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National Rural Health Mission


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Study on National Rural Health Mission

National Rural Health Mission

  1. 1. Making growth inclusive through social development
  2. 2. National Rural Health Mission (2005-2012) Reaching affordable, quality health care to the poorest households in the remotest regions
  3. 3. NRHM  • N…Newer Initiatives.  • R…Rural Poor Population  • H…Holistic Health Package.  • M…Monitoring mechanisms  To cater to the Primary health care needs of vulnerable segment of pop. to bring down IMR and MMR . to attain Pop. Stabilisation.
  4. 4. NHRM  The Government of India made a commitment to raise the public expenditure on health from 1% of GDP to 2-3% of GDP over the Mission period (2005-12).
  5. 5. NRHM entire country, with Entire Country Jammu and Kashmi r Uttar Prades h Madhya Prades h Sikkim Tripura Mizora m Uttaran chal Chhatti sgarh Bihar Jharkha nd Orissa Rajasth an Arunac hal Prades h Manipur Meghal aya Nagala nd Assam Himach al Prades h special focus on 18 states
  6. 6. Expected outcomes from the Mission  IMR reduced to 30/1000 live births by 2012.  Maternal Mortality reduced to 100/100,000 by 2012.  TFR reduced to 2.1 by 2012.  Cataract operations-increasing to 46 lakhs until 2012.  Leprosy Prevalence Rate –reduce less than 1 per 10,000 thereafter.  Tuberculosis DOTS series - maintain 85% cure rate through entire Mission Period.  Engaging 2,50,000 female Accredited Social Health Activists (ASHAs) in 10 states.
  7. 7. 1.DDK for Clean deliveries at home 2.Tab. Iron Folic Acid (L) 3.Tab Punarvadu Mandur (ISM Preparation of Iron) 4.ORS Packets 5.Tab. Paracetamol 6.Tab. Dicyclomine 7.Povidine Ointment Tube 8.Thermometers 9.Cotton Absorbent Roll 10.Bandages, 4cm X 4 meters 11.Tab. Chloroquine 12.Condoms 13.Oral Pills (In cycles)
  8. 8. IMR reduced to 30/1000 live births by 2012.  the number per 1,000 children before one year of age, is 57, which means over one in 18 infants die before they are one year old. (2005 – 2006)  While the figure is a marginal improvement over the IMR of 68 of NFHS-2 (1998-99) – about 1 in 14 – this is unacceptably high.
  9. 9. Infant mortality rate 3 0
  10. 10. Maternal Health Situation in India:  About 28 million pregnancies occur every year in India.  24 million deliveries  15% of these are likely to develop complications.  Complications cannot be predicted.  Over 67,000 avoidable maternal deaths per year 
  11. 11. Maternal Mortality reduced to 100/100,000 by 2012.  The Maternal Mortality Ratio has reduced from 301 per 100,000 births in 2001-03 period to 254 in the 2004-06 period
  12. 12. TFR reduced to 2.1 by 2012.  TFR of 2.7 (SRS 2007)  Ranks 83 in the world - India 2.72 2008 est.  Total fertility rate: 2.68 children born/woman (2009 est.)
  13. 13. 9,000 doctors 60,000 nurses/ANMs
  14. 14. Reproductive & Child Health Programme  MCP (MOTHER & CHILD PROJECTION CARD) CARD  Information right from the Antenatal test to growth monitoring of the newly born baby in continuation.
  15. 15. Key Strategies for MH under RCH  Essential obstetric and new born care for all .  Skilled attendance at every birth including essential new born care.  Emergency obstetric care for those having complications and referral services.  Provision of Safe Abortion Services and services .
  16. 16. Training  Training of SNs/LHVs/ANMs as Skilled Birth Attendant  Training of MBBS doctors in obstetric and anesthetic skills.  Setting up of Blood Storage Centers (BSC) at First Referral Units.
  17. 17. At Village Level (1000 population):  Every month at Anganwadi Center a Village Health and Nutrition Day is being organized with a focus on ANC, PNC, Immunization and Counseling on Nutrition and Family Planning Services.
  18. 18. Monthly Health and Nutrition Days  Water, sanitation, education, literacy, nutrition, women’s empowerment have all been brought together under convergent community institutions and Health Missions at various levels.
