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Integrated District Health Society SOUTH DISTRICT NRHM

Integrated District Health Society SOUTH DISTRICT NRHM. Dr. JYOTI SACHDEVA PO, NRHM. NRHM. Launched by the Prime Minister on 12 th April, 2005. Focuses on 18 states (EAG) including eight Empowered Action Group (EAG) States, the North-Eastern States, Jammu & Kashmir and Himachal Pradesh.

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Integrated District Health Society SOUTH DISTRICT NRHM

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  1. Integrated District Health Society SOUTH DISTRICTNRHM Dr. JYOTI SACHDEVA PO, NRHM

  2. NRHM • Launched by the Prime Minister on 12th April, 2005. • Focuses on 18 states (EAG) including eight Empowered Action Group (EAG) States, the North-Eastern States, Jammu & Kashmir and Himachal Pradesh. • Aims to focus on the 18 states having weak public health indicators (Arunachal Pradesh, Assam, Bihar, Chhattisgarh, H.P, Jharkhand, J&K, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura, Uttaranchal and Uttar Pradesh). • Enhancing the commitment of the government to raise expenditure on public health from 0.9 % to 2-3 % of GDP

  3. OBJECTIVES A All Levels Primary Secondary Tertiary ccessible ccountable cceptable ffordable • Quality Care • Rural & Vulnerable • Equitable • Strengthening • Communitization • IEC

  4. GOALS • Universal Access • Prevention and Control of CD &NCD • Access to integrated comprehensive Primary Health Care • Reduction in IMR & MMR • Population Stabilization, Gender and Demographic Balance • Revitalize local health traditions and mainstreaming AYUSH

  5. STRATEGIES • Decentralized Planning (Inter State & Inter District Profile) • ASHA • Strengthening of Primary Health Care Infrastructure • Ensuring Quality • Promotion of Non Profit Sector • New Health Financing Schemes • Integration of ongoing disease control Programs

  6. SUPPLEMENTARY STRATEGIES • Regulation of Private Sector • Promotion of PPP • Mainstreaming AYUSH • Reorienting Medical Education • Effective and Viable Risk Pooling and Social Health Insurance • Convergence

  7. GOALS (NPP - Immediate) • Maternal Mortality Rate (MMR) reduced from 407 to 100 per 1,00,000 live births. • Infant Mortality Rate (IMR) reduced from 60 to 30 per 1000 live births. • Total Fertility Rate (TFR) reduced from 3.0 to 2.1 • Effective healthcare to rural population. • Increase public spending on health from 0.9% GDP to 2-3%.

  8. COMMUNITIZE • Hospital Management Committee/PRIs at all levels • United grants to community/PRI Bodies • Funds, functions & functionaries to local community organizations • Decentralized planning, Village Health & Sanitation Committees • MONITOR, PROGRESS AGAINST STANDARDS • Setting IPHS Standards • Facility Surveys • Independent Monitoring Committees at Block, District & State levels • FLEXIBLE FINANCING • United grants to institutions • NGO sector for public Health goals • NGOs as implementers • Risk Pooling – money follows patient • More resources for more reforms NRHM – 5 MAIN APPROACHES • INNOVATION IN HUMAN RESOURCE MANAGEMENT • More Nurses – local Resident criteria • 24 X 7 emergencies by Nurses at PHC, AYUSH • 24 X 7 medical emergency at CHC • Multi skilling • IMPROVED MANAGEMENT THROUGH CAPACITY • Block & District Health Office with Management Skills • NGOs in capacity building • NHSRC/SHSRC/DRG/BRG • Continuous skill development support

  9. CONVERGENCE SANITATION NUTRITION HEALTH WATER SUPPLY EDUCATION

  10. Convergence with ICDS • Provision of • Weighing machines. • IEC Material . • Training of 257 CDPOs / Supervisors. • Malnutirtion / anemia -- planning Commission parameters. • Identification of malnourished and anemic children / woman and targeted supplementation / counseling / monitoring .

