FUNCTION: NURSING SERVICE
DESIRED STATE
OPD DEPT-
Health Facility
1. There will be a separate OPD
building just like a One stop
shop services.
2. IHOMIS should be fully
functional
3. Human Resource
1. Additional Doctor and 1
OPD trained nurses with
updated ACLS, BLS,
2. Additional 1 NA
3. Commodities
1. Additional medical
equipment /instruments
needed for RLED
EMERGENCY ROOM-
Health Facility
a. There will be a separate
Trauma room
b. There will be a Consultation
room
c. There will be an Isolation
room
d. IHOMIS should be fully
CURRENT STATE
Passageway of patients and watchers thus,
cross contamination of infection
IHOMIS is not implemented
1 Doctor is available ( OPD-ER Doctor)
1 nurse
Insufficient medical equipment’s
No available trauma room
No available consultation room
Present but converted to a blood station
room
GAP
There is a need to construct separate OPD
building for safer provision of OPD services.
There is a need to use IHOMIS for
centralized transaction
There will be more services to be offered;
To render quality health services
There will be 1 Doctor to Supervised OPD
Services
Procurement of Medical instruments
needed;
Delay of services
There is a need of construction of Holding
Facility in order to provide immediate and
proper treatment of patient; to prevent cross
contamination of infection
There is a need to provide consultation
room for patient; to provide privacy
There is a need of construction of Holding
Facility to prevent infection
There is a need to use IHOMIS for
 functional
Human Resource
a. Additional 3 trained ER
Nurses with updated ACLS,
BLS, IV insertion training
b. Additional 3 triage staff
Commodities
a. Available Emergency Drugs
b. Available medical
equipment/ instrument
CLINICal ward-
2. Health Facility
a. 2 available Nurse Station
b. Additional surgical room
c. Additional isolation for TB
patients
d. Additional geriatrics room
e. Expansion of
OB/Postpartum room
f. IHOMIS should be fully
functional
3. Human Resource
a. Additional 8 Ward
Nurses with updated
BLS and IV insertion
IHOMIS is not implemented
No Trained ER Staff
Insufficient medical equipment’s
1 Available nurse station
No Available surgical ward
Present but converted to COVID Ward
No Available geriatrics ward
1 Available OB ward
IHOMIS is not implemented
No Trained Ward Staff
centralized transaction
There is a need for training of ER Staff to
provide quality services;
For Compliance of Trained Staff for level 1
Procurement of Medical instruments
needed;
Delay of services
There is a need for additional nurse station
to provide quality services to patients;
For compliance of required additional nurse
station of RLED
There is a need for construction of medical
and surgical building to prevent
contamination of infection
There is a need for construction of Isolation
ward to prevent contamination of infection
There is a need for construction of geriatrics
ward to prevent nosocomial infection
There is a need for additional OB Ward due
to increasing number of OB patients
There is a need to use IHOMIS for
centralized and faster transaction
There is a need for training of Ward Staff to
 training.
c. Additional 3 NA
4. Commodities
a. Available Emergency Drugs
b. Available medical
equipment/ instrument
DELIVERY ROOM
5. Health Facility
a. To have a Halfway house
b. Separate building for
Holding Area Delivery room
c. IHOMIS should be fully
functional
6. Human Resource
a. Additional 3 trained Nurse
with updated EINC/Bemonc,
ACLS, BLS training
b. Additional 3 Midwife with
updated EINC/Bemonc
training.
7. Commodities
a. Available Emergency Drugs
b. Emergency Cart
c. Available medical
equipment/ instrument
OPERATING ROOM
1. Health Facility
a. To have a functional Operation
Insufficient medical equipment’s
Present but converted to Covid Holding
area
Present but exposed to infection due
converted halfway house
IHOMIS is not implemented
No Trained Nurse and midwife
No Standard E-cart for DR
Insufficient medical equipment’s
There is an operating room complex but it is
provide quality services;
For Compliance of Trained Staff for level 1
Procurement of Medical instruments
needed;
Delay of services
There is a need to construct Halfway house
for pregnant patients;
For safety and to monitored OB patient
There is a need to construct separate
holding area for pregnant patient
There is a need to use IHOMIS for
centralized and faster transaction
There is a need for training for DR staff;
To provide quality service in rendering
delivery;
For compliance of RLED
There is a need for standard E-cart for DR
Procurement of Medical instruments
needed;
To have a functional operating room;
 room not functional Needed for level 1

b. IHOMIS should be fully IHOMIS is not implemented There is a need to use IHOMIS for
functional centralized and faster transaction

