Month: May 2012

Dr. K. R. Thankappan and P. Sreedevi
PIB Features.,31st May – World No Tobacco Day
In India it is estimated that there are nearly 275 million (35 percent) tobacco users. Close to half (48%) of men and one fifth of women in India use some form of tobacco. Among the five greatest risk factors of mortality, tobacco use is world’s leading single preventable cause of death. When smokers smoke in their homes there is a major risk of other household members suffering due to second hand smoke related illness.
Tobacco Use in Kerala
According to Global Adult Tobacco Survey 2010 report, among the total adult population in Kerala 35.5% males and 8.5% females currently use some form of tobacco. Although the smoking prevalence among female population is low in Kerala, the threat for the health and well being of women and children from the secondhand smoke exposure, especially within the home is very high.
In Kerala, 42% of adults are exposed to secondhand smoke at home. There are at least 250 chemicals in secondhand smoke from cigarettes/bidis that are known to be toxic or carcinogenic.
When non smokers are exposed to second hand smoke, they inhale many of the same cancer causing chemicals that smokers inhale. Research has shown the harms of secondhand smoke to women and children including spontaneous abortion, low birth weight, poor lung function, and respiratory ailments. It is scientifically documented that smoke from a cigarette can remain in the air for 2-4 hours and the residue from smoke seeps into the house curtains and cushions and other cloth items negatively affecting everyone staying in the home.
Smoke Free Home Initiatives by the Project Quit Tobacco IndiaTo address the issue of protecting women and children from secondhand smoke in homes, which is a critical public health issue, Project Quit Tobacco India (QTI) has developed a smoke free homes initiative in rural communities in Kerala. This pioneering project is implemented through women’s groups like Kerala Mahila Samakhya Society and Kudumbasree which play a significant role in community level activities. The goal of ‘Smoke-free Household’ movement envisages that as all homes in a community collectively decide that they will not allow smoking inside any of the homes in their area.
The movement has been successfully implemented in the selected communities/wards of Nellanadu Grama panchayat in Trivandrum district.
Before introducing the concept of ‘Smoke-free home’, a community level household survey was conducted to assess women’s and children’s exposure to secondhand smoke both in indoor and outdoor places. In the survey it was identified that more than 70% smokers are smoking inside the home and their family members are inhaling the smoke. Majority of women are aware that second hand smoke is bad for health even though they do not know the specific health problems it can cause and personally disapprove of smoking in the home but most of them feel powerless to do anything about it. Very few homes have rules against the smoking inside the home. Women feel embarrassed or are shy to tell a guest not to smoke in the home. Eighty per cent of men, including those who smoke, expressed support for a community wide smoke free home policy.
As the first step for developing smoke free homes, a meeting was organized with elected Panchayat members and discussed about the objectives of this activity. The second step was to raise consciousness about the harm of secondhand smoke in the community. This was done with the support of the members of Kudumbasree and Mahila Samakhya to organize discussions on the problem of second hand smoke in the home and to provide education to the community about the harms of SHS to non smokers, especially to women and children. For ensuring the sustainability of this movement, a panchayat level resource team was formed and the team was provided training support on the linkages between tobacco and health. The resource team consisted of Health Inspectors, Junior Health Inspectors, Junior Public Health Nurses, Asha Workers, Anganwadi Teachers, Kudumbasree/Mahila Samakhya members etc.
The third step was to organize meetings with men and women to conduct health education campaigns in the community to introduce the concept and the need of ‘smoke free homes’.
All households in the community were given information stickers to be placed on the front door of their house stating that this is a smoke free home. Community members also had to place posters and banners in public places showing that this is a smoke free home community. Health education classes were organized in schools for students and they were also involved in the movement by taking part in the education program on second hand smoke. The students also involved in poster contests and they reminded their fathers and other men in their homes not to smoke in the home. The fourth step was a community-wide meeting where people came together to sign a formal declaration which says that in this community there is no smoking inside homes.
After this intervention program a survey was done to assess the impact of the program in the area. The post intervention survey results showed that the proportion of households having rules about no smoking inside the home increased from 20% in the baseline to 60%. 67% of smokers stopped smoking inside the home as a result of the intervention program.
In India smoking in public places is prohibited by law and as a result many smokers are shifting their location of smoking to their homes. Women are either hesitant or helpless to oppose men even though they dislike smoking. Nellanadu experience has shown that if the whole community raises the voice against smoking inside the home and organize it as a community based movement it will be more acceptable and effective.
The ‘Smoke-free Home’ movement is now progressing in Muhamma Grama Panchayat in Alappuzha District, Njarakkal Grama Panchayat in Ernakulam District.

