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Government of Punjab Department of Health and Family Welfare. Punjab Profile Population : 2.77 crores (2011 Census). Health Infrastructure. Health Indicators. Health Indicators. Public Health Expenditure. Administrative Set up of the Department. Director Health and Family Welfare

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slide1

Government of Punjab

Department of Health and

Family Welfare

slide2

Punjab Profile

Population : 2.77 crores (2011 Census)

slide7

Administrative Set up of the Department

  • Director Health and Family Welfare
    • Primary Health Care, Disease Control Programme, Regulations of Act (Food and Drug) and General Administration.
  • Director Health Services (Family Welfare)
    • Implementation of Family Welfare, Maternal RCH, Immunization, JSY and PNDT Act.
  • Director Health Services (Social Insurance)
    • Manages 7 ESI Hospitals, 70 ESI Dispensaries for the insured industrial and other workers.
slide8

Administrative set up of the Department

  • Punjab Health Systems Corporation

Manages 176 secondary level hospitals.

Main agency of the Department for infrastructure development.

  • State Health Society

Manages and monitors implementation of NRHM in the state.

  • Directorate of Ayurveda
    • Manages 5 Ayurvedic Hospitals and 524 Ayurvedic Dispensaries.
    • Licensing Authority of Ayurveda Manufacturing Units.
    • Handles around 21 lac OPD patients per annum.
slide9

Administrative set up of the Department

  • Homoeopathy Directorate
    • Manages 264 dispensaries and handles around 27.00 lacs OPD patients per annum.
  • Punjab State AIDS Control Society
    • Implement Government of India sponsored National AIDS Control Programme.
slide10

Major Achievements of the Department

  • Infrastructure Development
  • The Government of India in its 4th report of the Common Review Mission published in January, 2011 rated our health infrastructure as excellent and stated that the Punjab would be the first state to close the gap by 2012.
  • Major initiatives for upgradation of infrastructure under the Core Plan.
    • Two district hospitals (Nawan Shahar, Muktsar under construction)
    • Five new Sub-Divisional Hospitals at Khadoor Sahib (complete), Bholath, Moonak, Tappa, and Guddha in advanced stage of completion and other 3 will be completed by 31.5.2012.
    • Upgradation of Sub-Divisional Hospitals at Baba Bakala and Badal to be completed by 31.5.2012.
slide11

Major Achievements of the Department

  • Construction of 32 new Community Health Centres. 10 to be completed by 30.4.2012 and the remaining 22 by 31.7.2012.
  • Manpower
  • Major recruitment drive in the last two years
    • Doctors recruited … 804
    • Doctors to be recruited by Aug 2012 … 525
    • Ayurvedic and Homoeopathy Doctors … 330
    • Staff Nurses … 1455
    • Paramedical Staff … 1600
    • Total No. of doctors presently available … 2143
  • Recruitment under process for 574 Specialist doctors, 518 Medical Officers, 114 Dental Doctors and 1650 paramedics.
slide12

Major Achievements of the Department

  • Free Emergency Response Services
    • 240 Ambulances operationalized.
    • These Ambulances attend to trauma, medical emergencies and delivery cases.
    • Daily 800 emergencies are attended. 1.60 lacs lives have been saved (till 14.4.2012).
    • Total project cost is Rs.70 crore.
  • Advanced medical Equipment
  • Aphersis machines, Blood separators, Phaco machines, Dialysis units, New Dental Chairs, Laboratory equipment provided in the hospitals.
slide13

Major Achievements of the Department

  • Drug-De-addiction Centre
  • 20 Bedded Drug De-addiction Centres operationalized at Talwandi Sabo. Drug De-addiction Centres in 7 district hospitals operationalized. In the remaining 13 districts, these would be operationalized in the current year.
  • 252 Awareness camps were organized for school children by Homoeopathy Department.
  • Cancer Control Programme
  • A corpus of Rs.30 crore was set up for financial assistance up to Rs.1.5 lac per cancer patient. 2329 patients were given assistance of Rs.25 crore.
slide14

Major Achievements of the Department

  • RashtriyaSwasthyaBima Yojana
  • An insurance cover of Rs.30,000/- to BPL families extended. 2.04 lacs BPL families enrolled. Rs.16 crore claims paid to the BPL families.
  • State Illness Fund
  • A corpus of Rs.2.50 crore established to provide financial assistance to BPL families up to Rs.1.50 lacs for treatment of terminal illness.
  • Trauma Centres
  • Three Trauma Centres at a cost of Rs.12 crore set up in Civil Hospitals, Pathankot, Amritsar and Jalandhar. 1 more at Khanna will be operational by May, 2012.
slide15

