Post on 29-Aug-2018
Three Years Rolling Plan 2010-2013 District Multan
Three Year Rolling Plan
2010-2013
DISTRICT KHANEWAL
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Three Years Rolling Plan 2010-2013 District Khanewal
Table of Contents
Acronyms..............................................................................................................................................5
Executive Summary.............................................................................................................................7
SECTION 1: DISTRICT HEALTH PROFILE...........................................................................................8
Vision of the District....................................................................................................................8
Background of the District...........................................................................................................8
Map of the District........................................................................................................................9
Demography.................................................................................................................................9
Socio-Economic Indicators........................................................................................................10
Health Indicators.........................................................................................................................11
i. Reproductive Health*..............................................................................................................11
Organizational Structure of District Health Administration...................................................11
Health Resources.......................................................................................................................12
1. Health Facilities......................................................................................................................12
a) Public...................................................................................................................................12
b) Private.................................................................................................................................13
2. Human Resource....................................................................................................................13
a) Administrative.....................................................................................................................13
b) Facility Based......................................................................................................................13
c) Outreach..............................................................................................................................17
d) Training Institutions...........................................................................................................17
3. Health Financing....................................................................................................................18
Disease Pattern..........................................................................................................................19
Status of Vertical Programs.......................................................................................................20
1. National Program for FP & PHC............................................................................................20
2. EPI...........................................................................................................................................20
3. MNCH Program......................................................................................................................21
4. TB Control Program...............................................................................................................21
5. Malaria Control Program.......................................................................................................21
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Three Years Rolling Plan 2010-2013 District Khanewal
6. HIV/AIDS Control Program...................................................................................................21
7. Hepatitis Control Program....................................................................................................21
8. School Health Services Program...........................................................................................22
SECTION 2: PROBLEM ANALYSIS.....................................................................................................23
A. Objectives...................................................................................................................................23
B. Plan Development Process........................................................................................................24
1. Problem Identification.............................................................................................................24
Health Problems.................................................................................................................................24
1. Problem Prioritization...............................................................................................................25
Underlying causes of prioritized problems......................................................................................26
Service delivery/Management problems.............................................................................................27
Underlying causes of Management Problems..............................................................................27
C. MDGs and MSDS.........................................................................................................................29
a) Human Resource....................................................................................................................29
i. DHQ Hospital (Category c).................................................................................................30
ii. THQ Hospital Kabir Wala (Category B).............................................................................30
iii. THQ Hospital Mian Channu (Category B).......................................................................30
iv. THQ Hospital Jahanian (Category C)..................................................................................31
b) Equipment..............................................................................................................................31
i. DHQ Hospital Khanewal.....................................................................................................32
ii. THQ Hospital Kabir wala....................................................................................................36
iii. THQ Hospital Mian Channu............................................................................................40
iv. THQ Hospital Jahanian.......................................................................................................45
SECTION 3: INTERVENTIONS AND TARGETS..................................................................................51
A. Health Problems.........................................................................................................................51
B. Management Problems..............................................................................................................60
SECTION 4: COSTING AND FINANCING PLAN.................................................................................69
A. Activity based costing................................................................................................................69
i. Health Problems.........................................................................................................................69
ii. Management Problems..............................................................................................................78
B. Financial Outlay including 3YRP Activities..............................................................................89
i. Health Problems.....................................................................................................................89
ii. Management Problems..........................................................................................................91
C. Summaries..................................................................................................................................92
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Three Years Rolling Plan 2010-2013 District Khanewal
1. Problem-wise Costing..............................................................................................................92
a) Health Problems..................................................................................................................92
b) Management Problems.......................................................................................................93
2. Activity-wise Costing................................................................................................................94
a) Health Problems.................................................................................................................94
b) Management Problems.......................................................................................................99
SECTION 5: MONITORING & EVALUATION...................................................................................104
M&E of Plan......................................................................................................................................104
Annex-I..............................................................................................................................................107
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Three Years Rolling Plan 2010-2013 District Khanewal
Acronyms3YRP Three Years Rolling plan
ADB Asian Development Bank
AE Assistant Entomologist
APMO Additional Principal Medical Officer
ARI Acute Respiratory Infections
ASV Assistant Superintendent Vaccination
BHU Basic Health Center
BoD Burden of Disease
CDC Communicable Disease Control
CDR Case Detection Rate
CPR Contraceptive Prevalence Rate
DC District Coordinator
DHIS District Health Information System
DHQH District Head Quarter Hospital
DoH Department of Health
DR Default Rate
DSV District Superintendent Vaccination
EDO(H) Executive District Officer Health
EPI Expended Program on Immunization
HSRP Health Sector Reforms Program
IMR Infant Mortality Rate
IPC Interpersonal Communication
IV Inspector Vaccination
M & E Monitoring and Evaluation
M & R Maintenance and Repair
MCH Maternal Child Health
MMR Maternal Mortality Ratio
MNCH Maternal Newborn and Child Health
MO Medical Officer
MoV Means of Verification
MSDS Minimum Service Delivery Standards
PDSSP Punjab Devolved Social Services Program
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Three Years Rolling Plan 2010-2013 District Khanewal
PHC Primary Health Care
PMO Principal Medial Officer
POL Petrol, Oil and Lubricant
RHC Rural Health Center
SCR Sputum Conversion Rate
SHC Secondary Health Care
SMO Senior Medical Officer
TAMA Technical Assistance Management Agency
TB Tuberculosis
THQH Tehsil Head Quarter Hospital
TNA Training Need Assessment
WHO World Health Organization
WMO Women Medical Officer
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Three Years Rolling Plan 2010-2013 District Khanewal
Executive Summary
Prior to devolution, planning process was carried out at provincial level. Districts were supposed to implement plans and programs developed/designed at provincial and federal levels. Devolution brought a paradigm shift where planning became a district responsibility. This change provided an opportunity to the district at one hand and challenge on other due to their limited capacity in planning and budgeting. Planning focus also changed from short term to medium term planning recognizing the flexibility /adaptability it provided. Government envisions that medium term plan .i.e. 3YRP will be instrumental in using health resources effectively and efficiently through adapting Minimum Service Delivery Standards (MSDS) as the strategy to achieve objectives of MDGs.
Districts have been preparing 3YRP (medium term plan) for last few years under the auspices/patronage of Department of Health (DoH) Government of Punjab through technical assistance of Punjab Devolved Program Social Services Programme (PDSSP). This year government of the Punjab through Health Sector Reforms Program (HSRP) with the technical assistance from a team of consultants (SP09) and wide consultations/inputs from all key stake holders has established a bench mark in standardization of the format of 3YRP. Capacity building of the districts has been done on the standardized format.
Current 3 Years Rolling Plan (3YRP) plan is first attempt by the district on that agreed format. First section of the format (District Health Profile) contains all relevant information on Geography, Demographic, Socioeconomic and Health indicators of the district. It also takes stock of health resources in terms of human resource, infrastructure and others. District diseases pattern compiled from DHIS Primary and Secondary Health Care reports and current status of vertical /national programs is part of the profile. In fact district profile is a health related fact sheet of the district and depicts the true picture of health status and health resources/services of the district. An accurate district health profile provides a sound basis for evidence-based planning.
3YRP plan has been developed by following the standard planning cycle approach. 3YRP details the current year activities, physical targets and fiscal targets. Projections of second and third year physical and financial targets are given. Section Two includes problems identification from various perspectives, and their prioritization by applying WHO prioritization criteria. This section also contains underlying causes of the prioritized problems. Section Three of the plan relates to developing best possible interventions/activities and setting physical targets for each year. Section Four consists of costing based on additional requirements taking account of implementation of current status of activities. Best available estimates have been used to accurately cost the activities. The detailed activity based costing of the Health and Service Delivery problems has been developed on automated Excel sheets, and annexed for details as ready reference. Last section of the 3YRP consists of Monitoring and Evaluation of plan to gauge the progress of different activities and targets of the plan using reliable district data sources. This permits timely remedial action for smooth implementation of planned activities.
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Three Years Rolling Plan 2010-2013 District Khanewal
DISTRICT KHANEWAL
SECTION 1: DISTRICT HEALTH PROFILE
Vision of the District
Our vision is to provide preventive, curative, promotive and rehabilitative health services to each and every individual of district Khanewal, especially mothers and child.
Background of the District
Khanewal city was little more than a village up to 1919 when given the status of area committee, later upgraded to Municipal Committee in 1933; then to a district in 1985.
It is situated in the center of the country at an almost equal distance from Karachi and Peshawar and on the main routes of the railway and grand trunk road. The district is bounded on the north by district Jhang and district Toba Tek Singh; on the south by Vehari district; on the east by district Sahiwal and on the west by Multan district.
Geographically, district Khanewal lies in the upper Indus planes and its physical features are mainly the result of river action. The district is irrigated by a network of canals from various sources on the Ravi and Chenab rivers. Climate temperature ranges between 21ºC and 5ºC in January, and 42ºC and 29ºC in June respectively. A railway line connects Khanewal with Faisalabad and Multan. Khanewal district is basically an agricultural area with no significant industry and most of the people earn their living through agriculture.
About 63% of the district population speaks Punjabi language. Saraiki is the second most widely spoken language by 26 % of the population. Other languages spoken are Urdu and Pushto. The district is home to a variety of clans. The principle ones being the Arian , Jatt, Niazi , Gujjar, Pathan, Rajput Khiarah and Rehmani.
Area: The total area of the district is 4,349 square kilometers. Total population: 2,76,34,85
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Three Years Rolling Plan 2010-2013 District Khanewal
Map of the District
Demography
o Total Population 2763485o Annual growth rate 2.45%o Population density 850 persons per sq. km
1. Area-wise population
Area Population PercentageRural 165809 6%Urban 2597675 94%
Source: DCR 1998 (Projected population)
2. Gender-wise population
Gender Population PercentageMale 1354107 49Female 1409377 51
Source: DCR 1998 (Projected population)
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Three Years Rolling Plan 2010-2013 District Khanewal
3. Population groups
Population GroupsStandard Demographic
(%)Estimated Population
Under 1 year of age 2.7 74614Under 5 years 13.4 370307Under 15 years 44 1215933Women in child bearing age (15-49 years) 22 607966Married Child Bearing age Women 16 442157Expected pregnancies 3.4 93958Source: Standard Demographic Population groups may be based on DHIS
4. Tehsil wise distribution
Tehsil Number of UC Population
Khanewal 28 823579
Mian Channu 26 729031
Kabirwala 34 882618
Jahanian 12 328258
Source: Bureau of Statistics (Projected from Census 1998)
Socio-Economic Indicators
1. Education and Literacy
Overall district: 10+ years 56% Adult 51%
Source: MICS 2007
2. Housing
Ownership of house 86% Mean household size 6.6 Mean number of persons per room 3.6
3. Water and Sanitation
Access to drinking water 97% Use of improved drinking water sources 99% Use of properly treated water 1.1% Safe drinking water without bacteria 60%
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Three Years Rolling Plan 2010-2013 District Khanewal
Use of sanitary means of excreta disposal 64% Use of improved water sources and improved sanitation 64%
Health Indicators Infant Mortality Rate (per 1,000 births) 92 Under 5 mortality Rate (per 1,000 births) 138 Maternal mortality Ratio(per 100,000 births) 320 Malnutrition
Stunting prevalence: 24 % Wasting prevalence: 3.1 % Underweight prevalence: 10 %
Proportion of children under 2 years 80 % Fully immunized (Third Party Survey conducted by WHO in October 2009)
i. Reproductive Health*
a) Contraception
Use of contraceptives (any method) 24
Contraceptive drop out 1.6
Unwilling pregnancy 22
b) Maternal and newborn health
Antenatal care (ANC) 44 Skilled attendant at delivery 36 Institutional deliveries 31 Postnatal care (PNC) 36
* ( Source: MICS 2007-08)
Organizational Structure of District Health Administration
There exists a three-tier system in the health sector in the country. At federal level, Federal Secretary of Health is responsible to administer and supervise the health related activities and programs. Major function of federal tier is to provide policy guidelines and ensure quality of health care standards through federal legislation. After the 18th amendment in the constitution, and announcement of National Finance Award, most of the existing federal level programs will be transferred to the provincial level. At provincial level, provincial Secretary of Health along with Director General Health Services is responsible for managing and supervising health care services. The district is still an administrative entity in the system and EDO (Health) acts as head of the district health department, under overall supervision of DCO. The organizational structure at district level is as under:
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Three Years Rolling Plan 2010-2013 District Khanewal
Health Resources
1. Health Facilities
a) Public
Details of physical infrastructure of public health facilities in the district are given in the table below:
Sr Facility TypeNo. of
Health Facilities
Bed Strength
No. of Functional
BedsRemarks
1 DHQ Hospital Khanewal 1 125 1252 THQ Hospitals (60,60,40) 3 160 1603 Rural Health Centres 4 80 804 Basic Health Units 82 164 1645 Dispensaries 25 RDs -- --6 MCH Centres 4 -- -- --7 GRD 3 -- --8 TB Clinics 2 -- --9 Health Houses 1745 -- -- --
Data source: DHIS/EDOH office
b) Private
The district has provided a list of private service providers including hospitals, clinics, laboratories and maternity homes. These private providers are used for providing support in preventive programs like Polio and other EPI activities. With the passage of time, role of private providers will expand, and there is a need to develop an effective coordination between public and private sector.
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Executive District Officer
(Health)
Program Director
DHDC (1)
Medical Superintendent DHQ/THQ Hospitals (4)
District Officer (H)
01
Principal School of Nursing
(1)
Blood Transfusion Officer
(1)
District Superinte
ndent Vaccinati
on
CDC
Officer
District Sanitary Inspector
Medical Officer Basic
Health Units
Medical Officer Rural
Dispensaries Zila
Council
Drug Inspecto
r
Dy: District
Officer (H) 03
Medical Officer Govt. Rural
Dispensaries
Senior Medical
Officer RHCs (04)
Vertical
Programs
Three Years Rolling Plan 2010-2013 District Khanewal
2. Human Resource
The Human resource of district health department has been placed in following categories:
a) Administrativeb) Facility basedc) Outreachd) Training institutions
a) Administrative
Sr. Name of Post Sanctioned Filled
1 Executive District Officer Health 1 12 District Officer Health 1 1
3District Coordinator National Program/ Deputy District Officer Health (HQ)
0* 1
4 Deputy District Officers Health 3 35 Program Director DHDC 1 16 District Coordinator EPI Surveillance 0** 17 Drug Inspectors 4 48 District Sanitary Inspector 1 09 CDC Officer 1 0
10 District Superintendent Vaccination 1 111 Assistant Superintendent Vaccination 3 2
12 Tehsil Sanitary Inspector 3 113 Inspector Vaccination 3 2
** Post not sanctioned
b) Facility Based
i. Basic Health Units (82)
Sr. Name of Post/Designation Sanctioned Filled Vacant
1 Medical Officer 82 64 18
2School Health & Nutrition Supervisor
82 74 8
3 Medical Assistant 1 1 04 Computer Operator 82 70 125 Medical Technician 77 45 326 LHV 82 82 07 Dispenser 82 82 08 Midwife 164 52 1129 N/Qasid 82 82 0
10 Chowkidar 82 82 011 Sanitary Worker 82 81 1
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Three Years Rolling Plan 2010-2013 District Khanewal
ii. Rural Health Centre (4)
Sr. Name of Post/Designation Sanctioned Filled Vacant
1 Senior Medical Officers 4 4 02 Women Medical Officers 8 7 13 Dental Surgeons 4 3 14 Medical Officers 5 4 15 Charge Nurses 24 24 06 Homeo Doctors 3 2 17 Hakeems 1 1 08 Computer Operators 4 4 09 LHV 8 8 0
10 Lab. Technician 7 3 411 Dental Technician 6 6 012 Senior Clerk 4 4 013 Vaccinator 1 1 014 Homeo Dispenser 3 2 1
151 Dawasaz 1 1 016 Radiographer/X-Ray Asstt. 4 3 117 Dresser 4 4 018 Anesthesia Assistant 4 0 419 O.T.A 4 4 020 Dispenser 16 16 021 Dental Assistant 4 4 022 Laboratory Assistant 4 2 223 Midwife 16 8 824 Driver 4 4 025 T.O 4 4 026 Homeo Naib Qasid 2 2 027 Dawa Kob 1 1 028 Ward Servant 12 12 029 Sanitary Patrol 9 9 030 Naib Qasid 12 12 031 Mali 4 3 132 Cook 4 4 033 Chowkidar 8 8 034 Bahishti 4 4 0
iii. THQ Hospitals (3)
Sr. Post Sanctioned Filled Vacant1. Medical Superintendent 3 2 12. Addl. Principle Medical Officer 6 4 23. Addl. Principle Women Medical Officer 3 3 04. Surgeon 3 3 0
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. Post Sanctioned Filled Vacant5. Physician 4 0 46. Gynecologist 6 4 27. Pediatrician 3 3 08. Pathologist 3 3 09. Radiologist 3 0 310. Anesthetist 3 2 111. Ophthalmologist 3 2 112. Medical Officer 21 18 313. CMO 6 6 014. Women Medical Officer 9 7 215. Dental Surgeon 3 3 016. Pharmacist 2 2 017. Head Nurse 3 1 118. Charge Nurse 31 26 519. Hakeem 2 2 020. Homeo Doctor 3 3 021. Lady Health Visitor 3 3 022. Dawasaz 2 2 023. Homeo Dispenser 3 3 024. Dispenser / Dresser 19 19 025. Radiographer 6 6 026. Laboratory Assistant 3 3 027. Dental Assistant 3 3 028. Junior Clerk 3 3 029. Driver 5 5 030. Gate Keeper 3 3 031. Tube Well Operator 3 3 032. Ward Servant 14 12 233. Naib Qasid 3 3 034. Sweeper / Sweepress 15 15 035. Dhobi 3 3 036. Baildar 3 3 037. Chowkidar 3 3 038. Bahishti 2 2 039. Cook 2 2 040. Dawakob 2 2 0
iv. DHQ Hospital
Sr. No Post Sanctioned Filled Vacant
1. Medical Superintendent 1 1 02. Surgeon 1 1 03. Physician 1 1 0
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No Post Sanctioned Filled Vacant
4. Gynecologist 3 3 05. Pediatrician 1 0 16. Orthopedic Surgeon 1 0 17. Pathologist 1 1 08. Radiologist 1 0 19. Cardiologist 1 1 010. E.N.T. Specialist 1 1 011. Anesthetist 1 0 112. Ophthalmologist 1 1 013. Senior Medical Officer 1 1 014. Medical Officer/ Casualty Medical Officer 14 10 415. Women Medical Officer 6 6 016. Dental Surgeon 1 1 017. Pharmacist 1 1 018. Head Nurse 3 3 019. Charge Nurse 15 15 020. Hakeem 1 1 021. Homeo Doctor 1 1 022. Dawasaz 1 1 023. Homeo Dispenser 1 1 024. Dispenser / Dresser 11 11 025. Store Keeper 2 1 126. Radiographer 3 3 027. Laboratory Assistant 3 2 128. Junior Clerk 2 1 129. Midwife 2 2 030. Driver 3 3 031. Tube Well Operator 1 1 032. Ward Servant 23 23 033. Ward Cleaner 24 24 034. Naib Qasid 3 2 135. Dhobi 3 3 036. Baildar 1 0 137. Mali 2 2 038. Chowkidar 3 3 039. Bahishti 3 3 040. Cook 1 0 1
c) Outreach
This information is about outreach program workers such as Vaccinators, CDC Supervisors and Sanitary Inspectors which are not part of above mentioned health facilities.
