DISTRICT HEALTH ACTION PLAN 2012 – 2013

of 221

DISTRICT HEALTH ACTION PLAN 2012 –

2013

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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Acknowledgements 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:-

v Sri Balamurgan D ,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.

v Dr.Arvind kumar (A.C.M.O) Nodal officer for this action plan who always supported this endeavor through his guiding words and language.

v Mr. Nimish Manan, District Programme Manager was incharge for the development of the DHAP(2012-13) .

v Mr Ravi Shankar Kumar, District Planning Coordinator has given full time effort in developing DHAP(2012-13).

v Mr. Kaushal Kumar Jha, District Account Manager has put huge effort in financial Planning.

v Mr. Arvind Kumar, M&E Officer is the technical advisor for the data introduced inside this DISTRICT HEALTH ACTION PLAN.

v Mr. Kushal Mukharji, District Programme Officer, DFID (SWASTH), Jehanabad has given Technical support in Plan Preparation.

v All district level Programme officer for various Health Programmes,DCHM, B.H.Ms, M.O.I.C, Hospital Manager, PHCs, Field Office Staff have supported with their full participations, cooperation and learning spirit through out this process.

we on behalf of the District Health Society, Jehanabad acknowledge the grateful contribution of all those mentioned above.

Dr. Smt. Shobha Sinha Sri Balamurgan D

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

District Health Society, Jehanabad. District health society, Jehanabad

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District Patna

District Patna

Jehanabad

Kako Modanganj

Ratni Faridpur

Ghosi

Makhdumpur

Hulasganj

District Nalanda

District Arwal

District Gaya


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

N

Level2

District Patna

District Patna

Jehanabad Sadar

Kako Modanganj

Ratni Faridpur

Ghosi

Makhdumpurpur

Hulasganj

District Nalanda

District Arwal

District Gaya


PHC

PHC

PHC

PHC PHC

Mandil

Dedsaiyaa

Bharthu

Dehuni

HSC Badheta

Level 1

Murgav

HSC Ikkil

Daraurt

Level 3

N

W

S

E

APHC Sikariya

APHC Shakurabad

Bandhuganj

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STRUCTURE OF DISTRICT PLAN Chapter I: Introduction, profile of the district and process. PAGE NO § Introduction …………………………………………………………………………….. 8 § History of District………………………………………………………………………. 9 § District Profile…………………………………………………………………………… 11 § District Planning objective and priorities and planning Process… 19 Chapter II: *SWOT analysis……………… ……………………………………. 24 * HMIS DATA ANALYSIS…………………………………………………. 26 * Financial Progress up to NOV 2011…………………………….. 28 Chapter III: Part A

MATERNAL HEALTH 39

CHILD HEALTH 46

FAMILY PLANNING 53

Human Resource 55

ARSH 56

Human Resource 57

Training 61

NRHM Management Cost 62

Chapter IV: PART B

NRHM PART “ B”

ASHA 67

Untied Fund 71

Annual Maintance Grants 76

HOSPITAL STRENGTHENING 77

CORPUS GRANTS TO RKS 83

DE-CENTRALIZED PLANNING 84

PANCHAYTI RAJ INITIATIVE 85

IEC- BCC NRHM 86

MMU 87

REFERRAL TRANSPORT 88

PPP/NGO 89

MONITORING AND EVALUATION 91

PROCUREMENT 91

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Chapter V:

Part C – Immunization 96

Routine Immunization/Polio

Chapter VI:

Part D – National Disease Control Programmes

IDSP 99

IDD 116

NVBDCP 117

RNTCP 126

SUMMARY OF BUDGET 154

Chapter VII (ANNEXURE)

SADAR HOSPITAL GAPS: …………………………………………………… 155

VILLAGE HEALTH ACTION PLAN……………………………………………… 158

HSC NAME WITH BUILDING STATUS………………………………………… 176

FINAL BUDGET SUMMARY……………………………………………………… 183

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CHAPTER 1: INTRODUCTION, PROFILE OF THE DISTRICT & PROCESS

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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 favorable terrain for the

nexalites to operate and build their bases. Because of geographical constraints and

lack of Pucca 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.

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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.

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

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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 2011 census)

Sl. No.

Population Male Female Total

1. Bihar 54185347 49619290 103,804,637

2. Jehanabad 586202 537974 1124176

3. Rural Population 514724 475092 989816

4. Urban Population 71478 62882 134360

5. Literacy rate 79.30% 56.24% 68.27%

6. Rural 87.80% 88.31% 88.04%

7. Urban 12.20% 11.69% 11.96%

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District Profile :-

1. Area (in Sq. KM) 941.4 sq.km 2. Decadal growth rate 21.34%

(2001 to 2010) 3. Population density 1206 (Person per sq.km) 4. Sex ratio 918 (per 1000 male) 5. Villages Populated - 562

Uninhabited - 43 Total – 605

6. Town 02 7. Municipality 02 8. Rural Families 9. SC Population 168290 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 145523.03 Acres 17. Gross cropped area 260735.46 acr. 18. Net irrigated area 66450 Hec. 19. Area under forest 1574.94 Acres 20. Water area fishery 1176..46 Hec. 21. Total cattle 2.04 Lacs (1982) 22. Road length 23. Electrified villages 24. Hand tube well 25. Drilled tube well 26. Rural Water supply 27. Urban water supply

BLOCKS OF JEHANABAD DISTRICT

An Introduction:

Administration:

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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.

The educational infrastructure available in the district can be summarized

as following-

Primary schools - 561

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Middle schools - 198

High schools - 43

Sanskrit Schools - 07

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 - 96 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.

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

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

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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.

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BLOCKS

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

nj

Total area 33607.08 acres

142500 102463 100.63 SQ.Mile

23091

Total population

173770 147100 107649 259714 87262 254183 94498

Male population

90233 76740 55671 134612 45343 134116 49487

Female population

83536 70360 51978 125101 41918 120067 45014

Adolescent population (10-19yrs)

38340 15285

Sex Ratio

4380 2234

8760 7414

Child population: 0-6 months

:6mn-2yrs

:2-5yrs

13140 13925

7458 18410 21702 43701 16020 42720 21322 SC population :

0 00 00 ST population :

00 00 0 0

BPL population

17222 14826 13000 8847

No of Eligible couples

2499 21950 23138

Total no. of gram panchayat

16 14 10 22 08 14 09

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Total no. of revenue villages

95 85 53 118 54 99 48

No of APHCs 04 07 06 05 03 05 02

No of HSCs 21 12 9 21 12 12 9

No. of Anganwadi centers

139/143 117/123

87/89 210/215 70/70 178/208 67/77

No of Doctors 9 9 8 13 7 7

No of ANMs 46 39 29 47 42 28

No of Grade A Nurse

4 8 7 8 7 4

No of Paramedicals

8 4 9 1

No. of Anganwadi workers

139 117 87 210 70 178 67

No of ASHA 145 128 90 180 75 136 87

Total No. of SHG/ Mahila mandals

136 120 76

No. of primary schools

154 122 53 59 108 15

No. of electrified villages

85 56

48

275

21412

No. of villages having source

of drinking water:

Well

Tube-well 5870

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Pond- river

Piped water

Any other

No of villages having motorable roads

206 48

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PLANNING GOAL,OBJECTIVE

AND

PRIORITIES

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GOAL FOR YEAR 2012-13

Outcome indicator Bihar Jehanabad Goal for 2012-13

CBR 26.7 24.9 22

CDR 7.2 6.2 5

IMR 55 53 45

MMR 305 331 200

Neo Natal Mortality Rate

35 31 20

Source : Annual Health Survey 2010-11

Jehanabad District has targeted to reduce MMR from331 to 200 in year plan 2012-13, To reduce CBR 24.9 to 22 as CBR of Bihar State is 26.7, As IMR of District is 53 that has to bring at the point of 45. As District has Targeted to use more Contraceptive Pills according to DLHS 3 survey jehanabad has trend of use of contraceptive Pills 30%.

Planning Objective And Priorities

The Planning Objective for the District Health Action Plan 2012-13 has been decided on the basis of Goals of NRHM, Guidelines of State Health Society and DHAP of 2011-12. 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. Strengthening VHSND.

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 strengthening of

VHSC, effective functioning of Rogi Kalyan Samiti at PHC and Registration of RKS at APHC level and proper functioning of RKS at APHC level. Proper utilization of untied fund at PHC and HSC level and APHC level. To Functioning one APHC in each block as 24*7.

8. Training to all frontline facility providers to be given. 9. Awareness and BCC regarding all communicable and vector borne diseases. 10. To start one more NRC to Cover more SAM Children at Refral Hospital

Makhdumpur. 11. On PPP Mode Pathology Facility at APHC level. 12. To Insure at two HSC of District for Institutional Delivery. 13. To make sure use of Asha Drug Kit to better service quality at Village level. 14. Training to Asha on different Modules.

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Specific and Non-Negotiable Steps to be taken by Jehanabad district in the year 2012-2013 with special focus on Blocks situation:

1. Initiating SNCU in the District hospital , Jehanabad 2. Radiology, Pathology and Ultrasound facilities in all PHCs and Referral

hospitals. 3. ISO certification for District Hospital, Makdumpur Referral and Kako PHC. 4. Generic Drug Storage at all seven PHC. Presently storage is only in District

Hospital. 5. To provide special health facility in Naxal affected areas of Jehanabad district. 6. Establishment of “ICU” in Sadar Hospital, Jehanabad.

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Planning Process → Planning in the district began in October 2011 with Planning Team Formation. → The District Level planning team was formed and brifing was done by ACMO-

DPM-DPC. The District Level planning team consisted of the following members from Departments

· Civil Sirgeon · DPM · DPC · DAM · DIO · DPO-ICDS · Total Sanitation coordinator Phed · Development Partner DFID-Swasth- Unicef · MOIC of PHC The team after taking District 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 officers of the district participated in the workshop along with District

accounts Manager/BHM/BAM/MEO/ASHA coordinator/DHM. → Civil Surgeon had delighted the workshop by giving her presence and

participation throughout the day. She clarified and explain the Efficacy of DHAP.ACMO, who is the nodal person facilitated the workshop and announced the district Programme officers as the nodal officers for different blocks. DPO-ICDS- Total Sanitation coordinator Phed- Development Partners- DFID-Swasth team - Unicef facilitated the process and components of planning. Further formats were discussed by DPM, DPC and queries were resolved.

→ 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 with a Special focus on Village health planning and quality assurance of it 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.

→ Special focus was made for Village health action plan –the Facility survey-FGD-health services mapping and documentation process were explained and all the selected blocks Action Plan was prepared. The Dist Level Planning team members monitored the village level action Plan exercises at the block and villages

→ 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 first week of January 2012.

The final Draft of District Health Action Plan of Jehanabad district for the year 2012-13. With Block as the basis of planning came in this final shape.

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

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CHAPTER 2 SWOT ANALYSIS

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SWOT ANALYSIS

STRENGTH Every month DHS Meeting under the Leadership of District Magistrate and weekly meeting to review the progress and reduction of Gaps

*Experienced clinical and DHS staff.

* Experienced Doctors availibity.

Inter department coordination with ICDS-Phed-Education and development partner Unicef-WHO-DFID-MI-Nipi and NGOs

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

NRC is functional

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

* Ambulance facility at all PHC to quick refers according to requirement.

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

* Special Focus on Out reach area in RI Session.

All the blocks are having the New born corner

WEAKNESS · Lack of specialist Doctors. · Require More ANMS for quality service delivery

mechanism · Lack of all PHC Blood storage unit. · Lack of proper training to all clinical staff. · Lack of SNCU at district level. · Advanced Labor room required at PHC level & Delivery

Facility at HSC level. · Timely Availability of Drug. · Use the Fund of VHSC. · Demand of Doctor on HSC level. · OPD Daily Facility on HSC Level. · Drinking Water Facility should be made available in

Summer Season. · In cress in the APHC working Time. · Demand of 24*7 facility at APHC level.

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OPPORTUNITY · Opportunity to Start one more Ne NRC. · Strengthen All clinical staff after giving training. · Opportunity to start SNCU. ASHA working at Grass root

level that is Good. · Availability of Drug through ASHA Kit at emergency

time has Good Impact on Villagers. · People are Satisfied with RI Facility. · Villagers are satisfied with counseling session during

there visit about sanitation, Family Planning. ·

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.

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ANC Registration against Expected Pregnancies 93%

TT1 given to Pregnant women against ANC Registraion 78%

3 ANC Check ups against ANC Reigtrations 58% 100 IFA Tablets given to Pregnant women against ANC Registraion 81%

Deliveries Unreported Deliveries against Estimated

Deliveries 24% HOME Deliveries( SBA& Non SBA)

against Estimated Deliveries 2%

Institutional Deliveries against Estimated Deliveries 64%

HOME Deliveries( SBA& Non SBA) against Reported Deliveries 49%

Institutional Deliveries against Reported Deliveries 49%

C Section Deliveries against Institutional Deliveries( Pvt & Pub) 6%

Births & Neonates Care Live Births Reported against Estimated Live

Births 44% New borns weighed against Reported

Live Births 55%

Still Births (Reported) 189 New borns weighed less than 2.5 kgs

against newborns weighed 10%

Sex Ratio at Birh 1,054 New borns breastfed within one hr of

Birth against Reported live Births 57%

Child Immunisation( 0 to 11 months)

BCG given against Expected Live Births 82% Measles given against Expected Live

Births 91%

OPV3 given against Expected Live Births 54% Fully Immunised Children against

Expected Live Births 54%

DPT3 given against Expected Live Births 80%

Family Planning Family Planning Methods Users (

Sterilisations(Male &Female)+IUD+ Condom pieces/72 + OCP Cycles/13)

7,779 IUD Insertions against reported FP

Methods 54%

Bihar- Jehanabad HMIS DATA ANALYSIS 2011-12

BIHAR-JEHANABAD- Data Month April to September 2011

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Sterilisation against reported FP Methods 18% Condom Users against reported FP

Methods 18%

OCP Users against reported FP

Methods 10%

Other Services

OPD 4,91,846 Major Operations 870

IPD 13,766 Minor Operations 6,930

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Financial Progress Up To NOV 2011

DISTRICT HEALTH SOCIETY JEHANABAD BUDGET WISE EXPENDITURE REPORT FOR FY 2011-12

NRHM PART "A"

S.N. Name of Scheme

OPENING BALANCE

AS ON 1.04.2011 (including Advance)

FUND RELASED

FROM SHSB

TOTAL FUND

APPROVED BUDGET

EXPENDITURE UPTO

November, 2011

CLOSING BALANCE as on 30-11-11

(DHS+Agency)

A Maternal Health

1 Monitoring Progress and quality of services delivery

50,000 5800

2 Operationalise 24x7 PHC

2,25,000 38720

3 Operationalise Sub Centre

1,00,000 0

4 RCH Outreach Camps 98,000 71310

5 Monthly Village Heatlh & Nutrition Day

5,01,500 36350

6 Home Delivery 1,02,000 1500

7 Institutonal Delivery Rural

3,32,49,430 18127580

8 Institutonal Delivery Urban

7,00,000 290000

9 Institutonal Delivery C-section

1,31,258 43500

10 Administrative Exp. 3,24,892 0

11 Maternal Death Review

53,025 4250

Sub Total 3,55,35,105 1,86,19,010

B Child Health

1 Implementation of IMNCI Activity

50,000 0

2 Facility Based New Born Care

7,75,000 0

3 Nutritional Rehabitation Centre

36,44,100 677688

Sub Total 44,69,100 6,77,688

C Family Planning

1 Quality Assurance of Sterlization Services

20,000 0

2 Female Sterlization Camps

10,80,000 18800

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3 NSV Camps 20,000 29635

4 Compensatin for Female Sterlisation

42,70,000 1960437

5 Compensatin for Male Sterlisation

1,96,500 118115

6 Accredition of PP for Sterlisation

19,66,500 0

7 Pol for Family Planning

1,19,000 4856

8 IUD Camps 33,500 28500

9 Others (School Health)

723660

Sub Total 77,05,500 28,84,003

D ARSH

1 Arsh 0 0

Sub Total 0 0

E Tribal RCH

1 PNDT Sex Ratio 1,00,000 0

Sub Total 1,00,000 0

F

Infrastructure (Minor Civil

Work)Human Resource

(Except AYUSH)

