You are on page 1of 27

NATIONAL HEALTH MISSION,

HARYANA
Dr. Sube Singh Diwan
Deputy Director (CH)

NRHM- An Overview (now


NHM)
Launched on 12th of April, 2005 by Government of
India with aim to provide equitable, accessible,
affordable and effective primary health care and
bridging the gap in rural health care especially the
vulnerable groups.
An Umbrella Programme- Focus on Maternal & Child
Health and Disease Control programmes

Strategies

Main focus is to reduce IMR, MMR and Total Fertility Rate (TFR)
under RMNCH+A

To increase institutional deliveries & antenatal and postnatal


checkups, Anemia control in pregnant women and Maternal Death
Review (MDR) for reducing MMR

Improving full immunization, operationalization of SNCU, early


initiation of breast feeding and IDR for reducing IMR

Eligible couple identification, promoting spacing and permanent


methods, IEC for reducing TFR

Key Health Indicators


Key Health Indicators
Maternal Mortality Rate (MMR)
Infant Mortality Rate (IMR)
Neonatal Mortality Rate (NMR)
Early Neonatal Mortality Rate (ENMR)
Under 5 Mortality
Total Fertility Rate (TFR)
Sex Ratio at birth
Institutional Delivery

India

Haryana

167

127

(SRS 2011-13)

(SRS 2011-13)

40

36

(SRS 2013)

(SRS 2014)

28

26

(SRS 2013)

(SRS 2013)

22

19

(SRS 2013)

(SRS 2013)

49

45

(SRS 2013)

(SRS 2013)

2.3

2.2

(SRS 2013)

(SRS 2013)

909

864

(SRS 2013)

(SRS 2013)

79.7%

91.8%

(GOI Source)

(CRS May 2016)

Target 2017
80
28
23
15
32
2.0
940
100%

Maternal Health

Various activities under


Maternal Health

Promoting Institutional deliveries through JSY, JSSK & by operationalizing 24x7 delivery
facilities.

Under JSY Scheme, financial assistance is being given to Pregnant females of BPL and SC/ST
families.

Under JSSK pregnant female approaching Govt. Health Facilities are given free services and
ensure zero out of pocket expenditure.

Out of 497 Health facilities 377 are made 24X7 operational.

38 Facilities designated as First Referral Units.


New Initiatives by State:

Labour room interventions for improving Intra-partum and immediate Post partum care.

Policy for identification, referral and management of high risk pregnant females

Implementation of injectable Iron Sucrose upto PHC level for treatment of severe anaemia.

Preconception Care Programme (PCP)- Under this various risk factors effecting pregnancies
are taken care off.

Implementation of High Risk Pregnancy Policy (HRPP) under this High risk Pregnant casers
are identified and referred to Civil Hospital for further management by specialist doctors.
New Initiatives by this Government
Pradahan Mantri Surakshit Matritva Abhiyan (PMSMA)

Under this initiative, every pregnant female is examined by the Gynaecologist/ Medical
Officer on 9th of every month and high risk pregnant females identified are referred to
Specialist for further care and management.

Interventions at Labour
Rooms
Before

After

Reduction in MMR

SRS

Increase in Institutional
Delivery

Comparison of MMR in different states

Child Health &


Immunization

Trends of different Mortality Rates (SRS)


As per NFHS-4 (2015-16) IMR of Haryana is
33/1000 live births whereas under five mortality in
the State is 41/1000 live births.

Source: SRS

ADDRESSING
NEWBORN CARE
At Delivery
Most
newborns
only
require
essential
newborn
care

Newborn
corner

District
Hospital

CHC

(1 bed)

PHC
Community

Sick
Special newborn
newborn
care unit
(12-20 beds)

Stabilization units
(4 beds)

Only 10
%
newbor
ns need
to be
referre
d for
special
attentio
n

Programmes Initiated for Child


Survival

Facility Based Newborn Care (FBNC) through Special Newborn care


Units (SNCUs), Newborn Stabilisation Units (NBSU) & Newborn Care
Corners (NBCC)
Home Based Post Natal Care (HBPNC)
Infant and Young Child Feeding (IYCF) Practices.
Maternal and Infant Death Reporting System (MIDRS) and Child
Death/Still Birth Reviews
Integrated Management of Childhood Illnesses (IMNCI) and Facility
Based Integrated Management of Childhood Illnesses (F-IMNCI).
Micronutrient Supplementation Programme (MSP).
Nutritional Rehabilitation Centres (NRCs)
Intensified Diarrhoea Control Fortnights (IDCF)
New born Screening, Food Fortification (Pilot Project)
Birth Defect Surveillance

Facility Base Newborn care (FBNC) in


Haryana
22 Special Newborn Care Units (SNCUs) established in all 21 civil hospitals

and in SDH-Bahadurgarh.
66 New Born Stabilizing Units and 318 New Born Care Corners (NBCC) have
been established in the districts at various health facilities.

