NPHCE

NATIONAL PROGRAMME FOR HEALTH CARE OF ELDERLY : 

NATIONAL PROGRAMME FOR HEALTH CARE OF ELDERLY Dr Abhay Dhanorkar 7 Aug 2012 1

Scope: 

Scope Introduction Scenario in World & India Need for programme Policy & strategic framework for implementation Package of services Institutional framework for the implementation of NPHCE Activities under NPHCE at various levels Financial guidelines Evaluation Achievement References 7 Aug 2012 2

INTRODUCTION: 

INTRODUCTION Over the past few years, the world’s population has continued on its remarkable transition path from a state of high birth and death rates to low birth and death rates coupled with improvement in health services & standard of living. At the heart of this transition has been the growth in the number and proportion of older persons. Such a rapid, large and ubiquitous growth has never been seen in the history of civilization. The current demographic revolution is predicted to continue well into the coming centuries. 7 Aug 2012 3

BY Definition….: 

BY Definition…. 60-69 70-79 80+ Old Old - Old Oldest- Old 60-74 75- 84 85+ Young Old Middle old Old-Old Source: http://www.agingstats.gov/agingstatsdotnet/Data/2008_Documents/Population.aspx Source: National Policy on Older Person 1999 GOI

Global scenario of elderly population: 

Global scenario of elderly population Source: United Nations Population Division 2008 (http://esa.un.org/unpp) Year % 7 Aug 2012 5

World Population trend of 60+ Years 1980-2020 (in millions) : 

World Population trend of 60+ Years 1980-2020 ( in millions) 1980 1990 2000 2010 2020 World 381.2 484.7 608.7 754.2 1011.6 Developed 173.3 203.6 234.6 232.4 308.2 Developing 207.9 281.8 374.1 491.8 703.4 Asia (excl. Japan) 160 218.2 290 377.7 539.9 China 78.6 101.2 131.7 167.9 238.9 India 44.6 60.2 81.4 107 149.7 United Nations,World Demographic Estimate and Projections

PowerPoint Presentation: 

Changing world Scenario The world will have more people who live to see their 80s or 90s than ever before. The past century has seen remarkable improvements in life expectancy. Soon, the world will have more older people than children. The world population is rapidly ageing. Low- and middle-income countries will experience the most rapid and dramatic demographic change. 7 Aug 2012 7 Source :WHO 2010

Age distribution of population in India over years Census 2001: 

Age distribution of population in India over years Census 2001 7 Aug 2012 8

Ageing: The Indian Scenario…: 

Ageing: The Indian Scenario… India is one of the few countries in the world where sex ratio of aged is in favour of males. Population above 60 years - 10% suffer from impaired physical mobility. 10% Hospitalized at given point of time. Age more than 70 years - More than 50% suffer form 1 or more chronic conditions like CHD, Cancer and HT . 7 Aug 2012 9

Elderly population and future projection in India Source: United Nations Population Division 2008 (http://esa.un.org/unpp: 

Elderly population and future projection in India Source: United Nations Population Division 2008 (http://esa.un.org/unpp 7 Aug 2012 10 Year millions

Expectancy of life at birth and future projection in India Census 2001: 

Expectancy of life at birth and future projection in India Census 2001 62.85 64.65 66.44 67.92 7 Aug 2012 11 Age Year

Life Expectancy at 60 years (WHO-2009): 

Life Expectancy at 60 years (WHO-2009) 7 Aug 2012 12

PowerPoint Presentation: 

Number, Proportion and Sex Ratio of Elderly 2001 - 2051 7 Aug 2012 13

Socio-demographic profile of the elderly in India.: 

Socio-demographic profile of the elderly in India. 75% 48% 66% 73% 66% 7 Aug 2012 14 Source : Census 2001

States with more than 7% elderly population ( SRS 2010): 

States with more than 7% elderly population ( SRS 2010) 7 Aug 2012 15

STATEWISE ELDERLY POPULATION IN INDIA, CENSUS 2001.: 

STATEWISE ELDERLY POPULATION IN INDIA, CENSUS 2001. 7 Aug 2012 16 %

Life-course Perspective for maintenance of highest possible level of functional capacity: 

