1

Unnao City Program Implementation Plan

National Urban Health Mission

Prepared by District Health Officials with support from Urban Health Initiative

2

National Urban Health Mission

Uttar Pradesh

Project Implementation

Plan Year 2013-14

District: UNNAO District Health Society: UNNAO

3

4

Index

Abbreviation 4

Key Features Of NUHM 6-9

City Profile 10- 13

Health Scenario 13-21

Key Issues 22

Strategies, Activities & Work plan under NUHM 23

Programme Management Arrangements 29-30

Unnao City level targets & indicators 31-37

Gangaghat City level targets & indicators 43-47

Annexure 53-59

Abbreviations

ANC Ante Natal Care

ANM Auxiliary Nurse Midwife

ASHA Accredited Social Health Activist

5

BCC Behaviour Change Communication

BPL Below Poverty Line

CBO Community Based Communication

CHP City Health Plan

CPIP City Programme Implementation Plan

DPMU District Programme Management Unit

FHW Female Health Worker

GIS Geographical Information System

HP Himanchal Pradesh

HR Human Resources

HUPA Housing & Urban Poverty Alleviation

IEC Information Education Communication

IMR Infant Mortality Rate

IPC Inter Personal Communication

J&K Jammu and Kashmir

JNNURM Jawaharlal Nehru National Urban Renewal Mission

KFA Key Focus Area

LHV Lady Health Visitor

MAS Mahila Arogya Samiti

MD Mission Director

MMR Maternal Mortality Rate

MO Medical Officer

MOHFW Ministry of Health & Family Welfare

NGO Non Government Organisation

No. Number

NPSP National Polio Surveillance Project

NRHM National Rural Health Mission

NUHM National Urban Health Mission

OPD Out Patient Department

PIP Programme Implementation Plan

PMU Programme Management Unit

PPP Public Private Partnership

QA Quality Assurance

RAY Rajiv Awas Yojna

RE Revised Estimate

SPMU State Programme Management Unit

TB Tuberculosis

TOR Terms of Reference

TT Tetanus-toxoid

U5MR Under-5 year Mortality Rate

UCHC Urban Community Health Centre

UFWC Urban Family Welfare Centre

UHC Urban Health Centre

UHND Urban Health & Nutrition Day

ULB Urban Local Body

UPHC Urban Primary Health Centre

UT Union Territory

WHO World Health Organisation

Reference Material:

1. NUHM – Framework for Implementation

6

2. Broad framework for preparation of district health action plans

3. Indian Public Health Standards (IPHS), DGHS, MoHFW

4. DUDA Unnao

5. DLHS – 3

6. NFHS – 3

7. SRS Bulletin 2009

8. District HMIS Reports

District Planning Team

Name Designation

1 Dr.D.P.Mishra CMO

2 Dr. AK Rawat ACMO – RCH

3 Shimal Chand Verma Finance & Accounts Officer

4 Mr. R.R.Yadav Div Programme Manager

5 Dr.M.U.Ahmad District Programme Manager

6 Mr. Abhay Dewedi DCPM

7 Mr. R.R. Pandey Epidemiologist

8 Mr. D.K.Gupta Distt. Accounts Manager

9 Mr. Sudhansh Shekhar Distt. Data & Accounts Asst.

10 Mr. Prem Kumar LDC

KEY FEATURES OF NUHM

7

The Government of India has launched the National Urban Health Mission (NUHM) as a

sub-mission under the National Health Mission (NHM), the National Rural Health Mission

(NRHM) being the other sub-mission.

NUHM seeks to improve the health status of the urban population particularly slum dwellers

and other vulnerable sections by facilitating their access to quality health care. NUHM

would cover all state capitals, district headquarters and other cities/towns with a population

of 50,000 and above (as per census 2011) in a phased manner. Cities and towns with

population below 50,000 will be covered under NRHM. These guidelines are used to

enable the states and Union Territories to prepare the Programme Implementation Plans

(PIP) for 2013-14 under the NUHM and are to be read in conjunction with the NUHM

Framework for Implementation. Key features of NUHM are enumerated below:

Creation of service delivery infrastructure :

­ Urban - Primary Health Centre (U-PHC): Functional for approximately 50,000 population,

the U-PHC would be located within or near a slum. The working hours of the U-PHC

would be from 12.00 noon to 8.00 pm. The services provided by U-PHC would include

OPD (consultation), basic lab diagnosis, drug /contraceptive dispensing and delivery of

Reproductive & Child Health (RCH) services, as well as preventive and promotive

aspects of all communicable and non-communicable diseases.

­ Urban-Community Health Centre (U-CHC) and Referral Hospitals: 30-50 bedded U-

CHC providing inpatient care in cities with population of above five lakhs, wherever

required and 75-100 bedded U-CHC facilities in metros. Existing maternity homes,

hospitals managed by the state government/ULB could be de;

­ In towns/ cities, where some sort of public health institutions like Urban Family Welfare

Centres, Maternity Homes etc., exist effort will be made to strengthen them on the lines

of U-PHC and U-CHC.

Outreach:

­ Creation of Sub Centres has not been envisaged under NUHM. Outreach services will

be provided through Female Health Workers (FHWs)/ Auxiliary Nursing Midwives

(ANMs) headquartered at the UPHCs.

­ ANMs would provide preventive and promotive health care services to households

through routine outreach sessions.

­ Expansion of services through outreach to children by covering at least all government

schools and Anganwadi Centres. Other schools located in the slums would also be

covered. During such sessions, screening for birth defects, diseases, disability and

deficiency (4 Ds) would be carried out and follow-up actions would be initiated.

­ Various services to be delivered at the community level, UPHC and UCHC levels have

been elaborated in Table 17-1 of the NUHM Implementation Framework.

Targeted interventions for slum population and the urban poor:

­ Mahila Arogya Samiti (MAS) – will act as community based peer education group in

slums, involved in community mobilization, monitoring and referral with focus on

preventive and promotive care, facilitating access to identified facilities and management

8

of grants received. Existing community based institutions could be utilized for this

purpose.

­ Capacity building of community – NUHM would provide capacity building support to

MAS / Community Based Organisations for orientation, training, exposure visits,

participation in workshops and seminars etc., apart from annual grant of Rs.5000 per

MAS for mobilization, sanitation and hygiene, and emergency healthcare needs.

­ Link Worker / ASHA - One frontline community worker (ASHA) would serve as an

effective and demand–generating link between the health facility and the urban slum

population. Each link worker/ASHA would have a well-defined service area of about

1000-2,500 beneficiaries/ between 200-500 households based on spatial consideration.

However, the states would have the flexibility to either engage ASHA or entrust her

responsibilities to MAS. In that case, the incentives accruing to ASHA would accrue to

the MAS.

­ Outreach services – Weekly medical camp would be organised in slum areas.

Public Private Partnerships:

In view of presence of larger number of private (for profit and not for profit) health

service providers in urban areas, public – private partnerships particularly with not for

profit service providers will be encouraged. NUHM will also support innovations in public

health to address city and population specific needs. However, clear and monitorable

Service Level Agreements (SLAs) need to be developed for engagement with Private

Sector.

Role of Urban Local Bodies

The NUHM would promote active participation of the ULBs in the planning and

management of the urban health programmes. In the seven mega cities, namely Delhi,

Mumbai, Kolkata, Chennai, Bengaluru, Hyderabad and Ahmedabad, the NUHM would

be implemented through the City Urban Health Mission/Society. In other cities/ towns,

NUHM will be implemented through the District Health Society except the large cities

where in the view of the State Government, implementation of NUHM can be handed

over to the City Urban Health Mission.

Funding/budget mechanism

Funds will flow to the City Urban Health Society/ District Health Society, through the

State Government / State Health Society. The SHS/DHS will have to maintain separate

accounts for NUHM.

