sschub - This is the second part of Public Health series for UPSC, IAS, PCS, SSC CGL and Bank IBPS PO, Clerk. Before fighting prelimns exams we should clear basics of govt policies. many times they asks directly facts (not in case of UPSC). If you didn't go through part 1 then click Public Health part 1. Here we read about => public health policy like swastha bharat, rashtriya swasthiya bima yojana, sowa rigpa, ayush, annual health survey, rashtriya swasthya bima yojana, health insurance, arsh, sabla, janani suraksha yojna, tfr, mmr, imr, iucd, risyug etc.
Government schemes for Family planning
In villages, ASHA worker gets commission for
- Delivering contraceptives at doorstep
- Promoting couples to have time gap between two kids.
- Promoting institutional delivery for pregnant women.
- Encouraging couples to opt for permanent family planning (vasectomy, tubectomy.)
Also,
- National family planning insurance scheme: it provides money to if person dies during vasectomy / tubectomy or if the surgery fails or some complication arises.
so what is vasectomy
- for males
- vasectomy will take only few minutes. It does not require hospitalization
- Any plain MBBS with simple three-day training can do it.
- No Risk of infections and menstrual complications like excessive bleeding and pain in the abdomen.
- Men can go back to work immediately
what is tubectomy
- for females
- lengthy surgery
- tubectomy is done with the help of a laproscope, which means that only an expert and experienced doctor can do the job.
- Risk of infections and menstrual complications like excessive bleeding and pain in the abdomen.
- One month’s rest necessary
so what is the problem in above two = in rural areas, men force their wives to undergo tubectomy, rather than going through vasectomy themselves. why ? because men have two myths, that after vasectomy
they loses libido after vasectomy
they will not be able to do strenuous work or lift heavy objects. By the way, lets move to others birth control Devices.
Other Birth Control Devices
IUCD
- intrauterine contraceptive device (IUCD) for females.
- Made up of copper / plastic.
RISYUG
- Reversible Inhibition of Sperm Under Guidance
- Long term male contraceptive. (injection)
- Research still going on. (IIT Kharagpur)
Implanton
- Female contraceptive (sub-dermal rod)
- A matchstick-sized rod is inserted in the arm.
- It releases progestin hormone to prevent pregnancy.
what are TFR, MMR, IMR
This table is based on Economic survey 2012-2013.
| What? | Definition | Data for India* |
| TFR |
| 2.5 |
| MMR |
| 212 |
| IMR |
| 44 |
| Sex Ratio |
| 914 (0-6) and 940 (overall)(Census 2011) |
Why Five Year plans
- Universal Health Coverage (UHC)
- Prevent and reduce Communicable and Non-Communicable diseases (including mental illnesses)
- Reduction of poor households’ out-of-pocket expenditure. (meaning State should give out more free medical services to them).
- A large expansion of medical schools, nursing colleges.
- And many other things, I suggest you read third PDF, Chapter 20 (Health) of 12th FYP after prelim/CSAT is over.
What is Janani Suraksha Yojana
- Under National rural health mission
- Promote institutional (hospital) delivery among poor pregnant women
- 100% centrally sponsored
Janani Shishu Suraksha Yojana
- Pregnant women get free hospital delivery, caesarean section, food, drugs, medical checkup and transport.
Mother and Child Tracking system
- Under national E-governance plan (NeGP)
- Government keeps maintains data of the mothers with their addresses, telephone numbers, etc.
- This contact database is used for ante-natal (before birth) and post-natal (immediately after birth) check-up of mothers and vaccination for their babies.
- Another similar project is Health Management Information System (HMIS): software for online data capture at district level, regarding reproductive and child health (RCH).
Navjat Shishu Suraksha Karyakram (NSSK)
- To train heathcare personnel for taking care of infants: hypothermia, infection, premature birth, pneumonia, diarrhea, measles, resuscitation etc.
- Setup new-born care units at district level hospitals.
- Started in 2005 to to reduce Infant Mortality Rate (IMR) from to 30 by the year 2012.
Indira Gandhi Matritva Sahyog Yojana (IGMSY)
- Launched by Women and Child Development Ministry (and NOT by Health Ministry)
- To compensate mothers for wage-loss during childbirth and childcare.
- Available to all women for first two children.
- Not available to women who get paid maternity leave.
- Conditional cash transfer.
- Condition: she should get pre-natal checkups, get vaccination for infant, attend counseling session etc.
- The scheme is now covered under the Direct Benefit Transfer (DBT) programme
So challanges are Must (hahaha)
- Bogus Beneficiaries: A woman usually gives birth to a baby after nine months of pregnancy, but in Bihar almost 300 women claim to have delivered two to five children in a span of 60 days- as per the Government records!= bogus beneficiaries, local official chowing down the Government money.
- NRHM scam: worth thousands of crores rupees in Uttar Pradesh. Two chief medical officers died (or murdered) to keep a lid on the scam.
- Crib deaths: many infants died in the Government hospitals of West Bengal in 2012. Reason: they were already under-weight and got infection due to unhygienic condition in the Government hospitals. + manpower shortage
- Encephalitis: Hundreds of children died in Uttar Pradesh due to Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES). National Commission for Protection of Child Rights (NCPCR) concluded that Government’s casual approach was responsible for widespread deaths.