1 ANM Staff Nurse 2,04,54,000 14050363

2 Laboratory Technican

3,60,000 0

3 Salary for MO in Blood Bank

4,20,000 0

4 FP Councellor 3,60,000 0

5 Muskan (Incentive to ASHA & ANM)

12,24,248 1557360

Sub Total 2,28,18,248 1,56,07,723

G Training

1 SBA 5,92,350 352440

2 Training of MO and Para Medical Staff

2,30,000 0

3 IMNCI Training 47,22,380 505036 4 NSSK Training 2,11,600 0 5 Minilap Training 70,237 0

6 Training of MO in IUD Insertion

55,289 0

7 Training of ANM in IUD Insertion

88,260 0

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8 DPMU Training 50,000 0 Sub Total 60,20,116 8,57,476

H NRHM

Management Cost

1 Mobility Support (DMO)

1,80,000 0

2 Contractual Staff for DPMU

11,86,284 894025

3

Equipment / Furniture and mobility support for DPMU Staff

9,86,000 167621

4 Block PMU 51,49,200 3476152

5 Uptration of Tally Erp 9

8,100 8100

6 ANC 22,500 0

7 Hospital Manager/Accountant Fru

9,00,000 357000

8 Annual Audit of Programme ( Stutory Audit)

36,000 0

9 Concurrent Audit 2,40,000 45000 Sub Total 87,08,084 49,47,898

Grand Total 23829506 46826270 706557

76 8,53,56,153 4,35,93,798 2,70,61,978

DISTRICT HEALTH SOCIETY JEHANABAD BUDGET WISE EXPENDITURE REPORT FOR FY 2011-12

NRHM PART "B"

S.N. Name of Scheme

OPENING BALANCE

AS ON 1.04.2011 (including Advance)

FUND RELASED

FROM SHSB

TOTAL FUND

APPROVED BUDGET

EXPENDITURE UPTO

NOVEMBER, 2011


(DHS+Agency)

A ASHA

1 Selection & Training of ASHA

40,26,923 0

2 Procurement of ASHA drug Kit

2,17,750 0

3 TA /DA for ASHA Diwas

8,98,872 469296

4 Best Performance award to ASHA at District Level

14,000 1800

- 31 -

5 Identity Card for ASHA

360 0

6 ASHA Resource Center

18,10,750 607560

Sub Total 0 69,68,655 10,78,656

B Untied Fund

1 Untied Fund for SDH 50,000 6486 2 Untied Fund for PHC 2,25,000 104775

3 Untied Fund for APHC

8,00,000 39392

4 Untied Fund for HSC 9,20,000 644445

5 Untied Fund for VHSC

61,90,000 4350000

Sub Total 0 81,85,000 51,45,098

C Annual Maint.

Grant

1 Annual Maint. Grant for CHC

2,00,000

2 Annual Maint. Grant for PHC

2,00,000 27878

3 Annual Maint. Grant for APHC

7,50,000 210886

4 Annual Maint. Grant for HSC

5,10,000 33675

Sub Total 0 16,60,000 2,72,439

D Hospital

Strenthing

1 Installation of Solar Water System

3,20,500 8000

2 Sub-Centre Rent 3,06,000 13501

Sub Total 0 6,26,500 21,501

E New

Constraction & Renovation

1 Cons. Of HSC 0 3868000 2 Cons. Of APHC 0 0 3 Cons. Of PHC 0

4 Refurbishment of Existing Cold Chain Room

8,00,000 0

Sub Total 0 8,00,000 38,68,000

F Rogi Kalyan

Samiti

1 RKS SDH 5,00,000 407223 2 RKS Referral Hospital

3,00,000 18300

3 RKS PHC 7,00,000 1620029

- 32 -

4 RKS APHC 30,00,000 0

Sub Total 0 45,00,000 20,45,552

G Panchayati Raj

Initative

1 District Health Action Plan including Blocks & Village

4,51,000 192552

2

Orientation of Community leader of VHSC, PHS, PHC & CHC

1,39,500 10100

3

Orientation of Workshop, Training & Capacity building of PRI

61,800 0

Sub Total 0 6,52,300 2,02,652

H AYUSH

1 Salary for AYUSH MO 57,20,000 2848397

Sub Total 0 57,20,000 28,48,397

I BCC / IEC

1 Hording, Wall Painting & Others

4,05,000 218029

2 Health Mela (Leprocy)

4,000 0

Sub Total 0 4,09,000 2,18,029

J Referral

Transport

1 MMU 42,12,000 1497600 2 Dial 108 Ambulance

15,60,000 1064748

3 Dial 102 Ambulance 3,90,000 258675

Sub Total 0 61,62,000 28,21,023

K PPP/NGO

1 Outsourcing of Pathology & Radiology

40,00,000 1793382

2 Bio-Waste Management

11,04,000 0

Sub Total 0 51,04,000 17,93,382

L Innovations

1

Acceridition of Public and Private sector for safe abortion services

1,03,166 0

Sub Total 0 1,03,166 0

M Planning,

Implementation & Monitoring

- 33 -

1 Data Center (Dist. & Block)

8,10,000 673862

2 MCTS & HRIS 1,86,433 0 3 RI Monitoring 1,30,000 0 4 CPSMS 20,000 20000 5 HMIS 4,000 0

6 HMIS Supporting, Supervision & Data Validation

1,82,000 17500

Sub Total 0 13,32,433 7,11,362

N Procurement

1 Procurtement of Equipment (Labour Room)

18,42,104 458900

2 NBCC Equipment 4,02,328 272054 3 Minilap set 1,05,000 81180 4 NSV Kit 5,500 0 5 IUD Kit 15,000 0 6 Dental Chair 13,57,894 0 7 A.C 1.5 Ton Window

25,000 0

8 Parenteral Iron Sucrose

5,00,000 32425

9 IFA Tab. Pregnant Mother

6,57,456 0

10 IFA Small Tab/Syrup Children

8,18,438 0

11 IMNCI Drug Kit 6,00,000 0 12 General Drug Supply 48,78,900 1821842

Sub Total 0 1,12,07,620 26,66,401

O RNTCP

1 Supporting Strengthiing RNTCP

72,000 0

2 Payment of Monthly Bill to BSNL

27,240 0

Sub Total 0 99,240 0 Grand Total 17268995 30894015 48163010 5,35,29,914 2,36,92,492 2,44,70,518

- 34 -

DISTRICT HEALTH SOCIETY JEHANABAD

BUDGET WISE EXPENDITURE REPORT FOR FY 2011-12 NRHM PART "C"

A NAME OF SCHEME

OPENING BALANCE AS

ON 1.04.2011 (including Advance)

FUND RELEASED

FROM SHSB

TOTAL FUND

APPROVED BUDGET

EXPENDITURE


(DHS+Agency)

1 C (RI) 2468357 28,03,461 1662947 2 C (PP) 1443961

75,47,851 3444300

3 Cold Chain Main.

25619

Sub Total 3912318 3910615 7822933 1,03,51,312 5132866 2690067

NRHM PART "D"

A NAME OF SCHEME

OPENING BALANCE AS


FUND RELEASED

FROM SHSB

TOTAL FUND

APPROVED BUDGET

EXPENDITURE


(DHS+Agency)

1 IDD 11,000 1200

Sub Total 34351 34351 11,000 1200 33151

NRHM PART "E"

A NAME OF SCHEME

OPENING BALANCE AS


FUND RELEASED

FROM SHSB

TOTAL FUND

APPROVED BUDGET

EXPENDITURE


(DHS+Agency)

1 IDSP 8,54,000 210945

Sub Total 112898 213500 326398 8,54,000 210945 115453

NRHM PART "F"

A NAME OF SCHEME

OPENING BALANCE AS


FUND RELEASED

FROM SHSB

TOTAL FUND

APPROVED BUDGET

EXPENDITURE


(DHS+Agency)

1 Maleria, Falaria & Kalazar

411896

Sub Total 1178402 10000 1188402 8,02,130 411896 776506

NRHM PART "G"

- 35 -

A NAME OF SCHEME

OPENING BALANCE AS


FUND RELEASED

FROM SHSB

TOTAL FUND

APPROVED BUDGET

EXPENDITURE


(DHS+Agency)

1 Leprocy 93663

Sub Total 146720 8378 155098 2,93,750 93663 61435 NRHM PART "H"

A NAME OF SCHEME

OPENING BALANCE AS

ON 1.04.2011

FUND RELEASED

FROM SHSB

TOTAL FUND

APPROVED BUDGET

EXPENDITURE


(DHS+Agency)

1 Blindness 324799

Sub Total 2543770 0 2543770 31,07,015 324799 2218971

NRHM PART "I"

A NAME OF SCHEME

OPENING BALANCE AS


FUND RELEASED

FROM SHSB

TOTAL FUND

APPROVED BUDGET

EXPENDITURE


(DHS+Agency)

1 RNTCP 1057401

Sub Total 247647 1140550 1388197 24,08,475 1057401 330796

- 36 -

DISTRICT HEALTH SOCIETY, JEHANABAD SUMMRY REPORT

S.N. Name of Scheme

OPENING BALANCE AS


FUND RELASED

FROM SHSB

TOTAL FUND

APPROVED ANNUAL BUDGET

EXPENDITURE UPTO

NOVEMBER, 2011

CLOSING BALANCE as on 30-

11-11 (DHS+Age

ncy)

NRHM PART "A" 23829506 46826270 70655776 85356153 43593798 27061978

NRHM PART "B" 17268995 30894015 48163010 53529914 23692492 24470518

NRHM PART "C" 3912318 3910615 7822933 10351312 5132866 2690067

NRHM PART "D" 34351 0 34351 11000 1200 33151

NRHM PART "E" 112898 213500 326398 854000 210945 115453

NRHM PART "F" 1178402 10000 1188402 802130 411896 776506

NRHM PART "G" 146720 8378 155098 293750 93663 61435

NRHM PART "H" 2543770 0 2543770 3107015 324799 2218971

NRHM PART "I" 247647 1140550 1388197 2408475 1057401 330796

Grand Total:- 49274607 83003328 132277935 156713749 74519060 57758875

Up to November, 2011 Total Annual Budget 156713749 Total Available Fund 132277935 Target Achived 74519060 Total Expenditure 74519060

Balance Target to be Achived 82194689 % Expenditure of Available Fund 56.34

% Of Achivment 47.55

- 37 -

The District Health Action Plan for the year 2012-13 has the following components and consists of following sections-: Part A: Reproductive and Child Health priority areas under RCH-II flexible pool (Sub-Components – Maternal Health, Child Health, Fmily Planning, ARSH, Urban RCH, Vulnerable Groups, Innovations/PPP/NGO, Infrastructure and Human Resources, Institutitonal Strengthening (HMIS, M&E), Training, Procurement, Programme Management). Part B: Additionalities under NRHM (ASHA, Infrastructure, Contractual Manpower, PPP-Referral & Emergency Transport, Diagnostics, Data Centres, Procurement, Planning) Part C: Routine Immunisation Part D – I : National Iodine Deficiency Disorders Control Programme (NIDDCP)

· Integrated Disease Surveillance project (IDSP)

· National Vector Borne Disease Control Programme (NVBDCP) (Malaria, Kalazar, Filaria)

· National Leprosy Elimination Programme (NLEP)

· National Programme for Control of Blindness (NPCB)

· Revised National Tuberculosis Control Programme (RNTCP)

- 38 -

CHAPTER 3

NRHM PART “A”

- 39 -

Part A- RCH FLEXIPOOL Current Status –

Indicator Bihar Jehanabad

CBR 26.7 24.9

CDR 7.2 6.2

IMR 55 53

MMR 305 331

TFR 2.1 2.9 ( SRS 2010-11)

Source: Annual Health Survey 2010-11

Important RCH indicators such as MMR, IMR, MMR are showing declining trends whereas institutional delivery in government facility, complete ANC, contraceptive use in the District has increased.

Indicator Bihar Jehanabad

Natural Growth Rate 19.5 18.7

Neo Natal Mortality Rate 35 31

Post Neo Natal Mortality Rate

19 21

Under Five Mortality Rate 77 67

Sex Ratio at Birth 919 935

Sex Ratio ( 0- 4 Years) 931 930

Sex Ratio (All Ages) 950 995

Source: Annual Health Survey 2010-11

- 40 -

- 41 -

Source: DLHS 3 ( 2007-08)

- 42 -

RCH II Programme Objectives and Strategies Vision Statement NRHM seeks to provide universal access to equitable, affordable and quality health care which is uncountable at the same time responsive to the needs of the people, reduction of child and maternal deaths as well as population stabilisation, gender and demographic balance in this process. The mission would help achieve goals set under the National Rural Health Policy and the Millennium Development Goals. To achieve these goals NRHM will: * Facilitate increased access and utilization of quality health services by all. * Forge a partnership between the Central, state and the local governments. * Set up a platform for involving the Panchayati Raj institutions and community in the management of primary health programmes and infrastructure. * Provide an opportunity for promoting equity and social justice. * Establish a mechanism to provide flexibility to the District and the community to promote local initiatives. * Develop a framework for promoting inter-sectoral convergence for promotive and preventive health care.

- 43 -

A.1 MATERNAL HEALTH

Maternal Health:

Introduction Maternal health indicator for Fifth Millennium Development Goal (MDG) is reduction of maternal mortality ratio to less than hundred. Safe maternal health through ensuring whole gamet of quality reproductive services from early registration of ANC, Intra-natal care and post natal care. Currently Jehanabad MMR is 335 which is higher than current MMR of State 305. In FY 2012-13 We have targeted, it bring at 200. Objective to Reduce MMR 335 to 200 Strategy that should be Adopted to Achieve Target 1. To increase Antenatal check up. 2. To increase the consumption of 100 IFA tablets. 3. To reduce anaemia among pregnant mothers. 4. To increase institutional delivery. 5. To increase birth assisted by trained health personnel. 6. To increase the coverage of Post Natal Care. 7. To reduce the no. of unsafe abortions Activities—

· Strengthen VHSND Day through supportive supervision. · Monitoring chart should be made to insure monitoring. · Involvement of PRI members or those member of community who have worth in

society. · Improved Access of ANC Care · At HSC level ANC Check up should be insure through fixed day ANC check up day

and that should be monitored through Doctors, Block and District official by visit of HSC.

· Organizing RCH camp in each Block PHC areas. · Refresher training of ANMs on ANC care. · Proper maintenance of ANC Register and Eligible Couple Register. · To insure 24*7 Facility in at least one APHC at each Block. · To make available of equipments like BP Apparatus, Weighing Machines,

Heamoglobinometer etc to sub Centers. · Counselling of Mothers about ANC check up, where to go at the time of Delivery and

about Post Natal Care and appropriate complementary feeding (ACF). · Timely Purchase of IFA tablet and Distribution. · To make sure of Keeping Buffer Stock. · Awarness among villagers use of IFA Tablets Through ANM,ASHA.

