Health Campaigns

 
ARDRAM, one of the most prestigious missions conceived by the State government, aims to boost people-friendly public health care system. Medical colleges, general hospitals, district hospitals, taluk hospitals, community health centres and primary health centres will benefit from the mission. The project aims to revamp Primary Health Centres as Family Health Centres. The scheme ensures the availability of medicines and a patient-friendly infrastructure, with a focus on primary healthcare and treatment of non-contagious diseases. 
 
The mission's state level key resource team consists of 50 experts. 28 teams have been made of 150 experts to prepare guidelines for the treatment of cancer, blood pressure, diabetes, and haemorrhage. The guidelines for ophthalmological, dental and dermatological diseases are also in preparation. Special training sessions are being designed for the staff of health department, including doctors and staff nurses. Guidelines for the training are in preparation. As a first step, projects will be implemented in a select 152 primary health centres. 
 
For a hassle-free implementation of the project, the government has sought the help and support of 15 medical colleges, including private medical colleges.
 
 
To check the quality and working of the numerous clinics in private as well as government sector, an Act is in preparation. A draft of the Clinical Establishment Act is under the review of the cabinet. The E-Health Project targets to link these numerous establishments all over Kerala. The project aims to build a database of individual medical records, easily accessible to the medical practitioners. This could avoid the repeated medical tests and can thereby reduce rush in clinics and labs. Easy access to the records could also speed up the distribution of benevolent funds. The government is currently reviewing the proposals to establish cadre services in public health sector — a Hospital Administration Cadre and a Public Health Administration Cadre.
 
 
Projects are in design to assist the differently-abled population of the state. Pediatricians will be given special training to detect mental health problems in children, if any, at an early stage of childhood. The project to run special anganwadis for children in need is already in effect in Calicut district. Kannur, Kasargod, and Wayanad will follow suit immediately. Starting special centres in all the medical colleges for autistic children is also under the consideration of the government.
 
 
Special care will be given to the victims of HIV and Endosulfan. The inclusive health care policy of the government guarantees quality service to the marginalized sections of the population, such as transgenders. This project designed in association with the Indian Medical Association to reduce causalities during labour. Also, it needs to be noted that the government underlines that it will not tolerate attempts to build up an anti-scientific temperament. It has strongly dealt with the anti-vaccination campaigns promoted by a few conservative factions in the society, and has ensured the effective administration of preventive medicines and vaccinations, for diseases such as diphtheria and poliomyelitis.
 
To go by the saying, prevention is better than cure. The government will take initiatives to spread awareness among the people of various epidemics and of the consequences of life style changes. It believes in the motto that quality lifestyle leads to quality health and the general well-being of the population results in a healthy society.
 
 
The Ministry of Health & Family Welfare, Government of India, under the National Health Mission launched the Rashtriya Bal Swasthya Karyakram (RBSK), an innovative and ambitious initiative, which envisages child health screening and early intervention services, a systemic approach of early identification and link to care, support and treatment. This programme subsumes the existing school health programme. Child health screening and early intervention services basically refer to early detection and management of a set of 30 health conditions prevalent in children less than 18 years of age. These conditions are broadly defects at birth, diseases in children, deficiency conditions and developmental delays including disabilities - 4D's.
 
The RBSK programme corresponds to the Reproductive, Maternal, Newborn, Child Health and Adolescent Health strategy (RMNCH+A), Incheon Strategy to "Make the Right Real" for Persons with Disabilities in Asia and the Pacific, and Child Survival and Development – A Call to Action summit held in Mahabalipuram, Tamil Nadu in 2013. It aims at providing continuum of care from birth to throughout childhood period. It is a step towards ‘Health for All' or ‘Universal Health Care' wherein children would get free assured services under NHM. The task is gigantic but quite possible, through the systematic approach that RBSK envisages. Implemented in right earnest, it would yield rich dividends in protecting and promoting the health of our children.
 
 
Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Rural Health Mission (NRHM). This scheme is in operation in Kerala from 2005-06 and is implemented with the objective of reducing maternal and infant mortality by promoting institutional delivery. The beneficiaries are pregnant women falling in the BPL category, aged 19 years and above and also SC & ST categories opting deliveries in public or accredited private health institutions.
 
