Expansion of Healthcare Services
Public health being a State subject, the primary responsibility of providing health care services to the population including women and children in rural areas is that of respect State/UT Government. Under National Health Mission (NHM) support is being provided to States/ UTs to supplement the efforts of the States/UTs to strengthen their health care system for provision of accessible and affordable health care to all those who access public health facilities.
Some of the special measures taken under NHM for the expansion of health services after May, 2014 are given below:-
New initiatives for expansion of health services
1) Launch of India Newborn Action Plan (INAP): INAP was launched in September 2014, for accelerating the reduction of preventable newborn deaths and stillbirths in the country - with the goal of attaining ‘Single Digit Neo-natal Mortality Rate (NMR) by 2030’ and ‘Single Digit Still Birth Rate (SBR) by 2030’. Currently, there are estimated 7.47 lakh neonatal deaths annually.The neo-natal deaths are expected to reduce to below 2.28 lakh annually by 2030, once the goal is achieved.
2) Intensified Diarrhoea Control Fortnight was observed in July- August 2014 and 2015 focusing on ORS and Zinc distribution for management of diarrhoea and improved feeding practices.
3) Integrated Action Plan for Pneumonia and Diarrhoea (IAPPD) launched in four states with highest infant mortality (UP, MP, Bihar and Rajasthan).
4) National Deworming day was observed in eleven States/UTs, namely- Assam, Bihar, Chhattisgarh, Dadra & Nagar Haveli, Haryana, Karnataka, Maharashtra, Madhya Pradesh, Rajasthan, Tamil Nadu and Tripura.
5) Launch of Mission Indradhanush: Mission Indradhanush was launched in December 2014 to reach 90 Lakh unimmunized/partially immunized children by 2020. It has been implemented in 201 districts in 1stPhase, 297 additional Districts are to be covered in 2nd Phase. About 20 lakh children received full immunization during the Phase-1 of Mission Indradhanush.
6) New vaccines: launch of new vaccines has been announced of which Inactivated Polio Vaccine (IPV) has already been launched on 30th November, 2015 and Rotavirus vaccine is planned to be launched on first quarter of 2016. In addition, NVBDCP has recently identified 21 adult JE vaccination districts in Assam, Uttar Pradesh and West Bengal. Adult JE vaccination campaign has been completed in three districts of Assam, selected blocks of three districts of West Bengal and ongoing in selected blocks of six districts of Uttar Pradesh.
7) Launch of Nationwide Anti-TB drug resistance survey: Drug resistant survey for 13 TB drugs was launched to provide a better estimate on the burden of Multi-Drug Resistant Tuberculosis in the community. This is the biggest ever survey in the world with a sample size of 5214 patients. Results are expected by 2016.
8) Kala Azar Elimination Plan : Kala-Azar elimination Plan was rolled out to reduce the annual incidence of Kala-Azar to less than one per 10,000 population at block PHC level by the end of 2015, which inter-alia includes,
· New thrust areas launched for UP, Bihar, West Bengal and Jharkhand.
· New Action Plan to include active search, new drug regimen, coordinated Indoor Residual Spray (IRS) etc.
· New non-invasive Diagnostic kit launched.
9) Kayakalp –Award to Public Health facilities has been launched on 15th May 2015, as a national initiative to promote cleanliness, hygiene and infection control practices in public health facilities. Under this initiative public healthcare facilities shall be appraised and such public healthcare facilities that show exemplary performance meeting standards of protocols of cleanliness, hygiene and infection control will receive awards and commendation.
10) Operational Guidelines have been issued under NHM on :
(i) NHM Free Drugs Service Initiative
(ii) NHM Free Diagnostic Services Initiative
(iii) Mobile Medical Units
(iv) Swachhta Guidelines for public Health Facilities
11) New Guidelines: The following new guidelines to strengthen capacities of States to effectively treat women in rural and urban areas of the country have been prepared:
(ii) Engaging General Surgeons for performing C-Sections and Managing Obstetric complications
(iii) Maternal Near Miss Review Operational Guidelines
(iv) National Guidelines for Diagnosis and Management of Gestational Diabetes
(v) National Guidelines for calcium supplementation during pregnancy and lactation
(vi) National Guidelines for screening of hypothyroidism during pregnancy
(vii) Screening for Syphilis during pregnancy
(viii) DAKSHATA – A strategic initiative to strengthen quality of intra and immediate postpartum care empowering providers for improved MNH care during institutional deliveries
(ix) Daksh Skills Lab for RMNCH+A services (training manual for facilitators)
(x) Daksh Skills Lab for RMNCH+A services (training manual for participants)
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