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NRHM PIP for the State of KARNATAKA

NRHM PIP for the State of KARNATAKA. Mr. Nilaya Mitash. IAS Mission Director NRHM Karnataka. 6 ‘C’ Category Districts. 3 Tribal Districts. Situational analysis. Source SRS up to 2005, Estimates 2006 onwards. I.M.R. Source SRS. 2005. 2001. 2002. 2003. 2004. M.M.R. Source SRS.

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NRHM PIP for the State of KARNATAKA

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  1. NRHM PIP for the State of KARNATAKA Mr. Nilaya Mitash. IAS Mission Director NRHM Karnataka

  2. 6 ‘C’ Category Districts 3 Tribal Districts

  3. Situational analysis Source SRS up to 2005, Estimates 2006 onwards

  4. I.M.R Source SRS 2005 2001 2002 2003 2004

  5. M.M.R Source SRS 1997-98 2001-2003 1999-2000

  6. Trend in Institutional Delivery Rate (in %) Source CNAA

  7. Institutional Deliveries 1992-93 1998-99 2005-06

  8. Fig. in lakhs

  9. Background • NRHM is being implemented in Karnataka from April 2005 • During the period from 2005-07 there are improvements in Institutional deliveries - from 60% in 2005 to 72% Dec.07 • During 08-09 emphasis is more on • Operationalisation of 149 taluka hospitals as FRUs • Make 785 / 1679 PHCs 24x7 • 24x7 ambulance services at 149 Taluka hospitals • Targeted interventions for vulnerable & backward areas • Human Resources Development in all its components. • Institutional strengthening.

  10. Specific goal Current status 2008-09 2009-2010 Reduction in maternal mortality 228 SRS (2001-03) 190 150 Institutional deliveries 67.9%(CNAA 66.9% NFHS-3 75% 85% Safe deliveries 71.3% NFHS-3 80% 90% Reduction in infant mortality rate 48 (SRS- 2006) 40 30 Total fertility rate 2.08 NFHS-3 2.04 2.0 STATUS AND GOALS 06-07)

  11. Construction of Sub Centers : 152 under KHSDRP : 100 under State budget Construction of PHCs : 2 under NRHM, : 34 under KHSDRP : 70 under State Up gradation of PHCs : 2 under NRHM : 10 under State 9 District will be Up graded to IPHS : Equipments under NRHM EMRI : Shared between NRHM & State. Infrastructure strengthening: Capital Cost Including construction of Health Facilities Total Rs.5453.58- lakhs

  12. Man Power • ANMs in vacant sub centers : 1744 • 2nd ANM in 6 C category districts : 1500 • PHCs Medical officers in 6 C category districts : 100 • Staff nurses for 24x7 PHCs : 1570 • Staff nurses at 220 FRUs : 440 • Specialists for Taluk Hospitals : 149 • Lab Technician : 108 • Public health specialists & Hospital management specialists in 6 C category Districts : 12 • All appointments on Contract Basis • Total Cost-Rs.1013.20 lakhs

  13. Drugs • RCH Kits (A&B) • IFA tablets for pregnant women andchildren • Vitamin A Total cost-Rs.1700.00 lakhs Equipments • Sub centre kits (SSD kits, Preg. Det. kits) • Blood storage units • Boyles apparatus • Adult resuscitation kits • MVA equipments • IUD Kits • Child Health equipments Total Cost- Rs.539.35 lakhs

  14. Part A – RCH-II Maternal Health Service improvement Strategy • 785 / 1679 PHCs to be made 24x7 • 220 / 323 CHCs to be made FRUs • 149 taluk hospitals to be upgraded to IPHS • 149 taluk hospitals to have ambulances 24x7 for maternal cases • Promotion of institutional deliveries among vulnerable community through Chiranjeevi yojana • Incentives for night deliveries for Mos / SNs at PHC & CHCs • Incentives for ANMs for promoting institutional deliveries. • Awards for doctors/staff nurses/ ANM Demand generation strategies • JSY • Madilu (post natal care kit for BPL/SC/ST women) • Prasuthi Araike ((post natal care kit for BPL women among SC/ST who deliver in government institution)

