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Health

HEALTH AND FAMILY WELFARE

The Government of Karnataka has given significant importance to the health sector and Provision of good health care to the people is an essential component of the health strategy adopted by the State. The State has made substantial progress in building credible health infrastructure at different levels.

Health Indicators

The State has a wide institutional network providing health services both in urban and rural areas. Karnataka has performed in population control with total fertility rate reaching 1.7 by 2020 (As per NFHS 2019-20). The infant mortality has declined faster during the last few years and has reached 23 in 2020 (As per SRS 2018) from 35 in 2011 which is almost 12units reduction per 1000 live births in a span of 12 years.

Family Welfare

The State offers an excellent family welfare programme operating through the existing health infrastructure. The main objective of the programme is to provide better health services in general and family planning services in particular to check the rapid growth of population.

  1. National Health Mission

National Rural Health Mission (NRHM) was launched on 12th April 2005 by the Government of India to improve medical facilities in the rural areas of the country. It is modified as National Health Mission by combining the primary health care services to the urban and rural population.

  1. National Vector Borne Disease Control Programme (NVBDCP): The State is implementing the activities for prevention and control of Vector Borne Diseases like Malaria, Filaria, Dengue, Chikungunya and Japanese Encephalitis as per the guidelines of GOI, Directorate of NVBDCP Delhi.
  2. Dengue & Chikungunya: During 2020, till November, a total of 3390 confirmed Dengue cases, No deaths cases are reported, showing an increase compared to same period of last year. Further, a total of 1112 Chikungunya confirmed cases have also been reported showing increase compared to same period of last year. Acute Encephalitis syndrome / Japanese Encephalitis (AES/ JE) : AES cases are being reported from most of the districts. During 2020 till October, State has reported a total of 257AES and 12 JE cases and no JE death.
  3. National Tuberculosis Control Programme: The World Health Organisation (WHO) TB statistics give an estimated incidence figure of 2.60 million cases of TB for India during 2019 as per the global TB report 2020.

Tuberculosis in Karnataka

National Tuberculosis Elimination Program (NTEP) erstwhile Revised National Tuberculosis Control Program (RNTCP) was implemented in the State from 1998 and the entire State was covered in 2004.More than 90000 TB patients put on treatment annually in Karnataka TB program. Currently 1278 contractual employees are working for TB across the state. State TB cell under “Karnataka State Health and Family Welfare Society – TB Programme” and 31 districts TB Centres under “District Health Society – TB Programme” have been established to supervise and monitor the implementation of this Programme effectively. The total lost to follow up rate which was 10% in 2009 is reduced to 4 % in 2020 and death rates have decreased from 8% in 2009 to 6% in 2020 despite high HIV – TB burden. The success rates of TB treatment have improved to 82%.

TB Notification and Nikshay Registration

A total of 20095 TB cases have been notified from private sector in 2019 and in this current year despite of COVID-19 pandemic 14912 cases have been notified so far from January 2020 to November 2020.

CBNAAT (Cartridge Based Nucleic Acid Amplification Test) and Trunat

During Covid19 Pandemic

  1. The state took up innovative case finding strategies to address this issue with a fourpronged approach.
  1. State supplied 2 months door step drugs to all the TB patients in order to prevent drug stock outs at the patient's end.
  2. In the month of August from 10th August to 17th August a contact Tracing Drive.
  3. State has initiated Bidirectional Screening of TB patients for COVID symptoms and Covid positive patients for TB symptoms from October 2020.

Pilots in Karnataka which have become National Policies are:

  1. ATT-ART-CD4(HIV-TB)
  2. PITC (provider initiated testing and counseling) for presumptive TB patients.
  3. TB-DM bi-directional screening
  4. Human Resource for Health (aligning NTEP with NHM).

The current strategy of TB is as envisaged in the sustainable development goals (SDG) and it is called “The END TB STRATEGY.”

National Leprosy Eradication Programme

Introduction

The prevalence rate of leprosy as dropped in Karnataka from 40/10000 population in the year 1986 to 0.19/10000 population in November 2020 (Provisional).

Activities under NLEP

  1. Case Detection and Management:
  2. Under Urban Leprosy Elimination Programme (ULEP): 10 Towns 2 Medium cities 1 Mega City have been selected. Activities conducted under ULEP are Survey of Slums Residential Schools Hostels Leprosy Colonies Mutts running educational institutions Hard to reach areas tribal colonies and Monitoring Supervision & Coordination with NGOs & Other departments. This activity will be continued from 2020-21 as ACD& RS.

 

Surveillance for Leprosy (ACD& RS)

Active Case Detection and Regular Surveillance for Leprosy (ACD& RS):

  1. Capacity Building

Virtual Training of Division wise Medical officers, Health workers and ASHA, as a newer initiative Training of RBSK, RKSK and UHC is undertaken and completed this month. Intensified training will be given to Health workers and the Medical Officers to diagnose leprosy cases at the peripheral health centres itself through Virtual meeting.

  1. IEC

Special Drive to remove stigma surrounding leprosy and prevent discrimination was planned in the form of Sparsh Leprosy Awareness Campaign Anti Leprosy fortnight – (30th Jan to Feb 13th) of every year.

