

352

5903

023

310

1706

629

461

3381

1-

2038

7

5th Y

r27

901

5003

411

354

4092

562

492

2875

613

061

3515

837

977

-25

980

In-p

atie

nt

Adm

itte

d

1st Y

r64

914

8227

231

1617

95-

843

426

413

--

2nd Y

r25

614

7652

329

4020

17-

629

719

631

--

3rd Y

r28

114

0149

920

8919

5074

860

214

1562

112

19-

4th Y

r60

811

7643

125

9218

6771

363

612

6632

811

42-

5th Y

r76

591

954

729

6617

2812

2946

512

6310

7214

10-

No.

of S

urge

ries

done

1st Y

r35

667

516

915

7624

1-

386

573

255

--

2nd Y

r10

5210

8442

515

0324

9-

345

784

474

--

3rd Y

r15

7012

4270

370

627

180

714

079

151

881

4-

4th Y

r20

8712

9360

511

2128

274

156

072

564

980

5-

5th Y

r22

7217

5959

015

2429

210

2030

296

46

1314

-

No.

of

emer

genc

ies

1st Y

r12

028

013

979

1-

-52

614

7813

--

2nd Y

r61

348

293

735

--

533

1756

131

-76

8

3rd Y

r66

258

164

616

-40

422

1791

167

-95

6

4th Y

r10

724

772

823

-55

189

1933

106

-12

96

5th Y

r37

522

577

874

-11

422

626

7538

7-

1703

No.

of

adm

issi

on

thro

ugh

emer

genc

y

1st Y

r-

233

5174

454

7-

257

344

13-

-

2nd Y

r-

242

3765

347

3-

250

364

131

--

3rd Y

r-

141

4546

949

331

264

263

167

509

-

4th Y

r-

174

6159

476

232

100

453

106

558

-

5th Y

r-

261

7162

769

710

610

446

636

550

0-

(Con

td..

.)


Perf

orm

ance

(An

nual

)N

ame

of t

he C

HC

Bada

lFa

tega

rhFe

roz

shah

Goni

ana

Kart

arpu

rKh

emKa

ran

Long

o w

alM

achi

-W

ara

Mah

il-Pu

rM

ajit

haM

ana-

wal

a

No.

of m

edic

o-le

gal c

ases

1st Y

r-

197

49NA

203

-13

328

10

378

208

2nd Y

r-

169

4328

322

5-

122

315

041

525

7

3rd Y

r-

145

4924

823

7-

104

300

038

526

4

4th Y

r-

9172

354

305

-68

400

036

523

9

5th Y

r-

148

6828

239

0-

6735

20

293

218

No.

of

Post

mor

tem

1st Y

r-

-NI

L0

--

0-

0-

-

2nd Y

r-

-0

0-

-0

-0

--

3rd Y

r-

-0

0-

NA0

-0

--

4th Y

r-

-0

0-

NA0

-0

--

5th Y

r-

-0

0-

NA0

-0

--

No.

of N

orm

al

deliv

erie

s co

nduc

ted

1st Y

r18

636

230

942

NA1

--

2nd Y

r23

5613

102

2343

NA-

--

3rd Y

r10

169

1078

5664

3072

628

-

4th Y

r84

139

7882

8638

151

-32

-

5th Y

r8

47

7671

139

4354

-40

-

No.

of

Caes

aria

ns d

one

1st Y

r-

104

NIL

64-

-4

NA-

--

2nd Y

r-

73Do

47-

-0

NA1

--

3rd Y

r-

670

113

NIL

031

11

-

4th Y

r-

470

010

NIL

041

-3

-

5th Y

r-

90

07

NIL

05

-7

-


Tab

le 3

.20 S

taff

Po

sit

ion

at

CH

C

Nam

ePo

stBa

dal

Fate

garh

Fero

z sh

ahGo

nian

aKa

rtar

pur

Khem

Kara

nLo

ngo

wal

Mac

hi-

War

aM

ahil-

Pur

Maj

itha

Man

a-w

ala

Doct

ors/

GDM

O

Sanc

tion

111

55

61

-6

11

6

Vaca

nt6

-3

22

1-

1-

--

Ad h

ock

1-

--

--

--

--

-

Tota

l in

Posi

tion

41

23

4-

-5

11

6

Doct

ors

spec

ialis

t

Sanc

tion

34

11

-5

43

45

-

Vaca

nt2

1-

--

13

1-

1 (L

.L)

-

Ad h

ock

--

--

--

--

--

-

Tota

l in

Posi

tion

13

11

-4

12

44

-

Nurs

ing

Staf

f

Sanc

tion

104

95

57

710

64

5

Vaca

nt5

--

2-

55

11

--

Ad h

ock

3-

--

--

--

4-

1

Tota

l in

Posi

tion

24+

3(*)

93

52

29

5+1(

*)3+

7(*)

4

Tech

nici

an(M

LT)

Sanc

tion

13

33

24

34

12

5

Vaca

nt-

--

2-

1-

1-

-1

Ad h

ock

1-

1-

--

--

--

-

Tota

l in

Posi

tion

-3

21

23

33

12

4

Adm

inis

trat

ive

staf

f

Sanc

tion

1-

32

-1

-5

1-

6

Vaca

nt-

--

--

1-

1-

--

Ad h

ock

--

--

--

--

--

1

Tota

l in

Posi

tion

1-

32

--

-4

1 m

issi

ng-

5

Clas

s IV

Sanc

tion

220

96

414

723

110

40

Vaca

nt-

-1

--

2-

3-

-7

Ad h

ock

--

--

--

--

--

-

Tota

l in

Posi

tion

2+7(

*)20

86

412

720

17+

3(*)

33

(Con

td..

.)


Nam

ePo

stBa

dal

Fate

garh

Fero

z sh

ahGo

nian

aKa

rtar

pur

Khem

Kara

nLo

ngo

wal

Mac

hi-

War

aM

ahil-

Pur

Maj

itha

Man

a-w

ala

Safa

i Sew

ak

Sanc

tion

23

-3

--

33

12

5

Vaca

nt-

--

--

--

1-

--

Ad h

ock

--

--

--

--

--

-

Tota

l in

Posi

tion

2+3(

*)3

-3

--

32

1+2(

*)2+

2(*)

5

Phar

mac

ists

Sanc

tion

3-

23

12

--

1-

3

Vaca

nt-

--

--

--

--

--

Ad h

ock

--

--

--

--

--

-

Tota

l in

Posi

tion

3+4(

*)-

23

12

--

1-

8+1(

LL)

Opht

halm

olo-

Gist

s

Sanc

tion

-1

11

-1

--

--

-

Vaca

nt-

--

--

--

--

--

Ad h

ock

--

--

--

--

--

-

Tota

l in

Posi

tion

-1

11

-1

--

--

-

Radi

ogra

pher

Sanc

tion

-1

11

-1

--

1-

-

Vaca

nt-

--

--

--

--

--

Ad h

ock

--

--

-1

--

--

-

Tota

l in

Posi

tion

-1

11

--

--

1-

-

BEE

& C

ompu

ter

Sanc

tion

--

22

-2

--

--

-

Vaca

nt-

-1

1-

--

--

--

Ad h

ock

--

--

--

--

--

-

Tota

l in

Posi

tion

--

11

-2

--

--

-

MPW

/ Tr

aine

d Da

i

Sanc

tion

--

33

--

--

--

-

Vaca

nt-

--

--

--

--

--

Ad h

ock

--

--

--

--

--

-

Tota

l in

Posi

tion

--

33

--

--

--

-

Othe

rs (

Driv

er

Cook

)

Sanc

tion

--

--

-2

--

1-

-

Vaca

nt-

--

--

2-

--

--

Ad h

ock

--

--

--

--

--

-

Tota

l in

Posi

tion

--

--

--

--

1-

-

* Pl

aced

on

Depu

tati

on in

CH

C

LL S

taff

on

long

leav

e


Tab

le 3

.21

U

tilisati

on

of

User

Ch

arg

es in

dif

fere

nt

CH

C o

f P

HS

C (

Pu

nja

b)

Nam

e of

CH

CYe

ars

Tota

l Inc

ome

(Col

lect

ion)

Tota

l Ex

pend

itur

eDe

taile

d Ex

pend

itur

eRo

gi K

alay

an

Med

icin

eI.

F.P.

Build

ings

Equi

pmen

tER

F A\

cSa

lary

to

cont

ract

ual s

taff

Bada

l

2002

-03

5652

6464

4881

1270

3659

777

1783

247

650

-39

2586

2003

-04

3992

1147

0469

8357

551

130

1837

816

423

-23

7963

2004

-05

3485

7927

8619

8086

660

687

1580

911

391

-10

9866

2005

-06

3103

1723

5849

7205

448

060

1565

962

61-

9381

5

2006

-07

3687

9232

3920

6584

186

891

4742

917

888

1476

591

106

2007

-08

5332

0769

0227

1407

2718

2053

8734

811

0842

9123

1601

34

Tota

l25

,25,

370

25,8

0,96

55,

70,0

994,

88,5

982,

02,4

552,

10,4

5523

,888

10,8

5,47

0

Fate

h Ga

rh

Chur

ian

2003

-04

2150

0035

5131

1120

2311

2701

4880

672

215

-93

86-

2004

-05

4000

0043

4410

1598

5913

8416

4518

486

282

-46

33-

2005

-06

2804

2533

1667

1387

8090

569

3838

850

205

1372

500

0000

00

2006

-07

3665

2032

3200

8593

192

113

6007

475

812

9270

0000

0000

2007

-08

2192

4038

9692

1008

7014

0129

9395

3989

300

0000

0099

405

Tota

l14

8118

518

,34,

100

5,97

,499

5,73

,928

2,01

,847

3,24

,407

22,9

9514

,019

99,4

05

Fero

zsha

h

2004

-05

7021

347

001

1134

518

558

8337

8761

--

-

2005

-06

5834

442

493

2664

513

685

2080

83-

--

2006

-07

5126

321

298

6886

1000

035

2289

0-

--

2007

-08

3695

335

426

4658

1297

659

4459

04-

--

Tota

l2,

66,0

951,

79,2

1857

,465

75,5

7123

,468

16,7

70-

--

Goni

ana

2003

-04

2503

6680

1568

4291

9816

5769

9875

210

7849

--

-

2004

-05

7133

9154

3636

2189

8916

2089

2917

487

476

-45

908

-

2005

-06

6966

3674

4866

2788

5113

7195

3116

611

5240

6792

911

4485

-

2006

-07

9112

8667

4991

1672

4619

0755

2768

962

794

1265

07-

-

2007

-08

5628

0060

4410

1974

5610

2112

2150

093

508

1456

0344

231

1000

00

Tota

l35

5999

834

6947

113

9174

075

7920

2082

8146

6867

3400

3920

4624

1000

00

(Con

td..

.)


Nam

e of

CH

CYe

ars

Tota

l Inc

ome

(Col

lect

ion)

Tota

l Ex

pend

itur

eDe

taile

d Ex

pend

itur

eRo

gi K

alay

an

Med

icin

eI.

F.P.

