Professional Documents
Culture Documents
Swasth Hind Community Healthprovider Concept
Swasth Hind Community Healthprovider Concept
Swasth Hind Community Healthprovider Concept
[To provide the building bloc of developing curriculum and training module
for Community Health Providers- Middle level Health providers envisaged
under National health policy 2017 and NMC act 2019.]
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SUMMARY
DEVELOPMENT OF CURRICULUM AND TRAINING MODULE
FOR COMMUNITY HEALTH PROVIDERS –
Background
We need to congratulate the Health Ministry of GOI, for taking this bold
initiative to make an enabling provision in the NMC act for licensing the mid-
level Community Health Providers to strengthen the health systems and
primary health care in the remote areas in the country. This is a national need
which was waiting for emphatic action of Government of India for the last forty
years. We do hope that if this measure is implemented in its letter and spirit, it
will provide very solid foundation to the primary health care system on the
grass-root, enabling the more qualified health workforce to focus their
attention in provision of effective secondary and tertiary health care services.
There is need for community health experts to offer their services to assist the
Ministry and complement its efforts in this national endeavour.
Role –
The Community Health Provider will provide leadership to available community
health resources in the designated area – ASHA, ANMs and pharmacies,
supervisors, ICDS workers and informal health providers, VHSNC- PRI
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representatives.
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The focus of his/her action will be on health and wellness and prevention and
primary medical care of the chronic diseases ( Hypertension, diabetes, joint pain,
acidity and indigestion, anaemia, skin diseases, and others ). For the communicable
disease control and for Maternal and Child health services he will coordinate with
the district CMO and CHC and will provide the requisite support on the ground.
In all aspects of his work, he will activate the village residents and their local
committees to take lead in promoting positive health attitude and other life style
changes for primary and secondary preventive health action.
Responsibility
He/she will work under the overall supervision of the district CMO/ Medical
officer of CHC and will provide essential supervision for the health workforce in
the designated area. Qualitative surveys, prioritization in consultation with
community and a data based functional monitoring system will support this
supervision and results based accountable approach.
Selection
Preference will be given in the selection to young and middle aged educated
persons having hands on experience of health promotion at the village and
Grampanchayat level.
To enable motivated persons to gain right exposure and experience at the village
level health promotion work – provision will be made to run short certificate
courses of, say, 15 days duration, giving them the title of honorary health
animators ( purely voluntary). The incentive for them will be their probable
selection as mid- level provider licentiate course to enable them to practice as
community health providers.
Training
The formal training of Community Health Providers will be district based – for
one year with with hands on practical experience. There will be refresher trainings
of 15 days each year for the next three years. In addition this will be supported by
an element of distance education.
The training modules will be developed focusing on acquisition of functional
knowledge and skills. There will be provision for testing these within the class and
in the field.
A series of pilots will be run to validate the training content and methodologies.
A suitable program for training of trainers of community health providers will be
developed to enable to take the initiative to scale to meet the urgency of demand
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Data based
MIS and
Supervision of
ASHA and
ANMs and
others
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1 4
Self –
Health check up and Management Village&
Primary Health & 2 of Chronic Ward
Medical care Access to diseases –By level HMIS
Essential drugs / community
1. Positive health Community groups Patient
2. Family counselling Chest of Drugs Diabetes card and
3. Life style and /Anaemia register
At ward level
nutrition Old age care
and Gram Computeri
4. Treatment of Palliative care
panchayat level zed at
routine illnesses
PHC
5. Referral
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DETAILED PROJECT INFORMATION
1. Background
NATIONAL HEALTH POLICY 2017
11.4 Mid-Level Service Providers: For expansion of primary care from
selective care to comprehensive care, complementary human resource
strategy is the development of a cadre of mid-level care providers. This can be
done through appropriate courses like a B.Sc. in community health and/or
through competency-based bridge courses and short courses. These bridge
courses could admit graduates from different clinical and paramedical
backgrounds like AYUSH doctors, B.Sc. Nurses, Pharmacists, GNMs, etc and
equip them with skills to provide services at the sub-centre and other
peripheral levels. Locale based selection, a special curriculum of training close
to the place where they live and work, conditional licensing, enabling legal
framework and a positive practice environment will ensure that this new cadre
is preferentially available where they are needed most, i.e. in the under-served
areas.
This act was passed by the Parliament of India last month – which
supersedes the old MCI act. This act has made a provision for new
cadre of health workers at the middle level to be called Community
Health Workers. While this has been opposed by the IMA and other
association of doctors of modern, medical system, it has been
defended by the Health Minister in Parliament.
While further consultations are going to take place to operationalize the new
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The ambitious Ayushman Bharat initiative announced by GoI in this year’s Budget
Speech needs 1,50,000mid-level providers within the next 3-5 years to provide
comprehensive primary and preventive care.It will take 7-8 years to ramp up the
supply of doctors, therefore, in the interim we have no option but to rely upon
a cadre of specially trained mid-level providers who can lead the Health and
Wellness Centres.
of a medical doctor.
