NATIONAL RURAL HEALTH MISSION

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NATIONAL RURAL HEALTH MISSION

• PRESENTATION BEFORE
• CONFERENCE OF CHIEF SECRETARIES
• 19th July2006
• Ministry of Health Family Welfare

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• NRHM GOALS APPROACHES

Universal Health Care Reducing IMR, MMR,TFR
MONITOR AGAINST AGREED MILESTONES
COMMUNITY INVOLVEMENT
FLEXIBLE FINANCING
HUMAN RESOURCE MANAGEMENT
CAPACITY BUILDING
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NRHM ILLUSTRATIVE STRUCTURE
Health Manager
CHIEF BLOCK MEDICAL OFFICER / BLOCK LEVEL HEALTH
OFFICE --------------- Accountant
Store Keeper
BLOCK LEVEL HOSPITAL
100,000 Population 100 Villages
Accredit private providers for public health goals
Strengthen Ambulance/ transport Services Increase
availability of Nurses Provide Telephones Encourag
e fixed day clinics
Ambulance Telephone Obstetric/Surgical
Medical Emergencies 24 X 7 Round the Clock
Services
30-40 Villages
CLUSTER OF GPs PHC LEVEL
3 Staff Nurses 1 LHV for 4-5 SHCs Ambulance/hire
d vehicle Fixed Day MCH/Immunization Clinics
Telephone MO i/c Ayush Doctor Emergencies that
can be handled by Nurses 24 X 7 Round the
Clock Services Drugs TB / Malaria etc. tests
5-6 Villages
GRAM PANCHAYAT SUB HEALTH CENTRE LEVEL
Skill up-gradation of educated RMPs / 2 ANMs, 1
male MPW FOR 5-6 Villages Telephone Link
MCH/Immunization Days Drugs MCH Clinic
1000 Popu lation
VILLAGE LEVEL ASHA, AWW, VH SC
1 ASHA, AWWs in every village Village Health
Day Drug Kit, Referral chains
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Health is also
Economic productivity
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Administrative Actions
Health is also
Womens empowerment
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Manpower Strengthening
Health is
Womens right
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DECENTRALISATION CONVERGENCE
Healthy family
Healthy nation
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AGENDA FOR CHIEF SECRETARIES

• Operationalisation of Mission structure
  managerial support at state /District / Block
  levels.
• Selection, training and support for ASHA.
• Availability Utilisation of service delivery at
  facilities.
• Immunisation Institutional deliveries
  District wise.
• Preparation of District Plans
• Interdepartmental Coordination for convergence
• Release Utilisation of funds.
• Training/Capacity Building-Health
  Planning-District training Centre
• Delegation of administrative financial powers
  to various levels.

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• THANK YOU

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• STATE
• INITIATIVES

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STATE INITIATIVES

• Andhra Pradesh
• Woman Health Volunteers in each of the rural and
  tribal habitations.
• Setting up an additional 100 round-the-clock
  women health centres.
• A subsidized Emergency Health Transportation
  Scheme.
• Incentives to women health volunteers, village
  Panchayats that promote Immunization
  Institutional delivery etc.
• Arunachal Pradesh
• 16 PHCs contracted out to NGOs and Private
  practitioners.
• Link workers at village level.
• Outreach camps for service delivery at remote and
  inaccessible areas.
• Assam
• RMP Act enacted.
• Transfer and Postings of Medical Staff has been
  decentralized.
• Involvement of private sector to render ANC
  services under PPP.
• Infection Control System in all District
  Hospitals.
• Health Insurance Scheme introduced.
• 32 FRUs operationalised.

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STATE INITIATIVES

• Bihar
• Data centre for daily monitoring of OPD output by
  each participating institutions.
• 8000 villages covered with mobile medical units
  for under served population.
• Telephone connection to all PHCs of the state.
• CHhattisgarh
• Strengthening the role of the Panchayat and
  building on the community based link worker.
• Promoting emergency referral to public/private
  facility using coupons by Mitanins.
• Establishment of State Health Resource Centre.
• Delhi
• Basti Sevikas for Urban Slums as linked worker.

