steps taken towards elimination of Kala-Azar
To achieve the Kala-azar elimination goal by 2017 set by the WHO, the following steps have been taken:
1. National Roadmap for Kala-azar Elimination (2014) has been circulated to states with clear goal, objectives, strategies, timelines with activities and functions at appropriate level. This document has been developed for focused intervention at national, state, district and sub-district and village levels.
2. Treatment of Kala-azar patient with single day single dose Liposomal Amphotericin B (AmBisome) injection has improved treatment compliance. Unintrupted free supply of AmBisome is ensured by WHO.
3. Regular supply of diagnostic kit (rapid diagnostic test) and drugs in states is ensured.
4. Funds are provided to states for incentive of Rs. 500/- to Kala-azar patient and Rs. 2,000/- to PKDL case from GoI to compensate loss of wages.
5. Incentive of Rs. 300/- to ASHA /health volunteer to bring Kala- azar suspected case to health facility and to ensure complete treatment. ASHA is also being paid Rs. 200/- during indoor residual spray for social mobilization and community acceptance to allow spray in their rooms.
6. Active search of Kala azar and Post Kala-azar Dermal Leishmaniasis (PKDL) case and IEC/BCC with the help of development partners.
7. In 21 high endemic districts of Bihar (15 districts), Jharkhand (4 districts) and West Bengal (2 districts), DDT has been replaced by Syenthetic Pyrethroid where vector showed tolerance towards DDT. All endemic Kala-azar villages are covered with focal spray where new case is found during non IRS period. Hand Compression pumps are being used for spraying.
8. Govt. of India is closely working with development partners like Bill Melinda Gates Foundation(BMGF); KalaCORE Consortium; Rajendra Memorial Research Institute (RMRI); National Centre for Disease Control (NCDC), Patna and World Health Organisation (WHO) for achieving the desired goal of elimination.
9. The Kala-azar Elimintion is being reviewed on monthly basis by Prime Minister’s Office (PMO) and higher officials of Ministry of Health & Family Welfare.
Programme is striving hard to achieve elimination within the target set by WHO. With the supportive monitoring, regular reviews and field visits, 502 (80%) blockPHCs out of 625 endemic block PHCs have shown less than one case per 10,000 population in 2015 at block PHC level.
Addressing the Problems of Rural Health
The health status of the population, especially that of rural population, does require improvement. However, the condition of the health services in rural areas of the country has improved after the launch of the National Rural Health Mission.
As per the National Health Profile, 2015, the number of beds in rural hospitals is 183602 as against 492177 beds in urban hospitals.
Public health being a State subject, the primary responsibility to provide health care facilities lies with the State Governments. To address the healthcare challenges, particularly in rural areas, the National Rural Health Mission (NRHM) was launched in 2005 to supplement the efforts of the State/UT governments to provide accessible, affordable and quality healthcare. The National Rural Health Mission (NRHM) has now been subsumed under the National Health Mission (NHM) as its Sub-Mission, along with National Urban Health Mission (NUHM) as the other Sub-Mission.Support under NHM is provided to State/UTs for setting up new facilities or renovation of existing facilities, health human resource on contractual basis, drugs, equipment, diagnostics, Ambulances, Mobile Medical Units etc based on the requirement posed by the States/UTs in their Programme Implementation Plans (PIPs).
The government has already taken steps towards provision of free services for maternal health, child health, adolescent health, family planning, universal immunization programme, and for major diseases such as TB, vector borne diseases such as Malaria, dengue and Kala Azar, leprosy etc. Other major initiatives for which states are being supported include JananiShishuSurakshaKaryakram (JSSK), RashtriyaBalSwasthyaKaryakram (RBSK), RashtriyaKishorSwasthyaKaryakram (RKSK), implementation of National Health Mission Free Drugs Service Initiative and National Health Mission Free Diagnostics Service Initiative, Strengthening District Hospitals and implementation of National Quality Assurance Framework. To address health inequities, 184 High Priority Districts have been identified for enhanced fund allocation and focused attention.
As per the National Health Profile, 2015, the number of beds in rural hospitals is 183602 as against 492177 beds in urban hospitals.
Public health being a State subject, the primary responsibility to provide health care facilities lies with the State Governments. To address the healthcare challenges, particularly in rural areas, the National Rural Health Mission (NRHM) was launched in 2005 to supplement the efforts of the State/UT governments to provide accessible, affordable and quality healthcare. The National Rural Health Mission (NRHM) has now been subsumed under the National Health Mission (NHM) as its Sub-Mission, along with National Urban Health Mission (NUHM) as the other Sub-Mission.Support under NHM is provided to State/UTs for setting up new facilities or renovation of existing facilities, health human resource on contractual basis, drugs, equipment, diagnostics, Ambulances, Mobile Medical Units etc based on the requirement posed by the States/UTs in their Programme Implementation Plans (PIPs).
The government has already taken steps towards provision of free services for maternal health, child health, adolescent health, family planning, universal immunization programme, and for major diseases such as TB, vector borne diseases such as Malaria, dengue and Kala Azar, leprosy etc. Other major initiatives for which states are being supported include JananiShishuSurakshaKaryakram (JSSK), RashtriyaBalSwasthyaKaryakram (RBSK), RashtriyaKishorSwasthyaKaryakram (RKSK), implementation of National Health Mission Free Drugs Service Initiative and National Health Mission Free Diagnostics Service Initiative, Strengthening District Hospitals and implementation of National Quality Assurance Framework. To address health inequities, 184 High Priority Districts have been identified for enhanced fund allocation and focused attention.
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