1. health and fitness

SIHF
FW Raja
asthan
Electrronic New
wsletter
Vol. 2//Issue 6/J
June 2013
S
SIHFW:
an ISO 9001:2008
8 certified Insttitution
From th
he Director’s Desk
Dear Rea
aders
Greetingss from SIHFW
W, Rajasthan!
This year,, the state lau
unches RMNC
CH+A strategyy for Healthy Mother and Child.
C
The
innovation
n is a strategiic approach to
o Reproductiive, Maternal, Newborn, Ch
hild and
Adolescen
nt Health (RM
MNCH) in Indiia.
The RMN
NCH+A strateg
gic approach document ha
as been develloped to provi
vide an undersstanding
of ‘continu
uum of care’ to
t ensure equ
ual focus on various
v
life sta
ages. Priorityy interventionss for each the
ematic
area have
e been include
ed in this doccument to enssure that the linkages
l
betw
ween them are
e contextualizzed to
the same and consecu
utive life stage
e. The docum
ment also intro
oduces new in
nitiatives. The docum
ment develop
ped by Ministrry of Health and
a Family Welfare,
We
Govern
rnment of Indiia is to be use
ed
constructiively at the na
ational, state, district and sub-district
s
levvels to improvve the conditio
on of women and
children and
a fill in the gaps
g
at variou
us life stages leading to red
duced matern
nal and child mortality
m
and
better hea
alth for women and children across the country.
Please fin
nd the new iss
sue of our e-n
newsletter witth main article
e based on RM
MNCH+A stra
ategy.
Director
Inside:
•
•
•
•
•
•
ent Day
Worrld Environme
RMN
NCH+A Strate
egy
SIHF
FW in Action
Interr State Expos
sure visit to In
ndore
Feed
dbacks
Hea
alth News
Health Day
ys in June ‘1
13
W
World
Environ
nment Day 5 June
J
World
d Day Againstt Child Labour 12 June
W
World
Blood Donor
D
Day 14 June
RMNCH+
+ A Strategy
Reproducctive and child
d health strattegy is a com
mprehensive approach
a
linkking together a set of initia
atives
that addre
esses each stage of life. Itt is one of the
e most imporrtant steps tha
at the Govern
nment of India has
taken to fu
ulfill its comm
mitment to imp
proving materrnal health and child survivval.
In this reg
gard, the RMN
NCH +A strate
egy was laun
nched in India
a in the child survival
s
call to
o action summ
mit on
Feb 8-9th, 2013. The medical
m
health
h and family welfare
w
departtment, Rajastthan has also stepped up efforts
e
to launch a Reproduc
ctive, Maternal, Newborn,, Child and Adolescent
A
H
Health
(RMNC
CH+A) in Ud
daipur
division. The
T programm
me would be launched in entire
e
state bu
ut the funding
g in 10 high fo
ocus districts would
w
be 30% more
m
in compa
arison to othe
er districts. (So
ource: TOI, 18.5.13)
RMNCH + A Strategy: Services an
nd Interventions
There are
e two dimens
sions to healtthcare: (1) sttages of the life cycle and
d (2) places where the ca
are is
provided. These together constitute the ‘Continuum of Ca
are.’ This Co
ontinuum of Care approa
ach of
a
implemen
nting evidencce-based packages of serrvices for diffe
erent stages of the lifecyccle, at
defining and
various le
evels in the he
ealth system, has been ado
opted under the
t national health
h
program
mme.
The redifined new stra
ategic approa
ach is called Reproductive
R
, Maternal, Newborn,
N
Chilld Plus Adole
escent
RMNCH+A). The
T ‘Plus’ in the
t strategic approach de
enotes the (1)) inclusion of adolescence
e as a
Health (R
distinct ‘liffe stage’ in the overall strrategy; (2) lin
nking of mate
ernal and chilld health to reproductive health
h
and otherr components (like familyy planning, adolescent
a
he
ealth, HIV, gender
g
and Preconception
P
n and
Prenatal Diagnostic
D
Te
echniques (PC
C&PNDT); an
nd (3) linking of
o communityy and facility-based care as well
as referra
als between various
v
levelss of health ca
are system to
o create a co
ontinuous carre pathway, and
a
to
bring an additive
a
/syne
ergistic effect in terms of ovverall outcomes and impacct.
