Government accords high priority to noncommunicable disease




Government accords high priority to noncommunicable disease
United Nations Interagency Taskforce visits India



In another step reaffirming its commitment to address noncommunicable diseases (NCDs) in India, the Ministry of Health & Family Welfare (MoHFW), is hosting the joint mission of the United Nations Interagency Task Force (UNIATF) on prevention and control of NCDs, which is visiting India from 8-12 December 2014.The mission is in India to enhance the support of UN agencies to the Government of India to scale up the national multisectoral response to NCDs.

A high level stakeholder forum has been organized with officials of key government ministries under the chairmanship of ShriLovVerma, Secretary (HFW). MoHFW is facilitating the mission’s deliberations with different line ministers and departments.

The mission will hold consultations with key stakeholders, including civil society and the private sector during their visit to discuss the roles of various stakeholders in strengthening the multisectoral response to NCDs. It will map the ongoing bilateral and multilateral processes to support the government in its efforts to address NCDs within the context of India’s 12th Five Year Plan (2012-2017) and highlight approaches for effective coordination of national multisectoral response to NCDs.

The UNIATF mission comprises of representatives from WHO, UNDP, World Bank, UNFPA, UNICEF and other UN agencies.The UNIATF was established in July 2013 by the UN Secretary General to support UN agencies and international development partners to work together in a coordinated manner to assist national efforts to prevent and control NCDs. Due to the rising burden of NCDs in India, it is among the priority countries where UNIATF will help national efforts to respond to the NCDs problem and provide impetus to attaining national NCD targets.

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Healthcare Facilities in Rural Areas

Public health being a State subject, the primary responsibility to provide improved access to healthcare services is that of the State Governments. However, under National Health Mission (NHM) financial support is provided to State/UT Governments to strengthen their healthcare systems to provide better and easy access to healthcare services. As per Rural Health Statistics, 2014, there is a shortfall of 36346 Sub Health Centres (SCs), 6700 Primary Health Centres (PHCs), and 2350 Community Health Centres (CHCs) against the specified population norm.

As per Rural Health Statistics Bulletin (RHS) 2014, a total of 2225 (8.89%) Primary Health Centres (PHCs) are functioning without doctor, 9825 (39.26%) PHCs without Lab Technician and 5739 (22.94%) PHCs without a pharmacist in the country.

Under the National Health Mission (NHM), financial support is provided to the States /UTs to strengthen their health care system for augmentation of health human resources, provision of free essential medicines, etc. Some key support areas under NHM are:-

1) ASHAs: ASHA is a female voluntary health worker who acts as the link between the community and the public health facilities. She provides basic information regarding health and health care services and motivates people to access services from public health facilities.

2) Ambulances: Under NHM, support is provided to States/UTs to set-up a patient transport system where people can dial 108 or 102 telephone number for calling an ambulance. Dial 108 system is an Emergency Response System, primarily designed to cater to patients of critical care, trauma and accident victims, etc. 102 services is essentially the basic patient transport system aimed to cater to the pregnant women and sick children though other categories are also taking benefit and are not excluded.

3) Mobile Medical Units (MMUs): MMUs provide outreach services in rural and remote areas through a team of staff including one doctor, one nurse, one lab attendant, one pharmacist and a helper and driver.

4) Human Resources: Support is provided under National Health Mission to States and UTs for engaging health care staff at public health facilities on contractual basis, for providing incentives to doctors and other staff to work in rural and remote areas, for capacity building of staff, etc.

5) Infrastructure: Support under NHM is provided to States/UTs for establishment of new facilities based on population and time to care norms and for up-gradation of existing facilities by constructing new buildings or by renovation of existing ones.

6) Drugs & Equipment: To supplement the efforts of States/UTs in ensuring availability of drugs at public health facilities, Government of India has been providing free drugs /funds for free drugs to States/UTs under the Reproductive and Child Health (RCH) and National Disease Control Programmes for Tuberculosis, Vector borne diseases including Malaria, Leprosy and HIV/AIDS etc. Government is also encouraging the States/UTs to provide universal access to free essential medicines in public health facilities by providing funds and incentives under the National Health Mission (NHM). Up to 5% additional funding (over and above the normal allocation of the state) under the NRHM was introduced as an incentive from the year 2012-13 for those States that introduce free medicines scheme.

