Transcript Slide 1

RCH INTERVENTIONS
PUNJAB
SHIMLA MEETING: 24TH & 25TH SEPT. 08
1
MATERNAL HEALTH
INTERVENTIONS
2

Total Number of Institutions
Number
Delivery
Facilities
District Hospital
20
20
Sub- Division Hospital
38
38
CHCs
127
127
- PHSC CHCs
112
112
- DHS CHCs
15
15
Block PHCs
118
-
PHCs
394
75
Institutions
Sub-Centers
2858
3
 For 172 Regular Institutions the
State has 142 Gynecologists. 25
Gynecologists have been recruited on
contract basis. Advertisement has
been issued for recruitment of 40
Gynecologists
on
regular
basis.
Shortage of Gynecologists.
4
 Up-gradation of Institutions :
• 50 CHCs upgraded to EmOC centers with
appointment of 1 Gynecologist, 1 Pediatrician
and 5 Staff Nurses (wherever required) upto
the year 2007-08.
• 10 more CHCs being upgraded to
centers in the current financial year.
EmOC
• 75 PHCs upgraded into 24 x 7 delivery
institutions with appointment of 1 SafeMotherhood Consultant (lady doctor) & 3 Staff
Nurses upto the year 2007-08. 1 gen-set has
been provided in these institutions for 24 hr
electricity supply.
5
• 25 PHCs being upgraded into 24 x 7
delivery centers in the current financial
year.
• 135 Health Institutions given Rs. 20 lac
each for up-gradation to IPHS level.
• New born care corners and blood storage
units have been set-up in 25 EmOC
centers.
6
 Deliveries : (Appx.)
Total deliveries
4,90,000 per year
Home deliveries
2,35,000 (48 %)
Institutional deliveries
2,55,000 (52 %)
Government Institutions (22 %)
Private Institutions
(30 %)
7
 Deliveries in Govt. Institutions –
2007-08 & 2008-09:
2007-08
2008-09
upto August
upto August
16,599
20,990
(increase of 4391 i.e. about 26 % )
8
 Deliveries in upgraded Institutions :
Institutions
CHCs (50)
PHCs (75)
2007-08
1714
0
2008-09
2016
1675
9
JANANI SURAKSHA YOJANA
• Estimated No. of deliveries in a year in the
state of Punjab = 4,90,000
• Estimated No. of deliveries of BPL/SC/St
@35% = 1,75,000
• Estimated No. of Beneficiaries upto 2 living
Children @50% = 87,500
• Progress:
Year
2007-08
2008-09
Beneficiaries
29,256
13,683 (upto Aug.)
Marginal Improvement:
10
ASHA
• 13,351 ASHAs appointed in 12,550 villages in
the State (Jan. 2008).
• As per norm of 1 ASHA for 1000 population,
4,398 more ASHAs are to be appointed.
• Training of master trainers of ASHAs at
State level & district level has been
completed.
• The training of ASHAs at the block level will
be conducted in the month of October.
• Rs. 5.32 crore (Rs. 4,000/- per ASHA) given
to ASHAs and Rs. 1.18 crore spent so far.
11
 Efforts made by the Department :

Posting of Gynecologists has been rationalized
and 19 Gynecologists who were earlier posted in
dispensaries and PHCs have been posted in
regular CHCs and District Hospitals.

Recruitment drive for Gynecologists on contract
basis. Advertisement issued for the 3rd time
(by 30/9/2008).

Advertisement issued for recruitment of 49
Gynecologists on regular basis.

Institution-wise monitoring of deliveries is done
every month.

