SIKKIM - STATE ANNUAL PLAN 2001-2002MEDICAL AND PUBLIC HEALTHDEMAND NO. 30As envisaged in the Ninth Five Year Plan document, the strategy to be adopted during 2001-2002 is to continue consolidation of the gains made during the Eighth Five Year Plan and assure to the people better health care tacilities with a view to improve their standard of health and living. This is to be achieved through improvement in the quality of services by providing specialised services coupled with latest diagnostics and tratment equipment, trained and skilled manpower to handle such equipments efforts I nthe control of communicable diseases through effective mass awareness activities and improvement in the Health Mangement Information System for better planning, implementation, monitoring and evaluation. Review of the basic health facilities indicate that, while in terms of physical facilities, the State has already achieved the National Norm for Establishment of Primary Health Sub-Centre, Primary Health Centres and Community Health Centres, the situation in regard to development of secondary and tertiary level services in terms of equipments and trained and skilled manpower needs to be improved substantially. Health indicators show that there has been a significant impact on the health status of the people of the State through the years. Crude Death Rate has been brought down to 5.8/1000 population and infant Mortality Rate stands at 49/1000 live births. Crude birth rate has also been brought down to 21.6/1000 population. All these health indicators are below the National averages. However, these indicators are significantly high as compared to some of the developed states. High birth rate coupled with lwo death rate has led to a very high growth rate of population. Efforts therefore need to be made to further decrease the birth rate & control the growth rate. With the implementation of the Reproductive and Child Health Programme and Child Health Programme and Community Needs Assessment Approach under the Family Welfare Programme, it is hoped to increase the Couple Protection Rate from the present level of 21.9% to 60% by the end of the Plan Period. With the enforcement of the Bio-medical Waste (Handing & Management) Rules 1998, and the anticipated Central assistance, it is envisaged to streamline the scientific disposal of the bio-medical wastes. As soon as the Notification of the B.P.L. is issue, all B.P.L. patients requiring specialised treatment outside the state would be given full monetary assistance under the scheme. It is neeless to mention the Health Care needs a holistic approach through provision of safe drinking water, environmental sanitation, proper housing facilities, literacy etc. Greater coordination of the activities of other Government Deparmtent with the activities of the Health & Family Welfare Department therefore needs to be generated.
Rs 120 lakhs has been kept to meet the cost towards strengthening the Planning. Monitoring and Evaluation Cell and maintain the existing Health Management Information System. 15.00 lakhs has been earmarked to meet the cost towards salary of NLEP staff and Rs 15.00 lakhs for maintenance of vehicles, replacement of old vehicles. 2. Hospital & Dispensaries
The revenue component of Rs 177.50 lakhs has been kept to meet the costs towards strengthening and augmentation of the specialised services at STNM Hospital through qualified and trained manpower, equipments and drugs to improve the services available at STNM Hospital. It may be pertinent to mention here that specialised services at STNM Hospital and District Hospitals are suffering due to want of GNMs in the specialised clinics. Of the 593 sanctioned posts of GNMs only 150 posts have been filled up so far. Out of the total capital component of Rs 33.50 lakhs, Rs 10.00 lakhs has been earmarked for the construction of Central Medical Stores and Mechanical Workshop at Tadong. Rs 13.00 lakhs for balance payment of consultancy fees for preparation of Master Plan for development of STNM Hospital at Gangtok and the balance for construction of administrative bloc for the Singtam district hospital, construction of class IV, 6 unit quarter (1st phase). 3. Indigenous System of Medicine
The outlay is proposed to meet the expenditure on maintaining the Amji System of Medicine, which has gained popularty in the State and to extend the facilities to the District hospitals. It has also been envisaged to extend the facilities under the Indigenous System of Medicine in the Stgate. A post of Vaid has already been created and filled up. One post of Homeopath is to be created and filled up during 2001-2002. 4. Pradhan Mantri Gramodaya Yojana:
(A) Primary Health Sub-centre
The State has already achieved the National norm for establishment of 1 PHSC for 3000 population, with 147 PHSCs functioning in the State. The Capital Component has been kept to meeting the spillover cost for the ongoing construction work of PHSCs and for taking up construction of 5 new PHSCs including land compensation, etc. (B) Primary Health Centre
The State has also achieved the National norms for estabishment of 1 PHC for 20,000 population with 24 PHCs functioning in the State. The revenue expenditure has been kept to upgrade the diagnostic and referral facilities at the four sub-division level PHCs, improve the communication facilities and posting of 12 medical officers. The capital component has been earmarked to meet spillover liabilities in respect of ongoing construction works. (C) Community Health Centre