- 44 -

· Proper Functioning of Blood Bank, Sadar Hospital and Blood Storage Unit, Refral Hospital Makhdumpur.

· Training of MOs and Staff Nurses of PHCs in BEmOC. · Appointment of SBA trained ANM at PHC and APHC. · To Ensure use of Patograph at delivery Piont.. · Identification of High risk mother through ANMs and keeping special attention toward

High Risk Pregnant Mother for safe institutional Delivery. Provide incentives to ASHA for every institutional delivery achieved in her Village /

Designated area. · Identification of Vechiles for Referral system. · Ensuring proper practice of PNC services and follow-ups at the health facility level.

Utilizing the ASHA network to strengthen the follow up of PNC services through tracking of cases, mobilization to facilities and providing IPC based education/counseling. Strengthen the Coordination and cooperation between AWW.ASHA,ANM and PHED Block/Village Level Functioneris.

· ASHA incentives for completion of PNC follow-ups through NIPI. · Training of MOs and Nurses/LHV in MTP. · Accreditation of Private Nursing Home for safe Delivery. · On each month of last week MDR should be organized. · Quarterly Review Meeting should be held on MDR with MO and CS. · Monthly Meeting should be Organized at PHC level Among MO,BHM, One District

Officer, MOIC on the Topic of how we can insure better Health Facility.

list of APHC Selected for 24*7 Name of Block

Name of APHC

Jehanabad Sikaria Makhdumpur Dharaut Ratni Sakurabad Ghosi bharthu Modanganj Bandhuganj Kako Dedsaiya Hulasganj Murgao

· Budget Break Up VHSND

Review meeting

4 2500 10,000

Capacity building

Programme

93 panchayat

100 9300

871 asha 100 87100 868 aww 100 86800 290 ANM 100 29000

Pol for Block Level Monitoring

904 100* 3 times

271200

- 45 -

Budgetary Proposal: FMR Code

Budget Head Physical Target (where Applicable)

Unit Cost

Financial Requirement (in RS)

Committed Fund Required

A.1.1.1.2 Monitor Progress and Quality of Service Delivery

4 12500 50000

A.1.1.2 Operationalise 24*7 PHCs (MCH Centre- APHC)

7 25000 175000

A.1.1.5 Operationalise Sub Centres (MCH Centre- HSC)

2 50000 100000

A.1.3.1 RCH Outreach Camps/ Others

21 7000 147000

A.1.3.2 Monthly VHSND

904 4,93,400

A.1.4.1 Home Deliveries

300 500 150000

A.1.4.2.a Rural (Institutional Delivery)

23755 2000 4,75,10,000

A.1.4.2.b Urban (Institutional Delivery)

3224 1200 3,86,8800

A.1.4.2.C Institutional Deliveries C-section

260 1500 390,000

A.1.4.3 Administrative Expenses

324892

A.1.5 Maternal Death Review

200 750 150,000

Additional Budget

(A) Monitoring by MO Transportaion Expences to visit HSC on Fixed day in month three times at one HSC.

96 HSC* 3 Doctors*12 month

300 1,036,800

Total 54,395,892

Total 4,93,400

- 46 -

CHILD HEALTH

Introduction:---

The strategic approach for Child Health is reduction of neonatal and infant mortality, life cycle approach, improving service reach and coverage, inclusion of nutrition care in overall health care, skill building, public private partnership, inter-sectoral convergence, commoditization of services and effective IEC, BCC. Currently According to AHS 2010-11 IMR of Bihar is 55 while Jehanabad IMR is 53. In Financial year 2012-13 is has to bring upto 45. Neo Natal Mortality Rate of Bihar is 35 Jehanabad Neo Natal Mortality Rate is 31. In FY 2012-13 Target to Bring upto 20. Most deaths are caused by a few, preventable causes Three major causes contribute to 80% of deaths in the newborn period: Birth Asphyxia (inability to breathe well at birth), infections in the newborn and pre-maturity (being born before time). In addition, hypothermia (getting cold) contributes significantly. Most of these causes can be prevented or managed by a set of interventions delivered at household, community and health facility levels Inappropriate household practices increase the risk of newborn deaths. Besides the medical causes, certain practices at the household level increase the risk of deaths in the newborn period. Some of the key ones that are quiet prevalent in Jehanabad is : a) Delayed initiation of breastfeeding, breastfeeding is still delayed beyond the first hour, and in many cases beyond the first day. This increases the risk of dying by as much as 3 times. b) Delayed clothing and early bathing- babies are often not clothed adequately and bathed early: this increases the risk of baby getting cold (hypothermic) and subsequently dying. c) Not seeking care for newborns, babies are often not taken out of their households for first six weeks. This even applies for sick newborns, delaying seeking of appropriate care. d) Applying material on cord-stump-in many places, families put different material ranging from oil to cow-dung to the cord stump. This increases the risk of infection and sepsis among newborns. Strategy to Achieve the Target :--------

· Early initiation of breastfeeding: Initiation of breastfeeding within one hour of birth has been shown to improve newborn survival.

· Ensuring Warmth: Keeping babies warm at the time of birth improves newborn survival.

· Appropriate care of sick newborns at health facilities: When a newborn falls sick, she often requires specialized care at health facilities.

· Home visits to all newborns through IMNCI and through HBPNC Programme because of NIPI focus District.

· Strengthening PHCs for newborn care. · Special Care Newborn Units (SCNUs). · Reducing the load of Malnutritioned children through one more NRC.

- 47 -

· Micronutrient Management through initiation of ZINC Progamme.

Activities :-------

· To Ensure Early Breastfeeding through Mamta Health Worker. · Publication in News paper for generate awareness on Breastfeeding within one hour

of birth. · Vitamin A round to give micro nutrition. · Coordination with ICDS, PHED, local NGO, and Panchayti raj institution. · Joint meeting of MOIC,CDPO, Managers of Block for better implementation of

Programme. · Growth monitoring of Children and each quarter end Analysis of Data should be done

jointly with ICDS, Health Department. · Training to ASHA and AWW on Child growth measurement. · Insure to proper functioning and use of sick new born care in PHC. · To Start SNCU unit at District level. · To functioning of Newborn Stabilization Unit. · To make sure of Home visit by ASHA and AWW for Post Natal Care. · To conduct immunization session on fixed day for 100% coverage of Children. · Strengthen HMIS System to close monitoring and evaluation system on Child health

issue. · Increase strengthen ORS acceptance to stop Diarrhea. · New Building for NRC one for Sadar Hospital. · Organizing world breast feeding week and National Nutrition week as a part of theam

day at District,Block and HSC level with close coordination with ICDS and other Department.

- 48 -

A.2.7 Management of Childhood Diarrhea Through the Use of Zinc and ORS

District-Jehanabad

1. Introduction

India has a national policy for management of diarrhoea among children that recommends the use of Zinc tablets along with ORS in the treatment of diarrhoea as per the MOHFW, GoI directive dated 2nd Nov. 2006. A high-level meeting held under the chairmanship of Dr. M.K. Bhan, Secretary, Department of Biotechnology recommends for every case of diarrhoea, a dose of 20 mg/day for 14 days for children above age 6 months and 10mg/day for children aged 2-6 months.

The high-level committee recommendations emphasize that:

a) Zinc tablets should be available in all parts of the country including Anganwadicentres.. b) An effective communication strategy be put in place c) Health care providers including Anganwadi Workers and ASHAs are oriented and trained in the use of zinc along with ORS. 2. Situation Analysis:-

Indicator Jehanabad District

Bihar State

Source

Children suffered from Diarrhea in the last two weeks prior to survey (%)

7.0 12.1 DLHS-3

Children with Diarrhea in the last two weeks who were given treatment (%)

74.7 73.7 DLHS-3

Children with Diarrhea in the last two weeks who were received ORS (%)

13.6 22 DLHS-3

Women aware of ORS (%) 32.8 23.8 DLHS -3

IMR 53 55 Annual Health Survey,10-11

Under 5 Child Death 67 77 Annual Health Survey,10-11

3. Progress update and shortcomings during the current year (2011-12):

The HMIS data reveals that 3,323 cases of diarrhea and dehydration reported till the end of November 2011. However there is no data available with regard to the number of cases treated with ORS and Zinc.

- 49 -

The health and ICDS functionaries (MOs, CDPOs, LHVs, ANMs, Anganwadi Workers, ASHAs, BHMs, BCMs, Pharmacists, Staff Nurses) need to be trained on the childhood diarrhea management program using Zinc-ORS. Procurement of Zinc-ORS needs to happen at district-level and there is a need to ensure reporting of utilization of Zinc-ORS.

4. Plan of Action for 2012-2013:-

4.1 Specific Objectives (2012-13):

I) At least 1,19, 666 (50% of the total expected diarrheal cases in a year) childhood diarrheal episodes treated with ORS & Zinc through public health system (Sadar Hospital, PHCs, APHCs,HSCs, ASHAs and Anganwadi Workers)

II) At least 1, 19,666 numbers of Zinc syrup bottles and 2, 39,331 packets of ORS areprocured and distributed to AWWs, ASHAs, HSCs, APHCs, PHCs &Sadar Hospital. Population as per 2011 census

0-5 years Children (12.45% of the total population as per the CBR, Annual Health Survey, 10-11 for Jehanabad)

Expected yearly Childhood diarrheal cases (@1.71 per child/annual as per NCMH, 2005, GoI)

Target for 2012-13 (At least 50% cases will be reported and treated through public health system (At present 29% cases reported in public health system as per DLHS-3,India)

No. of bottles of Zinc Syrup to be procured for 12-13 (@ 1 bottle per episode)

No. of ORS packets to be procured for 12-13 (@ 2 packets per episode)

11,24,176 1,39,960 2,39,331 1,19,666 1,19,666 2,39,331

4.2 Implementation Strategies (2012-13):

· Procurement of Zinc Syrup & ORS packets at the district level. · Distribution of Zinc syrup & ORS packets to AWWs, ASHAs, HSCs, APHCs, PHCs &

District Hospital. · Ensure no stock-out of Zinc & ORS at all levels at all times · Training of all Medical Officers, CDPOs, ANMs, ICDS Supervisors, LHVs,

Pharmacists, Staff Nurses, BHMs, BCMs, AWWs, ASHAs on childhood Diarrhea management program and recording and reporting.

· Training of BCMs on supportive supervision and they will carry out supportive supervision visits to HSCs, AWCs, and ASHAs.

· Training of Data Entry Operators on recording and reporting. · Create awareness in the community about the importance of Zinc & ORS through

various BCC & Social Mobilization activities. · Celebrate important events like ORS-Zinc day/week · Quarterly review at district level under the chairmanship of DM/CS with key Health

and ICDS officials and quarterly review at block level under the chairmanship of MOIC with the presence of Health and ICDS officials.

- 50 -

· Monthly review meeting with BCMs on the supportive supervision visit findings at the district level and monitoring visits by DCM to BCMs during supportive supervision visits.

· Strong coordination with the development partners

4.3 Supports by other Development Partners (2012-13):-

Micronutrient initiative will provide the following support in 2012-13 to the district Jehanabad:

1) Techno-managerial support through the placement of Divisional Coordinator 2) Training of all Medical Officers, ANMs, Staff Nurses, ICDS Supervisors,

CDPOs,BHMs, BCMs, LHVs, Pharmacists, Staff Nurses, ASHAs and Anganwadi Workers on childhood diarrhea management program using Zinc and ORS.

3) Training of BCMs on supportive supervision and mobility support for supportive supervision visits by the BCMs

4) Distribution of Inter personal communication (IPC) tool kit and compliance card for counseling by ANMs, Anganwadi Workers and ASHAs

5) Training of Data Entry Operators on recording and reporting 6) Support in organizing district and block level review meetings. 7) Provide prototype soft copy of poster, wall painting, and display board. 8) Supply of printed recording and reporting formats and supportive supervision

checklists. 4.4 Following activities proposed under NRHM budget (2012-13):

· Procurement of Zinc Syrup (1,19,666) and ORS packets (2,39,331) for 1,19,666 diarrheal episodes

· Print and distribute posters and display boards at Sadar Hospital, PHCs, APHCs, HSCs, AWCs

· Mobility support for hiring vehicle for the distribution of Zinc and ORS from the district to block PHCs

· Undertake wall paintings in villages · Mobility support for DCM to carry out monthly monitoring visits · Monthly Review meeting of BCMs at the district level. · Celebrate ORS –Zinc day and week at the district and block levels

4.5 Estimated budget under NRHM for 2012-13:

Sl.No. Name of Activity Unit Cost (Rs.)

Unit No. Total Cost (Rs.)

1 Procurement

1.1 Zinc Sulphate Suspension (20mg/5 ml-100 ml bottle) 5.58 1,19,666 6,67,736.00

1.2 ORS Packet 2.29 2,39,331 5,48,067.00

Sub Total 12,15,803.00

- 51 -

2 Mobility Support

2.1 Hiring Vehicle for transportation of Zinc syrup and ORS from the district to PHCs 3000 07 21,000.00

2.2

Hiring vehicle for visit by DCM/DDA(ASHA) to blocks and field for monitoring supportive supervision visits undertaken by BCM(@4 visits/month)

1000 48 48,000

Sub Total 69,000.00 3 Review Meeting

3.1 TA to BCMs to attend the monthly review meeting at the district level (@Rs.150/- per BCM per month)

150 84 12,600

3.2

Provision of refreshment (working lunch) for monthly review meeting of BCMs at district level including logistics arrangements like hiring chairs etc.(@ Rs.100/- per BCM)

100 84 8400

Sub Total 21,000

3 BCC and Social Mobilization activities

3.1 Design and print poster on zinc-ors for Sadar Hospital (1), PHC(7), APHC (32), HSCs (92) & AWCs (1024)

25 1156 28,900.00

3.2 Design and Print Display Board for Sadar Hospital (1) and PHCs(7), APHCs (32), HSCs ( 92)

300 132 39,600.00

3.3 Wall Painting (4*4)(@ 2 numbers in HSC catchment villages)(92 HSC*2=184)(@Rs 12 per sqft)

192 184 35,328.00

Sub Total 1,03,828.00

4 Celebration of ORS-Zinc Week/Day at District and Block levels

4.1

Rallies and other mobilization activities at block PHCs (07) and district (1) (Drawing, prize banners, refreshment for rally, poster competition)

10,000 8 8,000.00

Sub Total 8,000.00

Grand Total 14,17,631.00

Vitamin A Round:-------

· Two Times Round in year. One in June month second round in December 2012. · Jehanabad have around 160,000 target Children. · District Level Meeting before round and after round.

