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State Health Society Welcomes Sri. Amit Mohan Prasad, Jt. Secretary, GOI Sub-Group Team Members from MoHFW, GOI

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State Health Society Welcomes Sri. Amit Mohan Prasad, Jt. Secretary, GOI Sub-Group Team Members from MoHFW, GOI

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    1. State Health Society Welcomes Sri. Amit Mohan Prasad, Jt. Secretary, GOI & Sub-Group Team Members from MoHFW, GOI

    6. Status Decrease in…. MMR from 371 ( 2001-2003) to 312 ( 2004-06) IMR from 61 ( 2005) to 56 per 1000 live births ( 2009) Total Fertility Rate (TFR) from 4.3 to 3.9 Increase in…. Institutional deliveries from 12.1 % (1992-93) to 22 % ( 2005-06) to 27.7% ( 2007-08) to 47.9% (CES 2008) Antenatal Care from 15.9 % (98-99) to 26.4 % ( 2007-08) Full Immunization coverage has increased from 10.7 % (92-93) to 53.8 % (ISB, 2009) Contraceptive use has increased from 23.1 percent (92-93) to 28.4 percent (2007-08) Sex ratio from 825 to 871 (CRS 2006-07)

    7. Contribution of State

    8. Activity Progress

    9. Full immunization percentage increased to 41.4% (DLHS II) to 53.8% (FRDS). ANM (R) Recruitment – 6000/11964 Rogi Kalyan Samitis registration- 513/653 Training of IMNCI, SBA, MTP and Neonatal resuscitation has been scaled up by incl. more districts and through private partners. ASHA training for Module 2,3 & 4 taken up. DPMU capacity building workshop done on various aspects of NRHM at State level. ANM/GNM schools, 22/22 ANM schools restarted and 6/6 GNM schools re-start. Total 909 students (ANM) and 268 (GNM) currently enrolled. Government of Bihar has decided to adopt “Lok Swasthya Pariwar Kalyan and Gramin Swaschata Samiti” constituted by Department of Panchayati Raj in Bihar as “Village Health and Sanitation Committee”. Total no. of VHSC constituted-3797/8548 Untied grant- 8095 Joint A/cs opened at HSC level Rate contracting of equipments/supplies for Child Health (SNCU & NSU) and Maternal Health (Labour room+ Beds) done, procurement initiated in the districts

    10. Doctors : 1763/2497 Staff Nurses : 3900/5019 ANM-R : 6000/11964 Health Managers : 477/533 Block Accountant : 533/533 ASHA Health Worker : 69640/87135 Lab. Tech : 401/680 OT Assistant : 48/67

    11. Progress in Infrastructure Development

    16. Month wise comparison of Sterilization 07-08 to 09-10

    17. Training Initiatives SBA Training – 114 Master Trainers, 304/1920 ANMs & 244/360 Staff Nurses trained (Accreditation of Pvt. Health facilities for SBA trg.) IMNCI Training -12469/22560 ANMs +AWWs trained EmOC Training- 45/304 doctors trained Anesthesia Training-70/304 doctors trained NSV Training- 21 doctors trained Minilap -18/240 doctors & staff nurse trained ASHA Trained on Module 1- 65402/87135 Mamta Training- 393/667 (Last batch of TOT in Feb’09) NSSK Training – 100/160 trained IDSP Training – 24/38 Epidemiologist trained Safe Abortion – MOU being signed with IPAS Swine Flu - 96/114 MOs Epidemic/Pandemic Preparedness – 10/10 MOs

    18. Initiatives in High Focus Districts 35 of the 38 districts are High Focus districts in Bihar Free Referral Transport for Pregnant Women (All HFDs) Maternal & Infant Death Audit (13 HFDs) Health Camps through 10 MMU in MahaDalit tolas Nutritional Rehabilitation Centres (NRCs) (All HFDs) Chiranjeevi Yojana (2 districts) Child Development and Nutrition Support Centres (CDNC) (5 blocks in 2 districts) Family Friendly Hospital Certification (2 facility per 5 HFDs) Iron Sucrose Inj. to AN mothers ISO Certification to Govt. Health Facilities MMU Up-scaling of 108 (Emergency Referral Transport)-2 HFDs Referral Transport Facility (Govt./Pvt. Ambulance) through NRHM

    19. Financial Status

    20. Budget Utilisation 2008-09 vs. 2009-10

    22. Systemic Changes Made…..

    23. HR Management Revised Organogram of SHSB Re-organizing and partly Rationalising the existing trained manpower Power to transfer doctors delegated to Civil Surgeons Web enabled system to capture district level cadre information New cadre policy for doctors modified District and state cadre Provision of three dynamic ACP at interval of 6 years Cadre rules notified for paramedics and health educator

