Director, Okram Ibomcha describes the Scope of National Health Mission in Manipur –Part II

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Water and Electricity during child delivery

“NHM is trying to cooperate with State PHED and DRDA department for water supply as labor room needs water. Wherever Electricity is lacking as ILR machine for keeping vaccine for immunization do not function we give away solar plates and battery to make things operational. For operating suction machine whenever needed for delivery we give medium size generator.

So far nonfunctional generators of 5 KV at Singjol. 2.5 KV at Ccpur only for labour room, Chakpikarong Solar power and a huge generator at Thoubal District Hospital meant for running the whole hospital installed by Simplex Company has been repaired and made functional. We repair at our own cost. In Chandel District hospital we change the battery and engine oil and it is made functional after nine long years. Such are the gaps and we are mending up and slowly things are becoming more efficient.

Vaccine medicine needs proper storage and electricity becomes vital.

Sincerity of Staffs

After gap analysis we are fixing up the gaps one by one in the high focus areas. District authority need to check the sincerity of the staffs. NRHM staffs are quite better comparing the State Health Department Staffs in terms of attendance and service targets.

Instruction are being made to conduct 20 health camps in a month in all the districts.

Manipur score best IMR of the country consecutively.

Health Indicator is conducted by Register General of India. In Manipur they keep 150 sampling Centre and they are not known to me or anyone from my office. In Rural area they have 110 sampling centers and in Urban 40. They secretly do random sampling. They sent their own people for Statistics. Last statistic was done in 2004, this time 2014 is the revision time. Every ten year as population increase they take up this statistics and study for health indicator.

They know in a locality how many child dies. IMR survey is done every year and IMR is published every year by SRS Bulletin which is gold standard. They publish during the month of September and October. Ignorant people think that it is a false report that our infant mortality is low and wee topped the Nation in scoring the least Infant Mortality. It is not done by us it is done by an independent agency.

Manipur gets Rs 358.49 last year, we get 325.15 this year for excellence in lowest IMR of India and to further decrease the infant mortality rate. By 2017, we are trying to get down to 6, as planning commission of India targets. Now we have 10 infant deaths in 1000 child birth. If we score first we will continue to get the prize money. This year also we are getting it, it is for three consecutive years.

This year also we might topped we are keeping our fingers cross.

Director’s Early Days in NRHM

“I was excited when I join NRHM, I took it as a big challenge. It suits me as I like action. It is an instant task. We have daily targets and completing with an instinct drives me to a satisfaction level. I become so restless on holiday. I search for anything to repair and did repairing work at home.

If we do not select people, output will be less, so I have to keep a balance and work out. Appointment within one month was made possible. 

At present we have 1551 staff altogether including Doctors and Nurses plus. The figure will be around 1650 after a result out of appointed staff in few weeks.    

I sleep to rest. Being a clinical practitioner I use to have huge workload. The responsibility now is different. However the work load is almost the same. Any challenging job we dare to do and that distinguishes our Health Mission from other.

I took any task as an operation to be conducted. I took care not to make any mistake or do it halfhearted, it has to be simply perfect. Any given task from the ministry I use to plan out and complete it in the targeted time.

We went far ahead sometimes they have change of mind and as we completed the task within days we have to repeat again with the new plan change with the ministry change of mind. These days sometimes they have given notion to wait a while before execution and we wait for their cross check before a task is given”, reveals the Doctor whole heartedly.

Challenges andIssues

“Departmental posting is a big challenge. In High caseload area where we decided to engage more doctors and nurses, we request the health directorate to make transfer and when they do not respond we are helpless.  In another situation when the service is going on very well at a health center with good child doctors gets transferred so it fluctuates and it still remains a big challenge.

Health Director need to corporate with NHM Director. If there is only one Director for Health Department and NHM it will be more efficient.   

In terms of Infrastructure development there arises a case of doubling as the health director buys the same equipment NHM acquire for a Health center. A coordinated effort or a single administration could have used the fund efficiently for various thing than doubling menace.

