Maternal Health: RajasthanMaternal Health: Rajasthan Health.pdf · Source: SIHFW: an ISO 9001: 2008...

Maternal Health: RajasthanMaternal Health: Rajasthan

State Institute of Health & Family Welfare, Jaipur

State Profile• Demographical

– Pop. 68,621,012• Male : 35,620,086• Female: 33,000,926

• Literacy Rate (%): 67.06

• Male: 80.51Male: 80.51

• Female: 52.66Age at Marriage: 20 7(Boys) &17 7(Girls)– Age at Marriage: 20.7(Boys) &17.7(Girls)

– Sex Ratio: 926 (Females per 1000 males)• Child Sex Ratio(Age 0 6 yr): 883Child Sex Ratio(Age 0 6 yr): 883

SIHFW: an ISO 9001: 2008 certified institution 2Source: Census 2011

Status Maternal Health –Rajasthan (March 11-12)Indicators Achievements April to June Achievement

(11-12)p to Ju e

(12-13)c e e e t

ANC registration 100.78% (1852221)

495349 (5.4% Increase) ( )

Early ANC registration

46.96 % (863131) 236136 (6.85% Increase)

Full ANC 72.99% (1341543) 324182 (13.31% Increase)u C 99% ( 3 5 3) 3 8 ( 3 3 % c ease)

Institutional delivery

77.34% (1279362) 266649 (4.6% increase)

JSY beneficiaries 1010210 215067 -

JSSY beneficiaries 430235 164461 -

F ti l FRU 98Functional FRU 98 - -

Maternal death reported

780 180 -

Maternal death audit

639 110 -

Source-DM&HS SIHFW: an ISO 9001: 2008 certified institution

Causes of Maternal Mortality

Haemorrhage37%

Other Conditions34%

Abortion8%

Sepsis11%

Hypertensive Disorder

5%

Obstructed Labour

5%

8%

5%5%

Source-SRS ,MATERNAL MORTALITY IN INDIA: 1997-2003

SIHFW: an ISO 9001: 2008 certified institution

Trends in Maternal Mortality Ratio (R j th )(Rajasthan)

MMR

501445500

600

388

318

300

400

148

100

200MMR

0

100

1999-2001 (SRS)

2001-03( SRS) 2004-05 ( SRS) 2007-09(SRS) Expected 2012 (MoHFW)(SRS) (MoHFW)

SIHFW: an ISO 9001: 2008 certified institution 5

Total Fertility Rate (Rajasthan)Total Fertility Rate (Rajasthan)

TFR

3.63

3.78

TFR

3.213.3

NFHS 1 NFHS 2 NFHS 3 SRS 2009


NFHS 1 NFHS 2 NFHS 3 SRS 2009

Trends of TFR-Rajasthan

4.5

5.0

4.0 3.9 3.8 3.7 3.73.5 3.4 3.3 3.33.5

4.0

2.8

2.5

3.0TFR

1.0

1.5

2.0

1.0

2001 2002 2003 2004 2005 2006 2007 2008 2009 2013 Expt.

YearsSource: Fifth Common Review Mission,9th November 20119th November 2011


Prevalence of Anemia in Rajasthan (NFHS)(NFHS)


Contraceptive Prevalence Rate in R j thRajasthan

Source: Pragati Prativadan


Institution Delivery y

62 65 69.44 77.34

ID in Rajasthan (%)

28

39.8752.24

62

28

2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12

10SIHFW: an ISO9001: 2008 certified institution

Source: www.rajswasthya.nic.in

PW receiving 2 TT injections: R j thRajasthan

1910849

1320162 1303812

1576257 1515772

1136508

No. of PW

2006‐07 2007‐08 2008‐09 2009‐10 2010‐11 2011‐12

Source: www.rajswasthya.nic.in


Status of 3 ANC checkups (R j th )(Rajasthan)

Maternal Health Interventions in St tState

• Rajasthan Janani Shishu Suraksha Yojanaj j(RJSSY)

• Provision of Emergency Obstetric Care• Provision of Skilled Birth Attendant• Provision of Skilled Birth Attendant• Provision of Safe Abortion Services• Provision of RTI/STI services in collaborationProvision of RTI/STI services in collaboration

with RSACS upto PHC level• Promotion of Evidence Based Practices

O i i MCHN D• Organizing MCHN Days• Maternal Death Audit


Rajasthan Janani Shishu SurakshaY jYojana

Entitlements for Pregnant WomenF d li•Free delivery

•Free caesarian section•Free drugs & consumables•Free drugs & consumables•Free diagnostics (Blood, Urine tests & USG etc.)•Free diet during stay (up to 3days for normalg y ( p ydelivery & 7 days for C-section)

•Free provision of bloodFree transport from home to health•Free transport from home to healthinstitutions, between health institutions in case ofreferrals and drop back home

•Exemption from all kinds of user chargesSIHFW: an ISO 9001: 2008 certified institution 14

Entitlements for Sick Newborn till 30 days afterbirth•Free and zero expense treatment•Free drugs & consumablesg•Free diagnostics•Free provision of bloodFree provision of blood•Free transport from home to healthinstitutions, between health institutions in case of,referrals and drop back to home

•Exemption from all kinds of user chargesp g


JSSY: PerformanceS.No Services No. of

beneficiaries (Sept 12, 2011

– March 31,

No. of beneficiaries(April 1 – July 15 2012)March 31,

2012)15 2012)