Convergence: Intra-sectoral convergence is envisaged to be established through integrated

planning for implementation of various health programmes like RCH,RNTCP, NVBDCP, NPCB,

National Mental Health Programme, National Programme for Health Care of the Elderly, etc. at

the city level.

Inter-sectoral convergence with Departments of Urban Development, Housing and Urban

Poverty Alleviation, Women & Child Development, School Education, Minority Affairs,

Labour will be established through city level Urban Health Committees headed by the

Municipal Commissioner/Deputy Commissioner/District Collector.

States are also encouraged to explore possibility of engaging the Railways, ESIC and

corporate sector (through CSR).

Other aspects:

9

­ Extensive use of Information Technology would be made for hospital management,

reporting and monitoring as well as service delivery.

­ Public Health laboratories would also be strengthened for early detection and

management of disease outbreaks.

Institutional Arrangements under Urban Health Mission

Achieving all the stated objectives through strategies that have already been identified and some yet to be identified is a challenging task requiring additional resources and capacities

at various levels. Recognizing this, A health society has been constituted at district level. This society is name as “DHS (DHS)”. DHS is headed by District Magistrate at capacity of society’s chairman. Under this society two programe units will be running at district level District

Programme Management Unit (DPMU) and City Management Unit (CMU). DPMU

works as the secretariat for the District NUHM programme. The CMO / Deputy CMO would be the nodal officer for the DPMUs and NUHM activities at district level. Role of the District Health Mission

o Responsible for planning, implementing, monitoring and evaluating progress of Mission. o Preparation of Annual and Perspective Plans for the district. o Suggesting district specific interventions. o Carrying out survey of non-governmental providers to see what contribution they can make. o Partnerships with NGOs, Panchayats for effective action. o Strengthening training institutions for ANMs/Nurses, etc. o Provide leadership to village, Gram Panchayat, Cluster & Block level teams. o Establish Resource Group for Professionals also can facilitate implementation of core

strategies of the Mission. o Experiment with risk pooling for hospitalization. o Ensure referral chain and timely disbursement of all claims. o Arrange for technical support to the blocks teams and for itself. o Arrange for epidemiological studies and operational research to guide district level planning.

Nurture community processes. o Transparent systems of procurement and accountability. o Activate women’s groups, adolescent girls’ to ensure gender sensitive approach o Provide _data analysis and compilation facility in order to meet regular MIS needs. o Carry out Health Facility Surveys and supervision of household surveys. o District Health Mission to ensure that district annual action plan as per RNTCP requirement

would continue to be submitted by the district to the state TB cell.

10

City Unit

The Proposed Organizational Structure would be as follows:

District Health Society

District Programme Manager

District Accounts

Manager

District Urban Health

Co-ordinator

District Data Entry

Operator

HMIS / MCTC Data

Entry Operator

City Public Health

Manager

11

District Profile – UNNAO

District UNNAO is situated between the Cities of Lucknow and Kanpur. It has

a rich heritage of sword and pen. Having produced great freedom fighters, poets

and writers. The district is roughly a parallelogram in shape and lies between

latitude 2608’ N & 27

02’ N and Longitude 80

03’E and 81

03’E. It is surrounded on

the North by district Hardoi on the East by the District Lucknow on the South by the

District Raibarelly and on the West by the River Ganga. which seprates it from

district of Kanpur and Fatehpur.

One of the most famous personalities of Unnao is Maulana Hasrat Mohani

(born 1881 at Mohan, Unnao). He was a freedom fighter and Urdu Poet. After his

graduation in 1903, inspired by Rao Ram Bux Singh, he threw himself into the

freedom struggle. He took up the Editing of the newspaper 'Urdu-A-Muallah' in 1913

and continued his struggle through his articles. As a consequence he was kept in

imprisonment from 1914 to 1918 but he continued his writing work in jail. He was

nominated the member of the State Assembly in 1946. On 15th May 1951, this

patriot breathed his last at Lucknow and left a void which is difficult to fill.

Among other noted personalities from Unnao are Chandrashekhar Azad,

Surya Kant Tripathi 'Nirala', Pandit Vishwambhar Dayal Tripathi, Dr Ram Vilas

Sharma, Shivmangal Singh 'Suman', Bhagwati Charan Verma,Raja Rao Ram

Baksha, Dr. Nishith Chaturvedi , and Shamshulullema Mohammad Abdul Jalil

Usmani [Source/Citation?]. Chaudhry Syed Qasim Husain Zaidi who was the

Taluqdar of Unnao and the first Chairman of the Municipal Board of Unnao, Dwarika

Prasad Mishra, who was Madhya Pradesh Chief Minister hailed from Padri Khurd a

village in Unnao district. His son Brijesh Mishra was security advisor to former Prime

Minister of India, Atal Bihari Vajpayee. Ziaur Rehman Ansari was Union Minister for

about 15 years. The father-in-law of Sheila Dixit, present chief minister of Delhi, was

Uma Shankar Dixit, Suneel Kumar Mishra, a village in Unnao. Sheila Dixit fought

parliamentary election from Unnao, but was heavily defeated. Veteran Bollywood

actor, Pran, also spend his early years in Unnao. His father was a civil contractor

who worked with the government department here.

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District Unnao Road Map

13

Demographic Profile of DistrictUnnao

Basic Information (2013-14)

District : UNNAO

Population 3110595 No. of Blocks 16

No. of Parliamentary Constituencies 1

Infrastructure

No. of District level Hospitals 2 No. of Block PHCs 16

Male 1 Name of Block PHCs working as 24X7

16

Female 1 Name of proposed Block

PHCs for 24X7 0

Combined 0 No. of NPHCs 40

Others (with facility for 24x7 delivery)

0 In Rented Bldgs 0

Others (non-maternity) 0 In Govt. Bldgs. 40

No. of Sub Centres ( 340 Sub Center +16 Main Center)

356

In Rented Bldgs 116

No. of Govt./Pvt Medical Colleges 0 In Govt. Bldgs. 240

No. of CHC’s 6 No. of AWC’s 2376

Name of CHCs working as FRU’s Nawabganj

Name of proposed CHCs as FRU’s

Staffing

No. of ANMs at Sub Centres 337 No. of Part-time Dais 200

Regular 337 No. of ASHAs 2268

Contractual 56 No. of Anganwadi Workers

2376

14

Indicator District

Total Population (In lakhs) (Census 2011) 3110595

Rural Population (In lakhs) (Census 2011) 2577949

Urban Population (In lakhs) (Census 2011) 532646

Number of Sub Division/ Talukas 5

Number of Blocks 16

Number of Villages (RHS 2012) 1798

Crude Birth Rate (SRS 2011) 21.8

Crude Death Rate (SRS 2011) 7.1

Natural Growth Rate (SRS 2011) 14.7

Sex Ratio (Census 2011) 901

Child Sex Ratio (Census 2011) 913

Total Literacy Rate (%) (Census 2011) 68.29

Male Literacy Rate (%) (Census 2011) 77.06

Female Literacy Rate (%) (Census 2011) 58.54

Status of Health Indicators:

Sl. No Indicators

AHS

2011

HMIS (2012)

1 Infant Mortality Rate

(SRS- 2011)

59 NA

2 Maternal Mortality Ratio

(SRS 2007-09)

330 NA

3 Total Fertility Rate (SRS

2011)

3.7 NA

4 Under-five Mortality Rate

(SRS 2011)

84 NA

5 Full Immunisation (In %) 36.1

15

Family Planning Indicators

The total fertility rate (TFR) is a more direct measure of the level of fertility than the

crude birth rate, since it refers to births per woman. This indicator shows the

potential for population change in the country. A rate of two children per woman is

considered the replacement rate for a population, resulting in relative stability in

terms of total numbers. Rates above two children indicate populations growing in

size and whose median age is declining.

