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 RHS (A)
 MSU
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Reproductive Health Service A Centres (RHS-A)

The Reproductive Health Services (RHS)-A centres are hospital based service delivery units.

 

                These RHS A centres provide full range of Reproductive Health services comprising of :-

 

i)                     Comprehensive Family Planning (FP) services which include conventional and clinical methods as well as male and female contraceptive surgery facilities in static units and in extension service camps under safe and sterile circumstances.

ii)                   Mother and Child Health (MCH) care.

iii)                  Prevention and management of RTIs/STIs and HIV/AIDS.

iv)                  Management of reproductive health related issues of adolescent boys and girls.

v)                   Management of other RH related issues of man and women.

vi)                  Management of Infertility

vii)                Early detection of breast and cervical cancers by promoting self examination.

 

                These services by reducing maternal and infant mortality, will improve general Health, of the population of Sindh.

               

                Besides these RH related issues the RHS A centers provide treatment for minor / general ailments, especially to mother and child.

 

TYPES OF RHS CENTRES

 

S.No

Description

Location

1.

Master Training Centre

JPMC, Karachi.

2.

Training Centre

-               Abbasi Shaheed Hospital Karachi

-               Civil Hospital Karachi 

-               Model Family Clinic Hyderabad

-               LMC, Hyderabad       

-               NMC, Nawabshah

-               Shaikh Zaid hospital, Larkana

3

RHS A Centre

Established in DHQ  & THQ Hospitals

4

RHS B Centres

Hospitals / Clinics of NGOs, PLD & Private Clinics

RHS TRAINING CENTRES AND TRAINING / ORIENTATION ACTIVITIES

 

                The Reproductive Health Service, Master Training and Training Centres conduct training of medical and paramedical staff of both programme and non-programme cadre.

 

                The RHS Training Centres are responsible for  following training activities:

 

a)                   Training (Basic/Refresher) of Programme and non-programme doctors including those from NGOs, Public Sector Organization (PSO) and Provincial Line Departments (PLDs), in clinical contraceptives and comprehensive Reproductive Health Services:

 

-               Counseling, interpersonal communication conventional and clinical contraceptives including IUCD insertion / removal techniques.

-               MIS

-               Norplant / Implanon insertion / removal techniques

-               Contraceptive Surgical techniques (Male & Female)

-               Infection Prevention / Asepsis

-               Surgical skills Development & Emergency Handling.

-               Diagnosis / management of infertility cases.

-               Promotion of self examination of breast for early detection of cancer.

-               Emphasis on breast feeding and child nutrition.

-               Creation of awareness on personal hygiene.

 

i)                     Training (basic/refresher) of programme and non-programme paramedics in theatre management and other techniques with particular emphasis on Asepsis/Infection prevention as per National Stranded of Reproductive Health Services.

ii)                   Development of training curricula, strategy, methodology and annual training plan for all the above mentioned training activities; and thereafter undertaking all training activities as per plan.

iii)                  Undertake the FP/health education programme at educational institutions and PLDs.

iv)                  Hold orientation workshops for doctors and paramedics for all categories to update knowledge of available FP services for the clients.

v)                   Responsible for providing on-the-job technical monitoring/supervision and guidance/assistance for strengthening the institutional set up of RHS A Centres and improvement in the quality of service provision.

vi)                  Medical Officer, Incharge from MTC and RHS Training centres will undertake 02 supervisory visits (of 3 days duration) every year. During each visit a minimum of 4 RHS A Centres will be covered for technical guidance and support.

vii)                The RHS Master Training Centre will ensure accomplishment of approved training activities and also evaluate different training activities including seminars and workshops/meetings carried out by the RHS Training Centres.

 

                In view of the above stated training activities and work load, the staff of RHS Training Centres will be provided teaching allowance as permissible under the Government rules.

 

                For basic clinical training in Minilaparotomy Techniques, the duration for the programme doctors will be of 28 days, extendable upto 06 months as per requirement, The basic training of Theatre nurses and Theatre technicians will be of 90 days. The training of non-programme doctors will be of 28 days duration extendable upto 2-4 months as per requirement. The training imparted to medical & paramedical staff will be as per national standards.

 

Ten days training of Post-graduate doctors in FP is mandatory and imparted to post graduate students nominated by College of Physicians and Surgeons of Pakistan (CPSP) at the Master Training Centre JPMC. Therefore efforts will made that Master Training Centre shall be recognized by CPSP (College of Physicians and Surgeons Pakistan).