    25. OT assistant, clerks, pharmacists, lab technicians, X-ray technicians cadre rules to be finalized soon (draft publication readied for x-ray technicians, OT assistants and clerks). Revision of pay-scale of Doctors (from Rs.20,000 to 30,000), Specialists (from Rs.25,000 to 35,000), Contract Staff Nurses (from Rs.7500 to 12000), Contract ANMs (Rs.6000 to 12000) and Paramedics like Lab. Technician, X-ray Technician, OT Assistant) from Rs.4000 to 6500) Dentist at PHC – From 2 days to 6 days

    26. Process for MCI Clearance for 3 Medical College Hospitals initiated and DPR Preparation is in final stage. ANM/GNM Training Utilization of all the available seats in the ANM/GNM Schools this financial year Filling faculty & staff in the ANM/GNM Schools on Contractual basis 6 Schools in PPP mode

    27. Policy Decisions/Institutional arrangement for improving expenditure 1. Civil Construction - Setting up of State Corporation for Equipment & Drug/Consumable Procurement which would also undertake Civil Construction 2. Operationalising all APHCs 3. New Financial System (Dist.- Khagaria)

    28. PPP Initiatives X-ray- 7.18 lakh tests conducted from July 06 to Dec 09 Pathology- 8.20 lakh tests conducted from July 06 to Dec 09 Hospital maintenance (cleanliness, diet, laundry, generator) 102 Ambulance services- 8326 calls, 6444 requisitions (01.04.09 to 31.12.09)

    29. Hospital Waste Management- Agencies finalised, NOC from BSPCB awaited Sterilization services through accredited private clinics – outsourced (25,000 cases done till Dec 2009) Generic Drug Shops – Revenue Sharing & Rental model Urban Health Centres through Private Clinics Mobile Medical Unit – Operational in 26 districts Emergency Referral Services (108) in Patna – No. of Calls-5342 (03.06.09 to 31.12.09)

    30. Outcome Analysis of Muskan: Ek Abhiyaan (Innovation)

    31. Objectives To achieve 100% immunization of Infants and Pregnant Women To Ensure 100% Institutional Delivery

    32. Components 1.Tracking of all Pregnant Women and Newborns Through House-to-house survey Registration of Pregnant Women and Children from 0 – 2 yrs age group in Muskan & MCH registers. 2.Immunization sessions at every Anganwadi Centers 3.‘Mahila Mandal’ Meetings (Participants – are pregnant ladies, lactating mothers, AWW, ASHAs, Mothers of targeted children)

    33. Evaluated % of Fully Immunized Child in Bihar

    34. Monthwise Reported Cumulative Coverage – Bihar (2008 & 2009)

    35. Positive Intervention in R.I./Muskan R.I. / Muskan Microplans revised in the state. Modified Muskan incentive structure based on number of beneficiaries instead of percentage. New revised R.I./Muskan Monitoring tool (both session site & H to H) implemented in the state. Urban Slum special R.I/ Muskan catch up drive implemented across the state.

    36. Free Radiology & Pathology services being offered to all Government patients. Free service right from PHC to District Hospital In MCH Free Diagnostic service extended to BPL patients

    38. Outlay for 2010-11

    39. Process of Plan Preparation (District –Katihar)

    40. DHAPS Facility Improvement – Madhubani Situational Analysis, RI & Kalazar - Samastipur

    41. Details of Activities

    42. BUDGET

    43. BUDGET 2010-11

    44. NRHM PART A : RCH II…..

    45. NRHM PART B : NRHM Additionalities

    47. NRHM PART B : NRHM Additionalities

    49. NRHM PART B : NRHM Additionalities

    50. NRHM PART B : NRHM Additionalities

    51. NRHM Part C : Immunisation

    52. NRHM PART D – NATIONAL DISEASE CONTROL PROGRAMME

    53. Concurrent Audit Appointment of 27 CAs done in all the districts ) CA ensuring streamlining of accounting as per NRHM norms and monthly audit is being ensured Audited reports flowing to SHSB except fm. Munger Block Accounts Managers (BAMs) in place in 533 blocks 2-day Orientation programme at SHSB done of District Accounts Managers Tally software introduced from 01.12.2009 at the District level and to be introduced in all PHCs from 01.04.2010

    54. HMIS Till Nov’09 data from 37 districts uploaded on GOI web portal SHSB with support from NHSRC conducted training of District as well as block level officers/Consultants on revised HMIS formats & web portals of NHSRC & NRHM, GOI Plan to conduct training below block level facilities on revised HMIS formats and to ensure data uploading on GOI portals using DHIS 2 & NHSRC software at block and district level and training at block/district/State level to analyse decision and action taking at each & every level. Printing of HMIS formats in hindi, to be then filled up by ANMs then sent to PHCs (blocks) and district online entry on DHIS 2

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