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7. Arrangent of referral for conditions like - skin problems, uterus
prolapse,psychiatric illness , congenital heart disease, correction of
refraction errors and dental problems.
VISION in LFA
NS OVI MOV RISKS
/ASSU
MPTIO
NS
SUPER GOAL
To develop a replicable model of
affordable rural primary health care (
including primary medical care)
focusing on prevention ( and early
detection and treatment) of
NCD/Chronic diseases of older age
group of population in Punjab
and treatment
To provide primary health ( and
primary medical ) care to residents 2. X% of residents doing regular
of villages in district of exercise and
4. x percent of patients of
Hypertension and y percent of
diabetes patients practice drug
adherence – reflected in the
stable levels
OUTPUT 1.1. Formation of ward level health
animation groups in x villages and
1. Community action for self- y wards
management of primary health 1.2. Community chest of drugs
and medical care established for x villages and y
2. Capacity building including wards
training and communication 2. Counselling and family therapy????
support for self- management 1.3. The formation of community
3. Provision of expert advise for health funds at ward and village
primary medical care at door step level
through mobile clinic 2.1. Induction and follow up training
/telemedicine programs organized for the 90
4. Special component on ward level groups and 18 village
community Action for health committees- including
Deaddiction VHNSCs)
2.2. Community groups enabled to
maintain their own records and
use these for focused action for
health improvement (Community
HMIS)
Outcome Indicators
Goal
1. The residents of the villages develop an attitude of positive health
2. Reduction in family discord through family therapy
3. Enhancement of happiness index
Purpose
1. Improvement from baseline in KAPs related to overall health and
management of priority diseases ( prevention and early detection and
treatment
2. X% of residents doing regular exercise and
3. y % improved nutrition ( including iron and vit D supplementation )
4. x percent of patients of Hypertension and y percent of diabetes patients
practice drug adherence – reflected in the stable levels
Output
1. Formation of ward level health animation groups in x villages and y wards
2. Community chest of drugs established for x villages and y wards
3. Counselling and family therapy????
4. The formation of community health funds at ward and village level
5. Induction and follow up training programs organized for the y ward level
groups and x village health committees- including VHNSCs)
6. Community groups enabled to maintain their own records and use these for
focused action for health improvement (Community HMIS)
7. Minimum 12 visit by medical doctor to each village in a year – total visits –
15
12X x
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8. Baseline health and disease data obtained and followed up ( Project HMIS)
2.2. PROPOSED INSTITUTIONAL MECHAMISM
OTHERS – IN FUTURE
To discuss the idea of community health fund in the SHGs meeting
To visit and inform the contiguous villages – identify at least three
villages for this purpose.
To consider playing the role of a community health provider including
health manager and leader
1 HHA ASHA
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Asha facilitator
Anganwadi worker
UPWARD LINKAGES
Ward level – HHA and community groups
Pind –village – village health committee/ VHNSC
Weekly mobile clinic
Collection and collation data
Training and mutual learning
Arranging referrals
Planning community campaigns
PHC- CHC – SMO / Block Extension Educator
Referral
Training support
Grant of funds and medicines for panchayat health activities
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1. Affordable primary medical care : The focus remains on the NCD and
old age care ( to include (i) wellness promotion, (ii) individual and family
counselling, (iii) nutrition and behaviour change and (iv) primary medical
care ( plus referral )
2. Provide clinical services for primary medical care – Twice and month in
each village -
3. Establish village heath committee and village health fund (with ward
based structure –having one health volunteer per ward )
4. Establish village level community pharmacy – with community chest of
drugs –in each ward
5. Training of HHAs and village health committee – technical , management
and governance
6. Link the project to Block level for referral CHC,
7. Sharing lessons with District MO, Punjab health mission and NHM
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1. Patient card
2. WARD BASED INFORMATION- ward HHA /
3. Information collected at weekly village clinic – Health committee-
VHSNC – patient attendance
4. Information from school / VDC meeting /MNREGA committee meeting
5. Cluster health manager
6. Information delivered to central office –
7. Key messages
8. Training programs
9. Posters and banners
10. Supply of drugs
Antihypertensive
Anti – diabetic
Analgesic –anti-inflammatory
Iron
Calcium and vit D
Eye /ear drop
Antibiotic
Bronchodilator
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2.3. TRAINING
2.3.1. COMPOSTION OF THE TEAM TO RUND THE PILOT
ROLE AND RESPONSIBILITY OF PILOT PROJECT
MANAGEMENT TEAM
TEAM
1. Health manager & Admin and Finance officer –
2. Weekly clinic doctor -1 –or More
3. Project health and Training coordinator -1 ––
4. MIS Manager and computer
5. pharmacy
6. identified Community health providers / Village Honorary health
animator- HHA
TRAINING CO-ORDINATOR at block level :
1. To work with Community Health Provider and HHAs to establish
Ward level health committees in villages and bring these together to
form a village health committee
2. To coordinate and participate in health education and training for the
honorary health animators / To ensure training of village level health
animators /To coordinate with village health animators
3. To maintain record of village health clinic / project health records –
village wise and project wise ( excel sheet to be developed)