Cash assistance under JSY: BPL or SC/ST mothers from rural area who are delivering in government hospitals/ accredited private hospitals- ` 700/-. BPL or SC/ST mothers from municipal/corporation area who are delivering in government hospital/accredited private hospitals -`600/-. Home delivery- ` 500/-
 
As the scheme targets the poor women who would generally be short of cash, it is ensured that the cash assistance provided under the scheme is made available to her in shortest possible time. Implementation of JananiSurakshaYojana has shown phenomenal progress in the last three years in the State, with number of women benefiting out of it increasing considerably over the year. This has been attributed to an increase in mass awareness and also by making the procedures simple. The State government has ordered to make all payments in one installment before discharge from the health care institutions after delivery. This facility can be availed on producing any document that proves the income status or caste in case of SC/ST.
 
 
The State aims to reduce the infant mortality, the Neonatal Intensive Care Unit (NICU), Special New Born Care Unit (SNCU) and New Born Care Corner (NBCC) and other new born care facilities attached to the delivery points will be further strengthened. Government attaches foremost importance to prevention of disabilities among children. A New Born Screening Programme for congenital diseases like G6 PD deficiency, adrenal hyperplasia, hypothyroidism and phenyl ketonuria has been started recently. This will be further expanded to cover other conditions. Community level disability detection and management through ASHA, Anganwadi worker and Health worker will be strengthened. Remedial measures in such cases will be made available free of cost by government. Though no polio cases were reported in the state since 2000, the VPDs like diphtheria, whooping cough, measles, and tetanus are still being reported. Health Department and Social Justice Department will collaborate to achieve universal immunization and nutritional monitoring.
 
 
All panchayaths prepare a Panchayat Health Plan, which includes the health priorities, local public health requirements and action to be taken by other departments to improve the health of the community. Panchayath Health Plans are consolidated at the Block level. Block Health plans were consolidated in the District level and prepared a District Health Plan with district level specific needs.
 
The Comprehensive Health Plan was planned, organized and conducted as a Decentralized Plan Campaign involving all the field staffs of Health/Health related departments and NGO's as a joint initiative of PRI's, NRHM and Health Department. As a result, Health plans of all wards of GramaPanchayaths were prepared and all such Plans were consolidated at Grama/ Block/District Panchayath level as Projects. The Community Medicine Departments of Medical Colleges in the State provided technical support, advocacy and training for the preparation and implementation of the Comprehensive Health Plan.
The key principle behind this exercise is the realization that people participation, local relevance, convergence of various departments are very crucial for developing regional and creative Health Plans. 
 
 
The State Government launched ‘Vimukthi‘ (Kerala State Mission for De-addiction), a project to conduct awareness campaigns against alcoholism and drug abuse, on 20 November 2016, with the help of Student Police Cadets, anti- addiction clubs of schools and colleges, National Service Scheme, Kudumbasree, State Library council, anti- alcoholic organizations, different student, youth and women's organisations. 
 
Addiction free Kerala is the aim of this mission. Statewide campaigns to make students and youth aware of the evils of drug addiction and alcoholism will be conducted. There will be committees at the district, local self government and institutional levels. 
 
 
A number of studies have revealed that risk owing to low level of health security is endemic for informal sector workers.The vulnerability of the poor informal worker increases when they have to pay fully for their medical care with no subsidy or support.On the one hand, such a worker does not have the financial resources to bear the cost of medical treatment, on the other; the health infrastructure leaves a lot to be desired.  Large number of people, especially those below poverty line, borrows money or sells assets to pay for the treatment in private hospitals. 
 
Thus, Health Insurance could be a way of overcoming financial handicaps, improving access to quality medical care and providing financial protection against high medical expenses.  To address such issues, the Union Government has launched a Health Insurance Scheme, the Rashtriya Swasthya Bima Yojana (RSBY), for BPL workers as defined by the Planning Commission and their families, in the unorganized sector. 
 