Sr. Post Sanctioned Filled
1 Vaccinators 92 902 CDC Supervisors 70 673 Sanitary Inspectors 77 774 Nutrition Supervisor 82 74
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Three Years Rolling Plan 2010-2013 District Khanewal
5 Social mobilizer NCHD 82 566 Sanitary Supervisor 82 82
d) Training Institutions
A number of training institutions are working in the district, which include the
following:
Type of institute NumberDHDC 1General School of Nursing 1Midwifery school 1
i. DHDC
Name of Post Sanctioned Filled Vacant
Program Director 1 1 0LHV Trainer 1 1 0Assistant 1 0 1Driver 1 1 0Naib Qasid 1 1 0Chowkidar 1 1 0
ii. General School of Nursing
Name of Post Sanctioned Filled Vacant
Principal 1 1 0Nursing Instructor 3 3 0Stenographer 1 1 0Accountant 1 1 0Senior Clerk 1 1 0Junior Clerk 1 0 1Sweeper 3 3 0Naib Qasid 1 1 0Chowkidar 2 2 0
iii. Midwifery School
No of current CMW students 34 No of passed and deployed in the community 131 No of passed CMWs 54
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Three Years Rolling Plan 2010-2013 District Khanewal
3. Health Financing
The provision of financial resources at district level is prime responsibility of district government. However, keeping in view the budget constraints at the district level, federal and provincial governments also augment financial resources in form of kind and cash, through different programs. Financial resources of the district during the last three years out of different sources are given as under:
Rs. Million
Source of funding
Year
2007-08 2008-09 2009-10 up to 01/2010
Allocation Exp. Allocation Exp. Allocation Exp.
Non-Development 318.333 269.925 361.926 342.565 413.901 306.852
Development 11.077 10.688 7.542 4.637 0.773 0.743
Sub Total 329.4 280.6 369.468 347.202 414.674 307.595
PHSRP 0.450 0.415 11.950 10.833 - -
PMDGP - - 102.220 - - 20.861
PDSSP 18.468 18.004 25.674 19.721 28.720 5.750
Grand Total 348.325 299.032 509.312 377.756 443.394 334.206
User charges
(like parchi fee, fees
for diagnostic
services)
2007-08 2008-09 2009-10 up to 03/2010
Target Remittance Target Remittance Target Remittance
4.149 3.984 4.896 4.901 4.896 4.160
Disease Pattern
The disease pattern is determined through regular and periodic reporting through surveys and studies. Punjab health department has adopted DHIS as regular reporting mechanism to collect information on diseases and other variables. Currently, DHIS is in transitional stage, and is establishing itself as a tool to be used for evidence based planning and management. The following trend of the diseases has been taken from the consolidated DHIS reports that include reports from PHC and SHC facilities.
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Three Years Rolling Plan 2010-2013 District Khanewal
Disease Group Percentage of MagnitudeRespiratory Diseases
1 Acute (Upper) Respiratory Infections 18.972 Pneumonia <5 years 0.433 Pneumonia >5 years 0.404 TB Suspects 1.26
5Chronic Obstructive Pulmonary Diseases
1.47
6 Asthma 2.64Gastro Intestinal Disease
7 Diarrhoea/Dysentery in <5 yrs 2.438 Diarrhoea/Dysentery in >5 yrs 2.629 Enteric / Typhoid Fever 0.32
10 Worm Infestations 1.0111 Peptic Ulcer Diseases 2.0912 Cirrhosis of Liver 0.06
Urinary Tract Diseases 13 Urinary Tract Infections 1.3014 Nephritis/Nephrosis 0.0515 Sexually Transmitted Infections 0.0816 Benign Enlargement of Prostrate 0.03
Other Communicable Diseases 17 Suspected Malaria 1.0818 Suspected Meningitis 0.0319 Fever due to other causes 3.83
Vaccine Preventable Diseases 20 Suspected Measles 0.0221 Suspected Viral Hepatitis 0.1022 Suspected Neo Natal Tetanus 0.00
Cardiovascular Diseases 23 Ischemic Heart Disease 0.7624 Hypertension 2.62
Skin Diseases 25 Scabies 6.5826 Dermatitis 2.0627 Cutaneous Leishmaniasis 0.05
Endocrine Diseases 28 Diabetes Mellitus 1.63
Neuro-Psychiatric Diseases 29 Depression 0.4930 Drug Dependence 0.0431 Epilepsy 0.02
Eye & ENT 32 Cataract 0.8733 Trachoma 0.5634 Glaucoma 0.14
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Three Years Rolling Plan 2010-2013 District Khanewal
Disease Group Percentage of Magnitude35 Otitis Media 1.13
Oral Diseases 36 Dental Caries 2.20
Injuries / Poisoning 37 Road traffic accidents 1.9038 Fractures 0.1239 Burns 0.1540 Dog bite 0.22
41Snake bite (with signs/symptoms of poisoning)
0.003
Miscellaneous Diseases (Surveillance Importance)
42 Acute Flaccid Paralysis 0.0
43 Suspected HIV/AIDS 0.0Any other Unusual Diseases (Specify) 0.0
Source: DHIS Reports
Status of Vertical Programs
The following paragraphs depict the current status of the program being implemented in the district. The indicators and their values have been taken from the program reports.
1. National Program for FP & PHC
No. of seats allocated for LHWs 2200 No. of LHWs working 1784 Percentage of Population covered by the program 43 % Important program indicators
a. IMR 72/1000b. MMR 342/100000 LBc. CPR 36%d. TT Coverage of pregnant women 92.6%
2. EPI
EPI Coverage rate of the district 95% Fully immunized children 0-23 months 95% Pregnant women received TT vaccine 49% Availability of cold chain equipment 90 Facilities have cold chain equipment while 4 facilities do not have required equipment
3. MNCH Program
We have developed 72 community midwifery homes. 50 more CMW homes will be established till 14th May 2010. 34 students class is currently under training. Community awareness and sensitization events are held on regular basis in the district.
CMW Students Admitted 194
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Three Years Rolling Plan 2010-2013 District Khanewal
Passed 185
4. TB Control Program
CDR all types 83% CDR NSS positive 66% SCR 91% TSR 89% DR 6%
5. Malaria Control Program
No. of slides examined 44577 No. of positive slides 04 Slides positively ratio 04% Percentage of plasmodium falciparum 0
6. HIV/AIDS Control Program
No. of HIV tests conducted 135000 No. of positive cases detected 0 No. of HIV/AIDS patients treated 0 No. of sentinel centres 0
7. Hepatitis Control Program
No. of Hepatitis tests conducted
o HBs 2090 o HCV 2854
No. of positive cases detected 299 C/ 35 B No. of persons vaccinated against Hepatitis B 5100 No. of cases treated for Hepatitis C 151
8. School Health Services Program
Total Visits to the School 729 No. Students Examined 5705 No of students referred to BHUs 4976 No. Students Treated at BHU 3310
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Three Years Rolling Plan 2010-2013 District Khanewal
No. of Students referred from BHU to higher facilities
571
No. of Schools in catchment Areas 1584 No. of Students 317696 No of Teachers Trained 5807 No of SH & NS 82
SECTION 2: PROBLEM ANALYSIS
The Health sector in Punjab is facing enormous health and service delivery problems. Common health problems are communicable, non communicable, MNCH related diseases and accident/ trauma. The society is passing through demographic and epidemiological transition. This is due to changing life style, urbanization, ecological and other factors. Disease pattern is changing
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Three Years Rolling Plan 2010-2013 District Khanewal
where non communicable diseases are gradually increasing and the communicable diseases are still posing serious threat. Punjab is practically facing Double Burden of Disease (BOD). Besides, health problems service delivery/ managerial issues are also hindering the access and quality of health services to the population. The service delivery/management problems are diverse in nature, and include shortage of technical human resource, capacity issues, lack of infrastructure and equipment.
Devolution was introduced during 2001 affecting the administrative and financial set up of the districts. The devolution also brought political culture in the decision making of the districts in the shape of Nazims, Naib-Nazims and Councilors. This system is now in the phase of reshaping and it is not clear what will be future structure and managerial shape when new local bodies system is put in place. The District Manager and functionaries are in the state of uncertainty and confusion in this scenario. However, one thing is clear that the district shall remain a hub of all primary and secondary health services delivery. Despite the source of funding in the future, either from provincial or district government, health planning at district level shall continue to play a pivotal role in provision of quality health services.
In view of the above situation the district considers following objectives for developing three year rolling plan.
A. Objectives
Improve health status of the population Meeting the requirements of national and provincial health policies Achievement of MDGs through MSDS Introducing evidence-based planning culture by addressing district specific
problems/issues Addressing emerging health needs or re-emergence of health problems (e.g. H1N1, HIV-
AIDS, Polio, T.B) Ensuring effective inter-sectoral coordination with a view to improving health
indicators
The objectives would guide in problem analysis, designing interventions, setting /phasing the targets, costing and monitoring the plan activities.
B. Plan Development Process
Plan development has been a systematic and consultative process. A core planning team consisting of EDO (H), DOH, MS DHQ and THQs, Statistical officer, and Budget and Accounts Officer, was designated by Director General Health Services Punjab. This team received three days customized training from SP-09 team at divisional headquarters. The main components of the trainings were: (i) developing a three-year rolling health sector plan using the standard three year rolling plan format; (ii) costing of the plan; (iii) preparing related budget projections; (iv) accounting procedures; (v) preparing adequate financial reports on the use of funds.
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Three Years Rolling Plan 2010-2013 District Khanewal
The district planning team adopted the following steps for the preparation of three years rolling plan:
Problem identification Prioritization of identified problems Identifying underlying causes of prioritized problems Developing interventions and activities Setting targets Determining resource requirements, costing and budgeting Preparing action plans Preparing monitoring plan
1. Problem IdentificationThis step involved assessment of the current situation from various perspectives to establish the actual health situation in terms of health and service delivery/management problems. Problem identification is based on the district health profile, review of previous plans, MIS (DHIS, Program reports and periodic reports etc.), District specific surveys (MICS), MSDS, and national and provincial policy guidelines.
The district planning team held meetings and started with identification of problem using the training received from SP-09 team and consulting the above mentioned documents. The problems identified were broadly divided into two categories i.e.
a) Health Problemsb) Health Service Delivery or Management Problems
Health Problems
The district specific health problems identification process started during the three years rolling plans workshop. The planning team in the initial stage prepared a long list of the health problems. The identification of health problems was based on various information sources including DHIS, and district specific reports. The enlisted health problems of the district are given in the following table.
1. ARI
2. Diarrhea3. Hepatitis4. T.B5. Road Side accidents6. Deliveries by unskilled birth attendants7. Diabetes 8. Dog Bite
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Three Years Rolling Plan 2010-2013 District Khanewal
1. Problem Prioritization
WHO has developed standard criteria for prioritization of health problems; which is based on the following five elements:
Magnitude Severity/danger Vulnerability to intervention (feasibility) Cost-effectiveness of the intervention Political expediency
Each element has been assigned a score from 1 to 4 depending upon grade/scale of that element i.e. Very High=4, High=3, Medium=2 and Low=1.
Elements of the prioritization criteria were applied to each of the enlisted health problems. The aggregate of individual scores assigned to the elements of the prioritization criteria gave the total score for a health problem. A cut-off point was decided, to establish the priority health problems of the district. This total score was then used to prioritize the health problems. These problems will be addressed in the three years rolling plan.
Problem Magnitude Severity Vulnerability to
intervention
Cost Effectiveness
Political Expediency
Total Score
Priority Number
ARI 4 3 4 2 4 17 2Diarrhea 4 4 4 2 4 19 1Hepatitis 2 3 2 3 2 12 6
T.B 3 3 4 2 2 14 4RSA 3 3 2 2 1 11 7
Deliveries by Unskilled
Birth Attendants
3 4 4 3 2 16 3
Diabetes Mellitus
2 3 3 2 2 12 6
Anemia (in pregnancy)
2 3 3 3 2 13 5
Underlying causes of prioritized problems
Health problems have their underlying causes. It is important to know the underlying causes of the health problems so that appropriate interventions are developed. There may be a long list of these causes but only few of them are vital ones; and rectifying these causes can resolve the problem to a large extent. Following table gives common causes of the prioritized health problems pertaining to the district.
Sr. # Health Problem Causes
1. Diarrhea Poor hygiene and sanitation
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. # Health Problem Causes
Lack of safe drinking water Unhygienic practices Lack of awareness among mothers about feeding and
weaning practices
2. ARI Malnutrition Air Contamination Over-Crowding/Poor Housing Facilities Lack of proper sanitation Seasonal Variation Lack of awareness related to winter season and
hygienic practices3. Deliveries by
unskilled birth attendants
Low access to appropriate health services Lack of awareness about danger signs of pregnancy Three delays (seeking health care, transportation,
and lack of referral back-up services) Lack of skilled birth attendants
4. Tuberculosis (TB) Low socio-economic status Over-Crowding/Poor housing facilities Malnutrition Seasonal Variation Lack of proper sanitation Lack of awareness and hygienic practices
5. Anemia (in pregnancy)
Poverty and malnutrition Lack of awareness about balanced diet Multiple pregnancies Inadequate and poor MCH Services Gender discrimination Worm Infestation
6. Hepatitis B&C Poor sanitation Unsafe drinking water Sharing of used syringes Transfusion of unsafe/unscreened blood and blood
products Unsafe sexual practices Ear piercing and tattooing Use of unsterilized equipment by dentists and
barbers
Service delivery/Management problems
This segment entails the district specific management problems. Management problems are result of deficiency/lack of resources; these problems range from administrative to financial issues, and cause hindrance in the smooth delivery of health services in the district. It was observed that solution of some of these problems lies with the provincial government; whereas remaining can be addressed at the district level. While proposing the interventions, their action at provincial or district level has been specifically mentioned. The planning team discussed these problems in detail and enlisted the main problems as under:
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Three Years Rolling Plan 2010-2013 District Khanewal
1. Shortages of skilled staff (Medics, Paramedics)
2. Shortage of medicines and supplies
3. Political/ Media interference
4. Inadequate district health budget for POL
5. Lack of equipment
6. Deficient infrastructure for MSDS services
Underlying causes of Management Problems
Sr. Service Causes
1. Shortage of skilled staff (Medics, Paramedics)
Non-availability of skilled staff Lack of sanctioned posts according MSDS Lack of permanent posts Frequent transfer postings Lack of incentivized and differential pay package Job insecurity Lack of basic amenities at workplace Lack of conducive environment including insecurity
and transport of children for education Political and media interference
2. Inadequate medicines and supplies
Less budget allocation for medicines Frequent increase in drug prices
3. Political and media interference
Undue pressure from local political figures especially in medico-legal cases
6. Inadequate district health budget for POL
Generator provision of backup of electricity supply Less budget allocation Frequent increase in prices
7. Deficient
infrastructure for MSDS services
Debilitated condition of existing infrastructure Lack of repair and maintenance Inadequate infrastructure for emergency, Operation
Theatre, OPD and inpatients, residencies for staff at THQ and BHQ Hospitals
8. Inadequate equipments
Deficient equipment to cater basic and comprehensive EmONC
Old and unserviceable equipment Shortage of budget for M&R Frequent cuts on M&R budget
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Three Years Rolling Plan 2010-2013 District Khanewal
C. MDGs and MSDS
The government is committed to achieve the MDGs targets. For this purpose, the government of Punjab has decided to adopt Minimum Service Delivery Standards (MSDS) as strategy to achieve the MDGs within the province. Health Department of Punjab is especially focusing on MNCH related component of MSDS for which substantial resources are coming from Asian Development Program funded Punjab Millennium Development Goal Program (PMDGP). MSDS entails a level-specific service delivery package (for primary and secondary health care) along with their standards and system specifications including human, infrastructure, equipment, medical supplies, medicine and other consumables.
In order to achieve the MDGs, the government of Punjab has adopted MSDS as strategic framework. During the development of three years rolling plans, gaps under MSDS focusing on MNCH interventions have been identified. Most essential areas for which gaps have been
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Three Years Rolling Plan 2010-2013 District Khanewal
identified are human resource and equipment of DHQ and THQ hospitals, as per lists notified by the government in accordance with MSDS standards.
a) Human Resource
With regard to MSDS gap analysis for human resource, the difference between the standards
proposed in MSDS and filled posts has been calculated as the vacancy gap. The hospitals
have been categorized based on their bed strength as follows:
Hospital Category Bed Strength
DHQ Hospital
A 400 and above Beds
B 251-400 Beds
C Up to 250 Beds
THQ Hospital
A Above 60 Beds
B 41-60 Beds
C Up to 40 Beds
i. DHQ Hospital (Category c)
Sr. PostStandard
as per MSDS
Sanctioned Filled
Vacancy Gap in
relation to Sanctioned Positions
Vacancy Gap in
relation to Filled
Positions1. Gynaecologist 3 3 3 0 02. Paediatricians 3 1 0 2 33. Anesthetists 3 1 1 2 24. MO/WMO/APMO/
SMO/SWMO APWMO
111 29 23 82 88
5. Lady Health Visitors 11 1 1 10 106. Nurses 75 15 15 60 60
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Three Years Rolling Plan 2010-2013 District Khanewal
ii. THQ Hospital Kabir Wala (Category B)
Sr. No.