1 Total Deliveries 430235 192210

2 N f t id d f di i 753058 3058442 No. of pregnant women provided free medicine 753058 305844

3 No. of pregnant women provided free lab tests 417319 186478

4 No of pregnant women availed free hot food 516437 1978164 No. of pregnant women availed free hot food 516437 197816

5 No. of pregnant women provided free referral transport from house to health facility 227716 142684

6 No. of pregnant women provided free referral transport from health facility to house 289978 153604

7 No. of pregnant women provided free blood facility 18860 13086

SIHFW: an ISO9001: 2008 certified institution 16Source:-DM&HS

JSSY: PerformanceS.No Services No. of

beneficiaries (Sept 12, 2011

– March 31,

No. of beneficiaries(April 1 –July 15March 31,

2012)July 15 2012)

1 No. of Sick Neonates (30 days) received free 132387 607771 medicine 132387 60777

2 No. of Sick Neonates (30 days) received free lab tests 35399 18002

3 No. of Sick Neonates (30 days) received free referral transport from house to health facility 8434 2712

4 No. of Sick Neonates (30 days) received free referral transport from health facility to house 13850 5212

No of Sick Neonates (30 days) provided free blood5 No. of Sick Neonates (30 days) provided free blood facility 711 723

SIHFW: an ISO9001: 2008 certified institution 17Source:-DM&HS

Provision of Skilled Birth Attendance and Emergency Obstetric Careand Emergency Obstetric Care

24 7 1100 PHC for pro iding basic24 x 7 - 1100 PHC for providing basic emergency obstetric and new born care

• Recruitment of GNM and ANM All PHCs have 3• Recruitment of GNM and ANM - All PHCs have 3 Staff nurses

• AYUSH Medical Officers• AYUSH Medical Officers• Residential Facility• Equipment and Lab Facility• Equipment and Lab Facility• BEmOC Training


M d l S bModel Sub center• Deliveries conducted in 3715 Sub-centres. • Additional labor rooms constructed in 1911 sub-

centres under Civil Works of NRHM.8183 /S ff / / / / S• 8183 ANMs/Staff Nurses/LHVs/PHN/NT/AYUSH doctors & compounders trained under the SBA TrainingTraining.

• 779 AYUSH personnel (557 MOs + 222 Nurses) trained for SBAtrained for SBA.

• Additional ANM


Facility Mapping and Micro PlanningLevel-III -172 (34 DH+12SDH+6 Satl.Hosp+120 CHCs) ( p )Level-II - 635 (227 CHCs + 408 PHCs)Level-I – 2250 (1000 PHCs+ 1250 Sub centers)

Performance Based Incentives-• Incentive money for Surgeon team conducting morey g g

than 5 caesarian at FRUs• For conducting 6 to 10 caesarian Rs. 10,000• For conducting more than 10 caesarian, upto Rs,.

20,000


RCH CRCH Camps-10,769 RCH Camps organized at remote PHCs of

th di t i t bi thl b ithe districts on bi-monthly basis.Maternal Death Review –13 (982 2010 111375 maternal death reported (982 in 2010-11 and

393 in 2011-12). C f M t l D thCauses of Maternal Deaths:-

• 66% obstetric causes• 26% medical• 7% others • 1% non maternal death causes

SIHFW: an ISO 9001: 2008 certified institution 21Source: MoHFW

Support to Maternal Health Servicespp

• ASHA– In position – Trained

• Jan Mangal Couples• Yashoda• AWW• Referral transportReferral transport

– 108– Community transport identifiedCommunity transport identified


Other Schemes for Maternal Health P tiPromotion

• Balika Sambal Scheme- Bond of Rs. 10000/- to maximum two girl child, if parents undergo sterilization.1458 ‘Balikayen’ have been benefitted.F il lf d h f d• Family welfare award scheme for good performing district, Panchayat Samiti, Gram Panchayat Govt Hospital & Private Hospital/Panchayat, Govt. Hospital & Private Hospital/ NGO.


Rajeev Gandhi Population and Health• Rajeev Gandhi Population and Health Mission

• Jyoti Yojana Any woman who has undergone• Jyoti Yojana- Any woman who has undergone sterilization after one or two girl child only would be empoweredbe empowered• Set as Role model for village• Preference for ASHA selection AWW ANMPreference for ASHA selection, AWW, ANM

selection• Preference in higher educationPreference in higher education

• Pregnancy, Child Tracking and Health Services Management System Plus (PCTS +)g y ( )


Some Innovations for Maternal H lth I R j thHealth In Rajasthan

Kale a• Kalewa• Jan Mangal

B lik S b l• Balika Sambal• Jyoti• Recognition and incentives to Health facilities

and PRIsP f i ti f C ti t FRU• Performance incentive for C-section at FRUs


Capacity Building of Human Resource for Maternal Health Deli erfor Maternal Health Delivery

Human Resource trained in 2011-12 (till Dec)(till Dec)

NSSK 2140

SBA 8346SBA 8346

IMNCI 2418

F IMNCI 4F-IMNCI 4

BEmOC 188

CE OC 51CEmOC 51

LSAS 137

MTP/ MVA 255


MTP/ MVA 255

Source: DM&HS

Thank You

For more details log on toFor more details log on towww.sihfwrajasthan.com

oror contact : Director-SIHFW on

[email protected]

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