Health sector interventions in Gujarat (Also available on CD)
Roychowdhury, Devashree
Health sector interventions in Gujarat (Also available on CD) - 2011 - iii,3,viii,137p.,CD-ROM
CONTENTSDEDICATION i ACKNOWLEDGEMENT ii LIST OF TABLES, MAPS AND GRAPHS iii EXECUTIVE SUMMARY vii 1: INTRODUCTION 1.1 STATEMENT OF PURPOSE 2 1.2 AIM 4 1.3 OBJECTIVES 4 1.4 METHODOLOGY 5 1.5 LITERATURE REVIEW 7 1.5.1 HEALTH 7 1.5.2 HEALTH DISPARITY 8 1.5.3 FACTORS AFFECTING HEALTH STATUS 10 1.5.4 HEALTH SYSTEM IN INDIA .10 1.5.5 RURAL HEALTH SYSTEM 13 1.5.6 HEALTH POLICY 14 1.5.7 HEALTH PLANNING 14 1.5.8 HEALTH FOR ALL 15 1.5.9 HEALTH AND DEVELOPMENT 16 1.5.10 HEALTH SITUATION IN INDIA 16 1.5.11 HEALTH SITUATION IN GUJARAT 17 1.5.12 MATERNAL HEALTH 17 1.5.13 REFERRAL SYSTEM FOR EmOC 18 1.6 SUMMARY 19 2: HEALTH SCENARIO IN GUJARAT: GOVERNMENT POLICIES AND PPP MODELS 2.1 OVERVIEW OF HEALTH SITUATION IN GUJARAT 21 2.1.1 DEMOGRAPHY 1 2.1.2 HEALTH INFRASTRUCTURE 22 2.1.3 SPATIAL DISTRIBUTION OF PHC'S IN GUJARAT 23A 2.2 NATIONAL RURAL HEALTH MISSION (NRHM) 23 2.2.1 INTRODUCTION 23 2.2.2 PROGRESS OF NRHM 23 2.2.3 INSTITUTIONAL FRAMEWORK 23 2.2.4 INFRASTRUCTURE 24 2.2.5 HUMAN RESOURCES .24 2.2.6 SERVICES 24 2.2.7 RCH FLEXIBLE POOL 25 2.3 CHIRANJEEVI YOJANA 25 2.3.1 BALSAKHA YOJANA 27 2.4 RASHTRIYA SWASTHYA BIMA YOJANA (RSBY) .27 2.5 EMERGENCY MANAGEMENT AND RESEARCH INSTITUTE (EMRI 108) 28 2.5.1 VISION 2011 29 2.5.2 ACCESSIBILITY OF EMRI 108 IN INDIA 30 2.5.3 AMBULANCE DISTRIBUTION IN VARIOUS STATES31 2.5.4 EMRI 108 IN GUJARAT 31 2.6 BUDGET 32 2.6.1 MEDICAL AND PUBLIC HEALTH 32 2.6.2 INSTITUTIONAL DELIVERY 33 2.6.3 CHIRANJEEVI YOJANA (CY) 33 2.6.4 RASHTRIYA SWASTHYA BIMA YOJANA (RSBY) 34 2.6.5 EMRI 10834 2.7 SUMMARY 35 3: STATE OF HEALTH IN BARODA: ANALYSIS OF HEALTH INDICATORS 3.1 SELECTION CRITERIA FOR PRIMARY CASE-STUDY 38 3.1.1 FULL ANTENATAL CHECKUP DISTRICTWISE 39 3.1.2 INSTITUTIONAL DELIVERY DISTRICTWISE 39 3.1.3 FULL IMMUNIZATION COVERAGE OF CHILDREN AGED 12-23 MONTHS.40 3.1.4 CONTRACEPTIVE PREVALENCE RATE FOR ANY METHOD 40 3.2 STUDY DESIGN AND SAMPLE SELECTION WITHIN BARODA DISTRICT 41 3.3.1 ADMINISTRATIVE STRUCTURE 42 3.3.2 DISTRICT HEALTH FACILITIES 42 3.3.3 HEALTH INFRASTRUCTURE IN BARODA .43 3.3.4 IMPORTANT STATISTICS 44 3.4 DISTRICT ANALYSIS 2006-2009 44 3.4.1 MATERNAL HEALTH 44 3.4.2 CHILD HEALTH 49 3.4.3 FAMILY PLANNING 52 3.5 SUMMARY 55 4: REVIEW OF NRHM IMPLEMENTATION IN GUJARAT: SECONDARY CASE- STUDIES OF SURAT AND BANASKANTHA