4. To plan the maintenance of the village clinics
5. To take blood pressure and glucose reading – to ask health worker
to do the same – under his guidance
6. To make strategy and plan for community health fund
7. To establish contact with other health initiatives in payal block.
It will be essential for The project to begin with recruiting a qualified medical
practitioner. He should be on the seat almost regularly and provide primary
medical care and health education through regular village clinics in x villages
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2.3.2. SELECTION OF HONORARY HEALTH ANIMATORS FOR
TRAINING
WILLINGNESS TO PAY
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1. What was your health expenditure in this month
2. What was your health expenditure in last three months ?
3. Did you borrow money to pay for the expenditure – how much
4. How much you are ready to contribute per month for primary medical care in
the community – none – 100 per month – 500 per month
5. Will you be ready to contribute to health fund for the poor and needy who
have no capacity to pay – how much
2.3.4. पाठ्यक्रम
i.प्रशिक्षण का करिचय क
ii.कशिलिशििाक–क(करर्ू वकमेंकशियशिात्स काे कअिभु र्क)क
iii. कचीचकचयि क(कएि टोमीकऔचककचीचका कसञ्य ििक(कशििशिि ोकिोिीक)क
iv. मख्ु कशििम िच ोंका कशििद िकऔचककइि िका कप्रिंधकऔचकव् र्स्थ क
v. ग ाँर्ककाीकदर् ईकरेटीक–क
vi. ग ाँर्क/ग्र मकरंय तकका कअरि कहेल्थकिण्डक
vii. ग ाँर्क/ग्र मकरंय तकका कस्र् स्् कऔचकिीम चीका कसर्ेक/किीम चीकऔचकइि िका क
िचाॉडवक
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7 ख िक स्ाे िीिक
8 िचंगकर्मवक िंगिकइन्िे लकिकऑफ़कशिस्ािक
9 खगं क-सख ू ीकख ंसीक ड्र ईकाफ़क
10 खगं कऔचकचे क क एा टू कब्रोन्ा ईटीसक
11 दम क/कस ंसकिूिि क अस्थम कक
12 ाब्िक ाोन्स्टीरेकिक
13 िख्मक र्ंडु क
इन्वेस्िीगेशन – जाांच
1 ब्िडकप्रेकचक BP
2 ब्िडकसगु चक Blood sugar
3 त रम िकटेम्रचे यच temperature
4 खिू काीकम त्र -कहीमोग्िोशिििक HB
• vH;ax] ysiu] ukM+h 'kks/ku] _rq ladze.k] x`gxzkeokfVdk] iapxO;] miokl] fojspu] dYi]
iztuu ,oa izlo] rhFkZ] nku] gkse] lqxfa /k&nqxafZ /k] /kkj.kk] /;ku] lkewfgd mRlo esa Luku]
ysiu] enZu] olar ,oa o"kkZ esa u`R;] vkx ,oa ?kwi lsd a us dh fof/k] pkrqekZl dk [k;ky
vkfnA
• izd`friwtk nok&nk#
• euksfpfdRlk mUekn fuokj.k
• ;K] ri vkSj LokLF;
• ekfy'k jk[k ] rsy ;k ikmMj ls\ nareatu dk [ksy
• xq# ,oa fpfdRld dk varj
• ,dhd`r uke ,oa xq.k /keZ dk ,dh d`r Kku fdlds gd esa\
• ;ksx thou 'kSyh ;k fpfdRlk i)fr\
• vk;qosZn ,dek= vf/kdkjh ugha- ;g dkykrhr osn ugha] ns'k dky l;kis{k ra=
'kks/ku fØ;k;s&
a dq¡ty] usfr;k¡] feêh&iêh] xje& B.Mh lsd] ,fuek] dfVLuku] jh<+
Page
टनजी कौशल
नजरिया कौशल कौशल टवकास
ह ाँकमैंकाचकसातीकहाँ िेत्रत्र्क अरि कि ोकड ट कशििखिक
3. For each village panchayat – one or more community health animators –and /or
ASHA worker, anaganawadi worker and ANM will be fully train fro delivery of
primary health and medical care
4. At the level of each electoral ward in a gram panchayat – a community health
committee will be set up and a community chest of drug shall be provided, This
will enable the self-management of routine ailments by the community close to
their habitation and settlement.
5. The currently extant artificial division and boundaries between different systems
of medicines will be done away with – e,g, allopathy – ayurved –unani –
homeopathy and yoga and naturopathy. At each level of care, emphasis will be
on coordinates action amongst the practitioners of different systems of
medicine on the ground level.
6. The current tendencies of medical sciences, technology and knowledge systems
to become instruments of the corporate medical industrial complex /pharma
industry will be effectively controlled and prevented. The programs of
vaccination, treatment of HIV/AIDS and that of Hepatitis B and C etc. will be
suitably reviewed and amended. Similarly the Ayushman -2 scheme will be
totally overhauled.
7. For the promotion of health, emphasis will be made on public education for
health. This will be based on the proper coorination and integration of attiude
of positive health on the one hand and – including individual counselling, family
therapy, nutrition, life style and primary medical treatment on the other hand.
