Jan 2009 - DOC by y18a5zKA


									Polio is a deadly disease caused by virus infection resulting in physical deformity among the children. It can be easily
prevented by immunising the child with polio vaccine given in the form of oral drops. It is essential to immunise all children
below 5 yrs of age to eradicate this dreaded disease from the society.
Government of Karnataka started the highly successful Polio Eradication Programme called “Pulse Polio” programme in
1995. No case of polio has been seen in the state since 2005.
In continuation of the effort, one more round of Polio programme is scheduled to be held on Sunday the 21 Dec 2008,
through out the state. 48,995 teams involving 97,990 workers will be conducting Polio immunisation in the vaccine
centres established for the purpose, for all the children below 5 yrs.
In addition, the teams will be conducting a door-to-door campaign, in the next 3 days, to ensure that all the children who
missed out getting the vaccine on 21 Dec 2008, are covered.

Pulse polio programme on 21 Dec 08
                         NATIONAL RURAL HEALTH MISSION                                KARNATAKA
                                                       January 2009
                                                      Volume 2, Issue 1

Inside this issue:
Fully functional Health Institutions   2

Mobile Medical units                   2

The village level Asha Scheme          2

Training Doctors in LSAS               3

New interventions under NRHM           3

Incentives for ANMs                    3

MVA - the safe abortion option         4

The Mission has identified many constraints, like non availability of doctors and paramedics, shortage of drugs and
vaccines, dysfunctional equipments, inflexible financial resources and lack of accountability framework, in the path towards
establishing fully functional sub centres, PHCs, CHCs and District Hospitals. To overcome these constraints action plan has
been developed and is being implemented. It includes,

 Development of Infrastructure, procurement and optimal use of equipments.
 Adequate management support
 Streamlined fund flows
 Contractual appointment of doctors and paramedics to support capacity development
 Pooling of staff for optimal utilization
 Improvement of MIS.
 Streamlined procurement
 Local level flexibility
 Community, Panchayat Raj Institutions and Rogi Kalyan Samitis to be toned up for accountability , monitoring and

 Adopting standard treatment guide lines for each facility and different levels of staffing
 To develop road maps to reach desirable levels in a period of five to seven years.
ASHA is the link worker between the community and the Government Health System.
ASHA is trained to create awareness and provide information to the community on determinants of health, counsel woken
on safe delivery, contraception etc., She mobilizes the community and facilitate in accessing health services. She provides
primary medical care and informs the relevant authorities about deaths and births in the village. She will promote
construction of house hold toilet under Total Sanitation Campaign.
Training of ASHAs :
The candidates selected are given training in all preventive healthcare aspects of pregnancy, antenatal care, delivery care,
postnatal care, newborn care, diarrhea, acute respiratory infections, first aid and treatment of minor ailments.
Budget for training :
The budget for ASHA workers training includes cost of training the trainers and coordinators in each district level training
institutions, travelling expenditure of candidates, their boarding cost at the training institution, cost of training material,
wage compensation for candidates for the duration of training etc. Provision has been made for an expenditure of Rs.
10,000 per candidate during a financial year.
Selection for 11,200 ASHA workers for districts of Bijapur, Bagalakote, Gulbarga, Bidar, Koppal and Raichur, is
completed, and it is proposed to select 10,000 link workers in the districts of Belgaum, Dharwad, Haveri, Gadag, Uttara
Kannada, Bellary and Kolar.
In all 38,000 ASHA workers will be functioning in the State by 2012

Action Plan to establish fully functional Health Institutions
The village level ASHA scheme
Services to be provided by Mobile Medical Units
Page 2

