Banda district’s health department has implemented various schemes to ensure child and mother healthcare, tackle malnutrition and keep fertility rate low – all this and more — without compromising on the quality of delivery of healthcare services, says Dr Santosh Kumar, Chief Medical Officer, Banda, in conversation with Arpit Gupta of Elets News Network (ENN).
Tell us about the various health schemes being implemented in Banda district to ensure mother and child health.
Banda district is part of Uttar Pradesh’s Bundelkhand region. The percentage of institutional deliveries in rural areas of the district is about 73, while this figure for urban areas is around 76 percent. The district grapples with issues like malnutrition. Since the most crucial period for child nutrition is from pregnancy to the second year of life, the district administration is implementing many schemes and programmes pertaining to mother and child health in a focused manner. These include:
Janani Suraksha Yojana (JSY)
It is being implemented with the objective of reducing maternal and neonatal mortality by promoting institutional delivery among poor pregnant women. Under this scheme, all the beneficiaries of institutional delivery are eligibility for cash assistance. There is a provision of providing Rs. 1,400 to the beneficieries from rural areas and Rs. 1,000 for the beneficiaries from urban areas through Public Financial Management System (PFMS).
Janani Shishu Suraksha Karyakaram (JSSK)
Under the Janani Shishu Suraksha Karyakaram, pregnant women who access government health facilities for their delivery are entitled for benefits like free and cashless delivery, free C-Section, free drugs and consumables, free diagnostics, free diet during stay in the health institutions, free provision of blood, exemption from user charges, free transport from home to health institutions, free transport between facilities in case of referral and free drop back from institutions to home after 48 hours of stay.
102 Ambulance Service (Drop Back Facility)
‘102 Ambulance service’ is offered at all government health facilities to provide free transport service to pregnant women, mothers of newborns and sick infants. The services under this initiative include pickup from home to health facility, free transport between facilities in case of referral, and drop back from the facility to home after delivery if the mother stays for minimum 48 hrs after delivery in case of pregnant women but without any condition for sick neonates.
Nutritional Rehabilitation Centres (NRC)
Severe Acute Malnutrition is an important contributing factor for most deaths amongst children suffering from common childhood illness, such as diarrhoea and pneumonia.
Nutritional Rehabilitation Centres (NRCs) have been set up in the health facilities for inpatient management of severely malnourished children, with counselling of mothers for proper feeding and once they are on the road to recovery, they are sent back home with regular follow up.
Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
The programme aims to provide assured, comprehensive and quality antenatal care, free of cost, universally to all pregnant women on the 9th of every month. PMSMA guarantees a minimum package of antenatal care services to women in their 2nd/3rd trimesters of pregnancy at designated government health facilities. The programme follows a systematic approach for engagement with private sector, which includes motivating private practitioners to volunteer for the campaign. So far, 2,176 pregnant women have benefitted in Banda district under this programme.
Throw some light on the status of neonatal care in Banda district.
To ensure quality neonatal care in Banda, Sick Newborn Care Units have been made operational in the government district hospital under the aegis of National Health Mission to provide quality care for sick newborns. It is a separate unit in close proximity to the labour room with 12 or more beds, and are managed by adequately trained doctors, staff nurses and support staff to provide 24/7 services.
What steps are being taken by the health department of Banda to ensure implementation of family planning programme?
The objectives of the Family Planning Programme are lowering fertility and slowing the population growth rate in the country. There are two types of contraception methods adopted under this programme in Banda district— permanent contraception methods and temporary contraception methods.
Permanent contraception methods include female and male sterilisation that involves a relatively simple surgical procedure that provides life-long protection against pregnancy. There is a provision of giving a cash reward of Rs. 2,000 to female beneficiaries and Rs. 3,000 to the male beneficiaries.
Temporary contraception methods include use of condom, Oral Contraceptive Pill, Emergency Contraceptive Pill, Intrauterine Contraceptive Device, Postpartum Intrauterine Contraceptive Device, ANTARA (Depo-Medroxyprogesterone Acetate) injection, which is a hormonal birth control method, and Chhaya (Centchroman non-hormonal pill) to keep a proper gap between children.
Please tell us about the health screening programme being implemented in Banda to ensure good health of children and adolescent.
Under the Rashtriya Bal Swasthya Karyakram (RBSK), outreach screening is done by dedicated Mobile Health teams for 6 weeks to 6 years at anganwadi centres and 6-19 years children at school. Under RBSK, there are 16 teams working in the district at block level, covering 4 ‘D’s — Defects at birth, Deficiencies, Diseases, and Development delays including disability. Under this initiative 93 children from 2,287 villages have been referred to either Banda District Hospital or hospitals in other districts to help them avail quality treatment.
Since there is an acute shortage of qualified health practitioners in Uttar Pradesh, how is Banda district administration tackling this significant issue?
To fill the gap left open due to non-availability of qualified health professionals, we have implemented the Central government’s AASHA (Accredited Social Health Activist) scheme. One of the key components of the National Rural Health Mission is to provide every village in the country with a trained female community health activist ASHA. The ASHAs receive performance-based incentives for promoting universal immunisation, referral and escort services for Reproductive & Child Health (RCH) and other healthcare programmes, and construction of household toilets.
“‘102 Ambulance service’ is offered at all government health facilities to provide free transport service to pregnant women, mothers of newborns and sick infants.”
There is a provision of appointing one ASHA worker per village with a population of 1,000-1,500. They are chosen through a rigorous process of selection involving various community groups, self-help groups, Anganwadi Institutions, the Block Nodal officer, District Nodal officer, the village Health Committee and the Gram Sabha. Presently, there are 1,441 ASHA workers in Banda district.
We have also appointed ASHA Sanginis, who are responsible for supervising and supporting 20 ASHA workers (including themselves). Presently, there are 54 ASHA Sanginis working in the district.
How are you incorporating AYUSH system of medicine in the treatment of patients?
There are 30 AYUSH doctors appointed in the district under the mainstreaming of Ayush scheme. They treat patients using traditional medicines and methods.
How do you ensure quality of healthcare services that are being delivered through the various health facilities in the district?
To ensure delivery of quality healthcare services, we have implemented the Quality Assurance programme, which includes a set of attributes that is central to the functioning of any organisation or sector. The quality of service delivery is adversely impacted if a public servant is not provided proper guidance and training and there is a lack of well-defined system and coordination. Keeping these requirements in view, the Quality Assurance programme was unveiled in the State in 2014. The objective of this programme is to ensure quality o services in health facilities of the State.
“102 Ambulance service’ is offered at all government health facilities to provide free transport service to pregnant women, mothers of newborns and sick infants.”
Under this initiative, two-pronged approach has been adopted and made operational in Banda. The first one includes ensuring cleanliness and maintenance of hospitals, management of bio waste, infection control, maintaining hygiene and clean environment, while the second one includes taking measures under National Quality Assurance Standards (NQAS), based on which health units are awarded certificates if they achieve the requisite quality parameters.