The document discusses India's National Rural Health Mission (NRHM) for improving primary health care. It notes that primary health care in India has historically been inadequate, with shortages of doctors and poor infrastructure in rural areas. NRHM was launched to address these issues by upgrading facilities, placing more health workers in villages, improving access to services like maternal and child care, and encouraging community involvement in local health planning. The goals of NRHM include reducing infant and maternal mortality and population growth rates by expanding coverage and access to basic health services, especially in underserved states.
Health policy is a national task based on meeting community needs and respecting social, geographical and cultural variations. Ministry of health and population (MOHP) is the formal organization responsible for health policy formulation. The Egyptian health care system faces multiple challenges in improving and ensuring the health and wellbeing of the Egyptian people. The system faces not only the burden of combating illnesses associated with poverty and lack of education, but it must also respond to emerging diseases and illnesses associated with modern, urban lifestyle. Emerging access to global communications and commerce is raising the expectations of the population for more and better care and for advanced health care technology.
This document discusses primary health care (PHC), including its definition, elements, principles, and basic requirements. PHC aims to make essential health care universally accessible and affordable. Its key elements include education, nutrition, immunization, treatment of common diseases, and safe water/sanitation. Principles of PHC are equitable distribution, community participation, intersectoral coordination, and appropriate technology. Basic requirements for sound PHC are that it be appropriate, available, adequate, accessible, acceptable, affordable, assessable, and accountable, with completeness, comprehensiveness and continuity.
Global health care challenges and trends_ bestyBesty Varghese
GLOBAL HEALTH CARE CHALLENGES AND TRENDS: Analyses the global healthcare trends and challenges.
Healthcare providers have a unique window of opportunity to embrace efficient new technologies that directly support better healthcare and patient experiences at a lower cost.
New healthcare systems will be:
Evidence- and prevention-based
Interdisciplinary and coordinated
Transparent, accessible, accurate, and understandable
Focused on improving patient outcomes and experience
Based on partnerships among stakeholders
Visionary in their long-term thinking
And in total International health + Global public health + Collective health + Global health diplomacy = LIFE’S RIGHT.
Global health care challenges and trends_ bestyBesty Varghese
GLOBAL HEALTH CARE CHALLENGES AND TRENDS: Analyses the global healthcare trends and challenges.
Healthcare providers have a unique window of opportunity to embrace efficient new technologies that directly support better healthcare and patient experiences at a lower cost.
New healthcare systems will be:
Evidence- and prevention-based
Interdisciplinary and coordinated
Transparent, accessible, accurate, and understandable
Focused on improving patient outcomes and experience
Based on partnerships among stakeholders
Visionary in their long-term thinking
And in total International health + Global public health + Collective health + Global health diplomacy = LIFE’S RIGHT
This document discusses reproductive health and maternal and child health care. It defines reproductive health and outlines its various components, including family planning services, safe motherhood practices, infertility treatment, and prevention of reproductive tract infections. It also discusses causes of maternal mortality and measures to reduce maternal mortality rates. The document then covers topics like the maternity cycle, objectives and components of maternal and child health care, and health issues faced by women at different life stages.
The document discusses health services and primary health care in Egypt. It provides background on the Ministry of Health and Population, which was established in 1936. It outlines Egypt's health system, which includes primary, secondary, and tertiary levels of care provided through public health units and hospitals. The document also discusses health insurance in Egypt, challenges in the health system, and strategic plans for health sector reform focusing on infrastructure development and improving human resources. It defines primary health care and reviews its principles, approaches like GOBI-FFF, essential services, and role in Egypt through primary health units. Criteria for effective primary health care include coordination, community participation, customer satisfaction, and monitoring and evaluation.
This document provides an introduction to integrated reproductive health. It defines reproductive health and integrated reproductive health, outlines the components of IRH including reproductive health information, safe motherhood, family planning, and adolescent health. It also describes Zambia's integrated reproductive health policy and its commitments. Finally, it discusses the 12 principles of IRH, including community participation, quality of care, appropriate technologies and skills, accessibility, and informed consent.
Health policy is a national task based on meeting community needs and respecting social, geographical and cultural variations. Ministry of health and population (MOHP) is the formal organization responsible for health policy formulation. The Egyptian health care system faces multiple challenges in improving and ensuring the health and wellbeing of the Egyptian people. The system faces not only the burden of combating illnesses associated with poverty and lack of education, but it must also respond to emerging diseases and illnesses associated with modern, urban lifestyle. Emerging access to global communications and commerce is raising the expectations of the population for more and better care and for advanced health care technology.
This document discusses primary health care (PHC), including its definition, elements, principles, and basic requirements. PHC aims to make essential health care universally accessible and affordable. Its key elements include education, nutrition, immunization, treatment of common diseases, and safe water/sanitation. Principles of PHC are equitable distribution, community participation, intersectoral coordination, and appropriate technology. Basic requirements for sound PHC are that it be appropriate, available, adequate, accessible, acceptable, affordable, assessable, and accountable, with completeness, comprehensiveness and continuity.
Global health care challenges and trends_ bestyBesty Varghese
GLOBAL HEALTH CARE CHALLENGES AND TRENDS: Analyses the global healthcare trends and challenges.
Healthcare providers have a unique window of opportunity to embrace efficient new technologies that directly support better healthcare and patient experiences at a lower cost.
New healthcare systems will be:
Evidence- and prevention-based
Interdisciplinary and coordinated
Transparent, accessible, accurate, and understandable
Focused on improving patient outcomes and experience
Based on partnerships among stakeholders
Visionary in their long-term thinking
And in total International health + Global public health + Collective health + Global health diplomacy = LIFE’S RIGHT.
Global health care challenges and trends_ bestyBesty Varghese
GLOBAL HEALTH CARE CHALLENGES AND TRENDS: Analyses the global healthcare trends and challenges.
Healthcare providers have a unique window of opportunity to embrace efficient new technologies that directly support better healthcare and patient experiences at a lower cost.
New healthcare systems will be:
Evidence- and prevention-based
Interdisciplinary and coordinated
Transparent, accessible, accurate, and understandable
Focused on improving patient outcomes and experience
Based on partnerships among stakeholders
Visionary in their long-term thinking
And in total International health + Global public health + Collective health + Global health diplomacy = LIFE’S RIGHT
This document discusses reproductive health and maternal and child health care. It defines reproductive health and outlines its various components, including family planning services, safe motherhood practices, infertility treatment, and prevention of reproductive tract infections. It also discusses causes of maternal mortality and measures to reduce maternal mortality rates. The document then covers topics like the maternity cycle, objectives and components of maternal and child health care, and health issues faced by women at different life stages.
The document discusses health services and primary health care in Egypt. It provides background on the Ministry of Health and Population, which was established in 1936. It outlines Egypt's health system, which includes primary, secondary, and tertiary levels of care provided through public health units and hospitals. The document also discusses health insurance in Egypt, challenges in the health system, and strategic plans for health sector reform focusing on infrastructure development and improving human resources. It defines primary health care and reviews its principles, approaches like GOBI-FFF, essential services, and role in Egypt through primary health units. Criteria for effective primary health care include coordination, community participation, customer satisfaction, and monitoring and evaluation.
This document provides an introduction to integrated reproductive health. It defines reproductive health and integrated reproductive health, outlines the components of IRH including reproductive health information, safe motherhood, family planning, and adolescent health. It also describes Zambia's integrated reproductive health policy and its commitments. Finally, it discusses the 12 principles of IRH, including community participation, quality of care, appropriate technologies and skills, accessibility, and informed consent.
