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Public Health Scenario :~
       The Cooch Behar District administration considers health sector is one of the core sectors for development. The important health indicators of the people of the district are still not at par with that of the national average and infact much below compare to many districts of our State itself. Hence serious efforts are being made to make improvement in the general health indicators in terms of IMR (Infant Mortality Rate), MMR (Maternal Mortality Rate), Safe Delivery, Death and Birth Rate etc. More focus is being given in improving the accessibility towards the preventive aspect of health care rather than curative aspect of health. At the district level the District Health & Family Welfare Committee is the nodal body for the implementation of various public health schemes of the Government. The District Health Plan under National Rural Health Mission was developed in 2007-2009. Moreover, being a backward district a Special Programme package in the Health Plan for the Year 2010-11 has been submitted.

       As for the health infrastructure in the district there is one district hospital (400 bedded) and four sub-divisional hospitals with 120 beds on the average in each hospital. There is one Infectious Disease cum TB Hospital (120 bedded) and a 10 bedded Mental Hospital. At the block level we have 12 BPHC with average of 30 beds followed by 37 nos. of PHC/ Charitable Dispensaries. Some of these PHC have been made bedded (10 beds) in recent times.

Status Report of Health & Family Welfare Department
Sl. no. Categories of unit Strength
1. District Hospital 1
2. Sub-divisional Hospital 4
3. Rural Hospital 1
4. Block PHC 10+2=12***
5. PHC 29
6. Charitable Dispensary 7
7. Sub-Centre 351
8. ID Hospital (not declared) 1
9. No. of PP Unit 3
10. No. of Urban Family Welfare Centre 3
11. No. of Leprosy Control Unit 4
12. No. of TB Centre 5
13. Cancer Hospital (Govt. aided) 1
14. Leprosy Hospital (Private) 1
15. Blood Bank (MJN Hospital, CBR Municipality, St. John Ambulance) 3
***  Block PHC of Mathabhanga - I and Haldibari are running with Mathabhanga SD Hospital at Haldibari Rural Hospital

Implementation of National Rural Health Mission (NRHM)


Janani Suraksha Yojana (JSY)

       Janani Suraksha Yojana (JSY) is a centrally sponsored scheme which replaces the National Maternity Benefit Scheme (NMBS). The main objective of JSY is to reduce overall maternal mortality rate and infant mortality rate, and also to increase the institutional deliveries in the families. Under the scheme a SC or ST pregnant women irrespective of their financial status and any BPL pregnant women, aged 19 years or above would be eligible to receive a grant of Rs. 500/- up to two live births. An additional benefit of Rs. 200/- + Rs.300/- = Rs. 500/- will be given to these women, if her delivery takes place in any government institutional facility.

       Following table shows the comparative performance under Janani Suraksha Yojana (JSY) during the last two years :

Name of the Component 2009-2010
(Beneficiary Numbers)
2010-2011 [upto May]
(Beneficiary Numbers)
JSY @ Rs.500/- 30483 4469
JSY @ Rs.400/- 309 7
JSY @ Rs.300/- 15549 5547
JSY @ Rs.200/- 17362 5597




Referral Transport Scheme (RTS)

       The Janani Suraksha Yojana is being further supported by yet another scheme known as the Referral Transport Scheme. The main objective of the RTS is to popularize and strengthen institutional delivery among pregnant women belonging to BPL families. Under this scheme financial grants are being provided to eligible pregnant women for coming to health institution for normal and complicated deliveries.

       Following table shows the comparative performance under Referral Transport Scheme (RTS) during the last two years :

Name of the Component 2009-2010
(Beneficiary Numbers)
2010-2011 [upto May]
(Beneficiary Numbers)
No. of Beneficiaries 20521 3662
Amount Disbursed (in Rs.) 56,94,222 7,26,000




Gram Panchayat Based Mobile Health Camps

       Shortage of adequate health infrastructure in the rural areas are being overcome by the conduction of Gram Panchayat Based Mobile Heath Camps. This scheme which has now been almost institutionalized provides for organizing Mobile Health Camps on a fixed day and fixed time each week in all Gram Panchayats Head Quarters throughout the district. This has improved the reach of RCH, Immunization, Family welfare and clinical services to larger section of population. The mobile camps provides services like ante-natal/post natal check-up, immunization of children including Vitamin –A supplementation, treatment of minor ailments and minor injuries including supply of drugs to patients, promotion of contraceptive services including IUD insertion, prophylaxis and treatment of anemia with IFA tablets, IEC and counseling etc. including different public health programmes. At present 61 Gram Panchayats out of the 128 Gram Panchayats of the district have been covered by GP based Mobile Health Camps.

