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REASON FOR IMPLEMENTATION NEW GLOPAL HEALTH POLICY

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Title: REASON FOR IMPLEMENTATION NEW GLOPAL HEALTH POLICY HEALTH FOR ALL IN 21ST CENTURY Author: Selvaraj Last modified by: Eugene Chubmkov – PowerPoint PPT presentation

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Title: REASON FOR IMPLEMENTATION NEW GLOPAL HEALTH POLICY


1
Dr.I.Selvaraj INDIAN
RAILWAY MEDICAL
SERVICE B.Sc., M.B.B.S., D.Ph., D.I.H.,
P.G.C.H.F.W (NIHFW, New Delhi)
Trained Epidemiologist
(CMC, vellore, T.N) Sr.
D.M.O/Health Unit/ S.Railway/Egmore/Chennai/
Tamil Nadu/ India
2
Dr.I.Selvaraj
3
HEALTH FOR ALL IN 21ST CENTURY
NEW GLOBAL HEALTH POLICY
4
INTRODUCTION
  • The member countries while attending a
    conference on Health For All And Primary
    Healthcare at Alma Ata, Kazakistan from 6th to
    12th September 1978, having committed to attain
    the goals of Health For All by the year 2000
    A.D. But it is now becoming very clear that the
    goal of Health For All by the year 2000 could
    not have been achieved. Two major factors are
    found for this failure.
  • Biased and poor socio-economic development
    between developed and developing countries.
  • Discriminative policies.

5
THE REASON FOR IMPLEMENTATION OF NEW GLOPAL
HEALTH POLICY HEALTH FOR ALL IN 21ST
CENTURY  Unacceptably high mortality and high
morbidity rate. Increasing burden of
accidental trauma cases due to raising vehicular
density. Higher incidence of micro-macro
nutritional deficiencies disorders such as LBW
with serious consequential mental and physical
retarded growth. To ensure the broad based
availability of health services to the
poor, under privileged citizenry of the country
on the basis of ground realistic consideration.
6
  • Inadequate availability of personnel with
    specialization in the Public Health and Family
    medicine to discharge the Public Health
    responsibility in the country.
  • The ratio of nursing personnel vis-à-vis
    doctors/beds is very low. There is also acute
    shortage of nurses trained in super specialty
    disciplines for deployment in tertiary care
    services.
  • There is an apprehension that globalization will
    lead to raising trends in the overall health
    cost.
  • The urban population is likely to go up to 33
    by 2010 resulting in urban slums without any
    infrastructure health support.

7
  • There is a serious bearing on the quality of life
    of the mentally affected persons and their
    Families because they are admitted in religious
    institution where reliance is placed on faith
    cure.
  • There is no accountability for effectiveness of
    I.E.C programmes with regard to the productive
    Use of funds allotted for public health
    programmes.
  • The urban population is likely to go up to 33
    by 2010 resulting in urban slums without any
    infrastructure health support.

8
THRUST AREAS IDENTIFIED
  • Nutrition
  • PFA Act
  • Environmental Health Hazards
  • Immunization Programme
  • MCH Services
  • School Health Programme
  • Industrial/Occupational Health Services
  • Mental health services
  • R.T.I / S.T.I Control Services

9
IMPLEMENTATION OF NEW GLOBAL HEALTH POLICY
10
VISION
  • Health for all
    in 21st century

11
OBJECTIVE
  • TO PROVIDE A COMPREHENSIVE PRIMARY HEALTH CARE
    SERVICES WHICH IS AFFORDABLE,FREELY AVAILABLE,
    EASILY ACCESSIBLE AND ACCEPTABLE BY THE
    COMMUNITY WITH THE SPIRIT OF SELF RELIANCE AND
    SELF DETERMINATION

12
GOAL
  • 1. To achieve all the public health
    indicators
  • 2. Health for all indicators
  • 3. All National Health Programs indicators
    before the target years.

13
TARGETS
  • 1. IMPROVE THE HEALTH EQUITY BY 2005
  • 2. INCREASE THE SURVIVAL BY 2020
  • 1. M.M.R 100/100000 LIVE
    BIRTHS
  • 2. I.M.R 45/1000 LIVE
    BIRTHS
  • 3. LIFE EXPECTENCY gt 70 YEARS
    FOR ALL COUNTRIES
  • 3. REVERSE GLOPAL TRENDS FOR FIVE MAJOR PANDEMICS
    by 2020 (TB, HIV/AIDS, MALARIA, TOBACCO RELATED
    DISEASES, and VIOLENCE/TRAUMA)
  • 4. ERADICATE AND ELIMINATE CERTAIN DISEASES
    (Measles, Filariasis, Chagas disease/2010,
    Leprosy/2010, Trachoma, and Vitamin-A, / Iodine
    Deficiency by 2020)
  • 5. IMPROVE ACCESS TO WATER, SANITATION, FOOD AND
    SHELTER BY 2020

14
STRATEGY
  • Bottom-up planning
  • Decentralization of implementation
  • Strengthening of infrastructure
  • Capacity building at districts for planning,
    Implementation, Management Information System,
    and concurrent evaluation
  • Quality up-gradation of services
  • Appropriate system support for better management,
    co-ordination, and smooth flow of funds,
    transport, and procurement system

15
PROGRAMME
  • A need based
  • Client centered
  • Demand driven
  • High quality integrated services
  • Decentralized planning with ultimate aim of
    population stabilization

16
ACTION PLAN FOR
IMPLEMENTATION
  • To identify the unmet need of the population
  • To select priorities among the felt needs
  • To formulate the objectives
  • Setting the goals
  • Planning the programme
  • Selection of suitable health personals
  • Re-orientation course / training for the selected
    health personals
    Cont..

