User:Dr meetsingh/NRHM

Life expectancy

 * Life expectancy at birth=It is 64.1 years for males and 65.8 years for females (2005).7.1 Life expectancy
 * Life expectancy at birth has increased for male and female in India. It is 64.1 years for males and 65.8 years for females (2005). This has revealed the decrease in death rate and the better improvement of quantity and quality health services in India. However, there are inter-state, inter-district and rural-urban differences in life expectancy at birth due to low literacy, differential income levels and socio¬economic conditions and beliefs. In Kerala, a person at birth is expected to live for 73 years while in states like Bihar, Assam, Madhya Pradesh, Uttar Pradesh, etc, the expectancy is in the range of 55-60 years.


 * Healthy life expectancy at birth in India was estimated to be 53.5 in 2002. This was 53.3 for males and 53.6 for females (WHO, World Health Report 2005).

Mortality
The incidence or prevalence of the diseases or conditions, as well as issues related to etiology, prevention efforts, prognosis and possibilities for control or elimination – this could also be derived from country burden of disease estimates, and condition specific indicators. The infant mortality rate has declined in India from 70 infants per 1000 live births in 1999 (SRS) to 57 in 2005-06 per 1000 live births. Under-five mortality rate per 1000 live births is 85 in 2002. According to MMR-RG, maternal mortality ratio per 100,000 live births is 301 in 2001-03. A diverse set of factors are thought to be associated with maternal mortality: factors that influence delays in deciding to seek medical care, in reaching a place where care is available, and in receiving appropriate care. The tenth plan document of India has targeted to reduce the IMR to 45 per 1000 live births by 2007 and 28 per 1000 live births by 2012. The main causes of high MMR being socio­economic status of women, inadequate antenatal care, the low proportion of institutional deliveries, and the non-availability of skilled birth attendants in two-thirds of cases. A World Health Report (1999) gives the main causes of mortality in India as non­-communicable diseases (48 percent), communicable diseases (42 percent) and injuries (10 percent). The dominant communicable diseases are infectious and parasitic diseases, respiratory diseases, maternal conditions, perinatal conditions and nutritional deficiencies. Non-communicable diseases are malignant neoplasm, diabetes mellitus, neuropsychiatric disorders, sense organ disorders, cardiovascular diseases, respiratory diseases, digestive diseases, musculo-skeletal diseases, congenital anomalies, oral diseases and other non-communicable diseases

Morbidity
NFHS-II conducted a study on four major diseases prevailing in India, i.e., asthma, tuberculosis, jaundice, malaria. In India around 2,468 persons per 100,000 populations were reported to be suffering from asthma at the time of survey. The prevalence of asthma is high in rural areas than in urban areas and is slightly higher in males than in females. The overall prevalence of tuberculosis in India is 544 per 100,000 populations. This is 16 percent higher than the survey done by NFHS-I (467 per 100,000). It is more in case of rural areas than in urban areas and more for male than females. It is more in males because of males are in contact with more people who might have TB and smoking is more in men. The prevalence of TB increases with age. Jaundice cases were reported to be 1361 persons per 100,000 populations. This is more prevalent in rural areas than in urban areas. However, it decreases with age. Thus, highest numbers of jaundice patients are in the age of 0-14. 3,697 persons per 100,000 populations were reported to have suffered from malaria. People of rural area suffer twice than that of urban area and it is slightly high for males than for females. All these diseases however vary and differ from state to state depending on the climate and geographical locations of the areas.

Disability
A survey by the National Sample Survey Organization 1991 estimates that around 1.9 percent of population are disabled in India. Other estimates suggest that between 6 and 10 percent of the population in any developing country is affected by disability, which means 60-100 million Indians are affected by disability. Four to 14 million people are blind, 3.2 million people with hearing impairment, over 16 million people are affected by locomotor disabilities and 3 percent of India's children are mentally retarded. The government of India has policies related for the disabled, rehabilitation schemes, grant-­in-aid schemes and schemes run through NGOs. According to ICMR (Indian council of Medical Research), cataract is the main cause of 55 percent of blindness. The major causes of blindness as seen in the survey conducted by the National Programme for Control of Blindness (NCB), included cataract, refractive errors, corneal opacities, glaucoma, trachoma and vitamin A deficiency.  Dr meetsingh Talk  18:27, 17 September 2011 (UTC)

ACCREDITED SOCIAL HEALTH ACTIVISTS (ASHA) The NRHM covers all the villages through village-based "Accredited Social Health Activists" (ASHA) who would act as a link between the health centers and the villagers. One ASHA will be raised from every village or cluster of villages. The ASHA would be trained to advise villagers about Sanitation, Hygiene, Contraception, and Immunization to provide Primary Medical Care for Diarrhea, Minor Injuries, and Fevers; and to escort patients to Medical Centers. They would also deliver Directly Observed Treatment Short (DOTS) course for tuberculosis and oral rehydration; distribute folic acid tablets and chloroquine to patients and alert authorities to unusual outbreaks. Although these ASHAs would be honorary volunteers, there is a provision to provide them with performance-based compensation for undertaking specific health or other social sector programmes with measurable outputs, thus promoting employment for these volunteers.