One of the main objectives of RCH-II program in Karnataka is reduction of maternal mortality rate and infant mortality
rate. To meet this objective focused efforts are being made for making First Referral Units (FRUs) fully functional.
EmOC at FRUs is an important commitment for saving the life of the pregnant woman. The main snag in fully
operationalising these FRUs is lack of anesthetist and obstetrician in the prevailing setup. In this regard, Government of
lndia has permitted the states to train the MBBS doctors in obstetrics and anesthesia. The medical colleges identified to
train the doctors are,
1. Bangalore Medical College
2. Mysore Medical College
3. VIMS, Bellary
4. KIMS, Hubli
5. Kempegowda Institute of Medical Sciences, Bangalore
6. JNMC, Belgaum.
192 MBBS doctors have given consent to under go training. Orientation Training Programme for the faculties of Medical
Colleges has been done.
39 doctors were trained in LSAS during 2007-08. 54 doctors in LSAS and 30 doctors in OBG will be undergoing training
during 2008-09. To motivate these trained MBBS doctors, it is proposed to give an incentive of Rs. 1000 per case, subject
to a maximum of Rs. 5000 per month.
Incentives for Jr. HA(F) safe delivery of high risk pregnancies:
If an ANM takes responsibility for follow up of High Risk pregnant women till she delivers in a hospital (PHC / CHC / Dist.
Hosp) she will be pain an incentive of Rs. 250 for each delivery. This is to ensure reduction in the maternal and neonatal
Awards for best performing ANMs:
An amount of Rs. 5,000 will be cash award to one best performing ANM per taluka per year. Selected ANMs will be
facilitated on World Health Day with the award. It also includes a citation and certificate. This is a motivational factor for
others to get motivated to perform better. The ANMs performance will be judged by a set of parameters decided by a
Incentives for night deliveries at PHCs:
In order to provide 24 hour delivery services at PHCs, Incentives to the doctor (Rs. 200) , staff nurse (Rs, 100) and the
cleaning personnel (Rs. 30) per case delivered at night from 8 PM to 7 AM , will be paid. In order to enhance the rate of
institutional deliveries, this incentive is continued and extended to all 1679 PHCs . Total budget allocation is made to cover
about 1,00,000 cases per year at Rs. 330 lakhs.

Training MBBS Doctors in Life Saving Anesthesia and
Obstetrics skills
Community Day Celebration

                                                                                                                      Page 3
Volume 1, Issue 1
Mission Director,
National Rural Health Mission,
3rd Floor,
Department of Health and Family Welfare,
Anandarao Circle,
Bangalore - 560 009
Tele-fax: 080 - 2237 3587
E-mail: mdnrhmkar@gmail.com
Web : www.karhfw.gov.in

  The Indian Paradox
  Health care in the world has made revolutionary strides in the past century. Many diseases have been wiped out.
  Many miraculous cures have been discovered. With the advancement of technology in the past couple of decades, the
  whole conception of surgery has changed. Life expectancy has doubled in the last half century.
  But here is the Indian paradox . While effective remedy has been found for almost all the dreaded diseases which
  consumed millions of people in yester years, the rural population in India still are succumbing to ordinary ailments,
  either because they are too poor to afford simple treatment, or it is not accessible to them. Awareness, and
  enforcement of Intellectual Property Rights around the globe through multi national agreements, have shot up the
  cost of drugs, implants and medical machinery, leaving poor masses of developing countries like India in a precarious
  condition. Impressive 8% industrial growth of India loses its significance in the above scenario.
  It is in this context that the National Rural Health Mission becomes crucial to our country’s development, because
  it addresses the most basic health care issues of Rural India in a mission mode.
  Bringing health care to the door steps of the poor rural masses is a gigantic task. The challenges are many. Huge
  population, inhospitable topography, inadequate infrastructure, lack of education, superstition, prohibitive costs are
  to name a few. The solution calls for holistic approach, to deal with multi faceted issues.
  NRHM has not come a day too soon. It has given us the drive and the direction. We owe it to ourselves to make
  this mission a success.
                                      NILAYA MITHASH                 IAS,
                                      Mission Director, NRHM
This is your page….

This page is for you to express your experiences with the mission. This page is for your opinions, suggestions,
feedbacks, achievements, success stories, and failures too, so that we can learn from them.

This page is for accolades and brickbats on the contents and quality of this bulletin. We welcome and value
your opinions.

Please send your lines by mail or email to the Mission Director, NRHM, at the address given above...