Build

ings

Equi

pmen

tER

F A\

cSa

lary

to

cont

ract

ual s

taff

Kart

arpu

r

2003

-04

4317

6542

6968

2172

2116

9371

3104

993

27-

--

2004

-05

4503

1535

9099

1660

5715

3339

3787

618

27-

--

2005

-06

4788

4357

2262

3229

7315

0704

3281

334

387

--

-

2006

-07

4923

7341

3679

2111

4910

4888

5494

842

694

--

-

2007

-08

4749

5946

9563

2202

6858

670

1381

5252

473

--

-

Tota

l23

,28,

255

22,4

1,57

111

,37,

668

6,36

,972

2,94

,838

1,40

,708

--

-

Khem

kara

n

2003

-04

1034

4789

751

4399

830

681

8732

6340

000

1072

243

-

2004

-05

1302

7079

366

2978

720

491

1419

314

855

000

1260

697

-

2005

-06

1280

9798

388

4818

222

396

4745

2070

523

6084

4840

-

2006

-07

1617

1215

9780

4150

851

864

4876

914

430

3309

1907

024

-

2007

-08

2070

6824

1751

1080

7494

624

9228

2493

048

95-

Tota

l7,

30,5

946,

69,0

362,

71,5

492,

20,0

5685

,667

81,2

6010

,564

-

Long

owal

2003

-04

1242

2915

8285

3612

820

271

1204

312

043

-78

000

-

2004

-05

7906

579

434

3304

518

359

1101

511

015

-60

00-

2005

-06

6650

580

028

3601

320

007

1200

412

004

-00

00-

2006

-07

5489

565

543

2949

416

386

9831

9832

-00

00-

2007

-08

1645

6413

0702

5881

632

676

1960

519

605

-00

00-

Tota

l3,

89,2

585,

13,9

921,

93,4

961,

07,4

9964

,498

64,4

99-

84.0

00-

Mah

ilpur

2003

-04

2810

5521

5745

1066

3644

143

5765

073

16-

--

2004

-05

3661

5228

5383

1234

7797

184

5276

611

056

--

-

2005

-06

5193

938

2006

2106

7214

8645

9839

1285

0-

--

2006

-07

3227

1933

0901

1386

0814

3693

2907

919

521

--

-

2007

-08

NANA

NANA

NANA

--

-

Tota

l13

,21,

865

12,1

4,03

55,

80,2

934,

33,6

651,

49,3

3450

,743

--

-

(Con

td..

.)


Nam

e of

CH

CYe

ars

Tota

l Inc

ome

(Col

lect

ion)

Tota

l Ex

pend

itur

eDe

taile

d Ex

pend

itur

eRo

gi K

alay

an

Med

icin

eI.

F.P.

Build

ings

Equi

pmen

tER

F A\

cSa

lary

to

cont

ract

ual s

taff

Maj

itha

2003

-04

1355

1013

5119

4597

012

824

1125

517

070

-48

000

-

2004

-05

1829

3018

7379

5849

240

568

1571

723

037

-49

565

-

2005

-06

1846

7818

7891

8429

948

859

1198

220

660

3456

1913

5-

2006

-07

2887

3521

9896

7488

466

133

3927

932

305

7295

--

2007

-08

2667

7026

6790

1255

6757

703

3858

540

025

4910

--

Tota

l10

,58,

623

9,97

,075

3,89

,212

2,26

,087

1,16

,318

1,33

,097

15,6

611,

16,7

00-

Mac

hiw

ara

2003

-04

2507

1714

8554

5085

362

351

1430

621

044

--

2004

-05

3633

8432

5598

1537

0810

7985

4562

518

280

--

2005

-06

3185

8023

3467

1119

3591

636

1055

491

0738

2564

10-

2006

-07

2931

9322

7145

9849

766

777

1870

843

163

2799

--

2007

-08

4014

4240

4630

1303

9214

9071

1784

110

7326

1393

5-

-

Tota

l16

,27,

316

13,3

9,39

45,

45,3

854,

77,8

201,

07,0

341,

98,9

2020

,559

6,41

0-

Man

awal

a

2003

-04

NANA

NANA

NANA

NANA

2004

-05

3,29

,175

1,07

,777

1,02

,643

49,9

4964

,581

-4,

225

-

2005

-06

4,36

,904

1,79

,740

1,27

,786

14,8

011,

08,2

97-

6,28

0-

2006

-07

3,20

,209

1,22

,149

1,08

,489

34,4

5249

,541

-5,

578

-

2007

-08

5030

435,

32,9

642,

20,7

401,

37,2

6192

,839

66,9

75-

15,1

4910

0000

Tota

l16

,19,

252

6,30

,406

4,76

,179

1,92

,041

2,89

,394

-31

,232

1,00

,000


Ta

ble

4. D

istr

ibu

tio

n o

f In

pati

en

ts b

y S

ex, A

ge G

rou

p, E

du

cati

on

, In

co

me &

ty

pe o

f H

ealt

h F

acilit

y U

tilised

N=2

24

Soci

oeco

nom

ic d

imen

sion

of

inpa

tien

tDi

stri

ct H

ospi

tal

Sub-

Divi

sion

al H

ospi

tal

CHC

Spec

ial H

ospi

tal

TOTA

L

Age

grou

p

Less

tha

n 15

21.

9%0 0%

0 .0%

14.

5%3

1.3%

15-3

046

43.8

%37

54.4

%14

48.3

%15

68.2

%11

250

.0%

31-4

519

18.1

%17

25.0

%4

13.8

%5

22.7

%45

20.1

%

46-6

024

22.9

%6

8.8%

724

.1%

14.

5%38

17.0

%

Abov

e 60

1413

.3%

811

.8%

413

.8%

0 .0%

2611

.6%

Sex

Mal

e47

44.8

%30

44.1

%19

65.5

%2

9.1%

9843

.8%

Fem

ale

5855

.2%

3855

.9%

1034

.5%

2090

.9%

126

56.3

%

Educ

atio

n

Illit

erat

e45

42.9

%19

27.9

%12

41.4

%4

18.2

%80

35.7

%

Prim

ary

2321

.9%

1826

.5%

724

.1%

731

.8%

5524

.6%

Seco

ndar

y26

24.8

%24

35.3

%6

20.7

%3

13.6

%59

26.3

%

Seni

or s

econ

dary

98.

6%3

4.4%

413

.8%

418

.2%

20 8.9%

Grad

uate

21.

9%1

1.5%

0 .0%

29.

1%5

2.2%

> Gr

adua

te0 .0%

34.

4%0 .0%

29.

1%5

2.2%

(Con

td..

.)


Soci

oeco

nom

ic d

imen

sion

of

inpa

tien

tDi

stri

ct H

ospi

tal

Sub-

Divi

sion

al H

ospi

tal

CHC

Spec

ial H

ospi

tal

TOTA

L

Inco

me

grou

p

Less

tha

n 20

0041

39.0

%26

38.2

%16

55.2

%7

31.8

%90

40.2

%

2001

-500

047

44.8

%27

39.7

%9

31.0

%5

22.7

%88

39.3

%

5001

-100

0012

11.4

%11

16.2

%2

6.9%

627

.3%

3113

.8%

1000

1-15

000

43.

8%4

5.9%

13.

4%3

13.6

%12 5.4%

Abov

e 15

000

11.

0%0 .0%

13.

4%1

4.5%

31.

3%


Ta

ble

5. A

dm

issio

n In

Dif

fere

nt

Cate

go

ries o

f H

osp

itals

Soci

oeco

nom

ic d

imen

sion

of

inpa

tien

tDi

stri

ct H

ospi

tal

Sub-

Divi

sion

al H

ospi

tal

CHC

Spec

ial H

ospi

tal

TOTA

L

Adm

issi

on t

hrou

gh

Emer

genc

y55

52.4

%38

55.9

%16

55.2

%6

27.3

%11

551

.3%

OPD

4946

.7%

3044

.1%

1344

.8%

1672

.7%

108

48.2

%

Can’

t sa

y1

1.0%

0 .0%

0 .0%

0 .0%

1 .4%


Tab

le 6

. U

ser

Ch

arg

es f

or

Serv

ice

s in

Vari

ou

s H

osp

itals

in

Pu

nja

b

Paym

ent

Type

of

Hos

pita

lTo

tal

Dist

rict

Hos

pita

lSD

HCH

CSp

ecia

l Hos

pita

l

Slip

/car

d m

akin

g

Yes

9287

.6%

5885

.3%

2896

.6%

1986

.4%

197

87.9

%

No13

12.4

%9

13.2

%1

3.4%

313

.6%

2611

.6%

No r

espo

nse

0 .0%

11.

5%0 .0%

0 .0%

1 .4%

Cons

ulta

ncy

char

ges

Yes

98.

6%7

10.3

%3

10.3

%4

18.2

%23

10.3

%

No96

91.4

%60

88.2

%21

72.4

%18

81.8

%19

587

.1%

No r

espo

nse

0 .0%

11.

5%5

17.2

%0 .0%

62.

7%

Paym

ent

for

adm

issi

on c

harg

es

Yes

8984

.8%

4464

.7%

2379

.3%

2090

.9%

176

78.6

%

No16

15.2

%23

33.8

%6

20.7

%2

9.1%

4721

.0%

No r

espo

nse

0 .0%

11.

5%0 .0%

0 .0%

1 .4%

Paym

ent

for

inve

stig

atio

n ch

arge

s

Yes

8883

.8%

5885

.3%

2896

.6%

1986

.4%

193

86.2

%

No16

15.2

%8

11.8

%0 .0%

313

.6%

2712

.1%

No r

espo

nse

11.

0%2

2.9%

13.

4%0 .0%

41.

8%

Paym

ent

for

any

othe

r

Yes

2725

.7%

2232

.4%

1034

.5%

313

.6%

6227

.7%

No62

59.0

%39

57.4

%12

41.4

%16

72.7

%12

957

.6%

No r

espo

nse

1615

.2%

710

.3%

724

.1%

313

.6%

3314

.7%


Ta

ble

7. E

xp

eri

en

ce a

t O

PD

/em

erg

en

cy/r

ecep

tio

n/A

dm

issio

n, Q

uality

of

Tre

atm

en

t, S

ecu

rity

& A

dm

issio

n P

roced

ure

of

Vari

ou

s H

osp

itals

Rati

ng e

xper

ienc

eTy

pe o

f H

ospi

tal

Tota

l

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

OPD/

Emer

genc

y

Good

79

75.2

%56

82.4

%19

65.5

%20

90.9

%17

477

.7%

Aver

age

20

19.0

%9

13.2

%9

31.0

%2

9.1%

4017

.9%

Poor

1

1.0%

34.

4%0 .0%

0 .0%

41.

8%

Can’

t sa

y

43.

8%0 .0%

13.

4%0 .0%

52.

2%

No r

espo

nse

1

1.0%

0 .0%

0 .0%

0 .0%

1 .4%

Rece

ptio

n/ad

mis

sion

Good

87

82.9

%59

86.8

%20

69.0

%20

90.9

%18

683

.0%

Aver

age

13

12.4

%7

10.3

%8

27.6

%2

9.1%

3013

.4%

Poor

0 .0%

11.

5%0 .0%

0 .0%

1 .4%

Can’

t sa

y

43.

8%0 .0%

13.

4%0 .0%

52.

2%

No r

espo

nse

1

1.0%

11.

5%0 .0%

0 .0%

2 .9%

Qual

ity

of t

reat

men

t in

hos

pita

l

Good

85

81.0

%50

73.5

%21

72.4

%21

95.5

%17

779

.0%

Aver

age

16

15.2

%14

20.6

%7

24.1

%1

4.5%

3817

.0%

Poor

1

1.0%

34.

4%0 .0%

0 .0%

41.

8%

Can’

t sa

y

32.

9%1

1.5%

13.

4%0 .0%

52.

2% (Con

td..

.)


