ORGANIZATION STRUCTURE OF DIRECTORATE OF HEALTH & FAMILY WELFARE, NAGALAND, KOHIMA

DIRECTORATE OF HEALTH & FAMILY WELFARE, NAGALAND, KOHIMA.

  1. Particulars of the Organization, Functions and duties

1.1 Inception and Introduction of Health Department

The Health and Family Welfare set up dates back to even before India's independence during the British period. At that time there were already 3 hospitals and 6 dispensaries. In 1959 when the Naga Hills and Tuensang Area of North East Frontier Agency (NEPA) was carved out under a Commissioner, the Health Services organization was placed under the Inspector of Civil Hospitals and Prisons at Kohima, with 3(three) District Medical Officers (DMO) positioned at Kohima, Mokokchung and Tuensang.

At the time of Nagaland attaining Statehood in 1963, a proper Directorate of Health Services was put in position with Lt. Col. S.M.Das as the first Director of Health Services, Nagaland with one Deputy Director and 3 Civil Surgeons at Kohima, Mokokchung and Tuensang. At that time there were 27 hospitals, 30 Dispensaries and total bed strength of 585.

1.2 Name of the Organization: Directorate of Health & Family Welfare, Nagaland, Kohima.

1.3 Vision of the Department           

To provide basic comprehensive Primary Health Care services to all citizens of the State by 2020.

1.4 Goals

  • Facilitate increased access and utilization of quality health services by all.
  • Ensure increased active participation of Communitization Institutions in the management of primary health programs and infrastructure.
  • Position mechanism for promoting inter-sectoral convergence for promotive and preventive health.

1.5 Objectives of the Department

  • Reduce Child and Maternal MortalityUniversal access to basic health care services especially those related to women and  children.
  • Universal Immunization
  • Prevention and control of communicable and non-communicable diseases, including  locally epidemic diseases
  • Vitalize local health traditions/practices and mainstream AYUSH (Ayurveda, Yoga, Unani, Sidha, Homoeopathy)
  • Stabilize population growth and ensure gender and demographic balance.
  • Promote healthy life-style.

1.6 Activities of the Department

  1. Provision of health infrastructure: To provide basic and essential health care services to the people,  networks of physical infrastructure in the form of District Hospital, Specialized Hospitals, Community Health Centres, Primary Health Centres and Sub-Centres are established all over the State. These Health Centres of various categories are established on population norms set by Govt. of India for the whole country, and local specific conditions and needs. Every District is provided a District Hospital which serves as the referral centre for all other health units. Community Health Centres are set up to cover a population of 80,000; Primary Health Centres to cover 20,000 population and Sub-Centres to cover 3000 population. As of today, the Department has 11 District Hospitals, 2 TB Hospital, 1 Mental Hospital, 21 Community Health Centres, 123 Primary Health Centres and 398 Sub-Centres.The aim of the Department is to provide essential network of health centres, both in the rural as well as well as urban areas, so that all citizens of the State are able to easily access essential and basic health services as near to their doorstep as possible.
  2. Provision of manpower and logistics: To man the health units, manpower in the form of doctors, nurses, paramedical support staff along with equipments, instruments, and all other logistics is positioned to make them function effectively.
  3. Control of Communicable Diseases:For this purpose the Department implements a number of national Health/disease Control programs which are centrally sponsored and a few health programs, sponsored by the state Government. Currently, the Department implements the following disease control and health programs:
    1. National Vector Borne Diseases Control Program(NVBDCP)
    2. National Leprosy Eradication Program (NLEP)
    3. Revised National Tuberculosis Control Program (RNTCP)
    4. Nagaland State AIDS Control Society (NSACS)
    5. Integrated Disease Control Program (IDSP)
    6. School Health Program(SHP)
    7. AYUSH (Ayurveda, Unani, Sidda, Homoeopathy) Program 
  4. Control of Non-Communicable Diseases: Non-communicable diseases (NCD) accounts for more than 50% of global disease burden (Global Burden of Disease, 2010). In 2016 - NCDs collectively caused 41million (~71%) deaths worldwide (World Health Statistics WHO, 2019) nearly 80% NCD deaths occurred in low-and middle-income countries (LMIC) (WHO NCD fact sheets 2018).

    In India, NCDs are the leading cause of death, accounting for over 60% of mortality. The disease burden from NCD increase from 30% to 55%(years) (ICMR INDIAB study 2017).

    • India (Diabetes and Hypertension in India: A Nationally Representative Study of 1.3 Million Adults 2018)
    – Diabetes – 7.6%
    – Hypertension – 26.5%)

    NCD’s are greatest health challenge, and leading cause of illness, disability and death in Nagaland. High prevalence of behavioural risk factors for NCDs is the major cause of increase
    in prevalence of NCD’s in Nagaland.
    • Nagaland (ICMR INDIAB study 2017)
    – Diabetes – 5%
    – Hypertension – 38%

    The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was launched in 2010 in 100 districts across 21 States and expanded to about 468 districts in 2012, in order to prevent and control the major NCDs with the main focus of the programme on health promotion, early diagnosis, management and referral of cases, besides strengthening the infrastructure and capacity building.
    In Nagaland, NPCDCS was initiated in September 2014. Initially during 2014-15 there were 3 District NCD clinics in Kohima DH, Dimapur DH and Tuensang DH. District NCD clinics are being currently expanded to all the 11 district hospitals. At present there is 1 state NCD cell, 11 District NCD clinics and 10 CHC NCD clinics (Bhandari, Pungro, Jalukie, Medziphema,Noklak, Tuli, Tobu, Aghunato, Tseminyu, Meluri). Activities include Population based screening, opportunistic screening, management of common NCDs, counselling, physiotherapy, health promotion including use of IEC for Behavioral Change Communication.