Out of the revenue component of Rs 208.50 lakhs, Rs 76.00 lakhs has been earmarked for strengthening and augmentation of the specialised services at the District. Out of the revenue component of Rs 208.50 lakhs. Rs 76.00 lakhs has been earmarked for strengthening and augmentation of the specialised services at the District Hospitals which are redesignated as Community Health Centre following enhancement in the target of Rs 590.00 lakhs during 2000-2001 to Rs 650.00 lakhs for 2001-2002 under the PMGY. The balance allocation of Rs 132.50 lakhs has been earmarked for procurement of drugs/diagnostics/DDKs and repair etc. for equipment and furniture. The capital component of Rs 270.00 lakhs has been earmarked for completion of the Community Health Centres at Gyalshing and Mangan, District Headquarters of West and North Districts respectively. 5. Medical Education, Training, Research & Civil Registration
The outlay has been projected to meet the cost towards in-service training of medical and paramedical personnels. The remaining amount of Rs 19.00 lakhs has been earmarded to emet the cost towards Civil Registration Scheme to ensure 100%, Rs 9.00 lakhs has been projected to meet the cost towards inservice training of medical and para-medical personnels. 6. Prevention and Control of Communicable Diseases
(A) NATIONAL ANTIMALARIA PROGRAMME
Resurgence of malaria in the State calls for putting a more rigorous effort for revamping the programme for effecting better preventive measures coupled with more intensive entomological and spray activities. (B) National Tuberculosis Control Programme
Tuberculosis is one of the greatest health hazards in the State. It is therefore proposed to intensify the activities under the programme and provide trained manpower with to view to eliminate the disease by the end of the Plan Period. GOI has also accepted the introduction of DOTs in the whole state. 7. Other Diseases Control Programme
The schemes to be covered under the heading include continuation of the ongoing activities under Thyroid Centre at Namchi, augmentation of services under Dental Health and Mental Health and Cancer Control. 8. Prevention of Food Adulteration
In view of the increased incidences in food adulteration in recent times. It is projected to substantially the activities of the programme in public interest and make all out efforts to create common awareness and curb adulteration. Although the Ministry of Health & Family Welfare has agreed to finance the cosntruction of a Food Testing Laboratory in the State through World Bank assistance, the proposal is still pending with the Government of India. Detail proposed on the matter has been submitted to the World Bank. 9. Public Health Education
(A) Health Education
Health awareness campaign through mass eduation and medica activities form an important component of all Health Progrmames in the drive to prevention of diseases in the community. It is therefore, proposed to intensity the I.E.C. activities to bring about greater awareness among the rural mass on environment sanitation, factors affecting the health of the individuals and the society and generate active participation of the community I all Health Programmes. (B) School Health Programme
The provision under the scheme is meant for meeting the expenditure of the ongoing activities including Health Education addressed for the benefit of the school childen, particularly girls. 10. Assistance State Blood Transfusion Council
As per the directives of the Hon’ble Supreme Court of India, the Central Government as well as the State Governments are required to constitute "Councils for Blood Transfusion" to manage and regulate transfusion of blood, effect control over blood donors, specially by professional blood donors and curb malpratises by private blood Banks. Accordingly, the State has already constituted the "Sikkim State Council for Blood Transfusion" and registered under rules. The funding of the State Blood Transfusion Council on 50:50 basis between the Centre and the State. Howver, as the Council is receiving the Central share directly, a provision of Rs 5.00 lakhs has been earmarked as an assistance to the council from the State Plan. 11. State Illness Assistance Fund
The Government of India has launched a new scheme by the name of State Illness Assistance Scheme for providing financial assistance to those poor people of the State lying below poverty line for treatment of the threatening diseases. The fund undr the scheme is to be creted on a 75:25 sharing basis between the Central Government and the State Government. As required under the scheme, the State has already cosntitued and Association by the name, "Sikkim Sttae Illness Assistance Fund Association" and registered vide Registration No. 1048 dated 17.10.98 after having duly formed the memorandum of Association and Constitution of the Association, for managing the activities undr the schemes. The Sikkim State Illness Assistance Fund Association (SSIAFA) has been receiving the Central share directly since initial release of the state share of Rs 50.00 lakhs during 1999-2000. The implementation of the scheme has been pending due to non-finanalisation of the BPL identification list by the State Government. Therefore, a token provision of Rs 1.00 lakhs has been earmarked for the current financial year as an assistance to the SSIAFA. 12. Purchase of Medical Equipment (EAP)
A provision of Rs 100.00 lakhs has been provided for adjustment of the balance payment in respect of the equipment procured under the French Protocol and also initiate some new projects. 13. Upgradation Grant Under Eleventh Finance Commission:
Under the aard of the Eleventh Commission a sum of Rs 60.00 lakhs allotted for the current year for health Services. The revenue component of Rs 50.00 lakhs constitutes procurement of equipment for the District Hospitals and the balance allocation of Rs 9.60 lakhs is for capital cost on housing/installation of the equipment. ABSTRACT(Rupees in lakhs)
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