Public health systems and the health of the publicJohn Middleton
A short presentation to the plenary of the 2nd Arab Public Health Association Conference, April 6th 2019. A longer presentation including professional public health standards and the work of the UK Faculty of Public Health is also available on slideshare.net 190405 ar pha middletonj vr 3 short final
COVID19 has affected many aspects of our lives. Its impact on nutrition and food security stands out as a major one in low-income countries like Ethiopia. The presentation is made based on a desk review of various studies made at national and global levels to stimulate programmatic dialogue and promote action. It attempts to build likely scenarios of the impact of COVID19 on health and food systems and what can be done to mitigat the impact of COVID19 on the progress made to date on nutrition in Ethiopia.
This document provides an introduction to integrated reproductive health, defining key terms like reproductive health and integrated reproductive health. It outlines the components of IRH, including reproductive health information, safe motherhood, family planning, and adolescent health. It also describes Zambia's integrated reproductive health policy and its commitments. Finally, it discusses 12 principles of IRH, including community participation, quality of care, and informed consent.
Dr. j melgar family planning and developmentrigelsuarez
Family planning provides significant benefits by improving health outcomes and empowering individuals and families. It saves lives by reducing maternal and infant mortality, improves social and economic development, and eases pressure on scarce resources. While initially controversial, most major medical organizations now recognize modern contraception as very safe and support access to family planning as a basic health right and smart investment.
This document discusses nutritional surveillance. It begins with an introduction defining nutritional surveillance as the regular collection and analysis of nutrition data. It then outlines the purpose of nutritional surveillance, which includes monitoring nutrition situations, informing policies, and tracking program progress. The document also provides a brief history of nutritional surveillance and describes the process involving data collection, analysis, dissemination and decision making. It further discusses challenges and provides guidance on establishing nutritional surveillance systems.
The document discusses the history and principles of primary health care (PHC). It begins by outlining the origins of PHC at the Alma-Ata conference in 1978 where it was established as a goal of the WHO. Key principles of PHC include equitable access, community participation, and focusing on prevention. The document then examines PHC in India, describing its establishment and evolution over time. It outlines services provided at PHC centers in India as well as ongoing challenges in effectively delivering PHC. Finally, the document argues that strengthening PHC systems combined with universal health coverage can help achieve health for all in the 21st century.
The document discusses India's National Urban Health Mission. The mission aims to provide equitable access to quality health care for the urban poor population as cities are seeing rapid growth. It focuses on improving the efficiency of the public health system and promoting partnerships between government and non-government providers. The mission seeks to meet the health needs of vulnerable groups like slum dwellers through primary health centers, community-based health insurance, and initiatives like the Urban Social Health Activist program. It was established to address the lack of standards and economic barriers to healthcare access faced by many in urban areas.
This document outlines the process of establishing a nutritional surveillance system. It discusses the purpose of nutritional surveillance, which is to monitor nutrition situations, identify malnutrition factors, and inform policies. The document describes the history of nutritional surveillance and challenges in establishing sustainable systems. It provides details on indicators, data collection methods, analysis, interpretation and dissemination of nutritional surveillance data.
The New York Health Care Proxy Law allows you to appoint someone you trust ... care agent, you can make sure that health care providers follow your wishes.
The document discusses universalizing India's primary healthcare system. It provides background on primary healthcare and outlines some key issues, such as shortages of doctors and facilities in rural areas. It then discusses India's National Rural Health Mission which aims to improve rural healthcare availability and outcomes by 2012. The mission focuses on increasing institutional deliveries, immunizations, access to family planning services, and reducing infant and child mortality rates. It uses approaches like community involvement, management capacity building, and flexible financing to achieve its goals.
The National Health Policy 2015 aimed to address inequities in India's health system and promote universal access to healthcare. It recognized achievements in reducing mortality rates but noted continued disparities between rural and urban areas. The policy sought to decentralize service delivery, strengthen primary healthcare, expand health insurance coverage, and increase investment in research. It also acknowledged the growing roles of the private healthcare sector and traditional medicine in meeting India's health needs.
The best job in the world: practising public health, past, present, future John Middleton
Presentation to University of Maastricht, International Masters in Public Health leadership and management course, December 14th 2018. 181214 middletonj maastricht
Lecture 1 Public health administration in the Pacific Islands.pptxLencyMuna1
Public health in Pacific Island Countries faces challenges of a rising non-communicable disease burden as well as communicable outbreaks. In Fiji, priorities include addressing non-communicable diseases through prevention and treatment programs, reducing maternal and child mortality, and controlling communicable diseases. Community health networks require strengthening to improve primary care access and health outcomes.
1. The document discusses the origins and history of primary health care from pre-colonial times through the colonial period and post-independence era, culminating in the 1978 Declaration of Alma-Ata which established primary health care as a global strategy.
2. The Declaration defined primary health care as including health promotion, disease prevention, treatment of common illnesses, and community participation at an affordable cost.
3. While the goals of primary health care were not fully realized due to lack of resources and commitment, the principles of equity, prevention and universal access remain important, and revitalizing primary health care is seen as critical to achieving health-related sustainable development goals.
The document discusses funding for health care at RMIT and around the world. It provides details on health spending as a percentage of GDP and sources of funding for different countries. It outlines the key principles of universal health care as access for all, no risk of poverty from health issues, shared costs, and efficient systems. Different methods for achieving universal coverage are examined, such as taxation, insurance, external funding, and support from charities. The document also reviews how governments can better spend on health and reduce costs through areas like health education, efficient resource use, and addressing leading causes of death.
health promotion and primary prevention: Mamta SuryavanshiMamtaSuryavanshi1
The document provides an overview of a seminar on primary health care and health promotion. It discusses the background and principles of primary health care, highlighting definitions from the Alma-Ata and Astana declarations. It describes the concepts of comprehensive primary health care and health and wellness centers in India. The role of nurses and challenges in implementing primary health care in India are also summarized, in addition to the topics of health promotion, government initiatives, and the seminar's learning objectives.
The document discusses health inequities in West Bengal, India. It notes that geographic, economic, social factors and lack of access lead to underserved populations. Specific districts and blocks are identified as facing health challenges like measles outbreaks. Factors like female literacy, poverty, and social determinants are linked to worse health outcomes. Solutions proposed include strengthening community outreach, improving access to clinics and facilities, and monitoring and support of the healthcare system.
Primary health care (PHC) refers to essential health care that is accessible, affordable, and provided at the local community level. It aims to address the most common health problems and is the first point of contact for individuals with the health system. PHC services include health promotion, disease prevention, treatment of common illnesses, and community development. It is intended to be universally accessible and rely on community participation. The principles of PHC emphasize equity, self-reliance, and intersectoral coordination.
Primary health care (PHC) refers to essential health care that is accessible, affordable, and provided at the local community level. It aims to address the most common health problems and is the first point of contact for individuals with the health system. PHC services include health promotion, disease prevention, treatment of common illnesses, and community development. It is intended to be universally accessible and rely on community participation. The principles of PHC emphasize equity, self-reliance, and involvement of all community sectors.
Public health systems and the health of the publicJohn Middleton
A short presentation to the plenary of the 2nd Arab Public Health Association Conference, April 6th 2019. A longer presentation including professional public health standards and the work of the UK Faculty of Public Health is also available on slideshare.net 190405 ar pha middletonj vr 3 short final
COVID19 has affected many aspects of our lives. Its impact on nutrition and food security stands out as a major one in low-income countries like Ethiopia. The presentation is made based on a desk review of various studies made at national and global levels to stimulate programmatic dialogue and promote action. It attempts to build likely scenarios of the impact of COVID19 on health and food systems and what can be done to mitigat the impact of COVID19 on the progress made to date on nutrition in Ethiopia.
This document provides an introduction to integrated reproductive health, defining key terms like reproductive health and integrated reproductive health. It outlines the components of IRH, including reproductive health information, safe motherhood, family planning, and adolescent health. It also describes Zambia's integrated reproductive health policy and its commitments. Finally, it discusses 12 principles of IRH, including community participation, quality of care, and informed consent.