Major Achievements of the Department

  • Nursing Schools
  • 3 Nursing Schools i.e. at Jalandhar, Patiala and Amritsar were operationalized. 4 more at Gurdaspur, Bathinda, Sangrur and Ropar would be operationalized during the current year.
  • Super Specialty Cancer Hospital under PPP format
  • Two 200 bedded super specialty hospitals have been set up under PPP format at Mohali and Bathinda.
  • 5% of the revenue to be paid by the private providers (MAX Healthcare) to be utilized for treatment of poor patients
slide16

Major

Centrally Sponsored

Programmes

slide17

Flagship Programme:

National Rural Health Mission

  • The state signed a Memorandum of Understanding with Government of India on 15.6.2006 for implementation of NRHM in the state.
  • The main aim of the NRHM is to fill critical gaps in the delivery of Rural Healthcare Services in terms of civil infrastructure, equipment and manpower.
  • Implementation of Family Welfare, Mother and Child Healthcare Programmes alongwith selected Disease Control Programme in an integrated manner.
slide18

Flagship Programme:

National Rural Health Mission

(Goals of NRHM)

  • Reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR).
  • Universalize access to Public Health Services for Women’s Health, Child Health, Water, Hygiene, Sanitation and Nutrition.
  • Prevention and control of Communicable and Non- Communicable Diseases, including locally Endemic Diseases
  • Access to integrated comprehensive Primary Healthcare.
  • Ensuring population stabilization, gender and demographic balance.
  • Revitalize local health traditions and mainstream AYUSH.
  • Promotion of healthy life styles.
slide19

Flagship Programme:

National Rural Health Mission

  • As per latest official figures published so far:-
  • Infant Mortality Rate declined by 4 points from 38 in 2009 to 34 in 2010 as per SRS bulletin 2011 (very few states have achieved this target). IMR indicator of India is 47.
  • Maternal Mortality Ratio has come down from 192 (2004-06) to 172 (2007-09) as per SRS bulletin 2011. MMR indicator of India is 212.
    • Sex Ratio improved from 876 (Census 2001) to 893 (Census 2011). Sex Ratio of India is 914 (Census 2011).
slide20

Flagship Programme:

National Rural Health Mission

  • 2011-12 IS THE FIRST AND ONLY YEAR SINCE 2005-06 (The first year of start of NRHM in India) during which fund utilization has been more than 100% over approved plan
slide21

Flagship Programme:

National Rural Health Mission

  • Again, 2011-12 emerged as the First and only Year during which NRHM Punjab managed to get released additional Rs 22 Crore in excess of the approved GOI allocation to the state during the year as depicted below
slide22

Flagship Programme:

National Rural Health Mission

  • Janani Shishu Suraksha Karyakaram - A new scheme - JSSK was introduced during 2011-12 for providing ‘Free Delivery Services’ to pregnant women. Under this scheme free admission, diagnostics, drugs, consumables, blood and referral transport are provided. Institutional Deliveries in Government Hospitals have registered phenomenal increase as shown below:.
slide23

Flagship Programme:

National Rural Health Mission

Janani SurakshaYojana- (Cash incentive to BPL mothers for institutional deliveries @ Rs.700 for Rural & Rs 600 for urban area and Rs 500 for home delivery)

Under this scheme during 2011-12, there has been a spurt in number of beneficiaries availing benefits as shown below:-

slide24

Flagship Programme:

National Rural Health Mission

  • Strengthening of healthcare deliveries specifically Emergency Obstetric Care in Community Health Centres and strengthening of 24x7 delivery services in Primary Health Centres.
  • Establishment of 25 Blood Storage Units in 25 CHCs and in remaining 89 CHCs, the work is in progress.
  • For proper implementation of these schemes, 19 Gynecologists, 24 Pediatricians, 40 Female Medical Officers, 1131 Staff Nurses and 1282 ANMs have been recruited on contract basis under NRHM.
slide25

Flagship Programme:

National Rural Health Mission

  • National Vector Borne Disease Control Programme:
  • For effective control of the endemic Dengue and Malaria in the state.
  • National Iodine Deficiency Disorder Control Programme:
  • The Government of India has appreciated the efforts of the State IDD Cell in effectively implementing the programme and considers the model adopted as “Unique” in the country.
  • State and District IDD Labs established.
  • Survey completed in five districts (2011-12).
slide26

Flagship Programme:

National Rural Health Mission

  • School Health Programme
  • Extensive School Health Check-ups in all 19810 (Government + Government aided/recognized) undertaken.
  • Out of 33224 school visits planned, 32458 (98%) visits completed.
  • Under this programme 22.80 lacs students were examined and advised to get services through State Health Network where ever required .
  • School going children suffering from Congenital Heart Disease, Rheumatic Heart Disease, Cancer and Thalassemia are provided free treatment in PGI, CMC, DMC, Silver Oak, IVY and MD Oswal Cancer Hospitals – 735 RHD & CHD cases operated. 221 Cancer and 108 Thalassemia ailing children put on treatment.
slide27

Flagship Programme:

National Rural Health Mission

  • ASHA (Community Level Healthcare)
  • Total number of ASHAs selected : 16800 in villages.
  • Total number of ASHA Facilitators selected: 898
  • Total number of ASHAs trained : 16214
  • Total number of ASHAs provided with drug kits: 16463
  • State trainers have been trained
  • ASHAs have been provided with I-cards.
  • ASHAs have been provided with Uniform.
  • Bank accounts of ASHAs have been opened up and payment is being made through Bank account only
slide28

Flagship Programme:

National Rural Health Mission

  • Infrastructure Upgradation under NRHM
  • Continuing the effort, infrastructure up gradation of Health Institutions (All DHs, 25 SDHs, 123 CHCs, 246 PHCs and 460 Sub- Centres) undertaken.
  • Civil Works of Rs. 90 crores completed and of Rs. 50 crores under progress
  • The Maternity Wards and Labour Rooms of the District Hospitals are being upgraded. 11 work completed.
  • Major Civil Work has been taken up in 3 SDHs Patti, Pathankot & Batalawork has been completed.
  • CHCs Lehragagga being upgraded to 50-bedded Hospital at the cost of Rs. 3.08 Crore
  • CHC Dhakoli (Mohali) has been taken up for major construction at a cost of Rs. 292.25 lakh work and the work is completed.
slide29

FLAGSHIP PROGRAMME:

NATIONAL RURAL HEALTH MISSION

  • Infrastructure Upgradation under NRHM
  • Other important Civil Work under NRHM
  • Major Civil Work of 5 District Hospitals were undertaken. 4 Completed (Mohali, Ludhiana, Patiala & Bathinda) and 1 in progress (40% completed in Gurdaspur)
  • Civil Work at 211 PHCs undertaken. Work completed 140, Work assigned to Department of Rural Development 46.
  • Repair & Renovation of 253 Sub-Centres undertaken – Work at 127 completed, rest in progress.
  • 207 New Buildings of existing Sub-Centres are being constructed – 84 work completed.
slide30

Flagship Programme:

National Rural Health Mission

(Immunization)

  • No polio case in the state since 2009.
  • 2nd doze of measles – launched on 20/12/2010. All children receive Measles-2 along with DPT Booster at the age of 1½ years.
slide31

Flagship Programme:

National Rural Health Mission

  • Accessibility and promotion of Health Schemes
  • Service Guarantee
  • IEC & reference material for service guarantee designed and displayed for the service provider and community.
  • Unique Signages for the FRUs and 24x7 PHCs.
  • Protocol for EmOC displayed at labour room for reference.
  • IEC material on available services for community.
  • Radio & TV Spots, Print Media, Hoardings, LED Displays at prominent places and other folk media.
slide32

Flagship Programme:

National Rural Health Mission

  • Mainstreaming of AYUSH
  • Ayurveda
  • 524 Dispensaries and 5 (50-bedded) Hospitals, 7 ISM Wings in District Hospitals operational –Medical Officers & Dispensers provided alongwith that there is a provision of Rs. 50,000 for drugs for each institution.
  • Homeopathy
  • 111 Dispensaries operational –Medical Officers & Dispensers provided. Drugs worth Rs. 7 Lakh provided.
  • Co-location under NRHM
  • Provision of one Ayurvedic Doctor and Dispenser in 236 PHCs (24x7), one Homeopathy Doctor & Dispenser in 114 CHCs and two Homeopathy Doctor & Dispenser 20 DHs
  • 205 Ayurvedic doctors in PHCs and 104 Homeopathic doctors in CHCs recruited on contract basis under NRHM.
  • 182 Ayurvedic Dispensers in PHCs and 107 Homeopathic Dispensers in CHCs recruited on contract basis under NRHM.
slide33

Flagship Programme:

National Rural Health Mission

Proposed PIP Budget for the Financial Year 2012-13Rs. in Crores

slide34

Flagship Programme:

National Rural Health Mission

Proposed PIP Budget for the Financial Year 2012-13

slide35

Flagship Programme:

National Rural Health Mission

New initiatives proposed in PIP 2012-13

  • Free diagnostics through Mammography Units & cervical cancer among women.
  • Setting up of New Born Stabilization Units at 10 DHs, 12 SDHs and 6 CHCs conducting more than 50 deliveries.
  • Infant Death Audit – approximately 16000 deaths apprehended.
  • Programme for Cancer Control – screening camps in districts – 1080 camps and IEC.
  • Tobacco Control Programme – public awareness material & mobility support.
  • Capacity Building Programme for management units under NRHM i.e. Training of Government rules/ procedures etc. to all employees, employed under NRHM but never trained (Around 4,000)
  • Dental check-up of all school going children.
  • Besides this, during discussion with GOI a pilot project on universal screening of 40+age will be discussed to approve over and above the NRHM PIP.
slide36

Flagship Programme:

National Rural Health Mission

Highlights of the proposed PIP 2012-13

  • Implementation of Janani Shishu Suraksha Karyakaram, JSY and Family Welfare.
  • School Health Programme including routine check-up of all school going children and treatment of complicated diseases among children – CHD/ RHD, Thalassemia, Cancer etc.
  • Tracking Machines for 900 ultrasound centres.
  • Trainings - focusing on Maternal, Child Health and other programmes.
  • ASHA Programme – trainings, drug kits & incentives.
  • Mandatory Grants.
slide37

Flagship Programme:

National Rural Health Mission

Highlights of the proposed PIP 2012-13

  • Infrastructure up-gradation of 10 DH and 5 SDH based on NABH / ISO standards.
  • Construction of Maternity Ward at District Hospital Barnala and OPD Block at Sub-Divisional Hospital Khanna.
  • Construction of new building of 40 Sub-Centres and repair and renovation of 75 Sub-Centres.
  • Procurement and supply of equipment and drugs.
  • Contractual appointment of one AYUSH Doctor and Dispensers in all 24x7 PHCs (Ayurveda) in all CHCs, SDH and 2 in all DH (Homoeopathy).
slide38

Other major

Centrally Sponsored Schemes

Punjab Nirogi Yojana: Financial assistance to the tune of Rs. 1.50 lacs is being provided to BPL families for treatment of life threatening diseases

Rashtriya Swasthya Bima Yojana: Under this scheme, indoor medical care is being provided to a BPL family up to Rs.30000/- in the 147 Government and 185 Private Hospitals.

Establishment of Trauma Centre: It is a 100% Government of India sponsored scheme, 3 Trauma Centres has been set up and 1 is under completion.

Upgradation and Strengthening of Nursing Services (Human Resource Health): The Government of India has sanctioned Rs.50 crore for establishment of 5 Nursing Schools in the District Hospitals.

Strengthening of Teaching Facilities in Government Mental Hospital, Amritsar : This is a 100% centrally sponsored scheme.

slide39

Other major

Centrally Sponsored Schemes

Mainstreaming of AYUSH under NRHM for procurement and supply of essential drugs:

Upgradation of AYUSH hospitals.

Strengthening of Drug Testing Laboratory of Ayush.

Establishment of ISM & H Wing of District Allopathic Hospitals.

Establishment of 116 OPD clinics in PHCs.

Upgradation of Government Ayurvedic Dispensaries.

slide40

Other Major

State Plan Schemes

  • Providing Hotline facilities in the District and Sub Divisional Hospitals
  • Strengthening of Logistic Services
  • Strengthening of Hospital Management Information Systems
  • Strengthening of Fire Safety Services
  • Strengthening of Drug De-addiction Centres
  • Cancer Relief Fund
slide41

Other Major

State Plan Schemes

  • Strengthening of Urban Health Infrastructure
  • Establishment of Mobile Cancer Detection Units
  • Incentive for delivery under Mata Kaushalya Scheme
  • Incentives for IMR
  • Strengthening of Civil Registration System
  • Upgradation and extension of Ayurvedic Pharmacy and Stores.
slide42

Achievements under other

National Programmes

  • Tuberculosis Control Programme
  • All 20 Districts implementing DOTS programme and by July 2012, all will start implementing DOTS plus programme.
  • During 2011, total 39,206 patients enrolled.
  • Cure Rate of TB is 88%.
  • AIDS Control Programme
  • Punjab State is a high vulnerable State.
  • Estimated adult prevalence 0.32% (India : 0.31%)
  • Total HIV cases detected in ICTC 30466 cases
  • 8719 AIDS Cases undergoing treatment in 6 ART Centres in the state.
slide43

Achievements under other

National Programmes

  • Leprosy Control Programme
  • State is a low prevalence State.
  • Prevalence rate is 0.23 per 10000
  • 532 patients are under treatment
  • State has achieved the GOI goal i.e. <1/10000
  • Polio Eradication Programme
  • Polio free State.
  • No case of Polio in the State in 2010 and 2011
slide44

