PUBLIC PRIVATE PARTNERSHIP

Transcription

1 PUBLIC PRIVATE PARTNERSHIP (URBAN HEALTH) Background (Current Status and situational analysis): The total urban population of Odisha is 55, 17,000, which covers 103 urban local bodies (Municipal Corporation 3, Municipality 37, Notified Area Council 63) as per the 2001 census. The health needs of these urban population are being addressed by 212 numbers of health institutions (74 institutions in 3 municipal corporations, 53 institutions in 37 Municipality and 63 institutions in 63 Notified Area Council) available across the State. About 43% of the population in the urban areas are Below Poverty Line as against 26% at the national level. Major Indicators (in %) DOTS Leprosy Eradication Malaria/Dengue/Chikun Guinea Marriage Mean age at marriage for girls 9marriage that occurred during the reference period 21.9 Current use of family planning methods Any method 62.1 Unmet Need for Family Planning Total unmet need 17.6 Antenatal Care Mothers who received antenatal checkup 91.5 Institutional Delivery 74.4 Prevention of Sex Selection Trend Analysis: Though the health scenario in the urban area is impressive, it needs much improvement. Source: DLHS 3

2 Scope of Intervention: Year NUHM Proposed Cities/Town NUHM proposes to cover 11 cities/towns, which includes: - Bolangiri Bhubaneswar Cuttack Berhampur Rourkela Industrial Estate Rourkela Municipality Sambalpur Balasore Puri Baripada Bhadrak Cities Currently covered /to be covered by NRHM Cities Presently covered under NRHM includes:- Bhubaneswar Cuttack Berhampur Rourkela Sambalpur Balasore Paradeep Jharsuguda Three more cities from the NUHM list will be covered by NRHM. The cities are:- Baripada Bhadrak Puri Remarks Two additional cities/town (Paradeep and Jharsuguda) have been taken into NRHM s fold in FY But another two cities, Bolangir and Rourkela industrial estate were left out. While Bolangir was not considered as it was not meeting the Urban Health Project Population criteria. Rourkela Industrial Estate was not considered because it is being covered under CSR activities of SAIL. Besides, NRHM also proposes to cover Angul and Barbil/Joda on and above the NUHM proposed city/town. The proposed urban health projects under NRHM aim to cover 9.50 lakhs slum population in 13 cities/towns in the State at a rate of 20,000-25,000 population per urban health project. These urban health projects would provide clinical, outreach and referral services to the vulnerable and needy urban slum population. Issues Weak involvement of urban local bodies for meeting public health challenges Scattered population and poor health indicators require more intensive input Poor convergence among wider determinants of health Unauthorized slums and floating population hinders the service delivery at a fixed time and fixed place. Poor environmental health, poor sanitation, lack of water supply, drainage and sewerage facilities Existing special schemes in the urban areas- related to health & determinants of health Health Related Areas 35 Urban Health Centers are operational in 7 cities/towns under NRHM Other Determinants of Health As many as 1468 ICDS centers are operational in 8 cities/towns (Bhubaneswar, Joda, Jharsuguda, Cuttack, Sambalpur, Rourkela, Berhampur and Puri).

3 City Sanitation Plans are being prepared for 8 class-1 cities/towns (Bhubaneswar, Puri, Cuttack, Berhampur, Sambalpur Balasore, Baripada and Rourkela) in the state as per the National Urban Sanitation Policy. The Integrated Low Cost Sanitation (ILCS) programme is proposed to be implemented in major urban locations of the state. Scientific disposal of solid waste is proposed to be undertaken in the twin cities of Bhubaneswar and Cuttack. 29 cities/towns are being covered under Integrated Housing and Slum Development Programme (IHSDP). Current Status Activities planned in Management of Urban Health Centre in urban slums Monitoring and evaluation( external agency) Training programme Budget Utilization Status Current status 35 UHCs are operational in 8 cities out of 46 planned The evaluation is completed in 12 UHCs out of 12 targeted and findings shared Monthly review meetings are conducted at districts level Quarterly review of urban health projects are conducted at State level Training programmes are conducted for Chief Functionaries, Project Coordinators and link volunteers, ANMs are conducted for management of urban health projects. 28% by December 2010 as per FMR Interventions Activities Outputs Time Frame Q 1 Q 2 Q 3 Q 4 Operationalisation of Urban Health Centres (Details of Urban Health Programme Model) * Urban Health Centers: Continuation of 35 Urban Health Centers in 8 cities Continued: Bhubaneswar-11,Cuttack-9, Balasore- 2,Samabalpur-2,Rourkela-3, Paradeep- 2,Berhampur-4,Jharuguda-2 With the completion of the new centers all the 46 urban health centers will be operational in 13 cities /town. 11 newly proposed UHCs in 5 new cities three old cities Newly proposed: Bhubaneswar- 1,Rourkela-1,Jatani-1, Bhadrak-2,Cuttack-1, Puri- 2,Baripada-1, Angul-1,Keonjhar-1

4 Training and Capacity Building Capacity Building of chief functionaries and other staffs Orientation programme of Urban Local Bodies ( Corporator/ Councilor) Monitoring & Evaluation Review Meeting Quarterly in State & Monthly in the district level Midterm and final Evaluation by external Agency/ Agencies Vulnerability assessment and mapping of urban cities Bhubaneswar by PFI-HUP,Cuttack and Berhampur by NRHM Establishment of Urban Health Cell at State level under NRHM In the view of NUHM, it will provide technical support (planning, research, documentation, guideline development, policy formation etc.) 368 persons trained in 15 batches 387 Persons trained in 16 batches 4 state level quarterly review meetings + 12 district level monthly review meeting organised Evaluation Report submitted & shared Vulnerability mapping assessment completed Urban Health Cell has been established and functional Strategies and Activities Urban Health Programme Model* The Urban Health Centers mainly provides outdoor services, which is imparted with partnership through the NGOs or private organizations that help in imparting service in the slum and vulnerable population in urban areas. The service provision under the urban health project is mentioned underneath. Curative Care OPD services (Managed by one part time Doctor, one ANM) Referral services (The cases, which is difficult to handle at OPD are referred to Identified Referral Centres) Strengthening of Referral Centres (The identified local health institutions are being strengthened with untied funds) Preventive and Promotive Care Outreach services in urban slum locations - Some of the activities here includes, health camps, immunization, family planning promotion, IEC/BCC, training for adolescents, adolescent reproductive sexual health, RTI/STI, services under National disease control Programme, Community Mobilisation, Capacity building of SHGs, CBD and urban local bodies etc. (It is managed by one Project Coordinator and five Link Volunteers)

5 Management Formation of slum development committee & capacity building of urban slum committee to ensure smooth management of programmes. Role of Population Foundation of India ( PFI )-HUP, Odisha Health of the Urban Poor programme supported by USAID INDIA, which has been implemented by the Population Foundation of India in Odisha will provide technical support to urban health cell of NRHM in the areas of Evidence based planning, supportive supervision, process and outcome monitoring, engaging community in planning, monitoring and management of resources. Hence, PFI as a technical agency would be supporting NRHM - Odisha in Urban Health affairs with its technical expertise and demonstration of good practices related to Urban Health.