    NCD Clinics in district Hospitals

    CHC NCD Clinics

    Kohima

    Tseminyu CHC

    Dimapur

    Medziphema CHC

    Mokokchung

    Tuli CHC

    Zunheboto

    Aghunato CHC

    Phek

    Meluri CHC

    Wokha

    Bhandari CHC

    Peren

    Jalukie CHC

    Mon

    Tobu CHC

    Tuensang

    Noklak CHC

    Kiphire

    Pungro CHC

    Longleng

     

     

     

    Indicator

    FY 2015-16

    FY 2016-17

    FY 2017-18

    FY 2018-19

    FY 2019-20

    1

    No. of patients attended NCD clinic

    6815

    7290

    10152

    30162

    53836

    2

    Patients diagnosed with

     

     

     

     

     

     

    Diabetes

    613

    779

    818

    1775

    2268

     

    Hypertension

    1677

    1519

    1743

    4786

    6756

     

    CVDs 

    507

    106

    459

    612

    693

     

    Cancers

    101

    113

    160

    193

    204

    Department implements the following non communicable disease control and health programs:

  5. Medical Education & Training:Apart from the training of doctors under various systems (Allopathy, AYUSH) and Dental, the Department also runs regular courses for training of Nurses through the Nursing Schools and ANM/FHW Schools. The Para medical Training Institute at Kohima provides training of technical para-medical personnel and continuing education and training to in-service personnel of the Department. To provide quality health care services using latest techniques and tools, the Department is moving towards setting up of Medical College, Nursing College as well as positioning of Institutes of Excellence. 
  6. Disease surveillance and epidemic control: Under the  Integrated Diseases Surveillance Project (IDSP) a computerized regular surveillance of disease prevalence, their pattern of occurrence etc. are monitored so as to be able to take timely and effective action response to contain and control them. 
  7. Regulation of private sector health/medical establishments: Through the Nagaland Health Care Establishments Act, the establishment and running of health/medial units by private individuals and groups are regulated for observance of quality standards
  8. Control of Drugs and safety of food articles: through the Drugs Control and Cosmetics Act and Rules and the Food Safety and Standards Act and Rules the Department regulates and monitors the manufacture, storage, distributions and sales of drugs and food articles.
  9. Social mobilization: Every health and disease control program, including the proper and effective management of health and medical units, have components where people's involvement and active participation are crucial to their success. For the general public to come forward and access the services, actively participate in the provision of management and utilization of the facilities, various educational, motivational and awareness activities are undertaken through the various health and disease control programs and the Information, Education and Communication (IEC) Bureau.

The Department has been able to design and launch the departmental website https://nagahealth.nagaland.gov.in/. With the help of NIC Nagaland, this contains basic information about the Department. The RTI manuals of the Department will also be made available in it.

1.7 Organizational Structure

At the Directorate the Department is headed by one Principal Director who is assisted by the following officers

  • Four Director (Health & Family Welfare)
  • Five Additional Director
  • Thirteen Joint Directors
  • Twenty Deputy Director
  • One Executive Engineer with 4 Junior Engineer
  • One Senior Accounts Officer
  • One Junior Account Officer
  • One Registrar
  • Research Officer
  • Five Superintendents
  • One Statistical officer

They are supported by Technical, Paramedical and Ministerial staff (Detailed list of Officers & staff is given in Manuals IX & X)

Subordinate establishments

There are 11 district health establishments under 11 Chief Medical Officers (CMOs) who are the district heads under the department. They are assisted by 11 Deputy Chief Medical Officers, 11 District Immunization Officers, 11 District Tuberculosis Officers, 11 District Malaria Officers and 7 Zonal Leprosy Officers. The 11 District Hospitals are headed by 11 Medical Superintendents assisted by Specialists in different grades (48 Sr. Grade Specialists, 18 Junior Grade Specialists, 28 Senior Medical Specialists, 37 Medical Officers, 12 Senior Dental Surgeons and 18 Junior Dental Surgeons). There are 2 (two) T.B Hospitals, 1 each at Mokokchung and Khuzama, and 1 (one) Mental Hospital at Kohima headed by Medical Superintendent and supported by 1 (one) Senior Medical Officer and 1 (one) Medical Officer.

Status of District-Wise Health Centres in the State:

District

C.H.Cs

P.H.Cs

S.H.Cs

Big Dispensaries

Sub-Centres

Total

Kohima

3

15

41

57

Mokokchung

3

14

2

52

70

Tuensang

2

12

1

39

53

Phek

3

23

45

69

Mon

2

15

51

67

Wokha

2

12

38

51

Zunheboto

2

13

49

62

Dimapur

2

9

48

58

Peren

1

8

17

25

Kiphire

1

4

21

24

Longleng

3

8

11

Total =

21

128

1

2

409

561

  1. District Hospitals (11)
  2. Health Centres (561)
  3. T.B. Hospitals (2)
  4. Mental Hospital (1)

All these establishments are supported by technical support staff such as Nurses (of various categories) technicians (of various categories and grades), ministerial staff and Grade IV staff.

1.8 Address of the Organization: Directorate of Health & Family welfare, Kohima 797001, Nagaland.

1.9 Office Timing: 9.30 am to 4.30 pm (summer) & 9.30 am to 4.00 pm (winter)

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