2011 5th Common Review Mission- Chhattisgarh 0 Contents 1. Introduction……………………………………………………………………………….2 2. Chapter 1 (Team members and Facilities Visited)……………………………………….3 3. Chapter 2 (Introduction and Baseline of Public Health System in the State)…………….7 4. Chapter 3 (findings of the 5th CRM in the State)…………………………………………12 LLIN intervention Success Story…………………………………………………………30 Recommendations………………………………………………………………………...43 5. Chapter 4 (Note on ASHAs)……………………………………………………………...48 Key findings/ comments of community interaction, FGDs with ASHAs, AWW………..50 Annexure-I (District Profile Kanker)……………………………………………………..51 Annexure-II (District Profile Kawardha)………………………………………………....69 1 Introduction The National Rural Health Mission (NRHM) was launched on 12th April 2005, to provide accessible, affordable and accountable quality health services to the remotest rural regions. The thrust of the Mission was on establishing a fully functional, community owned, decentralized health delivery system with inter sectoral convergence at all levels, to ensure simultaneous action on a wide range of determinants of health like water, sanitation, education, nutrition, social and gender equality. Institutional integration within the fragmented health sector was expected to provide a focus on outcomes. 5th Common Review Mission visit to the States is based on the mandate of review and concurrent evaluation of NRHM. A Twelve member CRM 5 Team visited the State during 9th – 15h November 2011 with the following members: 1. Mr. Biswajit Das, Director, MoHFW 2. Dr. Prema Ramachandran, Director, NFI 3. Dr. R.S Sharma, Joint Director, NVBDCP 4. Dr Manoj Nesari, Joint Advisor, AYUSH 5. Mr Gautam Chakraborthy, Advisor, NHSRC 6. Ms Ashi Kohli Kathuria, Sr Nutrition Specialist, World Bank 7. Dr. B. S. Deewan,NIHFW 8. Ms. Ekta Saroha, Strategic info & Policy, USAID 9. Dr. S. V. Gitte, RD, Raipur, Chhattisgarh 10. Dr. Subha Sankar Das, Consultant (SHP) 11. Dr. Hemant K Sharma, Consultant, NRHM 12. Mr Moni Mohan Manna, NRHM FMG The Team members (1,3,6,9,11,12) visited Kanker district and the rest members (2,4,5,7,8,10) visited Kawardha district during 9th – 15nd November 2011 after the state level briefing in Raipur on 9th November 2011. 2 Chapter – 1 5th Common Review Mission Time-bound quantifiable goals had been specified in the road maps as indicated in the State Programme Implementation Plan for strengthening the health infrastructure with appropriate linkages and financial allocations. The 5th Common Review Mission was undertaken to review the changes in strategies of Health delivery system, improvement in outreach and including quality of services against the stated goals, objectives, outcomes and time lines The Teams Kanker Kawardha Mr. N.K. Khaka, District Collector Mr Mukesh Bansal, District Collector Dr. R.N. Pandey, CMO Dr K K Mishra, Civil Surgeon 1. Mr Biswajit Das, Director, MoHFW 1. Dr Manoj Nesari, Joint Advisor, AYUSH 2. Dr. R.S Sharma, Joint Director, NVBDCP 2. Dr. B. S. Deewan,NIHFW 3. Dr Manoj Nesari, Joint Advisor, AYUSH 3. Dr. Prema Ramachandran, Director, NFI 4. Ms Ashi Kohli Kathuria, Sr Nutrition Specialist, 4. Mr Gautam Chakraborthy, Advisor, NHSRC World Bank 5. Ms. Ekta Saroha, Strategic info & Policy, 5. Dr. S Gitte, RD, Raipur, Chhattisgarh USAID 6. Dr. Hemant Sharma, Consultant, NRHM 8. Dr. Subha Sankar Das, Consultant (SHP) 7. Mr Mani Mohan