Indicators DLHS - 3 DLHS - 2

Total Rural Total Rural Family planning (currently married women, age 15-49)

Current Use :

Any Method (%) 31.5 31.3 21.7 15.8

Any Modern method (%) 22.7 22.6 18.9 13.5

Female Sterilization (%) 13.7 13.9 9.5 8.1

Male Sterilization (%) 0.0 0.0 - -

IUD (%) 0.9 0.9 2.0 1.2

Pill (%) 2.0 2.0 2.1 1.3

Condom (%) 5.9 5.5 5.1 2.8

Unmet Need for Family Planning:

Total unmet need (%) 35.9 36.3 43.1 44.2

For spacing (%) 13.8 14.0 19.6 20.8

For limiting (%) 22.1 22.3 23.5 23.4

Maternal Health Indicators

Indicators DLHS – 3 DLHS - 2

Total Rural Total Rural

Maternal Health: Mothers registered in the f irst trimester

w hen they were pregnant with last live birth/still birth (%)

17.1 16.5 - -

Mothers w ho had at least 3 Ante-Natal

care visits during the last pregnancy (%) 14.8 12.8 23.2 19.1

Mothers w ho got at least one TT injection w hen they were pregnant with their last live birth / still birth (%) # 50.7 49.7 53.0 50.6

Institutional births (%) 14.5 14.1 15.2 9.3

Delivery at home assisted by a doctor/nurse /LHV/ANM(%) 3.9 3.1 5.7 4.8

Mothers w ho received post natal care

w ithin 48 hours of delivery of their last child (%) 13.5 13.8 - -

16

Child Health Indicators Indicators DLHS - 3 DLHS - 2

Total Rural Total Rural Child Immunization and Vitamin A supplementation:

Children (12-23 months) fully immunized (BCG, 3 doses each of DPT, and Polio and one dose of Measles) (%)

14.1 14.0 14.9 12.4

Children (12-23 months) w ho have received BCG (%) 56.8 57.3 41.6 33.3

Children (12-23 months) w ho have received 3 doses of Polio Vaccine (%)

17.7 17.3 22.7 19.4

Children (12-23 months) w ho have received 3 doses of

DPT Vaccine (%) 17.7 17.3 23.8 20.2

Children (12-23 months) w ho have received Measles

Vaccine (%) 29.2 27.4 22.6 20.2

MMaapp SShhoowwiinngg CCHHCC//PPHHCC DDiissttrriicctt –– UUnnnnaaoo

17

18

Table showing the details of Uban Wards of Unnao

Sr.

No

.

Blo

ck

No

. o

f U

rba

n w

ard

Co

mm

itte

es

No

. o

f G

ram

S

ab

ha

s v

illa

ge

s

No

. o

f re

ve

nu

e

villa

ge

s

To

tal

Ny

ay

Pa

nc

ha

ya

ts

To

tal

ZP

Me

mb

ers

BD

C / M

an

da

l

Me

mb

ers

Pa

nc

ha

ya

t P

rad

ha

ns

M F T M F T M F T

1 S. Sirausi 0 53 93 14 1 3 4 28 54 82 28 25 53

2 Achalganj 0 67 119 14 2 2 4 34 67 101 30 37 67

3 Bighapur 10 58 133 15 1 1 2 21 42 63 20 38 58

4 Sumerpur 0 72 148 15 0 3 3 23 46 69 28 44 72

5 Nawabganj 10 72 124 10 1 2 3 27 52 79 24 48 72

6 Hasanganj 0 70 156 11 0 3 3 25 51 76 24 46 70

7 Miyaganj 0 66 140 10 0 3 3 25 48 73 22 44 66

8 Auras 10 56 94 10 2 1 3 22 43 65 21 35 56

9 Safipur 15 60 116 8 1 1 2 23 44 67 27 33 60

10 Fatehpur 84 10 61 116 9 1 2 3 22 43 65 26 35 61

11 Bangarmau 25 51 82 8 0 2 2 23 46 69 25 26 51

12 Ganj

Muradabad 10 56 86 8 2 1 3 22 43 65 22 34 56

13 Bichhiya 0 54 85 12 2 1 3 27 53 80 28 26 54

14 Purva 15 52 112 10 1 1 2 19 37 56 30 22 52

15 Hilauli 0 44 68 8 1 2 3 25 50 75 19 25 44

16 Asoha 0 62 122 11 1 2 3 23 45 68 23 39 62

Total 105 954 179

4 173 16 30 46 389 764 1153

397

557

954

19

Status of NGOs currently active in Health Sector

S.N. Name & address of NGO Key activities Area Covered

1 Awadh Sewa Sansthan –

Achalganj

Health & Social

Awareness

Block Achalganj

2 Vikas Bharti, Jawahar Nagar-

Unnao

Health & Social

Awareness

Block S. Sirausi

3 New Public School Samiti-

Unnao

Immunization and

other health awareness program

Block Safipur &

Fatehpur 84

4 Jan Shikshan Sansthan,

Unnao

Family planning

immunization ANC PNC

and other health

awareness program

Unnao Urban and

Nawabganj

5 Akhil Bhartiya Jan Kalyan

Samiti-Unnao

Clinical based services

and awareness

Block Nawabganj,

Asoha, Hasanganj

6 Utkarsh Samaj Kalyan Samiti

– Unnao

Commercial sex

workers identification treatment of AIDS

Shuklaganj and

Urban Unnao

20

Table 1: Demographic Profile (based on 2011 census)

Total Population (In lakhs) 3110595

Urban Population (In lakhs) 532646

Urban Population as percentage of total population 17%

Urban slum population (in lakhs) 82805

Slum population as percentage of urban population 15%

Number of Metro cities 0

Number of Million + cities (> 10 lakh population) 0

Number of cities with 1 to 10 lakh population 1

Number of towns with less than 1 lakh but more than 50 thousand population

2

Number of State HQs/District HQs which have less that 50 thousand population but are covered under NUHM

0

Table 2: Health indicators

Total Urban Urban Poor

(wherever available)

Infant Mortality Rate 59 AHS 2010-11

50 AHS 2010-11

-

Under-five Mortality Rate 84 AHS 2010-11

77 AHS 2010-11

-

Maternal Mortality Ratio 330 AHS 2010-11

- -

Total Fertility Rate 3.7 3.0 -

Full Immunization (percentage) 36.1% DLHS-3

35.3% -

Number of SAM children identified (ICDS

data)

- - -

Annual Blood Examination Rate (ABER) for

malaria

1.42 - -

Annual Parasite Index (API) 0.01 - -

Dengue Case Fatality Rate 0 - -

Annual New Smear Positive case detection

rate

71.09% - -

Treatment success rate among new smear

positive cases

90% - -

Leprosy Prevalence Rate 0.91 -

No. of outbreaks reported under IDSP in

past year

05 0

21

Table 3: Details of cities/towns to be covered under NUHM as per 2011 census Sl.no

.

Name of the

city/town

Type (state

capital/district headquarter

s/other)

Population

as per 2011 census

No. of

slums

Slum

population

Whethe

r covered under

JnNURM,

BSUP, IDSMT

1 Unnao City District Headquarter

177658 57 43150 JnNURH,RAY

2 Gangaghat

(Shuklaganj)

Town 84072 10 36318

Table 4: Details of cities/towns taken up for NUHM implementation in 2013-14

Sl. N

o.

