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State Health Action Plan Gujarat 2008-09

Goals: Reduce maternal and child mortality, address adverse sex ratio, stabilize population, implement national health programs effectively, enhance satisfaction with medical services, provide quality medical education. Actions include promoting institutional deliveries, preventing child marriage, improving antenatal and postnatal care, scaling up screening and care for pregnant women, addressing malnutrition, and controlling anemia.

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State Health Action Plan Gujarat 2008-09

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  1. State Health Action Plan Gujarat2008-09

  2. Our goals • Reduce • Maternal mortality • Child mortality • Address adverse sex ratio • Stabilise population • Effective implementation of national health programmes • Enhance satisfaction with medical services • Provide high quality medical education relevant to local needs

  3. Maternal health

  4. Institutional deliveries - increasing trend Focus on 100% institutional deliveries

  5. Poorly performing blocks

  6. Care of the motherSafe, Healthy & Wanted Birth of a Child • Prevent Child/Adolescent marriage (Social welfare/ Social defense) • Enhance Antenatal and post natal care through MAMTA Abhiyan (Health & WCD) • Care of expectant mothers with low BMI (WCD; health) • Scale up institutional deliveries through Chiranjeevi; extended chiranjeevi and Govt. Institutions strengthening (Health). Upgrading quality of environment and facility of labor rooms • Upscale screening of pregnant women for SCA and Thalessemia • Reviving Baby friendly hospitals – public and private (Health, FOGSI). Training of doctors in Intensive Neonatal Care Skills – Govt. & Chiranjivi (Health, FOGSI)

  7. Child health 2008-09 being celebrated as Nirogi Balak varsh with full backing and support of all departments of the state Government

  8. IMNCI Training

  9. No installation & training Irregular Upload Regular Upload Some Upload No Upload RIMS upload status As on 1 March’08 Gujarat is the only state in India which has uploaded their data for all districts on RIMS till Feb 2008 completely. Source:www.rimsindia.org

  10. Health care(Health & ICDS) • “IMNCI” upscaled to the entire state - Effective implementation • ‘Bal Chiranjeevi’ to ensure expert care in all areas in collaboration with private pediatricians – Public Private partnerships • Strengthening “Sick Newborn Care Units in District hospitals (Level 2 care) ” with stabilization units at all CEmONC centres, with all the human resources as well as equipments. • Developing separate neonatal department at medical colleges. Short term certificate course for doctors & nursing assistants for new born care • Distribution of ITNs to all BPL children in malaria endemic areas. • Audit of all deaths of mothers and children

  11. FW as a strategy to prevent mother and child deaths

  12. Special attention on male participation in family planning

  13. Addressing malnutrition

  14. Addressing Malnutrition • Formation of state nutrition cell • Nutrition support units in six regions at Medical colleges for technical oversight (Health) • Systematic growth monitoring for detecting FG/DG during MAMTA Divas (Health & ICDS) • Increase enrollment (by 6 lakh) & supplementation of ICDS (by 20%) to ensure focused coverage of all women with low BMI and underweight (FG/DG) children (Health and ICDS) • Common chain of command at the PHC level between WCD and Health for effective supervision & monitoring for health & ICDS • All village level functionaries to be sensitized and oriented for nutrition

  15. Addressing Malnutrition contd… 7. Identified mothers and children to be kept in the Child Development and Nutrition Resource centers (CDNC) to be set up in each block in the tribal belt and other underserved areas. (ICDS and Health) 8. Vit. A & IFA supplementation in primary school (Education & Health) 9. Growth monitoring in Primary school; referral for children with low BMI and Growth faltering (Education and health) 10. Grading of ICDS centres on the basis of malnutrition indicators based grading 11. Qualitative up scaling of Mid day meal (Education). Inclusion of Green Leafy Vegetables in food.

  16. Comprehensive Records

  17. RESIDENTIAL ARRANGEMENTS Proposed Child Development and Nutrition Center UNDERSTANDING THE GROWTH CHART

  18. Anemia control intervention • State specific Anemia management protocol for ANC and preschool children • Extension of Lifecycle approach including prophylaxis of under five, primary school children followed by Adolescent girls in schools and out of schools through Kishori shakti yojana • Regular deworming of under five & primary school children • Fortification of wheatflour • Addition of GLV in SNP (ICDS) & MDM (school) with introduction of community / kitchen garden concept • SCA and Fluorosis control interventions initiated • Intensive IEC/BCC drive focused on Anemia

  19. Addressing adverse sex ratio

  20. Sex ratio • “Beti bachao Abhiyan” Launched • Several community sensitisation and Advocacy seminars organised • District level Sensitisation workshops for members of FOGSI and Radiology association are done • IEC through Exhibitions, Rath, TV programs, News paper advertisements • 141 sonography machines sealed • 78 court cases registered under PNDT act - 2 sting operations carried out successfully • Sensitisation meeting with higher judiciary

  21. 144 Machine sealed 79 Court cases 17 32 37 34 32 34 # of Taluks with sex ratio less than 850

  22. Action taken on the comments of GOI

  23. ATN on the comments of GOI • Maternal health • NRHM additionalities • NRHM additionalities 2 • Adolescent health • IDSP • Training

  24. RCH • The Budget for RCH II has increased from Rs. 95.27 to 111.51 Crores. • The additionality is for establishing Programme Unit for Municipal Corporation (Rs. 19 Crores). • Training of ANMs / LHVs/FHW in IUD insertion for 2500 FHW or ANM (Rs. 1.05 Crores)

  25. NRHM • The Budget for NRHM has decreased from Rs. 333.67 to 319.5 Crores. Support for Insurance Project “Swasthya Bima Yojana” (Rs. 41 Crores) has been removed from the PIP.

  26. Immunization • The Budget proposed for Immunization has increased from Rs. 4.36 to 5.64 Crores. • The expenditure for Immunization is less because the vouchers are being submitted by blocks to districts. • RI fully on RIMS format • MICS being undertaken by the MCs • Therefore, budget for 2008-09 is justifiable and the proposed amount is required for strengthening RI. A new monitoring & supervision format to book expenses.

  27. Total Expenses (RCH, NRHM, EC & NHP)

  28. Summary Budget RCH-II

  29. RCH

  30. Quality of health careinfrastructure with NRHM funds

  31. Changing Scenario: Civil Hospital (Junagadh)

  32. GANDHIDHAM E TYPE STAFF QUARTERS

  33. Future directions CIVIL HOSPITAL – PROPOSED E BLOCK - VIEW

  34. Thank you Thank you Dr Amarjit Singh Commissioner, Department of Health Government of Gujarat

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