7) Untied Grants to facilities: Under NHM, support is given to States/UTs to strengthen Sub Centres, PHCs, CHCs and District Hospitals by provision of Untied Funds to undertake need based works for improving infrastructure and enhancing service delivery at these facilities.

8) Support for Reproductive, Maternal, New-born, Child & Adolescent Health (RMNCH+A): RMNCH+A seeks to address the major causes of mortality among women and children as well as the delays in accessing and utilizing health care services. The RMNCH+A strategic approach provides for ‘continuum of care’ to ensure equal focus on various life stages. The support to States/UTs under National Health Mission for RMNCH+A includes Janani Suraksha Yojana (J.S.Y), Janani Shishu Suraksha Karyakram (J.S.S.K), Maternal and Child Health Wings at facilities with higher case load, Integrated Management of Neonatal and Childhood Illness (IMNCI), Home Based New-born Care (HBNC), establishment of facility- based care for new-born and sick children including New Born Care Corners (NBCCs), New Born Stabilization Units (NBSUs), Special New Born Care Units (SNCUs), Nutritional Rehabilitation Centres (NRCs), Universal Immunization Programme, Rashtriya Bal Swasthya Karyakram (RBSK), Rashtriya Kishor Swasthya Karyakram and Family Planning Services.

9) Support for control of communicable and non-communicable diseases: Under NHM, support is provided to States/UTs for the control of the communicable diseases including vector borne diseases such as Malaria and Filariasis, Leprosy and Tuberculosis and for disease surveillance. Under the National Non-Communicable Disease Programmes, NHM supports prevention and control of Blindness, mental health issues, cardiovascular diseases and stroke, deafness, Tobacco related illnesses, oral health issues, Fluorosis, Iodine deficiency disorders, etc. In addition support is also provided to States/UTs for health care of elderly and palliative care.

The MoS, Ministry of Health and Family Welfare, Shri Shripad Yesso Naik stated this in a written reply in the Rajya Sabha here today.

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Steps taken to Accelerate the Pace of Reduction for MMR Under National Health Mission (NHM)

As per the latest report of the Registrar General of India, Sample Registration System (RGI-SRS), Maternal Mortality Ratio (MMR) of India is 178 per 100,000 live births for the period 2010-12. This translates into an approximate number of 47,100 deaths per year for India.

Establishing assured referral transport between the community and health facilities is important for addressing delay in reaching the health facility and timely care during any obstetric complications.

Reproductive health services under the overall umbrella of the National Health Mission are provided free at all Government Health Services through a continuum of care approach of Reproductive, Maternal, New Born, Child Health and Adolescent (RMNCH+A) Health.

It is a fact that some of the Government hospitals constructed much earlier have maternity and children ward located at different places.

Under National Health Mission (NHM), the key steps taken by Government of India to address the above concerns and also to accelerate the pace of reduction for Maternal Mortality Ratio (MMR) are:

 Promotion of institutional deliveries through Janani Suraksha Yojana.

 Janani Shishu Suraksha Karyakaram (JSSK) has been launched on 1st June, 2011, which entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section. The initiative stipulates free drugs, diagnostics, blood and diet, besides free transport from home to institution, between facilities in case of a referral and drop back home. Similar entitlements have been put in place for all sick infants accessing public health institutions for treatment.

 184 High Priority Districts (HPDs) have been identified and prioritized for Reproductive, Maternal, New Born, Child Health and Adolescent (RMNCH+A) interventions for achieving improved maternal and child health outcomes

 Capacity building of health care providers in basic and comprehensive obstetric care.

 Operationalization of sub-centres, Primary Health Centres, Community Health Centres and District Hospitals for providing 24x7 basic and comprehensive obstetric care services.

 To tackle the high bed occupancy in the maternity wards, Mother & Child Health Wings have been sanctioned at high case load facilities where the maternity and children ward are together for provision of continuum of care approach to pregnant women, newborns and children.