Gynecologist-wise
done month wise.
monitoring
of
deliveries
is
12
 A pilot project of on-line data management of care of
the pregnant women by ANMs and delivery details in 2
districts of the State is under process.
 Recruitment process for filling up 511 vacant posts of
ANMs and 954 second ANMs in bigger Sub-Centers
initiated.
 Department is going to monitor registration of
pregnancies, Sub-Centers and Districts wise.
 Data on status of ante-natal care in 25% population will
be available in about 4 months time in the survey being
undertaken (Sex-Ratio Survey).
 Task for web based application for on-line monitoring of
Pregnancy Registrations, Institutional Deliveries, JSY
beneficiaries, Immunization, Family Planning Programme,
Child Health Programme, Staffing Positions, Financial
Reports etc. has been initaited, work allotted to Punjab
Engineering College, will be completed by November 08
13
 Constraints in MCH Interventions :
• We have not been able to fill up the
following posts for the upgraded CHCs/
PHCs –
25 out of 50 Gynecologists in the 50 CHCs
31 out of 50 Pediatricians in the EmOC
Centers
27 out of 75 Medical Officers (Female) in 75
PHCs
14
• Main reason is difficult working hours and
locations and less remuneration.
Even
doctors in Village Dispensaries under Zila
Parishads are getting Rs. 25,000/- per
month. Ayurveda and Homepathic doctors on
contract basis have been given Rs. 20,000/per month. Salary of Rs. 20,000 and Rs.
15,000 for Gynecologists and MO(F) not
adequate. We are approaching GoI for its
enhancement.
• There is erratic & inadequate supply of
vaccines by GOI leading
immunization coverage.
to
gaps
in
15
There
is
shortage
of
Pediatricians, Anesthetists.
Gynecologists,
• For posting of Gynecologists in EmOC
centers, there is shortage of 25 out of 50.
• For posting of Pediatricians in EmOC centers,
there is shortage of 31 out of 50.
• For empanelment of Anesthetists, there is
shortage at 12 places.
• Female Medical Officers are not available at
27 places (24x7 PHCs).
• Staff Nurses are not available at 98 places.
• OT Assistants are not available at 35 places.
16
HEALTH INDICATORS
Birth Rate
India
Punjab
23.5
17.8
7.5
6.8
62.15
68.25
933
876
57
44
2.9
2.1
301
178
50.7
72.5
(NFHS III)
41
53
(NFHS III)
56
63.3
44
60
(SRS 2006)
Death Rate
(SRS 2006)
Life Expectancy at birth
Sex Ratio
IMR
TFR
(Census 2001)
(SRS 2006)
(SRS 2005)
Maternal Mortality Ratio
(SRS 2005)
Ante Natal Care (at least 3 checkup) (%)
(NFHS III)
Institution Delivery (%)
Contraceptive Use (%)
Vaccine coverage (%)
(NFHS III)
17
CHILD HEALTH INTERVENTIONS

Reducing early neonatal and neonatal deaths
through home based and institutional care of
the new born by creating awareness
generation and inter-personal communication
with special focus on management of
hypothermia, asphyxia and infections of the
new born.

Session wise computerized micro-plan of all
the beneficiaries (PW & Infants) prepared
for implementation of Immunization and MCH
services as well as M&E. Micro-plan available
on web-site.
18

Formats for M&E by DIOs and Civil Surgeons
already
in
use.
Scrutiny
of
formats
undertaken at State HQ by SEPIO.

Supervision of Immunization and MCH Program
by SEPIO.

4 districts i.e. Amritsar, Tarn Taran, Patiala
& Ludhiana selected as IMNCI districts.

IMNCI trainings undertaken.

For promotion of breast feeding, NGOs have
been involved. Baby friendly health initiative
has been incorporated under which ANMs and
Staff Nurses from Hospitals/ CHCs are to be
trained.
19
 34 sub-centers in the State & 16 slum areas in
Distt. Ferozepur have been adopted for coordination in MCH services by NGOs.
 Regular review meetings for sensitization and
monitoring of Immunization and MCH Program
held under the Chairpersonship of PSHFW.
 Current status of male & female IMR will be
available within 4 months from survey being
undertaken in the State (by hiring an agency).
20
IMMUNIZATION COVERAGE
Year
BCG
DPT
OPV
Measles TT-2
2005-06
561406
531806
531806
510755
534156
2006-07
548285
536117
537564
503062
537810
2007-08
516374
498503
498503
503062
471736
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FAMILY WELFARE PROGRAM
•
TFR in Punjab as per SRS data 2006 is 2.1
which is practically the maintenance level.
•
Progress:
•
Year
Vasectomy
Total Sterilization
2005-06
15,762
1,07,591
2006-07
5,615
93,758
2007-08
13,110
1,03,908
In the previous 3 years IUD insertions were
104.2%, 97.3% & 93.9% of ELA respectively.
22
•
PROGRAM MANAGEMENT
State Program Management Unitposts filled-up
Details
All the
Status
Family Welfare Specialist
1
Procurement Manager ( Vacant)
1
Manager Finance & Accounts
1
Manager (Monitoring & Evaluation)
1
Manager
Human
Development
1
Resource
State NGO Coordinator
1
Programme Coordinator – ARSH &
Gender
1
Programme Coordinator – BCC
1
23

