DISTRICT HEALTH ACTION PLAN 2011 –...

DISTRICT HEALTH ACTION PLAN 2011 –

2012

Name of District: - Jehanabad

District Patna

District Patna

Jehanabad

Kako

Modanganj

Ratni Faridpur

Ghosi

Makhdumpur

Hulasganj

District Nalanda

District Arwal

District Gaya

District Patna District Patna

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2

A c k n ow l e d g em e n t s

This District Health Action plan prepared Under a Short & Hard Process of

about survey of one month and this was a good Opportunity to revisit the

situation of health services status and national programmes in district as well as

to have a positive dialogue with departments like Public Health Engineering,

Women and Child Development, Maternal and Child Health care etc.

This document is an outcome of a collective effort by a number of

individuals, related to our institutions and programmes:-

� Smt. Palka Shahni ,Chairperson of District Health Society, Jehanabad was

a source of inspiration towards this effort vide her inputs to this process

during D.H.S review meetings.

� Dr.Arvind kumar (A.C.M.O) Nodal officer for this action plan who always

supported this endeavor through his guiding words and language.

� Mr. Nimish Manan, District Programme Manager was in incharge for the

development of the DHAP(2011-12) .

� Mr Ravi Shankar Kumar , Distirct Planning Coordinator has given full

time effort in developing DHAP(2011-12).

� Mr. Kaushal Kumar Jha, District Account Manager has put huge effort in

financial Planning.

� Mr. Arvind Kumar, M&E Officer is the technical advisor for the

data introduced inside this DISTRICT HEALTH ACTION PLAN.

� Mr. Manish Mani & Sefali from PHRN have given huge support.

� All district level Programme officer for various Health

Programmes, B.H.Ms, M.O.I .Cs, PHCs, Field Office Staff have

supported with their full participations, cooperation and

learning spirit through out this process.

I on behalf of the District Health Society, Jehanabad acknowledge the

grateful contribution of all those mentioned above.

Dr. Smt. Shashi Rani Smt. Palka Shahni

Civil Surgeon-cum-member secretary, District Magistrate-cum-chairman

District Health Society, Jehanabad. District health society, Jehanabad



3



4

District Patna

District Patna

Jehanabad

Kako

Modanganj

Ratni Faridpur

Ghosi

Makhdumpur

Hulasganj

District Nalanda

District Arwal

District Gaya




5

Level 1,2,&3 facilities selected for 24*7 institutional delivery

N

Level1

District Patna

District Patna

Jehanabad Sadar

Kakooo Modanganj

Ratni

Faridpur

Ghosi

Makhdumpur

pur Hulasganj

District Nalanda

District Arwal

District

Gaya


PHC

PHC

PHC

PHC PHC

DedhsaiyBharthu

Dehuni

HSC Badheta

Level 2

Keur

HSC Ikkil

Daraurt

Level 3

N

W

S

E



6

STRUCTURE OF DISTRICT PLAN

Chapter I: Introduction, profile of the district and process. PAGE NO

� Introduction …………………………………………………………………………….. 9

� History of District………………………………………………………………………. 10

� District Profile…………………………………………………………………………… 13

� District Planning objective and priorities and planning Process… 18

Chapter II: *SWOT analysis of Part A,B,C,D……………………………………. 22

* HMIS DATA ANALYSIS…………………………………………………. 26

Chapter III: Part A

MATERNAL HEALTH 34

CHILD HEALTH 65

FAMILY PLANNING 74

Chapter IV: PART B

Chapter V:

Part C – Immunization

Routine Immunization/Polio

Chapter VI:

Part D – National Disease Control Programmes

KALAZAR 88

BLINDNESS 91

LEPROSY 93

FILERIA 94

TB 96

NRHM PART “ B”

DECENTRALIZATION 79

INFRASTRUCTURE 81

CONTRACTUAL MANPOWER 82

MAINSTREAMING OF AYUSH UNDER NRHM 84

DE-CENTRALIZED PLANNING 85



7

Chapter VII:

BUDGET

NRHM Part A – RCH II

NRHM Part B – Additionalities

NRHM Part C – Immunization

NRHM Part D – NDCP

Summary of Budget

Chapter VIII

Annexure: A…………………………………………………………………………. 122

Annexure: B………………………………………………………………………….. 124

Annexure: C



8

CHAPTER 1:

INTRODUCTION, PROFILE OF

THE DISTRICT & PROCESS



9

Introduction :

Jehanabad district was carved out of the old GAYA district on 1st

August 1986. Earlier it was a subdivision of Gaya since 1872. It is situated 56

km to the south of the State Head Quarters, Patna and 47 km to the north of

Gaya by road and is well connected to both the stations via an electrified rail-

route as well. Again, in the year 2001, the district of Arwal was created out of

the district of Jehanabad.

Geography :

The district covers 941.4 sq. km. of geographical area in South

Bihar. The town of Jehanabad, which is the HQ of the district, is situated at the

confluence of rivers Dardha and Jamuna. Lying between 25-0’ to 25-15’ degree

north latitude and 84-13’ to 85-15’ degree eastern longitude, the district is

bounded by districts of Patna in the north, Gaya in the south, Nalanda in the east

and Arwal in the West.

Topography and Terrain :

Fertile alluvial soil locally called "Kewal" supports the district's

predominantly agricultural economy and is currently being tilled for production

of paddy, wheat, cane, potato, pulses, vegetables etc. The south-east area of the

district is hilly terrain bounding the district from this site and it offers feverable

terrain for the nexalites to operate and build their bases. Because of geographical

constraints and lack of metalled road communication carrying out of anti naxal

operations becomes a tedious task. Naxalites take shelter in theses areas and they

take advantage of the porous inter district boarders. Naxals run trainings in these

areas and commit crime after which they easily sleep into the border of the

neighboring district. The geographical features become obstacles in the smooth

movement of troops besides being vulnerable to planting of land mines and

becoming easy targets of ambush laid by naxalites. Since, there several

commoflause and concealment places the naxals take shelter in these areas and

convene secret meetings and out spread the extremist ideology.



10

History :

Description of Jehanabad in the history is found in the famous book

"AINA-E-AKBARY" wrote by Abul Fazal. The book states that in the 17th

century this place was badly affected by famine and people were dying of

hunger. Moghul emperor Aurangzeb, in whose times the book was re-written

established a "Mandi" for relief of the people and named it 'JEHANARABAD'.

The Mandi was under the direct control of Jehanara and she spent a great deal of

time here. In due course of time, the place became 'JEHANARABAD' and later

'JEHANABAD'

Dialect :

The dialect spoken here is Magadhi (Magahi).

Socio-Economic :

The relatively small sized district is a cauldron of conflict as far as

the socio-economic situation is concerned. There were extreme caste tensions

(with an economic bearing) prevailing in the whole Magadh area (old Gaya

district - now broken into 5 districts of Gaya, Aurangabad, Nawada, Jehanabad

and Arwal) and they were manifested in their worst forms in this district. Thus

this place has been badly affected by Naxalism (PWG, MCC, ML(Lib) etc.) and

has seen the emergence of rival outfits such as Ranvir Sena.

In the result this district has witnessed horrifying spate of large

scale carnages in the past which has resulted in the killing of hundreds of

innocents. Nonhi-Nagwan, Parasbigha, Khagari-Damuha, Laxmanpur-Baathe,

Rampur-Chauram, Senari, Shankarbigha and Narainpur - there is a long list of

villages where big massacres have occurred.



11

Natural Resources

The rivers- Falgu, Dardha, Jamuna and Morhar flow by crossing the

district's plan topography. The river Falgu has got religious importance where

'PIND DAN' is offered to their forefather's by the Hindus. All these rivers are

mainly rainfed, have a meagre discharge in the other parts of the year and go dry

in the summers.

As far as minerals are concerned, the district has only minor ones. The

sand available with the river beds in the major part of the year is collected and

transported to other parts of the district besides to the adjoining districts and is

useful in construction work.

The soil is alluvial- textured brown gray which cracks open in the dry

season and gets very sticky in the rains and the mud tracks become unmotorable

during that period. The fertility is reasonably good.

The forest cover of the district is small- 1030 hectares, which is mainly

concentrated near the Barabar Hills. They belong to the category of reserve

forests.

Human Resources

There are about 1.11 lakh cultivators including 92138 small and marginal

farmers, 1.78 lacs agricultural labourers, 7969 skilled labours, 5075 house hold

entrepreneurs and 95755 are engaged in allied agro business. The total

population in the working age group is 358723 out of which there are 236199

males and 122534 females.

Statistical Profile (based on 2001 census)

Sl. No.

Population Male Female Total

1. Bihar 43153964 39724832 82878796

2. Jehanabad 480518 443959 924477

3. Rural Population 420777 391807 812584

4. Urban Population 59741 52152 111893

5. Literacy rate 70.29% 40.43% 55.91%

6. Rural 69.03% 37.94% 53.99%



12

7. Urban 78.83% 58.62% 68.42%

District Profile :-

1. Area (in Sq. KM) 941.4 sq.km 2. Decadal growth rate 28.64%

(91 to 2001) 3. Population density 963 PPSK (Person per sq.km) 4. Sex ratio 928 (per 1000 male) 5. Villages Populated - 562

Uninhabited - 43 Total - 605

6. Town 02 7. Municipality 02 8. Rural Families 144199 9. SC Population 124856 10. Cultivator 1.40 Lacs 11. Small and margioner farmers 92138 12. Agriculture labours 1.78 Lacs 13 Skilled labours/ artisan 7967 14. House hold courtage workers 12661 15. Other workers 59716 16. Net area under cultivation 78000 Hec. 17. Gross cropped area 260735.46 acr. 18. Net irrigated area 66450 Hec. 19. Area under forest 1030 Hec. (0.41%) 20. Water area fishery 1176..46 Hec. 21. Total cattle 2.04 Lacs (1982) 22.

Road length Black top/Hard surface - 541.65 km Kacha or mud - 450.90 km

23. Electrified villages 241 24.

Hand tube well Urban- 764 Rural -7997 Total - 8761

25. Drilled tube well Urban - 0, Rural - 31 26. Rural Water supply 11 Schemes 27. Urban water supply 6 Schemes



13

BLOCKS OF JEHANABAD DISTRICT

An Introduction:

Administration:

There is one subdivision - Jehanabad and seven blocks in the district

- Jehanabad, Kako, Makhdumpur, Ghosi, Ratni Faridpur, Hulasganj and

Modanganj. There are 93 Gram Panchayats, 7 Panchayat Samities and one Zila

Parishad in this district. One Nagar Panchayat is at Makhdumpur and one Nagar

Parishad at Jehanabad, M.P. constituency - 01, MLA constituency - 3

Infrastructure:

The district is linked to the bigger cities of Patna & Gaya both by

road and rail route. The recently electrified Patna-Gaya branch railway line (P.G.

line) traverses through the district and links the Grand Chord with Patna. There

are four railway stations- Jehanabad, Court, Tehta and Makhdumpur in the 31

km long stretch of the railways. National Highway No. 83 comes from Patna via

Masaurhi, goes directly to Gaya through Makhdumpur and runs almost parallel

to the railway line. There is a network of PWD roads and REO roads across the

district, albeit in a bad shape. The total length of surfaced roads is 541.65 kms

and mud tracks are 450.90 kms. The condition of the roads in the rural parts is

good.

The district has wide network of markets dealing mainly with grains

and vegetables. Major centers of trade and commerce are located in Jehanabad,

Ghosi, Kako and Makhdumpur. Besides in rural areas hats function usually once

in the week. The trade consists mainly of export of oil seeds, rice, gur, stone

chips and vegetables. The principal imports are coal, cement and other

construction materials, clothes, K. oil, tea, tobacco, fresh fruits and other

perishable/ non perishable consumer goods.

The telecommunication network in the district is good. The whole of the

district is either covered by basic or mobile phones.



14

The educational infrastructure available in the district can be summarized

as following-

Primary schools - 561

Middle schools - 118

High schools - 43

Sanskrit Schools - 05

Colleges - 02

Besides, the Sarva Shiksha Abhiyaan (SSA) has been started in the district

in a big way and there is a lot of improvement underway in the quality of the

buildings through additional classrooms, toilets, hand pumps, annual repair and

maintenance grants etc. Distribution of Teaching and learning materials, text

books etc. is being simultaneously carried out in a big way.

Credit facilities

Banks - 34 PACS - 62 Hospitals

District Hospital - 1 Sub-Divisional Hospital - 1 Referral Hospital - 2 Block P.H.C. - 7 Addl. PHCs - 32 Sub-centre - 81 T.B. Sanitarium - 1 Leprosy control unit - 1

The district has no big industrial unit but there is a network of

village and cottage industries comprising hand looms, local spinning units, shoe

making, carpenters, brick kiln, stone crushers etc. We have an operational Milk

Chilling Plant with a capacity of 5000 Litres per day which is being run by

COMFED, Bihar.

As far as infrastructure for tourism is concerned, we have a few

places to mention. There are three historical places in the district. The foremost

one of Barabar or "Vanavar", situated 11 kms to the east of the NH - 31 from

Makhdumpur, has the temple of Lord Shiva in the name of Baba Sidheshwar



15

Nath, at the top of the hill, about 1100' above M.S.L. There are a few rock cut

caves namely Karna Chaupar and Sudama, relating to the times of Emperor

Ashoka. There is a Lomash Cave, named after a saint. A spring known as Patal

Ganga is said to be built by Ashoka. There is Nagarjuni caves located nearby.

The great Chinese traveler, Huen-Tsang, had visited this place and had described

it in his book. It has been described in E.M. Forster's "A Passage to India". In

recent times the district administration has renovated this place and constructed

two tourist bungalows, a restaurant, a cemented stair case to the top of the hill, a

children's park, boating facilities etc to promote tourism. Another Yatri Niwas is

coming up at the base camp under MPLADS. This place witnesses a huge fair in

the month of "Shravani" and it is estimated that about two to three lakhs of

devotees come to offer their prayers.

Situated 11 km south-east of Jehanabad railway station in Kako

block, Bhelawar is famous for an old temple of Lord Shiva. A big fair is

organised every year on the occasion of Maha Shivaratri. Specimens of art of the

Hindu and Muslim period have also been found here.

Also in Kako itself, which is equally important both for the Hindus

and the Muslims, there is a temple having old statue of Lord Sun in the North-

east of Kako village. It is said that Rani Kekai, wife of King Dasharatha and

step-mother of Lord Rama had domiciled here for sometime. On her name this

village got the name as 'Kako'. There is also a graveyard of a great Muslim Sufi

Lady-Hazrat Kamalo Bibi, aunt of Hazarat Makhdum Sahab of Bihar Sharif,

who is said to have been blessed with divine powers.



16

BLOCKS

Sl.No. Variable kako ratni ghoshi makdumpur okhari Jehanabad Hulasga

nj

Total area 33378 142500 102463 100.63 23091

Total

population

145920 215000 70116 126392 77248

Male

population

74000 71250 115219 36038 66010 40013

Female

population

71920 68148 99781 34078 60382 37235

Adolescent

population (10-

19yrs)

38340 15285

Sex Ratio 912 912 1000-866 918

4380 2137 2103

8760 6413 4207

Child

population: 0-6

months

:6mn-2yrs

:2-5yrs

13140 12825 6310

14165 9700 32250 12540 15271 SC population :

Male

: Female

13354 8500

103 00 00 ST population :

Male

: Female

128 00 00

BPL

population

17222 13000 8847

No of Eligible

couples

24820 19950 23138

Total no. of 16 14 10 22 08 14 09



17

gram

panchayat

Total no. of

revenue

villages

100 52 100 48

No of APHCs 04 07 06 05 03 05 02

No of HSCs 16 10 11 22 10 13 10

No. of

Anganwadi

centers

143 123 89 215 80 214 77

No of Doctors

No of ANMs

No of Grade A

Nurse

No of

Paramedicals

No. of

Anganwadi

workers

136 120 88 204 80 211 77

No of ASHA 151 135 100 182 80 138 85

Total No. of

SHG/ Mahila

mandals

136 80 76

No. of primary

schools

95 59 15

No. of

electrified

villages

85 13 52

48

275

No. of villages

having source

of drinking

water:

Well

21412

5870



18

Planning Objective And Priorities

The Planning Objective for the District Health Action Plan 2011-12 has been decided on the basis of Goals of NRHM, Guidelines of State Health Society and DHAP of 2010-11. Followings are the Objective and priorities of planning of Jehanabad district:

1. Strengthening safe institutional Delivery by JBSY 2. Reducing Maternal and infant mortality rate by adopting tools of maternal

autopsy and increasing focus on neo natal child care by starting SNCU in the district headquarter.

3. Special focus on ARSH Programme by starting separate clinics for adolescents, and training frontline workers to create awareness regarding RTI/STI and UTI.

4. Vulnerable sections to be given priority in all health care facilities. 5. Increasing Immunization Coverage. 6. Family planning and unmet needs of contraceptives to be met with. 7. Increasing community participation in the health system by formation and

strengthening of VHSC, effective functioning of Rogi Kalyan Samiti at PHC and Registration of RKS at APHC level. Proper utilization of untied fund at PHC and HSC level.

8. Training to all frontline facility providers to be given. 9. Awareness and BCC regarding all communicable and vector borne diseases.

Specific and Non-Negotiable Steps to be taken by Je hanabad district in the year 2011-12 with special focus on Blocks situation:

1. Initiating SNCU in the District hospital , Jehanab ad

2. Radiology, Pathology and Ultrasound facilities in a ll PHCs and Referral

hospitals.

3. Up gradation of Blood Bank of Jehanabad.

4. ISO certification for District Hospital, Makdumpur Referral and Kako PHC.

5. Generic Drug Storage at all seven PHC. Presently st orage is only in District

Hospital.

6. To provide special health facility in Naxal affecte d areas of Jehanabad district.

7. Establishment of NRC at district level.



19

Planning Process → Planning in the district began in September 2010 with the Fast Track Capacity

building Programme in State health Society, Patna. The District Level planning team was formed and training was given. The Jehanabad training team consisted of:

• DTO • DPM • DPC • DAM • MOIC of PHC Hulasganj.

→ The team after taking State level training organized a workshop in the District in

which MOICs, BHMs and accountant of each block were trained for preparing Block level planning.

→ All the Programme officers of the district participated in the workshop along with District accounts Manager.

Civil Surgeon had energized the workshop by giving his presence and participation throughout the day. ACMO, who is the nodal person facilitated the workshop and announced the district Programme officers as the nodal officers for different blocks. Mr. Manish Mani from NHSRC and Ms. Shefali from PHRN facilitated the process and components of planning. Further formats were discussed by DPM,DPC and queries were solved.

→ Further at each block a workshop was done and all the members of Block PHC and ANMs were sensitized and given orientation regarding the planning. The District Programme officers in charge for the block facilitated the workshop in their blocks.

→ All the blocks filled up the situation analysis format and took out the gaps present in their facilities.

→ Thereby district compiled the data and added the information, goals, issues, strategies, activities and budget of the district and submitted it to the State by 15th December 2010.

Thus the final Draft of District Health Action Plan of Jehanabad district for the year 2011-12. with Block as the basis of planning came in this final shape.



20

DISTRICT WORKSHOP: ----------------



21

CHAPTER 2

SWOT ANALYSIS OF PART

A,B,C,D



22

SWOT ANALYSIS

SWOT ANALYSIS OF PART “A”

STRENGTH *Skilled clinical staff.

* Doctors availibity.

* Blood Bank at DH, and blood storage unit at RH Makhdumpur.

* Better linkage facility to Gaya medical College and PMCH, Patna.

* Ambulance facility at all APHC to quick refer according to requirement.

* Good linkage facility and Pucca road village to PHC and higher level facility.

WEAKNESS • lack of specialist Doctors.

• Lack of all PHC Blood storage unit.

• Lack of proper training to all clinical staff.

• Lack of SNCU at district level.

• Lack of NRC for under nutrition child.

OPPORTUNITY • Opportunity to Start NRC.

• Strengthen All clinical staff after giving training.

• Opportunity to start SNCU.

THREAT • Threat of demotivation of clinical staff due to lack of HR Policies and

NAXAL AFFECTED AREA which will initiate adverse affect.

• Threat of Drought.



23

SWOT ANALYSIS OF PART “B”

STRENGTH • Well qualified Management and Administrative wing.

• To manage Asha now we have Block community Mobilizer.

• For Better Planning DPC at district level.

• AYUSH Doctor at APHC to initiate AYUSH Treatment.

• Better cold Chain Status.

• Functioning of RKS at all PHC.

WEAKNESS • Lack of Infrastructure.

• Lack of Functioning of RKS at APHC level.

• Lack of Some selected facility to delivery.

• Lack of proper procurement of Drug.

OPERTUNITY

• We have sufficient land to infrastructure strengthening.

• Opportunity to develop skill of ASHA to deliver Health Facility to

villagers.

• Opportunity to select some facilities for Deliveries.

THREATE

• Threat of Naxalism.



24

SWOT ANALYSIS OF PART “C”

STRENGTH • Better Cold Chain status.

• To monitor RI Program better Team as DIO, CS, ACMO, DPM,DCHM,

BHM,JCHM, DPC.

• Special focus to out reach site.

WEAKNESS • Lack of Proper Documentation.

• Lack of vehicle to monitor RI Programme.

• Lack of training to ANM on RI.

OPERTUNITY • Opportunity to insure 100% RI By Providing Vehicle to all Officers.

• By giving training Documentation can be done better,which will

insure improvement in RI coverage.

THREATE



25

SWOT ANALYSIS OF PART “D”

STRENGTH • Each separate Unit for each vector born and other disease.

• Additional support of outside agencies in Different programme as like

in TB Damien Foundation India Trust.

WEAKNESS • lack of proper coordination with other internal department.

• Lack of combined approach for improvement of health system.

• Lack of proper Documentation.

OPERTUNITY • NRHM part D component include all other diseases so opportunity to

bring under one umbrella.

• Opportunity to focus on each disease.