All decisions regarding the medical treatment of the patient shall be taken with
his participation in decision making and giving due space to his choice and
preferences.
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3.4. INFORMATION TO BE INCLUDED IN PATIENT CARD
FRONT PAGE – 1
तांदुरुस्ती जागरूकता
अच्छी सेहत औि प्राथटमक इलाज के टलए सीखना औि टसखाना
अच्छीकसेहतक–करहि कसख
ु कशििचोगीका क–कदिू कशििचकिेिकमेंकम क
स्र् स्् काीकच्षण क–किीम चीकसेकिय र्क–किीम चीका कतचु ं तकशििद िकऔचक
इि िक
Key health messages सबके टलए सन्देश
ब्लड प्रेशि की टनयटमत जाांच किवाएां औि टनयटमत दवाई लें
शूगि की टनयटमत जाांच किवाएां औि टनयटमत दवाई लें
िोज, टबना नागा एक्सिसाइज किें / उजाा सच ां ाि व्यायाम किें
िें शन को कम किें
अच्छी सेहत कायम किने के टलए औि बीमािी के इलाज के टलए एक दूसिे की मदद किें
इस कें द्र का मकसद आपकी अच्छी सेहत को कायम िखने में आपकी मदद किना है. साथ में बड़ी उम्र की कुछ
टबमारियों से कै से बचा जाये औि उनका प्रभावी इलाज कै से टकया जाए – इसकी व्यवस्था में आपकी मदद किना
है .अपनी देखभाल की टजम्मेदािी अपने ऊपि लेकि आप अच्छी सेहत कायम िख सकते हैं औि बहुत सािी
भयानक बीमारियों से बच सकते हैं. हमािे साप्ताटहक टवलेज टक्लटनक में डॉक्िि से टमलकि आप
Main complaints –
FINAL DIAGNOSIS –
C Regular use of
public/private health facility
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PAGE -2
________________________________________________________________
Residential address
________________________________________________________________
Investigation reports
PROVISIONAL DIAGNOSIS
PAGE -3
1. TESTS RECOMMENDED AND FOLLOW UP
1 HB
2 Blood Sugar –
Random
3 Blood Sugar –
HbA1C
4 Blood Pressure
5 Ultra sound
report / anyother
1. FINAL DIAGNOSIS
PROGRESS
SN DATE REMARKS
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Page 4-
1. TREATMENT RECOMMENDED
Sn DATE Treatment Number Special
recommended of days instructions
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Annex-3.5. : NCD survey in Punjab
Background
Efforts to assess the burden of non-communicable diseases risk factors has improved in low and
middle-income countries after political declarationof UN High Level Meeting on NCDs. However,
lack of reliable estimates of risk factors distribution are leading to delay in implementation of evidence
based interventions in states of India.
Methods
A STEPS Survey, comprising all the three steps for assessment of risk factors of NCDs, was
conducted in Punjab state during 2014–15. A statewide multistage sample of 5,127 residents, aged
18–69 years, was taken. STEPS questionnaire version 3.1 was used to collect information on
behavioral risk factors, followed by physical measurements and blood and urine sampling for
biochemical profile.
Results
Tobacco and alcohol consumption were observed in 11.3% (20% men and 0.9% women) and 15%
(27% men and 0.3% women) of the population, respectively. Low levels of physical activity were
recorded among 31% (95% CI: 26.7–35.5) of the participants. The prevalence of overweight and
obesity was 28.6% (95% CI: 26.3–30.9) and 12.8% (95% CI: 11.2–14.4) respectively. Central obesity
was higher among women (69.3%, 95% CI: 66.5–72.0) than men (49.5%, 95% CI: 45.3–53.7).
Prevalence of hypertension in population was 40.1% (95% CI: 37.3–43.0). The mean sodium intake in
grams per day for the population was 7.4 gms (95% CI: 7.2–7.7). The prevalence of diabetes
(hyperglycemia), hypertriglyceridemia and hypercholesterolemia was 14.3% (95% CI: 11.7–16.8),
21.6% (95% CI: 18.5–25.1) and 16.1% (95% CI: 13.1–19.2), respectively. In addition, 7% of the
population aged 40–69 years had a cardiovascular risk of ≥ 30% over a period of next 10 years.
Conclusion
We report high prevalence of risk factors of chronic non-communicable diseases among adults in
Punjab. There is an urgent need to implement population, individual and programme wide prevention
and control interventions to lower the serious consequences of NCDs.
Citation: Thakur JS, Jeet G, Pal A, Singh S, Singh A, Deepti SS, et al. (2016) Profile of Risk Factors
for Non-Communicable Diseases in Punjab, Northern India: Results of a State-Wide STEPS Survey.
PLoS ONE 11(7): e0157705. doi:10.1371/journal.pone.0157705
Editor: Hamid Reza Baradaran, Iran University of Medical Sciences, ISLAMIC REPUBLIC OF IRAN
Received: November 19, 2015; Accepted: May 8, 2016; Published: July 7, 2016
Copyright: © 2016 Thakur et al. This is an open access article distributed under the terms of
the Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting Information files.
