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

National Health Programme in UttaranchalStrengthening FRUs and referral services.Transferring the National Maternity Benefit Scheme to the Medical Department from the SocialWelfare Department. For nutritional support under this scheme, an amount of Rs 500 is paidto a pregnant mother above 19 years of age who is below the poverty line (BPL) for her firsttwo live births.Promoting exclusive breastfeeding through counselling of pregnant mothers and their relatives.Giving the AWWs of ICDS in rural areas of the state 10 days of basic training to be able to provideminimum health services in the villages. They will now help the local ANMs by identifying highriskmothers, identifying drop-out vaccination cases, and helping treat ARI and diarrhoea byproviding oral rehydration salts (ORS) and other common medicines. They will also assist inproviding nutritious diets to pregnant women and children.Many of the positions in the state are vacant. This isparticularly true in the case of Joint Directors (JDs), LMOs,matrons, staff nurses, and so forth. To further strengthenMCH services, LMO, staff nurse, and ANM staff positionshave been filled through contractual appointments.The state has been performing fairly well in terms of childimmunization. However, utilization of maternal healthservices is low. The rate of unsafe deliveries in the state is aproblem that is attributable to the low prevalence ofinstitutional deliveries and assistance by trained personnel.Table 1. Staff PositionsItem Sanctioned In Position VacantPostJD 12 6 6LMO Class I 24 8 16LMO Class II 147 94 53Matron 8 2 6Assistant Matron 24 9 15Sister 158 117 41Staff Nurse 571 398 173ANM 1,933 1,904 29Some of the difficulties in effectively implementing a RCH programme in the state include shortageof manpower, particularly of LMOs, anaesthetists, staff nurses, and so forth. Lack of properconnectivity and a good transportation network also hamper the programme. Certain hilly areasTable 2. MCH Programme in Uttaranchal, 2000/01 and 2001/02Programme 2000/2001 2001/2002Target Achievement % Target Achievement %DPT 232,505 234,166 100.7 2,412,279 233,767 95.4Polio 232,505 233,849 100.5 2,412,279 229,893 95.5BCG 232,505 235,402 101.2 2,412,279 232,695 96.4Measles 232,505 278,788 94.1 2,412,279 229,511 95.1TT for pregnant women 241,000 221,000 91.7 258,597 221,161 85.5IFA 241,000 184,000 76.3 258,597 174,852 67.6Institutional deliveries 35,000 80,617 29,272 36.3Deliveries by lady home visitor (LHV)/ANM 65,000 153,522 98,003 63.8Deliveries by untrained attendant 39,000 16,856Under 5 years, treated for ARI 33,023 27,294Under 5 years, treated for diarrhoea 33,691 51,31971