MAJOR SCHEMES/PROGRAMMES
The Punjab state
has always excelled in implementation and achievements under
various National Health Programmes. Various National / State
Health Programmes being implemented by the Director Health &
Family Welfare, Punjab are as under:-
1.NATIONAL
VECTOR BORNE DISEASE CONTROL PROGRAMME
MALARIA
National
Malaria Programme was launched in 1953. Under this programme
indoor residual spray was being done with DDT twice a year. As a
result incidence of malaria cases came down from 75 million cases
in 1953 to 2 million cases in 1958 in India. In 1958 this control
programme was switched over to National Malaria Eradication
Programme. At present this programme has been renamed as National
Vector Borne Disease Control Programme,
Objectives
1.
To prevent deaths due to Malaria
2.
To reduce the period of Morbidity
3.
To consolidate the achievement attained so far.
The main features
of this programme are as follows:-
a.
Surveillance
b.
Malaria Clinics
c.
Drug Distribution Centers
d.
Fever Treatment Depots
e.
Spray Operations
f.
Urban Malaria Scheme
a.
SURVEILLANCE
i) Active
Surveillance:-
Under this, the fortnightly domiciliary visits are made by MPHW(M)
under primary health care system & by this fortnightly visit large
Number of secondary cases can be avoided where malaria
transmission is seasonal. The components of active surveillance
are:
a) Search
for fever cases
b) Collection
of Blood smears from fever cases.
c) Administration
of appropriate presumptive treatment.
Malaria
surveillance includes maintenance of on going watch over the
status of malaria in a group or community. It provides a basis for
measuring effectiveness of anti malaria programme and helps
control measures. Malaria surveillance presumes that every malaria
case presents itself with symptoms of fever at some point of time
during the course of infection. These all fever cases are examined
for blood smears to know the malaria parasite load.
Malaria
Surveillance Includes:-
1.
Laboratory confirmation of presumptive diagnosis.
2.
To find out the source of the infection.
3.
Identification of
cases and susceptible contacts in order to prevent
further
spread of disease.
The timely
collection and examination of blood smears is the key elements in
the National Malaria Control strategy. By giving early radical
treatment in detected cases, the human reservoir of malaria
parasite is reduced.
ii) Passive
Surveillance:-
All the health institutions screen the fever cases visiting the
hospital for malaria by blood slides collection and giving
presumptive treatment.
Achievements for the year 2004, 2005 and 2006(upto June,06) as
under:-
|
Year |
Blood slides target (10% of population) |
No. of Blood slides collected |
% achievement |
Total Malaria+ve cases |
P.F. cases |
|
2004 |
2542721 |
2435476 |
95.78 |
1643 |
21 |
|
2005 |
2593982 |
2743340 |
105.8 |
1883 |
28 |
|
2006 (upto June, 06) |
- |
1098797 |
- |
200 |
4 |
b. MALARIA
CLINICS:-
Malaria
Clinics are working in the State in Medical Institutions were the
blood slides examined in the same day and Radical Treatment is
also given to positive cases at the spot.
|
Year |
No. of Malaria
Clinics |
Blood Slides
Collected |
Found +ve |
Radical
Treatment |
|
2004 |
611 |
396514 |
433 |
433 |
|
2005 |
604 |
452237 |
871 |
871 |
|
2006(Upto June,
06) |
609 |
185741 |
78 |
78 |
c.
Drug Distribution Centre
:-Anti
Malaria drugs are distributed to fever cases through drug
distribution centre (DDC) in the village of Punjab free of cost.
The DDC's do not collect blood slides but administer drugs to
fever cases.
|
Year |
No. of DDC
Established |
No. of cases
treated without blood slides |
|
2004 |
16742 |
684655 |
|
2005 |
16801 |
795750 |
|
2006(Upto June,
06) |
16740 |
67984 |
d.
Fever Treatment Depots:-
Fever treatment depots have been established in villages of Punjab
which are remote and with low population density to detect cases
early by collection of Blood slides where community is involved by
imparting training in blood slides collected and rendering
presumptive treatment.
|
Year |
No. of FTD |
Blood Slides
Collected / Examined |
Found +ve |
Radical
Treatment |
|
2004 |
1129 |
26552 |
6 |
6 |
|
2005 |
1199 |
38671 |
19 |
19 |
|
2006 (Upto
June, 06) |
1167 |
2895 |
- |
- |
e. SPRAY
OPERATION:-
As per guidelines from Govt. of India, sections/Sub Centres
reporting Annual Parasite Index (API) 2 or more than 2 at any
time during the last three years and sub centres/sections declared
as high risk areas to be covered with insecticidal spray. The
spray operation is commenced on 15th May and lasts till
30th September every year.
f. URBAN
MALARIA SCHEME:-
Urban Malaria Scheme is being implemented in 13 towns of
Punjab State i.e.
Amritsar, Jalandhar, Patiala, Ferozepur, Malerkotla, Bathinda,
Kapurthala, Rajpura, Nabha, Jagraon, Hoshiarpur, Gurdaspur and
Ludhiana.
In these towns
breeding of Malaria Vector Mosquitoes is checked by carrying out
Anti Larval Operations regularly at weekly interval in the
following manner:-
1.
SOURCE REDUCTION:-
Permanent & Temporary breeding sources of mosquitoes are
eliminated by filling of burrow pits, ditches, small irrigation
canal and unused well.
2.
BIOLOGICAL CONTROL:-
Larvivorus and Guppy fishes are used to check the mosquitoes
breeding in the wells, fountains, ornamental tanks and other
confirmed water collections. These lavivorus and guppy fishes
reduce the density of larva in the water collections.
3.
CHEMICALS AGAINST VECTOR MOSQUITO LARVES:-
Fenthion and Temphos larvicides are used to eliminate larval of
Vector Mosquito.
DENGUE
Dengue is caused by
Aedes Aegpti mosquito. The mosquito is a domestic breeder. It
breeds in water storage containers such as desert coolers, over
head tanks, discarded buckets, utensils, flower pots, tyres etc.
which are not emptied and clean weekly. So all such containers
should be emptied to stop breeding of mosquito and health
education to be imparted to aware the community regarding
preventive measures against dengue fever.
Year wise cases of
Dengue in Punjab State are as under:-
|
Year |
Total Dengue
Cases |
Deaths |
|
2004 |
52 |
Nil |
|
2005
|
253 |
2 |
|
2006(Upto June,
06) |
Nil |
Ni |
PREVENTION
The
department of Health & Family Welfare has a curative, preventive
and educative role to prevent and control of Dengue fever. Blood
component seprators have been installed at Ropar, Hoshiarpur,
Pathankot, Ludhiana, Jalandhar, Bathinda and Ferozepur Hospitals
and Medical Colleges Patiala and Amritsar. Special Dengue wards
are reserved in hospitals for free of cost treatment of dengue
cases. Health Deptt. has formed mass media teams to educate the
public that Aedes Aegypti Mosquito breeds in places in the houses
like desert coolers, tanks which should be emptied and cleaned
every week.