 Name Based Web enabled Tracking of Pregnant Women to ensure antenatal, intranatal and postnatal care.

 Mother and Child Protection Card in collaboration with the Ministry of Women and Child Development to monitor service delivery for mothers and children.

 Antenatal, Intranatal and Postnatal care including Iron and Folic Acid supplementation to pregnant & lactating women for prevention and treatment of anaemia.

 Engagement of more than 8.9 lakhs Accredited Social Health Activists (ASHAs) to generate demand and facilitate accessing of health care services by the community.

 Referral systems have been established including emergency referral transport for pregnant women, for which the states have been given flexibility to use different models.

 Village Health and Nutrition Days in rural areas as an outreach activity, for provision of maternal and child health services.

 Health and nutrition education to promote dietary diversification, inclusion of iron and folate rich food as well as food items that promote iron absorption.

The MoS, Ministry of Health and Family Welfare, Shri Shripad Yesso Naikstated this in a written reply in the Rajya Sabha here today.

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Government Plans to set up AIIMS in Each State

The Central Government plans to set up new AIIMS in each State in a phased manner. The Ministry of Health & Family Welfare has requested the Chief Ministers of different States to identify three or four alternative locations having 200 acres of land each and to undertake to provide free of cost land and other required infrastructure such as suitable road connection, sufficient water supply, electricity connection of required load and regulatory/statutory clearances.   Subsequently, a check-list has also been sent to the State Governments to furnish full details on each of sites/locations.



Insofar as Ministry of Health & Family Welfare is concerned, details are given below:-


S.
No.
Name of State/ UT
Name of Institute
1.
Bihar
All India Institute of Medical Sciences (AIIMS), Patna
2.
Chhattisgarh
All India Institute of Medical Sciences (AIIMS), Raipur
3.
Madhya Pradesh
All India Institute of Medical Sciences (AIIMS), Bhopal
4.
Odisha
All India Institute of Medical Sciences (AIIMS), Bhubaneswar
5.
Rajasthan
All India Institute of Medical Sciences (AIIMS), Jodhpur
6.
Uttarakhand
All India Institute of Medical Sciences (AIIMS), Rishikesh
7.
Delhi
All India Institute of Medical Sciences (AIIMS), New Delhi
8.

Safdarjung Hospital, New Delhi.
9.

Lady Hardinge Medical College & Associated Hospitals
10

Dr. Ram ManoharLohia Hospital, New Delhi.
11.
Jharkhand
Central Institute of Psychiatry, Ranchi
12
Karnataka
National Institute of Mental Health of Neuro Sciences, Bangalore
13.
Assam
LokpriyaGopinathBardolai Regional Institute of Mental Health, Tezpur.
14.
Meghalaya
North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences (NEIGRIHMS), Shillong
15.
Chandigarh
Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh
16.
Puducherry
Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry

The MoS, Ministry of Health and Family Welfare, ShriShripadYessoNaikstated this in a written reply in the RajyaSabha here today.

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Free Treatment Facility for Children with Cancer

The treatment of children with Cancer in various Government Hospitals is either free or subsidized both for the Central and State Government Hospitals. Cancer can be diagnosed and treated at various levels in the Government health care system. Hence the number of such facilities for the States is not centrally maintained.

Government of India provides facilities for treatment of cancer through Central Government Hospitals/Institutions in different parts of the country such as All India Institute of Medical Sciences, Safdarjung Hospital, Dr. Ram Manohar Lohia Hospital, PGIMER Chandigarh, JIPMER Puducherry, Chittranjan National Cancer Institute, Kolkata etc. Oncology in its various aspects has focus in case of new AIIMS and many upgraded institutions under Pradhan Mantri Swasthya Suraksha Yojna (PMSSY). The proposal of setting up of National Cancer Institute at Jhajjar and development of 2nd campus of Chittranjan National Cancer Institute, Kolkata has also been approved. 27 Regional Cancer Centres were recognized and supported under the erstwhile National Cancer Control Programme (NCCP) for treatment of cancer patients.

