STATE OF PUBLIC HEALTH IN INDIA BEFORE NRHM

Health gap at rural level

Multiple health crisis ( malnutrition, maternal and infant deaths, inadequate water supply etc..

Improve rural health delivery system

-accessible -affordable -accountable -equitable

Launched in 5th April 2oo5 for 7 years by GoI

Special focus on 18 states 8 NORTH EASTERN STATES (ASSAM, AP,

MANIPUR, MEGHALAYA, MIZORAM, NAGALAND, SIKKIM, TRIPURA)

8 EMPOWERED ACTION GROUP STATES ( BIHAR, JHARKHAND, MP,

CHATTISGARH,UP, UTTARANCHAL, ORISSA, RAJASTAN)

HP & JK

Child & maternal mortality rate Universal access to public health

services for food ,nutrition, sanitation and public health services addressing maternal and child health.

Prevention and control of CD’s and NCD’s

Access to primary health care Mainstreaming of AYUSH Promotion of healthy life style

Decentralisation of village and district level health planning and management

Appointing ASHA for facilitating the access to health services

Strengthen public health delivery services at primary and secondary level

Mainstreaming AYUSH Improve management capacity to

organise health systems and services Improve intersectorial coordination

Private partnership to meet national public health goals-’public pvt. Partnership’ (ppp)

Social insurance to raise the health security of poor

AT NATIONAL LEVEL IMR : Reduce to 30/1000 MMR : Reduce to 100/100,000 TFR : Reduce to 2.1 MALARIA MORTALITY RATE REDUCTION: 50% by 2010 , addtl 10% by 2012 FILARIA RATE REDUCTION : 70%(2010), 80%(2012), elimn by 2015 DENGUE MORTALITY RATE REDUCTION: 50%(2010) KALA AZAR MORTALITY RATE REDUCTION: 100%(2010) JE MORTALITY RATE REDUCTION: 50%(2010) CATARACT OPERATION: increase to 46 lakhs/year 2012

LEPROSY PREVALENCE RATE : reduce from 1.8/10,000 in 2005 to less than 1/10,000

TB DOTS SERVICES : 85% Cure rate Upgrading CHC to Indian Public

Health Standards Increase utilisation of FIRST REFERRAL

UNITS from <20% to 75% Engaging 250,000 female ASHA in 10

states

PHC/CHC should provide good hospital care. Generic drugs at subcentre level Access to UIP Facilities for institutional deliveries Trained community level worker at village

level Health day at ANGANWADI -immunisation - antenatal/postnatal check ups Provision of house hold toilets Improved outreach services through MOBILE

MEDICAL UNIT at district level Community health insurance

1)CREATION OF ASHA (ACCREDITED SOCIAL HEALTH ACTIVIST)

-health activist in the community -1ASHA= 1000 population -not a paid employee -create awareness about health & its

determinants -mobilise community to health care services - counsel women and escort them to

PHC/CHC & providing medical care for minor ailments

2) STRENGTHENING OF SUB CENTRES Supply of essential medicines Provision of MPW / additional ANM Provision of funds3) STRENGTHENING OF PHC 24 hr service in at least 50% of PHC incl.

AYUSH practitioner Upgradation for 24hr referral service Adequate and regular supply of essential

drug Strengthening CD control programme

4) STRENGTHENING OF CHC’S

3222 CHCs should function as first referral unit

Maintain ‘INDIAN PUBLIC HEALTH STANDARDS‘

Promotion of ‘ROGI KALYAN SAMITIS’

AT NATIONAL LEVEL: MISSION STEERING GROUP ,

-chairman is union minister of health and family welfare

AT STATE LEVEL : STATE HEALTH MISSION - led by CM

AT DISTRICT LEVEL : DISTRICT HEALTH MISSION

- Led by chairman of ZILA PARISHAD

Core unit in planning, budgeting and implementation of the programme.

FUNCTIONS Selection and training of ASHA Organising health camps at

ANGANWADI Mainstreaming AYUSH Upgrading CHCs to IPHS Outreach services through mobile

medical units

Baseline survey at district level & household level

Community monitoring at village level Eventual monitoring of the outcomes is

done by planning commission of India