NRHM – KEY FOCUS IN 2010-11

1. NRHM – KEY FOCUS IN 2010-11 Outcomes, service guarantees, effective supervision, skill s, community monitoring

2. NRHM – PIP 2010-11 • ROP under finalisation- to be issued by April • Need for; • Thrust on outcomes – planning for outcomes. • Focus on 235 Backward Districts. • Supervisory structure – to be put in place • Making RKS/VHSC/BHM/DHM/SHM vibrant. • District RoPs within 45 days of State RoP – fund release after receipt of District RoPs – full reflection of Backward district focus and special RCH Sub Plans.

3. Issues on Finance • FMR March 2010. Account closing priorities. • Getting audit of 2009-10 started. • Making HMIS fully functional – confirm data. • Electronic transfer of funds/account keeping. • Submission ofUtilization Certificates. • State share – Budget provision – credit SHS. • Details on Infrastructure Maintenance-passed on Treasure route

4. Key Areas needing attention • Tracking of Pregnant mothers and children • Identification of difficult, most difficult and inaccessible facilities. Mapping and Finalization – monetary and non monetary. • Transparent transfer and HR policy. • Procurement and logistics reforms. • Male Workers at Sub Centre for disease control programes. • NGO involvement in Asha training, community monitoring, skill development, capacity development of PRIs, SHGs. • Setting up SHSRCs, strengthening SIHFWs.

5. Training to be accorded priority • Skill training – ANMs, Nurses, Doctors, Male Workers, Lab Technicians, para medics. • Training institutions and their strengthening – To use GoI funded institutions – RHFWTCs, ANMTCs, LHVTCs, RRCs. • Use of Defence, Railways, NGOs, Mission Hospitals. • Training aids, enlarging pool of trainers by involving other agencies – govt., private. • Certification by third party of skills acquired. • Training Calendar –Immediate finalisation

6. Microplanning for every birth • Identifying needs, dates, institutions. • Strengthening institutions. • ANM conducting safe home deliveries. • Delivery hut in remote villages. • Complicated cases going to higher order institutions. • Referral transport linkages. • HR skill sets – common protocols. • ANCs/ PNC – thrust on quality and protocols.

7. Making VHNDs a platform for all health needs • ANC/PNC • Immunization. • Weight and height of children. • Basic drugs. • Behaviour change communication on nutrition, hygiene, sanitation. • Adolescent health issues. • Women’s health issues. • Child health issues. • Vector control – spray, LLINs, BCC • Promotion of rural toilets.

8. Thrust on disease control and surveillance – convergent action • VHSC’s role in community supervision. • ASHAs role in behaviour change. • Male Worker/ANMs role in spraying, RDK,ACT blood slide collection, surveillance. • Filling up regular and contractual positions • Supervisory structure for disease control and surveillance – lab tests, reagents. • Ensuring timely supplies, need based distribution, appropriate supervision. • Community led action for public health.

9. Population Stabilization • Fixed Day Family Planning Services in PHCs/CHCs/SDHs/DHs. • ANMs/Nurses trained in IUCDs. • Counselling of households. • Ensuring supply line for OC Pills, Condoms. • ASHAs as depot holder for contraceptives. • Promotion of NSV. • Activation of Quality Assurance Committee in districts – private sector participation in FP. • Post partum sterilization.

10. ASHA training – quality issues • Home based new born care and tackling malnutrition – refresher training. • Involvment of NGOs in training. Supportive supervision structure – ASHA Resource Centre. • NHSRC planning pool of trainers. • Timeliness of payments – Bank accounts. • Replenishment of drugs. • ASHA amenities in hospitals – Rest rooms, facilitation centers.

11. Using untied funds in time • Reiteration of guidelines – handholding. • Thrust on need based expenditure. • Giving confidence to spend – record keeping. • Publicity to accounts of RKSs/VHSCs. • Community Monitoring to speed up use. • District Monthly Concurrent Audit thrust on use of untied funds – timely reporting. • Patient welfare thrust in utilization. • State Governments to also contribute to untied funds.

12. NRHM – Infrastructure • Speeding up completion of on going works. • Creating institutions to manage works. • RKS to be involved in overseeing repair and maintenance works. • Clear perspective plan to ensure all Sub Centres with buildings ( possible expansion as well), especially in difficult, most difficult and inaccessible areas. • Block level Hospitals – thrust on quarters and essential requirements. • Civil work audit in States.

13. NRHM – Procurement and logistics • Warehouses – appropriate design. • Computerized inventory management. • Timeliness of supplies. • Quality control. • Essential Drug Lists. • Generic Drug prescriptions. • Rational Drug use. • Equipments with AMCs built in. • Enhancing per capita drug budget of States.

14. NRHM – 2010-11 • Thrust on difficult and under served areas and districts with poor health indicators. • Enhancing community monitoring. • Achieving State specific targets. • Speeding up utilization of funds. • Strengthening supervision. • Ensuring service guarantees from health facilities – supply chain, human resources. • Thrust on skills and training. • Promoting standard protocols. MAKING NATIONAL HEALTH GOALS AND MDGs ACHIEVABLE.