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DISTRICT HEALTH ACTION PLAN District: Ramban December 2007

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DISTRICT HEALTH ACTION PLAN District: Ramban December 2007 GOVERNMENT OF JAMMU & KASHMIR NATIONAL RURAL HEALTH MISSION DISTRICT HEALTH ACTION PLAN District: Ramban December 2007 1 2 Map of the District 3 PREFACE The Hon’ble Prime Minister launched the NRHM on 12 th April 2005 throughout the country with the basic objective of providing accessible, affordable and accountable health care in rural areas. Its primary focus is on making the public health system fully functional at all levels. While detailing the functioning of the NRHM, the present planning process initiated in the State provides the entire framework for making the Public Health System fully functional and standardized upto the Indian Public Health Standards at all levels. In doing so, it emphasizes the need for communitisation of the Public Health System, improved financing and management of public health, human resource innovations, and a long-term financial commitment to enable the state and districts to undertake programmes aimed at achieving the Mission goals. National Rural Health Mission envisages the planning process to be participatory and decentralized starting with the Village. It seeks to empower the community by placing the health of the people in their own hands and determine the ways they would like to improve their health. This is the only way to ensure that health plans are local specific and need based. The State should facilitate the processes by providing enabling environment and required financial and technical support. NRHM was launched in April 2005 and is being implemented by the Department of Health and Medical Education, Government of Jammu & Kashmir. In accordance with the National Rural Health Mission, Jammu & Kashmir. The district has constituted the District Health Mission and significant progress has been made since it’s beginning. As per the NRHM guidelines, it has merged multiple societies at the district level. The District Action Plan was the most important aspect of the NRHM and to make District Plan more meaningful and address local health problems, preparation of Block Health Plans was considered essential. The decentralized planning process involved village consultations and preparation of Village Health Plans by the Village Health Water and Sanitation committees; followed by development of Block Action Plans through integration of Health Facility Surveys and block specific needs. The Block Action Plans were then integrated to form District Action Plan. As result of this exercise, the district now has developed capacity for preparing the need based health action plans following participatory processes. A District Planning Team (DPT) was set up for this purpose in the month of May 2007 with representation from various sectors concerned with NRHM. This group was responsible for management of the entire planning process in the district 4 and also for provision of the technical support. The DPT is the standing body and will take charge of ensuring implementation of the plan. Thus the DPT not only owns the plan but will also be responsible for monitoring the progress of implementation to achieve the objectives of the plan. The members of the DPT are: # Name Designation Department 1. Sourav Bhagat DC Doda DC Office 2. A A Malik Chief planning officer DC Office 3. I A Shapu CMO Doda Health 4. Dr M I Zargar Dy. CMO Health 5. Kamlesha Kumar TSWO SWO 6. Shayesta Sultana CDPO Social welfare 7. Dr Kuldeep Kumar MO (ISM) ADMO 8. J M Tharmta DEPO Education 9. Dr M S Wani DHO Health 10. Waseem Raja District program manager Health 11. Ashok kumar District account manager Health 12. Surnnder Singh PMA Health 13. Tariq Hussan Data assistant Health The orientation of DPT, facilitated by EPOS Health India, was held on 12 th July 2007. This enabled the DPT members to not only understand NRHM approach, key components and strategies of NRHM, but also manage the planning process and develop the District Action Plan. The DPT met a number of times and the individual members reviewed the situation of their respective sectors/areas and collectively developed the strategic vision for improving the health status of the district population. We the members of the DPT on behalf of the entire Planning Team reiterate and certify that this District Action Plan has been prepared through participatory processes. It has been developed by integrating the Block Action Plans prepared by integrating health facility surveys and village health plans in each block of the District. This plan also incorporates the needs and plans from -47 Sub health centres, 15 PHCs, 3 CHCs in the District. Name of Chief Medical Officer Signature Date 5 CONTENTS PREFACE ...................................................................................................................................... 4 EXECUTIVE SUMMARY ...................................................................................................... 7 BUDGET AT A GLANCE ..................................................................................................... 8 PRIORITY MATRIX OF THE DISTRICT .......................................................................... 10 1. SITUATION ANALYSIS ................................................................................................ 16 SOCIO ECONOMIC AND HEALTH INDICATORS OF THE DISTRICT .................... 22 SOCIO-ECONOMIC INDICATORS .................................................................................. 22 HEALTH INDICATORS ...................................................................................................... 23 2. PLANNING PROCESS ................................................................................................. 35 3. PRIORITIES AS PER BACKGROUND AND PLANNING PROCESS .................. 38 4. GOALS .............................................................................................................................. 40 5. TECHNICAL COMPONENTS ....................................................................................... 41 PART A: REPRODUCTIVE AND CHILD HEALTH (RCH) II ............................................................ 41 Access for the quality IUD insertion at all the subcentres. .......................... 56 Strengthening linkages with ICDS programme and ISM (Ayurveda) .............. 56 PART B: NEW NRHM INITIATIVES ............................................................................................... 61 PART C: IMMUNIZATION ............................................................................................................... 79 PART D: NATIONAL DISEASE CONTROL PROGRAMME .............................................................. 84 6. INTER SECTORAL CONVERGENCE ........................................................................ 98 7. COMMUNITY ACTION PLAN ..................................................................................... 104 8. PUBLIC PRIVATE PARTNERSHIP ........................................................................... 106 9. GENDER AND EQUITY ............................................................................................... 109 10. CAPACITY BUILDING............................................................................................... 112 11. HUMAN RESOURCE PLAN ..................................................................................... 120 12. PROCUREMENT AND LOGISTICS ........................................................................ 126 13. DEMAND GENERATION - IEC ................................................................................ 128 14. FINANCING OF HEALTH CARE ............................................................................. 131 15. PROGRAMME MANAGEMENT .............................................................................. 133 16. BIO- MEDICAL WASTE MANAGEMENT .............................................................. 138 17. MONITORING & INFORMATION SYSTEM ........................................................... 140 DETAILED NRHM BUDGET (IN LAKHS) ................................................................... 143 ANNEXURE: ....................................................................................................................... 162 6 Executive Summary Since Ramban district has been recently formed from its parent district Doda and comprises of large unserved and underserved areas due to difficult hilly terrain. Hence there has been very little development including lack of health facilities, poor transport network and communication. Also as per the population norms there is a need to increase their numbers of CHCs, PHCs and Subcentres considering the difficult terrain of Subcentres. Not even one of the facilities is as per the IPHS standards. The health status of district Ramban is very poor since the district ranks 530 out of 593 districts in the country in terms of RCH indicators especially for the contraceptive prevalence rate for which the district is 543 in rank. The data collection and analysis needs strengthening. Regarding the HR status there are huge vacancies especially of some critical posts like ANMs, MOs, Staff Nurses. The District Action Plan was developed in a participatory manner with EPOS as a facilitator. There was wide participation from all the related departments. A District Planning Team was constituted who carried out the block consultations and the Subcentre level consultations. Facility Survey was carried out for each facility. The consultations focussed on each of the thematic areas with the present situation, the bottlenecks, strategies and how to
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