  15. Child Health Strategy: IMNCI- in 14 districts including 5 districts for 08-09 • Facility based new born care:in 1679 PHCs and 323 CHCs through skill based training and provision of equipments. • Home based new born care: All AWWs and community leaders through awareness programs at CHC and village level. Provision of drugs to AWW/ASHA in IMNCI districts. (in phased manner) • School health programme: Health check up “Suvarna Arogya Chaitanya” programme, Corrective surgeries, de worming and IFA tablets, inter-sectoral convergence and mid day meal.

  16. Constraints Man power • Shortage of General Duty MOs with MBBS • Shortage of specialists • Mismatching of specialists Training • Lack of technical guidance & on job training. • Shortage of grass root level trained workers Geographical • Geographical inaccessible hilly and forest areas Social • Female illiteracy & health seeking behaviour

  17. Budget for Maternal Health • JSY – (4.19 lakhs beneficiaries) • ASHA/Link workers (28000 nos.) • Incentives and Awards for staff • Chiranjeevi Yojana (low MMR district) • Madilu (1 lakh mothers) • ART (16 centers) • Follow up of HIV +ve ANC cases (@ Rs.3000/- for 1000 cases) Total: 1658.43 lakhs

  18. Child health • IMNCI • FBNC • HBNC • School health Total: 300.16 lakhs

  19. Tribal & Vulnerable • Chiranjeevi Yojana: out sourcing of deliveries to private providers : pilot in one district. • Continuation of services of 25 Tribal ANMs working in tribal areas • Mobile phones for ANMs in tribal districts • Tribal area allowance for Mos, SNs and ANMs working in tribal areas (Rs.2000, 1000 & 750) • Total Budget Rs.280.40 Lakhs.

  20. Adolescent Reproductive and Sexual health (ARSH) • Teen clinics at CHCs and PHCs (757) • Awareness programmes to • Out of School adolescents • School Children • NGOs, Private Practitioners & members of PRIs. • Production of IEC Materials on ARSH • To be implemented in selected 12 districts of all divisions. Total cost: Rs.40.00 lakhs

  21. Quality Assurance Programme to be implemented in 6 Districts • Total cost: Rs.48.00 lakhs. • PC & PNDT: • A separate Cell for PC & PNDT is already proposed. • Total cost is Rs. 34.20 lakhs • Urban Health Centres:26 centres – Rs.345.80 lakhs • Training : Rs.903.50 lakhs • BCC : Rs.583.50 lakhs • PPP : Rs.160.00 lakhs • Community monitoring: Rs.271.05

  22. NSV : Camps and training programmes planned IUD 380 A: Training for Medical and para medical staff (Belgaum is selected as pilot district for 07-08 and for 08-09 entire state will be covered) Sterilisation: 4 lakhs beneficiaries to be covered Total : Rs.1500 lakhs Family Planning:

  23. Part B – Additionalties to NRHM

  24. PART C- Immunisation • To achieve 100% immunisation the following interventions are planned • Alternate vaccine delivery system- • 4,92,000 Out reach Sessions in rural & under served areas & Incentive for social mobilisation- • Mobility support for DIO – • Focus on Urban Slums- • Training for ANMs, LHVs, MOs – Total Budget 979.25 Lakhs

  25. NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS

  26. Objectives: • ESTABLISH EYE CARE FACILITIES for every 5 lakh population • DEVELOP HUMAN RESOURCES FOR EYE CARE SERVICES – PHCs, CHCs, sub district levels • IMPROVE QUALITY OF SERVICE DELIVERY • SECURE PARTICIPATION – civil society and private sector

  27. Strategies under NPCB • Strengthening service delivery to improve physical, technical, managerial capabilities in Medical colleges, District Hospitals, CHCs, PHCs for high quality cataract treatment. • Developing human resources for eye care training manpower for Management at district level surgical services. • Promoting outreach activities and public awareness. • Developing institutional capacity. • To make eye care comprehensive, besides cataract surgery other interlobular surgical operations for treatment of Glaucoma. Diabetic Retinopathy may also be provided free of cost to poor patients through Govt. and NGOs. • Involvement of voluntary Organisation in various eye care activities.

