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GOAL To improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women and children. Health Indicators Current Status & Goals INDICATORS INDIA RAJASTHAN CURRENT GOAL 2011 CURRENT GOAL 2010 CRUDE BIRTH RATE (2004) 29.0 21.0 24.1 21.0 INFANT MORTALITY RATE (2004) 67 56 58 <30 MATERNAL MORTALITY RATIO (1998) 670 285 407 <100 TOTAL FERTILITY RATE (NFHS-II) 3.8 2.1 2.8 2.1 COUPLE PROTECTION RATE (2005) 43.9 65 45.4 60 Process Indicators for Achieving Goals Indicators Present Level 2006 Goals for 2011 •Full ANC • Complete immunisation of children 14.7 % 48 % 60 % 85 % • Unmet need 15 % 5% • Institutional deliveries 31.4 % 70% Sector Wide Concept NRHM Health RCH PH AYUSH NDCP Determinants IEC RHSDP Nutrition Sanitation Drinking Water NRHM State Project Management Unit District Project Management Unit State Health Mission State Health Society District Health Mission District Health Society Block Health & Sanitation committee Village Health & Sanitation committee CHC MRS PHC MRS Sub Centre ASHA PW Untied Fund NRHM Stakeholders AYUSH, PRI, DWCD ARC, SIHFW, IEC NRHM Transport, DPR Education, Coop, TSC, NGOs, PPP Village Level • 30,000 ASHA Sahyogini selected & trained (1st Round) • MCHN Day being organised in all 40,000 villages • Panchamrit campaign for underserved areas ( 20,000 pregnant women registered and 6.5 lac children immunized) • Microplanning for MCHN – Social Mobiliser identification • Community Needs Assessment survey completed Village Health & Sanitation Committee to be activated Village Household Survey to be undertaken Village Health Plan to be developed Identity Card & Drug Kit for ASHA under process Strengthening Health Facilities • 800 Sub Centre to be upgraded •Joint Bank Account of ANM & Sarpanch opened in 10030 Sub Centres. Untied Fund of Rs. 10000/- p.a. transferred to these accounts. •Untied fund used for buying weighing machine, B.P Instrument, repairs etc •Rs. 25,000/- released to all PHCs for strengthening • Rs. 1,00,000/- released to all CHCs. • Telephone connectivity in all PHC/ CHC • Funds received from GoI to upgrade all 325 CHCs to IPHS • CHCs being developed with RHSDP and Consultant Agency Components of IPHS • Hospital Building – RHSDP • Housing – NRHM • Drugs & Equipments – NRHM & RHSDP • Manpower – State Government / NRHM • Training – NRHM Man Power Planning under NRHM • Under NRHM implementation frame-work following additional manpower arrangements are envisaged :* 2 ANM Sub Centres. * 3 Staff Nurse per PHC * 7 Specialists and 9 staff nurse per CHC. * District cadre of ANMs and doctors. * Contractual engagements of doctors/specialists through Medical Relief Societies/District Health Societies. * Block Level Management of health system. * Incentives for rural posting of doctors. Operationalising 24 * 7 Facilities • 360 institutions selected for 24 * 7 services • 42 District/ Sub Division Hospitals, 213 CHCs, 105 PHCs • One functional facility in all 237 Blocks • Facility Survey completed for 180 institutions. • Ensuring functional services to be a priority of District Administration. Other Initiatives • Population Stabilization Pilot in Tonk & Jhalawar • Swasthya Sakhi Project initiated in 5 districts (Jhalawar, Barmer, Banswara, Bharatpur & Sikar) • Kaithun CHC telemedicine pilot with Sir Gangaram Hospital • School Health Programme • Drug supply for Sub Center / PHC/ CHC Action Plan & Challenges • Monitoring as per the State / District Template • Microplanning at village level • Support & Mentoring of ASHA- Sahyogini •Preparation of Village/ Block / District Action Plan • Ownership by stakeholders • Mainstreaming & empowering Programme Management Units. Fund Flow under NRHM • Funding for 05-06 for RCH / NRHM was Rs. 82.27 crore • Allocation for 06-07 is Rs. 407.9 crore, including : RCH flexi fund : Rs. 107.90 crore NRHM flexi fund : Rs. 99.84 crore National Disease Control Programme : Rs. 29.56 crore CSS : Rs. 135.46 crore • Ensuring payment to ASHA-Sahyogini • Timely submission of SoE / UC to enable fund flow • Observance of Financial propriety KEY THEMES FOR NRHM • Promotion of institutional deliveries through Janani Surksha Yojana. • Advocacy and action for legal age at marriage. • Improved access to quality contraception services. • Action against sex selection and female foeticide.