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poor Health scenario in Andhra Pradesh
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Andhra PradeshWelcomesSub-Group Team Membersfrom MOHFW & NHSRC, New Delhi
National Rural Health Mission (2005-2012)Project Implementation Plan 2010-11Presentation toSub-Group meeting(on 22.1.2010) Anil Chandra Punetha, IAS Commissioner of Family Welfare and EO Principal Secretary to Govt. (HM&FW dept.) Govt. of Andhra Pradesh :: Hyderabad
NRHM Expected Outcomes • Achieve a cure rate (TB - DOTS) of – 85% by 2012 • Reduce prevalence rate of Leprosy to – 0.43 per 10,000 by 2012 • Increase Cataract operations to – 6 lakhs per annum by 2012 (AP). • Reduce Malaria Mortality Rate to – 60% by 2012 • Reduce Filaria / Microfilaria rate to – 80% by 2012. • Upgrading all health facilities to IPHS. • Increase utilization of FRUs from 20% bed occupancy to 75%. Source: # SRS 2009* NFHS-III (2005-06) ** SRS Special Survey (2004-06)
Social Confounder for Safe & Institutional Deliveries (DLHS-3)
Program wise Budget / Expenditure for 2008-09 and 2009-10 (Rupees in crores)
Proposed PIP for 2010-11ABSTRACT (Rupees in lakhs)
Proposed PIP for 2010-11RCH Flexible Pool (Rupees in lakhs)
Proposed PIP for 2010-11RCH Flexible Pool (Rupees in lakhs)
Proposed PIP for 2010-11RCH Flexible Pool (Rupees in lakhs)
Proposed PIP for 2010-11Mission Flexible Pool (Rupees in lakhs)
Proposed PIP for 2010-11Mission Flexible Pool (Rupees in lakhs)
Proposed PIP for 2010-11Strengthening of Routine Immunization (Rupees in lakhs)
Proposed PIP for 2010-11Strengthening of Routine Immunization (Rupees in lakhs)
Proposed PIP for 2010-11National Disease Control Program (Rupees in lakhs)
Proposed PIP for 2010-11Convergence and Coordination (Rupees in lakhs)
Proposed PIP for 2010-11Direction and Administration (Treasury route) (Rupees in lakhs)
Proposed PIP for 2010-11Pulse Polio Immunization (Rupees in lakhs)
Introduction • Govt. of India has identified 4 high focused districts viz. Nellore, Adilabad, Warangal and Khammam. • GoAP considered low performing health facilities i.e. 180 PHCs and 30 CHCs in 18 districts. • Health facilities under 10 ITDA areas have also identified under this package including 2 PHCs which are far to reach in Non-ITDA areas. • Gujarat model (Chiranjivi) pilot project is proposed to be implemented in Tribal areas of Khammam District. • Provision made for Nutrition support to pregnant and lactating women in identified areas. • Focused on Maternal Death Audit and Impact Analysis. • Strengthening of HMIS
Areas Needs to Addressed • 20% of the high focused health facilities identified for implementation. • 300 PHCs and 30 CHCs are identified as high focused. • Focus on backward & inaccessible areas. • 184 PHCs and 20 CHCs of ITDA areas and inaccessible 24 PHCs of Non-ITDA Districts are identified as high focused. • Training & Skill Development. • Multi skill training program for Medical & Paramedical staff. • Sensitization workshops to VHSCs & HDS members. • Impact Analysis. • Proposed to conduct Baseline, Midline, End line surveys, and Maternal & Infant Death Audit. • Strengthening of MIS.
1) Identification of Focused Areas • Total PHCs … 1570 • Total high focus PHCs … 300(20% of PHCs are identified as High Focused PHCs) • Total CHCs … 169 • Total high focus CHCs … 30(20% of CHCs are identified as High Focused CHCs) • Selection Criteria: • Category–I : 30 PHCs each from GoI identified high focused 4 districts viz. Khammam, Warangal, Adilabad and Nellore. • Category–II : 10 PHCs each from rest of 18 districts except Hyderabad. • 30 CHCs: Selected on the basis of key performance indicators as a bench mark.
2) Identification of Backward & Tribal areas • Total ITDA areas … 10 • Tribal ITDA PHCs … 184 • Tribal CHCs … 20 • Inaccessible Non-ITDA PHCs … 24
Human Resources: Special drive to fill up all the vacancies in the identified SCs/ PHCs / CHCs Infrastructure Providing Furniture, Equipment and Television. Security and Clean bed sheets, clean toilets, facilities for bathing, adequate lighting, 24 hour water and electricity supply: Each PHC - Rs.1,00,000/- Each CHC - Rs.1,50,000/- Mobility: Provision of hiring vehicle to MOs Proposed Special Package Contd..
Providing CUG Mobile to ANM & ASHA To facilitate the ANM / ASHA to intimate the name based ANC Particulars for registrations. To intimate adverse conditions of pregnancy of an ANC to MOs. Transportation of ANC to delivery through 108. To inform near by FRU for immediate medical / surgical attendance. To intimate Maternal and infant deaths. Incentives to Staff: Performance based incentives @ Rs.50,000/- to PHCs & Rs.75,000/- to CHCs are proposed basing on following Indicators: OPD, 100% ANC, <80% institutional deliveries, <90% PN Care, 100% Sterilizations, 100% immunization and utilization NRHM funds. The awarded incentives will be shared among all the staff of the institution. Proposed Special Package
Special package for institutional Deliveriesin Tribal areas of Khammam district • The Special package for institutional deliveries is proposed to be implemented on a pilot basis in tribal areas of Khammam district. • Khammam has been identified as LWE by Ministry of Home Affaires and is one of the identified high focused district by GOI. • To improve access to institutional delivery Traibal areas. • To provide financial protection @ Rs.2000/- to poor families in remote, inaccessible and difficult areas. • The private empanelled providers are reimbursed on capitation payment basis according to which they are reimbursed at a fixed rate for each delivery carried out by them