Funding: National Health Mission, Punjab, India, JST. The funders had no role in study design, data
collection and analysis, decision to publish, or preparation of the manuscript.
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Competing interests: The authors have declared that no competing interests exist.
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ANNEX 3.6. EXECUTIVE SUMMARY OF PRI AND HFW PROGRAMMES
1. Background
1.1 Panchayats in India are an age-old institution for governance at village level.
Through the 73rd Constitutional Amendment, Panchayati Raj Institutions (PRI) were
strengthened with clear areas of jurisdiction, authority and funds. PRIs have been
assigned several development activities including health and population stabilization.
The Gram Sabha acts as a community level accountability mechanism to ensure that
the functions of the PRI respond to peoples needs.
1.2 Progress in engaging PRI has been uneven across states. While fiscal devolution
is a significant issue, lack of institutional modalities and clear guidelines on
PRI participation and variable capacity among PRI are key lacunae.
4.1 Critical Role of Panchayati Raj Institutions in the success of the National Rural
Health Mission
4.1.1 The National Rural Health Mission (NHM) is seen as a vehicle to ensure that
preventive and promotive interventions reach the vulnerable and marginalized
through expanding outreach and linking with local governance
institutions. PRIs are seen as critical to the planning, implementation, and
monitoring of the NHM. Implementation of the NHM in achieving its
outcomes is significantly dependent on well functioning gram, block and
district level panchayats. At the District level a District Health Mission will
coordinate NHM functions. Key to NHM success are: intersectoral
convergence, community ownership steered through village level health
committees at the level of the Gram Panchayat, and a well functioning
public sector health system with support from the private sector.
Committee (VHC) will form the link between the Gram Panchayat and the
community, and will ensure that the health plan is in harmony with the overall
local plan.
4.2.1 State legislatures have been behindhand in framing laws that endow
Panchayats with power and authority to enable their functioning. It has largely
been a matter of political will in each state and is governed by different
legislations, despite the central mandate. While PRI are mandated to carry
out health activities, they are not backed by the necessary policy/legal
framework, authority or fiscal commitments. Many centrally sponsored
schemes and others are implemented outside the purview of the panchayats,
thus keeping them out of the loop and undermining their credibility. Issues of
political patronage hamper functioning.
4.3 Enlisting NGO support in building capacity among PRI members to effectively
handle development related functions.
4.3.1 Capacity building of PRI is required in thematic areas and leadership skills,
negotiating, monitoring, ability to withstand patronage and political
interference. Capacity building processes need to be tailored to literacy levels,
sex and circumstances of PRI members.
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4.3.2 Joint orientation and sensitization meetings between PRI and health and
medical professionals could help to bridge the gap in education and social
strata. Developing Citizen Charter of Rights and Codes of conduct also lay
down guidelines for boundaries of operation and accountability.
4.4 Repealing penalties and disincentives such as the two child norm, which
violate individual rights and discriminate against womens participation in
panchayats.
4.4.1 Several states include disincentives in their population policies. The most
draconian is that which bars people who have more than two children
from holding office. Such policies are anti- women, threaten to undo the
good of a decades work in enabling women to participate in political
processes and violate womens freedom and individual rights. They feed son
preference actions such as sex selective abortions, pushing down an already
unfavorable sex ratio. There are cases of women being abandoned, the third
child given away or disowned, and consequent denial of the childs rights.
4.4.2 Policies and laws such as this need to be repealed or they might have serious
negative consequences for women and society at large. Population
stabilization is a function of womens empowerment, access to high quality RH
services and equal participation of men. PRIs should be encouraged to
support these interventions to further promote improved health.
Conclusion
There are enough portents to suggest that PRI engagement in improving key health
indicators will become a reality. However in order to expedite the process and to
make it more effective, consideration of key issues related to empowerment of
panchayats through funds, human resources and capacity are critical. PRI
engagement is perhaps the only existing mechanism to achieve large-scale
community participation and reach the marginalized and vulnerable, particularly
women, children, and the poor. Locating NHM functions within the gram panchayat
and implementing it through a village health committee/gram Sabha will f
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Government of India
Cabinet Committee on Economic Affairs (CCEA)
19-September-2018 13:25 IST
Cabinet approves ASHA Benefit Package
The Cabinet Committee on Economic Affairs, chaired by the Prime Minister Shri
Narendra Modi has given its ex-post facto approval to ASHA Benefit Package w.e.f.
October, 2018 (to be paid in November, 2018) with two components as under: -
The package entails an expenditure (Central funding) to Rs.1224.97 crore for two
years 2018-19 and 2019-20.
No of beneficiaries:
Details:
ASHAs and ASHA Facilitators meeting the age criteria of 18-50 years to be
covered under Pradhan MantriJeevanJyotiBimaYojana (Accident
insurance). The annual premium of Rs. 330 (average) will be paid by the
Central Government. Cover is for one-year period stretching from 1st June
to 31st May and benefit is Rs 2 Lakh in case of death due to any cause.
