Transcript Slide 1

PRESENTATION ON
NATIONAL RURAL HEALTH MISSION
(NRHM)
on
30TH OCTOBER 2008
NATIONAL RURAL HEALTH MISSION
• NRHM launched by Hon’ble Prime Minister on 12/4/2005.
• Aimed to ensure affordable, quality health care to the poorest
house holds in remotest areas.
• Special focus on 18 low performing States which have weak
public health indicators and weak infrastructure.
• Punjab is among the nine high performing States- Punjab,
Haryana, Gujarat, Maharashtra, Karnataka, Kerala, Tamil
Nadu, Andhra Pradesh, West Bengal.
7/7/2015
2
NRHM OBJECTIVES
• Universalized access to quality health care especially to rural poor
with focus on women and children.
• Reduced infant mortality rate and Maternal Mortality Rate.
• Ensuring population stabilization & gender equity.
• Prevention and control of communicable and non-communicable
diseases.
• Access to integrated comprehensive primary health care.
• Mainstream AYUSH- Integration of AYUSH with mainstream health
institutions .
• Promotion of Healthy life style.
• Emphasis on potable drinking water, hygiene, sanitation and
nutrition.
7/7/2015
3
KEY COMPONENTS OF NRHM
System strengthening
Community Partnership
Improved services
Infrastructure development
Village level planning
Monitoring through
computerisation
ASHA
Improved financial
management &
Human Resource
Village Health &
Nutrition Days
Specialist Services – On
call/contract
Public Private Partnership
Village Health &
Sanitation Committees
Immunization
strengthening
Telemedicine
Mobile units for un reached
Intra & inter sectoral
convergence
Increased involvement of
PRIs
24-Hour- delivery
services
Emergency Obstetric
Services
IMNCI
Adolescent health
Family welfare services
Accessibility, Approachability and Quality
NRHM STRATEGIES
•
Decentralization of the process of health planning and management from Village to
District level.
•
Involvement of PRIs and Village Health & Sanitation Committees.
•
Up-gradation of existing health institutions from Sub Centres to District Hospitals as
per Indian Public Health Standards (IPHS).
•
Flexible financing- untied funds for filling up the gaps in infrastructure and other
related activities.
•
Manpower requirement- recruitment of doctors, and paramedical staff in relation to
Woman & Child Health.
•
Improved management through capacity building- provision of computers, computer
operators, establishment of State, District and Block Programme Management Units
(PMUs).
•
Integration of AYUSH with the mainstream health institutions including recruitment
of Ayurvedic/Homeopathy doctors at PHC and CHC level.
•
Intersectoral Convergence with Nutrition, water and sanitation programmes.
•
Promotion of Public Private Partnership for achieving public health goals.
NRHM – ILLUSTRATIVE STRUCTURE
Health Manager
BLOCK LEVEL HEALTH OFFICE –---------------
Accountant
Store Keeper
Accredit private
providers for public
health goals
100,000
Population
100 Villages
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
VILLAGE LEVEL – ASHA, AWW, VH & SC
ASHAs, AWWs in every village; Village Health & Nutrition Day
Drug Kit, Referral chains
NRHM FIVE COMPONENTS
(PART- A)
(PART- B)
(PART- C)
RCH AND RELATED
ACTIVITIES
(RCH FLEXI POOL)
INITIATIVES UNDER NRHM
OTHER THAN RCH
(MISSION FLEXI POOL)
IMMUNIZATION
STRENGTHENING
PROGRAMME
(PART- D)
(PART- E)
NATIONAL DISEASE
CONTROL PROGRAMMES
INTER SECTORAL
CONVERGENCE
SCHEMES
INSTITUTIONAL ARRANGEMETS UNDER NRHM
STATE LEVEL
• State Health Mission chaired by Hon’ble Chief Minister.
• State Health Society chaired by Chief Secretary.
• Merger of all vertical societies into State Health Society.
• Signing of MoU with GoI.
