Transcript CHALLENGES & OPPORTUNITIES

Dr.S.P.Yadav
Director, Family Welfare
Government of Rajasthan
1
RCH- II Vision
To bring about outcomes as envisaged in
the State Population Policy, minimizing
regional variations in areas of RCH and
population
stabilization
through
an
integrated, focused, participatory program,
meeting unmet demands of the target
population and provision of assured,
equitable, responsive quality services.
2
Rajasthan Population Policy Goals
2001
2008
2011
TFR
3.78*
2.6
2.1
Birth Rate
31.1
24
21
Death Rate
8.0
7.0
7.0
IMR
80.0
62
56
Source: State Population Policy, 2000
3
RCH-II Key Strategies
1.
Strengthening Project Management Structure at state and
district
2. Strengthening Infrastructure at various levels of service
delivery
3. Human resource development and capacity building
4. Improving quality of services through setting standards,
indicators and process protocols
5. Strengthening Referral System
6. Strengthen and improve logistics and supply systems
7. Strengthening information system, monitoring and evaluation
8. BCC for increasing demand for RCH and contraceptive
services
9. Technical interventions under MH,CH, FP, ASRH and Gender
10. Separate Tribal and urban slum components
11. Strengthening Networking and Partnership with the civil
society
4
Strategy & Progress so far:
Strategy:1 Strengthening project management
structure
•State Health Society – constituted
•District Health Society – constituted in 32 districts
•RMRS in 298 CHCs and 358 PHCs registered. Other
under process
•SPMU – established
•DPM DAM & DA posted in almost all 32 districts
•Reorganization of Directorate and thematic division
set-up
•Key positions in each thematic division filled
5
Strategy:2 Strengthening
Infrastructure
• Development of 800 model Sub-centre with labour room
(200 developed 2005-06)
• Revolving funds to all 1488 PHC @Rs.25000/- for
maintenance
• Strengthening of 43 BEmOC @ Rs.4.9 lac/ each
• Facility survey planned for 228 PHCs
** A rationalization exercise undertaken to avoid duplicacy
128 CHCs under IPHS and 197 CHCs covered under
RHSDP
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Strategy:3 Strengthening Human Resources
• Orientation of District teams for operationalisation of
RCH II and NRHM interventions completed.
• Specialized skilled trainings – master trainers for
anesthesia, BEmOC and blood storage unit, SBA and
IMNCI developed.
• District level training for BEmOC, BSU, SBA, IMNCI
initiated.
• Midwifery Resource Centre for SBA TOT established.
• ASHA Resource Centre established.
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Strategy:4 Improving QOC and Referral
Services
•Referral protocols developed by RHSDP
•7 days mobility support to each PHC/CHC and Dy.CM&HO
office
•Money for referral transport at each SC/PHC/CHC given under
untied fund.
•Referral transport under JSY scheme.
Strategy:5
Drug Logistics and warehousing
•Establishment of corporation for procurement logistics and
warehouse on the line of TNDMC
•Cold chain equipment maintenance.
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Strategy:6 -Strengthening HMIS
• Eligible Couple Survey for CNAA completed.
• HMIS formats revised.
• Gram Set: The studio established and installation of equipment in
progress.
• Initiate concurrent evaluation and service statistics validation exercise
in 3 districts.
Strategy:7-Behaviour Change Communication (BCC)
• State Plan for BCC under finalization.
• Four thematic areas identified for intensive communication campaign.
–
–
–
–
Age at Marriage
Sex Selection
Institutional Delivery
Small Family-Happy Family
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Thematic Area Interventions
A. Maternal Health
Antenatal Care
• To improve the coverage of full ANC (three check-ups + 2 TT + 100 IFA)
from the current level 14.7 percent (DLHS-RCH 1998-99) to 60 percent by
2010
Intranatal Care
• To increase delivery by skilled birth attendant (doctor, ANM, Nurse) from
15.5 percent (DLHS-RCH 1998-99) to 35 percent by 2007 and 60 percent
by 2010.
• Increase the met need of EmOC by women manifesting with obstetrics
complications
Post natal care
• Increase the post natal care services (including 3 follow ups) from
current level to 50 percent by 2010.
Promotion of Safe Abortion Practices
• To increase the safe abortion services from current level to 50 percent
by 2010
RTI/STD Management
• To reduce the prevalence rate of RTI/STI among women from 37 percent
(DLHS-RCH 1998-99) to 22 percent by 2007 and 5 percent by 2010.
