Transcript Health and Nutrition

Health & Nutrition
Interventions under IKP
Outline of the presentation
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Goal
Objectives
Strategies
Tasks accomplished
Action plan for the year 2007-08
Conclusion
Goal
Improved health & nutritional
status in 45 IKP pilot mandals
with 1400 VOs of Andhra Pradesh
by 2008.
Objectives
• Empowered CBOs:
− Demand access and avail health & nutrition
services
− Improve house hold behaviours that help
maternal & child survival and control spread
of communicable diseases.
− Provide financial support during illnesses.
− Reduce expenditure on Health.
Strategies
• Continuous capacity building
• Convergence with line depts
• Communication for behaviour change
through Health CRPs and IEC
• Community Investment fund for need
based health and nutrition projects.
Tasks accomplished so far
Human Resources
VO,MMS and ZS level
– 1Health activist (HA) in every VO
– 5 member health subcommittee at VO,MMS and ZS
level
Mandal level:
– 1 HN CC per mandal
– 2 Master trainers with ANM qualification per mandal
– 3 DPM(HND)
State level:
– 2 Regional & 6 district field coordinators
– 1 Project Manager
Capacity building
• Institutionalized fixed days of training for Health Activists
with a fixed training calendar. (ie.,7th ,8th & 29th &30th)
• Capacity building of 5 member Health sub committee
(once in a quarter) by the SPMU team.
• fixed training calendar for regular training of SHG
members focusing on Sukhajeevana Suthralu (Neonatal
care, maternal care & general health care practices to
maintain good health.)
• Organized training cum exposure visit to Jamkhed for :
– 478 health sub committee members and health
CRPs.(6 days)
– 90 Master trainers (15 days of training)
– 35 HN CCs ( 10 days refresher training)
Fixed Nutrition &Health Days
(NHDs)
Against 1400 VOs, the Fixed NHDs
once in 15 days are institutionalized in 859
VOs in 38 mandals.
Health savings-Health Risk fund
• Against 45 mandals,38 mandals have initiated
regular and exclusive health savings.(Rs10-30 per
month).
• 1,03,771 of women in the SHGs (39%) have regular
and exclusive health savings to a total amount of Rs
45,89,629.
• Agianst Rs 13.20 crores (Rs 1 lakh/VO) sanctioned
for 1400VOs, 808 VOs were released with Rs
5,84,80,070.
• 6149 SHG members availed loans for health
purposes to an amount of Rs. 1,08,85,009. (i.e.,
42.2% of POP; 46.7% of poor and 10.7% of APL
members of the groups).
Nutrition cum day care centers
• 38 centers in 8 districts.
– 8 with project support (Krishna & Guntur)- Rs 13/1meal
– 8 with CFSL implementation (Vizag)- Rs 16/2 meals
– 22 with loan taken towards diet and support from VO
profits and dovetailing the sources from ICDS and JSY
( Vizianagaram, Vizag, E.G, W.G, Krishna, Guntur, Chittoor and
Karimnagar)-Rs 24/2 meals.
• Training module for the members at nutrition center and
make them as change agents.
• Regular ANC and PNC at the center.
• Counseling of mothers and mother-in-laws on harmful
myths that effect the mother and child during and after
delivery.
• Community Kitchen gardens to encourage the practice of
use of green leafy vegetables and other vegetables.
Impact on health outcomes
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Improved weight of the mother during pregnancy.
Normal deliveries.
Safe deliveries (Institutional/by trained personnel).
No complications during delivery
Birth weight of the baby is >3Kgs.
Practice of neonatal health care measures (2/3rd of
infants deaths are during the neonatal period)
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Feeding colostrum
Early and exclusive breast feeding.
Delay in bathing the baby
Kangaroo care for Low Birth Weight babies
• Decreased family expenditure on health of the mother
and the child.
(Towards reaching MDG 4,5 &6)
Community managed Health
Insurance scheme – KNR & Nalgonda
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ZS Partnership with Pvt medical college
3-5 years of coverage period
60,000-120,000 coverage cap
448-550 premium to all the SHG members and
their families
• Discount on tests and medicines
• Free In-patient treatment
Vizag model with 17 network hospitals is
Ready to launch!
