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Presentation on theme: "1 RCH INTERVENTIONS PUNJAB SHIMLA MEETING: 24 TH & 25 TH SEPT. 08."— Presentation transcript:




4 3  Total Number of Institutions InstitutionsNumber Delivery Facilities District Hospital20 Sub- Division Hospital38 CHCs127 - PHSC CHCs112 - DHS CHCs15 Block PHCs118- PHCs39475 Sub-Centers2858

5 4  For 172 Regular Institutions the State has 142 Gynecologists. 25 Gynecologists have been recruited on contract basis. Advertisement has been issued for recruitment of 40 Gynecologists on regular basis. Shortage of Gynecologists.

6 5  Up-gradation of Institutions : 50 CHCs upgraded to EmOC centers with appointment of 1 Gynecologist, 1 Pediatrician and 5 Staff Nurses (wherever required) upto the year 2007-08.50 CHCs 10 more CHCs being upgraded to EmOC centers in the current financial year.10 more CHCs 75 PHCs upgraded into 24 x 7 delivery institutions with appointment of 1 Safe- Motherhood Consultant (lady doctor) & 3 Staff Nurses upto the year 2007-08. 1 gen-set has been provided in these institutions for 24 hr electricity supply.75 PHCs upgraded

7 6 25 PHCs being upgraded into 24 x 7 delivery centers in the current financial year.25 PHCs 135 Health Institutions given Rs. 20 lac each for up-gradation to IPHS level.Health Institutions New born care corners and blood storage units have been set-up in 25 EmOC centers.

8 7  Deliveries : (Appx.) Total deliveries4,90,000 per year Home deliveries2,35,000 (48 %) Institutional deliveries2,55,000 (52 %) Government Institutions(22 %) Private Institutions(30 %)

9 8  Deliveries in Govt. Institutions – 2007-08 & 2008-09: 2007-08 2008-09 upto Augustupto August 16,59920,990 (increase of 4391 i.e. about 26 % )

10 9  Deliveries in upgraded Institutions : Institutions 2007-08 2008-09 CHCs (50) 17142016 PHCs (75) 01675

11 10 JANANI SURAKSHA YOJANA Estimated No. of deliveries in a year in the state of Punjab = 4,90,000 Estimated No. of deliveries of BPL/SC/St @35% = 1,75,000 Estimated No. of Beneficiaries upto 2 living Children @50% = 87,500 Progress: YearBeneficiaries 2007-0829,256 2008-0913,683 (upto Aug.) Marginal Improvement:

12 11 ASHA 13,351 ASHAs appointed in 12,550 villages in the State (Jan. 2008).13,351 ASHAs As per norm of 1 ASHA for 1000 population, 4,398 more ASHAs are to be appointed. Training of master trainers of ASHAs at State level & district level has been completed. The training of ASHAs at the block level will be conducted in the month of October. Rs. 5.32 crore (Rs. 4,000/- per ASHA) given to ASHAs and Rs. 1.18 crore spent so far.

13 12  Efforts made by the Department :  Posting of Gynecologists has been rationalized and 19 Gynecologists who were earlier posted in dispensaries and PHCs have been posted in regular CHCs and District Hospitals.  Recruitment drive for Gynecologists on contract basis. Advertisement issued for the 3rd time (by 30/9/2008).  Advertisement issued for recruitment of 49 Gynecologists on regular basis.  Institution-wise monitoring of deliveries is done every month. Institution-wise monitoring  Gynecologist-wise monitoring of deliveries is done month wise. Gynecologist-wise monitoring

14 13  A pilot project of on-line data management of care of the pregnant women by ANMs and delivery details in 2 districts of the State is under process.  Recruitment process for filling up 511 vacant posts of ANMs and 954 second ANMs in bigger Sub-Centers initiated.  Department is going to monitor registration of pregnancies, Sub-Centers and Districts wise.  Data on status of ante-natal care in 25% population will be available in about 4 months time in the survey being undertaken (Sex-Ratio Survey).  Task for web based application for on-line monitoring of Pregnancy Registrations, Institutional Deliveries, JSY beneficiaries, Immunization, Family Planning Programme, Child Health Programme, Staffing Positions, Financial Reports etc. has been initaited, work allotted to Punjab Engineering College, will be completed by November 08

