COMMUNITY REPORT DATE 12-02-2020

ORIENTATION & INTRODUCTION: As a part of our clinical posting, we were supposed to spend 4 weeks in rural areas. In view of this,
in order to achieve this objective, we were posted in Community Health Centre, Tripuri for a period of 4 weeks.

On 4th Feb. we along with Mrs.sweety (tutor ACON) and Mrs Sweety(tutor ACON) arrived Community Health Centre Tripuri at 09.00 am.
We were introduced to Dr.Anjina (Medical Superintendent) who gave us orientation of the whole community centre& services provided by
it .

Dr. Amisha (gynecologist) also shed light on various Gynaecology & Obstetric services and schemes running in hospital.

AREA COVERED BY THE COMMUNITY CENTRE: As per info gained there, CHC Tripurifunctions like Sub-District hospital and
covers more than 1.5 lac people. Areas mainly covered by the CHC, Tripuri are:

Areas of Abdulpur, Alipur Sikhan. Indernagar, Khansan, Raypur, Khalaspur.

OVERVIEW OF HOSPITAL: It is situated in main market of Tripure,because of this transportation & other facilities are easily accessible to
the people and it also becomes easy for the people to come and go after availing health facilities in the hospital.

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STAFFING PATTERN:

 Medicos: It includes
 One Medical officer( Dr.Anjina)
 Two Surgeons (Dr.Sanjay Bansal& Dr.Amisha)
 One General Physician (Dr. Sachian)
 One Pediatrician only for Tuesday in Theatre
 Dr Harpreet Kaur (Consultant Gynae/Obstetrics)
 One Anesthesiologist
 One Dental Surgeon.
 Paramedicals: It includes
 Four Staff Nurses
 Four ANM workers
 Two Theatre Assisstant
 Two Theatre Technician
 One X-ray Technician
 Two Ward Boys
Hospital has also got Chowkidar, Safaiwalas & Volunteer Persons.

Services Provided by Hospital:

 General Services
 Medicine, Emergency & Surgical Services
 Surgical Services includes:
 Choleycystectomy, Removal of Hernia, Removal of Polyp (on Elective Basis)

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 Gynae & Obstetric Services:
 ANC, INC, Post natal Services
 Elective LSCS
 Normal deliveries
 Immunization to Mother & Baby
 Schemes/ Programmes in Hospital:
National Health Mission;
 Janani Sheshu Suraksha Karyakram (JSSK scheme)
 Jani Suraksha Yojna (JSY)
 Rashtriya Bal Swisthya Karyarkam (RBSK)
 Immunization
 Revised National TB Control Program (RNTCP)

SERVICES PROVIDED IN CHC TRIPURI

1. Antenatal Care

Antenatal Care, The care that a woman receives during pregnancy, helps to ensure healthy outcomes for women and newborns.
Antenatal care is a key entry point for a pregnant woman to receive a broad range of health promotion and preventive health services,
including nutritional support and prevention and treatment of anaemia; prevention, detection and treatment of malaria, tuberculosis and
sexually transmitted infections HIV/AIDS (particularly prevention of HIV transmission from mother to child); and tetanus toxoid
immunization. Antenatal care is an opportunity to promote the benefits of skilled attendance at birth and to encourage women to seek
postpartum care for themselves and their newborns. It is also an ideal time to counsel women about the benefits of child spacing. Finally,
antenatal care is an essential link in the household-to hospital care continuum. It is an intervention that can be provided at both the household
and peripheral facility levels and helps assure the link to higher levels of care when needed.

Aims of antenatal Care

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 To support and encourage a family’s healthy psychological adjustment to childbearing.
 To promote an awareness of the sociological aspects of childbearing and rearing and the influences that these may have on the family.
 To monitor the progress of pregnancy in order to ensure maternal health and normal fetal development.
 To recognize deviation from the normal and provide management or treatment as required.
 To ensure that the woman reaches the end of her pregnancy physically and emotionally prepared for her delivery.
 To help and support the mother in her choice of infant feeding; to promote breast feeding in a sensitive manner and give advice about
preparation for lactation when appropriate.
 To offer the family advice on parenthood either in a planned programme or on an individual basis.
 To build up a trusting relationship between the family and their caregivers which will encourage them to participate in and make informed
choices about the care they receive.

Underlying Principles of Provision of Care

There are several general principles that are integral to the provision of high quality focused antenatal care for pregnant women. Care
should be:

 Woman-friendly: The woman’s health and survival, basic human rights and comfort are given clear priority. The woman’s personal
desires and preferences are also respected.
 Inclusive of a woman’s partner or other family memberRespect for the household decision-making process, communication,
participation and partnership in seeking and making decisions about care help to ensure a fuller and safer reproductive health experience
for the woman, her newborn and her family.
 Culturally appropriate: Every culture has specific beliefs, rituals taboos and practices surrounding pregnancy and childbirth. Cultural
awareness, competency and openness are essential in a care relationship with a woman during this important time in her life.
 Individualized: By taking into consideration all of the information known about a woman current health, medical history, daily habits and
lifestyle, household situation, cultural beliefs and customs.

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During our clinical posting we carried out antenatal examination on many mothers:

S.No. Name MRD No. Findings

1. Chandkiran 15979 30 wks

2. Harwinder Kaur 16000 28 wks

3. Baljeet Kaur 15279 32 wks

4. Ritu 16006 20 wks

5. Manpreet Kaur 16007 16wks

Conclusion:

The antenatal examination is carried out to determine any deviation from normal and to determine the risk factors in mothers which can
effect in the mother as well as fetus.

The various risk factors were identified like poor weight gain, weight loss, BP above 155/90 mmHg and uterus large for dates. These cases
were referred to the consultant for further management.

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 2.INTRANATAL CARE (CONDUCTING A NORMAL VAGINAL DELIVERY)

Childbirth is a normal physiological process. The need for effective intranatal care is therefore indespensible even the delivery is goining to
be normal one. The emphases is on the cleanliness. It entails –clean hands and fingernails, a clean surface for delivery, clean cutting and care
of the cord and keeping birth canal clean by avoiding harmful practices. The aims of good intranatal care are-

 Through asepsis
 Delivery with minimum injury to the infant and mother.
 Readiness to deal with complications such as prolonged labor,antepartum haemorrhage, convulsions malpresentations,prolapsed of cord
etc
 Care of the baby at delivery-resustation care of the cord, care of eyes etc.

3.POST NATAL CARE

OBJECTIVES:

 To prevent complication of the postnatal period

 To provide care for the rapid restoration of the mother to optimum health
 To check adequacy of breast feeding
 To provide family planning service
 To provide basic health education to mother/family