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NATIONAL RURAL HEALTH MISSION JHARKHAND

NATIONAL RURAL HEALTH MISSION JHARKHAND. Key Health Indicators. CHILD Health Indicator. Health Share in State Budget. 5. Percentage of Health Share in State Budget. (Overall increase is 14.33% in 2008 – 09). 1. MATERNAL HEALTH Mukhya Mantri Janani Shishu Swashthya Abhiyan (JSY)

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NATIONAL RURAL HEALTH MISSION JHARKHAND

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  1. NATIONAL RURAL HEALTH MISSION JHARKHAND

  2. Key Health Indicators

  3. CHILD Health Indicator

  4. Health Share in State Budget 5

  5. Percentage of Health Share in State Budget (Overall increase is 14.33% in 2008 – 09)

  6. 1. MATERNAL HEALTH MukhyaMantriJananiShishuSwashthyaAbhiyan (JSY) (Goal is to bring MMR to 100/100000 live birth by 2012 from the present 371) Target groups are 17% of total population are eligible couple and 3% of them are expected to be pregnant at any given time.) • Scheme to improve IMR & MMR. Indicator by encouraging institutional delivery and child immunisation • Voucher based scheme. • Enrollment of confirmed pregnant women • Registration 100 + ANC 400 (900 for institutional delivery) 500 (for home delivery) Rs. 600 for SAHIYYA packages) • Encourage institutional delivery and child immunization. • Being run by collaboration with 141 private sector facility also. 2 MOU with DVC and KGVK to be signed in addition. • 24x7 services to be ensured in all PHCs with 3 doctors, 3 staff nurses skilled for delivery and transport services and New born care • Upgrading all sadar and sub-divisional hospitals to the level of FRUs – with 7 specialists, blood storage facilities, caesarian delivery facility and anaesthesia

  7. MMJSSA(Mukhya Mantri Janani Shishu Swasthya Abhiyan) Constraints • Start from July 06 • Registration is high but institutional delivery is low • Lack of adequate awareness about the programme among the potential beneficiaries Target for 2007-08 Total Target - 634691 Total Reg. - 201298 Total Inst. Delivery - 51667 beneficiaries Institutional delivery at Private health facilities: 10389 Safe Home Delivery: 105468 By ANM – 80339 By SBAs - 105468 Fund Allotment & Expenditure

  8. Proposed Budget 2008 – 09 (in lakh) TOTAL BUDGET : 5800 lakhs

  9. 2. Child Health Goal: To bring IMR to 30 / 1000 live births by 2012 from the present 50 • IMNCI Training (Integrated Management of Neo – Natal & Child Illness) – 2 Districts (Ranchi, E. Singhbhum) 3763 persons has been trained. • IMNCI TOT Training (for Doctors & Staff Nurses) - 4 Districts (Bokaro, Lohardaga, Hazariabagh, Saraikela-kharsawa) 24 persons has been trained as IMNCI TOT 3. Sick Newborn Care Unit - 4 Districts (Dhanbad, Bokaro, Hazaribag, Saraikela) 4. Sick New Born Care Unit – 1 in Ghatshila in Collaboration with UNICEF – in Progress 5. Mother and Child Survival and Development 6. Cell set-up with help from UNICEF to monitor JSY, RI and other activities. 7. Vitamin A supplementation & Village Health Nutrition Day – Thursday in every month on AWWs. 8. Referral Transport – 146 ambulances in service in which 80 with NGOs. 9. Zero Diarrhea Death Programme – ORS, Bleaching Powder being provided to DH, PHC, HSC and Villages 10. Mobile Health Clinics in hard to reach areas. 11. SBA training – so far 20 SBA trainer available.

  10. Expenditure & Allotment in 2007 - 08 (Amount in Lakh) Proposed Budget 2008 – 09 (in lakh) TOTAL BUDGET : 3727.40 lakhs

  11. 3. Family PlanningGoal: To reduce TFR to 2.1 by 2012 from the present 3.1 in JharkhandTarget in 06 – 07 1.5 lakhsparmanent method + Tubectomy 94934 / NSV 6461Achievement – 1.01 lakh • Target for 2007-08 Achievement • IUD - 269002 58040 • Tubectomy - 150000 94215 • NSV - 15000 15923 • Other activities • Spacing Method – Condom & IUD Promotion • Social Marketing & social Franchises of Birth Spacing means • Fixed Days Sterilization • PPP (Private and Corporate Hospital) • Innovation way of Birth spacing – Standard days method – Pilot study taken up in 3 blocks of Ranchi district covering 68 health facilities and 198 villages.