ASHAs will get a minimum of Rs.2000/- per month from current Rs 1000/- per
month as incentives for routine activities. This is in addition to other task
based incentives approved at Central/State level.
The existing institutional mechanisms for the National Health Mission would be
utilised to implement the proposed ASHA Benefit package.
Targets:
तांदुरुस्ती जागरूकता
अच्छी सेहत औि प्राथटमक इलाज के टलए सीखना औि टसखाना
o अच्छीकसेहतक–करहि कसख ु कशििचोगीका क–कदिू कशििचकिेिकमेंकम क
o स्र् स्् काीकच्षण क–किीम चीकसेकिय र्क–किीम चीका कतचु ं तकशििद िकऔचक
इि िक
o
साि –सक्ष
ां ेप कम्युटनिी हेल्थ प्रोवाइडि -
रहिेकNMCकएलटकमेंकसचा चकआ र्ु ेशिदाकऔचकआ षु कशिडग्रीकध चाोंकाोकMBBSकाे क
समा्षणकिि िेकाे कशििएकएाकशिब्रिकाोसवकि ि कय हकचहीकथी.कइसकआईशिड काोकअिक
ड्र रकाचकशिद कग कहैक(कआईकएमक् एकाे कदि र्कमेंक?क).क
ाम् शिु िटीकहेल्थकप्रोर् इडचका कआ षु कसेकाोईकशििंाकिहींकहै.कइसा कर ठ् क्रमक
सशिटवशििाे टकऔचका मकआधशिु िाकशियशिात्स करद्धशितकाे कअंतगवतकहीकहोग .क
क दकइसाोकआक कर्ाव चका किड़ करूरकाहकसातेकहैंकिेशिािकअभीकइसकि चे कमेंकाोईक
भीकशिि म र्िीकसचा चकिेकिहींकिि ईकहैक....कक दक ेकच ज् कसचा चोंकाे कऊरचकछोड़क
शिद कि गे क–क क ेकभीकआक कऔचकआगं िर् डीकाीकतचहकसेकएाकसेंट्रिकस्ाीमकहोक
सातीकहै.कल कइसाोकग्र मकरंय तकाे कस्तचकरचकचख कि एग क–क कसिक–कसेंटचक क
PHCक के भीकस्रिकिहींक–कर्ैतशििाकहोग क कअर्ैतशििाक–क के भीकस्रिकिहीं.क
मेच कशिर्य चकसिसेकरहिेकहैकशिाकहमाोकग ाँर्क/र् डवकस्तचकरचकएाकहेल्थकएशििमेटचकय शिहएक
–कअभीकआक कमेचीकि िा चीकमेंकग्र मककरंय तकस्तचकरचकहैक–कशििसाीकआि दीकऔचक
्षणेत्रििकअिगकअिगकच ज् ोंकमेंकअिगकअिगकहोकसात कहै.कइसशििएकएाकआक क
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अप्र वप्तकहै.कहेल्थकएशििमेटचकाोकअर्ैतशििाकिि कि कसात कहैकऔचकउसाोकइसं ेंशिटर्क
ाीकव् र्स्थ कहोकसातीकहैक–कसम िकाे कद्व च क.
इिाे कसप्रु ेशिर्सिकऔचकम गवदकविकाे कशििएकPHCककस्तचकरचकएाकडॉलटचक/क काम् शिु िटीक
हेल्थकिसवक/क काम् शिु िटीकहेल्थकप्रोर् इडचकहोकसात कहैक–क के एाकसंभ शिर्तकतचीा कहोक
सात कहै.क के व् र्स्थ क–कर् डवकस्तचकरचकहेल्थकएशििमेटचकाीकअिरु शिस्तशिथकमेंकसििकिहींक
होगी.किकहीकहेल्थकएशििमेटचकाीकव् र्स्थ क–कPHCकसप्रु ेशिर्ििकाे कअभ र्कमेंकसििक
होगी.क
मेचीकप्रस्तशिु तकमेंकमेंकिोचकइिाीकचोिकएंडकचे स्रोशिन्सशििशिितीिकरिचभ शिषतकाचिेका कहै.क
इसाे कअि र् कप्रशिक्षण काीकशिर्शिधका कहैक–कशििसमेंकरसवििकशिस्ाल्सकाीकिहुतकिड़ीक
भशिू मा कहै,कशििसा कआक कर्ाव सवकाीकट्रेशििंगकमेंकरू वकअभ र्कचह कहै.क
र् डवकमेम्िचक-1 HHA -1
र् डवकमेम्िचक -2 HHA-2
र् डवकमेम्िचक -3 HHA-3
र् डवकमेम्िचक-4 HHA-4
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र् डवकमेम्िचक-5 HHA-5
र् डवकमेम्िचक-6 HHA -6
र् डवकमेम्िचक -7 HHA -7
सीखने के मुद्दे
LokLF; dk vk/kkj