Coverage
e targets for key RMNCH+A interventtions for 2017
•
•
•
•
•
•
•
•
•
•
•
•
•
In
ncrease facilitties equipped for perinatal care (designa
ated as ‘delivvery points’) by 100%
In
ncrease propo
ortion of all births in govern
nment and acccredited private institution
ns at annual rate
r
of
5.6 % from the
e baseline of 61%
6
(SRS 20
010)
In
ncrease propo
ortion of preg
gnant women
n receiving an
ntenatal care at annual ra
ate of 6% from
m the
ba
aseline of 53%
% (CES 2009
9)
In
ncrease propo
ortion of motthers and new
wborns receiiving postnata
al care at an
nnual rate of 7.5%
from the baseline of 45% (C
CES 2009)
In
ncrease propo
ortion of delivveries conduccted by skilled
d birth attend
dants at annu
ual rate of 2%
% from
th
he baseline off 76% (CES 2009)
2
In
ncrease exclu
usive breast feeding
f
rates at annual ra
ate of 9.6% frrom the base
eline of 36% (CES
20
009)
R
Reduce
prevalence of unde
er-five childre
en who are underweight
u
a annual rate
at
e of 5.5% from
m the
ba
aseline of 45%
% (NFHS 3)
In
ncrease cove
erage of thre
ee doses off combined diphtheria-tetanus-pertusis (DTP3) (1
12–23
m
months)
at ann
nual rate of 3..5% from the baseline of 7%
7 (CES 2009
9)
In
ncrease ORS use in underr-five children
n with diarrho
oea at annual rate of 7.2%
% from the basseline
off 43% (CES 2009)
2
R
Reduce
unmett need for fam
mily planning methods amo
ong eligible couples, marriied and unma
arried,
att annual rate of 8.8% from the baseline of 21% (DLH
HS 3)
In
ncrease met need
n
for mod
dern family pla
anning metho
ods among elligible couples at annual rate of
4.5% from the baseline of 47%
4
(DLHS 3)
R
Reduce
anaem
mia in adolesscent girls and boys (15–
–19 years) at
a annual ratte of 6% from
m the
ba
aseline of 56%
% and 30%, respectively(N
r
NFHS 3)
D
Decrease
the proportion off total fertility contributed by
b adolescentts (15–19 yea
ars) at annua
al rate
off 3.8% per ye
ear from the baseline
b
of 16% (NFHS 3)
•
Raise child sex
R
x ratio in the 0–6
0 years age group at an
nnual rate of 0.6%
0
per year from the basseline
off 914 (Census
s 2011)
‘Reaching
g the Unreach
hed’ in underrserved areass in urban slums, tribal arreas and vuln
nerable popu
ulation
including SC, ST, migrrants, urban poor
p
and adollescents will be
b the topmo
ost priority und
der the RMNC
CH+A
a
Accordingly 186
6 high priority districts were
e selected all over India, off which 10 disstricts
strategic approach.
he list of development partners
Th
in includes UNFPA – State Lead
artner,
U
UNICEF,
Pa
NIPI,
JH
HPIEGO, Save the Children,
HL
LFPPT, MSI, and
a PSI.
In the state con
nsultation me
eet on
MNCH+A strategy rollou
ut in
RM
Ra
ajasthan on May
M 10, 2013,, Smt.
Ga
ayatri. A. Rathore
R
(Mission
Dirrector, NRHM
M) stressed on
o the
challenges to be
b addressed
d to in
e smooth im
mplementatio
on of
the
RM
MNCH + A in the state.. She
foccused on the Qualityy of
Tra
aining, Qua
ality of MCHN
M
services, Use of data at local
a
levvels for monitoring and action
and Weak
Interdepartm
mental
ordination- WCD,
W
PRI.
coo
10 High FFocus Districtts in Rajasthaan or progress made
m
toward
ds the implem
mentation off RMNCH+ A in Rajastha
an has been listed
l
The majo
below
•
•
•
•
•
•
State RMNCH+A unit has been
b
formulated
Meeting of parrtners conduccted and districts distributed
M
d amongst pa
artners
o 4 UNIC
CEF, 4 UNFP
PA, 2 NIPI
R
RMHNC+
A co
oordinators de
eployed UNIC
CEF, UNFPA
Task force con
nstituted at the
e state level
uation analyssis completed.
Preliminary situ
O
Orientation
of district officia
als and detaile
ed evidence based
b
action plan develop
pment workshop as
pa
art of state launch for C 2 A was held on 23-24 May 2013.
Source: RMNCH+A
R
strrategic docum
ment
State Consultation on Intensifica
ation of Effortts in high priority Distric
cts for Improv
ved Materna
al and
Ch
hild Health
One day State
S
level consultation
n for
orts in High Priority
P
Districcts for
intensificcation of effo
Improve
ed Maternal and
a
Child he
ealth was he
eld on
10th Mayy 2013 at Hotel Radisson Blu in Jaipurr. The
consulta
ation was the
e first State level consulltation
after th
he RMNCH+
+A strategic framework was
initiated by the Ministry of He
ealth and Family
F
Welfare,, GoI. The consultation in Rajasthan
n was
jointly organised by the Mohfw,G
GoI , Dohfw ,GoR,
State lea
ad Partner UN
NFPA ,UNICE
EF and NIPI.
Senior officials fro
om GoI inccluding Addiitional
Secretarry, Ms.Anuradha Gupta, Joint
J
Secreta
ary,Dr.
K
Deputy
y Commission
ner CH Dr. Ajjay Khera , Deputy Commiissioner MH Dr.Dinesh
D
Baswal ,
Rakesh Kumar,
Deputy Commissioner
C
r FP Dr. Su
ushma Dureja ,Deputy Commissioner
C
r Dr.Tejaram
m and conssultant
Dr.Deepti Agarwal fac
cilitated the various
v
sessiions . From Rajasthan th
he Honourab
ble Health Miinister
Khan, Principal Health Se
ecretary Mr.D
Deepak Upre
eti , Secretarry and MD NRHM
N
Ms.G
Gayatri
Shr.A.A.K
Rathore ,D
Director RCH
H Dr.J.P.Singh
hal , Director PH Dr. B.R.M
Meena and Se
enior State offficials participated
in the con
nsultation . Th
he District Co
ollectors, Chie
ef Medical He
ealth officers and RCHOs of 10 high priority
p
districts participated in the consultation. Frrom the De
evelopment Partners
P
from Delhi, Deputy
D
Represen
ntative, UNFP
PA Mr. Anderss Thomsen, Deputy
D
Repressentative UNICEF Mr. Davvid, Chief of Health
H
Section UNICEF
U
Dr.Ge
enevieve, US
SAID officials Dr.Karan Sag
gar and Dr.Ra
ajesh Singh were
w
present in the
consultation . From th
he State representing Devvelopment pa
artners were UNFPA State Programme
e Coordinator Mr Sunil Tho
omas Jacob, UNICEF Sta
ate Chief Mr.Samuel Maw
wugnanidze,N
NIPI Sr.Progra
amme
officer Drr.S.P.Yadav apart from other
o
officials from the DP
Ps attended this
t
consultattion. Officialss from
JHPIEGO
O, HLFPPT, ARTH and Medical Colleges also attended
a
thiss consultation
n. Altogetherr 125
participan
nts attended th
his day long consultation.