       Following table shows the comparative performance under GP based Mobile Health Camps during the last three years :

Name of the Component 2008-2009
(April to March)
2009-2010
(April to February)
2010-2011
(upto May)
No. of Camps Held 2473 1888 373
No. of Patients Treated 2,23,192 1,61,317 25,009
No. of Patients Treated per Camp 90 85 67




Implementation of Accredited Social Health Activist (ASHA) Programme

       ASHA is one of the important programme under the NRHM. Under this scheme one social health activists is being engaged for every 800 to 1200 population to serve as a link between the community and rural health system. Such health activist The National Rural Health Mission provides for engagement of ASHA for every 800-1200 population to serve as a link between the community and rural health system. The nature of the jobs in her village is to attend the outreach session and sub centre on immunization, visit every household in a period, escort pregnant women to institutions for delivery, awareness and mothers meeting and reporting of incidence of outbreaks etc.





Implementation of 2nd Auxiliary Nurse Midwives (ANM)

       The National Rural Health Mission provides for engagement of Second ANMs in a phased manner up to 2010 in all the Sub-Centre in the state. These ANMs would be married women in the age group of 25-35 years and a resident of one of the villages comprising the sub Centre. They are engaged on a purely contractual basis by the Block Health and Family Welfare Samiti on behalf of the District Health Mission. The selected candidates are to receive 18 months of training in Government run or approved nursing training school. They would be posted in the sub centre for which they have been selected after successful completion of the training. At present the implementation of 2nd ANM has already been completed in the 7 Blocks out of 12 Blocks of the District.





Family Welfare Programmes

       Family Welfare Programme also constitutes an important intervention in our district Annual Health Plan. The achievement of the district with regard to various components of Family Welfare Programme has been very satisfactory and infact is more than the Expected Level of Achievement up to the month of February 2010.

       Following table shows the achievements of Family Welfare Programme against various components :

Sl. no. Name of the
Component
Annual
Planned
Proposed
Achievement
Achievement
in Feb. 2010
Achievement
upto Feb. 2010
Achievement
upto Feb. 2009
1. VASECTOMY 1590 1383 77 1764 1284
2. TUBECTOMY 13983 12165 1539 15391 11164
3. I.U.D. 6124 5328 372 4857 5626
4. C.C. Users 58015 - 187405 2828859 3465990
5. O.P. Users 55932 - 42636 424106 391408
6. T.T. [PW] 63930 58579 4577 48894 50321



Universal Immunizations Programme

       The district has been giving focused attention for the Universalization of Immunization in order to improve the health indicators with regard to IMR, MMR, Safe Delivery etc.

       Following table shows the progress of the Immunization Programme in the district :

Sl. no. Name of the
Component
Annual
Planned
Proposed
Achievement
Achievement
in Feb. 2010
Achievement
upto Feb. 2010
Achievement
upto Feb. 2009
1. B.C.G. 58120 53255 5850 54452 57713
2. D.P.T. 58120 53255 4750 55302 28552
3. O.P.V. 58120 53255 4805 50743 47028
4. Hepatitis - B 58120 53255 4049 31661 10199
5. MEASEALES 58120 53255 4544 49507 49538
6. VITA - A 1ST 58120 53255 4552 50998 50415




National Vector Born Disease (Malaria) Control Programme
Name of the Component 2007 2008 2009-2010
No. of Blood Slide Collection 2,67,532 2,43,264 2,59,605
No. of Blood Slide Examination 2,67,532 2,43,264 2,42,514
No. of +ve cases 2,011 971 755
No. of PF cases 313 249 147
No. of deaths 5 3 4




Water Born Disease (Diarrhoea) Control Programme
2007 2008 2009-2010
Attack Death
1,49,625 56
Attack Death
1,25,142 12
Attack Death
87,444 24



Rural Sanitation

       The district of Cooch Behar was selected for the implementation of Total Sanitation Campaign with effect from 2002-03. The basic aim of the TSC project is to provide accessibility to Sanitary facilities to each and every household. For this purpose, each and every house hold in the district is being persuaded or encouraged to use and maintain a IHL. The BPL house holds are provided with 75% subsidy to construct such IHL.

