Meeting of NGOs involved in Module 6 & 7 05.03.13

1. Meeting of NGOs involved in Module 6 & 705.03.13

2. Hundred and Fifty years ago, Rudolph Virchow, the father of social medicine, said: Do we not always find the diseases of the populace traceable to defects in society? Today, as never before. His words ring true across the globe

3. Bhore Committee- 1946 • “No permanent improvement of public health can be achieved without the active participation of the people in the local health program…. • We consider that the development of local effort and the Promotion of a spirit of self help in the community are as important to the success of the health program as the specific services, which the health officials will be able to place at the disposal of the people • Formation of village health committees and Voluntary health workers are needed who will need suitable training..”

4. People Centered Primary health care - Alma Ata -1978 -II WHO and UNICEF Study, 1977 - IIPrinciples to achieve primary health care: • Communities should be involved in the designing, staffing, and functioning of their local primary health care centres and in other forms of support. • The primary health care workers should be selected when possible by the community itself or at least in consultation with the community • Respect for the cultural patterns and felt needs in health and community development of the consumers…..

5. Alma Ata Declaration Alma Ata, 1978 The International Conference on Primary Health Care calls for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world by the year 2000.

6. Alma Ata Declaration • The people have the right and duty to participate individually and collectively in the planning and implementation of their health care. • Primary health care requires and promotes maximum community and individual self-reliance and participation in the planning, organization, operation and control of primary health care, making fullest use of local, national and other available resources; and to this end develops through appropriate education the ability of communities to participate

7. People - centered primary health care - according to WHO-DG’s • Unless we all become partisans in renewed local and global battles for equity, we shall indeed betray the future of our children and grand children. – Mahler, H, WHA, May 2008 • Grass roots movements are enormously important in the health field. These movements bring the views feelings and expressions of those who really know. We need to hear the voices of the community… - late Dr. Lee, WHA, May 2004 ( to PHM reps) • With the emphasis on local ownership, primary health care honored the resilience and ingenuity of the human spirit and made spaces for solutions created by communities, owned by them and sustained by them… not surprisingly the report on CSDH champions primary health care as a model for a health system that acts on the underlying social, economic and political causes of ill health –Margaret Chan, DG WHO, Lancet Editorial, Sept 2008

8. National Rural Health Mission 2005-2012 Evolving through the engagement with civil society Goal: • To improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women and children Principles: • It seeks to improve access to equitable, affordable, accountable, and effective primary health care. • It has as its they component provision of a female health activist in each village; a village health plan prepared through a local team headed by the village health and sanitation committee of the panchayath. • Train and enhance capacity of panchayathraj institution to own, control and manage public health service. (A national people Centered PHC initiative)

9. Communitization Process Strategy ASHA Resource Center Program Full time Management Voluntary Unit structure Unit structure State Project State Program State MGCA & Coordinator Unit Management Trainer District District MGCA DPMU Community & Trainer Mobiliser Block MGCA BPMU Block & Trainer Community Mobiliser PHC ASHA Facilitator SHC Swasthya ASHA Gram Samiti

10. Mission Strengthen communitisation process through development of support structure and maintaining dignity, high esteem, capacity building of ASHA with active support of community and Health department

11. Objective of the Meeting • To update the progress & Experience sharing • To make a common platform for understanding issues • To plan further strategy for improvement

12. ASHA Status in MP • No. of Villages – 55336 • No. of ASHA (Target) – 56941 • No. of ASHA Selected – 56070 • Training of ASHA on Module 5 – 42098 • ASHA Drug Kit – 52117 • Education standard of ASHA : • 5th standard - 29.51 % • 8th standard - 41.86 % • High school - 15.12 % • Higher secondary - 8.09 % • Graduate - 1.96 %

13. Status of Module 6 & 7 • State Trainers - 34 • District Trainers - 586

14. Module 6 component • Role of ASHA and its duties • Maternal health • Pregnancy diagnosis • Birth Preparedness • Anaemia • Complications during Pregnancy and delivery • Care during delivery • Post Natal Care • Child Health • Care during delivery • Home Visit • Examination of neonate • Breast Feeding • Keeping child warm • Treatment of fever

15. Module 7 Component • Child health and Nutrition • Feeding of infants and young child • Assessment of Malnutrition • Assessment of sick children • Classification of fever and check up • Diarrhoea treatment • ARI • Reproductive Health of women • Safe Abortion • Family Planning • RTI and STI • Health of Neo Nate • Assessment of risk in preterm and LBW child • Breast feeding in LBW/ Pre term child • Breathing problem • Sepsis • Infectious Diseases • Malaria & TB

16. ASHA Kit Procured and distributedModule 6 & 7 Training • Neo Natal weighing scale • Digital Thermometer • Digital wrist Watch • Baby blanket • Warm Sleeping Bag • Disposable mucus extractor • Baby Feeding spoon • 5 ml spoon • Bag for carrying kit • Iron sheet box

17. ASHA Drug Kit medicine/ material

18. ASHA Drug Kit medicine/ material

19. NGOs Role • Training site, Quality Food and Logistics • Display of budget • Training Kit to ASHA (Pad, pen, formats, module book) • Coordination with district health officials • Field visit preparation • Arrangements for ASHA’s children • Payments to ASHA, Trainers by cheque • Expenses booking as per number of ASHA and Trainers • Submission of batch wise report to district and state • Submit Audited UC, report for next installment

20. Quality concern • First batch in presence of state trainer and all district trainer • Residential training • ASHA being trained with ANM & LHV • Training by state trained district trainers only • Food, stay, training site comfortable • Availability of training material- Schedule, Training kit, Doll, Digital Watch, Module, Manual, formats etc • ASHA kit distribution with training • Monitoring by state trainers, MGCA members and district officials • Use of participatory methods, songs, movies, role play etc • Field visits • Training, trainees and trainers evaluation • Report submission, analysis and prompt action • Arrangement for children of ASHA’s

21. ASHA Training Hand Washing by ASHA

22. ASHA Sammelan

23. Transparency

24. ASHA Training 6&7 Module reported in Web site by state trainers • Five Days Reports (1st Round) - 235 • Five Days Reports (2st Round) -234 • Two Days Reports (1st Round) -98 • Two Days Reports (2st Round) -67 • Total Five Days Reports -469 • Total Two Days Reports -165

25. Trainer’s Report

26. Trainer’s Report

27. Trainer’s Report

28. ISSUES IN TRAINING • Co-ordination between NGO and District team • Timely communication of training plan • Timely payments of ASHA & trainers. • Timely payment to NGOs • Batches are not planed as per sanctioned though district trainers are available. • Lodging arrangements of district trainer is not properly maintained in some districts. • Training plan for next month is not coming before 20th of every month.

29. ISSUES IN TRAINING • Frequently changing training plan at district. • Some districts are not following State trainer’s instructions. • Some NGOs are not making arrangements for 4 vehicle as per provision. • Neat and cleanliness issue in training site. • Arrangements for ASHA’s children not proper. • In some district delay in fund release

30. THANK YOU