PostStandard
as per MSDS
SanctionedFilled
Vacancy Gap in
relation to Sanctioned Positions
Vacancy Gap in relation to
Filled Positions
1. Gynaecologist 2 2 1 0 12. Paediatricians 2 1 1 1 13. Anesthetists 3 1 0 2 34. Medical Officers/
APMO/APWMO WMO/ /SMO/SWMO
29 17 15 12 14
5. Lady Health Visitors
8 1 1 7 7
6. Nurses 24 11 8 13 16
iii. THQ Hospital Mian Channu (Category B)
Sr. No.
PostStandard
as per MSDS
SanctionedFilled
Vacancy Gap in
relation to Sanctioned Positions
Vacancy Gap in
relation to Filled
Positions1. Gynaecologist 2 2 2 0 02. Paediatrician 2 1 1 1 13. Anesthetists 4 1 1 3 34. MO/ WMO /
SMO/ SWMO / APMO/APWMO
29 17 17 12 12
5. Lady Health Visitors
8 1 1 7 7
6. Nurses 24 11 11 13 13
iv. THQ Hospital Jahanian (Category C)
Sr. No.
PostStandard
as per MSDS
SanctionedFilled
Vacancy Gap in
relation to Sanctioned Positions
Vacancy Gap in
relation to Filled
Positions1. Gynaecologist 2 2 1 0 1
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Three Years Rolling Plan 2010-2013 District Khanewal
2. Paediatricians 2 1 1 1 13. Anesthetists 3 1 1 2 24. Medical
Officers / WMO / SMO/ SWMO / APMO/APWMO
12 10 8 2 4
5. Nurses 15 9 7 6 86. LHVs 8 1 1 7 7
b) Equipment
Government of Punjab has notified a standard list as yard-stick of MNCH related equipment to provide comprehensive EmONC services in the DHQ and THQ hospitals. Provision of comprehensive EmONC services is essentially required to decrease the high MMR and IMR prevailing in the province.
Gaps in relation to the MNCH related equipment have been identified taking into account the equipment purchased or under process of purchase from all funds including PMDGP funds allocated/sanctioned to the district. The cost of equipment gap has been included in the equipment portion of the Management/Service delivery problems. The equipment gaps for DHQ and THQ hospitals are attached as Annex-I.
i. DHQ Hospital Khanewal
(Category C)
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A1 CTG (Cardiac
Tocography)1 1 2 1 0
2 Foetal Doppler 3 5 5 4 03 Diagnostic
Laparoscope1 1 2 0 1
4 Bulb Sucker 10 20 20 0 105 Baby Warmer 3 3 6 1 26 Mechanical Sucker 3 3 6 3 07 Fetal Stethoscope 4 4 4 4 08 Delivery Table 2 2 3 4 09 D&C Set 2 3 4 4 0
10 Outlet forceps 4 4 4 2 211 Myoma Screw 2 2 2 1 1
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A12 Kochers forceps 4 4 8 4 013 Volselum forceps 6 8 10 6 014 Lanes Tissue holding
forceps2 2 4 2 0
15 Vaginal Retractors 10 10 10 2 816 Polypectomy forceps 2 2 2 1 117 Sponge holder 10 15 20 10 018 Uterine elevator 1 1 1 1 019 Cusco Speculum
Small, Medium, Large (for each category)
6 10 10 10 0
20 Examination light 3 3 6 3 021 Suction Curette 1 2 2 30 022 Infant Resuscitation
Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light)
1 1 2 1 0
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light)
1 1 2 0 1
24 Cardiac Monitor 1 1 2 1 025 Pump Breast
Electronic1 1 1 0 1
26 Vaginal Hysterectomy Set
26.1 Toothed Tissue Forceps (8”)
2 2 4 3 0
26.2 Non-Tooted Tissue Forceps (8”)
2 2 4 4 0
26.3 Dissection Scissors (Curved 7”)
2 2 4 5 0
26.4 Dissection Scissors (Straight 7”)
2 2 4 5 0
26.5 Hysterectomy Clamps (Straight)
8 8 16 5 3
26.6 Hysterectomy Clamps (Curved)
8 8 16 5 3
26.7 Uterine Sound 2 2 4 1 126.8 Needle Holder (7”) 2 2 4 5 026.9 Needle Holder (10”) 2 2 4 2 0
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A26.10 Artery Forceps
(Straight 6”)16 16 32 16 0
26.11 Artery Forceps (Curved 6”)
16 16 32 16 0
26.12 Allis Forceps 8 8 16 8 026.13 Towel Clamps 8 8 16 6 226.14 Single blade Sims
speculum4 4 8 2 2
26.15 Double blade Sims speculum
4 4 8 0 4
26.16 Sponge holding forceps
8 8 16 8 0
26.17 Volselum forceps 4 4 8 2 226.18 Uterine Sound 2 2 4 2 026.19 Bladder Sound 2 2 4 1 1
27 Delivery Sets27.1 Episiotomy Scissors 10 10 15 2 827.2 Straight Scissors 10 10 15 10 027.3 Needle holder 10 10 15 18 027.4 Non-toothed tissue
forceps 8 inches10 10 15 10 0
27.5 Toothed tissue forceps 8 inches
10 10 15 10 0
27.6 Sims Speculum single blade
20 20 30 16 4
27.7 Sims Speculum double blade
20 20 30 20 0
27.8 Sponge holding forceps
40 40 60 40 0
27.9 Artery forceps 40 40 60 20 2027.10 Straight clamps (cord) 20 20 30 20 027.11 Vacuum Extractor
pump1 1 1 1 0
27.12 Towel clip 40 40 60 10 3028 Caesarian Section
28.1 Scalpel 6 8 10 5 128.2 Artery Forceps
Straight 6 inches24 32 40 24 0
28.3 Artery Forceps Curved 6 inches
24 32 40 24 0
28.4 Artery forceps 8 inches
24 32 40 24 0
28.5 Myoma Scissors straight 7 inches
6 8 10 6 0
28.6 Dissecting scissors (curved) 7 inches
6 8 10 6 0
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A28.7 Green Armtage
forceps 8 inches24 32 40 0 24
28.8 Obstetric outlet forceps (pair)
6 8 10 6 0
28.9 Doyene’s Retractor 6 8 10 6 028.10 Small Retractors 12 16 20 10 228.11 Towel Clippers 24 32 40 16 828.12 Suction Nozzle 6 8 10 6 0
29 MNCH Related Radiology Equipments
29.1 Ultrasound Machine 1 2 3 1 029.2 X-Ray Unit 500 kw 1 1 1 1 029.3 Color Doppler 0 1 1 0 029.4 Lead Screen for X-Ray
Unit1 1 1 0 1
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Gonadal Sheets
1 1 1 1 0
29.6 Safe Light 1 1 1 1 029.7 X-RT Film Processing
Tank1 1 1 1 0
29.8 Chest Stand 1 1 1 1 029.9 X-Ray film Illuminator 2 2 2 2 0
29.10 X-Ray Film Hangers All sizes
4 4 4 10 0
30 MNCH Related Paediatrics Equipments
30.1 Paediatric Ventilator 1 2 2 0 130.2 Incubator 1 1 2 1 030.3 Photo Therapy Unit 1 1 1 1 030.4 Over-head Radiant
Warmer1 1 1 1 0
30.5 Infant Length Measuring Scale
2 2 2 1 1
30.6 Infant Weighing Machine
2 2 2 1 1
30.7 Nebulizer 1 1 2 1 030.8 Billiubino-meter 1 1 2 0 130.9 Exchange Blood
Transfusion Set1 1 2 0 1
30.10 Nasal Probe Paed size 2 2 4 0 231 Anaesthesia/ICU
31.1 Anaesthesia Machine 1 1 2 3 031.2 Ventilators 1 1 1 2 0
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A31.3 Nebulizer 1 1 1 1 031.4 Pulse Oximeter 1 1 1 0 131.5 Defibrillator 1 1 1 1 031.6 Airway Oral and Nasal 2 3 4 2 031.7 Tracheostomy tube
(adult and paeds)2 2 4 0 2
31.8 Face mask of all sizes 2 2 4 2 031.9 Double Cuff
Tourniquet (for regional block)
1 2 2 0 1
31.10 AMBO bag adult 2 2 4 1 131.11 AMBO Bag paeds 2 2 4 1 131.12 Red Rubber Nasal
tubes all sizes without cuff
4 4 8 4 0
32 Blood Bank32.1 Blood storage cabinet
(100 bag capacity)1 1 2 2 0
32.2 Packed cell machine 1 1 1 0 132.3 Cell Separator 1 1 1 0 132.4 Freezer for Fresh
Frozen Plasma1 1 1 0 1
32.5 Blood bag shaker 1 1 2 1 032.6 RH view box 2 2 4 1 132.7 Water bath 2 2 2 1 132.8 Micro-pipette 4 6 8 6 032.9 Blood grouping tiles 3 3 6 2 1
32.10 Plasma Extractor 1 1 1 0 132.11 Platelets agitator 1 1 1 0 132.12 Blood thawing bath 1 1 1 0 132.13 Microscopes 1 1 2 1 0
33 Gynae & Labour Room Related Laboratory Equipment
33.1 Hematology Analyzer 1 1 1 0 133.2 Electrolyte Analyzer 1 1 1 1 033.3 Analyzer Bio-
chemistry Semi-automatic
1 1 1 1 0
33.4 Glucometer 2 2 2 1 133.5 Haemoglobino-meter 2 2 4 1 133.6 Centrifuge 1 1 2 1 0
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Three Years Rolling Plan 2010-2013 District Khanewal
ii. THQ Hospital Kabir wala
(Category B)
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A1 CTG (Cardiac
Tocography)1 1 1 0 1
2 Foetal Doppler 2 2 3 0 23 Diagnostic
Laparoscope1 1 1 0 1
4 Bulb Sucker 5 10 20 5 05 Baby Warmer 2 2 3 2 06 Mechanical Sucker 3 3 3 3 07 Fetal Stethoscope 2 3 4 2 08 Delivery Table 2 2 2 2 09 D&C Set 2 2 2 2 0
10 Outlet forceps 4 4 4 4 011 Myoma Screw 2 2 2 2 012 Kochers forceps 4 4 4 4 013 Volselum forceps 4 4 6 4 214 Lanes Tissue holding
forceps2 2 2 2 0
15 Vaginal Retractors 4 4 6 4 016 Polypectomy forceps 2 2 2 2 017 Sponge holder 10 10 15 10 018 Uterine elevator 1 1 1 1 019 CosCo Speculum
Small, Medium, Large (for each category)
4 6 6 4 0
20 Examination light 3 3 3 3 021 Suction Curette 1 1 2 0 122 Infant Resuscitation
Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light)
1 1 1 0 1
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light)
1 1 1 0 1
24 Cardiac Monitor 1 1 1 0 125 Pump Breast
Electronic1 1 1 0 1
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A26 Vaginal
Hysterectomy Set26.1 Toothed Tissue
Forceps (8”)2 2 2 2 0
26.2 Non-Tooted Tissue Forceps (8”)
2 2 2 2 0
26.3 Dissection Scissors (Curved 7”)
2 2 2 2 0
26.4 Dissection Scissors (Straight 7”)
2 2 2 2 0
26.5 Hysterectomy Clamps (Straight)
8 8 8 8 0
26.6 Hysterectomy Clamps (Curved)
8 8 8 8 0
26.7 Uterine Sound 2 2 2 2 026.8 Needle Holder (7”) 2 2 4 2 026.9 Needle Holder (10”) 2 2 2 2 0
26.10 Artery Forceps (Straight 6”)
16 16 16 16 0
26.11 Artery Forceps (Curved 6”)
16 16 16 16 0
26.12 Allis Forceps 8 8 8 8 026.13 Towel Clamps 8 8 8 8 026.14 Single blade Sims
speculum4 4 4 0 4
26.15 Double blade Sims speculum
4 4 4 8 0
26.16 Sponge holding forceps
8 8 8 4 4
26.17 Volselum forceps 4 4 4 2 226.18 Uterine Sound 2 2 2 2 026.19 Bladder Sound 2 2 2 2 0
27 Delivery Sets27.1 Episiotomy Scissors 6 6 10 6 027.2 Straight Scissors 6 6 10 6 027.3 Needle holder 6 6 10 6 027.4 Non-toothed tissue
forceps 8 inches6 6 10 6 0
27.5 Toothed tissue forceps 8 inches
6 6 10 6 0
27.6 Sims Speculum single blade
12 12 20 0 12
27.7 Sims Speculum double blade
12 12 20 12 0
27.8 Sponge holding forceps
40 40 40 40 0
27.9 Artery forceps 40 40 40 40 0
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A27.10 Straight clamps (cord) 20 20 30 20 027.11 Vacuum Extractor
pump1 1 1 1 0
27.12 Towel clip 40 40 40 0 4028 Caesarian Section
28.1 Scalpel 4 4 6 0 428.2 Artery Forceps
Straight 6 inches16 16 24 16 0
28.3 Artery Forceps Curved 6 inches
16 16 24 16 0
28.4 Artery forceps 8 inches
16 16 24 16 0
28.5 Myoma Scissors straight 7 inches
4 4 6 4 0
28.6 Dissecting scissors (curved) 7 inches
4 4 6 4 0
28.7 Green Armtage forceps 8 inches
16 16 24 16 0
28.8 Obstetric outlet forceps (pair)
4 4 6 4 0
28.9 Doyene’s Retractor 4 4 6 4 028.10 Small Retractors 8 8 12 8 028.11 Towel Clippers 16 16 24 16 028.12 Suction Nozzle 4 4 6 0 4
29 MNCH Related Radiology Equipments
29.1 Ultrasound Machine 1 1 2 1 029.2 X-Ray Unit 500 kw 1 1 1 1 029.3 Color Doppler 0 0 0 0 029.4 Lead Screen for X-Ray
Unit1 1 1 0 1
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Gonadal Sheets
1 1 1 0 1
29.6 Safe Light 1 1 1 1 029.7 X-RT Film Processing
Tank1 1 1 1 0
29.8 Chest Stand 1 1 1 1 029.9 X-Ray film Illuminator 2 2 2 2 0
29.10 X-Ray Film Hangers All sizes
4 4 4 4 0
30 MNCH Related Paediatrics Equipments
30.1 Paediatric Ventilator 1 1 2 0 1
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A30.2 Incubator 1 1 1 1 030.3 Photo Therapy Unit 1 1 1 1 030.4 Over-head Radiant
Warmer1 1 1 1 0
30.5 Infant Length Measuring Scale
2 2 2 2 0
30.6 Infant Weighing Machine
2 2 2 2 0
30.7 Nebulizer 1 1 1 1 030.8 Billirubino-meter 1 1 1 1 030.9 Exchange Blood
Transfusion Set1 1 1 1 0
30.10 Nasal Probe Paed size 1 2 2 0 131 Anaesthesia/ICU
31.1 Anaesthesia Machine 1 1 1 1 031.2 Ventilators 1 1 1 1 031.3 Nebulizer 1 1 1 1 031.4 Pulse Oximetry 1 1 1 1 031.5 Defibrillator 1 1 1 1 031.6 Airway Oral and Nasal 1 2 2 1 031.7 Tracheostomy tube
(adult and paeds)1 2 2 1 0
31.8 Face mask of all sizes 1 2 2 1 031.9 Double Cuff
Tourniquet (for regional block)
1 1 1 1 0
31.10 AMBO bag adult 1 2 2 1 031.11 AMBO Bag paeds 2 2 2 2 031.12 Red Rubber Nasal
tubes all sizes without cuff
4 4 4 4 0
32 Blood Bank32.1 Blood storage cabinet
(100 bag capacity)1 1 1 1 0
32.2 Packed cell machine 1 1 1 0 132.3 Cell Separator 1 1 1 1 032.4 Freezer for Fresh
Frozen Plasma1 1 1 1 0
32.5 Blood bag shaker 1 1 1 1 032.6 RH view box 1 2 2 1 032.7 Water bath 2 2 2 2 032.8 Micro-pipette 4 4 6 4 032.9 Blood grouping tiles 3 3 3 0 3
32.10 Plasma Extractor 1 1 1 1 032.11 Platelets agitator 1 1 1 1 032.12 Blood thawing bath 1 1 1 0 132.13 Microscopes 1 1 1 0 1
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A33 Gynae & Labour
Room Related Laboratory Equipment
33.1 Hematology Analyzer 1 1 1 0 133.2 Electrolyte Analyzer 1 1 1 0 133.3 Analyzer Bio-
chemistry Semi-automatic
1 1 1 0 1
33.4 Glucometer 2 2 2 0 233.5 Haemoglobino-meter 1 1 1 0 133.6 Centrifuge 1 1 1 0 1
iii. THQ Hospital Mian Channu
(Category B)
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A1 CTG (Cardiac
Tocography)1 1 1 1 0
2 Foetal Doppler 2 2 3 1 13 Diagnostic
Laparoscope1 1 1 0 1
4 Bulb Sucker 5 10 20 0 105 Baby Warmer 2 2 3 0 26 Mechanical Sucker 3 3 3 1 27 Fetal Stethoscope 2 3 4 3 08 Delivery Table 2 2 2 2 09 D&C Set 2 2 2 1 1
10 Outlet forceps 4 4 4 0 411 Myoma Screw 2 2 2 3 012 Kochers forceps 4 4 4 0 413 Volselum forceps 4 4 6 5 014 Lanes Tissue holding
forceps2 2 2 3 0
15 Vaginal Retractors 4 4 6 2 216 Polypectomy forceps 2 2 2 1 117 Sponge holder 10 10 15 2 818 Uterine elevator 1 1 1 0 119 CosCo Speculum
Small, Medium, Large (for each category)
4 6 6 0 6
20 Examination light 3 3 3 2 121 Suction Curette 1 1 2 3 1
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A22 Infant Resuscitation
Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light)
1 1 1 1 0
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light)
1 1 1 0 1
24 Cardiac Monitor 1 1 1 0 125 Pump Breast
Electronic1 1 1 0 1
26 Vaginal Hysterectomy Set
26.1 Toothed Tissue Forceps (8”)
2 2 2 2 0
26.2 Non-Tooted Tissue Forceps (8”)
2 2 2 2 0
26.3 Dissection Scissors (Curved 7”)
2 2 2 0 2
26.4 Dissection Scissors (Straight 7”)
2 2 2 0 2
26.5 Hysterectomy Clamps (Straight)
8 8 8 0 8
26.6 Hysterectomy Clamps (Curved)
8 8 8 0 8
26.7 Uterine Sound 2 2 2 1 126.8 Needle Holder (7”) 2 2 4 0 226.9 Needle Holder (10”) 2 2 2 0 2
26.10 Artery Forceps (Straight 6”)
16 16 16 2 14
26.11 Artery Forceps (Curved 6”)
16 16 16 0 16
26.12 Allis Forceps 8 8 8 8 026.13 Towel Clamps 8 8 8 0 826.14 Single blade Sims
speculum4 4 4 0 4
26.15 Double blade Sims speculum
4 4 4 0 4
26.16 Sponge holding forceps
8 8 8 0 8
26.17 Volselum forceps 4 4 4 0 426.18 Uterine Sound 2 2 2 0 2
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A26.19 Bladder Sound 2 2 2 0 2
27 Delivery Sets27.1 Episiotomy Scissors 6 6 10 2 427.2 Straight Scissors 6 6 10 2 427.3 Needle holder 6 6 10 0 627.4 Non-toothed tissue
forceps 8 inches6 6 10 0 6
27.5 Toothed tissue forceps 8 inches
6 6 10 0 6
27.6 Sims Speculum single blade
12 12 20 0 12
27.7 Sims Speculum double blade
12 12 20 0 12
27.8 Sponge holding forceps
40 40 40 0 40
27.9 Artery forceps 40 40 40 0 4027.10 Straight clamps
(cord)20 20 30 0 20
27.11 Vacuum Extractor pump
1 1 1 1 0
27.12 Towel clip 40 40 40 0 4028 Caesarian Section
28.1 Scalpel 4 4 6 0 428.2 Artery Forceps
Straight 6 inches16 16 24 0 16
28.3 Artery Forceps Curved 6 inches
16 16 24 0 16
28.4 Artery forceps 8 inches
16 16 24 0 16
28.5 Myoma Scissors straight 7 inches
4 4 6 0 4
28.6 Dissecting scissors (curved) 7 inches