Vitamin A Round

Activity unit unit cost total Budget

DCC meeting 2 5000 10,000 Review

Meeting at District level after around

2 5000 10,000

BCC meeting 7*2 1000 14,000 Vtamin A syp 3520*2 40.32 2,83,853 Training for

Vaccinator at Block level

1100*2 25 55,000

- 52 -

Honorium for Additional site

Vaccinator 50*2 150 15,000

Total 3,87,853

Budget break up NRC NRC

running cost

3,61,000*12 month

43,32,000

Training of ANMs and

local Supervisor on NRC of

two focused

Block

70 participants*100

7000

Training of ASHA/AWW

of Two focused

block

300 participants*100

30000

Annual Maintance

Cost 1,03,535 1,03,535

Total 44,72,535



Unit Cost Financial Requirement (in RS)


A.2.1.1 Implementation of IMNCI activities in districts

50000

A.2.2 New Born Stabilization Unit

1 7,75,000 7,75,000

A.2.6 Management of Diarrhoea, ARI and micronutrient malnutrition (NRC)

1 44,72,535 44,72,535

Innovation A.2.6 a Zinc ORS

programme 14,17,631

b. Promotion/ senitization programme on world breast

1* 2 event 7*2 event 96* 2 event

50000 10000 1000

100000 140000 192000

- 53 -

feeding week and National Nutrition week at District Block HSC level

A.2.7 Vitaming A round

2 Round 193926 387852

Total 6760018

‘

- 54 -

FAMILY PLANNING

Introduction:---

As we see the Data of District Health Society reported by PHCs. The total Data of Family Planning till November 2011 is 2076 while according to Population of Jehanabad census 2011 (1124176), We have to Achieve 1 % of total Population that is 11241. Its showing the only achievement of only 18.46% (till NOV.2011), which is poor condition. For better motherhood condition it is essential to be three years Gaps between children. So there is need to give more emphasis on family planning operation and using other method of Spacing. As total fertility rate of Bihar is 3.8 (source SRS 2008).

The Goal of Jehanabad is to Achieve the Target of Family Planning and more use of Spacing method.

Strategy:-------

· To achieve Target of Family Planning Operation at least 60% of Target. · More involvement of Male Participation in Family Planning Operation. · More focus on use of Contraceptive Pills, condoms, and IUD insetion. · Monitor of ensure to provide Quality services. · Focus on IEC display to generate awareness among communities. · Formation of Family Planning Cells at district and Block level comprises a team

member in the chairmanship of DM. Activities:---

· Organize RCH camp at HSC level. · In month at least two Family Planning Camp should be Organized. · Counselling session before Camp in concern area with high involvement of Doctors

and Block Team, after counseling session on the spot registration for Family Planning operation by help of ASHA, AWW,ANM.

· IEC display on family planning in surrounding. · Social Marketing on Contraceptive Pills, Condom through ASHA. · At Urban and Rural areas shop availability for Oral Pills and Condoms distribution. · Flex Banner on small family Benefit in villages. · Training on IUD insertion to ANMs. · Minilap training to MOs. · Incentive distribution to motivator and beneficiary.

INNOVATION-------------------

· Community debate competition one in month in Panchayat wise in presence of PRI member or the person who have worth among villagers.

· Counselling on family Planning Method to SHG and Mahila Mandal with the cooperation of ICDS and Women Development corporation (WDC).

- 55 -

· Micro plan preparation on Debate competition to each Block and involvement of Block and District officials and Doctors with Prize Distribution.

· Family Planning cell Member would be as: District Level— Chairman – District Magistrate. Members- Civil Surgeon, ACMO, DPM,DS, One Hospital Manager, M& E officer,DPO ICDS, Medical officer- 3 ( highly preferable Surgeon.) Block level Team--- Chairman— Pramukh of Block Members--- MOIC, Medical Officer- 3, CDPO, BHM, BCM,JCHM Health Educator, One ANM, one Block Based NGO. Budgetary Proposal: FMR Code




A.3.1.1 Dissemination of Manuals on Sterilization Standers & QA of sterilization services

20000

A.3.1.2 Female Sterilization Camps

216 5000 10,80,000

A.3.1.3 NSV Camps 4 5000 20000

A.3.1.4 Compensation for Female Sterilization

6000 1000 60,00,000

A.3.1.5 Compensation for Male Sterilization

744 1500 1116000

A.3.1.6 Accreditation of Private Providers for sterilization services

1000 1500 1,500,000

A.3.3 POL for Family Planning

119000

A.3.5.4 Provide IUD services at

28 camps for Block.

1500 42000

- 56 -

Health Facility (IUD camps)

1 mega camp for District

2000

2000

Innovation

Prize for Debate competition

93 panchayat

500 46500

Total 9,945,500

ARSH

Adolescent Reproductive And Sexual Health programme is very important aspect of district. If we analyse the data of Adolescent, jehanabad has around 2 lakh school going children. On the basis of census 2011 Total women population of jehanabad is 537974 and Adolesecent Girls Population is around 16.75% of Total Women Population after calculation Around 90111 Adolescent Girls. For School going children there health check up is making them aware about there health condition. School Health programme name is now Nayi Pidi Sawasth Guarnatee Yojana. For Adoloscent Girls Weekly IFA Supplement Programme will Help in Preparing for future mother.





A.4.2 School Health Programme

15,00,000

Weekly IFA Supplementation Programme

90111 52 tabs/year per girls* RS 0.105

4,92,006

Training of ANM,ASHA,AWW

290 ANM

871 ASHA

868 AWW

Total 2029

70 1,42,030

- 57 -

Budget for Social Mobilization and IEC, BCC material

868 AWC

96 HSC

Total 964

50 48,200

A.7.2 PNDT Sex Ratio 1 1,00,000 1,00,000

Total 22,82,236

Infrastructure (Minor Civil Works) Human Resource (Except Ayush)

The Human Resource condition of the District is as:----

Human Resource (contract)

S.NO Name of post Total No

1 Surgeons 0

2 Obstetricians/ Gynecologist 0

3 No of Physicians 0 4 No of Pediatricians 0 5 Anaestheatist 0 6 Eye Surgeon 0 7 Pharmacist 0 8 Lab Technician 17 9 Radiographer 0

10 Female Docotor 0

11 Block Extension Educator 0

12 O.T. Assistant 0 13 Health Educator 0

14 Health Assistant (Male) 0

15 Medical Officer 30

16 Health Assistant (F)/ LHV 0

- 58 -

Human Resource (Regular)

S.NO Name of post Total No

1 Surgeons 2

2 Obstetricians/ Gynecologist 4

3 No of Physicians 2 4 No of Pediatricians 2

17 ANM 139 18 Staff Nurse 39

- 59 -

5 Anaestheatist 1 6 Eye Surgeon 3 7 Pharmacist 5 8 Lab Technician 6 9 Radiographer 1

10 Female Docotor 4

11 Block Extension Educator 0

12 O.T. Assistant 0 13 Health Educator 27

14 Health Assistant (Male) 0

15 Medical Officer 40

16 Health Assistant (F)/ LHV 5

17 ANM 151 18 Staff Nurse 3

To Functioning of APHC into 24*7 the condition of Human Resource and there Requirement.

HR Staus of APHC for one APHC

Post Name

Sanctioned as per Govt

Norms

Total Requirement

Present Vacant Resource

Pull Remarks

Medical Officer

2 4 1 3 Contract

Ayush 1 1 0 Contract Pharmacist 1 1 0 1 Contract

Dresser 1 2 0 2 Contract ANM 2 6 2 4 Contract

A grade 1 1 0 Contract Lab

Technician 1 1 1 0 Contract

Health Educator

1 1 1 0

Ward Attendent

3 5 0 5 Contract

Clerck 1 1 1 1 cleaness

Staff 1 0 1 Contract

BUDGET:

Post Name unit total unit

unit cost

Budget Total

Budget

- 60 -

BUDGET

FMR Code Budget Head

Physical Target (where

Applicable)

Unit Cost

Financial Requirement

(in RS)

Committed Fund

Required

A.8.1.1

ANMs, Staff Nurses,

Supervisory Nurses (salary

Contractual ANM/Contractual

SN)

A Grade 39 22000*12 10296000 858000

ANM 139 12650*12 21100200 1758350

A.8.1.2 Laboratory

Technicains in Blood Banks

3 11000*12 396000

A.8.1.5

Medical Officers at CHCs/ PHC

(Salary of Mo in Blood Banks)

1 35000*12 420000 35000

Medical Officer

3*7 APHC

21 30,000 6,30,000*12

month 75,60,000

Pharmacist 1*7APHC 7 12,000 84000*12

month 10,08,000

Dresser 2* 7

APHC 14 8,000

1,12,000*12 month

13,44,000

ANM 4*7

APHC 28 11,500

3,22,000*12 month

38,64,000

ward Attendent

5* 7 APHC

35 6,000 2,10,000*12

month 25,20,000

cleaness Staff

1* 7 APHC

7 5,000 35,000*12

month 4,20,000

Total 1,67,16,000

- 61 -

A.8.1.7

Others- Computer

Assistants/ BCC Co-ordination etc (FP Counsellors)

1 15000*12 180000

A.8.1.8

Incentive / Awardws etc. to

SN,ANMs etc.(Muskaan Programme- incentive to

ASHA and ANM

871 200*3 time 522600

Innovation

HR Requiremet

for 7 APHC Functioning

1,67,16,000

Total 49,630,800

2651350

Training

If we Analyze the Training Situation of District. We need more SBA trained ANM. To reduction of MMR and IMR relates with Training condition of Health Functioneries. Training Condition of District. Medical officers and Staff Nurses require BEmOC Training. They also Require MTP training. Budgetary Proposal:

- 62 -

FMR Code


Unit Cost



A.9.3.1 Skilled Attendance at Birth

10 batch 88110 881100

A.9.3.7 Other MH training (any Integrated training,etc)

2 115000 230000

A.9.5.1 IMNCI 33 batches 2 TOT, 2 Follow up supervision

134760 159600 54860

4447080 319200 109720

A.9.5.5.3 NSSK Training 4 52900 211600

A.9.6.2 Minilap Training 1 70237 70237

A.9.6.4.1 Training of Medical Officers in IUD insertion

1 55300 55300

A.9.6.4.2 Training of ANMs/LHVs/SN in IUD Insertion

3 29425 88275

A.9.8.2 DPMU Training 1 50000 50000

Mamta Training 59 participants

48,785

Total 65,11,297

Programme /NRHM Management Costs

Programme Management is the one of important aspect of District Health Scoiety. The whole Programme implementation exist on DPMU and BPMU. At District level District Programme Manager, District Account Manager, District Planning Coordinator, M&E Officer, DCM (ASHA),DDA (ASHA), DCHM (NIPI), Epidemiologist, DDA (IDSP),DEO (IDSP),Assistant, Assistant (Account), Data operator is Present. While At Block level/ Sadar Hospital/ Refral Hospital has Hospital Manager, Block Health Manager, Block Account Manager, Block Community Mobilizer( ASHA), JCHM (NIPI)

- 63 -

is present. These personal require training and Skill Upgradation Session. We have experienced Managers.

· Beside these all things District Needed Physical and Financial Audit. · Quarterly Review meeting on How target can be Achieved. · Monthly Review meeting at District and Block Level in the Presence Civil surgeon. · Mobility Support for DPMU for supportive Supervision. · Provision of Ranking and according to Rank Reward provision. · Legal Advisor Provision on Call according to actual expense

Name of Post unit Cost Total

cost per month

Remarks

Assistant/Data Entry

Operator 2 12,000 24,000

Office Assistant

(Accounts) 1 12,000 12,000

Office Assistant

1 12,000 12,000

other expense (legal Advisor

Also) 57,000 57,000

There should be uniformity

in salary of

Assistant Grade and it should be similar to Block Account

Manager.

Total 1,05,000





A.10.1.5 Mobility Support (District

180000

- 64 -

Malaria Office)

A.10.2.1 Contractual Staff for DPMU Recruited and in Position

District Programme Manager

1 42000*12 5,04,000

District Accoutants Manager

1 35937*12 4,31,244

District M&E Officer

1 29947*12 3,59,364

District Planning Coordinator

1 22,000*12 2,64,000

Recurring Expenses

1,05,000*12 12,60,000

A.10.2.2 Provision of Equipment /furniture and mobility support for DPMU Staff

12,20,000

A.10.3 Strengthening of Block BPMU

56,64,120

A.10.4.2 Renewal (upgradation)

1 District

7 PHC

8100

2700

8100

18,900

A10.4.3 AMC (state, Regional &DHS)

1 District

7 Blocks

22,500

10,000

22,500

70,000

A.10.4.9 Management unit at FRU (Hospital Manager & FRU Accountant)

2 495000 990000

A.10.5.1 Annual Audit of the programme (Satutory

4 36000

- 65 -

Audit)

A.10.6 Concurrent Audit (state & District)

1 2,40,000

Total 11,268,228

TOTAL PART ‘A’ BUDGET FMR Code

Budget Head Financial Requirement (in RS)


- 66 -

A.1 Maternal Health

54,395,892

A.2 Child Health 67,60,018

A.3 Family Planning

9,945,500

A.4 ARSH 22,82,236

A.8 Infrastructure (Minor civil Works) & Human Resources (Except Ayush)

49,630,800 26,51,350

A.9 Training 65,11,297

A.10 Programme/ NRHM Management Costs

11,268,228

Total 14,07,93,971

26,51,350

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CHAPTER 4

NRHM PART”B”

About ASHA One of the key components of the National Rural Health Mission is to provide every village in the country with a trained female community health activist?? ASHA? or Accredited Social Health Activist. Selected from the village itself and accountable to it, the ASHA will be trained to work as an interface between the community and the public health system. Following are the key components of ASHA:

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ASHA must primarily be a woman resident of the village? Married/ widowed/ divorced, preferably in the age group of 25 to 45 years.

She should be a literate woman with formal education up to class eight. This may be relaxed only if no suitable person with this qualification is available.

ASHA will be chosen through a rigorous process of selection involving various community groups, self-help groups, Anganwadi Institutions, the Block Nodal officer, District Nodal officer, the village Health Committee and the Gram Sabha.

Capacity building of ASHA is being seen as a continuous process. ASHA will have t undergo series of training episodes to acquire the necessary knowledge, skills and confidence for performing her spelled out roles.

The ASHAs will receive performance-based incentives for promoting universal immunization, referral and escort services for Reproductive & Child Health (RCH) and other healthcare programmes, and construction of household toilets.

Empowered with knowledge and a drug-kit to deliver first-contact healthcare, every ASHA is expected to be a fountainhead of community participation in public health programmes in her village.

ASHA will be the first port of call for any health related demands of deprived sections of the population, especially women and children, who find it difficult to access health services.

ASHA will be a health activist in the community who will create awareness on health and its social determinants and mobilise the community towards local health planning and increased utilisation and accountability of the existing health services. She would be a promoter of good health practices and will also provide a minimum package of curative care as appropriate and feasible for that level and make timely referrals.

ASHA will provide information to the community on determinants of health such as nutrition, basic sanitation & hygienic practices, healthy living and working conditions, information on existing health services and the need for timely utilisation of health & family welfare services.

She will counsel women on birth preparedness, importance of safe delivery, breast-feeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/Sexually Transmitted Infections (RTIs/STIs) and care of the young child.

ASHA will mobilise the community and facilitate them in accessing health and health related services available at the Anganwadi/sub-centre/primary health centers, such as immunisation, Ante Natal Check-up (ANC), Post Natal Check-up supplementary nutrition, sanitation and other services being provided by the government.

She will act as a depot older for essential provisions being made available to all habitations like Oral Rehydration Therapy (ORS), Iron Folic Acid Tablet(IFA), chloroquine, Disposable Delivery Kits (DDK), Oral Pills & Condoms, etc.

At the village level it is recognised that ASHA cannot function without adequate institutional support. Women?s committees (like self-help groups or women?s health committees), village Health & Sanitation Committee of the Gram Panchayat, peripheral health workers especially ANMs and Anganwadi workers, and the trainers of ASHA and in-service periodic training would be a major source of support to ASHA.

