NRHM

▪ Launched in 5th April 2005

▪ 2005-2012 for 7 years

▪ Empowered Action Group(EAG)

Plan of action to strengthen infrastructure

1. Creation of a cadre of ASHA

2. Strengthening of sub centers

3. Strengthening of PHC

4. Strengthening CHC for FRU care

GOALS TO BE ACHIEVED BY NRHM

A. National Level

▪ IMR reduced to 30/1000 live births

▪ MMR reduced to 100/100000

▪ TFR reduced to 2.1

▪ Malaria mortality reduction – 50% by 2010, additional 10% by 2012

▪ Kala-azar morbidity rate reduction – 100% 2010

▪ Filaria/microfilaria rate reduction – 70% by 2010, 80% by 2012 and elimination by 2015

▪ Dengue mortality rate reduction – 50% by 2010 and sustaining that level till 2012

▪ JE mortality rate reduction – 50% by 2010 and sustaining that level till 2012

▪ Cataract operation – increasing 46 lakh per year by 2012

▪ Leprosy prevalence rate – reduce from 1.8/10000 in 2005 to less than 1/10000 there after

▪ TB dots services – maintain 85% cure rate

▪ Upgrading of CHC’s to IPHS

▪ Increase utilization of first referral unit from less than

20% to 75%

▪ Engaging 250000 female ASHA’s in 10 states

B. AT COMMUNITY LEVEL

▪ Trained community level worker at village level

▪ Health day at anganwadi level on a fixed day/month

▪ Generic drugs for common ailments at sub-centre & hospital level

▪ Good hospital care through assured availability of doctors, drugs, quality services at PHC, CHC level

▪ Improved access to universal immunization

▪ Improved facilities for institutional deliveries

▪ Provision of household toilets

▪ Improved outreach services through mobile medical unit

Selection of ASHA

Role & responsibility of ASHA

▪ Create awareness & provide information

▪ Counseling of women

▪ Mobilize community and facilitate them in accessing heath and health related services

▪ Work with village health and sanitation committee of the gram panchayat to develop a comprehensive village health plan

▪ Escort/accompany pregnant women and children to health facility

▪ Primary medical care, DOTS provider

▪ Act as a depot holder

▪ Inform live births, deaths, outbreaks etc to sub centre/ PHC

▪ Promote construction of household toilets under toilet sanitation campaign

Role and integration with Anganwadi

▪ Organize health day once/twice a month

▪ AWW & ANM will act as resource person in training of ASHA

▪ IEC activity on these days

▪ AWW ll be depot holder of drug kits and ll be issuing it to ASHA

▪ AWW ll update the list of eligible couple & children less than one years of age in the village with the help of ASHA

▪ ASHA ll support AWW in mobilizing pregnant, lactating women and children for nutrition supplement and also mobilize them to anganwadi centre to avail services

Role and integration with ANM

▪ ANM will hold weekly/fortnightly meetings with ASHA

▪ ANM will inform ASHA the date & time for outreach session and also guide her for bringing the beneficiary to the outreach session

▪ ANM will participate & guide in organizing health day in anganwadi

▪ ANM will take help from ASHA in updating eligible couple

▪ will utilize ASHAs help in motivating pregnant women and married couple to go to sub centre for check up and family planning services respectively

▪ ANM will guide ASHA in motivating pregnant women for taking IFA tablets, TT etc

▪ ANM will orient ASHA on dosage and side effects of OCPs

▪ ANM will educate ASHA the danger signs of pregnancy and labour

▪ ANM will inform time, date and place for initial and periodic training schedule and also ensure she gets compensation for performance and also TA/DA for attending the meeting

New initiatives (June 2011)

▪ Home delivery of contraceptives by ASHA

▪ Conducting District Level Household Survey(DLHS)- in states where Annual Health Survey(AHS) is not being done

▪ Modifications in the scheme for promotion of menstrual hygiene

▪ Involving ASHA in Home Based Neonatal Care (HBNC)

▪ Village health and sanitation committee to Village Health, Sanitation and Nutrition Committee (VHSNC)

▪ AYUSH hospitals and dispensaries for mainstreaming AYUSH under NRHM

▪ Revision in the criterion of allocation of funds to states under NRHM based on performance of states

▪ Monitoring and evaluation under NRHM

▪ NRHM + NUHM = NHM

▪ USHA