4 4 6 0 4
28.7 Green Armtage forceps 8 inches
16 16 24 4 12
28.8 Obstetric outlet forceps (pair)
4 4 6 0 4
28.9 Doyene’s Retractor 4 4 6 1 328.10 Small Retractors 8 8 12 0 828.11 Towel Clippers 16 16 24 0 1628.12 Suction Nozzle 4 4 6 12 0
29 MNCH Related Radiology Equipments
29.1 Ultrasound Machine 1 1 2 1 029.2 X-Ray Unit 500 kw 1 1 1 0 129.3 Color Doppler 0 0 0 0 0
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A29.4 Lead Screen for X-Ray
Unit1 1 1 0 1
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Gonadal Sheets
1 1 1 0 1
29.6 Safe Light 1 1 1 0 129.7 X-Ray Film
Processing Tank1 1 1 0 1
29.8 Chest Stand 1 1 1 4 029.9 X-Ray film
Illuminator2 2 2 0 2
29.10 X-Ray Film Hangers All sizes
4 4 4 0 4
30 MNCH Related Paediatrics Equipments
30.1 Paediatric Ventilator 1 1 2 0 130.2 Incubator 1 1 1 1 030.3 Photo Therapy Unit 1 1 1 1 030.4 Over-head Radiant
Warmer1 1 1 1 0
30.5 Infant Length Measuring Scale
2 2 2 1 1
30.6 Infant Weighing Machine
2 2 2 1 1
30.7 Nebulizer 1 1 1 0 130.8 Billiubino-meter 1 1 1 0 130.9 Exchange Blood
Transfusion Set1 1 1 0 1
30.10 Nasal Probe Paed size 1 2 2 0 231 Anaesthesia/ICU
31.1 Anaesthesia Machine 1 1 1 1 031.2 Ventilators 1 1 1 0 131.3 Nebulizer 1 1 1 0 131.4 Pulse Oximetry 1 1 1 0 131.5 Defibrillator 1 1 1 0 131.6 Airway Oral and
Nasal1 2 2 0 2
31.7 Tracheostomy tube (adult and paeds)
1 2 2 0 2
31.8 Face mask of all sizes 1 2 2 0 231.9 Double Cuff
Tourniquet (for regional block)
1 1 1 0 1
31.10 AMBO bag adult 1 2 2 0 231.11 AMBO Bag paeds 2 2 2 0 2
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Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap
C B A31.12 Red Rubber Nasal
tubes all sizes without cuff
4 4 4 0 4
32 Blood Bank32.1 Blood storage cabinet
(100 bag capacity)1 1 1 0 1
32.2 Packed cell machine 1 1 1 0 132.3 Cell Separator 1 1 1 0 132.4 Freezer for Fresh
Frozen Plasma1 1 1 0 1
32.5 Blood bag shaker 1 1 1 0 132.6 RH view box 1 2 2 0 232.7 Water bath 2 2 2 2 032.8 Micro-pipette 4 4 6 0 432.9 Blood grouping tiles 3 3 3 0 3
32.10 Plasma Extractor 1 1 1 0 132.11 Platelets agitator 1 1 1 0 132.12 Blood thawing bath 1 1 1 0 132.13 Microscopes 1 1 1 0 1
33 Gynae & Labour Room Related Laboratory Equipment
33.1 Hematology Analyzer 1 1 1 0 133.2 Electrolyte Analyzer 1 1 1 0 133.3 Analyzer Bio-
chemistry Semi-automatic
1 1 1 0 1
33.4 Glucometer 2 2 2 0 233.5 Haemoglobino-meter 1 1 1 0 133.6 Centrifuge 1 1 1 0 1
iv. THQ Hospital Jahanian
(Category B)
Sr. No.
Equipment Standard as per MSDS(Qty.)
Available Gap
C B A1 CTG (Cardiac
Tocography)1 1 1 0 1
2 Foetal Doppler 2 2 3 0 23 Diagnostic
Laparoscope1 1 1 0 1
Page 44
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Equipment Standard as per MSDS(Qty.)
Available Gap
C B A4 Bulb Sucker 5 10 20 5 55 Baby Warmer 2 2 3 2 26 Mechanical Sucker 3 3 3 3 07 Fetal Stethoscope 2 3 4 2 18 Delivery Table 2 2 2 2 09 D&C Set 2 2 2 2 0
10 Outlet forceps 4 4 4 4 011 Myoma Screw 2 2 2 2 012 Kochers forceps 4 4 4 4 013 Volselum forceps 4 4 6 4 014 Lanes Tissue
holding forceps2 2 2 2 0
15 Vaginal Retractors 4 4 6 4 416 Polypectomy
forceps2 2 2 2 0
17 Sponge holder 10 10 15 10 018 Uterine elevator 1 1 1 1 019 CosCo Speculum
Small, Medium, Large (for each category)
4 6 6 4 2
20 Examination light 3 3 3 3 021 Suction Curette 1 1 2 0 122 Infant Resuscitation
Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light)
1 1 1 0 1
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light)
1 1 1 0 1
24 Cardiac Monitor 1 1 1 0 125 Pump Breast
Electronic1 1 1 0 1
Page 45
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Equipment Standard as per MSDS(Qty.)
Available Gap
C B A26 Vaginal
Hysterectomy Set26.1 Toothed Tissue
Forceps (8”)2 2 2 2 0
26.2 Non-Tooted Tissue Forceps (8”)
2 2 2 2 0
26.3 Dissection Scissors (Curved 7”)
2 2 2 2 0
26.4 Dissection Scissors (Straight 7”)
2 2 2 2 0
26.5 Hysterectomy Clamps (Straight)
8 8 8 8 0
26.6 Hysterectomy Clamps (Curved)
8 8 8 8 0
26.7 Uterine Sound 2 2 2 2 026.8 Needle Holder (7”) 2 2 4 2 026.9 Needle Holder (10”) 2 2 2 2 0
26.10 Artery Forceps (Straight 6”)
16 16 16 16 0
26.11 Artery Forceps (Curved 6”)
16 16 16 16 0
26.12 Allis Forceps 8 8 8 8 026.13 Towel Clamps 8 8 8 8 026.14 Single blade Sims
speculum4 4 4 0 4
26.15 Double blade Sims speculum
4 4 4 8 0
26.16 Sponge holding forceps
8 8 8 4 4
26.17 Volselum forceps 4 4 4 2 226.18 Uterine Sound 2 2 2 2 026.19 Bladder Sound 2 2 2 2 0
27 Delivery Sets27.1 Episiotomy Scissors 6 6 10 6 027.2 Straight Scissors 6 6 10 6 027.3 Needle holder 6 6 10 6 027.4 Non-toothed tissue
forceps 8 inches6 6 10 6 0
27.5 Toothed tissue forceps 8 inches
6 6 10 6 0
27.6 Sims Speculum single blade
12 12 20 0 12
Page 46
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Equipment Standard as per MSDS(Qty.)
Available Gap
C B A27.7 Sims Speculum
double blade12 12 20 12 0
27.8 Sponge holding forceps
40 40 40 40 0
27.9 Artery forceps 40 40 40 40 027.10 Straight clamps
(cord)20 20 30 20 0
27.11 Vacuum Extractor pump
1 1 1 1 0
27.12 Towel clip 40 40 40 0 4028 Caesarian Section
28.1 Scalpel 4 4 6 0 428.2 Artery Forceps
Straight 6 inches16 16 24 16 0
28.3 Artery Forceps Curved 6 inches
16 16 24 16 0
28.4 Artery forceps 8 inches
16 16 24 16 0
28.5 Myoma Scissors straight 7 inches
4 4 6 4 0
28.6 Dissecting scissors (curved) 7 inches
4 4 6 4 0
28.7 Green Armtage forceps 8 inches
16 16 24 16 0
28.8 Obstetric outlet forceps (pair)
4 4 6 4 0
28.9 Doyene’s Retractor 4 4 6 4 028.10 Small Retractors 8 8 12 8 028.11 Towel Clippers 16 16 24 16 028.12 Suction Nozzle 4 4 6 0 4
29 MNCH Related Radiology Equipments
29.1 Ultrasound Machine 1 1 2 1 029.2 X-Ray Unit 500 kw 1 1 1 1 129.3 Color Doppler 0 0 0 0 029.4 Lead Screen for X-
Ray Unit1 1 1 0 1
Page 47
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Equipment Standard as per MSDS(Qty.)
Available Gap
C B A29.5 0.5 MN Lead Apron.
Lead Gloves, Goggles and Thyroid and Gonadal Sheets
1 1 1 0 1
29.6 Safe Light 1 1 1 1 029.7 X-RT Film
Processing Tank1 1 1 1 0
29.8 Chest Stand 1 1 1 1 029.9 X-Ray film
Illuminator2 2 2 2 0
29.10 X-Ray Film Hangers All sizes
4 4 4 4 0
30 MNCH Related Paediatrics Equipments
30.1 Paediatric Ventilator
1 1 2 0 1
30.2 Incubator 1 1 1 1 030.3 Photo Therapy Unit 1 1 1 1 030.4 Over-head Radiant
Warmer1 1 1 1 0
30.5 Infant Length Measuring Scale
2 2 2 2 0
30.6 Infant Weighing Machine
2 2 2 2 0
30.7 Nebulizer 1 1 1 1 030.8 Billirubino-meter 1 1 1 1 030.9 Exchange Blood
Transfusion Set1 1 1 1 0
30.10 Nasal Probe Paed size
1 2 2 0 2
31 Anaesthesia/ICU31.1 Anaesthesia
Machine1 1 1 1 0
31.2 Ventilators 1 1 1 1 031.3 Nebulizer 1 1 1 1 031.4 Pulse Oximetry 1 1 1 1 031.5 Defibrillator 1 1 1 1 031.6 Airway Oral and
Nasal1 2 2 1 1
Page 48
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Equipment Standard as per MSDS(Qty.)
Available Gap
C B A31.7 Tracheostomy tube
(adult and paeds)1 2 2 1 1
31.8 Face mask of all sizes
1 2 2 1 1
31.9 Double Cuff Tourniquet (for regional block)
1 1 1 1 0
31.10 AMBO bag adult 1 2 2 1 131.11 AMBO Bag paeds 2 2 2 2 031.12 Red Rubber Nasal
tubes all sizes without cuff
4 4 4 4 0
32 Blood Bank32.1 Blood storage
cabinet (100 bag capacity)
1 1 1 1 0
32.2 Packed cell machine 1 1 1 0 132.3 Cell Separator 1 1 1 1 032.4 Freezer for Fresh
Frozen Plasma1 1 1 1 0
32.5 Blood bag shaker 1 1 1 1 032.6 RH view box 1 2 2 1 132.7 Water bath 2 2 2 2 032.8 Micro-pipette 4 4 6 4 032.9 Blood grouping tiles 3 3 3 0 3
32.10 Plasma Extractor 1 1 1 1 032.11 Platelets agitator 1 1 1 1 032.12 Blood thawing bath 1 1 1 0 132.13 Microscopes 1 1 1 0 1
33 Gynae & Labour Room Related Laboratory Equipment
33.1 Hematology Analyzer
1 1 1 0 1
33.2 Electrolyte Analyzer
1 1 1 0 1
33.3 Analyzer Bio-chemistry Semi-automatic
1 1 1 0 1
33.4 Glucometer 2 2 2 0 2
Page 49
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Equipment Standard as per MSDS(Qty.)
Available Gap
C B A33.5 Haemoglobino-
meter1 1 1 0 1
33.6 Centrifuge 1 1 1 0 1
Page 50
Three Years Rolling Plan 2010-2013 District Khanewal
SECTION 3: INTERVENTIONS AND TARGETS
After enlisting the vital causes of prioritized health problems, team proposed appropriate interventions to tackle the problems. Once interventions and activities had been identified, next task the planning team performed was to set the number and quality of specific activities (targets) that have to be carried out. It is pertinent to mention over here that the plan envisages additional activities along with routine activities under regular budget.
A. Health Problems
Problem Causes Intervention Activity Unit Plan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
1. Diarrhoeal diseases
Poor Hygiene & sanitation
Coordination with TMA for improvement of water supply and sanitation
Quarterly co-ordination meetings with TMA and other agencies
Meetings 12 4 4 4 -
Lack of safe drinking water
Awareness raising campaign
Messages on local cable network
Monthly Telecast
36 12 12 12 -
Unhygienic practices
Proper treatment of Diarrhoea including ORT
Printing and distribution of IPC material
Brochure 150,000 50,000 50,000 50,000 -
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Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
Lack of awareness among mothers about feeding and weaning practices
Health awareness in the community
Training of medics and paramedics in IMCI
Batch 20 10 5 5 -
- Capacity building of health staff in Integrated Management of Childhood Illnesses (IMCI)
Procurement and distribution of ORS and Zinc Sulphate
ORS packets 700,000 220,000 230,000 250,000 -
- - Procurement and distribution of Zinc Sulphate
Syrup 450,000 150,000 150,000 150,000 -
2. Acute Respiratory Infections
Air contamination
Capacity building of health staff in Integrated Management of Childhood Illnesses (IMCI)
Messages on local cable networks
Monthly Telecast
36 12 12 12 Integrated activity
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Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
Over-crowding/Poor housing facilities
Provision of medicines for ARI
Messages through FM radio channels
Brochure & Poster
45,000 15,000 15,000 15,000 -
Lack of proper sanitation
Timely referral of complicated cases
Printing and distribution of IPC material
Batch 20 10 5 5 Integrated activity
Seasonal variation
- Training of medics and para-medics in IMCI
Oral Medicine Package
300,000 100,000 100,000 100,000 -
Lack of awareness related to winter season and hygienic practices
- Procurement of drugs
Injectable 45,000 15,000 15,000 15,000 -
- - - Drug 27,000 9,000 9,000 9,000
3. Delivery by unskilled birth attendants
Low access to appropriate health services
Behaviour Change Communication (BCC)
Messages on local cable network
Monthly Package
36 12 12 12 Integrated Activity
Page 53
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
Lack of awareness about danger signs of pregnancy
Improving transportation to appropriate level of care
Printing and distribution of IPC material
Brochure 30,000 10,000 10,000 10,000 -
Three delays (seeking health care, transportation, and lack of referral back-up services)
Strengthening healthcare facilities
Activation and use of Health Committees and women groups under LHWs
- 12 4 4 4 No cast Activity
Lack of skilled birth attendants
Refresher courses for TBAs
Training of TBAs with specific focus on safe delivery and danger signs
Batch of 25 TBAs for 2 days Training
16 8 4 4 -
- Provision of delivery kits
Procurement Kit 270,000 90,000 90,000 90,000 -
- Strengthening of referral system and provision of transport
Capacity building of WMOs and LHVs
training 20 10 5 5 -
Page 54
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
- Deployment of community midwives
Placement of mid-wives in their catchment area
- - - - - Plan
- - Repair of non functional ambulances for timely transportation of pregnant mothers
Ambulance 5 3 1 1 demand submission
- - Replacement of non functional ambulances for timely transportation of pregnant mothers
Ambulance 6 3 2 1 -
- - POL for ambulances
Litre 33,600 7,200 12,000 14,400 -
4. Tuberculosis (TB)
Low socio-economic status
Health education/promotion
Messages on local cable networks
Monthly telecast
36 12 12 12 Integrated activity
Page 55
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
Over-crowding/Poor housing facilities
Strengthening TB DOTS program through involvement of private sector
Messages through FM radio channels
Alternate Month
- - - - Integrated activity
Malnutrition - Printing and distribution of IPC and TB awareness material
Brochure 30,000 10,000 10,000 10,000 -
Seasonal variation
- Procurement of drugs to address deficiency according to regimen
Treatment 14,922,819 4,974,273 4,974,273 4,974,273 -
5. Anaemia in pregnancy
· Poverty & malnutrition
Awareness raising for behaviour change
Messages on local cable network
Monthly Messages telecast packages
36 12 12 12 Integrated activity
· Lack of awareness about balanced diet
Improving ante-natal coverage
Printing and distribution of IPC material
Brochure 30,000 10,000 10,000 10,000 -
Page 56
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
· Multiple pregnancies
Improving ante-natal coverage
Printing and distribution of IPC material
Brochure 30,000 10,000 10,000 10,000 -
· Inadequate and poor MCH services
Deworming campaign
· Short refresher trainings of LHWs about balanced diet and provision of micro-nutrients
Batch of 50 LHWs For 1 Days
36 16 10 10 -
· Gender discrimination
· Provision/Distribution of micro-nutrient supplements
· Procurement of de-worming tablets
No. of coursrs
200,000 100,000 50,000 50,000 -
· Worm infestation
· Diagnosis and treatment of infections
· Purchase of medicine
Pack of 100 Tablets
150,000 50,000 50,000 50,000 -
- - · Purchase of medicine
Pack of 100 Tablets
150,000 50,000 50,000 50,000 -
6. Hepatitis Poor Health Education/Prom
· Quarterly co-ordination
Others 12 4 4 4 Integrated activity
Page 57
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
sanitation otion meetings with TMA and other agencies
Unsafe drinking water
Campaign against quackery
· Messages on local cable network
Advertising & Publicity
36 12 12 12 Integrated activity
Sharing of used syringes
Strengthening blood transfusion services for safe transfusions
· Printing and distribution of IPC material
Printing and publication
3,000 1,000 1,000 1,000 -
Transfusion of unsafe/unscreened blood and blood products
Campaign against drug addiction
· Procurement and supply of screening kits
Medical and laboratory
450,000 150,000 150,000 150,000 -
Unsafe sexual practices
Regulatory mechanism to ensure use of safe instruments by dentists, barbers etc.