Dr. j melgar family planning and developmentrigelsuarez
Family planning provides significant benefits by improving health outcomes and empowering individuals and families. It saves lives by reducing maternal and infant mortality, improves social and economic development, and eases pressure on scarce resources. While initially controversial, most major medical organizations now recognize modern contraception as very safe and support access to family planning as a basic health right and smart investment.
This document discusses nutritional surveillance. It begins with an introduction defining nutritional surveillance as the regular collection and analysis of nutrition data. It then outlines the purpose of nutritional surveillance, which includes monitoring nutrition situations, informing policies, and tracking program progress. The document also provides a brief history of nutritional surveillance and describes the process involving data collection, analysis, dissemination and decision making. It further discusses challenges and provides guidance on establishing nutritional surveillance systems.
The document discusses the history and principles of primary health care (PHC). It begins by outlining the origins of PHC at the Alma-Ata conference in 1978 where it was established as a goal of the WHO. Key principles of PHC include equitable access, community participation, and focusing on prevention. The document then examines PHC in India, describing its establishment and evolution over time. It outlines services provided at PHC centers in India as well as ongoing challenges in effectively delivering PHC. Finally, the document argues that strengthening PHC systems combined with universal health coverage can help achieve health for all in the 21st century.
The document discusses India's National Urban Health Mission. The mission aims to provide equitable access to quality health care for the urban poor population as cities are seeing rapid growth. It focuses on improving the efficiency of the public health system and promoting partnerships between government and non-government providers. The mission seeks to meet the health needs of vulnerable groups like slum dwellers through primary health centers, community-based health insurance, and initiatives like the Urban Social Health Activist program. It was established to address the lack of standards and economic barriers to healthcare access faced by many in urban areas.
This document outlines the process of establishing a nutritional surveillance system. It discusses the purpose of nutritional surveillance, which is to monitor nutrition situations, identify malnutrition factors, and inform policies. The document describes the history of nutritional surveillance and challenges in establishing sustainable systems. It provides details on indicators, data collection methods, analysis, interpretation and dissemination of nutritional surveillance data.
The New York Health Care Proxy Law allows you to appoint someone you trust ... care agent, you can make sure that health care providers follow your wishes.
The document discusses universalizing India's primary healthcare system. It provides background on primary healthcare and outlines some key issues, such as shortages of doctors and facilities in rural areas. It then discusses India's National Rural Health Mission which aims to improve rural healthcare availability and outcomes by 2012. The mission focuses on increasing institutional deliveries, immunizations, access to family planning services, and reducing infant and child mortality rates. It uses approaches like community involvement, management capacity building, and flexible financing to achieve its goals.
The National Health Policy 2015 aimed to address inequities in India's health system and promote universal access to healthcare. It recognized achievements in reducing mortality rates but noted continued disparities between rural and urban areas. The policy sought to decentralize service delivery, strengthen primary healthcare, expand health insurance coverage, and increase investment in research. It also acknowledged the growing roles of the private healthcare sector and traditional medicine in meeting India's health needs.
The best job in the world: practising public health, past, present, future John Middleton
Presentation to University of Maastricht, International Masters in Public Health leadership and management course, December 14th 2018. 181214 middletonj maastricht
Lecture 1 Public health administration in the Pacific Islands.pptxLencyMuna1
Public health in Pacific Island Countries faces challenges of a rising non-communicable disease burden as well as communicable outbreaks. In Fiji, priorities include addressing non-communicable diseases through prevention and treatment programs, reducing maternal and child mortality, and controlling communicable diseases. Community health networks require strengthening to improve primary care access and health outcomes.
1. The document discusses the origins and history of primary health care from pre-colonial times through the colonial period and post-independence era, culminating in the 1978 Declaration of Alma-Ata which established primary health care as a global strategy.
2. The Declaration defined primary health care as including health promotion, disease prevention, treatment of common illnesses, and community participation at an affordable cost.
3. While the goals of primary health care were not fully realized due to lack of resources and commitment, the principles of equity, prevention and universal access remain important, and revitalizing primary health care is seen as critical to achieving health-related sustainable development goals.
The document discusses funding for health care at RMIT and around the world. It provides details on health spending as a percentage of GDP and sources of funding for different countries. It outlines the key principles of universal health care as access for all, no risk of poverty from health issues, shared costs, and efficient systems. Different methods for achieving universal coverage are examined, such as taxation, insurance, external funding, and support from charities. The document also reviews how governments can better spend on health and reduce costs through areas like health education, efficient resource use, and addressing leading causes of death.
health promotion and primary prevention: Mamta SuryavanshiMamtaSuryavanshi1
The document provides an overview of a seminar on primary health care and health promotion. It discusses the background and principles of primary health care, highlighting definitions from the Alma-Ata and Astana declarations. It describes the concepts of comprehensive primary health care and health and wellness centers in India. The role of nurses and challenges in implementing primary health care in India are also summarized, in addition to the topics of health promotion, government initiatives, and the seminar's learning objectives.
The document discusses health inequities in West Bengal, India. It notes that geographic, economic, social factors and lack of access lead to underserved populations. Specific districts and blocks are identified as facing health challenges like measles outbreaks. Factors like female literacy, poverty, and social determinants are linked to worse health outcomes. Solutions proposed include strengthening community outreach, improving access to clinics and facilities, and monitoring and support of the healthcare system.
Primary health care (PHC) refers to essential health care that is accessible, affordable, and provided at the local community level. It aims to address the most common health problems and is the first point of contact for individuals with the health system. PHC services include health promotion, disease prevention, treatment of common illnesses, and community development. It is intended to be universally accessible and rely on community participation. The principles of PHC emphasize equity, self-reliance, and intersectoral coordination.
Primary health care (PHC) refers to essential health care that is accessible, affordable, and provided at the local community level. It aims to address the most common health problems and is the first point of contact for individuals with the health system. PHC services include health promotion, disease prevention, treatment of common illnesses, and community development. It is intended to be universally accessible and rely on community participation. The principles of PHC emphasize equity, self-reliance, and involvement of all community sectors.
This study examined how addiction to fast food can turn into avoiding fast food due to health concerns. The researchers found that when people become more aware of the negative health effects of fast food, their addiction can transform into avoiding it for health reasons. Concerns about weight gain, high cholesterol and other diet-related diseases mediated the relationship between fast food addiction and anti-consumption of fast food.
This document discusses food preservation and spoilage. It outlines various intrinsic and extrinsic factors that influence microbial growth in foods, such as water availability, pH, temperature, and packaging methods. It also describes different types of food spoilage caused by bacteria and fungi, as well as foodborne illnesses. Common preservation techniques are then outlined, including removal of microorganisms, low temperature storage, high heat treatments like canning and pasteurization, controlling water availability through drying or adding salt/sugar, and use of radiation. Detection and surveillance of foodborne pathogens is also discussed.
This document summarizes food safety and sanitation. It discusses that foodborne illness affects millions in the US each year, costing billions. It outlines various foodborne pathogens and diseases. Proper food purchasing, receiving, storage, preparation, cooking, cooling, reheating, and serving are described to prevent contamination and growth of pathogens. The Hazard Analysis Critical Control Point (HACCP) system is introduced as a framework to identify and monitor critical points to reduce risk.
This document provides an overview of microbial food safety and foodborne illnesses. It defines foodborne infections as diseases resulting from eating food containing living pathogens, and foodborne intoxications as damage from toxins produced by microbes in food. The etiology of foodborne illness is discussed, along with those most at risk. Testing methods for foodborne pathogens are also summarized, including traditional culturing and newer molecular techniques. Limitations and the need for standardized testing methods are also addressed.
