Public Health Initiatives with special reference to the State of Rajasthan.

Health, Health Infrastructure and Health Policy of Rajasthan

• The State Government is having focus on the medical sector to promote health status of the people of the State especially for the weaker sections of the society.
• The State is committed to control and eradicate communicable and other diseases and for providing curative and preventive services to the people of the State.
• A number of initiatives have been taken to bring them into the mainstream.
• Medical & Health Department is committed to make Health facilities available to every common man of Rural and Urban areas in a planned manner for which medical infrastructure Developmetn & Strengthening is being done in accordance with the National Health Policy through Health Institutions.

Medical Infrastructure in Rahastahan

• There are 16 Medical Colleges in Rajasthan, out of which eight are in the Government sector including one under Government Society and remaining eight are in the private sector.
• There are 15 Dental colleges in the state, one in Government sector and 14 in Private sector.
• The Government Medical Colleges have an annual admission capacity of 1,450 students in UG, 829 students in PG course and 93 in Super-Specialty courses.
• The private medical colleges have an annual admission capacity of 1,150 students in UG and 173 students in PG courses.
• The Government Dental College has an annual admission capacity of 40 UG and 14 PG students.
• The private dental colleges have an annual admission capacity of 1,400 students in UG and 299 students in PG courses.
• For upgradation of 7 other district hospitals Alwar, Bharatpur, Churu, Barmer, Bhilwara, Pali and Dungarpur having bed capacity of 300 beds into medical colleges, except Alwar, construction is under progress in State.
• Establishment of state cancer institute under Sawai Man Singh (SMS) Medical College Jaipur, Two Tertiary Cancer Care Centers, one in Bikaner and other at Jhalawar are under process.
• Metro Manas Arogya Sansthan at Mansarovar Jaipur is running on PPP mode.
• The hospitals associated with Government Medical Colleges are playing a vital role in patient care for both indoor and outdoor patients and cater to the medical/health care needs of a large segment of the population.

AYURVED AND OTHER SYSTEMS OF MEDICINE

• Department of Ayurved has been functioning in the State, since 1950.
• At present there are 118 Ayurvedic hospitals (out of which one is established at Bikaner House in Delhi), 3,577 Ayurvedic Dispensaries, 3 Yoga & Naturopathy Hospitals, 3 Yoga & Naturopathy Dispensaries with 1 Mobile Surgical Unit (200 bedded) and 13 Mobile Units are functioning in the State.
• 33 Aanchal Prasuta Kendra, 33 Jaravastha Janya Vyadhi Nivaran Kendra, 33 Panchkarma Kendra & 33 Yoga and Naturopathy Research Centers are also functioning in the State

Mukhya Mantri Nishulk Dava Yojna

• “Mukhya Mantri Nishulk Dava Yojna” was launched on 2ndOctober, 2011. The scheme aims to benefit all the patients coming to government hospitals.
• Under this scheme, all outdoor and indoor patients visiting medical college attached hospitals, district hospitals, community health centers, primary health centers and sub centers, are provided commonly used essential medicines, free of cost.
• Rajasthan Medical Services Corporation (RMSC) has been constituted as a central procurement agency for purchase of medicines and surgical sutures for medical department and Medical Education department.
• RMSC is supplying medicines etc. to all Government health institutions through District Drug Ware Houses (DDWH) established in all 33 districts of the State. Quality of drugs being supplied is ensured by testing of drugs at empanelled drug testing laboratories.
• The list of drugs which is provided by Free Drug Distribution Centers has been displayed in Government Medical Institutions.
• Medicines are available for Outdoor patients according to OPD timings and 24 hour for Indoor and Emergency patients.
• In this scheme, according to need of hospitals, 10 per cent of annual budget can be used for local purchase. Under the scheme, medicines for the treatment of critical and severe disease are also available like 37 drugs for Cancer, 53 drugs for heart diseases, 20 drugs for Diabetes and 20 drugs for Asthma. Under the scheme, E-aushdhi software is established for tendering, indent sending, to know the status of drug consumption at medical hospitals, to ensure the quality of drugs, to submit the information about the debar medicines etc.