Name of City/Tow

n

Type (state capital/dist

rict headquarters/other)

Population

Slum populatio

n

Implementing Authority

(City/ Dist. Health Society)

Development Partner ,

if any

1 Unnao

City

District

Headquarter

177658 43150 District

Health Society

-

2 Gangagha

t (Shuklaga

nj)

Town 84072 36318 District

Health Society

-

(Source: ) Census 2011 , DUDA Unnao

22

Table 5: State’s Allocation under Urban RCH Component under NRHM-RCH Flexible

Pool:

FMR Code

Activity Amount Approved in 2012-13 (Rs in

Lakhs)

Amount Approved in

2013-14 (Rs in Lakhs)

A.5 URBAN RCH (focus on

Urban slums)

PIP funds yet to

be received from State

A.5.1 Identification of urban areas /

mapping of urban slums and planning

-

A.5.2 HR for urban health including doctors, ANMs, Lab techs

-

A.5.2.1 Doctors/MOs 891000

A.5.2.2 Specialist -

A.5.2.3 Dentists -

A.5.2.4 ANM 267300

A.5.2.5 Staff Nurse 445500

A.5.2.6 LHV -

A.5.2.7 LT -

A.5.2.8 Pharmacists -

A.5.2.9 Radiographers -

A.5.2.10 OT Technician -

A.5.2.11 Support staff 133650

A.5.2.12 Others (pl specify) -

A.5.3 Operating expenses for UHP and UHC

13500

A.5.4 Outreach activities 189000

A.5.5 Others (pl specify) 27000+27000

A.5.5.1 Infrastructure support for

Urban areas

TOTAL 1953950

1. Key Issues

The Eleventh Plan had suggested Governance reforms in public health system, such as Performance linked incentives and Devolution of powers and functions to local health care institutions and making them responsible for the health of the people living in a defined

geographical area. NRHM’s strategy of decentralization, PRI involvement, integration of vertical programmes, inter-sectoral convergence and Health Systems Strengthening has

been partially achieved. Despite efforts, lack of capacity and inadequate flexibility in programmes forestall effective local level Planning and execution based on local disease priorities.

In order to ensure that plans and pronouncements do not remain on paper, NUHM UP would strive for system of accountability that shall be built at all levels, reporting on service

23

delivery and system, district health societies reporting to state, facility managers reporting

on health outcomes of those seeking care, and territorial health managers reporting on health outcomes in their area. Accountability shall be matched with authority and delegation; the NUHM shall frame model accountability guidelines, which will suggest a

framework for accountability to the local community, requirement for documentation of unit cost of care, transparency in operations and sharing of information with all stakeholders.

The state will incorporate the core principles of The National Health Mission of Universal Coverage, Achieving Quality Standards, Continuum of Care and Decentralized Planning.

Following would be the issues for the cities to address: City Health Planning, Public

Private Partnership, Convergence, Capacity Building, Migration, Communitization, Strengthen Data, Monitoring and Supervision, Health Insurance, Information Dissemination

and Focus on NCDs/ Life-Style Diseases.

After considering the available data, city scenario and analysis, the City planning team has

identified issues at both service delivery & demand generation level. Following are the details of

issues which would be addressed through NUHM at the city level:

1) Need of community volunteers (ASHAs) for taking up the community mobilization activities

2) Need of Mahila Arogya Samiti (MAS- a group of 10-12 women) for wider spread of

information/ rights and entitlements

3) Strengthening of ANC, PNC & identification of high risk pregnancies at community level

4) Home based care of neonates at community level

5) Promotion of institutional deliveries

6) Health education for all, especially for adolescent group

7) Complete immunization of pregnant women & children

8) Needs to strengthen the existing health care facilities by recruiting human resources

9) Need assessment of community in health scenario

10) Need a better convergence with other programs and wider determinants

11) Need of training & capacity building of human resources

12) Need of Strengthened program management structure at district level

13) Need of intensive baseline survey to start the community processes and identifying local

needs

14) Involvement of local bodies in decision making and managing the program locally

15) Gap analysis of HR & recruitment

16) Promotion of family planning methods through basket of choice approach & counselling

because unmet need for family planning is high in Lucknow

17) Management of communicable & non- communicable diseases

18) Strengthening AYUSH

19) Constitution of BSGY team for urban areas.

20) Identification & management of SAM children

2. Strategies, Activities and Work plan

The key overarching strategies under NUHM for 2013-14 include data based planning, strengthening of management and monitoring systems at the state and district level, improving the primary health care delivery system and community outreach through

ASHAs, MAS and Urban Health and Nutrition Days(UHNDs).

24

The key activities at the district level will include convergence with key urban stakeholders,

sensitization of ULBs on their role in urban health, strengthening UPHCs for provision of primary health care to urban poor, community outreach through selection, training and support to ASHAs and MAS, conducting UHNDs and outreach camps to get services closer

to the community and reach complete coverage of slum and vulnerable populations.

With the aim to improve the health parameters of urban population in the city, structures and strategies as recommended for the NUHM in its framework will be adopted and

operationalised rapidly over the years.

Listing and Mapping of Households in slums and Key Focus Areas

Listing and mapping of households will provide accurate numbers for population their family size and composition residing in slums. Currently, estimates of population residing in slums

are available from District Urban Development Agency (DUDA) and National Polio Surveillance Project as the immunization micro plans (under NPSP) provide updated estimates of slum and vulnerable populations and are expected to be fairly complete. The

current plan for covering slums is based on the currently available data of urban population of each city.

Once the ASHA are deployed they will list all households and fill the Slum Health Index

Registers (SHIR) including the number and details of family members in each household. This data will be compiled for city and will provide the population composition of slums and key focus areas. This will also help the urban ASHA know her community better and build a

rapport with the families that will go a long way in helping her advocate for better health behaviors and link communities to health facilities under the NUHM. It is expected that once

the household mapping is completed in cities, the number of ASHAs will be reviewed and adjusted upwards or downwards and the geographical boundaries of the coverage area for each ASHA would be realigned. This is due to the reason that the actual population may be

higher or lower than the original estimate used for planning.

Facility Survey for gaps in infrastructure, HR, equipment, drugs and consumables

Facility survey will be carried out in the public facilities to assess the gaps in infrastructure, human resource, equipment, drugs and consumables availability as against expected

patient load. Further planning, particularly for UCHCs, will be based on these gaps. This work will be outsourced to a research agency. Development Partners like Health of the Urban Poor project will technically support this effort.

Baseline Survey

The state envisions monitoring progress in health indicators in urban areas and among urban poor over the period of implementation of NUHM. This proposed Baseline survey will generate data on the health and related indicators which will be reviewed during the course

of implementation of the program to assess the impact of implementation and necessary course corrections can accordingly be made and use of resources can be optimized.

25

Training and Capacity Building

ULB, Medical and Paramedical staff, Urban ASHAs and MAS will be trained. The trainings

will have to be followed by periodic refresher trainings to keep these frontline health workers motivated. NUHM will engage with development organizations to develop the training modules and facilitate the trainings.

Monitoring & Evaluation

The M&E systems would also capture qualitative data to understand the complexities in health interventions, undertake periodic process documentation and self evaluation cross learning among the Planning Units to be made more systematic.

The Monitoring and Evaluation framework would be based on triangulation of information. The three components would be Community Based Monitoring, HMIS for reporting and

feedback and external evaluations.

Strengthening of health facilities

Urban - Primary Health Centre (U-PHC) –

During the first year of implementation of the program, the existing urban health posts will be attempted to be strengthened. Towards this, the UHPs existing in rented accommodations will be shifted to adequately larger premises which would help in

rendering the mandated services. A provision of Rs. 15,000/- per month per UPHC is being proposed for immediate service provision capacity enhancement, but over the period of

time the said rented accommodations will be shifted to owned premises for sustained services. Accommodations belonging to other stakeholder government line departments will be explored and then adopted after entering into necessary agreements/ arrangements

with the said department.

Targeted intervention for urban poor –

The process of listing of households in the KFAs, mapping of KFAs and health facilities and baseline survey of the KFA households will help determine the scope and extent of

services required for targeting of the urban poor. A deliberate effort will be made to identify the vulnerable poor on the basis of their residence status, occupational status and social

status, besides other micro-level indicators, which will further help focusing the health care services to the most deserving.