District Program Management Unit
District Programme Management
Unit
Recruited
Vacant
District Programme Coordinator
District Procurement Officer
District Account Officer
Monitoring & Evaluation Officer
19
4
20
20
1
Maintenance Engineer
District Accountant / Cashier
District Statistical Assistant
BCC facilitator
17
19
17
16
1
3
4
-
24
 Block Program Management Unit
Category
Sanctioned Recruited Vacant
Block Statistical
Assistant
118
102
16
Block Accountant
cum Cashier
118
102
16
25
 Mobile Medical Unit
Mobile Medical Unit
Recruited
Vacant
Medical Officer (F)
17
3
Medical Officer (M)
15
5
Radiographer
17
3
Staff Nurse
18
2
Lab Technician
19
1
26
 Staff
for PHCs/CHCs
Staff for PHC/CHC
Recruited
Vacant
Female Medical Officer
48
27
Obstetrician
25
25
Paediatrician
19
31
Anaesthetist
38
12
Staff Nurses
377
98
OT Assistant
15
35
27
PNDT & SEX-RATIO
 Focused attention on improving sex-ratio.
 Integrated approach of strict implementation of
the PC & PNDT Act, advocacy & measures for
cause of the girl child and empowerment of the
women.
 PNDT cell has been created at the State HQs
under NRHM.
 Sensitization workshops are organized at the State
HQ as well as district level for orientation of
Appropriate Authorities to various provisions in the
PNDT Act & Rules.
 11 Panchayats awarded Rs. 3 lac each in the year
2006-07 for improving sex-ratio to 1000 or more.
28

This year there is provision of award of Rs.
1.5 lac each for 20 outstanding Panchayats
that achieve child sex-ratio of more than
1000.

There is incentive of Rs. 20,000/- each for
informers of violation of the PNDT Act.

There is incentive of Rs. 10,000/- each for
decoy patients who help to nab violators of
the Act.

Balri Rakshak Yojna, a State sponsored
scheme has already been launched for the
cause of the girl child.

99 court cases/ FIRs registered against
29
violators of the PC & PNDT Act till date.
 10 centers convicted by courts & 74 cases
pending.
 Direct action taken against 290 centers in the
form of suspension/ cancellation of registration
 As a result of strict implementation of the
Act, number of sensitization workshops/
seminars/ conferences organized and awareness
campaign undertaken, sense of fear is visible
amongst wrong doers in the State.
 As per SRS data pertaining to years 2004-06,
child sex-ratio (0-4 yrs) has improved to 821
in contrast to 796 in the year 2001 which
could have further declined to 765 in the
absence of measures taken.
30
 Contract for survey of sex-ratio of 25%
sample of State population has already been
awarded to an agency, out-come of which will
throw light on current region-wise, financial
status-wise, all ages sex-ratio & child sexratio scenario which will facilitate region-wise
future strategy for improving sex-ratio in the
State.
 Lot of awareness generation activities are
underway for bringing a change in the mindset of the society in favor of the girl child as
well as regarding important provisions in the PC
& PNDT Act.
 Few samples of display publicity are:
31
Why Female Foeticide ?
32
33
34
DAUGHTERS ARE PART OF LIFE
35
36
37
BCC/ IEC
•
•
•
Intra-communication with focus on NRHM
interventions has already been started. 4
regional workshops were organized in the year
2007-08 for sensitization of district and block
level stake holders to new interventions under
NRHM.
Focus has been given on inter-personal
communication by holding seminars/ conferences/
meetings/ focused group meetings at various
levels for creating awareness on NRHM
interventions especially RCH-II.
Besides paid publicity trust has been given on
awareness through news items.
38
•
Publicity through hoardings at important public
places, press advertisements, bus back & side
panels, exhibitions, wall display panels, posters,
song & drama shows, exclusive girl child
competitions with focus on MCH & Gender issues
is undertaken.
•
Television, cable network, Radio (primary and
FM channels) & folk media have been used for
spreading important messages through TV spots,
talks, interviews, discussions etc.
•
Co-ordination with the NGOs by holding
sensitization workshops on important themes.
39
40
PART A- RCH FLEXI POOL
Allocation
SN
1
2
3
4
5
6
7
Sub Components
Releases/ Expenditure
2008-092008-09
Maternal Health
Janani Suraksha Yojna
ASHA
Child Health & IMNCI
Family Planning
ARSH
Urban RCH
PNDT Sex Ratio
Innovations / PPP/NGO
235.00
186.00
334.50
86.15
920.60
27.07
135.60
64.84
442.50
37.49
93.00
396.03
.60
266.78
10.02
32.90
0
0
Infrastructure & Human Development
1558.50
236.93
323.34
40.08
461.88
285.49
9
Logistic Management
Quality Assurance and Infection Control
Programme
HMIS Monitoring and Evaluation
Training
10
Behaviour Change Communications
291.76
40.75
11
Procurement
Programme management Units SPMU
and DPMUs
Flexi pool
Total A (RCH II)
122.50
125.91
347.26
260.25
157.50
5695.00
1.20
1827.43
8
13
12