Rajiv Gandhi Creche
- Scheme for the Children of Working/Ailing Mothers:
- Basically NGOs given money to setup crèche for working women
- Condition: family’s monthly income < 12k, and kid is within 0-6 age group
School health program
- Regular medical checkup
- Nutrition, iron supplements.
SABLA
- Man, this SABLA is getting too clichéd for MCQs.
- Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (RGSEAG)-Sabla:
- all-round development of adolescent girls in the age group 11-18 years.
- The scheme has two major components, 1) nutrition and 2) non-nutrition.
| #1: Nutrition | Girls are given ‘take home rations’ or ‘hot cooked meals’ to out-of –school. |
| #2: Non-Nutrition | provided iron-folic acid supplementation, health check-up, health and skill education, vocational training etc. |
Weekly Iron Folic acid supplementation (WIFS)
- To reduce Anemia in adolescents (age group 15 to 19)
- In both rural and urban areas.
- Pills for iron and folic acid given to boys (only school going)
- Girls (both school going girls + not school going girls)
ARSH
- Adolescent reproductive and sexual health
- Adolescent are more vulnerable to sex-abuse, STD, HIV, pregnancy.
- Government launched toll free helpline, tele-counciling for them
- +life skill education programs.
Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
It has two objectives
#1: set up 8 new AIIMS-like institutions
- Bihar (Patna),
- Chattisgarh (Raipur),
- Rajasthan (Jodhpur)
- Madhya Pradesh (Bhopal),
- Orissa (Bhubaneswar),
- Uttaranchal (Rishikesh)
- West Bengal
- Uttar Pradesh
- Some books/ magazines / sites/ coaching material would say : PMSSY = 6 new AIIMs like institutions.
- But that information is outdated. Originally there were six, later Government added WB and UP.
#2: upgrade existing Medical colleges in several states.
Now steering committee on health for 12th Five Year Plan has recommended the Union government to create four new AIIMS like institutions
Health Insurance for BPL
| What? | Falls under this ministry |
| Health Insurance Scheme for BPL | Health |
| Rashtriya Swasthya Bima Yohana | Labour |
Rashtriya Swasthya Bima Yojana (Rsby)
- RSBY provides for ‘cash-less’, smart card based health insurance cover
- Upto Rs.30000k per annum
- For family upto 5 members.
- The beneficiary family pays only 30 per annum as registration/renewal fee.
- The scheme covers hospitalisation expenses (Out-patient expenses are not covered),
- includes maternity benefit, and pre-existing diseases.
- Even in private clinics.
- Funding: centre –state=75:25 and 90:10 for Jammu Kashmir and North-East.
- RSBY was originally limited to Below Poverty Line (BPL) families but was later extended to building and other construction workers, MGNREGA beneficiaries, street vendors, beedi workers, and domestic workers.
- In Budget 2013, Chindu extended this scheme to rickshaw, auto-rickshaw and taxi drivers, sanitation workers, rag pickers and mine workers.
Annual Health Survey
- To prepare district health profile including IMR, TFR etc.
- Done by Registrar General of India for Health Ministry.
AYUSH
- A=Ayurveda
- Y=Yoga and Naturopathy
- U=Unani
- S=Siddha
- H=Homeopathy
How AYUSH Regulation
- Ayurveda, Unani, Siddha and Homeopathy drugs are regulated under Drug and cosmetics Act 1940.
- Most of these drugs are manufactured from medicinal plant material, hence AYUSH department setup National medicinal plants board to regulate it.
Sowa Rigpa
- Latest addition in AYUSH system.
- ancient Tibetan medicinal system
- believed to have been taught by Buddha himself – Sowa Rigpa
- commonly known as Amchi system
- popular in the Himalayan region of India. Also in Tibet, Magnolia, Bhutan, some parts of China, Nepal.
- it is similar to Ayurveda, and also include few principles of Traditional Chinese Medicine.
Rashtriya Swasthya Bima Yojana (RSBY)
- RSBY provides for ‘cash-less’, smart card based health insurance cover
- Upto Rs.30000k per annum
- For family upto 5 members.
- The beneficiary family pays only 30 per annum as registration/renewal fee.
- The scheme covers hospitalisation expenses (Out-patient expenses are not covered),
- includes maternity benefit, and pre-existing diseases.
- Funding: centre –state=75:25 and 90:10 for Jammu Kashmir and North-East.
- RSBY was originally limited to Below Poverty Line (BPL) families but was later extended to building and other construction workers, MGNREGA beneficiaries, street vendors, beedi workers, and domestic workers.
- In Budget 2013, Chindu extended this scheme to rickshaw, auto-rickshaw and taxi drivers, sanitation workers, rag pickers and mine workers.
Swastha Bharat
- Health program on doordarshan and all India radio.
- World’s Biggest Public Health Media Initiative
- Shown 5 days — a week in 19 Indian languages and 17 Dialects
- Supported by Union Ministry of Health & Family Welfare