This document discusses safe food handling procedures. It describes how foodborne illnesses occur from bacteria growing in the "danger zone" between 41-140°F. It identifies potentially hazardous foods like meat, dairy and eggs that must be properly stored, cooked and handled to prevent bacteria growth. Proper personal hygiene, receiving, storage, thawing, cooking, holding, cooling, reheating, cleaning and sanitizing procedures are outlined to limit contamination and inhibit bacterial growth. Maintaining proper temperatures and sanitizing practices at each stage of food handling is key to preventing foodborne illness.
This document discusses food hygiene and safety. It defines food hygiene as practices that keep food clean and safe to eat, and food safety as the absence of adverse health effects from food consumption. It outlines several principles of food hygiene including personal hygiene, food storage, preventing cross-contamination, temperature control, and cleaning premises and equipment. It also discusses food contamination from physical, chemical and biological agents and the importance of food hygiene for food handlers and high-risk foods.
AnyConv.com__FSS Advance Retail & Distribution - 15.06.17.pptPriyankaSharma89719
This document discusses hygienic and sanitary practices for food retailers. It introduces food safety and food safety management systems. The key aspects covered are:
- Food safety means ensuring food is acceptable for consumption according to its intended use. A food safety management system involves good practices like HACCP.
- Schedule IV of the Food Safety and Standards Act lists basic hygiene and safety requirements that food businesses must comply with to obtain a license. Non-compliance can lead to penalties.
- Allergen management responsibilities of food businesses include proper labeling, formulation control, and preventing cross-contamination during processing and handling. Food handlers must be trained on allergen controls.
1) The document discusses various food safety issues related to India's food export and import trade. It outlines the national food control system and regulators like FSSAI that are responsible for food safety.
2) Key food safety hazards include physical, chemical and biological hazards as well as adulteration. Common causes of foodborne illness are discussed.
3) Ensuring proper hygiene, sanitation, cooking, storage and transportation of food is important to prevent contamination and food poisoning outbreaks. Street food safety is a particular challenge in India.
Vitamins are nutrients that our bodies cannot produce on their own and must be obtained through foods or supplements. The document discusses the top 10 questions asked about vitamin supplements, including whether to get vitamins from food or supplements, who should take a multivitamin, what RDA means, the differences between fat-soluble and water-soluble vitamins, and factors to consider before taking supplements. It also provides details on specific vitamins like B vitamins, Vitamin A, potential deficiencies, and risks of too much intake.
The physician undergoes extensive education and training, including obtaining a bachelor's degree, attending medical school for 4 years, and completing a residency program lasting 3-8 years. Physicians must pass a licensing exam to practice medicine and may specialize in areas like internal medicine, surgery, or pediatrics. Physician assistants and medical assistants support physicians but require less education, with physician assistants needing a master's degree and medical assistants typically receiving on-the-job or associate's degree level training.
Hariyali Teej is celebrated in August and marks the marriage of Lord Shiva and Goddess Parvati. Women dress in green, representing fertility and nature, and participate in rituals like applying henna and fasting to pray for their husbands' well-being. Key rituals include receiving gifts from in-laws and swinging on branches to celebrate married life. Kajari Teej in late August honors Parvati through traditional Rajasthani dress and songs. Hartalika Teej in early September sees women fasting and dressing in red and green to seek marital bliss from Parvati and Shiva.
The document discusses nutrition and its relationship to periodontal health. It defines key terms, classifies foods and nutrients, and describes the functions and effects of macronutrients, micronutrients, and minerals on periodontal health. Specific deficiencies are shown to increase risks of periodontal diseases by impacting collagen formation, wound healing, immune response and more.
This document discusses the six major classifications of nutrients: water, carbohydrates, lipids (fats), proteins, vitamins, and minerals. It provides details on the functions, sources, and examples of important nutrients within each classification, including key nutrients like water, carbohydrates, fats, proteins, vitamins, and minerals. The document emphasizes that nutrients are chemical substances in food that help maintain the body and notes there are over 50 nutrients divided into these six groups.
"IOS 18 CONTROL CENTRE REVAMP STREAMLINED IPHONE SHUTDOWN MADE EASIER"Emmanuel Onwumere
In iOS 18, Apple has introduced a significant revamp to the Control Centre, making it more intuitive and user-friendly. One of the standout features is a quicker and more accessible way to shut down your iPhone. This enhancement aims to streamline the user experience, allowing for faster access to essential functions. Discover how iOS 18's redesigned Control Centre can simplify your daily interactions with your iPhone, bringing convenience right at your fingertips.
Company Profile of Tempcon - Chiller Manufacturer In Indiasoumotempcon
This is the company profile of Tempcon - chiller manufacturer in India. Tempcon manufactures water cooled and air cooled chillers and industrial AC. The company has been in the business since 1983.
website: https://www.tempcon.co.in/
We’re Underestimating the Damage Extreme Weather Does to Rooftop Solar PanelsGrid Freedom Inc.
Grid Freedom is the best solar leads company based in New Jersey that provides Exclusive solar appointments of qualified solar appointments for guaranteed solar appointments for the best way to get solar leads throughout the nation. Grid Freedom is a solar lead provider, that connects exclusive pre-set appointments with pre-screened homeowners who are ready for solar company leads. The solar lead generators company was founded to provide solar appointment leads contractors with better solar sales leads-buying high-quality exclusive solar leads experience that gives pre-set solar appointments great ROI.
The Future of Wearable Technology in Healthcare: Innovations and Trends to WatchbluetroyvictorVinay
As wearable technology continues to shape multiple facets of our lives, its potential in healthcare is becoming increasingly apparent. With the rapid advancement of technology, the integration of wearables into healthcare systems worldwide is accelerating. In this evolving field, we delve into the latest innovations and trends that are transforming healthcare.
The Future of Wearable Technology in Healthcare: Innovations and Trends to Watch
DM1.ppt
1. National Rural Health Mission
for Primary Health Care?
Dr. Dhruv Mankad
Sr. Consultant, School of Health
Science, YCMOU, Nashik
2. Thursday, June 18, 2009 YSP5-IGIDR
Primary Health Care – Indian
vision, 1946
‘If it were possible to evaluate the loss, which this
country annually suffers through the avoidable
waste of valuable human material and the
lowering of human efficiency through
malnutrition and preventable morbidity, we feel
that the result would be so startling that the
whole country would be aroused and would not
rest until a radical change had been brought
about' (Bhore Committee Report 1946).
3. Thursday, June 18, 2009 YSP5-IGIDR
What is primary health care?
VI
• Primary health care is essential health care
based on practical, scientifically sound
• socially acceptable methods and technology
made universally accessible to individuals and
families in the community through their full
participation and
• at a cost that the community and country can
afford
Alma Ata Declaration, International Conference on Primary Health
Care, Alma-Ata, USSR* , 6-12 September 1978
* Now Almaty, Kazhakstan
4. Thursday, June 18, 2009 YSP5-IGIDR
Primary Health Care – an Alma Ata
product
VI
• It forms an integral part both of the country's
health system, of which it is the central function
and main focus, and of the overall social and
economic development of the community.
• It is the first level of contact of individuals, the
family and community with the national health
system bringing health care as close as possible
to where people live and work, and constitutes
the first element of a continuing health care
process.
