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People for health capacity building-final

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  • 1. People for Health: Advancing Human Resources for Public Health “Capacity Building” 3rd Feb. 2012 Bhubaneswar Dr Saurabh Jain MD, PGD-Health Econ, MPH State Health Resource Centre, Raipur Chhattisgarh 1
  • 2. “capacity building refers to the creation, expansion or upgrading of a stock of desired qualities and features called capabilities that could be continually drawn upon over time. . . The focus of capacity building therefore tends to be on improving the stock rather than on managing whatever is available.” - Paul (1995), Capacity building for health sector reform, WHO 2
  • 3. Capacity building vs Training vsHuman resource development 3
  • 4. Chhattisgarh, ninth largest state of India -25.5 *(census 2011) million population 4
  • 5. 80% of people living in villages/hamlets32% of Population are Tribal- 7 of India’s primitive tribal groups live here (Abujhmaria, Baiga, Bharia Saharia, Hill Korwa, Kamar , Birhor)
  • 6. Lush green Forests-44% of land area- is our asset and liability with Mines –Tin,Coal,Iron
  • 7. State Profile• Population of the State = 2.5 Crore No of Districts =27• No of Blocks = 146 No of villages = 20,126Health Facilities Number of functioning Population covered per facilities facilitySub-centres 5,076 3,862PHC 741 26,400CHC level hospitals 148 CHC +17 CH=165 1.54 LakhDistrict Hospitals 17 15.02 LakhMedical colleges 3 85.13 Lakh 7
  • 8. Health systems framework Interaction with context: * with national policies, culture, values Leadership & governance: * with international context * policy – making * with other sectors and actors * regulation * coordination 3 10Organisation of resources: 8 1 Organisation and delivery of Outcomes: * universal access human financing health care services: * quality of care resources * primary health care – specialised 4 5 * health problem specific – general * prevention – curative care 6 7Monitoring & * public – private, for profit – not for profit,Medical supplies evaluation / formal - informat& technologies information Goals: 1 * improved health * responsiveness Interaction with population: * social & financial * demand generation protection 9 * participation of individuals and groups in community * accountability Guiding by values and principles: * health care as a right * autonomy <> security * protection of public <> response to individual suffering * effectiveness <> efficiency * participation, accountability, trust 2 * social justice and equity * global social responsibility * sustainability: at which level? Source: Josefien et al, Inst. Trop. Med., Antwerp
  • 9. Training norms of GoISn. Category Training programme Duration GoI Norm Maternal Health1 Medical LSAS (*) 18 weeks One anaesthetist per FRU Officers EmOC/CEmOC(*) 16 weeks One Ob./Gy. per FRU (doctors) Management. Of 15 days One doctor per 24x7 PHC and CHC Common Obstetric Complications (SBA)(*) Blood Storage (*) 3 days One Doctor per FRU MTP (*) 15 days One doctor per 24x7 PHC and CHC RTI/STI (*) 2 days One doctor per 24x7 PHC and CHC2 ANM and SBA (**) 15 days All ANMs and Staff Nurses per 24x7 SNs PHC(all sanctioned post of ANM’s & SN’s taken in account for calculation)3 LTs Blood Storage(*) 3 days All LTs posted at FRU 9
  • 10. Training norms of GoI (contd.)Sn. Category Training Duration GoI Norm programme Child Health4 Medical F- IMNCI (**) 11 days One trained doctor per PHC and CHC Officers FBNC(*) 3 days One Trained doctor per dist hospital (doctors) NSSK (**) 2 days All doctors at PHC Immunisation (*) 2 days One trained doctor per PHC and CHC5 ANM/ IMNCI (*) 8 days All ANMs, Staff Nurses, AWW(all sanctioned LHV and post of ANM’s, SN & AWW taken in account SNs for calculation) FBNC (*) 3 days All staff nurses NSSK (*) 2 days All ANMs, LHV & SN(all sanctioned post of ANM’s, LHV & SN taken into account for calculation) Immunisation 2 days All ANMs (***) Family Planning, ARSH, IMEP, and Disease Control Programmes……………………so on and so forth 10
  • 11. Capacity building pyramid 11Source: Christopher Potter, Systemic capacity building, Health Pol and Planning
  • 12. Systemic capacity building 12
  • 13. 13
  • 14. Issues & Challenges• Training capacity/infrastructure- state/dist.• Training need assessment• Quality – functional status – faculty/resource pool – training plan – database 14
  • 15. Issues & Challenges (contd.)• Quality – rationalization of trained HRH – training material in local language – fund flow – tapping other resources (medical college..) – monitoring tools – evaluation 15
  • 16. Policy decisions• Efforts to strengthen SIHFW & RIHFW• Focus pvt public (nursing training)• Private sector allowed to use public health facilities for training• RMA MBBS bridge course• Bridge course for AYUSH 16
  • 17. Policy decisions (contd.)• PHRN engaged for ‘fast-track’ training of MOs and others• Mapping under MCH plan• EmOC and LSAS initiated for MOs• RMAs being trained for BEmOC and others• Mitanins promoted for ANM and B.Sc nursing course 17
  • 18. Policy decisions (contd.)• ANMs promoted for B.SC nursing course• MOs working in hardest areas given preference in PG seats 18
  • 19. Training institutions in the State Facility 2007-08 Current Status Govt. Pvt. Total Seats Govt. Pvt. Tota Seats lSIHFW 1 0 1 NA 1 0 1 NAHFW-TC 1 0 1 NA 1 0 1 NADist.TC 6 0 6 NA 14 0 14 NAB.Sc. Nursing 1 10 11 450 6 41 47 2220GNM-TC 4 2 6 161 4 25 29 981ANM-TC 7 1 8 320 13 57 70 2404MPW(Male) 3 0 3 180 3 41 44 2450TC 19
  • 20. Health Indicators: (as per *SRS and AHS 2011) India Chhattisgarh Indicators 2000 2008 2011 Changes (2000- 2000 2008 2011 Changes (2000- 2011) 2011) IMR Total 68 55 50 88 59 51 -18 -37 IMR Rural 74 61 55 94 61 55 -19 -39 IMR Urban 43 37 34 54 49 40 -9 -14Birth Rate Total 25.8 23.1 22.5 -3.3 31.2 26.5 23.9 -7.3Birth Rate Rural 27.5 24.7 24.1 -3.4 33.2 28 24.8 -8.4Birth Rate Urban 20.7 18.6 18.3 -2.4 23.5 19.9 20.6 -2.9Death Rate Total 8.5 7.4 7.3 -1.2 10.2 8.5 7.6 -2.6 Death Rate 9.3 8 7.8 11 8.5 8 -1.5 -3 Rural Death Rate 6.3 6 5.8 7.5 6.5 6.2 -0.5 -1.3 20 Urban
  • 21. Thanks 21

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