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National Rural Health Mission State Programme Implementation Plan

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National Rural Health Mission State Programme Implementation Plan GOVERNMENT OF NAGALAND NATIONAL RURAL HEALTH MISSION STATE PROGRAMME IMPLEMENTATION PLAN 2009-10 Draft v.1 February 2009 Submitted by State health Society National Rural Health mission Government of Nagaland TABLE OF CONTENTS CHAPTER CONTENT PAGE - EXECUTIVE SUMMARY 1 BACKGROUND 2 PROCESS OF PLAN PREPARATION 3 SITUATION ANALYSIS OF THE DISTRICT 3.1 BACKGROUND CHARACTERISTICS 3.2 PUBLIC HEALTH INFRASTRUCTURE 3.3 HUMAN RESOURCES IN THE STATE 3.4 FUNCTIONALITY OF THE HEALTH FACILITIES 3.5 STATUS OF LOGISTICS 3.6 STATUS OF TRAINING INFRASTRUCTURE 3.7 BCC INFRASTRUCTURE 3.8 PRIVATE AND NGO HEALTH SERVICES/ INFRASTRUCTURE 3.9 ICDS PROGRAMME 3.10 ELECTED REPRESENTATIVE OF PRIS 3.11 NGOS AND CBOS 3.12 KEY HEALTH INDICATORS (MH,CH AND FP) 3.13 NATIONAL DISEASE CONTROL PROGRAMMES 3.14 LOCALLY ENDEMIC DISEASES IN THE STATE 3.15 NEW INTERVENTIONS UNDER NRHM 3.16 CRITICAL ANALYSIS & REQUIREMENTS 4 PROGRESS AND LESSONS LEARNT FROM NRHM IMPLEMENTATION DURING 08-09 5 CURRENT STATUS AND GOAL 6 GOAL, OBJECTIVES, STRATEGIES, AND ACTIVITIES UNDER DIFFERENT COMPONENTS OF NRHM 6.1 PART A RCH PROGRAMME 6.2 PART B NRHM ADDITIONALITIES 6.3 PART C UNIVERSAL IMMUNIZATION PROGRAMME 6.4 PART D NATIONAL DISEASE CONTROL PROGRAMME 6.5 PART E INTERSECTORAL CONVERGENCE 6.6 PART F OTHER NEW PROGRAMMES 7 MONITORING AND EVALUATION/ HMIS 8 WORK PLAN 8.1 PART A RCH PROGRAMME WORKPLAN 8.2 PART B NRHM ADDITIONALITIES WORKPLAN 9 BUDGET 9.1 PART A RCH PROGRAMME 9.2 PART B NRHM ADDITIONALITIES 9.3 PART C UNIVERSAL IMMUNIZATION PROGRAMME 9.4 PART D NATIONAL DISEASE CONTROL PROGRAMME 9.5 PART E INTERSECTORAL CONVERGENCE 9.6 PART F OTHER NEW PROGRAMMES - ABBREVIATION - ANNEXURES 1 FORMAT FOR SELF ASSESSMENT OF STATE PIP AGAINST APPRAISAL CRITERIA (ANNEX 3 A OF RCH OPERATING MANUAL) 2 ACHIEVEMENT IN TERMS OF RCH PROGRAMME IN NAGALAND STATE PROGRAMME IMPLEMENTATION PLAN 2009-10 NAGALAND EXECUTIVE SUMMARY The National Rural Health Mission (NRHM) in Nagaland was launched in Feb‘06. Within the time span of these few years, the state has shown significant improvement in health care delivery both in terms of physical infrastructure and service delivery output. Taken the last facility surveys carried out in 2007 as the base line, during the current financial year reassessment of all the public health infrastructure were carried out. Household surveys and cluster survey were conducted throughout the state with the help of the Village Health Committees. This could be possible due to the existence of functioning Village Councils and very sound concept of communitization. Staff of health services department also assisted in the household surveys. The findings of the surveys along with the HMIS data have been used for situational analysis and for proposing adequate interventions to be taken up in days to come. The facility surveys bears out the fact that there is much to do in the infrastructural and manpower front. While construction works have been taken up on priority basis to upgrade the health infrastructure, very little could be done for providing adequate specialist manpower. It is to be understood that the state is not having even adequate number of graduate doctors and other para-medicals. Because of serious dearth of medical doctors / specialists, the state could not make many of its health facilities fully functional. Innovative ideas like the ‘alternative delivery system’ have made some improvement in overcoming these shortfalls. Incentive for the rural and posting at far flung areas have have also been of great motivational factor in the current year. Short term courses fot skill upgradation training for M.Os and continuing medical education programmes are going to make a positive impact in years to come. Block action plans based on village level needs and aspiration as expressed during the series of village level consultative meetings. To initiate the preparation of block action plans, many orientation and training programmes were organized for the state / district / block authorities cutting across different levels of officers. On the basis of field level situation, focus group discussions and cluster surveys of selected blocks, the block plans thus prepared were appraised at the district level, where officials from the state also attended. The state officials collected a copy of all block plans and also the key salient issues discussed in the appraisal meeting in terms of needs, resources available, aspiration etc and on that basis the state plan is prepared. The block / districts have focused on the need of adequate infrastructure, manpower and mobility in their programme implementation plans. District plans are prepared based on the block plans as the key document, which is used by the state as well as the GOI officials as the main tool for monitoring the field level activities and also to extend supportive monitoring to the field level officers. The plans are prepared based on the evidence and need based down to the grass root level. To meet the shortage of manpower in the state, PPP initiative in partnership with Christian Institute of Health Sciences and Research, Dimapur has been started. This is with the highest political commitment. The Nursing School in Dimapur is in fast progress and we should be able to achieve our target if fund flow is not interrupted. The existing infrastructure of Para Medical Training Institute is proposed to be used to offer a diploma course in Pharmacy and in the long run upgraded to College of Pharmacy. The Nursing College which was approved to be set up at Kohima is yet to get underway, it is expected that civil works will complete in the current year. This institute will be yet another milestone in ensuring quality health care personnel in the state. Kohima district hospital was referred to as state hospital in 2002 after the formation of Naga Hospital Authority. This hospital is now an autonomous institute, and the only referral hospital in the state. To cater to the increasing health care needs of the people a plan for setting up a new district hospital has been started and the initial works like identification and acquisition of plots are already in the process. Partnerships with NGOs and also the initiative taken under public private partnership will also pave the way to reach those yet inaccessible parts of the state. Improvements in quality and increase in the number of health care personnel will also increase the options of better services for the people of the state. 1 STATE PROGRAMME IMPLEMENTATION PLAN 2009-10 NAGALAND The main goals of RCH II programme in Nagaland are to reduce MMR to 200 by 2008-09 and 150 by 2009-10, to decrease IMR from 20 (SRS Oct 07)) to 18 by 2008-09 and 15 by 2009-10, to reduce TFR from 3.7(NFHS-3) to 3.5 by 2007-08 and 3.1 by 2008-09 and increase Contraceptive prevalence rate among Eligible couples. Various focused and need based interventions have been proposed for ensuring effective service delivery with regards to the diseases prevalent in the state. Adequate steps have been initiated to ensure convergence with the key stakeholders. The state government of Nagaland is committed to according higher priority to health sector & amply demonstrated its commitments. The status of program wise fund received and utilized since 2005-06 till Dec 08 is as under. In Crores of Rupees Received Expenditure Remark RCH Flexible 2005-06 6.61 3.14 As per Audit 2006-07 3.73 5.06 As per Audit 2007-08 4.96 6.55 As per Audit 2008-09 8.09 6.48 As per FMR Dec 08 Total 23.39 21.23 91% Utilization, unspent- 2.16 Cr NRHM Flexible 2005-06 3.72 0.87 As per Audit 2006-07 15.87 12.55 As per Audit 2007-08 29.37 21.71 As per Audit 2008-09 17.04 27.27 As per FMR Dec 08 and including last year’s advance of Rs. 9.87 Cr. Now shown as utilized as SOE/UC received. Total 66.00 62.40 95% Utilization, an amount of Rs. 3.6 Cr with the districts and implementing agencies as advance UIP 2005-06 0.21 0.19 As per Audit 2006-07 0.30 0.52 As per Audit 2007-08 0.66 0.40 As per Audit 2008-09 0.84 0.40 As per FMR Dec 08 Total 2.01 1.51 75% utilization, unspent – 0.5 Cr IPPI 2005-06 0.23 0.16 As per Audit 2006-07 1.04 1.09 As per Audit 2007-08 0.54 0.55 As per Audit 2008-09 1.41 1.42 Exp reports as on 15th Feb 2009 Total 3.22 3.22 No balance 2 STATE PROGRAMME IMPLEMENTATION PLAN 2009-10 NAGALAND NRHM encompasses all the different components, which projects requirement as shown below. Hopefully, if the amount, which has been sought for is approved timely then it will be a real boost for implementing different activities under NRHM. Part Programme Components Budget (Lakhs) A RCH 2949.62 B NRHM 6636.90 C UIP 95.22 D NDCP RNTCP 312.83 NVBDCP 851.62 NLEP 99.65 IDSP 107.02 NIDDCP 38.26 NPCB 405.28 E Convergence 46.00 Sub-Total (A) 11542.40 F Other New Programmes Tobacco Control 67.60 Oral Health 104.00 Non Communicable Diseases 162.22 AYUSH 2810.55 Sub-Total (B) 3144.37 Grand Total (A+B) 14686.77 Rupees One Hundred Forty Six Crores Eighty Six Lakhs and Seventy Seven Thousand only. 3 STATE PROGRAMME IMPLEMENTATION PLAN 2009-10 NAGALAND CHAPTER 1 BACKGROUND 1.1 Brief Profile of the State Nagaland, the 16th state of Indian Union, got statehood on the 1st December 1963.
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