DISTRICT HEALTH ACTION PLAN 2012-13 EAST CHAMPARAN BIHAR Kesaria Budha Stup Mr. Rana P.K. Solanki Dr. Kameshwar Mandal Mr. Abhijeet Sinha (IAS) District Prog.Manager C.S. Cum Member Secretaty D.M. Cum Chairman DHS-East Champaran DHS-East Champaran DHS-East Champaran DISTRICT HEALTH ACTION PLAN EAST CHAMPARAN Developed & Designed by – Mr. Rana P.K. Solanki District Programme Manager DHS, East Champaran Mr. Awadhesh Kumar District Data Assistant (ASHA) DHS , East Champaran Mr. Avinash Dutta Representative, Internal Auditor, DHS East Champaran DISTRICT HEALTH ACTION PLAN 2012-13, DHS. EAST CHAMPARAN (BIHAR) Page 2 of 238 Foreword Recognizing the importance of Health in the process of economic and social development and improving the quality of life of our citizens, the Government of India has resolved to launch the National Rural Health Mission to carry out necessary architectural correction in the basic health care delivery system. This District Health Action Plan (DHAP) is one of the key instruments to achieve NRHM goals. This plan is based on health needs of the district. After a thorough situational analysis of district health scenario this document has been prepared. In the plan, it is addressing health care needs of rural poor especially women and children, the teams have analyzed the coverage of poor women and children with preventive and primitives interventions, barriers in access to health care and spread of human resources catering health needs in the district. The focus has also been given on current availability of health care infrastructure in pubic/NGO/private sector, availability of wide rage of providers. This DHAP has been evolved through a participatory and consultative process, wherein community and other stakeholders have participated and ascertained their specific health needs in villages, problems in accessing health services, especially poor women and children at local level. The goals of the Mission are to improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women and children. I need to congratulate the State Health Society, Bihar for its dynamic leadership of the health sector reform programme and we look forward to a rigorous and analytic documentation of their experiences so that we can learn from them and replicate successful strategies. I also appreciate to facilitate our Civil Surgeon, ACMO, MOICs, BHM regarding preparation the DHAP. The proposed location of HSCs, PHCs and its service area reorganized with the consent of ANM, Male health worker and participation of community has finalized in the block level meeting. I am sure that this excellent report will galvanize the leaders and administrators of the primary health care system in the district, enabling them to go into details of implementation based on lessons drawn from this study. Rana P.K.Solanki District Programme Manager District Health Society East Champaran. DISTRICT HEALTH ACTION PLAN 2012-13, DHS. EAST CHAMPARAN (BIHAR) Page 3 of 238 About the Profile Under the National Rural Health Mission this District Action Plan of East Champaran district has been prepared. From this, the situational analysis the study proceeds to make recommendations towards a policy on workforce management, with emphasis on organizational, motivational and capability building aspects. It recommends on how existing resources of manpower and materials can be optimally utilized and critical gaps identified and addressed. It looks at how the facilities at different levels can be structured and reorganized. The information related to data and others used in this action plan is authentic and correct according to my knowledge as this has been provided by the concerned medical officers and Block Health Managers of every block. I am grateful to the District Magistrate, D.P.M., ACMOs, MOICs, BHMs and ANMs and from their excellent effort we may be able to make this District Health Action Plan of East Champaran District. I hope that this District Health Action Plan will fulfill the intended purpose. (Dr.Kameshwar Mandal) Civil Surgeon East Champaran DISTRICT HEALTH ACTION PLAN 2012-13, DHS. EAST CHAMPARAN (BIHAR) Page 4 of 238 EXECUTIVE SUMMERY The District Health Society working for all Programs Implementations under State Health society/NRHM for the government of Bihar and committed to towards promoting the right of every citizen specially rural women and child to enjoy a life of health and equal opportunity and is making all round effort in this direction. The District PIP based on the past experience for implanting the National Rural Health Mission at the all level. Goal The goal is to improve quality of life of the rural people by reducing the following:- Table 1: RCH Outcomes in the District: Goals Outcomes State Current District Goal Indicators Status 2012-13 MMR1 312 270 IMR 56 45 NMR3 42.1 30 TFR4 4.0 3 These goals clearly indicate that the district is planning to drastically upscale availability and accessibility and utilization of RCH services. The entire District Health