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Integrated District Health Society SOUTH DISTRICT NRHM. Dr. JYOTI SACHDEVA PO, NRHM. NRHM. Launched by the Prime Minister on 12 th April, 2005. Focuses on 18 states (EAG) including eight Empowered Action Group (EAG) States, the North-Eastern States, Jammu & Kashmir and Himachal Pradesh. - PowerPoint PPT Presentation
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Integrated District Health Society
SOUTH DISTRICTNRHM
Dr. JYOTI SACHDEVAPO, NRHM
• Launched by the Prime Minister on 12th April, 2005.
• Focuses on 18 states (EAG) including eight Empowered Action Group (EAG) States, the North-Eastern States, Jammu & Kashmir and Himachal Pradesh.
• Aims to focus on the 18 states having weak public health indicators (Arunachal Pradesh, Assam, Bihar, Chhattisgarh, H.P, Jharkhand, J&K, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura, Uttaranchal and Uttar Pradesh).
• Enhancing the commitment of the government to raise expenditure on public health from 0.9 % to 2-3 % of GDP
NRHM
• Quality Care
• Rural & Vulnerable
• Equitable
OBJECTIVES
A ccessibleccountablecceptableffordable
All Levels
1) Primary
2) Secondary
3) Tertiary
• Strengthening
• Communitization
• IEC
GOALSUniversal AccessPrevention and Control of CD &NCDAccess to integrated comprehensive Primary
Health CareReduction in IMR & MMRPopulation Stabilization, Gender and
Demographic BalanceRevitalize local health traditions and
mainstreaming AYUSH
STRATEGIESDecentralized Planning (Inter State &
Inter District Profile)ASHAStrengthening of Primary Health Care
InfrastructureEnsuring QualityPromotion of Non Profit SectorNew Health Financing SchemesIntegration of ongoing disease control
Programs
SUPPLEMENTARY STRATEGIESRegulation of Private SectorPromotion of PPPMainstreaming AYUSHReorienting Medical EducationEffective and Viable Risk Pooling and
Social Health Insurance Convergence
GOALS (NPP - Immediate)
Maternal Mortality Rate (MMR) reduced from 407 to 100 per 1,00,000 live births.
Infant Mortality Rate (IMR) reduced from 60 to 30 per 1000 live births.
Total Fertility Rate (TFR) reduced from 3.0 to 2.1
Effective healthcare to rural population.
Increase public spending on health from 0.9% GDP to 2-3%.
NRHM – 5 MAIN APPROACHESCOMMUNITIZE
1. Hospital Management Committee/PRIs at all levels
2. United grants to community/PRI Bodies
3. Funds, functions & functionaries to local community organizations
4. Decentralized planning, Village Health & Sanitation Committees
IMPROVED MANAGEMENT
THROUGH CAPACITY
1. Block & District Health Office with Management Skills
2. NGOs in capacity building
3. NHSRC/SHSRC/DRG/BRG
4. Continuous skill development support
FLEXIBLE FINANCING
1. United grants to institutions
2. NGO sector for public Health goals
3. NGOs as implementers
4. Risk Pooling – money follows patient
5. More resources for more reforms
MONITOR, PROGRESS AGAINST
STANDARDS
1. Setting IPHS Standards
2. Facility Surveys
3. Independent Monitoring Committees at Block, District & State levels
INNOVATION IN HUMAN RESOURCE
MANAGEMENT
1. More Nurses – local Resident criteria
2. 24 X 7 emergencies by Nurses at PHC, AYUSH
3. 24 X 7 medical emergency at CHC
4. Multi skilling
HEALTH
NUTRITION
EDUCATIONWATER SUPPLY
SANITATION
CONVERGENCE
Convergence with ICDS Malnutirtion / anemia --
planning Commission parameters.
Identification of malnourished and anemic children / woman and targeted supplementation / counseling / monitoring .
Provision of • Weighing machines.
• IEC Material .
• Training of 257 CDPOs / Supervisors.
Involving the Community (Communitisation)
ASHAROGI KALYAN SAMITIHEALTH AND SANITATION
COMMITTEES
COMPONENT ASHA (ACCREDITED SOCIAL HEALTH ACTIVISTS)Chosen by and accountable to the panchayat.Functions of ASHAAdvice rural community regarding Immunization, ANC registration, institutional delivery
contraception and sanitation, hygiene, etc.
Treatment for Minor ailments like- diarrhea, minor injuries and fever.
Accompany patients To health facilities. Deliver DOTs Overall bridge between the ANM and the village.Facilitate preparation & implementation of the Village Health
Plan.Eye Care
FLOW CHART
NRHMCELL/NHFW
SPMU
DPMU
BPMU
NATIONAL MISSION
DIRECTOR
STATE MISSION
DIRECTOR
DISTRICT MISSION
DIRECTOR
BLOCK PUBLIC HEALTH
MISSION
NHSRC
SHSRC
DHSRC
BHSRC
PROGRAMME MGT.PROG. SUPPORT TEC.
