NRHM

▪ Launched in 5 th April 2005 ▪ for 7 years ▪ Empowered Action Group(EAG)

Plan of action to strengthen infrastructure 1.Creation of a cadre of ASHA 2.Strengthening of sub centers 3.Strengthening of PHC 4.Strengthening CHC for FRU care

GOALS TO BE ACHIEVED BY NRHM

A. National Level ▪ IMR reduced to 30/1000 live births ▪ MMR reduced to 100/ ▪ TFR reduced to 2.1 ▪ Malaria mortality reduction – 50% by 2010, additional 10% by 2012 ▪ Kala-azar morbidity rate reduction – 100% 2010 ▪ Filaria/microfilaria rate reduction – 70% by 2010, 80% by 2012 and elimination by 2015 ▪ Dengue mortality rate reduction – 50% by 2010 and sustaining that level till 2012 ▪ JE mortality rate reduction – 50% by 2010 and sustaining that level till 2012

▪ Cataract operation – increasing 46 lakh per year by 2012 ▪ Leprosy prevalence rate – reduce from 1.8/10000 in 2005 to less than 1/10000 there after ▪ TB dots services – maintain 85% cure rate ▪ Upgrading of CHC’s to IPHS ▪ Increase utilization of first referral unit from less than 20% to 75% ▪ Engaging female ASHA’s in 10 states

B. AT COMMUNITY LEVEL ▪ Trained community level worker at village level ▪ Health day at anganwadi level on a fixed day/month ▪ Generic drugs for common ailments at sub-centre & hospital level ▪ Good hospital care through assured availability of doctors, drugs, quality services at PHC, CHC level ▪ Improved access to universal immunization ▪ Improved facilities for institutional deliveries ▪ Provision of household toilets ▪ Improved outreach services through mobile medical unit

Selection of ASHA

Role & responsibility of ASHA ▪ Create awareness & provide information ▪ Counseling of women ▪ Mobilize community and facilitate them in accessing heath and health related services ▪ Work with village health and sanitation committee of the gram panchayat to develop a comprehensive village health plan ▪ Escort/accompany pregnant women and children to health facility ▪ Primary medical care, DOTS provider ▪ Act as a depot holder ▪ Inform live births, deaths, outbreaks etc to sub centre/ PHC ▪ Promote construction of household toilets under toilet sanitation campaign

Role and integration with Anganwadi ▪ Organize health day once/twice a month ▪ AWW & ANM will act as resource person in training of ASHA ▪ IEC activity on these days ▪ AWW ll be depot holder of drug kits and ll be issuing it to ASHA ▪ AWW ll update the list of eligible couple & children less than one years of age in the village with the help of ASHA ▪ ASHA ll support AWW in mobilizing pregnant, lactating women and children for nutrition supplement and also mobilize them to anganwadi centre to avail services

Role and integration with ANM ▪ ANM will hold weekly/fortnightly meetings with ASHA ▪ ANM will inform ASHA the date & time for outreach session and also guide her for bringing the beneficiary to the outreach session ▪ ANM will participate & guide in organizing health day in anganwadi ▪ ANM will take help from ASHA in updating eligible couple ▪ will utilize ASHAs help in motivating pregnant women and married couple to go to sub centre for check up and family planning services respectively

▪ ANM will guide ASHA in motivating pregnant women for taking IFA tablets, TT etc ▪ ANM will orient ASHA on dosage and side effects of OCPs ▪ ANM will educate ASHA the danger signs of pregnancy and labour ▪ ANM will inform time, date and place for initial and periodic training schedule and also ensure she gets compensation for performance and also TA/DA for attending the meeting

New initiatives (June 2011) ▪ Home delivery of contraceptives by ASHA ▪ Conducting District Level Household Survey(DLHS)- in states where Annual Health Survey(AHS) is not being done ▪ Modifications in the scheme for promotion of menstrual hygiene ▪ Involving ASHA in Home Based Neonatal Care (HBNC) ▪ Village health and sanitation committee to Village Health, Sanitation and Nutrition Committee (VHSNC) ▪ AYUSH hospitals and dispensaries for mainstreaming AYUSH under NRHM ▪ Revision in the criterion of allocation of funds to states under NRHM based on performance of states

▪ Monitoring and evaluation under NRHM

▪ NRHM + NUHM = NHM ▪ USHA