- 69 -

ROLES & RESPONSIBILITIES ASHA will be a health activist in the community who will create awareness on health and its social determinants and mobilize the community towards local health planning and increased utilization and accountability of the existing health services. She would be a promoter of good health practices. She will also provide a minimum package of curative care as appropriate and feasible for that level and make timely referrals. Her roles and responsibilities would be as follows: Ø ASHA will take steps to create awareness and provide information to the community on determinants of health such as nutrition, basic sanitation & hygienic practices, healthy living and working conditions, information on existing health services and the need for timely utilization of health & family welfare services. She will counsel women on birth preparedness, importance of safe delivery, breastfeeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/Sexually Transmitted Infection (RTIs/STIs) and care of the young child. Ø ASHA will mobilize the community and facilitate them in accessing health and health related services available at the village/sub-center/primary health centers, such as Immunization, Ante Natal Check-up (ANC), Post Natal Check-up (PNC), ICDS, sanitation and other services being provided by the government. Ø She will work with the Village Health & Sanitation Committee of the Gram Panchayat to develop a comprehensive village health plan.

- 70 -

Ø She will arrange escort/accompany pregnant women & children requiring treatment/admission to the nearest pre- identified health facility i.e. Primary Health Centre/Community Health Centre/ First Referral Unit (PHC/CHC /FRU). Ø ASHA will provide primary medical care for minor ailments such as diarrhoea, fevers, and first aid for minor injuries. She will be a provider of Directly Observed Treatment Short-course (DOTS) under Revised National Tuberculosis Control Programme. Ø She will also act as a depot holder for essential provisions being made available to every habitation like Oral Rehydration Therapy (ORS), Iron Folic Acid Tablet (IFA), chloroquine, Disposable Delivery Kits (DDK), Oral Pills & Condoms, etc. A Drug Kit will be provided to each ASHA. Contents of the kit will be based on the recommendations of the expert/technical advisory group set up by the Government of India. Ø Her role as a provider can be enhanced subsequently. States can explore the possibility of graded training to her for providing newborn care and management of a range of common ailments particularly childhood illnesses. Ø She will inform about the births and deaths in her village and any unusual health problems/disease outbreaks in the community to the Sub-Centres/Primary Health Centre. Ø She will promote construction of household toilets under Total Sanitation Campaign. Ø Fulfillment of all the se roles by ASHA is envisaged through continuous training and upgradation

ASHA STATUS IN JEHANABAD BLOCK NAME TARGET SELECTED

ASHA ESTIMATED

VACANT

Jehanabad 138 136 2

Ghosi 100 90 10

Makhdumpur 182 180 2

Okari 80 75 5

Kako 151 145 6 Ratni-

Faridpur 135 128 7

Hulasganj 85 87 -2

Total 871 841 30

- 71 -

Budgetary Proposal

FMR Code

Budget Head

Physical Target (Where

Applicable)

Unit Cost

Fund Required

Committed Expenditure

B. 1.1.1 Asha Training 871 5100 44,42,100

B.1.1.2 Asha Drug kit

& Replenishment

871 250 2,17,750

B.1.1.3 Asha Divas 871 100 10,45,200

B.1.1.4.A Awards to Asha/ link 7 2000 14,000

2nd prize 7 1000 7,000 Worker 7 500 3,500

certificate Printing 21 250 5250

B.1.1.4.C Asha Identity Card 871 30 26,130

B.1.1.5 Asha Rsource centre DCM salry 1 22,000 2,64,000 DDA salary 1 18,150 2,17,800 BCM salary 7 13,200 11,08,800 Office expenditure T.A 7 1000 84000

mobile Recharge 2 300 7200

Internet Recharge 1 750 9000

BCM meeting Snacks 12 month 300 3600

Total 74,55,330

- 72 -

Untied Funds

Untied funds of Sadar Hospital, Refrral Hospital, Primary Health Centre, APHC, HSC, Village Health Sanitation Committee is used but problem occure in HSC and VHSC untied fund.

Activities proposed:----

· Calling PRI member for meeting on making awareness on Untied fund expenditure. · At block level training of ANM on Cash Book Management. · Monthly meeting between VHSC member on HSC.

Detail of Village Health Sanitation Committee Block Wise Name of Block – Okari

SNO Name of VHSC No of

Revenuue Village

Name of Mukhiya (President)

Mobile No Name of ANM

(Secretary) Mobile no

1 Okari 8 Shyamnandan Sharma 9431617368 Sarsawati Kumari 7654398629 2 Jaitipur Kurua 6 Naresh Bind 9801746472 Manju Devi 9576270601

3 Saristabad 6 Tulshi Kumar Albela 8809036672 Kumari Premlata

sinha 9955279500

4 Niama 8 Raj kishor Prasad 7739113917 Chinta Kumari 9955004106 5 Bandanduganj 7 Pritima Devi 9801510979 Kamla Kumari 8873074048

6 Gandhar 8 Shailesh Kumar

Ambedkar 9973163880 Kumari Manju Sinha 9430606079

7 Dewra 5 Kamlesh Devi 9973715992 Saroj Kumari 9525352384 8 Modanganj 6 Neha Sharma 9934235933 Durgawati Devi 9006238971 54

- 73 -

NAME OF BLOCK-- Jehanabad


Revenuue Village




1 Sewnan 6 Manju Kumari Sinha 8797299575 SANTOSH KUMARI 9507208874

2 Pandui 5 Pratima Devi 9955627630 GITA PRASAD SINGH 8434601606

3 Kalpa 4 Binay Kumar 9572228555 ANJU KUMARI 9279770173

4 Jamuk 7 Madan Kumar 9631624500 LILA SINHA 9430009521

5 Sikariya 9 Prabha Devi 8809252202 MANORMA KUAMRI 8434364157

6 Muther 6 Sanjay Singh 9263453500 SUSHILA KUMARI 9576149502

7 Nauroo 5 Sumantri Devi 9431830163 SNJOG KUMARI 9973592479

8 Gonwan 8 Belmanti Devi 9546516788 SUSHILA KUMARI 9386278983

9 Larsa 8 Dhannajay Kumar 9906376865 SRI KUMARI 9931935011

10 Amain 11 Sumitra Devi 9661241280 USHA KUMARI 9431618167

11 Mandil 6 Savitri Devi 9771879313 SHAIL KUMARI 9801398127

12 Bhawanichak 8 Rama Yadav 9955500784 SILA KUMARI 9931182972

13 Mandebigha 9 Tej Pratap Singh 9934634797 KRI. KIRAN SINGH 9931226417

14 Kinari 7 Arun Singh 8809256824 SUNAINA KUMARI 9934835807

Total 99

NAME OF BLOCK-- Makhdumpur


Revenuue Village




1 Bela Bira 6 Abhiram Paswan 9771854848 Bimala Sinha 9708984870 2 Solhanda 6 Saroj Devi 9771994104 Dayamanti Kumari 3 Rampur 4 Awadesh Sharma 9470851905 Meena Devi 9430841306 4 Bhaikh 3 Siyaram Prasad 9934621731 Shashikala Kumari 5 Darnai 5 Ajay Yadav 9934414377 Indu Kumari 8083385654 6 Kachnama 7 Ashok Kumar 9263675431 Anita Kumari 7677274664 7 Chariyari 6 Omprakash Singh 9431830378 Kalayani Kumari 9934485447 8 Pundha 11 Nirmala Devi 9801707913 Sarshawati Devi 9905487227

9 Kumardih 6 Asha Devi 9931878131 Binita Kumari

10 Manjhosh 5 Sunita Devi 9934103908 Pramila Devi 11 Kohara 4 Usha Devi 9934811871 Manju Devi 12 Paschim Saren 1 Sunita Devi 7739664914 Rina Kumari 13 Purvi Saren 6 Nirmala Devi 8298704877 Sita Devi 9708829804 14 Sugao 2 Lakhichand Yadav 9939988804 Madhuri Pandey 15 Kalanaur 6 Dukhanram 7250085634 Shakuntala Devi 9835343753 16 Makarpur 6 Abhiyanta Kumari 9162854521 Rina Kumari 8002670214 17 Dakara 7 Sushma Kumari 9006836931 Chinta Devi 9234665515 18 Dharaut 3 Mahendra Manjhi 9525887515 Shashikala Kumari 19 Malathi 8 Ramanand Manjhi 9576009517 Shakuntala Devi 9835343753 20 Sumera 4 Dayanand Prasad 9934907245 Lalti Kumari 9525426458 21 Jagpura 8 Israt Khan 9308002599 Sanju Kumari 9135092477 22 Jamanganj 4 Shivpujan Yadav 8521868191 Rita Kumari 9097932421

118

- 74 -

NAME OF BLOCK-- Ratni

Faridpur


Revenuue Village




1 Kaswa 3 Krishna Murari Sharma 9973938651 Renu Kumari 9931520392 2 Nehalpur 6 Lalit Narayan Sinha 7739666712 Rita Kumari 9199760679 3 Jhunati 7 Kamta Prasad 8084337644 Jayanti Kumari 9006234050 4 Lakhapur 5 Sanjeet Kumar 9708739484 Gita Kumari 9931913717 5 Sohraiya 8 Sumanti Devi 9955983589 Nirmala Kumari 8002009492 6 Noawa 2 Rajanti Devi 9431716702 Chandamani Kumari 8294756172 7 Kansua 7 Najma Khatun 99394452687 Renu Kumari 9905661070 8 Uchita 5 Saida Ahmad 9006239064 Kumkum Kumari 9 Ratni 9 Shanti Devi 9097792376 Renu Kumari 9931520392

10 Narayanpur 9 Lalita Devi 8651459696 Rajpati Devi 9334128104

11 Sikandarpur 4 Shyam Narayan

Chaudhari 8989259347 Kiran Kumari 7808789396

12 Seshambha 4 Sunita Sinha 9576431221 Kalavati Kumari 9931816717 13 Murahara 7 Shikanti Devi 7739493097 Meena Kumari 9905061223 14 Pandaul 9 Lakhandev Singh 9931616352 Kiran Kumari 7808789396

85

NAME OF BLOCK-- Ghosi


Revenuue Village




1 Ahiyasa 4 Anil Kumar Indu Kumari 2 Golakpur 3 Munarik Manjhi Shashikala Kumari 3 Sahobigha 6 Sanjeet Kumar Indu Kumari 4 Shahpur 9 Sunaina Devi Kausalya Kumari 5 Kure 5 Asha Devi Madhuri Kumari 6 Parawan 5 Malti Devi Premlata kumara 7 Uber 6 Sachidanand Singh Manju Kumari 8 Lakhawar 1 Jasiya Devi Chandrakanti Kumari 9 Bharthu 8 Neera Devi Reeta Kumari

10 Ghosi 6 Ajay Kumar Saroj Kumari 53

- 75 -

Name of Block- Kako


Revenuue Village




1 Paschimi Kako 1 Renu Kumari Manju Kumari Sinha 2 Maniyawa 6 Aditya Kumar Vaijanti Kumari 3 Purvi Kako 1 Survila Kumari Pratima Kumari 4 Nonhi 5 Sikandra Prasad Kiran kumara 5 Khalispur 4 MD. Idris Radha Kumari 6 Sulemanpur 11 Yogendra Paswan Sadhana Kumari 7 Bhadauna 10 Anita Devi Dharmashila Kumari 8 Barawa 8 Usha Devi Rashmi Ranjan 9 Uttarserthu 5 Ranjay Kumar Singh Manisha Kumari

10 Saidabad 4 Rekha Devi Meena Kumari 11 Damuha 7 Shashi Bhushan Prasad Renu Kumari 12 Nerthua 5 Tilak Chauhan Renu Bharti 13 Pinjoura 8 Surjmani Devi Usha Kumari 14 Dedsaiya 7 Rakesh Kumar Meera Kumari Bharti 15 Bara 5 Ganga Sagar Urmila Devi 16 Amthua 8 Pramila Devi Pravila Kumari

95

NAME OF BLOCK-- Hulasganj


Revenuue Village




1 Murgao 4 Sumintra Devi 8809221323 Rita Sinha 9955052328 2 Kokarasa 5 Vijay Bind 9162144700 Kanti Devi 9608285046 3 Keur 5 Kamlesh Prasad 9572010409 Manju Kumari 9608771040 4 Tira 6 Puja Devi 9006934792 Reeta Devi 9955052230 5 Dawathu 5 Umashankar Sharma 9934240667 Unil Kumari 9955131972 6 Bauri 6 Ravikant Sharma 88098544875 Savitri Devi 9631288474 7 Surajpur 4 Kapil Paswan 9507099210 Sunita Sinha 8873710467 8 Chiri 7 Madhuri Devi 9006029448 Malti Devi 9570696125 9 Khudauri 6 Bhibha Devi 9931215804 Malti Kumari 9934513156 48

- 76 -





B.2.1 Untied Fund for SDH/CHC

2 50000 1000000

B.2.2.a Untied Fund for PHCs

9 25000 225000

B.2.2 b Untied fund for APHCs

32 25000 800000

B.2.3 Untied fund for sub centre

96 10000 960000

B.2.4 Untied fund for VHSC

552 10000 5520000

Total 8505000

- 77 -

Annual Maintenance Grants





B.3.1 CHC (Referral Hospital)

2 3,00,000 6,00,000

B.3.2 Annual Maintenance Grant for PHCs

7 2,00,000 14,00,000

B.3.2.a Annual Maintenance Grant for APHCs

32 1,00,000 32,00,000

B.3.3 Annual Maintenance Grant for Sub Centre

96 25,000 24,00,000

Annual Maintance Grants For DH

1 5,00,000 5,00,000

Total 81,00,000

- 78 -

Hospital Strengthening

In financial year 2012-13 proposal of construction of HSC, APHC, NRC building Sadar Hospital Up gradation as are:

NAME OF BLOCK JEHANABAD

NAME OF SCHEME PARTICULARS NO OF UNITS

UNIT COST

TOTAL Assumed FUND Reqrired (lakh)

Cosntruction of PHC one more building

required on the above of build building

1 20

Renovation of PHC Renovation of Shabha

Ghar 1 9

Cosntruction of HSC 0 0 Renovation of HsC 0 0

Construction of APHC Kalpa ( Land Available) 1 75.99 75.99

Chainpura (Land

Available) 1 75.99 75.99

Mandil (Land Available) 1 75.99 75.99 Bistaul 1 75.99 75.99 land Reqrired 1acre 20 20

Renovation of APHC 0 0 Total 352.96

Construction of the

Building of Sadar Hospital Central Registration Hall 1 5

NRC Building 1 30

MO Quarter Multistorage

18 100

Staff Quarter Multi

Storage 30 200

DS Quarter 1 50 CS Quarter 1 60 New Building For Indoor 1 100

Renovation of the Building of Sadar Hospital

Renovation of Main Building

1 50

Total 595

- 79 -

Name of Block Kako


UNIT COST

TOTAL FUND REQURED (lakh)

Cosntruction of PHC Asha Rest Room 1 5 Male ward Room 1 10 Office 1 5

Quarter mo Multi

Storage 4 5 20

Quarter Staff Multi

Storage 6 5 30

Renovation of PHC 0 0 Cosntruction of HSC Barawa 1 9.5 9.5

Pinjaura 1 9.5 9.5 Asiyawa 1 9.5 9.5 Purvi Kako 1 9.5 9.5 Pashchami Kako 1 9.5 9.5 Bibipur 1 9.5 9.5 Land for ALL 6 6 3 18

