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National Rural Health Mission

National Rural Health Mission. Monitoring & Evaluation. Where we are …(1). Population Projections. Demographic scenario. Where we are …(2). Some Bare Facts. Funds not a constraint. Parameters of Health Care. Awareness Available Accessible Affordable Quality

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National Rural Health Mission

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  1. National Rural Health Mission Monitoring & Evaluation

  2. Where we are …(1)

  3. Population Projections

  4. Demographic scenario

  5. Where we are …(2)

  6. Some Bare Facts

  7. Funds not a constraint

  8. Parameters of Health Care • Awareness • Available • Accessible • Affordable • Quality • Performance vs agreed standards 8

  9. Monitoring Outcomes of NRHM • Right to Health • An inalienable right of all citizens • Incorporate in monitoring framework of Mission • Preparation of Household Specific Health Cards • Record of births, deaths, illness, disease, health expenditure • Age/sex profile of household • Means of livelihood, food availability, • Food habits, alcohol consumption etc • Availability of health facility/providers Through ASHA/AWW etc

  10. Monitoring Outcomes of NRHM (cont’d) • Preparation of Habitation/Village Health Register • Periodic Health Facility Survey at SC, PHC, CHC, DHQ • Facilities available • Service Guarantees • Formation of Health Monitoring & Planning Committees at PHC, Block, District and State Level • Regular Monitoring of Activities at each level • Inputs for planning for local level, IDHAP, SPIP etc

  11. Monitoring Outcomes of NRHM (cont’d) • Sharing of data at all levels – full transparency • Display of agreed service guarantees at health facilities • Sample household and facility surveys by external agencies/NGOs • Public Reporting of household & health facility findings

  12. MIES System Model in NRHM/RCH II Program Planning & Service Delivery MIES Validation Monitoring MIES Quality Assessment Evaluation 12

  13. Agreed Indicators … (1) 13 Process Indicators – 6 monthly review % of ANM positions filled % of states and districts having full time program manager for RCH with financial and administrative powers delegated % of sampled state and district program managers aware of their responsibilities % of sampled state and district program managers whose performance was reviewed during the past six months % of districts not having at least one month stocks of Measles vaccine, Oral Contraceptive Pills and Gloves 13

  14. Agreed Indicators … (2) 13 Process Indicators – 6 monthly review (cont’d) % of districts reporting quarterly financial performance in time % of district plans with specific activities to reach vulnerable communities % of sampled districts that were able to implement M&E triangulation involving communities % of sampled outreach sessions where guidelines for AD syringe use and safe disposal are followed % of sampled FRUs following agreed infection control and health care waste disposal procedures % of 24 hrs PHCs conducting minimum of 10 deliveries/month % of upgraded FRUs offering 24 hr. emergency obstetric care services % of sampled health facilities offering RTI/STI facilities as per agreed protocols 14

  15. Agreed Indicators … (3) Output Indicators from Mid & End-line Surveys The states are to set levels of achievement based on their own assessments. 1. Contraceptive prevalence rate 2. % eligible couples using any spacing method for more than 6 months 3. % of women delivered during past one year who received 100 IFA tablets 4. % deliveries conducted by skilled providers (doctors, nurses or ANMs) 5. % of 24 hrs PHCs conducting minimum of 10 deliveries/month 6. % of upgraded FRUs offering 24 hr. emergency obstetric care services 7. % of 12-23 months children fully immunized 8. % of mothers and newborn children visited within 2 weeks of delivery by a trained community level health provider/AWW or health staff (ANM/Nurse/Doctor) 9. % of children suffering from diarrhoea during past 2 weeks received Oral Re-hydration Solution 10. Polio free status achieved since Details of numerator and denominator and sources of information given in Appendix IV of National PIP 15

  16. Plan for Monitoring & Evaluation (M&E) • As an integral component in the State PIP and IDHAP • Plan for • Household, facility surveys • Resource mapping • Community Monitoring • External/NGO evaluation • IT interventions • H/W, S/W, Networking, Web-site • Training of manpower on IT – medical, paramedical also • MIS data • Maintain District and Sub-district MIS data for evaluation • Regular flow on New Format • On Public Domain • Disseminate data with analysis to all stakeholders (up & down stream) • Encourage Feedback • Reinforce with recognition/reward • Budget for M&E in the PIPs

  17. Thank You

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