Enhancing Emergency Obstetric and Newborn Care through First Referral Units
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FIRST REFERRAL UNIT
Introduction
Historical background
•
CSSM Programme- setting up FRUs at the
community health centers/sub-district
level hospitals.
•
RCH Programme
-Supply of Emergency
Obstetric Drug Kit
-Provision for Private
Anesthetic Services
•
Drug and
C
osmetics Rule
Tenth Plan: Recommended Approach
•
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Cont…..
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Critical Determinants of a
FRU’s
•
24-hour delivery services including normal
and assisted deliveries
•
Emergency Obstetric Care including
surgical interventions like Caesarean
Sections
and other medical interventions
•
New-born Care
•
Emergency Care of sick children
•
Full range of family planning services
including Laproscopic Services
Cont….
•
Safe Abortion Services
•
Treatment of STI / RTI
•
Blood Storage Facility
•
Essential Laboratory Services
•
Referral (transport) Services
Points to be consider while
selecting the facility
Infrastructure needs
•
A minimum bed strength of 20-30 and
North- East and EAG States of 10-12
beds
initially.
•
A fully functional operation theatre
equipped for undertaking anesthetic and
•
emergency surgical procedures.
•
A fully operational Labour Room.
Cont………
•
An area earmarked and equipped for New-
born Care in the Labour Room and also in
the ward.
•
A functional laboratory with facilities for
all essential investigations.
•
Blood storage facility as per the guidelines
issued by Govt. of India (GoI).
•
24-hour water supply.
•
Arrangements for waste disposal.
Cont……
•
Regular electricity supply with back-up
arrangements to ensure uninterrupted
supply
•
Telephone connection.
•
Ambulance (owned or arranged through
local hiring).
Cont….
•
Selection of sites
Under the RCH Programme
funds were provided
to
CHCs and district
hospitals.
Equipment Kits Supplied Under
CSSM Programme
Human resources: Re-deployment
and multi-skilling
Policy options for human resource
management
•
Facilities to manage Obstetrical and
medical emergencies
.
•
strength of 4 medical officers (surgeon,
obstetrician, physician and pediatrician)
was recommended.
•
A
dequate number of Medical Personnels
including nursing staffs.
•
In-patient wards.
Cont….
Re-deployment & multi-skilling
•
Strengthening of
BPHCs and PHCs will be
done in a need based manner.
•
All the block PHCs shall have minimum 30
indoor beds with complete facilities for
institutional delivery and usual indoor
treatment care.
•
Well-functioning PHCs running with
indoor facilities will be identified and their
infrastructure strengthened.
Cont….
•
The existing manpower will be
strengthened by withdrawing and posting
of manpower from PHCs that are
providing only OPD services.
•
All the staff of PHCs, doing outdoor
services shall be with drawn and re-
deployed in BPHCs and PHCs running
Cont….
•
Provision of
support services like blood
storage, Laboratory services, pharmacy
services.
•
Assessment of available manpower and
other resources in FRUs.
•
T
raining programme (FOGSI)
•
Multi-skilling training of paramedical
workers
Functional/financial
autonomy
•
Hire locally available specialists and/or
paramedical workers from the private/
NGO sector in case of need
•
Make local arrangements for referral
transport
•
Generate resources locally and
•
Out-source non-clinical services.
Referral Transport
(
i
)
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Selection of FRU Unit
Current Information
•
1992-1997 - 105
FRUs in Tamil Nadu
•
2009 - 291
FRUs in Tamil Nadu
Summary
Evaluation
1.
………, …………,$ ………….. are the clinical
facilities should be needed in PHCs or
CHCs to declare as a FRU.
2.
Under CSSM Programme, ……… number
of kits were designed for surgical
procedure.
3.
Up to 2009, the total number of FRUs
operationalised in Tamil Nadu is ………
Assignment
Write an assignment on standing
orders followed in FRU in case of
obstetrical emergencies.