  12. Expenditure & Allotment in 2007 - 08 (Amount in Lakh) Proposed Budget 2008 – 09 (in lakh) TOTAL BUDGET : 2557.19 lakhs

  13. 4. Strengthening Routine Immunisation The district wise immunization performance within the state seems to be satisfactory. But when this data is compared with the external data like that of NFHS3 there seems to be Large variance. • Source: *UNICEF, NFHS3) • Constraints for poor quality of immunization: • Lack of staff • Far-away sub-centres and improper transportation • Illiteracy • Suggestions for improving the quality of immunization: • Vacant staff positions should be filled-in • At least two months stock of all the vaccines at CHC level • Proper transportation facilities • Maximum IEC coverage so that people should know about the date and venue of immunization

  14. Expenditure & Allotment in 2007 - 08 Proposed Budget 2008 – 09 (in lakh) TOTAL BUDGET : 1711.11 lakhs

  15. NRHMAdditionalities

  16. [ 1 ] INFRASTRUCTURE Challenges : Infrastructure Gaps

  17. The qualitative View • Out of 3958 HSCs; only 1732 have their own structures. • Out of 330 Additional PHCs only 117 have their own miniscule structure • At block headquarters – 194 PHC structures 32 referral hospitals None of the facilities are as per IPHS

  18. Service area and location of PHCs and Health Sub centers to be reorganized. • GIS Maps : to be prepared at State Headquarters and sent to • the Deputy Commissioners. • 10 ANMTCs have been rejuvenated. • Plan for 2007-08 • PHYSICAL • CHC : 108 • PHC : 77 • Sub centers : 212 from State Budget • 148 HSC from Rural development • 24 HSC from DVC in 2 districts (Bokaro & Dhanbad) • FINACIAL • Fund released from State Budget : Plan Head & 12 Finance Commission – 15974 lakh • NRHM – 600.00 lakh Infrastructure Planning

  19. Proposed Budget 2008 – 09 (in lakh) TOTAL BUDGET : 32059.00 lakhs

  20. [2] Community ownership– Sahiyya Movement • Village health committees (VHCs) formed through community empowerment: Through NGOs • VHC chooses one (can choose more than one also if deems fit) woman to provided training in public health issues. • Sahiya is trained and supported by the network NGO in all community and health related aspects. Health department and State Resource Center provides technical support. • Sahiya works for the VHC and VHC can pay for services. • Sahiya acts as a bridge between Line department and Community and convergence of programs

  21. ASHA is our SAHIYYA • Total SAHIYYA to be selected : 50000 • 2005 – 06 1282 • 2006 – 07 13043 • 2007 – 08 22334 • Total Selected : 36659 • ASHA trained – 1st Module : 25000 (2096 in 06 – 07 rest in 07 – 08) • ASHA trained – 2nd Module : On - going • Tot for 1st & 2nd Module (State Level) : Completed • BTT trained : 3392 • No. of VHCs : 27022 • Village Covered : 26702 • Sahiyya identification by Badge, Bags, Cap, Patta : 36659 ready • Sahiyya Kits Procurement : Under Process Expenditure: 2005 – 06 – 69.72 lakhs 2006 – 07 – 87.15 lakhs 2007 – 08 – 224.37 lakhs

  22. Expenditure & Allotment in 2007 - 08 Proposed Budget 2008 – 09 (in lakh) TOTAL BUDGET : 2993.59 lakhs

  23. [ 3 ] Strengthening of Health Institutions Untied Fund • CHCs @25000: 194 fund disbursed to district 97.00 lacs • HSCs @10000: 3820 fund disbursed to district 1140 lacs Grant to HMS (RKS) • District Hospital : 22 @ 5 lacs • S. District Hospital : 6 @ 2 lacs • CHCs : 187 @ 1 lacs • PHCs : 231 @ 0.5 lacs Fund disbursed 443 lacs Annual Maintenance grant for PHCs @ Rs. 50000 each Fund disbursed 194 lacs

  24. Expenditure & Allotment of Untied Fund in 2007 - 08

  25. Proposed Budget 2008 – 09 (in lakh) TOTAL BUDGET : 3796.30 lakhs

  26. AYUSH • Infrastructure Available: • Ayush Dispensaries 267, Joint Dispensaries (DH) 22 • Human Resource: • B. Actions being taken to fill up the gap • Post advertised • Letters issued for interview • Recruitment on contract to be finalised by April – May, 2008 • Buildings: • 22 joint dispensaries building available, • 2 joint dispensaries building to be built in 2008 – 09

  27. AYUSH • 1. AYUSH college: Ayurvedic college in Chaibasa • Unani in Giridih • Homeopathic in Godda • established, functioning in rented building, • building sanctioned & under construction • Ayurvedic Pharmacy College in Sahibganj & Gumla sanctioned and being established • College of Yoga, Sidha & Panchkarma – Proposal to setup in 10 districts @10 lacs each – Provision of 1 crore made in 2008 – 09 State plan

  28. AYUSH • C. Mainstreaming • 91 AYUSH dispensaries in 16 districts tagged with91 block PHCs (CHC) • Provision of 465 lacs for infrastructure in state plan of 07 – 08 • Provision of 1100 lacs for Ayush made in state plan of 08 - 09 • GOI had allocated 309 lacs for AYUSH in years 2002 – 03 to 2005 -06 which was not • utilised. To utilised the fund meant for medicine test laboratory and state • enforcement mechanism for state licensing authority we have made outlay of 208 • lacs in 08 – 09 in state plan budget • Proposal to GOI for – • Organisation of Health Mela at block / district • Training for paramedicals of AYUSH • Reorientation for Ayush doctors • Hospital for Yoga, Sidha and Panchkarma in 14 districts • Additional fund for medicines for Ayush dispensaries • 50000 each for improvement of dispensaries and upgradation to 20 bedded for DH

