*January 13, 2011*

At the three-day meeting in Hyderabad held between 11th and 13th January
2011, under the chairmanship of the Union Minister of Health and Family
Welfare Shri Ghulam Nabi Azad, Ministers of Health and Medical Education
from 16 states and Principal Secretaries / Secretaries and Directors of
Health and Medical Education from 28 States/Union Territories and senior
officials of the Central Ministry of Health and Family Welfare discussed
issues related to Communicable and Non Communicable Diseases, Maternal
Health, Child Health, reforms in Medical Education and Regulatory Issues.

After detailed review of the ongoing National Programmes and threadbare
discussions on the newly initiated programmes, with a view to strengthening
the health programme, the meeting unanimously resolved as under:

*I.   Communicable diseases*

*Vector Borne Diseases*

Early diagnosis and complete treatment of Malaria will be ensured.

Long Lasting Insecticide Nets (LLINs) have been very successful in Orissa
and the North-Eastern States in reducing the mortality from Malaria, and
therefore the same will be scaled up.

Rapid Diagnostic Tests (RDTs) and Artemisinin based Combination Therapy
(ACTs) will be expanded to cover more areas.
A massive awareness programme/campaign/ jagran yatra will be launched for
spreading general awareness about hygiene and sanitation before the onset of
monsoon.

Zilla Parishads, particularly standing committee Chair persons of Education,
Public health and Sanitation will be involved in prevention and control
measures against vector borne diseases under the National Rural Health
Mission.

Untied funds provided under NRHM for Village Health and Sanitation
Committees, PHCs, CHCs and District Hospitals will henceforth be utilized
for prevention measures against mosquitogenic conditions in their respective
jurisdictions.

In urban areas, Corporations/Municipalities will be made stakeholders in
this campaign. Immediate steps to be initiated for covering overhead water
tanks in public and private buildings before the onset of monsoon every
year.

In view of spread of Malaria to low endemic and newer areas, strict fever
surveillance will be maintained and peripheral workers will be trained in
 the diagnosis and management of malaria in a time bound manner.

R&D efforts will be strengthened to address issues like resistance to
insecticides and drugs.

*Tuberculosis*

Concerted efforts will be made to improve case detection rate in 100
identified districts where case detection is less than 50% to raise it to
70% by 2012.

Multi-Drug Resistant Tuberculosis (MDR-TB) is emerging as a major public
health problem in the county and shall be urgently addressed.
*
II.   Reproductive and Child Health*

1. To bring down maternal and child mortality, it was resolved that the
following actions will be taken in a comprehensive manner:

§  Ensure minimum one doctor and one nurse at each PHC as a mandatory
requirement by 31st March 2012.

§  Full antenatal care of the pregnant mothers to be ensured

§  Universalisation of name based mother and child tracking system shall be
ensured to facilitate full ANC, safe delivery, post natal care and
immunization of children.

§  Blood banks at all district hospitals and blood storage facilities at
sub-divisional hospitals and CHCs shall be set up by December 2012.

§  Free delivery services to pregnant women in Government health facilities,
so that they do not incur any out of pocket expenses

§  Malnutrition and maternal anemia will be addressed on priority.

§  Institutional delivery to be facilitated by ensuring referral transport
and close follow-up

§  Infrastructure facility including labour room and operation theatre,
manpower, drugs, equipment etc., at all health centres to be improved

§  Facilities for new born care to be set up at all health centres

2.      In remote areas of designated hill states, desert areas and tribal
pockets, birth waiting homes will be set up so that pregnant mothers and
attendants can come in advance and stay for delivery.

3.      Minimum 70% of funds meant for infrastructure shall henceforth be
spent on sub-health centres and Primary Health Centres.

4.      Districts with poor health indicators and high disease burden shall
be identified for special focus and higher level of interventions.

5.      Multi-skilling of doctors be taken up to overcome shortage of
specialists like gynecologists, anaesthetists, etc.,

*III. Non Communicable Diseases*

*Cancer, Cardio-Vascular Diseases Stroke & Diabetes/Care of the Elderly*

·         For immediate and effective implementation of the newly initiated
‘Integrated National Programme for the Prevention and Control of Cancer,
Diabetes, Cardio-Vascular Diseases & Stroke [NPCDCS] & the National
Programme for Health Care of the Elderly [NPHCE]’ launched in 100 districts
spread over 21 states, the meeting of concerned district officials will be
called by the concerned state health ministers at the earliest.

·         All individuals over 30 years of age and pregnant women of all age
groups shall be screened for diabetes & hypertension and other NCDs. Name
based data will be generated to facilitate analysis of the causes of death,
district & block wise, around the country.

·         The threat of Non-Communicable Diseases, which account for 42% of
all deaths in the country, shall be clearly recognized, while planning for
investment in the 12th Plan.

