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Detailed implementation plan focusing on maternal & child health, family planning, adolescent health in Mizoram, covering strategies, objectives, and activities to improve healthcare indicators.
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PROGRAMME IMPLEMENTATION PLANMIZORAM 2008 - 2009 Dr. N. Pallai Mission Director Mizoram State Health Society (SPMSU)
Area : 21,081 Sq.Km Pop. : 8,88,573 Districts : 9 Blocks : 27 Villages : 817
REPRODUCTIVE & CHILD HEALTH -II RCH - IIPart ‘A’ of NRHM
REPRODUCTIVE & CHILD HEALTH - II 1. MATERNAL HEALTH Goal – To reduce MMR from 163 (RBD 2004 - 05) to <100 by 2010 Objectives : • To increase full ANC from 57.8% (NFHS-3) to 100% by 2010 • To reduce Aneamia with pregnancy from 50% NFHS-3 to 20% by 2009 Strategies : • To provide ANC & PNC to all activities • Daily ANC in FRU/CHC/32-24x7 PHCs • VHND in 1592 ANC every month • Early registration of pregnant women • Provision of IFA tablets • Mobility support to MO and ANM for visiting hard to reach areas every month • Provide nutritional counselling to pregnant women through ASHA/AWW/ANM
REPRODUCTIVE & CHILD HEALTH - II Objectives : Increase institutional deliveries from 64.6% NFHS-3 to 75.1% by 2009 Strategies & Activities • Operationalization of 4 CHC as FRU • Construction of birth waiting room in all PHC • EMoc and Ansthesia training for MO • SBA training for S/N and ANM • Continue JSY Scheme as per GOI guideline
REPRODUCTIVE & CHILD HEALTH - II 2. RTI/STI SERVICES Objectives : To promote RTI/STI services to decrease the prevalence of RTI/STI among women Strategies : Operationalize services for diagnosis and treatment at CHC. District Hospital etc. Activities : 108 nos of Lab. Technician are already trained RTI Taining to 56 MO IEC/BCC activities among eligible couples
REPRODUCTIVE & CHILD HEALTH - II • 3. CHILD HEALTH • Goal : • To reduce infant Mortality rate from 34 (NFHS- 3) to 25 by 2009. • Objective : • To improve facility/home based new born care • To promote of use of ORS for Diarrhoea & treatment of ARI • Strengthening of facilities of Health Institution • To increase fully immunised children from 46.4% (NFHS-3) to 65% by 2009 • Strategies : • Referral Transportation of sick neonates • Capacity building of service providers • Strengthening of Routine Immunization • Holding of Immunization week • Promote & improve IEC/BCC activities • Strengthening of facilities at Health institution
REPRODUCTIVE & CHILD HEALTH - II cont.. Child Health Activities : • Referral transportation for sick sick children • Proposed to implement pre services IMNCI activities in 4 institutions • IMNCI training for 180 ANMs and for 20 MOs SBA training for 20 SN and 29 ANM • Ensure sufficient supply of ORS and zinc tablets & IFA for children in the school and distribution through AWW/ASHA • Home visit motivate the target groups Ensure additional 3 visits of low birth weight babies by ANM/ASHA/LHV
REPRODUCTIVE & CHILD HEALTH - II • 4. FAMILY PLANNING • Objectives • To reduce unmet need – spacing methods from 12.4% (NFHS-3) to 10% and terminal method from 5% (NFHS-3) to 4 by 2009 • To increase CPR from 59.9%(NFHS-3) to 62% by 2009 • To increase male participation in Family Planning • Strategies : • Quality Assurance • IUD services in accredited private centre • Sterilization camp • BCC/IEC to Increase Male participation • Activities : • IEC/BCC activities with special focus on male participation and fixed day at Civil Hospital for male sterilization • Training for IUD insertion for 5 nos MO and 48 nos ANMs • Female Sterilization services on fixed day at 41 Health institution – 32 nos (24x7) PHC and 9 CHCsProvide female sterilization camp • Mobility support to Laparoscope/TT surgeon team • Empanel providers at private institution
REPRODUCTIVE & CHILD HEALTH - II • 5. ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH (ARSH) • Goal : • To promote the health of reproductive age group • Objective : • IEC/BCC amongst Adolescent • To reduce adolescent marriage/pregnancy • Improve/Promote health facilities for adolescent • To decrease anaemia and Iodine deficiency • Strategies : • Promote effective IEC activities • Training for service providers • Reduce the prevalence of anaemia • Activities : • IEC/BCC activities • 3 days training for 50 nos. of MO, 5 days training for ANMs • One day Orientation training for 500 nos of ASHA and 45 VHSC • Appointment of Councilors
REPRODUCTIVE & CHILD HEALTH - II • 6. HMIS/ME • Goal & Objective • To improve the quality of reports and monitoring at all levels • Strategies & Activities • Quarterly review meeting at State & District level and bi- monthly review meeting at PHC level • Timely submission of reports using prescribe formats • Regular feedback on monthly performance report • Field supervision from State & District Hqrs. • Appraisal and reward system develop • Procurement of Computers at State & District level
REPRODUCTIVE & CHILD HEALTH - II • 7. BCC/IEC • Goal & Objective • To promote health seeking behavior at household level • Change & behaviour among service providers • Increase awareness of scheme and services • Utilization among the communities Activities : • Engagement of IEC/BCC consultant • Continuous Spot Advertisement • Erection of hoarding, printing of IEC materials, sponsorship, wall writing • Group meeting with NGO leaders
REPRODUCTIVE & CHILD HEALTH - II RELEASED, EXPENDITURE AND PROPOSED BUDGET Deficit Budget of Rs. 28 lakhs. No separate Fund is released for JSY etc.