In addition, Government of India has in the year 2013-14, approved a scheme for enhancing the Tertiary Care Cancer facilities in the country. Under this scheme (Tertiary component of NPCDCS), Government of India will assist 20 State Cancer Institutes (SCI) and 50 Tertiary Care Cancer Centres (TCCC) in different parts of the country. The maximum assistance inclusive of State Share for SCI is Rs.120 crores and for TCCC is Rs.45 crores. The Central and State share will be in the ratio 75:25, and for North East and Hill States this ratio would be 90:10. Financial assistance to patients is also provided under the Health Minister’s Discretionary Grant and Health Minister’s Cancer Patient Fund under Rashtriya Arogya Nidhi.

The MoS, Ministry of Health and Family Welfare, Shri Shripad Yesso Naik stated this in a written reply in the Rajya Sabha here today.

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Mental Health Institutions in the Country



It is estimated that there are 3800 Psychiatrists, 898 Clinical Psychologists, 850 Psychiatric Social Workers and 1500 Psychiatric Nurses in the country. Recent estimates for State/UT wise details of trained mental health personnels are not available.



There are three centrally run mental health institutes, 40 State run mental hospitals and 398 Departments of Psychiatry in various medical colleges (183 in Government and 215 in private) across the country equipped to treat patients suffering from mental illness. The details of Central and State run mental health institutes in the country are given below:-

List of Govt. Mental Hospitals


S. No.
State
Name of the Mental Hospital
1.  
Andhra Pradesh
Institute of Mental Health, Govt. Hospital for Mental Care, S.R. Nagar, Hyderabad ANDHARA PRADESH
2.  
Government Hospital for Mental Care, Chinnawaltair, Vishakhapatnam, Andhra Pradesh
3.  
Assam
LokopriyaGopinathBordoloi Institute of Mental Health, P.O. Tezpur, Dist. Sonitpur, Assam (Central Government)
4.  
Bihar
Institute of Mental Health, Koelwar, Bhojpur, BIHAR
5.  
Jharkhand
Central Institute of Psychiatry, Kanke P.O. Ranchi, JHARKHAND (Central Government)
6.  
Ranchi Institute of Neuropsychiaty and Allied Science (RINPAS), Kanke, Ranchi, JHARKHAND
7.  
Delhi
Institute of Human Behavior & Allied Sciences, G.T. Road, P.O. Box 9520, Jhilmil, Delhi,
8.  
Goa
Institute of Psychiatry & Human Behavior, Altinho, Panaji, GOA
9.  
Gujarat
Hospital for Mental Health, Bhuj, Gujarat.
10.  
Hospital for Mental Health, Vikasgruh Road, Jamnagar, Gujarat
11.  
Hospital for Mental Health, Behind Kapadia High School, Outside Delhi Gate, Shahibaug Road, Ahmedabad
12.  
Hospital for Mental Health, Karelibag, Baroda
13.  
Himachal Pradesh
Himachal Hospital of Mental Health & Rehabilitation, Boileauganj
14.  
Jammu & Kashmir
Govt. Hospital for Psychiatric Diseases , Rainawari, Khatidarwaze, SRINAGAR (JAMMU & KASHMIR)
15.  
The Medical Superintendent, Psychiatric Diseases hospital GMC, Jammu, Ambphalla B.C. Road, Jammu
16.  
Karnataka
Karnataka Institute of Mental Health, Belgaum Road, Dharwad, Karnataka
17.  
National Institute of Mental Health and Neuro Sciences, Bangalore (Central Government)
18.  
Kerala
Mental Health Centre, Oolampara, Thiruvananthapuram, Kerala
19.  
Govt. Mental Health Centre, Kuthiravattom, Kozhikode, Kerala
20.  
Govt. Mental Health Centre, Poothole P.O., Trissur, Kerala
21.  
Madhya Pradesh
Gwalior ManasikArogyasala, Central jail Road, Gwalior, Madhya Pradesh
22.  
Mental Hospital, BangangaSawer Road, Indore, Madhya Pradesh
23.  
Maharashtra
Regional Mental Hospital, Nagpur, Maharashtra
24.  
Regional Mental Hospital, Yeravda, Pune, Maharashtra
25.  
Regional Mental Hospital, Wagle Estate, Thane (W) MAHARASHTRA
26.  
Regional Mental Hospital, Ratnagiri, MAHARASHTRA
27.  
Meghalaya
Meghalaya Institute of Mental Health & Neurosciences Shillong, Meghalaya
28.  
Modern Psychiatric Hospital, Narsingarh, Agartala, West Tripura. 
29.  
Nagaland
Mental Hospital, Kohima, Nagaland
30.  
Orissa
Mental Health Institute, S.C.B. Medical College, Cuttack, Orissa
31.  
Punjab
Dr. Vidyasagar Punjab Mental Hospital. Circular Road, Amritsar
32.  
Rajasthan
Mental Hospital (Psychiatric Centre), Janta Colony, Jaipur, Rajasthan
33.  
Mental Hospital, (Psychiatric Center), Shastri Nagar, JODHPUR
34.  
Tamil Nadu
Institute of Mental Health, Medavakkam Tank Road, Kilpauk, Chennai, Tamil Nadu
35.  
Uttar Pradesh
Institute of Mental Health & Hospital, Billochpura, Mathura Road, Agra, Uttar Pradesh
36.  
Mental Hospital Bareilly, Civil Lines, Bareilly, Uttar Pradesh
37.  
Mental Hospital, S2/1 Pandeypur, Varanasi, Uttar Pradesh
38.  
West Bengal
Lumbini Park Mental Hospital, 115, G.S, Bose Road, Calcutta, West Bengal
39.  
Institute for Mental Care, Purulia P.O., Purulia, WEST BENGAL
40.  
Mental Hospital Berhampore, Berhampore Mental Hospital, Berhampore, Murshidabad, WEST BENGAL
41.  
The Mental Hospital (Calcutta &Mankundu), 133, Vivekananda Road, Calcutta, West Bengal
42.  
Institute of Psychaitry7, D.L. Khan Road, Calcutta, West Bengal
43.  
Calcutta Pavlov Hospital, 18, Gobra Road, Calcutta, West Bengal