DISTRICT LEVEL
• District Health Mission chaired by Chairman Zila Parishad.
• District Health Society chaired by Deputy Commissioner.
• Rogi Kalyan Samities in District/Sub Divisional Hospitals.
• Merger of all vertical societies into District Health Society.
..contd.. INSTITUTIONAL ARRANGEMETS UNDER NRHM
BLOCK LEVEL
• Block Health Committees at Block PHC.
• PHC Management Committee at PHC level.
• Rogi Kalyan Samities.
VILLAGE LEVEL
• Village Health & Sanitation Committees in each village.
• Accredited Social Health Activist (ASHA) for every 1000
population.
HEALTH INDICATORS
India
Punjab
23.5
17.8
13.4
14.9
Manipur
Kerala
7.5
6.8
4.5
4.7
Manipur
Delhi
62.15
68.25
73.5
Kerala
933
876
1001
1058
Pondicherry
Kerala
57
44
11
15
Manipur
Kerala
TFR (SRS 2005)
2.9
2.1
1.7
Kerala
Maternal Mortality Ratio (SRS 2005)
301
178
110
Kerala
50.7
72.5
96.5
T.Nadu
Institution Delivery (%) (NFHS III)
41
53
100
Kerala
Contraceptive Use (%)
56
63.3
73
HP
44
60
81
T.Nadu
Birth Rate
(SRS 2006)
Death Rate
(SRS 2006)
Life Expectancy at birth
Sex Ratio
(Census 2001)
IMR
(SRS 2006)
Ante Natal Care (at least 3 checkup)
(%)
(NFHS III)
(NFHS III)
Vaccine coverage (%)
(NFHS III)
Best State
TARGETS FOR PUNJAB
At the start of RCH
SRS 1998-1999
Present
Status
2007-2008
Target by
2009-2010
Total Fertility Rate
2.5
2.1
1.8
Infant Mortality Rate
49
44
<30
199
178
<100
Institutional Deliveries
37.5%
(NFHS II)
52.5
80%
ANC Check-up with 03
contacts
58.4%
(NFHS II)
72.5
100%
Indicators
(per 1000 live births)
Maternal Mortality Ratio
(per 100000 live births)
HEALTH INSTITUTIONS
PUBLIC
SECTOR
PRIVATE
SECTOR
MEDICAL COLLEGES
3
5
DISTRICT HOPITALS
20
SUB DIVSIONAL HOSPITALS
42
COMMUNITY HEALTH CENTRES
128
PRIMARY LEVEL HEALTH INSTITUTIONS
(PRIMARY HEALTH CENTRES/ CLINICS/
POLY-CLINICS/ DISPENSARIES)
1823
3046
SUB CENTRES AT VILLAGE LEVEL
2858
--
4858
4034
INSTITUTIONS
TOTAL =
983
NRHM
OVER THE YEARS
A sum of Rs. 336.25 crore has been received
from GoI from 2005-06 to 2007-08 against
which a sum of Rs. 309.29 crore has been
spent. The plan for the current year 2008-09 is
for Rs. 210.70 crore (Rs. 180.00 crore GoI +
Rs. 30 crore GoP).
Up-gradation of Institutions
•
District Hospitals – 5 District Hospitals are being upgraded at a cost of Rs 13.00 crore
by adding 230 beds in the current year. The Hospitals are – Gurdaspur (100-150 beds),
Ludhiana (100-130 beds), Mohali (70-130 beds), Patiala (MKS) (154-250 beds) &
Bathinda.
•
Construction of Mother and Child Hospital at Fatehgarh Sahib which was lying
suspended for 2 years would be resumed at a cost of Rs. 7 crores.
•
Sub Divisional Hospitals – 4 Sub Divisional Hospitals are being upgraded at a cost of
Rs.6.50 crores in the current year. The Hospitals are Batala (50-80 beds), Pathankot
(100-130 beds), Nabha ( 100-130 beds) & Patti (50-80 beds) at a cost of Rs. 2.50 crore.