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B. Maternal Health Progress
• 24 hours delivery: 931 PHCs covered and 13274
•
•
•
•
deliveries conducted up to July 2006.
RCH camps: 20 camps per district per month. 583
RCH camps held between April to July 2006.
Dai trainings: 10000 TBA training per year planned &
1191 dais trained up to July 2006.
Hiring of Additional ANMs: 648 ANM hired against plan
for 1321 ANMs
Planned for hiring of additional 50 PHNs & Lab
Technician for 2005-06 and 100 for 2006-07.
(Contd….)
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C. Maternal Health Progress
• Operationalization of 360 institutions initiated (172
BEmOC + 60 CEmOC + 128 IPHS) for EmOC
services.
• Provision of safe abortion services at Govt. and
private institutions
• RTI/STD services available at all institutions
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D. Child Health
Objectives
• Increase coverage of complete immunization
of children in12 -23 months from 37.1
percent (DLHS –RCH 1998-99) to 50 % by
2007 and 85 % by 2010
• Increase in proportion of newborn children
provided newborn care at the time of delivery
and first week of postnatal period
• Increase in proportion of sick children
having access to clinical care ,especially
diarrhea ,ARI and child hood illness
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E. Child Health
Strategies
• Strengthen routine immunization
• Improve outreach services through MCHN days.-169095
days observed at AWW.
• Strengthening cold chain and Logistics
• Integrated Management of Neo-natal & Childhood Illness.
• Continuation of Vitamin A Bi-annual drives
• Progress
• Task Force constituted for Child Health.
• IMNCI intervention initiated 9 districts
• MCHN days: 169095 sessions observed at MCHN day sites
(89.6%)
• Immunization: 26.51% children were fully immunized up to July
06 against the yearly target.
14
F. ASRH Services
•
•
•
State level planning workshops held
Master Trainers training planned September,
2006
LSE training of Teachers under progress
15
Achievement of Various FP Methods
S.
No.
1
Contraceptive
Services
Sterilization
For the Year 2005-06
For the Year 2006-07
(up to July 2006)
Ach.
%
ELA
Ach.
%
317307
51.29
618686
57905
9.36
(up to 20-08-06)
2
IUD Insertions
305346
84.82
360000
107431
29.84
3
OP Users (NEW)
518465
99.22
522555
220973
42.29
4
CC Users (NEW)
574079
93.24
615725
249004
40.44
•Static centers-212
•Laproscopic tubectomy trained surgeon- 582
•NSV trained doctors- 121
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Strategy:9 Strengthening Networking and
Partnerships
•Selection of 19 MNGO & 1 Service NGO
completed.
•FCC through NGOs in 8 districts
•Up scaling of JSY helpline in 32 blocks
through NGOs
17
Strategy:10 Innovative Schemes and Pilot
Programmes
•Connectivity of district hospitals with medical colleges
proposed under Tele-medicine.
•Pilot project in Tonk and Jhalawar for population
stabilization.
•Establishment of PCPNDT Cell at SIHFW
•SHRC establishment under process
18
Strategy:11 (a) Tribal RCH
• Proposed to cover 6 districts.
• To ensure availability of skill service
providers by hiring Additional ANMs &
Specialists.
• To ensure reach of the services by
organizing outreach camps.
19
Strategy:11 (b) Urban RCH
• Proposed to cover 8 big cities.
• Provision of basic primary health care in
urban slums.
• Strengthening of referral network for subpopulation.
• Strengthen monitoring of services in urban
areas.
• Establishment of tier-I institutions on the
population of 50 thousand in urban slums.
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To Sum-up
• Increase absorption capacity of
health system.
• Implementation of complete range of
interventions.
• Monitoring quality of interventions
for RCH-II.
21
Financial Progress under RCH-II for the Yr 06-07
SPIP Approved by NPIP= Rs. 107.99 Crores
Item
Allotment
(Rs. In Crores)
Received
(Rs. In Crores)
Expenditure (Rs. In
Crores)
RCH-II
87.50
56.40
5.94
JSY
5.23
3.37
0.12
Sterilization 12.64
8.15
0.10
NSV
2.62
1.69
Nil
Total
107.99
69.60
6.16
22
Thanks
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