Manna, NRHM FMG Members from State/ District: Members from State/ District: 1. Mr B Ananda Babu, SS & MD NRHM, 1. Dr K R Sonwani, Deputy Director, NRHM Chhattisgarh 2. Mr Prakash Saheta, State Account officer 2. Mr. Urya Nag, State Program Manager 3. Dr J C Meshram, CMHO 3. Mr. Anand Sahu, State M&E Officer 4. Mr , Pravin Sharma, DPM Kawardha 4. Dr. Jai Prakash, SPO, NVBDCP 5. Dr Salil Mishra, District RCH officer 5. Dr. R N Pandey, CMHO, Kanker 6. Mr Prahlad Ghritlahare, District Data Officer 6. Mr Rajiv Singh, DPM Kanker 7. Dr. D K Ramteke, DMO Kanker De- briefing in the State 3 Objectives of the Mission Reduction in child and maternal mortality Universal access to public services for food and nutrition, sanitation and hygiene and universal access to public health care services with emphasis on services addressing women‟s and children‟s health and universal immunization Prevention and control of communicable including locally endemic diseases and non-communicable diseases. Access to integrated comprehensive primary health care. Population stabilization, gender disparity reduction and demographic balance. Revitalize local health traditions & mainstream AYUSH. Promotion of healthy life styles. Facilities Visited by the Teams I. Kanker Sl Name Address / Location Level (SC / PHC / Name of the Person in CHC/other) Charge 1 CMHO Office District HQ Kanker CMHO Dr. R.N. Pandey 2 District Hospital District HQ DH Dr. D.K. Ture Kanker 3 SHC Dawarkhar Block Naharpur SHC Smt. Surekha Darro 4 PHC Sarona Block Naharpur PHC Dr. S K Gupta 5 SHC Mussurputta Block Naharpur SHC Smt A. Sori 6 CHC Narharpur Block Naharpur CHC Dr. Prashant Kumar Singh 7 PHC Korer Block Bhanupratappur PHC Dr. Hemant Chandrakar 8 CHC Antgarh Block Antagarh CHC Dr. B K Ramteke 9 CHC Bhanupratappur CHC Bhanupratappur CHC Dr A K Dhruv 10 AWC Picchekatta Mullah, Block AWC ANM- Smt. A Thakur Bhanupratappur 11 CHC Dhanelikanhar CHC Bhanupratappur CHC Dr. P Nareti 12 Village Adar Para Mullah, Block Village Mr. Jagannath Singh VK Bhanupratappur 13 SHC Kurishtikur Block Dhanelikanhar SHC Smt. Nandini Jain 14 SHC Kanharpuri Block Dhanelikanhar SHC Smt Kusum Lata Jain 15 Village Baar Devri Block Dhanelikanhar Village Village 16 SHC Potgaon Block Dhanelikanhar SHC Smt Bhupesh Ramteke 17 SHC Kodagaon Block Dhanelikanhar SHC Smt Mani Sahu 18 SHC Talakurra Block Dhanelikanhar SHC Smt. Shishir Maravi 19 Village Kapsi Block Dhanelikanhar Village Village 20 SHC Udkuda Block Charama SHC Ku Bharti Kujum 21 Village Gotitola Block Charama Village Village 22 Village Piprod Block Charama Village Village 23 PHC Haradula Block Charama PHC Dr O P Shankhwar 4 24 CHC Charama Block Charama CHC Dr J L Ulke II. Kawardha : Sl Name Address / Location Level (SC / PHC / Name of the Person in CHC/other) Charge 1 CMHO Office District HQ Kawardha CMHO Dr. J.C. Meshram 2 District Hospital District HQ Kawardha DH Dr K K Mishra, Civil Kawardha Surgeon 3 S.Lohara, Block S.Lohara, CHC Dr A.K. Thakur(BMO) 4 Pandariya, Block Pandariya CHC Dr P.L. Kurre(BMO) 5 Bodla Block Bodla CHC Dr S. Kohade(BMO) 6 Bhimbhori Block S.Lohara PHC Dr Sontosh Luniya(Attached at DH) Ramgopal Yadu (RMA) Shri Ashok Dahariya (pharmasist) 7 Pondi Block Bodla PHC Ku. Pooja Keshrwani (RMA) 8 Dullapur Block Pandariya PHC Dr S.K. Bandhekar 9 Kukdoor Block Pandariya PHC Dr B. L. Raj 10 Chilfi Block Bodla PHC Rakesh Rathore (RMA) 11 Pori Block Bodla