National Health Mission, Assam Department of Health & Family Welfare Key health issues of mothers and children in tea gardens and how the National Health Mission (NHM) is addressing those challenges in the field (Date: 5th November 2016) National Health Mission, Assam Department of Health & Family Welfare Government of Assam

Areas of Major concern From the analysis of Annual Health Survey, conducted by Registrar General and Census Commissioner, India; it reveals that, MMR in Upper Assam Districts which have more tea garden areas contribute most of the Maternal Deaths.

To find out the major gaps Comprehensive survey of all Tea gardens was carried out with the help of Regional Resource Centre for NE States (RRC-NE), Ministry of Health & Family Welfare, Govt. of India. Booklet on Tea garden study prepared for each Tea gardens covering Physical Health Infrastructure, Service Delivery system, Referral Transport system, Human Resource and Community level feedback.

Infrastructure Gap - Availability of Hospital Total 428 (57%) Tea gardens have functional hospital out of total 758 Tea gardens surveyed. Another 221 (29%) have hospitals but without even Dressing Room.

Availability of Medical Officer (Allopathic) Total 324 (49.9%) have Medical Officer (Allopathic) out of total 649 Tea garden hospitals.

Availability of Staff Nurse Total 258 (40%) have Staff Nurse out of total 649 Tea garden hospitals.

Availability of Labour Room Total 301 (46%) have Functional Labour Room out of total 649 Tea garden hospitals.

Availability of New Born Care Corner (NBCC) Total 118 (18%) have Functional NBCC out of total 649 Tea garden hospitals.

Availability of Laboratory Total 146 (22.5%) have Functional laboratory out of total 649 Tea garden hospitals.

To provide Comprehensive Primary Care to Tea garden population with special focus to Mother & Children

PPP with Tea garden hospitals MoUs signed with 150 PPP Tea gardens under NHM. Necessary health infrastructure developed including Labour Room, NBCC etc under PPP. Healthcare services provided to Tea garden population under PPP. Financial support @Rs. 7.50 Lakhs each per annum provided to these Tea garden hospitals. Rs. 6.00 Lakhs is for salary of Medical Officer, Pharmacist, ANM, GNM, lab technician etc. Remaining Rs. 1.50 lakhs is for incurring cost of hospital consumables, ambulance running cost, maintenance cost and laboratory supplies etc.

Community Level Services Antenatal care services, Postnatal Care services and Immunization Services are provided to Pregnant Women, Mother & Children of Tea garden Population in Village Health & Nutrition Day (VHND) organized on monthly basis. ASHAs are deployed in Tea garden areas to create a bridge between the health system and people. New 111 ASHAs are engaged from Tea garden community. Various awareness programmes are organized in Tea garden areas to increase the health awareness with special focus on Mother, Child and Adolescent. Screening & referral of children are carried out at AWC and Schools under Rashtriya Bal Swasthya Karyakram (RBSK) programme.

Referral Services 248 numbers of Ambulances were provided to Tea garden hospitals under NHM in addition to existing ambulance provided by Tea garden management. Mrityunjoy 108 – Emergency Referral Service and 102 – National Ambulance service is also provided to Tea garden population for timely transportation of patient & pregnant women.

Secondary and Tertiary Care Services Pregnant Women referred to FRUs, District Hospitals and Medical Colleges are provided free treatment under JSSK. Sick newborns are treated in SNCUs of District Hospitals and Medical Colleges. Sick children are treated in PICU of Medical College and District Hospitals. As malnutrition is a major problem in Tea garden areas, NHM has established 23 NRCs for management of severely malnourished children.

Dedicated Mobile Medical Units for Tea gardens National Health Mission, Assam is going to launch a ambitious project to provide Comprehensive Primary Care to all Tea gardens of the State by deploying 80 dedicated Mobile Medical Units. Each MMUs will have 2 vehicles per unit, first vehicle will be equipped with laboratory equipments and examination provision, the second vehicle will be smaller vehicle for transportation of Medical Officer, ANM, Pharmacist and Paramedical Staff. These dedicated MMUs will organize camps in each Tea garden as per fixed schedule to provide general health checkup including Antenatal & Postnatal checkup of mother. The MMUs will be equipped with diagnostics facilities, laboratory services and essential drugs.

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