Comprehensive Rural Health Services Comprehensive Rural Health Services Project (CRHSP)Project (CRHSP)

BallabgarhBallabgarh

Centre for Community MedicineCentre for Community MedicineAll India Institute of Medical Sciences All India Institute of Medical Sciences

(AIIMS)(AIIMS)

AIIMSAIIMS

AIIMS Derives its mandate directly from AIIMS Derives its mandate directly from the Parliament of India.the Parliament of India.

Rated as One of the Top 10 medical Rated as One of the Top 10 medical institutions globally. institutions globally.

AIIMS Premier National Health Institute.AIIMS Premier National Health Institute.

22

Source: On Line poll of Internationl online Phyiscian Network.India Today magazine June 2006 Issue.

Ballabgarh HDSSBallabgarh HDSS

Started in1961 with aid of Rockefeller Foundation.Started in1961 with aid of Rockefeller Foundation.

Collaboration between:Collaboration between: All India Institute of Medical Sciences.All India Institute of Medical Sciences. Haryana State Government.Haryana State Government.

Primarily an academic & health delivery set upPrimarily an academic & health delivery set up Initiated to support AIIMS training activities and Initiated to support AIIMS training activities and

consistent with requirement of a Medical College in consistent with requirement of a Medical College in IndiaIndia

33

Objectives of CRHSPObjectives of CRHSP

To evolve through practice and research To evolve through practice and research a model of comprehensive health a model of comprehensive health services which is replicable at national services which is replicable at national level.level.

To orient and train undergraduates and To orient and train undergraduates and postgraduates in primary health care postgraduates in primary health care especially rural medicine.especially rural medicine.

The mandate is therefore for training, research and health care delivery

Current Core teamCurrent Core team

Dr. Chandrakant S. Pandav

Dr. Sanjeev K Gupta

Dr. Anand Krishnan

Dr. Puneet Misra

Support faculty membersSupport faculty members

Dr. Kiran Goswami

Dr. Shashi Kant

Dr. Baridalyne N.

Dr. Bir Singh

Dr. Y.S. Kusuma

Ballabgarh HDSS Field Team

Ballabgarh HDSSBallabgarh HDSS

PHCPHCDAYALPURDAYALPUR

Chandawali

Nawada Junehra

Dayalpur

Shahpurkalan

Nirhawali

PHCPHCCHHAINSACHHAINSA

Atali

FatehpurBilloch

Naryala

Chhainsa

Jaya Ladholi

Civil Hospital BALLBHGARH

Population of 85522(Dec 2008)

1010

0

5

10

15

20

25

30

35

40

45

50

1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008

Bir

ths

per

th

ou

san

d p

op

ula

tio

n

Years

Crude Birth Rate

Birth Rate (per thousand …

1111

02468

10121416

1972

1974

1976

1978

1980

1982

1984

1987

1992

1998

2002

2004

2006

2008

Crude Death Rate

1212

0

10

20

30

40

50

60

1972

1974

1976

1978

1980

1982

1984

1986

1988

1990

1992

1994

1996

1998

2002

2004

2006

2008

Neonatal Mortality Rate

1313

020406080

100120

Infant Mortality Rate

1414

40

50

60

70

80

90

100

110

19

88

19

90

19

92

19

94

19

96

19

98

20

00

20

02

20

04

20

06

20

08

pe

rce

nt

co

ve

rag

e

years

BCG DPT -3 OPV-3 Measles

Immunization Coverage

Publications Over The YearsPublications Over The YearsYear of PublicationYear of Publication NumbersNumbers PercentagePercentage

1969-19741969-1974 0505 03.403.4

1975-19791975-1979 0909 06.006.0

1980198419801984 1010 06.706.7

1985-19891985-1989 2424 16.116.1

1990-19941990-1994 2222 14.814.8

1995-19991995-1999 2121 14.114.1

2000-20042000-2004 3838 25.525.5

2005- till date*2005- till date* 2020 13.413.4

TotalTotal 149149 100.0100.0

1515

Domains Of Publications. Domains Of Publications.

Domains of PublicationDomains of Publication FrequencyFrequency PercentPercent

1. NCDs1. NCDs 3737 24.824.8

2. Child Health2. Child Health 3535 23.523.5

3. Communicable 3. Communicable DiseaseDisease 1717

11.4

4. Women’s Health4. Women’s Health 1616 10.710.7

5. Health Systems/ 5. Health Systems/ Operational ResearchOperational Research 1616 10.710.7

6. Demographic 6. Demographic SurveillanceSurveillance 88 5.45.4

7. Medical Education7. Medical Education 66 4.04.0

8. Others8. Others 1515 10.210.2

TotalTotal 149149 100.0100.01616

Major Historical Contributions in Public Major Historical Contributions in Public Health arena by CRHSPHealth arena by CRHSP

Demographic issuesDemographic issues Realized the need for Realized the need for

DenominatorsDenominators Birth & Death registrationBirth & Death registration

by MPWs -1975.by MPWs -1975.