Public is
always made aware through News papers and pamphlets to prevents
stagnation of water their houses and in the surrounding areas. The
public is advised to do the following:-
-
To sprinkle oil
in the stagnant water
-
To keep the water
pots covered
-
To keep over head
water tanks tightly covered
-
To prevent
stagnation of water in the broken bottles, flower pots, buckets
etc.
-
People are
advised to use mosquito nets, Mosquito repellent oils & creams
etc.
JAPANESE
ENCEPHALITIS, KALA AZAR:-
No
case of Japanese Encephalitis and Kala Azar is detected in Punjab
State in the year 2002, 2003, 2004 & only 1 suspected case of
Japanese Encephalitis was detected in District Gurdaspur in the
year 2005.
WATER BORNE DISEAES:-
To
provide to the potable drinking water to the people in the State
water samples are taken through Civil Surgeons and are sent to the
State Laboratory for testing. In case, sample found non-potable
then remedial measures are taken and public is prohibited to take
the water of that source, till sample is not found fit for human
consumption by testing in laboratory. To prevent Hepatitis A & E,
Cholera and Gastroenteritis, rotten and cut fruits, uncovered
eatable, ice cream made from un potable water is destroyed and
health education is imparted to take fresh and clean eatable.
Water samples
report for the Year 2004, 2005 and 2006(upto April, 06)is as
under :-
|
Year |
Water Sample
Taken |
Water Sample
Found Fit for Consumption |
Water Sample
Found not Fit for Consumption |
|
2004 |
5196 |
3417 |
1779 |
|
2005
|
8140 |
5271 |
2586
(Result awaited
283) |
|
2006(upto
June,06) |
4593 |
3005 |
1173
(Result awaited
415) |
The following number of cases of Gastroenteritis,
Hepatitis, Cholera were reported in year 2004, 2005 and 2006(upto
May, 06).
|
Year |
Total cases of Gastroenteritis
|
Total cases of Hepatitis |
Total cases of Cholera |
|
|
Cases |
Death |
Cases |
Death |
Cases |
Death |
|
2004 |
11372 |
6 |
1082 |
Nil |
171 |
Nil |
|
2005 |
6461 |
4 |
1345 |
1 |
15 |
1 |
|
2006
(upto April, 06) |
1040 |
- |
348 |
- |
- |
- |
and 2006(
2. NATIONAL LEPROSY ERADICATION PROGRAMME
Leprosy is an ancient
disease known since 600 B.C. It is also known as Hansen's disease
ever since 1873 when Dr. Armauer Hansen of Norway isolated the
disease-causing organism namely the Mycobacterium Leprae. There
are 32 Leper
Colonies with
2219 patients in 17 districts of Punjab. Categorization/ grouping
of the patients is made on the basis of diagnosis so as to provide
Multi Drug Therapy (MDT).
National Leprosy Eradication Programme (NLEP):
Leprosy control activities were launched by Govt. of India in
1955. In 1983 a new strategy based on Multi-Drug Therapy (MDT) was
introduced and the programme was renamed the National Leprosy
Eradication Programme. Multi-Drug Therapy (MDT) has substantially
helped in curing the patients and reducing the problem to a
greater extent. GOI has set the elimination level at less than
one case per 10,000 population. The main objectives of the
programme is to achieve elimination of leprosy at the national
level by the end of the Tenth Plan period i.e. by 2007. NLEP is
being implemented through District Leprosy Societies which came in
to being from 1995.
Status in Punjab about Leprosy.a)
Punjab is a low endemic state.b) Yearly Case Detection
varies between 1100 to 1200.At present the prevalence rate (PR)
works out to 0.44 per 10,000 population d) The percentage of
Punjabi People suffering from leprosy is about 20.
Punjab has achieved the elimination
goal of prevalence level of less than 1 case per 10,000 population
given by GOI.
One Sample Survey Assessment Unit sanctioned at
State headquarter under the control of State Leprosy Officer with
essential staff viz. Medical Officers, Senior Non-Medical
Supervisor one and Senior Para Medical Worker one. This SSAU
should conduct visits to randomly selected (at least) two
districts in each month and in each district, four PHCs in
different directions and in each PHC atleast two sub-centres and
two villages to be covered.
State Leprosy Society (S.L.S)
was established w .e. f. 12-01-2001 and the work of the District
Leprosy Societies is monitored by the State Leprosy Society,
Punjab. Principal Secretary, Health & FW, Punjab is the
Chairperson. The Director Health & FW is the Vice-Chairperson and
the State Leprosy Officer is the Member Secretary. Government of
India has allowed One Contractual Post of Budget & Finance Officer
and One Contractual Post of Data Entry Operator for the SLS
District Leprosy Societies (DLSs )
work in the districts is being implemented and looked after by 17
District Leprosy Societies set up in each district. The Deputy
Commissioner is the Chairperson; the Civil Surgeon is the
Vice-Chairperson and the District Leprosy Officer as Member
Secretary of the District Leprosy Society. One Driver and one
Para-Medical Worker on contractual basis have been sanctioned for
each DLS by GOI.
Multi Drug Therapy (MDT) has substantially helped to reduce the
disease. MDT for the patients is supplied free of cost by the
World Health Organization (WHO) through GOI and is made available
up to PHC level by the District Leprosy Officers. Other specified
Supportive Medicines are also made available to the leprosy
patients as per requirement.
From 2003-04 onward the leprosy cases are tabulated below:
|
Year |
Cases at the begin
ning of
the year |
Cases detected during the
year |
Total cases |
Cases discha-rged in the
year |
Balance cases on
record |
P.Ratc per 10000
population at/on. (pb.Popul-24358999 |
Punjabi cases (shown in
record from 2000-01) |
| |
|
Targets given by GIO |
Number Detect-ed |
|
|
|
|
|
|
2003-04 |
1192 |
100 |
1345 |
2537 |
1319 |
1218 |
0.47 |
256 |
|
2004-05 |
1218 |
100 |
1173 |
2391 |
1344 |
1047 |
043 |
235 |
|
2005-06
|
1047 |
100 |
1143 |
2190 |
826 |
1141 |
0.44 |
170 |
|
2006-07(upto June,06) |
1084 |
100 |
255 |
1339 |
291 |
1048 |
0.41 |
48 |
3. National Mental
Health Programme
Health as defined
by WHO is a state of positive well being and not an absence of
illness. Mental Health, therefore, forms an essential part of
'Total Health".
Following achievements were made, under the programme,
during last 3 years & till date.
-
Psychiatric
Hospitals/Nursing Homes:-
List of Psychiatric Hospitals/Nursing Homes in the state has
been updated. At present, there are 33 Psychiatric Hospitals/
Nursing Homes in the State as per the M.H.A., as per reports of
Civil Surgeons. All such 33 such Psychiatric Hospitals/Nursing
Homes have been issued licences.