Nishulk Sanitary Napkins Distribution Scheme

• Government of Rajasthan started a scheme for free distribution of sanitary napkins to all school going girls of class 6 to 12 of rural areas and non-school going girls of 10 to 19 years age of BPL families.
• In this scheme Ist phase of the free sanitary napkins distribution scheme for adolescent school girls of rural area and non-school going girls of BPL families has been completed.
• About 20 lakh adolescent girls are being benefitted under the scheme.
• These are the main objects of this scheme:-
• To make aware the adolescent girls of rural areas about menstrual hygiene.
• To improve the health of adolescent girls.
• To increase the attendance of adolescent girls in schools.
• To reduce the MMR and IMR in rural areas in the long term.
• To make clean and healthy Rajasthan.

Bhamasha Swasthaya Bima Yojana

• Bhamasha Swasthaya Bima Yojana was launched in the state on 13th December, 2015.
• The main objective of this scheme is to provide cashless healthcare services to the poor families (under selected families of NFSA – 2013 and RSBY) of Rajasthan thus providing social and financial security against illness to these families and reducing out of pocket expenditure.
• Around 97 lakh eligible families of Rajasthan are selected under the National Food Security Act (2013) and Rashtriya Swasthaya Bima Yojna (RSBY).
• Health Insurance cover of `30,000 (for general illnesses) and of 3.00 lakh (for critical illnesses) per family per year is provided on floater basis.
• Total 1,715 disease packages are offered under the scheme, for which reserved list include 1,148 secondary packages, 500 tertiary packages and 67 Government Medical Institution packages.
• Cashless IPD treatment facility is provided at empanelled hospitals.
• Includes 7 days pre- hospitalization and 15 days post- hospitalization expenses.
• No Third Party Administration (TPA).
• Presently, 499 Government and 674 private hospitals are empanelled for providing services under the scheme.

EMPLOYEES STATE INSURANCE SCHEME (ESI)

• Employees State Insurance Scheme is a social security scheme, which is operational in the State, since 1956 with the objective of providing free medical and health care facilities to employees and their dependent family members under the E.S.I. Act 1948, section 58 where the insured persons having salaries upto 21,000/- per month, working in industrial, commercial, educational, medical and other establishments covered under the Act.
• About 7.90 lakh insured persons and their 22.75 lakh dependent family members are being benefited in the State. Under E.S.I. Scheme, four E.S.I. hospitals (Bhilwara, Jodhpur, Kota, Pali) and 74 dispensaries are functioning in the state.

E-INITIATIVES BY RAJASTHAN GOVERNMENT

ASHA Soft

• ASHA Soft is an online system which facilitates the health department, to capture beneficiary wise details of services given by ASHA to the community.
• It also provides online payment of ASHA to their bank accounts and calculation of total incentive given will be in accordance with the actual health services provided which will help in strengthening of monitoring & management of physical & financial progress.
• Under National Health Mission, Rajasthan, the responsibility for preparing ASHA Soft has been assigned to NIC unit of Rajasthan State for the cooperation of which ASHA Soft Core Group has been constituted under the directions of Mission Director which is working on the progress of this software with the coordination of NIC.
• Till now, the profiles of all the working ASHAs have been prepared along with the work plan.
• The districts have been oriented on this work plan by Mission Director time to time during VC, Meeting of CM & HOs and PMOs.
• Bank of Baroda has been selected for online payment which will perform this work without any extra fees.
• The progress of the scheme is being reviewed time to time by Mission Director, NHM for operationalisation of the software on time. After a trial run with the Bank,ASHA Soft will be operationalise in the month of December 2014.

e-Aushadhi

• The e-Aushadhi is a web based application which deals with the management of stock of various drugs,sutures and surgical items required by different district drug warehouses of Rajasthan state.
• e-Aushadhi helps in as certaining the needs of various district drug warehouses such that all the required materials,drugs are constantly available to be supplied to the user district drug warehouses without delay.
• This includes classification or categorisation of items, codification of items, etc.
• The prime objective of a District Drug Warehouse is to supply drugs to the various medical institutes that are associated with the given district drug warehouse.