Achievements under other

National Programmes

  • Blindness Control Programme
  • 2.10 lakh cataract operations done in State in the year 2011-12 which is amongst highest per lakh population in the country.
  • National School Health Programme
  • 34.59 lakh students were medically checked up in 2011.
  • 4.03 lakh schools covered under Intensive Dental Health School Programme
slide46

PHSC MANAGES 176 SECONDARY LEVEL HOSPITALS

  • 19 District Hospitals (DH)
  • 2 Special Hospitals (SH)
  • 36 Sub-Divisional Hospitals (SDH)
  • 119 Block Level Community Health Centres (CHC)
  • One special Institute of Mental Health (Government Mental Hospital),
  • Amritsar.
  • New Upgradation and construction under Core Plan:
  • District Hospitals – 2
  • Sub-Divisional Hospitals : New – 5, Upgradation – 2
  • Community Health Centres : New – 29, Upgradation – 3
slide47

Performance of

Secondary Hospitals

slide48

Collection and Utilization

Of User Charges

  • User Charges which are collected by the Secondary level Health Institutions are being utilized by the hospitals itself
  • 45% of collections are being spent for purchase of drugs
  • 25% on improving facilities to patients
  • 15% each on building and equipment maintenance.
  • During the FY 11/12, Rs.30.28 crore user charges were collected as against Rs.26.33 crore during the FY 10/11.

CONT…

slide49

Collection and Utilization

Of User Charges

{Rs. Lakhs}

slide50

Important Projects of the PHSC

(Not Previously Covered)

  • Jan Aushadhi Stores in Districts
  • Implementation of Telemedicine Project
  • Monitoring Referral Ambulances Project
  • Strengthening of Mortuary Services
  • Accreditation of Hospitals with NABH and ISO
  • Strengthening of Physiotherapy Services
slide51

New Initiatives Taken

For Procurement of Drugs

  • Single rate contract in the state for purchase of
      • Medicines,
      • Consumables,
      • Scanning Material,
      • Lab. Reagents,
      • Hospital Linen and Hospital Furniture
  • Under different packages for the purchases being made by different Directorates / Wings of the Department from State Plan, Non-Plan, NRHM funds, Zila Parishads funds and user charges collections.
  • The tenders for all packages have been invited which are being received and will be evaluated.
slide52

New Initiatives for

Setting up Food and Drug Admn.

  • The Government of India has notified the Food Safety and Standard Rules, 2011 w.e.f. 5.8.2011.
  • The State Government has already appointed Commissioner for Food Safety.
  • The State Government has prepared a proposal to set up a separate Food and Drug Administration to fulfill the following objectives.
    • To enforce the Food, Drugs and Cosmetics Act fairly, to uphold safety standards and to protect consumers.
    • To set up the Drugs Technical Advisory Board, Drugs Consultative Committee, Indian Pharmacopoeia Committee and Central Committee for Food Standards.
slide53

New Initiatives for

Setting up Food and Drug Admn.

  • To regulate the analysis of samples of drugs and food through Drug and Food Control Laboratories.
    • To give additional revenue generation through an increase in fees.
    • To facilitate Human Resources Development through training and encouraging self-developmental efforts of employees.
    • To disseminate useful information to the public, industry and trade through meetings, lectures, organization of seminars, exhibition, workshops and brainstorming sessions.
slide54

Major Areas of Concern

  • Inadequate and untimely release of state plan scheme funds and state share of centrally sponsored schemes.
  • Vacant posts of doctors and paramedics. Presently, 1250 posts of doctors and 3600 posts of paramedics are vacant.
  • Non-availability of doctors of critical specialties like Gynaecologists, Paediatrics, Radiologists, Anaesthetists in the state (overall shortage)
  • Inadequate administrative staff in the Directorate, districts and specifically in newly formed districts.
  • Inadequate provision for office and POL expenses in Non Plan Budget.
slide55

Major Areas of Concern

  • Deteriorating conditions of residential quarters and non- availability of adequate funds for maintenance for which approximately Rs.25 crore is required.
  • Virtually non-existent maintenance provisions for hospitals. Around Rs. 15 crore is required every year.
  • Totally inadequate provision for security services in the hospitals. There is an immediate requirement of security personnel and installation of CCTV cameras.
  • Requirement of additional DG sets in the hospitals.
  • Requirement of additional ambulances in the hospitals
  • Insufficient provision for continuous trainings for clinical skills and

hands on trainings.

  • Insufficient provision for maintenance of equipment.