SUPPORT
National Level
State Level
District Level
Block Level
Decentralization
State specific
District specific
CNAA
PLANNeeds
Assessment
Ex-ante Evaluation (Evaluaability / Design
Assessment)
Decision of Implementation
Do
Implementation
ProcessEvaluation
Mid- termEvaluation
Terminal Evaluation
See
Post Implementation
Ex- postEvaluation
Feedback
State Health Society
GOI / State
Additionalities
DHS DSHM DFW
NPCB
NVBDCP
NIDDCP IDSP
Convergence with agencies /
Departments /ProgramsStandardization & Strengthening of Health Infrastructure to address heterogenity / multiplicity/ and give quality
healthcare.
Community involvement RKS / ASHAs
IDHS
PPIPNLE
PRCH
Department of Health & Family Welfare
RNTCP
Decentralization levels• Planning• Accounts• Implementation• Procurement• Recruitment• Reporting• Monitoring
Faster/ More logical solutions
Chairman District Health Society
(Deputy Commissioner)Mission Director
(Chief District Medical Officer) ACDMO
IDSP Officer
District Immunizati
on, NVBDCP &
NIDDCP Officer
NLEP Officer
DNBCP Officer
District RCH
Officer
District NRHM/ ASHA
PC PHDT & QAC
District Programme Management Unit
DPM DTC MIS BCC DAM
SpecialistsMO Paramedics
ASHA, MCD, IPP – VIII
(Nodal Officers)MonitoringCommittees
PIP approvedby GOI
Fundstransferred to States
Fundstransferred to
Districts
Funds transferredto PHC/CHC/OtherImpl. agencies
Reporting Back of Exp.from PHC/CHC/OtherImp. Agencies to District
Reporting Backof Exp. To State
Reporting Back ofExp. To Centre WithUC and Audit Report
Strengthening of District Infrastructure
DISTRICT BCC
CELL
DISTRICT STORE
DPMU
DISTRICT TRAINING CENTRE
Strengthening of Primary Infrastructure
Potential PUHCs
• Every PUHC is to cater to a population 50,000 each.
• The essential elements of a PUHC are Preventive, Promotive, Curative and Rehabilitative Primary Health Care
• The PUHC has to upgraded as per the Public Health Standards laid down by Department of Health & Family Welfare
• It aims at Community Participation and Community Linkage through Rogi Kalyan Samiti and ASHA respectively.
Strengthening of Primary Infrastructure Potential PUHCs
DGD (18) MCD ( Including IPPVIII)
Health centers attached to Maternity Homes
Non ASHA ASHAUnits
ASHAUnits
Non ASHA ASHAUnits
Non ASHA
9 9 10 M &CW +2 IPP VIII =12
1+0 0+1 3+0
Chaterpur Molarband
Sangamvihar K-II
Sangam vihar D Block
Tajpur Batla House
Sarai kalekhan Kalkaji
Begampur
Ber Sarai, Chirag Delhi,
Garhi, Khanpur, Madangir,
Sriniwaspuri, Sunlight
Colony Dakshinpuri
Jonapur
M&CW Center Madanpur Khadar
Fatehpur Beri Meharauli Tugklabad Nehru nagar
Jaitpur Dakshinpuri Block –
F 5 Madangir Kalkaji
Badarpur (IPP VIII)
Okhla Phase1 Nehru place
M&CW Center Defence
Colony
IPP VIII Badarpur Jungpura
Shri Niwaspuri
Defence Colony
Total Potential PUHC = 32 (18 DGD +11 M&CW +3 IPP VIII)
Strengthening of Maternity Home
Strengthening of Secondary Health Care
Coverage of Unserved/Underserved Areas
SEED PUHC
2008-09 2009-10Projected – 13 (in
2009-10) Functional - 7
Under Process – 2
Functional -1, (D5 Sangam Vihar) MOU done for -3 Seed PUHCs (Tughlakabad, Sangam Vihar H-Block, Aaya Nagar)
Harkesh Nagar, Meethapur Extn, Sangam Vihar L2, ABC Block, Abul Fazal Enclave
Projected – 2 (in 2010-11)
Madanpur Khadar Extn.
Public Private Partnership
MAMTA
• BPL/SC/ST• Move with private nursing home Mamta
Friendly Hospital• Antenatal/Intranatal Services/Postnatal/Early
Neonatal• Rs 4000/- per centre
ARPANA TRUST - NGO
HMIS• Decentralization of Reports- District -
Facility
• Tracking System • Eye Related Activities
THANK YOU