•
PHCs at Adampur & Rural Hospial Morinda are being upgraded at a cost of Rs. 1
crore.
•
CHCs – Community Health Centre at Dhakoli (Zirakpur) will be constructed at a cost
of Rs. 2.50 crore.
•
75 PHCs for 24 hour delivery upgraded during 2007-08 and 26 being upgraded 2008-09.
•
50 CHCs for Emergency Obstetric care upgraded during 2007-08 and 10 being
upgraded 2008-09.
•
A sum of Rs. 10.00 crore has been earmarked from ACA of 2008-09 for setting up of
Urban Healthcare Centres in Municipal Corporation town, Bathinda.
Equipment and Furniture
• Equipment and Furniture worth Rs. 6.5 crore to be provided to
CHCs as per IPHS Norms
Drugs
• Drugs and consumable Rs. 3.60 crore provide to CHCs, Rs. 4.84
crore provided to PHCs and Rs. 6.00 crore provided to SHCs. Total Rs. 14.44 crore
Rogi Kalyan Samities
• In the year 07/08 Corpus Grant of Rs. 5 lac for 20 district
hospitals, 1 lac each for 42 Sub Divisional Hospitals and Rs. 1
lac each for 100 CHCs was provided.
Untied Fund & Maintenance Grant
• Rs. 10,000 as Untied Funds to 12300VHSCs–Rs. 12.30 crore
has been provided each year.
• Rs. 10,000 as Untied Funds to 2858 Sub Centre–Rs. 2.85 crore
has been provided each year.
• Rs. 25,000 as Untied Funds for 484 PHCs – Total Rs. 1.21
crore has been provided each year.
• Rs. 50,000 as Untied Funds to 128 CHCs - Total Rs. 64.00 Lac
has been provided in 2008-09.
• Rs. 50,000 as Annual Maintenance Grant to 484 PHCs – Total
Rs. 2.42 Crore in 2007-08 and to 100 PHCs – Total Rs. 50.00
Lac in 2008-09.
• Rs. 1.00 Lac as Annual Maintenance Grant to 112 CHCs –
Total Rs. 1.12 crore
School Health Programme
• Under School Health Campaign health checkup of 32,64,826
students of Primary and Secondary level will be done and minor
ailments will be treated and referral will be provided wherever
necessary. Report from PGI regarding treatments of Congenital
Health Disease and Rheumatic Heart Disease among children has
been received and proposal is being finalized. A total outlay of
Rs. 5.00 crore has been provided for the programme.
Emergency Response Services
• 224 Ambulance (56 advance life saving and 168 with basis life
saving equipments) equipped with medical facilities and Medical
Technicians are to be deployed in the State with Public-Private
Partnership total initial cost will be Rs. 41.00 crore. Recurring
cost will be Rs. 25.00 crore per annum.
Mobile Medical Unit
• Mobile Medical Unit (Rs. 36.00 Lac each) equipped with one
Male Medical Officer, One Female Medical Officer, Lab
Technician, Radiographer and Staff Nurse has been deployed to
provide medical services in the rural and remote areas. Total
outlay of Rs. 7.00 crore.
Village Health and Sanitation Committees
• 11319 Village Health and Sanitation Committees constituted and
provided Rs. 10,000 each per year.
ASHA
• 13201 ASHA workers selected in the State. They are not paid
given any fixed salary but instead are given cash ncentives on the
basis of their performance in child health, family planning and
institutional deliveries.
RECRUITMENT STATE PROGRAMME MANAGEMENT UNIT
SN
Name of the Post
Sanctioned
Post
Filled
Vacant
Consolidated
Salary PM
Remarks
1
Director Finance
1
1
0
On Deputation
2
State Programme
Manager
1
1
0
From State Govt.