Rati

ng e

xper

ienc

eTy

pe o

f H

ospi

tal

Tota

l

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Secu

rity

of

hosp

ital

Good

54

51.4

%26

38.2

%13

44.8

%11

50.0

%10

446

.4%

Aver

age

20

19.0

%11

16.2

%1

3.4%

731

.8%

3917

.4%

Poor

15

14.3

%14

20.6

%8

27.6

%1

4.5%

3817

.0%

Can’

t sa

y

1615

.2%

1725

.0%

724

.1%

313

.6%

4319

.2%

Rati

ng o

f ad

mis

sion

pr

oced

ure

of h

ospi

tal

Good

11

10.5

%3

4.4%

13.

4%1

4.5%

16 7.1%

Aver

age

12

11.4

%8

11.8

%3

10.3

%4

18.2

%27

12.1

%

Poor

77

73.3

%55

80.9

%25

86.2

%17

77.3

%17

477

.7%


Tab

le 8

. P

ati

en

t’s R

esp

on

ses o

n Q

uality

of

Serv

ices in

Term

s o

f G

en

era

l C

lean

lin

ess, B

asic

Su

pp

ort

Serv

ices in

Ward

in

Vari

ou

s H

ealt

h S

ett

ing

s

War

d &

bed

- Ge

nera

l cha

ract

eris

tics

Type

of

Hos

pita

lTo

tal

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

lN=

224

War

d &

bed

- Ge

nera

l cl

eanl

ines

s

Good

64

61.0

%41

60.3

%23

79.3

%21

95.5

%14

966

.5%

Aver

age

38

36.2

%24

35.3

%6

20.7

%1

4.5%

9944

.2%

Poor

3

2.9%

34.

4%0 .0%

0 .0%

31.

3%

War

d &

bed

- lin

en

Good

63

60.0

%43

63.2

%29

100.

0%19

86.4

%14

966

.5%

Aver

age

35

33.3

%19

27.9

%0 .0%

313

.6%

6930

.8%

Poor

7

6.7%

68.

8%0 .0%

0 .0%

62.

7%

War

d &

bed

- co

mfo

rt

Good

76

72.4

%45

66.2

%26

89.7

%19

86.4

%16

674

.1%

Aver

age

28

26.7

%21

30.9

%3

10.3

%3

13.6

%57

25.4

%

Poor

1

1.0%

22.

9%0 .0%

0 .0%

13 5.8%

War

d &

bed

- lig

ht

& f

an

Good

81

77.1

%53

77.9

%24

82.8

%20

90.9

%17

879

.5%

Aver

age

20

19.0

%15

22.1

%5

17.2

%2

9.1%

4218

.8%

Poor

4

3.8%

0 .0%

0 .0%

0 .0%

31.

3%

(Con

td..

.)


War

d &

bed

- Ge

nera

l cha

ract

eris

tics

Type

of

Hos

pita

lTo

tal

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

lN=

224

War

d &

bed

- to

ilet

Good

4441

.9%

3247

.1%

1655

.2%

1463

.6%

106

47.3

%

Aver

age

4038

.1%

1623

.5%

1137

.9%

731

.8%

7433

.0%

Poor

1918

.1%

1927

.9%

26.

9%0 .0%

4017

.9%

Can’

t sa

y2

1.9%

11.

5%0 .0%

14.

5%4

1.8%

War

d &

bed

- fo

od

Good

1716

.2%

811

.8%

724

.1%

418

.2%

3616

.1%

Aver

age

32.

9%3

4.4%

0 .0%

14.

5%7

3.1%

Poor

0 .0%

11.

5%0 .0%

0 .0%

1 .4%

Can’

t sa

y85

81.0

%56

82.4

%22

75.9

%17

77.3

%18

080

.4%


Ta

ble

9. P

ati

en

ts O

bserv

ati

on

ab

ou

t th

e B

eh

avio

ur

& A

ttit

ud

e o

f N

urs

es, D

octo

rs, S

taff

du

rin

g s

tay in

Ho

sp

ital

Type

of

Hos

pita

lTo

tal

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Beha

viou

r of

nur

ses

duri

ng s

tay

in

hosp

ital

Good

9287

.6%

4667

.6%

2482

.8%

1881

.8%

180

80.4

%

Aver

age

1211

.4%

2130

.9%

26.

9%4

18.2

%39

17.4

%

Poor

11.

0%1

1.5%

26.

9%0 .0%

41.

8%

Can’

t sa

y0 .0%

0 .0%

13.

4%0 .0%

1 .4%

Beha

viou

r of

doc

tors

du

ring

sta

y in

ho

spit

al

Good

9792

.4%

6494

.1%

2793

.1%

2195

.5%

209

93.3

%

Aver

age

76.

7%3

4.4%

26.

9%1

4.5%

13 5.8%

Can’

t sa

y1

1.0%

11.

5%0 .0%

0 .0%

2 .9%

Beha

viou

r of

res

t of

st

aff

duri

ng s

tay

in

hosp

ital

Good

8278

.1%

4769

.1%

2069

.0%

1777

.3%

166

74.1

%

Aver

age

1918

.1%

1420

.6%

620

.7%

418

.2%

4319

.2%

Poor

11.

0%0 .0%

26.

9%1

4.5%

41.

8%

Can’

t sa

y3

2.9%

710

.3%

13.

4%0 .0%

11 4.9%

Atti

tude

of

sist

ers

at

adm

issi

on

Good

8480

.0%

4972

.1%

2275

.9%

1986

.4%

174

77.7

%

Aver

age

2019

.0%

1623

.5%

517

.2%

313

.6%

4419

.6%

Poor

0 .0%

11.

5%2

6.9%

0 .0%

31.

3%

Can’

t sa

y1

1.0%

22.

9%0 .0%

0 .0%

31.

3%


Tab

le 1

0.

Pati

en

t’s R

esp

on

ses o

n Q

uality

of

Serv

ices in

Term

s o

f A

vailab

ilit

y o

f M

ed

icin

es in

th

e W

ard

Lab

ora

tory

&

Rad

iolo

gic

al S

erv

ices

Type

of

Hos

pita

lTo

tal

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Avai

labi

lity

of

med

icin

es in

the

w

ard

All a

vaila

ble

1312

.4%

68.

8%4

13.8

%7

31.8

%30

13.4

%

Som

e av

aila

ble

5451

.4%

3652

.9%

2172

.4%

1463

.6%

125

55.8

%

None

ava

ilabl

e36

34.3

%25

36.8

%3

10.3

%1

4.5%

6529

.0%

Can’

t sa

y2

1.9%

11.

5%1

3.4%

0 .0%

41.

8%

Faci

litie

s fo

r la

bora

tory

&

radi

olog

ical

in

vest

igat

ions

Good

6965

.7%

3754

.4%

1551

.7%

1986

.4%

140

62.5

%

Aver

age

2725

.7%

1522

.1%

1137

.9%

14.

5%54

24.1

%

Poor

11.

0%2

2.9%

0 .0%

0 .0%

31.

3%

Can’

t sa

y8

7.6%

1420

.6%

310

.3%

29.

1%27

12.1

%

Tab

le 1

1.

Pati

en

t’s R

esp

on

se in

Term

s o

f an

y M

on

ey S

pen

t o

n M

ed

icin

e

Any

mon

ey s

pend

on

med

icin

e

Yes

9893

.3%

6810

0.0%

2069

.0%

1881

.8%

204

91.1

%

No 7

6.7%

0 .0%

931

.0%

418

.2%

20 8.9%

Paid

any

mon

ey t

o st

aff

mem

ber

duri

ng

stay

in h

ospi

tal

Yes

0 .0%

11.

5%0 .0%

0 .0%

1 .4%

No10

510

0.0%

6798

.5%

2910

0.0%

2210

0.0%

223

99.6

%


Tab

le 1

2. P

ati

en

t’s R

esp

on

ses o

n Q

uality

of

Serv

ices in

Term

s o

f A

deq

uacy o

f In

form

ati

on

Ab

ou

t R

ule

s, R

eg

ula

tio

n, D

isease

& T

reatm

en

t In

Healt

h S

ett

ing

s

Type

of

Hos

pita

lTo

tal

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Info

rmat

ion

abou

t ru

les

and

regu

lati

on

Yes

60

57.1

%38

55.9

%13

44.8

%11

50.0

%12

254

.5%

No 43

41.0

%30

44.1

%15

51.7

%11

50.0

%99

44.2

%

No r

espo

nse

2

1.9%

0 .0%

13.

4%0 .0%

31.

3%

Info

rmat

ion

abou

t di

seas

e &

tre

atm

ent

by d

octo

r

Com

plet

e

6965

.7%

4566

.2%

2482

.8%

1777

.3%

155

69.2

%

Part

ial

33

31.4

%16

23.5

%3

10.3

%3

13.6

%55

24.6

%

Inad

equa

te

11.

0%7

10.3

%1

3.4%

29.

1%11 4.9%

Can’

t sa

y

21.

9%0 .0%

13.

4%0 .0%

31.

3%

Tab

le 1

3.

Sati

sfa

cti

on

s o

f th

e P

ati

en

ts w

ith

Serv

ices o

f H

osp

ital at

the V

ari

ou

s H

ealt

h F

acilit

ies

Sati

sfac

tion

wit

h se

rvic

es o

f ho

spit

al

Yes

101

96.2

%59

86.8

%29

100.

0%22

100.

0%21

194

.2%

No4

3.8%

913

.2%

0 .0%

0 .0%

13 5.8%


Tab

le 1

4.

Su

gg

esti

on

s f

or

Fu

rth

er

Imp

rovem

en

t in

th

e S

erv

ices b

y t

he In

-pati

en

ts

S.N

oSu

gges

tion

s fo

r Im

prov

emen

t of

the

Ser

vice

s fo

r In

-pat

ient

Dep

artm

ent

N =

224

Perc

enta

ge

1.M

edic

ines

sho

uld

be a

vaila

ble

in t

he h

ospi

tal/

prov

ide

all m

edic

ines

.42

18.7

5

2.M

edic

ines

sho

uld

be p

rovi

ded

free

of

cost

or

subs

idis

e ra

te.

156.

7

3.H

ealt

h fa

cilit

ies

shou

ld b

e pr

ovid

ed f

ree

of c

ost

to B

PL/p

oor

fam

ilies

146.

25

4.Qu

alit

y of

med

icin

e sh

ould

be

impr

oved

, th

ose

are

supp

lied

by t

he h

ospi

tals

31.

34

5.Ne

eds

regu

lar

visi

ts o

f hi

gher

aut

hori

ties

for

day

-to-

day

wor

k of

the

hos

pita

ls/f

emal

e do

ctor

s/sp

ecia

list

shou

ld t

reat

gyn

ae. pr

oble

ms

&

doct

ors

shou

ld b

e av

aila

ble

in O

PD c

linic

on

fi xed

day

s.10

4.46

6.Do

ctor

s sh

ould

be

avai

labl

e in

hos

pita

ls a

t ni

ght

shif

ts/n

eeds

pro

per

care

at

nigh

t sh

ifts

in e

mer

genc

y.3

1.34

7.Be

havi

our

of s

taff

nur

ses

& c

lass

-IV

empl

oyee

s sh

ould

be

impr

oved

tow

ards

pat

ient

s.3

1.34

8.Ot

her

faci

litie

s ne

eds

to b

e im

prov

ed:

i) P

rovi

sion

of

food

for

the

pat

ient

s on

sub

sidi

se r

ate

ii) N

eeds

cle

anlin

ess

of t

oile

ts/s

epar

ate

toile

ts f

or m

ale

& f

emal

e.iii

) H

ospi

tal c

lean

lines

s.iv

) Dr

inki

ng w

ater

fac

iliti

es s

houl

d be

ava

ilabl

e /i

mpr

oved

.v)

All

diag

nost

ic f

acili

ties

for

tre

atm

ent

shou

ld b

e av

aila

ble

in t

he h

ospi

tals

on

subs

idis

e ra

te o

r fr

ee o

f co

st.

vi)

Prop

er S

ecur

ity

arra

ngem

ents

for

war

ds &

Hos

pita

l.vi

i) P

riva

te r

oom

s sh

ould

be

avai

labl

e in

hos

pita

ls f

or p

atie

nts

on p

aym

ent

basi

s/ne

eds

sitt

ing

arra

ngem

ents

& p

atie

nt’s

atte

ndan

ts.

