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CRM JHARKHAND. Team Shri Amarjeet Sinha,(JS), MoHFW Dr. G.K.Ingle, Director Prof, Maulana Azad Medical College Dr. J. N. Sahay, Advisor(QI), NHSRC Dr. Dinesh Baswal(AC) Training, MoHFW Dr. Manoj Kar, Advisor(CP), NHSRC Dr. Nupur Basu, Member, National AMG. STRENGTHS.
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CRMJHARKHAND Team Shri Amarjeet Sinha,(JS), MoHFW Dr. G.K.Ingle, Director Prof, Maulana Azad Medical College Dr. J. N. Sahay, Advisor(QI), NHSRC Dr. Dinesh Baswal(AC) Training, MoHFW Dr. Manoj Kar, Advisor(CP), NHSRC Dr. Nupur Basu, Member, National AMG
STRENGTHS • COMMUNITY PROCESS • Motivated SAHIYA -40764 Nos. • Village Health committee -30011 Nos. formed and its functions are in early stage of deployment • Active and regular participation of community representatives in Hospital Management society activities • MANAGEMENT OF HEALTH SERVICES • Very high level of commitment amongst Doctors and paramedics posted in PHCs evidenced by service delivery in difficult situations like scarcity of Water, Absence of power supply , difficult access and amidst extremist threats Cont.
STRENGTHS • SERVICE DELIVERY • Community perception of improved availability of drugs at all levels of health care delivery • Quantum jump in vaccination coverage from 9%(NFHS II) to 54% (DLHS III). • Reduction in IMR from 69(NFHS III ) to 48(SRS 08) • Commendable operations of Mobile Medical Units in all districts. • Intensive emphasis on anti tobacco campaign involving all stakeholders including Media. • Strengthening of Non Scalpel Vasectomy (NSV) • Decline in the Prevalence rate of Leprosy from 6.6(GOI,2003) to 1.08 (GOI,2008) Cont.
STRENGTHS • PLANNING PROCESS • Capacity building programme for district officials on district health planning conducted by NHSRC and PHRN. The acquired skill set is being utilized for current year’s PIP Development. • HUMAN RESOURCE • 100% Programme Managers deputed (DPM- 24/24, District Accounts Manager- 24/24, District Data Manager 24/24, Block Accounts Manager -194/194) • 3204 ANM appointed making it 6437 against requirement of 14176
OPPORTUNITY FOR IMPROVEMENT • Human resource shortage to the extent of 60% of the requirement together for doctors and paramedics. • Poor compliance of Biomedical waste management rules 1998 • Radiological facilities do not have Atomic Energy Regulatory Board (AERB) clearance. • HSC (3958/7088), PHCs(330/1005) , Additional PHC/CHC(31/188) are far less in numbers against the requirement as per IPHS. • Inconsistency in payment to Sahiyas for their services for MM JSY • Multiple reporting of Health care delivery data. • Replacement of Sahiya Drug kit is a concern. • Drug procurement and storage is not systematic .
OTHER CHALLENGES • Poor Road Conditions. • Community belief systems less conducive towards modern health care systems. • Political situation • Inter sectoral coordination. • Ground water table. • Migration from Jharkhand to other states.
SUGGESTIONS AND RECOMMENDATIONS • There is need to strengthen public health focus in the health system with creation of separate public health cadre. • State Health Resource Centre and SIHFW may actively participate in capacity building including multi skilling . Operationalization of Institute of Public Health may help in the process. There is a need for urgent capacity building of health functionaries and programme managers on implementation framework and financial management of NRHM . • Develop structured process for reviewing the implementation of guidelines cont..
SUGGESTIONS AND RECOMMENDATIONS • Jharkhand requires speedy development of infrastructures with respect to HSC, PHC ,Additional PHC/CHC. • Set up an efficient “Procurement and Logistic System” on the basis of other successful model. • Expansion of Nursing and medical education including multi skilling on top priority basis • Operationalize District health society as per NRHM framework of implementation
SUGGESTIONS AND RECOMMENDATIONS • Focus is required on generating reliable data sets e.g. malaria mortality etc. • Compensation and career progression of medical and paramedical personnel may be reviewed and considered for parity with other states including neighboring Bihar. • Planning and development of proper Signage system at all the hospitals/ health centres. • Sanitation, Security and Laundry Services need to be improved • Requirement of common items like Bed side lockers, IV Stand, Bed side Bowl, Linen etc should be evaluated and provided in all health care delivery centres.