Important Points - Conference of Health Ministers, Hyderabad

Item 1- NATIONAL VECTOR BORNE DISEASES CONTROL PROGRAMME

(NVBDCP)-

Malaria: -

1. Improving fever surveillance: District wise ABER

2. ASHA involvement in detection and treatment of malaria cases

• Any district in 257

• ASHA Training

• ASHA to be given ACT / RDT

3. Quality Indoor Residual Spraying (IRS)

• District wise micro plan

• Implementation

4. Contractual Posts

• Re-designate DMO - DVBDCO

• 3 Zonal Entomologists: Ferozepur, Jalandhar, Patiala

• 3 DMO's- need to be created / filled up

• Male contractual workers

Dengue: -

1. Vector control- IEC for community sensitization

2. Law by Local Government / GPS

3. More Hospitals for sentinel surveillance

CH Ludhiana, GMC Amritsar, GMC Patiala, CH Bathinda, CH Jalandhar, CH Mohali

Can we increase it? (Status last year / problems)

Item 2- REVISED NATIONAL TB CONTROL PROGRAMME (RNTCP)-

1. DOTS Plus- What required, what available?

2. Accreditated LABs in private sector / GMCs

3. CDR / NSP: 70%, 85%

District wise: TUs not meeting these parameters.

4. HR issues-

• STO- Whether sanctioned & filled up

• DTOs- Whether sanctioned, filled up as per qualification

• State TB Cell

• RNTCP cells in Districts

5. Gaps in infrastructure

• Designated Microscopy Centres (district wise)

• Drug storage capacity

• IRL

6. Effective Monitoring

• District wise / TU wise issues

• Identify issues, then status

Item 3- INTEGRATED DISEASE SURVEILLANCE PROJECT (IDSP)-

1. Contractual Manpower-

• Epidemiologists

• Microbiologists

• Entomologists

2. 50 Priority Labs- Our status

3. Referral Lab network in a priority States- Our status / issues

4. Data reporting- How many through e-mail or portal. All to be on portal

5. IT Network- Required / Provided / Gaps

Item 4- REPRODUCTIVE & CHILD HEALTH PROGRAMME (RCH) AND HEALTH

SYSTEM STRENGTHENING-

1. Focus Districts:

• Funds weightage of 1.3 to population

• Funds, manpower

• More drugs

2. Health Infrastructure: Facility Survey

• Web based proforma

• Photos

• Gaps in order of priority

3. Human Resources:

• Incentives for remote, difficult.

• Multi-skilling of Doctors

• Special incentives for specialists

4. Better coordination: DHS + Health Societies

• Public Health (SPM) trained doctors as DPMs & SPMOs.

5. State & District Health Mission / Societies:

• Constitution as per criteria

• Meetings Monitoring (Web based formats)- To be need / held

6. Rogi Kalyan Samities (RKS):

• Constitution as per criteria

• Meetings: Web based formats

7. ASHA:

• Training upto 5 module

• ASHA mentoring groups

8. Community Monitoring:

• Jan Samvad

• Village Report Cards

• Media workshops

• Village / facility score cards

• Posters

• Training Manuals

What else? Any guidelines?

• Grievance redressal NO / Centre

• Complaints

9. CES: Deliveries in private hospitals. Order by CS

MC Web based Private Hospitals

Birth Death

Key Issues under RCH-II:

1. EMOC: 24 x 7 : Gaps

EMOC : Gaps

Skilled Manpower: SBA - ANM, SN, LHV

MBBS - LSAS, EMOC

2. RTI / STI at PHC & CHC / FRU, MTP

3. VHND (Mamta Diwas):

• Register with ANM?

• Copy to Black?

• Web based monitoring formats?

4. Referral Transport:

• ZHL

• Department Ambulance etc.

5. PPP:

• Outsource RCH services

• Engagement of FOGSI for skill based training like SBA / EMOC

6. MCH Centres: ESP in focus districts:

• Human resource

• Drugs

7. Maternal Death Review (MDR):

• Monitoring

• CS Conference

8. MCH lands: Numbered

9. Name Based Training: Important

Key Issues for consideration under Maternal Health:

1. Human Resources:

• MBBS - LSAS

- EMOC (Extra services)

2. Absolutely free delivery: Kits (No out of pocked expense)

3. MCH Centres:

• Level 1 - Standard protocols

• Level 2 - Adherence

• Level 3 - Posters / guarantees

4. Janani Suraksha Yojna (JSY):

• JSY cards

• Micro birth plan

• Physical verification of beneficiaries

• Payment through bearer cheques

• ASHA to be paid through account payee cheques

• JSY beneficiaries (web based portal)

5. RCH:

(i) Integrated Management of Neonatal and Child Hood Illness (IMNCI)-

• Why not in all districts?

