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Detailing strategies and progress toward achieving realistic IMR reduction goals through child health activities and programs in priority districts. Emphasis on IMNCI, breastfeeding promotion, nutrition, and health system strengthening.
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Goal for IMR – Overall & Annual Goal to be realistic – in sync with current levels of IMR e.g. Uttarakhand currently has an IMR of 41 and reduction by 11 points over 4 years till 2010 is realistic Maximum annual IMR reduction in India in the past 3 decades has been 5 points(‘92-’93)
Situational analysis Progress to date in districts which had already been implementing IMNCI/FBNBC/Breastfeeding/SHS Progress to date in districts which initiated IMNCI/FBNBC/Breastfeeding/SHS in past year Progress in training to be measured in terms of total training load
Activities under Child Health Promotion of breastfeeding Integrated Management of Neonatal & Childhood Illnesses (IMNCI) Facility Based Newborn Care Micronutrient supplementation – Vitamin A, Iron folic Acid School Health Programme Management of malnutrition Some or all of the above activities would be reflected
Home Based Newborn and Child Care Reflected only in UP, MP, Orissa, Rajasthan, Bihar 2 districts in each of the above states Agency selected - SEARCH Implemented with funding from the India Norway Partnership Initiative (NIPI)
Promotion of breastfeeding Training Incentives to health care personnel eg Uttarakhand would pay Rs 50 to ASHA for every child with early initiation of breastfeeding Provision for IEC material Activities for health facilities eg BFHI
IYCN: Early Initiation of Breastfeeding Children under 3 yrs breastfed within 1 hr of birth
IYCN: Exclusive Breastfeeding Children age 0-5 months exclusively breastfed
Children 6-9 months receiving solid or semi-solid food and breast milk
IMNCI Planning for complete coverage of the state Implementation by our department or in conjunction with MWCD? Number of districts implementing IMNCI Number of districts envisaged for expansion, if any Basis of prioritization of districts Which areas of districts/ which levels of facilities are to be covered on priority
IMNCI (contd..) Levels of saturation with training envisaged Printing of training materials – J&K State, district and block level trainings Maintenance of quality aspect of trainings Concomitant training of ASHAs?
IMNCI - unfinished agenda Health system strengthening district and block level planning supervision of health care personnel referral chain in place equipment & medicines provided to workers & facilities regularly AMC for all equipment
IMNCI - unfinished agenda Community based initiatives Involvement of PRIs/SHGs Involvement of ASHAs Joint action with ICDS sector Educational activities planned Organization of VHNDs envisaged
School Health Scheme Designated health care personnel to visit school Frequency of visit determined/micro plan prepared (Tamil Nadu) Services to be provided defined List of equipments and drugs specified
Management of malnutrition States like Bihar, Maharashtra have dedicated Nutrition Rehabilitation Centres being set up, but only 1-2 per state. This needs an upward revision But since no state is free of malnutrition among children, more NRCs needed Selection of districts based on prevalence rates Basically, training of health care personnel (cascade model) and supply of therapeutic foods needs to be incorporated
Strategy in sync with goals? All states need to focus on breastfeeding promotion, facility strengthening Focus in high IMR states/districts needs to be on survival strategies Well performing states can focus more on facility based newborn & child care, school health: States with thriving facility based programmes - Maharashtra, Gujarat, Tamil Nadu
Supplies Kit A – Co-trimoxazole, ORS packets, IFA tablets, Vitamin A, Paracetamol tablets Equipments for health facilities: warmers, weighing machines, suction equipment Plan in place for quantities & place of delivery? Plan in place for procurement? Under which head is procurement envisaged?
Funds MUST be allocated from RCH flexi pool for the proposed activities It is crucial to ensure the above