Mahila Arogya Samiti (MAS)-

MAS will act as community based peer education group in slums, involved in community

mobilization, monitoring and referral with focus on preventive and promotive care, facilitating access to identified facilities and management of grants received. Existing community based institutions could be utilized for this purpose. City planning team is

proposing formation of only one MAS under each ASHA in the first year and the identification of the remaining planned MAS will be undertaken in the subsequent years.

ASHA-

For reaching out to the households ASHAs (frontline community worker) would serve as an effective and demand–generating link between the health facility and the urban slum population. Each link worker/ASHA would have a well-defined service area of about 1000-

2,500 beneficiaries/ between 200-500 households based on spatial consideration.

26

Outreach services –

Outreach services will be provided to the slum areas and KFAs through ANMs who would be responsible for providing preventive and promotive healthcare services at the household

level through regular visits and outreach sessions. Each ANM will organize a minimum of one routine outreach session in her area every month.

Special outreach sessions (for slum and vulnerable population) will be organized once in a week in partnership with other health professionals (doctors/ pharmacist/ technicians/ nurses – government or private). It will include screening and follow-up, basic lab

investigations (using portable /disposable kits), drug dispensing, and counseling. The outreach sessions (both routine and special outreach) could be organized at designated

locations mentioned in the aforesaid paras in coordination with ASHA and MAS members

School Health Services

School health program under NUHM has been an important component to provide not only the preventive and curative services to children but also to ensure their contribution in

overall health development of the urban communities. It is envisaged that the active involvement of children in the program will enable them to be a change agent for themselves as well as communities by taking home good knowledge and practices in terms

of preventive health care activities. It is planned that children will be engaged through innovative and creative actions to make the learning entertaining and educational.

Convergence –

Intra-sectoral convergence is envisaged to be established through integrated planning for implementation of various health programmes like RCH, RNTCP, NVBDCP, NPCB,

National Mental Health Programme, National Programme for Health Care of the Elderly, etc. at the city level. Inter-sectoral convergence with Departments of Urban Development,

Housing and Urban Poverty Alleviation, Women & Child Development, School Education, Minority Affairs, Labour will be established through city level Urban Health Committees headed by the Municipal Commissioner/ Deputy Commissioner/ District Collector.

Activity Plan under NUHM for the state and cities

Act. No.

Activity

Responsibility Months : October'13 - March'14 Remarks

State level

City level O

ct.

No

v.

De

c

Ja

n

Fe

b

Ma

r

1

Establishment of Platform for Convergence at state level

Circular to be isued from state level to all their district level nodal officers

2 Preparation & Finalization of Guidelines for City Coord. Committee/ City Program Management Committee

These will be one time activities and will apply across

3 Preparation & Finalization of Guidelines for Urban ASHAs

4 Preparation & Finalization of Guidelines for Mahila Arogya Samiti

27

5 Preparation & Finalization of Guidelines for UHND

the state

6 Preparation & Finalization of Guidelines for Outreach sessions/ School Health Programs

7 Preparation & Finalization of Job Descriptions for all district level NUHM positions

8 Preparation & Finalization of Guidelines for PPP

9 Induction of state level staff for Urban Health Cell

10 Induction of city level staff for Urban Health program

11 Meeting of DHS for establishment of City Program Management Committee (UH)

12 Sensitization of new probable members on NUHM

13 Identification of NGOs for their role under NUHM

14 Establishment & orientation of City Program Management Committee (UH)

15

Identification of groups, collectives formed under various govt. programs (like NHG under SJSRY, self help groups etc.) for MAS

16 Organize meetings with women in slums where no groups could be identified

17 Formation and restructuring of groups as per MAS guidelines

18 Orientation of MAS members

18 Selection of ASHAs

18a - Selection of local NGOs for ASHA selection facilitation

18b - Listing of local community members as facilitators by NGOs

18c - Listing of probable ASHA candidates and finalize selection

19 Convergence meeting with govt. Stakeholders

20 Mapping & listing exercise (for health facilities and slums)

20a

- Mapping of all urban health facilities (public & pvt.) for services

To continue in 2014-15

20b

- Mapping of slums (listed and unlisted)

To continue in 2014-15

20c

- Houselisting of slums/ poor settlements

To continue in 2014-15

21 Planning for strengthening of health facilites/ services

28

- Health Facility Assessment (of public facilities including listing of public facility wise infra & HR requirement)

To continue in 2014-15

22 Baseline survey of urban poor/ slums (KFAs)

(to determine vulnerability, morbidity pattern & health status)

23 Meetings of RKS for all the public health facilites under NUHM

24

Identification of alternate/ suitable locations for UPHCs under various urban devp. Programs

To continue in 2014-15

25 Strengthening of public health facilities

- Selection, training and deployment of HR in pub. health facilities

To continue in 2014-15

26 IEC activities

27 Outreach camps & UHNDs (from existing UHPs)

28

Empanelment of Private Health Facilities for health care provisioning

To continue in 2014-15

29 Involvement of CSR activities

3. Programme Management Arrangements

Districts Heath Society will be the implementing authority for NUHM under the leadership of

the District Magistrate. District Program Management Units have been further strengthened

to provide appropriate managerial and operational support for the implementation of the

NUHM program at the district level.

District Health Society under the chairmanship of the District Magistrate as the implementing

authority for NUHM

Fund flow mechanisms have been set up and separate accounts will be opened at in the district

for receiving the NUHM funds.

Urban Health will be included as a key agenda item for review by the District Health Society with

participation of city level urban stakeholders.

29

An Additional / Deputy CMO has been designated as the nodal officer for NUHM at the district

level. The District Program Management Unit will co-opt implementation of NUHM program in

the district and the District Program Manager will be overall responsible for the implementation

of NUHM. To support this the following additional staff and funds are proposed for strengthening

the District Program Management Units for implementing NUHM:

a. Urban Health Coordinator, Accountant and Data Entry Operators according to the

following norms:

District total Urban

population

Additional Staff Proposed

1lakh to 10lakhs 1 Urban Health Coordinator,1 Accountant and 1 Data Entry Operator

b. District Programme Manager will be nodal for all NUHM activities so extra incentive and

budget for 1 laptop to each DPM has been proposed for DPM for undertaking NUHM

activities.

c. A onetime expense for computers, printer and furniture for the above staff has been

budgeted along with the recurring operations expenses.

d. Onetime expenses have been budgeted for up-gradation of the office of Additional/

Deputy CMO and District Programme management

e. Unit.

The City Program Management Committee will function as an Apex Body for management of the City Health Plan, which will lead to delivery of Maternal, Newborn, Child Health and Nutrition

(MNCHN) and water, sanitation and hygiene (WASH) services to the urban poor and will work towards the following objectives:

1. Establish a forum for convergence of city level stakeholders for the delivery of

MNCHN and WASH services to the urban poor.

2. Serve as the nodal body for the planning and monitoring of MNCHN and WASH

service delivery to the urban poor.

3. Provide a forum for exploring, reviewing and approving PPP initiatives and

innovations to address the gaps in MNCHN and WASH service delivery to the urban

poor.

The structure proposed for the City Coordination Committee :

Chairperson - DM/ Municipal Commissioner Convener - CMO

Members – Health - ACMO-Urban Member – ICDS - CDPO

Member – Nagar Nigam - Sum Improvement Officer Member – Water & Sanitation- Sup. En. / Ex.En. JalKal Vibhag, Nagar Nigam

30

Member DUDA & UD - Project Officer

Members – School Education - BSA & DIOS Members – Dev. Partners - Partners working in urban NGO's

Review Meetings at UPHC and City Level

Nature of Meeting Periodicity Meeting Venue

Participants

Mahila Aarogya Samiti

Meeting

Once a month

for each MAS

Slum ANM, HV, Community

Organizer, Social Mobilization officer

Review meeting with

Link workers and MAS representatives

Once a month UPHC All ANMs, PHN, LMO,

Community Organizer, Social Mobilization officer

Meeting of UPHC Coordination

Committee

Once a month UPHC LMO, PHN/Community Organizer, Social Mobilization

officer, representative from 2nd tier facility, and reps.