c
The day long consulta
ation was co
o-ordinated by
b UNFPA an
nd anchored by the State
e Programme
e Coordinator UNFPA. The
e Principal He
ealth Secreta
ary welcomed
d the Senior officials from
m MOHFW an
nd the
representatives of the Development partners to the consultattion and apprreciated the support
s
of Go
oI and
the DPs in
n partnering with
w the Gove
ernment of Ra
ajasthan in acchieving the MDGs.
M
In her add
dress to the delegates, the
e Additional Se
ecretary and MD NRHM highlighted the
e following po
oints;
1. R
Rajasthan as evident from the recent AHS
A
Survey has
h achieved
d a good redu
uction in the MMR
an
nd also said
d that various other survveys have sh
hown that th
he indicators in Rajasthan are
im
mproving.
2. Even in the midst
m
of the positive impro
ovement, therre are challen
nges in the state
s
such ass wide
in
nter district variations
v
in terms of MM
MR, IMR
an
nd TFR ; hu
uman resourcce constraintts , less
fu
unctionality of
o institutions to provide services
ettc.
3. Quality
Q
of Care
e is an impo
ortant elemen
nt for the
hiigher utilisation of the services
s
and priority
ne
eeds to be giv
ven to the sam
me
4. There should be a sha
arper focus on the
re
eduction on the
t
Maternall and Child Mortality
re
eduction
5. There are diffe
erential progress in the in
ndicators
n the various districts and
d so there sh
hould be
in
diifferential programming
6. The high priority districts se
elected under the RMNCH+
+A strategy will
w get 30% additional alloccation
n the PIP and if this amoun
nt is not utilised , then thiss amount will go back to th
he NRHM Go
oI pool
in
an
nd cannot be utilised else where
7. Financial incen
ntives for the human resou
urces in the hard
h
areas in the high priority districts should
s
e encouraged
d and provide
ed. GoI is read
dy to bear the
e costs if the State
S
Government suggests
be
8. In
nnovation in service
s
deliverry will be encouraged by GoI
G
9. R
Rational Distribution of the HR to opera
ationalise the health institu
utions should be undertake
en. In
R
Rajasthan
man
ny providers are trained in
n the area of LSAS (Anae
esthesia) and SBA and the
ey are
no
ot posted in th
he right institu
utions.
10. La
ack of capac
cities in Data
a analysis is a major facto
or in not able to measure
e the progress as
in
ncomplete da
ata entry is re
esulting in the wrong mon
nitoring. The State and District level offficials
sh
hould utilise HMIS
H
data forr analysis and
d monitoring and
a providing
g feedback to the officials
11. Le
eadership at the District le
evel by the District
D
Collecttor and the CMHO
C
is important in achiieving
th
he MDGs and
d the reductio
on of MMR, IMR and TFR
R. The institu
utional mecha
anisms like DHS
D
,
D
District
level meeting
m
, Blocck level meetiing and secto
or level meeting should be
e utilised for critical
c
diiscussions
12. Functionality of
o the instituttions is critica
al in providin
ng timely and
d effective he
ealth care de
elivery
se
ervices. ASM
MD highlighted
d that in Raja
asthan only very
v
few sub
b centres are providing de
elivery
se
ervices and itt needs to be corrected
13. Continuum
C
of Care was emphasized and said th
hat RMNCH+
+A strategy is addressing the
ad
dolescents also as part of the continuum
m.
14. ASMD
A
emphas
sized on three
e elements to improve the
e health syste
em : Informattion , Supplie
es and
Services
15. ASMD
A
the DP
Ps and Government should partner together to ach
hieve the MD
DGs. In Raja
asthan
U
UNFPA
is the lead partner and the lead partner will co-ordinate
c
w other DPss to harmonisse the
with
in
nputs to stren
ngthen the efffective delive
ery of service
es. ASMD sa
aid each DP has its stren
ngths.
U
UNFPA
has itts strengths in
i Family Pla
anning and Adolescents
A
a
and
will utilise the strengtths in
R
RMNCH+A
strrategies. The lead partner in different states
s
should co-ordinate effectively
e
witth the
State Governm
ment in identiffying the nee
eds in the high
h priority disttricts and then
n facilitate foccused
atttention of the
e Government in these disttricts to addre
ess these nee
eds
16. The one conc
cept that ASM
MD highlighte
ed was “Time
e to Care Ap
pproach” whicch focuses on
o the
pe
ersonalised quality
q
care
The Joint
J
Secretarry (RCH) provvided an insig
ght on the
differentia
al indicators among
a
the disstricts in the State and
gave a brrief on the ba
asis of the identification of the high
priority districts in the State. Joint Secretary also talked
about the institutional mechanism
m
at the Countryy level and
the State level to roll out the RMNCH+A strategyy.
