The document discusses the National Rural Health Mission of India. It outlines the goals of universal healthcare, reducing mortality and fertility rates. It details the proposed structure from village to state level and initiatives in various states to strengthen rural healthcare.
The document discusses the National Rural Health Mission of India. It outlines the goals of universal healthcare, reducing mortality and fertility rates. It details the proposed structure from village to state level and initiatives in various states to strengthen rural healthcare.
The document discusses the National Rural Health Mission of India. It outlines the goals of universal healthcare, reducing mortality and fertility rates. It details the proposed structure from village to state level and initiatives in various states to strengthen rural healthcare.
The document discusses the National Rural Health Mission of India. It outlines the goals of universal healthcare, reducing mortality and fertility rates. It details the proposed structure from village to state level and initiatives in various states to strengthen rural healthcare.
FLEXIBLE FINANCING CAPACITY BUILDING www.drjayeshpatidar.blogspot.in
HUMAN RESOURCE MANAGEMENT 2
NRHM ILLUSTRATIVE STRUCTURE CHIEF BLOCK MEDICAL OFFICER / BLOCK LEVEL HEALTH OFFICE Accredit private providers for public health goals 100,000 Population 100 Villages ---------------
Health Manager Accountant Store Keeper
BLOCK LEVEL HOSPITAL
Ambulance Telephone Obstetric/Surgical Medical Emergencies 24 X 7 Round the Clock Services; 30-40 Villages
Strengthen Ambulance/ transport Services Increase availability of Nurses Provide Telephones Encourage fixed day clinics
CLUSTER OF GPs PHC LEVEL
3 Staff Nurses; 1 LHV for 4-5 SHCs; Ambulance/hired vehicle; Fixed Day MCH/Immunization Clinics; Telephone; MO i/c; Ayush Doctor; Emergencies that can be handled by Nurses 24 X 7; Round the Clock Services; Drugs; TB / Malaria etc. tests 5-6 Villages
GRAM PANCHAYAT SUB HEALTH CENTRE LEVEL
Skill up-gradation of educated RMPs / 2 ANMs, 1 male MPW FOR 5-6 Villages; Telephone Link; MCH/Immunization Days; Drugs; MCH Clinic
1000 Popu lation
VILLAGE LEVEL ASHA, AWW, VH & SC
1 ASHA, AWWs in every village; Village Health Day www.drjayeshpatidar.blogspot.in Drug Kit, Referral chains
NRHM- Institutional framework
1 2 3 Departments of H & FW merged State Health Missions Constituted District Health Missions Constituted Merger of Societies 34 states except UP 34 states except Delhi 33 states except Haryana, Delhi
State Level
29 States except Jharkhand, Rajasthan, U.P., Tripura, Delhi Chandigarh, Karnataka, Pondicherry 30 States except U.P., Lakshadweep, Delhi, Tamil Nadu, A&N Islands
MoU with Government of India
www.drjayeshpatidar.blogspot.in Health is also Economic productivity
Operationalise the State/District/Block health Missions.
Review of Acts, decentralisation Regulations & guidelines for
Health facilities to be planning and budgeting Units upto Block level. Set up procurement/logistics system www.drjayeshpatidar.blogspot.in empowerment Health is also Womens 5
Manpower Strengthening Attend to Shortfall of 84,000 staff nurses, 2 lakh ANMs, 5000 to 7000 Specialists in each specialty. Multi-skilling, incentives for rural posting, Compulsory Rural Posting, Block pooling, Rational cadre policy, Management through PRIs/ Rogi Kalyan Samitis, Increasing the age of retirement Appointment on contractual basis and local criterion.
Empower BMO designate as Chief BMO - to optimally deploy
doctors /paramedics in facilities within the block
Strengthen SIHFW, ANM schools, nursing / medical colleges/
increase seats
www.drjayeshpatidar.blogspot.in right Health is Womens
DECENTRALISATION & CONVERGENCE
Over 20% of the funds to be spent at the District level and 70% below the block level.
Review of Acts, Regulations & guidelines for decentralisation Health facilities to be planning and budgeting Units upto Block level. Monitor preparation of Integrated District Plans. Review health camps in each village by ANM, AWW and ASHA. Regular meeting of State Committee on Intersectoral Convergence. www.drjayeshpatidar.blogspot.in Healthy family Healthy nation
AGENDA FOR CHIEF SECRETARIES
Operationalisation of Mission structure & managerial support at state /District / Block levels.
Selection, training and support for ASHA.
Availability & Utilisation of service delivery at facilities. Immunisation & Institutional deliveries District wise. Preparation of District Plans Interdepartmental Coordination for convergence Release & Utilisation of funds. Training/Capacity Building-Health Planning-District training Centre www.drjayeshpatidar.blogspot.in Delegation of administrative & financial powers to various levels.8
Activity
Phasing and time line
Outcome Monitoring
Fully trained Accredited Social Health Activist (ASHA) for every 1000 population/large isolated habitations in 18 Special Focus States Village Health and Sanitation Committee constituted in over 6 lakh villages and untied grants provided to them. strengthened/established to provide service guarantees as per IPHS, in 1,75000 places. 30,000 PHCs strengthened/established with 3 Staff Nurses to provide service guarantees as per IPHS.
6500 CHCs strengthened 30% by 2007 /established with 7 Specialists and 9 S 50% by 2009 Nurses to provide service guarantees www.drjayeshpatidar.blogspot.in 100% by 2012 as per IPHS.
1800 Taluka/ Sub Divisional Hospitals strengthened to provide quality health services. 600 District Hospitals strengthened to provide quality health services. Rogi Kalyan Samitis /Hospital Development Committees established in all CHCs/Sub Divisional Hospitals/ District Hospitals. District Health Action Plan 20052012 prepared by each district of the country.
