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STATE PIP NRHM 2008-09

This article highlights the achievements and strategies in maternal and child health services in Madhya Pradesh, including the increase in institutional deliveries, improvement in ANC coverage, operationalization of CEmONCs and BEmONCs, and initiatives for population stabilization and child health. It also discusses the efforts to address malnutrition and enhance immunization coverage in the state.

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STATE PIP NRHM 2008-09

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  1. STATE PIP NRHM 2008-09 Department of Public Health and Family Welfare Madhya Pradesh

  2. RCH-Goal

  3. MMR-498(SRS-1998) MMR-379(SRS-2001-03) Reduction by 120 points in 5 years Goal for 2010-220; This implies reduction by 140 points in the year 2010, while institutional delivery was about 27% in the year 2003. Considering rapid increase in institutional delivery(62%), the target is achievable.

  4. Major Achievements Target-surpassing – Institutional Deliveries in MP • In year 2007-08 institutional delivery target 60%, • Institutional delivery increased from 51% (year 2006-07) to 62% (year 2007-08) • Strategies adopted - Cash incentive under JSY • Positioning of skilled man power • Strengthening of infrastructure • Implementation of Janani Sehyogi Yojana • Referral transport through Janani Express Inst. Del. (%age) Year

  5. Janani Suraksha Yojana 86.50% 48.47% 11.39%

  6. STATUS OF INSTITUTIONAL DELIVERIES APRIL-JAN. 2008 B H D M R N G L R D T A S O P S V P T K M R A W C T P N M C A K N G U N P A N S T N S D H N M D S S J P S A G V D S R J G D M H U M R S D L K T N R T M B P L U J N J B P R S S H E A N P N S P D D R I D R J B A M D L D H R D W S H S B S N I H R D < 50% C D W K N D B L G K R G B R W B T L 51%-70% B H P > 71%

  7. Identified 50 blocks strengthened to provide comprehensive health services: 100% institutional deliveries 100% immunisation 100% ANC checkup Dhanwantari Yojana

  8. Janani Sahyogi Yojana (PPP) Janani Express Yojana Provision of free referral transport services to pregnant women for institutional deliveries. Operational in 270 Blocks, 370 vehicles and 100000 Beneficiaries 2 Call Center – Bhopal and Guna Evaluation of the scheme being done by HOSMAC

  9. Improvement in ANC Coverage Target for 3 ANC – 60%, Achievement – 70.8% Strategies adopted – Demand generation through BCC Incentive to ASHA and service providers SBA Training to ANM, LHV

  10. Operationalization of CEmONCs Strategies adopted – availability of specialist ensured by increased honorarium, special incentive and difficult area allowance

  11. Operationalizing BEmONC (24x7) Strategies adopted – Contractual appointment of 1 additional MO, 2 SN and 2 ANM/LHV and SBA & BEmONC Training 360 SHC

  12. New initiative for improvement of MCH Services Matra Shakti Yojana • Identifying high risk pregnant women by ANM and management at CEmONCs and BEmONCs. Free treatment up to Rs.5,000/- • Launched from 1st Dec. 2007 in 7 identified block and 275 women have been benefited. Reaching Unreached and Underserved Population • MCH services being provided at CHC, PHC and Sub Health Centre through Specialists from Private sector (Gynae and Paed.) hired for Rs.1,000 per day. • Implemented since 1st Dec 2007 in 14 districts. Expenditure met from funds allotted for RCH Camps. • To be upscaled in all districts in year 2008-09.