5. Thursday, June 18, 2009 YSP5-IGIDR
Primary Health Care – an Alma Ata
product
• VII Primary health care:
1.reflects and evolves from the economic
conditions and sociocultural and political
characteristics of the country and its
communities and
2.is based on the application of the relevant
results of social, biomedical and health
services research and public health
experience;
6. Thursday, June 18, 2009 YSP5-IGIDR
Alma Ata Declaration 1978
3. addresses the main health problems in the community,
providing promotive, preventive, curative and
rehabilitative services accordingly;
4. includes at least: education concerning prevailing
health problems and the methods of preventing and
controlling them; promotion of food supply and proper
nutrition; an adequate supply of safe water and basic
sanitation; maternal and child health care, including
family planning; immunization against the major
infectious diseases; prevention and control of locally
endemic diseases; appropriate treatment of common
diseases and injuries; and provision of essential drugs;
7. Thursday, June 18, 2009 YSP5-IGIDR
Alma Ata Declaration, 1978
5. involves, in addition to the health sector, all related
sectors and aspects of national and community
development, in particular agriculture, animal
husbandry, food, industry, education, housing, public
works, communications and other sectors; and
demands the coordinated efforts of all those sectors;
6. requires and promotes maximum community and
individual self-reliance and participation in the
planning, organization, operation and control of
primary health care, making fullest use of local,
national and other available resources; and to this end
develops through appropriate education the ability of
communities to participate;
8. Thursday, June 18, 2009 YSP5-IGIDR
Alma Ata Declaration, 1978
6. should be sustained by integrated, functional and
mutually supportive referral systems, leading to the
progressive improvement of comprehensive health
care for all, and giving priority to those most in need;
7. relies, at local and referral levels, on health workers,
including physicians, nurses, midwives, auxiliaries and
community workers as applicable, as well as traditional
practitioners as needed, suitably trained socially and
technically to work as a health team and to respond to
the expressed health needs of the community.
9. Thursday, June 18, 2009 YSP5-IGIDR
Features of PHC -1
•Primary Health Care = a
paradox, it is complex
12. Thursday, June 18, 2009 YSP5-IGIDR
Features of PHC - 2
•Primary Health Care involves
community, evolves from its
social, cultural, political context
14. Thursday, June 18, 2009 YSP5-IGIDR
Features of PHC - 3
• Primary Health Care has
multidimensional, multidisciplinary,
multiagency approach
15. Thursday, June 18, 2009 YSP5-IGIDR
Content Activities Ministries/Agencies involved
Food Supply
Grains, Cereal, Tuber, Vegetables and
Fruit production Agriculture, Animal Husbandry, Fisheries
Proper Nutrition Milk and dairy products, meat and fish
Animal Husbandry, Dairies -
pvt/cooperatives, FDA
Food supply Agricultural Produce Markets Ration Shops
Food quality, safety FDA
ICDS, Women and Child Development
Safe Water
Drinking Water Resources, Sewage
drainage and disposal, Water
purification, Forest and Water
Conservation, Irrigation
PWD, Sewage drainage and disposal, Water
purification agencies, water purifier
producers
Sanitation Solid waste disposal PWDs, Urban Planning, Environmental
Mother (Women)
Care
Marriage registration, ANC, PNC, CaCx
detection, family planning
Public Health and Family welfare, FDA,
Pharmaceutical and Health device industry,
Gynaecological and Obstetric public and
private hospitals, fertility clinics
Child care
Trained Birth Attendant, Institutional
delivery, Birth registration, early Breast
feeding, Immunization, treatment of
illnesses, early child care
Public Health and Family welfare, FDA,
Pharmaceutical and Health device industry,
Paediatric clinics/hospitals, vaccine
industry
16. Thursday, June 18, 2009 YSP5-IGIDR
Content Activities Ministries/Agencies involved
Endemic Disease NHPs
Public Health departments, Integrated
surveillance system, Public and Private
health care providers, Pharmaceutical and
Health device industry,
Preventing methods
Pollution Control, Occupational
Hazards
All of above, Environmental Board, Traffic
Control, Disaster Management
Treatment of common
illnesses and
injuries Diagnose and treat illnesses
Public Health departments, Integrated
surveillance system, Public and Private
health care providers, Pharmaceutical and
Health device industry,
Essential drugs Treat common illnesses
Public Health departments, Integrated
surveillance system, Public and Private
health care providers, Pharmaceutical and
Health device industry,
Health Education For about all of the above
IEC bureau, Education ministry and
institution, ICT, ISRO, telecommunication,
communication media incl internet, radio,
television and film industry, advertisement
18. Thursday, June 18, 2009 YSP5-IGIDR
PHC Status in India
• ''In rural areas, there are no doctors. They
(PHCs) are functioning only on paper.
There is no facility at PHCs. Hospitals
function without any doctor,''
− a SC bench comprising Chief Justice K G
Balakrishnan and Justices Ashok Bhan and
P Sathasivam *
* ToI 2nd October 2008
19. Thursday, June 18, 2009 YSP5-IGIDR
STATUS OF RURAL HEALTH
SERVICES
• Greater Burden of Diseases
• Lower coverage of public health services
• Inequality in workforce distribution/
accessibility – globally, nationally
22. Thursday, June 18, 2009 YSP5-IGIDR
What about our villages,
city wards?
• Is there an equal distribution of HWs in
villages? Trend is – NO!
• One HW per 16 villages – Nasik survey
• Situated at market towns, In towns, at
marketplaces
• Shift from residential to market, from
family health care to consultancy!
23. Thursday, June 18, 2009 YSP5-IGIDR
Health Workforce in villages
Districts
1 doctor per
no. of villages
1 doctor per
rural
Population
Jalna 8 11346
Khammam 6 10340
Kozhikode 0.2 3180
Nadia 4 10820
Udaipur 4 4006
Ujjain 4 3612
Vaishali 6 10549
Varanasi 3 3979
Total 4 5963
25. Thursday, June 18, 2009 YSP5-IGIDR
PHC Economics – Current Scenario*
• RURAL (Primary/
Secondary) per 1000
Beds 0.2
Doctors 0.6
PE 80,000
OoPs! 750,000
IMR 74/1000 LBs
U5MR 133/1000 LBs
Births Attended 33.5%
Imm. 37%
ANC median 2.5
• URBAN (Secondary/
Tertiary) per 1000
Beds 3.0
Doctors 3.4
PE 560,000
OoPs!! 1,150,000
IMR 44/1000 LBs
U5MR 87/1000 LBs
Births Attended 73.3%
Imm. 61%
ANC median 4.2
* www.vatsalya.com based on CII McKinsey Study, 2001
26. Thursday, June 18, 2009 YSP5-IGIDR
PHC Current Scenario
Public Private
Rural Existing, Low
public exp,
Inaccessible, Weak
performance
Sporadic,
Inaccessible,
un/affordable,
Weak performance
Urban Low existence,
High public exp,
accessible, Mod.
performance
Strong existence,
Un/affordable,
Accessible, Good
and Limited
performance
27.
28. Thursday, June 18, 2009 YSP5-IGIDR
WHY NRHM? PROBLEM 1
• High and Static IMR
• High Out of pocket expenses
• Population Stabilization unstable
• Public Health System thinning down
29. Thursday, June 18, 2009 YSP5-IGIDR
WHY NRHM – PROBLEM 2
• Community involvement low
• Health structure run with saline-
syringes
• NGO involvement also low
• Pvt sector though large not linked
with public health programmes
30. Thursday, June 18, 2009 YSP5-IGIDR
WHY NRHM – PROBLEM 3
• Budgetary Allocation to Health had
declined 1999 – 2002
• GoI contributing less than State
• Health care services not for poor
• 10% covered under insurance
• Hospitalized patients pay about 58% of
their annual income, 40% borrow
ALL THESE WHEN WE HAD COMMITTED IN
1946!
31. Thursday, June 18, 2009 YSP5-IGIDR
A Rural Primary Health Care package
Universal Health Care
Accessibility and Affordability
Quality and Equity
Reduce IMR, MMR, TFR
NRHM - GOALS
32. Thursday, June 18, 2009 YSP5-IGIDR
NRHM - THE VISION
• Architectural correction in health care delivery
• Special focus on 18 states with weak indicators.
• Improve availability of quality health care in rural
areas
• Synergy between health and determinants of good
health
• Mainstream the Indian Systems of Medicine.
• Capacity Building.
• Involve the community in the planning process.
33. Thursday, June 18, 2009 YSP5-IGIDR
EXPECTED OUTCOMES
2005 - 12
• Universal Quality Health care.