· Procurement of syringe cutters
Medical and laboratory
500 300 100 100 -
Ear piercing and tattooing
- · Procurement of drugs for treatment of Hepatitis patients
Purchase of drug and medicines
3,000 1,000 1,000 1,000 -
Page 58
Three Years Rolling Plan 2010-2013 District Khanewal
B. Management Problems
Human Resource Plan to bridge gap between MSDS and existing sanctioned positions
Sr. No. Name of PostBasic Scale
Basic Pay
AllowancesRequirement
as per Gap
Physical Targets
Year I Year II Year III
1 Gynaecologist 18 12,910 18,099 2 1 1 -
2 Paediatricians 18 12,910 18,099 5 2 2 1
3 Anesthetists 18 12,910 18,099 9 4 3 2
4 MO / WMO 17 9,850 15,345 114 54 30 30
Page 59
Three Years Rolling Plan 2010-2013 District Khanewal
5 Nurses 16 6,060 8,934 94 44 25 25
6 Lady Health Visitors 9 3,820 4,750 31 15 8 8
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
1. Shortage of MNCH related
· Non- availability of trained staff
· Filling of the vacant posts
· Filling of the vacant posts of medics and the
- - - - - Recruitment
Page 60
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
skilled staff paramedics through existing recruitment committees
· Non-sanctioning of staff according to MSDS
· Sanctioning of trained staffs according to MSDS
Temporary filling of vacant positions on contract
- - - - - Recruitment
· Lack of permanent postings
· Incentivized pay package at all levels
· Demand generation and request to the Department of Health by the districts for recruitment through PSC against vacant posts
- - - - - Plan
· Lack of incentivized and differential pay package
· Well defined career structure including opportunities for higher education
· Orientation trainings of the recruited staffs
Batch 10 4 3 3 -
Page 61
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
· Frequent transfer postings
· High level political commitment for providing protection to staff working in health facilities
· Consensus building between the districts for uniform incentivized pay package for all categories and levels staff
- - - - - Meeting
· Job insecurity
- · Request to the Provincial Government for approval and implementation of agreed pay packages
- - - - - Plan
· Lack of basic amenities at workplace
- · Review and revise the career structure of medics and paramedics
- - - - - Technical assistance
· Lack of conducive environment including insecurity and transport of children for
- · Filling of Human Resource gaps as per MSDS
Posts 224 105 61 58 Detail HR plan is attached
Page 62
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
education
- Posts 31 15 8 8 Detail HR plan is attached
· Political and media interference
- HR 255 120 69 66 Detail HR plan is attached
- · Capacity and need assessment of the medics and the paramedics
- - - - - NO COST ACTIVITY
- · Prepare training programs for providing higher professional education based on TNA
- - - - - TNA
2. Inadequate medicine and supply
Less budget allocation for medicines
· Need-based demand for provision of sufficient budget for medicines and
· Inclusion of enhanced amount for medicines and supplies in the proposed annual budget according
- - - - - Need assessment
Page 63
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
supplies to the needs
Frequent increase in price
- Demand generation for medicine.
- - - - - Demand generation
- Procurement of essential drugs on the basis of allocated budget
- - - - - Already addressed in health problems
3. Political interference
· Undue pressure from local political figures especially in medico-legal cases
· High level political commitment to provide protection to the health staff against undue political interference
· Formulation of the Health committees
- - - - - plan
Advocacy at higher political level
· Meetings with political leaders
- - - - - Plan
Page 64
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
- Advocacy seminars
Seminar 6 2 2 2 -
4. Inadequate budget for POL
· Generator provision for backup of electricity supply
Rational increase in POL budget
Assessment of additional requirement
- - - - - NO COST ACTIVITY
· Less budget allocation
- Costing and submission of additional demand
- - - - - -
· Frequent increase in prices
- · Provision of POL budget for supervisory vehicles for DHQ
litre 14,400 4,800 4,800 4,800 -
- · Provision of POL budget for EPI
litre 54,000 18,000 18,000 18,000 -
- · Provision of POL budget for generator
litre 540,000 180,000 180,000 180,000 -
Page 65
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
5. Deficient infra structure
· Debilitated condition of existing infrastructure
· Make up the deficiencies against standards specified in MSDS
· Identify the gaps in infrastructure of THQ and DHQ hospitals individually
- - - - - -
· Lack of repair and maintenance
· Devise appropriate mechanisms for repair and maintenance
· Costing of the gaps
- - - - - -
· Inadequate infrastructure for Emergency, Operation Theatre, OPD and Inpatients, residences for staff at THQ and DHQ hospitals
· Provision of infrastructure at THQ and DHQ according to the MSDS
· Phasing - - - - - Demand submission
· Construction of residence of WMO at DHQ and THQ hospital
Construction of residences at DHQ hospital Khanewal
1100 per square yard
3,500 1,750 1,750 - -
Page 66
Three Years Rolling Plan 2010-2013 District Khanewal
Problem Causes Intervention Activity UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13 Remarks
- Construction of residences at THQ hospitals (3*2)
1100 per square yard
10,500 5,250 5,250 - -
6. Lack of MNCH related equipments
· Deficient equipment to cater basic and comprehensive EmONC at primary and secondary level of care
· Provision of the equipment in accordance with the notified equipment list
Procurement of equipments for THQ and DHQ hospitals based on the gaps between MSDS and existing available
- - - - - Detail attached
· Old and unserviceable equipment
· Provision of adequate budget for maintenance and repair
Allocation of enhanced amount for M&R of equipments
- - - - - Submission of demand
· Shortage of regular budget for M&R
· Capacity building of staff regarding maintenance of log books of each equipment
Orientation of staffs in maintenance of logos for equipments
- - - - - Plan
Page 67
Three Years Rolling Plan 2010-2013 District Khanewal
SECTION 4: COSTING AND FINANCING PLAN
A. Activity based costing
The planning team has used the best available data sources, for calculation of estimates for the intervention/activities. It is pertinent to mention that the costing of the plan is based on additional needs and activities. The detailed activity based costing of the Health and Service Delivery problems has been performed on automated Excel sheets, which are annexed with the plan as Annex-II and Annex-III. A moderate estimate of equipment cost has been taken, as there is wide variation between the minimum and maximum cost. The summary of activity and problem wise costing is given below.
i. Health Problems
ProblemActivity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
1 Diarrhoeal diseases
Quarterly co-ordination meetings with TMA and other agencies
Meetings 3,000 12 12,000 13,200 14,520 39,720 -
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Three Years Rolling Plan 2010-2013 District Khanewal
ProblemActivity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
Messages on local cable network
Monthly Telecast
36,000 36 432,000 475,200 522,720 1,429,920 -
Printing and distribution of IPC material
Brochure 5 150,000 250,000 275,000 302,500 827,500 -
Training of medics and paramedics in IMCI
Batch 83,000 20 830,000 456,500 502,150 1,788,650 -
Procurement and distribution of ORS and Zinc Sulphate
ORS packets
5 700,000 1,100,000 1,265,000 1,512,500 3,877,500 -
Procurement and distribution of Zinc Sulphate
Syrup 60 450,000 600,000 9,900,000 10,890,000 21,390,000 -
2 Acute Messages on local cable
Monthly Telecast
35,000 36 - - - - Integrated activity
Page 69
Three Years Rolling Plan 2010-2013 District Khanewal
ProblemActivity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
Respiratory
Infections
ARI
networks
Messages through FM radio channels
Brochure & Poster
30 45,000 450,000 495,000 544,500 1,489,500 -
Printing and distribution of IPC material
Batch - 20 - - - - Integrated activity
Training of medics and para-medics in IMCI
Oral Medicine Package
70 300,000 7,000,000 7,700,000 8,470,000 23,170,000 -
Procurement of drugs
Injectable 800 45,000 12,000,000
13,200,000
14,520,000 39,720,000 -
Page 70
Three Years Rolling Plan 2010-2013 District Khanewal
ProblemActivity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
- Drug 30 27,000 270,000 297,000 326,700 893,700 verify the cost
3 Deliveries by unskilled birth attendants
Messages on local cable network
Monthly Package
- 36 - - - - Integrated Activity
Printing and distribution of IPC material
Brochure 30 30,000 300,000 330,000 363,000 993,000 -
Activation and use of Health Committees and women groups under LHWs
- - 12 - - - - No cast Activity
Training of TBAs with specific focus on safe delivery and danger signs
Batch of 25 TBAs for 2 days Training
50,000 16 400,000 220,000 242,000 862,000 -
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Three Years Rolling Plan 2010-2013 District Khanewal
ProblemActivity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
Procurement Kit 50 270,000 4,500,000 4,950,000 5,445,000 14,895,000 -
Capacity building of WMOs and LHVs
Training 61,000 20 610,000 335,500 369,050 1,314,550 -
Placement of mid-wives in their catchment area
- - - - - - - Plan
Repair of non functional ambulances for timely transportation of pregnant mothers
Ambulance
20,000 5 60,000 22,000 24,200 106,200 demand submission
Replacement of non functional ambulances for timely transportation of pregnant mothers
Ambulance
3,800,000 6 11,400,000
8,360,000 4,598,000 24,358,000 -
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Three Years Rolling Plan 2010-2013 District Khanewal
ProblemActivity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
POL for ambulances
Litre 76 33,600 547,200 1,003,200 1,324,224 2,874,624 -
4 TB Messages on local cable networks
Monthly telecast
- 36 - - - - Integrated activity
Messages through FM radio channels
Alternate Month
- - - - - - Integrated activity
Printing and distribution of IPC and TB awareness material
Brochure 5 30,000 50,000 55,000 60,500 165,500 -
Procurement of drugs to address deficiency according to regimen
Treatment 25 14,922,819 124,356,825
136,792,508
150,471,758 411,621,091 -
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Three Years Rolling Plan 2010-2013 District Khanewal
ProblemActivity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
5 Anaemia in pregnancy
· Messages on local cable network
Monthly Messages telecast packages
- 36 - - - - Integrayed activity
· Printing and distribution of IPC material
Brochure 5 30,000 50,000 55,000 60,500 165,500 -
· Printing and distribution of IPC material
Brochure 30 30,000 300,000 330,000 363,000 993,000 -
· Short refresher trainings of LHWs about balanced diet and provision of micro-nutrients
Batch of 50 LHWs For 1 Days
52,000 36 832,000 572,000 629,200 2,033,200 -
· Procurement of de-worming tablets
No. of courses
20 200,000 2,000,000 1,100,000 1,210,000 4,310,000 -
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Three Years Rolling Plan 2010-2013 District Khanewal
ProblemActivity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
· Purchase of medicine
Pack of 100 Tablets
30 150,000 1,500,000 1,650,000 1,815,000 4,965,000 -
· Purchase of medicine
Pack of 100 Tablets
50 150,000 2,500,000 2,750,000 3,025,000 8,275,000 -
6 Hepatitis · Quarterly co-ordination meetings with TMA and other agencies
Others - 12 - - - - Integrated activity
· Messages on local cable network
Advertising & Publicity
Monthly Package
36 - - - - Integrated activity
· Printing and distribution of IPC material
Printing and publication
Brochure 3,000 5,000 5,500 6,050 16,550 -
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Three Years Rolling Plan 2010-2013 District Khanewal
ProblemActivity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
· Procurement and supply of screening kits
Medical and laboratory
Kits 450,000 7,500,000 8,250,000 9,075,000 24,825,000 -
· Procurement of syringe cutters
Medical and laboratory
Syringe cutter 500 150,000 55,000 60,500 265,500 -
· Procurement of drugs for treatment of Hepatitis patients
Purchase of drug and medicines
Injection 3,000 12,000,000
13,200,000
14,520,000 39,720,000 -
- - - - 192,005,025
214,112,608
231,267,572 637,385,205 -
ii. Management Problems
Human Resource Plan to bridge gap between MSDS and existing sanctioned posts
Page 76
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Name of Post
Bas
ic S
cale
Bas
ic P
ay
All
owan
ces
Req
uir
emen
t as
per
Gap
Financial Targets
Year I Year II Year III
Pay of Officers
Pay of other staff
AllowancesPay of
OfficersPay of
other staffAllowances
Pay of Officers
Pay of other staff
Allowances
1 Gynaecologist 18 12,910 18,099 2 154,920 - 217,188 340,824 477,814 374,906 525,595
2 Paediatricians 18 12,910 18,099 5 309,840 - 434,376 681,648 955,627 937,266 1,313,987
3 Anesthetists 18 12,910 18,099 9 619,680 - 868,752 1,192,884 1,672,348 1,687,079 2,365,177
4 MO / WMO 17 9,850 15,345 114 6,382,800 - 9,943,560 10,921,680 17,014,536 16,304,508 25,400,272
5 Nurses 16 6,060 8,934 94 3,199,680 - 4,717,152 5,519,448 8,137,087 8,271,173 12,193,838
6Lady Health
Visitors9 3,820 4,750 31 687,600 855,000 1,159,752 1,442,100 1,719,458 2,138,070
Total10,666,92
0687,600 17,036,028 18,656,484 1,159,752 29,699,512 27,574,932 1,719,458 43,936,939
Page 77
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Problem Activity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
1 Shortage of skilled staffs MNCH related
· Non-availability of trained staff
· Filling of the vacant posts
· Filling of the vacant posts of medics and the paramedics through existing recruitment committees
- - - - - Recruitment
· Non-sanctioning of staff according to MSDS
· Sanctioning of trained staffs according to MSDS
Temporary filling of vacant positions on contract
- - - - - Recruitment
· Lack of permanent postings
· Incentivized pay package at all levels
· Demand generation and request to the Department of Health by the districts for recruitment through PSC
- - - - - Plan
Page 78
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Problem Activity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
against vacant posts
· Lack of incentivized and differential pay package
· Well defined career structure including opportunities for higher education
· Orientation trainings of the recruited staffs
Batch 10 4 3 3 -
· Frequent transfer postings
· High level political commitment for providing protection to staff working in health facilities
· Consensus building between the districts for uniform incentivized pay package for all categories and levels staff
- - - - - Meeting
· Job insecurity - · Request to the Provincial Government
- - - - - Plan
Page 79
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Problem Activity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
for approval and implementation of agreed pay packages
· Lack of basic amenities at workplace
- · Review and revise the career structure of medics and paramedics
- - - - - Technical assistance
· Lack of conducive environment including insecurity and transport of children for education
- · Filling of Human Resource gaps as per MSDS
Posts 224 105 61 58 Detail HR plan is attached
- - - Posts 31 15 8 8 Detail HR plan is attached
Page 80
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Problem Activity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
· Political and media interference
- - HR 255 120 69 66 Detail HR plan is attached
- - · Capacity and need assessment of the medics and the paramedics
- - - - - NO COST ACTIVITY
- - · Prepare training programs for providing higher professional education based on TNA
- - - - - TNA
2 Inadequate medicine and supply
Less budget allocation for medicines
· Need-based demand for provision of sufficient budget for medicines and
· Inclusion of enhanced amount for medicines and supplies in the proposed annual budget
- - - - - Need assessment
Page 81
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Problem Activity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
supplies according to the needs
Frequent increase in price
- Demand generation for medicine.