 

RHS A CENTRES

 

                RHS Centres are functioning in the province. Types of RHS A centres are:

 

-               RHS MTC JPMC, Karachi and 01 MTC Shaikh Zaid Hospital Larkana planned to be upgraded during this plan period.                    

-               RHS training centre:                                                                                    05

(Established in teaching hospitals)

-               RHS A centres:                                                                                            67

(Established in DHQ / THQ hospitals).

 

                Most of these centres are located in separate buildings constructed by Population Welfare Department Sindh, in or adjacent to Gynae OPD for back-up support of Gynecologist as well as motivation and counseling of female patients visiting gynae OPD for contraception.

 

STANDARD LIST OF POSTS FOR RHS MASTER TRAINING CETNRE, TRAINING CENTRE AND RHS 'A' CENTRES FOR 11TH  PLAN PERIOD 2010-15

 

S.No

Designation

BPS

Master Training Center

 

Training Centers

RHSA Centers

Senior Medical Officer

19

1

1

-

 

Medical Officer

17/18

1

1

1

2

Projectionist

12

1

-

-

3

Theatre Nurse

14

3

2

1

4

F.W.Counsellor

11

1

1

1

5

Accounts Assistant

11

1

1

1

6

Lab. Technician

9

1

1

-

7

F.W.Worker

9

1

1

1

8

Th. Technician

7

1

1

1

9

FWA(F)

7

1

1

1

10

Driver

5

3

2

1

11

Aya

1

1

1

1

12

Sweeperess

1

1

1

1

13

Chowkidar

1

1*

1

1

 

Total

 

19

15

11

         40 RHS-A centers are working under regular PC-I, 34 RHSA centers at THQ hospital working under additional PC-I would be merged in regular scheme in 2010-2011.

ADMINISTRATIVE & TECHNICAL MONITORING AND SUPERVISION:

 

                The performance of the Reproductive Health Service Centres will be reviewed and monitored jointly by the Incharge RHS-A Centres and the DPWOs to ensure availability of all inputs, staff presence, contraceptive performance compared to previous month and amongst the centres, quality of service provision, payment for CS/IRC, training of staff and collaboration with Hospital. The Deputy DPWO (Tech) will assist the DPWO and Incharge of RHS-A Centres to provide technical guidance/support for ensuring availability of RH services. Technical Wing of MoPW and PWDs would act as the next tier for supervision and technical support to the Reproductive Health Service Centres.

 

QUALITY OF CARE:

 

                MoPW achieved International accreditation ISO 9001-2000 Certification for Quality service for selected service delivery points. On the basis of the experience from above process and to ensure quality of care throughout service delivery Net work of Population Programme. Standardization and optimization of reproductive health facilities in order to achieve clients satisfaction through continued improvement in quality services.

 

FP SERVICES AT RHS-A CENTRS

 

                Comprehensive FP Services at RHS-A Centres include motivation, counseling regarding temporary contraceptives like Norplant and Implnon insertion / removal techniques, IUCDs insertion / removal, Injectables, Oral Pills and Condoms, and permanent contraceptive methods i.e Contraceptive Surgery services for females and males and Emergency Contraception will also be provided.

 

CONTRACEPTIVE SURGERY PROCEDURES

 

                Minilaprotomy is the internationally recommended and preferred method for female voluntary surgical contraception. It is cost effective, simpler and safer surgical technique, and CS programme is geared to perform Minilaprotomy procedure. Therefore at static RHS Centres, the accepted proportion of Minilaprotomy procedure for CS will be more than 75% of the total CS performance, whereas during RHS extension camps 25% CS will be performed.

 

                For male CS No-Scalpel Vasectomy (NSV) technique is the preferred method as it is more simple and safe.

 

                The Medical Officer, Incharge of the RHS A Centre / Vasectomy Centre is required to note the complete address of the surgical clients and also ensure that:

 

     The ID Card of the clients should be provided at the time of contraceptive surgery.

     In case the ID Card of the client is not available, then the ID card of the husband should attached with IRC claims.

     If both are not available, then the ID card of the referrer should be attached with IRC claims.

     In addition, the complete addresses and phone number (if any) of the client should also be recorded carefully.

     Complete address of the referrer or whosoever accompanies the client be recorded as well.

 

EXTENSION CAMPS ACTIVITY

 

                To ensure availability of CS services on wider scale and to improve  performance, the RHS Centres will hold extension camp at appropriately equipped  Rural Health Centres.            