• IMR reduced to 30/1000 live births
• MMR reduced to 100/100,000 live births
• TFR reduced to 2.1
• Malaria Mortality Reduction Rate – 60%
• Kala Azar eliminated by 2010, Filaria
reduced by 80 % by 2010
• Dengue Mortality reduced by 50% by
2012
• TB DOTS series – maintain 85% cure rate
• Responsive Health System
34. Thursday, June 18, 2009 YSP5-IGIDR
Indicator 2005-06 2006-
07
2007-
08
2008-
09
2009-
10
Institutional
Deliveries
54.1 56.6 59.1 61.6 64.1
Skilled birth
Attendants
58.8 61.8 65.8 69.8 74.3
Fully Immunized
Children
80.6 83.6 88.6 90.6 93.6
Couple
Protection Rates
59.7 61.7 64.7 66.7 69.7
Full ANC care
Received
50.8 55.8 62.8 69.8 78.8
Unmet Need for
Family Planning
4.2 3.2 2.7 1.7 1.0
Goal Indicators
35. Thursday, June 18, 2009 YSP5-IGIDR
NRHM components
A RCH II
B Innovation under NRHM
C National Health Programs
D Disease Surveillance
Programs
E Inter-sectoral convergence
36. Thursday, June 18, 2009 YSP5-IGIDR
• Public Health expenditure - 2 – 3 % of GDP
• Merger of societies at District level
• Integration of existing schemes
• Decentralized planning
• Intersectoral convergence with other Health
determinants
• Community ownership of Health facilities
• Upgradation of CHCs / PHCs to IPHS
• Mainstreaming of AYUSH
• Partnership with non Government providers.
• Risk Pooling
• Fully trained ASHA in each village.
What’s New
37. Thursday, June 18, 2009 YSP5-IGIDR
NRHM-5 MAIN APPROACHES
COMMUNITIZE
IMPROVED
MANAGEMENT
THROUGH CAPACITY
BUILDING
MONITOR
PROGRESS AGAINST
STANDARDS
INNOVATION IN
HUMAN
RESOURCE
MANAGEMENT
FLEXIBLE
FINANCING
38. Thursday, June 18, 2009 YSP5-IGIDR
State and District Health
Mission
• State Health Mission led by
CM –
• SPMU - Mission Directorate,
SHRC
• Prepare and approve State
Health Action Plan
39. Thursday, June 18, 2009 YSP5-IGIDR
State and District Health
Mission
• District health mission led by
chair ZP, DHO, dept reps,
• DPMUs
• Prepares and implements
DHAP
40. Thursday, June 18, 2009 YSP5-IGIDR
Village Empowerment
• Village Health, Nutrition, Water
& Sanitation Committee
(VHNWSC)
• Village level revolving funds
• Preparation of village specific
plans
• Convergence of all
developmental activities
42. Thursday, June 18, 2009 YSP5-IGIDR
Reproductive and Child Health
(RCH) programme
Major component of NRHM
• Maternal Health
– 24x7 hrs services
– JSY
– Additional ANMs
– On contract Experts
– Infrastructure upto IPHS std
• Child Health
• Reproductive Health of Men and Women
43. Thursday, June 18, 2009 YSP5-IGIDR
Reproductive and Child Health
(RCH) programme
Major component of NRHM
• Child Health
– Immunization: BCG,OPV, DPT, TT, HepB
• Reproductive Health of Men and Women
– Family Planning
• OP, Tubectomy, CuT for women
• Condom, Non scalpel vasectomy for men
– Safe Abortion
– STD
– Adolescent RCH
44. Thursday, June 18, 2009 YSP5-IGIDR
Reduce maternal and infant death
thru’ institutional deliveries
JSY – AN INTEGRATED PACKAGE:
Tracking entire pregnancy period Adopt Micro-
birth plan
Providing appropriate referral and transport
assistance,
Building an effective link between service provider
and pregnant woman, through ASHA
PLUS CASH ASSISTANCE
RCH II Janani Suraksha
Yojana
45. Thursday, June 18, 2009 YSP5-IGIDR
• PROVISION FOR CAESAREAN SECTION :
– Empanel private/Govt. doctors,
– up to Rs. 1500/- per case for hiring services
of experts from private sector,
– If private doctors are not available, utilize
this amount for providing honorarium to
Govt. specialist.
RCH II Janani Suraksha
Yojana
46. Thursday, June 18, 2009 YSP5-IGIDR
N H Ps
• Revised National TB Control program
• National Vector Borne Diseases Programs,
eg Malaria, Urban Malaria, Dengue,
Chikunguniya, Filaria, Japanese
Encephalitis, Swine Flu
• National Leprosy Eradication Program
• National AIDS control Programme
• National STD Control Programme
47. Thursday, June 18, 2009 YSP5-IGIDR
N H Ps
• National Blindness Control Program eg Cataract
Operations, Refractory Errors in school children
• National Leprosy Eradication Program
• National Iodine Deficiency Control Program by
promoting iodated salt
• National Mental Health Programme
• National Cardio-vascular Diseases Control
Programme
• National Cancer Control Program
• National Occupation Disease Control Program
• National Diabetes Control Program
48. Thursday, June 18, 2009 YSP5-IGIDR
Revised National TB Control
Programme (RNTCP)
• Operational Structure
– Central Govt : Dy DGHS (TB)
– State Govt : State TB Cell with STO
– District: DTU with DTO
– Sub District – MO – TC ( 1 per 5/2.5 lakhs)
– Designated Microscopy Centre (DMC): for Med
College, NGO, Pvt Hospital nodal point for record
report at Sub District Level
– Peripheral Health Inst
• Diagnostic Laboratory Services
• Drug Stores
49. Thursday, June 18, 2009 YSP5-IGIDR
Revised National TB Control
Programme (RNTCP) – Lab/DOTS
• Central Laboratories with international
recognition at Chennai, Bangalore and
Delhi
• DMC and Sputum Collection Centres
networks
– Case Detection, finding and Diagnosis of Lung
TB
• DOTS
51. 53
OPERATIONALIZE 24/7 SERVICES – PHC & FRU
ACCREDIT PRIVATE INSTITUTIONS:
Empanel atleast two accessible private health
institutions in each Block,
Draw up a protocol of services to be delivered at these
recognized health centers,
Give wider publicity to such institutions by displaying
names of such institutions in every PHC/CHC/District Hospital
and the sub-center,
Constant monitoring of the Quality of services
Infrastructure Improvement
52. Thursday, June 18, 2009 YSP5-IGIDR
24 X 7 PHCs
Pre requisites for 24 x 7 PHC
delivery services
Sterilization services
STI / RTI management
Safe Abortion services (MVA)
24 x 7 services
Identify gaps & address appropriately
Repair of physical structure – labour room & OT
Skill enhancing training of MO, SBA
Transport & referral
Logistic support
Provision of 24X7 delivery services at least in
50% PHCs
53. Thursday, June 18, 2009 YSP5-IGIDR
PHCs
Strengthening PHCs
• Supply of essential drugs to PHCs
• Upgrading single-doctor PHC to two-doctor
PHC by posting AYUSH practitioner
• Providing standard treatment protocols
and training medical officers / paramedics
in their use
Repairs for SC / PHC:
• Sub-center upto Rs. 50,000/-
• PHC upto Rs.1.00 lakh
54. Thursday, June 18, 2009 YSP5-IGIDR
New and Old Construction
• Additional 2627 SCs, 394
PHCs, 95 FRUs
• Improvement Training
Centers
• Maintenance of existing and
new construction (35 DHs,
500 FRUs, 2200 PHCs)
55. Thursday, June 18, 2009 YSP5-IGIDR
Strengthening Sub-centres
•Untied fund @Rs.10,000/-
•Supply of essential drugs
•Additional outlays: local
ANMs on contract etc.
