Health Department,

ZP Amravati

 

General information


Sr. No.

Subject

Amravati District

Tribal Department

1

Total Population (as per 2001 census)

26,06,063

2,37,936

2

Survey Population (as on 2009)

26,70,000

2,84,524

3

Total Blocks

14

2

4

Geographical Conditions (per sq.km.)

12,212

3,957

5

Total Villages

1,394

334

6

Sex Ratio

938

948

7

District General Hospital

1

0

8

District Women Hospital

1

0

9

Sub-District Hospital

4

1

10

Rural Hospital

9

2

11

Primary Health Centre (PHC)

56

11

12

Sub-Centers (SC)

333

95

13

Ayurvedic Dispensaries

65

4

14

Allopathic Dispensaries

19

1

15

Primary Health Units (PHU)

12

6

16

Mobile Health Units

8

7

17

Anganwadi

1,477

344

18

Total Ashram Schools

36

27

19

Literacy Rate

59

48

 

Present Status of Health Indicators (2009-2010)

Sr.No.

Health Indicators

Amravati District
(SCD 2007)

Melghat Region

1

Birth Rate

14.56

23.07

2

Death Rate

6.96

6.92

3

Infant Mortality Rate (IMR)

35.24

54.00

4

Child Death Rate

7.90

14.65

5

Maternal Mortality Rate (MMR)

1.71

2.24

6

Institutional Deliveries

83.76

44.12

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Aims for recent years:-

1) To provide effective healthcare to rural population throughout the district with a special focus on Dharni and Chikhaldara blocks which have weak public health indicators and weak infrastructure,
2)  Special focus on Melghat Region,
3) To rise public spending on health with improved arrangement for community financing and risk pooling,
4) To undertake infrastructure development of the health system to enable it to effectively handle increase allocation and promote policies that strengthen public health management and service delivery in the district.
5)  Effective integration of health through de-centralized management at PHC level with determinants of health like sanitation and hygiene, nutrition, safe drinking water, gender and social concern.
6) To improve access to rural people especially poor women and children to equitable, accountable and effective primary health care.
Goals, Strategies and Out-come:-
Health Department is to bring about dramatic improvement in health system and the health status of the people, especially those who live in Melghat region of the district.
This new strategy seeks to provide quality healthcare, reduction of maternal and child deaths as well as population stabilization, gender and demographic balance. To achieve these goals health department will:-

  • Facilitate increased access and utilization of quality health services by all.
  • Develop a partnership between other departments and NGOs.
  • Setup a platform for involving the Panchayat Raj institutions and community in the management of primary health programmes and infrastructure.

Objectives:-

  • Reduction of Infant Mortality Rate (IMR) to 30,
  • To reduce Maternal Mortality to 1,
  • To achieve Total Fertility Rate (TFR) up to 2,
  • 100% Institutional Delivery,
  • To maintain Birth Rate to be static or less than 15.00.
  • Infrastructure Development of Sub-Centers,
  • Community based monitoring,
  • Prevention and control of communicable and non communicable diseases,
  • Initiation of Daycare Centre to reduce the Grade III and Grade IV malnutrition,
  • Initiation of Nutrition Guidance Centre (NGC).

 The expected out-comes at community level:-

  • Availability of trained ASHA at village level with drug kit for generic ailments,
  • Health Day at Anganwadi level on fixed day for provision of immunization. ANC, PNC check-up and services related to mother and child health care, including nutrition,
  • Availability of generic drugs for common ailments at PHC level and Sub-Centre level,
  • Access to good hospital care through assured availability of doctors, drugs and quality services at PHC level and assured referral – transport – communication systems to reach these facilities in time.,
  • Improved facilities for institutional deliveries through provision of referral transport, improved hospital care subsidized under Janani Suraksha Yojna (JSY) for below poverty line families,
  • Improved outreach services to medically underserved remote areas through mobile medical units in Melghat region,
  • Increase awareness about preventive health including nutrition.