ADDITIONALITIES Part ‘B’ of NRHM
A S H A ACTIVITIES UNDER NRHM Achievement : 943 ASHA selected and in place Training completed for 943 ASHA upto Module IV Drug Kits yet to be provided Activity proposed for 2008-09 Target Selection and Training of 38 ASHA : 38 ASHA Periodic continuous training (Quarterly) : 12 days for 943 ASHA already in place Provision of Drug Kits to 943+38 = 981 ASHA : 981 ASHA Quarterly Review Meeting of ASHA mentoring group : 12 meetings ASHA Facilitator for every five Village @ Rs.2000/ pm : 170 Facilitator Quarterly performance base Award for ASHA : Awards at PHC level Apron and Identity Card for ASHA : 981 ASHA
ACTIVITIES UNDER NRHM Total Mission Flexi Pool : Rs. 5096 lakhs Total Budget for Civil Works : Rs. 1528.1 lakhs (29.9%)
ACTIVITIES UNDER NRHM PROCUREMENT PLAN Drugs • Drugs will be procured through TNMSC at the approved rate as follows - • Rs. 18135 for Sub Centre • Rs. 3 lakhs for PHC • Rs. 10 lakhs for CHC & SDH • Rs. 20 lakhs for District Hospital Equipments & Furniture : • Facility survey has been conducted and critical gaps identified • Equipments and furniture for 130 S/C already constructed will be done as per Facility Survey report and IPHS guidelines • Equipments and furniture for 32 (24x7) PHC will be undertaken as per Facility Survey Report and IPHS guidelines • Equipments and furniture for 9 CHC will be procured as per Facility Survey Report and IPHS guidelines
ACTIVITIES UNDER NRHM ROGI KALYAN SAMITI (RKS) • Achievement : • RKS established and registered and provided seed money to - • 8 District Hospital • 1 Sub District Hospital • 9 CHC, 57 PHC
ACTIVITIES UNDER NRHM HUMAN RESOURCE • Current Status • 230 2nd ANM • 10 AYUSH Doctor at District Hospital • 66 Accountants at CHC & PHC • 20 Medical Officer • 5 Specialist manpower at CHC • Proposal : • Continue engagement of the above manpower • Contractual engagement of 60 Staff Nurse at Sub Centre • Contractual engagement of 5 Specialized manpower at CHC • Budget : • Rs. 2.6 crores for Remuneration of the above manpower • Rs. 0.378 crore for Contractual engagement of 60 Staff Nurse for 9 months • Rs. 0.15 crore for Remuneration of 5 Specialized manpower for 12 months
WORKSHOP & CAPACITY BUILDING ACTIVITIES UNDER NRHM
ACTIVITIES UNDER NRHM MOBILE MEDICAL UNIT • Current Status : • Rs. 649 lakhs received for 9 Units in 2006-07 • Rs. 632.2 lakhs utilized • Unspend balance Rs. 16.8 lakhs • All MMU in operation Total budget required during 2008-09 : Rs. 134.4 lakhs
ACTIVITIES UNDER NRHM RURAL POSTING INCENTIVE • 36 Areas identified as hard posting place • Incentives for hard area posting proposed as – • Rs. 2500/- per month for Staff Nurse • Rs. 3000/- per month for Medical Officer
ACTIVITIES UNDER NRHM COMPUTERISATION OF PHC, DISTRICT & STATE Present situation - • Data entry done manually at all levels, compilation of data is very time consuming • PHC level data not available at State, S/C level data not available at District • Hence, computerization of PHC, District and State is proposed for better data compilation and analysis
ACTIVITIES UNDER NRHM OTHER ACTIVITIES