  28. Budget PIP under NPCB - 2008-09

  29. IDSP Situation Analysis • Out of 8143 Syndromic form generating units 5451 are reporting. • Out of 2489 Presumptive form generating units 1234 are reporting. • Out of 1914 Laboratories forms 1015 are reporting. • Out of 253 Private Hospital Identified 99 units are reporting.

  30. Strategies • Upgradation of Laboratories by providing Laboratory equipments and lab consumables. • Upgradation of Information Technology and Communication through Edusat and Broad band facilities. • strengthening of Human Resources & Development by Out Sourcing Manpower and imparting training. • To ensure Operational Activities by Response Monitoring & Evaluation . • Achieving 100% reporting from Govt sector Health Institutions, Medical Colleges and well performing Major Private Hospitals.

  31. Constraints • Non availability of Microbiologists in 16 Districts. • Frequent transfers of DSO and other programme Officers. • Lack of Infrastructure like lab equipments and lab consumables (test kits) to perform Confirmatory diagnosis. • Non submission of data by District Hospitals, Medical Colleges and Major private Hospitals. (Action to be initiated through DHOs).

  32. Rs. in lakhs Budget

  33. RNTCP

  34. Situational Analysis

  35. RNTCP Constraints • Migrant population resulting in high defaulter rate & low cure rate • Admission of patients in 3 TB & Chest Disease hospitals attached to medical collages. • Poor involvement/ vacancy of MOs. • Lack of co operation from Private practitioners. • Poor Involvement / Vacancy of MPWs. • Vacancy of LTs in Microscopy centers.

  36. RNTCP Strategies • Greater involvement of AWWs and ASHA as DOT providers and paying honorarium . • Sensitizing faculty of Medical Colleges. • Training of MOs and issuing strict instructions. • Taking up sensitization programmes for PPs. • Training of MPWs on revised modules • Training of LTs in ICTC in Sputum Microscopy.

  37. RNTCP Budget Activities • Training - Rs.128 lakhs • Supervision - Rs.60 Lakhs • Medical Collage, PP involvement- Rs. 263 Lakhs • IEC / Publicity - Rs.64 Lakhs Total Budget 1308 lakhs

  38. NPPCD • 5 districts included for 2008-09 • Capacity building of ENT Ots at districts, • ENT kit for PHCs and CHCs in 5 districts • 7 Tier training component • Screening and ENT camps involving NGOs as PPP • Rehabilitation using surgeries, hearing aids Total – Rs.130 lakhs • Communicable disease control programme • KFD and Handigodu syndrome includes mobility, training and supplies Total – Rs.95 lakhs

  39. KARNATAKA STATE HEALTH AND FAMILY WELFARE SOCIETY LEPROSY DIVISION

  40. Situation Analysis: • Karnataka is considered as a low endemic state and the Prevalence Rate up to end of 31/01/2008 is 0.56. • Infrastructure facilities: JD (Leprosy), ‘EPST’, SSA Units-1, DLOs-25, NLCCs-20, MLCUs-9, ULCs-48, THWs-22, LTCs-2, LRPUs-2 and now 7 Voluntary Organization.

  41. Constraints in Implementing Programme: • Rendering all infectious cases into non-infectious in a short period by early detection and treatment. • Preventing deformities by early detection and regularly treatment. • IEC activities • Provide Rehabilitation Service to the cured.

  42. Strategies:- • Voluntary Reporting. • Regular Treatment. • Monitoring. • Follow –up of Defaulters. • DPMR activities.

  43. Part E • Coordinated health related activities by departments of Women and Child, Rural Water Supply and Sanitation, RDPR. • Orientation programmes for members of PRIs at village, taluk and district level. • Regular joint visits by health & Allied Dept.to supervise the Activities of VH&SCs.

  44. Rs. in Crores

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