From earning international accolades for commendable efforts at containing Polio, reduction in HIV cases, beginning mass screening for detecting Non Communicable Diseases like Diabetes to initiating new schemes for well being of mother and new born care, to making efforts for availability of generic drugs at affordable prices, the Ministry of Health and Family Welfare in the year 2011 took significant new steps. The multifarious efforts included transiting from prevention of food adulteration to more holistic food safety and regulation standards; increased focus on health research and development in the 100th year of ICMR to legislative efforts for establishing National Commission for Human Resources for Health. The year also threw up challenges of public health concerns – rising instances of Acute Encephalitis Syndrome, tackling newer infections like Crimean Congo Haemorrhagic Fever and concerns over falling child sex ratio – the Ministry took initiatives for multi pronged strategy. Recognising there is no room for complacency and much needs to be achieved yet, the Ministry is all poised to scale up plans for the XIIth Plan ahead.
IMPROVED HEALTH INDICATORS:
As per latest data available:
· Infant Mortality Rate has come down to 50 in 2009 from 58 per 1000 live births
in the year 2005;
· Maternal Mortality Ratio has also come down to 212 per 100,000 live births
during 2007-09 from 254 per 100,000 live births in 2004-06;
· Total Fertility Rate has come down to 2.6 in 2009 from 2.9 in 2005;
· Under the Universal Immunization Programme (UIP) 61% of children aged
12-24 months in India are fully immunized against 6 vaccine preventable
diseases;
· Longest polio-free period ever since eradication efforts were launched - Number of reported Polio cases have reduced from 676 (2006) to 42 (2010) and only one (1) case during 2011 till date.
· The institutional deliveries in the country have increased from 47% (in DLHS-III -2007-08) to 72.9%, as per the Coverage Evaluation Survey (CES 2009).
· 70% case detection rate and 85% Cure rate have been achieved under Revised National Tuberculosis Programme; TB mortality in the country has reduced by 43%, from an estimated 42 per lakh population in 1990 to 24 per lakh population in 2009, and the prevalence of TB in the country has reduced by 67%, from 568 per lakh population in 1990 to 185 per lakh population.
· Adult HIV prevalence at national level has declined from 0.41% in 2000 to 0.31% in 2009. The estimated number of new annual HIV infections has declined by more than 50% over the past decade from 2.7 lakh new infections in 2000 to 1.2 lakh in 2009. The Free Anti-Retroviral Treatment programme was scaled up to 324 centres, and 4,48,860 patients are receiving free ART as of September 2011.
NEW INITIATIVES
· Closest ever to eradicating polio, the Ministry of Health and Family Welfare, Government of India decided to treat any fresh case of polio as a “public health emergency” in order to achieve polio eradication from India at the earliest. An Emergency Preparedness and Response Plan has been drawn up to intensify measures to build the immunity of children in all high risk areas and also to conduct intensive immunization campaigns rapidly in response to any polio cases if they occurred.
· New vaccines have been introduced - Hepatitis B vaccine and second dose of measles vaccine are now part of the Universal Immunization Programme. In 2011-12, Hepatitis B vaccine has been expanded in the entire country. Pentavalent, a combination vaccine against five diseases (Diphtheria, Pertussis, Tetanus, Hepatitis B and Haemophilus influenzae B) has been introduced on pilot basis in 2 States – Tamil Nadu and Kerala covering 15 lakh children. This ensures complete immunization against 5 diseases and also reduces the chances of an Adverse Event Following Immunization due to less injection load.
· New schemes for well being of mother and new born care - Janani Shishu Suraksha Karyakaram (JSSK), launched on 1st June, 2011, entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section. The initiative stipulates free drugs, diagnostics, blood and diet, besides free transport from home to institution, between facilities in case of a referral and drop back home. Similar entitlements have been put in place for all sick newborns accessing public health institutions for treatment till 30 days after birth. 32 of the 35 States and Union Territories have implemented the scheme. In the current financial year i.e. 2011-12, based on the request received from the States, funds to the tune of Rs 1437 crores have been approved for the States to implement the scheme.
· Mother & Child Tracking System (MCTS), an e-governance initiative of the Ministry of Health and Family Welfare, has registered 1,27,41,402 women as on 11.12.2011. The Mother and Child Tracking System (MCTS) is designed to collate information of all pregnant women and infants so as to ensure delivery of maternal and child health services from conception till 42 days after delivery in the case of pregnant women and up to five years of age in the case of children so as to ensure that all pregnant women and all new born receive full maternal and immunization services. The number of children registered in the system is 69,55,165, as on 11.12.2011.
· A Joint Mother and Child Health Card of MoHFW and MoWCD has been launched as a tool for documenting and monitoring services for antenatal, intranatal and postnatal care to pregnant women, immunization and growth monitoring of infants.
· From a modest figure of 7.39 lakhs pregnant women as beneficiaries in 2005-06, Janani Suraksha Yojana, achieved phenomenal success by providing cash assistance to nearly 113 lakhs pregnant women in 2010-11. Similarly, the financial expenditure under the scheme has increased manifold from Rs 38 crores in 2005-06 to Rs 1,618 crores in 2010-11.
· A new scheme incentivizing ASHAs for providing Home Based Newborn Care up to 42 days of life was launched. Home Based Newborn Care Operational Guidelines - 2011 were shared with the states. Special New Born Care Units (SNCUs) at First Referral Units/Distt HQs and Newborn Stabilisation Units (NBSUs) have been established to provide care to sick newborns. By end of October 2011, 293 SNCUs and 1134 NBSUs were made functional in the country.
· For management of children with Severe Acute Malnutrition, 480 Nutrition Rehabilitation Centres have been operationalized in the country till October 2011. Operational Guide Facility Based Management of Children with Severe Acute Malnutrition-2011 has been shared with the States in 2011.
· As part of the improvement of the menstrual hygiene among adolescent girls, particularly in tribal and rural areas, a new scheme for supply of sanitary napkins at subsidized rates has been introduced. In the first phase, nearly 1.4 million girls in the age group of 10-19 in 152 districts of 20 States are being covered.
· The Ministry launched schemes for home delivery of contraceptives by ASHAs at doorsteps of beneficiaries to improve access to contraceptive by the eligible couples on the occasion of World Population Day 2011. This initiative is being implemented on a pilot basis in 233 districts of 17 States.