Life-course Perspective for maintenance of highest possible level of functional capacity 7 Aug 2012 17 Functional Capacity Life curve of highest Functional capacity Disability threshold Range of function Life curve of reduced Functional capacity * Change in the external environment can lower disability threshold Age

Health risks of elderly: 

Health risks of elderly 7 Aug 2012 18

COMMON MORBIDITIES IN ELDERLY IN INDIA: 

COMMON MORBIDITIES IN ELDERLY IN INDIA 7 Aug 2012 19 Ref – ICMR study 2001 Delhi & Hariyana

Prevalence of common health problems in elderly GOI study-2007: 

Prevalence of common health problems in elderly GOI study-2007 Percentage Health Problem 7 Aug 2012 20

Mortality in elderly: 

Mortality in elderly 7 Aug 2012 21 33% 10% 10% 6% 4% 17%

Need for Dedicated Health care for elderly ?: 

Need for Dedicated Health care for elderly ? 7 Aug 2012 22

Major constraints for geriatric health care: 

Major constraints for geriatric health care 7 Aug 2012 23

Major Govt. initiatives: 

Major Govt. initiatives 7 Aug 2012 24

NATIONAL POLICY ON OLDER PERSONS (1999): 

NATIONAL POLICY ON OLDER PERSONS (1999) Components Support for financial security Health Care Shelter Welfare and other needs of older persons Protection against abuse and exploitation Opportunities for development of the potential of older persons Improving quality of life 7 Aug 2012 25

NPOP agenda for health care for the elderly: 

NPOP agenda for health care for the elderly 7 Aug 2012 26

Maintenance and Welfare of Parents and Senior Citizens Act - 2007: 

Maintenance and Welfare of Parents and Senior Citizens Act - 2007 Article (20) : The State Government shall ensure The Government hospital or Govt. funded hospitals shall provide beds for senior citizens as far as possible. Separate queues be arranged for senior citizens. Facility for treatment of chronic, terminal and degenerative diseases is expanded for senior citizens Research activities for chronic elderly diseases and ageing is expanded Earmarked facilities for geriatric patients in every district hospital. 7 Aug 2012 27

Extract of Finance Minister’s Budget Speech 2008-09: 

Extract of Finance Minister’s Budget Speech 2008-09 “ The other major intervention will be for the elderly. A National Programme for the Elderly with a Plan outlay of Rs. 400 crore will be started in 2008-09. Among other measures, we will establish, during the XIth Plan Period two institutes of aging eight Regional Centres and a Department of Geriatric Medical Care in one of the Medical Colleges/Tertiary level Hospitals in each State.” 7 Aug 2012 28

NATIONAL PROGRAMME FOR HEALTH CARE OF ELDERLY (NPHCE-2010): 

NATIONAL PROGRAMME FOR HEALTH CARE OF ELDERLY (NPHCE-2010) 7 Aug 2012 29

The Vision & Objectives of NPHCE: 

The Vision & Objectives of NPHCE The Vision: To provide accessible, affordable, and high-quality long-term , comprehensive and dedicated care services to an Ageing population; Creating a new “architecture” for Ageing; To build a framework to create an enabling environment for “a Society for all Ages”; To promote the concept of Active and Healthy Ageing; 7 Aug 2012 30

PowerPoint Presentation: 

Objectives Provision of dedicated health care facilities at various level of State health care delivery system with referral support. Human resource development in geriatric Health. Strengthening of preventive, promotive and rehabilitative services. Promotion of Research in geriatric health care Convergence of NRHM, AYUSH & all other dept. 7 Aug 2012 31

PowerPoint Presentation: 

Strategies for NPHCE 2010 7 Aug 2012 32

Supplementary Strategies for NPHCE : 

Supplementary Strategies for NPHCE 7 Aug 2012 33

PowerPoint Presentation: 

Geriatric Department in 8 Regional medical Institutions/ State Medical Colleges Dedicated Health Care in 100 Districts(21 states) Geriatric unit at district hospitals Rehabilitation Units at CHCs Weekly Geriatric Clinic at PHCs Provision of supportive devices/equipments at sub centers Major Components of the programme 7 Aug 2012 34

Operational Guidelines: 

