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D F P P Dist Fam Plan Plan 20 Rict Mily Nnin N 12-1 G 13

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D F P P Dist Fam Plan Plan 20 Rict Mily Nnin N 12-1 G 13 Draft District Family Planning Plan NAYAGARH 2012-13 District Family Welfare Bureau Zilla Swasthya Samiti Nayagarh, Odisha 1 Chapter 1 Background The Nayagarh district, originally was a part of undivided Puri district, is located towards the west and surrounded by Cuttack district in the North, Phulbani district in the West, Ganjam district in the South and Khurda district in the East. The west side of Nayagarh is the hilly region, part of eastern Ghats with fertile valleys and the north and eastern part is constituted of agricultural plateaus intersected by small streams and rivers. River Mahanadi flows in the north and brings water for irrigation and calamity during floods. The climate of the District is extreme in nature with high temperature during summer and cooler in winter. Nayagarh is also acknowledged for its leather works, brass and bell utensils and sugar factory. Spread over an area of 3,890 Sq.Km square kilometers, with forest cover is as high has 2080.97Sq.Km. The population of the district is 9, 62,245 (2011 Census) with 6% Scheduled tribes and 14% Scheduled castes. The literacy rate of the district is 79% and the female literacy is 71% (2011 Census). Administratively the district has 8 blocks, 180 Grampanchyats and 1694 revenue villages. It has 4 towns and 2 urban local bodies i.e. NAC of Nayagarh and Khandapada. Out of the 8 blocks, 2 are categorized as RCH difficult or high focus blocks. Both the blocks are the most difficult in terms of accessibility with very low service utilization. The neonatal mortality rate of the district is high & contributes 56 % of total infant death. In addition to this, there is high morbidity and mortality due to communicable diseases (Malaria, ARI and water borne diseases).The institutional delivery is 86% as per HMIS of the total reported deliveries in the district. The major public health issue is malaria and each year the district reports high morbidity and mortality. Malnutrition and Anemia are two other major issues in the district. However, the immunization coverage stands at 86% as per HMIS data (49.2% as per DLHS III). Though the district has made progress with respect to improving the health of its people over the last two decades and there is significant improvement in the key health indicators in the district, but still there are challenges in health service delivery system. Non availability of doctors at periphery levels is seriously hampering public health delivery services, thus affecting management of complicated cases at facility levels. To tide over the situation, contractual doctors (including O & G & Paed Spl) have been given appointment for operationalisation of MCH Centers. 2 District Map of Nayagarh 3 DEMOGRAPHIC PROFILE SL. ITEMS INFORMATION NO. GENERAL 1 Area (sq. km) 3890 2 % in total state’s area 2.50 3 CD Blocks 8 4 Towns 2 5 No. of Village 1694 Inhabited 1151 (OHD Report, 2004) Uninhabited 543 5 No. of Tehsils 8 6 Towns & Urban Areas 2 7 No. of Gram Panchayats 179 (Dist.Panchayat Office, Nayagarh) 8 No. of NACs/Municipality/Corporation 02 (Nayagarh, Khandapara) DEMOGRAPHIC PARTICULARS (CENSUS 2011) 9 Population (Total) 962245 (2.29 % to total population of the State) 9a. Male 502194 (52.19% of Dist. Pop.) 9b. Female 460021 (47.80% of Dist. Pop.) Population in the age group of 0-6 years (2011) 1 Total 101337 (12.75% of dist. Pop.) 2 Male 54759 (10.90% of dist. Pop.) 3 Female 46578 (10.12 % of dist. Pop.) 4 % of 0-6 population to total population 10.53 % Population Density 1. 1991 201 per sq. km 2. 2001 222 per sq. km 3. 2011 247 per sq. km Sex Ratio (Census 2011) Sex Ratio 916 female/1000 male (2011 Census) Child sex ratio in the age group of 0-6 1. 1991 950 2. 2001 904 3. 2011 851 Literacy Rate (Census 2011) Literacy Rate (Total Population) 79.17 Literacy rate (Male) 86.63 Literacy Rate (Female) 71.08 4 HEALTH INFRASTRUCTURE Sl Number No. Type of Institutions 1 District Hospital 01 (DHH, Nayagarh) 2 District Post Partum Centre 01 (PPC, Nayagarh) 3 Block Post Partum Centre 01 (Ranpur PPC) Community Health Centers (CHC) 12 (Nuagadiasahi, Saranakul, Bhapur, Mahipur, Rajsunakhala, Gania, Badapandusar, 4 Madhyakhanda, Dasapalla, Ranpur, Odagaon & Khandapada) 5 Single Doctor PHC 36 6 Sub Centres 166 7 Mobile Health Unit 3 Nos 8 Anganwadi Centers 1544 (1142 Main AWC) Ayurvedic 9 Hospitals 0 Dispensaries 13 Homeopathy 10 Hospitals 0 Dispensaries 19 11 Other Hospital BMSN, Chandapur 12 AIDS Counseling & Testing Centers 5 ICTCs “Shradha” – AFHC Clinic 3 (DHH Nayagarh, Sarankul CHC 13 & Dasapalla CHC) Blood