 

Welfare measures for the Persons Affected by Leprosy

 

 

National Programme for Control of Blindness

The National Programme for Control of Blindness was started in 1976 as a Centrally Sponsored Scheme to counter the problems of Blindness due to various factors and also to reduce the prevalence of Blindness to 0.3% by 2020. The present prevalence rate of blindness is 1% as per National Survey 2006-07.

The Integrated Disease Surveillance Project (IDSP)

The Integrated Disease Surveillance Project was launched in 2005 and became programme in the year 2012. To improve the efficiency of the existing surveillance activities of disease control programs and facilitate sharing of relevant information with health administration community and other stakeholders so as to detect disease trends over time and evaluate control strategies.

Integrated Health Information Platform (IHIP)

Along with the 6 other States IHIP is launched on 26th November 2018 Secretary. Health MOHFW GoI in the Karnataka State. The reporting for “L” and "P” Forms under the IHIP is 59% and 63% respectively for the month of November 2020.

Other Major Health Programme Initiatives

The Department of health and family welfare services implements various National and State health programs of public health importance and also provides comprehensive health care services to the people of the State through various types of health and medical institutions.

  1. JANANI SURAKSHA YOJANE (JSY): The goals of JSY are reduction in maternal and infant mortality rate as well as to increase the institutional deliveries of BPL and SC/ST families. Under this scheme besides ensuring maternity services like 4 antenatal checkups and referral transport cash assistance is provided for deliveries taking place both in health institutions and home. In rural areas cash assistance to the mother for institutional delivery is Rs. 700 per case whereas in urban areas cash assistance to the mother is Rs. 600 for institutional delivery. The cash assistance is also available for women delivering at home with an amount of Rs. 500 being given per case. If specialists are not available in Government-run health centers or hospitals, the institution can hire such specialists to manage complications or for caesarean section.
  2. AROGYA KAVACHA 108: “ArogyaKavacha” 108 Emergency service was started in the state of Karnataka on November 1 2008 by the Karnataka Health and Family Welfare Department under a Private Public Partnership through an MOU signed with GVK EMRI. The Role and Mission of '108' is to save lives by providing a comprehensive 'Emergency Response Service' to those in Medical Police or Fire emergencies through a single integrated number - 108. We operate 24 x 7 and 365 days of the year with a fleet of 711 well equipped ambulances. The ambulances are manned by a trained Emergency Medical Technician (EMT) and a trained driver (Pilot). This service is available across the length and breadth of Karnataka i.e. all the 30 Districts.

 

The Ambulances are stationed strategically in all Districts and taluks across Karnataka so they can reach the incident location within the shortest possible time anywhere in the state. The services are operated through a centralized Emergency Response Center located at Bangalore. At present there is one ambulance for every 85000 populations with a total of 711 Ambulances throughout the state.

 

This service can be utilized by any individual who requires emergency help (Medical Police or Fire) irrespective of his economic status caste creed color ethnicity gender and/or literacy levels. The process of calling for an ambulance is simplified to such an extent that a call to the toll-free number '108' with details of emergency the number of people involved and the incident location supported with a landmark; would trigger an ambulance dispatch. This is an absolutely FREE SERVICE starting from the phone call till the point of reaching the hospital.

The medical emergencies can be availed for Accident and Trauma (Vehicular and non- vehicular) complaints related to Cardiac Respiration Diabetes pregnancy Stroke/Convulsions Suicide attempts Poisoning cases Assault/Violence Animal Attacks Neonatal Building Collapse Fire Burns hazardous material ingestion etc.

 

  1. JANANI SURAKSHA VAHINI: Janani Suraksha Vahini Programme was initiated under NHM in 2009-10 to ensure 24/7 round the clock free referral transport between the facilities for pregnant women and sick neonates/ infants. Out of the existing ambulances of the CHCs/ THs/ DHs one ambulance of each facility was designated as JSV Ambulance. At present there are 180 JSV Ambulances. Drivers are outsourced by District Health Societies from Manpower Agencies by calling tenders as per KTPP Act. 3 drivers (1 Regular and 2 Out sourced) are given to each vehicle to work in 8th hourly shifts.

 

  1. NAGU-MAGU: To provide Drop Back facility for post postnatal mothers and new born from Government Health Facilities to their residence 200 drop back vehicles called as “Nagu-Magu” were inaugurated on 5th February 2014. The Nagu-Magu vehicles are deployed one each at the District Hospital and Taluka Level Hospitals. Drivers for Nagu-Magu Vehicle are outsourced by District Health Societies from Manpower Agencies by calling tenders as per KTPP Act.

 

  1. BIKE AMBULANCES: (FIRST RESPONSE UNIT): The Bike Ambulances/ First Response unit th (FRU) is inaugurated on 15 of April 2015 by Government of Karnataka. It is the “Platinum Ten Minutes” trauma care initiative aimed at reducing deaths due to road accidents. It is an unique initiative and is the first of its kind to be taken up by the State Government in our Country.

 

The first aid and medical care during the “Platinum Ten Minutes” is paramount to save the life of an accident victim hence the pioneering attempt to start motorbike ambulance service.

The motorbike ambulance service is another pilot and pioneering initiative to ensure first aid to the victims during the Golden Hour They are useful for negotiating the small streets and heavy traffic in the large urban areas where it would be difficult to move ambulances through crowds. The fleet of high-powered touring motorcycles are available when required to respond to various trauma/medical incidents.

