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Revised Implementation Plan for RCH II in Meghalaya State

This plan outlines the current status and targets for the implementation of Reproductive and Child Health II (RCH II) initiatives in Meghalaya State. It includes strategies to improve maternal health, increase ANC coverage, promote institutional deliveries, and enhance postnatal care accessibility. The plan also addresses the need for capacity building, infrastructure development, and training of healthcare providers.

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Revised Implementation Plan for RCH II in Meghalaya State

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  1. State Implementation Plan Revised - 2008-09 NPCC Meeting_25/03/08 Government of Meghalaya Shillong

  2. RCH II GOAL MEGHALAYA STATE Current status (specify year & source) Target 08-09 09-10 MMR 450 (MIS 2005-06) 400 < 100 IMR 53 (2006 SRS) < 40 < 30 TFR 3.8 (NFHS 3) 3.5 2.1

  3. BACKGROUND (2001 Census) • Population of 232 Lakhs • 7 Districts • 10 Sub Division • 39 Community Development Blocks • Population Density is 103 person/Sq.M • Rural Population is 80.4 % • 6180 Villages • literacy is 62.6 %

  4. Planning Process Capacity building workshop was held for the state programme officer at Guwahati on 22 to 27 October 2007 regarding planning process. Similar capacity building workshop with MOs and Programme Manager of all 7 districts was held for a week from 26th November to 1st December 2007 at Shillong with support from RRC, Guwahati and NHSRC Delhi. Followed by it was a meeting with the BLOCK CORE GROUPS who were also involved in the planning process during 2006-07 and the newly appointed BPMUs. All block plans are available. At district level the block plans were collated by the District Core Group and the trained MO on planning process, so that the district plans were made. State plan is compilation of all the district plans and block plans.

  5. Percentage of children who are given ORS in diarrhoea is 67.7 (NFHS –3). – Target revised 2008-2009 – 70% 2009-2010 – 75% 2010-2011 – 85% 2011-2012 – 95%

  6. RCH Technical Strategies Part A

  7. Maternal Health Objective: Increase coverage of 3 ANC from 53.4% (NFHS-3) to 75%. Strategy: Increase accessibility of services at various level. Activities: • Renovation of SCs/PHCs/CHCs. • Focus on 38316 VHN Days (3193 AWC*12=38316) • Incentives of Rs. 20/- to ASHA per VHN Days. • Fixed ANC/PNC days in all PHCs & everyday at CHCs and DHs.

  8. Maternal Health • Strategy: Ensure ANC registration in inaccessible and uncovered areas. • Name of the Sub Centres with difficult area is provided in PIP where the 60 outreach camps will be held. • Strategy: Increase accessibility through institutional strengthening. • 18 PHCs are proposed for 24x7 in 08-09, 8 are already functioning as 24x7. • POL for ambulances for 24x7 PHCs is budgeted.

  9. Maternal Health Strategy: Promotion of institutional deliveries through cash incentives by promoting JSY scheme. Activities: • Monitoring of JSY • Listing of beneficiaries outside PHC/CHC • Monitoring quality of deliveries at Public Health Facilities • Accreditation and monitoring of private facilities are in process • 2 days stay after delivery is instituted in PHC and other facilities

  10. Maternal Health BREAK UP OF INSTITUTIONAL AND HOME DELIVERIES IN 07-08

  11. Maternal Health ESTIMATE CAPACITY FOR INSTITUTIONAL DELIVERIES IN 08-09.

  12. Maternal Health PLAN FOR CAPACITY AUGMENTATION FOR JSY IN 08-09 • Increase 3 ANC coverage to 75% • Ensure ANC registration in inaccessible and uncovered areas. • Increase institutional deliveries to 50%. • 26 PHCs to function as 24x7 • Strengthening referral transport • Training of SN/ANM on skilled deliveries

  13. Maternal Health • PLAN FOR CAPACITY AUGMENTATION FOR JSY IN 08-09 • Promotion of JSY • EmOC at 5 CHC and 3 DH • Multi Skilling of MOs • Recruitment of specialists • Incentives to medical officer and specialists • Upgrading facilities to IPH standard. • Ambulances • Blood storage to be operationalized • Monitoring quality of facilities conducting deliveries

  14. Maternal Health STEPS FOR OPERATIONALISATION OF FRUs • Training of MOs in Obstetric and Anesthesia outside state. • Provision of incentives to specialists • Provision of incentives to MO undergoing multi skilling training • Recruitment of specialists on contract basis • Increase coverage for ANC and PNC will reduced complications and will lead to timely referrals. • Availability of specialist as criteria for operationalisation of FRUs. • Incentives of Rs. 5000/- p.m. to MOs undergoing multi skill training. 2 MOs from 1st quarter, 6 from 2nd, 6 more from 3rd quarter and 6 more from 4th quarter, total of 20 doctors in 08-09.

  15. Maternal Health STATUS OF FRUS DURING 2007-08.

  16. Maternal Health Orientation Of Trained TBAs In 20% Inaccessible Areas.

  17. Maternal Health • Anemia among women is addressed in objective 6. 1. 1. 5.

  18. S 1 – Increase accessibility of PNC services A1: Repair and renovation of SCs/PHCs/CHCs and DHs. A2: Construction of new SCs A3: Focus on PNC during VHN days at AWC. A4: Recruitment of new ANMs. A5: Fixed PNC days will be held in all PHCs/CHCs and DHs. MH O – 9 To increase the coverage of PNC from 28. 8% (NFHS-3) to 50%.

  19. S 2 – Increase PNC at inaccessible and uncovered areas. MH O – 9 To increase the coverage of PNC from 28. 8% (NFHS-3) to 50%. A1: 1410 MSS to spread awareness on post natal care. A2: Additional MSS to be formed. A3: Mobility support for ANMs per SCs. A4: Outreach camps at uncovered and under covered areas.

