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There had been a tremendous impact in the Health sector since the implementation of NRHM in the
state. In the earlier days, Health sector had never been a priority in the state. And at the time of attainment of
statehood in 1963, Nagaland was only fortunate to inherit the legacy of a few hospital infrastructure in the then
District Headquarters. The spread of health infrastructure in the state had always been in a slow pace mostly due
to negligence and fund constraints in the State. Human resource in the health sector also had a setback with the
blanket ban on post creation since 1990. This may be due to poor socio - economic status of the State which
might have been responsible for the dismal Health Services. Thus, quality Health care has always been an
elusive dream for the people in this part of the country. The need for quality Health care has been obvious
giving the increasing number of patients from the state going out to the far and wide places in search of better
services. But with the coming of NRHM, the health sector in the State has boost up, be it be in the infrastructure
developments, capacity building or filling of manpower shortages and Health activities. The state seeing the
impact on the Health sector under the flagship of NRHM has been contributing the state share without hesitation
even with the financial crunches in the State.
For the year 2011-12, the state has taken an extensive exercise for developing the action plan right
from the grass root level. It began with the development of the village health plan involving the village health
committee (VHCs) and the communities in all the districts. The block health action plans were also done basing
on the needs from the village health action plans, ground realities and priorities. The District action plans had
been brought about with the accumulation of all the block health action plans and the district‟s specific needs.
Table: District wise Population and District Hq/Towns/Villages:
No. District Headquarter Population Towns Village
1 Kohima Kohima 219318 3 94
2 Mokokchung Mokokchung 227230 4 102
3 Tuensang Tuensang 164361 5 121
4 Phek Phek 148246 4 104
5 Mon Mon 260652 3 110
6 Wokha Wokha 161098 3 130
7 Zunheboto Zunheboto 189191 3 198
8 Dimapur Chumukedima 345237 3 216
9 Peren Peren 97068 3 106
10 Kiphire Kiphire 127448 2 103
11 Longleng Longleng 121581 2 40
Total 2061430 31 1324
Table: District wise distribution of PHIs as on 30.09.2010.
District DH CHC PHC SHC BD SC Total
1. Kohima 1 3 14 0 0 40 58
2. Mokokchung 1 3 14 0 2 51 71
3. Tuensang 1 2 11 1 0 39 54
4. Phek 1 3 24 1 0 44 70
5. Mon 1 2 15 0 0 50 68
6. Wokha 1 2 12 0 0 37 52
7. Zunheboto 1 2 13 0 0 47 63
8. Dimapur 1 2 8 0 1 47 59
9. Peren 1 1 8 0 0 16 26
10. Kiphire 1 1 4 0 0 19 25
11. Longleng 1 0 3 0 0 8 12
State Total 11 21 124 2 3 398 558
Table: Health Scenario:
Indicator Nagaland India
1. Birth rate * 17.5 22.8
2. Death rate* 4.6 7.4
3. Total Fertility rate** 3.7 2.7
4. MMR*** 240 259
5. IMR* 26 53
6. Full ANC** 31.6 50.7
7. Institutional Delivery** 12.2 40.7
8. SAB** 25.9 48.3
9. Full Immunization** 21 44
10. Contraceptive Use** 30 56.3
11. Total Unmet Need** 26.3 13.2
*Source: SRS Bulletin Oct 2009 **Source: NFHS III *** Source: India- The State of Population 2007
Year 2005-06 2006-07 2007-08 2008-09 2009-10 2010-2011
(upto Oct’10)
Patient Turnover
Out-patient Load 226957 295963 478078 523090 336959 341265
In-patient Load 18500 29158 34460 63805 54532 346683
Maternal Health
Institutional Delivery* 1182 5696 9943 12606 10765 9455
Child health **
BGG 35024 52450 49917 26799 35159 22345
DPT3 29912 60257 50441 23717 32373 19376
OPV3 30614 62653 52904 24586 33175 20067
Measles 27876 50180 51618 23157 34253 20693
Full immunization - 50180 51618 23157 34253 20693
*As per RCH/JSY Report as on Dec‟10 **As per UIP division
4. Manpower development
a. All the post of health professionals in the department is filled.
b. State has taken several measures to attract and retain manpower, however due to low remuneration,
disparity in pay structure among staff of various NDCPs, lack of difficult area incentive, lack of
quarters etc there is high attrition among contractual staffs. These issues are incorporated in the PIP
2011-12. The following personnel have been appointed on contractual basis till date.
