Government of West Bengal
Department of Health & Family Welfare
State Family Welfare Bureau
Swasthya Bhawan, GN 29, Sector V,
Salt Lake, Kolkata 700091
Memo No. H/SFWB/11M-02-2014/2579 Dated: 11.03.2014
The MMR of the state has gone down to 117 in the year 2010-12. To accelerate this decline for achievement of MDG i.e. to bring the MMR below 110 by 2015, tracking of high risk pregnant women and their timely management is of immense importance.
2. At present, the ANMs are conducting antenatal checkup at Sub center as well as at the home of the pregnant women and entering the findings in MCP card & RCH Register of MCTS. The ANMs are also identifying the high risk pregnant women e.g. Elderly primigravida, Short statured primigravida, Elderly grandmultipara, Hypertensive including pre-Eclampsia & Eclampsia, Anaemic including severely anaemic, having history of previous C -section, having bad obstetric history, Malpresentation, IUGR, APH, Threatened abortion, Twins, Hydramnios, Gestational diabetic, Prolonged pregnancy etc. by using the tools and referring them to the Medical officers of primary tier facilities (PHC/ BPHC/ RH). The number of such high risk pregnant women varies from 10-15% of total pregnant women and this group needs undivided attention and comprehensive and skilled care.
3. But it is noted that as there is no fixed day, fixed time and dedicated services for the pregnant women is almost all of the primary tier facilities and during the rush of the routine OPD hours, pregnant womens do not get proper attention and care.
4. After considering the above facts, in partial modification of the order No. HF/O/GA/2905/W-226/2010, dated, Kolkata, the 22nd November, 2010, the undersigned is pleased to direct that:-
a) “Antenatal Clinic” will be organized at each PHC, BPHC & RH of the state twice weekly on Monday and Friday as a value-added service.
b) Antenatal Clinic will start from 2-00 pm and will remain open up to 4-00 pm in addition to the routine OPD services as before from 9-00 am onwards at the PHC, BPHC & RH on those days.
c) Antenatal care services will be provided in this clinic to the pregnant women, specially to high risk pregnant women by the Medical Officer of the facility and he/ she will be assisted by on duty staff Nurse. The Supervisor of the GP, at which the PHC/ BPHC/ RH is situated, will also assist the MO to conduct the clinic particularly in maintaining the register, reports etc. as mentioned bellow.
d) Other support OPD services like pharmacy, laboratory diagnostics, imaging diagnostics etc. will be extended from 9-00 a.m. to 4-00 p.m. on those days.
e) A separate register will be maintained for Antenatal Clinic by each PHC, BPHC & RH as per format A as enclosed herewith.
f) The PHC, BPHC & RH will submit a monthly report to the BMOH of the block as per format B as enclosed herewith. This report will be compiled by the concerned GP Supervisor.
g) The BMOH of the block will submit a monthly report in format C to the CMOH of respective district as enclosed herewith. The BPHN/ PHN will compile such report. One of the earmarked DEO of the block will assist the BPHN/ PHN to compile the same.
h) The CMOH of the district will submit a monthly report in format D to the SFWO as enclosed herewith. The DPHNO will compile such report and DSM will assist DPHNO to compile the same.
i) All pregnant women specially the high risk pregnant women detected by ANMs will be referred to this Antenatal clinic.
j) ASHA of the concerned village must accompany the high risk pregnant women while she attends the antenatal clinic.
k) The severely anaemic high risk pregnant women may be referred directly to the nearest facilities having provision of blood transfusion (Blood Bank or BSU). The concerned GP Supervisor must accompany such pregnant women while she attends the facility.
l) Identified high risk pregnant women must be followed up by the concerned ANM & ASHA till delivery during post natal period.
m) All data related to detection of high risk pregnant women and their management must be entered in and HMIS and MCTS as the case may be at each facility level including Sub center in the related available fields.
n) The time schedule of Antenatal Clinic should be given wide publicity along with display of board at each PHC, BPHC & RH.
5. This order will take immediate effect.
Enclosure: As stated
Sd/- Principal Secretary
to Govt. of West Bengal