From other departments

Meeting with CMO & UH Program Coordinator

Once a month CMO Office

CMO, Program Coord., Asst. Program Coordinator, LMO/ PHN/ Community Organizer,

Social Mobilization officer

City Task Force Meeting

Once in two months

DM’s office

CMO, Program Coord. UH, Various departments’ reps. ,

private partners, NGOs

Plan of Unnao City The City area of Unnao consists of area and population of Unnao City, Karowan, Shuklaganj Town, Magarwara Town, Unnao Industrial Area and Magarwara Industrial Area. Population as of 2011 census is 270,517. The area of Unnao city Area is 70 km sq. There are four Railway Stations in Unnao city Area name-Shuklaganj, Magarwara, Unnao Junction and Unnao Rural near Unnao Industrial Area. The main localities of different city and town are- Kanchan Nagar (Shuklaganj), Industrial Area (Magarwara), Civil Lines (Unnao), Unnao Industrial Area (Village). As per provisional data of 2011 census, Unnao had a population of 178,681, out of which males were 94,080 and females were 84,601. The literacy rate was 83.72 per cent

31

Table 1 : Unnao City

Total Population of city (in lakhs) 177658 Source : Census 2011

Slum Population (in lakhs) 43500 Source : DUDA Unnao

Slum Population as percentage of urban population 24%

Number of Notified Slums 57 Source : DUDA Unnao

Number of slums not notified NA

No. of Slum Households 8630 Total slum population / 5

No. of slums covered under slum improvement programme

(BSUP,IDSMT,etc.) NA

Number of slums where households have individual water

connections* 31

Source : NPP Unnao and

Jan Nigam Unnao

Number of slums connected to sewerage network* 1 Source : NPP Unnao and

Jan Nigam Unnao

Number of slums having a Primary school 26 Source : BSA Unnao

No. of slums having AWC 50 Souce : ICDS Unnao

32

City

No. of slums having primary health care facility 4

Table 2 : Unnao City

Sl. No. Name of Disease/ cause of morbidity (e.g. COPD, trauma, cardiovascular disease etc.)

Number of cases

admitted in

2012

1 Injuries and Trauma 1527

2 Self inflicted injuries/suicide 0

3 Cardiovascular Disease 1172

4 Cancer (Breast cancer) 0

5 Cancer (cervical cancer) 0

6 Cancer (other types) 0

7 Mental health and depression 30

8 Chronic Obstructive Pulmonary Disease (COPD) 76

9 Malaria 53

10 Dengue 5

11 Infectious fever (like H1N1, avian influenza, etc.) 0

12 TB 0

13 MDR TB 18

14 Diarrhea and gastroenteritis 8856

15 Jaundice/Hepatitis 0

16 Skin diseases 0

17 Severely Acute Malnourishment (SAM) NA

18 Iron deficiency disorder 0

19 Others 0

Source : IDSP Unnao

33

Table 3 : Unnao City

Sl.no. Ward no. Name of the

slum Population

Quality of housing Quality of sanitation Status of water supply

(Piped, Hand pumps,

open wells,

none)

Location and distance of

nearest AWC

Location and

distance of nearest Primary

School

Location and distance of nearest Primary Health

Centre/UHP/UFWC

(kutcha/pucca/mixed) (IHL,community toilets,

OD)

1 1 iwju uxj 885 Mixed IHL gS.MiEi iwju uxj iwju uxj ftyk fpfdRlky;

2 1 nfj;kbZ [ksM+k 200 Mixed IHL gS.MiEi nfj;kbZ [ksM+k iwju uxj ftyk fpfdRlky;

3 12 iRFkj dVk

dkyksuh 970 Mixed IHL uxj ikfydk iRFkj dVk dkyksuh xka/kh uxj ftyk fpfdRlky;

4 17 xka/kh uxj 500 Mixed IHL uxj ikfydk xka/kh uxj xka/kh uxj ftyk fpfdRlky;

5 bZnxkg jksM

gfjtu cLrh 1250 Mixed IHL gS.MiEi

bZnxkg jksM gfjtu

cLrh xka/kh uxj ftyk fpfdRlky;

6 8 bczkfgekckn 605 Mixed IHL gS.MiEi Hkwjh nsoh ;w0,p0ih0

7 4 d"̀.kk nsbZ [ksM+k 1045 Mixed IHL gS.MiEi d"̀.kk nsbZ [ksM+k d"̀.kk nsbZ [ksM+k ;w0,p0ih1

8 4 ihrkEcj [ksM+k 750 Mixed IHL gS.MiEi ihrkEcj [ksM+k ihrkEcj [ksM+k ;w0,p0ih2

9 9 'ks[kiqj 1885 Mixed IHL gS.MiEi 'ks[kiqj 'ks[kiqj ftyk fpfdRlky;

10 9 dqn~nw [ksM+k

¼flaxjkslh½ 175 Mixed IHL gS.MiEi flaxjkslh

dqn~nw [ksM+k

¼flaxjkslh½ ftyk fpfdRlky;

11 7 tokgj [ksM+k 340 Mixed IHL gS.MiEi tokgj [ksM+k flaxjkslh ftyk fpfdRlky;

12 equOoj [ksM+k 300 Mixed IHL gS.MiEi tokgj [ksM+k flaxjkslh ftyk fpfdRlky;

13 9 njckjh [ksM+k 310 Mixed IHL gS.MiEi tokgj [ksM+k flaxjkslh ftyk fpfdRlky;

14 9 lqYrku [ksM+k 350 Mixed IHL gS.MiEi lqYrku [ksM+k lqYrku [ksM+k ftyk fpfdRlky;

15 9 vdjeiqj 1980 Mixed IHL gS.MiEi vdjeiqj vdjeiqj ftyk fpfdRlky;

34

16 3 pqHkuk [ksM+k 200 Mixed IHL gS.MiEi

dqn~nw [ksM+k

¼vdjeiqj½ vdjeiqj ftyk fpfdRlky;

17 9 dqn~nw [ksM+k

¼vdjeiqj½ 250 Mixed IHL gS.MiEi

dqn~nw [ksM+k

¼vdjeiqj½ vdjeiqj ftyk fpfdRlky;

18 5 jktsiqj 490 Mixed IHL gS.MiEi jktsiqj

vkokl fodkl

dkyksuh gksE;ksiSfFkd fpfdRlky;

19 8 xnu [ksM+k 1325 Mixed IHL gS.MiEi xnu [ksM+k xnu [ksM+k ftyk fpfdRlky;

20 20 vkn'kZ uxj 1500 Mixed IHL uxj ikfydk vkn'kZ uxj vkn'kZ uxj ftyk fpfdRlky;

21 20 fgju uxj 555 Mixed IHL uxj ikfydk fgju uxj fgju uxj ftyk fpfdRlky;

22 10 if'pe [ksM+k 300 Mixed IHL uxj ikfydk if'pe [ksM+k flfoy ykbu vk;qosZfnd fpfdRlky;

23 10 iwjc [kSM+k 150 Mixed IHL gS.MiEi iwjc [kSM+k flfoy ykbu vk;qosZfnd fpfdRlky;

24 dsoVk rkykc 1350 Mixed IHL uxj ikfydk dsoVk rkykc flfoy ykbu ftyk fpfdRlky;