· The Union Ministry of Health and Family Welfare asked the state authorities to ensure strict implementation of PC&PNDT Act. Ministry convened meetings of Ministers of Health, Health Secretaries and other senior officers from the 18 States where declining child sex ratio has been a matter of concern as apparent from the recent census figures. A multi-pronged strategy to check female foeticide, which includes legislative measures, awareness generation as well as programmes for socio-economic empowerment of women has been pursued - Central Supervisory Board (CSB) under the Act has been reconstituted; Act has been amended to provide for confiscation of unregistered machines and further punishment up to 3 years of imprisonment and fine up to Rs 50,000/; the National Inspection and Monitoring Committees (NIMC) intensified random field inspections of ultrasound clinics; MCI has been asked to develop accreditation guidelines for qualification and eligibility criteria for the doctors who can conduct ultrasound scans on pregnant women under the PC&PNDT Act; Medical Council of India has been directed to cancel registration of doctors convicted under PC&PNDT Act to curb malpractices
· For containment of epidemics and rapid response to disease outbreaks the Government decided to provide the services of epidemiologists in all district headquarters and state headquarters and entomologists and microbiologists in all state headquarters; of them so far 279 epidemiologists, 55 microbiologists and 22 entomologists have joined. The ongoing initiative of upgrading the National Institute of Communicable Diseases into National Centre of Disease Control with responsibility for enhanced capabilities for lab-based surveillance of communicable diseases and rapid response for minimizing the effects of disease outbreaks is a major development in this field.
· Under Integrated Disease Surveillance Programme, surveillance units have been established for effective disease surveillance and response system, at all state and district headquarters. Training of state/district surveillance teams has been completed in all states. Presently, more than 90% districts in the country report weekly surveillance data for epidemic prone diseases through e-mail/portal.
· A multi-pronged strategy to include safe water, sanitation, nutrition, community education, medical attention and rehabilitation, has been suggested to address the problem of Acute Encephalitis Syndrome / Japanese Encephalitis being reported from 135 districts of 17 States. A Group of Ministers (GoM) has been constituted to deliberate on these issues. A National Programme on prevention and control of AES/JE is being formulated with special emphasis on (i) public health measures (ii) expansion of JE vaccination in 62 new districts (iii) establishment of ICUs in 60 priority distts. GOI initiated JE vaccination programme for children between 1 and 15 yrs of age as an integral component of UIP. GOI has sanctioned additional amount of Rs 5.88 crores for upgradation of JE epidemic ward at BRD Medical College Gorakhpur.
· The Cabinet Committee on Economic Affairs approved the proposal of MoHFW for Intensified Malaria Control Project-II (IMCP-II) for seven North Eastern States (except Sikkim) under National Vector Borne Disease Control Programme with support from Global Fund for AIDS, TB and Malaria at an estimated cost of more than Rs. 400 crore.
· New DOTS logo was launched - “DOTS: Pura Course, Pakka Ilaaj” - signifies a response to the emerging challenges regarding tuberculosis and its manifestations in the form of multi-drug resistant TB (MDR-TB) and co-infection with HIV. MDR-TB services have been extended to 14 more states thus now covering 24 states. TB-HIV intensified package activities have been extended to 11 more states and now implemented in 22 states.
· 1st ever screening camp - Urban Slum Health Check Up Scheme for Diabetes and Blood pressure - organised in New Delhi in July 2011 under the National Programme for Prevention and Control of Cancer, Diabetes, Cardio Vascular Diseases and Stroke. Non Communicable Diseases’ Awareness was also the theme of the health pavilion at India International Trade Fair 2011 at New Delhi.
· New pictorial warnings notification for implementation for tobacco products packages was issued. Also rules for Cigarettes and other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) [second amendment rules] 2011 were notified. A mass media campaign on bidi smoking and its association with Cardio Vascular Diseases was also launched.
· A dedicated Geriatric OPD was opened in AIIMS under the National Programme for Health Care of Elderly. Guidelines for NPHCE were launched and National Institutes for Ageing to be set up at AIIMS Delhi and at Madras Medical College, Chennai.
· The Annual Health Baseline Survey was carried out during July, 2010 to March, 2011. The first set of data was released in the form of a State-wise bulletin. These indicators would provide requisite inputs for better planning of health programmes and pave the way for evidence based intervention strategies.
· The Transplantation of Human Organs Amendment Bill, 2011 was passed by both Houses of Parliament in the Monsoon Session (on 12th August, 2011 by the Lok Sabha and on 26th August, 2011 by the Rajya Sabha). The Bill received assent of Hon’ble President of India on 27th September, 2011 and the Amendment Act was published in the Official Gazette of India on 28th September, 2011.
· Ministry is formulating rules under the Clinical Establishments (Registration & Regulation) Bill for ensuring better health care services.
· The Union Cabinet approved the proposal for setting up of Central Procurement Agency (CPA) for Department of Health & Family Welfare. One-time budgetary support of Rs. 50 crore to enable establishment of CPA has been pledged.
· Model Accounting Handbooks for sub-district level finance/accounts personnel for systematizing accounting practices and guiding Sub Centers, CHCs/PHCs, Village Health and Sanitation Committees, Rogi Kalyan Samitis and Block level finance and accounts staff have been rolled out in the States for their day to day guidance.
· E-training modules on finance and accounts under NRHM have been rolled out in all States for help training and enhancing the financial management capacity of finance personnel at state, district and sub-district levels.
· E-Banking – E-transfers of funds under NRHM are being undertaken up to block level in all states countrywide. In the Ministry, these e-transfers are being effected using the accredited PSU bank of the Ministry. Utilization of funds under NRHM has increased from Rs. 3204.17 crore in 2005-06 to Rs. 16,137 crores in 2010-11.
· The official website of Office of the Chief Controller of Accounts, MoHFW was launched. The Website at http://www.ccahealth.gov.in hosts information related to Accounts including expenditure & receipts; Details of Grant-in-aid/Utilization Certificate making it easy at the click of the button to know the status of fund released and utilized.
Achievements of National Rural Health Mission
Health Infrastructure
· 594 District Hospitals, 2721 Community Health Centers (CHCs), 5459 Primary Health Centers (PHCs), and 31001 Health Sub-Centers have been taken up for new construction and upgradation/renovation.