Secretaryy and MD NR
RHM, provide
ed a brief pro
ogress on
the RMNC
CH+A interve
entions in the
e State and highlighted
the progrress in the in
ndicators acrross the continuum of
care. MD
D also share
ed about th
he score ca
ard which
D
Department
ha
as developed
d on the basiss of the HMIS
S and
S
Survey
based data.
Honourable He
H
ealth Ministerr in his addre
ess highlighted that
th
he status of the Mother and Child he
ealth in the State
sh
hows the leve
el of socioeco
onomic progrress that has been
acchieved by th
he State. Min
nister shared
d the various large
scchemes that the State has rolled out
o such as Free
G
Generics
Drug
g scheme , Free investigations sche
eme ,
S
Shubhalakshm
mi Yojana in making a diffference in the
e lives
off
the
co
ommunit
y.
Appreciating the NRH
HM progresss in the Statte, Hon’
Minister thanked
t
the GoI for the
eir support. Minister
declared the constitutiion of a sepa
arate division
n for the
High priorrity districts to
t look on prriority the fillin
ng up of
the Huma
an resources
s, the infrastrructural requiirements
and the se
ervice deliverry challenges..
Deputy Co
ommissioner Child Health talked in deta
ail about
how the score
s
card can
n be develope
ed on the bassis of the
16 dashb
board indicattors. DC also shared ab
bout the
Rashtriya Bal swasthya
a Karyakram and the National IFA
plus initiattive.
In the afte
ernoon sessio
on, UNFPA, UNICEF and
d NIPI affirme
ed their comm
mitment to RM
MNCH+A stra
ategy.
Deputy Representative
e UNFPA in his
h address to
o the delegate
es appreciated the committment and vission of
GoI in fra
aming this RM
MNCH+A stra
ategic framew
work and affirm
med that UN
NFPA will putt all its effortss as a
lead partn
ner in the statte to harmonisse the effortss of the DPs to
o catalyse th
he achieveme
ent of the MDG
Gs in
reducing MMR and IM
MR. UNFPA also shared the progresss so far in te
erms of the RMNCH+A
R
update
against th
he timeline de
ecided at the National
N
levell meeting. UN
NICEF shared
d a brief prese
entation on the skill
upgradatio
on as part of the RMNCH+
+A strategy.
There wa
as an open fo
orum for disccussion which
h was facilitatted by the Jo
oint Secretaryy RCH of Go
oI and
Principal Secretary
S
Health of Rajastthan.
The signiificance of World
W
Environ
nment Day
World Environment Da
ay (WED) is observed on June 5 everyy year to pro
omote
awarenesss on the im
mportance of preserving our biodiversity, the nee
ed to
identify prroblems relate
ed to the environment and ways to take
e corrective acction.
It was on this day in th
he year 1972
2 that the Unitted Nations Conference
C
o the
on
Human Environment was
w formed. First
F
celebrate
ed in 1973, World
W
Environ
nment
Day, also
o popularly known as Environment
E
Day, is a means to tackle
t
environme
ental challen
nges that in
nclude clima
ate change, global warm
ming,
disasters and conflic
cts, harmful substances, environme
ental governa
ance,
ecosystem
m manageme
ent and resource efficiencyy. World Environment Da
ay has receivved tremendo
ous support frrom the public, non-profit organizations and
governme
ents around th
he world. Varrious awarene
ess campaign
ns - beach cle
ean-ups, conccerts, exhibitss, film
festivals, community events and mu
uch more - arre organized to spread the
e message, which
w
is to improve
the qualitty of life of all
a living being
gs on this pllanet without harming natture. All the activities of World
W
Environment Day are carried
c
out to spread eco-a
awareness an
nd increase grreen footprintt.
n a different city
c with a diff
fferent theme for one week that
Each year, World Environment Dayy is hosted in
o June 5. A World Enviro
onment Day th
heme is seleccted along wiith an Environ
nment Day slogan,
kicks off on
which aim
ms to emphasize the imporrtance of prote
ecting our pla
anet and prom
mote an understanding tha
at they
each indivvidually can play
p
a significa
ant and effecttive role in tacckling environ
nmental issue
es.
ood Donor Day
D
World Blo
World Blo
ood Donor Da
ay, celebrated on 14 June
e every year,, serves to ra
aise awarene
ess of the nee
ed for
safe blood and blood products and
d to thank vo
oluntary unpa
aid blood don
nors for their life-saving gifts of
blood. With the slogan
n "Give the gift of life: donate blood", th
his year’s cam
mpaign, the 10th anniversary of
World Blo
ood Donor Da
ay, will focus on
o the value of
o donated blood to the pa
atient, not onlyy in saving liffe, but
also in he
elping people live longer an
nd more produ
uctive lives.
SIHFW in Action
Trainings
s/workshops
s organized:
S.
No.