12 15 11 5 4 4 4

5.36 6.7

4.91

2.23

1.79

1.79

1.79

9.Sa

tisfi

ed

wit

h th

e H

ealt

h Se

rvic

es.

94.

02

10No

res

pons

e11

250


Tab

le 1

5.

Dis

trib

uti

on

of

Ou

tpati

en

t b

y S

ex, A

ge G

rou

p, E

du

cati

on

, In

co

me a

nd

Typ

e o

f Facilit

y U

tilised

N=58

0

Type

of

Hos

pita

lTo

tal

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Sex

Mal

e11

6 (4

0.8)

65(4

8.1)

57 (50)

6(1

2.8)

244

(42.

1)

Fem

ale

168

(59.

2)70

(51.

9)57 (50)

41(8

7.2)

336

(57.

9)

Age

Less

tha

n 15

15 (5.3

)6

(4.4

)2

(1.8

)12

(25.

5)35 (6.0

)

15-3

011

0(3

8.7)

46(3

4.1)

22(1

9.3)

26(5

5.3)

204

(35.

2)

31-4

586

(30.

3)36

(26.

7)43

(37.

7)6

(12.

8)17

1(2

9.5)

46-6

054 (19)

28(2

0.7)

29(2

5.4)

1(2

.1)

112

(19.

3)

Abov

e 60

19 (6.7

)19

(14.

1)18

(15.

8)2

(4.3

)58

(10.

0)

Educ

atio

n

Illit

erat

e82

(28.

9)52

(38.

5)56

(49.

1)12

(25.

5)20

2(3

4.8)

Prim

ary

65(2

2.9)

34(2

5.2)

18(1

5.8)

13(2

7.7)

130

(22.

4)

Seco

ndar

y80

(28.

2)26

(19.

3)19

(16.

7)8

(17.

0)13

3(2

2.9)

Seni

or S

econ

dary

30(1

0.6)

16(1

1.9)

13(1

1.4)

10(2

1.3)

69(1

1.9)

Grad

uate

19 (6.7

)5

(3.7

)5

(4.4

)4

(8.5

)33 (5.7

)

>Gra

duat

e8

(2.8

)2

(1.5

)3

(2.6

)0

(0.0

)13 (2.2

) (Con

td..

.)


Type

of

Hos

pita

lTo

tal

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Inco

me

Less

tha

n 20

0085

(29.

9)49

(36.

3)52

(45.

6)11

(23.

4)19

7(3

4.0)

2001

-500

012

0(4

2.3)

42(3

1.1)

36(3

1.6)

22(4

6.8)

220

(37.

9)

5001

-100

0048

(16.

9)30

(22.

2)10 (8.8

)6

(12.

8)94

(16.

2)

1000

1-15

000

14 (4.9

)5

(3.7

)5

(4.4

)2

(4.3

)26 (4.5

)

Abov

e 15

000

16 (5.6

)6

(4.4

)2

(1.8

)5

(10.

6)29 (5.0

)

Don’

t Kn

ow1

(0.4

)3

(2.2

)9

(7.9

)1 (2.1

14 (2.4

)


Tab

le 1

6.

User

Ch

arg

es f

or

Serv

ices in

Vari

ou

s H

ealt

h C

are

Sett

ing

s

Type

of

Hos

pita

lTO

TAL

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

OPD

card

cha

rges

Yes

268

(94.

4)13

3(9

8.5)

106

(93.

0)43

(91.

5)55

0(9

4.8)

No16 (5.6

)2

(1.5

)8

(7.0

)4

(8.5

)30 (5.2

)

Cons

ulta

ncy

char

ges

Yes

13

(4.6

)5

(3.7

)4

(3.5

)6

(12.

8)28 (4.8

)

No26

9 (9

4.7)

130

(96.

3)10

9 (9

5.6)

41

(87.

2)54

9(9

4.7)

Can’

t sa

y2

(0.7

)0

(0.0

)1

(0.9

)0

(0.0

)3

(0.5

)

Inve

stig

atio

n ch

arge

s

Yes

196

(69.

0)97

(7

1.9)

81

(71.

1)32

(6

8.1)

406

(70.

0)

No82

(2

8.9)

33

(24.

4)29

(2

5.4)

15

(31.

9)15

9(2

7.4)

Can’

t sa

y6

(2.1

)5

(3.7

)4

(3.5

)0

(0.0

)15 (2.6

)

Mon

ey s

pent

on

med

icin

e

Up

to 1

0071

46.4

%27

17.6

%34

22.2

%21

13.7

%15

310

0.0%

101

- 20

068

51.5

%29

22.0

%26

19.7

%9

6.8%

132

100.

0%

201-

500

5859

.2%

2222

.4%

1111

.2%

77.

1%98

100.

0%

Abov

e 50

035

57.4

%12

19.7

%10

16.4

%4

6.6%

6110

0.0%


Tab

le 1

7. P

ati

en

ts O

bserv

ati

on

s a

bo

ut

Cle

an

lin

ess, B

asic

Su

pp

ort

Serv

ices a

nd

Pri

vacy D

uri

ng

Exam

inati

on

in

Vari

ou

s

Healt

h C

are

Sett

ing

s in

Pu

nja

b

Type

of

Hos

pita

lTO

TAL

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Gene

ral c

lean

lines

s

Good

210

(73.

9)96

(71

.1)

73 (

64.0

)41

(87

.2)

420

(72.

4)

Aver

age

65 (

22.9

)37

(27

.4)

39 (

34.2

)6

(12.

8)14

7 (2

5.3)

Poor

7 (2

.5)

0 (0

.0)

2 (1

.8)

0 (0

.0)

9 (1

.6)

Cann

ot s

ay2

(0.7

)2

(1.5

)0

(0.0

)0

(0.0

)4

(0.7

)

Wai

ting

are

a

Good

235

(82.

7)10

4 (7

7.0)

68 (

59.6

)44

(93

.6)

451

(77.

8)

Aver

age

45 (

15.8

)28

(20

.7)

42 (

36.8

)3

(6.4

)11

8 (2

0.3)

Poor

2 (0

.7)

0 (0

.0)

3 (2

.6)

0 (0

.0)

5 (0

.9)

Cann

ot s

ay2

(0.7

)3

(2.2

)1

(0.9

)0

(0.0

)6

(1.0

)

Ligh

t an

d fa

n

Good

225

(79.

2)11

3 (8

3.7)

59 (

51.8

)42

(89

.4)

439

(75.

7)

Aver

age

52 (

18.3

)18

(13

.3)

32 (

28.1

)5

(10.

6)10

7 (1

8.4)

Poor

3 (1

.1)

1 (0

.7)

22 (

19.3

)0

(0.0

)26

(4.

5)

Cann

ot s

ay4

(1.4

)3

(2.2

)1

(0.9

)0

(0.0

)8

(1.4

)

STD/

PCO

Boot

h

Yes

138

(48.

6)71

(52

.6)

19 (

16.7

)22

(46

.8)

250

(43.

1)

No13

5 (4

7.5)

54 (

40.0

)84

(73

.7)

25 (

53.2

)29

8 (5

1.4)

Can’

t sa

y11

(3.

9)10

(7.

4)11

(9.

6)0

(0.0

)32

(5.

5)

Sepa

rate

toi

let

for

wom

en

Yes

250

(88.

0)11

6 (8

5.9)

87 (

76.3

)46

(97

.9)

499

(86.

0)

No27

(9.

5)16

(11

.9)

15 (

13.2

)1

(2.1

)59

(10

.2)

Cann

ot s

ay7

(2.5

)3

(2.2

)12

(10

.5)

0 (0

.0)

22 (

3.8)

Drin

king

Wat

er

Yes

250

(88.

0)13

1 (9

7.0)

89 (

78.1

)47

(10

0.0)

517

(89.

1)

No31

(10

.90)

4 (3

.0)

16 (

14.0

)0

(0.0

)51

(8.

8)

Cann

ot s

ay3

(1.1

)0

(0.0

)9

(7.9

)0

(0.0

)12

(2.

1)

Confi

den

tial

ity

(scr

eene

d ex

amin

atio

n ro

om)

Yes

245

(86.

3)11

9 (8

8.1)

95 (

83.3

)47

(10

0.0)

506

(87.

2)

No34

(12

.0)

13 (

9.6)

5 (4

.4)

0 (0

.0)

52 (

9.0)

Cann

ot s

ay5

(1.8

)3

(2.2

)14

(12

.3)

0 (0

.0)

22 (

3.8)


Tab

le 1

8.

Qu

ality

of

Serv

ices in

Term

s o

f A

deq

uacy o

f In

form

ati

on

, A

vailab

ilit

y o

f M

ed

icin

e, Lab

ora

tory

Serv

ices,

Beh

avio

ur

of

Sta

ff

Type

of

Hos

pita

lTo

tal

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Adeq

uacy

of

info

rmat

ion

give

n to

pat

ient

abo

ut

dise

ase

and

trea

tmen

t by

do

ctor

Good

244(

85.9

)10

6 (7

8.5)

82(7

1.9)

40(8

5.1)

472

(81.

4)

Aver

age

31(1

0.9)

17(1

2.6)

26(2

2.8)

5(10

.6)

79 (

13.6

)

Poor

3(1.

1)7(

5.2)

2(1.

8)2

(4.3

)14

(2.4

)

Can

not

say

6(2.

1)5(

3.7)

4(3.

5)0(

0.0)

15(2

.6)

Avai

labi

lity

of m

edic

ines

All a

vaila

ble

17(6

.0)

23(1

7.0)

16(1

4.0)

4(8.

5)60

(10.

3)

Som

e av

aila

ble

154(

54.2

)92

(68.

1)83

(72.

8)35

(74.

5)36

4(62

.8)

None

ava

ilabl

e 11

1(39

.1)

19(1

4.1)

15(1

3.2)

8(17

.0)

153(

26.4

)

No r

espo

nse

2(0.

7)1(

0.7)

0(0.

0)0(

0.0)

3(0.

5)

Faci

litie

s fo

r la

bora

tory

and

ra

diol

ogic

al in

vest

igat

ion

Good

15

3(53

.9))

70(5

1.9)

41(3

6.0)

30(6

3.8)

294(

50.7

)

Aver

age

66(2

3.2)

23(1

7.0)

37(3

2.5)

2(4.

3)12

8(22

.1)

Poor

4(

1.4)

3(2.

2)4(

3.5)

0(0.

0)11

(1.9

)

Can

not

say

61(2

1.5)

39(2

8.9)

32(2

8.1)

15(3

1.9)

147(

25.3

)

Beha

viou

r of

res

t of

the

st

aff?

Good

15

9(56

.0)

81(6

0.0)

57(5

0.0)

33(7

0.2)

330(

56.9

)

Aver

age

98(3

4.5)

41(3

0.4)

46(4

0.4)

3(6.

4)18

8(32

.4)

Poor

5(

1.8)

)4(

3.0)

1(0.