· 8351 Primary Health Centers (PHCs) have been made functional 24x7 as compared to only 1262 in 2005.
· 2353 Health facilities which include District Hospital, Sub-District Hospital and community Health Centers are functioning as First Referral units (FRUs) as compared to 955 in 2005.
· 1834 Mobile Medical units are operating in different States providing services in the interior areas covering 444 districts.
Human Resources
· As on 30th September 2011, over 1.4 lakh Human Resources have been engaged across the country on contractual basis under National Rural Health Mission which includes- 66770 ANMs, 32850 Staff Nurses, 14273 Paramedics, 10897 AYUSH Doctors, 8640 Doctors, 2994 Specialists and 3857 AYUSH Paramedics.
System strengthening
· State and District Health Societies have been set up in all the State/UTs. Similarly, State Programme Management Units and Block Programme Management Units have been provided at the district and block level.
· Planning capacity at the district level has been strengthened and Intergraded District Health Action Plan has been prepared by 636 districts.
· Co-location of AYUSH doctors has been made in 15251 health facilities at PHC, CHC and Sub-District Hospitals.
Community Monitoring
· 29952 Rogi Kalyan Samitis have been registered in the health facilities upto PHC level. (A support of Rs. 5 lakh per DH, Rs. 1 lakh per CHC and Rs. 1 lakh per PHC are given.)
· A total of 4.97 lakh Village Health Sanitation & Nutrition Committees (VHSNCs) have been constituted and 4.27 lakh joint accounts at the Village Health and Sanitation Committees and 1.45 lakh at Sub-Centers opened.
· The Pradhan Mantri Swasthya Suraksha Yojana work is in full swing and the medical colleges are expected to be functional from academic session 2012-13 and hospital by 2013-14. The Residential complex at Jodhpur and Raipur has been completed and the work is in advanced stages at remaining sites except Bhubaneswar.
Medical Education
· Board of Governors of Medical Council of India reconstituted in May 2011.
· 21 new medical colleges have been established in 2011-12. A sum of Rs. 200 crore has been released to existing medical colleges in 2011-12 under the Up-gradation of colleges scheme. In 2011-12, a total number of 2350 PG seats and 4542 MBBS seats have also been added to the existing capacity. As on date, there are 335 medical colleges with more than 41569 MBBS and 21181 PG seats.
· A scheme for establishment of six colleges of nursing like AIIMS at the cost of Rs. 120 crores is under implementation.
· Under the National Mental Health Programme, Rs 470 crores have been allocated for Manpower Development through 11 Institutions of Excellence across the country, which will help produce 1,756 qualified mental health professionals annually.
· A scheme of Rs. 85 crore as financial assistance is under implementation for strengthening/up-gradation of pharmacy institutions across the country to conduct degree and PG courses.
· MoHFW set up a Task Force to frame curriculum for the Bachelor of Rural Health Care Course. The modalities if its implementation are being finalised.
· One year rotational, compulsory and paid internship was re-introduced in the Bachelor of Dental Surgery course. Accordingly now the tenure of the BDS Course is for a period of four years plus one year internship with effect from the academic year 2011-12 implemented in respect of the batches admitted from the year 2008-09.
· The National Commission for Human Resources for Health (NCHRH) Bill was tabled in Parliament to establish an overarching regulatory body for medical education and allied health sciences with a dual purpose of reforming the current regulatory framework and enhancing the supply of skilled manpower in the health sector. The proposed Commission would subsume the existing councils such as Medical Council of India, Dental Council of India, Nursing Council of India and Pharmacy Council of India.
Food regulation
· Food Safety and Standards rules were notified on 5th May 2011. Food Safety and Standards regulations were notified on 1st August 2011.With issuance of these notifications, the Food Safety and Standards (FSS) Act 2006 and Rules and Regulations made there under have come into force w e f 5th August 2011.
· The Food Safety and Standards Authority of India introduced online Licensing system for all the Food Business Operators who have an annual turnover of Rs 12 lakhs or more.
Drugs Regulatory Framework
· A 12 member Task Force formulated for Strengthening Drug Sector to evolve a long term strategy for addressing various issues faced by Indian Pharma Industry.
· Infrastructure strengthening - New office buildings for Zonal/Laboratories at Mumbai, Hyderabad, and Chandigarh have been set up. Pharmazone at Hyderabad Airport has been established.
· Enforcement of the drugs regulatory mechanism was made more effective. More than 100 import licenses were cancelled following cancellation of registration certificates due to submission non authentic GMP certificates; Conducted raids along with CBI in Tamil Nadu, Madhya Pradesh, Maharashtra to unearth spurious drugs; overseas inspections of manufacturing units started from May 2011.
· For Clinical Trials regulation 12 New Drug Advisory Committees and six Medical Device Advisory Committees were constituted.
· Every approval / permission for conducting clinical trials now includes a condition that in case of study related injury or death, applicant will provide complete medical care as well as compensation for the injury or death and statement to this effect should be incorporated in the informed consent form. Further in case of such injury or death, the details of compensation provided should be intimated to the office of DCG (I).
· Guidelines for conducting Clinical Trial inspection of site and sponsor /Clinical Research Organizations have been prepared and posted on CDSCO website.
· For approval of new drugs a system of pre-screening has been introduced to determine the acceptability of applications at the time of submission for manufacturing and marketing of fixed dose combinations.
· The National List of Essential Medicines (NLEM) 2011 containing 348 drugs was prepared. This was sent to the Department of Pharma for incorporation in the Drugs Price Control Order.
INTERNATIONAL PRESENCE
· India hosted the Twenty-ninth Health Ministers’ meeting of the Member States and partners in the South-East Asia Region and 64th Regional Committee Session of the South East Asian Region of the World Health Organisation in Jaipur. The ‘Jaipur Declaration’ adopted at the meeting, recognized that it is imperative that national governments accord utmost priority to hitherto neglected problem to preserve efficacy of the antimicrobial agents in our fight against microbial diseases.
· Sh Ghulam Nabi Azad led a High Level Delegation to United Nations Assembly’s special session on Prevention and Control of Non-Communicable Diseases with particular focus on developmental and other challenges and social and economic impacts, particularly for developing countries. India reaffirmed strong commitment to prevent and combat NCDs.
· India participated in the First Global Ministerial Conference on Healthy Lifestyles and Non-Communicable Disease Control held in Moscow in April where Mental Health issue was acknowledged as an important NCD at India’s instance.