15 14  Constraints in MCH Interventions : We have not been able to fill up the following posts for the upgraded CHCs/ PHCs – 25 out of 50 Gynecologists in the 50 CHCs 31 out of 50 Pediatricians in the EmOC Centers 27 out of 75 Medical Officers (Female) in 75 PHCs

16 15 Main reason is difficult working hours and locations and less remuneration. Even doctors in Village Dispensaries under Zila Parishads are getting Rs. 25,000/- per month. Ayurveda and Homepathic doctors on contract basis have been given Rs. 20,000/- per month. Salary of Rs. 20,000 and Rs. 15,000 for Gynecologists and MO(F) not adequate. We are approaching GoI for its enhancement. There is erratic & inadequate supply of vaccines by GOI leading to gaps in immunization coverage.

17 16 There is shortage of Gynecologists, Pediatricians, Anesthetists. For posting of Gynecologists in EmOC centers, there is shortage of 25 out of 50. For posting of Pediatricians in EmOC centers, there is shortage of 31 out of 50. For empanelment of Anesthetists, there is shortage at 12 places. Female Medical Officers are not available at 27 places (24x7 PHCs). Staff Nurses are not available at 98 places. OT Assistants are not available at 35 places.

18 17 IndiaPunjab Birth Rate (SRS 2006) 23.517.8 Death Rate (SRS 2006) 7.56.8 Life Expectancy at birth 62.1568.25 Sex Ratio (Census 2001) 933876 IMR (SRS 2006) 5744 TFR (SRS 2005) 2.92.1 Maternal Mortality Ratio (SRS 2005) 301178 Ante Natal Care (at least 3 checkup) (%) (NFHS III) 50.772.5 Institution Delivery (%) (NFHS III) 4153 Contraceptive Use (%) (NFHS III) 5663.3 Vaccine coverage (%) (NFHS III) 4460 HEALTH INDICATORS

19 18 CHILD HEALTH INTERVENTIONS  Reducing early neonatal and neonatal deaths through home based and institutional care of the new born by creating awareness generation and inter-personal communication with special focus on management of hypothermia, asphyxia and infections of the new born.  Session wise computerized micro-plan of all the beneficiaries (PW & Infants) prepared for implementation of Immunization and MCH services as well as M&E. Micro-plan available on web-site.

20 19  Formats for M&E by DIOs and Civil Surgeons already in use. Scrutiny of formats undertaken at State HQ by SEPIO.  Supervision of Immunization and MCH Program by SEPIO.  4 districts i.e. Amritsar, Tarn Taran, Patiala & Ludhiana selected as IMNCI districts.  IMNCI trainings undertaken.  For promotion of breast feeding, NGOs have been involved. Baby friendly health initiative has been incorporated under which ANMs and Staff Nurses from Hospitals/ CHCs are to be trained.

21 20  34 sub-centers in the State & 16 slum areas in Distt. Ferozepur have been adopted for co- ordination in MCH services by NGOs.  Regular review meetings for sensitization and monitoring of Immunization and MCH Program held under the Chairpersonship of PSHFW.  Current status of male & female IMR will be available within 4 months from survey being undertaken in the State (by hiring an agency).

22 21 IMMUNIZATION COVERAGE YearBCGDPTOPV Measles TT-2 2005-06561406531806 510755534156 2006-07548285536117537564503062537810 2007-08516374498503 503062471736

23 22 FAMILY WELFARE PROGRAM TFR in Punjab as per SRS data 2006 is 2.1 which is practically the maintenance level. Progress: Progress YearVasectomyTotal Sterilization 2005-06 15,762 1,07,591 2006-07 5,615 93,758 2007-08 13,110 1,03,908 In the previous 3 years IUD insertions were 104.2%, 97.3% & 93.9% of ELA respectively.