·         Mental illness, the illnesses of the elderly and diseases caused
by the use of tobacco shall be recognized as Non Communicable Diseases.

·         Government will launch a national programme for the eradication of
Thalassemia.

·         Recognizing the fact that according to latest Global Adult Tobacco
Survey (GATS) 26% of all adults use smokeless forms of tobacco (gutkha,
khaini, etc.) all State Governments resolved to chalk out a plan for an
awareness/education campaign aimed at that segment of the population which
is most vulnerable.

·         In view of increased incidence of cases of illness/neglect of
elderly persons, especially in towns and cities, State Governments /
Municipal Corporations shall be requested to allot land for construction of
Geriatric Homes/Hospital for Elderly.

*National Mental Health*

·     The states to send proposals to the Government of India for starting
new departments of psychiatric medicine, psychiatric nursing, clinical
psychology and psychiatric social work, in Medical Colleges.

·     Work on all 11 centres of excellence (including the two where the
State Government’s commitment has not been received) to be expedited on war
footing.

·   Steps will also be taken to complete the modernization of mental
hospitals & psychiatry wings of general hospitals where funds have been
released by  GOI.

·   The remaining  450 + districts would be covered under DMHP in the 12th
Plan.  The DMHP would be revamped based on the experience of implementation
 gained  in the 11th Plan.

*National Programme for Control of Blindness (NPCB)*

·   State should utilize the funding provided by Government of India to set
up dedicated Eye wards, Eye operation theatres, Eye banks to improve
infrastructure and to train Ophthalmic Surgeons and Assistants.

·   All States shall initiate urgent action to implement the new initiatives
launched in the 11th Plan which include Diabetic Retinopathy, Glaucoma,
Trachoma, Vitreoretinal surgery, Childhood blindness, etc.,

·   States will also avail of Central funding for strengthening of Medical
Colleges and Regional Institutes of Ophthalmology.

*IV. Human Resources in Health*

·   State Governments shall / will take immediate steps to increase intake
capacity at MBBS level up to 250 in all the Government Colleges across the
country.

·   State Governments will make full use of the GoI scheme for strengthening
and up-gradation of Government Medical colleges for increasing PG seats
/starting PG courses.

·   150 ANM/GNM schools sanctioned by GoI across the country shall be made
operational by March, 2012.

·   State Governments will take all steps to ensure early establishment of
the eight Regional Institutes of Paramedical Sciences financed by GoI by end
of 2010.

·   State Governments may make full use of the Central scheme for
Strengthening of Pharmacy Institutions and training of practicing
pharmacists which is shortly to be announced.

·   The introduction of the Bachelor of Rural Health Care Courses was
endorsed in the meeting unanimously.

·   Central Government to consider for inclusion in the 12th Plan a major
programme to support High Focus States to set up / expand Medical Colleges.
 The meeting further resolved that the GOI should consider the following;

i.  Assist in setting up new Medical Colleges in the un-served /
under-served areas

ii.  Financial assistance to State Government colleges for strengthening &
up-gradation to increase intake at UG/PG level.

iii.  Financial support to States to start a minimum of 50 Medical schools
for the BRHC course in the high focus states for the year 2011-12.

iv. Financial assistance to State Government to establish a college for
Nursing, college for Paramedics,  college of Pharmacy.

v.  The proposed scheme of common eligibility and entrance test (CEET)  was
discussed in detail and it was unanimously decided that the matter would be
discussed further to take on board the views and concerns of the states.

*Regulatory Issues*

·         It was resolved that the Central and State Governments will draw
up a time  bound action plan for creation  of new posts and filling up
vacant posts mainly of Drug Inspectors and also for upgradation of Drug
Testing Laboratories.

·         The issue of spurious / sub standard drugs also came up for
discussion. It was agreed that both Central and State Drug Control
Organisations will launch an effective campaign and take steps for
enforcement of provisions of drugs and cosmetics Act relating to spurious
drugs.  The states will designate special courts for speedy trial of drug
related offences.

·         It was also resolved that Central and State Governments will draw
up a time bound action plan to promote use of generic drugs so as to provide
affordable health care for all.

·          The states agreed to set up Jan Aushadhi Stores in all their
districts in a time bound phased manner.

·         For effective implementation of the provisions of Food Safety and
Standards Act, 2006 it was decided to launch a reward scheme for whistle
blowers for information on cases of food adulteration.

·         States were sensitized about the importance and the objectives of
the Clinical Establishments (Registration & Regulation) Act, 2010 and were
requested to adopt this law in their respective states as early as possible
by passing the enabling laws in their respective State Assemblies.

http://www.pib.nic.in/release/release.asp?relid=69052

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