· An International Conference-cum-Workshop on “Building Partnerships in Community Mental Health” was organized at National Institute of Health and Family Welfare, New Delhi.
· India was unanimously re-elected as the Chairperson of Partners in Population Development Forum, a South-to-South collaboration in the fields of reproductive health, population and development, for a further three year term.
DEPTT. OF AYUSH
· A Pharmacopoeia Commission for Indian Medicine was set up.
· Development of identity and quality standards of 256 Ayurveda, Siddha and Unani (ASU) and 92 homoeopathic drugs was done, including quality testing of 1342 ASU and 3709 homoeopathic samples during the 11th Plan.
· Chairs in Ayurveda and Unani were established in Charite, University of Western Cape, South Africa in 2011 to propagate the teaching of these systems.
· The Tele-homoeopathy services being implemented by the Department of AYUSH for providing essential health care through simple and safe Homoeopathic remedies in the remote part of the country was selected for the Best Jury Choice e-World award 2011 for e-Governance under the Public Private partnership category.
· For the first time, NSSO is collecting information on AYUSH in their 68th Round to be conducted from July 2011 to June 2012. This will give valuable insights into the extent of countrywide usage of A YUSH.
NATIONAL MEDICINAL PLANTS BOARD
· Supported cultivation of medicinal plants in 1,24,625.8 hectares - 74,142.8 hectares under the National Mission on Medicinal Plants and 50,483 hectares under Contractual Farming
· Vast network of ex-situ conservation established through 252 Herbal Gardens, 1798 School Herbal Gardens and 11420 Home Herbal Gardens
· NMPB supported Research Studies inter alia on Bioactivity guided fractionation studies; Sustainable harvesting; Post Harvest Management; Inter-cropping; Chemical and Molecular Profiling; Quality Planting Material
· Agro-techniques of 82 selected medicinal plants developed; 23 Facilitation Centres set up;
· Voluntary Certification for Quality Standards of Medicinal Plants finalised and Organic Certification of Medicinal Plants adopted
DEPTT. OF HEALTH RESEARCH
· Indian Council of Medical Research (ICMR) completed 100 years of its existence on 15th November, 2011. All through the year symposia and seminars were organized to reflect on the past and re-position the ICMR for future. ICMR also launched centenary fellowship and Shubash Mukherjee National Award for research contributions in the area of in vitro fertilization. To commemorate the contributions of ICMR Department of Posts, Ministry of Communications and Information Technology released a stamp on 8th November, 2011 at New Delhi. Further, Ministry of Finance released coins to acknowledge the contributions of ICMR on the concluding day on 15th Nov 2011.
· National Centre for Disease Informatics and Research, has been established at Bangalore by ICMR. This centre has the mandate to develop and sustain a national research data-base on cancer, diabetes, CVD and stroke through recent advances in electronic information technology with a national collaborative network, so as to undertake etiological, epidemiological, clinical and operational research on these diseases. It became functional on 15th September, 2011 with the holding of its first Scientific Advisory Committee.
· A new BSL IV laboratory, first of its kind in South Asia, has been established at Microbial Containment Complex, NIV Pune. This laboratory will enable the country to deal with any exotic and dangerous organism of medical importance.
· New viral and infectious disease laboratories at Chandigarh, Ranchi, Kolkatta have been approved during the year, these are in addition to labs approved last year at Lucknow, Jaipur, Bhubaneswar, Port Blair, Manipal, Trivandrum, Allapuzha and Raipur respectively.
· National Institute of Virology (ICMR, Pune) successfully identified the first ever reported case of human infection with Crimea Congo Hemorrhagic Fever.
· With the aim of improving the atmosphere for innovation and translation dedicated units in 26 ICMR Institutes and Headquarters have been established. During this period, ICMR continued to work programme to translate 75 such leads for development of new tools for vector control, diagnostic methods for various infectious diseases including dengue and chikunguniya, lung fluke, tuberculosis; new treatment methods to improve the treatment of tuberculosis, leprosy, cancer and many other conditions. Twenty of these technologies have become ready for application.
· New regimens for the treatment of Kala-Azar: During this period, results of clinical trials aimed at improving the treatment of Kalazar became available which are likely to lead to introduction of more user-friendly regimens in public health programme.
· A Vector Science Forum (involving different ICMR Institutes, National Vector Borne Disease Control, and other stake holders) became functional during the year. Joint programmes on research and action on vector control have been initiated.
· Introduction of Cholera vaccine into public health programmes: A heat killed oral cholera vaccine, whose trial was earlier carried out by ICMR’s NICED, at Kolkata is being introduced in cholera endemic areas of Orissa and West Bengal. Its pilot introduction in Cuttack was successful during 2011; this will now be extended by Govt of Odisha to its cholera endemic tribal districts.
· Diabetes Mellitus: Research programmes have been launched across the country to estimate the burden of diabetes and possible contributing factors. First phase of the programme has been completed during 2010. In 2nd phase, the studies have been initiated in North East States. The programme for the development of affordable diagnostic methods for diabetes, launched as initiative of HFM has gained momentum and ICMR has approved / is supporting 8 projects in the industry as well as academic institutions for this purpose.
· Tribal Health: A Tribal Health Research Forum, established in August 2010, became fully functional in 2011. This forum aims at synergising the research efforts of ICMR’s eight Institutes engaged in research on tribal populations.
DEPTT. OF AIDS CONTROL
· At the UN General Assembly special meeting for HIV/AIDS, India was acclaimed as a country with notable success in the AIDS programme. Recent HIV estimations highlight an overall reduction in adult HIV prevalence as well as new infections (HIV incidence) in the country, although variations exist across the states. Number of annual new HIV infections has declined by more than 50% during the last decade. This is one of the most important evidence on the impact of the various interventions under National AIDS Control Programme and scaled-up prevention strategies.
· Free Anti Retroviral Treatment programme was scaled up to 324 centres, and 4,48,860 patients are receiving free ART as of September 2011.
· Second line ART initiated in Centres of Excellence and more than 2,558 patients enrolled. NACO is supporting 1033 designated STI/RTI clinics and 90 new clinics been set up in 2010-11.
· Under the NACO-NRHM convergence, a joint operational framework has been prepared and standardized STI services are being operationlized with supply of color coded STI /RTI syndromic drug kits to all public sector health facilities and roll out of training through jointly developed training curriculum.