3
Maternal Health
Specialist
1
0
1
40,000
4
Family Welfare Specialist
1
1
0
40,000
5
Procurement Manager
1
0
1
25,000
6
Manager (HRD)
1
1
0
20,000
7
Manager (F&A)
1
1
0
25,000
8
Manager (M&E)
1
1
0
20,000
9
State NGO Coordinator
1
1
0
30,000
10
Programme Coordinator
(ARSH & Gender)
1
1
0
20,000
Services have been
terminated
Candidate resigned
…contd…
SN
Name of the Post
Sanctioned
Post
Filled
Vacant
Consolidated
Salary PM
11
Programme Coordinator
(BCC)
1
1
0
20,000
12
Consultant (Admn)
1
0
1
20,000
13
Consultant (M&E)
1
1
0
20,000
14
System Analyst
1
1
0
15,000
15
Accounts Officer
2
2
0
15,000
16
Statistical Assistant
4
4
0
10,000
17
Hardware Supervisor
1
1
0
10,000
18
Accountant/ Accounts
Clerk
1
0
1
10,000
19
Accountant-cum-Cashier
2
2
0
10,000
Remarks
Not to recruit
…contd…
SN
Name of the Post
Sanctioned
Post
Filled
Vacant
Consolidated
Salary PM
Remarks
20
Computer Assistant
4
4
0
8,000
Selection has been done for
the vacant position candidate
is yet to join
21
Office Assistant
9
9
0
7,000
Appointment orders to 4 OAs
are being given
22
Graphic Designer
1
1
0
10,000
Selection has been done for
the vacant position
23
Procurement Assistant
2
2
0
8,000
Candidates have been adjusted
at State HQ from the districts
24
Drivers
2
0
2
5,000
Action is being initiated
25
Class-IV
3
2
1
3,000
45
38
7
Total
Action is being initiated
RECRUITMENT DISTRICT PROGRAMME MANAGEMENT UNITS
SN
Name of the Post
Sanctioned
Post
Filled
Vacant
Consolidated
Salary PM
Remarks
1
District Programme
Manager
20
17
3
20,000
Selection has been Done.
2
District Accounts Officer
20
20
0
15,000
Selection has been Done.
3
District Monitoring &
Evaluation Officer
20
18
2
15,000
Selection has been Done.
4
Procurement Officer
20
4
16
15,000
No further recruitment to
be made
5
Maintenance Engineer
20
17
3
12,000
Selection has been Done.
6
Statistical Assistant
20
17
3
8,000
Selection has been Done.
7
Procurement Assistant
20
0
20
8,000
No further recruitment to be
made. Procurement Assistant
have been adjusted as
Statistical Assistant or
accountant as per their
qualification
8
Accountant-cum-Cashier
20
13
7
8,000
Selection has been Done.
9
BCC Facilitator
20
11
9
8,000
Selection has been Done.
Total
180
117
63
36 vacancies are not to be
filled
RECRUITMENT BLOCK PROGRAMME MANAGEMENT UNITS
Sanctioned
Post
Filled
Vacant
Consolidated
Salary PM
Remarks
1
Block Statistical
Assistant
118
93
25*
8,000
*Recruitment in final
stage at district level
2
Block Accountant cum
Cashier
118
102
16*
8,000
*Recruitment in final
stage at district level
3.
Computer Operator
173
97
76*
5,000
*Recruitment in final
stage at district level
Total
409
292
117
SN
Name of the Post
RECRUITMENT EmOCs
SN
1
2
3
4
5
Name of the Post
Obstetricians
Paediatricians
Anaesthesia
Staff Nurses
OT Assistant
Sanctioned Post
60
60
60
300
50
Filled
29
21
38
251
10
Vacant
Consolidated
Salary PM
31*
Rs. 20000/- +
Rs. 3000/- HRA+
Rs. 1000/ EmOC +
Rs. 500/- per
delivery conducted
+ Rs. 200/ MTP
*Appointment letter to
11 Obst. Are being
Issued on 30.10.2008
39*
Rs. 20000/- +
Rs. 200/- per
Emergency Case
during off duty
hours + Rs. 3000/HRA
*Appointment letter to
12 Paed are being
issued on 30.10.2008
22
Rs. 1500/- on call
per case + TA Rs.