THREATE



26

Bihar- Jehanabad HMIS DATA ANALYSIS 2009-10

BIHAR-JEHANABAD- Summary-Apr'09 to Mar'10

ANC

ANC Registration against Expected

Pregnancies 318%

TT1 given to Pregnant

women against ANC

Registraion

21%

3 ANC Check ups against ANC

Reigtrations 9%

100 IFA Tablets given to

Pregnant women against

ANC Registraion

2%

Deliveries

Unreported Deliveries against

Estimated Deliveries 34.4%

HOME Deliveries( SBA&

Non SBA) against

Estimated Deliveries

0.3%

Institutional Deliveries against

Estimated Deliveries 65.3%

HOME Deliveries( SBA&

Non SBA) against

Reported Deliveries

0.5%

Institutional Deliveries against

Reported Deliveries 99.5%

C Section Deliveries

against Institutional

Deliveries( Pvt & Pub)

0%

Births & Neonates Care

Live Births Reported against

Estimated Live Births 37%

New borns weighed

against Reported Live

Births

58%

Still Births (Reported) 233

New borns weighed less

than 2.5 kgs against

newborns weighed

9%

Sex Ratio at Birh 1,033

New borns breastfed

within one hr of Birth

against Reported live

Births

26%

Child Immunisation( 0 to 11 mnths) BCG given against Expected Live

Births 92%

Measles given against

Expected Live Births 79%

OPV3 given against Expected Live

Births 87%

Fully Immunised Children

against Expected Live

Births

35%

DPT3 given against Expected Live

Births 87%



27

Bihar-Jehanabad- Deliveries Apr'09 to Mar'10

Total Population 10,37,295 Expected Deliveries 31,437

Home SBA Home Non SBA Institutional Total Deliveries

Reported Unreported Deliveries

59 34 20,520 20,613 10,824

Home SBA % Home Non SBA% Institutional % Total Deliveries

Reported % Unreported Deliveries %

0% 0% 65% 66% 34%

Family Planning Family Planning Methods Users (

Sterilisations(Male &Female)+IUD+

Condom pieces/72 + OCP Cycles/13)

8,495 IUD Insertions against

reported FP Methods 36%

Sterilisation against reported FP

Methods 52%

Condom Users against


OCP Users against


Other Services OPD 4,84,225 Major Operations 50

IPD 110 Minor Operations 11,876



28

Bihar-Jehanabad- C sections & Complicated Deliveries Apr'09 to Mar'10

Institutional Deliveries (Public) Institutional Deliveries (Pvt)

20,520 -

C Section 59 -

C Section% 0% 0

Complicated Pregnancies attended 61 -

Complicated Pregnancies attended % 0% 0



29



30

Bihar-Jehanabad - Births - Apr'09 to Mar'10

Live Birth - Males

Live Birth - females

Live Birth - Total

Sex Ratio at birth Still Birth Abortion(

Induced/Spontaneous

5,607

5,792

11,399

1,033

233 13



31

Bihar-Jehanabad- Apr'09 to Mar'10

Total Abortions Abortion Rate

101 0.3%

Bihar-Jehanabad-Sterilisations - Apr'09 to Mar'10

Reported %age of Reported Sterilisation

Total

Sterilisation

4,405 -

NSV

2,394 54%

Laproscopic

- 0%

MiniLap

2,011 46%

Post Partum

- 0%

Male Sterilisation

2,394 54%

Female Sterilisation

2,011 46%

Bihar-Jehanabad-FP Methods - Apr'09 to Mar'10

Reported %age of All Reported FP Methods



32

Total Reported

FP Methodd (All

types) Users

8,495 -

Sterilisations

4,405 52%

IUD

3,074 36%

Condom Users

684 8%

OCP Users

332 4%

Limiting

Methods

4,405 52%

Spacing

Methods

4,090 48%

Bihar-Jehanabad- Service Delivery - Apr'09 to Mar'1 0

Operation major (General and

spinal anaesthesia)

Operation minor (No or local

anaesthesia) AYUSH Dental

Procedures

Adolescent counselling

services Total OPD

Total

IPD

50 11,876

24 24 - 4,84,225

110

Operation major (General and

spinal anaesthesia) as

%ge of OPD

Operation minor (No or local

anaesthesia)as %ge of OPD

AYUSH as %ge of

OPD

Dental Procedures as %ge of OPD

Adolescent counselling services as %ge of OPD

IPD as

percentage of

OPD

0.0% 2.5% 0.0% 0.0% 0.0% 0%



33

CHAPTER 3

NRHM PART “A”



34

Part A- RCH Maternal Health:

MATERNAL HEALTH

Logical Framework

Sl. Goal Sl. Impact indicators

1 To

improve

maternal

health

1.1 Reduction in MMR

Sl. Objective

s

Sl. Outcome

indicators

Sl. Strategy Sl. ACTIVITES

1.1.1.1 TO make

all PHC

functional

OT and

Labour

room with

equipment

1.1.1.2 All PHC

having

Obestetric

First Aid

medicine

24hrx 7

days

1 To

increase

100%

institutio

nal safe

delivery

by 42.5%

( DLHS3)

to 100%

by year

2012

1.1 % of

institutional

delivery

reported

1.1.1 To make

functional PHC

(24hr x7days) for

institutional

deliveries

1.1.1.3 Grade A

nurse

available

24hrx7days



35

1.1.1.4 functioning

all PHC

Neo-natal

care units

1.1.2.1 One FRUs

having

functional

blood

storage

units

linkage with

blood banks

and 24hr

ready

referral

transport

1.1.2.2 No of FRUs

having

EmOc and

CEmOc

facilities

1.1.2.3 No of FRUs

having

specialist

doctors/

multiskilled

Medical

Officers

1.1.2 To make

functional FRUfor

institutional

deliveries

1.1.2.4 No of FRU

having

functional

Neo-natal

care units

1.1.3 To provide

Referral transport

services at FRU

/PHC

1.1.3.1 No of

pregnant

women

availed the

referral

facilities

(pick up and



36

drop)

1.1.4 To strengthen

Janani Suraksha

Yojana / JSY

1.1.4.1 Nos

pregnant

women

reecieved

JSY

payments

immediatel

y after

delivery

2 To

increase

safe

delivery

by

trained

SBA

10.6%(

DLHS3) to

100% by

year 2012

2.1 Proportion of

birth

attendent by

skilled health

personnel

2.1.1 To ensure

support of SBA at

home deliveries

2.1.1.1 home

deliveries

attended by

SBA trained

ANM.

3.1.1.1 Almost all

HSCs having

ANMs

3.1.1 To strengthen

HSC for providing

outreach

maternal care

3.1.2 To organise

integrated RCH

camps specially

for hard to reach

areas, isolated

population and

Maha Dalit Tolas

3.1.2.1 f RCH

camps

planned

and held

3 To

increase

ANC

coverage

with

quality

30.6%

(DLHS3)

to 75% by

year 2012

3.1 ANC reported

through HMIS

formats / Form

-7

3.1.3 To improve

adolescent

reproductive and

sexual health

3.1.3.1 No of

pregnant

adolescent

counselled

by ANM/



37

AWW/ASHA

so activity

at HSC,

AWW

center.

3.1.4 To accelerate

APHC for OPD

and Fixed AN

clinics

3.1.4.1 Insure of

OPD clinics

organized

at APHC

level.

4 To

provide

safe

abortion

services

at all

facilities

4.1 % MTP cases

reported

through HMIS

formats / Form

-7

4.1.1 To provide MTP

services at health

facilities

4.1.1.1 No of

facilities

having MTP

services

(public and

private

involvemen

t)

5 To

increase

communi

ty

participat

ion in

maternal

care

5.1 % of Mahila

mandal

meetings

conducted.

5.1.1 To strengthen

Monthly Village

Health and

Nutrition Days

5.1.1.1 monthly

Village

Health &

Nutrition

Days

planned

and held

MATERNAL HEALTH

Sl

.

Strategy Sl Gaps Sl Activities

Infrastructure

A

1

To make

functional

PHC (24hr

x7days) for

institution

al

deliveries

1.1 All PHCs are

running with only

six bedded

facility. All of

facilities are not

adequate as per

IPHS norms.(List

attached,

1.1.1 Need based ( Service

delivery)Estimation of

cost for up gradation

of PHCs

Selection of any two

PHCs for ISO

certification in first

phase



38

1.2 At present 7 PHC are

working with average

10 delivery per day,

10 FP

operation/emergency

operation and 125

OPD per day in each

PHC. This huge

workload is not being

addressed with only

six beds inadequate

facility.

1.2.1 2. Preparation of priority

list of interventions to

deliver services and insure

use of patograph by ANM.

1.4 The comparative

analysis of facility

survey(08-09) and

DLHS3 facility

survey(06-07) , the

service availability

tremendously

increased but the

quality of services is

still area of

improvement.

1.4.1 2. Sending the

recommendation for the

certification with existing

services and facility detail.

1.5.1 3 Prioritizing the

equipment list according

to service delivery and

IPHS norms.

1.5 Lack of equipments as

per IPHS norms and

also under utilized

equipments.

1.5.2 Purchase of equipments

1.6 Lack of appropriate

furniture

1.6.1 Purchase of Furniture

1.11 Lack of facilities/ basic

amenities in the PHC

buildings

1.11.1 Rennovation of all 7 PHCs

1.12 As per IPHS norms

each PHC requires

the following clinical

staffs:(List attached)

Salary of Contractual

Doctors



39

1.12.1 Selection and recruitment

of Doctors on contractual

basis and give priority in

selection those who are

living in same PHC.

1.12.10.1

1.12.10

Salary of Contractual

Grade A+

Selection and recruitment

of grade A for conducting

delivery


of dresser


of Pharmacist.

Three month indication

training of Grade A nurse

under supervision of

District level resource

team.

1.13 1.13.1 Training need Assessment

of PHC level staffs

Honorarium of Block

Accountants

Rent of Data Center

Honorarium of BHM

Mobility support to BHMs/

Accountant

1.14 1.14.1 Appointment of Block

Health Managers,

Accountants in all

institutions.(7 PHCs, 2

Referrals and Sadar

hospital.) and 2 extra

Accountant in Sadar

Hospital and Referral

Hospital, Ghosi)

But the actual

position is not

sufficient as per IPHS

norms List of Human

resource is attached

in Annexure “A”

Process of all recruitments



40

Trainings of BHMs on

Health statistics

Training on Program,

Finance management and

HMIS

Drug Supply

1.16 Irregular supply of

drugs because of lack

of fund disbursement

on time.

1.16.1 Ensuring the availability of

FIFO list of drugs with

store keeper. And ABC

Analaysis.

1.17 Only 38 essential

drugs are rate

contracted at state

level .

1.17.1 Implementing

computerized invoice

system in all PHCs

Purchase of Drug invoice

software and one pc.

Lack of fund for the

transportation of

drugs from district to

blocks.

1.17.2 3.Fixing the responsibility

on proper and timely

indenting of medicines(

keeping three months

buffer stock)

1.18 1.18 .Payment from Rogi

Kalyan samiti account.

1.19 There is no clarity on

the guideline for need

based drug

procurement and

transportation.

1.19.1 5. Orientation meetings/

training on guidelines of

RKS for operation.

1.20.1 6. Enlisting of equipments

for safe storage of drugs.

1.20.2 7. Purchase of enlisted

equipments.

1.2 Drugs are not

properly stored

1.20.3 8.training of store keepers

on invoicing of drugs

Performance



41

1.21.1 Excessive load on PHC

in delivering all

services i.e. 10

deliveries per day, 4

inpatient Kala-azar,

10 FP

operation/emergency

operations and 120

OPD per day in each

PHC.

1.21.2 Doctor vacancies list

are enlisted in

annexure A

1.21.1 Recruitment of Doctors on

contractual basis

1.22.1 Hiring of rented houses

from RKS fund for the

residence of doctors and

key staffs.

1.22.2 Incentivizing doctors on

their performances

especially on OPD, IPD, FP

operations, Kala-azar

patients treatment.

1.22 All posted doctors are

not regularly present

during the OPD time

so the no of OPDs

done is very less( only

average16 patients

per Doctor per OPD

days, however the

IPHS norms says that

the OPD should be 40

per Doctor.) 1.22.3 Revising Duty rosters in

such a way that all posted

doctors are having at least

8 hrs assignments per day

1.24 07 PHCs are lacking

24 hrs new born care

services.

1.24.1 Ensure 24 hrs new born

care services in all 7 PHC.

1.27 Lack of 24 hrs BEmoC

services.

1.27.1 Ensure 24 hrs BEmoC

services at 07 PHC

Training of Doctor from

each PHC on BEmoC.

Equipments for BEmoC



42

1.29 All Phc have T.B lab

Technician. In

addition to this the

regular lab technician

has been deputed for

this purpose.

1.29.1 Deputation of regular Lab

tech at PHC level for

providing free of cost lab

services to all pregnant

women and BPL families.

Training of TB lab

technician on other

pathological tests.

1.3 1.30.1

Purchase reagent

(recurring) for

strengthening lab.

Purchase of equipments/

instruments if needed.

Fund could be rooted

through RKS and if it is not

utilized it could be

diverted to other women

and child friendly

activates.

1.32 Health facility with

AYUSH services is not

being provided

Establishing one

Panchkarm center in Kako.

Establising two

homeopathy centers in

Kako and Makhdumpur.

1.33 Referral Services

1.33.1 No pick up facility for

PW or BPL patients.

1.33.1.1 Provision for pick up &

drop out for pregnant

mothers and BPL families

free of cost using existing

Ambulance services at

PHC level.

Provide EDD list of

pregnant women to

Ambulance driver and

Number of ambulance

deriver and 102 /PHC tell



43

No to all Pregnant women

1.33.3 Lack of maintenance

of ambulances

1.33.3.1 Repairing of 2 defunct

Ambulances

1.33.4 Shortage of

ambulances

1.33.4.1 Hiring of ambulances as

per need.

Prepare list of Vehicle

those are utilised in

Monitoring work in PHC

that can be use in pick up

and drooping facility for

PW.

1.34.1 Assigning mothers

committees of local BRC

for food supply to the

patients in govt’s

approved rate.

Rewiev of Cleanliness

activity in all PHC by

Quality assurance

committee and payment

of agency should be link

with it.

1.34 Quality of food,

cleanliness (toilets,

Labour room, OT,

wards etc) electricity

facilities are not

satisfactory in any of

the PHC.

1.34.2 Hiring of workers for

cleanliness of OT and

Labour room in PHC

Perchage equipments and

uniform for clinginess in all

PHC

Training of Workers on

using

machine/equipments and

importance of clinginess .

Develop mechanism for

monitoring of clinginess



44

work

1.35 All PHCs have their

own generator sets

but are not in use.

1.35.1 Repairing of PHCs genets

and initiating their use.

1.7 Printing of formats and

purchase of stationeries

1.7.2 Biannual facility survey of

PHCs through BHM as per

IPHS format

1.7 Non availability of

HMIS

formats/registers and

stationeries

1.7.3 Regular monitoring of PHC

facilities through PHC level

supervisors in IPHS format.

1.8.1 Ensuring regular monthly

meeting of RKS.

1.8 Operation of RKS:

1.8.2 Appointment of Block

Health Managers,

Accountants in

institutions.( 01 Referral

Hospital Ghosi.)

1.9 Lack in uniform

process of RKS

operation.

1.9.1 Training to the RKS

signatories for account

operation.

1.9.2 Trainings of BHM and

accountants on their

responsibilities.

1.1 Lack of community

participation in the

functioning of RKS.

1.10.1 Meeting with community

(School children or

other)representatives on

erecting boundary,

beautification etc,

1.10.2 Meeting with local public

representatives/ Social

workers and mobilizing

them for donations to RKS.



45

1.36 In serving emergency

cases, there are

maximum chances of

misbehave from the

part of attendants, so

staffs reluctant to

handle emergency

cases.

1.36.1 Meeting in RKS with Local

Police Station in charge to

handle emergency

situation .

Training local

NCC/NYK/Scout &

Guide/NSS etc. volunteers

on identification of

emergency situation. And

deployment of volunteers

at PHC.

1.37 Several cases of theft

of instruments,

computers, and

submersible pumps

etc at PHCs.

1.37.1 Insurance of all properties

and staffs of PHC

1.38 No guidance to the

patients on the

services available at

PHCs.

1.38.1 Pictorial wall painting on

every section of the

building denoting the

facilities and attached

trained volunteers to

guide patients.

Name plates of Doctors 1.39 Non friendly attitude

of staffs towards the

poor patients in

general and women

are disadvantaged

group in particular.

1.39.1

Displaying Name

Photograph and DOB of all

staff of PHC and put

clinginess staff name on

top of the list.

1.41 Lack of counseling

services

1.41.1 LHV experience can be

utilize in counseling work

of women and adolescent

girls after training.

1.42 there is no hot water

facility for PW and

there is no adequate

liting facility at

adjoining area of PHC

1.42.1 Installation of solar heater

system and light with the

help of BDO/Panchayat at

PHC or purchase

equipments from market.



46

1.43 Lack of convergence 1.43.1 Convergence meeting by

RKS & DHS

1.44.1 Orientation of the staffs

on indicators of reporting

formats

1.44 Lack of timely

reporting and delay in

data collection

1.44.2 Purchase of Laptops for

DPC with internet facility.

1.45.1 Gardening

1.45.2 Sitting arrangement for

patients

Construction of patients

waiting shade

1.45.3 Installation of LCD

projector for manages

Waite over time of OPD

patients.

1.45.4 Installation of safe

drinking water

equipments/water cooler,

1.45.5 Apron with name plates

with every doctors

1.45.6 Presence of staffs with

uniform and name plates.

1.45 Lack of space for

waiting,

environmental

cleanliness around

PHC, provision for

hospitality etc

1.45.7 Payment of 63 MAMTA

@100 Rs.

2.1.1 Devlop PHC Makhdum,pur

and Sadar Hospital for C-

section facility

2.1.2 Training of MOs of 5 PHCs

in mullti skilling.

2.1 C-Section deliveries

are not conducted in

institution.

2.1.5 Specialist should be

posted at Sadar

Hospital/and above



47

mention five PHC

2.1.6 C-section in a month the

incentive money should be

distributed among all staff

of the PHC after the

decision of RKS.

2.1.8 Need based Equipments

and drugs in O.T and

Labour room.

None other of the

PHC provides 24 hour

blood transfusion

services, however

PHC Makhdumpur has

been established

blood storage unit.

Up gradation of district

blood bank.

Training of lab technician

on management of blood

storage

Infection control

protocols is not at all

maintain at all

facilities

2.2.2 Licensing blood storage /

blood bank

2.2.3 Meeting infrastructure

requirements as per

norms Blood BANK.

2.2.4 Training of MO and lab

tech/ staff nurse blood

storage on

grouping /cross matching

and management of

transfusion reactions

stabilized linkages with

mother blood bank.

2.2.5 Provide free of cost Blood

for pregnant women who

need blood transfusion for

severe anemia/ PPH on

prescribed through RKS



48

Fund

2.2.11 Organize Blood donation

camps at all institution

and mobilize community

for voluntary blood

donation

2.3.1 Provision of food for the

delivered mothers and

mothers under gone in

tubectomy in all the health

facilities.

2.3.2 Mobilize community

Resources for providing

Free food for PW at

Institution.

2.3 Welcome PW at

Institution and PHC

and FRU

2.3.3 Quality indicators (clean

environment, wards with

clean linen, clean toilets ,

clean labour rooms,

running waters supply, hot

water and protected

water for inpatients, new

born corners, treatment

protocols, aseptic

precautions, immediate

disbursement of

2.4.1 Training of ASHA & ANM

on reporting of Maternal

deaths and conduct

Verbal Autopsy

2.4.2 Incentives for maternal

death reporting by ASHA

@ Rs 50/-per maternal

death

2.4 Reporting of maternal

death Maternal death

reporting is usually

not reported by

worker

2.4.3 Reporting line should be in

five columns – name of

mother, place of death,

date of death, cause of

death and no. of birth.



49

2.4.4 Institution and urban

center also to report

Maternal death to the

district CS/CMO.

2.4.5 Maternal Death should be

reported by ASHA AWW,

ANM Staff Nurse &

Doctors to the district data

center .

2.4.6 Investigation of maternal

death by district team. and

third party review(District

magistrate)

2.4.7 Training of ASHA and

investigation team

objective and process of

investigation and review

of maternal death

2.5.1 Procurement of

equipment and staff

recruitment.

2.5 Biomedical waste

management is not

properly taken care

off at all institution 2.5.2 As per example Introduce

color coded buckets for

facilities as per IMEP

4.1 Tracking of pregnant

women from first

Trimester is not done

form the register.

4.1.1 Review of early

registration with 3 AN

checkup ,two TT.100/200

IFA Tab. in ASHA Diwas.

4.2.1 Ensure 100 %Pregnancy

Test Kit is to ASHA and

regular supply.

4.2 Too much

documentation

process. Photo

required for mother

and baby. It cost

Rs.30/- to Rs.60/- .

4.2.2 Direct transfer of funds

from district to PHC

through core banking /

directly from DHS



50

4.2.3 Finger print

technology for JSY

beneficiaries at

facility level where

computer with

internet facility is

available. This will

help in financial

monitoring.

4.2.4 The photo system

should be replaced by

some other

alternatives like-

bank account

opening of pregnant

women in first

trimester and directly

transfer the money to

their account after

delivery.

Incentive for

institutional delivery.

5.1.1 Home Delivery should

be conducted by SBA

trained Staff Nurse or

ANM.

5.1.2 Provision of Dai

Delivery kit(DDK) to

TBA where institution

access is poor. And it

should be supervised

by ANM for home

deliveries.

5 To ensure

support of

SBA at

home

deliveries

5.1 Home Delivery is

still prevailing

through untrained

traditional Dai’s

5.1.3 Delivery kit

(equipment,

medicine)for ANM

should be supplied



51

5.1.4 Supply of delivery Kits

as per number of

deliveries conducted

in home.

5.2 Reporting of

home delivery is

not done so the

PNC is not

provided

5.2.1 Incentive based

system for reporting

of home delivery by

ASHA and it should

linked with ANM

5.3 Non payment of

Home delivery

through JSY

5.3.1 The JSY money to the

mother who has

delivered baby at

Home paid by ANM.

Infrastructure

6.1 Out of 81HSCs

only 34 are having

own building

6.1.1 Strengthening of HSCs

having own buildings

6.2.1 White washing of HSC

buildings.

6.2.2 Organize adolescent

girls for wall painting

and plantation./hire

local painter for

colorful painting of

HSC walls.

6.2.3 List out all services

which is provided at

HSC level. On the

wall.

6.2 In existing 34

buildings 10 are in

running

comparatively in

good condition,

18 are being

renovated, one is

very poor

condition.

6.2.4 Gardening in HSC

premises by school

children.

6 To

strengthen

HSC for

providing

outreach

maternal

care

6.3 No one building is

having running

water and electric

supply.

6.3.1 Mobilize running

water facility from

near by house if they

have bore well and

water storage facility

and it could be on

monthly



52

rental.(Untied fund)

Arrangement of

water supply up to

HSC ( Wiring ) from

water source

6.4.1 Purchase of

Furniture Prioritizing

the equipment list

according to service

delivery(for ANC

/Family planning

/Immunization/)

6.4.2 Purchase of

equipments according

to services

6.4 Lack of

appropriate

equipments and

ANM are

reluctant to keep

all equipments in

HSC .