Operational Guidelines Package of Services at different levels (SC/PHC/CHC/RGC) Institutional framework for implementation Integration with NRHM State Health Society District Health Society Management Structure National/ State / District NCD cell composition & responsibilities Activities at various levels (SC/PHC/CHC/RGC) 7 Aug 2012 35

Package of Services: 

Package of Services The range of services will include Health promotion Preventive services Diagnosis and management of geriatric medical problems (out and in-patient) Day care services Rehabilitative services Home based care Districts will be linked to Regional Geriatric Centers for providing tertiary level care. Integration with existing primary health care delivery system and vertical at district and above as more specialized health care are needed for the elderly. 7 Aug 2012 36

PowerPoint Presentation: 

7 Aug 2012 37 ORGANIZATIONAL STRUCTURE

Services at Sub-centre: 

Services at Sub-centre Health Education related to healthy ageing Domiciliary visits to home bound / bedridden elderly persons . Arrange for suitable calipers and supportive devices. Linkage with other support groups and day care centers. 7 Aug 2012 38

Services at PHC: 

Services at PHC Weekly geriatric clinic by a trained Medical Officer Conducting a routine health assessment (eye , BP , blood sugar & record keeping). Provision of medicines and proper advice on chronic ailments Public awareness on promotional, preventive and rehabilitative aspects of geriatrics during health and village sanitation day/camps. Referral services. 7 Aug 2012 39

Services at District Hospital : 

Services at District Hospital Geriatric Clinic for regular dedicated OPD services to the Elderly with Lab facility & adequate medicine. Ten-bedded Geriatric Ward with existing specialties Provide services to referred by the CHCs/PHCs etc. Conducting camps for in PHCs/CHCs and other sites. Referral services to tertiary level hospitals 7 Aug 2012 40

Services at Regional Geriatric Centre : 

Services at Regional Geriatric Centre Geriatric Clinic (Specialized OPD) 30-bedded Geriatric Ward. Laboratory investigation with a special sample collection centre in OPD block. Tertiary health care to the cases referred from medical colleges, district hospitals and below. 7 Aug 2012 41

Institutional framework for the implementation of NPHCE: 

Institutional framework for the implementation of NPHCE Program Structure-Integration with NRHM Financial management group (FMG) of Programme Management support units at state and district level, which is established under NRHM, will be responsible for financial management Maintenance of accounts Release of funds Expenditure reports Utilization Certificates Audit arrangements 7 Aug 2012 42

Funding for Program: 

Funding for Program State Level Activity District Level Activity 7 Aug 2012 43

State Health Society (SHS): 

State Health Society (SHS) Under the NRHM framework different Societies of national programmes such as RCH, Malaria, TB, Leprosy, NBCP have been merged into a common State Health Society. Chief Secretary – Chairperson Principal Secretary ( H&FW)-vice chair person Mission director - Member - Secretary 7 Aug 2012 44

District Health Society (DHS): 

District Health Society (DHS) All programme societies have been merged into the District Health Society (DHS ). The Governing Body Chairperson - Chairman of the Zillah Parishad . Member -Secretary - DHO Executive Body Chair person - District Collector Member - Secretary - DHO. 7 Aug 2012 45

Management Structure: 

Management Structure National NCD Cell The NCD Cell constituted at the central level for planning, monitoring and implementation of the National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS) will also be responsible for NPHCE . 7 Aug 2012 46

PowerPoint Presentation: 

Main functions of National NCD cell MOU with the States/UTs seeking their commitments to implement and partially fund (20%) the programme. Preparation and dissemination of technical & operational guidelines. Plan for capacity building of health functionaries of Health care system at Primary, Secondary and Tertiary levels. 7 Aug 2012 47 Management Structure cont…

PowerPoint Presentation: 

Development of IEC strategy. Coordination and liaison with all stakeholders. Monitoring and review of programme activities at each level through MIS, review meetings and field observations. Release of funds and monitoring of expenditure under NPHCE Organizing External evaluation and coordinating Research in geriatrics and NPHCE 7 Aug 2012 48 Management Structure cont…

State NCD Cell: 

State NCD Cell Composition: State NCD Cell will be supported by following contractual staff State Programme Officer Programme Assistant Finance cum Logistics Officer Data Entry Operators (2) 7 Aug 2012 49

State contribution: 