-
Visitors
Committee:-
To carry out the inspection of all Psychiatric Hospitals/
Psychiatric Nursing Homes in the State Visitor Committees have
been formed in all the districts of Punjab.
-
District Mental
Health Programme:-
It is being implemented in Distt. Mukatsar. A proposal has
already been sent to Government for including two additional
districts namely, Hoshiarpur and Sangrur under this programme.
Ten beds have been earmarked in Civil Hospital, Mukatsar for
psychiatric patients. Psychiatric patients are being provided
both indoor and outdoor facilities.
-
Training
Programme for Doctors:-
A training programme for Medical Officers has been started at
Institute of Mental Health, Amritsar in December, 2004. The
objectives of this training programme are to impart basic mental
health skills to general duty Medical Officers and to train
doctors in the early detection & management of causative
psychiatric disorders of suicide. 32 doctors have been trained
so far.
-
Sensitization of
health staff:-
Health staff posted in seven suicide prone districts namely,
Amritsar, Bathinda, Ferozepur, Faridkot, Gurdaspur, Mansa and
Sangrur were sensitized about early diagnosis & management of
suicide prone cases. This was achieved by carrying out the
following activities as a campaign during the year 2004.
-
Number of
Seminars held = 29
-
Number of
Group Meetings held
=
395
-
Number of
Camps Organised
= 70
-
Number of
Panel discussions held
= 90
4. National
programme for Control of Blindness
WHO
defines blindness as "Visual acuity of less than 3/60 or its
equivalent". In order to facilitate screening of visual acuity by
non specialized personnel, in the absence of appropriate vision
charts, the WHO has now added the "Inability to count fingers in
day light at a distance of 3 meters" to indicate less then 3/60 or
its equivalent. The National Programme for Control of Blindness
was launched in 1976. It is cent percent centrally sponsored
programme.
According to Survey
the prevalence rate of blindness in India is about 1.3%. The
common causes of blindness are as under:-
|
Sr. No. |
Cause |
Punjab (%) |
India (%) |
|
1. |
Cataract |
50.5 |
62.6 |
|
2. |
Uncorrected
refractive errors |
18.6 |
19.7 |
|
3. |
Glaucoma |
13.4 |
5.8 |
|
4. |
Posterior
segment causes |
5.5 |
4.7 |
|
5. |
Surgical
Complications |
3.0 |
1.2 |
|
6. |
Corneal Opacity |
2.5 |
0.9 |
|
7. |
Posterior
Capsular Opacification |
0.3 |
0.9 |
|
8. |
Others |
6.3 |
4.1 |
According to
survey the prevalence of Blindness in India is about 1.3%. The
prevalence rate of blindness in Punjab is 0.73%. It has occupied
an important place on the health map of the country ever since it
was included in the Govt. of India's 20 point programme. Voluntary
organisations have been motivated to organise cataract operation
camps at different places.
State
Blindness Control Society has been formed on 29th April 2002 and
there is proposal to upgrade all District Hospitals, where modern
eye operation facilities will be provided. There is also proposal
to get some Eye Surgeons trained in Modern Eye Operation
Technique.
Since
nearly 80% of blindness was due to Cataract, major focus at
national level was on reducing the cataract prevalence by bringing
down the level of blindness from 1.3% to 0.3%. There are above 45
million blind person in the world (VA 3/60) out of this 7 million
are in India. During the year 2003-07. It is planned to tackle 2nd
commonest cause i.e. Refractive Error by having Ophthalmic
Officers at each PHC level so that the refractive services can be
provided at grass root level & strengthen school eye screening
programme jointly by Ophthalmic officers & Medical Officers of PHC
& distribution of free glasses through District Blindness Control
Societies.
The
performance Cataract operations performed during the last four
years is as under:-
Year |
Target |
Ach. |
%age |
|
2003-04 |
1,60,000 |
1,33,376 |
83.4 |
|
2004-05 |
1,60,000 |
1,59,933 |
100.0 |
|
2005-06 |
1,60,000 |
1,76,697 |
110.0 |
|
2006-07 (Upto
June,06) |
40,000 |
34,905 |
87.0 |
|
Year |
Target for
school eye screening |
No. of children
screened |
Children found
defective |
Provided
Glasses |
|
2003-04 |
7,00,000 |
5,71,964 |
26,207 |
5,327 |
|
2004-05 |
7,00,000 |
5,84,850 |
25,848 |
4,552 |
|
2005-06 |
8,00,000 |
3,79,322 |
24,383 |
4,249 |
|
2006-07 (Upto
June, 06) |
2,00,000 |
61,635 |
3,989 |
907 |
Activities under
Vision 2020 - Right to Sight
Ø
Political commitment
Ø Putting
up Blindness control on the agenda of Central Council of Health &
Family Welfare where Union & State Health Secretaries pass
resolution on health care.
Ø A
constitution of a working group at the national level with member
from Government, Non-Government & other funding agencies.
Ø Frequent
press releases and articles in leading newspapers of the country.
Ø
Increased frequency of broadcast & telecast of
messages on eye care to generate public awareness i.e. preventing
visual impairment i.e. fortification of common foods to prevent
nutritional blindness, environmental sanitation to prevent
trachoma etc. to generate public awareness.
Ø
Print media, Quarterly newsletters, articles in scientific
journals & development of prototype print material.
Ø
Introduction of topic on Eye Care in school curricula.
Ø
Distance Education modules for children as well as for Para
professionals.
Ø
Preventing disparity of eye surgeon between urban that is 1:20
thousand & rural which is 1:2.5 lakh of population.
Activities Under
10th Five-Year Plan:-
Ø
Involvement of voluntary organisation in various activities &
participation of Community, Panchayati Raj institutions in
organizing services in rural areas.
Ø
By
performing cataract operations during a period of 5 years with
minimum of 80% IOL implementation in the State.
Ø
Promoting eye donation, processing & utilization of donated eyes
for treatment of corneal blind.
Ø
Special focus on illiterate woman in rural areas convergence with
various on going schemes for development of women & children.
Ø
Screening of school going children for identification & treatment
of refractive errors & special attention in under served areas.
5 . Revised
National TB Control Programme
National
T.B. Control Programme (NTCP) was initiated in 1962 as a
decentralized programme in India. After a detailed evaluation of
NTCP a new approach i.e. the Revised National TB Control Programme
(RNTCP) was adopted by Govt. of India in 1993. RNTCP was
implemented in a phased manner and in Punjab it came into action
in the year 2001 in district Patiala, which was selected as the
pilot district. After the pilot district Patiala, three more
districts i.e. Bathinda, Ropar and Ludhiana were covered in
December, 2002. Another five districts Amritsar, Fatehgarh Sahib,
Hoshiarpur, Nawanshahr and Sangrur were covered in January, 2003.
