MANAV VIKAS MISSION- BIHAR 2013-17 and 2017-2022 (Population, - - PowerPoint PPT Presentation

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MANAV VIKAS MISSION- BIHAR 2013-17 and 2017-2022 (Population, - - PowerPoint PPT Presentation

MANAV VIKAS MISSION- BIHAR 2013-17 and 2017-2022 (Population, Health, Malnutrition related issues) HEALTH SECTOR VISION & COMMITMENT Mission statement: Bihar Health, Population and Nutrition Sector will compliment the Manav Vikas Mission


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SLIDE 1

MANAV VIKAS MISSION- BIHAR 2013-17 and 2017-2022

(Population, Health, Malnutrition related issues)

HEALTH SECTOR VISION & COMMITMENT

Mission statement:

Bihar Health, Population and Nutrition Sector will compliment the Manav Vikas Mission Goals by

  • Identifying and providing solutions for implementation bottlenecks,
  • Introducing out of the box interventions and processes for better
  • utcomes
  • Fast tracking of development of infrastructure and human resources
  • Coordinating for improved intersectoral convergence
  • Partnering with communities and strengthening community systems
  • Optimal utilization of available resources
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SLIDE 2

Achievements and Challenges

  • The improved governance in Bihar in the last 7-8 years has led to an economic revival in the

state through increased investment in infrastructure, better health care facilities, greater emphasis on education and a reduction in crime and corruption.

  • Bihar’s achievements in reducing maternal and child mortality in the recent past has been

impressive, yet challenges still remain.

  • The challenges would be met with intensive and concerted efforts of various stakeholders.

Sr. No

Indicator

Latest Situation Trend

1

Infant Mortality Rate (number/1000 Live Births) 44 (SRS 2011)

Improved from 61 in 2005

2

Maternal Mortality Ratio (number/lakh Live Births) 261 (SRS 2009)

Improved from 312 in 2005

3

Total Fertility Rate (no. of births/woman) 3.6 (SRS 2011)

Improved from 3.9 in 2005

4

Child marriage (marriage before 18 yrs) 23 (AHS 2010)

Improved from 46% in 2009

5

Life Expectancy at Birth 65.5(M) & 66.2 (F)

(SRS 2011) Improved from 61.6 (M) & 59.7(F) in 2001

6

Anaemia (All women 15-49 years) % 68.3 (NFHS 3, 2005-06)

Worsened from 63% in 1999

7

Malnutrition (children under 3 years of age)* 58.4 (NFHS 3, 2005-06)

Worsened from 54% in 1999

8

Sex Ratio (no. of females/1000 males) 916 (Census 2011)

Worsened from 921 in 2001

*Data available for under 3 children, however supplementary nutrition programme is proposed for all children up

to 14 years through AWCs and Schools

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SLIDE 3

Health, Population and Nutrition Sector- Goals

S. N

Indicators

Latest situation Target by 2017 Target by 2022

1

Infant Mortality Rate (IMR)

(number/1000 Live Births)

44 (SRS 2011) 26 <20

2

Maternal Mortality Ratio (MMR)

(number/Lakh Live Births -LLB)

261 (SRS 2009) 119 <90

3

Total Fertility Rate (TFR)

(number of births/woman)

3.6 (SRS 2011) 2.9** 2.1

4

Malnutrition (children under 3 years)%* 58.4 (NFHS-3, 2005-07) 29 <18%

5

Anaemia (All women 15-49 years)% 68.3 (NFHS-3, 2005-07) 34 <20%

6

Life Expectancy at Birth (years) (SRS 2011)

M – 65.5; F- 66.2

M- 68.6 F-68.7 M- 69.6 F- 70.2

7

Sex Ratio (no. of females/1000 males) 916 (Census 2011) 930 960

8

Child Marriage (marriage before 18 yrs)%

20.2 (AHS 2010) 14** <10

The targets given by MoHFW, GoI (12th Five Year Plan targets-Page-4 &16). **GoB estimates

*Data available for under 3 children, however malnutrition seems to be a problem amongst school age children

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SLIDE 4

Infant Mortality Rate (IMR): Trend and Targets

  • Poor progress in 2002-2005
  • Better than national average in 2008- 2011
  • Bihar caught up with National level IMR in 2011

62 61 60 61 61 60 58 56 52 52 48 44 40 36 33 30 28 26

10 20 30 40 50 60 70

MVM Goal

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SLIDE 5

Maternal Mortality Ratio (MMR): Trend and Targets

Good progress of reduction of MMR after 2005

531 400 371 312 261 201 183 165 149 133 119

100 200 300 400 500 600

MVM Goal

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SLIDE 6

Total Fertility Rate (TFR) : Trend and Targets

Total fertility rate in Bihar is one and half times

  • f All India average and is the highest

5.7 4.8 4.0 3.7 3.9 3.7 3.6 3.4 3.2 3.1 3.0 2.9

1 2 3 4 5 6 1980 1990 NFHS-I (92-93) NFHS-II (98-99) NFHS-III (05-06) 2009-10 2011-12 2013 2014 2015 2016 2017

MVM Goal

Pursuing formal Education of Girls up to 10+2 will facilitate Reduction of Fertility Rate by 70%

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SLIDE 7

Malnutrition: Trend and Targets

National Undernutrition Rate reduced by 2.3 % whereas in Bihar it increased by 4.1% between NFHS II and NFHS III a gap of 7 years

