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 CDs and NCDs 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 CHCS
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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
STATE LEVEL : STATE HEALTH MISSION - led by CM

AT

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