HPNSDP
Supported by:
Management Information System (MIS)
Directorate General of Health Services (DGHS)
Ministry of Health & Family Welfare (MOHFW)
Mohakhali, Dhaka-1212

Monirampur Upazila Health Complex Health Bulletin 2012
Preface
I am very glad to publish this health bulletin of Monirampur upazila. This bulletin contains all the health related information of 2011. This bulletin is published to disseminate the information of this upazila to other line department and development partners of health. I hope all the information of this bulletin will help for planning and bridging the gaps in health services of this upazila. Government health offices have many data stored in the file. This health bulletin will help us to find constrains and also to see the results and achievements of 2011.The bulleting contains the status of MDG 4 and MDG 5 which will help to localize the MDG targets. This health bulletin has also the information on safe drinking water and sanitation status of the upazila. All the sanctioned and vacant posts are published in this bulletin. I like to draw attention of the higher authority to look into this issue. Finally I would like to congratulate the initiator of the health bulletin software for setting us one step ahead towards Digital Bangladesh.
Dr.Md.Abul Kalam Azad
UH&FPO
Monirampur Upazila Health Complex

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Organization at a glance
Name of the UpazilaMonirampur
Name of UHFPO Dr.Md.Abul Kalam Azad
Telephone No. 04227-78230
FAX No.
Mobile No. 01718071234
Email manirampur@uhfpo.dghs.gov.bd
GPS location of UHFPO office Long: 89.23536 And Lati:   23.00881
No. of Unions in the Upazila17
No. of Households in the Upazila 99778
No. of Population in the Upazila 428878
Area of Upazila in sq km 444.75

Description about above data
Monirampur is a nearby upazila of Jessore district. It is 25 km south from Jessore. It has 17 union with 232 villeges with 99778 households. All the unions are accessible through roads. The population is around 428878. Shyamkur union is the most populated and largest union of this upazila. The upazila health complex is located in the center of the upazila on the Jessore-Satkhira highway. The socio-economic condition is average in this upazila. Most of the houses are made of mud and houses around the center are made of bricks and concrete. The road condition is also average. Jhapa is the main ditch ( large lake like area; called ‘baor’ in bangla ) which is situated in Jhapa union, is famous for fishing . Most of the people in this upazila depend on agriculture, fishing and small enterprise business.

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Existing health facilities in the Upazila
Facility Type
Total
No. of Beds
Upazila Health Complex 1 50
No. of Union Sub-Centres 15 N/A
No. of Union Health and Family Welfare Centres 16 N/A
No. of Rural Dispensaries 2 N/A
No. of Community Clinics 43 N/A
No of Trauma Centres 0 0
No. of MCWC 0 0
No. of Chest Disease Clinic (TB clinic) 0 N/A

Description about above data
Monirampur upazila health complex is 50 bedded but not equipped for EOC services yet. We have 15 sub- centers and 2 RDs run by Medical Assistants. Out of 43 community clinics 36 are running and 7 are waiting for handover . CHCP and Health Assistants are providing services at community clinics. There are 2 private clinic providing services in Upazila-bazaar . We also have 16 functional UH&FWC which are run by FWVs.

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Child health and MDG-4 (January-December, 2011)

Neonatal Mortality Rate (January-December, 2011)
Neonatal Mortality Rate is 5.44 per 1,000 live births.

Description:
MDG 4 is to reduce the mortality rate among children under 5 by two-thirds.The indicators are under -5 mortality and infant mortality. Last year our upazila reported 6982 live birth from all level facility. Most of the people live in village and prefer home delivery due to different superstitions. Sometimes if a baby die in the home delivery, it is not reported to the hospital. At upazila health complex only 10 babies were reported as still birth. 38 neonatal deaths reported due to birth asphyxia and septicemia at upazila health complex. 62 under -5 deaths reported last year. The major causes of the U-5 death are drowning, RTA and pneumonia. We have 5 trained person at the upazila with an IMCI corner. We need to advise all community people to report to hospital for any health related problem.

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Maternal health and MDG-5 (January-December, 2011)

Maternal health and MDG-5 (January-December, 2011)
Maternal Mortality Rate is 100.26 per 100,000 live births.
 

