1. Integrated District Health Society SOUTH DISTRICT NRHM
Dr. JYOTI SACHDEVA
PO, NRHM

2. NRHM Launched by the Prime Minister on 12th April, 2005.
Focuses on 18 states (EAG) including eight Empowered Action Group (EAG) States, the North-Eastern States, Jammu & Kashmir and Himachal Pradesh.
Aims to focus on the 18 states having weak public health indicators (Arunachal Pradesh, Assam, Bihar, Chhattisgarh, H.P, Jharkhand, J&K, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura, Uttaranchal and Uttar Pradesh).
Enhancing the commitment of the government to raise expenditure on public health from 0.9 % to 2-3 % of GDP

3. A OBJECTIVES ccessible ccountable cceptable ffordable Strengthening
All Levels
Primary
Secondary
Tertiary
ccessible
ccountable
cceptable
ffordable
Quality Care
Rural & Vulnerable
Equitable
Strengthening
Communitization
IEC

4. GOALS Universal Access Prevention and Control of CD &NCD
Access to integrated comprehensive Primary Health Care
Reduction in IMR & MMR
Population Stabilization, Gender and Demographic Balance
Revitalize local health traditions and mainstreaming AYUSH

5. STRATEGIES
Decentralized Planning (Inter State & Inter District Profile)
ASHA
Strengthening of Primary Health Care Infrastructure
Ensuring Quality
Promotion of Non Profit Sector
New Health Financing Schemes
Integration of ongoing disease control Programs

6. SUPPLEMENTARY STRATEGIES
Regulation of Private Sector
Promotion of PPP
Mainstreaming AYUSH
Reorienting Medical Education
Effective and Viable Risk Pooling and Social Health Insurance
Convergence

7. GOALS (NPP - Immediate)
Maternal Mortality Rate (MMR) reduced from 407 to 100 per 1,00,000 live births.
Infant Mortality Rate (IMR) reduced from 60 to 30 per 1000 live births.
Total Fertility Rate (TFR) reduced from 3.0 to 2.1
Effective healthcare to rural population.
Increase public spending on health from 0.9% GDP to 2-3%.

8. NRHM – 5 MAIN APPROACHES COMMUNITIZE
Hospital Management Committee/PRIs at all levels
United grants to community/PRI Bodies
Funds, functions & functionaries to local community organizations
Decentralized planning, Village Health & Sanitation Committees
MONITOR, PROGRESS AGAINST STANDARDS
Setting IPHS Standards
Facility Surveys
Independent Monitoring Committees at Block, District & State levels
FLEXIBLE FINANCING
United grants to institutions
NGO sector for public Health goals
NGOs as implementers
Risk Pooling – money follows patient
More resources for more reforms
INNOVATION IN HUMAN RESOURCE MANAGEMENT
More Nurses – local Resident criteria
24 X 7 emergencies by Nurses at PHC, AYUSH
24 X 7 medical emergency at CHC
Multi skilling
IMPROVED MANAGEMENT THROUGH CAPACITY
Block & District Health Office with Management Skills
NGOs in capacity building
NHSRC/SHSRC/DRG/BRG
Continuous skill development support

9. CONVERGENCE
SANITATION
NUTRITION
HEALTH
WATER SUPPLY
EDUCATION

10. Convergence with ICDS Provision of Weighing machines. IEC Material .
Training of 257 CDPOs / Supervisors.
Malnutirtion / anemia -- planning Commission parameters.
Identification of malnourished and anemic children / woman and targeted supplementation / counseling / monitoring .

11. Involving the Community (Communitisation)
ASHA
ROGI KALYAN SAMITI
HEALTH AND SANITATION COMMITTEES

12. COMPONENT ASHA (ACCREDITED SOCIAL HEALTH ACTIVISTS)
Chosen by and accountable to the panchayat.
Functions of ASHA
Advice rural community regarding
Immunization, ANC registration, institutional delivery contraception and sanitation, hygiene, etc.
Treatment for
Minor ailments like- diarrhea, minor injuries and fever.
Accompany patients
To health facilities.
Deliver DOTs
Overall bridge between the ANM and the village.
Facilitate preparation & implementation of the Village Health Plan.
Eye Care

13. FLOW CHART SPMU DPMU BPMU NATIONAL MISSION DIRECTOR STATE MISSION
NRHM
CELL/NHFW
SPMU
DPMU
BPMU
NATIONAL MISSION
DIRECTOR
STATE MISSION
DISTRICT MISSION
BLOCK PUBLIC
HEALTH
MISSION
NHSRC
SHSRC
DHSRC
BHSRC
PROGRAMME MGT.
PROG. SUPPORT
TEC.
SUPPORT
National Level
State Level
District Level
Block Level