               

                Camping site will be selected/finalized jointly by concerned DPWO/TPWO, Deputy District Population Welfare Officer (Technical) and Medical Officer, Incharge, RHS A Centre. For camping activity the policy/guidelines given in the Manual of National Standard for Family Planning Services will be strictly adhered to. Quality of care should be maintained at the camps.

STRENGTHENING OF HOSPITAL MANAGEMENT COMMITTEES

 

                The RHS-A Centre functioning within the hospital setup according to an agreement of payment on per case basis to the gynecologist and the MS of the hospitals for assistance and support will be strengthened and revised guidelines for strengthening Hospital Management Committees (HMCs) will be prepared. The salient features of Hospital Management Committee are as under:

 

The Medical Officer Incharge will be responsible for:

 

     Convening monthly meeting of HMC on regular basis.

     DPWO, M.S, Gynecologist and other relevant department of the hospital will be requested to attend the meeting for discussing the issues for smooth running of RHS-A centres.

 

Permanent agenda points for discussion:

 

     Assignment roster of staff of RHS A centres in the Gynae/Obst./Paeds wards and OPDs.

     Record of number of antenatal, postnatal and high risk cases motivated/counseled.

     Liaison with Registrar and senior doctors for facilitating ligation of complicated and difficult cases.

     Training of doctors and paramedics in contraceptive methods.

     Development of mechanism for validation of CS cases in the hospital and its regular monitoring.

     Other relevant issues.

 

CHARTER OF DUTIES OF RHS TRAINING CENTRES

 

i)                     Train (basic/refresher) programme and non-programme doctors including those from NGOs sector, Target Group Institutions (TGIs) and Provincial Line Department (PLDs) in contraceptive surgical techniques, counseling, interpersonal communication, Norplant/ Implanon insertion / removal techniques, asepsis, Management Information System (MIS) and provision of comprehensive Reproductive Health Service Package (CRHSP).

 

ii)                   Identification of difficult surgical cases, deal with surgical problems, assess and diagnose abnormal obstetric / gynaecological problems and diagnosis / management of infertility cases., Impart training in Norplant / Implanon insertion / removal techniques to the medical officers from RHS-A centres.

 

iii)                  Train (Basic / refresher) programme and non-programme paramedics in theatre management and other techniques with particular emphasis on asepsis / infection prevention.

 

iv)                  Develop training curricula, strategy, methodology and annual training plan for all the above mentioned training activities.

 

v)                   Undertake the FP/Health education programmes at educational institutions and PLDs.

 

vi)                  Hold orientation workshops for doctors and paramedics for all categories to update knowledge of what is available for the clients in the way of contraceptive services.

 

vii)                Provide on-the-job technical monitoring/supervision and guidance/assistance for strengthening the institutional set up of RHS centres and improvement in the quality of service provision.

 

viii)               Undertake four supervisory visits of RHS A Centres every month.

 

ix)                  Ensure accomplishment of approved training activities.

 

 

MALE INVOLVEMENT & VASECTOMY SERVICES

 

                Like all other male dominating societies, women in Pakistan including some of those  who belong to educated class are not allowed to make a decision themselves especially for contraceptive surgery, though it is strictly adviced by the gynecologist in view  that the poor woman can not bear one more pregnancy and she is at high risk for mortality, more emphasis is given on male participation by creating awareness and motivation with  special focus on provision of vasectomy services preferably by No-Scalpel vasectomy (NSV) techniques. Male doctors (Health/Private/NGOs etc) will continue to be  involved during this Five year plan through training, enhancing IRC per case and enlistment of more RHS B Centres.

STAFFING PATTERN PER VASECTOMY CENTRE

 

S.No

Designation

NSV Training Cetnre

NSV Centre

Sanctioned

1

Medical Officer (Male)

18

1

-

2

Medical Officer (Male)

17

1

1

3

Accounts Assistant

11

1

1

4

Theatre Technician  cum Male Motivator

7

1

1

5

Driver

5

1

1

6

Sweeper

1

1

1

7

Chowkidar

1

1

1

 

Total

 

7

6

 

 

 

 

 

.

Current List of RHSA

Main Sr. No.

Sr.No.