DISTRICTS 4.1 INTRODUCTION 57 4.2 METHODOLOGY AND STUDY DESIGN 57 4.3 SAMPLE DESIGN 57 4.4 KEY FINDINGS 58 4.5 INFERENCES 62 4.6 SUMMARY 63 5: UNDERSTANDING OF IMPLEMENTATION OF NRHM: A CASE-STUDY OF BARODA DISTRICT 5.1 ROLE OF DISTRICT HOSPITAL 65 5.2 ROLE OF COMMUNITY HEALTH CENTRE (CHC) 73 5.3 ROLE OF PRIMARY HEALTH CENTRE (PHC) 84 5.4 ROLE OF SUB CENTRE (SC) 93 5.5 ROLE OF ASHA WORKERS 101 5.6 ROLE OF GRAM PANCHAYAT SITUATION 104 5.7 STATE OF INDOOR/OUTDOOR PATIENTS 107 5.8 CHIRANJEEVI YOJANA ANALYSIS AND INFERENCES 116 5.9SUMMARY 117 6: PERFORMANCE OF GUJARAT IN RELATION TO OTHER STATES OF INDIA: COMPARISON OF BASIC INDICATORS 6.1 INTRODUCTION 120 6.2 FULL ANTENATAL CHECKUP BY STATES, DLHS 2 & 3 120 6.3 INSTITUTIONAL DELIVERY BY STATES, DLHS 2 & 3 121 6.4 FULL IMMUNIZATION COVERAGE, DLHS 2 & 3 122 6.5 CONTRACEPTIVE PREVALENCE RATE FOR ANY METHOD, DLHS 2 & 3 123 6.6 COMPARISION OF BASIC INDICATORS BETWEEN STATES OF INDIA 123A 6.7 SUMMARY 124 7: CONCLUSION AND RECOMMENDATIONS INTRODUCTION 126 7.2 POLICY RECOMMENDATIONS FOR NRHM BASED ON PRIMARY STUDY 127 7.3 NRHM BASED ON SECONDARY STUDY - MACRO LEVEL 129 7.4 SUMMARY OF ISSUES, CHIRANJEEVI YOJANA 130 7.5 POLICY RECOMMENDATIONS FOR REPLICABILITY OF CHIRANJEEVI YOJANA 131 BIBLIOGRAPHY 134
P TH-1244 / ROY
Health sector interventions in Gujarat (Also available on CD) - 2011 - iii,3,viii,137p.,CD-ROM
CONTENTSDEDICATION i ACKNOWLEDGEMENT ii LIST OF TABLES, MAPS AND GRAPHS iii EXECUTIVE SUMMARY vii 1: INTRODUCTION 1.1 STATEMENT OF PURPOSE 2 1.2 AIM 4 1.3 OBJECTIVES 4 1.4 METHODOLOGY 5 1.5 LITERATURE REVIEW 7 1.5.1 HEALTH 7 1.5.2 HEALTH DISPARITY 8 1.5.3 FACTORS AFFECTING HEALTH STATUS 10 1.5.4 HEALTH SYSTEM IN INDIA .10 1.5.5 RURAL HEALTH SYSTEM 13 1.5.6 HEALTH POLICY 14 1.5.7 HEALTH PLANNING 14 1.5.8 HEALTH FOR ALL 15 1.5.9 HEALTH AND DEVELOPMENT 16 1.5.10 HEALTH SITUATION IN INDIA 16 1.5.11 HEALTH SITUATION IN GUJARAT 17 1.5.12 MATERNAL HEALTH 17 1.5.13 REFERRAL SYSTEM FOR EmOC 18 1.6 SUMMARY 19 2: HEALTH SCENARIO IN GUJARAT: GOVERNMENT POLICIES AND PPP MODELS 2.1 OVERVIEW OF HEALTH SITUATION IN GUJARAT 21 2.1.1 DEMOGRAPHY 1 2.1.2 HEALTH INFRASTRUCTURE 22 2.1.3 SPATIAL DISTRIBUTION OF PHC'S IN GUJARAT 23A 2.2 NATIONAL RURAL HEALTH MISSION (NRHM) 23 2.2.1 INTRODUCTION 23 2.2.2 PROGRESS OF NRHM 23 2.2.3 INSTITUTIONAL FRAMEWORK 23 2.2.4 INFRASTRUCTURE 24 2.2.5 HUMAN RESOURCES .24 2.2.6 SERVICES 24 2.2.7 RCH FLEXIBLE POOL 25 2.3 CHIRANJEEVI YOJANA 25 2.3.1 BALSAKHA YOJANA 27 