 

The Bike ambulances will be currently deployed in Bangalore (19 Nos) Mangalore (2 Nos) and one each to the corporation areas of Mysore Kalburgi Belagavi Hubli -Dharwad Davanagere Tumkur Vijayapura Shimoga and Kolar Districts where heavy traffic congestion and narrow streets would be easily overcome by the agile nature of the bikes. The programme will be implemented through GVK-EMRI who are already experience in providing such services through Arogya Kavacha-108. Riders are paramedics or EMTs who are recruited and trained on managing emergencies. Motorbike ambulance drivers would be fully trained in rendering first aid and would start resuscitation measures to save the victim.

 

Two-wheelers by virtue of their size could manoeuvre through narrow and busy roads and reach accident spots with ease while they would be followed by a fully equipped four-wheel ambulance for shifting the victim to a nearest hospital for further treatment if necessary.

 

Bike ambulance is able to respond to a medical emergency much faster than an ambulance or a car in heavy traffic which can increase survival rates for patients suffering cardiac arrest/ accident/ other emergencies.

 

  1. AROGYA VANI-104: The Government of Karnataka has started the Arogya Sahayavani-104 service with the moto of reaching the unreached to provide all the health care services available in the public sector. Those patients residing in the remote rural villages who cannot access the medical doctors in the hospitals can now contact with the doctors through Arogya Sahayavani-104. “104” is a toll free number through which people can avail consultation for minor ailments counseling services information on services available in public Health facilities directory services (Eye bank Blood Bank) and grievance redressal (Services Epidemics Corruption Hygiene Drugs and Diagnostics ASHA grievances etc.)

 

Arogya Sahayavani-104 call centre is situated at IT Park Hubli and Sir. C V Raman Nagar Hospital with a capacity of 100 seater each. People (Citizens) from any part of the state can avail their service by calling 104. From April 2019 to Nov 2019 4502245 calls are received at the call centre out of which 4483234 calls are provided with the different services.

 

  1. VATSALYAVANI: For the first time in India A Three way call conferencing structure for Mother Child tracking system called “VatsalyaVani” is launched in Karnataka by then Chief Minister Shri. Siddaramaiah on 21st December 2015. This programme is implemented through Arogya Sahayavani104.

 

VatsalyaVani call center will offer the below services throughout the state:

 

  1. Monitor all pregnant woman and child through ANC/PNC advice.
  2. Promote protect and maintain the health of the mother and child through advice e.g. nutrition health & wellbeing.
  3. Providing information of various government health programs and schemes and their entitlements.
  4. Identify and t rack High Risk Pregnancies and low weight birth babies.
  5. Motivate mothers for Institutional Delivery and family planning methods.
  6. Arrange and monitor transfer to nearest delivery point through state ambulances.
  7. Eliminate home deliveries.
  8. Track Immunization status.
  9. Prevent dropouts.
  10. Ensure complete service delivery.

 

  1. ASHA: The ASHA worker is a woman selected by the community who is trained and supported to function in her village to improve the health status of the community through securing people's access to health care services through improved health care practices and behaviours. In Rural area 1 ASHA per 1000 population and in urban area 1 ASHA per 2500 population. She is incentivized for 34 different health activities.

 

The ASHA's work consists mainly of five activities:

  1. Home Visits
  2. Attending the Village Health and Nutrition Day (VHND)
  3. Visits to the health facility
  4. Holding village level meeting of women's groups
  5. Maintain records

In addition to above work raising the awareness on health issues mentioned below:

  1. Nutrition
  2. Health &Hygiene and Health seeking behaviours
  3. Healthy Lifestyle
  4. Available Health services and its proper utilisation.

 

Counselling services:

  1. Birth preparedness
  2. Institutional Delivery
  3. Importance of Breastfeeding
  4. Immunization
  5. Importance of Contraceptives
  6. RTI/STI

She is also working as a Member Secretary for Village Health, Sanitation and Nutrition Committee in rural area and for Mahilaarogyasamithi in urban area. Providing the legal framework to ASHA work, the certification process has been taken up. The main objective of the Certification of ASHAs is enhance the skill and competencies, through skill assessment and knowledge. MoHFW, GOI, has made the tripartite MOU between NIOS, NHSRC and MOHFW for conducting the Certification of ASHA. 303 ASHAs successfully completed 10 days refresher training along with Internal assessment, External evaluation and Theory examinations.

In addition to the incentive provided by NHM, Govt. Of Karnataka has provided the Rs.3500 as monthly fixed incentive since September 2017 onwards and as of by Enhancing Rs.500 ASHA is getting Rs.4000 as monthly fixed incentive from 1 November, 2019.

 

  1. SUVARNA AROGYA SURAKSHA TRUST (SAST):

“Ayushman Bharat-Arogya Karnataka” Scheme: Government of Karnataka has been very proactive in the goal of providing health care to its residents from a long time. Yeshasvini scheme the first such scheme was initiated in 2003. Later Suvarna Arogya Suraksha Trust was established in 2009 with the specific objectives of implementing health schemes. The first scheme was Vajpayee Arogyashree Scheme which provided cashless treatment for tertiary care to BPL families. In 2014 Rajiv Arogya Bhagya was introduced for APL families for tertiary care. About 250386 patients benefitted from VAS and RAB since their inceptions under VAS and RAB. RSBY Scheme provided secondary health care services to 62 lakh families in an insurance mode and about 168377 beneficiaries availed treatment under this scheme from the year 2016 till its closure on August 2018.