The annual insurance cover is for a maximum amount of Rs.30,000 for a family of five, including the worker, spouse, children and dependent parents (if included in the BPL family list), and the annual insurance premium not exceeding Rs.750 is to be decided through tender process. Under the scheme, the Union government will meet 75 percent of the premium (not exceeding Rs.565), and also the cost of a Smart Card for each family, estimated at Rs.60 per card. The beneficiaries have to pay an annual registration charge of Rs.30 per family (which is part of the insurance premium to be paid to the insurance provider), and the State Government is to pay the rest of the premium, together with the administrative cost. 
 
 
 
 
In addition to RSBY the State Government have decided to provide similar benefits to such other poor families as are not covered under RSBY and to those who opt to subscribe to the scheme by paying such amount as may be prescribed.   
 
The special feature of CHIS is that it extends to all the families other than the BPL families (Absolute Poor) as per the Planning Commission's guidelines who come under the RSBY. The non-RSBY population will be divided into two categories: (a) those belonging to the BPL (Poor) list of the State Government but not to the list as defined by the Planning Commission and (b) the APL families that belong neither to the State government list nor to the list prepared as per guidelines of the Planning Commission. In the case of families of the first category (a), the beneficiaries will have to pay Rs.30 per annum per family as beneficiary contribution, and the State Government will meet all the remaining expense including for the "smart card". In the case of families of the second category (b), the beneficiary contribution will cover the entire amount of the premium including the cost of the "smart card". In other words, the beneficiary contribution will be Rs.30 per family per annum for RSBY families and for families belonging to category (a) and the entire amount for families belonging to category (b). Accordingly, Government of Kerala has decided to launch these schemes in 14 district of the State.
 
Beneficiary Family:
Coverage under the scheme would be provided for BPL (Absolute Poor), other Poor workers and their families [up to a unit of five) and such other families who subscribe to the Scheme. This would comprise the Household Head, spouse, and up to three dependents. 
 
The dependents would include such children and/or parents of the head of the family as are listed as part of the family in the database provided by State Government.  If the parents are listed as a separate family in the database, they shall be eligible for a separate card. Issue of smart card would be the proof of the eligibility for the purpose of the scheme.
 
Benefits:
  1. The scheme shall provide coverage for meeting expenses of hospitalization for medical and/or surgical procedures of beneficiary members up to Rs.30,000 per family per year subject to limits, in any of the network hospitals. The benefit on family will be on floater basis, i.e., the total reimbursement of Rs.30,000 can be availed of individually or collectively by members of the family per year.
  2. Pre-existing conditions/diseases to be covered, subject to minimal exclusions.
  3. Coverage of health services relating to surgical nature can also be provided on a daycare basis.
  4. Provision for transport allowance (actual with limit of Rs. 100 per visit) subject to an annual ceiling of Rs. 1000 shall be a part of the package.
  5. Pre and post hospitalization up to 1 day prior to hospitalization and up to 5 days from the date of discharge from the hospital shall be part of the package rates.
  6. Domiciliary treatment: Not required.
 
Kudumbasree/CDS units in Kerala play a crucial role in the implementation of the scheme. The intermediary role played by them includes inviting people to enrollment stations organising awareness campaigns and initiating the needy beneficiaries to seek treatment benefits from empanelled hospitals.
 
 
A 24 x 7 helpline number provides assistance to public on CHIAK scheme. 
 
       1800 200 25 30 (Toll free no.)
 
The Insurer shall provide telephone services for the guidance and benefit of the beneficiaries whereby the Insured Persons shall receive guidance about various issues by dialing a State Toll free number. The services will be available in English and in local languages.
 
Call Centre Service will provide the Insurer the following:
 
  • Answers to queries related to Coverage and Benefits under the Policy.
  • Information on Insurer's office, procedures and products related to health.
  • General guidance on the Services.
  • For cash-less treatment subject to the availability of medical details required by the medical team of the Insurer.
  • Information on Network Providers and contact numbers.
  • Benefit details under the policy and the balance available with the Beneficiaries.
  • Claim status information.
  • Advising the hospital regarding the deficiencies in the documents for a full claim.
  • Any other relevant information/related service to the Beneficiaries.
  • Any of the required information available at the call centre to the Government/Nodal Agency.
  • Maintaining the data of receiving the calls and response on the system.
  • Any related service to the Government/Chiak.
 
 
When a mother dies, children lose their primary caregiver, communities are denied her paid and unpaid labour, and countries forego her contributions to economic and social development. 
 