· National AIDS Control Organization to restart its ‘Red Ribbon Express’ on 12th January 2012 on the National Youth day to particularly focus on AIDS prevention, treatment and counselling efforts amongst the Youth. This would also be supplemented with Red Ribbon Buses. In its last runs the Red Ribbon Express had reached 182 stations covering over 80 lakh people across the country.
IMPROVED HEALTH INDICATORS:
As per latest data available:
· Infant Mortality Rate has come down to 50 in 2009 from 58 per 1000 live births
in the year 2005;
· Maternal Mortality Ratio has also come down to 212 per 100,000 live births
during 2007-09 from 254 per 100,000 live births in 2004-06;
· Total Fertility Rate has come down to 2.6 in 2009 from 2.9 in 2005;
· Under the Universal Immunization Programme (UIP) 61% of children aged
12-24 months in India are fully immunized against 6 vaccine preventable
diseases;
· Longest polio-free period ever since eradication efforts were launched - Number of reported Polio cases have reduced from 676 (2006) to 42 (2010) and only one (1) case during 2011 till date.
· The institutional deliveries in the country have increased from 47% (in DLHS-III -2007-08) to 72.9%, as per the Coverage Evaluation Survey (CES 2009).
· 70% case detection rate and 85% Cure rate have been achieved under Revised National Tuberculosis Programme; TB mortality in the country has reduced by 43%, from an estimated 42 per lakh population in 1990 to 24 per lakh population in 2009, and the prevalence of TB in the country has reduced by 67%, from 568 per lakh population in 1990 to 185 per lakh population.
· Adult HIV prevalence at national level has declined from 0.41% in 2000 to 0.31% in 2009. The estimated number of new annual HIV infections has declined by more than 50% over the past decade from 2.7 lakh new infections in 2000 to 1.2 lakh in 2009. The Free Anti-Retroviral Treatment programme was scaled up to 324 centres, and 4,48,860 patients are receiving free ART as of September 2011.
NEW INITIATIVES
· Closest ever to eradicating polio, the Ministry of Health and Family Welfare, Government of India decided to treat any fresh case of polio as a “public health emergency” in order to achieve polio eradication from India at the earliest. An Emergency Preparedness and Response Plan has been drawn up to intensify measures to build the immunity of children in all high risk areas and also to conduct intensive immunization campaigns rapidly in response to any polio cases if they occurred.
· New vaccines have been introduced - Hepatitis B vaccine and second dose of measles vaccine are now part of the Universal Immunization Programme. In 2011-12, Hepatitis B vaccine has been expanded in the entire country. Pentavalent, a combination vaccine against five diseases (Diphtheria, Pertussis, Tetanus, Hepatitis B and Haemophilus influenzae B) has been introduced on pilot basis in 2 States – Tamil Nadu and Kerala covering 15 lakh children. This ensures complete immunization against 5 diseases and also reduces the chances of an Adverse Event Following Immunization due to less injection load.
· New schemes for well being of mother and new born care - Janani Shishu Suraksha Karyakaram (JSSK), launched on 1st June, 2011, entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section. The initiative stipulates free drugs, diagnostics, blood and diet, besides free transport from home to institution, between facilities in case of a referral and drop back home. Similar entitlements have been put in place for all sick newborns accessing public health institutions for treatment till 30 days after birth. 32 of the 35 States and Union Territories have implemented the scheme. In the current financial year i.e. 2011-12, based on the request received from the States, funds to the tune of Rs 1437 crores have been approved for the States to implement the scheme.
· Mother & Child Tracking System (MCTS), an e-governance initiative of the Ministry of Health and Family Welfare, has registered 1,27,41,402 women as on 11.12.2011. The Mother and Child Tracking System (MCTS) is designed to collate information of all pregnant women and infants so as to ensure delivery of maternal and child health services from conception till 42 days after delivery in the case of pregnant women and up to five years of age in the case of children so as to ensure that all pregnant women and all new born receive full maternal and immunization services. The number of children registered in the system is 69,55,165, as on 11.12.2011.
· A Joint Mother and Child Health Card of MoHFW and MoWCD has been launched as a tool for documenting and monitoring services for antenatal, intranatal and postnatal care to pregnant women, immunization and growth monitoring of infants.
· From a modest figure of 7.39 lakhs pregnant women as beneficiaries in 2005-06, Janani Suraksha Yojana, achieved phenomenal success by providing cash assistance to nearly 113 lakhs pregnant women in 2010-11. Similarly, the financial expenditure under the scheme has increased manifold from Rs 38 crores in 2005-06 to Rs 1,618 crores in 2010-11.
· A new scheme incentivizing ASHAs for providing Home Based Newborn Care up to 42 days of life was launched. Home Based Newborn Care Operational Guidelines - 2011 were shared with the states. Special New Born Care Units (SNCUs) at First Referral Units/Distt HQs and Newborn Stabilisation Units (NBSUs) have been established to provide care to sick newborns. By end of October 2011, 293 SNCUs and 1134 NBSUs were made functional in the country.
· For management of children with Severe Acute Malnutrition, 480 Nutrition Rehabilitation Centres have been operationalized in the country till October 2011. Operational Guide Facility Based Management of Children with Severe Acute Malnutrition-2011 has been shared with the States in 2011.
· As part of the improvement of the menstrual hygiene among adolescent girls, particularly in tribal and rural areas, a new scheme for supply of sanitary napkins at subsidized rates has been introduced. In the first phase, nearly 1.4 million girls in the age group of 10-19 in 152 districts of 20 States are being covered.
· The Ministry launched schemes for home delivery of contraceptives by ASHAs at doorsteps of beneficiaries to improve access to contraceptive by the eligible couples on the occasion of World Population Day 2011. This initiative is being implemented on a pilot basis in 233 districts of 17 States.