17
  • Mobilization of financial / material resources
  • Behavioral changes by I.E.C activities
  • Intersectoral coordination of sister
    organizations of Indian railways
  • Monitoring and evaluation of the programme
  • Feedback
  • Reassessment of the programme

18
MONITORING AND EVALUATION OF HEALTH PROGRAMME
19
The indicators formulated by the public health
administrators to monitor and evaluate the
various activities are based on a valid,
reliable, reproducible, repeatable, sensitive,
specific and relevant data. The type of
indicators thus identified by the public health
administrators are given below
20
PUBLIC HEALTH INDICATORS
  • SOCIAL AND ECONOMICAL INDICATORS
  • Per Capita Income Crude Birth Rate
  • Crude Death Rate
  • GNP/GDP
  • Literacy Rate
  • Unemployment Rate

21
R.C.H PROGRAMME
  • ACCESSIBILITY INDICATORS
  • No. Of eligible couples registered.
  • No. Of eligible couples motivated by staff nurse
    / ANM / midwife / CHI
  • No. Of ANC sessions held
  • No. Of immunization sessions held
  • No. Of well baby clinic conducted
  • No. Of Health Education sessions conducted
  • No. Of school Health check up conducted
  • Total number of population covered
  • No. Of RTI/ STD special clinic conducted

22
R.C.H PROGRAMME
  • QUALITY INDICATORS
  • No. Of ANC registered
  • No. Of ANC with 3 Ante natal visits
  • No. Of Ante natal cases receiving prophylactic/
    therapeutic FST tablets
  • No. Of High risk Ante natal cases referred
  • No. Of Ante natal cases received 2 doses of
    injection T.T
  • No. Of Normal deliveries conducted
  • No. Of high risk Ante natal referral cases
    followed up

23
  • No. Of Post natal cases with 3 post natal clinic
    visit
  • No. Of Post natal case received Family Planning
    Counseling
  • No. Of New born children fully immunized
  • No. Of Infants with ADD treated
  • No. Of Infants with ARI treated
  • No. Of New born children given Vitamin A
    solution
  • No. Of infants with malnutrition treated
  • No. Of Eligible couples adapted temporary/
    permanent sterilization

24
R.C.H PROGRAMME
  • IMPACT INDICATORS
  • IMR
  • MMR
  • NMR
  • CPR (Couple Protection Rate)
  • No. Of New born children given breast feeding
    within 6hrs of delivery
  • No. Of New born children with LBW

25
ACCESSIBLE INDICATOR OF COMPREHENSIVE HEALTH
CARE SERVICES
  • Population/Health unit/Divisional
    hospitals/Zonal hospitals
  • Population/per doctor/Health unit
  • Population/per midwife/per Trained Birth
    Attendent
  • Population within 5 km/Health
    unit/Sub.Divisional Hospital/Divisional
    Hospital/Zonal hospitals
  • Population satisfied

26
  • General indicator of well being
  •  
  • Life expectancy

27
Suggestion for improving the performance of all
public health programme
  • 1. To conduct C.M.E programme and in-service
    training for the Medical Personals to update
    their knowledge in the management skills and
    subjects in the respective field
  • 2. To involve N.G.O actively in the Health and
    Family Welfare activities
  • 3. The hierarchical pattern has to be modified
    at the Divisional level to look after the
    curative and preventive services separately

28
7. The Public Health Administrator has to be
nominated as Nodal Officer at Divisional level
for AIDS, TB, MALARIA and LEPROSY 8. The Public
Health Administrator has to be included in the
hospital infection control committee to monitor
the nosocomial infection in the zonal hospitals
9. To impart training to paramedical personals,
health inspectors, midwives and staff nurses in
the field of health and family welfare activities
at zonal level by the public health
administrators
29
  • 13. The following 50 comprehensive R.C.H
    services to be effectively carried out for the
    entire population
  • M.C.H Services
  • Nutritional Services
  • Management of childhood diseases
  • Referral Services
  • Fertility Services
  • Population control and sexuality educational
    Services
  • R.T.I / S.T.I Control Services
  • Health education regarding gender issues
  • Formal and Non-formal education about
    public health
  • Forty Plus Care etc.,

30
ACTION PLAN FOR CARRYING OUT R.C.H PROGRAMME
  • Goal Health For All
    Objective Population
    stabilization by 2045
    Target Total
    fertility rate to the replacement level by 2010
    and to achieve the other indicators of health
    for all
  • Program Comprehensive R.C.H services
    Plan
    High quality, integrated, decentralized,
    needs based and holistic approach
    Monitoring Evaluation
    R.C.H indicators/Feedback data
  •  

31
ACTION PLAN FOR R.N.T.C.P
  • Goal To extend the RNTCP to cover the entire
    population of the country by 2005
  • Objective 1) To cure 85 of the sputum
    positive cases
  • 2) To detect 70 of the
    estimated cases of T.B
  • Target Three million cases have to be
    treated and 1.5 million cases have to be cured.
  • Program RNTCP
  • Strategy DOTS
  • Monitoring Evaluation
  • 1) Sputum conversion rate
    2) Cure rate

32
CONCLUSION  The Public Health
Administrators have to prepare the action plan
for Implementation of all National Health
Programme. They have to identify the magnitude of
the problem existing in their respective zone.
The Zonal Hospital / Divisional Hospital has to
be made as sentinel center. The data collection
from this center will be utilized by the Public
Health Administrators to keep a continuous vigil
on the occurrence and distribution of diseases,
population dynamics, community behavior, and
environmental changes that result in an increased
risk of ill health in the community.
DR.I.SELVARAJ I.R.M.S
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