If rural women want counselling on important issues such as birth preparedness, importance of safe delivery, breastfeeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/Sexually Transmitted Infection (RTIs/STIs) and care of the young child, they may contact the concerned ASHA who shall be happy to provide them with all relevant guidance and assistance.

The general norm as decided under the Programme is ‘One ASHA per 1000 population’. In tribal, hilly, desert areas the norm could be relaxed to one ASHA per habitation, dependant on workload etc.

Criteria for selection as ASHA

ASHA must be primarily a woman resident of the village - ‘Married/Widow/Divorced’ and preferably in the age group of 25 to 45 yrs. ASHA should have effective communication skills, leadership qualities and be able to reach out to the community. She should be a literate woman with formal education up to Eighth Class. This may be relaxed only if no suitable person with this qualification is available. The selection of ASHAs is being done by the District Health Society envisaged under NRHM. Over 3,51,000 ASHAs have already been selected from various States, out of which, more than 2,26,000 have been trained in the first module.

Survey and Project
This project seeks to identify the determinants of health among the rural population of Udaipur district in Rajasthan, India. We have collected data on healthcare facilities and the health status of people in 100 villages in the district. The data sources include an integrated household questionnaire about socio-economic and health status; a survey of village infrastructure; detailed surveys of public, private, and traditional health facilities available to villagers; and a yearlong continuous absenteeism survey in all public health facilities serving the sample villages. Together, these sources provide a comprehensive picture of healthcare delivery, health seeking behavior, and health status in rural areas of Udaipur district.

HIDE PROJECT EVALUATION DETAILS Preliminary data analysis has revealed that the health status of the population is very poor. This is likely due to a variety of factors, including poor levels of nutrition, bad sanitation infrastructure, a very low quality of healthcare, and poor take-up of preventative health measures. On the basis of what has been learned in this study so far, Seva Mandir, a local NGO, is initiating an action research project composed of four pilot projects, each designed to influence health status through a different channel.

These four pilot projects are: (1) iron fortification of flour using village-level mills, (2) chlorination of drinking water sources in the village, (3) improving subcenter reliability by adding a part-time nurse who is accountable to Seva Mandir, and (4) improving immunization take-up by administering immunization camps and offering incentives to parents who bring their children to be immunized.

Results:

The weekly absenteeism survey reveals that, on average, 45% of medical personnel are absent in subcenters and aidposts, and 36% are absent in the (larger) Primary Health Centers and Community Health Centers. Moreover, there is no pattern, either in terms of the day of the week or the time of the day, by which the centers are found to be open. Households report spending 7.3% of their monthly budget on healthcare. Visits to traditional healers account for 19% of all health visits in the last month, and 12% of the health expenditure of the average household. Poorer households are more likely to visit traditional healers than richer households (27% of the visits and 19% of the average monthly health expenditure), especially in villages served by public health facilities that are more closed. Dr meetsingh  Talk  18:43, 17 September 2011 (UTC)

Poverty
The incidence of poverty has declined by almost 50 percent between 1977-78 and 1999-2000, from 51.3 percent in 1977-78 to 28.6 percent in 1999-2000. During the same period, the rural poverty declined from 53.1 percent to 27.1 percent and urban poverty from 45.2 percent to 23.6 percent (10th Plan). As per survey conducted in the year 1999-2000, 34.7 percent of India’s population was living on less than US $ 1/day (World Development Indicators, 2005).

Healthcare statistics
India has 5,03,900 doctors, 7,37,000 nurses, 162 medical colleges, 143 pharmacy colleges and 3,50,000 chemists. There are 15,097 hospitals accounting for 8,70,161 hospital beds in India. There is an extensive three-tiered government healthcare infrastructure comprising 23,000 Primary Health Centres(PHC) and 1,37,000 sub-centres serving the semi-urban and rural areas and 3000 (CHC) Community Health Centres-(Source: OPPI 2000 Estimates)