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Government of Jammu & Kashmir GOVERNMENT OF JAMMU & KASHMIR DISTRICT HEALTH ACTION PLAN BUDGAM December 2007 1 2 3 CONTENTS PREFACE ......................................................................................................................................................5 EXECUTIVE SUMMARY .............................................................................................................................7 PRIORITIES OF THE DISTRICT ................................................................................................................9 BUDGET SUMMARY .................................................................................................................................13 1. SITUATION ANALYSIS ........................................................................................................................17 Development Indicators of the District ...........................................................................................18 Socio Economic and Health Indicators of the District ....................................................................19 2. PLANNING PROCESS ..........................................................................................................................34 3. PRIORITIES AS PER BACKGROUND AND PLANNING PROCESS ..........................................39 4. GOALS .....................................................................................................................................................41 5. TECHNICAL COMPONENTS ..............................................................................................................42 PART A: Reproductive and Child Health (RCH) II ........................................................................42 PART B: New NRHM Initiatives ...........................................................................................................56 PART C: Immunisation ........................................................................................................................69 PART D: National Disease Control Programme ...........................................................................77 6.INTER-SECTORAL CONVERGENCE ........................................................................................87 7. COMMUNITY HEALTH ACTION .........................................................................................................92 8. PUBLIC PRIVATE PARTNERSHIP ....................................................................................................94 9. GENDER AND EQUITY ........................................................................................................................95 10. CAPACITY BUILDING ........................................................................................................................96 11.HUMAN RESOURCE PLAN .............................................................................................................102 12.PROCUREMENT AND LOGISTICS ................................................................................................108 13. DEMAND GENERATION – IEC .......................................................................................................110 14. FINANCING OF HEALTH CARE ....................................................................................................112 16. BIO-MEDICAL WASTE MANAGEMENT .......................................................................................115 4 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. Department of Health, Government of J & K is implementing the NRHM in right earnest. A number of enabling actions were taken by the State Health Society. This created environment conducive for decentralized planning by the district. District Action Plans is the most important unit of the planning process as the Government of India and the state government would 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 integrated to form District Action Plans. We now have 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 June, 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 plans but will also be responsible for monitoring the progress of implementation to achieve the objectives of the plan. The members of the DPT are: S. No. Name Designation Department 1 Mr.Farooq Ahmad Ranzoo Deputy Commissioner Headquarter 2 Dr. Mushtaq Ahmad Kichloo Chief Medical Officer Health 3 Dr. Bashir Ahmad Janawari Dy. Chief Medical Officer Health 4 Basharat Ahmad Makhdoomi Chief Planning Officer D.C Office 5 Ahmad Ullah Owaise Chief Education Officer Education 6 Dr.Mahmood Ahmad ADMO(ISM) Health 7 Dr. Riyaz Hamdani Medical Superintend(DH) Health 8 Manzoor Ahmad Sofi District Panchayat Officer 9 Yasmeen Akhter DSWO Social Welfare 10 Javid Sofi Assistant Executive Engineer PHE 11 Er.Altaf Ahmad Executive Engineer PHE 12 Rizwan Alam Thakur DPM Health The orientation of DPT, facilitated by the Dr. Abu Altamash Faizi, Head, Kashmir Division form EPOS, New Delhi, and Mr. Abdul Latif Dar District Co-ordinator Budgam was held on 27 th June 5 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 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 134 Sub health centres, 45 PHCs, 9 CHCs and a district hospital in the District. DR.MUSHTAQ AHMAD KICHLOO (CHIEF MEDICAL OFFICER 6 EXECUTIVE SUMMARY Budgam district covering an area of 1,371 sq and situated at an average height of 5,281 ft above sea-level. Budgam is formed of three tehsils namely Budgam, Chadoora, Beerwah. The district is divided into 10 medical blocks. District headquarters is situated at Budgam. The district has recorded a population of 5, 93,768, (2001 Census) with a decadal growth rate of 26.5 per cent and a Sex-Ratio of 940 females per 1,000 males. The overall literacy rate has been recorded at 39.54 %, With a predominantly rural outlook, 86 % of the population in Budgam district live in its villages and are primarily involved in agricultural operations. The NRHM seeks to provide accessible, affordable and quality health care to rural population, especially the vulnerable sections. It also aims at reducing the Maternal Mortality Ratio (MMR) in the country from 407 to 100 per 1, 00,000 live births, Infant Mortality Rate (IMR) from 60 to 30 per 1000 live births and Total Fertility Rate (TFR) from 3.0 to 2.1 within the 6 year span of the Mission (2006-07 to 2011-12). The District health Action Plan has been prepared using decentralized planning process. Village and block plans converged to form the district plan. It is also based on the data collected during the block consultation “Facility Survey” in July 2007 covering 134 Sub Centres, 45 PHCs, 9 CHCs and a District hospital. These facilities are providing Health care to about 6.8 lakh population living in 622 villages and 10 urban towns in the district. International Institute For population Sciences, Mumbai ranked 593 districts in the country on the basis of children parity, contraceptive prevalence rate (CPR), under five child mortality and ANC. The overall ranking of the district Budgam is 338. In this ranking system, the lower is the rank, the better the district. In terms of major challenges, the district needs to increase institutional deliveries and deliveries by skilled personnel which are currently at 43% and 67% respectively. The share of male participation in use of family planning methods is almost negligible. Prevalence of anaemia amongst pregnant women is quite high as per DLHS report. These issues have to do both with demand and supply of health services. This is a district where average literacy
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