A woman's death is more than a personal tragedy--it represents an enormous cost to her nation, her community, and her family. Any social and economic investment that has been made in her life is lost. 
 
More than a decade of research has shown that small and affordable measures can significantly; reduce the health risks that women face when they become pregnant. Most maternal deaths could be prevented if women had access to appropriate health care during pregnancy, childbirth, and immediately afterwards.
 
Kerala State has launched the Name Based Information Tracking System of Pregnant Mother and Child Immunization (NBITS) project as per directions from MOHFW, Government of India. The aim of NBITS is to monitor ante natal care checks ups of pregnant women, institutional deliveries and post natal care in order to reduce maternal mortality and tracking of children for regular immunization and to prevent drop out cases thus ensuring 100% immunization. Relevant data of all new cases of pregnant women registered from 1st April 2009 at Sub Centre level shall be ported to the NIC software.
 
The State plans to train all health staff engaged in data reporting to operate the NBITS software with technical support from NIC and has initiated the process.
 
 
Twelve government hospitals in the district will undergo an accreditation, standards, and quality improvement programme — Kerala Accreditation Standards for Hospitals (KASH) — initiated by the government that is intended to ensure that all public sector hospitals deliver an optimum level of services.
 
Under KASH, government hospitals will receive accreditation from the State if these fulfill certain criteria. The programme was initiated as it will be too expensive a process for any government to bring up all its hospitals to meet the stringent standards of NABH. The 12 hospitals that will go through the quality improvement drive under KASH are the district hospitals at Parassala, Neyyattinkara, and Peroorkada; General Hospital, taluk hospitals at Nedumangad, Chirayinkeezhu, and Varkala; Balaramapuram primary health centre (PHC); and community health centres (CHCs) at Vilappil, Kanyakulangara, and Aryanad.
 
Patient care, patient safety, infection control, medication safety, and equity in delivering healthcare are some of the main components of KASH. KASH will be implemented in a time-bound manner and the NRHM has earmarked the funds for the first phase in this year's allocation.
 
 
The Union Ministry of Health and Family Welfare (MoHFW) has launched Rashtriya Kishor Swasthya Karyakam (RKSK) to address the health problems of adolescents in a comprehensive manner. RKSK has been introduced under the National Rural Health Mission. RKSK is based on the fact that Adolescence is the most important stage of the life cycle for health interventions Adolescents aged 10 to 19 years constitute about one-fifth of India's population and young people (aged 10-24 years) about one-third of the population. The Rashtriya Kishor Swasthya Karyakram was launched on 7th January, 2014. The key principle of this programme is adolescent participation and leadership, equity and inclusion, gender equity and strategic partnerships with other sectors and stakeholders. The programme envisions enabling all adolescents in India to realize their full potential by making informed and responsible decisions related to their health and well-being and by accessing the services and support they need to do so.
 
 
JATAK: Jatak aims to monitor Nutritional status of children at Attappadi block of Palakkad district in Kerala on real-time. The system collects Weight-for-Age data and provides feedback on Nutritional Status of children as per WHO growth standard. Report of children in need of immediate care is sent to functionaries as notification for screening of Wasting children and subsequent interventions. Location of every child is captured in GIS to know high concentration of malnourished children. It also becomes useful to locate cluster of vector-borne and other infectious diseases.
 
JANANI: Knowing health status of every pregnant woman on real time ensuring safe motherhood and healthy child in Attappadi, Kerala
 
 
'Arogyakiranam', an ambitious programme launched by the state government offers free treatment to all children aged below 18 is now clubbed with the centrally sponsored Rashtriya Bal Swasthya Karyakram (RBSK). The programme entitles all beneficiaries (excluding dependents of government servants and income tax payers) from birth to 18 years to free investigation and treatment for all health conditions other than the 30 conditions covered under RBSK guidelines.
 
RBSK is intended to provide comprehensive healthcare and improve the quality of children's life through early detection of birth defects, diseases and deficiencies. But the main problem the state will encounter under the scheme is that -- there are no adequate centres offering specialised treatment facilities.
 