6/KM upto 50 KM
Remarks
*Empanelment for 12
CHCs under process
59
Rs. 8500/- + Rs.
1500/- (if
accommodation is
not provided)
*Recruitment Final
stage at district level
40
Rs. 4000/- + 300/evey Major OT
Case + Rs. 1500/HRA
Not required to recruit
RECRUITMENT PHCs 24x7 & Mini PHCs
SN
1
Name of the Post
Female Medical Officer
2
Staff Nurses
3.
Medical Officer Mini
PHCs
Sanctioned
Post
75
225
95
Filled
24
168
0
Vacant
Consolidated
Salary PM
Remarks
51*
Rs. 15000 PM +
Rs. 500 per
Delivery+ Rs.
200/ MTP + Rs.
3000/- HRA
*Appointment letter to 13
FMOs are being issued on
30.10.2008
57*
Rs. 5000/- + Rs.
500/- per delivery
conducted + Rs.
100/- per delivery
assisted and Rs.
1500/- HRA (if
accommodation
is not provided)
*Recruitment under
process at district level
Rs. 16,000/- PM
Appointment letter to 61
MOs are being issued on
30.10.2008
95
RECRUITMENT Mobile Medical Unit (MMU)
SN
Name of the Post
Sanctioned
Post
Filled
Vacant
Consolidated
Salary PM
Remarks
1
Medical Officer (Male)
20
20
0
22,000
Appointed in August 2008
2
Medical Officer
(Female)
20
20
4
22,000
Selection at final stage
3
Nurses
20
18
2*
8,000
*Recruitment under process at
district level
4
Radiographer
20
20
0
8,000
*
5
Lab Technician
20
20
0
8,000
*Recruitment under process at
district level from July 2008
and reports being received
6
Driver
20
20
0
7,000
*Placement agency hired
7
Helper
20
20
0
4,000
*Placement agency hired
RECRUITMENT ANM for Urban Slum Area & Sub-Centres
SN
Name of the Post
1
MPHW (Female) for
urban slums
2
ANM for vacant subcentres (2211)
3
2nd ANM
centres
for 954 sub-
Sanctione
d Post
230
514
954
Filled
114
0
0
Vacant
*116
514
954
Consolidated
Salary PM
Remarks
6,000
*Recruitment under process
at district level from July
2008 and reports being
received
6,000
Advertisement given on
23.08.2008 recruitment in
final stage
6,000
Advertisement given on
23.08.2008 recruitment in
final stage
Essential Services to be provided at EmOCs (FRUs)
•
24-hour delivery services including normal and assisted deliveries
•
Emergency Obstetric Care including surgical interventions like Caesarean
Sections(*) and other medical interventions
•
New-born Care(*)
•
Emergency Care of sick children
•
Full range of family planning services including Laproscopic Services
•
Safe Abortion Services
•
Treatment of STI / RTI
•
Blood Storage Facility (*)
•
Essential Laboratory Services
•
Referral (transport) Services
•
Janani Suraksha Yojna
•
(*): Critical determinants of functionality
Essential service package to be provided at 24x7 PHC
•
•
•
•
24-hour delivery services, both normal and assisted (*)
Essential newborn care (*)
Referral for emergencies (*)
Ante-natal care and routine immunisation services for children
and pregnant women (besides fixed day services).
• Post-natal care
• Early and safe abortion services (including MVA)
• Family planning services
• Prevention and management of RTIs/STIs
• Essential laboratory services
• Janani Suraksha Yojna
(*): Critical determinants of functionality
Services at Mini PHCs
• Routine OPD
• Management of National Health Programmes
–
–
–
–
–
–
–
RCH Service
Immunization Programmed
National TB Control Programme
National Leprosy Eradication Programme
National Vector Borne Disease Control Programme
Integrated Disease Surveillance Programme
School Health Programme
• Supervision of services at Sub-Centre Level
THANK YOU