HSR Orissa

Health Sector Reform ORISSA : 

Health Sector Reform ORISSA Dr Nihar Ranjan Ray Bhubaneswar, India

OVERVIEW ORISSA : 

OVERVIEW ORISSA Orissa formed on 1st April 1936 4.87% of the total area of India having 3.28 % population Badly affected with natural calamities. Rich with minerals The root causes of poor health are poverty, social deprivation, low levels of literacy and inefficient health systems and infrastructure

Demographic Profile : 

Demographic Profile Total Population 3.68 cr No of Dist. 30 SC 16.53% ST 22.13% Rural 85% Sex Ratio 972 BPL 47.14% Life Expectancy 61.64 yrs

Health Infrastructure : 

Health Infrastructure Medical Colleges 06 District Hospitals 32 SD Hospitals 22 CHCs 231 PHCs 117 PHC new 1162 SCs 6688 MOs 762 Asst Surg. 2629 Specialist 824 Pharmacist 2039 Nurses 2244 HS M&F 3102 HW M&F 12032 LT 801 Radiographer 162

Basic Theme of Reform : 

Basic Theme of Reform Project approach Multilateral agencies Focusing on high priority area of investment & applying for loans. Alternate sourse of Financing. Human resourse development Decentralisation KBK Strategy

REFORMS : 

REFORMS Public Private Partnership-Handing over PHCs to NGOs Outsourcing of cleaning in hospitals Initiatives in Decentralization Formation of Zilla Swasthya Samitis Centralized Drug Procurement & Distribution System16-17-18-19 Establishment of a State Health and Family Welfare Society

Zilla Swasthya Samiti : 

Zilla Swasthya Samiti Formation of Zilla Swasthya Samitis in 1993 Amalgamation of Zilla Swasthya Samitis ZSS GB EB Dist. Magistrate CDMO Collection & utilization users fee Maintenance of Infrastructures Ensuring community participation Implementation of program

Reforms related to Human Resources : 

Reforms related to Human Resources Increase in MBBS seats in Medical Colleges by 43 each Mandatory pre-PG rural service Internship training program for better community health orientation Short-course training in anaesthesia administration Appointment of staff on a contractual basis & enhancement of remenuration in KBK districts.

Reforms related to Human Resources : 

Reforms related to Human Resources Increase in incentive from 2000 to 8000 in difficult areas for doctors Increase in salary for Junior Doctors.12000-16000 Up gradation of posts at entry level for Doctors from Class ll to class l Increase in specialist allowance from 150 to 3000 pm. Doubling of seats of LTs, RTs, ANMs. Formation of district cadres for paramedics Multi-skilling of health personnel New courses: MSc & BSc Nursing

Drug Policy Reform : 

Drug Policy Reform Doubling of Budget Central procurement Adequate availability of ELDs (generic) Strict control of corruption.

Public-Private Partnership (PPP) Initiative in Health Sector in Orissa : 

Public-Private Partnership (PPP) Initiative in Health Sector in Orissa Contracting out Primary Health Centre (N). Mother NGO (MNGO) – Service NGO (SNGO) Programme. Urban Health Centres for slum population. PPP in Malaria Control. Janani Express. Accreditation of Private NGO Hospitals for Institutional Delivery. Capacity Building of ASHA involving – MNGO / FNGO. Outsourcing cleaning and security services at Health Institutions.

Slide 12: 

National Rural Health Mission IMR Mission Navajyoti- The new light to address IMR & MMR Reproductive Child Health (RCH-II) IMR 50 MMR 250 TFR 2.1 By 2010 Janani Surakhya Yojana Transport of sick children & Expectant Mothers Chloroquin Prophylaxis Performance linked incentive

Outcome of the Reform : 

Outcome of the Reform Birth Rate 21.5 Death Rate 09.2 Contraceptive use 36-51 Antenatal care 64-87 Institutional Deliveries 14-39 Infant Mortality Rate 112-65 Maternal Mortality Ratio 375-330 Immunization 36-52 Total Fertility Rate 2.9- 2.4

Orissa: 2010 Goal : 

Orissa: 2010 Goal MMR 250 IMR 50 TFR 2.1 ANC 80% Inst. Delivery 80% Full Immunization 85% CPR 65%

Slide 15: 

Thank You