14. Decentralization
State specific
District specific
CNAA

15. PLAN Feedback See Do Needs Assessment Ex- post Evaluation
Ex-ante Evaluation
(Evaluaability / Design Assessment)
Feedback
Post Implementation
Decision of Implementation
Monitoring
See Do
Implementation
Terminal
Evaluation
Mid- term
Evaluation
Process
Evaluation

16. Department of Health & Family Welfare
State Health Society
GOI / State
Additionalities
DHS DSHM DFW
NPCB
NVBDCP
NIDDCP
IDSP
Convergence with agencies / Departments /Programs
Standardization & Strengthening of Health Infrastructure to address heterogenity / multiplicity/ and give quality healthcare.
Community involvement
RKS / ASHAs
IDHS
PPIP
NLEP
RCH
Department of Health & Family Welfare
RNTCP
State Health Society – ALL the key players 16

17. Faster/ More logical solutions
Decentralization levels
Planning
Accounts
Implementation
Procurement
Recruitment
Reporting
Monitoring
Faster/ More logical solutions

18. Chairman District Health Society (Deputy Commissioner)
Mission Director
(Chief District Medical Officer)
ACDMO
PC PHDT & QAC
District NRHM/ ASHA
District RCH Officer
DNBCP Officer
NLEP Officer
IDSP Officer
District Immunization, NVBDCP & NIDDCP Officer
District Programme Management Unit
DPM
DTC
MIS
BCC
DAM
ASHA, MCD, IPP – VIII
(Nodal Officers)
Monitoring
Committees MO
Specialists
Paramedics

19. Imp. Agencies to District Reporting Back of Exp. To State
PIP approved
by GOI
Funds
transferred
to States
transferred to
Districts
Funds transferred
to PHC/CHC/Other
Impl. agencies
Reporting Back of Exp.
from PHC/CHC/Other
Imp. Agencies to District
Reporting Back
of Exp. To State
Reporting Back of
Exp. To Centre With
UC and Audit Report

20. Strengthening of District Infrastructure
DPMU
DISTRICT STORE
DISTRICT TRAINING CENTRE
DISTRICT BCC CELL

21. Strengthening of Primary Infrastructure
Potential PUHCs
Every PUHC is to cater to a population 50,000 each.
The essential elements of a PUHC are Preventive, Promotive, Curative and Rehabilitative Primary Health Care
The PUHC has to upgraded as per the Public Health Standards laid down by Department of Health & Family Welfare
It aims at Community Participation and Community Linkage through Rogi Kalyan Samiti and ASHA respectively.

22. Strengthening of Primary Infrastructure
Potential PUHCs
DGD (18)
MCD
( Including IPPVIII)
Health centers
attached to Maternity Homes
Non ASHA
ASHA
Units 9
10 M &CW +2 IPP VIII =12
1+0
0+1
3+0
Chaterpur
Molarband
Sangamvihar K-II
Sangam vihar D Block
Tajpur
Batla House
Sarai kalekhan
Kalkaji
Begampur
Ber Sarai,
Chirag Delhi,
Garhi,
Khanpur,
Madangir,
Sriniwaspuri,
Sunlight Colony
Dakshinpuri
Jonapur
M&CW Center
Madanpur Khadar
Fatehpur Beri
Meharauli
Tugklabad
Nehru nagar
Jaitpur
Dakshinpuri Block – F 5
Madangir
Badarpur
(IPP VIII)
Okhla Phase1
Nehru place
Defence Colony
IPP VIII
Jungpura
Shri Niwaspuri
Total Potential PUHC = 32 (18 DGD +11 M&CW +3 IPP VIII)

23. Strengthening of Maternity Home
Strengthening of Secondary
Health Care

24. Coverage of Unserved/Underserved Areas
SEED PUHC
Projected – 13 (in )
Functional - 7
Under Process – 2
Functional -1, (D5 Sangam Vihar)
MOU done for -3 Seed PUHCs (Tughlakabad, Sangam Vihar H-Block, Aaya Nagar)
Harkesh Nagar, Meethapur Extn, Sangam Vihar L2, ABC Block, Abul Fazal Enclave
Projected – 2 (in )
Madanpur Khadar Extn.

25. Public Private Partnership
MAMTA
BPL/SC/ST
Move with private nursing home Mamta Friendly Hospital
Antenatal/Intranatal Services/Postnatal/Early Neonatal
Rs 4000/- per centre
ARPANA TRUST - NGO

26. HMIS Decentralization of Reports- District - Facility Tracking System
Eye Related Activities

27. THANK YOU