In line with the policy goals of the “Karnataka Integrated Public Health Policy 2017” which envisages merging all social health insurance schemes into a single health assurance plan to improve efficiency and outreach and to achieve the goal of Universal, Equitable and Sustainable healthcare as envisaged in the Vision document-2025; all the existing schemes were merged and “Arogya Karnataka” a Universal Health care Scheme was launched on 2/3/2018, wherein cashless treatment upto Rs. 2.00 lakh for specified 1516 secondary, tertiary and emergency health care treatments was provided in an Assurance Mode based on eligibility criteria as per the National Food Security Act 2013. 19 lakh APL families are also covered for financial assistance upto 30% of the package rates.

 

Government of India has come out with its own scheme called Ayushman Bharat - National Health Protection Mission, on 25.9.2018, later renamed as PradhanMantri Jan ArogyaYojana (PMJAY), to provide health protection to over 10 Crore poor families identified based on the latest SocioEconomic Caste Census (SECC) data, (50 crore beneficiaries). Since both Arogya Karnataka and Ayushman Bharat have the same goal, scope and similar modalities for providing specified treatments to the poor and vulnerable sections of society, integrating both the schemes was imperative for smooth implementation especially at the field level. A single integrated scheme under a co-branded name as “Ayushman Bharat-Arogya Karnataka” is now being implemented in an Assurance Mode.

 

A MoU has been signed with National Health Agency, Government of India in order to implement this integrated scheme on 30/10/2018. The Government Order No. HFW 69 CGE 2018 dated 15.11.2018 was issued for implementation of integrated Ayushman Bharat-Arogya Karnataka scheme. This is the only scheme at present that covers beneficiaries of all the other hitherto existing schemes and is an Universal Health Coverage Scheme.

 

Entitlement and Eligibility for availing the scheme are as below;

  1. Eligible Patient: A patient who is a resident of Karnataka State and belongs to “Eligible Household” as defined under the National Food Security Act, 2013; This category shall also include the beneficiaries listed in the SECC data and the enrolled members of the hitherto existing Rashtriya Swasthya Bhima Yojane.
  2. General Patient: A patient who is a resident of Karnataka State but does not come under the definition of “Eligible Household” as defined under the National Food Security Act, 2013, or does not produce the eligible household card.

Enrolment of patients:

  1. One-time enrollment of patients, on an IT portal to be established by SAST as and when they approach any PHI for treatment for the first time or any other enrollment facility as designated from time to time
  2. For single incident patient can get treatment under the scheme by producing his Aadhar card and PDS card.
  3. A patient approaching an empanelled private hospital in case of emergency without a referral from a PHI can be enrolled at a designated enrollment center or a PHI after stabilization and discharge from hospital.

AB-ArK Card:

 

Cost of treatment to be borne by the Government

For “Eligible Patients” the financial assistance up to Rs.5.00 lakh will be provided for specified simple secondary care, complex secondary health care, tertiary health care and emergency health care per annum, for a family. This will be on family floater basis meaning one or more persons of the family can use the full cover of Rs. 5.00 lakhs. One person can also use the entire Rs.5.00 lakh. For “General Patient” the benefit limit is 30% of Government package rates, with overall annual limit of Rs.1.50 lakh per family, per year on co-payment basis.

Under integrated Ayushman Bharat Arogya Karnataka scheme, the treatments provided for primary health care and benefit packages are as follows;

Jyothi Sanjeevini Scheme (JSS):

This health assurance scheme is specifically for the benefit of all State Government Employees and their dependents without any cap on the financial limit and the treatment is totally cashless. The scheme was launched on 20-01-2015. The only expenditure to be borne by the beneficiary is:

  1. If the beneficiary wishes to have a higher stent, prosthetics or implants other than those specified under SAST benefit package.
  2. If the beneficiary wishes to avail a higher ward other than the ward eligible for will have to be borne by the beneficiary. Eligibility of general ward, semi-private and private wards depends on the basic pay drawn by the employee.

During the current financial year (2019-20) from April 2019 till November 2019, a total of 888 employees have availed benefit and an amount of Rs.597.78 lakhs has been paid to the network hospitals for treating these beneficiaries.

Organ Transplant Scheme:

Government of Karnataka has implemented the 'Organ Transplantation Scheme' for poor/BPL patients of Karnataka, vide GO No. HFW 64 FPE 2018, Bengaluru, dated: 3-12-2018.

Main features of the scheme are as under;

Eligibility:

Referral:

Treatment & Benefit packages

Suvarna Arogya Suraksha Trust (SAST) is the nodal agency to implement the scheme. SAST will be responsible for empanelment of private hospitals, pre-authorization and payments for transplants to hospitals as per the mechanism followed in the Ayushman Bharath-Arogya Karnataka Scheme.

