JEEVAN
REKHA
( GOVERNMENT OF CHHATTISGARH )
LAUNCHED ON 1ST
November, 2001
BY
Smt. Sonia Gandhi
Hon’ble Leader of Opposition in Parliament
Chhattisgarh
Some Important Indicators
Indicator |
India |
Chhattisgarh |
| Population
(crs.)
|
102.70 |
2.07 |
| Decadal
Growth Rate (%)
|
21.34 |
18.06 |
| Sex
Ratio |
933 |
990 |
| Literacy
Rate
|
65.38 |
65.18 |
| Female
Literacy Rate
|
54.16 |
52.40 |
Chhattisgarh
Some Important Indicators
Indicator |
India |
Chhattisgarh |
| Human
Development Index
|
45 |
39 |
| Birth
Rate (1997) |
27.2 |
28.3 |
| Death
Rate
(1997) |
8.9 |
10.6 |
| Total
Fertility Rate
(1997) |
3.3 |
3.6 |
| Infant
Mortality Rate
(1997) |
71 |
84 |
| Couple
Protection Rate
(By
Sterilization
%) |
30.2 |
29.5 |
Major Gaps in Health Sector
( As on 1st November, 2000 )
Health
Sector Achievements Since Statehood
l One New Medical College at Bilaspur
l One New dental College at Rajnandgaon
l Three New Medical Colleges with 3-Year Courses
l Four New District Hospitals
l 4 New Community Health Centers
l 6 New Primary Health Centers
l Alternative Medicine Courses in Medical College Raipur
l Paramedical Courses
l Rajiv Jeevan Rekha
( includes the component of Indira Swasthya Mitanin Yojana )
l Components: -
– "Mitanin“
under Indira Swasthya Mitanin Yojana
– Decentralization
and Capacity Building of PRIs and Urban Local Bodies
– Public-Private
Partnerships
– Mobile Hospitals
in Haat Bazars
– "Rajiv
Jeevan Rekha Kosh"
Indira Swasthya "Mitanin" Yojana
Community selects a Health Volunteer
– the
"Mitanin" – to help
in developing a
“Village Health Plan”.
She also helps with "Community
Action in Health"
["Mitanin" : literally, a Friend ]
The
concept of “Mitanin”
under the
Indira Swasthya Mitanin Yojana
lis
about Empowerment
lis
about Participation
lis
about Sharing
lis
about Caring
lis
about Gender Equity
lis
about Self Reliance
Selection
lSelection
by the Community
lHelped
by trained Facilitators
lApproval
by Gram Sabha
lTraining
facilitated by Government/ panchayats
Eligibility to be a “Mitanin”
lA
woman from the same habitation
lPreferably
a married woman
lAcceptable
to the Community
lNot
necessarily educated formally
Remunerated by the Community
lCash
contribution jointly by families, and/or
lPayment-in-kind
at harvest time, and/or
lLand
in the form of service land identified by the community and allotted by government, and/or
lCash
fee on user-pays principle for certain services, and/or
lAny other
method of compensation that the community decides upon
Role of Mitanin
l Providing elementary Health
Education
l Assuming
Leadership in Community Action for Health
l Imparting First
Aid & OTC Drugs
l Treatment of
Minor Ailments
l Ensuring Timely
referral
Relationship with ANM
Role of ANM |
Role of “Mitanin”
|
| l Support to Mitanin |
l Be a link between ANM and
community
|
| l Give refresher training every fortnight |
l Help in National and State Health Programmes |
| l Visit the Mitanin often |
l Provide basic information |
| l Give the Mitanin Legitimacy and Confidence |
|
| l Help her in referral |
|
Relationship with Panchayats
Role of PRIs |
Role of “Mitanin”
|
| l
Facilitate approval of Selection by Gram Sabha |
l Provide information that PRIs may seek about health status of
people
|
l
Provide all inputs' support incl. irrigation of “Mitanin
Land”
|
l Help PRIs in developing a Health Plan
|
l
Monitor activities of “Mitanin”
|
l Bridge between Gram Panchayat and the community
|
l
Sponsor “Mitanin” training
|
l Help PRIs in other Social Sector Programmes
|
l
Ensure supplies of essential medicines
|
|
l
Seek help from “Mitanin” for other social sector
programmes
|
|
Training: Objectives
l
Attitudes: - Positive attitudes about Choices with People,
Empowerment of Women, Strength of Community work etc.
l
Knowledge: - Knowledge about basic concepts in Public
Health, various Government schemes, National Health Programmes, Signs and Symptoms of
common diseases etc.
l
Skills: - Skills of communication, managerial, group
behavior, diagnosis and treatment of common ailments etc.
Training: Methodology
l Participative, Gradual, Repetitive, Fun filled, Practical with
field experience, at the pace of learning of “Mitanins”
l Initiation training: Mainly on attitudes, behavior,
communication, working in groups, community participation, concepts in Public Health
l Refresher training: mainly for knowledge and skills of diagnosis
and treatment of common ailments
l Responsibilities will be increased gradually with “On the
Job Training”
Other Associated Activities
l Decentralization
and delegation of powers to PRIs
l Capacity
building of PRIs
l Capacity
building of Sector Health Team
l Creating a good
Referral system
l Developing
positive links with the Private Sector and NGOs
Expected Outcomes
l Demystification
of Medical Knowledge
l Empowerment of
people and community action for health
l Preparation of a
do-able health plan for each village
l Achievement of
the Goal of "Health for All" in a
definite time-frame of 3 years
l Addressing
equity and gender concerns
Evaluation methodology
l Evaluation ( Internal & External ) through -
-
Concurrent social audit by the Community itself
-
Non Government Community Based Organizations
l Evaluation on impact indicators -
– Number and quality of village health plans made and implemented
– Additional resources mobilised by the community for health
– Improvement in the health indicators
– Community Feedback on performance of "Mitanin"
– Improvement in utilization of Health services
– Health Plan and monitoring would form part of village Jan Rapat
Sources of Funds
l RCH Programme ( tied up ) – Rs. 18 crores for 3 yrs.
l European Commission's Sector Investment Programme ( tied up )
– Rs. 18 crores for 3yrs.
l Danida Assisted Basic Health Services Project ( tied up ) – Rs. 15
crores for 3 years
l State Budget ( for residuary needs )
l Community participation in the remuneration package for Mitanins
Achievements
l "Rajiv Jeevan Rekha" launched on 1st Nov. 2001.
l Rajiv Jeevan Rekha Kosh , a Fund for providing financial
assistance to the poor for treatment of serious illnesses, created and a sum of Rs 1.27
Crores has been provided as initial corpus.
l Assistance of more than Rs. 30 lakh already given and over 40 Persons assisted in serious illnesses like
cancer, heart and kidney malfunction etc. at the very best medical facilities in the
country.
l "Strategy for implementation of Indira Swasthya Mitanin
Yojana finalized through national level workshop
l Sources of Funds tied up for Rs. 51 crs. for 3 yrs.
l Training module for Facilitators is now ready
l Selection of Mitanins is being done by Gram Sabhas – 54000
to be identified. Satisfaction of communities being the criterion, Gram Sabhas not being
‘rushed’.
Constraints
l The participatory approach implies a slow and qualitative
approach rather than physical target alone. Even so we hope to cover all 54000 habitats by
end March 2003.
l Training high quality facilitators is a severe challenge.
l There are very few health sector NGOs of standing in several
districts.
l In order to overcome these constraints, we are utilizing the
opportunity thrown up by the Gaonla Chalav Campaign for working with Gram Sabhas in
identifying Indira Swasthya Mitanins.