Read more / Original news source: http://manipur-mail.com/tobacco-smoke-free-homes/

Dr. K. R. Thankappan and P. Sreedevi
PIB Features.,31st May – World No Tobacco Day
In India it is estimated that there are nearly 275 million (35 percent) tobacco users. Close to half (48%) of men and one fifth of women in India use some form of tobacco. Among the five greatest risk factors of mortality, tobacco use is world’s leading single preventable cause of death. When smokers smoke in their homes there is a major risk of other household members suffering due to second hand smoke related illness.
Tobacco Use in Kerala
According to Global Adult Tobacco Survey 2010 report, among the total adult population in Kerala 35.5% males and 8.5% females currently use some form of tobacco. Although the smoking prevalence among female population is low in Kerala, the threat for the health and well being of women and children from the secondhand smoke exposure, especially within the home is very high.
In Kerala, 42% of adults are exposed to secondhand smoke at home. There are at least 250 chemicals in secondhand smoke from cigarettes/bidis that are known to be toxic or carcinogenic.
When non smokers are exposed to second hand smoke, they inhale many of the same cancer causing chemicals that smokers inhale. Research has shown the harms of secondhand smoke to women and children including spontaneous abortion, low birth weight, poor lung function, and respiratory ailments. It is scientifically documented that smoke from a cigarette can remain in the air for 2-4 hours and the residue from smoke seeps into the house curtains and cushions and other cloth items negatively affecting everyone staying in the home.
Smoke Free Home Initiatives by the Project Quit Tobacco IndiaTo address the issue of protecting women and children from secondhand smoke in homes, which is a critical public health issue, Project Quit Tobacco India (QTI) has developed a smoke free homes initiative in rural communities in Kerala. This pioneering project is implemented through women’s groups like Kerala Mahila Samakhya Society and Kudumbasree which play a significant role in community level activities. The goal of ‘Smoke-free Household’ movement envisages that as all homes in a community collectively decide that they will not allow smoking inside any of the homes in their area.
The movement has been successfully implemented in the selected communities/wards of Nellanadu Grama panchayat in Trivandrum district.
Before introducing the concept of ‘Smoke-free home’, a community level household survey was conducted to assess women’s and children’s exposure to secondhand smoke both in indoor and outdoor places. In the survey it was identified that more than 70% smokers are smoking inside the home and their family members are inhaling the smoke. Majority of women are aware that second hand smoke is bad for health even though they do not know the specific health problems it can cause and personally disapprove of smoking in the home but most of them feel powerless to do anything about it. Very few homes have rules against the smoking inside the home. Women feel embarrassed or are shy to tell a guest not to smoke in the home. Eighty per cent of men, including those who smoke, expressed support for a community wide smoke free home policy.
As the first step for developing smoke free homes, a meeting was organized with elected Panchayat members and discussed about the objectives of this activity. The second step was to raise consciousness about the harm of secondhand smoke in the community. This was done with the support of the members of Kudumbasree and Mahila Samakhya to organize discussions on the problem of second hand smoke in the home and to provide education to the community about the harms of SHS to non smokers, especially to women and children. For ensuring the sustainability of this movement, a panchayat level resource team was formed and the team was provided training support on the linkages between tobacco and health. The resource team consisted of Health Inspectors, Junior Health Inspectors, Junior Public Health Nurses, Asha Workers, Anganwadi Teachers, Kudumbasree/Mahila Samakhya members etc.
The third step was to organize meetings with men and women to conduct health education campaigns in the community to introduce the concept and the need of ‘smoke free homes’.
All households in the community were given information stickers to be placed on the front door of their house stating that this is a smoke free home. Community members also had to place posters and banners in public places showing that this is a smoke free home community. Health education classes were organized in schools for students and they were also involved in the movement by taking part in the education program on second hand smoke. The students also involved in poster contests and they reminded their fathers and other men in their homes not to smoke in the home. The fourth step was a community-wide meeting where people came together to sign a formal declaration which says that in this community there is no smoking inside homes.
After this intervention program a survey was done to assess the impact of the program in the area. The post intervention survey results showed that the proportion of households having rules about no smoking inside the home increased from 20% in the baseline to 60%. 67% of smokers stopped smoking inside the home as a result of the intervention program.
In India smoking in public places is prohibited by law and as a result many smokers are shifting their location of smoking to their homes. Women are either hesitant or helpless to oppose men even though they dislike smoking. Nellanadu experience has shown that if the whole community raises the voice against smoking inside the home and organize it as a community based movement it will be more acceptable and effective.
The ‘Smoke-free Home’ movement is now progressing in Muhamma Grama Panchayat in Alappuzha District, Njarakkal Grama Panchayat in Ernakulam District.

