Transcript Convergence with NRHM - Department of Women and Child

National Rural Health Mission:
Convergence with ICDS
1
National Rural Health Mission
• The Prime Minister launched a National
Rural Health Mission on 12th April 2005.
• The Mission is for a period of 7 years
(2005-12).
• The Outlay for NRHM for 2005-06 is over
Rs.6700 crore.
• High focus on 18 States (8 EAG, 8 North
East, Jammu & Kashmir and Himachal
Pradesh)
• Reproductive
and
Child
Health
Programme (RCH-II) is an important
component of NRHM
2
Reproductive Child Health
Programme
RCH-II is the Flagship programme under NRHM.
Its strategies include:
• Maternal Health – Institutional deliveries EmOC,
BCC, Mobilization Strategies, improved coverage
and quality of ANC, skilled care to Pregnant
women, Post -partum care at Community level.
• Child health - UIP, IMNCI
• Population Stabilization – contraceptive choice,
private sector intervention, stimulating demand
for FP services
• Urban and tribal health – similar initiatives with
special focus disadvantages
3
NRHM Goals
• To provide effective health care to rural population
(especially for Women & Children).
• Improve access to health care.
• Enable community ownership and demand for
services.
• Strengthen public health system for efficient service
delivery.
• Enhance equity and accountability.
• Promote decentralization.
• Mainstream AYUSH.
• Integration with other sectors (ICDS, Sanitation,
Drinking water )
• Focus to change from Outlays to Outcomes.
4
NRHM – The Concept
Health
RCH-II
AYUSH
Health Determinants
NDCP
General
Curative
Care
Nutrition
Sanitation
& Hygiene
Drinking
Water
Supply
5
Institutional Framework
National Steering Group
Mission Steering Group
Empowered Programme Committee
Mission Directorate
State Health Mission
District Health Mission ------------Rogi Kalyan Samitis
Panchayat
Village Health
Committee
Village Health
Committee
Village Health
Committee
6
Core Strategies
• Train and enhance capacity of PRIs to own,
control and manage public health services.
• Promote access to healthcare to household
through the female Accredited Social Health
Activist (ASHA).
• Health Plan for each village.
• Untied fund for Sub-centre.
• Upgrading all CHCs to Indian Public Health
Standards.
• Integrating relevant vertical Health and Family
Welfare programmes at National, State and
District levels.
• Mainstreaming AYUSH. – revitalizing local
health traditions.
7
Intersectoral Convergence
under NRHM
1)
2)
3)
4)
5)
6)
7)
Mission Steering Group chaired by Union Minister for Health
and Family Welfare. Dy. Chairman, Planning Commission,
Minster for HRD, PR & Rural Development members.
Empowered Programme Committee has representatives from
cognate Ministries - DWCD,PR, RD, NE and AYUSH
Committee on Intersectoral Convergence constituted under
Mission Director.
Preparation and Implementation of an inter-sectoral District
Health Plan prepared by the District Health Mission, including
drinking water, sanitation & hygiene and nutrition.
Theme Papers on Convergence shared with DWCD, PRI TSC,
NACO
In-principle agreement on NRHM framework
Common strategy being evolved for IEC & Training among
DWCD, DoHFW & PR
8
ASHA under NRHM
• Community based functionary - a
change agent of health in a village.
• First port of call for any health related
demand.
• Create
awareness
and
provide
information to the community.
• Counsel women on birth, safe delivery,
breast feeding etc.
9
ASHA under NRHM (II)
• Mobilize the community and facilitate health
related services.
• Work with the village health and sanitation
committee of Gram Panchayat.
• Arrange escort / accompany pregnant women
and children requiring any health services.
• Provide primary medical care.
• Will be equipped with Drug Kit
• Promote construction of household toilets
under Total Sanitation Campaign.
10
Village Level Convergence
under NRHM
1) Anganwari to be hub of mother and child care
activity at village level
2) Village Health Team: ANM, AWW, ASHA,
SHG etc. under Village Health & Sanitation
Committee of the Gram Panchayati
3) Monthly Health Camp at Anganwari to
promote ANC, PNC, Universal Immunisation,
Nutrition, Micronutrient supplementation –
ASHA to support AWW in mobilising pregnant
women and infants.
4) AWW to be the Mentor for ASHA
5) AWW will be the depot holder for drug kits
and will be issuing them to ASHAs.
11
Micronutrient Deficiency
1) Micronutrients of Public Health significance:
Iron, Iodine, Vitamin A & Zinc
2) Three strategies for correcting micronutrient
deficiencies are:
* Supplementation
* Fortification
* Dietary diversification
3) Convergence between ICDS & Health and Family
Welfare important for strategies on dietary
diversification and supplementation.
12
Government Programmes for
Nutrition Intervention







Integrated Child Development Scheme (ICDS)
Mid Day Meal Programme (MDMP)
Wheat Based Programme (WBP)
Reproductive and Child Health Programme
for Iron Folic Acid and Vitamin ‘A’
supplementation.
National Iodine Deficiency Disorders Control
Programme (NIDDCP)
Pilot Programme against Micronutrient
Malnutrition for School children, adolescents
etc introduced in 1995 - to assess levels of Iron,
Vitamin A and Zinc deficiency.
Notification to ban sale of non-iodated salt
issued on 27.5.2005
13
Micronutrient Programmes and
Convergence under RCH & ICDS
• Vitamin ‘A’ Deficiency
– The AWW / ASHA to bring children to
Anganwadi Centres or health Sub-centres
for supplementation of Vitamin ‘A’ by
ANM.
– ANM, ASHA and AWW to create awareness
about vitamin ‘A’ deficiency.
14
IRON DEFICIENCY ANAEMIA
• AWW / ASHA & ANM to distribute iron
folic acid tablets to pregnant and lactating
mothers.
• Educate the consequences of anaemia.
• Awareness about regular consumption of
fruits and vegetables.
• Promote good food habits.
15
IODINE DEFICIENCY
DISORDERS
• AWW, ASHA / ANM to educate
public about various iodine deficiency
disorders.
• Promote regular consumption of
iodated salt.
• Demonstrate qualitative testing of
house hold salt.
16
OPPORTUNITIES OF CONVERGENCE
WITH DWCD AND MOH&FW
• Mutual Institutional support by both the Ministries for
Women and Child programme
• Capacity building of functionaries of both departments.
• Identification and training of village level community
workers.
• Joint training of health and ICDS functionaries and
usage of common facilities.
• Fixed health and nutrition days block level resource
mapping organised jointly by AWW/ANM/ASHA
• Village Health Plan to include ICDS/Health components
• Community based monitoring system for ICDS and
health programmes.
17
Immediate Action Points
• Expression of general support for NRHM particularly the
ASHA to be mentored by the Anganwari system.
• State level meeting between Secretary HFW and DWCD and
issuance of Guidelines on common goals for NRHM and
National ICDS program
• Guidelines for Common Training Program
• Setting up of State Level Task Force for Common IEC
Strategy.
• Setting up Convergence Mechanism between Institutes of
Training of DWCD and HFW for development of common
training material, programme, curriculum etc.
• Discussion about financial compensation to AWW for
mentoring role.
• Physical infrastructure at Anganwari by Health Sector
• Preparation of District Plan for Health and Nutrition
• Quarterly Joint Review Mechanism to monitor progress at all
levels – Block, District, State and National
18
Medium Term Plan
• Health Data System including emoding to be made available to
ICDS
• Convergence of management of
Stores, Training Institutions and
Physical Infrastructure including
residential colonies, fund flow,
logistics and supplies for better
efficiencies.
19
THANK YOU
20