  19. 19. At the level of Sub- Centre (3000-5000 population):  The ANMs at the sub-center are being trained as Skilled Birth Attendant(SBA).  50% of the PHCs under NRHM are being developed as 24X7 PHCs with inputs of 3 or more SNs/ANMs and one Medical Officer.  To improve the proficiency, skills and quality of these SNs/ANMs as skilled provider for delivery, GOI has launched Skilled Birth Training.
  20. 20. Primary Health Centre (20,000-30,000 population):  Funds have been given to the States for infrastructural development including labour rooms and equipments as per the laid down standards under IPHS.  All CHCs are aimed to be converted as First Referral Units (FRU) with provision of 1 ObGyn or a Trained MBBS Doctor for EmOC, 1 Anesthetist or Trained MBBS Doctor proficient in Anesthetic Skills, Functional OT and a Blood Storage facility.
  21. 21. The scheme focuses on the poor pregnant woman with special dispensation for states having low institutional delivery rate.
  22. 22. key achievement of the NRHM  One of the key achievement of the NRHM is a visible growth in the field of institutional delivery.  Institutional Delivery:  3.449 M women benefited so far in 06-07  5.135 M in 07-08,  8.378 M in 2008-09
  23. 23. Leprosy eliminated at National level
  24. 24. Rs 125/- for glasses for poor children
  26. 26. 28 Gujarat - Chiranjeevi Yojana  A Health financing scheme for safe maternity services to BPL beneficiaries  More than 7793 BPL mothers, that is nearly 31 % of BPL pregnant mothers have safely delivered, under the scheme.  not a single death in mothers has been reported
  27. 27. 29 Haryana -Delivery Hut  Delivery Huts established within villages for providing services during delivery in institutions having facilities for normal deliveries and referral support.  400 Delivery Huts have been established, 16,500 deliveries conducted, 1756 high-risk referred of RTI / STI.
  28. 28. Madhya Pradesh - Sponsors 500 students  The state government has come up with decision to strengthen the nursing cadre by sponsoring M Sc, B Sc and post basic B.Sc,nursing students.  These students have to serve compulsorily in rural areas for 7 years after completing the course.
  29. 29. Tamil Nadu Free heart surgery for children . Free spectacles for children who are studying .
  30. 30. Kalaignar Kappeetu Tittam
  31. 31. In 2006-07 Rs. 38 Crores In 2007-08 880 Crores In 2008-09 Rs. 1207.17 Crores. In 2009 –10 Rs.2,057 crores  Health related indicators would suggest that significant gains have been made over the years.  India fares poorly in most of the indicators in comparison with developing countries like China and Sri Lanka.
  32. 32. Challenges  India needs over 6,800 more hospitals in rural areas to provide basic health facilities to people.  There is still a shortage of 4,477 primary healthcare centre's and 2,337 community healthcare centre's as per the 2001 population norms, Total of 15196 PHC’s & CHC’s and sub centers are functiona
  33. 33. Current Population of India in 2010 - 1,150,000,000 (1.15 billion)  This means the requirement for hospitals will be much more if the population figure in 2010 is taken into account.
  34. 34. 26000 Dr’s : 750 Million pop  we have 30,000 MBBS graduates coming out of our Colleges every year.  The entire rural health system for more than 750 million people never has more than 26000 doctors.
  35. 35. Challenges  The annual survey presented in parliament said:  "Almost 29 percent of the existing health infrastructure is in rented buildings.  Poor upkeep and maintenance, and high absenteeism of manpower in the rural areas are the main problems in the health delivery system."
  36. 36. Solution …  Transparency  Monitoring  Additional weight age of marks that will be given for service in rural areas.  Doctors who work in rural areas will be compensated with extra money
  37. 37. Thank you Deepa Himanshu Kapil Billa Pankaj Subhangkar Tony 700 consultants (MBA/CA) have been appointed for state/ district level Program ManagementUnits.