  29. National Disease Control Programme • Blindness Control Programme • National Vector Borne Disease • Revised National Tuberculosis Programme • Leprosy Eradication Programme

  30. 1. JHARKHAND STATUS (Blindness)

  31. JHARKHAND STATUS (Blindness) Fund Allotted (2006 – 07): 180.15 lacs Expenditure: 173.97 lacs Fund Allotted (2007 – 08): 285.09 lacs Expenditure: 210.00 lacs till 28.02.2008 Proposed Budget: 1088.63 lacs

  32. 2. JHARKHAND STATUS (Malaria)

  33. NVBDCP (National Vector Borne Disease Control Programme) • Goal: • Elimination of Kala – Azar by 2010 • Elimination of Filariasis by 2015 • Reduce the Morbidity & Mortality of Malaria by 50% by 2012 • To reduce the morbidity & Mortality of JE & Dengue 50% by 2012 • STATUS OF JHARKHAND • 1. State Malaria Programme in all 24 districts – under plan head in Schedule area & • under non – plan head in non schedule area. • 2. EMCP – Enhanced Malaria Control Programme was launched in 18 districts covering • 147 PHCs by World Bank • 3. IMCP – Under Global Funding (Intensified Malaria Control Programme) was started • in 07 districts (Hazaribagh, Giridih, Bokaro, Chatra, Koderma, Deoghar, Palamu).

  34. STRATEGIES Early Diagnosis & complete treatment Transmission on risk reduction by Vector control IEC / BCC for Malaria Control Capacity Building MIS Rapid Response team & management of serious cases Targeted Area : 2937 HSC Targeted Population : 1.62 lakh Targeted Coverage : 1.09 in 2006 & 2007 7. For controlling the Malaria Parasites, Gambuzia Fish Culture to be raised.

  35. 3. Kala Azar elimination Jharkhand shows the way…………. Affected area: Dumka, Godda, Pakur, Sahibganj districts Target in elimination by 2010 through institutional care and support to Kalazar patients in the endemic districts • Innovative scheme under PPP • Tripartite MOU involving an International Development Partner (CRS) and grass • root level Faith based Organisations (DSES) • Goal – To achieve Kala Azar elimination by 2010 through Institutional Care and • support to Kala Azar patients in the endemic districts of Dumka, Sahibganj, • Pakur and Godda • Free diagnostic and indoor treatment facilites with 3 time nutritious meals, for 28 • days to the Kala Azar patients. • In the very 1st quarter (Oct 1 – 31st , Dec,06) of the 2 year project 432 Kala Azar • patients were successfully treated by the 14 FBO’s in the 4 districts.

  36. Kala Azar elimination Jharkhand shows the way…………. Affected area: Dumka, Godda, Pakur, Sahibganj districts Target in elimination by 2010 through institutional care and support to Kalazar patients in the endemic districts District wise & Year wise cases and treatment

  37. KALA-AZAR REPORT (up to November, 2007)

  38. JHARKHAND STATUS (NVBDCP) Fund Allotted (2006 – 07): 809.08 lacs Expenditure: 307.52 lacs Fund Allotted (2007 – 08): 914.76 lacs Expenditure: 280.02 lacs till December, 2007 Proposed Budget(2008 – 09): 1407.78 lacs

  39. Indicators showing achievements of RNTCP 2006-07 • Goal: Search / identification of patients – at least 70% of the possible patients to the searched (144 per lakh Population) • At least 85% of them to be treated and cured. • Sputum of the patients to be examined for diagnosis • Smear positive patients to be put on DOTs after registration • Free distribution of drugs under DOTs – Directly Observe Treatment • Short Course • As per WHO Norms • 3 patients at every 2 minutes interval die of TB • Identification should be 144 per lakh per year • The service delivery in jharkhand was started in 2000 in 2 districts Ranchi & Palamu including Latehar. Today all 24 districts are added the entire State having access to DOTS service

  40. Indicators showing achievements of RNTCP 2001-07

  41. Infrastructure for RNTPC • No. of District TB Control Society : 22 • No. of TB Unit : 65 • No. of DMC (Microscope Centre) : 299 • No. of DOTS Centres : 9961

  42. JHARKHAND STATUS (RNTCP) Fund Allotted (2006 – 07): 4.20 lacs Expenditure: 229.00 lacs Fund Allotted (2007 – 08): 360.00 lacs Expenditure: 264.00 lacs till 13th December, 2007 Proposed Budget (2008 – 09): 791.58 lacs

  43. 6. JHARKHAND STATUS (Leprosy) • National PR is 1.09 to bring below 1

  44. Leprosy Prevalence Status

  45. JHARKHAND STATUS (Leprosy) Fund Allotted (2006 – 07): 131.40 lacs Expenditure: 68.51 lacs Fund Allotted (2007 – 08): 75.12 lacs Expenditure: 48.28 lacs till 13th December, 2007 Proposed Budget(2008 – 09): 612.66 lacs

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