COVID-19

The Government of Karnataka has proactively initiated various measures to combat ongoing COVID-19 pandemic. In the beginning treatment was carried out only in the Public Health Institutions later private hospitals, nursing homes and other licensed health facilities have been permitted for treatment of COVID 19 patients. 108 ambulance facilities has been provided for the admission of COVID 19 infected, referred from the public health authority. For infected patients injection Remedesivir has been supplied and treatment facility provided by SAST. The treatment cost has been funded by the AB-ARK. Totally 894 hospitals empaneled of which 216 government and 678 private hospitals. Department has taken necessary steps to ensure the availability of Quality Drugs, Remedesivir injections, adequate medical oxygen, Hand Sanitizer and adequate masks as per the National Pharmaceutical Prizing Authority, New Delhi Guidelines. Drug testing laboratories are purchasing high capacity equipment for analysis of drug samples.

Jyothi Sanjeevini Scheme (JSS)

This health assurance scheme is specifically for the benefit of all State Government Employees and their dependents without any cap on the financial limit and the treatment is totally cashless. During the current financial year (2020-21) from April 2020 till November 2020, a total of 869 employees have availed benefit and an amount of Rs.547.62 lakhs has been paid to the network hospitals for treating these beneficiaries.

Implementation Performance

Child Health Programme: The Child Health Programme comprehensively integrates interventions that improve child survival and addresses factors contributing to Infant and Under 5 Mortality. Many initiatives have been taken up to provide preventive promotive curative & rehabilitative health care services through evidence-based interventions like Facility Based New born Care (SNCU NBSU NBCC) Home Based Newborn Care Janani Shishu Suraksha Karyakrama (JSSK) Child Death Review Kangaroo Mother Care and Lactation Clinic Integrated Management of Neonatal & Childhood Illnesses (IMNCI) and Intensified Diarrhoea Control Fortnight (IDCF).

Child Health Achievements

  1. Karnataka bags award at the 5th National Health Summit on Good and Replicable Practices 2018 in Public Health Care at Kaziranga Assam India.
  2. 5th National Health Summit on Good and Replicable Practices in Public Health Care was held from 30th October 2018 to 1st November 2018 at Kaziranga Assam India. Mission Director National Health Mission along with state level officials participated in the summit.
  3. Kangaroo Mother Care wards and lactation clinics are established in all District Hospitals as an adjunct to SNCUs to provide supportive services to low birth weight/ preterm babies to improve survival rate and to increase the early initiation of breast-feeding rates respectively.
  4. All DTC principals & SNCU Staff nurses were trained as TOTs in KMC at St John's medical college as part of IAPNEOCON 2019 BY National stalwarts in the field of Kangaroo Mother Care.
  5. All SNCU Paediatricians were trained in Invasive and Non-invasive ventilation.
  6. SNCU Mentoring is going on in 6 SNCUs for improving the quality of new-born care services
  7. State level consultative meet for drafting Karnataka New-born Action Plan was conducted during March 2019, wherein Deputy Commissioner (CH division, MoHFW), Experts in the field of Neonatology from National & State level, representatives of NNF, SNCU Nodal Officers, RCHOs and other stakeholders took active part in drafting KNAP, dissemination and fine tuning of KNAP is planned for District administrators.
  8. New born resuscitation skill enhancement corners are established in 37 SNCUs for capacity building of staff nurses and medical officers involved in new born care services.
  9. Basic NRP training in association with IAP for 860 participants (staff nurses and medical officers from delivery points NBSUs and SNCUs) was conducted in 29 districts to improve the essential new born care practices amongst staff nurses.
  10. State Resource Centre for Facility Based New-born Care is established at IGICH, Bengaluru and till date 76 staff nurses from SNCUs are trained at FBNC according to MoHFW FBNC training module.

The following programmes and activities are being carried out in Karnataka to reduce the U5MR, IMR and NMR in the Child Health Section:

  1. Facility Based New Born Care (FBNC):

New Born Care Corner (NBCC): 1070 NBCC are functioning at all delivery points as on 2016. Newborn care corners are established in labour rooms &Operation Theatres in all the 24X7 PHCs CHCs Taluk Hospitals and District hospitals. 

New Born Stabilization Units (NBSU): 165 NBSUs are functioning as on 2016. NBSUs have been established in all First Referral Units (FRUs) and Taluk Hospitals.

Special Newborn Care Unit (SNCU): 42 SNCUs are functioning at all district hospitals & government medical college hospitals and some high performing Taluk hospitals. At present 877 beds with an average of 70,000 newborn admissions at all functional SNCUs in the State. Establishment 8 SNCUs at Taluka hospital are in pipeline (at Hospet, Humnabad, Jewargi, Sira, Holenarasipura, KR Pete, Gokak & CV Ramannagar)

SNCU Online Monitoring Software: All 42 SNCUs are now integrated with the SNCU Online Monitoring Software at their units.

Kangaroo Mother Care wards: Kangaroo Mother Care (KMC) ward and Lactation Clinics are being established in all the District Hospitals adjacent to SNCUs to strengthen the supportive care to the newborn. KMC wards are established in all hospitals with SNCUs and health care personals are trained in KMC at state level. Further community KMC will be rolled out in order to increase the survival of low birth weight babies.