The remaining eight districts were covered in December, 2004 thus
covering whole of the state under RNTCP. Success rate with NTCP
was 35% while under RNTCP it is 85%. The programme is being run by
the District TB Control Societies(DTCS). Funds are released by
Government of India through the State TB Control Society which is
monitoring the work of DTCS.
The
Directly Observed Treatment Short Course Chemotherapy (DOTS)
strategy adopted in the RNTCP is the comprehensive strategy for TB
control. DOTS is the systematic strategy under which medicines and
sputum check up is done free of cost in all the designated
Microscopy Centre (MCs). Drugs are supplied in patient wise boxes
(PWBs) containing the full course of treatment from Central TB
Division, New Delhi.
The essential element of India's RNTCP based on the WHO Directly
Observed Treatment Short Course (DOTS) model include passive case
finding and diagnosis by sputum smear directly observed therapy,
effective patient education to maintain patient adherence, a
secure uninterrupted supply of drugs, individual patient
registration, follow up and out come evaluation by health worker
and the political commitments. This all ensure that the defaulter
rate is reduced to minimum and spread of infection is checked.
The
physical achievements during the year 2004 to June, 2006
| |
2004 |
2005 |
2006 (upto June,
06) |
| |
Target |
Achieve-ment |
%age |
Target |
Achieve-ment |
%age |
Target |
Achieve-ment |
%age |
| Total TB
Cases detected |
40251 |
20146 |
50.1 |
67090 |
30764 |
45.9 |
|
18864 |
56% |
| New Sputum+ve
cases |
14879 |
7370 |
49.5 |
24795 |
11944 |
48.2 |
12342 |
7084 |
57% |
6. National Iodine Deficiency
Disorders Control Programme
Iodine is an essential micronutrient with an average
daily requirement of 100-150 micrograms for normal human growth
and development. There is an increasing evidence of distribution
of environmental Iodine deficiency in various parts of the
country. These disorders include abortions, still birth, mental
retardation, deaf mutism, squint, goiter and neuromotor defects.
Objectives of the programme
Ø
To undertake surveys to assess the magnitude of
Iodine Deficiency Disorders (IDDs).
Ø
To supply iodated salt in place of common salt.
Ø
To reconduct surveys to assess the impact of
control measures after every 5 years.
Ø
To undertake Monitoring of the quality of iodated
salt and assess Urinary iodated excretion pattern.
Ø
To conduct Health Education and publicity.
7. National Cancer Control
Programme
Cancer has become a major public health problem due to
increase in expectancy and changing lifestyles. There are about
15-20 lakh cases of cancer in the country at any given point of
time and approximately 7 lakh new cases come up every year. It was
in this context that the National Cancer Control Programme,
started in 1975 was revised in 1984-85 to strengthen it with the
objective of:
Ø
Primary prevention of cancers by health education.
Ø
Secondary prevention i.e. early detection and
diagnosis of common cancer such as cancer of cervix, mouth, breast
and Tobacco related cancer by screening self-examination methods.
Ø
Tertiary Prevention by strengthening of the
existing institutions for comprehensive therapy including
palliative care.
PGI Chandigarh has
been designated as Regional Cancer Centre(RCC) by Govt. of India.
Under this RCC, one of the programmes is District Cancer Control
Programme(DCCP). This programme is to be launched in 2 districts
of Punjab namely Patiala and Hoshiarpur.
Under this
programme (i) Awareness will be generated among the masses
regarding early signs & symptoms of Cancer & their prevention (ii)
Stress will be laid on early diagnosis of Cancer (iii) Pain relief
measures for patients of Cancer in advance stages.
8. SCHOOL HEALTH
PROGRAMME
School
Health Programme is an important component of total health care
delivery system in the state, which helps in keeping close watch
on the health of school going children in the State.
The main
objectives of the School Health Programme are as under:-
· To
reduce morbidity amongst school children by preventing them from
falling prey to the preventable diseases and thus help to reduce
the drop-out rate amongst school children.
· Early
detection of defects in children and their proper treatment
through referral services.
· To
impart health education to the school children and the teachers.
· To
advice the school authorities about safe drinking water supply,
good environmental sanitation and cleanliness etc.
· To
provide curative, referral and follow-up services to the students
of Primary and Middle classes of the schools through medical
check-ups.
Achievement during the years 2003 to 2006 (Upto June 06) is as under:
|
Year |
No. of School
Children |
%age |
|
|
Examined |
Suffering from
various ailments |
|
|
2003 |
2903289 |
522195 |
17.98 |
|
2004 |
3229719 |
575455 |
17.81 |
|
2005 |
3391808 |
689012 |
20.31 |
|
2006 (Upto
June, 06) |
420325 |
98500 |
23.43 |
HEALTH EDUCATION
Health
does not merely mean absence of diseases or infirmity but stands
for complete physical, social and mental well being. To ensure
good health to the people, it is essential that they be educated
to regulate their life and behaviour in such a way as is conducive
to their positive physical, social and mental well being.
ACTIVITIES
State
Health Education Bureau in the State, carries out the following
activities:-
-
Planning,
organising and directing State wide health education activities.
-
Distribution of
health education material on various health programmes.
-
State wide
publicity by Publicity Team through exhibitions.
-
Preparing Radio,
TV talks and arranging for broadcast/telecasts.
-
Publishing of
press advertisement IEC on various topics concerned with health
department.
State Health
Education Branch is imparting education on various National Health
and Nutrition Programme to create awareness among masses through
Radio, TV talks and by putting up an exhibitions by State
Exhibition Unit.
Detail of
exhibitions held during the 2004, 2005 and 2006 (Upto June, 06) is
as under:-
|
Year |
Total No. of Exhibitions held |
|
2004 |
29 |
|
2005 |
41 |
|
2006 |
12 |
NUTRITION
ACTIVITIES IN PUNJAB
The aim
of nutrition education is to guide people to choose optimum and
balanced diet, remove prejudices and promote good dietary habits.
Nutrition education is a major intervention for the prevention of
malnutrition, promotion of health and improving the qualities of
life.
In
pursuance to the National Nutrition Policy, Nutrition Branch
carries out the following activities in the State.
-
Popularising low
cost nutritious food through group meetings, mass meetings,
lectures, seminars, health education and OT Camps etc.
-
Popularising
breast feeding amongst the women as there is no other substitute
of human milk for infants.
-
Putting up
exhibitions on proper nutrition.
-
Distribution of
publicity material on nutrition.
-
Educating the
people in proper nutrition through talks on Radio and TV.
-
Prophylaxis
against Vitamin-A deficiency in children in the age group of
nine months to 3 years by providing Vitamin-A doses.
-
Prophylaxis
against nutritional anaemia in women and children by providing
Iron and Folic Acid tablets to them.
-
Celebrating
Brest-Feeding Week from Ist August to 7th August and
National Nutrition Week from Ist September to 7th
September every year.
