Health Policy Issues and Health Programmes in ... - Amazon S3

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Access to Health Services in UttaranchalTable 4. Accessibility of Service Delivery Points for Modern Family Planning Methods in RuralAreas of UttaranchalPERFORM, NainitalOral pill Condom IUCD SterilizationDistance to the nearest sourceWithin village/town/city 26.7 27.2 14.4 5.41–2 kms 17.3 16.3 17.4 10.83–5 kms 41.5 42.7 38.6 39.6>5 kms 14.5 13.8 29.6 44.2Total 100.0 100.0 100.0 100.0PERFORM, DehradunOral pill Condom IUCD SterilizationDistance to the nearest sourceWithin village/town/city 35.8 37.8 20.2 8.61–2 kms 20.8 21.3 21.4 16.23–5 kms 14.3 12.6 20.3 24.4>5 kms 29.1 28.3 38.1 50.8Total 100.0 100.0 100.0 100.0PERFORM, Tehri GarhwalOral pill Condom IUCD SterilizationDistance to the nearest sourceWithin village/town/city 3.3 3.0 2.3 1.61–2 kms 21.0 22.6 14.3 11.93–5 kms 16.9 15.9 13.4 14.9>5 kms 58.8 58.5 70.0 71.6Total 100.0 100.0 100.0 100.0PERFORM, AlmoraOral pill Condom IUCD SterilizationDistance to the nearest sourceWithin village/town/city 14.5 16.6 10.8 4.21–2 kms 23.0 22.3 13.6 13.73–5 kms 31.2 28.5 24.4 17.9>5 kms 31.3 32.6 51.2 64.2Total 100.0 100.0 100.0 100.0Base: Aware of a sourcellllllllllNumber of BPHCsNumber of BPHCs not connected by a pucca roadAverage distance from a pucca roadNumber of BPHCs above 7000 feetNumber of APHCsNumber of APHCs not connected by a pucca roadAverage distance from a pucca roadNumber of sub-centresNumber of sub-centres not connected by a pucca roadPercentage of villages not connected by a pucca road151
Access to Health Services in UttaranchallllAverage distance from a pucca roadAverage number of villages covered by each sub-centreAverage distance of villages to the sub-centre.Table 5 illustrates that most of the BPHCs in the 9 districts were connected by a pucca road andlocated beside the road. However, in Almora district, seven of 11 BPHCs were located at anaverage distance of two kilometres from a pucca road. Two BPHCs, one in Tehri Garhwal andone in Uttarkashi, were located at an altitude of over 7000 feet. With regard to APHCs, Almorawas less accessible by pucca road and the average distance of the centres from a pucca roadranged between 3 and 8 kilometres. In Champawat, one APHC was not accessible by road; thedistance from the pucca road was as far as 23 kilometres.At the sub-centre level, all the districts had, on average, about 20 centres that were notconnected by a pucca road. The percentage of sub-centres not connected by pucca road variedfrom 10% in Almora district to about 50% in Champawat District, with the average distance froma pucca road varying from 3 to 12 kilometres. Besides this, each sub-centre, on average, coveredabout five to eight villages with the distance from villages to the sub-centre in the range of 2 to42 kilometres. Uttarkashi figured prominently in this category as it had villages that were farthestfrom the sub-centres. Similarly, there is wide variation in the percentage of villages that are notconnected by pucca roads in these eight districts. The findings from the survey on clientperspective, along with that compiled from the state, reinforce the fact that accessibility ofservices (the client reaching the nearest facility or the service provider visiting the villages) is anissue of concern.Until now, the discussion has revolved around physical access to health facilities where theclient had to traverse long distances to reach the nearest health facility or provider. The state, asa matter of fact, does not even have sufficient health infrastructure or human resources to caterto the existing set-up. The issue of resource shortages are presented in the following sections.Problems of Access due to Insufficient Health InfrastructureTable 6 shows that the state has an insufficient number of health facilities as per theGovernment of India (GoI) norms. The state has only 1609 sub-centres compared with therequirement of 2162 sub-centres. Likewise, there are 257 PHCs compared with the required324—a shortfall of 21%, while the shortfall for CHCs was 72%.In addition, many of the sub-centres and PHCs are located in rented buildings with inadequatespace. Table 7 shows that about three-fourths of sub-centres and one-fifth of PHCs are locatedin rented buildings.Problems of Access due to Shortage of ManpowerThere are many vacancies at various levels in the health department. Problems of access due tochallenging mountainous terrain are compounded by the fact that many health providers arenot willing to stay in these hard-to-reach places because of the lack of social infrastructure. Theavailability of staff compared with sanctioned posts is shown in Table 8.152
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Health Policy IssuesandHealth Progr
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ContentsContentsPrefaceList of Part
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I would also like to thank our tech
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List of ParticipantsIndu Kumar Pand
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List of ParticipantsMohmed ShaukatD
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List of ParticipantsR K PurohitAddi
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GlossaryGlossaryAbbreviationsAIIMSA
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GlossaryLHVLILMISMAPMCMCHMDRTBMDTM&
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GlossaryTHRTRCTRIPsTTTUUDCUIPUPUTVC
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Inaugural Sessionwould be the first
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Inaugural SessionOnly 18% of the pr
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Inaugural SessionMadhukar Gupta, Ch
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Inaugural Sessionrotational basis f
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Inaugural Sessiontell you more abou
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Public Health Issues, Priorities, a
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National Health Programmes: An Over
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Implementation of National Health P
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Use of Epidemiological Surveillance
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Designing a Surveillance SystemFurt
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Designing a Surveillance Systemsurv
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National Health Programme in Uttara
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IEC Strategies for Health in IndiaS
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IEC Strategies for Health in Indial
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IEC Strategies for Health in IndiaS
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IEC Strategies for Health in IndiaA
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IEC for Health Programmes in Uttara
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Session 3Private and Public SectorP
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Page 172 and 173: Quality of RTI/STI Case Management
Page 182 and 183: HIV/AIDS: International Perspective
Page 188 and 189: HIV/AIDS in India and UttaranchalSe
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Hospital Waste ManagementSession 6H
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Hospital Waste ManagementA hospital
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Hospital Waste Managementbe without
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Hospital Waste ManagementTreatment
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Hospital Waste Management4. Tempera
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Hospital Waste ManagementTable 6. U
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Streamlining the Drug Procurement a
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Sanitation and Public Health Issues
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Ayurveda and Unani Department and t
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Specific Health Policy and Programm
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