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National Rural Health Mission

National Rural Health Mission. 2 nd Common Review Mission 16-21 st December, 2008 Mizoram. Sh. Rajesh Bhatia Joint Director MOHFW. Dr. Ashoke Roy RRC, Guwahati. Dr. Vijay Aruldas General Secretary CMAI. Accompanied by Dr. P. Sangzuala, Jt. DHS (FW), Dr. Zahmingthanga, CMO

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National Rural Health Mission

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  1. National Rural Health Mission 2nd Common Review Mission 16-21st December, 2008 Mizoram

  2. Sh. Rajesh Bhatia Joint Director MOHFW Dr. Ashoke Roy RRC, Guwahati Dr. Vijay Aruldas General Secretary CMAI Accompanied by Dr. P. Sangzuala, Jt. DHS (FW), Dr. Zahmingthanga, CMO Ms. Lalsangkimi Zote, DPM Dr. M.K. Talukdar Senior Consultant NHSRC Accompanied by Mr P Ragui State Facilitator RRC Dr. Sharad Iyengar Secretary AGCA Dr. Hmingthanzuala MO, NRHM, Mizoram State: Mizoram Composition of the Teams District Kolasib  DistrictSerchhip

  3. District Hospital Kolasib District Hospital Serchhip Vairengte CHC ThenzolCHC Bilkhawthlir PHC Chinchhip PHC Kanpui PHC Thingsuliah PHC Lungdai PHC Chinchhip Sub Centre Bilkhawthlir Sub Centre Buangpui Sub Centre Diakkaun Sub Centre Thenzol Sub Centre Thingdawal Sub Centre Bualpui Sub Centre Zanlawn Sub Centre District Kolasib District Serchhip Facilities Visited

  4. Preparedness of Health Facilities and Utilization of Services • Health Facilities well equipped and maintained with medicos and paramedics available at all levels leading to good utilization of services by patients • Significant no. of deliveries at CHCs and PHCs with increase after JSY • Presence of Regular Medical Officer has made positive impact on the trend in IPD / OPD at PHCs • PHCs adequately equipped in laboratory facilities • Deliveries not being conducted normally at Sub Centres inspite of available space for Labour Room – a significant number of home deliveries being conducted by ANMs of the same Sub Centres • Sspecialist manpower lacking • Need of effective equipment repair and maintenance strategy to ensure regular availability and effective utilization of diagnostic & investigative facilities

  5. Infrastructure • Infrastructure strengthening and upgradation being undertaken with engineering cell • Needs strengthening to meet the requirement and demand with effective monitoring and supervision to ensure quality • Empowerment for effective decentralization and flexibility for local action • RKS & VHSCs Operationalised – significant involvement in various activities • active involvement of youth, women and senior citizens groups in various activities -need for more intersectoral facilitation • Untied fund and RKS grants are being kept in separate bank accounts; separate registers maintained, being utilized as per the resolutions of the respective RKSs • The untied fund, annual maintenance grant being disbursed in cash –– Male Health Worker having joint account at various Sub Centres

  6. Health Human Resource Planning • Doctors: increase in doctors (general) & lab technicians resulting in an increase in service availability-distribution may be rationalized. • Nurses:2 ANMs present in Sub Centres • Specialist mix not available in CHC and FRUs- acute shortage of specialist doctors • The Programme management structure at the state and district levels - evolving • Presence of DPMS a strong support to the district health administration –contributed a great deal in the forward movement of the NRHM • DPMS need to have strong technical mentorship to enhance managerial skills to the health system

  7. Community Processes under NRHM • ASHA • ASHA in position in all visited facilities - well accepted by community, closer connect with families • Need of more clarity about role of ASHA and differentiation from Health-workers • Effectiveness of the disease control programmes including vector control programmes through active community participation in in operationalization and monitoring • Systems of financial management • System of financial recording in place with specific personnel at various facilities visited • Delays observed in JSY payments due to delays in requisition, processing and payout – need to ensure clear instruction flow and effective system for timely payments

  8. Overall: • Progress under NRHM has been significant and has achieved considerable impact in revitalising the system, enhancing staff availability creating locally responsive facilities, community mobilisation and increasing public and staff satisfaction • Need to stress more on improving outreach activities with effective IEC strategy • Some areas slower than others; this needs to be analysed, and corrective steps taken to avoid major long term difficulties • Need to use information base for local action and to define and ensure performance and accountability at each level

  9. THANK YOU!

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