 
The State government has drawn up guidelines for its free cancer care scheme, ‘Sukrutham,' in an attempt to make it more streamlined and protocol-driven so as to provide optimized care to the beneficiaries. Those on the BPL list who may have reimbursement or insurance coverage would not be eligible for any benefits under Sukrutham.
 
The government has also directed that a subcommittee, consisting of the Directors of the Regional Cancer Centre and Malabar Cancer Centre and representatives from medical college hospitals, be constituted to draw up treatment protocols and to ensure that measures for the primary and primordial prevention of cancers be made an essential part of the scheme.
 
The scheme formulated with no restrictions regarding the type of cancer/stages of the disease when treatment may be effective, but all aspects of treatment of cases, including investigations, minor procedures, surgery, radiation, prostheses and supportive therapy using blood products would be covered under Sukrutham up to a ceiling of Rs.3 lakh. Any treatment above this limit would be scrutinized and considered for the approval of subcommittee.
 
 
DISHA-1056 is a joint venture undertaken by National Health Mission (NHM) and Department of Health and Family welfare. It is a 24 #7 Tele- health Helpline providing guidance, counseling and information service on physical and mental health issues. Established on march 2013 , it is the facility one of its kind in State's initiatives in Health Helpline operating as a statewide BSNL free call services reaching all parts within Kerala and Lakshadweep. 
 
With a goal to educate and empower society with relevant, authentic and validated health related information in order to foster a better living and good health, Disha aims to improve health status and quality of life of people by providing comprehensive health knowledge, proper guidance, emotional support and counseling to individuals, communities and societies on physical and mental health issues for the promotion of healthy lifestyle as well as social, physical and mental well being.
 
Functioning in Technopark office of DISHA is well equipped and furnished through extensive use of proven software and use of appropriate information and communication technologies to provide reliable and better services.
 
 
'Ushus' , the Anti Retroviral Treatment (ART) centres set up in all the Government Medical Colleges in Kerala functioning under the department of medicine, provides ARV treatment, drugs for opportunistic infections and the CD4 testing all provided free of cost to HIV positives. Kerala is the first state in India to start ART for HIV positive people in 2004, by meeting funds from its exchequer. Since 2006, the ART centres are supported by National AIDS Control Organization.
 
Services Provided at ART centres include: All HIV positive persons can register at ART centres for HIV care. These centres also provide prophylaxis and treatment for opportunistic infections. Counseling is given for ART preparedness and adherence. CD4 cell count estimation, which is to be done once in six months for all HIV positive persons is facilitated through ART centres and done free of cost. Ushus centres are linked to Community Care centres, where People Living with HIV/AIDS requiring nutritional support, counseling, treatment of minor opportunistic infections is referred to.
 
 
With a view to provide full immunization against preventable childhood diseases to every child, the Government of India launched the Universal Immunization Program (UIP) in 1985, one of the largest health programs of its kind in the world. Despite being operational for over 30 years, UIP has been able to fully immunize only 65% children in the first year of their life and the increase in coverage has stagnated in the past 5 years to an average of 1% every year.
 
To strengthen and invigorate the program and achieve full immunization coverage for all children at a rapid pace, the Government of India launched Mission Indradhanush in December 2014.
 
Mission Indradhanush will ensure that all children under the age of two years and pregnant women are fully immunized with all available vaccines.
 
 
Kerala has the highest segment of elderly persons in the whole country. Along with the achievement of longevity of life, we have to formulate appropriate strategies to address the health and social needs of the ageing population.
 
Velinallur Block Panchayat in Kollam District of Kerala implemented a Geriatric Health Care Programme "Ayurarogyam" in association with NRHM and later in all the Grama Panchayats of the Block. The scheme is mainly aimed at improving the health status and quality of life of elderly people. The target population includes the elderly population who are daily labourers in the cashew, rubber plantations and coir factories, retired employees from Government and Private sectors etc.
 
Specific objectives of the project include: To prove the importance of the participation of society and emphasize the ability of public health department in providing health care services for senior citizens; To protect senior citizens from the exploitation of private healthcare institutions; To ensure the balanced supply of health care services to people from different social, economical backgrounds; To create awareness on the need of addressing the different aspects of ageing with equal importance by providing counseling etc.
 