9)1(

2.1)

11(1

.9)

Can

not

say

22(7

.7)

9(6.

7)10

(8.8

)10

(21.

3)51

(8.8

)

Paym

ent

to a

ny s

taff

m

embe

r

Yes

9(3.

2)4(

3.0)

3(2.

6)1(

2.1)

17(2

.9)

No

275(

96.8

)13

1(97

.0)

111(

97.4

)46

(97.

9)56

3(97

.1)

Rati

ng t

he q

ualit

y of

tr

eatm

ent

in t

he h

ospi

tal

Good

22

3(78

.5)

104(

77.0

)69

(60.

5)44

(93.

6)44

0(75

.9)

Aver

age

53(1

8.7)

25(1

8.5)

41(3

6.0)

3(6.

4)12

2(21

.0)

Poor

5(

1.8)

3(2.

2)0(

0.0)

0(0.

0)8(

1.4)

Can

not

say

3(1.

1)3(

2.2)

4(3.

5)0(

0.0)

10(1

.7)

(Con

td..

.)


Type

of

Hos

pita

lTo

tal

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Beha

viou

r of

res

t of

the

st

aff?

Good

15

9(56

.0)

81(6

0.0)

57(5

0.0)

33(7

0.2)

330(

56.9

)

Aver

age

98(3

4.5)

41(3

0.4)

46(4

0.4)

3(6.

4)18

8(32

.4)

Poor

5(

1.8)

)4(

3.0)

1(0.

9)1(

2.1)

11(1

.9)

Can

not

say

22(7

.7)

9(6.

7)10

(8.8

)10

(21.

3)51

(8.8

)

Sati

sfac

tion

wit

h th

e se

rvic

es o

f th

e ho

spit

al

Yes

223(

78.5

)10

8(80

.0)

91(7

9.8)

30(6

3.8)

452(

77.9

)

No61

(21.

5)27

(20.

0)23

(20.

2)17

(36.

2)12

8(22

.1)


Tab

le 1

9.

Pati

en

ts’ O

bserv

ati

on

s R

eg

ard

ing

Healt

h M

an

Po

wer

in V

ari

ou

s H

ea

lth

Care

Sett

ing

s in

Pu

nja

b

Type

of

Hos

pita

l

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Coop

erat

ion

at t

he r

ecep

tion

of

the

coun

ter

Good

225

(79.

2)10

4 (7

7.0)

80 (

70.2

)44

(93

.6)

Aver

age

50 (

17.6

)30

(22

.2)

33 (

28.9

)3

(6.4

)

Poor

5 (1

.8)

1 (0

.7)

1 (0

.9)

0 (0

.0)

Can

not

say

4 (1

.4)

0 (0

.0)

0 (0

.0)

0 (0

.0)

Avai

labi

lity

of d

octo

rsAv

aila

ble

270

(95.

1)13

2 (9

7.8)

102

(89.

5)46

(97

.9)

Not

avai

labl

e14

(4.

9)3

(2.2

)12

(10

.5)

1 (2

.1)

Avai

labi

lity

of s

peci

alis

tsAv

aila

ble

256

(90.

1)11

6 (8

5.9)

74 (

64.9

)43

(91

.5)

Not

avai

labl

e28

(9.

9)19

(14

.1)

40 (

35.1

)4

(8.5

)

Avai

labi

lity

of n

urse

sAv

aila

ble

229

(80.

6)10

4 (7

7.0)

89 (

78.1

)36

(76

.6)

Not

avai

labl

e55

(19

.4)

31 (

23.0

)25

(21

.9)

11 (

23.4

)

Beha

viou

r of

doc

tors

Good

264

(93.

0)12

4 (9

1.9)

98 (

86.0

)44

(93

.6)

Aver

age

16 (

5.6)

9 (6

.7)

13 (

11.4

)3

(6.4

)

Poor

1 (0

.4)

0 (0

.0)

0 (0

.0)

0 (0

.0)

Can

not

say

3 (1

.1)

2 (1

.5)

3 (2

.6)

0 (0

.0)

Beha

viou

rs o

f sp

ecia

lists

Good

245

(86.

3)10

6 (7

8.5)

66 (

57.9

)41

(87

.2)

Aver

age

13 (

4.6)

10 (

7.4)

12 (

10.5

)3

(6.4

)

Poor

3 (1

.1)

0 (0

.0)

0 (0

.0)

0 (0

.0)

Can

not

say

23 (

8.1)

19 (

14.1

)36

(31

.6)

3 (6

.4)

Beha

viou

r of

nur

ses

Good

179

(63.

0)84

(62

.2)

78 (

68.4

)33

(70

.2)

Aver

age

41 (

14.4

)21

(15

.6)

16 (

14.0

)4

(8.5

)

Poor

3 (1

.1)

2 (1

.5)

1 (0

.9)

0 (0

.0)

Can

not

say

61 (

21.5

)28

(20

.7)

19 (

16.7

)10

(21

.3)


Tab

le 2

0. W

ait

ing

Tim

e f

or

Reg

istr

ati

on

, C

on

su

ltati

on

wit

h D

octo

rs a

nd

Sp

ecia

list,

In

vesti

gati

on

s a

nd

Receiv

ing

Med

icin

es

Type

of

Hos

pita

lTO

TAL

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Regi

stra

tion

tim

e

Up

to 1

5 m

inut

es23

583

.6%

123

91.1

%10

995

.6%

4595

.7%

512

88.7

%

16 -

30

min

utes

3512

.5%

10 7.4%

54.

4%2

4.3%

52 9.0%

Abov

e 30

min

utes

11 3.9%

21.

5%13 2.3%

Tota

lCo

unt

Col %

281

100.

0%13

510

0.0%

114

100.

0%47

100.

0%57

710

0.0%

Spec

ialis

t co

nsul

ting

ti

me

Up

to 1

5 m

inut

es89

55.6

%63

79.7

%36

72.0

%13

46.4

%20

163

.4%

16 -

30

min

utes

3823

.8%

1316

.5%

1326

.0%

828

.6%

7222

.7%

Abov

e 30

min

utes

3320

.6%

33.

8%1

2.0%

725

.0%

4413

.9%

Tota

lCo

unt

Col %

160

100.

0%79

100.

0%50

100.

0%28

100.

0%31

710

0.0%

Inve

stig

atio

n ti

me

Up

to 3

0 m

inut

es17

380

.5%

7291

.1%

7386

.9%

2978

.4%

347

83.6

%

31 -

60

min

utes

2411

.2%

45.

1%7

8.3%

616

.2%

41 9.9%

Abov

e 60

min

utes

18 8.4%

33.

8%4

4.8%

25.

4%27 6.5%

Tota

lCo

unt

Col %

215

100.

0%79

100.

0%84

100.

0%37

100.

0%41

510

0.0%

Tim

e ge

ttin

g m

edic

ine

Up

to 1

0 m

inut

es13

474

.0%

8581

.0%

9490

.4%

3286

.5%

345

80.8

%

11 -

20

min

utes

3921

.5%

1413

.3%

65.

8%5

13.5

%64

15.0

%

Abov

e 20

min

utes

84.

4%6

5.7%

43.

8%18 4.2%

Tota

lCo

unt

Col %

181

100.

0%10

510

0.0%

104

100.

0%37

100.

0%42

710

0.0%


Tab

le 2

1. P

ati

en

t’s E

xp

eri

en

ce (

Rati

ng

) at

OP

D o

f V

ari

ou

s H

ealt

h C

are

Sett

ing

s

N=58

0

Type

of

Hos

pita

lTo

tal

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

Good

203

(71.

5)98

(72

.6)

65 (

57.0

)40

(85

.1)

406

(70.

0)

Aver

age

75 (

26.4

)32

(23

.7)

45 (

39.5

)7

(14.

9)15

9 (2

7.4)

Poor

3 (1

.1)

4 (3

.0)

1 (0

.9)

0 (0

.0)

8 (1

.4)

Can’

t sa

y3

(1.1

)1

(0.7

)3

(2.6

)0

(0.0

)7

(1.2

)


Tab

le 2

2.

Su

gg

esti

on

s f

or

Fu

rth

er

Imp

rovem

en

t in

th

e S

erv

ices

Type

of

Hos

pita

lTO

TAL

Dist

rict

Hos

pita

lSu

b-Di

visi

onal

Hos

pita

lCH

CSp

ecia

l Hos

pita

l

No s

ugge

stio

n82

(29.

0)33

(24.

6)30

(26.

8)18

(38.

3)16

3(2

8.3)

Pro

vide

all

med

icin

e at

leas

t to

poo

r pe

ople

151

(53.

4)58

(43.

3)56

(50.

0)26

55.3

%29

150

.5%

Prop

er s

uper

visi

on o

f hi

gher

offi

cial

s2

(0.7

)0 .0%

1 .9%

0 .0%

3 .5%

Pro

per

care

/ em

erge

ncy

care

sho

uld

be

prov

ided

7(2

.5)

75.

2%6

5.4%

12.

1%21 3.6%

Pro

vide

mor

e do

ctor

s or

spe

cial

ists

10 (3.5

)14

10.4

%13

11.6

%0 .0%

37 6.4%

Cle

anlin

ess

20 (7.1

)7

5.2%

0 .0%

12.

1%28 4.9%

Pro

visi

on o

f fe

mal

e do

ctor

s0

(0.0

)2

1.5%

0 .0%

0 .0%

2 .3%

Pu

nctu

alit

y of

sta

ff s

houl

d be

mai

ntai

ned

0(0

.0)

21.

5%1 .9%

0 .0%

3 .5%

Goo

d be

havi

our

of s

taff

1(0

.4)

21.

5%0 .0%

12.

1%4 .7%

Pro

vide

mor

e st

aff

1 .4%

1 .7%

0 .0%

0 .0%

2 .3%

Pro

visi

on f

or f

emal

e pr

ivac

y2 .7%

0 .0%

0 .0%

0 .0%

2 .3%

Sat

isfi e

d w

ith

pres

ent

cond

itio

n4

1.4%

86.

0%1 .9%

0 .0%

13 2.3%

Sho

uld

get

cost

ly m

edic

ines

1 .4%

0 .0%

32.

7%0 .0%

4 .7%

Pro

visi

on o

f fo

od2

(0.7

)0 .0%

1 .9%

0 .0%

3 .5%


Typ

e o

f H

ealt

h In

sti

tute

= D

istr

ict

Ho

sp

ital

Regi

stra

tion

tim

eDo

ctor

s co

nsul

ting

ti

me

Spec

ialis

ts c

onsu

ltin

g ti

me

Inve

stig

atio

ns t

ime

Tim

e in

get

ting

m

edic

ines

Mon

ey s

pent

to

buy

med

icin

e

Mea

n12

.19

30.4

822

.24

29.9

19.

5244

9.77

Med

ian

10.0

025

.00

12.5

020

.00

10.0

020

0.00

Mod

e10

300

3010

150

Std.

Dev

iati

on13

.005

27.4

8123

.133

32.9

197.

375

1378

.487

Rang

e10

420

912

030

750

1300

0

Min

imum

11

00

00

Max

imum

105

210

120

307

5013

000

Typ

e o

f H

ealt

h In

sti

tute

= S

ub

-Div

isio

nal H

osp

ital

Stat

isti

csRe

gist

rati

on t

ime

Doct

ors

cons

ulti

ng

tim

eSp

ecia

lists

con

sult

ing

tim

eIn

vest

igat

ions

tim

eTi

me

in g

etti

ng

med

icin

esM

oney

spe

nt t

o bu

y m

edic

ine

Mea

n8.

0917

.21

11.9

921

.67

9.50

245.

