Draft DISTRICT HEALTH SOCIETY DHUBRI, ASSAM. Prepared By DPMU, NRHM, Dhubri DHUBRI/DHAP/2010-11 1 CHAPTER CONTENT PAGE - EXECUTIVE SUMMARY 3-5 1 BACKGROUND 6-22 2 PROCESS FOR PLAN DEVELOPMENT 23-24 3 SITUATION ANALYSIS OF THE DISTRICT 25-44 4 PROGRESS MADE DURING 2005-06, 06-07, 07-08 & 08-09 45-67 5 CURRENT STATUS AND GOAL 68-76 6 GOAL, OBJECTIVES, STRATEGIES AND ACTIVITIES UNDER DIFFERENT 77 COMPONENTS OF NRHM PART A: RCH PROGRAMME 78-104 PART B: NRHM ADDITIONALITIES 105-121 PART C: UIP 122-139 PART D: NATIONAL DISEASE CONTROL PROGRAMME 140-192 PART E INTERSECTORAL CONVERGENCE 193 7 MONITORING AND EVALUATION/ HMIS 194-208 8 WORK PLAN 209-237 9 SUMMARY BUDGET 238 PART A: RCH PROGRAMME 239 PART B: NRHM ADDITIONALITIES 240-241 PART C: UIP 242-249 PART D: NATIONAL DISEASE CONTROL PROGRAMME 250-256 PART E: INTERSECTORAL CONVERGENCE 257 10 DETAILED BUDGET (ANNEXURE 3 E) 258-291 ANNEXURES DHUBRI/DHAP/2010-11 2 EXECUTIVE SUMMARY Dhubri district PIP for the year of 2010-11 (Programme Implementation Plan) prepared under NRHM is a synopsis of various tasks and activities that are to be executed in the financial year 2010-11. The PIP is primed considering the Goals and main objectives of NRHM, in order to enhance the health scenario of the district. The main goals of NRHM in Dhubri district are Reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR), Prevention and control of communicable and non-communicable diseases, including locally endemic diseases, an increase of contraceptive prevalence rate among eligible couples etc . To achieve these goals we have adopted some strategies and that are: Maternal Health: 1. To provide quality antenatal care to all pregnant woman by increasing the access through existing Govt. facilities. 2. To provide quality antenatal care to all pregnant woman in inaccessible and uncovered areas 3. Quality improvement of the ANC. 4. To increase awareness amongst the mothers and communities about the need of ANC. 5. Increasing the access through facility strengthening. 6. Social mobilization for institutional deliveries (Janani Suraksha Yojana) 7. Referral of obstetric emergencies 8. To improve the comprehensive EmOC in the CHCs and FRU. 9. Awareness of communities and PRIs about facilities having comprehensive EmOC facilities. 10. Capacity building of ANM/GNM by SBA training : 11. Ensure post partum care by AWW/ANM/LHV 12. Operatonalize services for diagnosis & Treatment at CHC/DH 13. Capacity building ANM/SN and Medical Officer & Lab Tech for managing RTI/STI 14. Promote communication activities for prevention and early care seeking for RTI/STI. 15. Increase the access to safe abortion in Govt. facilities. CHILD HEALTH 1. Strengthening of the Govt facilities to provide newborn care. 2. Introduce a communication package of home-based newborn care by ASHA, AWW, ANM, CBO, and FNGO. 3. Referral of sick neonates who cannot be managed at home. DHUBRI/DHAP/2010-11 3 4. Declaring Mother and Child Health Month during the month of September and March (bi- annually). 5. To increase awareness amongst mothers on benefits of breast-feeding upto 6 months and need of complementary feeding from 6 month onwards. 6. To raise awareness amongst mothers and communities on diarrhea. 7. Making ORS and zinc tablets available in remote/rural/tribal areas and difficult to reach areas through depot holders. 8. Strengthen facilities at PHC, CHC, SDH and DH. 9. To raise awareness amongst mothers and communities on ARI. 10. Promote referral services of severe cases of ARI and diarrhoea. 11. To prevent and treat anemia in children. 12. To work closely with ICDS functionaries to reduce malnutrition. FAMILY PLANNING 1. To raise awareness amongst the couples and communities about the advantage of contraceptives and small family. 2. Increase the number of service delivery points. 3. Improve the service delivery to provide quality male and female sterilization. 4. To raise awareness among the community regarding Non Scalpel Vasectomy. ADOLESCENT HEALTH 1. Community awareness by BCC. 2. To educate and raise awareness amongst the adolescent boys and girls about human physiology, RTI, STI, HIV/AIDS, EC and safe sex. 3. To assess service delivery by identifying institutions and also identifying counselors. 4. Required models, charts of human anatomy as teaching aids to be used. 5. A booklet will be developed on adolescent health including all the components preferably in local languages. 