The Service Delivery Frame work

Dept of OBGYN- Swami Dayanad Hospital, Dilshad Garden
1. Antenatal Care
Level 3 Institutional (Comprehensive Level)

ANC session includes:-

• Registration (within 1^st trimester)
• Physical examination + weight + BP+ abdominal examination
• Identification and referral for danger signs
• Ensuring consumption of at least 100IFA tablets(for all pregnant women)/200 (for anaemic women)
• Blood crossing matching
• Essential lab investigations (HB%, Urine for Albumin/ sugar, Pregnancy test)
• TT immunisation (Two doses at interval of one month)
• Counselling on nutrition, birth preparedness, safe abortion and institutional delivery.
• Management of severe anaemia
• Management of complications in pregnancy referred from Levels 1 and 2

2. Intranatal Care :-

Level 3 Institutional (Comprehensive Level)

Normal delivery with use of patograph

• Active management of third stage of labour
• Infection prevention
• Episiotomy and suturing cervical tear
• Assisted vaginal deliveries like outlet forceps, vacuum
• Management of obstructed labour
• Surgical intervention like caesarean section
• Comprehensive management of all obstetric emergencies, e.g PIH/ Eclampsia, sepsis, PPH retained placenta, shock etc.
• Availability of above service round the clock
• In-house blood bank

3.Postnatal and Newborn care :-

Level 3 Institutional (Comprehensive Level)

FRU comprehensive obstetric and neonatal care

• Minimum 6 hrs stay post delivery
• Counselling for feeding , nutrition, family planning , hygiene immunisation and PN check up
• Clinical management of all maternal emergencies such as PPH, Puerperal sepsis, Eclampsia , Breast abscess, post surgical complication, shock and any other postnatal complication such as RH incompatibility etc.

4. Newborn care :-

• Warmth
• Hygiene and cord care
• Care of LBW newborn <2500gm
• Zero day immunisation OPV, BCG, Hepatitis B
• Management of complication
• Care of LBW newborn <1800gm
• Establish referral linkages with higher facilities

5. Safe Abortion service as per MTP act :-
Level 3 Institutional (Comprehensive Level)

Counselling and facilitation for safe abortion service

• Essential –MVA up to 8 weeks
• Desirable first trimester services (up to 8 weeks) as per MTP act and guidelines
• Post abortion contraceptive counselling
• Treatment of incomplete / inevitable/ spontaneous abortions
• Medical methods of abortion (up to 7 weeks of pregnancy)
• Second trimester MTP as per MTP act and guidelines
• Management of all post abortion complications

6. Management of RTI/STIs :-

• Counselling, prevention
• Identification and management of RTI/STIs

7. Family planning services as per the FP guidelines :-

• Emergency contraception pills
• Counselling, motivation for small family norm, distribution of condom, oral contraceptive pills, IUD insertion
• Follow up services for contraceptive acceptors, including post sterilisation acceptors
• Desirable- male sterilisation include non scalpel vasectomy tubectomy
• Female sterilisation (mini lap and laparoscopic tubectomy)
• Manage of all complications

8. Special clinics :-

• Monday- Infertility clinic 02:00 PM to 04:00 PM
• Wednesday – Post natal clinic 02:00 PM to 04:00 PM
• Thursday – Cancer screening 02:00 PM to 04:00 PM

9. Comprehensive diagnostic and surgical treatment of Gynaecological disorders :-

• Prolapse surgery
• Fibroid surgery
• Urogenital surgery
• Tubal recanalization surgery

10. Basic and level 2 laparoscopic surgeries.

11. Teaching and auditing in the department on monthly bases.

NDVH done on 15-12-2014 for anterior wall fibroid at the level of internal os.