Annual Performance Review FY 207172 DISTRICT Hospital OF

Annual Performance Review FY 2071/72 DISTRICT Hospital OF DARCHULA

Outline of Presentation Human resource Infrastructure Financial Situation Major Hospital Services Service Statistics Hospital's own new initiation Hospital Strength Major Challenges Recommendations

Human resource GOVERNMENT SN POSTS Sanctioned Fulfilled post (in number) CURRENTLY AVAILABLE Among government sanction (in number) Local and other resources (in number) Technical Staffs 14 11 11 2 1 Medical Doctor 2 1 1 1 2 Nursing staff 5 5 5 0 3 paramedics 7 5 5 1 Administrative (Non. Technical) 10 7 7 0 1 Adm. Na. su. 1 1 1 0 2 Shreni bihin ka. sa. 9 7 7 0 24 18 18 2 Total

Infrastructure Hospital owned land: 17 Ropani Building: › › Hospital Room: Inadequate Doctor quarter: Inadequate Staff quarter: Inadequate Other: Ambulance : Functioning Major Medical Equipments: › › x-Ray - Functioning Aultrasaund - Functioning Microscope -Functioning Teli- medicine= Not functioning

Hospital Bed No of Sanctioned Bed: 15 No of available bed: 25 › General: 17 › Emergency: 8 › Cabin: 0

Finical resource Budget Allocated Budget Released 17, 00, 000/- 16, 90, 000/- 0 0 0 Recurren 14087413/t Total 15787413/- 14087413/- 12959441/- 0 0 0 15787413/- 14649441/- 0 0 0 Budget Capital Budget Irregularities (BERUJU) % Expenditur Amount Clearance e s s Budget Expenditure by source Source Government Budget Allocated 15787413/- Budget Released 15787413/- Budget % Expenditure 14649441/- 93% EDPs 0 0 Total 15787413/- 14649441/- 93%

Financial resource Locally Managed Source Budget Allocated Budget Released Budget Expenditure % Expenditur e HDC Darchula 2329126. 60/- 2410144. 00/- 103% Total 2329126. 60/- 2410144. 00/- 103% EDP Support Name of EDP Types of Support (specify) Technical Logistics Financial ---------------- 0 0 0

Major Hospital Services Ø Preventative q Immunisation q Nutrition q Safe motherhood programme 1. iiiiiiiiiiiiimmunization 2. nutrition 3. counseling 4. Rabies vaccine 5. ANC/PNC service Ø Promotive q Councelling q Health education Nutrition q

Major Hospital Services Ø Curative q Lab services q Opd services q Emergency services q Delivery services q Miner surgery Ø Rehabilitative § No rehabilitative services

Hospital Services FY 2071/72 Outpatient Services Age Group New Clients Served Female Male Emergency Services Total Clients Served Female Total Male Female 0 - 9 Years 1151 1306 1224 1433 2657 10 - 19 Years 1087 1249 1224 1365 20 - 59 Years 3082 3329 3526 ≥ 60 Years Total Clients Served Total Male 644 558 2589 426 477 903 6855 810 864 1674 1202 207 194 209 240 270 510 104 103 5514 6093 6017 6594 12611 1984 2002 3986

Hospital Services FY 2071/72 Free Health Services and Social Security Programme Sr. Ultra Helpless Citizens Patients at Poor/ / Disabled > 60 Poor Destitute Years Outpatients 367 Gender FCHV Based Others Violence Total 52 7 265 9 0 0 700 Inpatients 354 0 0 119 0 0 0 473 Emergency 312 1 0 201 1 0 0 515 Referral In 0 0 0 Referred Out 246 0 0 35 0 0 0 281

Hospital Services S. No Indicators Trend ( - or + ) 2069/70 2070/71 2071/72 13480 15202 12611 _ 1 Total Number of OPD Cases 2 Total Number of Emergency Cases 6944 1089 3986 + 3 Total Number of Inpatients admission 1569 1244 1220 - 4 Total Number of Inpatients Discharged 1541 1241 1078 _ 5 Total Number of Preventative Services Provided 798 273 192 = 6 Total Number of Lab Services Provided 11197 5137 14820 + 7 Total Number of Hospital Services 23037 Provided 6960 16597 +

Hospital Services S. No Indicators 2069/70 Trend ( - or + ) 2070/71 2071/72 8. 1 No of Normal spontaneous 373 Delivery 289 508 + 8. 2 No of Forceps/Vacuum Delivery 19 21 12 - 8. 3 No of C/S Delivery 0 0 2 + 9 Number of major surgical cases performed 0 0 0 = 10 Number of hospital acquired infection cases among the major surgical cases 0 0 0 = 11 Referral Cases (In) Total 0 0 0 =

Hospital Services 2069/7 2071/7 Trend 2070/71 0 ( - or + ) 2 S. No Indicators 12 Referral Cases (Out) Total 73 27 155 + 13 Total Maternal Deaths 0 0 0 = 14 Total Neo-natal Deaths 2 0 2 + 15 Total Hospital Deaths 6 2 3 + 16 Number of Hospital 2 Development Committee Meetings Held 0 2 +

