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Survey Register updation improves as knowledge gap among ASHAs were addressed

Survey Register updation improves as knowledge gap among ASHAs were addressed

“Initially when the block coordinators reviewed my register there were errors. I used to get confused in filling the data. However, when we received the training, it gave us clarity over data collection and how we should maintain the survey registers timely. Moreover, the block coordinators guide us whenever needed and our queries are clarified in the weekly meetings.”

-Sulochana Devi (ASHA, Sarthua village, Udwant Nagar block)

SITUATIONAL INSIGHTS

As the teams dived deeper to diagnose the loopholes in the Routine Immunization system, it was assessed that the inaccuracy in survey registers is one of the major reasons behind low immunization coverage in the district. The first page of the survey register was not updated in most blocks that citied the total population of the village, number of newly identified pregnant women and number of newborn children. This revealed the existing knowledge gap among ASHAs that further created an ambiguous situation. Our team felt the need to capacitate them and provide handholding support at every step. Their weekly meetings were monitored and the data was cross-checked to ensure accuracy.

 

One hurdle in achieving full immunization coverage in Bhojpur was the timely update made in the survey registers. Since the number of dropouts and left outs as well as the due list was not accurate, it affected the immunization rates adversely. The knowledge gap that existed among ASHAs further created ambiguous situation for them. Therefore, there was need to guide ASHAs for maintaining updated due list and survey register.

To address the issue, PCI team took a deep dive from 7th Sept 2022. They first visited all the blocks of Bhojpur to identify the loopholes. When the survey registers of all the blocks were reviewed, several flaws were noted. The first page of the survey register was not updated for most of the blocks in which the total population of the village, total number of newly identified pregnant women and number of new-born children must be mentioned. Besides, in some of the completely updated registers as claimed by ASHAs, the date of investigation in the details under pregnant women section was missing and vaccination dates of children were not mentioned. Hence, it was concluded that the data was not collected through regular home visits.

After assessing these challenges, the PCI team brought this in the knowledge of District Immunization Officer (DIO) and devised a place to orient and hand-hold ASHAs on this issue. One-day training session on survey register validation for ASHAs was conducted in the presence of the block coordinators. As per the guidance received, the block coordinators selected one ASHA each from their respective blocks and accompanied them for house to house visit to show how they should update the survey register. Later based on the experiences from Udwant Nagar Blok, a due list updation drive was conducted in April’23 across the district and was cross checked by the ASHA Facilitators, BCM and PCI Block Coordinators in their respective blocks.

A house-to-house survey was conducted in every block by the PCI team along with the selected ASHA didi from 17 – 20 December 2022. A difference was noted in the data taken earlier as compared to the data collected after house visits. It was seen that the number of dropouts and left out children was not matching. There was a significant change in name of head of the family, the number of couples employed, number of pregnant women, how many children are boys and girls and number of children from 0 to 5 years. Moreover, in some blocks, a few more new houses were listed which was earlier not included in the register.

When the work of survey register validation began via visits to the ASHA’s house, during HSC meetings and in ASHA’s weekly meeting, a visible change was observed in their working pattern. The knowledge gap that existed among the ASHAs was resolved and now they updated the register on time with accurate information. They started attending the weekly meetings regularly where their registers are reviewed and data is being cross-checked.

Author: Swati Savarn (Consultant)

Editor: Ronnie Clive Francis (Manager Comms KM)

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