Read more / Original news source: http://manipur-mail.com/tobacco-smoke-free-homes/

S. B. Sharan, Director (M&C), PIB, New Delhi.
Varun Bhardwaj, Assistant Director, PIB, New Delhi.
(PIB Features.)
On Completion of 1 Year of JSSK – June 1

A unique initiative of the Ministry of Health and Family Welfare, the Janani Shishu Suraksha Karyakram (JSSK), launched on June 1, 2011, has placed for the first time utmost emphasis on “ENTITLEMENTS”.
The idea is to eliminate out-of-pocket expenses for both pregnant women and sick neonates.
The initiative entitles all pregnant women delivering in public health institutions to absolutely free and No-Expense delivery, including caesarean operation. All expenses related to delivery in a public institution are borne entirely by the government and no user charges are levied.
A pregnant woman is entitled to free transport from home to the government health facility, between facilities, in case she is referred on account of complications, and also drop-back home after 48 hours of delivery.
WHY JSSK?
Various complications during pregnancy like haemorrhage, infection, high blood pressure, unsafe deliveries and so on may result in maternal and infant mortality.
While India has made considerable progress in reduction of Maternal Mortality Ratio (MMR) and Infant Mortality Rate (IMR), but the pace at which these health indicators are declining needs acceleration.
The number of institutional deliveries has increased significantly, after the launch of Janani Suraksha Yojna (JSY) in the year 2005 but many of
those who opted for institutional deliveries were not willing to stay for 48 hrs, hampering the provision of essential services both to the mother and neonate. The first 48 hours after delivery are critical as some complications might develop during this period.
Access to mother and child health care services was also hindered by High out of pocket expenses on User charges for OPD, drugs and consumables, Diagnostic tests etc. Also in some cases such as severe
Anaemia or emergencies required Blood Transfusion which increased immediate expenses. A
nd if there was a caesarean case, the expenses would become still higher.
So, JSSK has been launched, to ensure that each and every pregnant woman and sick neonates upto 1

month gets timely access to health care services free of cost. Under the JSSK, the state governments issue an entitlement order detailing the free entitlements.
The Entitlements include free drugs and consumables, Free Diagnostic Services, Free Blood Transfusion Services wherever required and Free diet for the duration of a woman’s stay in the facility. These services are provided free of cost to eliminate out of pocket expenses and ensure Zero expense deliveries. Entitlements
Entitlements for Pregnant Women
Under JSSK, free Institutional Delivery services (including Caesarean operation) are provided in government health facilities. Also, medicines including supplements such as Iron Folic Acid are to be given free of cost to pregnant women.
Further, pregnant women are entitled to both essential and desirable investigations like Blood, Urine tests and Ultra-Sonography etc. Furthermore, they are to be provided with free Diet during their stay in the health institutions (up to 3 days for normal deIivery & 7days for caesarean section).Not only this, there is a provision of free bIood transfusion if the need arises.
A significant number of maternal and neonatal deaths can be saved by providing timely referral transport facility to the pregnant women. Pregnant women are entitled to free transport from home to health centre, referral to higher facility in case of need and drop back from the facility to home.
Besides, under JSSK there is exemption from all kinds of User Charges including OPD fees and admission charges.
Entitlements for Sick Newborn
Free treatment is also provided to the sick Newborn upto 30 days after birth and all drugs and consumables required are provided free of cost.
As in the case of the mother, the new born too is provided with free diagnostic services and there is a provision of free blood transfusion if the need arises. The facility of free transport from home to health institutions and back is also available.
Implementation of JSSK
For implementation of JSSK, a government order on entitlements is issued at the state level and a State
Nodal Officer is nominated. The state government takes necessary steps and ensures that all services, the beneficiaries are entitled to are provided.
Equal importance is given to dissemination of entitlements in the public domain.
These are to be prominently displayed on hoardings and boards in all Government facilities so that they are visible from a distance. In fact, there is an Information, Education Communication component under NRHM which is utilized for this purpose.
Grievance Redressal
Every health facility should prominently display the names, addresses, emails, telephones, mobiles and fax numbers of grievance redressal authorities at health facility level, district level and state level. Some states have set up help desks and suggestion/complaint boxes at government health facilities.
It is also required to keep fixed hours (at least 1 hour) on any two working days per week, in all the healthy facilities for meeting the complainants and redressing their grievances related to free entitlements.
At the National Level, the Maternal Health Division of the Ministry of Health and Family Welfare has brought out guidelines for JSSK. However, the actual implementation of the scheme hinges on the proactive role played by state governments.
The degree to which the scheme is successful would be determined by the extent to which the programme implementation is carried out by the State functionaries.