58. Thursday, June 18, 2009 YSP5-IGIDR
Workforce
Planning
Political
Commitment
Motivational
Environment
CRITICAL FACTORS
Long term
•recruitment
•training
•Pre service
training
•Sustained
Long term efforts
•High Investment
•Information
• Incentive and
Motivating work
environment
TRAINING POLICY
Quick Fix Medium term Long term
ODL, On Job,
Flexi
Curriculum reform
Outsource trg,
Build Instt
KMC
More Primary
Care Providers
More Nurse, MPH
More Spl Dr,
MDG 6 MDG 5 MDG 4
CHR ILLNESSES
59. Thursday, June 18, 2009 YSP5-IGIDR
ASHA (NRHM)
•Accredited (Trained through recognized
institution)
•Social (NGO-SHG-PRI network)
•Health (managing biomedical and social
determinants of health)
•Activist (non-profit based services, and
community active model)
60. Thursday, June 18, 2009 YSP5-IGIDR
ASHA: TASKLIST
• Village microplanning with others
• Improvement of hygiene and sanitation
through IEC-BCC
• Maternal and child health, helping AWW
and ANM, for preventing malnutrition
• Basic medical care
• Referral and JSY
• Depot holder for DOT and malaria
• Helping in all National Health
Programmes (NHP).
• Reporting outbreaks and keeping basic
health records
61. Thursday, June 18, 2009 YSP5-IGIDR
ASHA: TRAINING
• Home based neonatal care
• Treatment of common childhood
illnesses like diarrhea, ARI
• Identification of high risk mother
& child & appropriate referral
• Health & nutrition education
62. Thursday, June 18, 2009 YSP5-IGIDR
ASHA – YCMOU’s Arogyamitra
• Woman selected by GP/ SHG/ Youth
• VII std
• 21 years age
• Training 28 days (32 CPs)
• Fee = 800 YCMOU, 2500 SC
• 5 books+Wkbk+exam
63. Thursday, June 18, 2009 YSP5-IGIDR
Arogyamitra Program
2007-08 Results
Women
Learners
Men
Learner Total
No. % No. % No. %
Passed 305 77 224 78 529 78
0-49.99
(Failed) 90 23 63 22 153 22
Total 395 100 287 100 682 100
67. Thursday, June 18, 2009 YSP5-IGIDR
Strengthening Nursing
• Strenghtening SCs with
12000 ANMs
• Strengthening 21 Training
Schools
• Strengthening PHCs with
about 1500 staff nurses,
Blocks with a PHN
• Nursing Cell at the state
68. Thursday, June 18, 2009 YSP5-IGIDR
Rogi Kalyan Samiti
• People’s reps, Health Officials, Local
District Officials, community Leaders
medical Supdt, IMA Rep, donors
• Flexi fund available DH, RH and PHC
level. Can raise addl. Funds to
– Improve existing services, facilities
– Introduce new services
– Can procure medicines, equipments,
recruit addl staff, have PPP MoU etc.
70. Thursday, June 18, 2009 YSP5-IGIDR
Services guaranteed in CHC with
IPHS
• New born care
• Routine and emergency care of
sick children
• National Health Programmes
• Blood storage facility
• Essential laboratory services
• Referral services
71. Thursday, June 18, 2009 YSP5-IGIDR
Quality Assurance
• Regulation
• Accreditation
• IPHS
• Revised PHC Manual and
Treatment Protocol
• RKS as Quality Assurance
Mechanism
• Citizen’s Charter and Guarantee
Scheme
72. Thursday, June 18, 2009 YSP5-IGIDR
Quality Assurance
Area Specific Activities
Technical
Quality
Improvement
• Standard Treatment Protocols.
• Grading of PHC done by state
government Technical parameters
• Grading of public health institutions
(CHC/FRU/DH)
• Accreditation scheme for private sector
hospitals
• CME for Private Medical Practitioners.
• Refresher's skill training to ANM, MO for
building confidence , training in IMNCI
etc.
• Management Development trainings for
program managers at all levels
73. Thursday, June 18, 2009 YSP5-IGIDR
Area Specific Activities
Managerial
Quality
Improvement
• Random visits to check humane approach and 3rd
delay in treatment
• Developing a procurement and distribution system
• Improved monitoring of infrastructure, staff
availability, functionality of equipment, institutions
• Equipment maintenance contract (AMC)
• Inter-departmental convergence
• Client satisfaction surveys
• Special training package
• Financial management and audit
• Use of MIS analysis and feedback
• Sensitization on gender and equity issues,
• Feedback and follow-up of trainings
Quality Assurance
74. Thursday, June 18, 2009 YSP5-IGIDR
District Health Action Plan
• Microplanning
• DHAP built up on Monthly
Plan
• HH facility periodic survey as
basis
• PPP with NGO, professionals
75. Thursday, June 18, 2009 YSP5-IGIDR
Next funds will be released on receipt
of SOEs for atleast 50% of previous
releases
Expenditure & physical performance
(no. of beneficiaries) should match
Ensure grants are used for the
purpose for which grants given
All activities in the PIP should be
initiated
Diversion of grants not permitted
PERFORMANCE BASED
FUNDING FOR RCH
76. Thursday, June 18, 2009 YSP5-IGIDR
State Resource Center
• An agency to pool the technical
assistance from all the
Development Partners
• A single window for consultancy
support
• for capacity building not only for
SRHM but for improving health
sector service delivery
78. Thursday, June 18, 2009 YSP5-IGIDR
I D S Program
• Integrated Disease Surveillance
Program
– decentralized, state based
– improve information about communicable
and non communicable diseases
– identify major risk factors incl.
environmental, social and political
79. Thursday, June 18, 2009 YSP5-IGIDR
I D S Program
It would also
– Improve laboratory support;
– Train stakeholders in disease surveillance and
action;
– Coordinate and decentralize surveillance
activities
– Involve private sector
80. Thursday, June 18, 2009 YSP5-IGIDR
Monitoring & Evaluation
• Habitation/ Village Health Register
• Periodic Health Facility Survey at
SHC, PHC, CHC, District level
• Formation of Health Monitoring and
Planning Committees at PHC, Block,
District and State levels
• Sample household and facility
surveys
• Community based monitoring
81. Thursday, June 18, 2009 YSP5-IGIDR
Monitoring & Evaluation
Outputs/ Outcomes Objectively verifiable
indicator (OVI)
I) General goals and objectives of NRHM
Reduction in IMR, TFR
and MMR
MMR reduced to 200 by
2010
IMR reduced by 20 by
2010
Neonatal mortality rate
reduced to 10 by 2010
TFR brought down to 2.0
by 2010
82. Thursday, June 18, 2009 YSP5-IGIDR
Monitoring & Evaluation
Sr.No. Overall Results Indicators Expected level of achievements
Indicators Baseline 2006-7 2007-08 2010-11
1 Contraceptive prevalence rate (Current use of any contraceptive method among
currently married women)
61.6 70 75
2.75 % Eligible couples using IUD for more than 12 months 57 60
3.6 % of mothers who delivered during past 3 years & who received IFA for 3+ months 36% 90 95
4.95 % Deliveries assisted by skilled attendants at birth One-fourth home
births (36%)
83 95
5.95 % of 24hr PHCs conducting minimum 10 deliveries/ months All 7 currently
conducting >10
del
35 50
6.5 No. of Upgraded FRUs offering 24hr. emergency obstetric care services 28? 150
7.15 % of 12-23 months of age fully immunized children 84% 90 95
8.95 % of mothers and newborn children visited within 1 week of birth among non
institutional deliveries
NA 50 60
9.6 % of children under 3 years of age with diarrhea in the previous 2 weeks who
received oral dehydration salt
NA 45 60
10.6 % of children under 3 years of age with diarrhea in the previous 2 weeks who
received oral dehydration salt
NA 45 60
11.6 Polio free status achieved since when Not yet Polio-free Polio-free
12 No. of institutions upgraded to IPHS Process begun 198 360
Selection and training of ASHA Starting year 1300
84. Thursday, June 18, 2009 YSP5-IGIDR
Interdepartment Convergence
• WCD for Nutrition, Women Empowerment
• TDD for Tribal Health Monitoring, Pada
Swayamsevak, Shabari taxi Yojana
• Water and Sanitation
• Rural Development for EGS, Income Gen Schemes
• Urban Development for RCH
• PWD for construction
• Med Education Dept for IDSP, Medical Audits
• MUHS for CME
• DoEdu for Annual health check up
• Missions – RJCHNMission, HDMission for Nutrition
85. Thursday, June 18, 2009 YSP5-IGIDR
Public Private Partnership
PPP in health is an
approach to solving
public health
problems by
complimentary
efforts of public,
private and NGOs by
contributing or
sharing their core
competency
Synergy is the spirit of better health outcomes
86. Thursday, June 18, 2009 YSP5-IGIDR
Current Focus of PPP in Health
• Develop strategies to utilize untapped
strengths of the NGO sector
• Enhance the capacity to meet
growing health needs
• Sharing responsibilities of public
health activities by the government
with NGO
• Reaching remote areas; target
specific group of populations
• Improving efficiency through
evolving new management structures
88. Thursday, June 18, 2009 YSP5-IGIDR
State Specific Innovative
Schemes
Eg in Maharashtra
1. Sickle Cell Anemia
2. State Nutrition Bureau
3. State Public Health Institute
4. Action research project eg HBNC
in 4 districts
5. Computerization of HMIS
6. Arogya Jaal - DIGITAL CHC WITH
TELE DIAGNOSTICS
7. Untied funds for awards,
scholarship, study tour etc.