9. Intensive
Dental Health Care Programme
A survey conducted
by the Health Department during the year 1989-90 revealed that
nearly 84.4 % of the State's population was suffering from one or
the other Dental diseases. It was noticed that this alarming rise
in the Dental diseases was mainly due to the lack of awareness
among the people about the prophylactic, interceptive and curative
treatment available in the existing infrastructure of the Dental
Health Care Services in the State. It was also noticed that the
Dental Surgeon population ratio was 1: 30000 in the urban areas.
But only the ratio in the rural areas is 1:1.19 lacs
To provide the
best of the Dental Health Care Services to the people of the
State, the Punjab Govt. has launched INTENSIVE DENTAL HEALTH
CARE PROGRAMME for school children, school teachers and
general public, which is first of its kind in the country. To
reach the far-flung areas of each district one mobile Dental
Clinic Van was provided to give intercept and curative treatment
to the people at their doorstep. To monitor and implement all the
dental programmes it was proposed to establish a post of District
Dental Health Officer for all the districts of the State.
AIMS AND
OBJECTIVE:
i) To bring
down the incidence of oral and dental diseases to less than 40 %.
ii) To bring
down the Decayed Missed Filled Teeth (D.M.F.T.) in School children
of 6 - 12 years less than two.
iii) To
achieve 25 % reduction in number of persons without teeth after
the age of 60 Years.
iv) To
provide one dental clinic to serve the population of 30,000 in the
rural areas by opening 354 new Dental Clinics by the end of five
years plan.
v) To
provide total oral health coverage to all the school going
children in the age group of 6 - 12 years.
vi) To
provide Dental Health Education Training to all the primary school
teachers, medical & paramedical personnel.
vii) To
organize special Dental Health Fortnights.
viii) To
provide on the spot diagnostic preventive interceptive & curative
Dental Health Care Services to the people in the far - flung rural
areas of the state and the school children through fully equipped
Mobile Dental Clinic Vans.
INTENSIVE DENTAL
HEALTH CARE PROGRAMME:-
Punjab is the only state in India which has launched Intensive
Dental Health Care Programme in the year 1989-90. Under this
Programme one sub-division is selected and the schools are covered
block - wise. After covering the whole Sub-division the next
Sub-division is taken up. At present three Medical Officers
(School Health Clinic-I, Intensive Dental Health Care Programme-I
&P.H.C. Medical Officers (Dental) - I) visits the schools as per
the detailed programmes circulated to them. The Special feature of
this Programme is that in addition to the imparting of Dental
Health Education training to the School children & detailed Oral
Health check up, each child is given a mouth rinses with the
freshly prepared 2 % solution of sodium fluoride to arrest the
initiation & progress of dental caries and this process is
repeated after every six months. The children suffering from
Dental Diseases are provided necessary Dental treatment on the
Mobile Dental Clinic Vans.
A)
For
school Children:
Targets and
achievements are as under:
|
Year |
Target |
Achievements |
Children found
suffering from various Dental Diseases |
% age of
children found suffering from various Dental Diseases |
|
2003-04 |
2 lacs |
224987 |
98998 |
44.0% |
|
2004-05 |
2 lacs |
351099 |
145992 |
41.6% |
|
2005-06
|
2.25 Lacs |
342213 |
123905 |
36.2% |
|
2006-07 (
Upto June, 06) |
|
56881 |
20891 |
36.7% |
B) Imparting
of Dental Health Education To School Teachers, Medical And
Paramedical Personnel:
One day
dental health education training workshop/camps are being held for
primary school teacher, Medical and Paramedical Personnel.
|
Year |
Target |
Achievement |
|
2003-04 |
5500 |
5541 |
|
2004-05 |
6500 |
8965 |
|
2005-06 |
6500 |
9505 |
|
2006-07(upto
june06) |
|
1427 |
A)
Organization of Dental Health Fortnights:
In order to create
awareness about oral and Dental Diseases and to provide curative
services by involving Voluntary Organization, special Dental
Health Fortnights & Mass Dental Camps are being organized. This
year 14th Dental Health Fortnight was organised from 16th
November to 30th November 2005, in which 63753 patients
were treated and 1379 poor and needy patients were given full set
of artificial dentures:
Targets and
Achievements:
|
Year |
Target |
Achievements |
|
2002-03 |
a) 70 mass
dental camps
b) 1.25 lac
patients to be examined
c) 2500
Artificial complete Dentures.
|
a) 70 mass
Dental camps
b) 1.50 lac
patients examined
c) 2566
artificial complete Dentures Provided |
|
2003-04 |
a) 60 mass
dental camps
b) 1 lac
patients to be examined
c) 2500
Artificial complete Dentures.
|
a) 73 mass
Dental camps
b) 1.27 lac
patients examined
c) 2500
artificial complete Dentures Provided |
|
2004-05 |
a) 60 mass
dental camps
b) 0.5 lac
patients to be examined
c) 1000
Artificial complete Dentures.
|
a) 64 mass
Dental camps
b) 0.73 lac
patients examined
c) 1231
artificial complete Dentures Provided |
|
2005-06 |
a) 60 mass
dental camps
b) 0.5 lac
patients to be examined
c) 1000
Artificial complete Dentures.
|
a) 93 mass
Dental camps
b) 63753
patients examined
c) 1379
artificial complete Dentures Provided |
2) Advanced Dental
Training & Research Center.
In order to impart
training in service PCMS Dental Doctors, so as to update their
knowledge in the field of dentistry, an
Advanced Dental
Training
& Research
Center
has been established at Mohali. Re-orientation Training Programme
Workshop and Seminars etc. are being conducted regularly.
3) Mobile
Dental Clinic Van:
Since the
incidence of Dental Diseases is very high amongst the school
children particularly in rural areas curative Dental Health Care
Services and effective Prophylaxis against Dental Caries can only
be provided on the Dental Chair. So, it was decided to establish
seventeen Mobile Dental Clinics in the State (one for each
District) so as to provide curative and prophylactic Dental Health
Care Services in the far-flung rural areas of the State and also
to provide effective prophylaxis against Dental Caries to the
children in the Schools.
No. of Patients
examined by the Mobile Dental Van during the year 2004-05,
2005-06 & 2006-07 (Upto June, 06)are as under:-
|
Year |
Target |
Achievement |
|
2004-05 |
65000 |
98172 |
|
2005-06 |
65000 |
114287 |
|
2006-07 (Upto
June,06) |
- |
18014 |
10.
Implementation of Persons with Disabilities Act 1995
Role of Department
of Health and Family welfare for disabled is prevention, early
detection and Medical Rehabilitation. Under various clauses of
Section 25 concerning Health Department of the PWD Act, following
steps have been taken:
a) Undertake
or cause to be undertaken surveys, investigations and research
concerning the cause of occurrence of disabilities.
i. As
per 2001 census results by Directorate of Census Operations,
Punjab, 1.7% of Punjab's Population is suffering from disability
either in vision, speech, hearing, movement and mental state.