       Second, important component of the TSC is the School Sanitation programme including that for the AWCs and other such institutions. Here the aim is to inculcate hygiene and sanitary habits among school children. This also helps in the retention of the girl children in our schools and ultimately the school children acts as “Messengers of Sanitation” for the community.

       Similarly the project also provides for installation of community run toilet blocks in important public places like rural hats, market places, highways etc.

       The overall ultimate aim is the 100% stoppage of open defecations throughout the district, to develop sanitary and hygienic habits and cleanliness among the masses and to make the district Nirmal District or fully Sanitized District in the long run.

       So far one Panchayat Samiti namely Mathabhanga-II and 29 Garam Panchayat of the District has been awarded with Nirmal Gram Purashkar by the Govt. of India for the effective implementation of the total sanitation programme. For the year 2009-10 sixty numbers of Gram Panchayat and two numbers of Panchayat Samities have been proposed for moving the GOI for Nirmal Gram Purashkar.

       Following table shows the status of various components of sanitation programme in the District :


Total Sanitation Campaign
Name of the Component Target for the district Achievement
upto May 2010
% of Achievement Remarks
Construction of IHHL 254422 (APL)
181902 (BPL)
436324 nos.
321523 nos. 73% Target for 2010-11 = 100000
Achieved till date = 15793
School Sanitation
(Primary School)
3715 nos. single unit 2021 nos. (TSC)
1815 nos. (other sources)
100% 2nd unit to be covered under revised proposal
School Sanitation
(H.S. & Madrasha)
230 single units
230 double units
230 single units
23 double units
100%
10%
2nd unit to be covered under revised proposal
SSK 696 nos. (single units) 696 nos. (single units) 100% Through TSC fund only
MSK 117 nos. (double units) 117 nos. (double units) 100% Through TSC fund only
AWC 3041 nos. (1580) 528 nos. (TSC)
1052 nos. (other sources)
52% 1461 does not have own land
Community Toilet Block 50 nos. 48 nos. 96% Rest under process



Drinking Water Supply

       Providing safe drinking water to our people has always remains priority sector in this District. Though piped water supply is the most popular source of drinking water in the District only about 45% - 47% of the population of this district have access to piped water supply. The major source of drinking water in the District are presently the hand bore tube well provided under schemes like the RWS and the ARWSP. There are at present 87 nos. of Piped water supply schemes maintained and operated by the PHE department. These covers as many as 349 villages of the district. In addition to this as many as 8 nos. of such PHE operated piped water supply schemes has now been handed over to local Panchayats for operation. The Zilla Parishad has sanctioned 15 nos. of community water supply schemes under Swajal Dhara Prokolpa. These schemes are community owned maintained and operated piped water supply schemes.

       Following table shows the status different types of drinking water sources in the district :

Sl. no. Type of source No. of sanctioned Operational at present Defunct
1. Piped Water Supply Scheme 87 87 Covers 349 villages
2. Ordinary Hand Tube well 39,959 35,805 4,154
3. DWP 1,567 1,333 234
4. RBTW 148 19 129
5. Swajal Dhara 15 6 9 (under process)



Animal Health Care Facilities
1) Dairy and Poultry Training Center 1 no.
2) Poultry & Duck Multiplication Center 1 no.
3) State Animal Health Center 6 nos.
4) Central Medical Store 1 no.
5) Veterinary Pathology Center
 (1 no. Dist. Investigation & 2 nos. Clinical Investigation Labs. )
3 nos.
6) Block Livestock Development Office 12 nos.
7) Addl. Block Animal Health Center 9 nos.
8) Animal Development Aid Center 125 nos.






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