PHC Ku. Pooja keshwarni, (RMA) 12 Daniyakhurd Block S.Lohara SC Smt. Dharmin Mehara(ANM) 13 Chilfi Block Bodla SC 1.Ku.Dhan Bai Dahariya(ANM) 2. Mr D.K. Berwanshi (MPW) 14 Oriya Kala Block S.Lohara SC Smt. Laxmi Gupta(ANM) 15 Visheshra (Parshwara Block Pandariya SC Smt. Nisha Sharma (ANM) SC) 16 Singhampuri Block S.Lohara SC Smt. K. Das (ANM) 17 Vishehara Block Pandariya Anganwadi (VHND) Smt. Sulochani Rajput 18 Daniyakhurd Block S.Lohara Anganwadi (VHND) Smt. Chandra Kumari Patel 19 Chilfi Block Bodla Anganwadi (VHND) Smt Asha Bai Dharvia(AWW) 20 Behsin Jhori Block S.Lohara Anganwadi (VHND) Savita Chhatari (ANM) [Bamhantola (SC)] 2.Urmila Sahu( AWW) 3. Maya Tiwari( AWW) 21 Pipartola Block S.Lohara[Mahartola Anganwadi (VHND) 1.Subhadra Chandrakar (SC)] (ANM) 2.Smt. Bisani sahu (AWW) 5 22 Surjapura, Block S.Lohara Ayurvedic Dispensary Dr. Sudesh Tiwari 23 Chilfi Block Bodla Ayurvedic Dispensary Chitranjan Das Bariha 24 Dullapur Block Pandariya AYUSH Gram Dr S K Sarnakar 25 Govt Primary School, Block Bodla Govt School Mr. Shiv Ram Jhariya Chilfi , 26 Govt Primary School Block Pandariya Govt School Ramanuj Sharma, HM Bisesera 27 Goraj Children Kawardha(Urban) Private hospital Dr. Govardhan Singh Hospital Private Thakur hospital Accredited under RSBY 6 Chapter – 2 Introduction: Chhattisgarh: The Profile – State: Geography Chhattisgarh is one of the few landlocked states of the country. Uttar Pradesh and Bihar bind the State in north, in the east it is bound by Orissa, in the south by Andhra Pradesh and in the west by Madhya Pradesh and Maharashtra. A large part of the state comes under Vindhyachal range that divides the Indian subcontinent into two. Mahanadi and Narmada are the principal rivers of the state. Narmada has its origin in Amarkantak, which lies in Chhattisgarh. History Chhattisgarh carved out of Madhya Pradesh came into being on 1st November 2000 as the 26th State of the Union. It fulfills the long-cherished demand of the tribal people. In ancient times the region was known as Dakshin-Kausal. This finds mention in Ramayana and Mahabharata also. Between the sixth and twelfth centuries Sarabhpurias, Panduvanshi, Somvanshi, Kalchuri, and Nagvanshi rulers dominated this region. Kalchuris ruled in Chhattisgarh from 980 to 1791 AD. With the advent of Britishers in 1854 Raipur gained prominence instead of capital Ratnapur. In 1904 Sambalpur was transferred to Orissa and estates of Sarguja were transferred from Bengal to Chhattisgarh. The state of Chhattisgarh has an area of 1, 35,191 sq. km. and a population of 25.5 million. There are 18 districts, 146 blocks, and 20308 villages. The State has population density of 154 per sq. km. (as against the national average of 312). 7 The decadal growth rate of the state is NA (against 21.54% for the country) and the population of the state is growing at a slower rate than the national rate. Situation analysis in beginning: The Indian state of Chhattisgarh was created on November 1, 2000. Carved out of the state of Madhya Pradesh, the new state, the 9th largest in the country with 24 million people, faced enormous socio-economic and development challenges- ranging from low literacy rates; low population density and geographically scattered communities; lack of basic public infrastructure; a population made up of roughly 1/3 tribal peoples; and a history of left-wing extremism and Naxalite conflict.