· The Union Ministry of Health and Family Welfare asked the state authorities to ensure strict implementation of PC&PNDT Act. Ministry convened meetings of Ministers of Health, Health Secretaries and other senior officers from the 18 States where declining child sex ratio has been a matter of concern as apparent from the recent census figures. A multi-pronged strategy to check female foeticide, which includes legislative measures, awareness generation as well as programmes for socio-economic empowerment of women has been pursued - Central Supervisory Board (CSB) under the Act has been reconstituted; Act has been amended to provide for confiscation of unregistered machines and further punishment up to 3 years of imprisonment and fine up to Rs 50,000/; the National Inspection and Monitoring Committees (NIMC) intensified random field inspections of ultrasound clinics; MCI has been asked to develop accreditation guidelines for qualification and eligibility criteria for the doctors who can conduct ultrasound scans on pregnant women under the PC&PNDT Act; Medical Council of India has been directed to cancel registration of doctors convicted under PC&PNDT Act to curb malpractices
· For containment of epidemics and rapid response to disease outbreaks the Government decided to provide the services of epidemiologists in all district headquarters and state headquarters and entomologists and microbiologists in all state headquarters; of them so far 279 epidemiologists, 55 microbiologists and 22 entomologists have joined. The ongoing initiative of upgrading the National Institute of Communicable Diseases into National Centre of Disease Control with responsibility for enhanced capabilities for lab-based surveillance of communicable diseases and rapid response for minimizing the effects of disease outbreaks is a major development in this field.
· Under Integrated Disease Surveillance Programme, surveillance units have been established for effective disease surveillance and response system, at all state and district headquarters. Training of state/district surveillance teams has been completed in all states. Presently, more than 90% districts in the country report weekly surveillance data for epidemic prone diseases through e-mail/portal.
· A multi-pronged strategy to include safe water, sanitation, nutrition, community education, medical attention and rehabilitation, has been suggested to address the problem of Acute Encephalitis Syndrome / Japanese Encephalitis being reported from 135 districts of 17 States. A Group of Ministers (GoM) has been constituted to deliberate on these issues. A National Programme on prevention and control of AES/JE is being formulated with special emphasis on (i) public health measures (ii) expansion of JE vaccination in 62 new districts (iii) establishment of ICUs in 60 priority distts. GOI initiated JE vaccination programme for children between 1 and 15 yrs of age as an integral component of UIP. GOI has sanctioned additional amount of Rs 5.88 crores for upgradation of JE epidemic ward at BRD Medical College Gorakhpur.
· The Cabinet Committee on Economic Affairs approved the proposal of MoHFW for Intensified Malaria Control Project-II (IMCP-II) for seven North Eastern States (except Sikkim) under National Vector Borne Disease Control Programme with support from Global Fund for AIDS, TB and Malaria at an estimated cost of more than Rs. 400 crore.
· New DOTS logo was launched - “DOTS: Pura Course, Pakka Ilaaj” - signifies a response to the emerging challenges regarding tuberculosis and its manifestations in the form of multi-drug resistant TB (MDR-TB) and co-infection with HIV. MDR-TB services have been extended to 14 more states thus now covering 24 states. TB-HIV intensified package activities have been extended to 11 more states and now implemented in 22 states.
· 1st ever screening camp - Urban Slum Health Check Up Scheme for Diabetes and Blood pressure - organised in New Delhi in July 2011 under the National Programme for Prevention and Control of Cancer, Diabetes, Cardio Vascular Diseases and Stroke. Non Communicable Diseases’ Awareness was also the theme of the health pavilion at India International Trade Fair 2011 at New Delhi.
· New pictorial warnings notification for implementation for tobacco products packages was issued. Also rules for Cigarettes and other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) [second amendment rules] 2011 were notified. A mass media campaign on bidi smoking and its association with Cardio Vascular Diseases was also launched.
· A dedicated Geriatric OPD was opened in AIIMS under the National Programme for Health Care of Elderly. Guidelines for NPHCE were launched and National Institutes for Ageing to be set up at AIIMS Delhi and at Madras Medical College, Chennai.
· The Annual Health Baseline Survey was carried out during July, 2010 to March, 2011. The first set of data was released in the form of a State-wise bulletin. These indicators would provide requisite inputs for better planning of health programmes and pave the way for evidence based intervention strategies.
· The Transplantation of Human Organs Amendment Bill, 2011 was passed by both Houses of Parliament in the Monsoon Session (on 12th August, 2011 by the Lok Sabha and on 26th August, 2011 by the Rajya Sabha). The Bill received assent of Hon’ble President of India on 27th September, 2011 and the Amendment Act was published in the Official Gazette of India on 28th September, 2011.
· Ministry is formulating rules under the Clinical Establishments (Registration & Regulation) Bill for ensuring better health care services.
· The Union Cabinet approved the proposal for setting up of Central Procurement Agency (CPA) for Department of Health & Family Welfare. One-time budgetary support of Rs. 50 crore to enable establishment of CPA has been pledged.
· Model Accounting Handbooks for sub-district level finance/accounts personnel for systematizing accounting practices and guiding Sub Centers, CHCs/PHCs, Village Health and Sanitation Committees, Rogi Kalyan Samitis and Block level finance and accounts staff have been rolled out in the States for their day to day guidance.
· E-training modules on finance and accounts under NRHM have been rolled out in all States for help training and enhancing the financial management capacity of finance personnel at state, district and sub-district levels.
· E-Banking – E-transfers of funds under NRHM are being undertaken up to block level in all states countrywide. In the Ministry, these e-transfers are being effected using the accredited PSU bank of the Ministry. Utilization of funds under NRHM has increased from Rs. 3204.17 crore in 2005-06 to Rs. 16,137 crores in 2010-11.
· The official website of Office of the Chief Controller of Accounts, MoHFW was launched. The Website at http://www.ccahealth.gov.in hosts information related to Accounts including expenditure & receipts; Details of Grant-in-aid/Utilization Certificate making it easy at the click of the button to know the status of fund released and utilized.
Achievements of National Rural Health Mission
Health Infrastructure
· 594 District Hospitals, 2721 Community Health Centers (CHCs), 5459 Primary Health Centers (PHCs), and 31001 Health Sub-Centers have been taken up for new construction and upgradation/renovation.
· 8351 Primary Health Centers (PHCs) have been made functional 24x7 as compared to only 1262 in 2005.
· 2353 Health facilities which include District Hospital, Sub-District Hospital and community Health Centers are functioning as First Referral units (FRUs) as compared to 955 in 2005.
· 1834 Mobile Medical units are operating in different States providing services in the interior areas covering 444 districts.