 
Children and adolescents form about 22% of the population of Kerala. Early identification of developmental and emotional problems in children is important. Adolescence is a period which requires special consideration. The program implemented in the model of District Mental Health Program as per the guidelines set by the Government of India. A team of psychiatrist, medical officer, psychiatric social worker, clinical psychologist, pharmacist and nursing orderly visits the selected community health centers/primary health centers once a month and give treatment to the target population. The treatment includes free supply of medicines and other services.  The programme is run with the support of Institute of Mental Health and Neuro Sciences, Kozhikode (IMHANS).
 
 
The real challenges ahead in the health sector, in short, are ensuring the equity, efficiency and accessibility of health care, particularly for the poor and marginalized groups, cutting down the cost of care and chalk out strategies for alternative financing for health. One solution is - liberalizing the standards without compromising the quality of doctors regarding norms for establishment of medical colleges and teaching standards. The other solution could be Cuban concept of Family Doctors with a new category of Diploma Doctors or Medical/ Health Assistants with diploma in Family Medicine or Public Health. These Diploma Doctors having three years diploma in Family Medicine and Public Health could be placed in Primary Health Centers and Sub centers as well. 
 
The Cuban Model of Health definitely provides a pointer towards the reforms esp. revival of Family Doctor Concept. As a part of the initiative the Vattiyoorkavu PHC maintains clinical registry of each person in the jurisdiction with complete follow up of patients by ASHAs. 
 
 
Polyclinic facility in peripheral hospitals like Primary and Community Health Centres are introduced to ensure services of specialist doctors and diagnostic facilities to the people from rural and remote rural area, contrary to the current system of having these facilities in major hospitals alone.
 
Services include: Specialty outpatient services on selected days in a week; Special out Patient clinic for pregnant and other women; Facility for minor surgeries; Blood testing facility for diagnosing liver, kidney, cholesterol related problems apart from common laboratory examinations; E.C.G facility; and Steps are being taken to have scanning, X-Ray facility and Health Insurance through RSBY in future.
 
Polyclinic facilities are currently available in Vattiyoorkkavu PHC in Thiruvananthapuram; Pinarayi and Pazhayangadi PHCs in Kannur.
 
 
Primary Health Centres (PHCs) are responsible for providing basic health services related to antenatal care, immunization and other health programmes in rural areas and the activities are carried out by multipurpose health workers at sub-centres. The mobile based application "mCARE" developed by C-DAC enables health workers to use handheld devices such as Personal Digital Assistant (PDA) for capturing data from field to analyse it from grass root level.  The mobile based health care application minimizes or eliminates redundant data entry and provides a permanent storage system for archiving the needed data.
 
The pilot implementation of "mCARE" is carried out at 120 health sub-centres in 20 PHCs covering three blocks Vettom, Valavannur and Kuttippuram under Tirurtaluk of Malapuram district in Kerala jointly by CDAC and NRHM. An extensive training programme was also conducted at these three blocks for all the health workers. Medical Officers and other supervisory staffs are also trained and are very delighted with the new initiative.  Health workers at these three blocks in TirurTaluk have started making use of smart phones for providing better health care services to the rural masses.
 
 
Radio Health is a unique radio-based health literacy programme conceived and implemented by NRHM, Kerala since 2008. It is a cost effective, sustainable and participatory community health education programme. 
 
Radio as a community health medium has distinct advantages over television and print media. Apart from its scope for universal subscription, it is techno friendly, cost effective, more democratic, maintains privacy and serves as a platform for coordinating health practitioners: from specialist doctors to the peripheral health workers and ASHA workers. 
 
The focus of Radio Health is on primary and secondary health care and health workers working there. It facilitates continuing education for JPHN and ASHA workers. With this view, the content of the programmes is prepared under the direct supervision of expert doctors, public health experts and executed by creative persons and health communication network members.
 
 
Telemedicine is the use of electronic signals to transfer medical data (photographs, x-ray images, audio, patient records, videoconferences etc.) from one site to another via Internet, Intranets, satellites, or videoconferencing telephone equipment in order to improve access to health care. Real time telemedicine could be a simple telephone call, video-conferencing, remote monitoring or consultation using tele-otoscope, a tele-stethoscope, tele radiology, remote microscope etc. 
 