To address the huge burden of mental disorders, the Government of India has introduced the National Mental Health Programme (NMHP) in the country since 1982. A total of 232 districts in the country have been covered under the District Mental Health Program (DMHP) to provide detection, management and treatment of mental disorders/ illness. With the objective to address the shortage of mental health professionals in the country, 11 Centres of Excellence in Mental Health and 27 PG training departments in mental health specialties have been funded. Besides, three Central Institutions viz. National Institute of Mental Health And Neuro Sciences, Bangalore, LokopriyaGopinathBordoloi Regional Institute of Mental Health, Tezpur and Central Institute of Psychiatry, Ranchi have been strengthened for augmenting the human resources in the area of mental health and for capacity building in the country. During the 12th Five Year Plan, the District component of National Mental Health Programme has further been restructured to include additional components like suicide prevention services, work place stress management, life skills training and counseling in schools and colleges.

No financial benefits are provided to the persons suffering from mental illness or mental retardation under the various schemes of the National Mental Health Programme.



There is no provision for direct funding of mental health care research under the extant District Mental Health Programme. The details of expenditure incurred by the National Institute of Mental Health and Neuro Sciences, Bangalore and LokopriyaGopinathBordoloi Regional Institute of Mental Health, Tezpur, Assam on research in the field of Mental Health during the last three years is given below:-



Details of expenditure incurred on research in the field of Mental Health

(Rs. in lakhs)


S.No.
Institute
2011-12
2012-13
2013-14
1
National Institute of Mental Health and Neuro Sciences, Bangalore
4.16
11.08
19.70
2
LokopriyaGopinathBordoloi Regional Institute of Mental Health, Tezpur, Assam
85.79
38.43
50.52


The MoS, Ministry of Health and Family Welfare, ShriShripadYessoNaikstated this in a written reply in the RajyaSabha here today.
Government accords high priority to noncommunicable disease Government accords high priority to noncommunicable disease Reviewed by Ajit Kumar on 8:52 AM Rating: 5

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