National Rural Health Mission - Amravati

7. Referral Transport:
• Every state is advised to have a comprehensive referral policy with scope of flexibility and
variations from district to district as per the local need and situations.
• Tribal and hilly areas must have linkages like Palki or similar facilities for bringing the
pregnant women upto the road head from where a referral transport can pick her. Such
places can be linked with Birth waiting rooms at health facilities on Tamil Nadu pattern.
• There is a need for assured referral linkage both from the beneficiary/community to the
facilities and also between the facilities.
• State needs to establish such system either through government mechanism or through
outsourcing.
• Norms for reimbursement to beneficiary should be as per JSY.
• Outsourcing of referral transport can be preferred than the purchase of government vehicle
and regular driver for providing Referral transport.
• Outsourcing of referral transport should be through the process of competitive bidding.
• Cost benefit analysis of referral transport mechanism should be done taking into
consideration cost incurred per referral, no of pt being referred to pvt sector and no of lives
saved in public sector.
• EMRI model /call centers for referral should be evaluated in terms of cost & benefit before
scaling up.
• Payment for referral can be differential and may be linked with range of km travelled.
8. RCH Camps:
• State is organizing RCH Camps since RCH‐I but the benefits have not yet been analyzed.
• In RCH II focus is on Operationalising health facilities and as such camp mode is suggested as
time gap arrangement restricted for hard to reach areas. State should also indicate that how
many health facilities have been operationalized in hard to reach areas till now.
• RCH Camps should be organized and funded as per GoI norms.
• Stress should be kept on organizing VHNDS regularly.
• Inter‐sectoral co‐ordination should be emphasized while organizing these camps.
• Such outreach camps have taken out the focus on operationalisation of facilities and this may
be one of the reasons for decline in Maternal Health parameters in the state.
• State is requested to analyze the functioning and benefits of Mobile Medical Unit along with
the services rendered on pilot basis before scaling up. Such analysis may please be shared
with GoI. Since MMU for RCH services is a type of outreach and various types of out reaches
hampers the focused activities of ANC, PNC etc being undertaken at VHNDs.
• While planning for such outreach activities it should be ensured that routine service
delivery by MOs/ health workers at fixed health facilities (PHCS/CHCs/DHs etc)
does not suffer.
B. TRAININGS:
1. Life Saving Anesthesia Training:
• Target for LSAS training should be calculated after taking into account the no. of FRUs to be
operationalized, CEmOC target and total no. of specialist to be appointed.
• Target and Achievement of the MOs for 2010‐11 and Training plan for 2011‐12 should be
shared with GoI by the State as per the enclosed formats
• No of trained doctors posted at FRUs
• Trainings should be conducted as per GoI norms.
• Training institutes should be strengthened as per the GoI protocols. Funds can be kept under
Training head.