And there are places in the hills where even the local staffs took two days to reach his office. We need to monitor posting and optimize facility”, explained Dr Ibomcha.

Some achievement of Dr Okram Ibomcha, Mission Director

Dr. Okram Ibomcha has certain achievement so far in his career. He has an instinct of serving the people with his surgery skills. The first demonstration operation at Thoubal and Chandel is being done by him successfully. He worked wholeheartedly in starting up operation at District Hospitals of Thoubal, Chandel and Churachandpur where presently lots of caesarean case is taken up. He was the man behind the whole set up of making things operational. Now that people living in the said district need not travel far to get an operation done.

During his student life he is a recipient of National Science Talent scholarship which was to achieve his times and only three person able to make it from Manipur including the former VC of Manipur University C. Amuba.  At present the scholarship is open to all subject stream.

Staff coordination

“All staff in NHM is good. They enjoy the working style. We also give encouragement and incentives. Most importantly travel bills, paper and computer. Vehicle and expenses for meal at the time of travel or any immediate purpose where one has to leave for office before meal like in the case of camp.

I came to know when I am in the management task that every individual attains happiness at the completion of a work or a task. There is an instinct within the self to attain that satisfaction which compel him to do the work with zeal. Once an individual became passionate about these happiness they automatically started working efficiently. I came across these thought when the hospital began to operate smoothly after a period of set ups and drill works. The hospital is completely different now”, opined Dr. O. Ibomcha happily.

Dr Ibomcha spent sleepless night in the Hospital. He converted the western potty toilets into Indian style to save water and stop people from littering with biological waste as they are not accustom to. After a couple of work out in the overall functioning of the hospital and a rechecked with the staffs he found all the lazy people working in full dedication. Incinerator which was not functional was found operational as the staffs have dedicated themselves and worked out. The inner satisfaction they achieve have ignited themselves and things became different comparing to the nonfunctional mode in earlier times. 

Functioning of Staff under NHM – a sketch

Direct coordination with the Union Ministry of Health through Medical Secretariat at Nirman Bhavan is one operational mode of NHM, Manipur. Reports and meetings are being done with the Mission Director from time to time.

Under program management unit there are State Program Manager, District Program Manager for each district, at District level Chief Medical Officer is the Director of NHM for the District. For Statistic – there are District Data Manager for each district. Block Program Managers and Block Data Manager at the Block level.

Rest of the technical staffs including doctors, nurses, ASHA workers are posted in different health centers across the State.

For Pregnant Women & Newborn – issued by National Health Mission.

JSSK – Janani Shishu Suraksha Karyakram is a safe motherhood intervention under the National Rural Health Mission being implemented with the objective of reducing maternal and neo natal mortality by promoting institutional delivery among poor pregnant women. (BPL only)

JSY integrates cash assistance with delivery and post-delivery care. The success of the scheme would be determined by the increase in institutional delivery among the poor families.

 Assures Nil out of Pocket expenses in all Government Health Institutions

Entitlements for Pregnant Women as set by the Ministry

·         Free Delivery

·         Free caesarean section at District Hospitals/JNIMS

·         Free Drugs and consumables upto Rs 350 (Normal) and Rs 1600/- (C-Section)

·         Free Diagnostics ( Blood,Urine routine for sugar and protein, Haemoglobin test, pregnancy tests etc.) upto Rs 200.

·         Free transport from Home to nearest delivery point/health institution, between health institutions in case of referrals and drop back home up to Rs 1000/-

·         Free provision of blood at FRU/District Hospitals/JNIMS up to Rs 300.

·         Exemption from all kinds of User Charges

 

Entitlement for sick New born up to one year after birth

·         Free and zero expense treatment

·         Free drugs and consumables up to Rs 200

·         Free Diagnostics Rs 100

·         Free provision of blood at FRU/District Hospitals/JNIMS/RIMS

·         Free transport between nearest health facilities in case of referral and drop back from nearest health institutions to home.

·         Exemption from all kinds of User Charges

 

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