  13. Population Stabilization FP Indicators of MP better than national average( NFHS -3) • Population stabilization efforts • To achieve TFR of 2.1 from present level of 3.6 (SRS 2005) • Strategies adopted:- • acceptability of male and female sterilization increased through BCC. Increase focus on man sterilization by organizing NSV Camps. • Fixed day strategy for LTT and NSV. • Capacity building of service providers for FP services. • Sterilization – 62.7% of service need • IUD – 54.7% of service need

  14. Child Health Services in Madhya Pradesh Trend in I.M.R. … Reasons for high IMR – still 38% domiciliary deliveries, less coverage of EMOnC services, inadequate availability and essential and sick new born care, high percentage of malnourished children Source: SRS, India

  15. Child survival initiatives - IMNCI • IMNCI implementation in 12 districts • For Monitoring and supervision IMNCI coordinator placed at state and district level. ( UNICEF Support)

  16. Addressing Malnutrition in Children Establishment of NRCs under Bal Shakti Yojana – 61 functional, 9403 grade – 3 and 4 malnourished children treated Laxman with Grade IV malnutrition stabilized in district hospital Guna rehabilitated in NRC and followed up in the community

  17. Facility Based Care Establishment of Sick New Born Care Unit • 20 Bedded unit including 6 step- down beds • 4 Pediatricians and 14 staff nurses along with 2 lab technicians. • Scale- up proposed in all 12 IMNCI implementing districts.

  18. Fully Immunized Children in Madhya Pradesh • Improvement in immunization coverage by strengthening monitoring mechanism – • Establishment of RI Cell at State & Divisional level (with UNICEF Support) • Capacity building of ANMs • Defaulter Tracking System • RIMS upload

  19. Improving diarrhoea Management Low formula ORS made available state wide State level procurement of zinc under process Communication strategy focusing on ORS use with zinc in place Health worker giving ORS and Zinc Poster on ORS and Zinc

  20. Steps towards Quality Immunization Services • 40 districts have uploaded the data on RIMS • Safe disposal procedures followed • AEFI committee formed at State & District level

  21. Urban Health • Mapping done in all proposed 8 cities. • 7 new urban health centers operationalized (3 through PPP) • 340 USHA selected. • 230 outreach camps organized. • 40+ clinic functional in 6 divisional head quarters districts for cervical and breast cancer screening.

  22. Challenges and constraints • High MMR and IMR of the state. • Adverse sex ratio. • High proportion of marginalized population. • Shortage of skilled manpower for operationalizing EmONC services. • Difficult outreach areas. • Poor health seeking behavior in community. • Unequal distribution of Private and NGOs sector in urban and rural areas.

  23. Road ahead • Public Private Partnership in increasing number of trained Medical and Paramedical professionals. • Attractive honorarium, incentives and difficult area allowances to ensure manpower retention. • To improve access of services through infrastructure strengthening and PPP. • Effective BCC strategy for awareness and demand generation. • Focused strategy for vulnerable group. • Emphasis on population stabilization through male participation and spacing methods. • Increasing access of services by inter sectoral convergence with WCD and Rural Development Deptt. and other stake holders. Effective monitoring • Capacity building of health providers.

  24. Budget Summary-RCH-II

  25. Budget Summary Conti….

  26. Maternal Health

  27. Child Health

  28. Cont…..

  29. Family Planning

  30. ARSH & Gender

  31. Urban Health

  32. Tribal Health Vulnerable Group MNGO Scheme

  33. Major Civil work for operationalisation of FRUs& BEmONCs

  34. LOGISTICS

  35. Introduce a web based Health Management Information System (HMIS) for planning and monitoring health services. Clinical Information system, Hospital and patient information system) Financial Management information system) Inventory management Health Programs (MRHM/RCH) Human Resource HMIS

  36. HMIS

  37. Quality Assurance

  38. Trainings under RCH

  39. IEC/BCC

  40. Programme Management

  41. NRHM Additionalities

  42. NRHM Budget Summary 2008-09

  43. IPHS • Facility survey of DH/CH/CHC/CH as per IPHS norms completed in all identified 763 institutions. • 12 DH identified for NABH accreditation • 96 CHCs/ Civil Hospitals identified for upgradation as per IPHS norms . • Fund of Rs. 103 crores proposed for upgradation of DH/CHCs/CHs as per IPHS norms.

  44. NRHM

  45. NRHM

  46. NRHM

  47. NRHM

  48. NRHM

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