Urban Health Mission

NATIONAL URBAN HEALTH MISSION (NUHM)

Mizoram is one of the smallest and most backward states in the country. The entire state of Mizoram is tribal dominated Area, hilly terrain characterized by poor transport and communication facilities. Although, the population of cities/towns in the state may be less than cities in other big states but the towns and cities are recognizing rapid expansions due to large scale migration from rural to urban areas in search of works, education and other opportunities. It may also be noted that migration from neighbouring States – Assam, Manipur and Tripura and neighbouring countries Myanmar & Bangladesh is also contributing a lot in the rapid increase of urban population. In Mizoram, urban population as per Census 2011 stands at 52.11% (571771) which is 29.64% more than the last decade.

The National Rural Health Mission (NRHM) was launched in 2005 which make opportunity for the rural population to access health facilities and better health Care services. There have been little efforts in provisions of health care services for the urban poor community especially those who are dwelling in the outskirt of the city and towns. Since 2003-04 Urban Health Scheme has been taken up as one of the RCH Programmes covering two major Townships which is observed as not enough to meet the increasing demand of health care needs. It is necessary to address the health of urban poor in proportion to the growth of population.

The launch of National Urban Health Mission is much appreciated and anticipated while considering the health concerns of urban community. It will envisage systematically approach to provide integrated and sustainable health care service delivery for Primary, Secondary and Tertiary sectors in the urban areas of the State with focus on poor slums and other vulnerable groups.

OBJECTIVES: 

Provision of integrated and sustainable Primary Health Care to promote the health Status of urban poor community/ low income neighbourhoods, particularly those who are dwelling in the outskirt of the cities, towns and vulnerable sections, KFAs

ACHIEVEMENT UNDER NUHM 2023-24

Supervisory Visit to facilities during 2023-2024

Training imparted during FY 2023-2024

1. MAS training conducted during  January to March at three District i.e. Aizawl, Lunglei, Champhai
2. Urban ASHA Training conducted on 26^th -28^th, March, 2023
3. State Review meeting conducted on 6^th August, 2023

Activities conducted

1. No of UHND Conducted : 3984
2. No. Of outreach Conducted : 103
3. No.of Specialist Service  Conducted: 276
4. No. of OPD cases: 72876
5. No. Of Delivery Conducted: 65
6. No. of Laboratory test Conducted: 51732
7. No. of individual screen for NCD: 
8. Hypertension: 27603
9. Diabetes: 10409
10. Oral cancer: 14645
11. Breast cancer: 5012
12. Cervical Cancer: 370

Good Practices:

1. ULB, NGO have donated a plot of land for construction of UPHC
2. ULB, NGO and other association have been donated  hospital equiptment and goods for all UPHC for better functioning of UPHC
3. TT injection has given to all sanitation workers during sanitation worker screening
4. All facility except Hlimen UPHC have conducted diagnostic test for free of cost 

Supports received from partner:

1. Sustainable energy Solution SELCO foundation have already installed Solar panel and functioning in all facilities except Hrangchalkawn UPHC

Convergence:

• Convergence of H&FW, UD&PA and AMC, RIPANS and Apollo school of Nursing, MCON, Laithangpuii College of Pharmacy, ZMC, MSACS                       
• Convergence with all Programme under NHM and UPHC performance related to other programme are highlighted in NUHM monthly report.
• Screening and Health Check-up of Sanitation Workers are conducted everyyear since 2018.

Achievement during 2022-23

RECRUITMENT OF STAFF

1. Staff Position 

1. Three Public Health Manager posted at Three Districts Aizawl East, Aizawl West and Lunglei.
2. TwoConsultant recruited for State.

Training:

ASHA:Training for Urban ASHA is conducted for 2022-2023.

MAS   : Training of MAS is conducted for 2022-2023.

MAS   : In 2022-2023 ROP, 65 MAS member are approved and Functioning.

ASHA:87 Urban ASHA are approved and recruited.

Convergence:

1. Convergence of H&FW, UD&PA and AMC, RIPANS and Apollo school of Nursing, MCON, Laithangpuii College of Pharmacy, ZMC.                            
2. Convergence of State NCD cell.

