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4Th COMMON REVIEW MISSION REPORT for UTTAR PRADESH

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4Th COMMON REVIEW MISSION REPORT for UTTAR PRADESH 4th COMMON REVIEW MISSION REPORT FOR UTTAR PRADESH 16 – 22 December 2010 National Rural Health Mission, Ministry of Health and Family Welfare, Government of India New Delhi. Lakhimpur Kheri Sonbhadra Page 1 of 37 Acknowledgement The Common Review Mission team sincerely expresses its deep appreciation and thanks to the officials of the Government of Uttar Pradesh, State NRHM Mission, Directorates of Health & Family Welfare, the staff of the health facilities visited by the team, officers of the regional Health Systems Resource Centre and other partners for the excellent cooperation and hospitality provided to the team. The team greatly appreciates the participation of the State Mission in the debriefing session and the positive openness with which various issues were not only discussed but also taken note of for consideration. Page 2 of 37 Contents CHAPTER 1 ................................................................................................................................................ 4 TEAM: ...................................................................................................................................................... 4 CHAPTER 2 ................................................................................................................................................ 5 2. A) INTRODUCTION ......................................................................................................................... 5 2. B) BASE LINE OF PUBLIC HEALTH SYSTEM IN THE STATE ................................................ 5 CHAPTER 3 ................................................................................................................................................ 8 FINDINGS OF 4th CRM ....................................................................................................................... 8 3. A) INFRASTRUCTURE UPGRADATION ..................................................................................... 8 3. B) HUMAN RESOURCES ............................................................................................................... 10 3. C) Health Care Service Delivery – Facility Based - Quantity and Quality .............................. 13 3. D) Outreach services ........................................................................................................................ 19 4.E) ASHA - Programme ..................................................................................................................... 21 3.F) RCH II (Maternal Health, Child Health and Family Planning Activities) ........................... 22 3.G) NUTRITION ................................................................................................................................. 24 3.H) National Disease Control Programmes (NDCP) ..................................................................... 25 3.I) PROGRAMME MANAGEMENT IN THE STATE ................................................................... 28 3. J) FINANCIAL MANAGEMENT .................................................................................................. 28 3. K) DECENTRALIZED LOCAL HEALTH ACTION ................................................................... 30 CHAPTER 4 .............................................................................................................................................. 32 RECOMMENDATIONS ...................................................................................................................... 32 Page 3 of 37 CHAPTER 1 TEAM: The Fourth CRM Team visited the state of Uttar Pradesh from December 16th to 22nd 2010. The Team consisted of the following members; S. No Names of the Team Designation & Address Tel/Email Members 1 Dr. Ajay Khera Deputy Commissioner, 9810226150/23061281 Ministry of Health & Family [email protected] Welfare, Govt. of India 2 Dr. P. Saxena Sr. Chief Medical Officer 9810249099 (SAG), Central TB Division [email protected] 3 Mr. Billy Stewart (Health Adviser), DFID, 9873660184 British High Commission, [email protected] New Delhi 4 Mr. V.K. Tiwari (Professor), National Institute 9312309283 of Health & Family Welfare [email protected] 5 Dr. Almas Ali (Independent Public Health 0674-2397124 Consultant) [email protected] 6 Dr. B. Subha Sri (Civil Society Member) 9840260715 [email protected] 7 Dr. Rakesh (Consultant), National Rural 9810546495 Rajpurohit Health Mission [email protected] 8 Ms. Isha Rastogi Finance Assistant (NRHM 9818716169 Finance ) [email protected] The CRM team visited Lakhimpur Kheri and Sonbhadra districts in Uttar Pradesh. The facilities visited by the teams are detailed below. Page 4 