Health CRP strategy for BCC
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Constitution of 5 member team identified from 5
different districts with best practitioners in:
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Introducing health agenda in SHG/VO/MMS/ZS meetings
Training of SHG members on preventive and Promotive health care
measures.
Promotion of health savings and HRF
Promotion of Comprehensive Food security and establishment of
Nutrition cum day care centers
Social mobilization for convergence activities
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Fixed NHDs with ICDS and Health dept
Environmental sanitation and water safety through Panchayat
Screening camps for women
Weaning foods for infants
26 days stay in 3 phases (12+12+2) to develop internal
CRPs to take it forward.
External CRPs work for 15 days outside the VO and 15
days for their own VO.
Achievements in 4 months (Jan-April 07)
• 110 external health CRPs were trained to work
in 8 districts and covered 52VOs (8+22+22).
• Health agenda is being introduced in all the
SHG & VO meetings.
• 100% members have regular health savings.
• 90% of members enrolled under CFSL.
• 24 Nutrition cum day care centers providing diet
for 280 pregnant and lactating women from POP
and Poor.
• 3 Community kitchen gardens under IGA.
• Fixed NHDs are institutionalized.
Achievements in 4 months (Jan-April 07)
• Convergence at VO level is improved in
conducting health educations sessions by the
HA &AWW and ANM.
• Organized screening camps for women and
referrals & follow up arrangements.
• Formation of youth and adolescent groups to
focus on bringing awareness on environmental
sanitation and personal hygiene in the
community and the families.
• Regular monitoring and review by the health sub
committees at VO,MMS and ZS meetings.
Budget - Expenditure
• Total budget available : 984.39 lakhs
• Expenditure incurred:
 2005-06 :
268.41lakhs
 2006-07
• IHCB
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320.10 lakhs
• Total expenditure : 588.51lakhs
• Budget proposed for 2007-08 : 533lakhs
Plans for 2006-07
• Continuation of the over arching activities planned such
as capacity building.
• Roll out of the Health CRPs strategy and with the
involvement of youth and with the support of local
Panchayats.
• Establishment of community managed Nutrition cum day
care centers ( Pregnant, Lactating, Children upto 2 yrs )
by dovetailing funds from ICDS and Janani Suraksha
Yojana Funds.
• Establishment of Drug depots managed at MMS and
Village diagnostic centers managed at VO level.
Plans for 2006-07
• Establishment of need based CIFs such as sanitary
napkin units to encourage adolescent girls and women to
maintain menstrual hygiene and protect themselves form
RTIs and communicable diseases such as HIV/AIDS.
• Adoption of tools for community based monitoring and
evaluation and make midcourse actions at all levels.
• Replication of HN interventions in 55 mandals supported
by DFID under health sector reform strategy. List of 55
mandals proposed is annexed. Still clearance need to
be obtained from the dept of Medical health and
Family welfare.
Health and Nutrition
Budget estimates for the year 2007-08
Amount to
be released
S.No Particulars
1 Capacity building of
2 Health CRP strategy
Total
3 CIFs
Grand Total
vo, MMS & ZS
Responsible for
implementation
27942200 VO,MMS &ZS
25361000 SPMU & MMS
53303200
203940000 VO,MMS &ZS
257243200
Thank you
Schedule to cover in 45 pilot mandals by External & Internal health
CRPs
Phase
I
Districts
1.
2.
3.
4.
5.
6.
7.
8.
II
1.
2.
3.
4.
5.
6.
7.
III
1.
2.
3.
4.
5.
6.
7.
Giripragathi 1.
2.
3.
Vizag
Guntur
Chittoor
Kareemnagar
Vizianagaram
E.Godavari
W.Godavari
Krishna
Ananthapur
Warangal
Nizamabad
Kurnool
Prakasam
Nalgonda
Srikakulam
Adilabad
Mahabubnagar
R.Reddy
Medak
Kadapa
Nellore
Khammam
Adilabad
Warangal
Khammam
Period
of
External Health
CRP stay
Jan –Aug07
Period
of
internal Health
CRP stay
Sept 07-Feb 08
March –Oct 07
Nov 07- April
08
Sept
08
07-March April 08- Sept
08
Nov 07-June 08
July 08-Dec 08
April 08 – Oct Nov 08-Apri 09
08
July 08 –Feb 09
March –Aug 09
May 07-Dec 07
Jan – June 08
Draft plan for coverage of entire district with health CRP strategy
Coverage of 8 Vos by External Health CRP teams
Period
Internal teams
Number of
developed from the Vos teams emerge
from a VO (@
2 teams from
VO)
No.of VOs
can be
covered in
the same
mandal
Jan-Feb 07
No internal teams yet formed.