Renovation of HSC Uttar Serthu Major

repairing 3

Safepur ( Baundary

wall) 2

Ainwa (Major Repairing) 3

Hatee ( Major

Repairing) 3

Emaliya (Baundary) 2 Bembhai (Baundary) 2 Nonhi (Baundary wall) 2

Choti Murari (Baundary

Wall) 2

Construction of APHC Ali Nagar Pali 1 75.99 75.99

Renovation of APHC Bhelawar (Major

Repairing) 1 6 6

Kajisariya (major

Repairing) 1 6 6

Dedsaiya ( Major

Repairing) 1 6 6

Total 257.99

- 80 -

Name of Block Ghosi


UNIT COST


Cosntruction of PHC Women ward 1 10 baundary Wall 1 15 Indoor Building 1 15

Quarter mo ( Multi

Storage) 2 10

Quarter Staff ( Multi

Storage) 8 18

Rogi Sade 1 5 meeting Hall 1 5

Renovation of PHC 0 0 0 0 Cosntruction of HSC Dhuriyari 1 9.5 9.5

Lakhawar 1 9.5 9.5 Ahiyasa 1 9.5 9.5 Saho Bigha 1 9.5 9.5 Uber 1 9.5 9.5 Land for All 5 Hsc 5 2 10

Renovation of HSC 0 0 Construction of APHC Nandana 1 75.99 75.99

Kora 1 75.99 75.99 Sonwa 1 75.99 75.99 Lakhawar 1 75.99 75.99 Land For all 4 APHC 4 5 20

Construction of Incomple referral Hospital

0 0

Total 459.46

Name of Block Hulasganj


UNIT COST


Cosntruction of PHC 0 0 Renovation of PHC 0 0

Cosntruction of HSC Khudauri (land Available but controversial)

1 9.5 9.5

Adrakhi bigha 1 9.5 9.5 land for one Hsc 1 2 2

Renovation of HSC Murgao 1 3 Construction of APHC Murgao (land Available) 1 75.99 75.99

Keur 1 75.99 75.99 Land for 1 APHC 1 5 5 Total 180.98

- 81 -

Name of Block Okari


UNIT COST


Cosntruction of PHC MO Quarter Multistorage

7 30

Quarter Staff (Multi

Storage) 10 50

Renovation of PHC Repairing of Old

Building 1 8

Cosntruction of HSC Naima 1 9.5 9.5 Modanganj 1 9.5 9.5 Land for 2 Hsc 2 2 4

Renovation of HSC Dewara Minor 1 1 Aarhit Major 1 3 Saistabad Minor 1 1 Muriya Bigha Major 1 3 Baina Minor 1 1 Sakrautha minor 1

Construction of APHC Bandhuganj Land

Available 1 75.99 75.99

Jalalpur Land Available 1 75.99 75.99 Total 272.98

Name of Block Ratni Faridpur


UNIT COST


Cosntruction of PHC Quarter MO (Multi

Storage) 2 15

Quarter Staff ( Multi

Storage) 6 30

Sakurabad Meeting Hall 1 5 Renovation of PHC Old building Sakurabad 1 6

Cosntruction of HSC Dhanadihri 1 9.5 9.5 sarta 1 9.5 9.5 Pokhawa 1 9.5 9.5 Ratni-bazar 1 9.5 9.5 Kundila 1 9.5 9.5 Sohriya 1 9.5 9.5 Murhara land Available 1 9.5 9.5 land for all 6 6 2 12

Construction of APHC Nehalpur 1 75.99 75.99 Lakhapur 1 75.99 75.99 Uttarapati 1 75.99 75.99 Pandual 1 75.99 75.99 Kaswa 1 75.99 75.99

- 82 -

Noawa 1 75.99 75.99 land for all 6 6 5 30 Total 620.44

Name of Block Makhdumpur


UNIT COST


Cosntruction of PHC 0 0

Renovation of PHC Renovation of PHC

Building 1 5

Cosntruction of HSC Newari 1 9.5 9.5 suppi 1 9.5 9.5 shekhpura 1 9.5 9.5 tilkai 1 9.5 9.5 Makarpur 1 9.5 9.5 Sugao 1 9.5 9.5 Nawabganj 1 9.5 9.5 Mahamatpur 2 1 9.5 9.5 Machil 1 9.5 9.5 Land for all 9 9 2 18

Renovation of HSC Ikil (Baundary Wall) 1 3 Sumera (Major) 1 3 Dhoda (minor) 1 1 Umta (Minor) 1 1 Vishunganj (Minor) 1 1

Construction of APHC Sagarpur land avialble 1 75.99 75.99 Chatiyana land available 1 75.99 75.99 Tehta 1 75.99 75.99 Saren 1 75.99 75.99 land for 2 aphc 2 5 10 Total 431.46

Grand Total 6322.54

Quarters for Medical officers and Staffs.

- 83 -





B.4.3 Sub Centre Rent and Contingencies

36 500 2,16,000

B.5.2 b

Construction of Residential quarters for Doctors and Staff nurses

15 45,000,00

B.5.2 c Strengthening of Cold Chain

800000

Construction, Renovation of PHC,APHC,HSC,SD (fund Demanded through District PIP- through DM Office)

6322.54 (Lakh) proposed Budget

Bihar Govt.

B.5.2.a

Construction of APHC

2 75.99lakh

88,20,000

Construction of HSC

6 9.50 lakh 22,80,000

Total 5,516,000

1,11,00,000

- 84 -

CORPUS GRANTS TO RKS

Rogi Kalyan Samiti is operational in District Hospital, All Referral Hospital, All PHCs. In APHC RKS Registration done account opening is in process. In FY 2012-13 Special attention toward Strengthening of APHC RKS Functioning, so that we could make possible to provide 24*7 Services at APHCs.

Activities:---

· Timely Meeting of RKS.

· Change of Membership after completion of time period of 3 year.

· Insure presence of Member in RKS meeting.

· RKS members Joint Meeting with District Official in the Chairmanship of District Magistrate.





B.6.1 District Hospitals

1 500000 500000

B.6.2 CHCs (RH) 2 100000 200000

B.6.3 PHCs 7 100000 700000

B.6.4 Others (APHCs) 32 100000 3200000

Total 4,600,000

- 85 -

District Action Plans (including Block, Village)

To Keeping the view of Decentralization Plan preparation of District is directed throw bottom down to top up. Now plan is prepared first on village then at HSC, that is compiled in Block Plan finally District Plan Prepared and send to state for further process. Now District has Strategic Planning Expert District Planning Coordinator. District need strengthen Planning Process. FY 2012 -13 has target of 25 villages Plan, 92 HSC plan, 7 Block Health action Plan.

Activities:--

· Capacity Building workshop to all ASHA, AWW, ANM, Block and District officer on Planning with the Help of State, so that it could be strengthen.

· One full time vehicle hiring for DPC for supportive supervision.

· One Data operator to strengthen Planning Cell.

· Orientation to all PRI members for important role in Planning Process at HSC and at Village level Planning.





B.7 District Action Plans (including Block, Village)

96 HSC

25 village

7 PHC

1 DHAP

1 Data Operator

1500

1000

5000

50,000

6000

1,44,000

25000

35000

50,000

72,000

Total 3,26,000

- 86 -

Panchayati Raj Initiative

Panchayati Raj Initiative is one the important aspect of Strengthening of NRHM Goal. We could access Complete Health Package for Villagers. A common efforts of All department including Panchayati Raj reduce MMR,IMR others Health target. Prosperity of Villagers would be Better after involvement of PRI Members.



Unit Cost



B8.1 Constitution and orientation of Community leader & of VHSC, CHC,PHC,SHC etc.

93 1500 139500

B.8.2 Orientation workshops, trainings and capacity Building of PRI at State/ District Health Societies,CHC,PHC

102 606 61812

Total 201,312

Mainstreaming of AYUSH

Jehanabad has 27 AYUSH Doctors. They all are Posted at APHC. There is Challangeous Task of Mainstreaming of AUSH Doctors.

Activities:---

· Orientation of AYUSH Doctors.

· Fixed Day Counselling session at APHC to Villagers twice in Week for use of Home made Treatment/ Natural Therapy.

· At school level visit Of AYUSH Doctors to Teach Children on use of local/ Natural Resources for better Health condition.

· Regular Drug Supply for AYUSH.

- 87 -





B.9.1 a AYUSH Specialists

27 20,000 64,80,000

Total 64,80,000

IEC-BCC NRHM

IEC-BCC Activities has deep impression on Community and Villagers. The condition of IEC Activity in District is not good as it should be. So In FY there is Need on Focus on IEC activities as:--

Activities:--

· Miking at Block and Village level.

· Wall writing and Flex ,VHDND,FP, other Health Programme.

· One Big Hording at Block PHC,and at all APHC.

· Quarterly BCC Campaign with Help of other Partner Agencies.

· Organizing Health Mela.

· Publication in Newspaper during Breast feeding week about benefit of Breastfeeding to children.





B10.1 Development and operationalize of State BCC/IEC Strategy

1400000

B 10.3 Health Mela 2 5000 10000

- 88 -

(Leprosy)

Total 1410000

Mobile Medical Units (including Recurring expenditure)

MMU fit for Jehanabad Naxal Affected area. The Out reach area where People have Problem to Communicate nearest Health Facilities. There MMU is helpful. The Monitoring Aspect of MMU is week. There is Need of special Focus on Monitoring Aspect so we could reach Quality service of MMU to Villagers.

Activities:--

· Microplan Preparation of MMU Visit.

· Monitoring chart preparation at Block and District level.

· Identification of One Nodal Officer at District and at Block Level.

· Assurance of Quality Service Delivery through MMU.





B.11 MMU 1 4212000

Micro plan Preparation at District and at Block Level with Monitoring Chart

7 1500 10,500

Total 42,22,500

- 89 -

Referral Transport

Ambulance status of Jehanabad

Sno Name of Facility Ambulance

1 Sadar Hospital,Jehanabad

Tata Winger- 2, Red Cross - 1, 108

ambulance

2 PHC, Jehanabad Red Cross- 1

3 PHC, Ratni Faridpur Maruti Eco-1

4 Referral Hospital, Makhdumpur Maruti Eco-1

5 PHC, Hulasganj Red Cross- 1

6 PHC, Okari Maruti Eco-1

7 PHC, Ghosi Maruti Eco-1 8 PHC, kako Red Cross- 1

9 Referral Hospital, Ghosi Nil

· To convert 24*7, Seven APHC require one Ambulance at each centre.





B.12.2.d 102 Ambulance Service

7 (APHC) 15000*12 1,260,000

B.12.2.c 108 ambulance

1 1,716,000

B.12.2.c BLS Ambulance

8 1,16,700*12 11,203,200

Total 1,41,79,200

- 90 -

PPP/NGOs

The above Data reveals that in PHC Ghosi, Ratni faridpur have not Radiology facility.

And in 7 APHC In FY 2012-13 have to start Pathology Service.

7 silent Gensate for APHC & Dietry Provision at APHC.





B.13.3.b Outsourcing of Pathology and Radiology Services from PHCs to DH

14 4,500,000

B.13.3.d IMEP (Bio Waste Management)

13 1,104,000

District Health Society,Jehanbad Pathology and Radiology Status

Pathology unit/ Collection

Centre Radiology Unit

Sl.No Facility Name

Govt. Private Govt. X-ray

Private X-ray

Private Ultra

sound

Remarks

1 Sadar

Hospital Yes Yes Yes Yes Yes

2 Kako No Yes No Yes No 3 Ghosi Yes Yes No No No 4 Ghosi Refral Yes NO Yes No No

5 Makhdumpur Yes Yes No Yes No

6 Ratni

Faridpur No Yes No No No

7 Hulasganj No Yes No Yes No

8 Okari/

Modanganj No Yes No Yes No

9 Sadar Block Jehanabad

No Yes No No No

- 91 -

Pathological Services for APHC

7 300,000

Outsourcing of Silent Gensate of 5 KV

7 RS 150 *24 hrs *30 days*12 month

9,072,000

Outsourcing of dietry Provision at APHC

7 RS 50*5 patient* 30 days *12 month

6,30,000

Total 1,56,06,000

INNOVATIONS Budgetary Proposal: FMR Code




B.14.b Yukti Yojana Accreditation of Public and Private Sector For Providing Safe Abortion Services

304 103166

Total 103166

- 92 -

Monitoring and Evaluation Programme implementation then Monitoring and Evaluation of the Programme is one of important aspect of the District. Expected Outcome will come after Supportive Supervision and taking remedial Action.





B.15.3.1.a State, District , Divisional, Block Data Centre

9 10,000*12 1,080,000

B.15.3.2.a MCTS and HRIS

6 186433

B.15.3.2.b RI Monitoring 7 130000

B.15.3.3.b Plan for HMIS supportive Supervision and Data Validation

182000

Total 15,78,433

Procurement





B.16.1.1 Procurement of Equipment : (MH Labour Room)

11 167,464 1842104

- 93 -

B.16.1.2 Procurement of equipment : CH (SCNU &NBCC ,icu

For ICu Equipment

49,00,000

B.16.1.3.a Procurement of Minilap Set :FP

35 3000 105000

B.16.1.3.b Procurement of NSV Kit (FP)

5 1100 5500

B.16.1.3.c Procurement of IUD Kit (FP)

1 15,000 15,000

B.16.2.1.A Parental Iron sucrose (IV/IM) as therapeutic measure to pregnant women with severe Anemia

1 7,00,000 7,000,00

B.16.2.1.B IFA Tablets for Pregnant & Lactating Mothers

800000

B.16.2.2.a IFA small Tablets and syrup for children 6-59 months

1,000,000

B.16.2.2.b IMNCI Drug kit 2400 250 6,00,000

B.16.2.5 General Drugs & Supplies for Health Facilities

12400000

Total 22,367,604

- 94 -

Support Services





B.22.4 Support Strengthening RNTCP

79,200

B.23.A Payment of Monthly Bill to be BSNL

29,964

Total 1,09,164

- 95 -

TOTAL PART ‘B’ BUDGET

FMR Code Budget Head Financial Requirement (in RS)


B.1 ASHA 74,55,330

B.2 Untied Fund 85,05,000

B.3 Annual Maintenance Grants 81,00,000

B.4 & 5 Hospital Strengthening

New Constructions/ Renovation and Setting UP

5,516,000 11,100,000

B.6 Corpus Grants to HMS/RKS 4,600,000

B.7 District Action Plans (including Block, Village)

3,26,000

B.8 Panchayati Raj Initiative 201,312

B.9 Mainstreaming of AYUSH 64,80,000

B.10 IEC/BCC 14,10,000

B.11 MMU 42,22,500

B.12 Referral Transport 14,179,200

B.13 PPP/NGOs 15,606,000

B.14 Innovations 1,03,166

B.15.3 Monitoring and Evaluation 15,78,433

B.16 Procurement 22,367,604

B.22 Support Services 1,09,164

Total 10,07,59,709

11,100,000

- 96 -

CHAPTER 5

NRHM PART “C”

- 97 -

Routine Immunization & PP

Objective:- To Achieve 100% Coverage.

Gaps: --

· Lack of Drug of Trivalent for OPV.

· Require New Cold Chain Room At District level for better Management of Logistic.

· Specail Genset Require 10 kv for Cold Chain.

· Require Automatic ILR- 1 * 7 PHC = 7

4 ILR for District

Activities:--

· Refreshment Training to all MOIC, BHM, MO on RI.

· RI Micro plan Preparation.

· Regular incentive Payment to all ASHA, ANM.

· Additional session plan and manpower for 100% coverage.

· Supportive supervision and RI Monitoring.

· Additional Manpower required for Additional Session Plan.

· Specail attention toward low coverge Blocks.

·

- 98 -





C. RI 3,364,153

Pulse Polio

9,45,914

Total 3,364,153 9,45,914

- 99 -

CHAPTER 6

NRHM PART “D - I”

- 100 -

Integrated Disease Surveillance Project (IDSP)

(Use of revised guidelines subject to approval of restructuring and extension of IDSP project)

DSU IDSP JEHANABAD

- 101 -

INTEGRATED DISEASE SURVEILLANCE PROJECT (IDSP)

BACKGROUND:

The Government of India has initiated a decentralized, state based Integrated Disease

Surveillance Project (IDSP) in the country in response to a long felt need expressed by

various expert committees. The project would be able to detect early warning signals

of impending outbreaks and help us to initiate effective response in a timely manner. It

is also expected to provide essential data to monitor progress of ongoing disease

control programs and help to allocate health resources more optimally.