Documentation of rates and causes of death at Documentation of rates and causes of death at different ages especially childhooddifferent ages especially childhood

1717

Focused on Demographic issues till about mid-eighties when focus shifted to disease specific projects

0

5

10

15

20

25

30

35

40

45

50

1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008

Bir

ths

per

th

ou

san

d p

op

ula

tio

n

Years

Crude Birth Rate

Birth Rate (per thousand …

Major Historical Contributions in Public Major Historical Contributions in Public Health arena by CRHSPHealth arena by CRHSP

Operational / Health System ResearchOperational / Health System Research Multipurpose Purpose Health Multipurpose Purpose Health

Worker Scheme -1972.Worker Scheme -1972. Addition of Curative services Addition of Curative services

to MPWs – 1973.to MPWs – 1973.

Computerized Health management information system-Computerized Health management information system-1988.1988.

1818Focused on delivery of health services to rural areas

Pulse Polio strategy Pulse Polio strategy (vaccinating all on a single day) -1985.(vaccinating all on a single day) -1985.

Diarrhea epidemiology and controlDiarrhea epidemiology and control

ARI epidemiology and controlARI epidemiology and control

Measles Epidemiology and ControlMeasles Epidemiology and Control

Field trial of High Dose Iron & Folic Acid for Pregnancy-1987.Field trial of High Dose Iron & Folic Acid for Pregnancy-1987.

Major Historical Contributions in Public Major Historical Contributions in Public Health arena by CRHSPHealth arena by CRHSP

1919All address national health priorities and we have led the way

Facilitating the national response to epidemiological transition

Contribution in NRHMContribution in NRHM

Technical Support – Member of Task Force(s) Technical Support – Member of Task Force(s) Indian Public Health Standards (IPHS)Indian Public Health Standards (IPHS) Medical EducationMedical Education Urban healthUrban health MOU with National Health Systems Resource CentreMOU with National Health Systems Resource Centre

Training - National Level trainers for Training - National Level trainers for Integrated Management of Neonatal and Child Integrated Management of Neonatal and Child

IllnessesIllnesses Integrated Disease Surveillance Project Integrated Disease Surveillance Project District EpidemiologistsDistrict Epidemiologists

Contribution in NRHMContribution in NRHM

Implementation – Implementation – Ballabgarh BlockBallabgarh Block Providing mentorship to two districts – Faridabad, Providing mentorship to two districts – Faridabad,

PalwalPalwal

EvaluationEvaluation Janani Suraksha Yojana (JSY) evaluation in Janani Suraksha Yojana (JSY) evaluation in

JharkhandJharkhand Accredited Social health Activist (ASHA) and JSY Accredited Social health Activist (ASHA) and JSY

evaluation in Faridabadevaluation in Faridabad

Future Plans- Infrastructure upgradeFuture Plans- Infrastructure upgrade

Upgrading Infrastructure Upgrading Infrastructure New HospitalNew Hospital New Community Health CentreNew Community Health Centre Extramural training- Hostels and training Extramural training- Hostels and training

facilitiesfacilities TelemedicineTelemedicine

Increasing the population base to over Increasing the population base to over 100,000.100,000.

Stronger collaboration with District LevelStronger collaboration with District Level

Future Plans- Areas of interestFuture Plans- Areas of interest

Disease Burden- Influenza, CVDsDisease Burden- Influenza, CVDs

Community Intervention Trials: Community Intervention Trials: Vaccine –InfluenzaVaccine –Influenza Behavioral- NCDsBehavioral- NCDs

Neonatal Health care delivery ModelNeonatal Health care delivery Model

Collaboration with INDEPTHCollaboration with INDEPTH

Fertility MonographFertility Monograph Mortality MonographMortality Monograph Member of Following Interest GroupsMember of Following Interest Groups

NCDsNCDs COPDCOPD Vaccines and child survivalVaccines and child survival Sexual & Reproductive HealthSexual & Reproductive Health TuberculosisTuberculosis

Other Research CollaboratorsOther Research Collaborators

NationalNational Indian Council for Medical Indian Council for Medical

ResearchResearch Media Lab AsiaMedia Lab Asia National Health system National Health system

Resource CentreResource Centre Ministry of Health & Ministry of Health &

Family WelfareFamily Welfare

InternationalInternational World Health World Health

OrganizationOrganization Centers for Disease Centers for Disease

ControlControl University of AlabamaUniversity of Alabama

In Conclusion…….In Conclusion…….

Unique features of Ballabgarh HDSSUnique features of Ballabgarh HDSS Forty eighth year of existenceForty eighth year of existence Run by Public fundsRun by Public funds Primary Health Care Service ProviderPrimary Health Care Service Provider Run by Medical CollegeRun by Medical College Computerized database since 1991Computerized database since 1991 Monthly update of the databaseMonthly update of the database

Welcome to all of Welcome to all of you from you from Balabgarh HDSSBalabgarh HDSS