2
teams of External teams will work in 8
Vos and the internal teams will be
developed after 6 months of work in
their own VO.
Vo1,VO2
March-April 07
May-June07
No.of
Mandals to
cover
Period of reaching the 30th VO in a
mandal
July 07'
Aug-07
VO3,VO4
Mandal 1
08-Feb
Sep-07
VO5,VO6
Oct-07
VO7,VO8
July -Aug 07
Period by which the
Internal Health CRP
teams will be
developed from the
Vos
Coverage of 22 Vos by Internal Health CRPs developed in the 8VOs
Sept-Oct 07
Nov-Dec 07
Jan-Feb 08
VO1 & VO2
VO1 & VO2, Vo3 & VO4
VO1 & VO2, Vo3 &
VO4,VO5
V9,VO10,
VO11,VO12
April-May 08
(2+2) =4
June-July 08
(4+2+2)=8
VO13,Vo14,V
O15,VO16,V
O17,VO18,V
O19,V20
Mandal 1
(8+2)=10
Vo21,VO22,V
O23,VO24,V
O25,VO26,V
O27,Vo28,V
O29,VO30,
08-Apr
08-Jun
Aug-Sept 08
08-Aug
No.of health CRPs teams developed in 1 mandal to cover other mandals (50)of the district
Period
April-May 08
Internal teams from the
Vos
Vo1,VO2,VO3,VO4,VO5,
VO6,VO7&VO8
VO9,VO 10,VO11,VO12
VO13,Vo14,VO15,VO16,
VO17,VO18,VO19,V20
Aug-Sept 08
Vo21,VO22,VO23,VO24,
VO25,VO26,VO27,Vo28,
08-Sep VO29,VO30
Total no.of mandals can be covered with
the 60 internal teams developed in
30VOs developed by 2 teams of exteranl
CRPs in one mandal:
June-July 08
Number of
teams emerge
from a VO (@
2 teams from
VO)
No.of VOs
can be
covered in
the other
mandal
As done in
Mandal
&2
16 As
done1in
No.of
Mandals to
cover
Period by which the
Internal Health CRP
teams will be
developed from the
Vos
Period of reaching the VO9-VO30 by
the Internal Health CRP teams in
same mandal/theother mandals
8 March 08-Oct o8
09-Apr
4 May 08 to Dec 08
09-Jun
8 July 08 to Feb 09
09-Aug
As done in
20 Mandal 1 &2
10 Sept 08 to April 09
09-Oct
60
30
8 Mandal 1 &2
As done in
16 Mandal 1 &2
March 08- Oct 09
Note 1:
1. 2 teams of External Health CRP teams (5 members) will cover 8VOs in 8 months (Jan 07-Aug 07).
2. 12 Internal health CRP teams developed from 6VOs will cover 24 Vos of the same mandal in 6 months (Sept 07-Feb 08)
3. 20 Health CRP teams developed by Internal Health CRP teams will be able to cover 10 mandals @2 teams /mandal.(March 08-Oct 09)
4. 12 newly emerged External CRPs teams developed from 6VOs will cover 6 mandals .(March 08-Apri 09)
* 60 teams will be developed by Sept 08 in Mandal 1 and to use them in 30 additional mandals of the same district (@ 2 teams /mandal) and
reach 30thVO in all 30 mandals by October 09.
*14 months are required to cover 30 Vos in a mandal by External Health CRPs for 8 months (8VOs) and Internal Health CRPs for 6months(22
Vos).
*The Internal teams developed by External teams (VO1 to VO8) will be used to cover 8VOs in 3 disability and 5 DFID support mandals from
March 08 to Dec 08 and the internal CRPs developed will cover VO9-VO30 from Jan-June 09.
*120 teams will be developed in 2 HN pilot mandals simultaneously to cover additional 50mandals in a
district from March 08-Oct 09 with the 4 External health CRP teams alloted (@ 2 teams per mandal) to the
district for 8months to cover 8VOs in each of the HN pilot mandal.