24 23 PROGRAM MANAGEMENT State Program Management Unit- All the posts filled-up DetailsStatus Family Welfare Specialist1 Procurement Manager ( Vacant)1 Manager Finance & Accounts1 Manager (Monitoring & Evaluation)1 Manager Human Resource Development 1 State NGO Coordinator1 Programme Coordinator – ARSH & Gender 1 Programme Coordinator – BCC1

25 24  District Program Management Unit District Programme Management Unit RecruitedVacant District Programme Coordinator191 District Procurement Officer4 District Account Officer20- Monitoring & Evaluation Officer20- Maintenance Engineer17- District Accountant / Cashier191 District Statistical Assistant173 BCC facilitator164

26 25  Block Program Management Unit CategorySanctionedRecruitedVacant Block Statistical Assistant 11810216 Block Accountant cum Cashier 11810216

27 26  Mobile Medical Unit Mobile Medical UnitRecruitedVacant Medical Officer (F)173 Medical Officer (M)155 Radiographer173 Staff Nurse182 Lab Technician191

28 27  Staff for PHCs/CHCs Staff for PHC/CHCRecruitedVacant Female Medical Officer4827 Obstetrician25 Paediatrician1931 Anaesthetist3812 Staff Nurses37798 OT Assistant1535

29 28  Focused attention on improving sex-ratio.  Integrated approach of strict implementation of the PC & PNDT Act, advocacy & measures for cause of the girl child and empowerment of the women.  PNDT cell has been created at the State HQs under NRHM.  Sensitization workshops are organized at the State HQ as well as district level for orientation of Appropriate Authorities to various provisions in the PNDT Act & Rules.  11 Panchayats awarded Rs. 3 lac each in the year 2006-07 for improving sex-ratio to 1000 or more. PNDT & SEX-RATIO

30 29  This year there is provision of award of Rs. 1.5 lac each for 20 outstanding Panchayats that achieve child sex-ratio of more than 1000.  There is incentive of Rs. 20,000/- each for informers of violation of the PNDT Act.  There is incentive of Rs. 10,000/- each for decoy patients who help to nab violators of the Act.  Balri Rakshak Yojna, a State sponsored scheme has already been launched for the cause of the girl child.  99 court cases/ FIRs registered against violators of the PC & PNDT Act till date.

31 30  10 centers convicted by courts & 74 cases pending.  Direct action taken against 290 centers in the form of suspension/ cancellation of registration  As a result of strict implementation of the Act, number of sensitization workshops/ seminars/ conferences organized and awareness campaign undertaken, sense of fear is visible amongst wrong doers in the State.  As per SRS data pertaining to years 2004-06, child sex-ratio (0-4 yrs) has improved to 821 in contrast to 796 in the year 2001 which could have further declined to 765 in the absence of measures taken.

32 31  Contract for survey of sex-ratio of 25% sample of State population has already been awarded to an agency, out-come of which will throw light on current region-wise, financial status-wise, all ages sex-ratio & child sex- ratio scenario which will facilitate region-wise future strategy for improving sex-ratio in the State.  Lot of awareness generation activities are underway for bringing a change in the mind- set of the society in favor of the girl child as well as regarding important provisions in the PC & PNDT Act.  Few samples of display publicity are:

33 32 Why Female Foeticide ?

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39 38 BCC/ IEC Intra-communication with focus on NRHM interventions has already been started. 4 regional workshops were organized in the year 2007-08 for sensitization of district and block level stake holders to new interventions under NRHM. Focus has been given on inter-personal communication by holding seminars/ conferences/ meetings/ focused group meetings at various levels for creating awareness on NRHM interventions especially RCH-II. Besides paid publicity trust has been given on awareness through news items.

40 39 Publicity through hoardings at important public places, press advertisements, bus back & side panels, exhibitions, wall display panels, posters, song & drama shows, exclusive girl child competitions with focus on MCH & Gender issues is undertaken. Television, cable network, Radio (primary and FM channels) & folk media have been used for spreading important messages through TV spots, talks, interviews, discussions etc. Co-ordination with the NGOs by holding sensitization workshops on important themes.

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42 AllocationReleases/ Expenditure SNSub Components 2008-092008-09 1 Maternal Health235.0037.49 Janani Suraksha Yojna186.0093.00 2ASHA334.50396.03 3Child Health & IMNCI86.15.60 4Family Planning920.60266.78 5ARSH27.0710.02 6Urban RCH135.6032.90 7 PNDT Sex Ratio64.840 Innovations / PPP/NGO442.500 8 Infrastructure & Human Development1558.50236.93 Logistic Management 323.3440.08 Quality Assurance and Infection Control Programme HMIS Monitoring and Evaluation 9Training461.88285.49 10Behaviour Change Communications291.7640.75 11Procurement122.50125.91 13 Programme management Units SPMU and DPMUs 347.26260.25 12Flexi pool157.501.20 Total A (RCH II)5695.001827.43 PART A- RCH FLEXI POOL


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