Facility Based Services

Facility based EmONC, immunization and nutrition services are being provided through Basic Health Units, Rural Health Centers, Tehsil Head Quarter Hospitals and District Head Quarter Hospitals. The number of health facilities in each category are given in tables below.

Normal BHUs 1397
BHU Plus 298
24/7 BHUs 803
RHCs 308
THQHs 116
DHQHs 26

24/7 Basic EmONC Services

Following the floods of 2010, a special initiative was launched in the seven flood affected districts for provision of round the clock basic EmONC services. BHUs nearby flood affected areas of these districts were selected for this purpose. Till 2014, this initiative was funded through UNICEF and UNFPA for 90 health facilities.
The Government started provision of additional funds to 150 BHUs for provision of round the clock services, followed by addition of 550 more by end of 2015. Further 103 BHUs were included in 2017. At the moment:

  • 803 Selected Basic Health Units from all districts are providing round the clock provision of basic EmONC services through
    • Provision of additional HR (LHVs, Ayas, Security Guards)
    • Provision of additional equipment and supplies
  • 305 Rural Health Centers are also providing these services round the clock at primary level
  • Way forward: 200 more 24/7 BHUs will be up graded in January 2018

Scope of service

The following services for maternal and child care are provided at these health facilities:

  1. Antenatal care including history taking, general physical examination, obstetric examination, basic diagnostic tests including urine (for pregnancy and proteinuria), blood (for Blood Glucose levels, Hemoglobin levels, Hepatitis screening and HIV screening)
  2. Delivery services covering all aspects of basic EmONC
  3. Newborn care including helping babies breathe, use of chlorhexidine for cord care, early initiation of breast feeding and skin to skin care
  4. Childhood immunization (birth doses as well as other doses as per EPI schedule)
  5. Pneumonia and diarrhea treatment and referral services for children under the age of five

Nutrition

Following the floods of 2010, a special initiative was launched in the seven flood affected districts for provision of malnutrition treatment services. BHUs nearby flood affected areas of these districts were selected for this purpose and Outdoor Therapeutic Program (OTP) counters were established at these BHUs. Moreover, stabilization centers were also set up at DHQH level. Till 2014, this initiative was supported by UNICEF and WHO. However, as malnutrition was identified as a major issue in Pakistan in the National Nutrition Survey 2011, Government of the Punjab decided to scale up the OTPs to selected BHUs and SCs to all DHQHs and teaching hospitals.

Scope of Services

  1. Screening of children and PLWs is being done at the community level by LHWs (all districts) and at the facility level by the LHVs at OTPs.
  2. Preventive services area also being provided through the LHWs including provision of iron folic acid tablets, multi micronutrient sachets, Lo-ORS and Zinc for diarrhea cases, etc.
  3. MAM and SAM treatment and counseling services are offered in 22 districts through 804 OTPs at the moment. Scale up in remaining 14 districts is planned in the year 2018.
  4. Treatment of complicated SAM children is offered at the stabilization centers. Each of these SCs has an OTP attached to it.