54.3 58.4 49 42 37 33 29

10 20 30 40 50 60 70

NFHS -2 (1998-99) NFHS -3 (2005-06) 2013 2014 2015 2016 2017 Child Undernutrition Index HIGHEST in Bihar Malnutrition associated with 54% of Under Five Year Children Deaths Data available for under 3 children, however malnutrition seems to be a problem amongst school age children

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SLIDE 8

Anaemia: Trend and Targets

National and Bihar Anaemia rate has increased by 4% between NFHS II and NFHS III a gap of 7 years

63.4 68.3 57 49 43 38 34 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 NFHS -2 (1998-99) NFHS -3 (2005-06) 2013 2014 2015 2016 2017

MVM Goal

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SLIDE 9

Sex Ratio: Trend and Targets

Sex ratio in the urban areas of Bihar has declined sharply to only 916 females against 1000 males as per the 2011 census

1061 1051 1020 995 1002 1000 1005 957 948 907 921 916 930 940

800 850 900 950 1000 1050 1100

1901 1911 1921 1931 1941 1951 1961 1971 1981 1991 2001 2011 2017 2022

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SLIDE 10

Child Marriage: Trend and Targets

45.9 20.2 18.0 16.0 14.0

5 10 15 20 25 30 35 40 45 50 DLHS-III (2007-08) AHS (2010-11) 2013-14 2015-16 2017-18

MVM Goal

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SLIDE 11

Life Expectancy at Birth: Trend and Targets

2001-05 2006-10 2011-15 2016-20 Male 62.0 65.5 68.6 69.6 Female 60.1 66.2 68.7 70.2 62.0 65.5 68.6 69.6 60.1 66.2 68.7 70.2 54.0 56.0 58.0 60.0 62.0 64.0 66.0 68.0 70.0 72.0

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SLIDE 12

Expand Human Resources in Health

( Recommendations of High Level Expert Group Report- Universal Health Coverage(UHC)

  • As per WHO norms:
  • 1. Human Resources (HR): 100 Medical Officers; 300 nurses (ANM+GNMs);

230 health workers per 100,000 population. As of now, Bihar has only 4 Medical Officers; 18 Nurses and 22 health workers per lakh population.

  • 2. Hospital Beds: 100 beds per 1 lakh population. As of now, Bihar has

26,896 beds (as against 1,00,000 beds) The shortage of manpower in the Department is enormous, but the Department systematically envisages the gaps and has planned to bridge them in phased

  • manner. Steps in this direction would include
  • Opening new medical colleges, both govt. and private
  • Increasing the number of seats of existing colleges-
  • Upgrading district hospitals into teaching hospitals
  • Expanding PG seats to provide faculty and also specialty care
  • Introduce Public Health Cadre first line supervisors
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SLIDE 13

The Department Areas needing convergence

Social Welfare (ICDS)

Growth monitoring, Nutrition & IFA supplementation for pregnant & nursing women and adolescents and promoting Positive Deviance Approach (PDA) for convincing families for better feeding and care. Universalization of ICDS services Capacity Building of AWWs on IMNCI Programme Promotion of Kitchen Gardens through MNREGA with involvement of PRI members

PHED

Safe water supply and household toilet building

Education (Primary & Secondary)

IFA weekly supplementation, hand wash and other hygiene practices, use of toilets. Improve the nutritional value of Mid-Day-Meal for ALL schools Messages of “Dus Ka Dum, Shwathy Rahenge Hum” in school and college books

Panchayati Raj Dept.

IEC/Communication with PRI and Community mobilization Orientation of PRI Members on Newborn Care VHSC- provide mobility support to transport the sick newborns Support to VHSND Operationalization Monitoring & Supervision of ANM/AWW activities through their standing committees . Strengthening PDS and food security

Intersectoral Convergence

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SLIDE 14

A

ONGOING INTERVENTIONS

1 Infrastructure

(Upgradation of PHC to CHC; Establishment of SNCU/NBSU; L1 centers etc)

20,156 2 Human Resources

(Medical Officers, Specialist, ANMs, Staff Nurses, Paramedics etc)

1,412 3 Drugs and Consumables

(SNCU/ICU/Emergency/FP etc)

653 4 Equipments & Diagnostics

(MH,CH,FP,Training etc)

21 5 Capacity Development

(Maternal health, Child Health, PNDT,FP,ARSH,WIFS etc)

63 6 Patient Transport Services

(Ambulances-102/108)

1,551 SUB TOTAL

23,856

B NEWER INTERVENTION

1

The Bihar Model of Preventive Health Care(Dus Ka Dum (DKD) – Swasth Rahengey Hum)

10 2

Common Minimum Programme-Innovative Solutions (DPF)

61 3

Mukhya Mantri Kanya Suraksha Yojna (Bihar) Proposed revision…

9,600 4

Nutrition Care (Nanny’s at AWC)

36 5

Promote Directly Observed Consumption (DOC)

  • f IFA supplementation in Schools:

1 SUB TOTAL

9,707

GRAND TOTAL

33,563

  • Sr. No.

Major Heads Total Cost (in Cores)

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SLIDE 15

Policy considerations:

  • Integrated Health Policy including mainstreaming
  • f AYUSH
  • State Health Human Resource policy
  • State nutrition policy
  • State Nutrition Mission
  • Policy to encourage private sector participation

in health sector

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SLIDE 16