National Rural Health Mission

2. The Paradigm Shift under NRHM Decentralised planning Outputs and Outcome based Pro-Poor Focus: Equitable systems Quality of Care and the IPHS norms Rights based service delivery Pre stated entitlements at all levels Inputs computed as function of the entitlements and estimated patient load Judicious mix of dedicated budget lines - untied funds Monitor quality Community Participation

3. The Paradigm Shift under NRHM Bringing the public back into public health At hamlet level : ASHA, VHSC, SHGs, Panchayats. At the facility level: RKS At the management level : health societies Governance reform Manpower, Logistics & Procurement processes. Decision making processes Institutional design, Accountability framework Convergence Water and sanitation Nutrition Education

4. Reduce maternal and child mortality - address malnutrition Address adverse sex ratio Stabilize population Effectively implement the national health Programmes Enhance equity, quality, access, cost-effectiveness and satisfaction with health services Provide state of the art health and medical education relevant to local needs Provide an environment in which the health team blossoms fully to lead a fulfilling life and effectively achieves the above goals

5. Current Status

8. Broad Issues Non - availability of O & G specialists Accessibility of services-Tribal and urban slums Poor utilization of services- Low felt need of health & medical services Lack of user friendly & quality public health services Costly private health and medical services No health insurance coverage

9. Strategies Chiranjeevi Yojana Extended Chiranjeevi Yojana Janani Suraksha Yojana Operationalising FRUs/B/CEmOCs/, training of MOs in LSAS and training of SBA. Appointment of staff nurses at PHCs for safe delivery & specialists on call basis. Monitoring of each pregnant mother as per EDD and birth micro plan prepared & Involving EMRI. Incentive to the staff in govt. for the better performance (state govt. initiative) Outreach Primary health care through MAMTA Abhiyan

12. Our Achievement: 54 poor performing talukas (having less than 70% institutional delivery rate) reduced to 39 as on (Oct 2008)

16. Tribal districts

18. Objective To reduce Neonatal mortality and Infant mortality To ensure IYCF practices. Growth monitoring and Nutrition practices. To ensure full immunization. To reduce morbidity & mortality among children due to Diahorreal & ARI diseases. To reduce the Low birth weight babies & malnutrition among child.

19. Excellent. Let’s have separate parts for anemia; Neo natal health and child healthExcellent. Let’s have separate parts for anemia; Neo natal health and child health

20. Strategies : Child Health Implementation of IMNCI/ENBC in 18 districts, started in 2006 Mamta Abhiyan (Divas,Mulakat, Nondh, Sandarbh) implementation & convergence of Health with ICDS. Started in 2006 Training of health workers in Immunization; Cold chain handler’s training Immunization strengthening: RIMS, fully operational as from 2007 Upgrading skills of MBBS doctors in Emergency Newborn Care Strengthening Government facilities for newborn care (new born corner, Sick baby corners & neonatal care units ) “The Bal Sakha Yojana” PPP for newborn care under process Pediatrician on call scheme is launched in the entire state.

21. Infant Mortality Rate - Region Wise

24. Mamta Divas Outreach Performance- 2008-2009

28. Full immunization independent evaluation by Taleem

29. Routine Immunization Monitoring System (RIMS)

31. Malnutrition management pyramid

33. Bal Sakha Scheme – 1 for Chiranjivi Beneficiaries [BPL] Proposed charge to be paid to the pediatrician for 100 children

34. Bal Sakha Scheme – 2 for Other Beneficiaries [BPL] Proposed charge to be paid to the pediatrician for 100 sick children referred

35. Objective Reduce TFR up to 2.1 Increase the couple protection rate Quality assurance in Family planning services Provision of safe abortion services Ensure Male participation.

38. Ongoing Strategies Training of surgeons for NSV/Laparoscopic TL: 150 surgeons trained in NSV and within 2007-08 state is going to have 250 trained surgeons 770 surgeons trained and certified for laparoscopic TL surgery Training of doctors and FHW in IUD: project initiated in all district Contraceptive update to FHW IEC/BCC campaigning and distribution of pills and condoms Block wise analysis of FP data and action Kalyan Chab CBD outlet for condoms, IFA tablets, ORS, Choroquine etc.

40. SterilizationsTotal

41. IUD insertions

46. Trend performance

51. Gujarat state has been in the target zone, consecutively in last eleven quarters 25 / 29 (86%) reporting units are in the target zone 100/130 (77%) TB Units are in the target zone NSP Case Detection Rate - 3q08 : 78% NSP Cure Rate - 3q07 : 87% NSP Conversion Rate - 2q08 : 91% Total TB patients put on treatment : 19,961 NSP Cases put on treatment : 8805 Gujarat State has achieved 3rd place in NSP case detection rate & cure rate during 2Q08 (As per National Performance report 2Q08) Since the inception of RNTCP up to 30-9-08 Total TB Patients put on DOTS treatment, : 6,07,062 New Smear Positive patients put on treatment : 2,46,212 Total lives saved : 1,09,271

54. PHYSICAL PERFORMANCE 2008-09 (UP TO NOVEMBER.)

57. EYE DONATION ACTIVITIES(UP TO NOVENBER-2008) No of Eyes Collected :3861 No of Eyes Utilized :2918 No of Eyes sent to other Eye Banks : 943

58. Integrated Disease Surveillance Project Progress : Reporting units – 1544 99% Reporting every week. Feed-back provided through weekly alert. Concerned authority informed to take actions for increasing trend in disease in respective reporting unit. Microbiologist are appointed at General Hospital Gandhinagar & General Hospital Sola Ahmedabad. Interview of Entomologist, Microbiologist & Epidemiologist was held on Dt.21-22 November-08 by NHSRC.

59. IDSP Major Outbreaks Investigated Jan. to Nov.- 08

63. Overall work done through Sickle Cell Anemia Control Project.during Feb 2006 to March-08.

69. Declining Trend of crude death rate

70. Risk Categorization of Districts 2006

73. IEC, Mainstreaming & Social Mobilization

74. Victorious Journey of RRE in Gujarat

75. Care, support & Treatment (CS & T) 7000 patients are being treated through Nodal ART Centers 6 (3 proposed) & LAC 14 (2 proposed) Operationalization of DAPCU 11 districts & Surat city, Staff appointed including 5 HIV positives