Outreach: No. of outreach conducted 98

UHND            : No of UHND conducted 3906

UPHC PERFOMANCE 2022 - 2023:

Achuievement 2018-19

• Construction of Zemabawk UPHC and Hlimen UPHC have been completed on 15th, March 2018 and April 2018 respectively.
• Construction of Hrangchalkawn UPHC and Lawipu UPHC are ongoing and soon to be completed.
• Ongoing renovation of ITI UPHC and Sihphir UPHC is completed.
• 1^st responder training was conducted on 7^th February, 2018.
• NUHM workshop of city level staffs was conducted on 2^nd February, 2018.
• Convergence of H & FW, UD & PA and AMC, RIPANS and Apollo school of Nursing.
• 60 camps conducted as approval (Rs. 10,000 sanctioned per camp)
• Urban Health and Nutrition Day (UHND) held 332 times (Rs. 200 sanctioned per camp)
• Specialist visit time is made for once a month at the UPHC.
• Medicines are purchased by floating Open Tender through Local Newspaper as per requirement listed out by each UPHC which is tallied to fall under the budget as per ROP approval
• Equipment are purchased by floating Open Tender through Local Newspaper as per requirement listed out by each UPHC which is tallied to fall under the budget as per ROP approval
• Upgradation of ITI & Chawlhhmun UPHC to Health & Wellness Centre on August 2018.

Achievement during 2016-2017

Civil Works :

• Completion and inauguration of Sazaikawn UPHC. The date of commencement was 19.06.2015 and it was completed on 13.10.2016 with the sanctioned amount of Rs.75,00,000.

1. Completion and inauguration of Chawlhmun UPHC. The date of commencement was 29.10.15 and it was completed on 18.11.2016 with the sanctioned amount Rs. 74,09,025.
2. Newly approved for Construction of Lawipu and Hrangchalkawn UPHCs. Site selection completed.
3. Currently in the 2^nd phase of Construction of Zemabawk UPHC andHlimen UPHC .

Recruitment of Staff :

• Recruitment of Public Health Managers for Aizawl East, Aizawl West and Lunglei district and 1 Consultant for State.
• 50 MAS members recruited and trained.
• 79 ASHA approved but selection of Urban ASHA and release of fund is pending.

Training :

• Awareness campaign/Orientation training of Stakeholders Under NUHM ( Aizawl East, Aizawl West and Lunglei) was conducted on 18^th may 2016,19^TH May 2016 and 24^TH May 2016 respectively
• Orientation of Urban Local Bodies of UPHC Under NUHM in Aizawl & Lungleiwas conducted on 14^th-16^th of February 2017 at Civil Hospital Conference Hall
• Quality Assurance Training of UPHC Service Providers in Aizawl & Lunglei was conducted on 28^th February 2017 at Civil Hospital Conference Hall, Aizawl.
• Orientation of RKS Members from Aizawl East & West CMO under NUHM was held on 8^TH February 2017 at Civil Hospital Conference Hall, Aizawl.
• Training of Staff from Lunglei, Aizawl East & Aizawl West UPHC was held on 21^st February 2017 at Civil Hospital Conference Hall, Aizawl.
• Training of Staff on Quality Assurance from Lunglei, Aizawl East & West CMO under NUHM was held on 9^th march 2017 at Lunglei, Aizawl East & West CMO under NUHM.
• Management Training programme for staff under NUHM was conducted on 15^th March 2017 at Civil Hospital Conference Hall, Aizawl.
• Financial Management training of UPHC Accounts Clerk from Aizawl CMO East and West under NUHM was heldon 5^TH May 2017 at Office Room of State Finance Manager, NHM,Dinthar Aizawl.
• Biomedical Waste Management Training of Staff Helpers from Aizawl East & West CMO under NUHM.

Meeting

• Annual Review Meeting andDistrict Level Quarterly Review Meeting held.

1. A meeting was called at the Office Chamber of Commissioner and Secretary, H&FW Dept on 20.04.2017 (Thursday) regarding Convergence of H&FW department with UD&PA and AMCto work together on a common mission called Swacch Bharat.
2. 1^st Executive Meeting was held on 25^TH May at Whitestone Hall, Ramhlun Northto create a road map on Convergence of H&FW, UD&PA and AMC.