Your Page ….
                                          HEALTH FOR ALL
                                        HEALTH EVERYWEHRE
School Health Programme is an important programme to ensure proper health of our children. Earlier only children studying
in 1st 4th and 7th standard were examined for health assessment. But later on all the students from standard 1 to 10 are
being examined. The State celebrated the golden jubilee in 2006, and hence the programme was named “Suvarna Arogya
Chaitanya” in its commemoration. The programme is not just about health examination, but involves follow up remedial
Almost 90% of the detected cases are of minor diseases and have been treated in PHCs and District Hospitals and cured.
A few detected cases of heart diseases, squint eyes, split lips etc., which need surgery, have been operated free of cost in
Yashasvini Network Hospitals. As on 22-7-2008, 118 children have been operated under this programme, incurring an
expenditure of Rs. 47.60 lakhs.
High lights of the Programme:

 Health check up for all students studying in 1st standard to 10th standard.
 Detected cases of diseases to be treated free of cost in PHCs, Taluk Hospitals and District Hospitals.
 Cases needing specialized surgical treatment, to be operated in Yashasvini Network Hospitals under the assistance of
   NRHM. Free service includes Medical examination and diagnostic tests, surgical implants, and surgery.

 Travelling expense for the child and the parents not exceeding Rs. 1000.
In 2008-09, , the In 2008-09 under the vision of “Health for everyone” the programme was taken up in mission mode, and
not only the children studying in Government schools but also those studying in Private aided, Unaided and Residential
schools were given health checkup from 18 Aug 08 to 12 Sept 08, covering 88% the total children studying in Standard 1
to 10. It is aimed to complete check up of 100% of the children by 31 Dec 2008.
Volume2, Issue 1
January 2009
Printed and published by Mission Director, NRHM, 3rd floor, Department of Health and Family Welfare, Anandarao Circle, Bangalore. For
Internal Circulation only. Not for sale

A considerable number of maternal deaths are abortion related. This number could be dramatically reduced with the
adoption of simple and safe abortion procedures like Mannual Vacuum Aspiration (MVA).
MVA is both safe and cost effective abortion option. World Health Organisation (WHO) recognized MVA as the best method
of treatment of incomplete abortion and as an essential element of care at the first referral level of the heath care system.
MVA equipment costs less and is easier to process after use. The procedure itself is less painful and does not require
anesthesia and the women recover much faster.
Advantages of MVA:

  Safe, simple and effective
  Not dependent upon electricity
  Can be performed at PHCs
  No requirement of anesthesia
  Complication rate is low
  Easy to inspect the aspirate
The object of introducing MVA technique is not to replace the existing methods of termination but to provide an additional

MVA - The safe abortion option
Incentives for the committed personnel
Suvarna Arogya Chaitanya Programme - 2008
The Mobile Medical Units operationalised to make health care services available in the under served areas aims to provide

 Reproductive and Child Health Services,
 Family Planning Services,
 Diagnostic Services.
RCH services include services like, ante-natal check up and related basic laboratory tests, referral for complicated
pregnancies, promotion of institutional delivery, post natal checkup, immunizations clinics coordinated with local sub
centres, treatment of common childhood illness such as diarrhea, pneumonia, measles etc..
It will undertake Family Planning services like counseling for spacing of pregnancies and permanent sterilization.
Distribution of condoms, oral contraceptives, emergency contraceptives and IUD insertions would also be a part of the
It would also provide diagnostic facilities like hemoglobin, urine examination for sugar and albumin, smear test for malaria,
vaginal smear for trichomonas, screening of breast cancer, cervical cancer etc.
MMUs would be geared to provide emergency services and care in times of disasters, epidemics, public health
emergencies, and accidents.
It becomes and important tool for Information-education-communication (IEC) disseminating material on health including
personal hygiene, proper nutrition, use of tobacco, diseases, PNDT Act, RTI, STI, HIV, AIDS etc.
The team comprises of a Medical Officer, a Staff Nurse, a Laboratory Technician, a Pharmacist, a helper and a driver. The
Unit would carry a BP apparatus, stethoscope, weighing machine, thermometer, stretcher, oxygen cylinder with accessories,
sterilizer, provision for IV lines, artery forceps and an examination table, apart from Primary Carte Drugs, emergency drugs
and protocol drugs.

Mr. Nilaya Mitash, IAS, Mission Director, NRHM addressing the trainees during the Technical Training Camp, on Community Day at
                                               Kalasapura, Chikmagalur District.
Year      Children    Detected cases of
          examined    diseases

2006-07   50,93,590   4,34,122

2007-08   72,52,670   8,20,175

2008-09   80,82,192   12,45,639

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