Description:
MDG 5 is to improve maternal health. Though our upazila is not under EOC services but caesarian section is possible in this upazila health complex because of availability of Junior Consultants of Guynae and Anesthesia. In 2011 1564 caesarian section were done at UHC. According to MDG of Maternal Mortality Rate (MMR) target is 143 by 2015. In this upazila the MMR is 0.27 (statistically it is not the real picture, because we could not detect or calculate maternal death of home delivery) . We should increase the services at community clinics by Community Health Care Provider (CHCP) to increase the Antenatal and Post natal coverage (ANC & PNC) in the upazila to decrease the maternal death.

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No. of OPD & Emergency visits & Deaths at UHC
Health Facility
OPD
Emergency
Death
T M F Child T M F Child T M F Child
Upazila Health Complex 54755 18903 21683 14169 5261 2640 1782 839 37 19 18 0
Union Sub-Centre 0 0 0 0 0 0 0 0 0 0 0 0
Union Health and Family Welfare Centre 256633 85967 118820 51846 0 0 0 0 0 0 0 0
Rural Dispensary 12924 3630 7120 2174 0 0 0 0 0 0 0 0
Community Clinic 94752 30234 61396 3122 0 0 0 0 0 0 0 0
Trauma Centre 0 0 0 0 0 0 0 0 0 0 0 0
MCWC 0 0 0 0 0 0 0 0 0 0 0 0
Chest Disease Clinic (TB clinic) 0 0 0 0 0 0 0 0 0 0 0 0

Description:
We have treated around 419064 patients last year through UHC, UH&FWCs, sub-centers and community clinics. The upazila health complex consults around 5000 patient every month. The patient load is very high in this hospital and as the human resource is low, sometimes it is very difficult to manage all patients. The patient load will be decreased after completion of the training of the CHCP when the community clinics will be fully functional.

No. of Admissions & Deaths at UHC
Health Facility
Admission
Death
T M F Child T M F Child
Upazila Health Complex 4014 1608 2126 280 37 19 18 0
Trauma Centre 0 0 0 0 0 0 0 0
MCWC 0 0 0 0 0 0 0 0

Description:
37 deaths were reported by the upazila health complex last year. Out of that, 7 were mother .The causes of other death cases were senility and RTA. The upazila managed 5261 emergency cases and admitted around 4014 patients last year.

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Top 10 diseases according to the number of patients admitted in the UHC during the reporting period
Total number of admitted patients during the reporting period 5454
Serial No.
Disease name
No. of cases
%
1 Diarrhoea 566 10
2 Peptic Ulcer 528 10
3 Assault 522 10
4 Poisoning 310 6
5 Pneumonia 254 5
6 Road Traffic Accident 251 5
7 Viral Fever 217 4
8 CVA 189 3
9 Bronchial Asthma 116 2
10 Abortion 115 2

Description:
Diarrhea is very common disease in this upazila due to lack of knowledge and awareness simply about hand washing and personal hygene.The children are most vulnerable to this disease. Peptic ulcer disease is also common due to defective eating habit. The third most common case is ‘poisoning’ which indicates social and familial disharmony to some extend. Pneumonia is also a common disease during winter. We should increase the IMCI services in order to control this problem. Being situated on highway we got a good amount of RTA. Severely injured cases are referred to the district hospital, Jessore.

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Top 10 diseases according to the number of deaths among admitted patients in the UHC during the reporting period
Total number of Deaths during the reporting period 37
Serial No.
Disease name
No. of cases
%
1 CVD 9 24
2 VSD 5 14
3 MI 4 11
4 HTN 3 8
5 Asthma 2 5
6 Acute Abdomen 2 5
7 Physical Assault 2 5
8 COPD 2 5
9 Poisoning 1 3
10 PUO 1 3

Description:
The top two causes of death in this upazila were CVD and MI, as the facility does not have the necessary equipment to provide life support. Most of the time, patients came at late stage of complication. At that time we usually refer the case to secondary level for further management.

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Water & sanitation
Indicators
Upazila %
Coverage of households having access to safe drinking water (%) 71.00
Coverage of households having access to sanitary latrines (%) 100.00

Description:
The status of our safe drinking water and sanitation is good. So the incidence of diarrhea is not very high. Though we should be careful about this problem . We are hopeful that if the Public health engineering department provides necessary logistic in time, we can increase the coverage of households regarding safe drinking water and sanitary latrines .