Outreach Camps :

• 29 camps conducted out of60 camps approved to be conducted.
• Urban Health and Nutrition Day (UHND) held 332 times.
• Rs. 10,000 sanctioned per camp
• Rs. 200 sanctioned per camp

Performance Reports

URBAN PUBLIC HEALTH CENTRES:

As already mentioned, Urban Health has been taken up as one of the scheme under RCH/NRHM in two major city/town viz. Aizawl (capital city) and Lunglei township ( 2^nd biggest town) since 2004. 6 UPHCs and 2 UPHCs have been established each in Aizawl and Lunglei respectively in 2014-15 and these UPHCs are providing round the clock services. As approved by GOI, construction of 3 UPHCs building have been initiated in 2014-2015, two buildings in Aizawl City and 1 in Lunglei Town. In 2015-2016, construction of 1 UPHCS building i.e Zemabawk in the eastern part of the Aizawl City is proposed

Major services provided through UPHCs are as summarized below:

1.Provision of OPD & IPD services for general patients

2.Conducting Deliveries

3.Management of minor injuries/First Aid Services

4.Referral to higher facilities as necessary

5.Outreach service / Home visits for early detection of pregnancy by ANM & ASHA.

6.Counselling of mother for fully immunization

7.Provision of services related to Vector Born diseases

8.FP Services – Distribution of condoms and oral pills

In order to provide integrated better health care service to the vulnerable groups (KFA) dwelling in the KFAs cities and town, launching of NUHM is worth mentioning. Therefore the State Planning Team proposed to extent Urban Health in all the district capitals. As envisaged in the guidelines NUHM would have high focus in the State of Mizoram in addition to the existing services as mentioned below:

Activities under NUHM:

Major activities to be undertaken under NUHM are as summarized below:

1.Provision of ANC, INC, PNC, conducting deliveries in the UPHCs.

2.RTI/STI Services in convergence with SACs

3.Child Health -Immunization services, promotion of early breast feeding, management of child hood illnesses etc.

4.Counselling on MH, CH, FP, ARSH & Prevention from HIV/AIDS

5.First Aid treatment

6.Referral to FRUs / Higher facilities as necessary.

7.Orientation of MAS and make them functional as per guidelines.

8.Creating mentoring groups/ support structures for MAS/ ASHA through NGOs/CBOs

9.Outreach Sessions as per guidelines

10.Convergence with community organizations, Urban Local Bodies and other health determinants – Clean water supply, sanitation, nutrition, health care, education skill development etc.

11.Convergence with other health programmes such as RNTCP, NVBDCP, NPCB, IDSP etc and other department – PHE, UD&PA, SWD, and School Health etc.

12.Capacity building of stake holders – ULBs, Medical and paramedic staff, community levels structures.

13.Wide range of IEC/BCC activities.

14.Community Monitoring

15.Implement JSY & JSSK as per guidelines.

In order to achieve the above, operationalization of UPHC has been proposed . All the existing UPHCs are providing round the clock services like other Urban PHCs, Health Care services like OPD, IPD , ANC, PNC, Institutional deliveries, Immunization services etc.

Major Achievements under NUHM against the planned activities since the Inception are as furnished below:

• 1.Planning & Mapping of Aizawl City & Lunglei Town Completed
• 2.Renovation & Upgradation of 2 UPHC buildings ( Gov’t Building) completed (2013-14 budget)
• 3.Medicine procured from 2013-14 budget
• 4.Training Completed
• -8 ULBS
• -29 MAS
• -Orientation cum Accounts Clerk training
• 5.Staff Recruited:
• -3 Medical Officers
• -6 Staff Nurses
• -7 ANMs
• -8 Accounts Clerks
• 6.Establishment of 3 new UPHC i.e Sihphir & Lawipu UPHC in Aizawl and Sazaikawn in Lunglei Town
• 7.Establishment of 3 new UPHC – Sihphir & Lawipu UPHC in Aizawl city and Sazaikawn UPHC in Lunglei Town.
• 8.Construction of 3 new UPHC buildings 2 in Aizawl and 1 in Lunglei ( Work in Progress)
• 9.6 Outreach Camps conducted.
• 10.Untied fund fully released to all UPHCs
• 11.Building rent released till March 2015.