Society East Champaran Team is working in Mission mood to achieve the goals set by the state and it’s trying to effectively deal with challenges. These strategies have impact on all the component of RCH viz. Maternal Health, Child Health, Family Planning etc where as specific core programm strategies have wider impact on the specific program component it has been recognized that all these strategies should converge and go hand in hand to achieve the program outcome. The district considers that strengthening institutional mechanisms, infrastructure development, insuring adequate and trained human resources etc are fundamental requirements for getting better program outcomes. Accordingly document is presented with backward linkages from core program strategies to institutional framework. Trauma centre As a result of economic development and motorization, the number of traffic accidents and the mortality rate from them have rapidly increased and accidents became the second leading cause of death. The district had a higher mortality rate from traffic injury. Reduction of traffic accidents and provision of quality service are emphasized. Reduction of the mortality rate from injury depends largely on prevention of traffic accidents, timely provision of first aid and transport, appropriate care at health institutions. The project aims to bring about comprehensive improvement in these areas. As a result of traffic safety activities, the percentage of bike riders who wear a helmet and car drivers who wear a seat belt increased. The project trained emergency medical care and first aid staff members from district hospitals and volunteer organizations. They have promoted local health care by applying the acquired skills and knowledge at work. Therefore, effectiveness of the project is high. DISTRICT HEALTH ACTION PLAN 2012-13, DHS. EAST CHAMPARAN (BIHAR) Page 5 of 238 Trauma Centers There will be two Trauma Centers proposed in the East Champaran district. One on Sugauli Highway and second will be on Mehsi Highway. Maternity Ward 30 Bedded Maternity ward Required at District Hospital to fulfill the need to 48 hour stay mother and child for better care. RKS at All HSC Required to formation of Rogi Kalyan Samiti at All Health Sub-Centre for better management of Facilities. Solar Lighting Systems to All APHC. Required Solar Lighting Systems to all APHC for better visible of health Institutions. Required to formation of Rogi Kalyan Samiti at All Health Sub-Centre for better management of Facilities. Bicycle, Weighing Machine and B.P Instruments to All ASHA Need to Provide Bicycle, Weighing Machine and B.P Instrument to All ASHAs in District to Provide better Health Services to the concern Beneficiaries. Kalazar Ward East Chapparan District is affected to Kala Azar and there are many Mahadalit Tola are not detected by the local Facilities. So, there are need to make some special Plan to detect the widely effected area to give special focus and provide them better services to eradicate it. For this Purpose we have selected five Blocks on the basis past records and No. of patient registered in District Hospital and Concerned PHCs. Such as:- 1. KESARIA 2. CHAKIA 3. KALYANPUR 4. TURKAULIA 5. MOTIHARI SADAR BLOCK So, there are need to select Mahadalit Tola and to organize weekly health checkup camps and quarterly spry of DDT in such Tola. NEEDS 1. Special vehicle to collect the patient from there door stop to concerned point. 2. Need five bed to each concerned point for Kalazar effected patient. 3. Loss of wages should be paid daily. 4. Required One Community mobilizer in each Mahadalit Tola. 5. One Special Doctor for the treatment of the Kalazar patient in above mentioned DISTRICT HEALTH ACTION PLAN 2012-13, DHS. EAST CHAMPARAN (BIHAR) Page 6 of 238 PHC. 6. Availability of the medicine & injection. A Separate 30 beded Kalazar Unit is required in District Hospital to provide better services to the Kala- Azar affected Patients. DISTRICT HEALTH ACTION PLAN 2012-13, DHS. EAST CHAMPARAN (BIHAR) Page 7 of 238 Introduction 1.1 Background Keeping in view health as major concern in the process of economic and social development revitalization of health mechanism has long been recognized. In order to galvanize the various components of health system, National Rural Health Mission (NRHM) has been launched by Government of India with the objective to provide effective health care to rural population throughout the country with special focus on 18 states which have weak public health indicators and/or weak infrastructure. The mission aims to expedite achievements of policy goals by facilitating enhanced access and utilization of quality health services, with an emphasis on addressing equity and gender dimension. The specific objectives of the mission are: . Reduction in child and maternal mortality . Universal access to services for food and nutrition, sanitation and hygiene, safe drinking water . Emphasis on services addressing women and child health; and universal immunization .