State contribution 20% of the total expenditure Provision of land Support of lab services Provision of manpower in disciplines other than medical specialty Additional support for medicines Maintenance of equipments, wards and OPD 7 Aug 2012 50

PowerPoint Presentation: 

Role and responsibilities of the State NCD Cell: Preparation of State action plan for implementation. Organize State & district level trainings for capacity building Liaison with Regional Geriatric Centre for tertiary Care, Training & Research . Ensure appointment of contractual staff sanctioned for various facilities Release of funds to districts. 7 Aug 2012 51 State NCD cont…

PowerPoint Presentation: 

Maintaining State and District level data on physical and financial progress of NPHCE Monitoring of the programme through HMIS, Review meetings, field observations. Public awareness regarding health promotion, prevention and rehabilitation of the elderly and services made available under NPHCE. 7 Aug 2012 52 State NCD cont…

District NCD Cell: 

District NCD Cell Composition : District NCD Cell will be supported by following contractual staff District Programme Officer Programme Assistant Finance cum Logistics Officer Data Entry Operator 7 Aug 2012 53

Role and responsibilities of the District NCD Cell: 

Role and responsibilities of the District NCD Cell Preparation of District action plan. Maintain and update district database & Conduct sub-district/ CHC level trainings for capacity building Engage contractual personnel sanctioned for various facilities in the district Maintain fund flow and submit UC. Convergence with NRHM activities & Other Depts. Ensure availability of rehabilitative services for the Elderly. 7 Aug 2012 54 District NCD Cell cont…

PowerPoint Presentation: 

Provision of health care facilities for elderly at district level and below in 100 districts 7 Aug 2012 55

Programme Coverage at district level and below: 

Programme Coverage at district level and below 100 districts covering 21 states Coverage in each district District Hospital – 1 All CHCs, PHCs & Sub-centers 7 Aug 2012 56

Phasing of physical targets: 

Phasing of physical targets Physical target 2010-2011 2011-2012 Establishment of Geriatric Department at 8 Regional Inst. 8 Regional Inst. Construction & Manpower deployment etc. Fully functional Geriatric Dept in 8 Regional Inst. Setting up of Geriatrics Unit at 100 District Hospitals 30 Districts Construction and equipment & Manpower deployment etc. 30 Districts Fully functional Geriatric Unit 70 Districts Construction and equipment -Manpower deployment 7 Aug 2012 57

Identified States and 30 districts (2010-11): 

Identified States and 30 districts (2010-11) States Districts Andhra Pr. Nellore, Vijayanagram Assam Dibrugarh, Jorhat Bihar Vaishali, Rohtas CH Bilaspur Gujarat Gandhi Nagar, Surendranagar Haryana Mewat HP Chamba J&K Leh , Udhampur Jharkhand Bokaro Karnataka Shimoga, Kolar Kerala Pathanathitta States Districts Madhya Pr. Ratlam Maharashtra Washim , Wardha Sikkim East Sikkim Orissa Naupada Punjab Bhatinda Rajasthan Bhilwara, Jaisalmer Uttrakhand Nainital Tamil Nadu Theni Uttar Pr. Rae Bareli, Sultanpur West Bengal Darjeeling 7 Aug 2012 58

70 districts added in 2011-12: 

70 districts added in 2011-12 States Districts Andhra Pr. Srikakulam , Chittoor , Cuddapah , Krishna, Kurnool, Prakasham Assam Lakhimpur , Sibsagar , Kamrup Bihar Muzaffarpur , Paschim Champaran , Poorva Champaran , Keimur CH Jashpur Nagar, Raipur Gujarat Rajkot, Jam Nagar, Porbandar , Junagarh Haryana Yamuna Nagar, Kurukshetra , Ambala HP Lahaul & Spiti , Kinnaur J&K Kupwara , Doda (Erstwhile), Kargil Jharkhand Ranchi, Dhanbad Karnataka Udupi , Tumkur , Chikmagalur Kerala Kozikode (Calicut), Allappuzha , Idukki , Thrishur States Districts Madhya Pr. Hoshangabad , Chindwara , Jhabua , Dhar Maharashtra Gadchiroli , Bhandara , Chandrapur , Amaravati Sikkim South Sikkim Orissa Balangir , Nabrangpur , Koraput , Malkangiri Punjab Gurdaspur , Hoshiarpur Rajasthan Jodhpur, Ganga Nagar, Bikaner, Barmer , Nagaur Uttrakhand Almora Tamil Nadu Coimbatore, Virudhnagar , Toothukudi , Tirunelveli Uttar Pr. Jhansi, Lakhimpur Kheri , Farookhabad , Firozabad, Etawah , Lalitpur , Jalaun West Bengal Jalpaiguri , Dakshin Dinajpur 7 Aug 2012 59