The project is assisting the State to:

¨ Surveillance of limited number of health conditions / diseases and risk factors;

¨ strengthen data quality, analysis and links to action;

¨ Improve laboratory support;

¨ Train stakeholders in disease surveillance and action;

¨ Coordinate and decentralize surveillance activities;

¨ Integrate disease surveillance at the state and district levels, and involve communities

and other stakeholders, particularly the private sector.

- 102 -

Original Project Development objectives (PDOs) and scope

The original project development objective was to improve the information available to the government health services and private health care providers on a set of high priority diseases and risk factors, with a view to improving the on the ground responses to such diseases and risk factors.

The five year project (launched in 2004) was to support the longer-run program to consolidate and integrate disease surveillance in the country. The new integrated disease surveillance system was to put greater emphasis on building the links between the collection and analysis of information and the actual on the ground interventions (medical or otherwise) by the public and private sectors. The long run goal was to effect a complete shift from the present centrally driven, fragmented disease surveillance system, to an integrated disease surveillance and control program coordinated by the center but fully implemented by the States, districts and communities.

The project was to assist the Government of India and the States and Union Territories to:

· Surveil a limited number of health conditions and risk factors; · Strengthen data quality, analysis and links to action; · Improve laboratory support; · Train stakeholders in disease surveillance and action; · Coordinate and decentralized surveillance activities; · Integrate disease surveillance at the State and district levels, and involve

communities and other stakeholders, particularly the private sector.

3. Proposed changes in the restructured project

3.1 Modified Project Development Objectives (PDO) for 2010-2012:

To support the first phase of India's long run vision to improve and integrate disease surveillance compliant with the IHR 2005 requirement by:

I. Supporting a nation-wide effort for surveillance preparedness for immediate reporting of outbreaks, regular surveillance and weekly reporting with emphasis on provisional diagnosis by medically trained staff from public and private sectors to generate early warning signals for appropriate and timely public health actions.

II. Demonstrating establishment and operation of decentralized surveillance

systems meeting performance standards (timeliness, improved quality of outbreak investigation including mobilizing the human and other appropriate samples for confirming the diagnosis by laboratory network, Strengthening analysis and use of surveillance data and response) in at least 9 Indian States, viz. Tamil-Nadu,Karnataka, Gujarat, Punjab, West Bengal, Andhra Pradesh, Rajasthan, Maharashtra and Uttarakhand.

- 103 -

The outcome indicators pertaining to above project development objectives are summarized in table below:

Components Indicators for each component

Surveillance preparedness:

· 80% of districts having full-time epidemiologists in 9 identified States and 60% in other States.

· 80% of districts with fully functional IT systems with on-line data entry and analysis in 9 identified States and 60% in other States.

· 80% of districts having systems in place for SOS reporting (Toll Free Number, Media Scanning etc) in 9 identified States and 60% in other States.

· 50% of referral laboratories & priority laboratories undertaking routine laboratory surveillance in 9 identified States and 25% in other States.

· 50% of referral laboratories meeting the EQAS standards in 9 identified States and 25% in other States.

Outbreak investigation and Response

· 50% Outbreaks detected by system within one week of first case diagnosis in 9 identified States and 25% in other States.

· 80% Outbreaks/rumors reported by other systems/media verified within 48 hours (documented in electronic register) in 9 identified States and 60% in other States.

· 50% of outbreaks for which adequate specimens reached the laboratory in 9 identified States and 25% in other States.

· 25 % of reported outbreaks for which full documentation (first and final investigation reports) is available with CSU, IDSP.

Analysis and use of data

· 80% districts undertaking weekly surveillance analysis of data including graphs for trends over time and maps for incidence by area in 9 identified States and 60% in other States.

· 80% districts providing monthly feedback (one page bulletin/news letter) to sub units, policy makers and general public in 9 identified States and 60% in other States.

4. Detailed Project Description

Component 1: Strengthening nation-wide improvements in Surveillance Preparedness to ensure compliance with IHR-2005:

· Enhancing the quality and frequency of use of communication networks; regular

video conferencing is being now held with States to discuss outbreaks and control measures, but improvement in quality (several observed sessions had impaired audio quality), appropriate content (personnel, subject documentation), and frequency of utilization of this tool is needed.

· For the 9 enhanced focus States, CSU would be monitoring outbreak

investigation frequency, availability and utilization of laboratory confirmation.

- 104 -

· Further training for district epidemiologists and data managers on use of the

portal (and confirming and enhancing portal functioning) will provide needed analytic capacity at the district level.

· With the approval of modified P and L forms for IDSP, there would be definite

improvement in quality and timeliness of reporting. New P and L forms were uploaded in portal. The rollout of the new forms to the States and districts were done.

Component 2: Demonstrating timeliness and improved quality of outbreak

investigation and response in all States: · The CSU would expand the variables collected systematically in the Outbreak

Reporting System. CSU would also continuously monitor the data collected by this system, and work with States and districts if the CSU identify evident problems with timeliness of reporting, laboratory confirmation, and appropriate interventions will be ensured.

· The 1075 call centre will be publicized to health professionals, and would

particularly serve as an important supplement source of information and outbreaks in areas where surveillance infrastructure is yet to develop.

· Similarly, the media scanning service would be useful for all these States, but

may be particularly important as a supplement in areas where surveillance infra-structure is still under-development.

· The CSU would establish real time collaboration modalities between the newly

recruited epidemiologists and National/ State Microbiologists/ State laboratory coordinators.

· Outbreaks reported and responded by IDSP system would be subjected to competency assessment tool developed for this purpose.

· Medical colleges would be involved in disease surveillance and reponse Component 3: Strengthening analysis and use of surveillance data in 9

States that achieved surveillance preparedness demonstrating quality data analysis and assessing analytic quality of outbreak investigations:

· Epidemiologists in CSU would formally review a sample of outbreaks reported

using the suitably adapted assessment tool created for the outbreak investigation module.

· CSU epidemiologists would undertake analyses of IDSP data to better

understand data contained in the system. · Effective communication of key findings and issues to IDSP sub-units, State and

national policy leaders, and as appropriate, to the public. To facilitate this, the NCDC requires support from experts in disciplines like communications, economics and public policy.

· Interesting and well conducted outbreak investigations would be actively used as

models—e.g. through write-ups in IDSP bulletins, presentations on teaching and video-conferences.

- 105 -

Component 4: Supporting human health related activities under India’s avian

influenza pandemic control program: · The health sub-component of IDSP Avian Influenza (AI) component aided to

strengthen and network reference laboratories for prompt confirmation of AI human cases & H1N1 and re-establish Seasonal Influenza surveillance system for India building on the network established by the Department of Health Research (DHR).

· In the proposed AI lab network CSU, NCDC Delhi would take care of some

critical operational issues such as (a) strict compliance with the definition of Influenza Like Illness; (b) adequate training of epidemiologists and lab personnel to ensure quality in sample collection, transport and testing; (c) use of standardized testing strategy developed in consultation with National Institute of Virology, Pune and WHO.

5. Activities Agreed under different Components

(a) Surveillance Preparedness:

· Training of epidemiologists (district and State), microbiologists (State and priority labs) and entomologists by NHSRC, the recruiting agency has the responsibility of capacity building of the newly recruited additional dedicated IDSP staff. They have completed the Master Trainers training through faculty development programme. Subsequent training of actual staff will be done regionally by drawing the faculty from the resource group. The entomologists and microbiologists group training will be facilitated by respective units of NCDC.

· Training of District Surveillance Teams: the regular training under IDSP is due in some of the States specially Phase III states.

· Additional Training for improved reporting and decentralized analysis will be done for health supervisors, block health management teams, pharmacists etc. This is a key activity to be taken up fresh in the nine priority States. The pharmacists, Medical Record Technicians, Nurses attached to sub-district, district and Medical college hospitals @ 5 to 6 per facility will be trained in simple tasks of collating the data from multiple OPDs, in patients and laboratory and preparing weekly report to be shared with DSU.

· Ensuring fully functional IT systems in Place :

Ø A mechanism will be developed to enhance data integration and flow from Telephone (mobile, voice and text, and landlines), Email, and Fax.

Ø Decentralization of the recruitment and management of the IT Human Resource (DMs and DEOs) directly to the SSUs/ DSUs, to enhance accountability.

- 106 -

Ø Revision of remuneration to bring these at par with other national health projects will reduce attrition.

Ø SSUs/ DSUs will now be authorized to have broadband connectivity thru BSNL and disburse their broadband bills.

Ø Training of DMs and DEOs has been initiated – training modules have been developed and a detailed training schedule has been prepared.

Ø Bandwidth capacity of EDUSAT will be upgraded from the present 512 Kbps to 1 Mbps.

Ø The causes of the Toll free number issues are being analyzed and investigated. This analysis will form the basis of corrective actions that could include resolving technical issues, changing of the 1075 service provider and/or the Call Centre service provider.

Ø To promote the use of the toll- free services, the number will be publicized amongst health providers in conferences of IMA, IAP, private hospitals and amongst the general public by tagging to other information and dissemination opportunities such as advertisements, bulletins on public health etc.

Ø The CSU/ SSU- Andhra Pradesh is conducting an independent assessment of the SMS syndromic-reporting model, incorporate any necessary revisions / refinements and scale up the model in A.P. and the other priority States.

Ø The existing infrastructure at SSU/DSU will be used to implement a Media Scanning and Verification System in the 9 priority States. Karnataka has initiated such efforts and it appears that existing equipment and Human Resource are adequate to establish and implement the system. The Media Surveillance System functional at the CSU will serve as the model for the State Media Scanning Cells. The CSU will develop guidelines; provide training, hand holding and monitoring support.

· For 50 Priority district labs:

Ø Procurement of equipments by the States to be expedited through rigorous monitoring- Ensure maintenance of equipment.

Ø Develop a specimen collection system within the district.

Ø To expedite placements of new medical and non medical microbiologists at district labs and at State level under IDSP

- 107 -

Ø To organize training for new microbiologists by identifying 3 additional training institutes. An informal dialogue with representatives from CMC Vellore, BJ Medical College, Pune was initiated through NHSRC on course content and methodology of training. This activity dependent on joining of the selected candidates.

Ø To prepare and distribute SOP manuals for the district priority labs inclusive of bio waste management guidelines and mechanisms for internal quality controls.

Ø Regular monitoring of the functioning of district priority labs

Ø Providing guidelines for procurement of quality kits and supervise the implementation of these guidelines.

Ø To identify one or two External Quality Assessment Scheme (EQAS) organizers and organize EQAS once the district priority labs become functional, by early 2010 (depends upon the units to be functional for at least 3 months).

· For Referral laboratory Network in 9 priority States:

Ø Enabling the States to establish a system of collection and transport of samples from linked districts to the referral labs.

Ø Providing guidelines for procurement of quality kits and supervise the implementation of these guidelines.

Ø To hold meeting with the SSU & all other stake holders in the Referral Plan & enabling them to establish a Referral Network for the identified state.

Ø Regular (yearly, quarterly?) supervising and evaluating of the functioning of the lab network and adapt according to the local and national needs

Ø Identifying specialized laboratories for testing of rare but contagious diseases. Establishing a system of EQAS for the referral labs, by early 2010.

Ø Identifying good examples of networking among these States and sharing with the other States (yearly)

· For entomological surveillance:

Ø Training of newly recruited entomologist will be completed.

- 108 -

Ø Mapping, monitoring entomological density and bionomics and sensitivity to insecticides will be done by these entomologists in consultation of programme officer of NVBDCP & DMO

Ø Undertake entomological investigations whenever there are vector borne disease outbreaks.

(b) Outbreak investigation and Response:

· 50% Outbreaks detected by system within one week of first case diagnosis in 9 identified States and 25% in other States.

· 80% Outbreaks/rumors reported by other systems/media verified within 48 hours (documented in electronic register) in 9 identified States and 60% in other States.

· 50% of outbreaks for which adequate specimens reached the laboratory in 9 identified States and 25% in other States.

· Full documentation (first and final investigation reports) of 25 % of reported outbreaks in 9 priority States will be available on the IDSP portal.

(c) Analysis and use of data:

· 80% districts undertaking weekly surveillance analysis of data including graphs for trends over time and maps for incidence by area in 9 identified States and 50% in other States.

· 80% districts providing monthly feedback (one page bulletin/news letter) to sub units, policy makers and general public in 9 identified States and 60% in other States.

Major Components of IDSP

• Integration and Decentralization of Surveillance activities

• Strengthening of Public Health Laboratories

• Human Resource Development - Training of SSO, DSO, RRT, other medical

and paramedical staff

- 109 -

• Use of Information Technology for collection, compilation, analysis &

dissemination of data

Organizational structure

National Surveillance Committee

(Central Surveillance Unit)

State Surveillance Committee

(State Surveillance Unit)

District Surveillance Committee

(District Surveillance Unit)

Reporting Unit

(PRU)

Data source

S, P & L forms (Weekly Reporting)

- Form S

(Syndromic Reporting) - Health Workers (Sub Centres)

– Form P

(Probable Cases which are clinically diagnosed by a medical doctor) - PHC, CHC,

Hospitals

– Form L - Lab Confirmed Cases

A probable case that is Laboratory confirmed

Data source

Weekly & SOS reporting on EWS format and monitoring of outbreaks

- 110 -

• Supplemental Information:

– IDSP 24x7 Call Centre

Information about outbreaks received on a toll free number – 1075 &

information shared with SSO/DSO

– Media Scanning & Verification Cell

Provides information about outbreaks by scanning media; shared with stakeholders

Data transmission methods

• e-mail: S,P,L forms & EWS

• IDSP Portal (www.idsp.nic.in)

• SMS reporting thru mobiles.

- 111 -

•

- 112 -

L For

Format for instantaneous reporting of Early Warning Signal / outbreaks

as soon as it is detected

State : District: Date of reporting:

Is there any unusual increase in Cases/Deaths or unusual event in any area? Yes/No

If yes, provide the following information

Response Mechanism

§ Multidisciplinary Rapid Response Team (RRT) constituted/ trained at all State and

district headquarters; comprises of:

1.Public Health Expert – Epidemiologist/(District Surveillance Officer/ Faculty of Community

Medicine)

2. Clinician

3. Microbiologist/ Lab personnel

4. Entomologist (for Vector Borne Diseases)

§ Video Conferencing for interaction on outbreak investigations.

Important Purposes of data analysis

� Identifying outbreaks / Potential outbreaks (alert the health services system) e.g. a

case of measles should alert services system

� Identifying ‘High-risk population groups’ (person/place) so that targeted intervention

can be provided

� Identifying regional differences for improving services (e.g. measles: low vaccination

in a area)

� Predicting changes in disease trends over time (prevention/IEC)

- 113 -

Identifying problems in health systems so that gaps can be effectively plugged (e.g. possibility

of increased vector density/poor mosquito control/migration of infected people to the region)

Reports to be generated

1. Timeliness/completeness

2. Description by time, place and person

3. Trends over time

4. Compare with Threshold levels

5. Compare reporting units

6. Compare private / public

7. Compare health providers and laboratory

2. SITUATION ANALYSIS:

The project is being implemented at the State, District and Peripheral level by

· Formation of District Surveillance Units at Revenue Districts.