Da
ate
e
Title
Cadre
e (Total
Partic
cipants
Spons
soring
Agenc
cy
ation at SIHFW
W
Routtine Immuniza
94 (M
MOs)
DM&H
HS
Natio
onal Cold Cha
ain Managem
ment
Info System
S
(NCC
CMIS)
RCH
HO Review Me
eeting
omputer
52 (Co
Assista
ant/RCHO/RM
M)
22
(RCHO
Os/DPM/BCM
MO)
80 (AEN/Director/Jo
E
oint
Directo
or)
HS
DM&H
Irrigation
Departtment
29 (MO
Os)
RCH
CL
RMSC
Workkshop on Flou
urosis
160
(DDW//CO/Pharmasstic)
PD
Immun
nization./Co.A
ASH
A/Data
a managers
PRI/NG
GO/Media
RI fo
or Health workkers at Jhunju
unu
36 (He
ealth workers)
RCH
Health workers tra
ainings (With
SBA-Plan 4) at Jh
hunjunu
14 (He
ealth workers)
RCH
Tra
ainings at SIHFW
1.
2.
3.
30 April -2 May,, 7-9,
14--16, 21-23, 28
8-30
Ma
ay 2013 (5
battches)
6-8
8, 9-11 May 2013
2
(2 batches)
Ma
ay 8-9
4.
13--15, 22-24 Ma
ay
2013 (2 batches
s)
5.
6.
16 May-14 June
e
2013
18 May 2013
7.
28--29 May 2013
3
8.
29 May 2013
ange
Workkshop on Cha
Mana
agement und
der EU-SPPIrriga
ation Manage
ement & Train
ning
Instittute
Foun
ndation Coursse for Newly
Recrruited Medica
al Officers
Workkshop on Flag
gship Scheme
e
MND
DY, GoR
Train
ning on DevIn
nfo software&
PCTS
HS
DM&H
S
DMHS
Districct
Admin
nistrationCMHO
O Jaipur-II
Tra
ainings at Districts
9.
10.
7-8
8 May and 17
7-18
Jun
ne 2013 (2
battches)
20 May 19 June
e
2013
Fro
om now onwa
ards, all ASHA
A trainings in the state will be facilitated
d by SIHFW.
Monitorin
ng/Field Visitts
PDC Visitt to Indore
Participan
nts of PDC VII
V Batch vissited RHFWT
TC, Indore, MP
M during May
M
20-25, 20
013. This wa
as an
important activity unde
er Professional Developme
ent Course going
g
on at SIHFW
S
during
g 25 April to 3 July
2013. A te
eam of 15 me
embers includ
ding PDC partticipants and SIHFW facilittators visited Indore in this visit.
ose of the visit was to know
w the variouss innovations of other state
e governmentts introduced in the
The purpo
health secctor and obse
ervation of fun
nctioning of th
he same.
The institu
utions visited included M Y Hospital, In
ndore, CHC Sanwar,
S
Dewa
as, Killor Khurd and Sub Centre
C
Tillor.
During th
he visit, participants were
e divided in sub groups of 3-4 particcipant each group for making
m
observatio
ons on speciffic topic assig
gned to the grroup. These to
opics were – Quality Contrrol and Manp
power,
Physical Infrastructure and Servicess available at facilities.
After returning from th
he visit, each
h group made
e presentations on the ob
bservations and
a
learning of
o the
Exposure Visit, in a se
ession chaire
ed by Dr Sanjjaya Saxena, Registrar-SIHFW, and Dr Mamta Cha
auhan
and Dr Visshal Singh, fa
aculties, SIHF
FW.
ng visit by Re
egistrar
Monitorin
Dr Sanjayya Saxena, Registrar
R
SIHF
FW visited Jh
hunjunu for monitoring
m
of ongoing Integ
grated Trainin
ng for
Health wo
orkers –Plan 4 (with SBA)) on 30 May, 2013. Dr Saxena interactted with healtth workers att PHC
Pilani, forr post-training
g Follow-up for RI trainin
ng for health workers, He
e did a quickk knowledge recall
assessme
ent and discus
ssed challeng
ges faced by trained particcipants in convverting leanin
ng to practice.
Celebrattion
Ms Richa Chabbra’s biirthday was celebrated on 2 May 2013 at
a SIHFW.
The Forrthcoming
1. In
ntegrated Fou
undation training of Newly Recruited Me
edical Officerss, 17 June to 16 July 2013.
2. Consultation
C
of
o Seva Mandir, 13-14 June
e 2013.
Feedba
ack
1.
2.
3.
4.
Method of pres
M
sentation wass liked the mo
ost in RI training.
D S.S Yadav’s session wa
Dr.
as excellent.
A
Accommodatio
on facility and
d lectures are best.
Trainer’s way of
o explaining any problem related to RI training with good examples, was liked the
m
most.
5. Demonstration
D
n of waste disposal management was ve
ery well done
e.
6. Faculty at SIHFW is very go
ood, supportivve and also understands th
he basic prob
blems of docto
ors
fa
aced in comm
munity.
7. Training was ra
ated excellen
nt by 86% of participants
p
(R
RI during 14-1
16 May 2013.)
(Source: feedbac
ck forms from
m participants))
Health News
Global
WHO's Health Assem
mbly
•
•
•
•
•
WHO's Health
H
Assem
mbly opened its 66th Session on 20 May 2013 in Geneva with
w
around 3000
participan
nts from aroun
nd the world. Major health issues to be discussed
d
incclude:
preventing
g and contro
olling non-com
mmunicable diseases
d
succh as diabete
es, heart dise
ease, cancerss and
chronic lung disease;
monitoring
g of progress countries are
e making towa
ards the Mille
ennium Development Goals;
intensifyin
ng efforts to eradicate
e
polio
o;
protecting
g more childre
en from vaccin
ne-preventab
ble diseases;
supporting
g countries in
n their efforts to
t move forwa
ard with unive
ersal health coverage.
c
Health in the post-2015 agenda, WHO’s budg
get for 2014--2015, and progress
p
on the
t
Organiza
ation’s
reform are
e also on the agenda.