• How many districts

(ii) Pre service IMNCI: Started by how many colleges?

(iii)Facility based IMNCI

(iv) SNCU: Special New Born Care Units (in very district)

NBSU: New Born Stabilization Units (every CHC)

(v) NSSK: A basic New Born Care and Resuscitation Programme

(vi) IYCF: Promotion of Infant & Young Child Feeding Practices

(viA) Prevention of Blood Hemorrhage after pregnancy, TN experiment

under NGU

(vii) Immunization:

• Manpower for urban areas

• Immunization card, tickler bag, tally sheet, monitoring chart,

cold chain temp monitoring charts, vaccine inventory charts.

• Hepatitis B

• 2nd

dose of Measles

• IEC activity for ORS use, Care seeking for ARI & Zinc

supplements.

• Monthly stock position to be updated to GoI.

• Short supply of vaccines by the suppliers.

• Strengthening the cold chain mechanism.

(viii) Family Planning:

• Fixed day static service & move away from seasonal camp

approach.

• Revitalize Postpartum Family Planning

• Ensuring quality of family planning services by strengthening

DQACs / SQAc.

• Increase male participation

• Accreditation of private providers

• Distribution of contraceptives- community based, RISUG

Item 5- POPULATION STABILIZATION-

1. 100% birth-death registration

(Registers + Stationary)

2. PNDT: Sex ratio

(i) Deliveries in Government + Private hospitals

(ii) As per birth - death registration (from computers)

(iii) Requirement of Act- our status.

(iv) State Supervisory Board

• Constitution of Advisory Committees

• AA at DH / SDH

• State Inspection & Monitoring Committees

3. Measures need to be put in place for effective implementation of Act

(Page 64)

• Website for State (PNDT) complete date

• e-complaints

• Awareness, Training of AA

• Strict Enforcements (Guidelines, Training material for AA / public).

4. Annual Health Survey of all districts- Health indicators at district level to be

published, monitored and compared against benchmarks (Page 68)

5. Strengthen Post Partum family planning services where deliveries take place

(Page 69)

(Item 5: Supplementary) Health Management Information System (HMIS):

1. How many components?

2. Requirements?

3. Our status- infrastructure, NVBDCP, FMR, MDR, HR

(Annual Health Survey)

4. Shift to facility based

• HMIS reporting

• Completeness and quality of data

• Training and awareness.

5. Mother & Child Tracking System

6. Capture info from private hospitals

Item 6- NATIONAL PROGRAMME FOR CANCER, DIABETES, CVD AND STROKE

(NPPCDS) (80:20)

• During the 11th

five year plan, the NPCDCS will be implemented in 100

districts in 21 States.

• 30 districts in 2010-11

• 70 districts in 2011-12

(Page 74)

Bathinda in Punjab

Strategy: NCD Clinic at:

• CHC, DH level

• Tertiary level health facilities

Action Points: (Page 76)

1. List- To be done, done, what needs to be done?

2. Identify a GMC for Tertiary Cancer Centre

Item 7- NATIONAL PROGRAMME FOR HEALTH CARE OF ELDERLY (NPHCE)

• 30 districts in 2010-11

• 70 districts in 2011-12

Component: Bathinda District

• Geriatric Unit

• Rehabilitation Unit CHC

• Weekly Geriatric Clinic at PHC

• Supportive devices at Sub-Centres.

To be done:

• MoU to be signed

• Separate Account etc.

Item 8- MENTAL HEALTH PROGRAMME

1. Any fund released to State Health Societies?

2. DRME: Point (ii) Page 83- Priority may be given for creation of posts of faculty and

other technical staff for initiating post graduate courses in the mental health

specialities of Psychiatry, Clinical Psychology, Psychiatric Social Work and

Psychiatric Nursing under the scheme for setting up Center of Excellence in Mental

Health and Scheme for Manpower Development in Mental Health (Departments in

Medical Colleges).

3. Training to MOs in Mental Health.

4. Have we recruited team members?

5. Ucs to be sent

6. Posting of Mos as per DMHP norms.

7. DRME: Point (vii) Page 83- Upgradation of Psychiatry wings in Medical Colleges /

General Hospitals and Modernisation of State run Mental Hospitals have been

supported under the NMHP. In most of the institutes, the work is yet to be initiated /

completed. This should be completed in time bound manner.