- - - - - Demand generation
- - precurment of essentional drugs on the basis of allocated budget
- - - - - Already addressed in health problems
3 Political interference
· Undue pressure from local political figures especially in medico-legal cases
· High level political commitment to provide protection to the health staff against undue political interference
· Formulation of the Health committees
- - - - - plan
Page 82
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Problem Activity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
- Advocacy at higher political level
· Meetings with political leaders
- - - - - Plan
- - Advocacy seminars
Seminar 6 2 2 2 -
4 Inadequate budget for POL
· Generator provision for backup of electricity supply
Rational increase in POL budget
Assessment of additional requirement
- - - - - NO COST ACTIVITY
· Less budget allocation
- Costing and submission of additional demand
- - - - - -
· Frequent increase in prices
- · Provision of POL budget for supervisory vehicles for DHQ
litre 14,400 4,800 4,800 4,800 -
Page 83
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Problem Activity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
- - · Provision of POL budget for EPI
litre 54,000 18,000 18,000 18,000 -
- - · Provision of POL budget for generator
litre 540,000 180,000 180,000 180,000 -
5 Deficient infra structure
· Debilitated condition of existing infra-structure
· Make up the deficiencies against standards specified in MSDS
· Identify the gaps in infrastructure of THQ and DHQ hospitals individually
- - - - - -
· Lack of repair and maintenance
· Devise appropriate mechanisms for repair and maintenance
· Costing of the gaps
- - - - - -
· Inadequate infrastructure for Emergency,
· Provision of infrastructu
· Phasing - - - - - Demand submission
Page 84
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Problem Activity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
Operation Theatre, OPD and Inpatients, residences for staff at THQ and DHQ hospitals
re at THQ and DHQ according to the MSDS
- Construction of residence of WMO at DHQ and THQ hospital
Construction of residences at DHQ hospital Khanewal
1100 per square yard
3,500 1,750 1,750 - -
- - Construction of residences at THQ hospitals (3*2)
1100 per square yard
10,500 5,250 5,250 - -
6 Lack of MNCH related equipments
· Deficient equipment to cater basic and comprehensive EmONC at primary and secondary level of care
Provision of the equipment in accordance with the notified equipment list
Procurement of equipments for THQ and DHQ hospitals based on the gaps between MSDS and existing
- - - - - Detail attached
Page 85
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No.
Problem Activity Define Financial Targets Total Cost Remarks
Unit Rate Quantity Year I Year II Year III
available
· Old and un-serviceable equipment
Provision of adequate budget for maintenance and repair
Allocation of enhanced amount for M&R of equipments
- - - - - Submission of demand
· Shortage of regular budget for M&R
Capacity building of staff regarding maintenance of log books of each equipment
Orientation of staffs in maintenance of logos for equipments
- - - - - Plan
Page 86
Three Years Rolling Plan 2010-2013 District Khanewal
B. Financial Outlay including 3YRP Activities
The costing of the plan includes routine recurring budget with 15% price escalation for subsequent years and additional cost involved on the basis of health and management problems; which is essentially required to bring visible improvement in the health system. Other financial resources expected from provincial level through ADP and PMDGP are also part of this plan. Overall financial outlay of the plan is as under:
i. Health Problems
Object Classification
2010-2011 2011-2012 2012-2013
Regular Additional Total Regular Additional Total Regular Additional Total
A03907 258,750 432,000 690,750 297,563 475,200 772,763 342,197 522,720 864,917
A03902 341,550 1,405,000 1,746,550 392,783 1,545,500 1,938,283 451,700 1,700,050 2,151,750
A03820 - 12,000 12,000 - 13,200 13,200 - 14,520 14,520
A03927 402,500 163,326,825 163,729,325 462,875 187,854,508 188,317,383 532,306 206,760,958 207,293,265
A13101 1,107,450 - 1,107,450 1,273,568 - 1,273,568 1,464,603 - 1,464,603
A09501 - - - - - - - - -
A09601 1,099,400 11,400,000 12,499,400 1,264,310 8,360,000 9,624,310 1,453,957 4,598,000 6,051,957
A03903 - - - - - - - - -
A03801 - 2,672,000 2,672,000 - 1,584,000 1,584,000 - 1,742,400 1,742,400
Page 87
Three Years Rolling Plan 2010-2013 District Khanewal
Object Classification
2010-2011 2011-2012 2012-2013
Regular Additional Total Regular Additional Total Regular Additional Total
A09601 1,099,400 - 1,099,400 1,264,310 - 1,264,310 1,453,957 - 1,453,957
A09404 - 12,150,000 12,150,000 - 13,255,000 13,255,000 - 14,580,500 14,580,500
A03807 12,259,000 547,200 12,806,200 14,097,850 1,003,200 15,101,050 16,212,528 1,324,224 17,536,752
A03906 44,850 - 44,850 51,578 - 51,578 59,314 - 59,314
A09802 - - - - - - - - -
A01277 - - - - - - - - -
A13001 1,610,000 60,000 1,670,000 1,851,500 22,000 1,873,500 2,129,225 24,200 2,153,425
Total 18,222,900 192,005,025 210,227,925 20,956,335 214,112,608 235,068,943 24,099,785 231,267,572 255,367,358
Page 88
Three Years Rolling Plan 2010-2013 District Khanewal
ii. Management Problems
Object Classification
2010-2011 2011-2012 2012-2013
Regular Additional Total Regular Additional Total Regular Additional Total
A03801 - 1,322,000 1,322,000 - 1,090,650 1,090,650 - 1,199,715 1,199,715
A09601 1,099,400 14,047,555 15,146,955 1,264,310 39,222,230 40,486,540 1,453,957 24,603,770 26,057,727
A01101 - 10,666,920 10,666,920 - 18,656,484 18,656,484 - 27,574,932 27,574,932
A01270 - 17,036,028 17,036,028 - 29,699,512 29,699,512 - 43,936,939 43,936,939
A03820 - 40,000 40,000 - 44,000 44,000 - 48,400 48,400
A03807 12,259,000 15,210,000 27,469,000 14,097,850 16,731,000 30,828,850 16,212,528 18,404,100 34,616,628
A03902 341,550 - 341,550 392,783 - 392,783 451,700 - 451,700
A01102 - 687,600 687,600 - 1,159,752 1,159,752 - 1,719,458 1,719,458
A12402 - 7,700,000 7,700,000 - 8,470,000 8,470,000 - - -
Total 13,699,950 66,710,103 80,410,053 15,754,943 115,073,628 130,828,570 18,118,184 117,487,315 135,605,498
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Three Years Rolling Plan 2010-2013 District Khanewal
C. Summaries
1. Problem-wise Costing
a) Health Problems
Sr. No. ProblemFY I FY II FY III Total Cost Rs.
Amount (Rs.) Amount (Rs.) Amount (Rs.) Amount (Rs.)
1 Diarrhoeal diseases 3,224,000 12,384,900 13,744,390 29,353,290
2 Acute Respiratory Infections 19,720,000 21,692,000 23,861,200 65,273,200
3 Delivery by unskilled birth attendants
17,817,200 15,220,700 12,365,474 45,403,374
4 Tuberculosis (TB) 124,406,825 136,847,508 150,532,258 411,786,591
5 Anaemia in pregnancy 7,182,000 6,457,000 7,102,700 20,741,700
6 Hepatitis 19,655,000 21,510,500 23,661,550 64,827,050
Total 192,005,025 214,112,608 231,267,572 637,385,205
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Three Years Rolling Plan 2010-2013 District Khanewal
b) Management Problems
Sr. No. ProblemFY I FY II FY III Total Cost Rs.
Amount (Rs.) Amount (Rs.) Amount (Rs.) Amount (Rs.)
1 Shortage of skilled staffs MNCH related
29,712,548 50,606,398 74,431,045 154,749,990
2 Inadequate medicine and supply - - - -
3 Political interference 40,000 44,000 48,400 132,400
4 Inadequate budget for POL 15,210,000 16,731,000 18,404,100 50,345,100
5 Deficient infra structure 7,700,000 8,470,000 - 16,170,000
6 Lack of MNCH related equipments 14,047,555 39,222,230 24,603,770 77,873,555
Total 66,710,103 115,073,628 117,487,315 299,271,045
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Three Years Rolling Plan 2010-2013 District Khanewal
2. Activity-wise Costing
a) Health Problems
Sr. Problem Activity FY-I FY-II FY-III Total
1 Diarrhoeal diseases Quarterly co-ordination meetings with TMA and other agencies
12,000 13,200 14,520 39,720
Messages on local cable network
432,000 475,200 522,720 1,429,920
Printing and distribution of IPC material
250,000 275,000 302,500 827,500
Training of medics and paramedics in IMCI
830,000 456,500 502,150 1,788,650
Procurement and distribution of ORS and Zinc Sulphate
1,100,000 1,265,000 1,512,500 3,877,500
Procurement and distribution of Zinc Sulphate
600,000 9,900,000 10,890,000 21,390,000
2 Acute Respiratory Infections
Messages on local cable networks
- - - -
Messages through FM radio 450,000 495,000 544,500 1,489,500
Page 92
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. Problem Activity FY-I FY-II FY-III Total
channels
Printing and distribution of IPC material
- - - -
Training of medics and para-medics in IMCI
7,000,000 7,700,000 8,470,000 23,170,000
Procurement of drugs 12,000,000 13,200,000 14,520,000 39,720,000
- 270,000 297,000 326,700 893,700
3 Delivery by unskilled birth attendants
Messages on local cable network
- - - -
Printing and distribution of IPC material
300,000 330,000 363,000 993,000
Activation and use of Health Committees and women groups under LHWs
- - - -
Training of TBAs with specific focus on safe delivery and danger signs
400,000 220,000 242,000 862,000
Procurement 4,500,000 4,950,000 5,445,000 14,895,000
Capacity building of WMOs 610,000 335,500 369,050 1,314,550
Page 93
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. Problem Activity FY-I FY-II FY-III Total
and LHVs
Placement of mid-wives in their catchment area
- - - -
Repair of non functional ambulances for timely transportation of pregnant mothers
60,000 22,000 24,200 106,200
Replacement of non functional ambulances for timely transportation of pregnant mothers
11,400,000 8,360,000 4,598,000 24,358,000
POL for ambulances 547,200 1,003,200 1,324,224 2,874,624
4 Tuberculosis (TB) Messages on local cable networks
- - - -
Messages through FM radio channels
- - - -
Printing and distribution of IPC and TB awareness material
50,000 55,000 60,500 165,500
Procurement of drugs to address deficiency according to regimen
124,356,825 136,792,508 150,471,758 411,621,091
Page 94
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. Problem Activity FY-I FY-II FY-III Total
5 Anaemia in pregnancy · Messages on local cable network
- - - -
· Printing and distribution of IPC material
50,000 55,000 60,500 165,500
· Printing and distribution of IPC material
300,000 330,000 363,000 993,000
· Short refresher trainings of LHWs about balanced diet and provision of micro-nutrients
832,000 572,000 629,200 2,033,200
· Procurement of de-worming tablets
2,000,000 1,100,000 1,210,000 4,310,000
· Purchase of medicine 1,500,000 1,650,000 1,815,000 4,965,000
· Purchase of medicine 2,500,000 2,750,000 3,025,000 8,275,000
6 Hepatitis · Quarterly co-ordination meetings with TMA and other agencies
- - - -
· Messages on local cable network
- - - -
· Printing and distribution of IPC material
5,000 5,500 6,050 16,550
Page 95
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. Problem Activity FY-I FY-II FY-III Total
· Procurement and supply of screening kits
7,500,000 8,250,000 9,075,000 24,825,000
· Procurement of syringe cutters 150,000 55,000 60,500 265,500
· Procurement of drugs for treatment of Hepatitis patients
12,000,000 13,200,000 14,520,000 39,720,000
Total 192,005,025 214,112,608 231,267,572 637,385,205
b) Management Problems
Page 96
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Problem Activity Costing (Rs.)
FY-I FY-II FY-III Total
1 Shortage of MNCH related skilled staff
· Filling of the vacant posts of medics and the paramedics through existing recruitment committees
- - - -
Temporary filling of vacant positions on contract
- - - -
· Demand generation and request to the Department of Health by the districts for recruitment through PSC against vacant posts
- - - -
· Orientation trainings of the recruited staffs
1,322,000 1,090,650 1,199,715 3,612,365
· Consensus building between the districts for uniform incentivized pay package for all categories and levels staff
- - - -
· Request to the Provincial Government for approval and implementation of agreed pay
- - - -
Page 97
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Problem Activity Costing (Rs.)
FY-I FY-II FY-III Total
packages
· Review and revise the career structure of medics and paramedics
- - - -
· Filling of Human Resource gaps as per MSDS
10,666,920 18,656,484 27,574,932 56,898,336
- 687,600 1,159,752 1,719,458 3,566,810
- 17,036,028 29,699,512 43,936,939 90,672,479
· Capacity and need assessment of the medics and the paramedics
- - - -
· Prepare training programs for providing higher professional education based on TNA
- - - -
2 Inadequate medicine and supply
· Inclusion of enhanced amount for medicines and supplies in the proposed annual budget according to the needs
- - - -
Demand generation for - - - -
Page 98
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Problem Activity Costing (Rs.)
FY-I FY-II FY-III Total
medicine.
Procurement of essential drugs on the basis of allocated budget
- - - -
3 Political interference · Formulation of the Health committees
- - - -
· Meetings with political leaders
- - - -
Advocacy seminars 40,000 44,000 48,400 132,400
4 Inadequate budget for POL Assessment of additional requirement
- - - -
Costing and submission of additional demand
- - - -
· Provision of POL budget for supervisory vehicles for DHQ
360,000 396,000 435,600 1,191,600
· Provision of POL budget for EPI
1,350,000 1,485,000 1,633,500 4,468,500
· Provision of POL budget for generator
13,500,000 14,850,000 16,335,000 44,685,000
Page 99
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Problem Activity Costing (Rs.)
FY-I FY-II FY-III Total
5 Deficient infra structure · Identify the gaps in infrastructure of THQ and DHQ hospitals individually
- - - -
· Costing of the gaps - - - -
· Phasing - - - -
Construction of residences at DHQ hospital Khanewal
1,925,000 2,117,500 - 4,042,500
Construction of residences at THQ hospitals (3*2)
5,775,000 6,352,500 - 12,127,500
6 Lack of MNCH related equipment
Procurement of equipments for THQ and DHQ hospitals based on the gaps between MSDS and existing available
14,047,555 39,222,230 24,603,770 77,873,555
Allocation of enhanced amount for M&R of equipments
- - - -
Orientation of staff in maintenance of logs for equipments
- - - -
Total 66,710,103 115,073,62 117,487,31 299,271,04
Page 100
Three Years Rolling Plan 2010-2013 District Khanewal
Sr. No. Problem Activity Costing (Rs.)
FY-I FY-II FY-III Total
8 5 5
Page 101
Three Years Rolling Plan 2010-2013 District Khanewal
SECTION 5: MONITORING & EVALUATION
The monitoring and evaluation targets and indicators mentioned below will be used to
gauge the progress of implementation of the plan. Monitoring and evaluation of the
three years rolling plan would be carried out through the proposed indicators, targets
and means of verifications, by the district health authorities.
M&E of Plan
Indicators Target % Achievement MoV Responsibility Frequency of
monitoring
Remarks
% of planned supervisory visits conducted
50 visits /year by
each supervisor
Inspection Book
EDOH/DOH/ DDOH
Quarterly
% of RHCs with availability of specialists of essential specialties (Physician, Surgeon, Paediatrician and Gynaecologist)
100%During 1st
year
Pay Roll EDOH / DOH 6 monthly
% of health facilities with availability of essential MNCH related equipment (level specific)
100%During 1st
year
Stock Register
EDOH/ DOH/ MSs 6 monthly
Availability of relevant (MNCH) laboratory equipment at appropriate level of care
100%During 1st
year
Stock Register
EDOH/ DOH/MSs, Store keeper
Quarterly
% facilities with availability of essential medicines
100%During 1st
year
Stock Register
EDOH/ DOH/ MSs, Store keeper
Monthly
% of functional ambulances in the district
100%(DHQH/ THQH/ RHCs)
Log Book EDOH/DOH/ Transport officer
Quarterly
% utilization of sanctioned budget
100% of yearly budget
Quarterly Reports
EDOH/ DOH/ MSs/ Accounts officer
Quarterly
% of facilities with availability of basic EmONC services
100% in 3 years(50%
during 1st
year)
Supervisory visit report
EDOH/DoH/ DDOH
Quarterly
Page 102
Three Years Rolling Plan 2010-2013 District Khanewal
Indicators Target % Achievement MoV Responsibility Frequency of
monitoring
Remarks
% of DHQ/THQ hospitals with Comprehensive EmONC services
100% in 3 years(50%
during 1st
year)
Supervisory visit report
EDOH/DoH/ DDOH
Quarterly
% of facilities with availability of separate or partitioned room reserved exclusively for delivery
100% in 3 years (50%
during 1st
year)
Supervisory visit report
EDOH/DoH/ DDOH
Quarterly
% of targeted pregnant women newly registered by LHW
50000 pregnant
women in 3 years
(30000 during 1st
year)
DHIS Report EDOH/ Statistical Officer
Quarterly
% of targeted pregnant women received TT-2 vaccine
50000 pregnant
women in 3 years
(30000 during 1st
year)
DHIS Report EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
Delivery conducted by or under supervision of skilled persons reported
90%(60%
During 1st
year)
DHIS Report EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
%of target children between 18 - 23 months of age fully immunized
100%(200,000 children)
DHIS Report EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
% of referred cases attended
100% DHIS Report/ LHWs monthly report
EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
% of targeted eligible couples provided knowledge and information on Family Planning methods
70% LHW’s monthly/ quarterly report
EDOH/ Statistical Officer /Coordinator NP-FP&PHC
Quarterly
No. of meetings with participation from other sectors
12 meetings per year
Minutes of meetings
EDOH/ Focal person/s
Quarterly
Page 103
Three Years Rolling Plan 2010-2013 District Khanewal
Annex-I
Costing of Equipment gaps for DHQ and THQs
DHQ HOSPITAL KHANEWAL
Sr. No.