PowerPoint Presentation: 

At Sub Centre level: Provision of walking sticks, calipers & other supportive equipments to the needy elderly Information on healthy diet, yoga, and life style diseases through charts, pamphlets Domiciliary visit to the house of elderly by ANM/ Male worker and maintenance of record Arrangement of ambulance for disabled bed ridden elderly for referral to PHC/CHC. Activities under NPHCE at various levels 7 Aug 2012 60

PowerPoint Presentation: 

Following items will be made available at the Sub-centre level: Walking Sticks Calipers Infrared Lamp Shoulder Wheel Pulley Walker (ordinary) No additional contractual staff. 7 Aug 2012 61 Activities at SC level

PowerPoint Presentation: 

At PHC level : The weekly geriatric clinic by trained medical officer. Coordination with CHC, district hospital, sub centers, other National Health Programmes/ Departments for medicines, ambulances Training of manpower & Separate registration counter for elderly. Public awareness during health and village sanitation day/camps. Provision of medicine to the elderly for their medical ailments. 7 Aug 2012 62

PowerPoint Presentation: 

Following items will be made available at the PHC: Nebulizer Glucometer Shoulder Wheel Walker (ordinary) Cervical traction (manual) Exercise Bicycle Lumber Traction Gait Training Apparatus Infrared Lamp etc. The medicines for general treatment will be provided from the stock available at PHCs . 7 Aug 2012 63

PowerPoint Presentation: 

At RH/CHC level: First level medical referral centre for medical care and rehabilitation services Twice weekly health clinics for the elderly persons Rehabilitation unit Domiciliary visits for care of disabled persons by Multi rehabilitation worker Referral Services to DH Training of staff 7 Aug 2012 64

PowerPoint Presentation: 

Following items will be made available at the CHC: Nebulizer Glucometer ECG Machine Pulse Oximeter Defibrillator Multi - Channel Monitor Shortwave Diathermy Cervical traction (intermittent) Walking for gait training equipment Walking Sticks / Calipers Shoulder Wheel Pulley Walker (ordinary) Cervical traction (manual). Additional Staff Sanctioned at CHC level under NPHCE 7 Aug 2012 65

PowerPoint Presentation: 

At District Hospital level Regular Geriatric OPD with Specialty Care for Elderly. Geriatric Ward (10-bedded) for in-patient care to the Elderly. Training to the Medical officers and paramedical staff of CHC’s and PHC’s Camps for Geriatric Services in PHCs/CHCs and other sites Referral services for severe cases to tertiary level hospitals/ Regional Geriatric Centers Drugs – 10 Lakhs 7 Aug 2012 66

Additional Staff Sanctioned at DH under NPHCE: 

Additional Staff Sanctioned at DH under NPHCE 7 Aug 2012 67

PowerPoint Presentation: 

Following items will be made available at the District Hospital: Nebulizer Glucometer ECG Machine Defibrillator Multi-channel Monitor Non invasive Ventilator Shortwave Diathermy Ultrasound Therapy Cervical traction (intermittent) Pelvic traction (intermittent) Tran electric Nerve stimulator (TENS) Adjustable Walker. 7 Aug 2012 68

Regional Geriatrics Centers: 

Regional Geriatrics Centers 7 Aug 2012 69 Sr No Regional Institutes States Linked 1 All India Institute of Medical Sciences, New Delhi Delhi, Haryana, Uttarakhand, Punjab Himachal Pradesh, M.P. 2 Institute of Medical Sciences, Banaras Hindu University, Uttar Pradesh Uttar Pradesh, Bihar, Jharkhand, West Bengal 3 Grant Medical College & JJ Hospital, Mumbai, Maharashtra, Maharashtra, Goa, Northern Districts of Karnataka,Chattisgarh 4 Sher-e-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir Jammu & Kashmir 5 Govt. Medical College, Tiruvananthapuram, Kerala, Kerala, Southern Districts of Karnataka & Tamil Nadu 6 Guwahati Medical College, Guwahati, Assam Assam & NE States 7 Madras Medical College, Chennai, TN. Tamil Nadu, Andhra Pradesh, Orissa 8 SN Medical College, Jodhpur, Rajasthan Rajasthan & Gujarat