6. Ensure service delivery and infrastructure facility 7. To prevent and treat anemia in adolescents. DHUBRI/DHAP/2010-11 4 Programme Management Arrangement: The DPMU (District Programme Management Unit) consist of one Management specialists, Media Expert, Accounts Manager, Data Manager, Drug Store Manager, Computer Assistant and they are working under the guidance of Joint Director of Health Services cum Member Secretary, DHS, Dhubri. Moreover the whole activities are supervised by Deputy Commissioner cum Chairman, DHS, Dhubri. For Strengthening the NRHM activities and to build skill and capacity of Top level officials to middle level officials example - DPMU, BPMU, ASHA, ANM, GNM, AWW, MO etc sensitize orientation training is proposed in the PIP. In the Block PHC level Block Programme Manager, Block accounts Manager are also appointed. Pharmacists, Lab Technicians, PHC Accountant, Asst. BPM, GNM, ANM, ASHA, ASHA Supervisor etc are alos posted in the PHCs, SDs, SHC, SCs and in the PIP requirement for additional skill manpower like MO, Specialists, BPM, GNM, ANM has been proposed. BUDGET The district proposes a total budget of Rs. 16,92,81,623.23 in the PIP for the year 2010-11. The budget summary is as follows: Summary of Budget Programme Amount ( In Rs.Cr) RCH-II Flexipool 32,345,665.23 NRHM Mission Flexipool 10,99,21,450.00 Immunization(UIP) 6,018,968.00 National Disease Control Programme 0.00 (i) NVBDCP 7,469,840.00 (ii) RNTCP 7,974,000.00 (iii) NPCB 1,771,000.00 (iv) NLEP 943,100.00 (v) IDSP 1,121,600.00 (vi) NTCP 1,216,000.00 (vii) NMHP 500,000.00 Total 16,92,81,623.23 DHUBRI/DHAP/2010-11 5 CHAPTER- 1 BACKGROUND 1.1 THE DISTRICT AT A GLANCE: Dhubri District - the gateway of western Assam happened to be in the past a meeting place of different racial groups which mingled together and formed a unique Cultural Heritage and Historical Background. The growth of blended culture in this region particularly in case of Language, Art and Religion is due to continuous process of assimilation of various races, caste & creed of local people, invaders & migrated people. Dhubri District is bounded both by inter-state and international border i.e. West Bengal and Bangladesh in the west, Goalpara and Bogaigoan district of Assam and Garo Hills district of Meghalaya in the east, Kokrajhar district in the north, Bangladesh and state of Meghalaya in the south. Covering an area of 2,838 Sq. Kms. including forests, riverines, hills etc. the district has become the most densely populated district in India with a density of 584 persons per Sq. Km. (As per 2001 census). Dhubri District is bounded both by inter-state and international border i.e. West Bengal and Bangladesh in the west, Goalpara and Bogaigoan district of Assam and Garo Hills district of Meghalaya in the east, Kokrajhar district in the north, Bangladesh and state of Meghalaya in the south. This district is located on the globe between 89.42 to 90.12 degree east longitude and 26.22 to 25.28 degree north latitude. The district is situated at 30 meters above the sea level on average. General topography of Dhubri district is plain with patches of small hillocks like Tokorabandha, Dudhnath, Chandardinga, Boukumari, Boropahar, Chakrasila etc. All these are situated in the north eastern part of the district. Mighty river Brahmaputra is flowing through this district from east to west with its tributaries like Champabati, Gourang, Gadadhar, Gangadhar, Tipkai, Sankosh,Silai, Jinjiram etc. DHUBRI/DHAP/2010-11 6 DHUBRI/DHAP/2010-11 7 Table:1 Demography Characteristics of the District: Total Population : 16, 37, 344 Nos Male 8,41,044 Nos. (51.37 %) Female 7,96,300 Nos. (48.63 %) Sex Ratio 1000 : 947 General Population 12,36,054 Nos. (92.76%) Schedule Caste 64,161 Nos. (4.82%) Schedule Tribe 32,260 Nos. (2.42%) Urban Population 1,61,981 Nos. (12.16%) Rural Population 11,70,494 Nos. (87.84%) Density 577 Nos. per Sq. Km. Percentage of Decadal growth rate (91-01) +23.42 Crude Birth Rate 31% Crude Death Rate 9% Maternal Mortality Rate 4/1000 Infant Mortality Rate 78/1000 Literate Person 6,25,369 Nos. (48.2%) Male 3,73,446 Nos. (55.91%) Female 2,51,923 Nos. (40.04%) http://dhubri.gov.in/demography_dhubri.htm AS PER 2001 CENSUS Table: 2 Administration of the District: The present Dhubri District with an area of 2838 sq. km. has three Sub-divisions viz. (a) Dhubri(Sadar), (b) Bilasipara and (c) South Salmara/Mankachar 1. Revenue Circle : 8 Nos. 2.Tahsil : 7 Nos. 3. Sub Tahsil : 2 Nos. 4. Revenue Village : 1374 Nos. (Prior to BTAD) 5. Model Village : 3 Nos. 6. Revenue Village : 1133 Nos. (Excluding BTAD) 7. Anchalik Panchayat : 14 Nos. 8. Mahkuma Parishad : 3 Nos. 9. Municipal Board : 1 No. 10 . Gaon Panchayat : 172 Nos. (Prior to BTAD) 11 . Development Block : 14 Nos. 12 . Gaon Panchayat : 168 Nos. (Excluding BTAD) 13 . Police Outpost : 7 Nos. 14 . Basic Town : 4 Nos. 15 . Govt. Raliway Police Outpost : 2 Nos. 16 . Police Station : 8 Nos. 17 . Regular Fire Service Station : 2 Nos. 18 . Police Watchpost : 36 Nos. 19. Border Outpost : 35 Nos. 20 . River Police Outpost : 3 Nos. DHUBRI/DHAP/2010-11 8 Table: 1.2.