Lactation Clinics: Lactation clinics are established in district hospitals to increase the early initiation of breast feeding and exclusive breastfeeding rates. This will be established at all the delivery points and further existing lactation clinics will be upgraded to lactation management centres and mothers will be supported to store the expressed breast milk.

Neonatal Transportation: Neonatal ambulances ensemble with intensive care will be provided for four divisions to transfer sick neonates. This will be rolled out to all other districts based on the experience of piloting.

 

  1. Integrated Management of Neonatal & Childhood Illnesses (IMNCI): IMNCI is an approach where the field level workers (ANMs &Anganwadi workers) are trained to identify common diseases of early child hood (Pneumonia, Diarrhoea, Measles, Ear Infections, Malaria, Malnutrition, Anemia) and its management or prompt, timely referral.Staff nurses and medical officers also trained at F-IMNCI to enhance their capacity in managing the neonatal and child hood illness and also to stabilize the cases prior referral.
  2. Home Based Newborn Care (HBNC): ASHAs visit the neonates at least 6 times in the first 42 days after delivery. 41222 ASHAs are trained to identify common neonatal illnesses & educate the mothers regarding Breast feeding & care of new born. In case of SNCU graduates and low birth weight babies, additional visits at 3rd 6th 9th & 12th month at the incentive of Rs. 50/- per each visit is carried out by ASHA. They are provided with a kit containing essential equipment & drugs to car for the newborn. Knowledge of ASHAs is being reinforced through the SATCOM facility where the State Officials directly interacted with ASHAs and cleared their doubts. Similarly Medical Officers and Staff Nurses of PHCs were also oriented regarding RMNCH+A strategies through SATCOM.
  3. Janani Shishu Suraksha Karyakrama (JSSK): Janani Shishu Suraksha Karyakrama (JSSK) was introduced in early 2012 to reduce the out of pocket expenditure of the parents towards the treatment of sick newborn. An amount of Rs. 200/- for Drugs and Consumables Rs. 100/- for diagnostics and Rs.300/- for Referral Transport was allocated per sick newborn as an indicative unit of calculation. The required amount may be spent with justification. In the year 2013-14 the facility was extended for any sick child below one year of age.
  4. Child Death Review (CDR): Child and infant Death Review have been implemented in all Districts of Karnataka. State and District level Child Death Review committees have been formed and are meeting regularly. All reports being sent are being reviewed validated and feedback given to districts. Through all these efforts the State has reduced the Under 5 Mortality to 29 per 1000 live births and Infant Mortality Rate to 25 per 1000 live births as per SRS 2017. State level Reorientation and review of CDR was conducted for district & Taluk administrators for successful implementation of CDR and thereby take necessary actions to fill the gaps to reduce the Child deaths.
  5. National New-born Week: New-born week is being celebrated in Karnataka since 2016. This is a programme launched by Government of India to highlight care of new-borns and to emphasize the importance of improving new-born care. It is celebrated every year in the second week of November. Multiple training programmes awareness activities and IEC activities are carried out in the community and at health care facilities across the state. During the National New-born week 2019, 24085 new-borns were visited at home by ASHAs, 6972 new-borns were screened for birth defects at Public Health facilities and 30401 mothers were counselled for essential new-born care practices.

National Urban Health Mission:

Preamble: National Urban Health Mission was launched on May 1 2013 as a sub-mission of the National Health Mission (NHM) to strengthen the primary health care system in cities & towns to provide essential primary health services to the entire urban population and Special focus on People living in listed unlisted slums and other low income neighborhoods All other vulnerable population such as homeless rag-pickers street children rickshaw pullers and other temporary migrants.

It aims to improve the health status of the urban poor particularly the slum dwellers and other staged sections by facilitating equitable access to quality health care through a revamped public health system partnerships and with the active involvement of the urban local bodies.

Considered all districts and state headquarters and towns and cities with more than 50000 populations are incorporated and implemented in all 79 cities and towns of Karnataka as per the Government of India guidelines. Totally 364 Urban Primary Health Centers (UPHCs) out of which 204 UPHCs are in Non-Metro and 160 UPHCs (Including 27 Maternity Hospital) are in Metro city which comes under urban development department. All the 364 Urban Primary Health Centers (UPHC) 9 Urban Community Health Centres (UCHC)/Referral Hospital 8 Mobile Medical Units (MMUs) 49 Health KIOSKs and 2 Transit clinics are implemented in urban area with inter-sectoral coordination with urban development and Municipalities.

The NUHM activities are implemented in Metro city through BCH&FWS constituted during 2014-15 but made more functional from 2016-17 onwards. The BBMP has 198 wards which includes the 135 wards of erstwhile BBM and 63 wards coming under Bengaluru District Health & Family Welfare Officer in so far as provision of health services are concerned. The NUHM implementations in all the 198 wards were brought functionally under the unified command of BCH & FWS headed by the Commissioner BBMP.

As a community activities special outreach camps will be conducted by Auxiliary Nurse Midwives (ANM) to ensure health care delivery at the door-step. Community participation will be facilitated by the Mahila Arogya Samithis (MAS) which will act as a bridge between the communities and the nearest health facility. The U-ASHAs will play the role of provider of first contact care and also generate community awareness with regards to various health issues sanitation and nutrition. Special care will be taken to ensure that MAS would be constituted by drawing representation of people from local population by ensuring adequate representations to the SC ST and other minorities.