of 37 CHAPTER 2 2. A) INTRODUCTION Uttar Pradesh is the most populous state in the country accounting for 16.4 per cent of the country’s population. It is also the fourth largest state in geographical area covering 9.0 per cent of the country’s geographical area. The state of Uttar Pradesh has an area of 240,928 sq. km. and a population of 166.20 million. There are 71 districts, 813 blocks and 107452 villages. The State has population density of 689 per sq. km. (as against the national average of 312). The decadal growth rate of the state is 25.85 (against 21.54% for the country) and the population of the state continues to grow at a much faster rate than the national rate. Number of Districts 71 Number of Sub Division/ Talukas 303 Number of Blocks 813 Number of Villages 107452 2. B) BASE LINE OF PUBLIC HEALTH SYSTEM IN THE STATE There are five super specialty institutes and 18 medical colleges. There are 61 district male hospitals, 53 district female hospitals and 20 combined hospitals. Out of 438 functional CHCs, 413 CHCs are functioning as 24x7 units. There are 470 functional BPHs, 2680 functional additional PHCs and 20621 sub-centres. The Total Fertility Rate of the State is 3.8. The Infant Mortality Rate is 67 and Maternal Mortality Ratio is 440 (SRS 2004 - 2006) which are higher than the National average. The Sex Ratio in the State is 898 (as compared to 933 for the country). Comparative figures of major health and demographic indicators are as follows: Demographic, Socio-economic and Health profile of Uttar Pradesh State as compared to India figures Page 5 of 37 S. Item Uttar Pradesh India No. 1 Total population (Census 2001) (in 166.20 1028.61 millions) 2 Decadal Growth (Census 2001) (%) 25.85 21.54 3 Crude Birth Rate (SRS 2008) 29.1 22.8 4 Crude Death Rate (SRS 2008) 8.4 7.4 5 Total Fertility Rate (SRS 2008) 3.8 2.6 6 Infant Mortality Rate (SRS 2008) 67 53 7 Maternal Mortality Ratio (SRS 2004 - 2006) 440 254 8 Sex Ratio (Census 2001) 898 933 9 Population below Poverty line (%) 31.15 26.10 10 Schedule Caste population (in million) 35.15 166.64 11 Schedule Tribe population (in million) 0.11 84.33 12 Female Literacy Rate (Census 2001) (%) 42.2 53.7 COMPLETE LIST OF FACILITIES VISITED BY THE TEAM 4th Common Review Mission 16th December 2010 to 22nd December 2010 Name of the State UTTAR PRADESH Names of the Districts Visited Sr. Name District HQ Name of DM Name of CMO No 1 Lakhimpur Kheri Lakhimpur Mr Sameer Verma Dr Rajendra Singh Dr J P Bhargav 2 Sonbhadra Robertsganj Sh. Pandhari Yadav Dr. Mahendra Kumar Dr. G.K. Kuril Page 6 of 37 Health Facilities visited Sr. Name Address/Location Level Name of the Person No (SC/PHC/CHC in charge /Other) Lakhimpur Kheri District 1 District Male Lakhimpur kheri District Dr S. K. Mittal Hospital Hospital District Female Lakhimpur District Dr P. L. Singh Hospital kheri Hospital Palia Palia CHC/ FRU Dr R. K. Verma Gola Gola CHC/ FRU Dr G. P. Sharma Phardan Phardhan BPHC Dr A. K. Singh Samrai Phardhan APHC S.K. Kaushal Chandan Chowki Pallia SC Mannu Singh Rasalganj Phardhan SC Rajda Praveen Bahellia Buzurg Phardhan SC Shushila Mishra Sonbhadra District 2 District Hospital Lodhi, Robertsganj District Dr. Akhilesh Kumar Robertsganj Hospital Urban Health Robertsganj Urban Health Dr. Daya Shankar Centre Centre Myorpur Myorpur CHC/ FRU Dr. U.N. Gautam Chopan Chopan CHC/ FRU Dr. A.P. Sinha Dudhi Dudhi CHC/ FRU Dr. U.P. Pandey Nagawa Nagawa BPHC Dr. P.K. Singh Babhani Babhani BPHC Dr. S. N. Sharma Bijpur Bijpur APHC Dr. A.K. Singh Kachanarawa Kachanarawa APHC Dr. Santosh Kumar Babhangawa Babhangawa SC Smt. Sona Devi Rathara Rathara SC Smt. Sheelam Yadav Kewal Kewal SC Smt. Chandrawati Devi Page 7 of 37 Kirbil Kirbil SC Smt. Shusheela Devi CHAPTER 3 FINDINGS OF 4th CRM 3. A) INFRASTRUCTURE UPGRADATION The progress of Health Infrastructure Upgradation in the State is slow. A total of 129 District Hospitals were identified for upgradation to IPHS standards during the last two years and it was noted that construction in only 3 District Hospital have achieved more than 50% completion and the rest are still in process. There is a huge gap in the building position of CHCs, as still 308 more CHCs are required. Out of 50 CHCs chosen for upgradation for (2009-10), only 5 CHCs have been able to achieve more than 50 % completion and rest are still under construction. The State had set a target to establish 180 First referral units till 2011, and the state has established 154 FRUs till date. There are 3692 PHCs in the State, out of which 3187 are in Government building and construction of 505 PHCs are yet to be completed. Out of 942 JSY wards, 133 have been completed construction and rests 774 are under construction. 11 Regional Family Welfare Training Centres were to be strengthened for the year 2009- 10, but only 2 have achieved 50 % completion.
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