gj balku LoLFk jguk pkgrk gSA lexz LokLF; dk rkRi;Z 'kkjhfjd] ekufld] oSpkfjd
,oa HkkoukRed LoLFkrk ls gSA FkksM+k /;ku nsus ij ;g le> esa vkrk gS fd jksx ds
eq[;r% nks dkj.k gSa
igyk&ekufld ruko] thus esa my>usa] fj'rkas esa erHksn] eueqVko] bZ";kZ&}s"k vkfnA
nwljk&gekjs [kku&iku] jgu&lgu esa dfe;k¡] fnup;kZ esa 'kkjhfjd Je&O;k;ke
,oa lkQ gok&ikuh dk vHkko] [kkuk&ihuk ,oa lksuk bR;kfn lgh le; ij u
gksuk A
LoLFk jgus ds ewy esa lq[kiwoZd thus dh lgh le> vkSj volj vko';d gSA lHkh ds
fy, ;g tkuuk vko';d gS fd euq"; ds thou dk D;k iz;kstu gS vFkkZr ge D;ksa ft;sa
vkSj dSls ft;sa\ vius lHkh fj'rksa ¼lac/a kks½a esa ,d nwljs ls gekjh D;k vis{kk,¡ gaS vkSj mUgsa
iwjh djus dh ;ksX;rk geesa dSls fodflr gks\ 'ks"k izÑfr ds lkFk gekjk D;k laca/k gS
vkSj izkÑfrd fu;eksa ,oa pØh;& vkorZu'khy O;oLFkk dks igpku dj ge viuh 'kkjhfjd
vko';drkvkas dh iwfrZ dSls djsa\ bUgha lokyksa ds loZekU; mÙkjkas dk feyuk gh lq[k dh
igpku gSA 'kjhj dh lnqi;ksfxrk ds fcuk LokLF; ifjHkkf"kr gh ugha gksrk gSA ru
LoLFk gks blds fy, eu%LoLFkrk Hkh vko';d gSA fujksxh 'kjhj dk lq[k rHkh fey ikrk
gS tc eu LoLFk gksA vHkh ekuo HkkSfrd lk/kuksa vkSj laosnukvksa esa lq[k [kkst jgk gS] bl
çfØ;k esa eu o 'kjhj nksuksa dk LokLF; xM+cM+k tkrk gSA LokLF; ds fy, tks la;e
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'kjhj&'kks/kd o ey fu"dkld
1. गााँव में िहने वाले प्रत्येक व्यटि का अटधकाि है टक एक टडग्री प्राप्त योग्य टचटकत्सक के द्वािा
उसका मेटडकल जाांच हो औि उसका मेटडकल काडा में उस जाांच को रिकॉडा टकया जाए
49
टजससे उसको अपनी सेहत औि बीमािी के बािे में सही जानकािी हो. टवशेषकि मटहलाओ ां
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औि बुजुगों के टलए –हिेक के टलए – ये जाांच होना जरूिी है – ब्लड प्रेशि; ब्लड सुगि ; औि
खून में हीमोग्लोटबन
2. हि व्यटि को टनयमटत कसित किने के टलए - जीवन शेली के रूप में इसे अपनाने के टलए –
टशटक्षत औि प्रेरित किने की जरूित है. प्रत्येक व्यटि को कम से कम २० टमनि कसित किने
का टनयम बनाना चाटहए. कसित का तिीका उसकी व्यटिगत रूटच के अनुरूप हो सकता है.
इसमें प्राणायाम औि आसन का उटचत समावेश उपयोगी है. इसको टदन के अलग अलग
समय में िुकड़ों में भी टकया जा सकता है.
3. इसके साथ कुछ टवशेस टबमारियों के टलए – कमि की माांसपेटशयों को मजबतू किने के टलए
– एक्स्तेंसि मसल एक्स्सटसासे – औि घुिनों के ददा के टलए पिे ल्ला स्रे टचांग एक्सिसाइज; औि
गदान के ददा या तथा कटथत सवााइकल पैन के टलए – गदान की माांसपेटशयों के टलए प्रेशि
एक्सिसाइज - सीखना औि किना आवश्यक है.
4. इलाज के टलए आने वाले लगभग सभी परिवािों औि व्यटियों द्वािा िें शन की समस्या का
टजक्र टकया जाता है – इसको आगे औि समझने की जरूित है.
