National Rural Health Mission - India

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National Rural Health Mission - India
shiv_mathur_at_hotmail.com

• Shiv Chandra Mathur
• Director
• State Institute of Health and Family
• Welfare, Rajasthan, Jaipur

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Preamble

• The Mission is an articulation of the commitment
  of the Government to raise public spending on
  Health from 0.9 of GDP to 2-3 of GDP, over the
  next 5 years.
• It aims to undertake architectural correction of
  the health system to enable it to effectively
  handle increased allocations as promised under
  the National Common Minimum Programme.

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Preamble

• Provision of a health activist in each village
  ASHA
• Village health plan prepared through panchayat
  involvement
• Strengthening of the rural hospital on IPHS
• Integration of vertical Health FW Programme

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ASHA

• The acronym stands for accredited social health
  activist
• Accreditation to a female activist volunteering
  to take up community health work at grassroots
  will be given after a four phase modular training
• She will strength primary health care
  particularly in inaccessible area

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Village Health Plan

• Planning for health to be initiated from village
  level will transfer the ownership of all health
  program to the villagers
• District Annual Plan would generate from village
  level through a participatory approach.
• Plan will largely indicate expected level of
  achievement for each of the health program

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Indian Public Health Standards

• All peripheral health facilities would be
  rejuvenated on standards developed at the central
  level by Ministry of Health and Family Welfare.
• This initiative will take care of rectifying the
  manpower weaknesses, equipment and appropriate
  furnishings in health facilities.

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Integration of Vertical Health Program

• All vertical health program like Malaria control,
  TB control, Leprosy control, Blindness Control,
  Water and Sanitation and Reproductive and Child
  Health program would be merged.

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Guiding principles

• Promote Equity
• Enhance People orientation and community based
  approaches
• Ensure Public Health Focus
• Recognize value of traditional knowledge base of
  communities
• Decentralize and involve local bodies.

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Goals

• Reducing IMR and MMR by 50 from existing levels
  in next 7 years
• Universalize access to public health services
  such as Womens health, child health,
  water, sanitation, immunization, Nutrition.
• Prevention and control of communicable and
  non-communicable diseases, including locally
  endemic diseases
• Access to Integrated comprehensive primary
  healthcare
• Assuring Population stabilization and , gender
  balance.
• Promotion of healthy life styles

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Institutional Mechanism - National

• National Mission Steering Group chaired be
  co-chaired by Health and Family Welfare Minister
  with Deputy Chairman Planning Commission.
  Membership would cover Ministers of Panchayat
  Raj, RD, HRD. Public health professionals would
  be nominated by HFM in consultation with PM.
  Health and Family Welfare Secretary would be its
  Convener.
• At lower level an Empowered Programme Committee
  will be chaired by Secretary HFW. There will
  also be Standing Mentoring Group for ASHA

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Institutional Mechanism - State

• State Health Mission (Chaired by Chief Minister
  co-chaired by Health Minister State Health
  Secretary as Convener- representation of related
  departments, NGOs, private professionals etc)
• District Health Mission (under the leadership of
  Zila Parishad (District Council) with District
  Health Head as Convener and all relevant
  departments, NGOs, private professionals etc
  represented on it)

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Institutional Mechanism (cont.)

• Village Health Sanitation committee (at village
  level consisting of Panchayat Representative/s,
  ANM/MPW, Anganwadi worker, teacher, ASHA,
  community health volunteers)
• Autonomous societies for community management of
  public hospitals

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Role of Peripheral Democratic Bodies

• ASHAs would be selected by and be accountable to
  the Village Panchayat.
• The Village Health Committee would prepare the
  Village Health Plan, and promote inter-sectoral
  integration.
• The untied fund at Sub-centers to be deposited in
  a Bank Account, jointly operated by ANM and
  Sarpanch.
• District Health Mission to be led by the Zila
  Parishad. The DHM would also guide activities
  of sanitation.

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Role of Peripheral Democratic Bodies (PRIs)

• The DHM will control, guide and manage all public
  health institutions in the district, Sub-centres,
  PHCs and CHCs.
• PRI involvement in autonomous societies for good
  hospital management.
• Training to members of PRIs.
• Making available health related databases to all
  stakeholders, including Panchayats at all levels.
• States to indicate in their MoUs their commitment
  for devolution of funds and programmes to PRIs.

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Role of NGOs for the Mission

• In institutional arrangements
• Standing Mentoring Group for ASHA
• Member of Task Forces
• Provision of Training, BCC and Technical Support
  for ASHAs/DHM
• Health Resource Organizations
• Service delivery for identified population groups
  on select themes

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Milestones to be achieved

• Health Provider in each village
  2005-2008
• Upgrading of Rural Hospitals
  2005-2007
• Creation of New Hospitals 2005-2008
• District Planning operational 2005-2007
• Village Health Plans 2006
• Merger of Multiple societies into April
  2005
• District/State Mission
• Operational PMUs
  2005-2006
• Technical Support 2005-2007