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Nagaland SPIP 2011-12 1 CONTENTS EXECUTIVE SUMMARY CHAPTER-1 Outcome Analysis of PIP 2009-10 and 2010-11 CHAPTER-2 Policy An

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Nagaland SPIP 2011-12 1 CONTENTS EXECUTIVE SUMMARY CHAPTER-1 Outcome Analysis of PIP 2009-10 and 2010-11 CHAPTER-2 Policy An CONTENTS EXECUTIVE SUMMARY CHAPTER-1 Outcome analysis of PIP 2009-10 and 2010-11 CHAPTER-2 Policy and Systemic reforms in strategic areas CHAPTER-3 Conditionalities CHAPTER-4 Scheme/Program A. RCH Flexi Pool B. NRHM Flexi pool C. Immunization D. Disease Control Programs E. Inter-sectoral Convergence CHAPTER-5 Monitoring and evaluation CHAPTER 6 Financial Management CHAPTER-7 State Resources and other sources of funds for health sector Priority Projects that can be considered if additional resources CHAPTER-8 are available Nagaland SPIP 2011-12 1 EXECUTIVE SUMMARY: There had been a tremendous impact in the Health sector since the implementation of NRHM in the state. In the earlier days, Health sector had never been a priority in the state. And at the time of attainment of statehood in 1963, Nagaland was only fortunate to inherit the legacy of a few hospital infrastructure in the then District Headquarters. The spread of health infrastructure in the state had always been in a slow pace mostly due to negligence and fund constraints in the State. Human resource in the health sector also had a setback with the blanket ban on post creation since 1990. This may be due to poor socio - economic status of the State which might have been responsible for the dismal Health Services. Thus, quality Health care has always been an elusive dream for the people in this part of the country. The need for quality Health care has been obvious giving the increasing number of patients from the state going out to the far and wide places in search of better services. But with the coming of NRHM, the health sector in the State has boost up, be it be in the infrastructure developments, capacity building or filling of manpower shortages and Health activities. The state seeing the impact on the Health sector under the flagship of NRHM has been contributing the state share without hesitation even with the financial crunches in the State. For the year 2011-12, the state has taken an extensive exercise for developing the action plan right from the grass root level. It began with the development of the village health plan involving the village health committee (VHCs) and the communities in all the districts. The block health action plans were also done basing on the needs from the village health action plans, ground realities and priorities. The District action plans had been brought about with the accumulation of all the block health action plans and the district’s specific needs. Table: District wise distribution of PHIs as on 30.09.2010. District DH CHC PHC SHC BD SC Total Kohima 1 3 14 0 0 40 58 Mokokchung 1 3 14 0 2 51 71 Tuensang 1 2 11 1 0 39 54 Phek 1 3 24 1 0 44 70 Mon 1 2 15 0 0 50 68 Wokha 1 2 12 0 0 37 52 Zunheboto 1 2 13 0 0 47 63 Dimapur 1 2 8 0 1 47 59 Peren 1 1 8 0 0 16 26 Kiphire 1 1 4 0 0 19 25 Longleng 1 0 3 0 0 8 12 State Total 11 21 124 2 3 398 558 Table: Health Scenario: Indicator Nagaland SRS 2006 SRS 2007 SRS 2008 SRS 2009 Birth rate 16.4 17.3 17.4 17.5 Death rate 3.8 4.8 5.0 4.6 IMR 18 20 21 26 Indicator NFHS I NFHS II NFHS III DLHS II (1992-93) (1998-99) (2005-06) (2002-04) Total Fertility rate 3.3 3.8 3.7 Full ANC 15.0 21.9 31.6 33.1 Institutional Delivery 6 12 12.2 17.8 Assisted Delivery 18.9 32.8 25.9 81.8 Full Immunization 4 14 21 14.4 Contraceptive Use 13 30 30 33.0 Total Unmet Need 26.7 30.2 26.3 33.8 MMR - - - - Nagaland SPIP 2011-12 2 Table: Performance of Major Activities over the years Year 2005-06 2006-07 2007-08 2008-09 2009-10 2010-2011 (upto Oct’10) Patient Turnover Out-patient Load 226957 295963 478078 523090 336959 341265 In-patient Load 18500 29158 34460 63805 54532 346683 Maternal Health Institutional Delivery* 1182 5696 9943 12606 10765 9455 Child health ** BGG 35024 52450 49917 26799 35159 22345 DPT3 29912 60257 50441 23717 32373 19376 OPV3 30614 62653 52904 24586 33175 20067 Measles 27876 50180 51618 23157 34253 20693 Full immunization - 50180 51618 23157 34253 20693 *As per RCH/JSY Report as on