|NRHM State PIP presents an overview of the different activities that are to be taken in the year 2007-08 in order to boost the health scenario of the region keeping in mind the mission’s main objective of making the health facilities easily available and accessible to the rural people.
The main goals of RCH II programme in Assam are reduction of MMR from the current 490 (NFHS- 3) to less than 350 by the year 2007-08, IMR from 66 (NFHS – 3) to 58 by the year 2007-08, reduction of Total Fertility Rate from the current 2.42 (NFHS 3) to 2.2 by the year 2007-08 and an increase of contraceptive prevalence rate among eligible couples from the current 56.5 % (NFHS – 3) to 65% by the year 2007-08.
Main Strategies adopted to achieve these goals are:
- Focus on quality antenatal care to all pregnant women by increasing the access through existing Govt. facilities.
- Quality improvement of the ANC through reorientation.
- To increase awareness amongst mothers and communities about the need of ANC.
- Focus on 24-hour institutional delivery with basic emergency care in all PHCs and referral of obstetric emergencies.
- Social mobilization for institutional deliveries by involvement of MSS, Mahila Mandals, PRI through orientation to motivate pregnant women and their families for institutional delivery.
- Focus on selected CHCs (across the state) becoming venues for comprehensive emergency obstetric care.
- Building up of transport and referral systems.
- Involvement of Pvt. Sector hospital to deliver basic & comprehensive EmOC.
- Ensuring clean home deliveries by skilled birth attendants in uncovered and SFG areas.
- To reduce unsafe abortion by increasing access to safe abortion in Govt. & Pvt. facilities and promoting awareness about harmful effect of unsafe abortion amongst women, community, PRI.
- To increase institutional delivery by continuing with the JSY Scheme.
- To provide routine immunization including the booster dose to all children by strengthening sub-centre level services and increasing access through Govt. and Pvt. facilities.
- Prompt and appropriate community level care for all sick children and neonates and prompt referral where indicated.
- To increase awareness amongst mothers on benefits of immediate breast feeding and need and importance of exclusive breast feeding for 6 months and supplementary feeding from 6 month onwards.
- Improve management of children with ARI and diarrhoea and reduce deaths due to it.
- Adequate referral arrangement and strengthening health facilities for treating a sick child or neonate when it requires hospitalization.
- Involvement of Pvt. Sector hospital to provide new born care services.
- To standardize the case management of sick newborn and children under IMNCI.
- To raise awareness amongst couples, communities and PRIs about the contraceptives and advantage of small family.
- Increase the number of service delivery points and to promote contraceptive use through social marketing.
- Focus on quality male & female sterilization and conduction of sterilization camps in uncovered areas.
- To improve the number and skill of service providers by training of doctors on lap sterilization and NSV, training of GNMs to assist lap sterilization and ANMs on IUD insertion.
- Public Pvt. partnership for increasing contraceptive use and sterilization.
- To educate and raise awareness amongst the adolescent boys and girls about human physiology, RTI, STI, HIV/AIDS, EC and safe sex.
- To open adolescent health clinic at block level.
Programme Management arrangements:
For strengthening of planning and implementation and to build capacity at the level of State, district and below for good governance, decentralization of powers and professionalism management structures has been proposed as follows:
The State Programme Management Unit will be strengthened with an additional State Programme Manager, Finance Manager, Consultant- Maternal Health, Consultant-Child Health, HMIS Consultant, Consultant ASHA, Procurement Expert, BCC Expert and HRD Consultant and setting up of a Construction cell to look after the civil works under the mission.
At the district level, the District Programme Management Unit will continue to support the Health Society with the Programme Manager, Media Expert, Accounts Manager and Data Manager
At block level, the Programme Management unit which comprises Block Programme Manager and Accounts Manager will continue to work in co-ordination with other related departments and involving PRIs.
To improve the skills of the health manpower, various trainings have been proposed. It has also been proposed to improve the infrastructure of the lone training institute of the state, i.e., SIHFW. The Plan also highlights some of the initiative that will be implemented under the mission like construction of new PHCs, introduction of Boat Clinic in char areas, emphasis on PPP with the tea garden hospitals, construction of Sick Newborn Care Unit, ORT corner, Adolescent Clinic, Homeo Clinic and Oncology wards.
Various other innovative concepts like Mobile Medical Units, introduction of Health Insurance on pilot basis, conceptualizing HMIS on a broader dimension etc have been proposed.
Strategic interventions have also been undertaken for improving immunization with improved focus on char and outreach areas.
Upgradation of the 3 tertiary hospitals (GMC, AMC and SMC) have also been proposed.
To reduce incidence of prominent diseases like malaria, TB to name a few, various strategies has been reflected in the PIP.
Steps have also been initiated to ensure convergence with the key stakeholders, so as to run the programme effectively.
Growth Rate of State Government’s Budget:
|Buget Estimated/Revised Budget (in Crs)
For the year 2007-08, similar trend is estimated.
The state proposes a total budget of Rs. 868 crores for the year 2007-08. The budget summary along with the actual requirement for the year is as follows:
BUDGET SUMMARY FOR NRHM FOR 2007-08 (Rs. in crore)
|Budget estimate for 07-08
||Remarks (Fund required for 2007-08)
||Reproductive and Child Health Programme II
||Universal Immunization Programme
||National Disease Control Programmes