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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 funds

3) 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
National rural health mission

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National rural health mission

  • 1.
  • 2. 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..
  • 3. Improve rural health delivery system -accessible -affordable -accountable -equitable
  • 4. 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
  • 5. 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
  • 6. 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
  • 7. Private partnership to meet national public health goals-’public pvt. Partnership’ (ppp)  Social insurance to raise the health security of poor
  • 8. 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
  • 9. 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
  • 10. 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
  • 11. 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
  • 12. 2) STRENGTHENING OF SUB CENTRES  Supply of essential medicines  Provision of MPW / additional ANM  Provision of funds 3) 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
  • 13. 4) STRENGTHENING OF CHC’S  3222 CHCs should function as first referral unit  Maintain ‘INDIAN PUBLIC HEALTH STANDARDS‘  Promotion of ‘ROGI KALYAN SAMITIS’
  • 14. 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
  • 15. 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
  • 16. Baseline survey at district level & household level  Community monitoring at village level  Eventual monitoring of the outcomes is done by planning commission of India