National Rural Health Mission      

 

 

National Rural Health Mission launched in April, 2005

*      Rejuvenate the Health delivery System

*       Universal Health Care

-          Accessible

-          Affordable

-          Equitable                                                                                                                       

-          Quality care

Goals –

*      Reduction of Infant Mortality Rate (IMR)

*      Reduction of Maternal Mortality Ratio (MMR)

*      Reduction of Total Fertility Rate (TFR)

*       Universal Access to Public Health service viz. Women’s Health/Child Health, Water Sanitation Hygiene and Nutrition.

*      Prevention and Control of Communicable and Non Communicable Disease,

*      Population Stabilization, Gender & Demographic balance

*      Main Streaming AYUSH

*      Promotion of Healthy Lifestyle.

                                            

 Strategies –

*         Improve Infrastructure

*          Augment manpower

*          Improve management

*          Flexibility to states to deploy funds

*          Decentralization

*         Communitization

The Paradigm Shift –

  Community Participation

  Flexible Funding at all levels

  Governance reform

•          Manpower Management

•          Logistics & Procurement processes.

•          Decision making processes

•          Institutional design

•          Accountability framework

  Convergence

•          Water and sanitation

•          Nutrition

•          Education

New Paradigms under NRHM -

*         Community Link Worker – ASHA Supervisor /ASHA

*         Involvement of PRIs through Village Health & Sanitation Committee

*         Reforms in Medical Education – Compulsory Rural posting of Doctors

*         Integration of AYUSH

*         Better programme management through recruitment of Management Experts, Accountants, Computer Experts

Action Taken to Reduction MMR –

  1. Implementation of JSY & JSSK
  2. Micro Birth Planning:

*         Early Registration (1st Check-up) before 12 weeks, *2nd Check-up 16-20 weeks, *3rd check-up 28-32 weeks * 4th Check-up 36 weeks

*         Promoting Institutional Delivery: Identifying the Institution for delivery as per merit.

*         3 Post Natal Check-up: Within 48 hours/within 1st week/within 6 weeks

*         Involvement of ASHAs equipped with drug kit and pregnancy kit for maternal and child health care.

*         Support to ASHAs by appointing 18 ASHA Supervisor. 

*         Organizing Village Health & Nutrition Day every month.

*         Micro Birth Planning by the ANM for all the pregnant women

*         “Mamoni” Nutritional Support of Rs. 1000/- to pregnant women – an initiative by Govt. of Assam.

*         Cash assistance to mothers under JSY scheme.

*         Encouraging mothers to stay in the Hospital up to 48 hours after delivery to prevent post partum hemorrhage by providing Baby Kit (Mamata Kit).

*         Training of ANMs/Staff Nurse for SBA

*         Training of Medical Officers on EmOC/BEmOC and LSAS

*         All the SCs have been provided with SC Kit – A and B.

*         Up-gradation of Sub Center for Delivery (191 SCs taken up in 14 high focus districts).

*         Rural Health Practitioners have been posted in the Sub-centres

*         Compulsory one year Rural Posting for  MBBS doctors to get admission in the  PG courses.

*         Construction of Labour Room/ Ward in PHC/SD/SHC and operationalizing as 24X7.

*         Up-gradation of SDCH/ CHC to First Referral (FRU) Unit having specialist doctor with provision of C-section operation and Blood Storage facility.

*         Strengthening of referral mechanism from village to Health Institutions through ‘108 Mrityunjoy’ Emergency Referral Transport and by providing ambulances to health institutions.

Hospital Functionality –

Services to be available in 24 X 7 PHCs

*         24 hours delivery – normal and assisted

*         Essential newborn care

*         Referral of emergencies

*         Antenatal care and routine immunization of children and pregnant women

*         Post natal care

*         Family planning services (IUCD, OCP and CC)

*         Essential Laboratory services.

To Reduce IMR –

  IMNCI Training of AWW & ANMs

  NSSK training to the Health Care Provider working in 24x7 PHC.

  Constructing New Born Care Corner along with labour rooms of 24x7 PHC.

  Strengthening Routine Immunization with special focus in Difficult areas.

  Special Vit. A and Deworming drive bi-annually.

  Establishment of Sick Newborn Care Unit in District Hospital (6 functional)

  Establishment of Newborn Stabilization Unit in all the SDCH/ CHC/ PHC, manpower training under process)

  Setting up of Nutritional Rehabilitation Center for malnourished children.

To Reduce TFR –

  Fixed day sterilization in all the District Hospital.

  Special monthly sterilization camp in CHC/ PHC

  IUCD insertion facility in all Govt. hospital and Sub Center

  No scalpel Vasectomy (NSV) camp cum training

  Training of Medical Officers and O&G Doctors on Mini Lap and Laparoscopic Sterilization

  Training of ANMs, Staff Nurse and Medical Officer on IUCD insertion.