25 19 rkfyc lajk; 2940 Mixed IHL uxj ikfydk rkfyc lajk; dsljxat ;w0,p0ih0

26 6 uq:n~nhu uxj 750 Mixed IHL uxj ikfydk jke uxj jke uxj ;w0,p0ih

27 6 jke uxj 1085 Mixed IHL uxj ikfydk jke uxj jke uxj ;w0,p0ih

28 9 iqjkuh cktkj 600 Mixed IHL uxj ikfydk iqjkuh cktkj dsljxat ;w0,p0ih

29 25 iqjkuh dksrokyh 275 Mixed IHL uxj ikfydk iqjkuh dksrokyh dsljxat ;w0,p0ih

30 27 ÅVlkaj 1000 Mixed IHL uxj ikfydk ÅVlkaj fxjtkckx ;w0,p0ih

31 15 eksrh uxj ¼xfM+;u

[ksM+k½ 500 Mixed IHL uxj ikfydk

eksrh uxj ¼xfM+;u

[ksM+k½ eksrh uxj ;w0,p0ih

32 26 ,0ch0 uxj 800 Mixed IHL uxj ikfydk ,0ch0 uxj ,0ch0 uxj ftyk fpfdRlky;

33 7 ukjsUnz uxj 575 Mixed IHL gS.MiEi dysDVjxat dysDVjxat ftyk fpfdRlky;

34 22 yks/kugkj 935 Mixed IHL gS.MiEi yks/kugkj yks/kugkj vk;qosZfnd fpfdRlky;

35 22 iz;kx ukjk;.k

[ksM+k 350 Mixed IHL uxj ikfydk iz;kx ukjk;.k [ksM+k

dY;k.kh

gfjtu cLrh vk;qosZfnd fpfdRlky;

36 22 xaxw [ksM+k 410 Mixed IHL gS.MiEi xaxw [ksM+k yks/kugkj vk;qosZfnd fpfdRlky;

37 18 dY;k.kh gfjtu

cLrh 500 Mixed IHL uxj ikfydk dY;k.kh gfjtu cLrh

dY;k.kh

gfjtu cLrh vk;qosZfnd fpfdRlky;

38 7 ddjgkckx 250 Mixed IHL uxj ikfydk ddjgkckx dysDVjxat ftyk fpfdRlky;

39 28 vCckl ckx

tokgj uxj 500 Mixed IHL uxj ikfydk

vCckl ckx tokgj

uxj dysDVjxat ftyk fpfdRlky;

35

40 lRrh rkykc 1000 Mixed IHL uxj ikfydk lRrh rkykc dysDVjxat ftyk fpfdRlky;

41 16 jke cD'k [ksM+k 390 Mixed IHL gS.MiEi vk;qosZfnd fpfdRlky;

42 16 fd'kksjh [ksM+k 565 Mixed IHL gS.MiEi fd'kksjh [ksM+k fd'kksjh [ksM+k vk;qosZfnd fpfdRlky;

43 28 cq/kokjh 1200 Mixed IHL uxj ikfydk cq/kokjh ftyk fpfdRlky;

44 23

vkokl fodkl

dkyksuh nqxkZ

efUnj jksM 1000 Mixed IHL uxj ikfydk

vkokl fodkl

dkyksuh nqxkZ efUnj

jksM

vkokl fodkl

dkyksuh nqxkZ

efUnj jksM gksE;ksiSfFkd fpfdRlky;

45 25 cqpM+ku 200 Mixed IHL uxj ikfydk cqpM+ku dsljxat ;w0,p0ih

46 25 Hkwjh nsoh 400 Mixed IHL uxj ikfydk Hkwjh nsoh Hkwjh nsoh ;w0,p0ih

47 25 dsljxat 355 Mixed IHL uxj ikfydk dsljxat dsljxat ;w0,p0ih

48 11 igyh [ksM+k 375 Mixed IHL uxj ikfydk igyh [ksM+k Hkwjh nsoh ;w0,p0ih

49 11 dkflQ vyh

lajk; 200 Mixed IHL uxj ikfydk dkflQ vyh lajk; Hkwjh nsoh ;w0,p0ih

50 11 fxjtkckx 250 Mixed IHL uxj ikfydk fxjtkckx fxjtkckx ;w0,p0ih

51 8 dkfle uxj 455 Mixed IHL uxj ikfydk dkfle uxj Hkwjh nsoh ;w0,p0ih

52 27 tsj/kql 4000 Mixed IHL uxj ikfydk tsj/kql tsj/kql ;w0,p0ih

53 15 dkth lajk; 450 Mixed IHL uxj ikfydk dkth lajk; ftyk fpfdRlky;

54 24 ifM+;u Vksyk 900 Mixed IHL uxj ikfydk ifM+;u Vksyk ÅVlkaj ;w0,p0ih

55 21 tqjk[ku [ksM+k 1000 Mixed IHL uxj ikfydk tqjk[ku [ksM+k tqjk[ku [ksM+k ftyk fpfdRlky;

56 4 ihrkEcj [ksM+k

Hkkx&2 ¼f'ko uxj½ 475 Mixed IHL uxj ikfydk

ihrkEcj [ksM+k Hkkx&2

¼f'ko uxj½

vkokl fodkl

dkyksuh ;w0,p0ih

57 1 cUnwgkj 800 Mixed IHL gS.MiEi cUnwgkj iwju uxj ftyk fpfdRlky;

Source : Names of slums & slum population -DUDA Unnao

Quality of Sanitation - Sanitory Inspector NPP Unnao

Status of Water Supply - Jal Sansthan & NPP Unnao

AWC centers - CDPO Unnao

Primary Schools - BSA Unnao

36

Table 4 : Unnao City

Sl.

No.

Name & type of

facility (DH, Maternity Home, CHC, other ref.

hospital UFWC, UHP

PHC,Dispensary etc.)

Managing Authority

(Municipal Council, State

Health Department, facilities

functioning on PPP basis)

Location of

Health facility

Population covered

by the facility

Services

provided

Human Resources

available – list type and

number of HR available i.e. ANM, LT, SN,

MOs, Specialists etc.

No. and type of equipment

available: X-ray machine, USG, autoclave etc.

1 UHP State Health Department

Purani Bazar Unnao

50000 RI and OPD

MO - 1 , SN-1, ANM-1

NA

2 District Hospital State Health

Department AB Nagar Unnao 31 lakhs

RI , IPD

and OPD

MO-26, SN-14, LT-

2,Pharmacist-10

X-

Ray,USG,Autoclave etc

3

State

Homoeopathic Dispensery

State Health

Department

Awas Vikas

Colony 5 lakhs OPD

MO - 1 ,

Pharmacist -1 NA

4 State Ayurvedic Dispensary

State Health Department

Kalyani Harijan Basti 5 lakhs OPD

MO - 1 , Pharmacist -1

NA

37

Unnao City

City Level Indicators and Targets

Processes & Inputs

Indicators Baseline (as

applicable)

Number Propose

d (2013-14)

Number

Achieved

(2013-14)

Community Processes

1. Number of Mahila Arogya Samiti (MAS) formed *( 1 per 1000 slum population)

0 44

2. Number of MAS members trained *( 1 MAS comprises of 10 people)

0 440

3. Number of Accredited Social Health Activists (ASHAs) selected and trained *( 1 ASHA per 2000 slum population )

0 22

Health Systems

4. Number of ANMs recruited *( 5 ANM per 1 UHP to be recruited) 0 15

5. No. of Special Outreach health camps organized in the slum/HFAs (1 outreach camp per 10,000 population /month )

0 18

6. No. of UHNDs organized in the slums and vulnerable areas * 0 74

7. Number of UPHCs made operational * 0 0

8. Number of UCHCs made operational * 0 0

9. No. of RKS created at UPHC and UCHC * 0 0

10. OPD attendance in the UPHCs

11. No. of deliveries conducted in public health facilities 0

RCH Services

12. ANC early registration in first trimester 0

13. Number of women who had ANC check-up in their first trimester

of pregnancy 0

14. TT (2nd dose) coverage among pregnant women 0

15. No. of children fully immunised (through public health facilities) 3954

16. No. of Severely Acute Malnourished (SAM) children identified and referred for treatment

Communicable Diseases

17. No. of malaria cases detected through blood examination 53

18. No. of TB cases identified through chest symptomatic 0

19. No. of suspected TB cases referred for sputum examination 16953

20. No. of MDR-TB cases put under DOTS-plus 18

Non Communicable Diseases

21. No. of Diabetes cases screened in the city 2636

22. No. of Cancer cases screened in the city 0

23. No. of Hypertension cases screened in the city 5355

Name of the City: Unnao City

38

Plan of Gangaghat (Shuklaganj) Shuklaganj is lies in Unnao district, and it is also a suburb of Kanpur, Uttar Pradesh, situated on the banks of holy river Ganges about 5 km from Kanpur on the SH 58 to Unnao.