  11. Involving the Community (Communitisation) • ASHA • ROGI KALYAN SAMITI • HEALTH AND SANITATION COMMITTEES

  12. COMPONENT ASHA (ACCREDITED SOCIAL HEALTH ACTIVISTS) • Chosen by and accountable to the panchayat. Functions of ASHA Advice rural community regarding • Immunization, ANC registration, institutional delivery contraception and sanitation, hygiene, etc. Treatment for • Minor ailments like- diarrhea, minor injuries and fever. Accompany patients • To health facilities. • Deliver DOTs Overall bridge between the ANM and the village. • Facilitate preparation & implementation of the Village Health Plan. • Eye Care

  13. PROG. SUPPORT TEC. FLOW CHART SUPPORT PROGRAMME MGT. NRHM CELL/NHFW NHSRC NATIONAL MISSION DIRECTOR National Level SPMU SHSRC STATE MISSION DIRECTOR State Level DHSRC DISTRICT MISSION DIRECTOR DPMU District Level BLOCK PUBLIC HEALTH MISSION BHSRC BPMU Block Level

  14. Decentralization • State specific • District specific CNAA

  15. PLAN Ex- post Evaluation Ex-ante Evaluation (Evaluaability / Design Assessment) Needs Assessment Feedback Post Implementation Decision of Implementation Monitoring See Do Implementation Terminal Evaluation Mid- term Evaluation Process Evaluation

  16. GOI / State Department of Health & Family Welfare DHS DSHM DFW State Health Society IDHS Additionalities PPIP RNTCP NPCB NVBDCP NIDDCP IDSP NLEP RCH Community involvement RKS / ASHAs Convergence with agencies / Departments /Programs Standardization & Strengthening of Health Infrastructure to address heterogenity / multiplicity/ and give quality healthcare.

  17. Decentralization levels • Planning • Accounts • Implementation • Procurement • Recruitment • Reporting • Monitoring Faster/ More logical solutions

  18. Chairman District Health Society (Deputy Commissioner) Mission Director (Chief District Medical Officer) ACDMO PC PHDT & QAC District NRHM/ ASHA District RCH Officer DNBCP Officer NLEP Officer IDSP Officer District Immunization, NVBDCP & NIDDCP Officer District Programme Management Unit DPM DTC MIS BCC DAM ASHA, MCD, IPP – VIII (Nodal Officers) Monitoring Committees MO Specialists Paramedics

  19. Funds transferred to States PIP approved by GOI Reporting Back of Exp. To Centre With UC and Audit Report Funds transferred to Districts Funds transferred to PHC/CHC/Other Impl. agencies Reporting Back of Exp. To State Reporting Back of Exp. from PHC/CHC/Other Imp. Agencies to District

  20. Strengthening of District Infrastructure DPMU DISTRICT STORE DISTRICT TRAINING CENTRE DISTRICT BCC CELL

  21. Strengthening of Primary Infrastructure Potential PUHCs • Every PUHC is to cater to a population 50,000 each. • The essential elements of a PUHC are Preventive, Promotive, Curative and Rehabilitative Primary Health Care • The PUHC has to upgraded as per the Public Health Standards laid down by Department of Health & Family Welfare • It aims at Community Participation and Community Linkage through RogiKalyanSamiti and ASHA respectively.

  22. Strengthening of Primary Infrastructure Potential PUHCs Total Potential PUHC = 32 (18 DGD +11 M&CW +3 IPP VIII)

  23. Strengthening of Maternity Home Strengthening of Secondary Health Care

  24. Coverage of Unserved/Underserved Areas SEED PUHC

  25. Public Private Partnership MAMTA • BPL/SC/ST • Move with private nursing home Mamta Friendly Hospital • Antenatal/Intranatal Services/Postnatal/Early Neonatal • Rs 4000/- per centre ARPANA TRUST - NGO

  26. HMIS • Decentralization of Reports- District - Facility • Tracking System • Eye Related Activities

  27. THANK YOU

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