Bank(BB) / BSUs 1 BB at DHH/ 1 BSU at Dasapalla 14 CHC 15 ANM Training Center, Dasapalla 1 STD Clinic at DHH 1 16 No of ASHA sanctioned 885 17 No of ASHA in-position 884 18 RKS at DHH is formed 1 19 RKS at CHC level 12 20 RKS at PHC (N) level/others 37 21 Physiotherapy Centre (PPP) at DHH 1 22 Tele-Medicine Centre 1 23 Central Drug Warehouse 1 24 Janani Express 12 25 Ambulance 9 26 Accredited Family Planning Center 1 (Krishna Clinic, Nayagarh) 27 Total Bed Strength 650 5 MCH CENTER/ DELIVERY POINTS LINKAGES: Human Resource: (A) Sanctioned Staff (Regular) Sl. Name of the Sanctioned In position Post 1 O & G 15 06 2 Pediatrics Spl 13 04 3 Anesthetist 2 01 Blood Bank 1 01 Officer 1 Asst. Surgeon 44 17 Total Doctors 127 62 2 Staff Nurse 91 79 3 Pharmacist 89 88 3 MPHW(M) 139 86 4 MPHW(F) 187 184 5 MPHS(M) 48 37 6 MPHS(F)/LHV 30 24 7 L.T. 20 18 8 Radiographer 8 8 6 The above table clearly indicates that there are high vacancies in technical human resources. More over the vacancies in FRU & 24 x 7 institutions are largely high. Most of the Specialist, especially O & G and Paed Spl. are lying vacant in FRU and 24x7 Institutions. However to operationalise the MCH Center the district has initiated steps by giving Contractual O&G & Paed Spl. At Gania (L2) & in Rajsunakhala CHC (L3) and Retd MBBS doctors at MCH centres/ delivery points for utilization of Maternal and child health services. it has been experienced in the year2011-12 that contractual doctors have also been engaged in providing family planning services at designated facilities at Mahipur and Daspalla( L2 and L3 facilities) (B) Contractual staff engaged by NRHM: Sl. Name of the Post Sanctioned In position 1. Staff Nurse 47 26 2. Additional ANM 32 32 3. LT 4 3 4. AYUSH doctor 40 36 5. Work Consultant 3 3 6. Assistant Engineer 1 1 7. Immunization (computer Asst) 1 1 8 System Incharge-cum-DEO 1 1 9 BPO 8 7 10 Block Accountant 8 7 11 DPM 1 1 12 DAM 1 1 13 DHIO 1 1 14 District ASHA Coordinator 1 1 15 DMCH 1 1 16 DPMU Accountant 1 1 17 Hospital manager 1 1 18 DHH Accountant 1 1 19 Vaccine & Logistics Manager 1 1 20 MIS Cum Field Coordinator 8 8 21 Office Asst. DPMU 1 1 22 Accountant, Area Hospital 4 3 7 Chapter- 02 Family Planning performance in the Nayagarh in percentage Family planning Achievement Vs Target F.W. 2009-2010 2010-2011 2011-12 Activities Sterilization 3767 1970 52.30 3782 3274 86.57 3787 3829 101.11 IUD 9175 4769 51.98 6104 5130 84.04 4572 3991 87.29 CC 19876 9685 48.73 14087 5763 40.91 9161 7727 84.34 Oral Pill 10702 5893 55.06 7043 5260 74.68 5398 5122 94.88 It has been experienced from the 3 years family planning data that there has been a remarkable progress with regards to achievement of ELA, particularly in the year 2011-12. Besides achieving district target some blocks like Ranapur, Gania, and Mahipur have demonstrated 100% achievement with regards to sterilization. There has been a remarkable increase in sterilization achievements from 57% to 87% and from 87% to 100% (2011-12). The interventions by district heealth administration for this success are 1. Adherence to Fixed day Family planning services at all L3 centers and selected L2 centers. 2. Regular and focused Block wise review at district health review meeting by CDMO and ADMO (FW). 3. Capacity building of technical and paramedics personnel’s (on Minilap and IUCD) from MCH centers on priority. 4. Support to poor performing blocks with regardds to instruments and equipments availability, regular monitoring by Wing officers and district 8 nodal officers, diverting of trained surgeons to poor performing blocks on Parivar Kalyan Diwas. 5. Maximum emphases at ASHA sector meeting for mobilization of cases to FDS. 6 .Strategic utilization of 4 Camp cost budget Situation Analysis: Population stabilization and reduction of TFR (total fertility rate) are the goals of NRHM which contributes significantly to improve the maternal and child health outcomes. Though family planning has been one of the major components of the RCH program, yet it has been out of focus in the last couple of years for one reason or the other. The performance in family planning processes is seasonal with most of the achievements occurring during October to March. However from 2011 July Population week , district has accelerated Family Planing interventions like( Fixed day static services, up gradation of OT for operation at L2 institutions , accelerating training program of personnels from 43 MCH Centres and procurements of Family planning instruments, which has shown result in the year 2011-12. Unmet Need DLHS II DLHS III Unmet Need 0 5 10 15 20 25 A comparison of DLHS-II and DLHS- III data on family planning indicators shows a mixed scenario of the district.
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