6.4.3 Purchase one almarah

for keep all

equipment safely and

it could be keep in

AWW / ASHA house.

6.5.1 Strengthening of HSCs

running in rented

buildings.

6.5.2 Estimation of backlog

rent and facilitate the

backlog payment

within two months

6.5.4 Purchase of

Furniture as per need

where building is on

rent

To

strengthen

HSC for

providing

outreach

maternal

care

6.5 Non payment of

rent of 20 HSCs

for more than

three years

6.5.5 Prioritizing the

equipment list

according to service

delivery



53

6.5.6 Purchase of

equipments as per

need

6.6.1 Preparation of PHC

wise priority list of

HScs according to

IPHS population and

location norms of

HScs

6.6.2 Community

mobilization for

promoting land

donations at

accessible locations.

6.6 The district still

needs 83 more

HSCs to be

formed.

6.6.3 Meeting with local

PRI /CO/BDO/Police

Inspector in smooth

transfer of

constructed HSC

buildings.

6.7.1 Biannual facility

survey of HSCs

through local NGOs as

per IPHS format

6.7.2 Regular monitoring of

HSCs facilities

through PHC level

supervisors in IPHS

format.

To

strengthen

HSC for

providing

outreach

maternal

care

6.7 Non participation

of Community in

monitoring

construction work

6.7.3 Monitoring of

renovation/constructi

on works through

VHSC members/

Mothers

committees/VECs/oth

ers as implemented in

Bihar Education

Project.



54

6.7.4 Training of

VHSC/Mothers

committees/VECs/Ot

hers on technical

monitoring aspects of

construction work.

6.7.5 Quarterly Meeting of

one representative of

VHSC/Mothers

committees on

construction work

and other issues

6.8.1 Formation and

strengthening of

VHSCs, Mothers

committees,

6.8.2 “Swasthya Kendra

chalo abhiyan” to

strengthen

community

ownership

One week Training of

Nukkad Natak team

on IPHS

6.8.3 Nukkad Nataks on

Citizen’s charter of

HSCs as per IPHS

6.8 Lack of

community

ownership in the

6.8.4 Monthly meetings of

VHSCs, Mothers

committees

Human Resource

7.1.1 Selection and

recruitment of 67

ANMs

7

7.1 1.Out of 13

sanctioned post

of LHVs only 05

are placed,

2.All 240 posted

ANM are not

trained enough to

deliver services.

3. 67 seats of

7.1.2 Selection and

recruitment of 28

male workers



55

7.1.3 Training need

Assessment of HSC

level staffs by BHM in

weekly meeting

contractual are

Vacant.

7.1.4 Training of staffs on

various services in the

PHC,

7.2.1 To Start an ANM

Training School in the

District.

7.2.2 Deployment of

required

staffs/trainers

7.2.3 Hiring of trainers as

per need

7.2.4 Preparation of annual

training calendar

issue wise as per

guideline of Govt of

India.

To Open

ANM

Training

School for

providing

regular

training to

ANMs.

7.2

7.2.5 Allocation of fund and

operationalization of

allocated fund

Drug Kit Availability 8 To

strengthen

HSC for

providing

outreach

maternal

care

8.1 No drug kit as

such for the HSCs

as per IPHS

norms.(KitA, Kit B,

drugs for delivery,

drug for national

disease control

program (DDT,

MDT, DOTs,

DECs)and

contraceptives,

8.1.1 Weekly meeting of

HSC staffs at PHC for

promoting HSC staffs

for regular and timely

submission of indents

of drugs/ vaccines

according to services

and reports



56

8.1.2 Ensuring supply of Kit

A and Kit B biannually

through Developing

PHC wise logistics

route map

8.1.3 Hiring vehicles for

supply of drug kits

through untied fund.

8.1.4 Developing three

colored indenting

format for the HSC to

PHC(First reminder-

Green, Second

reminder-Yellow,

Third reminder-Red)

8.1.5 Hiring of couriers as

per need

No Drug kit for

AWCs(@one kit

per annum,) . No

ASHA kit, only

need based

emergency but

that too being

irregular in supply

8.1.6 Payment of courier

through ANMs

account

Performance

9.1.1 Training of signatories

on operating Untied

fund account, book

keeping etc

9.1.2 Timely disbursement

of untied fund for

HSCs

9.1 Unutilized untied

fund at HSC level

9.1.3 Assigning a person at

PHC level for

managing accounts

9.2.1 Identification of the

best HSC on service

delivery

9 To

strengthen

HSC for

providing

outreach

maternal

care

9.2 No ANC at HSC

level Only 26.7%

PW registered in

first trimester

with three ANCs is

30.6%, TT1

coverage is 54.5%

9.2.2 Listing of required

equipments and

medicines as per IPHS

norms in facility

survey



57

9.2.4 Honoring the ANM

those who develop

women friendly HSC

in given criteria (list is

attached)

9.3.1 Gap identification of

39 HSCs through

facility survey

9.3.2 Eligible Couple Survey

9.3.3 Ensuring supply of

contraceptives with

three month’s buffer

stock at HSCs.

9.3.4 One day training of

AWW/ASHA on family

planning methods

and RTI/STI/HIV/AIDS

9.3 Family Planning

Status:-Any

method-

28.2%,Any

modern method-

24.01%,No

sterilization at

HSC level,IUD

insertion -

1%,Pills-

0.9%,Condom-

1.6%,Total unmet

need is 39.8%, for

spacing-15.3%

,Lack of

counseling Skill. 9.3.5 Training of ANMs on

IUD insertion

9.4.1 Review of all disease

control programs HSC

wise in existing

Tuesday weekly

meetings at PHC with

form 6.( four to five

HSC per week)

9.4.2 Strengthening ANMs

for community based

planning of all

national disease

control program

9.4.3 Reporting of disease

control activities

through ANMs

To

strengthen

HSC for

providing

outreach

maternal

care

9.4 HSC unable to

implement

disease control

programs

9.4.4 Submission of

reports of national

programs by the

supervisors duly

signed by the

respective ANMs.



58

9.5 80% of the HSC

staffs do not

reside at place of

posting

9.5.1 Submission of

absentees through

PRI. NO proper

arrangement for stay

over there

9.6.1 Fixed Saturday for

meeting day of ANM,

AWW, ASHA,LRG with

VHSCs rotation wise

at all villages of the

respective HSC.

9.6 Lack of

convergence at

HSC level

9.6.1 Monthly Video shows

in all schools of the

concerned HSC area

schools on health,

nutrition and

sanitation issues.

9.7.1 Training to the field

staffs in filling up

form 6, Form 2,

Immunization report

format, MCH

registers, Muskan

achievement reports

etc

9.7 Lack of

Knowledge and

skill of filled level

staff of data

compilation in

HMIS formats and

format.

9.7.2 Printing of adequate

number of reporting

formats and registers

10.1.1 Identifying Socially

Backward, Slums &

Maha Dalit Tolas.

1

0

To

organize

integrated

RCH camps

specially

for hard to

reach

areas,

isolated

population

and Maha

10.1 Out reach camps

are not organized

in planed manner.

It is totally base

on demand of

organization and

it eventually it is

not reported to

respective HSCs

and PHC.

10.1.2 Hiring trained

alternate vaccinator/

retired ANMs and

Medical officer .hiring

vehicle for fixed day

out reach camps with

drugs.



59

10.1.3 Fixed day OPD clinics

at APHC level and

adjoining HSC of

respective APHCs.

with dedicated MO

and support staff.

10.1.4 To make calendar for

camps with date and

identified areas. And

link NGOs those who

are willing to

organized Camps.

Dalit Tolas

10.1.5 Community based

reporting system

through SMS. involve

PRI members and

training on reporting

and Camp approach

11.1 No training

Programme for

adolescent

particularly health

and sex.

11.1.1 Multipurpose

counselor can be

used for adolescent

care. For this services

of LHV can be used.

and calendar of

activity could be

develop.

11.2 Preventions of

anemia in

adolescence girls

11.2.1 Linkage with

adolescent anemia

control Programme in

Schools with Unicef.

And training to the

one teacher from the

school

11.3 Marriage before

legal age.

11.3.1 Sensitization of PRI

members particularly

women

1

1

To

improve

adolescent

reproducti

ve and

sexual

health

11.4 Preventions of

teen age

pregnancy and

abortion.

11.4.1 Adolescent

pregnancy should be

addressed with

priority care(

eclampsia, 3 ANC,

anemia, 100 IFA,

100% institution



60

delivery, low birth

Wight baby, Brest

feeding. PNC with in

48 hours.

11.6.1 Family counseling for

adolescent pregnancy

tracking on above

mention through

ASHA and AWW.

11.6.2 State to develop and

issue guidelines for

implementation of

Kishori Mandals

Formation of Kishori

Mandals by

registration of all

girls(11-18 yrs)

11.6.3 Prepare a monthly

plan of activities for

one day per week

11.6.4 Counseling nutrition,

health and social

issues every week at

AWCs by AWW

11.6.5 Weekly distribution of

IFA Tablets to out-of-

school girls at AWCs

11.6.6 Deworming

adolescent every 6

months

To

improve

adolescent

reproducti

ve and

sexual

health

11.6 Limited

interventions for

empowering

adolescent girls

11.6.8 Initiate family schools

for learning child care

, safe mother hood

life skills and Family

life education

1

2

To provide

MTP

services at

12.1 MTP services are

not available in

Public sectors

12.1.1 Selection of facilities

for provision of safe

abortion services



61

12.1.2 Location of facility

availability of trained

service provider,

space, equipments.

12.1.3 To Provide

appropriate

equipments at all

facilities and MVA

syringes.

12.1.4 Putting the trained

doctors at

appropriate facilities

to commence the

services

12.1.5 Training of Medical

officers and Para

medical staffs on Safe

abortion services

training including

awareness about

legal aspects of MVA/

EVA and Medical

abortion by IPAS .

12.1.6 Formation of district

level committee (DLC)

to accredit private

sites as per GOI guide

line .

12.1.7 Develop reporting

system of MTP

services in private

and public sector.

health

facilities

12.1.8 Through training

program make the

govt. doctors skilled

to perform MTP in

the approved sites.



62

12.1.9 To Involve community

to aware about

location of services ,

process and legal

aspects of MTP

services through -

AWW, ASHA & ANM,

LRG and mass

media.(IEC)

12.1.10 The services of

Pregnancy testing

should be strengthen

and it should be

linked with MTP

services.

12.1.11 NGO’s and local

Practitioner should be

involved for

counseling and

information of facility

12.1.12 Assurance of privacy

and link with family

welfare services

counseling at all

facility.

12.1.13 Linkage with MTP

services with NGOs

(PPP) those who are

working in Safe

abortion services. and

create one modal

center at district and

PHC level.

To provide

MTP

services at

health

facilities

12.1.14 Training of ASHA on

medical abortion.

13.1.1 AWC should be

develop Hub of

activities (VHND)

1

3

To

strengthen

Monthly

Village

Health and

Nutrition

13.1 Nutrition and

Counseling

Component is not

visible in VHND

and there is no

monitoring of

VHND activity by

13.1.2 Develop an activity

plan calendar for

VHND as seasonality.



63

13.1.3 Counseling of

mothers on ANC,

preparation for Child

care ,STI/RTI, and

AYUSH, adolescent

Health

13.1.4 Organize VHND in

Four Table concept

regularly where One

place is for

registration, one is for

weighing, one is for

immunization and

fourth is for

counseling

13.1.4 Meeting of VHSC and

preparation for area

specific

epidemiological

planning and

community based

monitoring.

13.1.5 Skill development

training is required to

ANM , ASHA & AWW

and Dular (LRG)

13.1.6 Develop monitoring

plan map of each

village and displaced

at AWC with

identification of

priority houses with

PW, lactating women

,Malnourish children ,

New born, DOTs and

other services

Days Community.

13.1.7 SMS reporting system

of conducting VHND

and ANM collect Data

from field level and

compile it in

weekly/Monthly



64

B APHC Infrastructure

To form

/strenghte

n APHC in

Phase

manner

1.3 Out of 32 APHCs

only 11 are having

own building

1.3.1 Registration of RKS

1.4 Existing 11

buildings are not

properly

maintained

1.4.1 Rennovation of

APHCs buildings from

RKS Fund

1.5 Non payment of

rent of 16 APHCs

for more than one

year.

1.5.1 Payment Of Rent of

APHC building

1.6 Lack of

equipments,

1.6.1 Purchase of

equipment as per

service need from

RKS fund

1.7 Lack of

appropriate

furniture

1.7.1 Purchase of Furniture

from RKS fund

Human Resource

2.1 in the district no

any APHC

functioning as per

IPHS norms

2.1.1 Operational sing one

APHC in each PHC by

conducting daily OPD

by Doctor. And

support staff.

2

2.2 2.2.1 Notification from

district for

operational sing APHC

Drug Supply 3

3.1 No drug kit as

such for the

APHCs as per IPHS

norms.

3.1.1 Purchasing 23 listed

OPD Drugs of PHC for

APHC

5 RTI/STI

services at

health

5.1 No regular clinic

at all PHCs &

APHCs.

5.1.1 Trained service

provider on syndrome

management of

RTI/STI (As per GOI



65

guide line) up to

APHC level.

5.1.2 Logistics of setting of

clinics and free drugs

availability

5.1.3 Integrated Counseling

services in four public

sector facilities by

trained personnel.

facilities

5.1.4 IEC/BCC for

awareness available

RTI/STI services at all

health facilities.

Child Health

Logical Framework


1.1 Reduction in IMR 1

To improve Child health & achieve child survival

1.2 Child performance in the school - enrolment, attendance and dropout

Sl. Objectives Sl. Outcome indicators

Sl. Strategy Sl. Output indicators

1 To increase ORS distribution from 13.6%(DLHS3) to 80%

% increase of ORS distribution .

1.1.1

2 To increase treatment of diarrohoea from 74.7% to 90%

1.1

% increase of treatment of diarrhea within two weeks

IMNCI,Home Based Newborn

Care/HBNC

% of PHC initiated

IMNCI and HBNC

training.



66

within two weeks

3 To increase treatment of ARI/Fever in the last two weeks from 72.6%(DLHS3) to 95%

% increase of treatment of ARI/Fever in the last two weeks

4 To increase of infant care with in 24hr of delivery from 29.8%(DLHS3) to 50%

% increase of infant care with in 24hr of delivery .

Straitening of Facility Based Newborn Care/FBNC and trained workers on using equipments.

All PHC initiated HBNC with trained MAMTA, ASHA on facility based new born care..

To increase % of breastfeeding from 18.6% to 70% within 1 hr of birth

% increase of breastfeeding within 1 hr of birth .

To increase initiation of complimentary feeding among 6 month of children from 84.5% to 90%

% increase of complimentary feeding among 6month of children.

To increase exclusive breastfeeding among 0-6 month of children from 10.9% to 80%

% increase of exclusive breastfeeding among 0-6 month of children.

To increase immunizatio

% increase of full

1.1.2

Infant and Young Child Feeding/IYCF

No of training

orgnised in PHC on

IYCF



67

n coverage from47.3% to 70%

immunization coverage .

To increase vit A coverage of received at least one dose (9month to 35 months ) from 66.00% to 80% and include up to 5 years.

To increase Vit A reported adequate coverage among (9m to 5ys )

1.1.3

Management of diarrhea, ARI and Micronutrient Malnutrition through Child survival months

Two round of Child survival Month organized in one finical year.

1.1.4 Care of Sick Children and Severe Malnutrition and strengthen VHND at all AWCs

No of VHND organized vs. Planed.

2

To decrees Malnutrition

form 58%(NFHS III state ) to 30% of the age group of (0 to 5

yrs)

2.1

% of decrease Malnutrition

age group of (0 to 5 yrs)

2.1.1

School Health Programme

No Of school health Programme organized in the PHC

Sl. Strategy Gaps Activities

Assessment of Training

load and prepare

calendar of training

Incorporate ASHA in

IMNCI training team

IMNCI,Home Based Newborn Care/HBNC

Training

Gaps(AWW-

905/925,ASHA-

0,ANM-

150/249,MPW-

0,MO-

100/140,CDPO-

05/7,ICDS Super-

05,Health

supervisors-

15,NGOs-06)

No ASHA is

ASHA kit regular supply

and incorporate use of

ASHA Kit in training

curriculum.



68

trained on

IMNCI

Division of area among

all trained supervisiore

for revision of IMNCI

activity in their area.

BHM will be responsible

for review of health

supervisor and

LS(ICDS)on given format.

Unicef staff will support

in developing review

mechanism in PHC.

Incorpate IMNCI reports

in HIMS format

Encouraging mother

regarding child care. in

VHND

Frequent checkups of

babies by

Pediatrician.Distribute

telephone number to

AWW and ANM of

respective doctors those

who are supervising

them in the field.

Inadequate monitoring of this activity at field level

Wednesday could be

fixed a day for IMNCI

related work at HSC

level



69

Community based

Monitoring support

system develop with

SHG in seven PHC

Training of Group

members

seed money to SHG for

referral services and

other need based

services.

only one

institutions has

baby warmer

machines but

maintenance of

machine is not

up to the mark

and.

All PHCs should be

equipped with baby

warmer machines.

ANMs and

Doctors are not

trained to

operate these

machines

Training of Doctors and

ANM to operate baby

warmer machine.

There is no

provision of stay

of mothers of

neonates at

PHC.

Organize training

programme for newborn

care for the nurses in

the district hospitals

Neonatal Care

Unit not up to

mark.

District level Supporting

supervisory team should

be developing with the

responsibility of

nonfunctioning of

neonatal care

unit.Training of team on

monitoring of NCU

Facility Based Newborn Care/FBNC

Untrained of

“MAMTA” at

PHC level.

Training of Mamta and

staff nurse on logistics of

New born Care units. by

district level supervisory

Team.



70

Colostrums feeding and

breast feeding

inclusively for six

months. Through IMNCI

Training.

Baby friendly hospital

Training of one doctor

form each Nursing

hospital at District Level

Two days training of one

staff nurse from each

private hospital on

counseling skill.

Non awareness

of breast

feeding and

proper diet of

young children.

Accreditation of nursing

home and facility

according to norms of

baby friendly hospital

Development and

Printing of BCC

materials

Preparing adolescent

and pregnant mother

on IYCF by IPC through

AWW, LRP and ASHA

Poor

knowledge

regarding new

born care and

child feeding

practices

Linking JBSY with

colostrums feeding

Infant and Young Child Feeding/IYC

F

Myths and

misconception

s about early

initiation of

breast feeding,

exclusive

breast feeding

and

complementar

Counseling and

orientation of local

priests, opinion

leaders, fathers,

mother in laws by

ICDS/ Health

functionaries in

mothers meetings and

VHSCs meetings



71

Folk performance to

promote exclusive

breast feeding

y feeding

Uniform message on

radio from state head

quarter

Organize social events

through VHSCs

Strengthening of

Mahila Mandal

meetings- fortnightly

with involvement of

adolescent girl

Organize Mela on

healthy baby shows,

healthy mother /

pregnant woman.

Appreciation and

reorganization of

positive practices in

community. For this

purpose hiring a

documentation

specialist.

Celebration of

“Annaprashan(

Muhjutthi) Day” at

AWC

Lack of

awareness on

importance of

appropriate

and timely IYCF

Demonstration of

recipes.

Exposure visits to

existing NRCs to

observe different

models in the country



72

Care of Sick Children and Severe Malnutrition

There is not a single unit in the district where severally malnourished children could be treated.

Establish rehabilitation

center in district

hospital, FRU and one

PHC and promote local

available food formula

for nutritional Therapy

as Hadrabad Mix

Procurement of ,ORS ,

Vitamin A

supplementation(9m to

5 years children) with

De-worming pediatric

IFA syrup.

Include coverage of Vitamin A and IFA, children in New HIMS format.

Insure two round of Vitamin A and deworming for the age group of (9m to 5 yrs) & (2 yrs to 5 yers) respectively in the month of April And Oct as per GOI guide line.

Management of diarrhea, ARI and Micronutrient Malnutrition

There is high prevalence of PEM and anemia among children because of Child nutrition is least priporty among service providers.

Involvement of ICDS,

school teachers and PRI

for monitoring and

evolution

No Pre School

Health checkup

& complete

Immunization

card.

Half yearly health

checkup camp for

children in schools

should be organized.

School Health Programme

No training of

school teacher

for basic health

care and

personnel

hygiene.

Training of school

teacher by the medical

personnel with support

administrative person.



73

No regular

health checkup

camp at school.

Quarterly meetings of

VEC representatives by

attending existing

meetings of VECs

representatives at block

level by the concerned

MOICs and BHMs.

No Training &

Screening of

school’s teacher

for eye sight

test.

Linking existing

ophthalmic paramedics

with this program and

developing school wise

calendar.

School health anemia

control programme

should be strengthen

with bi annually de

worming.

Organizing

competitions/Debates/P

ainting

competitions/Essay/de

monstration and model

preparation of

nutritional food and

health.

Half yearly Health

checkups and health

card of all school going

children.

Films shows on health,

sanitation and nutrition

issues

Social Since Lab

activities.

Rally and Prabhat Phery

in epidemic areas. (Kala-

azar & Malaria)

No other

specific program

has been

formulated in

the district.

Referral system for the

school children for

higher medical care.



74

Family Planning


1 Population stablisation

1.1 To decrease TFR upto replacement level To increase sex ratio

Sl. Objectives Sl. Outcome indicators

Sl. Strategy Sl. Output indicators

2.1.1 Terminal/Limiting Methods

2.1.1.1 % of terminal/limiting methods use

2.1.2 Dissemination of manuals on sterilization standards & quality assurance of sterilization services

2.1.2.2 No of facilities providing quality manuals on sterilization standard of sterilization services.

2.1.3 Female Sterilization camps

2.1.3.3 No of camps organize for female sterilization.

2.1.4 Compensation for female sterilization

2.1.4.4 % of Female received compensation

2.1.5 IUD camps

2.1.5.5 No of IUD used in Camps

2 To increase female sterilisation from present 20.01% (DLHS3) to 50%

2.1 % increase in female sterilisation

2.1.6 Accreditation of private providers for IUD insertion services

2.1.6.6 No of Private providers accrediation for IUD Insertion services.



75

3.1.1

NSV camps

3.1.1.1 No of NSV Camps organize.

3.1.2 Compensation for male sterilization

3.1.2.2 % of Male recived compensation

3 To increase male sterilization from 0.6%( DLHS 3) to 2%

3.1 % increase in male sterilisation

3.1.3 Accreditation of private providers for sterilization services

3.1.3.3 No of Private providers accrediate for Sterilization services.

4.1.1

Promotion to Social Marketing of condoms

4.1.1.1 Insure distribution of Condom through Social Marketing.

4 To increase use of condoms from 1.6% (DLHS3) to 5%

4.1 % increase in the use of condoms

4.1.2

Contraceptive Update seminars

4.1.1.2 No of Seminars Organized on Contraceptive Update.

5 To increase use of pills from present 0.9%(DLHS3) among current married women age 15-49 yrs to 5%

5.1 % increase in the use of pills

5.1.1

Promotion to Social Marketing of pills

5.1.1.1 Pills distribution through Social Marketing.

Sl. Strategy Gaps Activities

Ensure one MO

trained on on

minilap and NSV

up to PHC

Training of nurses

and ANMs on IUD

and other spacing

methods at PHC

level.