Disability rate in
Punjab
is lower than that of the country (2.1%).
ii. As
per 2001 census total disabled population of Punjab is 4,24523.
The category wise detail is as follows:-
|
Mentally
Disabled |
Visually
Disabled |
Hearing
Impairment |
Speech
Disabled |
Locomotor
Disabled |
|
63,808 |
170,853 |
17,348 |
22,756 |
149,758 |
b) Promote
various methods of preventing disabilities:
Health
Deptt. Punjab, has taken various steps to prevent disability due
to various medical problems. In 151 hospitals of the state,
Specialist and secondary level health services are being provided
by Punjab Health Systems Corporation. Trauma wards have been
established in major hospitals where specialist doctors and
equipment have been provided.
(i)
Polio
- Polio is a major
cause of disability. To prevent Polio, an intensive campaign,
Pulse polio immunisation (PPI) is undertaken in the state every
year since the past few years during which all the children under
5 yrs. of the age are administered polio drops. NGO's actively
participated in this programme. During the last three years i.e.
2003,2004 & 2005 there have been only 2 polio cases in the state
and these two children also travelled to Punjab from Bihar & U.P.
Achievements for
the year 01.04.2005 - 31.03.2006
|
Sr. No. |
Immunization |
Proposed
Targets |
Achievements |
%age |
|
1. |
T.T. (Pregnant
women) |
591082 |
534156 |
90.4% |
|
2. |
B.C.G. (Infant) |
509942 |
561406 |
110.1% |
|
3. |
O.P.V.
D.P.T. |
509942
509942 |
531806
531806 |
104.3%
104.3% |
|
4. |
Measles |
509942 |
510755 |
100.2% |
|
5. |
D.T. 5 Years |
578682 |
612307 |
105.8% |
|
6. |
T.T. 10 Years |
465012 |
546770 |
117.6% |
|
7. |
T.T. 16 Years |
439178 |
485175 |
110.5% |
(ii)
Control of Blindness:- To prevent night blindness, Vit.
A drops are administered to children.
Under the National Programme for Control of blindness, cataract
and Glaucoma operations are performed in all the major hospitals
of state. NGO's are actively associated in holding the eye camps.
Achievements
under National Programme for Control of Blindness year
(2005-2006)
Cataract
operations performed 176697
110%
IOL Implantation
144727
113%
School Eye Screening Programme
Children
Examined 379322
Children found
with refractive errors
28054
Children provided
with glasses
4249
Teachers
trained
2661
Eye
Donation
138
(iii)
Leprosy:
To prevent deformities due to leprosy emphasis is given on early
detection of cases and treating them with Multi drug therapy
(MDT). A special drive named Modified Leprosy Elimination campaign
(MLEC) is carried out during which special Skin Camps are held and
survey of migrant population is undertaken. Health Education is
provided through various media. Under the World Bank Project,
facilities for reconstructive surgery for deformed leprosy
patients are being provided in the Medical College Hospitals and
some district hospitals. Punjab is a low endemic state in terms of
prevalence of Leprosy. The prevalence rate of Punjab is 0.44/
10,000 population. Govt. of India has set the leprosy elimination
level at less than one case per 10,000 population since prevalence
rate of Punjab is less than one, so Punjab has achieved the
National target of elimination level.
(iv)
National Iodine Deficiency Disorders Control Programme
- Iodine
deficiency may lead to various disabilities like mental
retardation, growth retardation etc. To prevent Iodine deficiency
it has been made mandatory that only Iodised salt is sold for
human consumption. Samples of common salt are taken to check
Iodine content.
(v)
Locomotor disabilities -
Trauma wards have
been established in major hospitals of the State where
orthopaedic/ surgical specialists have been posted and necessary
equipment's made available to treat accident victims.
c) Screen all
the Children at least once in a year :-
In school Health programme, school children are
regularly examined for health check up. Disabled children are
identified and provided necessary help. According to reports sent
on Disability Certificates of the children upto 14 yrs. of age
issued by Civil Surgeons of districts.
d) Provide
Facilities for Training to the Staff at Primary Health Centres.
§
668
PHC Medical Officers and 9 Master Trainers have been imparted
training in disability at vocational Rehabilitation Training
Centre Ludhiana, which is a recognised Centre by Rehabilitation
Council of India, New Delhi.
§
Training of Medical Officers is also done regularly in various
programmes like Reproductive Child Health Services (RCH), National
Leprosy eradication Programme etc
e) Sponsor or Cause to be sponsored awareness campaigns and
Disseminate or Cause to be disseminated, information for General
Hygiene, Health and Sanitation
Special Medical & Health Education Camps are organised
from time to time in which people are educated about general
hygiene, sanitation and preventive measures such as role of
vaccines in preventing diseases, role of nutrition, iron & folic
acid in pregnancy, role of iodised salt, Vitamin A etc.
f)
Take measures for prenatal, natal and postnatal Care of mother and
Child.
Family
Welfare department provides pre-natal, natal and postnatal
services. All the pregnant mothers are registered in the first
trimester and given Iron and Folic Acid Tablets to prevent
anaemia. Inj. TetanusToxoid is also given to pregnant mothers to
prevent Tetanus. Women are also advised about diet during
pregnancy and lactation. Efforts are made to promote Institutional
deliveries. For care of mothers and children, RCH Project has
been launched in the State.
g) Educate
the Public through the Preschools, Schools, PHC's, Village Level
Workers and Anganwadi and Anganwadi workers: -
During
block level meetings, Health education is provided to the
community. Similarly during school health programme, children are
educated about hygiene and nutrition.
h)
Create awareness amongst the masses through Television, Radio and
other media on the causes of disabilities and Preventive measures
to be adopted.
Awareness is created from time to time through print and
electronic media. Under Pulse Polio immunisation campaign
activities like hoardings depicting schedule of immunisation are
displayed at major Bus Stands, wall paintings in rural and urban
areas are being made . Under National Leprosy Eradication
Programme to create awareness about leprosy pamphlets are
distributed.
The total
Number of Disability Certificate issued in Punjab State from
01.01.1996 till 31.3.2006 are 1,95,576.
|
|
Performance
u/s 25 of PWD Act |
2003-04 |
2004-05
|
2005-06 |
2006-07 (Upto
June, 06) |
|
1 |
No. of
Disability Certificates issued |
12120 |
31871 |
21725 |
11055 |
|
2 |
No. of
Disabled children |
3939 |
3288 |
2297 |
1248 |
|
3 |
No. of Camps
held in the year |
34 |
53 |
111 |
57 |
|
4 |
No. of Persons
examined in Camps |
4535 |
12962 |
952 |
563 |
|
5 |
No. of
Assistive Devices distributed |
2912 |
1151 |
682 |
110 |
|
6 |
IEC Activities
regarding prevention of disability for the year |
16 |
836 |
85 |
35 |
|
7 |
|
126 |
57 |
35 |
6 |
11. Tobacco
Control Program
The Cigarette &
other Tobacco products (Prohibition of Advertisement & Regulation
of Trade & Commerce, Production, Supply distribution) Act, 2003
was implementation in India w.e.f.1st May, 2004 and in the state
of Punjab from 25th June, 2004. The main provisions of
the act are as under:-
·
Prohibition of smoking in public places
·
Prohibition of Advertisement, Sponsorship of tobacco products.