GENERAL INFORMATION OF AIZAWL CITY

AIZAWL:

Introduction: Aizawl is the biggest city in Mizoram and also the Capital of the State. The city is located in the northern part of Mizoram. It has a population of 2,29,714 as per 2001 census and 2,93,416 as per 2011 census exhibiting a rise of 27.73% over the last decade. Urban population comprises 77.4% in Aizawl District. The population density in 2011 is 234/Sq.km. It is also the centre of all important offices, State Assembly house and civil Secretariat. Aizawl city occupies an area of 457 Sq.km.

Geography: Aizawl is located north of the Tropic of Cancer in the northern part of Mizoram. It is situated on a ridge 1,132 metres above sea level with Tlawng river valley to its west and the Tuirial River to the east. Aizawl has a mild, sub-tropical climate due to its location and elevation. In the summer the temperature ranges from 20-30 degrees Celsius, and in the winter 11-21 degrees C.

Administration: The Aizawl Municipal Council (AMC) is in charge of civic Administration of Aizawl City. It was formed in 2010 with 19 members. Administered by Council Chairman, Vice Chairman and three Executive Members. The AMC consists of 19 members representing 19 Wards of the City of Aizawl. One- thirds of the total members is reserved for women. The tenure of the Council is five years. There is a Ward Committee in every ward. The Ward Committee consists of a Chairman, who is an elected Counselor from the Wards, and two each from Local Councils within the Ward. There is also 78 Local Councils in Aizawl City with a term of 3 years.

Economy: Around 40% of families are basically depending on Government Job as it is the Capital of Mizoram. The rest are mainly Merchants, Cultivators, Daily Labourers and Hawkers etc.

Transport: Aizawl is connected by road with Silchar (District Capital of Cachar, Assam) through National Highway 54, with Agartala through National Highway 40 and with Imphal through National Highway 150. Aizawl is also connected by Air through Lengpui Airport which is situated nearby Aizawl City. As for Railway, It is connected by Rail road up to Bairabi town, Kolasib District (Assam Border).

LOCALITIES, NO OF HOUSEHOLDS & POPULATION COVERED BY UPHC (GIS MAPPING – 2011 CENSUS):

AIZAWL CITY: 

LOCATIONS OF UPHC IN AIZAWL TOWN

ITI :

Urban Health Centre in ITI locality was established in 2004 under Reproductive and Child Health Programme. It is situated in the eastern part of Aizawl City. The UHC building and staff quarters (25 nos) were constructed by the state government through loan taken from NABARD with an expenditure of Rs 127.50 lakhs and Rs.339.06 lakhs respectively. The population coverage by the UHC is around 28,535 with 5,829 households. The UHC covers 6 wards as per 2011 census which are depicted in the map provided herewith. They were Ward nos: 33, 34, 35, 36 , 37 and 41. As approved by the GOI, renovation and upgradation of UPHC building had been done during 2014-2015.

Chawlhhmun:

Chawlhhmun UHC was established in 2004 under RCH Programme and is situated in the western part of Aizawl City and is catering a large number of low income neighbourhoods. When the Plan for NUHM has been formulated, convergence with urban local bodies has been initiated and frequent joint committees were conducted with Health Department delegates and Urban local bodies. Construction of UPHC was already started in 2014-2015 unexpected to be completed within due course.

Hlimen UHC:

Hlimen UHC was like the other UHC established in 2004 to address primary health care delivery to the poor population dwelling in the southern part of the City. This UHC is running in a rented house since the inception. As per ROP 2014-2015 construction of UPHC building is going on. This UPHC covers ward No. 47,48,49,50 with a population of 9314 and 1961 households. Like other UHC, up gradation in terms of facilities – furniture, equipment etc. is done from funds allocated during 2013-14. Apart from the designated ward, this UPHC is currently catering the nearby hamlets and villages.

ZEMABAWK (Ramhlun UHC):

The existing UPHC established at Ramhlun locality is functioning in a rented building, is being proposed to be shifted at Zemabawk locality, as the Local Council in this area is unable to donate land. It is considered that shifting of UPHC will capture more vulnerable population. Zemabawk is located in the northeastern part of Aizawl city. There are no health facilities in this area except cancer hospital and sub-centres. The area has a large concentration of migrating population as well as low income neighbourhoods. The UPHC is catering a large number of KFAs which is indicated in the map provided herewith. The nearest Health service delivery point from this area is located at 2 kms away. The expected number of population covers by UPHC is 24,400 with households of 4,877. As per GIS mapping it covers Ward No 8,9,10,11,12,13. The local authority has agreed to donate a vast area for construction of UPHC and quarters (Copy of the same enclosed for reference).