Human Resources
· As on 30th September 2011, over 1.4 lakh Human Resources have been engaged across the country on contractual basis under National Rural Health Mission which includes- 66770 ANMs, 32850 Staff Nurses, 14273 Paramedics, 10897 AYUSH Doctors, 8640 Doctors, 2994 Specialists and 3857 AYUSH Paramedics.
System strengthening
· State and District Health Societies have been set up in all the State/UTs. Similarly, State Programme Management Units and Block Programme Management Units have been provided at the district and block level.
· Planning capacity at the district level has been strengthened and Intergraded District Health Action Plan has been prepared by 636 districts.
· Co-location of AYUSH doctors has been made in 15251 health facilities at PHC, CHC and Sub-District Hospitals.
Community Monitoring
· 29952 Rogi Kalyan Samitis have been registered in the health facilities upto PHC level. (A support of Rs. 5 lakh per DH, Rs. 1 lakh per CHC and Rs. 1 lakh per PHC are given.)
· A total of 4.97 lakh Village Health Sanitation & Nutrition Committees (VHSNCs) have been constituted and 4.27 lakh joint accounts at the Village Health and Sanitation Committees and 1.45 lakh at Sub-Centers opened.
· The Pradhan Mantri Swasthya Suraksha Yojana work is in full swing and the medical colleges are expected to be functional from academic session 2012-13 and hospital by 2013-14. The Residential complex at Jodhpur and Raipur has been completed and the work is in advanced stages at remaining sites except Bhubaneswar.
Medical Education
· Board of Governors of Medical Council of India reconstituted in May 2011.
· 21 new medical colleges have been established in 2011-12. A sum of Rs. 200 crore has been released to existing medical colleges in 2011-12 under the Up-gradation of colleges scheme. In 2011-12, a total number of 2350 PG seats and 4542 MBBS seats have also been added to the existing capacity. As on date, there are 335 medical colleges with more than 41569 MBBS and 21181 PG seats.
· A scheme for establishment of six colleges of nursing like AIIMS at the cost of Rs. 120 crores is under implementation.
· Under the National Mental Health Programme, Rs 470 crores have been allocated for Manpower Development through 11 Institutions of Excellence across the country, which will help produce 1,756 qualified mental health professionals annually.
· A scheme of Rs. 85 crore as financial assistance is under implementation for strengthening/up-gradation of pharmacy institutions across the country to conduct degree and PG courses.
· MoHFW set up a Task Force to frame curriculum for the Bachelor of Rural Health Care Course. The modalities if its implementation are being finalised.
· One year rotational, compulsory and paid internship was re-introduced in the Bachelor of Dental Surgery course. Accordingly now the tenure of the BDS Course is for a period of four years plus one year internship with effect from the academic year 2011-12 implemented in respect of the batches admitted from the year 2008-09.
· The National Commission for Human Resources for Health (NCHRH) Bill was tabled in Parliament to establish an overarching regulatory body for medical education and allied health sciences with a dual purpose of reforming the current regulatory framework and enhancing the supply of skilled manpower in the health sector. The proposed Commission would subsume the existing councils such as Medical Council of India, Dental Council of India, Nursing Council of India and Pharmacy Council of India.
Food regulation
· Food Safety and Standards rules were notified on 5th May 2011. Food Safety and Standards regulations were notified on 1st August 2011.With issuance of these notifications, the Food Safety and Standards (FSS) Act 2006 and Rules and Regulations made there under have come into force w e f 5th August 2011.
· The Food Safety and Standards Authority of India introduced online Licensing system for all the Food Business Operators who have an annual turnover of Rs 12 lakhs or more.
Drugs Regulatory Framework
· A 12 member Task Force formulated for Strengthening Drug Sector to evolve a long term strategy for addressing various issues faced by Indian Pharma Industry.
· Infrastructure strengthening - New office buildings for Zonal/Laboratories at Mumbai, Hyderabad, and Chandigarh have been set up. Pharmazone at Hyderabad Airport has been established.
· Enforcement of the drugs regulatory mechanism was made more effective. More than 100 import licenses were cancelled following cancellation of registration certificates due to submission non authentic GMP certificates; Conducted raids along with CBI in Tamil Nadu, Madhya Pradesh, Maharashtra to unearth spurious drugs; overseas inspections of manufacturing units started from May 2011.
· For Clinical Trials regulation 12 New Drug Advisory Committees and six Medical Device Advisory Committees were constituted.
· Every approval / permission for conducting clinical trials now includes a condition that in case of study related injury or death, applicant will provide complete medical care as well as compensation for the injury or death and statement to this effect should be incorporated in the informed consent form. Further in case of such injury or death, the details of compensation provided should be intimated to the office of DCG (I).
· Guidelines for conducting Clinical Trial inspection of site and sponsor /Clinical Research Organizations have been prepared and posted on CDSCO website.
· For approval of new drugs a system of pre-screening has been introduced to determine the acceptability of applications at the time of submission for manufacturing and marketing of fixed dose combinations.
· The National List of Essential Medicines (NLEM) 2011 containing 348 drugs was prepared. This was sent to the Department of Pharma for incorporation in the Drugs Price Control Order.
INTERNATIONAL PRESENCE
· India hosted the Twenty-ninth Health Ministers’ meeting of the Member States and partners in the South-East Asia Region and 64th Regional Committee Session of the South East Asian Region of the World Health Organisation in Jaipur. The ‘Jaipur Declaration’ adopted at the meeting, recognized that it is imperative that national governments accord utmost priority to hitherto neglected problem to preserve efficacy of the antimicrobial agents in our fight against microbial diseases.
· Sh Ghulam Nabi Azad led a High Level Delegation to United Nations Assembly’s special session on Prevention and Control of Non-Communicable Diseases with particular focus on developmental and other challenges and social and economic impacts, particularly for developing countries. India reaffirmed strong commitment to prevent and combat NCDs.
· India participated in the First Global Ministerial Conference on Healthy Lifestyles and Non-Communicable Disease Control held in Moscow in April where Mental Health issue was acknowledged as an important NCD at India’s instance.
· An International Conference-cum-Workshop on “Building Partnerships in Community Mental Health” was organized at National Institute of Health and Family Welfare, New Delhi.
· India was unanimously re-elected as the Chairperson of Partners in Population Development Forum, a South-to-South collaboration in the fields of reproductive health, population and development, for a further three year term.
DEPTT. OF AYUSH
· A Pharmacopoeia Commission for Indian Medicine was set up.