 
Utilization of services at Upazila Health Complex
Indicators
Upazila
Average Length of Hospital Stay (No. of days per patient) 2.71
Bed Occupancy Rate (%) 128.18
Hospital Death Rate (%) 0.69

Description:
The average length of hospital stay is 3 days this year. Many patients were refused for hospital admission due to shortage of bed; specially the children. Some beds are already damaged and need repair immediately. The hospital death rate is low. Now-a-days the health seeking behavior is changing and the people are now coming to hospital. There are still some people who prefer traditional healers in this upazila.

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Surgeries & Interventions done in the Upazila Hospital
Type
No.
Major Surgeries 304
Minor Surgeries 61
Major Procedures other than surgery 0
Minor Procedures other than surgery 0

 
Description:
Among the major surgeries caesarian section is the top of the list. Next bulk of major surgeries are appendicectomy and herniotomy. Many cut injuries were repaired in emergency department. We have a good number of sterilizing and surgical kits for conducting the surgical procedures.

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Class wise Manpower
Class Sanctioned Filled-up Vacant Vacancy %
M F
Class I Doctor 26 13 4 9 34.62
Non Doctor 0 0 0 0 0.00
Class II 10 0 10 0 0.00
Class III 166 106 39 21 12.65
Class IV 21 16 4 1 4.76

 
Description:
Last year we had adequate doctors and nurse. Most importantly the adhoc doctors appointed by present government .Midwifery nurse were also available at the beginning of the year. With average adequacy of human resources we could provide a level of satisfactory services to the beneficiaries.

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Catagory wise Manpower
Manpower Community Clinic USC/UHFWC/RD UHC Others IMCI trained Basic EOC trained
Sanctioned Filled-up Sanctioned Filled-up Sanctioned Filled-up Sanctioned Filled-up
Physician 0 0 17 10 9 7 0 0 0 1
Nurse 0 0 0 0 10 10 0 0 0 0
Medical Assistant 0 0 17 15 2 1 0 0 0 0
Medical Technologist 0 0 0 0 8 7 0 0 0 0
CHCP 43 43 0 0 0 0 0 0 0 0
HI 0 0 0 0 4 4 0 0 0 0
AHI 0 0 0 0 13 9 0 0 0 0
HA 0 0 0 0 65 52 0 0 0 0
CSBA trained*** 0 0 0 0 9 9 0 0 0 0

Description:
The human resource chart show that 80 to 100% posts of different categories 9 (physician: 77% ) were filled up during 2011 in this upazila. So we could run the health complex and the sub-centers averagely well.In our Upazila no sanctioned CSBA post but we have 9 Female HA trained on CSBA. We are hopeful that our higher authority will provide manpower in the blank posts in this year so that we can run our UHC excellently.

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Existing equipments at UHC
Equipment Total (No.) Functional (No.) Non-functional
Repairable (No.) Non-repairable (No.)
Ambulance 2 1 1 0
X-ray machine 2 0 2 0
ECG machine 2 1 1 0
Colorimeter 2 1 1 0
Computer 1 1 0 0
Printer 1 1 0 0
FAX 0 0 0 0
Multimedia 0 0 0 0
Laptop 1 1 0 0

Description:
In this upazila here is no X-ray facility. We had to send the fracture cases to district for X-ray. The X-ray machine is repairable. We have communicated with proper authority but they are not responding. We have ECG machine; so we can diagnose and provide emergency management for cardiac pain and then can refer those cases in time. We have no multimedia projector. It is very difficult to organize meeting without multimedia projector.

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Important information and necessary issues for Monirampur Upazila Health Complex
Important information and necessary issues for Monirampur Upazila Health complex. Last year we tried to give our maximum efforts to improve the health status . Here I like to mention some important factors which will help us to achieve more good result in future. (1) The vacant post should be filled . (2) Our X-ray machine should be repaired immediately (3) Non structured community clinics and RDs should be made structured soon.( 4) All the repairable equipments should be repaired as soon as possible. Finally I am very happy to write this health bulletin of 2011 because this document will help us to compare our progress in upcoming years. This is very useful document and will help the public to understand health services and to provide us the useful advices to improv in future.