Age limit relaxed for financial assistance to institutional deliveries #Goodnews


AARTI DHAR, The Hindu

Move expected to reduce neonatal, maternal mortality in young mothers

The Ministry of Health and Family Welfare has relaxed eligibility parameters for the Janani Suraksha Yojana (JSY), which provides financial assistance to mothers for institutional deliveries. Now, Below Party Line (BPL) women can access JSY benefits irrespective of their age and number of children.

All women from BPL category, Scheduled Castes and Scheduled Tribes in all States and Union Territories will be eligible for JSY benefits if they have given birth in a government or private accredited health facility. BPL women who prefer to deliver at home can also get JSY benefits.

Launched in 2005, the JSY is the government’s main scheme to enable women — especially those from vulnerable sections — to access institutional delivery. This was done to reduce maternal and neonatal mortality.

“The decision was taken after it was realised that a majority of women, who needed JSY benefits, remained out of the purview of the scheme because they had to prove they were 19 years of age and had no more than two children,” Anuradha Gupta, Additional Secretary and Mission Director, National Rural Health Mission (NRHM), told The Hindu on Tuesday.

The highest maternal mortality is reported among girls aged 14-15; the majority of these were out of the purview of the JSY as they were unable to produce proof of age or verify the number of children they had, Ms. Gupta explained.

Till now, the scheme provided assistance for institutional delivery to all pregnant women who give birth in a government or private accredited health facility in Low Performing States (those with bad health indicators, such as Uttar Pradesh, Bihar, Chhattisgarh, Madhya Pradesh, Uttarakhand, Jharkhand and Assam). A woman gets Rs.1,400 for delivery in a government facility or accredited private facility and Accredited Social Health Activist (ASHA) gets Rs. 600 in rural areas. In the urban areas, the amounts paid are Rs.1,000 and Rs. 400 respectively.

However, in High Performing States (those with good health indices, such as Kerala, Tamil Nadu and Karnataka), assistance for institutional delivery was available to women from BPL/SC/ST households, aged 19 or above and only up to two live births for delivery in a government or private accredited health facility. The financial entitlement was Rs. 700 to the mother and Rs. 600 for the ASHA in rural areas and Rs. 600 and Rs. 400 in urban settings.

Further, in all States/Union Territories, the scheme provided Rs. 500 to BPL women — aged 19 or above and who deliver up to two live births — who prefer to deliver at home. With the amendments, all women who deliver at home will be entitled to this amount, basically for nutrition.

The government claims that as a result of the scheme, there has been an increase in institutional deliveries — from 47 per cent in 2007-08 to 72.9 per cent in 2009 (Coverage Evaluation Survey) and, most recently, to approximately 79 per cent — as per Health Ministry data.

 


  • Henceforth, all BPL women will get JSY benefits
  • Many were excluded for being under 19

 

National Urban Health Mission (NUHM) as a sub-mission under the National Health Mission (NHM)


PIB PRESS RELEASE

The Union Cabinet gave its approval to launch a National Urban Health Mission (NUHM) as a new sub-mission under the over-arching National Health Mission (NHM). Under the Scheme the following proposals have been approved :

1.        One Urban Primary Health Centre (U-PHC) for every fifty to sixty thousand population.

2.        One Urban Community Health Centre (U-CHC) for five to six U-PHCs in big cities.

3.        One Auxiliary Nursing Midwives (ANM) for 10,000 population.

4.        One Accredited Social Health Activist ASHA (community link worker) for 200 to 500 households.

The estimated cost of NUHM for 5 years period is Rs.22,507 crore with the Central Government share of Rs.16,955 crore. Centre-State funding pattern will be 75:25 except for North Eastern states and other special category states of Jammu and  Kashmir, Himachal Pradesh and Uttarakhand for whom the funding pattern will be 90:10.

The scheme will focus on primary health care needs of the urban poor. This Mission will be implemented in 779 cities and towns with more than 50,000 population and cover about 7.75 crore people.

The interventions under the sub-mission will result in

·         Reduction in Infant Mortality Rate (IMR)

·         Reduction in Maternal Mortality Ratio (MMR)

·          Universal access to reproductive health care

·         Convergence of all health related interventions.

The existing institutional mechanism and management systems created and functioning under NRHM will be strengthened to meet the needs of NUHM. Citywise implementation plans will be prepared based on baseline survey and felt need. Urban local bodies will be fully involved in implementation of the scheme.

NUHM aims to improve the health status of the urban population in general, particularly the poor and other disadvantaged sections by facilitating equitable access to quality health care, through a revamped primary public health care system, targeted outreach services and involvement of the community and urban local bodies.

Background

The Union Cabinet in its meeting held in April 2012 has already approved the continuation of the National Rural Health Mission (NRHM) and the other sub-mission under NHM till 31.3.2017.