5. इसके साथ ही – कुछ क्रोटनक टबमारियों के टनयटमत इलाज की व्यवस्था भी जरूिी है –
इसके साथ इन टबमारियों के कािण औि इलाज की दवाइयों के बािे में जरूिी जानकािी औि
टशक्षण भी मिीज को देना जरूिी है. इसके आधाि पि ही ये सटु नटित टकया जा सकता है टक
मिीज अपनी दवाई को टनयटमत लेगा औि अपनी जीवन शेली में आवश्यक् परिवतान स्थाई
तौि से किे गा – इसमें – खून की कमी, ब्लड शुगि औि ब्लड प्रेशि तथा जोड़ों औि शिीि की
माांसपेटशयों में ददा प्रमुख है
6. प्रत्येक टपांड में एक दवाई की पेिी िखी जानी चाटहए टजसमें कुछ आवशयक दवाइयों को
टनयटमत तौि से िखा जाए औि जो दवाइयाां समाप्त हो जाएाँ उनको तुिांत सप्लाई की जाय
7. अगि गााँव के लोगों को सेहत् में सुधाि औि बीमािी के इलाज के टलए सही जानकािी दी जाए
तो वे इसको अपनाने के टलए तैयाि हैं – जैसे अपनी जाांच किवाना – दवाई टनयम से लेना –
योग इत्यटद कसित किना. इसके टलए वे अपनी जानकािी बढाने, नया सीखने औि जीवन में
बदलाव लाने के टलए तैयाि हैं
8. गााँव में डॉक्िि के सापताटहक टवटजि के पूिक के रूप में एक टशटक्षत मटहला की पहचान
किके उसको हेल्थ एटनमेिि के रूप में रे टनांग किना – ये एक आवश्यक कदम है
9. कुछ टवशेष टबमारियों के टलए िे फिल की व्यवस्था बनाना - टस्कन की बीमारियााँ; बच्चेदानी
का बाहि आना; मानटसक िोग; टदल में बचपन से छे द; आाँखों में चश्मा लगवाना; दाांतों की
बीमािी
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स्वस्थ टहन्द के टलए िाटररय दृटि
1. रचू े कदेककाे कशििए,ककएाकअशिधा चकप्र प्तकस्र् त्तकस्र् स्् कसेर् कशििगमकस्थ शिरतकशिा कि एग .कक
इसाीकमख्ु कशििम्मेद चीक–कसमन्र् काचिेकऔचकशिर्शिभन्िकस्र् श्थ् कऔचकशियशिात्स कसस्ं थ शििंकाीक
िर् िकदेशिहकाीकहोगी.क
2. प्रत् ाे कशिििेकमेंकसम िकाे कशिर्त्ती ककसह ोगकऔचक ोगद िकसेकएाकहेल्थकिण्डकाीकस्थ रि क
होगी.कस मदु शि ाकस्र् स्् काें द्रककऔचकशििि कअस्रत िकाीकव् र्स्थ काोकरू वकसदृु ढ़कशिा क
ि ग .कक
3. प्रत् ेाकग्र मकरंय तककमेंकएाकसेकअशिधाकस्र् स्् का ा व त वक–कआक ,कआगं िं कर् ड़ी, एएिक
एमक् ाोकप्र थशिमाकस्र् स्् कऔचकइि िककाे क्षणेत्रकमेंकरू कव प्रशिकशि्षणतकशिा कि एग क–काम् शिु िटीक
हेल्थकप्रोर् इडचक/कआिचे चीकहेल्थकएशििमेटचक
4. प्रत् ेाकर् डवकाे कस्तचकरचकएाकर् डवककस्र् स्् -कसगं तककऔचकएाकाम् शिु िटीकयेस्टकऑफ़कड्रग्सकाीक
स्थ रि काीकि ेगीक–कशििससेक८०कप्रशितकतकशििम िच ोंका कइि िकग ाँर्कमेंकिस र्टकाे कइदवकशिगदवक
हीकसंभर्कहोकसाे क
5. र्तवम िकमेंकशिर्शिभन्िकशियशिात्स ककरद्धशित ोंकाे काृशित्रमकशिर्भ ििकाोकसम प्तकाचकशिद कि ग .क–क
एिॉरथीक–कआ र्ु ेद/क िू िीकक–कहोशिम ोरैथी-कप्र ाृशिताकशियशिात्स कऔचक ोग.कप्रत् ेाकस्तचक
रचकशिर्शिभन्िककशियशिात्स ककरध्हशित ोंकऔचकउिाे कशियशिात्साोकाे कआरसीकसमन्र् करचकिोचकशिद क
ि एग .कक
6. मेशिडािकस इसं , तािीाकऔचकज्ञ िकतंत्रकाे काॉरोचे टकि म वक-कउद्योगकाे कअिगु मीकिििेकरचक
चोाकिग ीकि गी.ककटीा ाच , हेरेट इशिटसकिक–कसक, औचककएयकआईकर्ीककसंक्रम कऔचक
इि िकाे कशिर्ष ोंकरचकआध चभतू करिु शिर्वय चकशिा कि ग .कइसीकप्रा चक–कआ ष्ु म िक-२क
ा ेक्रमकाीकरचू ीकतचहकसेकरिु चव यि काीकि ेगी.कक
7. स्र् स्् काे कसर्धविकाे कशििएकिोाकशिक्षण ककरचकिोचकहोग कऔचकइसमेंक–करॉशििशिटर्कहेल्थक–क
ा उंसशििंगकएर्ंकिॅ शिमिीकथेचेरी, रोष , िीर्िकैिीकऔचकप्र थशिमाकइि िका कउशियतक
समिव् कहोग .ककइि िकसम्िन्धीकसभीकशिि व ोंकमेंकमचीिकाीकच कऔचकउिाीकप्र थशिमात ओकं
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ा कउशियतकसम र्ेककाचिेकरचकििकशिद कि एग .क
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