Terminal/Limiting Methods

Lack of

knowledge of

small family

norms.

Ensure availability

of contra septives

(indenting ,



76

logistic

Trained doctors

on laparoscopy.

Procure

Laparoscopy

equipments for

trained doctors

Female Sterilization

camps

Laparoscopy

surgery not

done.

Training of

doctors needed.

NSV camps

Trained doctors

are not

available.

Procurement of

equipment.

Compensation for female sterilization

Immediate

disbursement of

incentive after

sterilization

camps.

Logistic planning is

needed before

organizing camps.

Block Health

manager could be

hire one support

staff for

disbursement for

logistic support.

Immediate

disbursement of

incentive after

sterilization

camps.

Compensation for male

sterilization

Fund for Compensation for sterilization is not available on time at facility.

Logistic planning is

needed before

organizing camps.



77

Block Health

manager could be

hire one support

staff for

disbursement for

logistic support.

Accreditation of

private nursing

home. As per GOB

IUD camps

Camps not held

Training of ANM &

staff nurse for IUD

insertion.

Procurement of

IUD.

Equipments for

IUD insertion

Accreditation of private providers for IUD insertion

services

No

accreditation of

private

providers for

IUD insertion

services

Accreditation of

private providers

for IUD insertion

services. As per

GOI guide lines.

Social marketing

of need based OC

& IUD.

Social Marketing of contraceptives

Monitoring of Social Marketing is not monitored by PHC.

Increasing access

to contraceptive

through

communities

based distribution

system free of

cost.

seminars for MO

and other through

Professional

bodies (FOGSI.

BMA, Nursing

association etc. on

Contraceptive Update seminars

Not being held.

Copper-t 380-A

should be



78

popularized.

Awareness for

emergency

contraceptive.



79

CHAPTER 4

NRHM PART”B”



80

NRHM PART “B” DECENTRALIZATION

Issues Objective Gaps Strategy Activities

Asha

support

system

Untied

Fund of

HSC ,

APHC, PHC

Village

health and

sanitation

committee

To Strength

Asha and

deliver

quality

services at

village level

Proper

utilization of

untied fund

at all level

Sentisization

On VHSC.

1. Training needed

to Asha on

various model.

2. unavailable of

asha drug kit.

3. lack of

motivation to

Asha.

4. lack of dress

code.

1. problem

of

under

utilizati

on of

untied

fund.

1.lack of knowledge of ANM

and PRI member about

meaning of VHSC.

1.

2. Gap of utilization of fund of

VHSC.

Capacitate

Asha to

better

approach

at village

level.

Empowring

all level by

giving

knowledge

of use of

untied

fund.

2. Training

needed to

all Asha

on various

model.

3. motivatio

nal

package

for those

Asha who

working

best to

motivate

every

month

Asha.

4. Purchase

s of Asha

drug kit.

5. Distributi

on of

sharee to

Asha

1.workshop on utilization

of untied fund to ANM, MOIC.

1. Combined

meeting of

ANM and PRI

member at

block level with

intervention of

District.

2. work shop

at Block

level on

VHSC.

3. Meeting



81

Rogi

Kalyan

Samiti.

1. lack of proper interest of

member in RKS meeting.

2. Gap of non functional of RKS

at APHC level.

with PRI

member in

presence of

DM & CS.

1.change of those member who

are more than 2 year.

2.quarterly meeting of RKS

member with DH in the presence

of DM.

3.Regestration of RKS at APHC

level.

1.



82

INFRASTRUCTRUE STRENTHING.

ISSUES OBJECTIVE GAPS STRATEG

Y

ACTIVITIES

Infrastructure

stretching

To insure

better

infrastructure

for all level

(HSC,APHC,

PHC, RH,DH)

1.out of 92 HSC

only 34 are

having own

Building.

2.in existing 34

building 10 are

running in good

condition.

3.lack of water

And electricity at

HSC.

4.lack of

equipment

5.There are 32

APHC out of this

11 having own

building that

needed

renovation

Lack of

furniture and

equipment at

APHC level

6. 7 PHC needed land

and new building for

upgradation.

7. DH Hospital

Needed new building

for increase capacity

8.lack of Building for

RH Makhdumpur to

expand but

availability of land

over there.

Special

attention

toward

those

facility

where

needed

building

to satart

24*7

facility

for

Delivery.

1. For 3 HSC

need new

building.

2. for 3 APHC

needed 3

new

construction

of Building.

3. One RH

Makhdumpur

needed

Building.

4. one multiplex

building

needed for

DH.

5. Renovation of

those building

whise needed

at any level(

HSC,APHC,PH

C,RH,DH)



83

Contractual Manpower HR status.

Issues Objective Gaps Strategy Activities.

Block

programme

Management

Unit.

District

Programme

Management

unit.

Other clinical

staffs and

doctors.

Training

status of

different

staffs.

To

strengthen

HR and

capacitate to

more quality

work and

maintain

Motivation

level

1. less salary

structure

of all

staffs like

BHM,

BAM,

DPM,

DPC,DAM,

M&E

Officer,

ANM and

other

clinical

staff.

2. lack of

manpowe

r

3.lack of

training to all

clinical staffs.

4.ANM in

sanctioned

307 out of

that 240 in

position.

5.Doctors

Sanctioned

144 out of

that 99 in

position.

Specialists

sanctioned 51

out of that 10

in position.

6.training

Workshop and

training for both

managerial and

clinical personal.

1.BHM salary 18000/-,BAM salary

12000/-,DPM salary3300/-,DPC

salary 30000/-,DAM salary 27000/-,

M&E Officer Salary 22500/-

And 10% increment every year.

2.clinical staffs salary should increase

50%.

3. selection of 67 ANM.

4.selection and recruitment of 7

male workers.

5.Selection of 45 MO.

6. Selection of 41 Specialist.

7. training to clinical and managerial

staffs.

8.training calendar.



84

status added

in annexure B

7.One accountant

for DH, one Data

Operator for DH.

8.10 system and

10 personal to

establish

centralize server.



85

Mainstreaming of Ayush Under NRHM

Indicators Objective Gaps Strategy Activities

AYUSH Doctors Bringing

Ayush

therapy for

each people

1. Unavailable

of drug for

Ayush.

2. Need

separate

building for

Ayush.

3. No IEC

display.

4. Training for

Ayush

Doctor.

A separate Unit

should be

understand.

1. procurement of Drug.

2.Occupy building at all

APHC for Ayush or

during construction of

building of APHC design

for separate building for

AYYUSH.

3.Training for all AYUSH

Doctor at District level

with the help of state.

4. IEC display at all main

place of villages, wall

painting what the

benefit of Ayush

therapy.

5.A special meeting at

village level with old

peoples also involving

villagers in the

presence of PRI

member in that Ayush

doctor of that APHC will

Involve.



86

De-centralized Planning

Indicators Objective Gaps Strategy Activities

Decentralized

planning

DPC

Strengthen

Planning

Process.

1. Less Interest

of all DPO

and all

officer in

Planning.

2. Unavailable

of data for

planning.

3. No system

of

communicat

ion so that

all

information

of District

could reach

to DPC.

4. No assisting

Hand for

data

compilation

and in

collecting of

data.

5. No vehicle

for data

collection

and for

coordination

.

6. less Salary of

DPC.

A separate

important work

could be

understand.

1.Need orientation

to all officer about

planning so that it

could be

understand

important part of

system.

2.There should be

made mandatory

of all Health

related District

information could

also flow to DPC so

that Better

planning could be

done.

3.one data

operator and one

clerical staff

needed for

planning process.

4.one laptop For

DPC with internet

Data card with

printer should be

available.

5.one full time

vehicle should be

available for DPC

so that in

Coordination with

all DPO, PHC and

with other

department could

be done for

convergence and



87

data collection for

better planning.

6.One mobile

phone needed to

DPC for data

collection and

Communication.

7.Joint signatory

Power to DPC with

CS of Planning

Budget so that

according to need

fund could used.

8. Salary of DPC

should be 30000/-

pm.



88

CHAPTER 6

NRHM PART “D”



89

PART D- NVBDCP

Kala azar

Gaps Objective Strategy Activities

To

increase the

coverage of

DDT spray in

the endemic

zone , there

should be

proper

monitoring

by the

supervisors,

capacity

building of

the sprayer,

supervisors

and other

healthcare

professionals

1. Ensure planning for timely spray

of DDT in Feb-March and May-June for

40 days in each block

2. Identification of Houses with Kala-

azar patients by ANM & ASHA @ 50/

per village.

3. Two round of spraying scheduled

in Feb-March and May-June should be

strictly observed

Vector

control

through

insecticide

spray in

the attack

area

Monitoring

of the

spraying

squad by

MOIC

4. DDT spray should be at the rate of

1gm/sq. meter upto the height of 6

feet.

1

Poor

coverage of

DDT spray

Less time

spent on

spraying

DDT

Training and

capacity

building for

proper

spraying

Regular capacity building training on

prescribed module for the sprayer to

ensure that very corner of the house is

properly spray up to height of six feet

from ground level.



90

Poor

condition

of Sprayer,

pump and

nozzles etc

No of

Pumps

available-

0, No of

pumps

required-

30, No of

bucket

savailable-

70, No of

buckets

required-

70, No of

gallon

available-

21, No of

gallon

required-

49, No of

pond

measure

available-

21, No of

pond

measure

required-

49, .

Regular

checking of

the spraying

pumps for

better

functioning

and timely

replacement

of the faulty

pieces.

Fund allocation and timely release for :

maintanceof old sprayer pumps,

Purchase of new pumps and other

articles needed- buckets, mugs etc.

Inadequate

stock of

DDT, DDT

available-

9.5mt.

(Not

required)

Making

available

DDT during

spraying

round

Ensure adequate Stock of DDT through

proper & timely indenting to improve

the quality of spray

Faulty

payment

plan

Appropriate

fund

allocation for

the payment

of the

spraying of

Fund would be allocated for regular

payment of wages (147 SFW to be

used and 735 FW to be used for

monitoring and spraying work)



91

DDT

Early

diagnosis

and

treatment

through

PHC

system

Case

detection

rate should

be increased

with

appropriate

diagnostic

test

Increase efficiency of case detection

through training of Community

workers on signs and symptoms of

Kala-azar: 1) three weeks persisten

fever not responding to antibitics,

malaria being excluded, with palpable

spleen.2) Ensure availability of

aldehyde test at PHC level 3) Purchase

of RK 39 kit for detection of Kalazar

1. Ensuring availability of

Amphotoricin at all level

Loss of wages for KZ patients(case

detection in year 2007-3275)

2. Replacing of medicines on priority

based

2

Poor rate of

case

detection of

Kalazar

Reduction

of kala-

azar

mortality

and

morbidity

Early

diagnosis

and

treatment

through PHC

system

3. Training of ANMs and ASHA for IM

injection

3

Lack of

monitoring

and

supervision

mechanism,

Monitoring

and

supervision

mechanism

Preparation of Monthly visit plan for

supervision :

- Checking spraying schedule

- For supervision & treatment follow

up

Office expenses

1. Fund allocation for training activities 4 Lack of

appropriate

BCC &

Community

Increasing

awareness

for

prevention

Community

participation

in reducing

mortality and

2. Identification of NGO/Private

partner as trainer



92

3. Knowledge sharing with the

community on signs and symptoms of

Kala-azar through VHSC

4. Training of VHSC/PRI and

community health worker on sign &

symptom of Kala-azar

5. Regular monitoring of IEC

activities

6. IEC activities through nukkad natak,

kalajatha mass media like radio

7.Activity for survilence like polio

survilence

8.Wall painting of Tretment protocole

and provisions for pateints in PHC in

Hindi.

Mobilization. of Kala-

azar

morbidity

due to Kala-

azar

IEC van for each PHC

Blindness

issues Strategy Activities

Staff shortage Recruitment Recruitment of Eye Specialists and surgeons on contractual basis.

Recruitment of Opthalmic Assistants on contractual basis.

Untrained staffs Capacity building Training of Doctors on IOL technique

Training of Opthalmic Assistant

Low achievement Increasing noof camps Organising Operations at District level



93

PPP

Accreditation of Nursing Homes capable of doing Cataract surgeries

Establishing another Cataract Operation Center at PHC Kako.

Purchase of equipments and medicines

Lackof awareness Awareness building Assigning LHV/Supervisor counseling work

Organising eye screening camps in villages/ schools

IEC on cataract and its facilities

InvolvingNGOs

Meeting with Local NGOs onthis issue

Lackof adequate referal

services

Strengthening referal

system

Arrangement of carrying patients to the Operation Centers and then taking them back homes

Monitoring and follow up

Monitoring and follow up Mobility support for Visiting homes of the patients tomanage any post treatment complication.

Developing records of cataract cases from OPD registers at PHC level



94

Leprosy

Gaps issues Strateg

y

Activities

· Existing PR of the district is 1.1 and the

target is only 1, so the existing program

performance is good.

• Lack of awareness is still a problem with

the Leprosy Program as most of the cases

are detected accidentally.

Lack of

Awarene

ss

Awarenes

s

generatio

n

IEC on Leprosy

• Inadequate staff, Only 6 supervisors and

11 Non Medical Assistants are working while

the requirement of Supervisor is 17 and that

of NMA is 33( One NMAeach in each APHC)

Lack of Human Resource

Staff

Recruitm

ent in

contract

basis

Recruitment of 11

supervisors

• There is no active involvement of the

Medical officers at sector and Block levels. Orientation of Mos

and staffs on

Leprosy

Case validation, to

have check on

wrong diagnosis and

re registration

Prompt and early

detection of the

cases to avoid

deformity and

disability,

• Lack of PHC staff involvement. No

manpower support,

Strength

en

Health

Care

Services

Ulcer care foot ware

reorientation

training of medical &

para medical staff.

No lab testing facility in the district Infrastructure

Establish

ing Lab

Establishing Lab at

district level



95

Gap Recurring

expenditure like

reagents

Updation of master

register

Mobility support for

DLO

Lack of monitoring at all level Monitoring Gap

Increasin

g

mobility

Office expenses

Fileria

Gaps issue

s

Strategy Activities

Line listing of the cases

Purchse of equipments for the management of Filaria cases like towel, Bucket, soap, mug etc

DEC distribution through AWCs and paying hon to AWWs for this.

It affects mainly the

economically weaker sections of

communities

1. Single dose DEC

mass therapy once a

year in identified blocks

and selected DEC

treatment in filariasis

endemic areas.

Purchse of DEC



96

Training to AWWs/ASHA on DEC distribution and filaria case management

Result in low priority being

accorded by governments for

the control of lymphatic

filariasis.

2. Continuous use

of vector control

measures.

Meeting with VHSC members

Low effectiveness of the tools

used by the control programme

Detection

and

treatment

of micro-

Filaria

carriers,

treatment

of acute

and chronic

filariasis.

The chronic nature of the disease

4. IEC for ensuring

community awareness

and participation in

vector control as well as

personal protection

measures.

Wall paintings



97

TUBERCULOSIS----------------------------

ANNUAL PLAN FOR PROGRAMME PERFORMANCE & BUDGET FOR THE YEAR 1ST APRIL 2011 TO 31ST MARCH 2012

District:- JEHANABAD. State :- BIHAR.

Name_Dr. Vijay Kumar Singh, Designation_DTO_ _____

Section-A – General Information about the District

1 Population (in lakh) please give projected population 2009 1154545*

2 Urban population 102061

3 Tribal population -

4 Hilly population -

5 Any other known groups of special population for specific interventions

(e.g. nomadic, migrant, industrial workers, urban slums)

-

(These population statistics may be obtained from Census data /District Statistical Office)

Does the district have a DTC Yes

ORGANIZATION OF SERVICES IN THE DISTRICT:

Please indicate if the

TU is-

No. of MCs S.

No.

Name of the TU Population

(in Lakhs)

Govt NGO Govt NGO Private

1 DTC, Jehanabad. 681323 1 0 4 0 0

2 Ghosi 473222 1 0 4 0 0

DISTRICT 1154545 02 0 08 0 0



98

RNTCP performance indicators:

Important: Please give the performance for the last 4 quarters i.e. July 2008 to June 2009

Plan for the next

year

TB Unit

Total

number

of

patients

put on

treatment

Annualized

total case

detection

rate (per

lakh pop)

No of

new

smear

positive

cases put

on

treatment

Annualized

New

smear

positive

case

detection

rate (per

lakh p op)

Cure rate for

cases

detected in

the last 4

corresponding

quarters

Annualized

NSP CDR

Cure

rate

(85%)

Proportion

of TB

patients

tested for

HIV

DTC 723 60% 319 70% 73% 65% 85%

Ghosi 468 53.2% 182 56.6% 85.4% 65% 85%

District 1191 501

Section B – List Priority areas for achieving the objectives planned:

S.No. Priority areas Activity planned under each priority area

1 Training Training of MO's

Training of ASHA, ANM worked in all PHC by STS

2 IEC / Publicity Wall Writing, Hording, Banners, Print Publicity, Mice.

3 Supervision Vehicle Hiring for DTO & MO-TC



99

Section C – Plan for Performance and Expenditure under each head:

Civil Works

Activity No.

required

as per

the

norms

in the

district

No.

actually

present

in the

district

No.

planned

for this

year

Pl provide

justification if

an increase is

planned (use

separate

sheet if

required)

Estimated

Expenditure

on the

activity

Quarter in

which the

planned

activity

expected

to be

completed

(a) (b) (c) (d) (e) (f)

DTC 1 1 0

TUs 2 2 0

DMC 8 8 0

Total 15100.00

Laboratory Materials

Activity Amount

permissible

as per the

norms in

the district

Amount

actually

spent in

the last 4

quarters

Procurement

planned

during the

current

financial

year (in

Rupees)

Estimated

Expenditure

for the next

financial

year for

which plan

is being

submitted

(Rs.)

Justification/

Remarks for (d)

(a) (b) (c) (d) (e)

Purchase

of Lab

Materials

150000.00 67798.00 150000.00



100

Honorarium

Activity

Amount

permissible

as per the

norms in

the district

Amount

actually

spent in

the last 4

quarters

Expenditure

(in Rs)

planned for

current

financial

year

Estimated

Expenditure

for the next

financial

year for

which plan

is being

submitted

(Rs.)

Justification/

Remarks for (d)

(a) (b) (c) (d) (e)

Honorarium

for DOT

providers

(both tribal

and non

tribal

districts)

200000.00 20000.00 180000.00

200000.00

We have

planed to

distribute the

recommended

insentive to

DOT

Providers for

cured /

completed TB

Patients.

Honorarium

for DOT

providers

of Cat IV

patients

Equipment Maintenance:

Item

No.

actually

present

in the

district

Amount

actually

spent in

the last 4

quarters

Amount

Proposed

for

Maintenance

during

current

financial yr.

Estimated

Expenditure

for the next

financial

year for

which plan

is being

submitted

(Rs.)

Justification/

Remarks for

(d)

(a) (b) (c) (d) (e)



101

Office Equipment

(Maintenance includes

computer software and

hardware upgrades,

repairs of photocopier,

fax, OHP etc)

1 11774.00 0.00

30000.00

Binocular Microscopes (

RNTCP)

8 0.00 13500.00

43500.00

Training:

No. planned to be

trained in RNTCP

during each quarter

of next FY

(c)

Activity No. in

the

district

No.

already

trained

in

RNTCP

Q1 Q2 Q3 Q4

Expenditure

(in Rs)

planned for

current

financial

year

Estimated

Expenditure

for the next

financial

year for

which plan

is being

submitted

(Rs.)

Justification/

remarks

(a) (b) (d) (e) (f)

Training of

MOs

Training of

LTs of

DMCs-

Govt + Non

Govt

15000.00

Training of

MPWs

Training of

MPHS,

pharmacists,

nursing



102

staff, BEO

etc

Training of

Comm

Volunteers

Training of

Pvt

Practitioners

Other

trainings #

Re- training

of MOs

84 66 20 20 20 20 32000

Re- Training

of LTs of

DMCs

10 10 10 10 5000 20000.00

Re- Training

of MPWs

20000.00

Re- Training

of MPHS

10000.00

Re- Training

of

Pharmacists

Re- Training

of nursing

staff, BEO

Re- Training

of CVs

Re-training

of Pvt

Practitioners

700 700 200 200 150 150 38000.00

TB/HIV

Training of

MOs

10000.00



103

TB/HIV

Training of

STLS, LTs ,

MPWs,

MPHS,

Nursing

Staff,

Community

Volunteers

etc

TB/HIV

Training of

STS

Training of

MOs and

Para

medicals in

DOTS Plus

for

management

of MDR TB

Provision for

Update

Training at

Various

Levels(key

staff & MO-

PHIs)

10000.00

Any Other

Training

Activity( Key

staff & MO-

PHIs)

75000.00 75000.00

# Please specify



104

Vehicle Maintenance:

Type of

Vehicle

Number

permissible

as per the

norms in

the district

Number

actually

present

Amount

spent on

POL and

Maintenance

in the

previous 4

quarters

Expenditure

(in Rs)

planned for

current

financial

year

Estimated

Expenditure

for the next

financial

year for

which plan

is being

submitted

(Rs.)

Justification/

remarks

(a) (b) (c) (d) (e) (f)

Four

Wheelers

- - - -

Two

Wheelers

02 02 19618.18 50000.00 50000.00

Vehicle Hiring:

Hiring of

Four

Wheeler

Number

permissible

as per the

norms in

the district

Number

actually

present

Amount

spent in

the

previous

4

quarters

Expenditure

(in Rs)

planned for

current

financial

year

Estimated

Expenditure

for the next

financial

year for

which plan

is being

submitted

(Rs.)