56

Med

ian

5.00

10.0

010

.00

15.0

010

.00

200.

00

Mod

e5

510

3010

200

Std.

Dev

iati

on7.

581

19.8

7515

.931

27.2

088.

266

226.

589

Rang

e44

120

120

180

6012

60

Min

imum

10

00

020

Max

imum

4512

012

018

060

1280


Typ

e o

f H

ealt

h In

sti

tute

= C

HC

Stat

isti

csRe

gist

rati

on t

ime

Doct

ors

cons

ulti

ng

tim

eSp

ecia

lists

con

sult

ing

tim

eIn

vest

igat

ions

tim

eTi

me

in g

etti

ng

med

icin

esM

oney

spe

nt t

o bu

y m

edic

ine

Mea

n6.

6818

.37

11.4

019

.71

7.47

216.

67

Med

ian

5.00

10.0

010

.00

10.0

05.

0015

0.00

Mod

e5

100

55

200

Std.

Dev

iati

on5.

112

18.0

1713

.288

27.3

015.

951

220.

623

Rang

e29

119

6015

030

999

Min

imum

11

00

01

Max

imum

3012

060

150

3010

00

Typ

e o

f H

ealt

h In

sti

tute

= S

pecia

l H

osp

ital

Stat

isti

csRe

gist

rati

on t

ime

Doct

ors

cons

ulti

ng

tim

eSp

ecia

lists

con

sult

ing

tim

eIn

vest

igat

ions

tim

eTi

me

in g

etti

ng

med

icin

esM

oney

spe

nt t

o bu

y m

edic

ine

Mea

n7.

2618

.87

26.2

526

.14

8.59

195.

93

Med

ian

5.00

12.5

020

.00

20.0

010

.00

100.

00

Mod

e5

515

3010

100

Std.

Dev

iati

on4.

623

17.6

4218

.540

19.4

054.

524

186.

691

Rang

e19

5755

7819

988

Min

imum

13

52

112

Max

imum

2060

6080

2010

00


Tab

le 2

3. R

esp

on

ses o

f th

e D

ep

uty

Co

mm

issio

ners

Faci

lity/

Nam

e of

the

Di

stri

ctAm

rits

arBa

thin

daFe

rozp

urGu

rdas

pur

Jala

ndha

rLu

dhia

naM

ukts

arSa

ngru

rTa

ran

Ta

Leng

th o

f se

rvic

e5

mon

ths

8 m

onth

s1

yrs.

2 m

onth

s<

2 yr

s.<

2 yr

s.1

yrs.

1 yr

.5

mon

ths

Over

all f

unct

ioni

ng o

f CH

C, S

DH a

nd D

HO.

KAv

erag

eNo

t w

ell

Good

Can’

t sa

yGo

odOK

Lack

of

doct

ors

Good

Avai

labi

lity

of s

taff

-Sh

orta

ge o

f st

aff

Shor

tage

of

staf

fSh

orta

ge o

f st

aff

--

Shor

tage

of

staf

fLa

ck o

f do

ctor

sSh

orta

ge o

f st

aff

Exte

nt o

f fu

lfi lm

ent

of h

ealt

h ne

eds

of

com

mun

ity

50%

Part

ially

70 -

80%

Good

Can’

t sa

yLa

rge

Not

Good

Larg

e Ex

tent

40%

Refe

rral

ser

vice

s No

Ide

aNo

n-av

aila

bilit

y is

a p

robl

emAm

bula

nce

not

fully

equ

ippe

dNo

t Go

odCa

n’t

say

Yes

Not

Good

Sati

sfac

tory

Sati

sfac

tory

Know

ledg

e of

RKS

BPL

Card

sYe

sYe

sYe

s-

-Ye

sNo

Yes

Fund

fl o

wNo

pro

blem

Not

thro

ugh

DC-

Not

full

utili

sed

Inad

equa

te-

-No

pro

blem

Not

thro

ugh

D.C.

Poor

pat

ient

s ex

empt

fr

om U

ser

Char

ges

BPL

Card

ho

lder

sRe

d Cr

oss

Yes

Yes

part

ially

-BP

L Ca

rds

Yes

part

ially

Red

Cros

sYe

s

Mot

ivat

ion

Leve

l-

Very

low

Good

Good

--

Good

Not

low

Low

Perc

eive

d Ba

rrie

rs

Avai

labi

lity

Nil

Nil

Nil

Nil

Yes

-Ye

sNi

l↓

CHC

Acce

ssib

ility

Nil

Nil

Nil

Nil

Yes

-Ye

sN

il↓

CHC

Utili

sati

onNi

lNi

lNi

lNi

lYe

s-

No↓

↓ CH

C

Acce

ptab

ility

Nil

Nil

Nil

Nil

Yes

-No

↓↓

CHC


Tab

le 2

4. R

esp

on

ses o

f th

e M

LA

/ele

cte

d R

ep

resen

tati

ve a

t D

istr

ict

Level

Amri

tsar

Bath

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

Sang

rur

Tara

n Ta

Leng

th o

f se

rvic

e>

2 yr

s.-

>2 y

rs.

1.5

yrs.

1 yr

.1.

5 yr

s.>2

yr

s.>

2 yr

s.>

2 yr

s.>

2 yr

s.

Over

all f

unct

ioni

ng

Good

Aver

age

Sati

sfac

tory

OKAv

erag

eGo

odGo

odW

ell

Poor

in C

HC

Not

very

goo

d

Avai

labi

lity

of s

taff

Yes

Doct

ors

post

va

cant

Shor

tage

of

D&N

Shor

tage

Som

etim

esSc

arci

tyYe

s, B

ut

shor

tage

of

Doct

ors

Less

in n

o.No

doc

tors

Yes

Avai

labi

lity

of M

edic

ines

in

OPD

NoNo

Yes

Less

NoSo

me

Yes

Not

enou

ghNo

t en

ough

NoSo

me

Over

all s

ervi

ces

of

Hos

pita

lO.

K.Av

erag

eSa

tisf

acto

ryAv

erag

e-

Good

Aver

age

Gyna

e-Ba

dSa

tisf

acto

ryAv

erag

e

Exte

nt o

f fu

lfi lm

ent

of h

ealt

h ne

eds

of

Com

mun

ity

80%

30%

Good

no.

60%

Only

poo

r us

e it

< 50

%To

som

e ex

tent

60%

60-7

0%40

%

Wai

ting

Tim

e2

- 5

min

s.No

t m

uch

20-3

0 m

ins.

2-3

hrs.

Not

muc

h2-

3 hr

s.30

-60

min

s.No

t m

uch

Not

muc

hNo

t m

uch

Clea

nlin

ess

Good

Not

prop

erGo

odGo

odO.

K.Go

odGo

odNo

t go

odSa

tisf

acto

ryGo

od

Beha

viou

r of

sta

ff

Good

Not

sati

sfac

tory

Good

Good

Fine

Rude

Nur

ses

& C

lass

IV

Good

OKVe

ry G

ood

Good

Refe

rral

ser

vice

s No

pro

blem

-Sa

tisf

acto

ryN.

A.No

t go

odSc

arci

ty o

f Am

bula

nce

Yes

Not

avai

labl

eVe

ry G

ood

No a

mbu

lanc

e

Know

ledg

e of

RKS

Yes

NoYe

sYe

sNo

Yes

BPL

Card

s Ye

s.No

NoNo

Poor

pat

ient

s ex

empt

ed

from

tre

atm

ent

char

ges

Yes

-Ye

sYe

sNo

NoNo

Red

Cros

s Fu

nds

From

NGO

s-

Perc

eive

d Ba

rrie

rs

Avai

labi

lity

Nil

Nil

Nil

Nil

Nil

Less

Med

icin

eNi

lAm

bula

nce

Serv

ice

Nil

Nil

Acce

ssib

ility

Nil

Nil

Nil

Refe

rral

Requ

ires

mon

eyNi

lNi

lNi

lNi

lNi

l

Utili

sati

onNi

lNi

lNi

lM

edic

ines

Med

icin

es n

ot

avai

labl

eSc

arci

ty o

f M

edic

ine

-Le

ss f

acili

ties

↓ CH

C↓

Acce

ptab

ility

Nil

Nil

Nil

Nil

Nil

Non

avai

labi

lity

of

equi

pmen

ts

-Ni

l↓

CHC

↓


Tab

le 2

5: R

esp

on

ses o

f th

e C

ivil S

urg

eo

ns

Amri

tsar

Bath

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

Sang

rur

Tara

n Ta

ran

Leng

th o

f se

rvic

e<1

yea

r2

year

s1.

5 ye

ars

-1.

5 ye

ars

1.5

year

s2.

5 m

onth

s2

mon

ths

-1.

5 ye

ars

Over

all f

unct

ioni

ng o

f CH

C, S

DH a

nd D

HOP

D -

O.K,

In

door

- Pr

oble

m

Over

uti

lised

Wel

lW

ell

CHC-

poor

DH

-Go

odEx

cept

CH

C re

st w

ell

Wel

lCH

C OP

D la

cks

man

pow

er

rest

O.K

.

Not

fully

Ut

ilise

dCH

C-Av

erag

e, S

DH-

Good

, DH

-New

, co

min

g up

Bed

Occu

panc

y (%

)

CHC

5050

-10

- 1

5%-

6050

2050

40

SDH

5070

-10

0%50

.870

.890

9080

.990

D.H

.50

100

-10

0%50

.870

8710

080

.990

Exte

nt o

f fu

lfi lm

ent

of h

ealt

h ne

eds

of

Com

mun

ity

Full

60%

50 -

60%

Sati

sfac

tory

Larg

e ex

tent

Not

fulfi

lled

at V

illag

e le

vel

90%

70%

60 -

70%

Larg

e ex

tent

Med

icin

e in

OPD

Ye

sNo

NoNo

Yes

NoNo

NoNo

No

Wai

ting

Tim

eNi

lLe

ssLo

ngLe

ssLo

ngLo

ngLe

ssLo

ngLo

ngLe

ss

Clea

nlin

ess

Not

prop

erNo

t go

odGo

odVe

ry G

ood

Good

Not

good

Good

O.K.

Not

clea

nAv

erag

e

Beha

viou

r of

sta

ff

Over

wor

k le

ads

to

irri

tati

on

Good

Good

Doct

ors

- Go

odNu

rses

-O.K

Good

Sati

sfac

tory

Cord

ial

Good

Aver

age

Need

s im

prov

emen

t

Refe

rral

ser

vice

s No

dri

ver,

only

1

ambu

lanc

e

Sati

sfac

tory

Not

good

No p

robl

emGo

odAm

bula

nce

shor

tage

-Le

ss n

o. o

f am

bula

nce

Ambu

lanc

e w

ith

paym

ent

Sati

sfac

tory

Fund

fl ow

No p

robl

emOn

ly u

ser

char

ges

User

cha

rges

No p

robl

emNo

fun

dsNo

pro

blem

-Sl

ight

del

ayNo

pro

blem

Only

und

er N

RHM

Man

pow

er M

anag

emen

t

Mot

ivat

ion

leve

lLo

wGo

odSa

tisf

acto

ryV.

Good

O.K.

Low

Good

Good

Low

Low

Perc

eive

d Ba

rrie

rs

Avai

labi

lity

Nil

CHC

±Ni

lNi

l-

Nil

Nil

Lack

of

Man

pow

er in

SD

H &

CH

C

O.K.

O.K.

Acce

ssib

ility

Nil

Nil

Nil

Nil

-Ni

lNi

lYe

sNi

l↓

CHC

Uti

lisat

ion

Nil

↓ CH

CNi

lNi

l-

Nil

Med

icin

e fa

cilit

yNo

O.K.