89. Thursday, June 18, 2009 YSP5-IGIDR
Proposed District Specific
Innovations
Eg Nashik DHAP
• Management by alliance
• Transportation with Taxi
90. Thursday, June 18, 2009 YSP5-IGIDR
Innovations To be Tapped
• Convergence of TDD’s Taxi
scheme and referral transport for
BPL /ST patients
• Collaboration with dai for
antibleeding medicines
91. Thursday, June 18, 2009 YSP5-IGIDR
Lateral Thinking Options in NRHM
• Technology Options
– Water Sources, GPRS-Internet, simplify technology –
auto-destructive syringe for gentamycin (test level),
solar disinfections, ppt as trg mode, cell phone or FM
• Structural-managerial Options
– RKS in designing, financing and constructing,
managing health units, flexi funds, local procurement/
purchase
• Collaborative Options
– with NGOs, CBOs, religious, political, social,
professional organizations, military, corporate sector,
experts and volunteers
92. Thursday, June 18, 2009 YSP5-IGIDR
NRHM
Is it a ‘Mission Impossible IV’ ??
Workable but highly ambitious mission, bcoz…
• Mindsets ready for some U turns?
• Staff availability?
• Decentralization nebulous
• ASHA – training, supervising plan? no economic
incentive?
• Workforce training plan?
• HR environment – motivation, recruitment,
transfer, punishment posting
• Incentives to staff for retention, motivation?
• Intra department Convergence - Does the left
hand knows what the right hand is doing?
93. Thursday, June 18, 2009 YSP5-IGIDR
NRHM
Make it a ‘Mission Impossible IV’ !!
• Insuring Health, Ensuring Equity - Which
Health Insurance model to work?
• Is community/govt prepared for
innovations?
• Political Will – for?
– Will for a Visionary plan
– Will for High human/financial investment
– Will for real PPP : within govt., with civil
society, corporate
– Will for effective regulation
94. Thursday, June 18, 2009 YSP5-IGIDR
PHC ‘Economics’
“The important thing for government is
not to do things which individuals are
doing already, and to do them a little
better or a little worse; but to do
those things which at present are not
done at all”
- J. M. Keynes 1926
95. Thursday, June 18, 2009 YSP5-IGIDR
People’s Health Watch Report –
General Findings
• No evidence of infrastructure
improvement
• Shortage of Medicines, staff and so IPHS
facilities a far cry
• ASHA selection, training, performances
and payment distorted
• RKS defunct/ disfunctional
96. Thursday, June 18, 2009 YSP5-IGIDR
People’s Health Watch Report –
General Findings
• Institutional delivery incentives – a problem
– competition between ASHA, ANM, AWW etc.
– ID does not = delivery by trained or EmOC
• No decentralization/communitization
• DHAP is really TD DHAP
• Insufficient, inadequate Monitoring and analysis
documentation
• Corruption !? Reports from orissa, MP,
Maharashtra
• Political will NOT for reforms but for repackaging
SO WHAT IS THE OPTION ?
98. Thursday, June 18, 2009 YSP5-IGIDR
Why AB?
• Developing a first contact cae model where
there is no primary health care provider
• Addressing common health problems of
community
• Promoting activities for healthy lifestyle
• Providing referral services, pre and post
referral counseling to patients
• Managing emergency and disaster
management services
• Facilitating home based health care services
99. Thursday, June 18, 2009 YSP5-IGIDR
What do people need?
– Simple treatment for simple illnesses
– Monitoring health problems eg Heart
attack, Brain hemorrhage, Diabetes,
T.B., AIDS, Cancer, Malaria,
Chikunguniya etc
– Actions/steps during any outbreak
– Home based caring services for elderly,
post illness recuperating, temporarily
disabled, long term health monitoring
services
– Effective health commnication
– Screening illnesses
– Health counseling
100. Thursday, June 18, 2009 YSP5-IGIDR
The AB Model
• A Shelter – existing building, a shop or a
kiosk with adequate space, scrap vehicle, a
locally made shelter
like these…
101. Thursday, June 18, 2009 YSP5-IGIDR
The AB Model – a multiowned
model
• With logos – of implementing agency,
concept developer agency, supporting
agency: a multi logo with a logo of
Arogyamitra
• like these…
102. Thursday, June 18, 2009 YSP5-IGIDR
The AB Model – what all it can
have
• Furniture/Equipmen
ts
• Chair, table,
cupboard
• Stetho, BP, trays,
dressing material
• Boxes for storing
medicines
• Bandages, slings,
splints
103. Thursday, June 18, 2009 YSP5-IGIDR
The AB Model – what all it can
have
• OTC medicines,
medicines for MPWs
• First Aid material
• Ayurvedic Medicines
• Homeopathic medicines
• Home remedies
• Reagents/strips for
Sugar,protein and Hb
tests
• Massage oil
104. Thursday, June 18, 2009 YSP5-IGIDR
The AB Model – what all it can
have
• PC with printer, CD
drive
• Internet connectivity
• Learning Material CD
• Health Education CD
• Print materials, books
etc.
• Cellphone
105. Thursday, June 18, 2009 YSP5-IGIDR
The AB Model – what all it
can do
• Provide First Contatct
care through ASHA/
USHA/MPW
• Participate in Public
Health Programmes
• 0-5 child care
• Provide emergency first
aid
• Provide support care
• Screen illnesses like BP,
Diabetes, disabilities etc
106. Thursday, June 18, 2009 YSP5-IGIDR
The AB Model – what all it
can do
• Provide HE, School Health
• Provide information
through internet, print
material
• Contact referral units
through email, cellphone,
• Can escort patient to
secondary/ tertiary care
level
• Self learning centers
107. Thursday, June 18, 2009 YSP5-IGIDR
The AB Model – other possible
uses
• Health Insurance
Agency
• Healthy food,
Health and beauty
product outlet
• Non medical
equipment outlet
• Computer Literacy
Centre
108. Thursday, June 18, 2009 YSP5-IGIDR
Expected Impact
• Improved quality of
life of vulnerable
population
• Improved responses
from community in
personal and
collective emergencies
• An innovative primary
health care model