Conclusion
THANK YOU
Historical background and strategic approach to improve emergency obstetric and newborn care through the establishment of fully functional First Referral Units (FRUs) in districts, focusing on critical services, infrastructure needs, and essential facilities. The initiative aims to provide 24-hour delivery services, emergency obstetric care, newborn care, family planning services, and other essential medical interventions. It also emphasizes the importance of safe abortion services, STI/RTI treatment, blood storage, referral services, and infrastructure requirements for FRUs.
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Presentation Transcript
Introduction Historical background CSSM Programme- setting up FRUs at the community health centers/sub-district level hospitals. RCH Programme -Supply of Emergency Obstetric Drug Kit -Provision for Private Anesthetic Services Drug and Cosmetics Rule
Tenth Plan: Recommended Approach Identified establishment of fully functional and operational FRUs as the priority area for the provision of Emergency Obstetric and New-born Care. By the end of the Tenth Five Year Plan, each district should have at least 3-4 fully functional facilities which are equipped to provide Emergency Care on a round-the- clock basis.
Cont.. Mapping the existing health facilities, available manpower and other resources for each district
Critical Determinants of a FRU s 24-hour delivery services including normal and assisted deliveries Emergency Obstetric Care including surgical interventions like Caesarean Sections and other medical interventions New-born Care Emergency Care of sick children Full range of family planning services including Laproscopic Services
Cont. Safe Abortion Services Treatment of STI / RTI Blood Storage Facility Essential Laboratory Services Referral (transport) Services
Points to be consider while selecting the facility Infrastructure needs A minimum bed strength of 20-30 and North- East and EAG States of 10-12 beds initially. A fully functional operation theatre equipped for undertaking anesthetic and emergency surgical procedures. A fully operational Labour Room.
Cont An area earmarked and equipped for New- born Care in the Labour Room and also in the ward. A functional laboratory with facilities for all essential investigations. Blood storage facility as per the guidelines issued by Govt. of India (GoI). 24-hour water supply. Arrangements for waste disposal.
Cont Regular electricity supply with back-up arrangements to ensure uninterrupted supply Telephone connection. Ambulance (owned or arranged through local hiring).
Cont. Selection of sites Under the RCH Programme funds were provided to CHCs and district hospitals.
Equipment Kits Supplied Under CSSM Programme
Human resources: Re-deployment and multi-skilling Policy options for human resource management Facilities to manage Obstetrical and medical emergencies. strength of 4 medical officers (surgeon, obstetrician, physician and pediatrician) was recommended. Adequate number of Medical Personnels including nursing staffs. In-patient wards.
Cont. Re-deployment & multi-skilling Strengthening of BPHCs and PHCs will be done in a need based manner. All the block PHCs shall have minimum 30 indoor beds with complete facilities for institutional delivery and usual indoor treatment care. Well-functioning PHCs running with indoor facilities will be identified and their infrastructure strengthened.
Cont. The existing manpower will be strengthened by withdrawing and posting of manpower from PHCs that are providing only OPD services. All the staff of PHCs, doing outdoor services shall be with drawn and re- deployed in BPHCs and PHCs running
Cont. Provision of support services like blood storage, Laboratory services, pharmacy services. Assessment of available manpower and other resources in FRUs. Training programme (FOGSI) Multi-skilling training of paramedical workers
Functional/financial autonomy Hire locally available specialists and/or paramedical workers from the private/ NGO sector in case of need Make local arrangements for referral transport Generate resources locally and Out-source non-clinical services.
Referral Transport (i) Appropriate referral transport from the periphery to the functioning First Referral Units providing emergency services and (ii) Also from FRUs to district/tertiary level institutions.
Current Information 1992-1997 - 105 FRUs in Tamil Nadu 2009 - 291 FRUs in Tamil Nadu
Evaluation 1. , ,$ .. are the clinical facilities should be needed in PHCs or CHCs to declare as a FRU. 2. Under CSSM Programme, number of kits were designed for surgical procedure. 3. Up to 2009, the total number of FRUs operationalised in Tamil Nadu is
Assignment Write an assignment on standing Write an assignment on standing orders followed in FRU in case of orders followed in FRU in case of obstetrical emergencies. obstetrical emergencies.