National Immunization Schedule


Age

Vaccines given

Birth

BCG, OPV, Hepatitis B

6 Weeks

OPV, Pentavalent*, fIPV, Rotavirus,

10 weeks

OPV, Pentavalent*, Rotavirus

14 weeks

OPV, Pentavalent*, fIPV ,Rotavirus

9-12 months

Measles (MCV1), JE**

16-24 months

Measles (MCV2), JE**, DPT-B, OPV B

5-6 years

DPT-B2

10 years

TT

16 years

TT

Pregnant
Mother

TT1, 2 or TT Booster***

*Pentavalent vaccine provides protection for Diphtheria, Pertussis, Tetanus, Hepatitis B, Haemophilus
influenza B
** in endemic districts only
*** one dose if previously vaccinated within 3 years

Children age 12-23 months fully


immunized (BCG, measles, and 3 doses
each of polio and
DPT) (%)

Source- NFHS-4 Data (201516)

Overview of Mission
Indradhanush

Mission Indradhanush (Rainbow):


Reaching all children

Launched by MoHFW on 25 Dec 2014 as a special drive to strengthen


routine immunization in the country initially planned in the 201 high
focus districts of the country
The aim is to provide protection against 7 vaccine preventable diseases
(Indradhanush). Campaign started on 7 th of each month for 7
consecutive days
Focuses on interventions to ensure high coverage of children and
pregnant women with all available vaccines throughout the country
Special attention to high focus districts with nearly 50% of all
unvaccinated or partially vaccinated children
Active engagement of state governments & partner agencies WHO,
UNICEF, Rotary and others

Areas under focus - Mission Indradhanush


The following key areas will be reached through Mission Indradhanush:
Areas with vacant sub-centers: No ANM posted for more than three months
Villages/areas with three or more consecutive missed routine immunization (RI) sessions: ANMs
on long leave or other similar reasons
HRAs identified by the polio eradication programme, including urban slums with migration,
nomadic sites, brick kilns, construction sites, other migrant settlements (fisherman villages,
riverine areas with shifting populations), underserved and hard-to-reach populations
Areas with low RI coverage, identified through measles outbreaks, cases of diphtheria and
neonatal tetanus in last two years
Small villages, hamlets, dhanis, purbas, basas (field huts), etc. clubbed with another village for
RI sessions and not having independent RI sessions

Strategy for Mission Indradhanush


Two major mechanisms were identified to reach out to unreached or poorly reached
beneficiaries
1) Operational planning :
Fixed and outreach sessions
Mobile sessions

2) Communication planning: Need-based communication and social mobilization activities:


National Communication Plan
State Communication Plan
District Communication Plan
Block Communication Plan
Community-level Communication Plan

State, district and block level activities for


Mission Indradhanush
State

District

Meeting of state task


Meeting of district
force for immunization
task force for
(STFI)
immunization (DTFI)
State-level training
District-level
workshops for
workshops for
o District Immunization
Officers
o Sensitization of media
personnel

Block

Training of frontline
workers and
mobilizers
Preparation of
microplans at
block/urban health
o Medical officers
post
o NHM
programme/accounts Block/Urban health
managers
micro-planning
o Data handlers
meeting
o Vaccine and cold
Block meeting with
chain handlers
frontline workers
o Sensitization of media
and mobilizers for
personnel
microplan
District microdistribution
planning meeting

Implementation of Mission Indradhanush


in Haryana
Phase-1 :Four rounds were conducted between April and June
2015 under the mission in all 21 districts
Phase- 2: Four Rounds were conducted between November
2015-February 2016 in 14 districts of the State
Phase-3: Four rounds were conducted between April 2016 to
July 2016 in 6 districts of the State.
ANMs planned activities for seven days of each drive, including
1-2 days of activities in ANMs own sub-center and remaining
days in same/adjoining blocks or urban areas of her district
Mission Indradhanush was implemented according to rosters
prepared during micro-planning meetings at block and district
levels for each ANM in the district.

Phase-1:Haryana

Phase-2:Haryana

Phase-3:Haryana

THANKS

You might also like