Introduction: National Urban Health Mission (NUHM) aims to improve the health status of the urban poor particularly the slum dwellers and other disadvantaged sections by facilitating equitable access to quality health care through a revamped public health system partnerships and with the active involvement of the urban local bodies.

The main focus of the NUHM will be urban poor population living in listed and unlisted slums all other vulnerable populations such as homeless rag-pickers street children rickshaw pullers construction brick lime kiln workers commercial sex workers and others.

NUHM will cover all the District headquarters and other cities/towns with a population of 50000 and above (as per census 2011) in a phased manner. Cities and towns with population below 50000 will be covered under NRHM.

As per 2011 census 236.25 lakh people reside in urban areas and the urban slum population is 38.61 lakhs in Karnataka state. The challenge is that the state has 38.67% of population living in urban areas as against the National Average of 31.57%.

Under NUHM the emphasis will be to improve existing public health delivery system with a thrust on making available adequate health human resources upgrading the existing health facilities in terms of infrastructure and equipment and also establishing new health facilities wherever necessary by providing specialist care as well as strengthening emergency response systems. This will enable the Health and Family Welfare Department or City Municipalities/Corporations to effectively provide adequate primary health care to the urban poor focus on promotive preventive and curative aspects of both communicable and non-communicable diseases domestic violence on women and strengthen trauma care and emergency care to the urban poor.

The strategy will comprise of strengthening the existing primary health care centers establishing new primary health care centers wherever appropriately needed. Further special outreach camps will be conducted by ANMs and ASHAs to ensure health care delivery at the door-step. Community participation will be facilitated by the MahilaArogyaSamithis (MAS) which will act as a bridge between the communities and the nearest health facility. The ASHAs will play the role of provider of first contact care and also generate community awareness with regard to various health issues sanitation and nutrition.

It is generally felt that there is nonavailability of reliable data on health status of people living in urban areas. A comprehensive baseline survey and mapping is being undertaken to gain insight into the dynamics of health needs of existing listed and unlisted slum pockets urban poor concentration areas and other vulnerable population. This will help in assessing their health seeking behavior health indicators such as morbidity and mortality patterns ongoing health needs and existing provisions for health care and out of pocket expenses etc.

An amount of Rs 5081.05 Lakhs is provided during 2013-14 of which State share is Rs 1270.00 Lakhs and Central share is 3811.00 Lakhs. Sanction has been accorded by the Government for implementation Of National Urban Health Mission in 135 wards of BBMP 63 wards of Bangalore Urban Mysore Bagalkote Mangalore and Ullal of Dakshina Kannada. Total number of cities taken up for implementation of NUHM in 2014-15 were 25 of which 5 are part of 2013-14 and 18 are new cities. The amount approved was Rs. 86.24 Crores of which GOI share was Rs. 64.68 Crores and GOK share was Rs. 21.56.Crores.The 18 new cities are Belagavi Bellary Bidar Vijayapura Chikkaballapur Davangere Hubli-Dharwad Gadag Kolar Kalaburagi Sedum Gangavathi Raichur Udupi Yadgir Dandeli Puttur and Bantwal. In 2015-16 total budget approved is Rs. 104.21 Crores.

During the financial year 2016-17 54 cities /Towns have been added to the list with a total amount of Rs 131 crores with a Centre state sharing pattern of 60:40. In the financial year 2017-18 2 cities have been added to the list in the state of Karnataka for FY 2019-20 National Urban health Mission is implemented in 79 cities.

Human Resource:

To improve existing public health delivery system with a thrust on making available adequate health human resources upgrading the existing health facilities in terms of infrastructure and equipment and also establishing new health facilities wherever necessary by providing specialist care as well as strengthening emergency response systems.

Infrastructure: One urban primary health centre (UPHC) may be planned for every 50-60 thousand population under NUHM. In case there is an existing Urban Family Welfare Centre Urban RCH Centre Urban Health Centre Urban Health Post etc. the same may be upgraded and strengthened as UPHC. Where none exists new UPHCs will have to be planned and the Dist. Health Society will initiate the process of identification of location/ land. NUHM will provide both capital and recurrent cost for up gradation and maintenance of the UPHCs as per the norms. The Dist. Health Society can also hire premises for new UPHCs where land is not available.

Renovation/ Upgradation of existing Urban Health Centre: The existing health facilities to be up-graded into urban-Primary health centres. Though an amount of Rs. 10 lakhs will be given per health facility the amount will be utilized based on the requirement such as, the condition of the health facility, utilization of health services and number of OPD cases per month and deliveries conducted.

 

HMIS & RCH in Karnataka

HMIS (Health Management Information System)

In Karnataka uploading of Information on HMIS portal from facility level is existing since Aug 2010 by which it is easier to get timely information. In Karnataka after the implementation of HMIS 98% of the information is collected online as data is being uploaded before 5th of every month & more emphasis is given to improve the quality of the data.

District Level Action Plans / PIP formulation and monitoring the progress through Star rating of facilities using HR Infrastructure data equipment availability and service utilization are being done based on HMIS data.

HMIS Portal Training

RCH Portal: RCH portal started in the State from October 2018 and around 89% of Pregnant woman and 89.51% of Children registered in RCH portal during the year 2018-19 and 79% of Pregnant woman & 89% of Children registered in RCH portal during the year 2019-20 (up to October).