Equipment Standard as per MSDS
Available Gap Cost/Unit Total Cost
(Qty.)C B A
1 CTG (Cardiac Tocography)
1 1 2 1 0 285000 0
2 Foetal Doppler 3 5 5 4 0 101000 03 Diagnostic
Laparoscope1 1 2 0 1 1200000 1200000
4 Bulb Sucker 10 20 20 0 10 45 4505 Baby Warmer 3 3 6 1 2 850000 17000006 Mechanical
Sucker3 3 6 3 0 28000 0
7 Fetal Stethoscope 4 4 4 4 0 1500 08 Delivery Table 2 2 3 4 0 17500 09 D&C Set 2 3 4 4 0 2100 0
10 Outlet forceps 4 4 4 2 2 900 180011 Myoma Screw 2 2 2 1 1 320 32012 Kochers forceps 4 4 8 4 0 235 013 Volselum forceps 6 8 10 6 0 235 014 Lanes Tissue
holding forceps2 2 4 2 0 400 0
15 Vaginal Retractors
10 10 10 2 8 350 2800
16 Polypectomy forceps
2 2 2 1 1 750 750
17 Sponge holder 10 15 20 10 0 300 018 Uterine elevator 1 1 1 1 0 150 0
19 CosCo Speculum 6 10 10 10 0 550 020 Examination light 3 3 6 3 0 18000 021 Suction Curette 1 2 2 30 0 95 0
Page 105
Three Years Rolling Plan 2010-2013 District Khanewal
22 Infant Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light)
1 1 2 1 0 95000 0
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light)
1 1 2 0 1 110000 110000
24 Cardiac Monitor 1 1 2 1 0 500000 025 Pump Breast
Electronic1 1 1 0 1 250000 250000
26 Vaginal Hysterectomy Set
2 2 4 0 2 30000 60000
26.1 Toothed Tissue Forceps (8”)
2 2 4 3 0 55 0
26.2 Non-Tooted Tissue Forceps (8”)
2 2 4 4 0 55 0
26.3 Dissection Scissors (Curved 7”)
2 2 4 5 0 150 0
26.4 Dissection Scissors (Straight 7”)
2 2 4 5 0 150 0
26.5 Hysterectomy Clamps (Straight)
8 8 16 5 3 150 450
26.6 Hysterectomy Clamps (Curved)
8 8 16 5 3 175 525
26.7 Uterine Sound 2 2 4 1 1 90 9026.8 Needle Holder
(7”)2 2 4 5 0 150 0
26.9 Needle Holder (10”)
2 2 4 2 0 300 0
26.1 Artery Forceps (Straight 6”)
16 16 32 16 0 110 0
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Three Years Rolling Plan 2010-2013 District Khanewal
26.11 Artery Forceps (Curved 6”)
16 16 32 16 0 125 0
26.12 Allis Forceps 8 8 16 8 0 230 026.13 Towel Clamps 8 8 16 6 2 125 25026.14 Single blade Sims
speculum4 4 8 2 2 275 550
26.15 Double blade Sims speculum
4 4 8 0 4 250 1000
26.16 Sponge holding forceps
8 8 16 8 0 200 0
26.17 Volselum forceps 4 4 8 2 2 250 50026.18 Uterine Sound 2 2 4 2 0 1500 026.19 Bladder Sound 2 2 4 1 1 1500 1500
27 Delivery Sets 10 10 15 10 027.1 Episiotomy
Scissors10 10 15 2 8 125 1000
27.2 Straight Scissors 10 10 15 10 0 360 027.3 Needle holder 10 10 15 18 0 135 027.4 Non-toothed
tissue forceps 8 inches
10 10 15 10 0 100 0
27.5 Toothed tissue forceps 8 inches
10 10 15 10 0 100 0
27.6 Sims Speculum single blade
20 20 30 16 4 275 1100
27.7 Sims Speculum double blade
20 20 30 20 0 250 0
27.8 Sponge holding forceps
40 40 60 40 0 250 0
27.9 Artery forceps 40 40 60 20 20 275 550027.1 Straight clamps
(cord)20 20 30 20 0 175 0
27.11 Vacuum Extractor pump
1 1 1 1 0 19000 0
27.12 Towel clip 40 40 60 10 30 125 375028 Caesarian
Section6 8 10 6 0
28.1 Scalpel 6 8 10 5 1 50 5028.2 Artery Forceps
Straight 6 inches24 32 40 24 0 125 0
28.3 Artery Forceps Curved 6 inches
24 32 40 24 0 125 0
28.4 Artery forceps 8 inches
24 32 40 24 0 175 0
28.5 Myoma Scissors straight 7 inches
6 8 10 6 0 150 0
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Three Years Rolling Plan 2010-2013 District Khanewal
28.6 Dissecting scissors (curved) 7 inches
6 8 10 6 0 270 0
28.7 Green Armtage forceps 8 inches
24 32 40 0 24 300 7200
28.8 Obstetric outlet forceps (pair)
6 8 10 6 0 900 0
28.9 Doyene’s Retractor
6 8 10 6 0 200 0
28.1 Small Retractors 12 16 20 10 2 300 60028.11 Towel Clippers 24 32 40 16 8 125 100028.12 Suction Nozzle 6 8 10 6 0 250 0
29 MNCH Related Radiology Equipments
0 0
29.1 Ultrasound Machine
1 2 3 1 0 575000 0
29.2 X-Ray Unit 500 kw
1 1 1 1 0 6000000 0
29.3 Color Doppler 0 1 1 0 0 5750000 029.4 Lead Screen for
X-Ray Unit1 1 1 0 1 30000 30000
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Gonadal Sheets
1 1 1 1 0 100000 0
29.6 Safe Light 1 1 1 1 0 5000 029.7 X-RT Film
Processing Tank1 1 1 1 0 5000 0
29.8 Chest Stand 1 1 1 1 0 4500 029.9 X-Ray film
Illuminator2 2 2 2 0 4000 0
29.1 X-Ray Film Hangers All sizes
4 4 4 10 0 4000 0
30 MNCH Related Paediatrics Equipments
0 0
30.1 Paediatric Ventilator
1 2 2 0 1 1200000 1200000
30.2 Incubator 1 1 2 1 0 1500000 030.3 Photo Therapy
Unit1 1 1 1 0 22000 0
30.4 Over-head Radiant Warmer
1 1 1 1 0 910000 0
30.5 Infant Length Measuring Scale
2 2 2 1 1 5000 5000
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30.6 Infant Weighing Machine
2 2 2 1 1 3100 3100
30.7 Nebulizer 1 1 2 1 0 22000 030.8 Billiubino-meter 1 1 2 0 1 36000 3600030.9 Exchange Blood
Transfusion Set1 1 2 0 1 2000 2000
30.1 Nasal Probe Paed size
2 2 4 0 2 7000 14000
31 Anaesthesia/ICU 0 031.1 Anaesthesia
Machine1 1 2 3 0 321000 0
31.2 Ventilators 1 1 1 2 0 525000 031.3 Nebulizer 1 1 1 1 0 165000 031.4 Pulse Oximetry 1 1 1 0 1 21000 2100031.5 Defibrillator 1 1 1 1 0 500000 031.6 Airway Oral and
Nasal2 3 4 2 0 500 0
31.7 Tracheostomy tube (adult and paeds)
2 2 4 0 2 1000 2000
31.8 Face mask of all sizes
2 2 4 2 0 1000 0
31.9 Double Cuff Tourniquet (for regional block)
1 2 2 0 1 320 320
31.1 AMBO bag adult 2 2 4 1 1 2450 245031.11 AMBO Bag paeds 2 2 4 1 1 3000 300031.12 Red Rubber Nasal
tubes all sizes without cuff
4 4 8 4 0 1000 0
32 Blood Bank 0 032.1 Blood storage
cabinet (100 bag capacity)
1 1 2 2 0 812000 0
32.2 Packed cell machine
1 1 1 0 1 600000 600000
32.3 Cell Separator 1 1 1 0 1 5225000 522500032.4 Freezer for Fresh
Frozen Plasma1 1 1 0 1 1150000 1150000
32.5 Blood bag shaker 1 1 2 1 0 10000 032.6 RH view box 2 2 4 1 1 1000 100032.7 Water bath 2 2 2 1 1 3000 300032.8 Micro-pipette 4 6 8 6 0 8000 032.9 Blood grouping
tiles3 3 6 2 1 3000 3000
32.1 Plasma Extractor 1 1 1 0 1 1000000 1000000
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Three Years Rolling Plan 2010-2013 District Khanewal
32.11 Platelets agitator 1 1 1 0 1 1000000 100000032.12 Blood thawing
bath1 1 1 0 1 3000 3000
32.13 Microscopes 1 1 2 1 0 115000 033 Gynae & Labour
Room Related Laboratory Equipment
0 0
33.1 Hematology Analyzer
1 1 1 0 1 425000 425000
33.2 Electrolyte Analyzer
1 1 1 1 0 625000 0
33.3 Analyzer Bio-chemistry Semi-automatic
1 1 1 1 0 690000 0
33.4 Glucometer 2 2 2 1 1 2500 250033.5 Haemoglobino-
meter2 2 4 1 1 1000 1000
33.6 Centrifuge 1 1 2 1 0 133000 0Grand Total= 14083555
THQ HOSPITAL JAHANIAN
Sr. No.
Equipment Standard as per MSDS
Available
Gap Cost/Unit
Total Cost
(Qty.)C B A
1 CTG (Cardiac Tocography) 1 1 1
0 1 285000 285000
2 Foetal Doppler 2 2 3 0 2 101000 2020003 Diagnostic
Laparoscope 1 1 10 1 1200000 1200000
4 Bulb Sucker 5 10 20 5 0 45 05 Baby Warmer 2 2 3 2 0 850000 06 Mechanical
Sucker 3 3 33 0 28000 0
7 Fetal Stethoscope 2 3 4 2 0 1500 08 Delivery Table 2 2 2 2 0 17500 09 D&C Set 2 2 2 2 0 2100 0
10 Outlet forceps 4 4 4 4 0 900 011 Myoma Screw 2 2 2 2 0 320 012 Kochers forceps 4 4 4 4 0 235 013 Volselum forceps 4 4 6 4 0 235 0
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Three Years Rolling Plan 2010-2013 District Khanewal
14 Lanes Tissue holding forceps 2 2 2
2 0 400 0
15 Vaginal Retractors 4 4 6
4 0 350 0
16 Polypectomy forceps 2 2 2
2 0 750 0
17 Sponge holder 10 10 15 10 0 300 018 Uterine elevator 1 1 1 1 0 150 0
19 CosCo Speculum 4 6 6 4 0 550 020 Examination light 3 3 3 3 0 18000 021 Suction Curette 1 1 2 0 1 95 9522 Infant
Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light) 1 1 1
0 1 95000 95000
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light) 1 1 1
0 1 110000 110000
24 Cardiac Monitor 1 1 1 0 1 500000 50000025 Pump Breast
Electronic 1 1 10 1 250000 250000
26 Vaginal Hysterectomy Set 2 2 2
2 30000 60000
26.1 Toothed Tissue Forceps (8”) 2 2 2
2 0 55 0
26.2 Non-Tooted Tissue Forceps (8”) 2 2 2
2 0 55 0
26.3 Dissection Scissors (Curved 7”) 2 2 2
2 0 150 0
26.4 Dissection Scissors (Straight 7”) 2 2 2
2 0 150 0
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Three Years Rolling Plan 2010-2013 District Khanewal
26.5 Hysterectomy Clamps (Straight) 8 8 8
8 0 150 0
26.6 Hysterectomy Clamps (Curved) 8 8 8
8 0 175 0
26.7 Uterine Sound 2 2 2 2 0 90 026.8 Needle Holder
(7”) 2 2 42 0 150 0
26.9 Needle Holder (10”) 2 2 2
2 0 300 0
26.1 Artery Forceps (Straight 6”) 16 16 16
16 0 110 0
26.11
Artery Forceps (Curved 6”) 16 16 16
16 0 125 0
26.12
Allis Forceps8 8 8
8 0 230 0
26.13
Towel Clamps8 8 8
8 0 125 0
26.14
Single blade Sims speculum 4 4 4
0 4 275 1100
26.15
Double blade Sims speculum 4 4 4
8 0 250 0
26.16
Sponge holding forceps 8 8 8
4 4 200 800
26.17
Volselum forceps4 4 4
2 2 250 500
26.18
Uterine Sound2 2 2
2 0 1500 0
26.19
Bladder Sound2 2 2
2 0 1500 0
27 Delivery Sets 6 6 10 6 027.1 Episiotomy
Scissors 6 6 106 0 125 0
27.2 Straight Scissors 6 6 10 6 0 360 027.3 Needle holder 6 6 10 6 0 135 027.4 Non-toothed
tissue forceps 8 inches 6 6 10
6 0 100 0
27.5 Toothed tissue forceps 8 inches 6 6 10
6 0 100 0
27.6 Sims Speculum single blade 12 12 20
0 12 275 3300
27.7 Sims Speculum double blade 12 12 20
12 0 250 0
27.8 Sponge holding forceps 40 40 40
40 0 250 0
27.9 Artery forceps 40 40 40 40 0 275 0
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Three Years Rolling Plan 2010-2013 District Khanewal
27.1 Straight clamps (cord) 20 20 30
20 0 175 0
27.11
Vacuum Extractor pump 1 1 1
1 0 19000 0
27.12
Towel clip40 40 40
0 40 125 5000
28 Caesarian Section 4 4 6
4 0 0
28.1 Scalpel 4 4 6 0 4 50 20028.2 Artery Forceps
Straight 6 inches 16 16 2416 0 125 0
28.3 Artery Forceps Curved 6 inches 16 16 24
16 0 125 0
28.4 Artery forceps 8 inches 16 16 24
16 0 175 0
28.5 Myoma Scissors straight 7 inches 4 4 6
4 0 150 0
28.6 Dissecting scissors (curved) 7 inches 4 4 6
4 0 270 0
28.7 Green Armtage forceps 8 inches 16 16 24
16 0 300 0
28.8 Obstetric outlet forceps (pair) 4 4 6
4 0 900 0
28.9 Doyene’s Retractor 4 4 6
4 0 200 0
28.1 Small Retractors 8 8 12 8 0 300 028.1
1Towel Clippers
16 16 2416 0 125 0
28.12
Suction Nozzle4 4 6
0 4 250 1000
29 MNCH Related Radiology Equipments
0 0
29.1 Ultrasound Machine 1 1 2
1 0 575000 0
29.2 X-Ray Unit 500 kw 1 1 1
1 0 6000000 0
29.3 Color Doppler 0 0 0 0 0 5750000 029.4 Lead Screen for
X-Ray Unit 1 1 10 1 30000 30000
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Gonadal Sheets 1 1 1
0 1 100000 100000
29.6 Safe Light 1 1 1 1 0 5000 0
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Three Years Rolling Plan 2010-2013 District Khanewal
29.7 X-RT Film Processing Tank 1 1 1
1 0 5000 0
29.8 Chest Stand 1 1 1 1 0 4500 029.9 X-Ray film
Illuminator 2 2 22 0 4000 0
29.1 X-Ray Film Hangers All sizes 4 4 4
4 0 4000 0
30 MNCH Related Paediatrics Equipments
0 0
30.1 Paediatric Ventilator 1 1 2
0 1 1200000 1200000
30.2 Incubator 1 1 1 1 0 1500000 030.3 Photo Therapy
Unit 1 1 11 0 22000 0
30.4 Over-head Radiant Warmer 1 1 1
1 0 910000 0
30.5 Infant Length Measuring Scale 2 2 2
2 0 5000 0
30.6 Infant Weighing Machine 2 2 2
2 0 3100 0
30.7 Nebulizer 1 1 1 1 0 22000 030.8 Billiubino-meter 1 1 1 1 0 36000 030.9 Exchange Blood
Transfusion Set 1 1 11 0 2000 0
30.1 Nasal Probe Paed size 1 2 2
0 1 7000 7000
31 Anaesthesia/ICU 0 031.1 Anaesthesia
Machine 1 1 11 0 321000 0
31.2 Ventilators 1 1 1 1 0 525000 031.3 Nebulizer 1 1 1 1 0 165000 031.4 Pulse Oximetry 1 1 1 1 0 21000 031.5 Defibrillator 1 1 1 1 0 500000 031.6 Airway Oral and
Nasal 1 2 21 0 500 0
31.7 Tracheostomy tube (adult and paeds) 1 2 2
1 0 1000 0
31.8 Face mask of all sizes 1 2 2
1 0 1000 0
31.9 Double Cuff Tourniquet (for regional block) 1 1 1
1 0 320 0
31.1 AMBO bag adult 1 2 2 1 0 2450 0
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Three Years Rolling Plan 2010-2013 District Khanewal
31.11
AMBO Bag paeds2 2 2
2 0 3000 0
31.12
Red Rubber Nasal tubes all sizes without cuff 4 4 4
4 0 1000 0
32 Blood Bank 0 032.1 Blood storage
cabinet (100 bag capacity) 1 1 1
1 0 812000 0
32.2 Packed cell machine 1 1 1
0 1 600000 600000
32.3 Cell Separator 1 1 1 1 0 5225000 032.4 Freezer for Fresh
Frozen Plasma 1 1 11 0 1150000 0
32.5 Blood bag shaker 1 1 1 1 0 10000 032.6 RH view box 1 2 2 1 0 1000 032.7 Water bath 2 2 2 2 0 3000 032.8 Micro-pipette 4 4 6 4 0 8000 032.9 Blood grouping
tiles 3 3 30 3 3000 9000
32.1 Plasma Extractor 1 1 1 1 0 1000000 032.1
1Platelets agitator
1 1 11 0 1000000 0
32.12
Blood thawing bath 1 1 1
0 1 3000 3000
32.13
Microscopes1 1 1
0 1 115000 115000
33 Gynae & Labour Room Related Laboratory Equipment
0 0
33.1 Hematology Analyzer 1 1 1
0 1 425000 425000
33.2 Electrolyte Analyzer 1 1 1
0 1 625000 625000
33.3 Analyzer Bio-chemistry Semi-automatic 1 1 1
0 1 690000 690000
33.4 Glucometer 2 2 2 0 2 2500 500033.5 Haemoglobino-
meter 1 1 10 1 1000 1000
33.6 Centrifuge 1 1 1 0 1 133000 133000Grand Total= 6656995
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Three Years Rolling Plan 2010-2013 District Khanewal
THQ HOSPITAL KABIR WALA
Sr. No.