The core Strategies:-

  • Promote access to improved health care at household level through female health activist (ASHA),
  • Health plan for each village through village health committee of the Panchayat,
  • Strengthening Sub-Centre through better human resource development, clear quality standards, better community support and untied fund to enable local planning and action,
  • Strengthening existing PHCs through better staffing and human resource development policy, clear quality standards and better community support,
  • Preparation and implementation of inter sector of District Health Plan prepared by District Health Mission including drinking water, sanitation, hygiene and nutrition,
  • Strengthening capacities for data collection, assessment and revive for evidence based planning, monitoring and supervision,

 

Special Focus:-

 
It has been identified the 2 blocks (Dharni and Chikhaldara) for special attention. These blocks are the ones with high IMR, MMR and increase of Grade III and Grade IV malnutrition. Along with this, Melghat region has weak public health infrastructure. In the Melghat region particularly, PHC – Kalamkhar, Bijudhawadi, Bairagad and Sadrawadi are having high IMR pocket areas. It is also articulated with a need to cover all the PHCs in Melghat region while planning for District Health Plan.

 

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Different Schemes under NRHM implemented in Amravati District


1) Janani Suraksha Yojna (JSY):-
Through this scheme, ANC women are promoted for the conduction of institutional deliveries and main corner stone of this scheme is to reduce Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR).
The terms and conditions of this scheme are:-

  • ANC women should be BPL Card-holders (Rural and Urban areas),
  • Scheme valid up to only 2 issues,
  • During ANC registration, mother’s age should be at least 19 years.
  • This scheme is applicable to women of SC and ST communities of society.

Honorarium to such ANC women:-

  • If the delivery is conducted in the institute, an honorarium of Rs. 700/- is given to ANC women within 7 days.
  • For home delivery, Rs. 500/- as honorarium.
  • For Caesarian section, Rs. 1500/- as honorarium is given.

 
2) Matrutva Anudan Yojna:-

During ANC Period, hard-work is dangerous to health of the mother, so that during first trimester there may the chances of abortion. Due to this reason, ANC registration should be as early as possible and regular check-up is necessary.
The terms and conditions of this scheme are:-

  • This scheme is applicable to all institutional deliveries including both Government and Non-Government institutes.
  • BPL Card-holders (Rural and Urban areas).
  • Honorarium to such ANC women is Rs. 400/- by cash and Rs. 400/- is given for medicine.
  • If the delivery is conducted in the institute, an honorarium of Rs. 400/- as cash is given to ANC women as early as possible.

3) Family Planning Programmes:-
The main aim of family programme is to reduce birth rate as well total fertility rate. Under this programme, if the family planning operations are held in the Government institutes the following honorarium is given to the beneficiaries.

  • Male Sterilization     (All beneficiaries)                   –  Rs. 1,100/- as Honorarium,
  • Female Sterilization (BPL/ SC/ ST beneficiaries) –  Rs. 600/- as Honorarium,
  • Female Sterilization (Above BPL beneficiaries)     –  Rs. 250/- as Honorarium,

4) Immunization Strengthening:-
Immunization session is organized on fixed day, fixed place and at a fixed time in each village in Anganwadi.

  • Due to immunization, all vaccine preventable diseases such as Tetanus, Diphtheria, Pertussis, Tuberculosis, Measles, Polio, Hepatitis-B and Japanese Encephalitis can be prevented. 
  • Immunization as per age in the child develops immunity.
  • All vaccines are given as per Universal Immunization Programme.

5) NRHM Additionalities:-
I) ASHA (Accredited Social Health Activist):-

  • Under NRHM, to provide better quality of health services in rural areas particularly in Melghat region­­­ ASHA are appointed.