↓ CH

C

Acce

ptab

ility

Nil

↓ CH

CNi

lNi

l-

Nil

Nil

No↓

CHC

↓ CH

C


Tab

le 2

6. R

esp

on

ses o

f T

he S

MO

s In

ch

arg

e o

f D

istr

ict

Ho

sp

itals

Amri

tsar

Bath

inda

Fero

zpur

Gurd

aspu

rH

oshi

arpu

rJa

land

har

Ludh

iana

Muk

tsar

Sang

rur

Tara

n Ta

ran

Leng

th o

f se

rvic

e<

2 yr

s.>

2 yr

s.<

2 yr

s.15

day

s>

2 yr

s.4

yrs.

< 2

yrs.

3 yr

s.3

year

s5

mon

ths

OPD

Serv

ices

- St

aff

stre

ngth

Adeq

uate

Shor

tage

of

para

med

ics,

st

aff

Nurs

es

Less

Sp

ecia

lists

Adeq

uate

Suffi

cien

t Do

ctor

s. L

ess

clas

s IV

Shor

tage

of

nur

ses

&

Jr.d

octo

rs

No s

ecur

ity

guar

dsSp

ecia

lists

la

ckin

g

Radi

olog

ist

– ab

sent

. EM

O,

Psyc

hiat

rist

vac

ant

Shor

tage

of

staf

f

Bed

Occu

panc

y R

ate

(%)

80%

100%

98-1

00%

100%

75-7

6%70

%75

%60

-70%

74%

60-7

0%

Med

icin

es t

o po

or in

OPD

Yes

BPL

Yes

Yes

Yes

Yes

Som

e-

Very

few

Mos

tly

all

Not

all

Exis

tenc

e of

RKS

Yes

Yes

(Rec

entl

y)Ye

sNo

Yes

Yes

Yes

Yes

(Rec

entl

y)Ye

sYe

s

Info

rmat

ion

rega

rdin

g NH

PAv

aila

ble

Avai

labl

eYe

sYe

sYe

sYe

sYe

sYe

sNo

t un

der

PHSC

Yes

Exte

nt o

f fu

lfi lm

ent

of

heal

th n

eeds

of

Com

mun

ity

By p

oor

and

mid

dle

clas

sFu

ll10

0%10

0%-

Full

By p

oor

pati

ents

m

ostl

y

Mor

e fo

r OP

D80

%Ov

er u

sed

IPD

Serv

ices

Nur

se/B

ed

rati

o1:

2Nu

rses

Les

s (1

:40)

1:4.

51:

20-

--

1:5

1:5

1:6

Staf

f St

reng

th D

octo

rs/B

ed

rati

o1:

21:

71:

61:

25-

--

-1:

51:

5

Clea

nlin

ess

Sati

sfac

tory

Not

good

O.K.

OKOu

tsou

rced

-On

con

trac

tOn

con

trac

tDi

ffi cu

lt t

o m

aint

ain

On c

ontr

act

Emer

genc

y Se

rvic

e Av

aila

ble

roun

d th

e cl

ock

Yes

Yes

Yes

Yes

Yes

Yes

Yes

On c

all

Yes

Yes

Fund

fl ow

No p

robl

emSh

orta

geNo

pro

blem

No p

robl

emNo

fun

ds o

nly

User

Cha

rges

No m

oney

gi

ven

No p

robl

emSa

ncti

ons

from

CS/

DMC

No r

ole

of S

MO

No f

und

Perf

orm

ance

app

rais

al

syst

emYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s

Perc

eive

d Ba

rrie

rs

Avai

labi

lity

Nil

No p

robl

emNi

lNi

lSh

orta

ge o

f st

aff

Nil

Lack

of

info

rmat

ion

Not

Good

Lack

of

Staf

fNi

l

Acce

ssib

ility

Nil

No p

robl

emNi

lNi

lSh

orta

ge o

f M

edic

ines

Nil

Lack

of

info

rmat

ion

Not

Good

Nil

Nil

Utili

sati

onNi

lNo

pro

blem

Nil

Nil

Shor

tage

of

Faci

litie

sNi

lLa

ck o

f in

form

atio

nNi

lNi

lNi

l

Acce

ptab

ility

Yes

No p

robl

emNi

lNi

l-

Nil

Nil

Nil

Nil

Nil

Biom

edic

al W

aste

M

anag

emen

tYe

sYe

sYe

sYe

sYe

sYe

sYe

sOn

con

trac

tYe

sNo

Bag

s su

pplie

d


Tab

le 2

7. R

esp

on

ses o

f T

he M

LA

/ele

cte

d R

ep

resen

tati

ve a

t S

ub

Div

isio

nal Lev

el

Faci

lity

Nam

e of

the

Dis

tric

t

Bhat

inda

(Tal

wad

di)

Fero

zpur

(Faz

ilzka

)Gu

rdas

pur

(Bat

ala)

Hos

hiar

pur

(Das

uya)

Jala

ndha

r(N

avod

ar)

Ludh

iana

(Jag

rrao

n)M

ukts

ar(M

alou

t)Sa

ngru

r(M

alar

kott

a)Ta

ran

Tara

n(P

atti

)

Leng

th o

f se

rvic

e>2

yrs

>2 y

rs<2

yrs

>2 y

rs>2

yrs

>2 y

rs>2

yrs

>2 y

rs<2

yrs

Func

tion

ing

of h

ealt

h se

rvic

es in

the

dis

tric

tSa

tisf

acto

rySa

tisf

acto

ryOK

Sati

sfac

tory

Good

Good

OKNo

t m

uch

impr

oved

Good

Avai

labi

lity

of s

taff

Doct

ors

not

avai

labl

eSh

orta

geSN

, Do

ctor

sYe

sYe

sYe

sSp

ecia

list

not

avai

labl

eDo

ctor

s no

t av

aila

ble

Yes

Avai

labi

lity

of M

edic

ines

in

OPD

Mos

tly

Not

avai

labl

eYe

sLe

ssVe

ry f

ewNo

t al

lNo

t al

l.On

ly 7

es

sent

ial o

nes

OKLe

ss

avai

labi

lity

No a

ntib

ioti

cs

Over

all s

ervi

ces

of H

ospi

tal

Not

Very

. Go

odSa

tisf

acto

ryOK

OPD,

Em

erge

ncy

&

lab

good

Good

Good

OKLe

ss

deve

lope

dSa

tisf

acto

ry

Exte

nt o

f fu

lfi lm

ent

of

heal

th n

eeds

of

Com

mun

ity

30%

- 4

0%-

Good

Full

To q

uite

an

exte

ntGo

odAv

erag

e20

%80

%

Wai

ting

Tim

eVa

riabl

e, d

epen

ding

up

on t

he a

vaila

bilit

y of

doc

tors

15 -

30 m

inut

es2-

3 hr

sDe

pend

s on

no

of p

atie

nts

Not

muc

h30

min

– 2h

rsNo

t be

tter

Quit

e so

me

tim

eVe

ry le

ss

Clea

nlin

ess

Sati

sfac

tory

Good

OKBa

dBa

dGo

odAv

erag

eNo

t cl

ean

Good

Beha

viou

r of

sta

ff

Frie

ndly

Good

OKOn

ly d

octo

rs

good

, re

st b

adO.

K.

Good

Not

good

Varia

ble

Very

goo

d

Refe

rral

ser

vice

s Go

odSa

tisf

acto

ryNA

Ambu

lanc

e on

pa

ymen

t-

Avai

labl

eGo

odAm

bula

nce

on

Paym

ent

No t

rans

port

Know

ledg

e of

RKS

Yes

Yes

NoNo

NoYe

sYe

sNo

No id

ea

Poor

pat

ient

s ex

empt

ed

from

tre

atm

ent

char

ges

Yes

Yes

Yes

No-

Yes

Yes

NoYe

s

Perc

eive

d Ba

rrie

rs

Avai

labi

lity

Nil

Nil

Nil

Med

icin

e &

eq

uipm

ents

Nil

Nil

Yes

Nil

Nil

Acce

ssib

ility

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Utili

sati

onLo

wNi

lNi

lNi

lUS

G m

achi

neNi

lNi

lNi

lNi

l

Acce

ptab

ility

Low

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil


Tab

le 2

8. R

esp

on

ses o

f th

e S

MO

In

ch

arg

es o

f S

ub

-div

isio

nal H

osp

itals

Amri

tsar

(Ajn

ala)

Bhat

inda

(Tal

wad

di)

Fero

zpur

(Faz

ilzka

)Gu

rdas

pur

(Bat

ala)

Hos

hiar

pur

(Das

uya)

Jala

ndha

r(N

avod

ar)

Ludh

iana

(Jag

rrao

n)M

ukts

ar(M

alou

t)Sa

ngru

r(M

alar

kott

a)Ta

ran

Tara

n(P

atti

)

Leng

th o

f se

rvic

e6

mon

ths

< 2

yrs.

3 m

onth

s<

2 yr

s.<

2 yr

s.7

mon

ths

> 2

yrs.

1 yr

.3

year

s<

2 yr

s.

OPD

staf

f st

reng

thGo

odPo

orAd

equa

tele

ssSh

orta

ge o

fCl

ass

IVSp

ecia

lists

sh

orta

geAd

equa

teLe

ssAd

equa

teGo

od

Bed

Occu

panc

y Ra

te (

%)

40-6

5%50

-60%

90%

100%

70%

100%

90-1

00%

50-5

5%70

%85

-90%

Med

icin

e to

poo

r in

OPD

Yes

Yes

Yes

Tedi

ous

Proc

edur

eYe

sM

ostl

ySo

me

Som

eSo

me

Yes

Exis

tenc

e of

RKS

Yes

Yes

Yes

Not

func

tion

ing

Not

func

tion

ing

Yes

Yes

Yes-

not

clea

rM

oney

was

re

ceiv

edYe

s

Info

rmat

ion

rega

rdin

g NH

PYe

s (e

xcep

t M

alar

ia)

Yes

(exc

ept

STD)

Yes

Yes

Yes

Yes-

all

Yes

Yes

Yes

exce

pt

for

STD

Yes

Exte

nt o

f fu

lfi lm

ent

of h

ealt

h ne

eds

of

com

mun

ity

75%

50%

100%

80%

-10

0%50

%OP

D-H

igh

IPD-

Low

Aver

age

75%

IPD

Serv

ices

(Nu

rse/

Bed

rati

o)1:

31:

41:

41:

3.5

-Su

ffi ci

ent

Nurs

es1:

121:

51:

5O.

K.

Doct

or/B

ed r

atio

1:3

1:10

1:10

1: 4

--

1:5

1;7

1:6

O.K.

Clea

nlin

ess

Good

Staf

f ab

sent

O.K.

Good

Shor

tage

of

staf

fO.

K.On

con

trac

tPo

orNo

pro

blem

O.K.

Emer

genc

y se

rvic

esYe

sYe

sYe

sOn

cal

lYe

sYe

sYe

sYe

sYe

sYe

s

Fund

fl ow

Only

Use

r ch

arge

sNo

pro

blem

Not

muc

h pr

oble

mO.