Table: Manpower Appointment and Institutional Strengthening at State and District Programme
Management Units:
No. Manpower Grand Total
1 Medical Officer (Specialist) 7
2 Medical Officer (General) 55
3 Medical Officer (AYUSH) 21
4 Dental Surgeon 26
5 Additional Staff Nurse 162
6 Additional ANM 364
7 Additional PHN 41
8 Pharmacist 4
9 Lab Technician 48
10 CT Scan Technician 1
11 ECG Technician 0
12 X-ray Technician 1
13 Telemedicine Operator 1
14 District Programme Manager 11
15 Media Officer 11
16 Block Programme Manager 45
17 ASHA Coordinator 40
18 Accountant 11
19 Data Entry Operator 10
20 Computer Operator 11
21 Driver for Medical Mobile Units 22
Total 892
22 ASHA (Voluntary Link Worker) 1700
2008-09 Radio jingles on NRHM goals and RCH In Nagamese and all Naga dialects
themes
Group interaction with women from eligible In 474 selected villages in stabilization
couples on maternal health, child health and
population all 11 districts
Exhibition stalls set up during State Road shows where IEC/BCC materials were displayed and
distributed.
Capacity building done for all district IEC/BCC officials.
Regular advertisements published in local papers (including local dialect papers) under RCH
2009-10 themes, H1N1 flu, Tobacco control.
IEC materials (pamphlets, posters) made under RCH themes, H1N1 flu, Tobacco control.
Radio programme series (15 minutes, 12 episodes) and 5 jingles under RCH theme produced and
aired in All India Radio Kohima and FM Mokokchung.
18. Name Based Tracking System (NBITS) / Mother & Child Tracking System (MCTS):
Completed training of district trainers for MCTS, nodal officers at district and state identified and notified,
designing and printing of MCTS registers and formats completed and dissemination to districts underway. To
operationalise by Mar 2011.
20. Communization:
The primary health care approach lays emphasis on health care provision by the people. The State
government recognizing the need for Community Participation as a fundamental requirement to achieve health
and sustainable development, initiated measures to harness its rich social capital to vitalize the public
institutions by launching the “Communitization Policy” with the enactment of Nagaland Communitisation of
public institutions and services Act in 2002.
As an approach to strengthen the health systems, health institutions were communitized under the Act by
fostering partnership with the community and transferring the ownership and management of health institutions
and services to the community. It also paved way for active participation of community in preventive and
promotive measures, contributing their share to make health a reality in their own community.
The communitization policy resulted in strengthening and revitalization of the dismal health system in the
State. However, its rudimentary infrastructure and services is still unable to meet the expectations and needs of
the people.
Ongoing Initiatives:
Provision of Decentralised Funds- Medicine & Emergency Funds.
Infrastructure strengthening.
Training and capacity building of the various Committees to sustain Communitisation
Annual Convention of Health Committees being organised.
Award for Best performing Communitised village has been budgeted
Monitoring & Evaluation of the implementation of the Communitisation process
Outcome:
The decentralization has led to empowerment of the community with transparency in the form of financial
management, planning, implementation, monitoring and social auditing. Besides development of health
infrastructure, community led adoption of resolutions relating to health promotion and prevention, such as:
Compulsory check-up of pregnant mothers & delivery at hospitals/should be attended by trained health
personnel.
Compulsory immunization of children and participation in health programs.
Health Education on Sanitation and various health issues such as Confinement of pet animals.
Active participation in Village Health and Nutrition Day.
Table: SC building Construction undertaken under Communitization (State).