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STATE INITIATIVES

• Gujarat
• Chiranjivi Yojana scheme to contract out
  private providers for delivery care and
  management obstetric complications
• Block Level Programme Management arrangements.
• Haryana
• Health link workers in every village.
• A couple aged 60 years with only a girl child is
  being given a pension of Rs. 300/- per month and
  Rs. 500/- per month to the girl child under
  Ladli Scheme.
• Himachal Pradesh
• Rs. 30,000 to FRUs as untied fund for emergency
  transport.
• PPP Cell at State and District level.
• Involvement of departments like Ayurveda, social
  justice and woman empowerment for distribution of
  contraceptives.

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STATE INITIATIVES

• Jammu Kashmir
• Granting autonomy to hospitals
• Utilizing the Rehbat-I-Sehat (RIS) teachers
  network for providing access to health services
  to tiny villages scattered in the district.
• Karnataka
• Incentives to Doctors and Staff Nurses for
  providing 24x7 services.
• Health insurance for SC/ST population
• Kerela
• RCH services at medical colleges
• Maternity Security Scheme
• Tribal and Coastal Health Plans.
• Involvement of ISM and homeopathy system with the
  health facilities.

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STATE INITIATIVES

• Madhya Pradesh
• Outsourcing PHCs to NGOs.
• State Logistics Management Unit at State level
• Prasav Hetu Parivahan Yojana(LY85000
  beneficiaries)
• Incentive to MOs at PHCs and CHCs for promotion
  of institutional deliveries
• Maharashtra
• Setting up of PPP cell at state and district
  level.
• Incentive to tribal pregnant woman for ANC and
  institutional deliveries under Matrutav Anudan
  Yojana of Nav Sanjivini Scheme.
• Association of Mahila Gram Sabha and Mahila Vikas
  Samitis of Jan Swarajaya for implementation of
  RCH.
• Mizoram
• Incentives for doctors serving in remote areas

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STATE INITIATIVES

• Orissa
• Delegation of powers to the ED , State Health
  society
• Consideration of key HRD steps such as a
  differentiated Public Health Management cadre,
  policy / incentives for postings to less
  developed districts
• Health institutions resource mapping on GIS.
• Pondicherry
• Family based health cards.
• Punjab
• Balika Rakshak Yojana for adopting terminal
  method of sterilization after the birth of only
  one or two girl children _at_ Rs. 500/- and Rs.
  700/- respectively.
• A prize of Rs. 3 lakhs for panchayats achieving
  CSR of 1000 in a year and Rs. 2.5 lakhs for
  panchayats achieving CSR of 951 to 1000 in a
  year.
• Nutritional supplement for mothers and children
  belonging to SCs and other reconstruction of the
  society.

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STATE INITIATIVES

• Rajasthan
• Panchamrit for catch up rounds for 5
  interventions (Immunization, Vitamin A, Neo Natal
  Care, Family Planning, Safe Motherhood).
• Considerable emphasis on quality of services
  through setting standards, indicators and process
  protocols
• Technical resource cell involving NGOs for
  monitoring and implementation of PNDT act.
• Sikkim
• Link workers at all the villages.
• Setting up committees at State / District Level
  for implementation of PNDT act.
• Link up with AWW and School Health Programme to
  operationalize regular de-worming of children.
• Untied fund at SC to meet transportation cost and
  accompany link workers if it is justifiable by
  Village Health Committees.

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STATE INITIATIVES

• Tamil Nadu
• Integration of ISM with primary health care
  systems
• Convergence with HIV/ AIDS/TB at PHCs.
• Efficient logistic and procurement arrangements.
• Tripura
• Outsourcing of investigation services including
  imaging.
• Uttar Pradesh
• Involvement of cooperative sector for
  distribution of contraceptives under Family
  Planning programme.
• Private lady doctors are being contracted for
  providing 2 hour daily OPD services at CHCs and
  PHCs on fix incentive basis.
• Yuva Mangal Mela and Adarsh Dampati Samman will
  be organised in selected districts. This year 25
  Districts selected having poor health indicators.
• Strengthening of MIS by linking District through
  NIC Network

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STATE INITIATIVES

• Uttaranchal
• Involvement of community in monitoring and giving
  feedback on all the programmes.
• Documentation of practices on traditional
  healers.
• West Bengal
• Piloting of Voucher Scheme for providing services
  through private sector.
• Ranking of blocks as per key health indicators.