SIHPHIR:

Sihphir UPHC was established in State Government constructed Building in 2014-2015. The estimated population covered is around 13,185 covering ward No. 1, 2, 3& 4 with a households of 2,690. This building is already occupied.

LAWIPU:

Lawipu, a locality in Aizawl City is one of the most targeted area under NUHM being located in an isolated area and is catering the most vulnerable population in the city. The State Government also make efforts to promote the living conditions of the poor neighbourhood through Slum Housing scheme under JnNURM etc. The State government has created a housing complex in this locality that will be able to accommodate around 400 households. In addition to this, the area has wide areas of stone quarries with a resident population engaged in the stone quarries comprising of foreign laborers and immigrants who are deprived of proper health care. It covers Ward No.54, 55, 56, 57 & 58 as per GIS mapping. The population covers as per census is 14,915 with households of 3,075. Also there is a PHE Pump House in the area for the whole Aizawl City where a number of Government quarters for the employees are constructed and occupied. As such all these Government employees will be able to avail this centre. The UPHC is now functioning in a rented building. Construction of UPHC building has been proposed during 2015-2016.

GENERAL INFORMATION OF LUNGLEI TOWN

Lunglei City/ town:

Introduction:

Lunglei the 2^nd biggest city after Aizawl in Mizoram is located in the south-central part of the State. Lunglei is situated at a distance of 235 km from Aizawl City. Lunglei was the Capital South of Lushai (Mizo) Hill District for 10 years from 1888, as was Aizawl for the North Hill Districts. Lunglei has had an importance till partition of India as it had direct access to Chittagong, a big city in Bangladesh which made Lunglei the Commercial and Education Centre. As per Census 2011, the population of Lunglei is 57011 which is a rise of 20.39% the last decade.

Geography: Lunglei is located at 22.88 N 92.73E; it has an average elevation of 722 metres (2368 feet)

Administration: 

LungleiTown is divided into four (4) constituencies which include the surrounding villages and is divided into 23 sub-wards under population census 2011. The Administration of Lunglei Town is indirectly managed from the State Government. Sometimes back, the Govt. of Mizoram constituted Lunglei High Power Committee (LHPC) to look after and manage development of Lunglei Town. All the development Programme either from the State or GOI have been routed through LHPC.

Economy: 

25% of the total households are depending on Government services, the rest are depending on mainly agriculture and non-regular income like trading, daily wage laborers, hawkers, peddlers etc.

GIS MAPPING OF DIFFERENT LOCALITIES IN LUNGLEI WITH POPULATION DETAILS (As per census 2011)

LUNGLEI TOWN: 

LOCATIONS OF UPHC IN LUNGLEI TOWN

LUNGLEI TOWN:

HRANGCHALKAWN UPHC: 

This UHC was established along with UHCs established in Aizawl City in 2004. The location was chosen as it lies in as strategically suitable place which can cater the population of the outskirt of Lunglei town as well as peri-urban areas with the nearby villages. It is therefore, proposed construction of UPHC building for providing better health care services to the vulnerable population and community. It covers around 7,357 population, with total households of 1568 and covering ward no: 19, 20, 21, 22 & 23. The local authority donated a land for construction of UPHC (Copy of the same enclosed for ready reference.) The construction of new building will be proposed in the next financial year.

SAZAIKAWN UPHC:

Saizaikawn is located in the western part of the Lunglei Town. It covers 3 localities and 5 catering villages, the population covered is around 15,580(excluding the villages) with households of 3,316 in the ward no.3, 4, 5, 6, 7 & 8. The local Authority donated a land for construction of UPHC (copy of the same enclosed for ready reference.) As approved in the PIP of 2014-15,

MAHILA AROGYA SAMITIS: 

As envisaged in the guidelines, Mahila Arogya Samitis are formed to participate in community mobilization for the successful implementation of NUHM. The Accredited Social Health Activists are entrusted as Leader of MAS wherever applicable. The orientation of these MAS has been completed.