Justification/

remarks

(a) (b) (c) (d) (e) (f)

For DTO 01 01 66184.00 143816 268800

For MO-

TC

02 02 0.00 58800.00

202616 268800



105

NGO/ PP Support: (New schemes w.e.f. 01-10-2008)

Activity No. of

currently

involved

in

RNTCP

in the

district

Additional

enrolment

planned

for this

year

Amount

spent in

the

previous

4

quarters

Expenditure

(in Rs)

planned for

current

financial

year

Estimated

Expenditure

for the next

financial

year for

which plan

is being

submitted

(Rs.)

Justification/

remarks

(a) (b) (c) (d) (e) (f)

ACSM Scheme:

TB advocacy,

communication,

and social

mobilization

0.00

SC Scheme:

Sputum

Collection

Centre/s

Transport

Scheme:

Sputum Pick-

Up and

Transport

Service

DMC Scheme:

Designated

Microscopy

Cum Treatment

Centre (A & B)

LT Scheme:

Strengthening

RNTCP

diagnostic

services



106

Culture and

DST Scheme:

Providing

Quality Assured

Culture and

Drug

Susceptibility

Testing

Services

Adherence

scheme:

Promoting

treatment

adherence

Slum Scheme:

Improving TB

control in

Urban Slums

Tuberculosis

Unit Model

TB-HIV

Scheme:

Delivering TB-

HIV

interventions to

high HIV Risk

groups (HRGs)

TOTAL 0.00



107

Miscellaneous:

Activity* Amount

permissi

ble as

per the

norms

in the

district

Amou

nt

spent

in the

previ

ous 4

quart

ers

Expendit

ure (in

Rs)

planned

for

current

financial

year

Estimated

Expenditure for the

next financial year

for which plan is

being submitted

(Rs.)

Justification/

remarks

(a) (b) (c) (d) (e)

165000 8768

0

77319 165000

165000

* Please mention the main activities proposed to be met out through this h

Contractual Services:

Activity No.

required

as per the

norms in

the district

No.

actuall

y

prese

nt in

the

distric

t

No.

planned

to be

additional

ly hired

during

this year

Amoun

t spent

in the

previou

s 4

quarter

s

Expendi

ture (in

Rs)

planned

for

current

financia

l year

Estimated

Expenditure for

the next

financial year

for which plan

is being

submitted

(Rs.)

Justifi

catio

n/

remar

ks

(a) (b) (c) (d) (e)

Medical

Officer-DTC

Not to be

filled

- - - -

STS 02 02 00 172226

.00

144000.

00

288000.00

STLS 02 02 00 304284

.00

120000.

00

288000.00

TBHV 00 00 01 0.00 0.00 0.00



108

DEO 01 01 00 126048

.00

44625.0

0

120000.00

Accountant

– part time

00 00 01 0.00 0.00 36000.00

Contractual

LT

04 00 362801

.00

187000.

00

480000.00

96535

9.00

49562

5.00

1548000.00

Printing:

Activity Amount

permissible

as per the

norms in

the district

Amount

spent in

the

previous

4

quarters

Expenditure

(in Rs)

planned for

current

financial

year

Estimated

Expenditure for the

next financial year

for which plan is

being submitted

(Rs.)

Justificati

on/

remarks

(a) (b) (c) (d) (e)

Printing*

100000.00 26936.0

0

73064.00 100000.00

* Please specify items to be printed



109

Research and Studies:

Any Operational Research project planned (Yes)

(Post Graduate grant for one research paper from each Medical College)

Estimated Budget (to be approved by STCS).___________________________________

Medical Colleges

Activity Amount

permissible as

per norms

Estimated

Expenditure for the

next financial

year(Rs.)

Justification/

remarks

(a) (b) (c)

Contractual Staff:

� MO (In place: Yes/No)

� STLS (In place: Yes/No)

� LT (In place: Yes/No)

� TBHV (In place: Yes/No)

Research and Studies:

� Thesis of PG Student

� Operations Research*

Travel Expenses for

attending STF/ZTF

meetings

IEC: Meetings and CME

planned



110

Procurement of Vehicles:

Equipment No.

actually

present in

the

district

No.

planned

for this

year

Estimated Expenditure for

the next financial year for

which plan is being

submitted (Rs.)

Justification/

remarks

(a) (b) (c) (d)

4-wheeler **

2-wheeler

** Only if authorized in writing by the Central TB Division

Procurement of Equipment:

Equipment No. actually

present in

the district

No.

planned

for this

year

Estimated

Expenditure for

the next financial

year for which

plan is being

submitted (Rs.)

Justification/

remarks

(a) (b) (c) (d)

Office

Equipment

(computer,

modem,

scanner, printer,

UPS etc)

Any Other



111

Section D: Summary of proposed budget for the district –

Budget estimate for the coming FY

2011- 12

S.No. Category of Expenditure (To be based on the planned

activities and expenditure in Section

C)

1 Civil works 15100.00

2 Laboratory materials 150000.00

3 Honorarium 200000.00

4 IEC/ Publicity 75000.00

5 Equipment maintenance 43500.00

6 Training 75000.00

7 Vehicle maintenance 50000.00

8 Vehicle hiring 268800.00

9 NGO/PP support 150000.00

10 Miscellaneous 165000.00

11 Contractual services 1548000.00

12 Printing 100000.00

13 Research and studies 0.00

14 Medical Colleges 0.00

15 Procurement –vehicles 0.00

16 Procurement – equipment 0.00

TOTAL 2840400.00

** Only if authorized in writing by the Central TB Divisio

Annual Action Plan Format Advocacy, Communication and Social Mobilization

(ACSM) for RNTCP



112

1) Information on previous year’s Annual Action Plan 2011-12

a) Budget proposed in last Annual Action Plan: 100000.00

b) Amount released by the state:20000.00

c) Amount Spent by the district- 0.00

2) Permissible budget as per norm : 75000.00

3) Budget for next financial year for the district as per action plan detailed below: 75000.00

Program

Challenge

s to be

tackled

by ACSM

during

the Year

2009 - 10

WHY

ACSM

Objective

For

WHO

M

Targe

t

Audie

nce

WHAT

ACSM

Activities

When

Time

Frame

By

WHO

M

Monitori

ng and

Evaluati

on

Budget

Based on

existing TB

indicators

and

analysis of

communic

ation

challenges

(Maximu

m 3

Challenge

s )

Desired

behavior

or action

(make

SMART:

specific,

measurabl

e,

achievable

, realistic

& time

bound

objectives

)

Activiti

es

Media

/

Mater

ial

Requi

red

Q

1

Q

2

Q

3

Q

4

Key implementer and RNTCP officer responsible for supervision

Outp

uts;

Evid

ence

that

the

activ

ities

have

been

done

Ou

tc

o

m

es

:

Evi

de

nc

e

th

at

it

ha

s

be

en

eff

ect

ive

Total

expendit

ure for

the

activity

during

the

financial

year



113

Challenge 1. Low Case Detection (example)

Advocacy Activities

District

Magist

rate/

DHS

√

No cost

involved

Health

and

other

depart

ment

admini

strator

s

√

Cost of

sensitiza

tion

meeting

Private

Health

care

provid

ers

√

Cost of

commun

ication

material

Low Case

Detection

Gaining

Administr

ative

support

from

District

authorities

for

increase

referral

from OPD

1.One

to one

meetin

g

district

author

ities

2.Sens

itizatio

n

meetin

g

3.

Briefin

g

meetin

gs

4.

Progra

mme

inform

ation,

5.

Factsh

eets

6.

World

TB

Day

Public

ation

s

PPT

-

Audio

Visual

Adds

-

Poste

rs-

bookl

ets/br

ochur

e

-

poste

r in

local

langu

age

-

Facts

heets

-

succe

ss

storie

s

√

1.

Distri

ct

Progr

am

Mana

gers

2.

MOTC

( with

suppo

rt

from

WHO

Cons

ultant

)

1.Me

etin

g

Minu

tes

2.Ph

otog

raph

s

3.

Rep

orts

4.

Revi

ew

mee

ting

by

the

auth

oriti

es

1.

In

cr

ea

se

ref

err

al

of

ch

est

sy

m

pt

o

m

ati

c2

Pr

og

ra

m

m

e

Da

ta

Cost of

World

TB Day

activities



114

Communication Activities

To inform

communiti

es and

care

providers

about the

DOT

services

for early

detection

Develop

1Gene

ral

Public

2.

School

s

3.

Religio

us

bodies

4.

Care

provid

er

Use of

region

al /

cable

chann

els

Partici

pate in

the

biannu

al

health

mela

Bookl

et,

Flip

Book,

Poste

rs,

Stick

ers,

Bann

ers,

Pamp

hlet,

Patie

nt

infor

matio

n

bookl

et

√

√

√

√

Distri

ct

Progr

am

Mana

gers

MOTC

1.De

velo

ped

IPC

Mate

rial

and

evid

ence

of

pre

testi

ng

of

mat

erial

2.

Flip

book

s for

STS

and

CFs

3.

Wall

writi

ngs

4.

Stoc

k

Regi

ster

Cost of

develop

ment of

material

including

Low Case

Detection

Awarenes

s

Generatio

n in

general

public

Genera

l

Public,

school

s,

Wall

paintin

g on

TB

√

DTO,

MO-

TC,

MO,

IEC

Office

r

1.Vis

ible

wall

pain

tings

at

Sub

cent

er

1.I

nc

re

as

e

sel

f

re

po

rti

ng

/

ref

err

al

2.

An

aly

sis

of

da

ta

3.

KA

P

st

ud

y

aft

er

on

e

yr

kn

ow

th

e

Cost of

wall

writings



115

level

Puppet

shows,

street

play

Script

and

profe

ssion

al

group

s

√

√

DTO,

Com

muni

catio

n

Facilit

ator,

STS,

IEC

Office

r,

NGO

Partn

ers

Doc

ume

ntati

on/

repo

rt

2.

Scri

pt

for

stre

et

play

s 3.

Phot

ogra

phs

4.

Scho

ol

quiz

form

at

Cost of

hiring of

professi

onal

agency(

cost per

play X

no. of

activities

)

News

Paper

Advert

iseme

nt

Adver

tisem

ent

for

news

paper

,

Letter

to

NEWs

Paper

Editor

.

√

√

DTO,

Com

muni

catio

n

Facilit

ator,

STS,

IEC

Office

r,

NGO

Partn

ers

NEW

S

pape

r

Clipp

ings

aw

ar

en

es

s

lev

el

of

ge

ne

ral

pu

bli

c.

Cost of

newspap

ers

writings

Social Mobilization

Low Case

1.Generat

Comm

Comm

Flip

MO-

TC,

Minu

tes

In

cr

Cost of

material



116

unity

Meetin

g

Chart

and

Poste

rs,

Talks

√

√

√

√

IEC

Office

r,

Com

muni

catio

n

Facilit

ator,

STS

of

Meet

ings

Displ

ay of

Post

ers

Flip

Char

t

ea

se

Se

lf

re

po

rti

ng

in

ch

est

sy

m

pt

o

m

ati

c

+ cost

of

commun

ity

meeting

s total

number

of

meeting

s

planned

Celebr

ation

of

World

TB day

Displ

ay

Mater

ial for

World

TB

Day

DTO,

MO-

TC,

MO,

Com

muni

catio

n

Facilit

ator,

STS

Doc

ume

ntati

on

of l

worl

d TB

Day

activ

ities

Pr

e-

po

st

ev

alu

ati

on

of

W

TB

Da

y

act

ivi

tie

s

wit

h

sp

eci

fic

ob

jec

tiv

es

Budgete

d above

Detection e

Awarenes

s in

general

public

2.

Encourage

early self

reporting

3.

Communit

y Groups.

PRI

unity

Genera

l

Public,

Patient

s,

DOTs

Provid

ers

Exhibit

ions

displa

y

DTO,

-

Doc

ume

In

cr

Cost of

Hiring of



117

/Mela’

s /

Popula

r

Events

in

Distric

t.

Mater

ial (

Poste

rs,

Stick

ers,

Bann

ers,

Pamp

hlet)

Inter

active

game

s

√

√

MO,

Com

munic

ation

Facilit

ator,

ntati

on

of

activ

ity

Writ

e

ups

/

brief

used

in

play

s

ea

se

Se

lf

re

po

rti

ng

of

TB

pa

tie

nt

s (

KA

P

st

ud

y

aft

er

on

e

yr)

place

and

display

material

& cost

interacti

ve

games,

prizes

etc.

School

Childre

n

Drawi

ng &

Quiz

Compe

titions

Game

s –

Snak

e and

ladde

r,

Chakr

aview

Game

etc.

Pamp

hlets]

IEC

Mater

ial

√

√

√

DTO,

Com

muni

catio

n

Facilit

ator,

STS,

IEC

Office

r,

NGO

Partn

ers

Doc

ume

ntati

on

of

Activ

ities/

Phot

ogra

phs

Pr

e-

po

st

int

er

ve

nti

on

ev

alu

ati

on

Cost of

one

school

activity

X no. of

activities

planned

in the

distict=

Colleg

e &

School

NSS

Studen

TB

Sessio

ns

during

NSS

caps

Game

s –

Snak

e and

ladde

r,

DTO,

Com

muni

catio

n

Facilit

Doc

ume

ntati

on

of

Activ

Da

ta

An

aly

sis

4000



118

ts in

school

and

college

,

Drawi

ng &

Quiz

Compe

titions

Help

Moha

n etc.

Pamp

hlets]

IEC

Mater

ial

ator,

STS,

IEC

Office

r,

NGO

Partn

ers

ities/

Phot

ogra

phs

Challenge 2: High Default Rate (example 2)

Advocacy Activities

High

Default

Rate

Sensitizin

g district

authorities

about the

importanc

e of

reducing

default

cases &

for their

support

for

necessary

instruction

s to the

Programm

e staff

1.Healt

h care

provid

ers

Public

&

Private

1.Inter

action

Meetin

gs

2.One

to One

Intera

ction

Meetin

gs

3. Use

of

Inform

ation

Bookle

t

Audio

Visual

Adds

-

Poste

rs-

bookl

ets/br

ochur

e

-

poste

r in

local

langu

age

-

Facts

heets

-

succe

ss

storie

s

Distri

ct

Progr

am

Mana

gers

MOTC

Revi

ew

of

defa

ult

case

TU

wise

Reco

rd of

mee

tings

Re

du

cti

on

in

de

fa

ult

rat

e

by

2

%

-

Da

ta

an

aly

sis

St

ud

y

to

do

cu



119

m

en

t

de

fa

ult

wit

hi

n

on

e

yr

Communication Activities

Patient

s,

Their

Family

Membe

rs,

DOTs

Provid

ers

Sharin

g of

experi

ence

of

cured

patient

s /

Patient

s

during

Treat

ment.

√

√

√

√

MO,

STS

&

Com

muni

catio

n

facilit

ators

High

Default

Rate

To

motivate

patients &

their

families

for

completio

n of

treatment

Comm

unity

TB

Groups

/ NGOs

Patie

nt

intera

ction

meeti

ngs

&

involv

emen

t of

cured

perso

ns

Flip

Chart

Devel

opme

nt

Devel

opme

nt of

mater

ial for

Com

munit

y

DOT

Provi

√

√

√

√

MO-

TC,

STS,

ANMs

Reco

rds

of

mee

ting

Evid

ence

of

mat

erial

deve

lopm

ent

–

pre

testi

ng

Incr

ease

in

no.

com

muni

ty

base

Re

du

cti

on

in

de

fa

ult

rat

e

by

2

%

-

An

aly

sis

of

pr

og

ra

m

m

e

da

ta

Re

du

cti



120

ders d

NGO

s

invol

vem

ent

on

in

ti

m

e

for

ret

rie

val

of

de

fa

ult

s

One

to one

meetin

g with

the

patient

Interp

ersona

l

comm

unicati

on

with

patient

s

Patie

nt

infor

matio

n

bookl

et

√

√

√

√

MO,

STS,

DOT

Provi

der

Evid

ence

of

such

mee

ting

Patie

nt

infor

mati

on

book

let

Re

du

cti

on

in

de

fa

ult

s

Cost of

patient

informat

ion

booklet

(if not

budgete

d above)

(no cost

for one-

to one

IPC)

Social Mobilization

High

Default

Rate

To link

poor

patient

s to

the

welfar

e

schem

es

Sensiti

zation

of

Depart

ments

Social

welfar

e

schem

es

Poste

rs,

progr

amm

e fact

sheet

,

Prese

ntatio

n

Annu

al

√

√

DTO,

MO

TC

Doc

ume

ntati

on,

Reco

rds

,

Phot

ogra

phs

Data

of

Re

du

cti

on

in

de

fa

ult

s

Do

Cost of

one

meeting

no of

meeting

s



121

repor

ts

refer

ral

of

TB

patie

nts t

sym

pto

mati

c will

incre

ase

cu

m

en

tat

ion

of

eff

ect

ive

ne

ss

of

su

ch

lin

ka

ge

s

thr

ou

gh

a

st

ud

y

aft

er

on

e

ye

ar

For

mobilizing

support

from

Communit

y groups

Comm

unity

suppor

t

groups

Cured

patient

s

Intera

ction

meetin

gs

Infor

matio

n

mater

ial,

√

√

MO-

TC,

STS,

Com

muni

catio

n

Facilit

ators

For

mati

on

of

TB

supp

ort

grou

ps in

X

no.

of

villa

ges

De

cr

ea

se

in

th

e

no

.

of

de

fa

ult

s

Cost of

such

meeting

s



122

in

su

ch

vill

ag

es

Challenge 3:-

Advocacy activities

Communication activities

1.

Social Mobilization Activities

TOTAL



123

CHAPTER 8

ANNEXURE



124

ANNEXTURE: A

DISTRIC HOSPITAL GAPS:

Gaps of Blood Bank:::: -------

• Walls and floor needed tiles.

• Through out repairing of blood bank building.

• Water problem Plumbing.

• Need lab renovation.

• Need of some equipments as heamoglobinometer , foam some stationary item

• There is gap of fund transfer to blood bank in charge for proper management of blood bank.

Gaps of District Hospitals:---

# Safety and security and Dignity----1. there is need of patient privacy and during general OPD. 2.

Free movement of patient attended in labor room and Gyne OT as needed guard for that to not

inter in that area.

3. lack of proper documentation. 4. lack of the safety and security to patient personal property.

# Regulatory complains------- 1. No Hospital waste management.

2. X-ray machine are used without AERB clearness as State have to interven in this regard to IGMS

System.

3. No fire safety.

# Administrative problem---------

1. lack of written communication

2. Negligence to medical services.

3. Lack of ABC inventory system so needed one operator and one desktop with all accessories.

4. Lack of Drug .

5. Lack of HR department at District level.

6. Lack of Feed back system so need of one feedback department.

7. Lack of intercom phone connectivity so that one department and other staff could

communicate with them so medical services should be insure properly.

8. Lack of central sterilization services department.

9. Lack of Regular Audit According to IPHS norms. Need quarterly audit after formation of Audit

team.

10. Lack of tries area.

11. Lack of cafeteria.

12. Need of insect cacher .

13. Lack of management in Dietary services Delivery.

14. Lack of Laundry department.

15. Lack of hot water arrangement.



125

HR Requirement in Disrict Hospital and some common Department for

District.

Department

name

Required Personal and Expected output.

Filling and Record

maintains

Department at

district Hospital.

Need 10 personal ( in that 4 should be diploma in medical record + 4

clerks and 2 fourth grade staff with 24*7).

HR department for

district

Need 2 Data operator 4 Clerks 2 Managers. Total of 8 personal team

which will work for entire district and proper use of human resource

could be used as DPC could work as HR Head of Department as it is

immense part of Planning.

Data Operator and

Accountant to

Department

TB, NLEP need one Data operator and one Accountant.

Central Sterilization

service

Department for

District Hospital.

4 personal for this department, they all will be master in sertization

OT assistant for

district

30 OT assistant for all district so that C-Section could be Strengthen.

Sanctioned Current working Vacant position

ANM 307 240 67

MO

144 99 45

SPECIALIST 51 10 41



126

ANNEXURE “B” Training required for MO.

Facility Name Lsas Emoc Mtp Nssk f-

imnci

Imnci Mini-

lap

Laproscopy Nsv Iucd Ot

he

rs

Sadar Hp 4 4 4 4 4 4 2 2 4 4

RH

Makhdumpu

r

4 4 4 4 4 4 4 4 4 4

PHC Ratni 4 4 4 4 4 4 4 4 4 4

PHC

Hulasganj

2 2 2 2 2 2 2 2 2 2

PHC kako 2 2 2 2 2 2 2 2 2 2

PHC Sadar 2 2 2 2 2 2 2 2 2 2

PHC Okari 3 3 3 3 3 3 3 3 3 3

Total 21 21 21 21 21 21 19 19 21 21

Training Required to ANM.