30% by 2007 50% by 2010 100% by 2012 30% by 2007 60% by 2009 100% by 2012
Untied grants provided to each 50% by 2007 Village Health and Sanitation Committee, Sub Centre, PHC, CHC to 100% by 2008 promote local health action. www.drjayeshpatidar.blogspot.in
THANK YOU
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STATE INITIATIVES
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STATE INITIATIVES Andhra Pradesh Woman Health Volunteers in each of the rural and tribal habitations. Setting up an additional 100 round-the-clock women health centres. A subsidized Emergency Health Transportation Scheme. Incentives to women health volunteers, village Panchayats that promote Immunization Institutional delivery etc.
Arunachal Pradesh 16 PHCs contracted out to NGOs and Private practitioners. Link workers at village level. Outreach camps for service delivery at remote and inaccessible areas. Assam RMP Act enacted. Transfer and Postings of Medical Staff has been decentralized. Involvement of private sector to render ANC services under PPP. Infection Control System in all District Hospitals. Health Insurance Scheme introduced. 32 FRUs operationalised. www.drjayeshpatidar.blogspot.in
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STATE INITIATIVES Bihar Data centre for daily monitoring of OPD output by each
participating institutions. 8000 villages covered with mobile medical units for under served population. Telephone connection to all PHCs of the state.
CHhattisgarh Strengthening the role of the Panchayat and building on the
community based link worker. Promoting emergency referral to public/private facility using coupons by Mitanins. Establishment of State Health Resource Centre.
Delhi Basti Sevikas for Urban Slums as linked worker. www.drjayeshpatidar.blogspot.in
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STATE INITIATIVES Gujarat Chiranjivi Yojana scheme to contract out private providers for delivery care and management obstetric complications Block Level Programme Management arrangements.
Haryana
Health link workers in every village. A couple aged 60 years with only a girl child is being given a pension of Rs. 300/- per month and Rs. 500/- per month to the girl child under Ladli Scheme.
Himachal Pradesh Rs. 30,000 to FRUs as untied fund for emergency transport. PPP Cell at State and District level. Involvement of departments like Ayurveda, social justice and woman empowerment for distribution of contraceptives. www.drjayeshpatidar.blogspot.in 15
STATE INITIATIVES
Jammu & Kashmir Granting autonomy to hospitals Utilizing the Rehbat-I-Sehat (RIS) teachers network for providing access to health services to tiny villages scattered in the district.
Karnataka Incentives to Doctors and Staff Nurses for providing 24x7
services. Health insurance for SC/ST population
Kerela RCH services at medical colleges Maternity Security Scheme Tribal and Coastal Health Plans. Involvement of ISM and homeopathy system with the health facilities. www.drjayeshpatidar.blogspot.in 16
STATE INITIATIVES Madhya Pradesh Outsourcing PHCs to NGOs. State Logistics Management Unit at State level Prasav Hetu Parivahan Yojana(LY85000 beneficiaries) Incentive to MOs at PHCs and CHCs for promotion of institutional deliveries
Maharashtra Setting up of PPP cell at state and district level. Incentive to tribal pregnant woman for ANC and institutional deliveries under Matrutav Anudan Yojana of Nav Sanjivini Scheme. Association of Mahila Gram Sabha and Mahila Vikas Samitis of Jan Swarajaya for implementation of RCH. Mizoram www.drjayeshpatidar.blogspot.in Incentives for doctors serving in remote areas 17
STATE INITIATIVES Orissa Delegation of powers to the ED , State Health society Consideration of key HRD steps such as a differentiated Public Health Management cadre, policy / incentives for postings to less developed districts Health institutions resource mapping on GIS. Pondicherry Family based health cards. Punjab Balika Rakshak Yojana for adopting terminal method of sterilization after the birth of only one or two girl children @ Rs. 500/- and Rs. 700/- respectively. A prize of Rs. 3 lakhs for panchayats achieving CSR of 1000 in a year and Rs. 2.5 lakhs for panchayats achieving CSR of 951 to 1000 in a year. Nutritional supplement for mothers and children belonging to SCs and other reconstruction of the society. www.drjayeshpatidar.blogspot.in 18
STATE INITIATIVES Rajasthan
Panchamrit for catch up rounds for 5 interventions (Immunization, Vitamin A, Neo Natal Care, Family Planning, Safe Motherhood). Considerable emphasis on quality of services through setting standards, indicators and process protocols Technical resource cell involving NGOs for monitoring and implementation of PNDT act.
Sikkim
Link workers at all the villages. Setting up committees at State / District Level for implementation of PNDT act. Link up with AWW and School Health Programme to operationalize regular de-worming of children. Untied fund at SC to meet transportation cost and accompany link workers if it is justifiable by Village Health Committees. www.drjayeshpatidar.blogspot.in 19
STATE INITIATIVES Tamil Nadu
Integration of ISM with primary health care systems Convergence with HIV/ AIDS/TB at PHCs. Efficient logistic and procurement arrangements.
Tripura
Outsourcing of investigation services including imaging.
Uttar Pradesh
Involvement of cooperative sector for distribution of contraceptives under Family Planning programme. Private lady doctors are being contracted for providing 2 hour daily OPD services at CHCs and PHCs on fix incentive basis. Yuva Mangal Mela and Adarsh Dampati Samman will be organised in selected districts. This year 25 Districts selected having poor health indicators. www.drjayeshpatidar.blogspot.in Strengthening of MIS by linking District through NIC Network 20
STATE INITIATIVES
Uttaranchal
Involvement of community in monitoring and giving feedback on all the programmes. Documentation of practices on traditional healers. West Bengal
Piloting of Voucher Scheme for providing services through private sector. Ranking of blocks as per key health indicators. www.drjayeshpatidar.blogspot.in 21
