1. Comprehensive Rural Health Services Project (CRHSP) Ballabgarh Centre for Community Medicine All India Institute of Medical Sciences (AIIMS)

2. AIIMS  AIIMS Derives its mandate directly from the Parliament of India.  Rated as One of the Top 10 medical institutions globally.  AIIMS Premier National Health Institute. 2 Source: On Line poll of Internationl online Phyiscian Network. India Today magazine June 2006 Issue.

3. Ballabgarh HDSS  Started in1961 with aid of Rockefeller Foundation.  Collaboration between:  All India Institute of Medical Sciences.  Haryana State Government.  Primarily an academic & health delivery set up  Initiated to support AIIMS training activities and consistent with requirement of a Medical College in India 3

4. Objectives of CRHSP  To evolve through practice and research a model of comprehensive health services which is replicable at national level.  To orient and train undergraduates and postgraduates in primary health care especially rural medicine. The mandate is therefore for training, research and health care delivery

6. Current Core team Dr. Chandrakant S. Pandav Dr. Sanjeev K Gupta Dr. Anand Krishnan Dr. Puneet Misra

7. Support faculty members Dr. Kiran Goswami Dr. Shashi Kant Dr. Baridalyne N. Dr. Bir Singh Dr. Y.S. Kusuma

8. Ballabgarh HDSS Field Team

9. Ballabgarh HDSS PHCDAYALPUR Chandawali Nawada Junehra Dayalpur Shahpur kalan Nirhawali PHCCHHAINSA Atali Fatehpur Billoch Naryala Chhainsa JayaLadholi Civil Hospital BALLBHGARH Population of 85522 (Dec 2008)

10. 10

11. 11 Crude Death Rate

12. 12 Neonatal Mortality Rate

13. 13 Infant Mortality Rate

14. 14 Immunization Coverage

15. Publications Over The Years Year of Publication NumbersPercentage 1969-1974 0503.4 1975-1979 0906.0 19801984 1006.7 1985-1989 2416.1 1990-1994 2214.8 1995-1999 2114.1 2000-2004 3825.5 2005- till date* 2013.4 Total 149100.0 15

16. Domains Of Publications. Domains of Publication FrequencyPercent 1. NCDs 3724.8 2. Child Health 3523.5 3. Communicable Disease 17 11.4 4. Women’s Health 1610.7 5. Health Systems/ Operational Research 1610.7 6. Demographic Surveillance 85.4 7. Medical Education 64.0 8. Others 1510.2 Total 149100.0 16

17. Major Historical Contributions in Public Health arena by CRHSP  Demographic issues  Realized the need for Denominators  Birth & Death registration by MPWs -1975. by MPWs -1975.  Documentation of rates and causes of death at different ages especially childhood 17 Focused on Demographic issues till about mid-eighties when focus shifted to disease specific projects

18. Major Historical Contributions in Public Health arena by CRHSP  Operational / Health System Research  Multipurpose Purpose Health Worker Scheme -1972.  Addition of Curative services to MPWs – 1973.  Computerized Health management information system- 1988. 18 Focused on delivery of health services to rural areas

19.  Pulse Polio strategy (vaccinating all on a single day) -1985.  Diarrhea epidemiology and control  ARI epidemiology and control  Measles Epidemiology and Control  Field trial of High Dose Iron & Folic Acid for Pregnancy-1987. Major Historical Contributions in Public Health arena by CRHSP 19 All address national health priorities and we have led the way

21. Facilitating the national response to epidemiological transition

22. Contribution in NRHM  Technical Support – Member of Task Force(s)  Indian Public Health Standards (IPHS)  Medical Education  Urban health  MOU with National Health Systems Resource Centre  Training - National Level trainers for  Integrated Management of Neonatal and Child Illnesses  Integrated Disease Surveillance Project  District Epidemiologists

23. Contribution in NRHM  Implementation –  Ballabgarh Block  Providing mentorship to two districts – Faridabad, Palwal  Evaluation  Janani Suraksha Yojana (JSY) evaluation in Jharkhand  Accredited Social health Activist (ASHA) and JSY evaluation in Faridabad

24. Future Plans- Infrastructure upgrade  Upgrading Infrastructure  New Hospital  New Community Health Centre  Extramural training- Hostels and training facilities  Telemedicine  Increasing the population base to over 100,000.  Stronger collaboration with District Level

25. Future Plans- Areas of interest  Disease Burden- Influenza, CVDs  Community Intervention Trials:  Vaccine –Influenza  Behavioral- NCDs  Neonatal Health care delivery Model

26. Collaboration with INDEPTH  Fertility Monograph  Mortality Monograph  Member of Following Interest Groups  NCDs  COPD  Vaccines and child survival  Sexual & Reproductive Health  Tuberculosis

27. Other Research Collaborators National  Indian Council for Medical Research  Media Lab Asia  National Health system Resource Centre  Ministry of Health & Family Welfare International  World Health Organization  Centers for Disease Control  University of Alabama

28. In Conclusion…….  Unique features of Ballabgarh HDSS  Forty eighth year of existence  Run by Public funds  Primary Health Care Service Provider  Run by Medical College  Computerized database since 1991  Monthly update of the database

29. Welcome to all of you from Balabgarh HDSS