Pregnancy, Child Tracking & Health Services Management System(PCTS)

• Pregnancy, Child Tracking & Health Services Management System is online software used as an effective planning & management tool by Medical, Health & Family Welfare department, Government of Rajasthan.
• The system maintains online data of more than 13,000 government health institutions in the state.)
• Integrated system for monitoring of PCPNDT ACT
• PCPNDT ACT is an Act to provide for the prohibition of sex selection, in order to stop female foeticides and arrest the declining sex ratio.
• The website was launched on October 01, 2012 by the National Informatics Centre (Rajasthan) which helps in monitoring of the form A, form -F and tracking devices fitted in sonography machines atthe registered sonography centres and generates various analytical and geographical reports.
• It is an intensive inspection drive using technology of all Government district, Subdivision, Community Health Center(CHC), Primary Health Center (PHC) hospitals.
• It is an integrated streamlined system to keep the employee data.

Government of India is committed to the goal of ‘Health for All’  The obligation of the Government to ensure the highest possible health status of India’s population and access to quality health care has been recognized by a number of key policy documents.Health care system supplement in improving the health of individuals, particularly those belonging to socially and economically disadvantaged groups,which is a key objective of the Indian government and a major consequence of a Constitution.

Recognizing the importance of Health in the process of economic and social development and improving the quality of life of our citizens, the Government of India has resolved to launch the National Rural Health Mission to carry out necessary architectural correction in the basic health care delivery system.

Mission of Madhya Pradesh aims at providing the necessary knowledge and skills to keep all rural people living in the state of Madhya Pradesh to ensure equitable, accountable and effective primary health care especially to the poor women and children and to promote the quality of their lives. And to enable them to lead a healthy productive life. Thus, there are two main components of the Programs: To provide the knowledge needed to keep the first people healthy and empower the people living in the state, secondly, Madhya Pradesh has adopted the vision adopted by the National Health Mission, Government of India. In order to keep the people healthy, the necessary skills and knowledge are being provided throughout the state and the villagers of the state Provide effective health services for the population to be strengthened to poor infrastructure and as worst performing districts.

Under Universal access to basic health facilities consisting of health card, medical examination following programs / facilities have been initiated by Central and State Government in Uttarakhand:-

• National Rural Health Mission (NRHM)
• National AIDS and STD Control Programme

  Under the programme, following activities are carried out:
  (i)Preventive measures,
  (ii) Targeted Intervention among High Risk Groups,
  (iii) Information, education and communication activities in States and UTs,
  (iv) Treatment of sexually transmitted infections, (v) Blood safety and quality assurance,
  (vi)Integrated Counselling & Testing facilities including prevention of Parent to Child Transmission,
  (vii) Rural outreach through Link Worker Scheme,
• National AYUSH Mission (NAM)

  Under the mission activities, it is aimed to provide AYUSH services at health centres and promotion of farming of medicinal plants
• Supply of Contraceptives

   Supply of condoms to consumers free of cost; Condom Social Marketing and publicity campaign.
• Assistance to Voluntary Organisations for Welfare of SCs

  Grant support to NGOs/ voluntary organisations for service activities such as medical centres, dispensaries.
• Health System Development Project (EAP)

   the capacity of existing health service providing institutions are strengthened by way of stewardship and capacity building and involvement of Private Partners in providing health services.
• Mukhyamantri Swasthya Sudrikaran Yojana

   health card is being provided to families for getting free of cost treatment in selected hospitals for identified diseases.
• Safe Blood Transfusion Services