· Development of identity and quality standards of 256 Ayurveda, Siddha and Unani (ASU) and 92 homoeopathic drugs was done, including quality testing of 1342 ASU and 3709 homoeopathic samples during the 11th Plan.
· Chairs in Ayurveda and Unani were established in Charite, University of Western Cape, South Africa in 2011 to propagate the teaching of these systems.
· The Tele-homoeopathy services being implemented by the Department of AYUSH for providing essential health care through simple and safe Homoeopathic remedies in the remote part of the country was selected for the Best Jury Choice e-World award 2011 for e-Governance under the Public Private partnership category.
· For the first time, NSSO is collecting information on AYUSH in their 68th Round to be conducted from July 2011 to June 2012. This will give valuable insights into the extent of countrywide usage of A YUSH.
NATIONAL MEDICINAL PLANTS BOARD
· Supported cultivation of medicinal plants in 1,24,625.8 hectares - 74,142.8 hectares under the National Mission on Medicinal Plants and 50,483 hectares under Contractual Farming
· Vast network of ex-situ conservation established through 252 Herbal Gardens, 1798 School Herbal Gardens and 11420 Home Herbal Gardens
· NMPB supported Research Studies inter alia on Bioactivity guided fractionation studies; Sustainable harvesting; Post Harvest Management; Inter-cropping; Chemical and Molecular Profiling; Quality Planting Material
· Agro-techniques of 82 selected medicinal plants developed; 23 Facilitation Centres set up;
· Voluntary Certification for Quality Standards of Medicinal Plants finalised and Organic Certification of Medicinal Plants adopted
DEPTT. OF HEALTH RESEARCH
· Indian Council of Medical Research (ICMR) completed 100 years of its existence on 15th November, 2011. All through the year symposia and seminars were organized to reflect on the past and re-position the ICMR for future. ICMR also launched centenary fellowship and Shubash Mukherjee National Award for research contributions in the area of in vitro fertilization. To commemorate the contributions of ICMR Department of Posts, Ministry of Communications and Information Technology released a stamp on 8th November, 2011 at New Delhi. Further, Ministry of Finance released coins to acknowledge the contributions of ICMR on the concluding day on 15th Nov 2011.
· National Centre for Disease Informatics and Research, has been established at Bangalore by ICMR. This centre has the mandate to develop and sustain a national research data-base on cancer, diabetes, CVD and stroke through recent advances in electronic information technology with a national collaborative network, so as to undertake etiological, epidemiological, clinical and operational research on these diseases. It became functional on 15th September, 2011 with the holding of its first Scientific Advisory Committee.
· A new BSL IV laboratory, first of its kind in South Asia, has been established at Microbial Containment Complex, NIV Pune. This laboratory will enable the country to deal with any exotic and dangerous organism of medical importance.
· New viral and infectious disease laboratories at Chandigarh, Ranchi, Kolkatta have been approved during the year, these are in addition to labs approved last year at Lucknow, Jaipur, Bhubaneswar, Port Blair, Manipal, Trivandrum, Allapuzha and Raipur respectively.
· National Institute of Virology (ICMR, Pune) successfully identified the first ever reported case of human infection with Crimea Congo Hemorrhagic Fever.
· With the aim of improving the atmosphere for innovation and translation dedicated units in 26 ICMR Institutes and Headquarters have been established. During this period, ICMR continued to work programme to translate 75 such leads for development of new tools for vector control, diagnostic methods for various infectious diseases including dengue and chikunguniya, lung fluke, tuberculosis; new treatment methods to improve the treatment of tuberculosis, leprosy, cancer and many other conditions. Twenty of these technologies have become ready for application.
· New regimens for the treatment of Kala-Azar: During this period, results of clinical trials aimed at improving the treatment of Kalazar became available which are likely to lead to introduction of more user-friendly regimens in public health programme.
· A Vector Science Forum (involving different ICMR Institutes, National Vector Borne Disease Control, and other stake holders) became functional during the year. Joint programmes on research and action on vector control have been initiated.
· Introduction of Cholera vaccine into public health programmes: A heat killed oral cholera vaccine, whose trial was earlier carried out by ICMR’s NICED, at Kolkata is being introduced in cholera endemic areas of Orissa and West Bengal. Its pilot introduction in Cuttack was successful during 2011; this will now be extended by Govt of Odisha to its cholera endemic tribal districts.
· Diabetes Mellitus: Research programmes have been launched across the country to estimate the burden of diabetes and possible contributing factors. First phase of the programme has been completed during 2010. In 2nd phase, the studies have been initiated in North East States. The programme for the development of affordable diagnostic methods for diabetes, launched as initiative of HFM has gained momentum and ICMR has approved / is supporting 8 projects in the industry as well as academic institutions for this purpose.
· Tribal Health: A Tribal Health Research Forum, established in August 2010, became fully functional in 2011. This forum aims at synergising the research efforts of ICMR’s eight Institutes engaged in research on tribal populations.
DEPTT. OF AIDS CONTROL
· At the UN General Assembly special meeting for HIV/AIDS, India was acclaimed as a country with notable success in the AIDS programme. Recent HIV estimations highlight an overall reduction in adult HIV prevalence as well as new infections (HIV incidence) in the country, although variations exist across the states. Number of annual new HIV infections has declined by more than 50% during the last decade. This is one of the most important evidence on the impact of the various interventions under National AIDS Control Programme and scaled-up prevention strategies.
· Free Anti Retroviral Treatment programme was scaled up to 324 centres, and 4,48,860 patients are receiving free ART as of September 2011.
· Second line ART initiated in Centres of Excellence and more than 2,558 patients enrolled. NACO is supporting 1033 designated STI/RTI clinics and 90 new clinics been set up in 2010-11.
· Under the NACO-NRHM convergence, a joint operational framework has been prepared and standardized STI services are being operationlized with supply of color coded STI /RTI syndromic drug kits to all public sector health facilities and roll out of training through jointly developed training curriculum.
· National AIDS Control Organization to restart its ‘Red Ribbon Express’ on 12th January 2012 on the National Youth day to particularly focus on AIDS prevention, treatment and counselling efforts amongst the Youth. This would also be supplemented with Red Ribbon Buses. In its last runs the Red Ribbon Express had reached 182 stations covering over 80 lakh people across the country.
No comments:
Post a Comment