Dr Supratim Biswas, Consultant-Community Process, RRCNE (Branch of NHSRC), Ministry of Health & Family Welfare, Government of India
Public health is a major challenge in our country. Tripura, a small state in North East India, has made several efforts to bring about changes in public healthcare domain and has given priority to healthcare sector. The state is making significant investments to improve the healthcare infrastructure, which is further accelerated under National Health Mission (NHM). True to its vision, NHM improved the availability of and access to quality healthcare, especially for those residing in rural areas. Under NHM, a manifold increase in the allocation for the health sector in Tripura has taken place. There are also significant improvements in institutional delivery, immunization, family planning services, and also increasing out-patient load in both Allopathic and AYUSH systems in the government health facilities. As numerous augmentation and development avenues emerge, the state of Tripura is embarking on a vibrant journey to achieve the health indicators as per the national target for making a better healthy Tripura.
Highlights on Key Strategies for 2017
Reducing infant mortality. Tripura has made significant progress in child mortality in the last couple of years. IMR of the state has come down 17 points in the last 7 years and as per the latest Sample Registration System (SRS), 2015 (published in December, 2016), the IMR of the state is 20. The state is going to undertake the following interventions for child survival in 2017:
Establishment of special newborn care units (SNCUs) in four district hospitals; expected to be functional by March, 2017 and further it will be extended to rest of the three district hospitals, which will be proposed in the State Program Implementation Plan of 2017-18; Commissioning of newborn stabilization unit (NBSUs) in six sub-divisional hospitals (SDHs); Two nutrition rehabilitation centers (NRCs) will be functional in two district hospitals; Child health screening (0–18 years children) and early intervention services will be accelerated to cover 30 identified health conditions for early detection and free treatment and management through camp-based health service approach at tertiary health facility level; and Care for every newborn through a series of home visits by an ASHA in the first 6 weeks of life under Home Based New Born Care (HBNC) program.
Reducing maternal mortality. Maternal mortality and infant mortality are sensitive indicators. The percentage of institutional deliveries (delivery in hospitals and health centers) in Tripura is 89 against the national average of 80 as per Health Management Information System data. The following interventions will be undertaken for addressing maternal care at health-facility level:
Sixty ideal delivery points (IDP) have been functional in the state so far along with a functional newborn care unit (NBCC) at each facility and further 20 health facilities will be made IDPs along with functional NBCCs in the year 2017-18; Kayakalp Award for better health facility management and ensuring sanitation, hygiene, and quality services will be given to one DH, one SDH in the state and one PHC in each district in the year 2017 through four-assessment (baseline/internal/peer/external) processes; and Mayer Ghar (mother's houses) are being operationalized in four health facilities to reduce the number of home deliveries in the selected interior and tribal areas, and thereby cut down on maternal and infant deaths and further, it is proposed to be extended in the new seven health facilities in 2017-18.
Strengthening community process. In 2017, the state is going to accelerate the strategy for Health Care Approach, i.e., disseminating health messages through centralized IEC approach and centralized drug procurement and distribution process and currently the state intends to come up with human resource management information system (HRMIS) for regulation and management of all human resources from the state to health facility level.
ASHAs will be certified by National Institute for Open Schooling (NIOS) through examination process in 2017 and in this year, ASHAs will be enrolled for Digital Literacy Certification Program, the first of its kind digital literacy training curriculum for frontline workers in the state.