Facility Name NSSK SBA IMCI IUCD OTHERS

PHC okari 9 6 9 9

PHC Sadar 9 6 9 9

PHC Kako 4 4 4 5

PHC Hulasganj 4 4 4 4

PHC Ratni 3 1 3 3

RH Makhdumpur 8 8 8 8

District Hospital 9 9 9 9

HSC OF all District 100 39 100 100

Total 146 77 146 147



127



Month Name of PHC/Hospital OPD Indoor Delivery Referred

Case Emergency Family Planning

General Operation Mother Child Polio

New Born

Childs Polio New Born

Childs

Apr-2010 Jehanabad Sadar 7718 1971 767 65 837 15 202 201 1076 0.91% 390

Apr-2010 Kako 4149 89 83 9 117 13 40 361 1767 0.42% 265

Apr-2010 Ghosi 4161 104 74 16 214 15 106 221 1357 0.85% 198

Apr-2010 Ghosi Refral 2416 80 19 3 186 3 80

Apr-2010 Makhdumpur 5601 259 152 11 181 20 348 425 3003 1.60% 372

Apr-2010 Ratni Faridpur 5103 101 91 21 151 2 37 321 1558 1.60% 210

Apr-2010 Hulashganj 3074 183 80 7 346 18 17 179 1171 0.83% 117

Apr-2010 Okari / Modanganj 2170 67 46 11 134 15 84 189 1138 0.48% 134

Apr-2010 Jehanabad Block 6028 7 0 11 0 7 12 441 2329 0.77% 240

Apr-2010 District 40420 2861 1312 154 2166 108 926 2338 13399 1.00% 1926 May-2010