In her ope
ening address
s to the Healtth Assembly, WHO Director-General Dr
D Margaret Chan
C
noted that the
world is facing
f
challe
enging times, including fin
nancial crisis, job insecurrity, armed conflicts
c
and large
numbers of people living on the ed
dge, fearing fo
or their lives.“In these trou
ubled times, public
p
health looks
more and
d more like a refuge, a safe
s
harbor of
o hope that allows, and inspires, all countries to work
together for
f the good of
o humanity,” says
s
Dr Chan
n.
She also acknowledged the important role of the Internatiional Health Regulations for detecting
g and
respondin
ng to public he
ealth emergencies, including those caussed by a new
w disease.
In additio
on to the delegates
d
fro
om WHO Member
M
State
es, represen
ntatives from many agen
ncies,
organizatiions, foundatiions and othe
er groups con
ntributing to im
mproving publlic health will also be in Ge
eneva
to engage
e in dialogues
s around key topics
t
at WHO
O’s World He
ealth Assemblly.
In a recen
nt survey, abo
out the work of
o WHO, morre than 4 out of 5 key public health stakkeholders rep
ported
that WHO
O is either ind
dispensable or
o important for improving
g people's he
ealth. In addittion nearly 90
0% of
these global health pa
articipants reported that WHO
W
was the
e most effective organiza
ation at influe
encing
global hea
alth policy.
The outco
omes of the World Health
h Assembly are
a particularrly significantt this year ass the Organizzation
enters a new
n
six-year cycle of health programm
ming as define
ed in the Gen
neral Program
mme of Workk. The
Health Asssembly will also
a
take imp
portant decisio
ons on how the
t Organizattion continues to move forward
reforming itself to be po
ositioned to work
w
effectively in the 21st century healtth landscape..
Source: www.who.int/m
w
mediacentre/n
news/20.5.13
India
Miles to go
g in maternal mortality rate
r
The 2015
5 deadline forr the Millennium Development Goals (MDGs) agre
eed to by wo
orld leaders over
o
a
decade ago, is fast ap
pproaching. According
A
to the UN 2012
2 report on th
he 5th MDG 'Improve maternal
Health', "Maternal mortality has ne
early halved since 1990, but levels are far removved from the 2015
target."
The Mille
ennium Development Goa
als (MDGs) agreed to byy world lead
ders over a decade ago have
achieved important res
sults. Working together, governments,
g
the United Nations,
N
priva
ate sector and
d civil
aving many livves and impro
oving conditio
ons for many more.
society accross the country have succceeded in sa
"There ha
ave been important impro
ovements in maternal health and reduction in ma
aternal deathss, but
progress is still slow. Reductions in adolescentt childbearing
g and expanssion of contra
aceptive use have
continued
d, but at a slow
wer pace sincce 2000 than over the deca
ade before, re
eads the repo
ort.
Improving
g maternal he
ealth is one of
o the eight Millennium
M
D
Development
Goals (MDGs) adopted by
b the
internation
nal community in 2000. Under
U
MDG5, countries committed to reducing maternal mortality by
three quarters between
n 1990 and 20
015. Since 19
990, maternall deaths world
dwide have dropped by 47
7%.
ernal mortality
y ratio in deve
eloping counttries is 240 per
p 100,000 births
b
versus 16 per 100,0
000 in
The mate
developed
d countries. There
T
are larrge disparities between co
ountries, with
h few nationss having extre
emely
high mate
ernal mortality
y ratios of 10
000 or more per 100,000 live births. There
T
are alsso large dispa
arities
within cou
untries, betwe
een people with
w high and low income and
a between people living in rural and urban
areas.
The risk of maternal mortality
m
is highest
h
for ad
dolescent girlls under 15 years
y
old but according to
t the
report, few
wer teens arre having children in mosst regions, but
b progress has slowed. "Complicatio
ons in
pregnancyy and childbirth are the leading causse of death among
a
adolescent girls in
n most develloping
countries.. Maternal health and newborn health are
a closely linkked. More tha
an three millio
on newborn babies
b
die every year, and an additional 2.6
6 million babies are stillborrn," reads the
e report.
n developing countries ha
ave on avera
age many mo
ore pregnanccies than women in deve
eloped
Women in
countries,, and their life
etime risk of death
d
due to pregnancy iss higher. A woman's lifetim
me risk of maternal
death - the probability that a 15 yea
ar old woman will eventuallly die from a maternal cause - is 1 in 38
800 in
developed
d countries, versus
v
1 in 15
50 in developing countries.
"Women die as a resu
ult of compliccations during
g and following pregnancyy and childbiirth. Most of these
complications develop
p during preg
gnancy. Othe
er complications may exxist before pregnancy
p
bu
ut are
worsened
d during pregnancy. The major
m
compliccations that account
a
for 80%
8
of all ma
aternal deathss are,
severe ble
eeding (mostly bleeding affter childbirth), infections (usually
(
after childbirth), high blood pre
essure
pregnancyy (pre-eclamp
psia and ecla
ampsia) and unsafe
u
abortio
on," said form
mer supdt. Za
anana Hospita
al, Dr.