Safe abortion indicator

Hospital Indicators SN Indicators 2069/70 2070/71 2071/72 Trend ( - or+ ) 1 % of Emergency Visits Among Total hospital 3 Visits 21 24 + 2 Bed Occupancy Rate 92 66 67 + 3 Proportion of Non-communicable Disease among Inpatients 82 89 80 - 4 Number of CAC Services Provided 172 146 286 + 5 Death Rate among Surgery (%) 0 0 0 = 6 Death Rate among In-patients 0. 26 0. 07 0. 25 + 7 Total Surgery Cases 510 128 8 % of Major Surgery among Total Surgery Cases 0 0 0 = 9 Doctor: In-patient Ratio 430 348 406 + 10 Doctor: Out patient Ratio 4493 2601 4203 + 11 Nurse: In-patient Ratio 322 348 406 +

Added slide Medico legal cases performed in FY 2071/72 Cases No. Data Source* Autopsy 30 Based on HMIS Sexual Assault 3 Emergency report Age estimation 0 …… Physical Injury 24 Emergency report Drunkenness 56 Report from police Other(traffic accidennt) 60 based on HMIS Total

Lab Services Health Laboratory Services (Number) FY Haema Immu tology nolog y Bioche Bacteri mistry ology Virology Parasit ology Her Other mo Tests nes /En doc rino logy Total 2069/70 5159 1084 1657 1654 105 1654 0 1551 11210 2070/71 7458 3554 3199 2724 0 1250 18185 2071/72 7804 968 2483 1346 251 1968 0 0 14820

Diagnostic Services in the Hospital 2071/2072 SN Indicators Unit Number 1 X-ray no. 1649 2 Ultrasonogram (USG) no. 810 3 Echocardiogram(Echo) no. 0 4 Electro Encephalo Gram(EEG) no. 0 5 Electrocardiogram (ECG) no. 158 6 Trademail no. 0 7 Computed Tomographic(CT) Scan no. 0 8 Magnetic Resonance Imaging (MRI) no. 0 9 Endoscopy Person 0 10 Colonoscopy Person 0 11 Nuclear Medicine Person 0

Top 10 Morbidity and Mortality among Inpatients FY 2071/72 Morbidity FY 2070 / 71 Mortality FY 2071 / 72 Top Ten Diseases among inpatients Top Ten causes of Mortality among inpatients 1. ARI 1. COPD 2. Gastritis(APD) 2. TB 3. Typhoid 3. ARI 4. ABD Pain 4. typhoid 5. Bronchitis 5. Bronchial Asthama 6. Skin disease 6. Falls injury 7. UTI 7. pneumonia 8. Headache 8. PID 9. Falls injury 9. hypertension 10. pneumonia 10. other

Hospital Deaths FY 2071/72 Death Information Hospital Death Early Neonatal Late Neonatal Maternal (All) Post-operative Other Brought Dead Postmortem Done Female Male 0 0 0 2 0 0 0 0 15

Top 10 Emergency Surgical and Elective Number of Surgery Top 10 Emergency Surgical Interventions Top 10 Elective Surgeries Cases No. 1. c/s cases 3 1. ----- 2. ------- -- 2. --- 3. ----- 4. ------ --- 5. ------ 6. ----------- 7. ------ 8. ------ 9. ----- 10. 10 ------

Hospital Service a) Number of Free Surgical Treatment 87 a) Number of Free Indoor Medical Treatment 439 a) Total NRs. Exempted for Treatment 394500

Free Health Service Indicators 2069/70 2070/71 2071/72 1. New OPD visits by targeted groups as % of total OPD visits 34. 66 22. 66 21. 19 2. Inpatients by targeted groups as % of total inpatients 38. 55 33. 95 33. 53 3. Emergency visits by targeted groups as % of total Emergency case 89. 25 59. 26 64. 45 4. laboratory services to targeted groups as % of total Lab services 9. 55 5. 65 3. 89

Free Health Service Total Amount Exempted for Free Treatment Services (in Rs) Total Number of Patients receiving Free Services Male Female Total 2268 2391 4659 3494250

Income, Expenditure & Balance on Free Health Programme: FY 2071/72 Total Income (Amount in Rs. ) Expenditure Balance 4765000/- 4639000/- 126000/-

Impoverished citizen (Bipanna Nagarik) Treatment fund activities Diseases (Treated Numbers) Male Total Female Heart 5 6 11 Kidney 0 2 2 Cancer 5 7 12 Spinal Injury 0 0 0 Head Injury 0 0 0 Parkinsonism 0 0 0 Alzheimer's disease 0 0 0 Sickle cell anemia 0 0 0 10 15 25 Total

Activities carried out under Hospital strengthening Program FY 2071 -72 Activities Achieve-ment Budget Expend (Rs) Maitenance of Health Facility 99. 42% 1690000/- Strenthing of District Hospital 86. 05% 2237000/-

Requirement of Hospital equipment (for New and upgraded Hospital only) Equipment list - New Requirement Quantity Not commissioned equipments

GAP ANALYSIS Major Achievement CEONC services Performance Gaps Delay is started Causes/ Reasons Recommended Actions for improvements Due to incomplete infrastructure Defficulties Lack of training to facing while the health worker Trainning to the H. W. doing work. Lack of man Sanctioned post not Full filled all sectined post power. ful filled and inadequate sactioned post Create adequate post

GAP ANALYSIS Major Achievement Performance Gaps Causes/ Reasons Telemedecine is Not available man not in use power and inadequate instrument Recommended Actions for improvements provide Human resources and adequate instrument

STRENGTH/OPPORTUNITY 24 hour emergency services Regular OPD services Pathology and Radiology services 25 bed hospitals in operation (normally District Hospital has 15 bed) CCENC services available. CAC and PAC services Services provided despite limited infrastructure 24 hour Ambulance service Alternate electrical supply (generator)

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