2.4 RASHTRIYA SWASTHYA BIMA YOJANA (RSBY) .27 2.5 EMERGENCY MANAGEMENT AND RESEARCH INSTITUTE (EMRI 108) 28 2.5.1 VISION 2011 29 2.5.2 ACCESSIBILITY OF EMRI 108 IN INDIA 30 2.5.3 AMBULANCE DISTRIBUTION IN VARIOUS STATES31 2.5.4 EMRI 108 IN GUJARAT 31 2.6 BUDGET 32 2.6.1 MEDICAL AND PUBLIC HEALTH 32 2.6.2 INSTITUTIONAL DELIVERY 33 2.6.3 CHIRANJEEVI YOJANA (CY) 33 2.6.4 RASHTRIYA SWASTHYA BIMA YOJANA (RSBY) 34 2.6.5 EMRI 10834 2.7 SUMMARY 35 3: STATE OF HEALTH IN BARODA: ANALYSIS OF HEALTH INDICATORS 3.1 SELECTION CRITERIA FOR PRIMARY CASE-STUDY 38 3.1.1 FULL ANTENATAL CHECKUP DISTRICTWISE 39 3.1.2 INSTITUTIONAL DELIVERY DISTRICTWISE 39 3.1.3 FULL IMMUNIZATION COVERAGE OF CHILDREN AGED 12-23 MONTHS.40 3.1.4 CONTRACEPTIVE PREVALENCE RATE FOR ANY METHOD 40 3.2 STUDY DESIGN AND SAMPLE SELECTION WITHIN BARODA DISTRICT 41 3.3.1 ADMINISTRATIVE STRUCTURE 42 3.3.2 DISTRICT HEALTH FACILITIES 42 3.3.3 HEALTH INFRASTRUCTURE IN BARODA .43 3.3.4 IMPORTANT STATISTICS 44 3.4 DISTRICT ANALYSIS 2006-2009 44 3.4.1 MATERNAL HEALTH 44 3.4.2 CHILD HEALTH 49 3.4.3 FAMILY PLANNING 52 3.5 SUMMARY 55 4: REVIEW OF NRHM IMPLEMENTATION IN GUJARAT: SECONDARY CASE- STUDIES OF SURAT AND BANASKANTHA DISTRICTS 4.1 INTRODUCTION 57 4.2 METHODOLOGY AND STUDY DESIGN 57 4.3 SAMPLE DESIGN 57 4.4 KEY FINDINGS 58 4.5 INFERENCES 62 4.6 SUMMARY 63 5: UNDERSTANDING OF IMPLEMENTATION OF NRHM: A CASE-STUDY OF BARODA DISTRICT 5.1 ROLE OF DISTRICT HOSPITAL 65 5.2 ROLE OF COMMUNITY HEALTH CENTRE (CHC) 73 5.3 ROLE OF PRIMARY HEALTH CENTRE (PHC) 84 5.4 ROLE OF SUB CENTRE (SC) 93 5.5 ROLE OF ASHA WORKERS 101 5.6 ROLE OF GRAM PANCHAYAT SITUATION 104 5.7 STATE OF INDOOR/OUTDOOR PATIENTS 107 5.8 CHIRANJEEVI YOJANA ANALYSIS AND INFERENCES 116 5.9SUMMARY 117 6: PERFORMANCE OF GUJARAT IN RELATION TO OTHER STATES OF INDIA: COMPARISON OF BASIC INDICATORS 6.1 INTRODUCTION 120 6.2 FULL ANTENATAL CHECKUP BY STATES, DLHS 2 & 3 120 6.3 INSTITUTIONAL DELIVERY BY STATES, DLHS 2 & 3 121 6.4 FULL IMMUNIZATION COVERAGE, DLHS 2 & 3 122 6.5 CONTRACEPTIVE PREVALENCE RATE FOR ANY METHOD, DLHS 2 & 3 123 6.6 COMPARISION OF BASIC INDICATORS BETWEEN STATES OF INDIA 123A 6.7 SUMMARY 124 7: CONCLUSION AND RECOMMENDATIONS INTRODUCTION 126 7.2 POLICY RECOMMENDATIONS FOR NRHM BASED ON PRIMARY STUDY 127 7.3 NRHM BASED ON SECONDARY STUDY - MACRO LEVEL 129 7.4 SUMMARY OF ISSUES, CHIRANJEEVI YOJANA 130 7.5 POLICY RECOMMENDATIONS FOR REPLICABILITY OF CHIRANJEEVI YOJANA 131 BIBLIOGRAPHY 134
P TH-1244 / ROY