Name of outlet / Centre

Complete Address with Location / distance from Main raod

Date of establishment of the centre present location

1- DISTRICT HYDERABAD

  

 

 

01

01

RHS 'A' Centre MFC Hyderabad

RTI, Murshidabad, Hyderabad

1996

02

02

RHS 'A' Centre LMC Hyderabad

OPD LMC Hyderabad

1994

03

03

RHS 'A' Centre Preetabad Hyderabad

Taluka Hospital, Pretabad, Hyderabad

2008

04

04

RHS 'A' Cum Vasectomy Centre, Qasimabad

Taluka Hospital, Qasimabad, Hyderababd

2008

05

05

RHS 'B' Centre Green Star

B No. A-113 (6), Block-E, Unit No.6, Latifabad, Hyderabad

1999

06

06

RHS 'B' Marie Stopes Soceity

D-22, Unit No.11, Near Wahab Plaza, Latifabad, Hyderabad

1998

2- DISTRICT KARACHI (WEST)

 

 

07

01

RHS 'A' Centre Abbasi Shaheed Hospital

Abbasi Shaheed Hospital, Nazimabad No.3, Karachi

Hospital Based

08

02

RHS 'A' Centre Sindh Govt. Hospital, New Karachi

Sindh Govt. Hospital, UP Society, New Karachi

Hospital Based

09

03

RHS 'A' Centre Sindh Govt. Qatar Hospital, Orangi Town

Sindh Govt. Qatar Hospital, Orangi Town, Karachi

Hospital Based

10

04

RHS 'B' Centre Green Star Plus (SMP)

Dua-e-Fatima Medical Centre, 1443-Block-J, Sector 11  1/2 Orangi Town, Karachi

2008

3- DISTRICT KARACHI (SOUTH)

 

 

11

01

RHS 'A' Centre, Civil Hospital, Karachi

RHS 'A'  Civil Hospital, Main Civil Hospital, Karachi

1990

12

02

RHS 'A' Centre Cum MTC JPMC

RHS 'A' JPMC Jinnah Hospital, Karachi

1988

13

03

RHS 'A' Centre, Sobhraj

Sobhraj Maternity Home, Near Urdu Bazar, Karachi

1990

14

04

RHS 'A' Centre, Lyari

RHS 'A' Lyari General Hospital, Lyari, Karachi

1992

15

05

RHS 'A' Centre, LDH Karachi

RHS 'A' Lady Differn Hospital, Near Light House, Karachi

1990

16

06

RHS 'A' Centre, Police Hospital

RHS 'A' Police Hospital, Near Jobli Chowk, Karachi

2008

4- DISTRICT KARACHI (EAST)

 

 

17

01

RHS 'A' Centre, Saudabad

Sindh Govt. Hospital No.2, Malir

-

18

02

RHS 'A' Centre. Ibrahim Hyderi

Sindh Govt. Hospital Ibrahim Hyderi, Near UC Ibrahim Hyderi

-

5- DISTRICT LARKANA

 

 

19

01

RHS 'A' Centre, Larkana

Near Children Hospital, Larkana

15.7.1995

20

02

RHS 'B' Centre, Green Star

Vakeel Colony Larkana

-

21

03

RHS 'B' Centre, PAVHNA

Near Shah Latif Market, Lahori Mohalla, Larkana

-

6- DISTRICT KHAIRPUR

 

 

22

01

RHS 'A' Centre Kot Diji

Taluka Hospital, Kot Diji

2007

23

02

RHS 'A' Centre, Khairpur

Civil Hospital, Khairpur

1994

24

03

RHS 'A' Centre, Gambat

Taluka Hospital, Ghambat

2003

25

04

RHS 'B' Centre, Muthar Medi Care Clinic, Khairpur

Gajani Centre, Civil Hospital Road, Khairpur

-

26

05

RHS 'B' Centre, Ali Clinic and Maternity Home Ranipur

Near Main National Highway Road, Ranipur

-

7- DISTRICT DADU

 

 

27

01

RHS 'A' Centre, Dadu

Civil Hospital, Dadu

1.1.96

28

02

RHS 'A' Centre, KN Shah

Taluka Hospital, KN Shah

1.1.2008

29

03

RHS 'A' Centre, Mehar

Taluka Hospital, Mehar

1.1.2008

8- DISTRICT BADIN

 

 

30

01

RHS 'A' Centre, Badin

Civil Hospital, Badin

1995

31

02

RHS 'A' Centre, Matli

Taluka Hospital, Matli

2004

32

03

RHS 'A' Centre, Tando Bago

Taluka Hospital, Tando Bago

2007

33

04

RHS 'B' Centre, Family Health Hospital, FPAP, Badin

Main Road, Badin

2004

9- DISTRICT SANGHAR

 

 

34

01

RHS 'A' Centre, Sanghar

Civil Hospital, Sanghar

19.05.1995

35

02

RHS 'A' Centre, Shahdadpur

THQ Hospital, Shahdadpur

1999

36

03

RHS 'A' Centre, Khipro

THQ Hospital, Khipro

2006

37

04

RHS 'A' Centre, Tando Adam

THQ Hospital, Tando Adam

2008

10- DISTRICT SUKKUR

 