Jehanabad Sadar 8569 1564 637 93 903 7 174 224 946 1.83% 321

May-2010 Kako 5087 79 71 14 119 7 44 453 1808 1.48% 246

May-2010 Ghosi 4741 157 79 29 258 10 111 247 1150 0.70% 147

May-2010 Ghosi Refral 2914 101 33 3 203 4 91

May-2010 Makhdumpur 6765 314 186 4 282 17 409 523 2857 1.11% 328

May-2010

Ratni Faridpur 4899 99 62 28 173 4 66 357 1342 1.25% 167

May-2010 Hulashganj 3487 245 80 7 409 9 16 224 902 0.48% 121

May-2010

Okari / Modanganj 2475 97 63 16 178 0 132 235 1087 1.36% 114

May-2010

Jehanabad Block 8353 17 0 15 0 17 17 486 2150 1.54% 193

May-2010 District 47290 2673 1211 209 2525 75 1060 2749 12242 1.17% 1637



129




New Born


Childs

Jun-2010

Jehanabad Sadar 7255 1002 595 80 1045 0 0 223 1084

Jun-2010 Kako 3436 101 86 13 169 4 46 518 1954

Jun-2010 Ghosi 4859 144 76 30 253 2 105 299 1244

Jun-2010 Ghosi Refral 2654 104 32 2 241 1 124

Jun-2010 Makhdumpur 6399 357 230 8 320 10 449 525 2398

Jun-2010

Ratni Faridpur 6517 86 78 27 215 3 85 408 1313

Jun-2010 Hulashganj 2668 250 81 9 382 17 22 235 1051

Jun-2010

Okari / Modanganj 3200 84 63 48 143 0 174 209 1240

Jun-2010

Jehanabad Block 6333 14 0 8 0 14 10 569 2457

Jun-2010 District 43321 2142 1241 225 2768 51 1015 2986 12741

Jul-2010 Jehanabad Sadar 9916 2405 878 91 1043 6 196 215 1323 1.00% 583

Jul-2010 Kako 5940 112 97 8 159 13 41 413 1653 0.93% 494

Jul-2010 Ghosi 7750 189 85 33 248 21 211 315 1336 0.65% 302

Jul-2010 Ghosi Refral 3764 95 41 1 264 3 207

Jul-2010 Makhdumpur 8879 410 247 2 259 29 537 610 2703 2.29% 707

Jul-2010 Ratni Faridpur 4873 124 103 38 233 10 85 292 1395 0.39% 367

Jul-2010 Hulashganj 3645 232 115 6 518 36 17 244 1156 0.91% 223

Jul-2010 Okari / Modanganj 5934 99 59 28 176 15 44 213 1122 0.87% 226

Jul-2010 Jehanabad Block 9084 26 0 12 0 27 17 526 2252 1.15% 403

Jul-2010 District 59785 3692 1625 219 2900 160 1355 2828 12940 1.12% 3305



130




New Born


Childs

Aug-2010

Jehanabad Sadar 11359 2186 1090 106 957 3 176 263 964

Aug-2010 Kako 4307 134 129 14 193 5 51 421 1559

Aug-2010 Ghosi 6647 225 159 28 318 8 323 262 1181

Aug-2010 Ghosi Refral 3703 116 64 3 206 3 161

Aug-2010 Makhdumpur 8642 511 355 18 211 15 523 507 2529

Aug-2010

Ratni Faridpur 7362 153 147 25 306 4 88 363 1428

Aug-2010 Hulashganj 4263 257 173 4 466 15 17 228 1090

Aug-2010

Okari / Modanganj 6631 140 120 25 198 6 82 195 1153

Aug-2010

Jehanabad Block 7279 11 0 8 0 13 17 475 2102

Aug-2010 District 60193 3733 2237 231 2855 72 1438 2714 12006

Sep-2010

Jehanabad Sadar 5974 1345 876 78 808 0 0 149 1150 1.30% 811

Sep-2010 Kako 5252 170 164 17 202 6 52 268 2126 0.91% 919

Sep-2010 Ghosi 6432 213 162 22 299 20 253 224 1507 0.49% 617

Sep-2010 Ghosi Refral 939 103 60 3 245 8 58

Sep-2010 Makhdumpur 8187 511 352 2 203 50 478 451 2918 0.43% 1346

Sep-2010

Ratni Faridpur 6148 160 133 32 260 9 66 353 1525 0.91% 783

Sep-2010 Hulashganj 3615 319 225 0 483 20 21 234 911 0.91% 524

Sep-2010

Okari / Modanganj 4174 119 108 26 186 8 97 200 1243 0.91% 475

Sep-2010

Jehanabad Block 7085 0 0 0 0 0 0 82 513 1.36% 871



131




New Born


Childs

Sep-2010 District 47806 2940 2080 180 2686 121 1025 1961 11893 0.86% 6346

Oct-2010 Jehanabad Sadar 9339 1912 893 87 818 13 315 105 1402

Oct-2010 Kako 9064 226 198 16 224 30 0 347 2105

Oct-2010 Ghosi 5446 202 163 26 300 23 167 199 1425

Oct-2010 Ghosi Refral 1312 96 64 2 184 7 37

Oct-2010 Makhdumpur 7529 526 369 5 246 54 486 367 2936

Oct-2010 Ratni Faridpur 8955 164 146 46 266 6 69 246 1723

Oct-2010 Hulashganj 3101 259 206 4 520 29 20 149 1258

Oct-2010 Okari / Modanganj 2935 148 122 43 194 14 47 151 1317

Oct-2010 Jehanabad Block 3895 24 0 0 0 25 6 424 2782

Oct-2010 District 51576 3557 2161 229 2752 201 1147 1988 14948 Nov-2010

Jehanabad Sadar

Nov-2010 Kako

Nov-2010 Ghosi

Nov-2010 Ghosi Refral

Nov-2010 Makhdumpur

Nov-2010

Ratni Faridpur

Nov-2010 Hulashganj

Nov-2010

Okari / Modanganj

Nov-2010

Jehanabad Block



132




New Born


Childs

Nov-2010 District

Dec-2010

Jehanabad Sadar

Dec-2010 Kako

Dec-2010 Ghosi

Dec-2010 Ghosi Refral

Dec-2010 Makhdumpur

Dec-2010

Ratni Faridpur

Dec-2010 Hulashganj

Dec-2010

Okari / Modanganj

Dec-2010

Jehanabad Block

Dec-2010 District

Jan-2011 Jehanabad Sadar

Jan-2011 Kako

Jan-2011 Ghosi

Jan-2011 Ghosi Refral

Jan-2011 Makhdumpur

Jan-2011 Ratni Faridpur

Jan-2011 Hulashganj

Jan-2011 Okari / Modanganj

Jan-2011 Jehanabad Block



133




New Born


Childs

Jan-2011 District Feb-2011

Jehanabad Sadar

Feb-2011 Kako

Feb-2011 Ghosi

Feb-2011 Ghosi Refral

Feb-2011 Makhdumpur

Feb-2011

Ratni Faridpur

Feb-2011 Hulashganj

Feb-2011

Okari / Modanganj

Feb-2011

Jehanabad Block

Feb-2011 District

Mar-2011

Jehanabad Sadar

Mar-2011 Kako

Mar-2011 Ghosi

Mar-2011 Ghosi Refral

Mar-2011 Makhdumpur

Mar-2011

Ratni Faridpur

Mar-2011 Hulashganj

Mar-2011

Okari / Modanganj



134




New Born


Childs

Mar-2011

Jehanabad Block

Mar-2011 District

MONTHS Jehanabad Sadar 60130 12385 5736 600 6411 44 1063 1380 7945 2105

MONTHS Kako 37235 911 828 91 1183 78 274 2781 12972 1924

MONTHS Ghosi 40036 1234 798 184 1890 99 1276 1767 9200 1264

MONTHS Ghosi Refral 17702 695 313 17 1529 29 758

MONTHS Makhdumpur 52002 2888 1891 50 1702 195 3230 3408 19344 2753

MONTHS Ratni Faridpur 43857 887 760 217 1604 38 496 2340 10284 1527

MONTHS Hulashganj 23853 1745 960 37 3124 144 130 1493 7539 985

MONTHS Okari / Modanganj 27519 754 581 197 1209 58 660 1392 8300 949

MONTHS Jehanabad Block 48057 99 0 54 0 103 79 3003 14585 1707

MONTHS District 350391 21598 11867 1447 18652 788 7966 17564 90169 13214



135

Sl. No. Month Name of

PHC/Hospital OPD Indoor Delivery Referred Case Emergency Family

Planning General

Operation Mother Child Polio New Born

Childs Polio

New Born

Childs

1 Apr-2009 Jehanabad Sadar 8503 1671 456 45 670 20 215 103 1179 1.82% 328

2 Apr-2009 Kako 1947 86 69 18 145 22 81 206 2551 0.75% 276

3 Apr-2009 Ghosi 2880 65 56 8 133 13 57 145 1422 0.36% 186

3 Apr-2009 Ghosi Refral 1541 55 24 2 114 9 60

4 Apr-2009 Makhdumpur 4937 260 172 10 302 27 405 392 3094 1.56% 433

5 Apr-2009 Ratni Faridpur 2198 118 110 29 201 1 54 219 2527 0.38% 226

6 Apr-2009 Hulashganj 2596 94 66 1 375 18 50 121 1255 1.11% 142

7 Apr-2009 Okari / Modanganj 1111 206 186 12 173 8 47 149 939 1.07% 151

8 Apr-2009 Jehanabad Block 3825 0 12 0 13 7 301 2663 1.62% 274

9 Apr-2009 District 29538 2555 1139 137 2113 131 976 1636 15630 1.12% 2016

1 May-2009

Jehanabad Sadar 9220 1585 478 64 884 20 305 158 1176 2.58% 326 1.33% 217

2 May-2009 Kako 2919 106 73 22 203 33 78 272 1758 0.38% 434 0.71% 165

3 May-2009 Ghosi 3148 58 41 26 183 7 107 229 2111 0.38% 303 1.03% 147

3 May-2009 Ghosi Refral 2227 80 25 5 160 17 101

4 May-2009 Makhdumpur 5970 312 140 4 304 93 420 415 3214 1.25% 603 1.07% 241

5 May-2009

Ratni Faridpur 1966 123 112 25 225 0 64 204 2451 0.67% 289 1.54% 147

6 May-2009 Hulashganj 3128 163 67 11 495 54 87 139 1420 1.11% 248 0.40% 89

7 May-2009

Okari / Modanganj 1682 78 56 9 81 0 47 138 1269 0.74% 213 1.72% 92

8 May- Jehanabad 4397 0 15 0 27 9 324 2603 0.37% 338 0.77% 174



136



Planning General


Childs Polio

New Born

Childs

2009 Block

9 May-2009 District 34657 2505 992 181 2535 251 1218 1879 16002 0.97% 2754 1.09% 1272

1 Jun-2009

Jehanabad Sadar 11123 1628 519 60 1012 10 245 205 1000 1.33% 258

2 Jun-2009 Kako 3488 98 94 29 181 4 76 329 1463 1.03% 232

3 Jun-2009 Ghosi 5688 89 57 10 205 9 111 227 2183 0.38% 189

3 Jun-2009 Ghosi Refral 2991 55 28 5 130 3 95

4 Jun-2009 Makhdumpur 7266 315 144 18 379 47 354 402 2728 1.00% 300

5 Jun-2009

Ratni Faridpur 2491 113 100 45 269 5 64 266 2110 0.74% 207

6 Jun-2009 Hulashganj 4149 228 64 12 596 49 77 192 1089 0.74% 124

7 Jun-2009

Okari / Modanganj 2591 157 129 5 136 3 13 108 1081 1.07% 136

8 Jun-2009

Jehanabad Block 7087 0 12 3 9 8 385 2588 0.74% 201

9 Jun-2009 District 46874 2683 1135 196 2911 139 1043 2114 14242 0.89% 1647

1 Jul-2009 Jehanabad Sadar 12086 1771 717 67 886 33 235 254 1070 1.33% 258

2 Jul-2009 Kako 4228 143 128 19 189 15 76 427 1720 1.03% 232

3 Jul-2009 Ghosi 5732 134 63 21 248 15 95 281 2699 0.38% 189

3 Jul-2009 Ghosi Refral 3868 71 38 7 140 5 86

4 Jul-2009 Makhdumpur 7789 345 220 9 391 16 418 629 3392 1.00% 300

5 Jul-2009 Ratni Faridpur 2825 148 129 49 280 0 73 367 2509 0.74% 207

6 Jul-2009 Hulashganj 4659 184 84 19 554 15 50 194 1542 0.74% 124



137



Planning General


Childs Polio

New Born

Childs

7 Jul-2009 Okari / Modanganj 2666 163 126 9 113 7 40 221 1641 1.07% 136

8 Jul-2009 Jehanabad Block 7776 0 17 0 34 0 496 2929 0.74% 201

9 Jul-2009 District 51629 2959 1505 217 2801 140 1073 2869 17502 0.89% 1647

1 Aug-2009

Jehanabad Sadar 12349 2098 917 37 867 15 237 228 1056 1.25% 399

2 Aug-2009 Kako 4081 154 129 13 214 54 65 246 1456 1.11% 367

3 Aug-2009 Ghosi 4888 176 110 19 275 9 77 215 2139 0.00% 311

3 Aug-2009 Ghosi Refral 3531 100 57 5 186 7 101

4 Aug-2009 Makhdumpur 7400 449 295 17 480 51 448 401 3080 1.38% 525

5 Aug-2009

Ratni Faridpur 2978 204 181 34 294 25 60 234 2034 0.38% 301

6 Aug-2009 Hulashganj 4532 199 117 10 501 22 54 198 1468 1.07% 193

7 Aug-2009

Okari / Modanganj 2708 142 88 20 184 7 29 201 1218 0.43% 242

8 Aug-2009

Jehanabad Block 7148 0 4 0 56 3 407 2970 1.33% 367

9 Aug-2009 District 49615 3522 1894 159 3001 246 1074 2130 15421 0.92% 2705

1 Sep-2009

Jehanabad Sadar 9350 2059 991 56 902 46 190 226 1366 2.12% 608

2 Sep-2009 Kako 3262 198 160 12 285 66 52 241 1569 0.74% 461

3 Sep-2009 Ghosi 3748 138 106 23 222 11 49 215 2412 0.42% 331

3 Sep-2009 Ghosi Refral 2580 102 62 7 157 13 105

4 Sep-2009 Makhdumpur 5098 559 373 22 561 51 420 527 3426 1.13% 669

5 Sep-2009

Ratni Faridpur 1753 290 265 31 325 20 47 239 2133 1.48% 339



138



Planning General


Childs Polio

New Born

Childs

6 Sep-2009 Hulashganj 2930 220 160 6 437 15 57 188 1783 0.80% 233

7 Sep-2009

Okari / Modanganj 1739 135 99 26 181 13 23 165 1396 0.80% 239

8 Sep-2009

Jehanabad Block 5398 0 13 0 71 7 395 2852 0.40% 410

9 Sep-2009 District 35858 3701 2216 196 3070 306 950 2196 16937 1.05% 3290

1 Oct-2009 Jehanabad Sadar 8014 2255 1202 66 757 71 247 177 1805

2 Oct-2009 Kako 2937 219 181 13 242 90 58 263 1703

3 Oct-2009 Ghosi 3590 165 128 14 231 28 50 156 2413

3 Oct-2009 Ghosi Refral 2778 98 62 5 160 20 125

4 Oct-2009 Makhdumpur 6578 693 440 19 607 98 487 353 3021

5 Oct-2009 Ratni Faridpur 1862 326 286 17 362 32 34 207 1817

6 Oct-2009 Hulashganj 2905 220 157 5 512 31 59 123 1484

7 Oct-2009 Okari / Modanganj 1857 189 133 21 208 51 24 120 1668

8 Oct-2009 Jehanabad Block 5426 0 18 0 39 5 295 2679

9 Oct-2009 District 35947 4165 2589 178 3079 460 1089 1694 16590

1 Nov-2009

Jehanabad Sadar 7705 2513 1146 57 636 95 239 205 1558 1.61% 692

2 Nov-2009 Kako 2834 251 163 9 207 92 41 191 1514 0.50% 857



139



Planning General


Childs Polio

New Born

Childs

3 Nov-2009 Ghosi 4835 210 118 17 228 59 41 140 1810 0.88% 681

3 Nov-2009 Ghosi Refral 2127 107 57 4 127 34 74

4 Nov-2009 Makhdumpur 6100 542 358 17 439 100 385 259 3000 0.69% 1104

5 Nov-2009

Ratni Faridpur 2036 330 262 24 360 89 47 182 1711 1.86% 775

6 Nov-2009 Hulashganj 2517 239 154 5 321 73 40 73 1416 1.13% 427

7 Nov-2009

Okari / Modanganj 1833 173 108 14 146 75 21 106 1296 1.82% 433

8 Nov-2009

Jehanabad Block 5862 0 0 0 153 7 228 2742 3.55% 770

9 Nov-2009 District 35849 4365 2366 147 2464 770 895 1384 15047 1.36% 5739

1 Dec-2009

Jehanabad Sadar 7786 2287 989 57 599 104 196 176 1717 1.54% 473

2 Dec-2009 Kako 4264 220 117 12 160 102 51 222 1620 1.20% 387

3 Dec-2009 Ghosi 2926 138 79 11 160 42 35 141 2404 0.38% 310

3 Dec-2009 Ghosi Refral 2048 89 50 5 139 22 50



140



Planning General


Childs Polio

New Born

Childs

4 Dec-2009 Makhdumpur 6094 529 320 12 418 141 452 316 3449 0.77% 579

5 Dec-2009

Ratni Faridpur 2216 269 240 23 288 50 38 162 1795 1.27% 314

6 Dec-2009 Hulashganj 2228 216 131 3 336 71 44 116 1769 1.30% 209

7 Dec-2009

Okari / Modanganj 2164 162 78 1 136 23 20 99 1586 1.11% 226

8 Dec-2009

Jehanabad Block 6304 0 0 0 133 20 269 3023 1.47% 378

9 Dec-2009 District 36030 3910 2004 124 2236 688 906 1501 17363 1.15% 2876

1 Jan-2010 Jehanabad Sadar 6070 2625 821 46 571 46 243 176 1216 2.40% 443

2 Jan-2010 Kako 3139 164 106 8 156 69 48 196 1331 0.93% 347

3 Jan-2010 Ghosi 2277 87 68 22 155 26 24 121 1791 0.71% 228

3 Jan-2010 Ghosi Refral 1360 48 29 0 129 9 53

4 Jan-2010 Makhdumpur 4445 411 251 15 123 96 308 215 3083 1.36% 515

5 Jan-2010 Ratni Faridpur 1612 233 212 36 265 39 39 133 1208 1.60% 272



141



Planning General


Childs Polio

New Born

Childs

6 Jan-2010 Hulashganj 1628 190 119 8 311 45 35 85 1642 0.91% 209

7 Jan-2010 Okari / Modanganj 1477 105 71 5 78 27 15 86 1334 0.91% 185

8 Jan-2010 Jehanabad Block 4986 0 0 0 65 15 264 2631 1.36% 333

9 Jan-2010 District 26994 3863 1677 140 1788 422 780 1276 14236 1.21% 2532

1 Feb-2010

Jehanabad Sadar 7442 2456 824 27 313 72 224 176 1124 1.20% 382

2 Feb-2010 Kako 3245 142 101 9 134 55 44 214 1289 0.48% 299

3 Feb-2010 Ghosi 4092 84 50 10 131 38 61 121 1875 0.87% 150

3 Feb-2010 Ghosi Refral 2006 58 27 4 106 12 77

4 Feb-2010 Makhdumpur 5742 362 180 5 123 123 391 247 2865 1.19% 305

5 Feb-2010

Ratni Faridpur 2420 207 176 12 204 30 38 188 1752 1.00% 209

6 Feb-2010 Hulashganj 2332 175 82 2 243 73 26 92 1649 0.00% 147

7 Feb-2010

Okari / Modanganj 1903 126 82 11 110 41 53 90 1432 0.95% 143



142



Planning General


Childs Polio

New Born

Childs

8 Feb-2010

Jehanabad Block 5517 92 0 0 0 92 13 264 2673 0.91% 273

9 Feb-2010 District 34699 3702 1522 80 1364 536 927 1392 14659 0.88% 1908

1 Mar-2010

Jehanabad Sadar 7653 2711 857 69 921 60 212 181 1339 2.86% 394

2 Mar-2010 Kako 3945 131 97 14 152 62 59 341 1910 1.11% 364

3 Mar-2010 Ghosi 4088 99 55 28 199 14 97 185 1427 1.12% 217

3 Mar-2010 Ghosi Refral 2296 71 21 0 158 11 82

4 Mar-2010 Makhdumpur 5710 279 141 6 171 67 361 434 3043 1.71% 490

5 Mar-2010

Ratni Faridpur 2005 166 140 14 226 41 45 306 1678 0.77% 282

6 Mar-2010 Hulashganj 3101 176 84 3 298 39 29 148 1554 1.34% 152

7 Mar-2010

Okari / Modanganj 2337 110 86 20 146 21 42 153 1164 2.41% 183

8 Mar-2010

Jehanabad Block 6244 68 0 12 1 69 18 408 2590 0.83% 351

9 Mar-2010 District 37379 3811 1481 166 2272 384 945 2156 14705 1.53% 2433



143



Planning General


Childs Polio

New Born

Childs

1 MONTHS Jehanabad Sadar 107301 25659 9917 651 9018 592 2788 2265 15606 4561

2 MONTHS Kako 40289 1912 1418 178 2268 664 729 3148 19884 4256

3 MONTHS Ghosi 47892 1443 931 209 2370 271 804 2176 24686 3095

3 MONTHS Ghosi Refral 29353 934 480 49 1706 162 1009

4 MONTHS Makhdumpur 73129 5056 3034 154 4298 910 4849 4590 37395 5823

5 MONTHS Ratni Faridpur 26362 2527 2213 339 3299 332 603 2707 23725 3421

6 MONTHS Hulashganj 36705 2304 1285 85 4979 505 608 1669 18071 2208

7 MONTHS Okari / Modanganj 24068 1746 1242 153 1692 276 374 1636 16024 2287

8 MONTHS Jehanabad Block 69970 160 0 103 4 761 112 4036 32943 3896

9 MONTHS District 455069 41741 20520 1921 29634 4473 11876 22227 188334 29547



144



Planning

General

Operation

Mother Child Polio New Born

Childs

1 Apr-2008 Jehanabad Sadar 8167 2262 455 47 753 29 332 54 995 1.78% 250

2 Apr-2008 Kako 2172 97 74 7 213 28 35 17 2069 1.03% 216

3 Apr-2008 Ghosi 4656 99 84 23 353 8 65 210 1688 0.38% 169

4 Apr-2008 Makhdumpur 4516 209 140 16 280 14 270 296 3202 1.48% 314

5 Apr-2008 Ratni Faridpur 1479 31 54 39 148 20 64 152 2966 1.60% 176

6 Apr-2008 Hulashganj 2018 46 46 6 330 19 34 198 1625 0.80% 108

7 Apr-2008 Okari / Modanganj 1809 74 47 15 129 15 66 347 1110 0.40% 119

8 Apr-2008 Jehanabad Block 1850 0 20 24 178 2643 1.54% 179

9 Apr-2008 District 26667 2818 900 153 2206 153 890 1452 16298 1.07% 1531

1 May-2008 Jehanabad Sadar 10509 2346 404 43 836 6 385 85 1036 1.78%

2 May-2008 Kako 3420 127 81 22 217 12 70 297 2072 1.03%

3 May-2008 Ghosi 6432 101 63 33 353 7 126 273 2362 0.38%

4 May-2008 Makhdumpur 5681 221 143 18 304 16 319 744 3643 1.48%

5 May-2008 Ratni Faridpur 2052 91 74 20 161 13 85 232 2654 1.60%

6 May-2008 Hulashganj 2637 60 60 7 416 34 47 342 1969 0.80%

7 May-2008

Okari / Modanganj 2813 68 39 21 104 8 100 187 1317 0.40%

8 May-2008 Jehanabad Block 1869 0 9 27 310 2847 1.54%



145



Planning

General

Operation


Childs

9 May-2008 District 35413 3014 864 164 2391 105 1159 2470 17900 1.07%

1 Jun-2008 Jehanabad Sadar 10719 1953 400 43 732 10 337 238 648 0.97% 289

2 Jun-2008 Kako 3900 117 93 11 248 21 53 394 1575 1.07% 273

3 Jun-2008 Ghosi 6402 106 64 28 340 26 109 532 1134 1.03% 168

4 Jun-2008 Makhdumpur 6044 241 149 15 280 17 309 1267 3108 1.07% 391

5 Jun-2008 Ratni Faridpur 2434 78 59 24 140 16 63 310 2579 0.37% 229

6 Jun-2008 Hulashganj 2770 60 60 9 436 13 51 367 1651 0.74% 147

7 Jun-2008 Okari / Modanganj 2861 71 37 19 108 12 84 379 1438 0.71% 146

8 Jun-2008 Jehanabad Block 2300 2 26 19 686 2768 1.67% 251

9 Jun-2008 District 37430 2626 864 149 2284 141 1025 4173 14901 0.95% 1894

1 Jul-2008 Jehanabad Sadar 12254 2504 573 40 952 8 304 273 1020 2.40% 306

2 Jul-2008 Kako 3804 114 108 10 191 7 76 551 1329 1.07% 219

3 Jul-2008 Ghosi 3659 113 75 21 169 0 47 736 1455 0.74% 136

3 Jul-2008 Ghosi Refral 3454 75 33 8 151 11 94

4 Jul-2008 Makhdumpur 7855 316 197 14 350 14 386 1198 2591 0.83% 337

5 Jul-2008 Ratni Faridpur 3013 99 78 32 177 4 71 473 1851 0.83% 191

6 Jul-2008 Hulashganj 3958 123 84 9 490 14 72 359 1242 1.38% 117

7 Jul-2008 Okari / Modanganj 3105 73 52 23 114 11 72 51 944 0.00% 137

8 Jul-2008 Jehanabad Block 2552 0 9 31 568 2623 1.07% 243



146



Planning

General

Operation


Childs

9 Jul-2008 District 43654 3417 1200 157 2594 78 1153 4209 13055 1.04% 1686

1 Aug-2008 Jehanabad Sadar 12225 2771 799 62 1059 27 306 195 896 2.40%

2 Aug-2008 Kako 4427 148 135 40 234 48 101 539 890 1.07%

3 Aug-2008 Ghosi 4013 78 80 12 164 19 712 1766 0.74%

3 Aug-2008 Ghosi Refral 3581 99 37 16 137 41 53

4 Aug-2008 Makhdumpur 10360 472 308 32 485 56 457 1113 2590 0.83%

5 Aug-2008 Ratni Faridpur 3203 164 131 40 240 16 60 672 1498 0.83%

6 Aug-2008 Hulashganj 3425 216 123 12 521 51 67 409 949 1.38%

7 Aug-2008

Okari / Modanganj 2882 620 78 26 161 27 79 271 717 0.00%

8 Aug-2008 Jehanabad Block 4542 0 46 19 1044 2495 1.07%

9 Aug-2008 District 48658 4568 1691 240 3001 312 1161 4955 11801 1.04%

1 Sep-2008 Jehanabad Sadar 14777 3441 909 44 975 21 195 208 1092 1.15% 647

2 Sep-2008 Kako 5219 244 218 43 257 70 73 303 1184 0.80% 896

3 Sep-2008 Ghosi 4949 119 112 13 209 70 344 1540 0.40% 610

3 Sep-2008 Ghosi Refral 3888 127 54 13 130 46 50

4 Sep-2008 Makhdumpur 11393 552 404 15 558 72 721 893 2930 0.38% 1210

5 Sep-2008 Ratni Faridpur 3465 200 159 26 253 33 60 622 1718 1.07% 677



147



Planning

General

Operation


Childs

6 Sep-2008 Hulashganj 3862 253 166 9 596 73 74 295 926 1.11% 387

7 Sep-2008 Okari / Modanganj 3385 178 109 30 193 42 81 307 584 0.42% 474

8 Sep-2008 Jehanabad Block 3824 0 96 15 917 2384 1.11% 721

9 Sep-2008 District 54762 5114 2131 193 3171 453 1339 3889 12358 0.82% 5622

1 Oct-2008 Jehanabad Sadar 11490 3972 1078 67 957 29 163 200 1495 1.15%

2 Oct-2008 Kako 4203 254 193 25 276 68 98 372 1859 0.80%

3 Oct-2008 Ghosi 3753 145 143 17 235 48 224 2064 0.40%

3 Oct-2008 Ghosi Refral 3145 139 64 4 195 51 112

4 Oct-2008 Makhdumpur 7676 669 561 8 640 57 525 532 3182 0.38%

5 Oct-2008 Ratni Faridpur 3411 239 218 19 312 32 76 541 2549 1.07%

6 Oct-2008 Hulashganj 3814 187 155 8 485 46 60 211 1404 1.11%

7 Oct-2008 Okari / Modanganj 2560 252 151 7 215 34 58 298 1340 0.42%

8 Oct-2008 Jehanabad Block 3617 0 30 100 29 686 3272 1.11%

9 Oct-2008 District 43669 5857 2563 185 3315 417 1169 3064 17165 0.82%

1 Nov-2008 Jehanabad Sadar 11482 3390 914 47 760 73 252 176 1590 1.38% 642

2 Nov-2008 Kako 3570 284 231 13 316 54 142 421 1604 0.38% 811

3 Nov-2008 Ghosi 3268 121 129 10 191 59 226 1933 0.77% 606

3 Nov-2008 Ghosi Refral 2571 93 29 16 120 35 34

4 Nov-2008 Makhdumpur 6956 548 456 9 524 98 427 496 3414 0.97% 1200

5 Nov-2008 Ratni Faridpur 2280 308 313 25 383 45 73 489 2200 1.07% 642



148



Planning

General

Operation


Childs

6 Nov-2008 Hulashganj 3356 176 135 1 318 38 60 174 1295 0.74% 407

7 Nov-2008 Okari / Modanganj 2215 188 136 18 187 44 109 210 1042 0.74% 451

8 Nov-2008 Jehanabad Block 5597 0 30 88 12 540 2844 0.71% 856

9 Nov-2008 District 41295 5108 2343 169 2799 475 1168 2732 15922 0.86% 5615

1 Dec-2008 Jehanabad Sadar 11716 3496 949 51 637 90 280 189 1754 1.72% 454

2 Dec-2008 Kako 3294 300 213 13 262 114 121 481 1933 1.49% 588

3 Dec-2008 Ghosi 3032 90 83 18 180 18 42 260 1988 0.36% 387

3 Dec-2008 Ghosi Refral 2856 144 54 5 154 71 70

4 Dec-2008 Makhdumpur 7135 633 422 9 502 141 435 558 3897 1.33% 743

5 Dec-2008 Ratni Faridpur 2156 304 211 24 317 142 53 432 2247 1.29% 466

6 Dec-2008 Hulashganj 3308 230 139 1 429 93 86 214 1430 1.33% 317

7 Dec-2008 Okari / Modanganj 1782 204 161 12 189 96 112 195 1340 1.07% 291

8 Dec-2008 Jehanabad Block 6248 0 23 1 143 16 519 3123 0.38% 534

9 Dec-2008 District 41527 5401 2232 156 2671 908 1215 2848 17712 1.14% 3780

1 Jan-2009 Jehanabad Sadar 5804 2790 663 29 450 20 51 39 559

2 Jan-2009 Kako 2755 230 130 8 186 109 75 415 765

3 Jan-2009 Ghosi 1182 111 79 3 128 51 11 120 1826

3 Jan-2009 Ghosi Refral 653 52 32 3 118 39 26

4 Jan-2009 Makhdumpur 2314 527 326 7 389 129 304 387 1703

5 Jan-2009 Ratni Faridpur 1839 293 187 20 228 88 49 352 1510



149



Planning

General

Operation


Childs

6 Jan-2009 Hulashganj 2268 179 96 1 280 171 54 157 1171

7 Jan-2009 Okari / Modanganj 1329 163 87 12 93 82 38 139 846

8 Jan-2009 Jehanabad Block 2290 0 1 0 52 0 122 1049

9 Jan-2009 District 20434 4345 1600 84 1872 741 608 1731 9429

1 Feb-2009 Jehanabad Sadar 10383 2929 641 41 457 65 100 143 1390 5.28% 388

2 Feb-2009 Kako 2820 217 126 8 177 94 70 345 2383 0.69% 446

3 Feb-2009 Ghosi 1998 87 66 9 133 33 19 368 2270 0.38% 324

3 Feb-2009 Ghosi Refral 1428 44 32 3 96 18 25

4 Feb-2009 Makhdumpur 4074 570 363 11 421 162 367 606 3516 1.03% 647

5 Feb-2009 Ratni Faridpur 1786 260 159 26 239 89 50 340 2437 0.71% 381

6 Feb-2009 Hulashganj 2119 124 83 1 290 89 25 166 1552 0.38% 213

7 Feb-2009 Okari / Modanganj 1559 185 122 10 121 61 34 224 1367 1.61% 251

8 Feb-2009 Jehanabad Block 4043 0 3 0 172 2 393 2995 0.94% 421

9 Feb-2009 District 30210 4416 1592 112 1934 783 692 2585 17910 1.52% 3071

1 Mar-2009 Jehanabad Sadar 10529 2774 621 56 709 54 152 206 1351 1.82% 328

2 Mar-2009 Kako 2263 143 120 13 171 38 78 344 1540 0.75% 276

3 Mar-2009 Ghosi 3420 99 66 16 145 14 46 366 1907 0.36% 186

3 Mar-2009 Ghosi Refral 2040 45 27 5 104 18 78

4 Mar-2009 Makhdumpur 5594 380 254 6 341 62 405 767 3326 1.56% 433

5 Mar-2009 Ratni Faridpur 2030 165 119 33 208 31 58 405 1789 0.38% 226



150



Planning

General

Operation


Childs

6 Mar-2009 Hulashganj 2907 109 77 4 376 70 86 226 1382 1.11% 142

7 Mar-2009 Okari / Modanganj 1548 189 133 17 149 36 52 287 1395 1.07% 151

8 Mar-2009 Jehanabad Block 4946 0 3 0 104 7 510 2394 1.62% 274

9 Mar-2009 District 35277 3904 1417 153 2203 427 962 3111 15084 1.12% 2016

1 MONTHS Jehanabad Sadar 130055 34628 8406 570 9277 432 2857 2006 13826 3304

2 MONTHS Kako 41847 2275 1722 213 2748 663 992 4479 19203 3725

3 MONTHS Ghosi 70380 2087 1406 276 3805 487 1203 4371 21933 2586

4 MONTHS Makhdumpur 79598 5338 3723 160 5074 838 4925 8857 37102 5275

5 MONTHS Ratni Faridpur 29148 2232 1762 328 2806 529 762 5020 25998 2988

6 MONTHS Hulashganj 36442 1763 1224 68 4967 711 716 3118 16596 1838

7 MONTHS Okari / Modanganj 27848 2265 1152 210 1763 468 885 2895 13440 2020

8 MONTHS Jehanabad Block 43678 0 2 90 1 865 201 6473 31437 3479

9 MONTHS District 458996 50588 19397 1915 30441 4993 12541 37219 179535 25215



151

National Rural Health Mission

Strategy & Activity Plan with budget

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to b

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Ten

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X x

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Bud

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{Y

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Bud

geta

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ourc

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than

NR

HM

sou

rce)

Remarks

O

1 2 3 5 6 8 9

11 12 13 15

Activities

Q

1 Q2

Q3

Q4



153

A.1.1

1.1Operationalise facilities (dissemination, monitoring & quality) (details of infrastructure & human resources, training, IEC / BCC, equipment, drug and supplies in relevant sections)

A.1.1.1

1.1.1 Operationalise Block PHCs/ CHCs/ SDHs/ DHs as

2 2 0 342000

684000

684000

211422 4725

78 3256578

3256578

NRHM

RS. 472578

(PREV.YEAR

)



154

FRUs

A.1.1.1.1

1.1.1 Operationalise FRUs (Diesel, Service Maintenance Charge, Misc. & Other costs) 1.1.1.1 Operationalise Blood Storage units in FRU

0



155

A.1.1.2

1.1.2 Operationalise 24x7 PHCs (Organise workshops on various aspects of operationalisation of 24x7 services at the facilities @ Rs. 25,000 / year / district)

0 8 8 25,000

0 0 0 200,000

200,000

NRHM

NO ANY WORKSHOP FOR THE FINANCIAL

YEAR

2010-11 , DISTRICT & BLOCK LEVEL WORKSHOP (24X

7)



156

SHOULD BE CO

MPLETED AT 3RD QUARTE

R FOR THE YEA

R 2011

-2012

A.1.1.

MTP services at 0



157

3 health facilities

A.1.1.4

RTI/STI srvices at

health facilities

0

A.1.1.5

Operationalise Sub-centres

6

3 APHC & 3HSC

6 200000

0 0 0 0 1200000

1200000

NRHM

NEW

PLAN

A.1.2

1.2 Referral Transport 0



158

A.1.2.1

1.2.1. To develop guidelines regarding referral transport of the pregnant women and sick new born / children and dissemination of the same @ Rs. 50,000 for the state

0

A.1.2.2

1.2.2. Payment to Ambulances for all PHCs @ Rs. 200 / case of pregnancy for Jehanabad district

0



159

(Pilot basis)

A.1.3.

1.3. Integrated outreach RCH services

0

A.1.3.1

1.3.1. RCH Outreach Camps in un-served/ under-served areas

##

833

140000

3000 137000

137000

137000

NRHM



160

A.1.3.2.

1.3.2. Monthly Village Health and Nutrition Days at AWW Centres

1 IN YEAR

0 1 Y

NOT FINAL DATE

112360

112360

0 112360

112360

NRHM

A.1.4

1.4. Janani Evam Bal Suraksha Yojana/JBSY

0

A.1.4.1

1.4.1 Home deliveries (500/-)

102000 1020

00 0 210000

210000

A.1.4.2

1.4.2 Institutional Deliveries

##

##

## #

# 0



161

A.1.4.2.1

1.4.2.1 Rural (A) Institutional deliveries (Rural) @ Rs.2000/- per delivery for 10.00 lakh deliveries

2000

41,000,000

24,002,203

16997797

67900000

67900000

NRHM

A.1.4.2.2

1.4.2.2 Urban (B) Institutional deliveries (Urban) @ Rs.1200/- per delivery for 2.00 lakh deliveries

1200

250000 2000

00 50000

550000

550000



162

A.1.4.2.3

1.4.2.3 Caesarean Deliveries (Facility Gynec, Anesth & paramedic) 10.3.1 Incentive for C-section(@1500/-(facility Gynec. Anesth. & paramedic)

1500

150000 100,

000 50000

175000

175000

A.1.4.3

1.4.3 Other Activities(JSY) 1.4.3. Monitor quality and utilisation of services and Mobile Data Centre at HSC and APHC Level

540

540000

0 540000

540000

540000



163

and State Supervisory Committee for Blood Storage Unit

Total (JSY) 0

A.1.5

1.5 Other strategies/ac

tivities 0

A.1.5.1

1.5.1 Maternal Death Audit 1.1.3 Survey on maternal and perinatal deaths by verbal autopsy method (in two districts) @ 850 per

0 0 0 0 0 250,000

250,000



164

death

A.2

2. Child Health 0



165

A.2.1

2.1. Integrated Management of Neonatal & Childhood Illness/IMNCI (Monitor progress against plan; follow up with training, procurement, review meetings etc) 2.1. IMNCI (details of training, drugs and supplies, under relevant sections) 2.1.1. Monitor progress

135000

0



166

against plan; follow up with training, procurement, review meetings etc



167

A.2.2

2.2 Facility Based Newborm Care/FBNC in districts (Monitor progress against plan; follow up with training, procurement, view meeting etc.) 2.2.1. Implementation of FBNC activities in districts. (Monitor progress against plan; follow up with training,

38 38,000

0 ###

38000

38,000

38,000



168

procurement, etc.)

A.2.3.

2.3 Home Based New born care/HBNC

0

A.2.4

2.4 School Health Programme (Details annexed)

3000

2212413 2910

00 1921413

3097379

3097379

A.2.5.

2.5 Infant and Young Child Feeding/IYCF

0



169

A.2.6.

2.6 Care of sick children & severe malnutrition

469070

1758070

0 0 1758070

1758070

1758070

A.2.7.

2.7 Management of Diarrhoea, ARI and Micro nutrient

25 111000 2364

0 87360

87360

87360

A.3

3.Family Planning 0

A.3.1.

3.1.Terminal/Limiting Methods

0



170

A.3.1.1.

3.1.1. Dissemination of manuals on sterilisation standards & quality assurance of sterilisation services

22000

22000

0 22000

22000

22000

A.3.1.2

3.1.2 Female Sterilisation

camps 10

00 168000 0 1680

00 168000

168000

A.3.1.3 3.1.2.2.

3.1.3 3.1.2.2. NSV camps (Organise NSV camps in districts @Rs.10,000 x 500 camps)

10000

160000

0 160000

160000

160000



171

A.3.1.4

3.1.4 Compensation for female sterilisation 3.1.2.3. Compensation for female sterilisation at PHC level in camp mode 3.1.2.1. Provide female sterilisation services on fixed days at health facilities in districts (Mini Lap)

##

##

## #

# 1000

4255000 1351

771 2903229

7158229

7158229

A.3.1.5 3.1

3.1.5 Compensation for male slerilisation

##

20

## #

# 1500

337500 1700

0 320500

320500

320500



172

.2.4

3.1.2.4. Compensation for NSV Acceptance @50000 cases x1500

A.3.1.6 3.1.3.1

3.1.6 Accreditation of private providers for sterilisation services 3.1.3.1 Compensation for sterilization done in Pvt.Accredited Hospitals (1.50 lakh cases)

4170000 0 4170

000 4170000

4170000

A.3.2

3.2. Spacing Methods 0



173

A.3.2.1

3.2.1. IUD Camps 1

6 0 1

6 1

6 15

00 240000

0 240000

240000

240000

A.3.2.2

3.2.2 IUD services at health facilites/compensation

50 196998

0 196998

196998

196998

A.3.2.3

Accreditation of private providers for IUD insertion services

0

A.3.2.4

Social Marketing of contraceptiv

es

0 50000

50000

A.3.2.5 3.2.2.

3.2.5 3.2.2. Contraceptive Update Seminars (Organise Contraceptiv

7135

49910 0 4991

0 4991

0 4991

0



174

e Update seminars for health providers (one at state level & 38 at district level) (Anticipated Participants-50-70)

A.3.3

3.3 POL for Family Planning for 500 below sub-district facilities

129600

7100 122500

125500

125500

A.3.4

3.4 Repair of Laproscopes (Rs. 5000 x 40 nos.)

0



175

A.3.5

3.5 Other strategies/activities 3.1.4. Monitor progress, quality and utilisation of services 3.5. Establishing Community Based Condom and OCP Distribution Centres (pilot in one district/1 PHC)

0

A.4

4. Adolescent Reproductive and Sexual Health (ARSH)

0



176

(Details of training, IEC/BCC in relevant sections)

0

A.4.1

Adolescent services at health facilites. 4.1.1. Disseminate ARSH guidelines.4.1.2. Establishing ARSH Cells in Facilities 4.1.2.1. Developing a Model ARSH Cell for the facilities 4.1.2.2. Establishing ARSH Cell at

0



177

Patna District Hospital 4.1.2.3. Establishing ARSH Cell is 50% PHCs of Patna District 4.2 Conducting ARSH Camps at all PHCs for a week (as ARSH Week) 4.2.2 Establishing Youth friendly health clinics in Urban Area/ Universities Campus / Market Place



178

A.4.2

4.2 Other strategies/activities

0

A.5

5. Urban RCH 0

A.5.1

5.1. Urban RCH Services (Development of Micro-plans for each urban area already mapped for delivery of RCH services, both outreach and facility based through private agencies/ins

0



179

titutions/organisations-50lakhs & Operationalising 20 UHCs through private clinics @540000/- pm

A.6

6 Tribal Health 0

A.6.1

Tribal RCH services 0

A.6.2

Other strategies/activities

0

A.7

7. Vulnerable Groups

0



180

A.7.1

7.1 Services for Vulnerable groups

0

A.7.1

7.1 Services for Vulnerable groups

0

A.7.2

7.2 Other strategies/activities

0

A.8

8. Innovations/PPP/NGO

0



181

A.8.1

8.1.PNDT and Sex Ratio 8.1.1. Orientation programme of PNDT activities, Workshop at State, District and Block Level (1+38+533) (amount Rs.50 Lakhs) 8.1.2 Monitoring at District level and Meetings of District level Committee (100 Lakhs)

10 1 9 9 y

25000

250000 2000

0 230000

230000

230000



182

A.8.2.