Dec’10 **As per UIP division PROGRESS OF THE STATE SINCE LAUNCH OF NRHM: 1. Output Indicators: Indicator 2010-11(April- 2008-09 2009-10 October) BCG 76.0% 100.0% 63.8% DPT 67.0% 92.4% 55.3% OPV 70.0% 94.7% 57.3% Measles 66.0% 97.8% 59.1% Fully immunised 66.0% 97.8% 59.1% 1. Immunisation* Prophylaxis Against Blindness – 1st Dose 48.4% 45.0% 38.1% Prophylaxis Against Blindness – 2ndose 35.2% 23.5% 21.1% Prophylaxis Against Blindness – 3rdDose 30.4% 17.8% 15.0% ANC Registration against Expected Pregnancies 56.3% 88.0% 43.5% TT1 given to Pregnant women against ANC Registraion 23.4% 41.1% 20.0% Tetanus Immunisation (Expectant Mothers) 22.4% 35.0% 17.0% 3 ANC Check ups against ANC Reigtrations 14.0% 26.0% 14.0% 100 IFA Tablets given to Pregnant 2. Maternal and Child women against ANC Registraion 6.5% 23.0% 19.1% Health Pregnant women detected with hypertension 0.0% 1.1% 0.4% Pregnant women detected with anaemia 0.0% 2.5% 1.8% HOME Deliveries( SBA& Non SBA) against Estimated Deliveries 9.0% 13.4% 7.5% Institutional Deliveries against Estimated Deliveries** 27.9% 33% 25.8% C Section Deliveries against Institutional Deliveries( Pvt & Pub) 0.7% 2.4% 1.0% Live Births Reported against 3.Births & Neonates Care Estimated Live Births 26.5% 44.0% 22.4% Still Births (Reported) 1% 1% 0% Nagaland SPIP 2011-12 3 Sex Ratio at Birh 993 928 947 New borns weighed against Reported Live Births 57.4% 74.1% 68.1% New borns weighed less than 2.5 kgs against newborns weighed 12.3% 9.0% 5.0% New borns breastfed within one hr of Birth against Reported live Births 0.8% 51.0% 62.0% Post-partum check-up within 48 hrs 4.Post Natal Care after delivery 9.3% 30.0% 32.2% Post-partum check-up between 48 hrs and 14 days after delivery 17.1% 18.3% 23.5% Condom-User 36.0% 96.0% 84.4% Oral Pill Users 15.2% 25.5% 12.1% IUD Insertions 2.0% 6.5% 2.7% 5. Family Planning Sterilisation 1.4% 4.0% 2.0% Tubectomy 1.2% 3.8% 2.0% Vasectomy 0.1% 0.1% 0.0% OPD 523090 336959 341265 IPD 63805 54532 346683 Major Operations 158 853 1482 6.Other Services Minor Operations 124 4474 6074 Number of villages 1278 No. of VHND Conducted 5 329 997 Number of times the Ambulance was used for transporting patients 15 424 457 7.Childhood Diseases Pertussis 0 2 7 2. Civil works: Table: List of various civil works under NRHM Total Units S. No Name of Work Approved Completed Under process 1 Sub Centre 135 85 50 2 PHC 19 6 13 3 CHC 8 5 3 4 DistrictHospital (Upgradation) 11 11 0 5 Staff Quarters (CHC) 19 8 11 6 Staff Quarters (CHC) 30 8 22 7 Drug Warehouse 5 2 3 8 NursingSchool Strengthening 2 2 0 9 NursingSchool Dimapur 2 2 0 10 Up Gradation Of NursingSchool To College 1 1 0 11 Upgradation Of NursingSchool Tsg 1 0 1 Nagaland SPIP 2011-12 4 3. Manpower development Table: Manpower Appointment and Institutional Strengthening at State and District Programme Management Units: No. Manpower Grand Total 1 Medical Officer (Specialist) 7 2 Medical Officer (General) 55 3 Medical Officer (AYUSH) 21 4 Dental Surgeon 26 5 Additional Staff Nurse 162 6 Additional ANM 364 7 Additional PHN 41 8 Pharmacist 4 9 Lab Technician 48 10 CT Scan Technician 1 11 ECG Technician 0 12 X-ray Technician 1 13 Telemedicine Operator 1 14 District Programme Manager 11 15 Media Officer 11 16 Block Programme Manager 45 17 ASHA Coordinator 40 18 Accountant 11 19 Data Entry Operator 10 20 Computer Operator 11 21 Driver for Medical Mobile Units 22 Total 892 22 ASHA (Voluntary Link Worker) 1700 4. Procurement & Supply of Medicines: The NRHM is supplementing the medicine supply under state procurement and RCH to all the health units as stated under. No. Unit Total no. of Units 2008-09 Rs. In Lakhs 2009-10 Rs. In Lakhs 1 SC 397 34.62 143.99 2 PHC 123 38.34 36.80 3 CHC 21 87.12 86.24 4 DH 11 103.59 110.00 TOTAL 263.61 377.03 5. Procurement & Supply of Equipments and Instruments: The following amount was incurred for Procurement & Supply of Equipments and Instruments for various health units as per approved RoP over the years. No. Unit Total no. of Units 2008-09 Rs. In Lakhs 2009-10 Rs. In Lakhs 1 SC 397 50.00 0.00 2 PHC 123 69.39 138.55 3 CHC 21 216.78 31.95 4 DH 11 53.66 0.00 TOTAL 389.83 170.50 Nagaland SPIP 2011-12 5 6. Procurement & Supply of Ambulance: No. Unit No. of Health Units No. of Ambulances provided 2008-09 2009-10 Rs.
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