Read more / Original news source: http://manipur-mail.com/healthy-mother-healthy-child-zero-expense-deliveries-through-jssk/

S. B. Sharan, Director (M&C), PIB, New Delhi.
Varun Bhardwaj, Assistant Director, PIB, New Delhi.
(PIB Features.)
On Completion of 1 Year of JSSK – June 1

A unique initiative of the Ministry of Health and Family Welfare, the Janani Shishu Suraksha Karyakram (JSSK), launched on June 1, 2011, has placed for the first time utmost emphasis on “ENTITLEMENTS”.
The idea is to eliminate out-of-pocket expenses for both pregnant women and sick neonates.
The initiative entitles all pregnant women delivering in public health institutions to absolutely free and No-Expense delivery, including caesarean operation. All expenses related to delivery in a public institution are borne entirely by the government and no user charges are levied.
A pregnant woman is entitled to free transport from home to the government health facility, between facilities, in case she is referred on account of complications, and also drop-back home after 48 hours of delivery.
WHY JSSK?
Various complications during pregnancy like haemorrhage, infection, high blood pressure, unsafe deliveries and so on may result in maternal and infant mortality.
While India has made considerable progress in reduction of Maternal Mortality Ratio (MMR) and Infant Mortality Rate (IMR), but the pace at which these health indicators are declining needs acceleration.
The number of institutional deliveries has increased significantly, after the launch of Janani Suraksha Yojna (JSY) in the year 2005 but many of
those who opted for institutional deliveries were not willing to stay for 48 hrs, hampering the provision of essential services both to the mother and neonate. The first 48 hours after delivery are critical as some complications might develop during this period.
Access to mother and child health care services was also hindered by High out of pocket expenses on User charges for OPD, drugs and consumables, Diagnostic tests etc. Also in some cases such as severe
Anaemia or emergencies required Blood Transfusion which increased immediate expenses. A
nd if there was a caesarean case, the expenses would become still higher.
So, JSSK has been launched, to ensure that each and every pregnant woman and sick neonates upto 1

month gets timely access to health care services free of cost. Under the JSSK, the state governments issue an entitlement order detailing the free entitlements.
The Entitlements include free drugs and consumables, Free Diagnostic Services, Free Blood Transfusion Services wherever required and Free diet for the duration of a woman’s stay in the facility. These services are provided free of cost to eliminate out of pocket expenses and ensure Zero expense deliveries. Entitlements
Entitlements for Pregnant Women
Under JSSK, free Institutional Delivery services (including Caesarean operation) are provided in government health facilities. Also, medicines including supplements such as Iron Folic Acid are to be given free of cost to pregnant women.
Further, pregnant women are entitled to both essential and desirable investigations like Blood, Urine tests and Ultra-Sonography etc. Furthermore, they are to be provided with free Diet during their stay in the health institutions (up to 3 days for normal deIivery & 7days for caesarean section).Not only this, there is a provision of free bIood transfusion if the need arises.
A significant number of maternal and neonatal deaths can be saved by providing timely referral transport facility to the pregnant women. Pregnant women are entitled to free transport from home to health centre, referral to higher facility in case of need and drop back from the facility to home.
Besides, under JSSK there is exemption from all kinds of User Charges including OPD fees and admission charges.
Entitlements for Sick Newborn
Free treatment is also provided to the sick Newborn upto 30 days after birth and all drugs and consumables required are provided free of cost.
As in the case of the mother, the new born too is provided with free diagnostic services and there is a provision of free blood transfusion if the need arises. The facility of free transport from home to health institutions and back is also available.
Implementation of JSSK
For implementation of JSSK, a government order on entitlements is issued at the state level and a State
Nodal Officer is nominated. The state government takes necessary steps and ensures that all services, the beneficiaries are entitled to are provided.
Equal importance is given to dissemination of entitlements in the public domain.
These are to be prominently displayed on hoardings and boards in all Government facilities so that they are visible from a distance. In fact, there is an Information, Education Communication component under NRHM which is utilized for this purpose.
Grievance Redressal
Every health facility should prominently display the names, addresses, emails, telephones, mobiles and fax numbers of grievance redressal authorities at health facility level, district level and state level. Some states have set up help desks and suggestion/complaint boxes at government health facilities.
It is also required to keep fixed hours (at least 1 hour) on any two working days per week, in all the healthy facilities for meeting the complainants and redressing their grievances related to free entitlements.
At the National Level, the Maternal Health Division of the Ministry of Health and Family Welfare has brought out guidelines for JSSK. However, the actual implementation of the scheme hinges on the proactive role played by state governments.
The degree to which the scheme is successful would be determined by the extent to which the programme implementation is carried out by the State functionaries.

Read more / Original news source: http://manipur-mail.com/healthy-mother-healthy-child-zero-expense-deliveries-through-jssk/