NRHM Telemedicine Project for revitalization of existing telemedicine centres and scaling up telemedicine facility to more primary care centres in Kerala is presently being implemented.
 
 
Floating Dispensary is an innovative step of National Rural Health Mission-Kerala to bring health care professionals and services to the people of the island panchayats of Ernakulam and Alappuzha districts. the socio economic situation of the people outskirts of the Ernakulam city, is poor. The one and only health facility for the Islanders was PHC Pizhala till the introduction of the Floating Dispensary; lack of bridges to interconnect the islands and the city makes people's access to medical services difficult. Furthermore, lack of night boat services added to the vulnerability of these Islanders.
 
Considering the success of floating dispensaries in Alappuzha and Ernakulam it is proposed to have two more dispensaries – One in Perumbalam Island in Alappuzha and another in Valanthakad area in Ernakulam.
 
 
Government of India has launched a programme for the promotion of menstrual hygiene among adolescent girls in rural areas. This programme will be targeted at adolescent girls in the age group of 10-19 years, residing in rural areas, to ensure that they have adequate knowledge and information about the use of sanitary napkins, that high quality safe products are made available to them, and that environmentally safe disposal mechanisms are readily accessible.
 
Objectives of the programme are: To increase awareness among adolescent girls on menstrual hygiene, build Self-esteem, and empower girls for greater socialization; To increase access to and use of high quality sanitary napkins by adolescent girls in rural areas; To ensure safe disposal of sanitary napkins in an environment friendly manner.
 
The initiative will be rolled out in the following 7 districts of the state during the first phase, i.e. Idukki, Kottayam, Palakkad, Malappuram, Wayanad, Kannur and Kasaragod.
 
 
Geo-Spatial Rural Health Information System is revolutionary query info software for geo spatial mapping of health facilities, community functionaries, epidemiology and health programmes that aims at GIS based mapping of health institutions all over Kerala. 
 
Advantages of GRHIS include:
  • Facilitate query and identification to provide spatial and non spatial information of the basic details of Health Institution, availability of medical, paramedical and other staff, hospital facilities, equipments and various services.
  • Facilitate spatial information on the allocation and availability of Community Functionaries under NRHM viz. ASHA, JPHN and Anganwadi workers along with the names, addresses and phone.
  • It will also enable Spatial monitoring of the performance of various State and National Health Programmes at Institutional and area levels with respect to population and time
  • Provide spatial query and information on trends in occurrence of Communicable diseases with respect to area, population and time.
  • Facilitate spatial information on generation of Panchayat Health Plans, District Action Plans, Ward Health and Sanitation Committees, Hospital Management Committees.
  • Facilitate spatial information on Fund allocation to Sub centre and expenditure with respect to time and purpose.
  • Facilitate spatial information on JSY, amount handed over by hospitals to various categories of beneficiaries.
  • Provide Routing information to Health Institutions.
  • The GRHIS software will also provide analytical information in graphical format besides spatial and non spatial reports all of which can be printed for use.
  • The software is provided with Zoom-in, Zoom-out, Pan, Identify functions.
 
 
The Government of Kerala has launched a new programme on ‘Medical Care for Victims of Gender Based Violence/Social Abuses' in selected institutions of 14 districts, funded by State Plan Fund. For coordinating the activities and counselling of cases one female coordinator/counselor is appointed in each GBV Centre. The main objective of this centre is to provide counselling to the victims of GBV and strengthen the capacity of health care providers in the hospital and also district to respond to survivors of violence against women.
 
This project is a new intervention by Government of Kerala in association with NRHM.  
 
 
Social Audit (SA) has gained special significance in India, particularly in the context of Right to Information Act, 2005 and the Government of India flagship programme of Mahatma Gandhi National Rural Employment Scheme (MGNREGS) wherein SA has been made mandatory. 
 
NRHM aims to create awareness among the community on the various services as well as to bring in necessary improvement based on public scrutiny. Besides, such an exercise can facilitate NRHM to plan strategies to institutionalize the process of SA thereby ensuring its sustainability. Though SA is envisaged in the Implementation Framework of NRHM, the process of SA is yet to gain momentum in NRHM. Centre for Management Development, an autonomous institution of Government of Kerala, is entrusted with the work.