The Mission Steering Group of the National Rural Health Mission (NRHM) has approved the proposal to include Haemophilus influenzae b (Hib) vaccine as liquid pentavalent vaccine (DPT+Hep B+Hib) under the universal immunisation programme in six more states from October this year.
The Mission Group, which met here recently, also approved an outlay of Rs.332.70 crore towards of the cost of medicine from October, 2012 to December 2014. The pentavalent vaccine was introduced in Kerala and Tamil Nadu on pilot basis. Now it will be expanded to Gujarat, Haryana, Karnataka, Goa, Jammu & Kashmir, and Puducherry.
Proposal for modifying the hospitals and dispensaries scheme of AYUSH was also placed in front of the MSG. Important decisions were made to remove the ceiling of remuneration for various contractual manpower employed under the different components of the Scheme, and to strengthen the Programme Management Unit at Centre level with deployment of the additional manpower.
For a more meaningful mainstreaming, it was decided to direct the States to create Institutional Mechanisms for mainstreaming of AYUSH in the States/ District Level and include AYUSH Mainstreaming in the MIS monitoring and evaluation cell under NRHM at district/ State level. The guidelines for the modified scheme were placed in front of the MSG and were approved, according to an official release.
Union Minister of Health and Family Welfare Ghulam Nabi Azad chaired the eighth meeting of the Mission Steering Group (MSG) which took up proposals forwarded by the Empowered Programme Committee for detailed discussion. The MSG is the highest decision making body of NRHM that takes decisions on the policies and programs under the Mission.
Addressing the meeting, Azad said Maternal and Child Health has been a key focus under NRHM. It is a matter of satisfaction that both MMR and IMR have started showing consistent and steady decline. The fact that the decline is sharper in rural areas and also that Empowered Action Group states have by and large shown better than National performance, points to the success of several interventions made under NRHM, he added.
As a part of the communitization strategy of NRHM, it was proposed to involve ASHAs in convening the VHSNC meeting at the village level. For this, an incentive of Rs.150 to ASHAs for facilitating the monthly meeting of VHSNC followed by the meeting of women and adolescent girls was decided. Guidelines in this regard will also be issued to the States as recommended by the MSG. An honorarium for performance based community level testing and creating awareness about use of iodated salt through Salt Testing Kits @ Rs.25/month to each ASHA on testing of, at least, 50 salt samples per month for 303 endemic districts in the country was also approved.
“Reaching out to the unreached is of utmost importance to ensure that health care services are easily accessible. Presently NRHM supports only one MMU per district in a State. A proposal for relaxing this norm and providing up to 5 MMUs per district was proposed and approved. Increase in the recurring expenditure cost of North-Eastern states, J&K and Himachal Pradesh for diagnostic van from Rs. 23.71 lakhs to Rs. 28.00 lakhs was also approved. For other states the recurring cost would be revised from Rs.19.87 lakhs to Rs.24.00 lakhs as approved by MSG. To provide a national identity, a universal name “Rashtriya Mobile Medical Unit” was approved for all MMUs funded under NRHM. Also uniform color with emblem of NRHM, Government of India and State government would be used on all the MMUs,’’ said the release.
Emergency Medical Transport System has been successfully developed and are being implemented almost all the States of the country. It was decided to extend the financial support for the same beyond three years. Thus, 20 % operational expenditure incurred by states on Emergency Medical transport System (EMTS) would be supported by NRHM beyond 3rd years under NRHM with the cap of Rs.3 lakh per year per ambulance.
It has been proved by various studies that spacing between children have a positive impact on reducing maternal deaths; if spacing between two children is 27-32 months (2-2½ yrs), maternal mortality would decline by 61% (from 9.5 deaths per 10,000 women to 3.7 deaths per 10,000 women). Further spacing also indirectly helps in reducing infant mortality. It was therefore considered that services of the ASHA should be used for counseling eligible couples for ensuring healthy spacing between births. For this, incentives to ASHAs are to be introduced as decided by MSG.