The national Health Facility Assessment (HFA) was conducted from October 2010 to May 2011 covering all Provinces and Regions of Pakistan as part of the implementation of the Monitoring and Evaluation (M&E) Framework of the National Maternal Newborn and Child Health Programme (NMNCHP).The HFA aims to describe the availability, level of functioning and quality of health services in the public health sector facilities.
2,018 health facilities assessed across the country. Secondary health care (SHC) hospitals including 108 District Headquarter (DHQ) and Agency Headquarter (AHQ) Hospitals, and 280 Tehsil Headquarter (THQ) and Civil hospitals were assessed for provision of 24/7 Comprehensive Emergency Obstetric and Newborn Care (EmONC) services; 638 Rural Health Centres (RHCs) were assessed for 24/7 Basic EmONC services and 992 sampled Basic Health Units (BHUs) were assessed for availability of 8/6 Preventive MNCH services. Further, status of DHQ, THQ and Civil Hospitals were also assessed for their readiness to deliver 24/7 Basic EmONC services.
Functional status of a health facility was based on overall availability of 5 specified required iinputs for support services proposed in the PC-1 of the National MNCH Programme
This assumption was based on availability of inputs and did not imply the provision of services by the surveyed health facility.
Health facility assessment
Health Facility AssessmentNATIONAL MATERNAL NEWBORN AND CHILD HEALTH PROGRAMME PAKISTAN
Health Facility AssessmentAims & Objectives Monitoring and Evaluation (M&E) Framework of the National Maternal Newborn and Child Health Programme (NMNCHP). To assess the availability, functioning, and quality of health care services in the public sector health facilities. To ascertain gaps in availability of infrastructure, human resource (HR), drugs and supplies; equipment; and level- specific support services; as well as management basics The information provided will be used to improve services
Health Facility AssessmentSpecific objectives : To assess the health facility status and quality of MNCH services (Comprehensive and Basic EmONC, Preventive MNCH and Family Planning) at district level; To assess clients’ satisfaction and perception of MNCH services; To provide information for systematic planning for procurement and supply of goods and commodities (listing the medical equipment and instruments which needs to be replaced or purchased); and To update and assess the contributions made by the development partners for improving MNCH and FP services in the selected districts
Health Facility Assessment: Progress 2,018 health facilities assessed across the country.Provision of 24/7 CEmONC services; 108 District Headquarter (DHQ) and Agency Headquarter (AHQ) Hospitals and 280 Tehsil Headquarter (THQ) and Civil hospitals 24/7 Basic EmONC services 638 Rural Health Centres (RHCs) DHQ, THQ and Civil Hospitals8/6 Preventive MNCH services 992 sampled Basic Health Units (BHUs)
Health Facility AssessmentMNCHP Analytical FrameworkSupport Service Inputs: infrastructure, human resource, equipment, Drugs & Supplies Level specific support services
Health Facility AssessmentAssessment Criterion for Support services : Meeting 100% - all required inputs are available in the HF, Meeting 75% - overall availability of more than 75% of required inputs, and minimum of 70% for each input criteria
SERVICE PACKAGES BHUs: Facility RHCs: Facility DHQ/THQ available for available for Hospitals: Facility available for8/6 Preventive 24/7 Basic EmONC 24/7 ComprehensiveMNCH Services Services EmONC services ∙Parenteral ∙Antenatal antibiotics checkup ∙Parenteral oxytocic ∙Surgery (C- drugs section)∙Lab (Anemia, ∙Blood transfusion ∙ParenteralMalaria, pregnancy anticonvulsants for ∙Newborn caretest, urine test for pregnancy induced (resuscitation &sugar & Protein) convulsions (due to incubator)∙Normal delivery hypertension) +∙Family planning ∙Manual removal of ∙Gynaecologicservices (at least 3 placenta al caremethods) ∙Removal of retained products ∙Comprehensive∙TT immunization family planning ∙Assisted vaginal∙EPI vaccination services including delivery (vacuum∙Growth monitoring extraction, forceps) sterilisation∙Nutrition counseling ∙Newborn resuscitation ∙ HR (skilled staff for∙HR (at least one LHV + conducting, C-section,or Doctor) ∙ Post abortion blood transfusion and care anaesthesia), ∙HR (skilled female and providers-WMO and LHVs), and ∙Preventive ∙Preventive MNCH MNCH and Basic EmONC
Re-EvaluationAssumption based on Provision of Services 1. Preventive MNCH services, available for 8 hours a day, 6 days a week – BHUs 2. Basic EmONC services (including 1. above), available for 24 hours a day, 7 days a week - RHCs, THQ, CH, DHQs 3. Comprehensive EmONC services (including 1. & 2. above), available for 24 hours a day, 7 days a week - DHQ, THQ and Civil Hospitals
Components of Services Package8/6 Preventive MNCH 24/7 Basic EmONC 24/7 ComprehensiveServices Services EmONC Services•Antenatal checkup •Parenteral antibiotics •Surgery (C-section)•Lab (Anemia, Malaria, •Parenteral oxytocic drugs •Blood transfusionpregnancy test, urine test for •Parenteral anticonvulsants •Newborn care (resuscitationsugar & Protein) •Manual removal of placenta & incubator)•Normal delivery •Removal of retained •+•Family planning services (at products •Gynaecological careleast 3 methods) •Assisted vaginal delivery •Comprehensive family•TT immunization (vacuum extraction, forceps) planning services including•EPI vaccination •Newborn resuscitation sterilisation•Growth monitoring •+ • HR (skilled staff for•Nutrition counseling • Post abortion care conducting, C-section, blood•HR (at least one LHV or •HR (skilled female transfusion and anaesthesia),Doctor) providers-WMO and LHVs), •and and •Preventive MNCH and Basic •Preventive MNCH EmONC •
Re-Evaluation: Progress Health Facility Tabulations ; Region, District , and Facility-Wise. Punjab HFA Report Edited and Restructured. Facility Wise Analysis