 

38

01

RHS 'A' Centre, Sukkur

Civil Hospital, Sukkur

15 years

39

02

RHS 'A' Centre, Rohri

Taluka Hospital, Rohri

2 years

40

03

RHS 'B' Centre, Railway Hospital, Sukkur

Centre Railway Hopsital Sukkur

3 years

41

04

RHS 'B' Centre, Red Crescent Hospital

Red Cross Hospital, Minara Road Sukkur

10 years

42

05

RHS 'B' Centre, Marie Stops Society, Sukkur

Marie Stops Society, Bhutta Road, Sukkur

6 years

43

06

RHS 'A' Centre, Pano Akil

Sakhee Baba Maternity Home, Pano Akil

1 year

11- DISTRICT TANDO MUHAMMAD KHAN

 

 

44

01

RHS 'A' Centre, Tando Muhammad Khan

Civil Hospital Main Road Tando Muhammad Khan

10.12.2007

12- DISTRICT TANDO ALLAHYAR

 

 

45

01

RHS 'A' Centre, Tando Allahyar

Civil Hospital, Tando Allahyar

15.04.2008

13- DISTRICT KASHMORE

 

 

46

01

RHS 'A' Centre, Kandhkot

Civil Hospital, Kandhkot

under construction

14- DISTRICT THARKARPAR @ MITHI

 

 

47

01

RHS 'A' Centre, Mithi

DHQ Hospital, Mithi

1.6.2004

48

02

RHS 'A' Centre, Nanghar Parkar

THQ Hospital, Nanghar Parkar

1.7.2006

15- DISTRICT GHOTKI

 

 

49

01

RHS 'A' Centre, Ghotki

THQ Hospital, Ghotki

Since long  

50

02

RHS 'A' Centre, Mirpur Mathelo

Civil Hospital/DHQ Mirpur Mathelo

Since long  

51

03

RHS 'A' Centre, Ubauro

THQ, Hospital, Ubauro

2007

16- DISTRICT MATIARI

 

 

52

01

RHS 'A' Centre, Hala

THQ Hospital Hala

11.3.2000

17- DISTRICT KAMBER

 

 

53

01

RHS 'A' Centre, Kamber

Near Wagan Road, Civil Hospital, Kamber

1.7.2006

54

02

RHS 'A' Centre, Warah

THQ Warah

1.7.2006

55

03

RHS 'A' Centre, Miro Khan

THQ, Hospital, Miro Khan

1.7.2008

56

04

RHS 'A' Centre, Shahdadkot

Taluka Hospital, Kandhkot

under construction

18- DISTRICT SHAHEED BENAZIRABAD

 

 

57

01

RHS 'A' Centre, Shaheed Benazirabad

NMC Nawabshah

11.11.1995

58

02

RHS 'A' Centre, Sakrand

THQ Hospital, Sakrand

25.09.2006

59

03

RHS 'B' Centre, (MSS) Benazirabad

House No.41, Muhalla Liaquatabad Pak Colony, Shaheed Benazirabad

20.07.2001

19- DISTRICT UMARKOT

 

 

60

01

RHS 'A' Centre, Umerkot

Civil Hospital Umarkot

26.11.2007

61

02

RHS 'B' Centre, MSS Umerkot

Commerical Area, Satellite Town, Mirpurkhas

-

62

03

RHS 'B' Centre, Kunri Christian Hospital (Green Star)

Kunri Christian Hospital, Mirpurkhas

-

20- DISTRICT THATTA

 

 

63

01

RHS 'A' Centre, Thatta

Civil Hospital Makli

Since long time

64

02

RHS 'A' Centre, Mirpur Sakro

Shaikh Zaid Medical Centre, Mirpur Sakro

Since long time

65

03

RHS 'A' Centre, Sujawal

Taluka Hospital, Sujawal

Recently completed

66

04

RHS 'A' Centre, Mirpur Bathoro

Taluka Hospital, Mirpur Bathoro

Recently completed

67

05

RHS 'A' Centre, Jati

Taluka Hospital, Jati

under construction

21- DISTRICT JACOBABAD

 

 

68

01

RHS 'A' Centre, Jacobabad

Civil Hospital, Jacobabad

23.10.1989

69

02

RHS 'A' Centre, Thull

Taluka Hospital, Ghari Khairo

1.10.2008

 

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