Public Private Partnerships

0

A.8.3

NGO Programme 0

A.8.4

Other innovations (if any)

0

A.9

INFRASTRUCTURE & HR

0

A.9.1

Contracutal Staff & Services

0



183

A.9.1.1 9.1.1 ANMs

10.1.1.2. Hiring of 1000 Retired ANMs or ANMs from other states for out reach services @ Rs. 5000 / month / ANM

0

A.9.1.2

9.1.2 Laboratory

Technicians

234000

351000 0 3510

00 351000

351000

A.9.1.3

Staff Nurses 12000

7200000

5400000

1800000

9000000

9000000



184

A.9.1.4

9.1.4 Doctors and Specialists

(Anaesthetists,

Paediatricians, Ob/Gyn, Surgeons,

Physicians) Hiring

Specialists 1.1.1.1

Operationalise Blood Storage

units in FRU -Salary of Medical Officer -

1,82,40,000/-; 10.1.2.1.

Empeanelling

Gynaecologists for

gynaecology

35000

840000

0 840000

840000

840000



185

OPD in under or un

served areas @ Rs. 1000/-

week x 52 weeks ; 10.1.2.3.

Empanelling Gyaneocolo

gists for PHCstoprovi

de OPD services @

Rs. 300/- weekx 52 weeks; 10.1.2.4 Hiring

Anaesthetist positions @ Rs.1000 per

case x 120000; 10.1.2.5. Hiring

Paediatricia



186

n for facilities

where there are vacant

Paediatricians positions

@ Rs. 35,000/-

month (2 per district); 10.1.2.6 Hiring

Gynaecologists for

facilities that have vacant positions @ Rs. 650 per

case x 75000 cases



187

A.9.1.5

Other contractual

Staff 9.1 Fast-Track

Training Cell in SIHFW 9.2

Filling Vacant

Position at SIHFW/Hiring Consultant

at SIHFW 10.1.1

Honorarium of Voluntary Workers @ of 1200/- PA x 3106 No.

63157

10900

52257

52257

52257

A.9.1.6

Incentive/Awards etc.

8.2.1 Incentive for

ASHA per AWW center (80000x200 per month)

6918000 3202

931 3715069

6918000

6918000



188

and Incentive

toANMs per Aganwari

Centre under

Muskan Programme (@80000 x Rs.150 Per

Month A.9

.2 9.2. Major civil works

(new construction/extension/a

ddition)

0

A.9.2.1

9.2.1 Major Civil works

for operationali

sation of FRUS

0 200000

200000



189

A.9.2.2

9.2.2 Major Civil works

for operationalisation of 24

hour services at

PHCs

0 700000

700000

A.9.3

9.3 Minor Civil Works 7000

00 0 7000

00 700000

700000



190

A.9.3.1

9.3.1 Minor civil works

for operationali

sation of FRUs 10.4.1

Facility improvemen

t for establishing

New Born Centres at 76 FRUs

across the state - @ Rs. 50,000 / per

FRU

0



191

A.9.3.2

9.3.2 Minor civil works

for operationalisation of 24

hour services at

PHCs 10.4.2. Facility

improvement for

establishing New Born Centres at

PHCs across the

state - @ Rs. 25,000 / per

PHC

0

A.9.4

9.4 Operationalise IMEPat

health facilites

1490316

0 1490316

1490316

1490316

A.9.5

9.5 Other Activities 0



192

A.10

10. Institutional Strengthening

0

A.10.1

10.1 Human Resource Development

0 500000

500000

A.10.2

10.2 Logistics management/improvement

0 300000

300000

A.10.3

10.3 Monitoring Evaluation/HMIS 11.3 Monitoring & evaluation through monitoring cell at SIHFW

292113 1130

0 280813

772926

772926



193

A.10.4

10.4 11.4 Sub-centre rent and contingencies @ 1770 no. x Rs.500/- x 60 months

96000 3900

0 57000

153000

153000

A.10.5.

10.5. Other strategies/activities TA & DA for the 30 days contact programme

0 300000

300000

A.11

11 Training 0

A.11.1

11.1 Strengthening of Training Institutions

0



194

A.11.2

11.2 Development of training packages

0

A.11.3

11.3 Maternal Health Training

0

A.11.3.1

11.3.1 Skilled Birth Attendance /SBA 12.1.2 Skilled Attendance at Birth / SBA--Two days Reorientation of the existing trainers in Batches 12.1.3 Strengthening of existing

176220

444400

-

268180

712580

712580



195

SBA Training Centres 12.1.4 Setting up of additional SBA Training Centre- one per district 12.1.5 Training of Staff Nurses in SBA (batches of four) 12.1.6 Training of ANMs / LHVs in SBA (Batch size of four) 20 batches x 38 districts x Rs.59,000/-



196

A.11.3.2

EmOC Training 12.1.3 EmOc Training of (Medical Officers in EmOC (batchsize is 8 )

0 50000

50000

A.11.3.3

11.3.3 Life Saving Anaesthesia Skills training 12.1.5 Training of Medical Officers in Life Saving Anaesthesia Skills (LSAS)

0



197

A.11.3.4

11.3.4 MTP Training 12.1.6.1 Training of nurses/ ANMs in safe abortion 12.1.8 Training of Medical Officers in safe abortion

50000 0 5000

0 5000

0 5000

0

A.11.3.5

11.3.5 RTI/STI Training

0

A.11.3.6

Dai Training 0

A.11.3.7

Other MH Training 0

A.11.4

IMEP Training 0



198

A.11.5

11.5 Child Health Training

0

A.11.5.1

11.5.1 IMNCI 12.2.1.1. TOT on IMNCI for Health and ICDS worker 12.2.1.2. IMNCI Training for Medical Officers (Physician) 12.2.1.3. IMNCI Training for all health workers 12.2.1.4. IMNCI Training for ANMs / LHVs/ AWWs 12.2.1.6

0 200000

200000



199

Followup training (HEs,LHVs)

A.11.5.2

11.5.2 Facility Based Newborn Care 12.2.2.1 SNCU Training 12.2.2.2.NSU (TOT)

0 100000

100000

A.11.5.3

11.5.3 Home Based Newborn Care

0

A.11.5.4

11.5.4 Care of Sick Children and severe malnutrition

0



200

A.11.5.5

11.5.5 Other CH Training (Pl. Specify)

0

A.11.6

11.6 Family Planning Training

0

A.11.6.1

12.6.1 Laproscopic Sterilisation Training

0

A.11.6.2

11.6.2 Minilap Training 12.3.2.1. Minilap training for medical officers/staff nurses (batch size of 4)

70240

0 70240

70240

70240



201

A.11.6.3

11.6.3 NSV Training 12.3.3 Non-Scalpel Vasectomy (NSV) Training

33900 0 3390

0 3390

0 3390

0

A.11.6.4

11.6.4 IUD InsertionTraining 12.3.4 IUD Insertion (details in Annexure) 12.3.4.1 State level (TOT for the districts) 12.3.4.2 District level training (one district total ) 12.3.4.3 PHC level training (for

169450

0 169450

169450

169450



202

one district only)

A.11.6.5

Contraceptive Update Training

0

A.11.6.6

Other FP Training 0

A.11.7

11.7 ARSH Training 12.4.1 ARSH training for medical officers 12.4.3 One Day ARSH Orientation by the MOs of 25% ANMs 12.4.4 One Day ARSH Orientation

0



203

of PRI by the MOs of50% ANMs

A.11.8

11.8 Programme Management Training

0



204

A.11.8.1

11.8.1 SPMU Training 12.5.4 State PMU to be trained/attend workshops in various areas like HR, Procurement & Logistics, PPP, FRU review and/or undertake study of various programmes in one good and one poor performing districts

0



205

A.11.8.2

11.8.2 DPMU Training 12.5.1 Training of DPMU staff @ 38 x Rs.10,00012.5.2. Training of SHSB/DAM/BHM on accounts at Head Quarter level @ 6x1500x12=1,08,000/- +DAM=38x1500x4 + BHM=538x1500x4 12.5.3 Training for ASHA Help Desk to DPMs (38), Block level

58000

0 58000

58000

58000



206

organisers (533) and MOICs (533), @ 1104 x 1000/-

A.11.9

Other Training 0



207

A.11.9.1

11.9.1 Continuing Medical & Nursing

Education 11.2

Training of 20 (for total

state) regular

Government doctors in

Public Health at

Public Health

Institute, Gujarat or at

Wardha institute or

Vellore institute to increase

their administrative skills @

0



208

Rs.50,000/-

A.12

12. BCC/IEC (for NRHM Part A, B & C)

0

A.12.1

12.1 Strengthening of BCC/IEC Bureaus (State and District Levels)

244500 4200

0 202500

420000

420000



209

A.12.2

12.2 Development of State BCC/IEC strategy 13.3 Concept and material development workshops by State BCC/IEC Cell 13.8 Establishment cost of the State BCC/IEC Cell 13.10 Technical support at District level

0

A.12.3

12.3 Implementat

ion of BCC/IEC stretegy

0



210

A.12.3.1

12.3.1 BCC/IEC

activities for MH

0

A.12.3.2

BCC/IEC activities for

CH 0

A.12.3.3

12.3.3 BCC/IEC

activities for FP

0

A.12.3.4

12.3.4 BCC/IEC

activities for ARSH

0



211

A.12.4

12.4 Other activities 13.4 State Level events 13.5 District Level events ( Radio, TV, AV, Human Media as per IEC strategy dissemination) 13.6 Printed material (posters, bulletin, success story reports, health calendar,Quarterly magazines & diaries etc) 13.7 Block level BCC

0



212

interventions (Radio, kalajattha and for IEC strategy dissemination) 13.11 Media Advertisements on various health related days 13.12 Various advertisements/tender advertisements/EOIs in print media at State level 13.13 Developing Mobile Hoarding Vans and A



213

V Van for State and District 13.14 Hiring an IEC Consultancy at state level for operationation of BCC Strategy. (@ Rs. 50000 x 1 x 12) 13.16 Implementation of specific interventions including innovations of BCC strategy/plans block level 13.17 Implementation of



214

specific interventions including innovations of BCC strategy/plans District level (Rs. 5000 x 38 x 12) 13.18 Implementing need based IEC Activities in Urban Areas (Support for Organization of need based IEC Activities in Urban Areas) (Rs.50000 x 9 x 2) 13.19 Capacity building of



215

frontline functionaries (ANM, ASHA) in IPC skills building 13.20 Research, M&E, IEC prototypes etc

Sub-total IEC/BCC 0



216

A.13

Procurement 0

A.13.1

13.1 Procurement of Equipment

0



217

A.13.1.1

13.1.1 Procurement of equipment 14.2. Equipments for EmOC services for identified facilities (PHCs, CHCs) @ Rs 1 Lac / facility / year (in two districts - kishanganj and jehanabad) 14.4. Equipments / instruments for Blood Storage Facility /

37200

0 37200

37200

37200



218

Bank at facilities 14.6. Equipments / instruments, reagents for STI / RTI services @ Rs. 1 Lac per district per year



219

A.13.1.2

13.1.2 Procuremen

t of equipment :

CH

0

A.13.1.3

13.1.3 Procurement of equipment : FP

0 50000

50000

A.13.1.4

13.1.4 Procuremen

t of equipment :

IMEP

0

A.13.2

13.2 Procurement of Drugs &

supplies 0

A.13.2.1

13.2.1 Drugs & Supplies

for MH 35340

0 35340

35340

35340



220

A.13.2.1.2

13.2.1.2 Drugs &

Supplies for MH

47820

0 47820

47820

47820

A.13.2.1.3

13.2.1.3 Drugs &

Supplies for MH

30620

0 30620

30620

30620

A.13.2.1.5

13.2.1.5 Drugs &

Supplies for MH

1282625

0 1282625

1282625

1282625

A.13.2.3.1

13.2.3.1 Drugs &

Supplies for FP

105000 0 1050

00 105000

105000

A.13.2.3.2

13.2.3.2 Drugs &

Supplies for FP

5500 0 5500 5500 5500

A.13.2.3.3

13.2.3.3 Drugs &

Supplies for FP

15000 0 1500

0 1500

0 1500

0



221

A.13.2.2

13.2.2 Drugs & Supplies

for CH 0

A.13.2.3

13.2.3 Drugs Supplies for

FP 0

A.13.2.4

13.2.4 Supplies for

IMEP 0

A.13.2.5

General drugs &

supplies for health

facilities

12496000 0 1249

6000 12496000

12496000

A.14

14. Prog. Manag- ement 0



222

A.14.1

Strengthening of State Society/SPMU 16.1. Strengthening of State society/State Programme Management Support Unit 16.1.1. Contractual Staff for SPMU recruited and in position 16.5.1. Last pay drawn – Pension = Approx exp of Rs.20,000/-PM @ 20,000x6x12

0



223

A.14.2

14.2 Strengthening of District Society/DPMU 16.2.1. Contractual Staff for DPMSU recruited and in position

1961120 5610

00 1400120

3361240

3361240



224

A.14.3

14.3 Strengtheningof Financial Management Systems 16.3.1.Training in accounting procedures 16.3.2. Audits 16.3.2.1. Audit of SHSB/ DHS by CA for 2009-10 16.4 Appointment of CA 16.4.1 At State level 16.4.2 At District level 16.5 Constitution of Internal Audit wing at SHSB

240000

81000

159000

399000

399000



225

A.14.4

14.4 Other activities (Programme management expenses,mobility support to state,district, block) 16.1.2. Provision of mobility support for SPMU staff @ 12 months x Rs.10.00 lakhs Updgration of SHSB Office 16.2.2.Provision of mobility support for DPMU staff @ 12 months x 38 districts x Rs.69945.17/-

0



226

Total Prog. Mgt. 0

A.15

Others/Untied Funds 0

Total RCH II Base Flexi

Pool 0

Total JSY, Sterilisation

and IUD Compensation, and NSV

Camps

0

Grand Total RCH II 0

TOTAL

92,085,972.0

0

36,234,027.0

0

55,851,945.0

0

134,409,898.00

134,409,898.00



227

Budget Plan

2010-2011FY 2011-2012FY

Sr. NO

Com

pone

nt C

ode

(onl

y at

sta

te le

vel)

Ten

tativ

e U

nit C

ost (

A)

Bud

get P

lann

ed

{

X x

(A

)} =

B

Bud

get r

ecei

ved

B o

r C

(<

or >

than

pla

nned

)

Bud

get u

tilis

ed {

Y x

(A

)} =

D

unde

r or

ove

r-ut

ilise

d B

udge

t

{

(B~D

} =E

adva

nce

Bud

get P

lann

ed (

incl

udin

g sp

ill o

ver

amou

nt)

{(

AP

x A

) ±± ±±

E}

= B

P

budg

et fo

r 20

11-1

2

Bud

geta

ry S

ourc

e (o

ther

than

NR

HM

sou

rce)

Rem

arks

Activities

B NHRM ADDITIONALITIES



228

Please Note: plan all possible activities you think necessary for your area to realistically operationalise each

strategy.

Consider during planning: Infrastructure, Human Resources- all specialist, Para medics etc, Infection control & Environmental Plan, Logistics Management, HMIS, Mon itoring & evaluation, Training- PMU, Dai, others, B CC/

IEC, Procurement of equipments/ Drugs, Strengthenin g Societies, PMU, RKS, VHSC, AYUSH inputs, initiat ives for quality management

B.1 Decentrlisation

1.11

B.1.11

ASHA Support system

at State level

B.1.12

ASHA Support System

at District Level

695907 695907 347953 347954 1043807 1043807

B.1.13

ASHA Support System

at Block Level

672000 672000 107200 564800 1572800 1572800

B.1.14

ASHA Support System

at Village Level

0 0 0

B.1.15

ASHA Drug Kit &

Replenishment

1650806 1650806 0 1650806 1650806 1650806

B.1.16 Motivation of ASHA

645475 645475 79020 566455 566455 566455



229

B.1.18 ASHA Divas

898872 898872 334564 564308 1165200 1165200

B.1.20

Untied Fund for Health

Sub Center,Additional

Primary Health Center

and Primary Health

Center

1637000 1637000 876000 761000 2847000 2847000

B.1.21 Village Health and

Sanitation Committee

6207500 6207500 3912500 2295000 6615000 6615000

B.1.22 Rogi Kalyan Samiti

2100000 2100000 1120980 979020 1400000 1400000

B.2

Infrastrure

Strengthening

0

B.2.1 Construction of HSCs (

315 No.)

15.57

0 0 0 8091000 8091000

bihar govt.

Rs.3420000 as per last year budget 2009-10

B.2.2A Construction of PHCS &

APHCS

75.99

0 0 29175000 29175000

bihar govt.

Rs.6378000 as per



230

last year budget 2009-10

B.2.2B

Construction of

Doctor,Staff,and

Nurses(Residential

Quarter) PHC,APHC

AND DISTRICT

HOSPITAL

12000000 12000000

bihar govt.

B.2.4 Up gradation of CHCs

as per IPHS standards

0 0 0 4000000 4000000

Rs 4000000 as per last year budget 2009-10

B.2.5

Annual Maintenance

Grant

1839000 1839000 367,122 1471878 2871878 2871878

B.2.7 Anm Training Schools

0 0 0 0 12000000 12000000 bihar

govt. B.3 TOTAL 0



231

INFRASTRUCTURE

strengthening

B.3.2

Block Programme

Mannagement Unit

3481380 3481380 1838163 1643217 7512084 7512084

B.3.4

Additional Manpower

for NRHM : Hospital

Managers in FRUs

450000 450000 45833 404167 1004167 1004167

B.4.3 Advanced Life Saving

Ambulance(call 108)

0 2340000 2340000

B.4.4 Referal Transport in

District

2574000 2574000 403698 2170302 4744302 4744302

B.6

Services of Hospital

Waste Treatment and

Disposal in all

Government Health

facilities up to PHC in

Bihar (IMEP)

0 1016300 1016300

B.7

Dialysis unit in various

Government Hospitals

of Bihar

0

B.8

Setting Up of Ultra-

Modern Diagnostic

Centers in Regional

Diagnostic Centers

(RDCs) and all

Government Medical

College Hospitals of

Bihar

0

B.9

Outsourcing of

Pathology and

Radiology Services

from PHCs to DHs

808333 808333 110625 697708 2217708 2217708



232

B.10 Operationalising MMU

0 0 0 8424000 8424000

B.11

Monitoring and

Evaluation (State ,

District & Block Data

Centre)

900000 900000 240525 659475 1559475 1559475

B.14

Strenthening of Cold

Chain (infrastrcure

strengthening)

800000 800000 111180 688820 1488820 1488820

B.15 Mainstreaming Ayush

under NRHM

6025200 6025200 0 6025200 12050400 12050400

B.18.2

Procurement of SCNU

equipment for DH &

Newborn corner

equipments for PHCs

418476 418476 0 418476 418476 418476

B.19 De-Centralised

Planning

455000 455000 135000 320000 835000 835000

B.21 Anm { R } 7392000 7392000 6409857 982143 10800000 10800000

B.22 Incentive for AWW

under Muskan Project

1676000 1676000 375400 1300600 1318600 1318600

0

TOTAL

41,326,949.00 41,326,949.00

16,815,620.00

24,511,329.

00

140,728,278.00

140,728,278.00



233

Activity Plan Budget Plan

2010-2011 FY 20011-2012 FY 2010-2011FY 2011-2012FY

Out

put 2

012

Act

ivity

pla

nned

(X

)

Act

ivity

Exe

cute

d (Y

)

Var

ianc

e (

X~Y

)

Rea

sons

for

Var

ianc

e

Act

ivity

pla

nned

incl

udin

g pr

evio

us y

rs g

ap {

Z+(

X~Y

)} =

AP

Spe

cial

effo

rts

to o

verc

ome

cons

trai

nts

(Pro

cess

to b

e ad

opte

d)

time

line

of a

ctiv

ities

Ten

tativ

e U

nit C

ost (

A)

Bud

get P

lann

ed

{

X x

(A

)} =

B

Bud

get r

ecei

ved

B o

r C

(<

or

> th

an p

lann

ed)

Bud

get u

tilis

ed {

Y x

(A

)} =

D

unde

r or

ove

r-ut

ilise

d B

udge

t

{

(B~D

} =E

adva

nce

Bud

get P

lann

ed (

incl

udin

g sp

ill o

ver

amou

nt)

{(A

P

x A

) ±± ±±

E}

= B

P

budg

et fo

r 20

11-1

2

Bud

geta

ry S

ourc

e (o

ther

than

NR

HM

sou

rce)

Rem

arks

Q1 Q2 Q3 Q4

2427103 2427103 713165 1713938 4141041 4141041



234

8549927 8549927 396047

7 4589450 13139377 13139377

0

10977030

10977030

4673642

6303388 0 17280418 17280418



235

2010-2011 FY 20011-2012 FY 2010-2011FY 2011-2012FY

Act

ivity

pla

nned

(X

)

Act

ivity

Exe

cute

d (Y

)

Var

ianc

e (

X~Y

)

Rea

sons

for

Var

ianc

e

Act

ivity

pla

nned

incl

udin

g pr

evio

us y

rs g

ap {

Z+(

X~Y

)} =

AP

Spe

cial

effo

rts

to o

verc

ome

cons

trai

nts

(Pro

cess

to b

e ad

opte

d)

time

line

of a

ctiv

ities

Ten

tativ

e U

nit C

ost (

A)

Bud

get P

lann

ed

{

X x

(A

)} =

B

Bud

get r

ecei

ved

B o

r C

(<

or

> th

an p

lann

ed)

Bud

get u

tilis

ed {

Y x

(A

)} =

D ti

ll no

v 10

unde

r or

ove

r-ut

ilise

d B

udge

t

{

(B~D

} =E

adva

nce

Bud

get P

lann

ed (

incl

udin

g sp

ill o

ver

amou

nt)

{(A

P

x A

) ±± ±±

E}

= B

P

budg

et fo

r 20

11-1

2

Bud

geta

ry S

ourc

e (o

ther

than

NR

HM

sou

rce)

Rem

arks

3160948 3160948 46000 3114948 3114948 3114948

23640 23640 23640 0 47280 47280

673000 673000 358000 315000 1843640 1843640

432285 432285

115000 317285 749570 749570



236

744850 744850 0

744850 744850

744850

0

54100 54100 0

54100 54100

54100 432750 432750 398000 34750 467500 467500

2075000 2075000 505000 1570000

2840400 2840400

7,596,573.00

7,596,573.00 1445640

6150933 0 9862288 9862288



237

BUDGET AT A GLANCE 2011-12

Sl. No, Budget Head Budget Amount % age

1 NRHM PART - A, RCH 134409898 44.47%



238

2 NRHM PART - B, NRHM Additionalities 140728278 46.56%

3 NRHM PART - C, RI, PP 17280418 5.72%

4 NRHM PART - D, Diseases Control Programme 9862288 3.26%

TOTAL 302,280,882.00 100%



DISTRICT HEALTH ACTION PLAN 2011 –...

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