2. Human Resource Insufficient OR Staff ( 1 nurse and 1 Trainings needed for OR Staff for at least 3
a. Additional 2 trained nurses with midwife) months
updated OR, ACLS, BLS Untrained OR staff
training.
b. Additional 2 NA with updated
OR training. There is a need for standard E-cart for OR;
3. Commodities No E-cart available for OR Procurement of Medical instruments
a. Emergency Drugs No available drugs needed;
b. Anesthesia Drugs Insufficient medical equipment’s
c. Available medical equipment/
instrument
4. Others Available but not functional Need to be repaired in preparation for fully
Repair of electrical supply in OR complex functional operating room

PATIENT TRANSPORT
8. Health Facility
a. Decrease number of High number of referred pts Need to upgrade hospital services to
referrals perform procedures

b. To procure additional fully No available license ambulance Need to fully equipped ambulance in order
equipped/license of emergency needs
ambulance
9. Human Resource No available escort Need to for additional staff/ proper
Escort/reliever scheduling of staff
COMMUNITY ISOLATION ROOM
10. Health Facility
a. Completion of the Medical
extension and TTMF 1 (under construction) There is a need for construction of
11. Human Resource community isolation room;
a. Com. Isolation nurse with No staff There is a need of additional staff for
updated ACLS, BLS, IV Community isolation area
 insertion training

CSR
12. Health Facility No available gondola There is a need to purchase gondola for
a. There will be a 2 Supply proper placement of supply
gondola
13. Human Resource 1 available Need additional staff
a. Additional 2 CSR staff

Desired State
Animal Bite Program
Expanded Newborn Screening and
Universal Newborn Hearing Program
 Calibrated Hearing Machine
TB DOTS PROGRAM
 Renovation/ improvement of TB dots
center
 Trained TB coordinator
AHDP
 Fully operated hospital Adolescent
health development program
 Trained AHDP coordinator
Smoke Cessation Program
 Separate room for smoking
cessation clinic
Maternal and Child Health Program
 Visible breastfeeding booth for
every section\area in the facility
FUNCTION: PUBLIC HEALTH PROGRAM
Current State
Sustainable Animal Bite Program
(Renewed license of ABT staff)
Not calibrated hearing machine
Non functionaltb dots center due to
Not trained TB Dots coordinator
Initial assessment done by pho ahdp
coordinator
Not trained AHDP coordinator
No available room for smoking cessation
clinic
Only 1 breastfeeding room present in the
facility
Gap
None
There’s a need for calibration of hearing
machine to have accurate data/test
There’s a need to renovate for a safer
provision of TB Dots services
There’s a need for training in handling TB
program in order to effectively provide
proper treatment; To have an accurate
report
Fully functional adolescent health
development program
There’s a need for training in handling ahdp
in order to maintain privacy that conducive
for counselling adolescent patients
There’s a need to construct smoking
cessation clinic to maintain confidentiality
and conducive for counselling
To provide breastfeeding rooms in every
section for the privacy of breastfeeding
mothers
  To have a trained BF coordinator Not trained BF coordinator There’s a need to attend lactation training in
order to relay knowledge to all the MarDH
staff

Family Planning Trained FP coordinator (Level 1) There’s a need to update trainings; to

 Trained FP coordinator render additional FP services
 FUNCTION: DISASTER RISK REDUCTION
DESIRED STATE CURRENT STATE GAP
Health Facility: No available room and insufficient or not There is a need to have a DRR room to
organize emergency equipment further implement the programs.
To have a DRR room and have a sufficient
emergency equipment.

.
Human Resource: The DRR committee is not that active. There is a need to update, renew and
recruit new members to have a functional
To have a functional/active disaster Risk DRR committee. Conduct constant meeting
Reduction committee among the members.

To have effective and competent DRR Only one program is implemented. There is a need to attend training and
committee/members in the hospital to conduct training among the members.
implement the different programs.