·
Prohibition of sale of tobacco products to minors.
·
Prohibition of sale of tobacco products near educational
institutions.
Violation of any
provisions of the act is an offence punishable with a fine of
Rs.200/-.
Authorised persons for implementing the act are:-
Ø
Superintendent of Police or any representative of the police
department not below the rank of Sub-Inspector.
Ø
Drug
Inspector of Health Department
Ø
'No
Tobacco Day' is celebrated on 31st May every year. On
this day educational advertisements in newspapers, exhibitions &
workshops/seminars in the state are regular features.
Ø
A
Tobacco Control Cell has been established in the office of
Director, Health Services, Punjab at Chandigarh.
Ø
Wide
publicity in print & electronic media regarding the harmful
effects of tobacco is given from time to time.
Ø
Hotels with a seating capacity of thirty people are to create
'Smoking' & Non-Smoking' zones. Ashtrays from hotels are removed.
12.
CIVIL REGISTRATION
SYSTEM
Civil Registration
System is the recording of vital events i.e. live births,
still births and deaths under the statutory provisions on
continuous and permanent basis.
The registration
records are useful primarily as legal documents and secondarily
as a source of statistics. For individuals, it is legal
proof of age, identity, nationality, heritance and civil status.
The vital records are also useful for administrative purposes
for managing public health, maternity and child welfare,
education, electoral rolls, social security benefits and other
such welfare programme.
The information
generated through these records provides estimation and
projection of population, vital rates, demographic structure etc.
for plan purposes.
The Registration
of Births and Deaths Act,1969 was enacted and enforced
throughout the Country on an uniform pattern w.e.f.01.4.1970.
Its complete implementation in the Punjab State could be done
w.e.f. 22.9.1972 on the notification of Punjab Registration
of Births and Deaths Rules,1972. All the previous laws and rules
ceased to operate with the enforcement of this specific Act. At
present, the Punjab Registration of Births and Deaths Rules 1972
have been repealed. The Government has notified new Rules called
the Punjab Registration of Births & Deaths Rules 2004 vide
No.G.S.r.9/CA18/1969/S-30/2004 dated 21.1.2004.
The Director Health
and Family Welfare Punjab is the Ex-officio Chief Registrar,
Births and Deaths for discharging the responsibilities of the
Chief Executive Authority for proper implementation of the
RBD Act, 1969. He is assisted by Deputy Chief Registrar,
Births and Deaths at the State Headquarter. The Civil
Surgeon is Ex-officio District Registrar, Births and Deaths
for ensuring implementation of the R.B.D. Act, 1969 within the
district. The District Health Officer and in his absence the
Assistant Civil Surgeon has been notified as the Ex-officio
Additional District Registrar for assisting the District
Registrar in discharging his functions for proper implementation
of R.B.D. Act, 1969.
The registration
area has been divided in two Sectors i.e. Rural and Urban.
Panchayat Secretaries of the Gram panchyats have been appointed
as Registrars within the jurisdiction of their Gram Panchayat vide
the Notification of the Govt. No.2/Pb/03/3HB6/160 dated 1.1.2004.
Under the R.B.D. Act, it is the responsibility of the head of the
household in case of domiciliary and Medical Officer incharge of
the institution in case of institutional to report the
occurrence of birth/ death events to the local Registrar in
Form No. 1, 2 & 3 under his own signature.
Urban Area
The Municipal
Corporation/ Council/ Notified Area Committee is the local
registration centre in the Urban Area. The Municipal Medical
Officer of health and in his absence the Executive Officer /
Secretary is the Local Registrar, Births and Deaths.
The Local
Registrar, Births and Deaths both in the urban and rural Areas
in the State send the information in respect of all events of
registered, Births and Deaths to the District Registrar/
Chief Registrar, Births and Deaths in the State on monthly
basis. The Statistical data thus received is scrutinised,
compiled, tabulated and analysed to work out the estimates of
population growth and other vital statistics.
The comparative
information for the year 2002 and 2003 is given below:-
Live Births by Sex
The number of live
births by sex has been depicted in the table below so as to know
the sex ratio at births.
Live births
registered during the year 2001to 2005 are as under:-
|
Sex |
2001 |
2002 |
2003 |
2004 |
2005 (Upto
Nov,06) |
|
Male |
2,68,328 |
258952 |
2,66,387 |
267624 |
248872 |
|
Female |
2,02,219 |
201315 |
2,10,140 |
212464 |
197831 |
|
Both Sex |
4,70,547 |
460267 |
4,76,527 |
480088 |
446703 |
|
Sex Ratio
(Females per 1000 males) |
754 |
777 |
789 |
794 |
795 |
Deaths
During the year
under report 1,64,258 deaths were registered in the State as
against 1,54,403 registered during the preceding year. The death
rate worked out during the year 2003 has been 6.5 per thousand
persons as against 6.2 during the preceding year. Death during
the year 2003 deaths registered 164258.
Deaths Registered During the Year 2001to 2005 are as under:-
|
Sex |
2001 |
2002 |
2003 |
2004 |
2005 (Upto Nov,
06) |
|
Males |
93311
|
93258 |
99992 |
90437 |
75684 |
|
Females |
59355 |
61145 |
64266 |
59528 |
51595 |
|
Both Sexes
|
152666
|
154403
|
164258
|
149965 |
127279 |
13.
NATIONAL
FAMILY WELFARE PROGRAMME
Back
Ground
The National Family welfare programme was launched in India in
1951-52 with an objective of reducing the birth rate to the extent
necessary to stabilise the population at a level consistent with
the requirement of the national economy. Since then, Family
Welfare programme continues to occupy an important position in our
socio economic development plans. In spite of the considerable
progress made in the promotion of health & family programme and
in the development infrastructure, eradication of large scale
epidemics, introduction of new and modern methods of treatment
and other resources during the past fifty years, the demographic
and health picture of the country still continues to be a cause of
serious and urgent concern.
The experiences gained in the course of time amply established
that health of women in the reproductive age group and of younger
children (upto 5 years of age) is of crucial importance for
effectively tackling the problem of growth of population and
effective implementation of family planning. This led to change in
approach from Family Planning to Family Welfare. Since the seventh
Plan implemented during 1984-89, the FW Progamme has evolved with
the focus on health needs of children below the age of 5 years and
women in the reproductive age group. Family Welfare services are
provided to the community by well trained medical & paramedical
personnel.