K.No

pro

blem

No f

unds

No p

robl

emNo

del

ayOn

ly U

ser-

char

ges

No f

und

Perf

orm

ance

app

rais

al

syst

emYe

s-AC

RYe

s-AC

R &

Be

nch

mar

ksNo

Benc

h m

arks

fo

r do

ctor

sPe

rson

al

perc

epti

onYe

s-w

eekl

y re

view

Yes

Doct

ors

Benc

h m

ark,

ACR

ACR

Yes-

ACR

Perc

eive

d Ba

rrie

rs

Avai

labi

lity

-Do

ctor

s no

t av

aila

ble

Nil

Nil

Doct

ors

Over

burd

ened

Nil

-Sp

ecia

list

abse

ntLa

ck o

f st

aff

& m

edic

ine

Nil

Acce

ssib

ility

-Ni

lNi

lNi

l-

Nil

-Ni

lNi

lNi

l

Utili

sati

on-

Nil

Nil

Nil

-Ni

lIn

fras

truc

ture

an

d st

aff

Beha

viou

r

Nil

Nil

Nil

Acce

ptab

ility

-Ni

lNi

lNi

l-

Nil

-Ni

lNi

lNi

l

Bio-

med

ical

was

te

man

agem

ent

Yes

Yes

Yes

Outs

ourc

edYe

s (s

hort

age

of b

ags)

Yes

Yes

Yes

Yes

– On

co

ntra

ctBa

gs n

ot

avai

labl

e


Tab

le 2

9. R

esp

on

ses o

f th

e E

lecte

d R

ep

resen

tati

ves o

f C

HC

Are

as

Nam

e of

the

Dis

tric

t (C

HC)

Amri

tsar

(Man

awal

a)Bh

atin

da(G

onia

na)

Fero

zpur

(Fir

ozsh

ah)

Gurd

aspu

r((

Fata

ihga

rh

Chur

ian)

Hos

hiar

pur

(Mah

ilpur

)Ja

land

har

(Kar

tarp

ur)

Ludh

iana

(Mac

hhiw

ara)

Muk

tsar

(Bad

al)

Sang

rur

(Lon

gwal

)Ta

ran

Tara

n(K

hem

Ka

ran)

Leng

th o

f se

rvic

e>5

yrs

.>2

yrs

.>2

yrs

.>2

yrs

.>

2 yr

s.>2

yrs

.>2

yrs

.>2

yrs

.>

2 yr

s.<

2 yr

s.

Over

all f

unct

ioni

ng o

f CH

C, S

DH a

nd D

HGo

odV.

Good

Not

good

Doct

ors

not

avai

labl

e (g

o fo

r pv

t.

prac

tice

)

Good

Bett

er n

owBe

tter

now

Quie

t sa

tisf

acto

ryGo

od

Avai

labi

lity

of S

taff

Yes

Yes

Yes

No

gyna

ecol

ogis

tBa

dYe

sYe

sO.

K.No

doc

tors

Yes

Avai

labi

lity

of M

edic

ine

in O

PDPa

rtly

Mos

tly

Yes

Yes

V.Fe

wYe

sNo

t al

lLe

ssYe

sNo

t al

l

Over

all s

ervi

ces

of t

he

Hos

pita

lNo

t go

odGo

odO.

K.O.

K.Av

erag

eGo

odAv

erag

eO.

K.O.

K.Sa

tisf

acto

ry

Exte

nt o

f fu

lfi lm

ent

of h

ealt

h ne

eds

of

Com

mun

ity

50%

50%

10%

O.K.

Only

MLC

ca

ses

(<10

%)

Suffi

cien

t ex

tent

Larg

e ex

tent

Larg

e ex

tent

10 -

20%

80%

Wai

ting

Tim

e5

min

utes

45 m

ins.

- 1

hr

s.Ni

lNo

t m

uch

Not

muc

hLo

ngLo

ng

som

etim

esNo

t m

uch

Not

muc

hNo

t m

uch

Clea

nlin

ess

Good

V.Go

odGo

odO.

K.Ve

ry B

adGo

odGo

odNe

eds

impr

ovem

ent

Sati

sfac

tory

Good

Refe

rral

ser

vice

s No

Yes

Lack

ing

Yes

No a

mbu

lanc

e-

Avai

labl

e bu

t no

t al

way

sNo

am

bula

nce

Good

No

Know

ledg

e of

RKS

-No

NoYe

sNo

Yes

Yes

Yes

NoNo

Beha

viou

r of

sta

ffGo

odV.

Good

Good

Good

Not

Good

Bad

Nurs

es

beha

viou

rGo

odNo

t Go

odVe

ry .

Good

Very

Goo

d

Poor

pat

ient

s ex

empt

ion

from

Use

r ch

arge

sNo

No-

NoNo

NoYe

sYe

sNo

-

Perc

eive

d Ba

rrie

rs

(Con

td..

.)


Nam

e of

the

Dis

tric

t (C

HC)

Amri

tsar

(Man

awal

a)Bh

atin

da(G

onia

na)

Fero

zpur

(Fir

ozsh

ah)

Gurd

aspu

r((

Fata

ihga

rh

Chur

ian)

Hos

hiar

pur

(Mah

ilpur

)Ja

land

har

(Kar

tarp

ur)

Ludh

iana

(Mac

hhiw

ara)

Muk

tsar

(Bad

al)

Sang

rur

(Lon

gwal

)Ta

ran

Tara

n(K

hem

Ka

ran)

Avai

labi

lity

Nil

Nil

No m

edic

ine

Nil

Doct

ors

not

avai

labl

eLe

ss M

edic

ine

Nil

Mor

e do

ctor

sNi

lVe

ry .

Far

Acce

ssib

ility

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Yes

Nil

Nil

Utili

sati

onNi

lNi

lLe

ss d

octo

rsNi

lLa

ck o

f m

edic

ines

Lack

of

Med

icin

eNi

lNi

l↓↓

Nil

Acce

ptab

ility

Nil

Nil

Rest

ricte

dNi

lLa

ck o

f Se

rvic

esNi

lQu

alit

y of

Fa

cilit

y to

be

impr

oved

Nil

↓↓Ni

l


Tab

le 3

0.

Resp

on

ses o

f th

e S

MO

In

ch

arg

es o

f C

HC

S

Nam

e of

the

Dis

tric

t (C

HC)

Amri

tsar

(Maz

itha

)Am

rits

ar(M

anaw

ala)

Bhat

inda

(Gon

iana

)Fe

rozp

ur(F

iroz

shah

)Gu

rdas

pur

((Fa

taih

garh

Ch

uria

n)

Hos

hiar

pur

(Mah

ilpur

)Ja

land

har

(Kar

tarp

ur)

Ludh

iana

(Mac

hhiw

ara)

Muk

tsar

(Bad

al)

Sang

rur

(Lon

gwal

)Ta

ran

Tara

n(K

hem

Ka

ran)

Leng

th o

f se

rvic

e<

2 yr

s.1

mon

th>

2 yr

s.7

mon

ths

2.5

yrs.

6 m

onth

s6

mon

ths

>2 y

ears

< 2

yrs.

6 m

onth

s16

mon

ths

OPD

Staf

f st

reng

thSh

orta

geSh

orta

ge o

f do

ctor

sSh

orta

geAd

equa

teO.

K.Le

ss n

o. o

f do

ctor

s &

Cl

ass

IV

Shor

tage

Adeq

uate

. On

ly M

.O p

ost

vaca

nt

Spec

ialis

ts

lack

ing

Exce

pt

med

icin

e al

l av

aila

ble

Shor

tage

Bed

Occu

panc

y Ra

te

(%)

5-10

Bed

s ar

e oc

cupi

ed10

-15%

100%

10%

50%

5 –

10%

-25

.04

15-

20%

10 –

15%

30-4

0%

Med

icin

es t

o po

or

in O

PDYe

sSo

me

Yes

Yes

Yes

Yes

Yes

Yes

-Ye

sYe

s (s

ome

to b

e pu

rcha

sed)

Exis

tenc

e of

RKS

Yes

Yes

Yes

Yes

Not

func

tion

ing

Not

yet

form

edYe

sYe

s-

Yes

Yes

Info

rmat

ion

rega

rdin

g NH

PYe

sOn

ly T

.B.

&

Mal

aria

Yes

Yes

-No

to

all

exce

pt T

.BYe

sYe

s al

l exc

ept

STD

-Ye

s ex

cept

ST

DNo

t al

l (i.e

. M

alar

ia,

STD)

Exte

nt o

f fu

lfi lm

ent

of h

ealt

h ne

eds

of

Com

mun

ity

90%

50%

70%

Unde

r ut

ilise

d-

OPD

60-8

0%IP

D=5-

10%

100%

Sati

sfac

tory

-Ve

ry L

ess

70.8

0%

IPD

Serv

ices

(Nu

rse/

Bed

rati

o)-

1:5

1;10

1:1.

2-

1:5

Staf

f sh

orta

ge1:

3-

1:7

1:10

Doct

or/B

ed r

atio

-1:

301:

71:

61:

21:

5St

aff

shor

tage

1:5

O.K.

1:15

1:4

Clea

nlin

ess

O.K.

Not

upto

th

e m

ark

Good

Good

O.K.

O.K

Good

Shor

tage

of

staf

fO.

K.M

anag

ed b

y ow

n st

aff

O.K.

Fund

fl ow

No p

robl

emM

anag

ed b

y C.

S.No

pro

blem

No p

robl

em-

No p

robl

emNo

Bud

get

rece

ived

No p

robl

em-

N.A

Thro

ugh

C.S

Perf

orm

ance

ap

prai

sal s

yste

mYe

sAC

RYe

sRe

cord

s &

m

eeti

ngs

Doct

ors-

Benc

h m

ark

Yes

– AC

RAp

prec

iati

on

lett

erAn

nual

C.R

Doct

ors-

Benc

h m

ark

Yes

– AC

RYe

s (A

CR)

(Con

td..

.)


Nam

e of

the

Dis

tric

t (C

HC)

Amri

tsar

(Maz

itha

)Am

rits

ar(M

anaw

ala)

Bhat

inda

(Gon

iana

)Fe

rozp

ur(F

iroz

shah

)Gu

rdas

pur

((Fa

taih

garh

Ch

uria

n)

Hos

hiar

pur

(Mah

ilpur

)Ja

land

har

(Kar

tarp

ur)

Ludh

iana

(Mac

hhiw

ara)

Muk

tsar

(Bad

al)

Sang

rur

(Lon

gwal

)Ta

ran

Tara

n(K

hem

Ka

ran)

Perc

eive

d Ba

rrie

rs

Avai

labi

lity

Nil

-St

aff/

Med

icin

e no

t av

aila

ble

Doct

or n

ot

avai

labl

e-

Nil

Staf

f sh

orta

geNi

l-

Staf

f no

t av

aila

ble

Less

sta

ff

Acce

ssib

ility

Nil

-No

pro

blem

sNi

l-

Nil

Nil

Nil

-Ni

lYe

s Bo

rder

ar

ea

Utili

sati

onNo

Sp

ecia

list

-Ni

lUn

der

utili

sed

-Ni

lLe

ss d

ue t

o la

ck o

f fu

nds

Need

s to

be

incr

ease

d-

Low

Shor

tage

of

Drug

s

Acce

ptab

ility

Nil

Non

avai

labi

lity

of s

taff

/

med

icin

es

Nil

Low

-Ni

lNi

lNi

l-

Less

no.

of

doct

ors

-

Bio-

med

ical

Was

te

Man

agem

ent

Yes

Yes

Yes

Yes

-2

colo

ured

ba

gs u

sed

Yes

Yes

Cont

ract

edYe

s –

on

cont

ract

Yes

A Study to Review

National Institute of Health and Family WelfareBaba Gang Nath Marg, Munirka, New Delhi - 110067

The Health Care Delivery System Provided by PHSC

PunjabPunjab Health Systems Corporation

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pun jab study final

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