PowerPoint Presentation: 

Provide tertiary level services for complicated/serious Geriatric Cases. Post graduate courses in Geriatric Medicine. Training to the trainers of identified District hospitals and Medical Colleges. Developing evidence based treatment protocols for Geriatric diseases prevalent in the country. Developing/and updating Training modules & guidelines and IEC materials. Research on specific elderly diseases. 7 Aug 2012 70 At Regional Geriatric Centers level

PowerPoint Presentation: 

Specialized OPDs in all the specialties available with them for the benefit of the Elderly. Deployment of Specialists: Additional contractual staff for Regional Geriatric Centre recruitment will be made by the Medical Institution. Drugs & consumables – 20 lakhs 30 bedded geriatrics ward 7 Aug 2012 71

Developing Geriatric Department in Medical college of each States/UTs: 

Developing Geriatric Department in Medical college of each States/UTs It is proposed to develop 12 additional Regional Geriatric Centers in selected Medical Colleges of the country 7 Aug 2012 72 Sr No State Medical College 1 Punjab PGIMER, Chandigarh 2 Uttar Pradesh KGIMS, Lucknow 3 Jharkhand Ranchi Medical College, Ranchi 4 West Bengal Kolkatta Medical College, Kolkata 5 Andhra Pradesh Nizam Institute of Medical Sciences, Hyd. 6 Karnataka Bangalore Medical College, Bangluru 7 Gujarat B.J.Medical College, Ahmadabad 8 Maharashtra Government Medical College, Nagpur 9 Orissa S.C.B.Medical College, Cuttack 10 Tripura Agartala Medical College, Agartala 11 Madhya Pradesh Gandhi Medical College, Bhopal 12 Bihar Patna Medical College, Patna

PowerPoint Presentation: 

Machinery and equipment required at RGC 7 Aug 2012 73

PowerPoint Presentation: 

Additional Staff Sanctioned at RGC under NPHCE 7 Aug 2012 74

Activities at State level: 

Activities at State level Community awareness. Planning, Monitoring & Supervision. Training Financial Management 7 Aug 2012 75

Responsibility of reporting, flow of information and frequency of reporting: 

Responsibility of reporting, flow of information and frequency of reporting 7 Aug 2012 76

PowerPoint Presentation: 

Training of Human Resources Plan for training institutions, duration , broad curriculum & preparation of training calendar for Doctors Nurses Physiotherapist / Rehabilitation Workers Medico-social Worker ANM , and Male Health Worker Training guidelines and financial norms developed under NPCDCS will be applied for training under NPHCE. Financial Management for various components. 7 Aug 2012 77

Detailed training plan of staff: 

Detailed training plan of staff 7 Aug 2012 78

Training at various level: 

Training at various level 7 Aug 2012 79 Dr Arun Humne Dr Doiphode Dr Zanwar

Activities at Central level: 

Activities at Central level Selection of States and Districts Information, Education & Communication Support to Regional Geriatric Centers Training through RGC & along with NPCDCS Monitoring, Evaluation and Research through State & Independent 7 Aug 2012 80

FINANCIAL GUILDEINES: 

FINANCIAL GUILDEINES Financial management groups (FMG) of Programme Management are established under NRHM The funds will be released to States/UTs through the State Health Society. Funds release from State to District Health Society for CHCs, PHCs and Sub- centers to cover the entire District. 7 Aug 2012 81

Financial Guidelines contd…: 

Financial Guidelines contd … State shall have the flexibility for inter-usability of funds from one component to another limited to a ceiling of 10 %. NPHCE would operate through NCD Cells constituted under NPCDCS at State and District levels. A separate bank account in a nationalized bank should be opened for NPHCE. 7 Aug 2012 82

Assistance for Sub Centre: 