Community Need
Assessment Approach (CNNA)
Since 1996-97, a major Policy Reform has been introduced by the
Department of Family Welfare for Decentralized Participatory
Planning implemented through Community Need Assessment Approach (CNAA).
This means by giving up target based system, which was in vogue
for about 4 decades in Family Welfare programme. Basic objective
of CNAA is to ensure quality of Primary Health Care Services and
Client's satisfaction. The important component of CNAA is to
prepare action plan at the grassroots level after assessing the
need of the people, mainly for primary health care services under
RCH programme. CNAA action plan will thus be prepared right from
Sub-Centre level upto District/ State level. One of the important
aspects of CNAA is to ensure community participation by way of
associating local leaders, MSS, AWW etc. at the grassroot level
i.e. at village level.
Now the
Annual Action Plan for the State level is prepared every year and
submitted to the Govt. of India regularly. This Action Plan is
prepared on the bases of the data received from all the districts
which in turn is prepared on the requirement worked out by the
grassroot level workers in each district.
Demographic Indicators:
Over the
years the impact of the implementation of the programme can be
judged from the followings demographic indicators:
|
|
Indicators |
1981 |
1991 |
2001 |
2004 |
By 2010
(N.P.P.) |
|
1. |
Birth Rate
(per 1000 Population) |
30.3 |
27.7 |
21.2 |
18.7 |
21.0 |
|
2. |
Death Rate(per
1000 Population) |
9.4 |
7.8 |
7.0 |
6.4 |
|
|
3. |
Infant
Mortality Rate (per 1000 live births) |
81 |
58 |
51.0 |
45 |
30 |
|
4. |
Expectation of
Life at Birth Years
Male
Female |
1981-85
58.5
57.9 |
91-96
66.6
66.6 |
|
99-03
67.6
69.6
|
|
|
5. |
Total
Fertility Rate(Average Children would be born per women) |
4.0 |
3.1 |
|
2.3 |
2.1 |
|
6. |
Maternal
Mortality Rate(per 1 lac birth) |
|
199## |
|
|
100 |
|
7. |
Institutional
deliveries |
|
24.8 |
37.0 |
53@ |
|
|
8. |
Couple
protected by family planning methods |
57 |
|
66.7* |
67.2# |
|
Reproductive & Child Health Programme
The RCH-II
(2005-10) is key component of NRHM. It is an integrated vision on
maternal health, new-born/ child health, RTI/ STI, Behaviour
Change Communication (BCC), Adolescent Health, Gender Issues,
Family Planning etc. within a comprehensive approach involving
both public and private/ NGO sectors. It will support the paradigm
shift in India's Family Welfare Programme by promoting state
ownership with a pro-poor focus. It encompasses programmes in
rural and urban areas and address a significant proportion of
mortality and morbidity burden among women and children, and also
contributed to strengthening of public health systems. Thus it
includes many of the key strategies proposed under NRHM and
contributes to several of its key outcomes.
The states were asked to develop programme Implementation Plans
(PIP) on the basis of a two step planning process consisting of
(a) A basic minimum service delivery package and (b) A package
over and above the basic minimum service delivery package as
prioritized from the detailed situation analysis.
For activities under RCH-II (including NMBS, Janani Surkasha Yojna
and Compensation Scheme), state was told that as per framework
approved for the NRHM, the allocation of funds to the state as Rs.
29.00 crore for each of the 1st two years and,
subsequently, with an increase of 25% for each of the following
three years. Accordingly a detailed physical and financial action
plan for RCH-II activites under NRHM for the year 2005-06 with an
outlay of Rs. 29.00 crore was submitted to Govt. of India on
22.06.2005 which has been approved by the Govt. of India and it is
now under implementation in the state.
SEX-RATIO IN PUNJAB VIS-À-VIS
INDIA
Sex-ratio in India is defined as
no. of females per 1000 males. Child sex-ratio is the no. of
female children (0 to 6 years) per 1000 male children.
Biological sex-ratio is the no. of female babies born per 1000
male babies born naturally. At the Inter-National level 105
boys are born naturally for every 100 girls born. During the
early childhood survival of the female children is better than the
male children naturally and by adulthood the ratio of the females
and males becomes equal.
The sex-ratio in Punjab has
traditionally been low as sex-ratio for all ages in Punjab in the
year 1901 was 832 in contrast to 972 of the country. This was
still lower in the year 1911 at 780. However it gradually
increased to 882 in the year 1991 and then it slightly declined to
876 in the year 2001. Whereas the sex-ratio in Punjab has
been showing an upward trend, the sex-ratio of the country has
been declining during the last century as is evident from the
following graphs.
DECLINE IN CHILD SEX-RATIO IN
PUNJAB VIS-À-VIS INDIA
The heinous crime of infanticide
(female) is ages old and has been prevalent in many Asian
countries. With the development of medical technology especially
the non-invasive sonography infanticide decreased, but foeticide
increased. This technology has been misused by some doctors to
determine the sex of the foetus leading to selective female
foeticide and resultant low child sex-ratio. Analysis of
child sex-ratio during the last 4 decades shows that it has been
declining continuously and the decline has been sharp from 1981
onwards as is evident from the following graph:
The decline has been sharp from
1981 onwards in the country and in the last decade i.e. 1991 to
2001, the decline in child sex-ratio has been sharpest, more so in
Punjab, Haryana, Delhi and Chandigarh as is illustrated in the
graph below:
The decline in child sex-ratio in
Punjab is a matter of serious concern for the State as the child
sex-ratio has declined by 77 points from 875 in the year 1991 to
798 in the year 2001 as per census figures. District
Fatehgarh Sahib has the dubious distinction of having the lowest
child sex-ratio of 766 in the country. All the 17
districts of the Punjab state fall in the last 34 districts of the
country with lowest child sex-ratio and the range is 766 to 819
girls per 1000 boys.
The district wise decline in
sex-ratio for all ages and the child sex-ratio in Punjab during
the last decade is illustrated below:
SEX-RATIO IN PUNJAB
IN 1991 & 2001:
|
Sr. No |
Name of the State/ District |
Sex ratio: all ages |
Child Sex ratio |
|
1991
|
2001 |
1991 |
2001 |
|
|
Punjab |
882 |
876 |
875 |
798 |
|
1 |
Amritsar |
873 |
874 |
861 |
790 |
|
2 |
Bathinda |
884 |
865 |
860 |
785 |
|
3 |
Faridkot |
883 |
881 |
865 |
812 |
|
4 |
Ferozepur |
895 |
883 |
887 |
822 |
|
5 |
Fatehgarh Sahib |
871 |
851 |
874 |
766 |
|
6 |
Gurdaspur |
903 |
888 |
878 |
789 |
|
7 |
Hoshiarpur |
924 |
935 |
884 |
812 |
|
8 |
Jalandhar |
897 |
882 |
886 |
806 |
|
9 |
Kapurthala |
896 |
886 |
879 |
785 |
|
10 |
Ludhiana |
844 |
824 |
