District Health Action Plan Kargil
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GOVERNMENT OF JAMMU & KASHMIR DISTRICT HEALTH ACTION PLAN KARGIL December 2007 2 3 DISTRICT: KARGIL INDEX DISTRICT HOSPITAL CHC/SDH PHC SUB-CENTRE 4 CONTENTS PREFACE ................................................................................................................................. 6 PRIORITIES OF THE DISTRICT ............................................................................................... 8 Budget Summary ..................................................................................................................... 12 1. SITUATION ANALYSIS ....................................................................................................... 16 Socio Economic and Health Indicators of the District ................................................... 19 2. PLANNING PROCESS ......................................................................................................... 32 3. PRIORITIES AS PER BACKGROUND AND PLANNING PROCESS ........................ 37 4. GOALS .................................................................................................................................... 39 5. TECHNICAL COMPONENTS ............................................................................................. 40 PART A: Reproductive and Child Health (RCH) II ........................................................... 40 Part B: NRHM Initiatives ...................................................................................................... 73 PART C: Immunisation ......................................................................................................... 94 PART D: National Disease Control Programme ................................................................. 99 6: INTER SECTORAL CONVERGENCE............................................................................ 114 7.COMMUNITY ACTION PLAN ............................................................................................ 120 8.PUBLIC PRIVATE PARTNERSHIP .................................................................................. 123 9. GENDER AND EQUITY ..................................................................................................... 127 10. CAPACITY BUILDING ..................................................................................................... 130 11. HUMAN RESOURCE PLAN ........................................................................................... 138 12. PROCUREMENT AND LOGISTICS .............................................................................. 142 13. DEMAND GENERATION - IEC ...................................................................................... 144 14. FINANCING OF HEALTH CARE ................................................................................... 147 15.HMIS, MONITORING AND EVALUATION .................................................................... 149 16. BIO- MEDICAL WASTE MANAGEMENT .................................................................... 152 Annexure .................................................................................................................................. 153 5 PREFACE The 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 need based. The state would play a facilitators role. NRHM was launched in April 2005 and is being implemented by the Department of Health; Government of Jammu & Kashmir is the NRHM. A number of enabling actions have been taken by the State Health Society. This has created an environment conducive for decentralized planning by the district. The District Action Plan is the most important aspect of the planning process and the Government of India and the state government can hence monitor the progress of implementation district wise. The district is also the key administrative unit for most of the development activities. To make District Plans more meaningful and address local health problems, preparation of Block Health Plans is 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 Plans. The district now has the capacity for preparing the need based plans following participatory processes. A District Planning Team (DPT) was set up for this purpose in the month of July 2007. It has representation from various sectors concerned with NRHM. This group was responsible for management of the entire planning process in the district and also for provision of the technical support. The DPT is the standing body and will take charge of the implementation of the plans thus prepared. 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. 6 The members of the DPT are: # Name Designation Department 1. Mr. Bhagat Deputy Commissioner Dist.Admn. 2. Dr. Gulam Jeelani Zargar CMO Health 3. Dr. Abrahim Khan Dy.CMO Health 4. Mr. Bahuddin CPO Dist.Admn. 5. Kachu Ahemad Khan Prog, Coordinator Ecology 6. Dr. M. Jaffar Akbar DIO 7. Dr. Asgar Ali Dist. Immunization Officer Health 8. Mr. Fiza Hussain Wazir Ex. Eng. PHED 9. Ms. Nargis Banu CDPO ICDS The orientation of DPT, facilitated by EPOS Health India, was held at District HQ. 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 Core Group 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 121 Sub health centres, 17PHCs, 2CHCs in the District. Name of Chief Medical Officer Signature Date 7 Priorities of the district S.No Thematic Critical Issues of the Specific Priorities Area District 1. District Different health .Integrate all district societies into District Health societies are not Health society and function as one unit. Management integrated in the Capacity building of the members of the : district. District Health Mission and District Health Society regarding the programme, their Training role, various schemes and mechanisms for monitoring and regular reviews and also on Monitoring and GoI / GoJ&K guidelines for running the evaluation. District. Health & FW Society Improving the Review and planning meetings through a holistic review of all the programmes under NRHM and proper planning. Formation of a monitoring Committee from all departments. 2. District & Hiring of Contractual appointments of various Block contractual staff categories of staff have not been made by Programme the District Health Society. Management Strengthening Development of total clarity amongst monitoring and officials and Consultants about NRHM reporting activities. Training of district officials and Block SMOs Streamlining Financial management and systems Capacity building of the DPMU personnel for monitoring 3. Reducing • Increasing Construction/repair of S/Cs and PHCs maternal and Institutional where ever required child deaths deliveries Operationalisation of 24X7 PHCs and SCs Ensuring availability of personnel especially specialists and Public Health Nurses for the 24 hour PHC, CHC and ANMs at the sub centres Plan IEC/BCC activities • Timely incentive to JSY beneficiaries & ASHAs 8 • Strengthen FRUs for Emergency Obstetric Care services along with minimum basic infrastructure, drugs, blood storage facility and equipments. 4. Family Low level of FP Vacant positions to be filled in on a Planning acceptance. contractual basis. Lack of Increased awareness for Emergency motivation for Contraception and 10 yr Copper T. adoption of FP Partner with private doctors for FP and methods RCH services Low level of Plan IEC/BCC for family planning methods male participation 5. Adolescent Adolescent boys Implement life skills programme through Health are exposed to schools and NGOs to increase the smoking, drug knowledge levels of Adolescents on RH addictions, and and Life skills alcoholism. Operationalise Adolescent Friendly Health Lack of knowledge services at the health facilities. amongst adolescent boys and girls about RH and life skills 6. Mobile Remote population Provide MMUs equipped with GPRS for Medical Units is not covered services. (MMUs) Sufficient staff and Contract MOs and staff nurses for MMUs logistics. 7. Upgrading No district hospital Upgrade CHC n to district hospital as per district No CHC is as per IPH standard hospital & IPH standard. Upgrade all CHCs to IPHS . CHCs to IPHS 8. Upgrading No PHC is All PHCs to be upgraded to IPHS PHCs for 24 functioning