Rashtriya Bal Swasthya Karyakram (RBSK)

This programme is being implemented in Co-ordination with Department of Health and Family Welfare, Women and Child Development, Public Instruction and PU Board. Progress report for the period of 2020-21 (Apr-20 to Nov-20) During 2020-21, out of an target of 7840988, 4797036 students enrolled in Anganwadies Centres were screened and 184 children's (Apr-20 to Oct-20) have undergone for different surgeries.

Weekly Iron & Folic Acid Supplementation Program for Adolescents (WIFS):

To reduce the prevalence and severity of nutritional anaemia in adolescent children this program has started. Students studying in 1st to 5th standard and 6th to 10th standard in all Government and Government Aided School Children are covered in this program.

Universal Immunization: Goals

Achievement

Causes of Death for Mother and Infant

For the effective control of maternal and infant mortality, it is important to understand the causes of such mortality. The major causes of infant deaths are due to prematurity or low birth weight. Pneumonia, Heart Disease and birth asphyxia also account for a major proportion of deaths.

Among females in the age group of 15-49, Hypertensive disorders in pregnancy (Include eseclampsia, pre-eclampsia, and hypertension) and Haemorrhage are the leading causes of death- it may be attributed to rise in diagnosis and reporting of new cases.

Mental Health

Mental Health Programme (DMHP) under National Mental Health Programme is implemented in all the 30 districts and BBMP in Karnataka, and in 10 Talukas.

Community Mental Health Day Care Programme (Manasadhara): Community Mental Health Day care Programme, funded by the state. One for each District. Day Care Centre / Rehabilitation centre for the recovered mentally ill persons by recognized NGO's. These centres are functional in 14 districts (Bangalore Rural, Kodagu, Udupi, Tumkur, Hassan, Dharwad, Gadag, Mandya, Chitradurga, Haveri, Chickkaballapura, Mysore, Kolar and Belagum). Efforts are continued to start these centres in all the districts. (Due to COVID-19 Pandemic Progress of the programme is lacking 4 Manasadhara centers has not worked).

Innovations Under Mental Health

An e-initiative for Monitoring District Mental Health Program in Karnataka

Tele-mentoring: It is being offered to PHC medical officers. The PHC medical officers, while seeing their general patient pool, are offered guidance and training to identify and treat psychiatric disorders.

Quality Assurance Programme:

National Quality Assurance Standards (NQAS): NQAS is a comprehensive quality improvement program dedicatedly for public health facilities in the country was developed as per IPHS standards and was released as Operational Guidelines for Quality Assurance in Public Health Facilities - 2013”. In 2020-21, 609 public health facilities including State level virtual assessment.

Karnataka State Aids Prevention Society (KSAPS)

Karnataka State AIDS Prevention Society Programmes

  1. Care Support & Treatment: During 2020-21, currently 68 ART centers and 311 Link ART Centers are functioning. The cumulative number of HIV cases registered at ART Centers till November 2020 are 352030 out of which, 168001 cases are alive and on ART. State is following "Treat All" policy since 14th June 2017 which mandates free ART treatment initiation irrespective of CD4 count & WHO staging.
  2. Information Education and Communication: IEC activities Report from April 2020 till November 2020

Financial Progress: FY – 2020-21

Department of Ayush

Department of AYUSH has the broad man date of providing Ayush services, regulating Ayush education and drug enforcement in the state. 662 Ayush dispensaries and 160 hospitals are providing medical services through Ayurveda, Unani, Homoeopathy, Yoga & Nature Cure with a total bed strength of 2534.

AYUSH Training Centre: AYUSH Training Centre at Sugganahalli, Ramanagara district has been set up to provide technical and other training to AYUSH officers/Medical officer’s staff.

Medical Education

 

Ayush Department Achievements

Proposed Plan For The Year 2021-22

  1. A new programme “Nutrition and Livelihood through AYUSH” will be implemented to control Anaemia and malnutrition among women and children and to provide livelihoods, linkages to SHGs at a cost of Rs.20.00 crores. An amount of Rs.5.00 crores is provided for the year 2021-22.
  2. Homeopathy units will be established in the 231 talukas of Karnataka which do not have homeopathy medical facilities at a cost of Rs.61.27crores in a phased manner. An amount of Rs.30.00 crores is provided for this programme in the year 2021-22.

Drugs Control Department

The State Drugs Control Department is existing since 1956 as an Independent body under the control of the Ministry of Health and Family Welfare Karnataka. It is headed by the Drugs Controller. The main objective of the Department is to implement the Drugs and Cosmetics Act, 1940 and Rules there under and to ensure the quality of Drugs and Cosmetics manufactured and marketed in the state in the interest of the public health. By exercising strict control and vigilance on the drugs marketed in the State, the Department eradicates the menace of Spurious and substandard drugs, ensures safety of drugs and their availability at the controlled prices to the public.

The Department functions under three wings:

The action taken from the Department to prevent the Covid-19

National Health Mission Expenditure on Covid-19

(Source: Economic Survey 2019-20, 2020-21, Department of Planning, Government of Karnataka)

 

Last Updated : 09-09-2021 02:09 PM Aprover: Admin

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