The population was 261,000 as of the 2001 census. It has 80% of literacy and is 5 km from Kanpur Cantonment. Shuklaganj was once known as Gangaghat. Though it lies

in Unnao district, it lies nearer to Kanpur and hence is a suburb of Kanpur.

Table 1 : Shuklaganj ( Gangaghat)

39

Total Population of city (in lakhs) 84072 Source : Census 2011

Slum Population (in lakhs) 33500 Source : DUDA Unnao

Slum Population as percentage of urban

population 43%

Number of Notified Slums 10 Source : DUDA Unnao

Number of slums not notified NA

No. of Slum Households 7263 Total slum population / 5

No. of slums covered under slum improvement programme (BSUP,IDSMT,etc.)

NA

Number of slums where households have

individual water connections* 2 Source : NPP

Shuklaganj

Number of slums connected to sewerage

network* 0 Source : NPP

Shuklaganj

Number of slums having a Primary school 1 Source : BSA Unnao

No. of slums having AWC 0 Souce : ICDS Unnao

No. of slums having primary health care facility

3

Shuklaganj ( Gangaghat)

Sl. No. Name of Disease/ cause of morbidity (e.g. COPD, trauma, cardiovascular disease etc.)

Number of cases admitted in 2012

1 Injuries and Trauma 450 Medico-legal cases

2 Self inflicted injuries/suicide 0

3 Cardiovascular Disease 0

4 Cancer (Breast cancer) 0

5 Cancer (cervical cancer) 0

6 Cancer (other types) 0

7 Mental health and depression 0

8 Chronic Obstructive Pulmonary Disease (COPD) 0

9 Malaria 5

10 Dengue 2

11 Infectious fever (like H1N1, avian influenza, etc.) 0

12 TB 25

13 MDR TB 2

14 Diarrhea and gastroenteritis 0

15 Jaundice/Hepatitis 4

40

16 Skin diseases 0

17 Severely Acute Malnourishment (SAM) NA

18 Iron deficiency disorder 0

19 Others

41

Table 3 : Shuklaganj (Gangaghat)

Sl.no. Ward

no. Name of the

slum Population

Quality of housing Quality of sanitation

Status of water supply (Piped, Hand

pumps, open wells,

none)

Location and

distance of nearest

AWC

Location and

distance of nearest Primary School

Location and distance of nearest

Primary Health Centre/UHP/UFWC (kutcha/pucca/mixed)

(IHL,community toilets, OD)

1 1 loksZn;k uxj

ywyhiqjok 4454 Mixed IHL uxj ikfydk - uRFkw [ksM+k ;w0,p0ih0

2 5 izse uxj 2501 Mixed IHL gS.MiEi - vkn'kZ uxj ;w0,p0ih0

3 2 bfUnjk uxj 3257 Mixed IHL gS.MiEi - ;w0,p0ih0

4 7 lhrkjke dkyksuh 3251 Mixed IHL uxj ikfydk - izkFkfed fpfdRlky;

5 19 *'kfDr uxj euksgj

uxj 4070 Mixed IHL gS.MiEi - izkFkfed fpfdRlky;

6 14 *'kfDr uxj iksuh

jksM xka/kh uxj 3030 Mixed IHL gS.MiEi - ;w0,p0ih0

7 17 feJk dkyksuh 3062 Mixed IHL gS.MiEi - feJk dkyksuh ;w0,p0ih0

8 25 xksrk[kksj 3052 Mixed IHL gS.MiEi - ;w0,p0ih0

9 11 pEik iqjok 3307 Mixed IHL gS.MiEi - ;w0,p0ih0

10 13 pEik iqjok &2 3033 Mixed IHL gS.MiEi - ;w0,p0ih0

Note: No AWC Centers present in Shuklaganj area

Only 3 Primary Government Schools present

42

Table 4 : Shuklaganj ( Gangaghat)

Sl. No.

Name & type of facility (DH,

Maternity Home, CHC, other ref. hospital UFWC,

UHP PHC,Dispensary

etc.)

Managing Authority (Municipal

Council, State Health

Department, facilities functioning on

PPP basis)

Location of Health facility

Population covered by

the facility

Services provided

Human

Resources available –

list type and number of

HR available

i.e. ANM, LT, SN, MOs,

Specialists etc.

No. and type of

equipment

available: X-ray

machine, USG,

autoclave

etc.

1 APHC State Health

Department Shuklaganj 2.8 lakhs

RI, IPD

and OPD

MO - 2 ,ANM-1,Pharmacist

-1,WB-1, LA -1

Not Available

2 UHP State Health Department

Bhramnagar,Shuklaganj 35 thousands RI and OPD

MO - 1 , SN-1, ANM-1

Not Available

3 UHP State Health

Department

Champapuwa ,

Shuklaganj 40 thousands

RI and

OPD

MO - 1 , SN-

1, ANM-1 Not Available

4 State Ayurvedic

Hospital

State Health

Department Adarshnagar , Shuklaganj 2.8 lakhs OPD

MO-1 ,

Pharmacist-1 Not Available

43

Shuklaganj ( Gangaghat)

City Level Indicators and Targets

Processes & Inputs

Indicators Baseline (as applicable)

Number Proposed

(2013-14)

Number

Achieved

(2013-14)

Community Processes

1. Number of Mahila Arogya Samiti (MAS) formed *( 1 per

1000 slum population) 0 36

2. Number of MAS members trained *( 1 MAS comprises of 10 people)

0 360

3. Number of Accredited Social Health Activists (ASHAs) selected and trained *( 1 ASHA per 2000 slum population )

0 18

Health Systems

4. Number of ANMs recruited *( 5 ANM's per 1 UHP to be recruited)

0 10

5. No. of Special Outreach health camps organized in the slum/HFAs *(1 outreach camp per 10,000 population /month )

0 8

6. No. of UHNDs organized in the slums and vulnerable areas *

0 34

7. Number of UPHCs made operational * 0 2

8. Number of UCHCs made operational * 0 0

9. No. of RKS created at UPHC and UCHC * 0 2

10. OPD attendance in the UPHCs NA

11. No. of deliveries conducted in public health facilities 150 -

RCH Services

12. ANC early registration in first trimester 92 -

13. Number of women who had ANC check-up in their first

trimester of pregnancy 36 -

14. TT (2nd dose) coverage among pregnant women 90% -

15. No. of children fully immunised (through public health facilities)

63% -

16. No. of Severely Acute Malnourished (SAM) children

identified and referred for treatment 2 -

Communicable Diseases

17. No. of malaria cases detected through blood examination 0 -

18. No. of TB cases identified through chest symptomatic 25 -

19. No. of suspected TB cases referred for sputum

examination 1000 -

20. No. of MDR-TB cases put under DOTS-plus 2 -

Non Communicable Diseases

21. No. of Diabetes cases screened in the city NA -

22. No. of Cancer cases screened in the city NA -

23. No. of Hypertension cases screened in the city NA -

44