Equipment Standard as per MSDS
Available
Gap
Cost/Unit
Total Cost
(Qty.)C B A
1 CTG (Cardiac Tocography) 1 1 1
0 1 285000 285000
2 Foetal Doppler 2 2 3 0 2 101000 2020003 Diagnostic
Laparoscope 1 1 10 1 1200000 1200000
4 Bulb Sucker 5
10
20
10 0 45 0
5 Baby Warmer 2 2 3 0 2 850000 17000006 Mechanical
Sucker 3 3 33 0 28000 0
7 Fetal Stethoscope 2 3 4 3 0 1500 08 Delivery Table 2 2 2 2 0 17500 09 D&C Set 2 2 2 2 0 2100 0
10 Outlet forceps 4 4 4 0 4 900 360011 Myoma Screw 2 2 2 0 2 320 64012 Kochers forceps 4 4 4 0 4 235 94013 Volselum forceps 4 4 6 4 0 235 014 Lanes Tissue
holding forceps 2 2 20 2 400 800
15 Vaginal Retractors 4 4 6
4 0 350 0
16 Polypectomy forceps 2 2 2
0 2 750 1500
17 Sponge holder 10
10
15
10 0 300 0
18 Uterine elevator 1 1 1 0 1 150 15019 CosCo Speculum 4 6 6 6 0 550 0
20 Examination light 3 3 3 3 0 18000 021 Suction Curette 1 1 2 0 1 95 95
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Three Years Rolling Plan 2010-2013 District Khanewal
22 Infant Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light) 1 1 1
0 1 95000 95000
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light) 1 1 1
0 1 110000 110000
24 Cardiac Monitor 1 1 1 0 1 500000 50000025 Pump Breast
Electronic 1 1 10 1 250000 250000
26 Vaginal Hysterectomy Set 2 2 2
2 0 30000 0
26.1 Toothed Tissue Forceps (8”) 2 2 2
2 0 55 0
26.2 Non-Tooted Tissue Forceps (8”) 2 2 2
2 0 55 0
26.3 Dissection Scissors (Curved 7”) 2 2 2
2 0 150 0
26.4 Dissection Scissors (Straight 7”) 2 2 2
0 2 150 300
26.5 Hysterectomy Clamps (Straight) 8 8 8
0 8 150 1200
26.6 Hysterectomy Clamps (Curved) 8 8 8
0 8 175 1400
26.7 Uterine Sound 2 2 2 2 0 90 026.8 Needle Holder
(7”) 2 2 42 0 150 0
26.9 Needle Holder (10”) 2 2 2
2 0 300 0
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Three Years Rolling Plan 2010-2013 District Khanewal
26.1 Artery Forceps (Straight 6”)
16
16
16
16 0 110 0
26.11
Artery Forceps (Curved 6”)
16
16
16
0 16 125 2000
26.12
Allis Forceps8 8 8
8 0 230 0
26.13
Towel Clamps8 8 8
8 0 125 0
26.14
Single blade Sims speculum 4 4 4
4 0 275 0
26.15
Double blade Sims speculum 4 4 4
4 0 250 0
26.16
Sponge holding forceps 8 8 8
8 0 200 0
26.17
Volselum forceps4 4 4
4 0 250 0
26.18
Uterine Sound2 2 2
2 0 1500 0
26.19
Bladder Sound2 2 2
2 0 1500 0
27 Delivery Sets6 6
10
6 0 0
27.1 Episiotomy Scissors 6 6
10
0 6 125 750
27.2 Straight Scissors6 6
10
6 0 360 0
27.3 Needle holder6 6
10
6 0 135 0
27.4 Non-toothed tissue forceps 8 inches 6 6
10
0 6 100 600
27.5 Toothed tissue forceps 8 inches 6 6
10
0 6 100 600
27.6 Sims Speculum single blade
12
12
20
0 12 275 3300
27.7 Sims Speculum double blade
12
12
20
0 12 250 3000
27.8 Sponge holding forceps
40
40
40
0 40 250 10000
27.9 Artery forceps 40
40
40
40 0 275 0
27.1 Straight clamps (cord)
20
20
30
0 20 175 3500
27.11
Vacuum Extractor pump 1 1 1
1 0 19000 0
27.12
Towel clip 40
40
40
0 40 125 5000
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Three Years Rolling Plan 2010-2013 District Khanewal
28 Caesarian Section 4 4 6
0 4 0
28.1 Scalpel 4 4 6 0 4 50 20028.2 Artery Forceps
Straight 6 inches16
16
24
0 16 125 2000
28.3 Artery Forceps Curved 6 inches
16
16
24
0 16 125 2000
28.4 Artery forceps 8 inches
16
16
24
16 0 175 0
28.5 Myoma Scissors straight 7 inches 4 4 6
0 4 150 600
28.6 Dissecting scissors (curved) 7 inches 4 4 6
0 4 270 1080
28.7 Green Armtage forceps 8 inches
16
16
24
0 16 300 4800
28.8 Obstetric outlet forceps (pair) 4 4 6
0 4 900 3600
28.9 Doyene’s Retractor 4 4 6
4 0 200 0
28.1 Small Retractors8 8
12
8 0 300 0
28.11
Towel Clippers 16
16
24
0 16 125 2000
28.12
Suction Nozzle4 4 6
0 4 250 1000
29 MNCH Related Radiology Equipments
0 0
29.1 Ultrasound Machine 1 1 2
1 0 575000 0
29.2 X-Ray Unit 500 kw 1 1 1
0 1 6000000 6000000
29.3 Color Doppler 0 0 0 0 0 5750000 029.4 Lead Screen for
X-Ray Unit 1 1 10 1 30000 30000
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Gonadal Sheets 1 1 1
0 1 100000 100000
29.6 Safe Light 1 1 1 0 1 5000 500029.7 X-RT Film
Processing Tank 1 1 10 1 5000 5000
29.8 Chest Stand 1 1 1 0 1 4500 450029.9 X-Ray film
Illuminator 2 2 20 2 4000 8000
Page 119
Three Years Rolling Plan 2010-2013 District Khanewal
29.1 X-Ray Film Hangers All sizes 4 4 4
0 4 4000 16000
30 MNCH Related Paediatrics Equipments
0 0
30.1 Paediatric Ventilator 1 1 2
0 1 1200000 1200000
30.2 Incubator 1 1 1 1 0 1500000 030.3 Photo Therapy
Unit 1 1 10 1 22000 22000
30.4 Over-head Radiant Warmer 1 1 1
0 1 910000 910000
30.5 Infant Length Measuring Scale 2 2 2
0 2 5000 10000
30.6 Infant Weighing Machine 2 2 2
0 2 3100 6200
30.7 Nebulizer 1 1 1 1 0 22000 030.8 Billiubino-meter 1 1 1 0 1 36000 3600030.9 Exchange Blood
Transfusion Set 1 1 10 1 2000 2000
30.1 Nasal Probe Paed size 1 2 2
0 2 7000 14000
31 Anaesthesia/ICU
0 0
31.1 Anaesthesia Machine 1 1 1
1 0 321000 0
31.2 Ventilators 1 1 1 1 0 525000 031.3 Nebulizer 1 1 1 1 0 165000 031.4 Pulse Oximetry 1 1 1 1 0 21000 031.5 Defibrillator 1 1 1 1 0 500000 031.6 Airway Oral and
Nasal 1 2 20 2 500 1000
31.7 Tracheostomy tube (adult and paeds) 1 2 2
0 2 1000 2000
31.8 Face mask of all sizes 1 2 2
0 2 1000 2000
31.9 Double Cuff Tourniquet (for regional block) 1 1 1
1 0 320 0
31.1 AMBO bag adult 1 2 2 1 1 2450 245031.1
1AMBO Bag paeds
2 2 20 2 3000 6000
31.12
Red Rubber Nasal tubes all sizes without cuff 4 4 4
0 4 1000 4000
32 Blood Bank 0 0
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Three Years Rolling Plan 2010-2013 District Khanewal
32.1 Blood storage cabinet (100 bag capacity) 1 1 1
1 0 812000 0
32.2 Packed cell machine 1 1 1
0 1 600000 600000
32.3 Cell Separator 1 1 1 0 1 5225000 522500032.4 Freezer for Fresh
Frozen Plasma 1 1 10 1 1150000 1150000
32.5 Blood bag shaker 1 1 1 0 1 10000 1000032.6 RH view box 1 2 2 0 2 1000 200032.7 Water bath 2 2 2 0 2 3000 600032.8 Micro-pipette 4 4 6 4 0 8000 032.9 Blood grouping
tiles 3 3 33 0 3000 0
32.1 Plasma Extractor 1 1 1 0 1 1000000 100000032.1
1Platelets agitator
1 1 10 1 1000000 1000000
32.12
Blood thawing bath 1 1 1
0 1 3000 3000
32.13
Microscopes1 1 1
1 0 115000 0
33 Gynae & Labour Room Related Laboratory Equipment
0 0
33.1 Hematology Analyzer 1 1 1
0 1 425000 425000
33.2 Electrolyte Analyzer 1 1 1
0 1 625000 625000
33.3 Analyzer Bio-chemistry Semi-automatic 1 1 1
1 0 690000 0
33.4 Glucometer 2 2 2 0 2 2500 500033.5 Haemoglobino-
meter 1 1 10 1 1000 1000
33.6 Centrifuge 1 1 1 1 0 133000 0Grand Total= 2283680
5
THQ HOSPITAL MAIN CHANNU
Sr. No.
Equipment Standard as per MSDS
Available Gap Cost/Unit
Total Cost
(Qty.)C B A
Page 121
Three Years Rolling Plan 2010-2013 District Khanewal
1 CTG (Cardiac Tocography) 1 1 1
1 0 285000 0
2 Foetal Doppler 2 2 3 1 1 101000 1010003 Diagnostic
Laparoscope 1 1 10 1 1200000 1200000
4 Bulb Sucker 5 10 20 0 10 45 4505 Baby Warmer 2 2 3 0 2 850000 17000006 Mechanical
Sucker 3 3 31 2 28000 56000
7 Fetal Stethoscope 2 3 4 3 0 1500 08 Delivery Table 2 2 2 2 0 17500 09 D&C Set 2 2 2 1 1 2100 2100
10 Outlet forceps 4 4 4 0 4 900 360011 Myoma Screw 2 2 2 3 0 320 012 Kochers forceps 4 4 4 0 4 235 94013 Volselum forceps 4 4 6 5 0 235 014 Lanes Tissue
holding forceps 2 2 23 0 400 0
15 Vaginal Retractors 4 4 6
2 2 350 700
16 Polypectomy forceps 2 2 2
1 1 750 750
17 Sponge holder 10 10 15 2 8 300 240018 Uterine elevator 1 1 1 0 1 150 15019 CosCo Speculum 4 6 6 0 6 550 3300
20 Examination light 3 3 3 2 1 18000 1800021 Suction Curette 1 1 2 3 0 95 022 Infant
Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light) 1 1 1
1 0 95000 0
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light) 1 1 1
0 1 110000 110000
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Three Years Rolling Plan 2010-2013 District Khanewal
24 Cardiac Monitor 1 1 1 0 1 500000 50000025 Pump Breast
Electronic 1 1 10 1 250000 250000
26 Vaginal Hysterectomy Set 2 2 2
2 30000 60000
26.1 Toothed Tissue Forceps (8”) 2 2 2
2 0 55 0
26.2 Non-Tooted Tissue Forceps (8”) 2 2 2
2 0 55 0
26.3 Dissection Scissors (Curved 7”) 2 2 2
0 2 150 300
26.4 Dissection Scissors (Straight 7”) 2 2 2
0 2 150 300
26.5 Hysterectomy Clamps (Straight) 8 8 8
0 8 150 1200
26.6 Hysterectomy Clamps (Curved) 8 8 8
0 8 175 1400
26.7 Uterine Sound 2 2 2 1 1 90 9026.8 Needle Holder
(7”) 2 2 40 2 150 300
26.9 Needle Holder (10”) 2 2 2
0 2 300 600
26.1 Artery Forceps (Straight 6”) 16 16 16
2 14 110 1540
26.1 Artery Forceps (Curved 6”) 16 16 16
0 16 125 2000
26.1 Allis Forceps 8 8 8 8 0 230 026.1 Towel Clamps 8 8 8 0 8 125 100026.1 Single blade Sims
speculum 4 4 40 4 275 1100
26.2 Double blade Sims speculum 4 4 4
0 4 250 1000
26.2 Sponge holding forceps 8 8 8
0 8 200 1600
26.2 Volselum forceps 4 4 4 0 4 250 100026.2 Uterine Sound 2 2 2 0 2 1500 300026.2 Bladder Sound 2 2 2 0 2 1500 300027 Delivery Sets 6 6 10 6 0
27.1 Episiotomy Scissors 6 6 10
2 4 125 500
27.2 Straight Scissors 6 6 10 2 4 360 144027.3 Needle holder 6 6 10 0 6 135 810
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Three Years Rolling Plan 2010-2013 District Khanewal
27.4 Non-toothed tissue forceps 8 inches 6 6 10
0 6 100 600
27.5 Toothed tissue forceps 8 inches 6 6 10
0 6 100 600
27.6 Sims Speculum single blade 12 12 20
0 12 275 3300
27.7 Sims Speculum double blade 12 12 20
0 12 250 3000
27.8 Sponge holding forceps 40 40 40
0 40 250 10000
27.9 Artery forceps 40 40 40 0 40 275 1100027.1 Straight clamps
(cord) 20 20 300 20 175 3500
27.1 Vacuum Extractor pump 1 1 1
1 0 19000 0
27.1 Towel clip 40 40 40 0 40 125 500028 Caesarian
Section 4 4 6 4 0
28.1 Scalpel 4 4 6 0 4 50 20028.2 Artery Forceps
Straight 6 inches 16 16 240 16 125 2000
28.3 Artery Forceps Curved 6 inches 16 16 24
0 16 125 2000
28.4 Artery forceps 8 inches 16 16 24
0 16 175 2800
28.5 Myoma Scissors straight 7 inches 4 4 6
0 4 150 600
28.6 Dissecting scissors (curved) 7 inches 4 4 6
0 4 270 1080
28.7 Green Armtage forceps 8 inches 16 16 24
4 12 300 3600
28.8 Obstetric outlet forceps (pair) 4 4 6
0 4 900 3600
28.9 Doyene’s Retractor 4 4 6
1 3 200 600
28.1 Small Retractors 8 8 12 0 8 300 240028.1 Towel Clippers 16 16 24 0 16 125 200028.1 Suction Nozzle 4 4 6 12 0 250 029 MNCH Related
Radiology Equipments
0 0
29.1 Ultrasound Machine 1 1 2
1 0 575000 0
29.2 X-Ray Unit 500 kw 1 1 1
0 1 6000000 6000000
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Three Years Rolling Plan 2010-2013 District Khanewal
29.3 Color Doppler 0 0 0 0 0 5750000 029.4 Lead Screen for
X-Ray Unit 1 1 10 1 30000 30000
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Gonadal Sheets 1 1 1
0 1 100000 100000
29.6 Safe Light 1 1 1 0 1 5000 500029.7 X-RT Film
Processing Tank 1 1 10 1 5000 5000
29.8 Chest Stand 1 1 1 4 0 4500 029.9 X-Ray film
Illuminator 2 2 20 2 4000 8000
29.1 X-Ray Film Hangers All sizes 4 4 4
0 4 4000 16000
30 MNCH Related Paediatrics Equipments
0 0
30.1 Paediatric Ventilator 1 1 2
0 1 1200000 1200000
30.2 Incubator 1 1 1 1 0 1500000 030.3 Photo Therapy
Unit 1 1 11 0 22000 0
30.4 Over-head Radiant Warmer 1 1 1
1 0 910000 0
30.5 Infant Length Measuring Scale 2 2 2
1 1 5000 5000
30.6 Infant Weighing Machine 2 2 2
1 1 3100 3100
30.7 Nebulizer 1 1 1 0 1 22000 2200030.8 Billiubino-meter 1 1 1 0 1 36000 3600030.9 Exchange Blood
Transfusion Set 1 1 10 1 2000 2000
30.1 Nasal Probe Paed size 1 2 2
0 2 7000 14000
31 Anaesthesia/ICU
0 0
31.1 Anaesthesia Machine 1 1 1
1 0 321000 0
31.2 Ventilators 1 1 1 0 1 525000 52500031.3 Nebulizer 1 1 1 0 1 165000 16500031.4 Pulse Oximetry 1 1 1 0 1 21000 2100031.5 Defibrillator 1 1 1 0 1 500000 50000031.6 Airway Oral and
Nasal 1 2 20 2 500 1000
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Three Years Rolling Plan 2010-2013 District Khanewal
31.7 Tracheostomy tube (adult and paeds) 1 2 2
0 2 1000 2000
31.8 Face mask of all sizes 1 2 2
0 2 1000 2000
31.9 Double Cuff Tourniquet (for regional block) 1 1 1
0 1 320 320
31.1 AMBO bag adult 1 2 2 0 2 2450 490031.1 AMBO Bag paeds 2 2 2 0 2 3000 600031.1 Red Rubber Nasal
tubes all sizes without cuff 4 4 4
0 4 1000 4000
32 Blood Bank 0 0 032.1 Blood storage
cabinet (100 bag capacity) 1 1 1
0 1 812000 812000
32.2 Packed cell machine 1 1 1
0 1 600000 600000
32.3 Cell Separator 1 1 1 0 1 5225000 522500032.4 Freezer for Fresh
Frozen Plasma 1 1 10 1 1150000 1150000
32.5 Blood bag shaker 1 1 1 0 1 10000 1000032.6 RH view box 1 2 2 0 2 1000 200032.7 Water bath 2 2 2 2 0 3000 032.8 Micro-pipette 4 4 6 0 4 8000 3200032.9 Blood grouping
tiles 3 3 30 3 3000 9000
32.1 Plasma Extractor 1 1 1 0 1 1000000 100000032.1 Platelets agitator 1 1 1 0 1 1000000 100000032.1 Blood thawing
bath 1 1 10 1 3000 3000
32.1 Microscopes 1 1 1 0 1 115000 11500033 Gynae & Labour
Room Related Laboratory Equipment
0 0
33.1 Hematology Analyzer 1 1 1
0 1 425000 425000
33.2 Electrolyte Analyzer 1 1 1
0 1 625000 625000
33.3 Analyzer Bio-chemistry Semi-automatic 1 1 1
0 1 690000 690000
33.4 Glucometer 2 2 2 0 2 2500 5000
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