 

#India – If you are a tribal woman in Shahpur…, near Mumbai #Vaw


 

SHAHPUR, THANE, MARCH 29, 2013, Meena MENON, THE hINDU

File photo shows women attending a public hearing under the National Rural Health Mission (NHRM) in Sayvan village in Thane district.

Special Arrangement File photo shows women attending a public hearing under the National Rural Health Mission (NHRM) in Sayvan village in Thane district.

While Mumbai has an obscene array of five star health care, neighbouring Thane district is a picture of neglect

If you are a tribal woman in Shahpur, and pregnant at that, the chances of getting a sonography done are only on the third Wednesday of every month at the sub-district hospital. There is no radiologist here. In the whole of Thane district (with 15 talukas) there are only two government radiologists who work almost 24 hours to cover all hospitals in turn. Most tribal women shell out Rs. 700 to 800, money they can ill afford, to pay private practitioners rather than wait for weeks.

Since four or five months, the government has not distributed folic acid tablets and essential drugs are always in short supply in this tribal dominated taluka of Thane district, which is barely 100 km from Mumbai.

If a tribal woman manages to reach her full term of pregnancy and goes to the same sub-district hospital for delivery, it can be a great misfortune if she has to use the toilet as Savita Mukne from Vashind discovered last month.

Ms. Mukne escorted by Accredited Social Health Activist (ASHA) Anju Dongre went outside the labour room to find the two toilets shut and used as storerooms. Ms. Dongre recalls, “It was on February 25, I took Savita out of the labour room to find the nearest toilet which was a little further down and to my horror the baby’s head popped out. I was in a dilemma and had to keep holding the head while a vehicle was procured to get Savita back into the labour room. ” The child suffocated in the meantime and Ms. Mukne in a critical condition, had to be rushed to Thane civil hospital that night, a good three-and-a-half hour drive. It took her six days to recover. “See what problems this lack of toilet has caused,” Ms. Dongre said.

While Mumbai has an obscene array of five star care, neighbouring Thane district is a picture of neglect. At the Jansunwai or public hearing in Shahpur on Thursday under the community based monitoring programme of the National Rural Health Mission (NRHM), government doctors and officials tried to save face while a litany of complaints was read out against corruption, the condition of PHCs and lack of anganwadis (in 25 villages), the improper supply of medicines including folic acid tablets for months and non availability of rations for mid-day meal schemes.

Dr. Bharat Masal, medical superintendent, Shahpur sub-district hospital, said that every month only 30 to 35 cases were taken up for sonography since the radiologist who comes from Thane could only work between 9 am to 1 pm. Due to rampant misuse of sonography for pre-natal sex determination, the law was strict about uploading information on each case on the internet on the same day, said Dr. Mahesh Renge, resident medical doctor of the Thane civil hospital. The government offers a radiologist a salary of Rs. 50,000 a month at the Shahpur hospital but there are no takers. Of the 95 total sanctioned posts at the hospital, 18 are vacant. There are 2000 women in the high-risk category registered with the hospital who are given preference for sonography, said Dr. Masal.

One other issue was the non-supply of food grains last year from June to September to women running self help groups (SHGs) who cook mid-day meals. The public distribution system (PDS) centres refuse to stock the grains since it is not profitable, said an official. The SHGs had to put in their own money to buy grains or get it from the PDS shops they ran. A grave issue was the lack of supply of folic acid tablets, crucial during pregnancy since most of the tribal women suffered from anemia. Ms Indavi Tulpule of the Shramik Mukti Sanghatana said that for four months there was no supply of folic acid tablets. Dr. Pooja Singh, additional district health officer, admitted there was a shortage but she said the government had launched a new Weekly Iron Folic Acid Supplementation (WIFS) scheme under which four lakh tablets were given to Shahpur taluka alone on January 28. However, these tablets were sent for testing last December and the report had not come. While Dr. Singh said the tablets were released, the taluka medical officer said these tablets were not available.

Lack of supply of medicines at the nine PHCs and 60 sub-centres in Shahpur came in for much criticism. At Vashind PHC the medical officer Dr. Vinay Devlalkar almost got beaten up because he could not provide the drugs required and he rarely gets what he indents for. He had to buy extra medicines to fulfil demands. The State rarely gives what the PHCs require and even Dr. M S Dhere from Dolkhamb PHC admitted to being low on essential medicines.

At the PHC at Tanki Pathar, the contractor vanished without fitting a water tank. Now bullock carts ferry water to the PHC. The two doctors and staff cannot live there. The condition of other PHCs too is pathetic with leakages during monsoon and poor construction. Access is also an issue for many people. There is one PHC located near a poultry farm and people want it to be relocated due to the high risk of infection.

Dr Nitin Jadhav, state coordinator of the NGO SAATHI for community based monitoring, said that these issues were raised at other public hearings in the area but they have not been resolved. “There has to be a process to resolve them at local levels,” he said.

 

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