   Safe Blood Transfusion Services are being provided through Blood banks.
• Integrated Child Development Services (ICDS)

   children of age group 0-6 are immunised
• Beti Bachao Beti Padhao

  The specific objectives of the scheme are:
  i.Prevention of gender based sex selection
  ii.Ensure survival of girl child
  iii.Protection of the girl child and
  iv.Ensure education of the girl child.
• Janani Suraksha Yojana (JSY )

   Cash incentive is provided to mothers delivering in hospital. In this scheme, the States where there is a low rate of Institutional deliveries is classified as ‘Low Performing States (LPS)’ (the States of Uttar Pradesh, Uttaranchal, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Assam, Rajasthan, Odisha and Jammu and Kashmir), whereas the remaining States are termed as High Performing States

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  (HPS). Cash benefits to them are as under:
  Low Performing State: Mothers’ package (₹1400), ASHA Package (₹ 600) totalling ₹ 2000.
  High Performing States: Mothers’ package (₹ 700), ASHA Package (₹ 600) totalling ₹ 1300. These costs are applicable to rural areas only.
• Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (RGSEAG) - SABLA

  The scheme has special focus on adolescent girls of the age group, 11 to 18 years. The scheme has two major components namely, nutrition and non-nutrition component.
  Nutrition is being given in the form of Take Home Ration or Hot Cooked Meal to out-of-school girls of age group 11-14 years and to all adolescent girls of age group 14-18.
  In the non-nutrition component, the out-of-school adolescent girls of age group 11 to 18 years are being provided IFA supplementation, Health check-up and Referral services, Nutrition and Health Education, Counselling and guidance on family welfare, Adolescent Reproductive Sexual Health (ARSH), child care practices, Life Skill Education and vocational training.
• Integrated Child Development Services (ICDS)

  Following services are sponsored under ICDS:
  1.Immunisation of 0-6 age group children
  2. Supplementary nutrition to children, pregnant women and lactating mothers
  3.Health check-up of children, pregnant women and lactating mothers
  4.Referral services
  5.Pre-school non-formal education to children 6.Nutrition and Health information to women.

• National Nutrition Mission

  Basic activities under National Nutrition Mission:
  (i)Strengthen and restructure the ICDS scheme,
  (ii) Introduce a multi-sectoral programme to address maternal and child malnutrition in selected 200 high-burden districts,
  (iii) Introducing a nation-wide information, education and communication campaign against malnutrition and
  (iv) Making nutrition a focus in the programmes and schemes of line Ministries.
  (v)This scheme is now a sub-scheme under Integrated Child Development Scheme.
• Indira Gandhi Matritva Sahyog Yojana (IGMSY )

  Cash assistance directly to pregnant and lactating women (P & L Women) from the end of 2nd trimester of pregnancy up to 6 months after delivery. ₹ 6000

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  provided to the pregnant and lactating women in response to fulfilling specific conditions related to health and nutrition of mother and child. The scheme would address short-term income support objectives with long-term objective of behaviour and attitudinal change. The scheme attempts to partly compensate for wage loss to pregnant and lactating women both prior to and after delivery of the child.
• Aajeevika - National Livelihood Mission

   Food Security Risk fund is provided to SHG/ volunteer organisations, cluster level SHG federation. In addition, activities such as IEC on education and nutrition are conducted in VO / SHG meetings.
• National Institutes for Blind, Deaf, Mentally Retarded and Orthopedically

  They provide professional training courses with a view to developing trained manpower in the disability sector and also providing various other rehabilitation services.
• Aids and Appliances for the Handicapped

   Grants-in-aid to various implementing agencies to assist the needy disabled persons in procuring durable, sophisticated and scientifically manufactured, modern, standard aids and appliances that can promote their physical, social and psychological rehabilitation. PWDs can get the aids and appliances.
• Artificial Limbs Manufacturing Corporation

  Empowerment of Persons with Disabilities and restoration of their dignity by way of manufacturing and supplying durable, sophisticated, scientifically manufactured modern and ISI standard quality assistive aids. The aids are supplied to PWDs