Shashi Gu
upta.
Every dayy, approximattely 800 wom
men die from preventable causes relate
ed to pregnancy and child
dbirth.
99% of all maternal deaths occur in developing countries.
c
Maternal mortality is
s higher in women livin
ng in rural areas and among poo
orer commun
nities.
Young ad
dolescents face a higher risk of complications and death as a result of pregnancy than older
women.
Skilled ca
are before, during
d
and after
a
childbirth
h can save the lives of women and
d newborn ba
abies.
Between 1990 and 201
10, maternal mortality
m
worlldwide droppe
ed by almost 50%
Source: TOI,
T
07.05.13
Rajasthan
New prog
gramme on health
h
and fa
amily welfare
e departmentt's anvil
The mediccal health and
d family welfa
are departmen
nt has steppe
ed up efforts to
t launch a ne
ew programm
meReproducctive, Materna
al, Newborn, Child
C
and Ado
olescent Heallth (RMNCH+
+A) in Udaipu
ur division.
The senio
or health depa
artment officia
als reached Udaipur
U
and held a meeting
g with the dep
partment officcials
in districtss of Udaipur division.
d
Bansswara, Chittorrgarh, Dungarrpur, Rajsama
and, Pratapga
arh, and Udaiipur
were discussed in the meeting.
An officiall said that the
e department has started itts preparation
ns for RMNCH
H+A, which will be launche
ed in
the entire state.
A meeting
g of all chief medical
m
health
h officers and block chief medical
m
officers was held to
o provide all the
t
necessaryy information on the new programme.
p
T medical directorate
The
d
offiicers also visiited rural area
as in
the tribal region
r
of Uda
aipur division.
"The prog
gramme would
d be launched
d in entire sta
ate but the fun
nding in 10 hig
gh focus distrricts would be
e 30%
more in co
omparison to other districtss," the officiall said.
The health departmentt is preparing a complete project
p
to makke use of the RMNCH+A fu
ully to improve
e
health ind
dicators.
Source: TOI,
T
18.5.13
Rajasthan Records Highest
H
declin
ne in MMR
The Annu
ual Health Surrvey (AHS), which
w
was con
nducted on niine states, shows that Raja
asthan has
recorded the highest decline in mate
ernal mortalityy rate (MMR)). The survey was released
d in May.
The surve
ey states that the MMR in Rajasthan
R
declined by 67 points,
p
which is highest am
mong the nine
e
states surrveyed. This is a positive sign
s
as state'ss MMR is usually above the
e national ave
erage.
The reporrt says that the state has shown significant improvem
ment in contro
olling materna
al deaths from
m
financial year
y
2010-11 to 2011-12. This
T
can be attributed
a
to th
he state goverrnment's flagsship schemess
implemen
nted in the pas
st two years which
w
proved life saving fo
or the pregnan
nt women.
The mediccal health and
d family welfa
are departmen
nt also made its contributio
on, but is yet to achieve the
target set by the ministtry of health. The
T departme
ent has been directed to re
educe the MM
MR to 150 dea
aths
per 100,000 live births till 2015-17.
The otherr states includ
ded in the survvey are Biharr, Jharkhand, Odisha, Raja
asthan, Madhya Pradesh,
Chattisgarh, Uttar Prad
desh, Uttarakhand and Asssam.
In Rajasth
han, the surve
ey was condu
ucted on 4.46 lakh female population
p
an
nd 1.29 lakh liive births in all
a
districts of the state.
In 2011-2012, the MMR
R in the state reduced to 264
2 per 100,000 live births. It was 331 per
p 100,000 livve
births in 2010-11.
2
The surve
ey report state
es that the pro
oportion of maternal death
hs declined in the two conssecutive yearss. In
2011-2012, out of 2,26
64 female dea
aths, which wa
as taken as a sample, 341 were matern
nal deaths. While
W
1,923 fem
males died from non-matern
nal reasons.
While in 2010-11,
2
out of
o 2,028 fema
ale deaths, the
ere were 430 maternal dea
aths while 1,5
598 were nonmaternal deaths.
d
Meanwhile, Uttarakhan
nd recorded th
he lowest MM
MR with 162 maternal
m
deatths per 100,00
00 live
births. Asssam recorded
d highest MMR with 347 maternal
m
death
hs per 100,00
00 live births, the survey sa
aid.
Source: TOI,
T
07.05.13
Udaipur division:
d
significant decline in MMR
The districcts in Udaipur division havve reported a significant de
ecline in the maternal
m
morta
ality ratio (MM
MR).
Most of th
hese divisions
s are tribal are
eas and were
e placed in the
e high-focused districts by the medical,
health and
d family welfa
are departmen
nt.
According
g to the Annua
al Health Survvey 2011-12 which was re
eleased in the first week of May by the
Centre, Udaipur divisio
on reported a fall of 79 poin
nts in MMR. The
T MMR in districts
d
in Udaipur division
n
including Rajsamand, Udaipur,
U
Dungarpur, Bansswara and Chittorgarh has reduced to 285 per 1,00,0
000
live births. This was 36
64 per 1,00,00
00 live births in 2010-11.