  20. MH O – 9 To increase the coverage of PNC from 28. 8% (NFHS-3) to 50%. S 3 – Increase awareness among mothers and community about need of PNC services. A1: ANMS, ASHAs and AWWs will engage in counselling for PNC. A2: Follow up of deliveries and referral follow up will be ensured by ANMs and ASHAs. A3: Communication material on PNC.

  21. MH O – 9 To increase the coverage of PNC from 28. 8% (NFHS-3) to 50%. S 4 – Ensure PNC and Post Partum Care. A1: PHC & CHC will be upgraded as per IPH standard. A2: Staff to be trained in PNC care, referral and PP services.

  22. Child Health

  23. Child Health Objective 6. 1. 2.(i) 2. Promote exclusive breastfeeding. Adequate emphasis will be given to 5 districts with low coverage particularly in Jaintia Hills and West Khasi Hills. Objective 6. 1. 2 (i). 5. Improve the coverage of vitamin A Vitamin A will be administered during VHN Days. Objective 6. 1. 2 (i). 6. Increase use of ORS among children with diarrhoea.

  24. Child Health Objective 6. 1. 2.(i) 7. Address underweight children and assess children for nutritional problem. A1: assess height and weight of children below 5 years. A2: underweight child to get supplementary food from ICDS. A3: ASHA and ANM will promote child nutrition through VHN Days. A4: IEC/BCC on child nutrition S 1- ensure routine check up of children for both weight and height for age

  25. Family Planning

  26. FP O – 2 To reduce TFR from current 3.8 (NFHS –3) to 3.4 by 2010. S 3 – Organize contraceptive update workshop and dissemination of manuals. A1: One day state level workshop on contraceptive updates and emergency contraceptive. A2: Guidelines, manuals will be disseminated to all facilities till SC level.

  27. FP O – 2 To reduce TFR from current 3.8 (NFHS –3) to 3.4 by 2010. S 4 – Enhance capacity of facilities for taking family planning activities. A1: Quality Assurance Committee will be formed at district level. A2: Promotion of contraceptives by GoM through change in directives and SO. A3: Training of manpower in mini laparoscopic surgery and IUD insertion. A4: Provision of compensation to people for tubectomies and NSV

  28. FP BUDGET

  29. Adolescent Reproductive Health

  30. 5 days training of adolescent boys and girls need no budget. ASHA/AWW can undertake training at AWC/School. • Similarly follow up training need no budget. • Adolescent clinics are already part of regular clinics at DH. So there is no additional budget requirement. • 75 MOs and 472 ANMs will be trained in ARSH. • Orientation of VHSC on adolescent issues can be done during regular meetings.

  31. Quality Assurance, Monitoring and Evaluation

  32. QUALITY ASSURANCE COMMITTEE AT STATE (MD- NRHM, SPM, Consultant MCH&FP, Consultant HMIS, DHS (MCH&FW), member of RKS. QUALITY ASSURANCE COMMITTEE AT DISTRICT (DHMO, Monitoring officer, DPM, DHE, Member of RKS) QUALITY ASSURANCE COMMITTEE AT BLOCK (MO I/c CHC, BPM, and member of RKS)

  33. Training Plan

  34. Training by skill category, volume, duration and location is provided in PIP. • Existing MO I/c training will be the nodal person to manage and coordinate all training in state and will assist the MD – NRHM. • Over period till 2011 the SIHFW will be strengthened to undertake skill based training and will be the nodal agency for planning, conducting, managing and organizing all state level training. • Training on RTI/STI for 75 MOs is proposed.

  35. B U D G E T S U M M A R Y O F RCH -II Continues in next page

  36. B U D G E T S U M M A R Y O F RCH -II

  37. B U D G E T S U M M A R Y O F RCH -II

  38. Annexure 3 a Annexure 3 b Annexure 3 c Annexure 3 d Annexure 3 e Annexure 3 f

  39. Part B: NRHM Initiatives

  40. ASHA • Total selected is 5438, remaining 742 is being selected and will be in place by April end. • 143 ASHA facilitators are for mentoring ASHA at facility level. (104 PHCs and 39 CHCs).

  41. VHSC • Total 4102 VHSC constituted and untied fund has been released. • Post office option for saving account or other sources will be explored.

  42. Sub Centres • Post office option for saving account or other sources will be explored. • Procurement of haemoglobinometers for each 401 SCs @ Rs. 600/-

  43. Primary Health Centres • Burial pits proposed last year were made. • Procurement of 10 ambulances is proposed. • POL and maintenance for ambulances budgeted @ Rs. 6000/- per month for 20 ambulances.

  44. Burial Pits • All burial pits proposed last year were made at PHC, CHC and District Hospital Strengthening the logistics – Drug Warehouse • Transportation cost from State HQ to Districts will be from state pool. • Salary of staff in warehouse needed as they will operate from rented warehouse. • Rent of state warehouse @ Rs. 25, 000/- per month proposed. • Emergency generator @ 8, 00, 000/- plus POL for generator @ Rs. 180000 for whole year.

  45. Strengthening RIHFW • Driver will be made available from state pool. Specialized care by NEIGRIHMS • 2 PHC of diengpasoh and Mawphlang will act as rural units for NEIGRIHMS.

  46. New Initiatives • Mobile phone for ANMs is removed. • Household cards for records is also removed • Mobility for cold chain mechanic is budgeted under UIP.

  47. B U D G E T S U M M A R Y O F NRHM Continues in next page

  48. B U D G E T S U M M A R Y O F NRHM Continues in next page

  49. B U D G E T S U M M A R Y O F NRHM

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