District State
No of SC Completed 2009-10 Total
Kohima 40 5 2 7
Mokokchung 51 5 2 7
Tuensang 39 4 1 5
Phek 44 3 0 3
Mon 50 3 1 4
Wokha 37 2 1 3
Zunheboto 47 3 1 4
Dimapur 47 3 1 4
Peren 16 3 1 4
Kiphire 19 3 1 4
Longleng 8 2 0 2
State Total 398 36 11 47
a. The setting up of the North East Regional Paramedical Institute at Dimapur wherein the MoU was jointly
signed on 22nd September 2010 between the Ministry of DoNER, Government of India and the Nagaland
Government and the Christian Institute of Health Sciences and Research (CIHSR) in the presence of the
Union Minister of DoNER and Mines, Shri B.K. Handique.
b. Under the CIHSR tripartite Memorandum of Association (MoA), CHC Dhansaripar was adopted by CIHSR
For innovative community health programmes, Conducting periodic training programmes to all categories
of the staff, To improve the quality of data collection and its utilization for effective management, To
conduct health education in schools and community, To assist in the implementation of all the National
health programmes and To use the Health Centre as centre for field work for various training programmes
of the CIHSR.
c. To augment the training programmes, the CIHSR Dimapur has been designated as a Training Centre under
the tripartite of MoA CIHSR. Through this initiative the CIHSR will be providing its technical support in
various training programmes beginning from the current FY. The training cost will be borne by NRHM as
per GoI guideline.
The first activity of this partnership will be short term multi-skilling training for doctors on LSAS &
EmOC and nurses OT Techniques at CMC Vellore for a period of 3 months and 2 months respectively.
Also to take the opportunity, the following programmes- Lap ST, Mini Lap, NSV, Safe abortion & IUCD
insertion for the doctors and SBA and & IUCD insertion for the Nurses will be incorporated in the training
programme. A team of doctors and nurses will be selected from identified CHCs so that on completion of
the training a readymade team will be in position for immediate operationalization of the health facility.
The training for the first batch will commence from 1st Feb 2011.
In the Second phase beginning from 2011-12, CIHSR will also provide the following in-service
training programmes on SBA, Lap ST, Mini Lap, NSV, Safe abortion and IUCD insertion. Besides, the
Institute will also support the state in the induction training of various categories of health personnel. All
the training programmes under this Institution will be residential.
d. Another important milestone is the partnership with the Medecins Sans Frontieres (MSF) on the other for
collaboration to improve access and provision of quality health care services in Mon District through the
District Hospital. The MoU was signed between the two on 21st July 2010.
The progress made so far through this initiative has brought tremendous changes for the first time in the
district and is benefitting scores of underserved people.
e. As approved by NPCC in the RoP 2010-11 under „Weaving a Dream: a People‟s Initiative for Health Care‟,
the MoU between DoHFW and Eleutheros Christian Society (ECS) for the management of the Langpong
Health Centre was signed.
The purpose of the collaboration between and ECS is to collaborate in the management of the
Langpong Health Centre presently managed by ECS, as a 24x7 PHC facility to promote and provide
universally acceptable, accessible, equitable and quality health care services for the population of
Changsang Range and Tuensang district in general. Remarkable community participatation in promotion
health is exempleray under this project.
f. The Department of Health & Family Welfare (DoHFW) also entered into a partnership with the Police
Department for effective and collective utilization of its available manpower which resulted strengthening
the Central Hospital Chumukedima to a First Referral Unit (FRU) for delivery of quality health care. The
Police Central Hospital was inaugurated on 17th December 2010. This partnership will also incorporate the
National Disease Control Programmes in the services delivery and participation in the Health Information
Management System (HMIS) in all the Health Units under Police Department.
The facility has started to function as FRU.
Indicator 2010-11(April-
2008-09 2009-10
October)
iv. Accelerating the reversal of communicable diseases with special attention to vector borne diseases.
vi. Accelerating capacity building programme including multiskilling training through partnership.