Item 9- NATIONAL TOBACCO CONTROL PROGRAMME:

1. Activities to be undertaken by State- our status, our obligations.

2. Page 85- Any district of Punjab included in National Tobacco Control Programme-

Any funds received.

3. Labs for Nicotine testing

Item 10- NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS (NPCB)

1. Comprehensive eye care- diabetic retinopathy, glaucoma etc.

2. Screening of above 50 years population

3. Unserved area- through NGOs.

4. Screening of school children.

New Initiatives:

1. Eye OT in District Hospital

2. Contractual appointments- Ophthalmic Assistants, Eye Donation Counselors.

3. GIA to NGOs for other eye diseases

• Rs 750/- per case for cataract / IOL Implantation Surgery.

• Rs 1000/- per case for other eye diseases.

4. Mobile Eye- vans.

5. Maintenance of eye equipment

Issues:

1. Posting of eye-surgeons in non-surgical positions.

2. Training- Problem of non-operating eye-surgeons.

Item 11- NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME

(NIDDCP)

1. Any district in the list of 263 endemic districts (prevalence more than 10%).

2. IDD Control Cell?

3. IDD Monitoring Lab

4. IDD surveys by States in the remaining districts.

5. Extremely poor utilization by Punjab (Page 94). Fix responsibility.

2008-09 2009-10 2010-11

Allocation Release Utilization Allocation Release Utilization Allocation Release Utilization

20.00 7.04 0.75 20.00 x 2.17 20.00 19.92 -

Item 12- ISSUES IN MEDICAL EDUCATION: Relates to DRME

Item 13- NATIONAL COUNCIL OF HUMAN RESOURCES IN HEALTH (NCHRH): Bill

Punjab yet to furnish comments

Item 16- ESTABLISHMENT OF NIPS, RIPS

1. Punjab : Chandigarh RIPS

Land not indicated (DRME)

2. Manpower Development Scheme- to support GMCs in:

(a) Proposal for commencement of UG / PG in paramedical sciences.

(b) Increase intake in about courses. Has Punjab sent any proposal?

Item 17- ESTABLISHMENT OF ANM / GNM SCHOOLS

1. Punjab Case- Amritsar (GNM) not finalized yet in view of divergence between GoI

choice (Ropar) and State choice (Amritsar).

2. What about upgradation proposals?

Item 19- DRUGS CONTROL PROGRAMME

1. 3 categories:

• Branded medicines (Patented / originator brand name)

• Generic medicines (different brand name from originator)

• Branded Generic

2. Advertisement for Generic- Generic & its branded counterparts (chart)

3. Special shops through Jan Aushadhi for selling Generic medicines (less than 50%

MRP) Jan Aushadhi Versus Generic Stores.

(A) Rogi Kalyan Samiti (for JAS):

• Financial assistance to RKS (Rs 50,000 to Rs 2 lacs) for setting up.

• Constraints- (to be addressed)

o Space for JAS

o RKS or good NGO

o Prescription of generic drugs

o Public awareness

What has been done?

(B) New Drug Act: ('a' to 'e' Page 125)

a) Maximum penalty life imprisonment and fine of Rs 10 lacs or 3 times the value

of the confiscated goods, whichever is more.

b) Some of the offences cognizable and non-bailable;

c) Besides officers from the Drug Controller's Office, other gazette officers also

authorized to launch prosecution under the Act.

d) Specially designated courts for trial of offences covered under the Act;

e) Provision for compounding of minor offences.

What has Punjab done?

Special Courts not yet set up?

(C) Strengthening Drug Organizations:

• Well equipped drug lab

• Manufacturers: Total, status of licenses.

• Manpower, infrastructure.

Item 20- FOOD SAFETY PROGRAMME

Obligation of States: (as per page 131)

(i) Constitute a Department of Food Safety.

(ii) Food Safety Commissioners

(iii) Food Safety Officers

(iv) System for Licensing

(v) Strengthening, recognizing or designated food testing labs.

(vi) Appointment of Food Analysts as per requirement

(vii) Appointment and notification of Adjudicating Officers

(viii) Appointment of Presiding Officer.

(ix) Constitution of Special Court etc.

Food Adulteration:

• Advisory Committees

• Legal Cell

• Public Awareness (VAN)

Item 23- E-HEALTH INITIATIVES INLCUDING TELEMEDICINE

(Relates to DRME)

- x -

GENERAL POINTS:

1. Sex Ratio: by ESO / Health Department.

2. Utilization Certificates- Liquidate old arrears / unutilized amount of 2005-06 to 2009-10.

3. Health rates

4. Two walls in village for health messages.