Assistance for Sub Centre Assistance for Primary Health Centre 7 Aug 2012 83

Assistance to Community Health Centers: 

Assistance to Community Health Centers 7 Aug 2012 84

Assistance to District Hospital: 

Assistance to District Hospital 7 Aug 2012 85

Assistance for Regional Geriatric Centre: 

Assistance for Regional Geriatric Centre 7 Aug 2012 86

Financial Assistance to States: 

Financial Assistance to States Construction of Building Equipments Drugs and consumables Manpower recruitment IEC and Research Training of manpower 7 Aug 2012 87

Proposed Financial Assistance during 11th plan: 

Proposed Financial Assistance during 11 th plan Items RMI DH CHC PHC S. C construction 2 crore 80 lakh - - - Equipments 1.7 crore 10 lakh 1 lakh Rs.50000 Rs.32000 Drugs 20 lakh 10 lakh - - - Training 5 lakh Rs. 70000 1.15 lakh Rs.32000 - IEC activities - 5 lakh - - - Research 50 Lakh - - - - Manpower recruitment 88.4 lakh 28 .2 lakh 1.8 lakh - - 7 Aug 2012 88

Achievements: 

Achievements Developed operational guidelines 1 st installment released to 27districts in 2010-11 and 48 districts in 2011-12 1 st installment released to all the 8 RMI MOU signed with – 18 States Submitted 12 th plan proposal- all the States/districts proposed to be covered 7 Aug 2012 89

Issues for consideration: 

Issues for consideration Create awareness among policy maker & programme officers Training of manpower Utilization of released Budget Monitoring & Maintenance of database 7 Aug 2012 90

Release of Fund: 

Release of Fund Year No. of districts Amount released ( crore ) No. of RMI Amount released ( crore ) 2010-11 27 60 4 41.15 2011-12 48 75 4 30.31 Total 75 135 8 71.46 7 Aug 2012 91

Manpower provision at RGC : 

Manpower provision at RGC Sr. No Staff Salary (per month ) No Total (in thousands) 1. Professor in Geriatrics Rs. 75,000/- 1 75 2. Asstt . Professor Geriatrics Rs. 50,000/- 2 100 3. Medical Officer Rs. 40,000/- 4 160 3. Nurses Rs. 15,000/- 16 240 4. Physiotherapist (3) and OT (1) Rs. 15,000/- 4 60 5. Medical Social Worker Rs. 15,000/- 1 15 6. Lab Technician Rs. 15,000/- 1 15 7. Program Assistant Rs. 12,000/- 1 12 8. Hospital Attendant Rs. 7,500/- 4 30 9. Sanitary Attendant Rs. 7,500/- 4 30 Total 38 737 7 Aug 2012 92

Manpower at District Hospital and CHC: 

Manpower at District Hospital and CHC Sr. No. Staff Salary per month (Rs.) No. Total (per month) (In thousands) 1 Consultant in Medicine 50, 000 /- 2 100 2. Nurses 15,000/- 6 90 3. Physiotherapist 15,000/- 1 15 4. Hospital Attendants 7,500/- 2 15 5. Sanitary Attendants 7,500/- 2 15 Total 13 235 Rehabilitation Unit at CHC 1 Multi rehabilitation Worker-1 15,000/- 1 15 Total 1 15 7 Aug 2012 93

EXPENDITURE ON CONSTRUCTION AND FURNITURE : 

EXPENDITURE ON CONSTRUCTION AND FURNITURE Component Sr. No. Activity level Unit Cost 2010-11 2011-12 Total Construction cost with furniture 1 District 0.8 25.60 38.40 64.00 2 Regional Institutions 2.00 08.00 08.00 16.00 Total 33.60 46.40 80.00 (Rs. In crore ) 7 Aug 2012 94

EXPENDITURE ON MACHINERY AND EQUIPMENT: 

EXPENDITURE ON MACHINERY AND EQUIPMENT Component S. No. Activity level Unit Cost 2010-11 2011-12 Total Machinery & Equipments 1 PHC 0.005 6.40 9.60 16.00 2 CHC 0.01 3.20 4.80 8.00 3 District 0.1 3.20 4.80 8.00 4 Regional institutions 1.7 6.80 6.80 13.60 Total 19.70 26.00 45.60 7 Aug 2012 95 (Rs. In crore )