Dungarpu
ur chief medic
cal health officcer Kantilal Mochi
M
said, "W
We are identifyying high-risk pregnant women
in our disttrict. The high
h-risk pregnan
nt women are
e those who are less than 4 feet tall, lesss than 18 yea
ars or
more than
n 33 years. Allso, the high-rrisk pregnant women include those who
o have alread
dy delivered fo
our
times."
Besides, the
t districts in
n Jaipur division, including Jhunjhunu, Alwar,
A
Dausa, Jaipur and Sikar,
S
reported
highest de
ecline in MMR
R in the state.. The MMR was
w 319 in 201
10-11, which reduced to 23
38 in 2011-12
2.
Similarly, the districts in Bikaner division reported
d a decline off 80 points, Ko
ota reported a fall of 82 po
oints
but Bhara
atpur division reported lowe
est decline of 41 points in MMR.
M
Annual he
ealth survey 2011-12
2
Division MMR
M
(per 1,00
0,000 live birtths)
Bikaner 264 (331)
Jaipur 238
8 (319)
Bharatpurr 251 (292)
Ajmer 293
3 (338)
Jodhpur 262
2 (322)
Kota 261 (343)
Udaipur 285
2 (364)
(Figures of
o annual hea
alth survey 2010-11 given in bracket)
Source: TOI,
T
07.05.13
Anti-mala
aria activities
s well in advance
Nearly 70
0% of malaria cases are reported in the tribal and dessert areas. To
o curb malaria
a deaths in sttate,
the mediccal health and
d family welfarre departmen
nt has stepped
d up anti-mala
aria activities well in advan
nce
before the
e rainy season sets in.
According
g to the Draft Annual
A
Action
n Plan 2013-1
14, A Stephen
nsi, A Culicifa
acies and Aed
des Aegypti are
a
the vectorrs responsible
e for causing malaria and dengue.
d
epartment dire
ector (health) Dr BR Meena
a said, "We have
h
started our
o anti-malarria activities in
n
Health de
tribal area
as. Our additio
onal director is camping in
n Udaipur divission and prep
paring to deal with malaria
cases. Alsso, officials in
ncluding joint directors
d
and microbiologissts are inspeccting other disstricts to ensu
ure
there is re
eduction in ca
ases of malaria and other vector-borne
v
d
diseases
this year. Vector--borne diseasses
spread du
uring the rainy
y season, so we
w have startted the prepa
arations well in
n advance."
epartment succcessfully deccreased the ca
ases of malarria and related deaths," he
e
"In 2012, the health de
said.
w hilly terra
ain are not eassily accessiblle, therefore, prevention off diseases
Since the tribal areas with
becomes challenging. Also, disease
es spread quicckly in these areas due to low literacy and
a socioeconomicc status couple
ed with culturral taboos and
d ethnic probllems, report says.
s
"These tribal areas con
ntribute 20-40
0% of the dise
ease burden. During the last decade, we
estern districtts
such as Jaisalmer and Barmer repo
orted highest Annual
A
Parassite Incidence
e (API) and the area was
serious ca
ause of conce
ern especiallyy between 200
01 to 2003. Breeding
B
of ve
ectors in the household
h
drin
nking
water rese
ervoirs was re
esponsible for persistent endemic
e
in the
ese areas along with the migration
m
and
seepagess in the India Gandhi
G
Canal as other riskk factors in so
ome areas," th
he report sayss.
Additional director (rura
al health) Dr PC
P Dhindhoriia, said, "We are making itt sure that chloroquine drug
g is
available at each and every
e
heath centre
c
in Udaipur division fo
or treatment of
o malaria casses. Also, we
e have
started an
nti-malaria acttivities in Uda
aipur."
Moreoverr, as Jaisalme
er is the largesst district of In
ndia with lowe
est population
n density of about 11 per sq
s
km, the fa
ar-flung areas
s with low pop
pulation density are the ma
ajor hindrance
e in implemen
ntation of publlic
health pro
ogramme in western
w
Rajassthan, the hea
alth departme
ent claimed.
Source: TOI,
T
20.5.13
MoU sing
ged for 108 Service
S
The health departmentt has signed a memorandum of undersstanding (MoU
U) with GVK--EMRI (Emerg
gency
Managem
ment and Res
search Institutte on 23 Apriil 2013 to run
n 108 ambula
ance emergen
ncy services in the
state.
The healtth departmentt will pay Rs 1.12 lakh to GVK-EMRI per
p ambulancce per month for its operattion in
the state. There are 46
64 ambulance
es, which wou
uld be run by GVK-EMRI. However, the
e state govern
nment
has planss to add more ambulance
es to its fleet,, as Chief Minister Shri Ashok
A
Gehlot announced in his
budget sp
peech 2013-14.
The MoU is for two years
y
and the
e company would
w
take ovver the 108 ambulance services
s
from
m next
month. Till then the hea
alth departme
ent would con
ntinue operating it in the state.
Source: TOI,
T
24.5.13
We soliciit your feedba
ack:
State Insttitute of Healtth & Family Welfare
W
Jhalana Institutional Area,
A
South off Doordarshan
n Kendra Jaip
pur (Raj)
Phone-2
2706496, 2701938, Fax- 27
706534
E-mail:-ssihfwraj@yma
ail.com; Webssite: www.sihffwrajasthan.ccom