Total ASHAs in Amravati District – ___________

  • Health planning at village level.
  • Communication to change behavior regarding health in people.
  • Co-ordination with ANMs, MPWs, Anganwadi Workers, Dai Workers.
  • Counseling.
  • To help the patient during patient referral.
  • To provide First-Aid for minor illness and maintain Medicine Kit and records.

II)  Village Health and Sanitation Committee (VHSC):-

  • To provide pure and potable water, health related programmes and malnutrition are related to each other so to implement this programme Village Health and Sanitation Committee (VHSC) is established at village level.
  • NRHM provides funds of Rs. 10,000/- for each committee for total 1,547 villages.

Work and Responsibilities:-

  • Public awareness regarding health programmes.
  • Discussion about health problems and available facilities in village meetings.
  • Discussion about important points and questions of health and nutrition at village level and send reports to concern officers.
  • Take all facilities from ANM and MPW.
  • Family Survey to find out the health problems.
  • To maintain health register at Anganwadi level.

6) Untied Funds (Sub-centers/ PHC):-
Untied funds are used at SC and PHC level for the facilities where fixed funds are not available.
i) Funds available for PHC               – Rs. 25,000/-
ii) Funds available for Sub-Centre – Rs. 10,000/-

7) Annual maintenance Grant (Sub-centers/ PHC):-
These funds are utilized for maintenance of hospital premises, instruments, furnitures, official items.
i) Funds available for PHC               – Rs. 50,000/-
ii) Funds available for Sub-Centre – Rs. 10,000/-

8) RuGna Kalyan Samitee:-
This fund is utilized for upgrading available health facilities at PHC level.
Available fund is Rs.1,00,000/-

9) Indian Public Health Standard (I.P.H.S.):-
According to Indian Public Health Standard up gradation of,
i) Funds available for PHC               – Rs. 5,00,000/-
ii) Funds available for Sub-Centre – Rs. 1,00,000/-

10) School Health:-
Under NRHM, School Health Programme is implemented to care students to find out diseases and provide facilities for students of 1st to 10th Standards.

 

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The priorities, the constraints and action to overcome them:-

Sr. No.

Priorities

Constraints

Action to overcome constraints

1

Functional facilities –
SC/ PHC

  • Absent physical infrastructure,
  • Infrastructure Strengthening at each level
  • Non-availability of doctors/ Para-medicals,
  • Vacancy position of doctors and Para-medicals are fulfilled as early as possible,
  • Drugs/ Vaccine shortages,
  • Steam-line fund flows,
  • Untimely procurements,
  • Pooling of Staff,

2

Increasing and improving human resources in Melghat areas.

  • Non-availability of doctors,
  • Vacancy position of doctors are fulfilled as early as possible,
  • Non-availability of Para-medicals,
  • Contractual appointment to facility for filling short term gaps
  • Shortage of ANM/ MPW
  • Management of Facilities including personal by PRI committee.
  • Large Jurisdiction and poor monitoring

 

  • Trained and developed local resident of remote areas with appropriate cadre structure and incentives.

3

Reducing maternal and child deaths and population stabilization

  • 28 PHCs are 24 x 7,

 

  • Up to 2015, all 56 PHCs are to aimed be 24 x 7,
  • Lack of facilities for obstetric care,
  • Trained ANM locally recruited,
  • Unsatisfactory access and utilization of skilled assistance at birth,
  • Institutional Deliveries,
  • Lack of sensitivity in Family Welfare Services,
  • Providing Quality Sterilization services on regular basis so as to meet existing demands and unmet needs,
  • No system of New Born Care with adequate referral support.
  • Navjat Shishu Suraksha Karyakram (NSSK) Training for reducing neonatal mortality.

4

Disease Surveillance

  • Vertical programmes for communicable diseases.
  • Horizontal integration of programmes through SC, PHC.

5

 

Forging hamlet to hospital linkage for curative services

  • Entitlements of households not defined
  • ASHA/ AWW/ ANM
  • No community worker
  • Appointment of Counselor.

 

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