Expenditure on central and state activities : 

Expenditure on central and state activities COMPONET ACTIVITY LEVEL Year Wise Cost TOTAL 2010-11 2011-12 Monitoring & Evaluation (Recurring) Central 1.20 0.93 2.13 Total 2.13 Office Expenses (Recurring ) State 0.55 0.55 1.10 Total 1.10 7 Aug 2012 96 (Rs. In crore )

Year wise cost on Drugs and Consumables : 

Year wise cost on Drugs and Consumables Components Activity level Units Nos. Unit cost Total cost 2010-11 2011-12 Drugs and Consumables District 32 80 0.1 11.20 Regional Institutes 4 8 0.2 2.40 Total 13.60 7 Aug 2012 97 (Rs. In crore )

Year wise cost on training at each level of activities: 

Year wise cost on training at each level of activities Component Activity level Units Nos. Unit cost Total cost 2010-11 2011-12 Training (Recurring) PHC 1280 1920 0.0032 10.24 CHC 320 480 0.0115 9.20 Districts 32 48 0.007 0.56 Regional Institutes 4 4 0.05 0.40 Total 20.40 7 Aug 2012 98 (Rs. In crore )

PowerPoint Presentation: 

Component Activity Level Units No Unit Cost Total 2010-11 2011-12 Research Regional Institutes 4 8 0.5 6.00 Awareness & IEC (Recurring) District 32 80 0.05 5.60 Miscellaneous Expenditure on Calipers Sub-Centre 6400 9600 0.0032 51.20 Year wise cost on Research and IEC activities and Miscellaneous Expenditure 7 Aug 2012 99 (Rs. In crore )

Cost on Manpower : 

Cost on Manpower Components Activity level Units Nos. Unit cost ( crore ) Total cost ( crore ) 2010-11 2011-12 Manpower Cost (Recurring) CHC 320 800 0.018 20.16 District 32 80 0.282 31.58 Regional Institutes 4 8 0.8844 10.61 Total 62.36 7 Aug 2012 100

PowerPoint Presentation: 

Integrated monitoring by NCD Cells at centre , States, districts and CHCs. Monthly Progress Report to be submitted by NCD cells. RDs of the respective states to coordinate in monitoring activities between centre and state nodal officers Half yearly progress review meeting for assessing the status of implementation of the programme activities. Yearly Combined field visit by Central and State Cells for on the spot assessment of progress of the activities. Proposed MONITORING strategy 7 Aug 2012 101

REFERENCES: 

REFERENCES National Program for Health Care of the Elderly (NPHCE) : Towards active and healthy ageing. Operational Guidelines. Director General of Health Services, MOHFW, Government of India. Situation Analysis of The Elderly In India, June 2011. Central Statistics Office, Ministry of Statistics & Programme Implementation, Government of India Rajan SI. Population ageing and health in India. The Centre for Enquiry into Health and Allied Themes (CEHAT), Mumbai. July 2006. National Policy on Older Persons (1999). Ministry of Social Justice and Empowerment, Government of India, Shastri Bhawan , New Delhi. Maintenance and Welfare of Parents and Senior Citizens Act – 2007, Ministry of Social Justice and empowerment Government of India Morbidity, Health care and the Condition of the aged. NSSO (64 th round)Jan-June 2004, National Sample Survey Organization, Ministry of Statistics and Programme Implementation, Government of India, March 2006. 7 Aug 2012 102

PowerPoint Presentation: 

Two years (2009-2011) Achievements and New Initiatives. NRHM, Ministry of Health and Family Welfare, Government of India. Ingle GK, Nath A. Geriatric Health in India: Concerns and Solutions. Indian J Comm Med, 2008; 33 (4); 214-18. Prevention & Control of Non-Communicable Diseases (NCDs): Proposal for the 12 th Plan, Report of the Working Group on Disease Burden: Non-Communicable Disease (NCDs), Director General of Health Services, MOHFW, Government of India. Planning Commission. 11 th five year plan (Draft), Government of India; Accessed on 27/02/2012 at URL: http://www.planningcommission.nic.in 7 Aug 2012 103

PowerPoint Presentation: 

Thank you!!!