· Strengthening the existing laboratory facilities at Peripheral, District and State

levels (L1, L2 and L3)

· Provision of Satellite Interactive Terminal (EDUSAT) and modern

communication facilities (Computers / Fax) by statewide networking for the

rapid flow of information for immediate action

· Improvement of management and technical skills to the health and laboratory

personnel by training.

ACTION PLAN FOR THE YEAR 2012-13

Manpower

Ø To ensure 100 % Appointment by 2013

Civil work & Furniture/Fixtures:

Furniture and fixtures have been procured and installed in DSUs for the videoconferencing facility (EDUSAT) at the District Surveillance Office. Similarly, lab.furnitures and fixtures have been supplied to 20 district level laboratories

- 114 -

Training Ø Initiate Training for RRT – Members (will be done by CSU)

Ø Conduct Orientation Training for Data Entry Operators

Ø Re – Orientation training for Data Managers

Ø Training the District Accountants in Booking Keeping and Double Entry System of

Accounting etc.,

Ø Reorientation training for Lab personals at all levels.

Information Technology Ø To ensure, effective functioning of EDUSAT in all places.

Ø Interact with all the DSUs and Govt. Medical Colleges from the State Surveillance Units

Ø Online reporting through EDUSAT

Reporting Ø To improve reporting of clinically confirmed cases by promoting coordination between

different players within public sector such as major hospitals, medical colleges and local

self NGOs.

Ø To improve the timeliness of reporting.

Ø To improve the reports collected from private sector and to involve private lab.

Ø To achieve 100% reporting from District Head Quarters Lab.-L2

Ø To achieve 100% quality report from all L1, L2 and L3 laboratories.

Ø Analysis of the data based on time, place, person.

Ø To involve all major private hospital and private medical colleges in surveillance.

Review Ø To conduct regular and in-depth district performance evaluation and review

Ø Monitor the Training conducted by the Districts.

Ø Surprise visit to Public / Private Reporting units

- 115 -

*SUB –ACTIVITY TASKS –JEHANABAD UNIT COST.2012-13

- To conduct regular and in-depth District performance evaluation and review.

- Monitor the training conducted by the Districts.

- Surprise visit to public/private Reporting units 1. Budgeting

Draft - Annexure

Budget Sheet for DSU JEHANABAD(BIHAR)

Sub-activity

Tasks Unit Cost

No. of Units

2012 - 13 Remarks

1.1 Epidemiologists 33,000 1

33,000 *12=

396,000

Epidemiologists salary per month

1.2 District Data Manager

14,850 1

14,850 * 12 =

178,200

DDM Salary per month

1. Staff Salary

1.3

1.4

Data Entry Operator

Administrative Assistant

9350

7000

1

1

9350 * 12 =

112,200

7000x12

=84000

per month for future which is mention in IDSP PIP (Tentative cost)

Sub Total 770,400

2.1 Mobility Support 20000 1 20000 * 12 =240000

20000 Per month for Each District

2.2 Office Expenses 10000 1 10000 * 12 =120000

10000 Per month for Each District

2. Operational Cost

2.3 ASHA incentives for Outbreak reporting

100 10 1000*12=

12000

Estimated to get 10 information’s per month from volunteers a total of 120 such information in a year per district. Each informant to be given an incentive of

- 116 -

Rs.100/-

2.4 Consumables for District Labs

150000 1 150000

2.5 Collection & transportation of samples

75000 1 75000

2.6 IDSP reports including alerts 20 52 * 1 1040

2.7 Printing of Reporting Forms 20 52 *15 15600

2.8 Broadband Expenses 2000 1 1000 * 12 =

24000

Sub Total 6,37,640

3. New Innovations 3.1 IEC at District

Level 50000 1 50000*1

=50000 1 Districts

3.2 Advertisement Media and local media

30000 1 30000*1=

30000 I Districts

3.3

Laptop for presentation and mobile work of office

40000 2 40000*2

=80000

DSU for Epidemiologists and Data Manager

3.4 Mobility support for DSU &RRT Team

50000 1 50000*1=

50000 1 Districts

3.5 Mobile expenses for DSUl 500 2

500*2*12=

12000

Each DSU two mobile for Epidemiologists and Data Manager

Sub Total 222000

TOTAL 1630040

- 117 -

PRONE DESIASE LIST OF JEHANABAD DISTRICT

1. MALARIA

2. LEPROSY

3. FALIRIA

4. ACUTE DIARRHOEAL DISEASE DYSENTERY

LIST OF PATHOLOGICAL LABORATORY REGISTERED AND UNREGISTERED IN JEHANABAD

THESE LAB WORKING UNDER DHS CONTRACT

1. CENTAL DIAGNOSTIC RATNI PHC 2. CENTRAL DIAGNOSTIC KAKO PHC 3. CENTRAL DIAGNOSTIC HULASGANG PHC 4. CENTRAL DIAGNOSTIC SADAR PHC 5. CENTRAL DIAGNOSTIC OKARI PHC 6. CENTRAL DIAGNOSTIC GHOSI PHC 7. CENTRAL DIAGNOSTIC MAKDUMPUR PHC 8. CENTRAL DIAGNOSTIC SADAR HOSPITAL JEHANABAD .

IDD · Before Round District Level Coordinatiion Meeting in the Presence of District

Magistrate and Civil Surgeon.

· Block level Meeting.

· Training Before round to ASHA,ANM, AWW.

Budgetary Proposal

FMR Code

Budget Head

Physical Target (where

Applicable

Unit Cost

Financial Requirement

(inRS) Committed Fund

Required

D IDD 11000

Total 11000

- 118 -

NVBDCP

Kalaazar

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

1

Poor coverage of DDT spray

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.

- 119 -

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.

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

- 120 -

Faulty payment plan

Appropriate fund allocation for the payment of the spraying of DDT

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)

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

4 Lack of Increasing Community 1. Fund allocation for training activities

- 121 -

2. Identification of NGO/Private partner as trainer

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.

appropriate BCC &

Community Mobilization.

awareness for

prevention of Kala-

azar

participation in reducing

mortality and 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

- 122 -

Low achievement Increasing noof camps Organising Operations at District level

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

- 123 -

Leprosy

Gaps issues Strategy

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 Awareness

Awareness generation

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 Recruitment 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,

Strengthen

Health Care

Services

Ulcer care foot ware reorientation training of medical & para medical staff.

No lab testing facility in the district Infrastructure

Establishing Lab

Establishing Lab at district level

- 124 -

Gap Recurring expenditure like reagents

Updation of master register

Mobility support for DLO

Lack of monitoring at all level Monitoring Gap

Increasing

mobility

Office expenses

Fileria

Gaps issues

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

- 125 -

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

- 126 -

BUDGET

Name of Programme Particulars Budget Total

Budget

Leprosy Asha 63000 DPMR 57000 Urban 114000

Material & Supplies 80000

Stigma Reduction (IEC) 100000

Training 124900

Monitoring & Supervision 20000

Programme

Management (Contractual Post)

54000

612900 Filaria Drug Distribution 212800

Monitoring & Supervision 22875

District coordination Meeting 8000

IEC 84116

Paramedical training 22000

MO Training 21500

Mobility Management 1404

Contigencies for all PHC 20000

Survey 26,625 District 19000

Block Fund for all PHC 19000

438320 Kalazar 1996000 Malaria 21000

Blindness 1644508

Total 4712728

- 127 -

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

ANNUAL PLAN FOR PROGRAMME PERFORMANCE & BUDGET FOR THE YEAR

1ST APRIL 2012 TO 31ST MARCH 2013 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

- 128 -

RNTCP performance indicators:

Important: Please give the performance for the last 4 quarters i.e. July 2010 to June 2011

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 682 56% 264 234 65% 85%

Ghosi 360 39% 118 150 65% 85%

District 1042 382

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

4 Human Resource To Fill up all Contractual vacancies and to make a Panel of reserved Candidates

- 129 -

5 Payment of Honorarium Payment of Honorarium to be initiated for increased participation of community DOT Providers.

6 TB HIV Collaboration Formation of District Coordination Committee and initiating cross referrals from ICTC to RNTCP and Vice Versa.

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 70868.00 79132.00 150000.00

- 130 -

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 35000.00 165000.00

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

12500.00

Equipment Maintenance:

Item


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

Justification/ Remarks for

(d)

- 131 -

(Rs.)

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

Office Equipment

(Maintenance includes computer software and hardware upgrades, repairs of photocopier, fax, OHP etc)

1 3500.00 26500.00

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


(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

- 132 -

MPHS, pharmacists,

nursing 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

- 133 -

TB/HIV Training of MOs

10000.00

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

Vehicle Maintenance:

- 134 -

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



(Rs.)


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

Four Wheelers

- - - -

Two Wheelers

02 02 7958.00 42042.00 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


Estimated Expenditure for the next financial year for which plan is being submitted (Rs.)


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

For DTO 01 01 71750.00 42042.00 268800

For MO-TC

02 02 0.00 58800.00

197050 268800

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

- 135 -

Activity No. of currently involved in RNTCP in the district

Additional enrolment planned for this year




(Rs.)


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

ACSM Scheme: TB advocacy, communication, and social mobilization

1 150000.00

It is planned to give ACSM

scheme to one NGO to cover

both the TUs in the district

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

Culture and DST Scheme: Providing Quality Assured

- 136 -

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 150000.00

- 137 -

Miscellaneous:

Activity* Amount permissible as per the norms in the district




(Rs.)


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

150000.00 28018.00

121982.00 150000.00 For payment of telephone and internet bills and for office furniture for DTC and TU.

150000.00

* 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. planned to be additionally hired during this year




(Rs.)


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

Medical Officer-DTC

1 - 1 - 120000.00 336000.00

STS 02 02 00 190426.00 151200.00 302400.00

STLS 02 02 00 216031.00 151200.00 302400.00

TBHV 00 00 01 0.00 32000.00 96000.00

MO will be recruited in the coming financial year

- 138 -

DEO 01 01 00 79739.00 56100.00 112200.00

Accountant – part time

00 00 01 0.00 12000.00 36000.00

Contractual LT

04 00 289520.00 252000.00 504000.00

DOTS Plus cum TB HIV supervisor 0 01 90000.00 180000.00 1869000

Printing:

Activity Amount permissible as per the norms in the district




(Rs.)


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

Printing*

100000.00 26936.00

73064.00 100000.00

* Please specify items to be printed

- 139 -

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.)


(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

- 140 -

Procurement of Vehicles:

Equipment No. actually present in the district




(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




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

Office Equipment (computer, modem, scanner, printer, UPS etc)

Any Other

- 141 -

Section D: Summary of proposed budget for the district –

Budget estimate for the coming FY 2012- 13

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 212500.00

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 150000.00

11 Contractual services 1869000.00

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 3158900.00

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

Annual Action Plan Format Advocacy, Communication and Social Mobilization (ACSM) for RNTCP

- 142 -

1) Information on previous year’s Annual Action Plan- a) Budget proposed in last Annual Action Plan: b) Amount released by the state: c) Amount Spent by the district-

2) Permissible budget as per norm : 3) Budget for next financial year for the district as per action plan detailed

below:

Program Challenges to be tackled by ACSM during the Year 2009 - 10

WHY

ACSM Objective

For WHOM

Target Audience

WHAT

ACSM Activities

When

Time Frame

By WHO

M

Monitoring and Evaluation

Budget

Based on existing TB indicators and analysis of communication challenges

(Maximum 3 Challenges )

Desired behavior or action (make SMART: specific, measurable, achievable, realistic & time bound objectives)

Activities

Media/

Material Required

Q1

Q2

Q3

Q4

Key implementer and RNTCP officer responsible for supervision

Outputs;

Evidence that the activities have been done

Outcomes:

Evidence that it has been effective

Total expenditure for the activity during the financial year

- 143 -

Challenge 1. Low Case Detection (example)

Advocacy Activities

District Magistrate/ DHS

√

No cost involved

Health and other department administrators

√

Cost of sensitization meeting

Private Health care providers

√

Cost of communication

material

Low Case Detection

Gaining Administrative support from District authorities for increase referral from OPD

1.One to one meeting district authorities

2.Sensitization meeting

3. Briefing meetings

4. Programme information,

5. Factsheets

6. World TB Day

Publications

PPT

-Audio Visual Adds

-Posters-booklets/brochure

-poster in local language

-Factsheets

-success stories

√

1. District Program Managers

2. MOTC ( with support from WHO Consultant)

1.Meeting Minutes

2.Photographs

3. Reports

4. Review meeting by the authorities

1. Increase referral of chest symptomatic2 Programme Data

Cost of World TB Day

activities

- 144 -

Communication Activities

To inform communities and care providers about the DOT services for early detection Develop

1General Public

2. Schools

3. Religious bodies

4. Care provider

Use of regional / cable channels

Participate in the biannual health mela

Booklet, Flip Book, Posters, Stickers, Banners, Pamphlet, Patient information booklet

√

√

√

√

1. DTO

District Program Managers

MOTC

1.Developed IPC Material and evidence of pre testing of material

2. Flip books for STS and CFs

3. Wall writings

4. Stock Register

Cost of development of material including

Low Case Detection

Awareness Generation in general public

General Public, schools,

Wall painting on TB

√

DTO,

MO-TC, MO, IEC Officer

1.Visible wall paintings at Sub center

1.Increase self reporting/ referral

2.Analysis of data

3. KAP study

after one yr know the

Cost of wall

writings

- 145 -

level

Puppet shows, street play

Script and professional groups

√

√

DTO, Communication Facilitator, STS, IEC Officer, NGO Partners

Documentation/ report

2. Script for street plays 3. Photographs

4. School quiz format

Cost of hiring of professi

onal agency( cost per play X no. of

activities)

News Paper Advertisement

Advertisement for news paper, Letter to NEWs Paper Editor.

√

√


NEWS paper Clippings

awareness

level of general public.

Cost of newspap

ers writings

Social Mobilization

Low Case

1.Generat

Comm

Comm

Flip

MO-TC,

Minutes

Incr

Cost of material

- 146 -

unity Meeting

Chart and Posters, Talks

√

√

√

√

IEC Officer, Communication Facilitator, STS

of Meetings

Display of Posters

Flip Chart

ease Self reporting in chest symptomatic

+ cost of

community

meetings total

number of

meetings

planned

Celebration of World TB day

Display Material for World TB Day

DTO, MO-TC, MO, Communication Facilitator, STS

Documentation of l world TB Day activities

Pre- post evaluation of WTB Day activities with specific objectives

Budgeted above

Detection e Awareness in general public

2. Encourage early self reporting

3. Community Groups. PRI

unity

General Public, Patients, DOTs Providers

Exhibitions

display

DTO, MO-

Docume

Incr

Cost of Hiring of

- 147 -

/Mela’s / Popular Events in District.

Material ( Posters, Stickers, Banners, Pamphlet)

Interactive game s

√

√

TC, MO, Communication Facilitator, STS

ntation of activity

Write ups / brief used in plays

ease Self reporting of TB patients ( KAP study after one yr)

place and

display material & cost

interactive

games, prizes etc.

School Children

Drawing & Quiz Competitions

Games – Snake and ladder, Chakraview Game etc.

Pamphlets] IEC Material

√

√

√


Documentation of Activities/ Photographs

Pre- post intervention evaluation

Cost of one

school activity X no. of activities planned in the

distict=

College & School NSS Studen

TB Sessions during NSS caps

Games – Snake and ladder,

DTO, Communication Facilit

Documentation of Activ

Data Analysis

4000

- 148 -

ts in school and college, Drawing & Quiz Competitions

Help Mohan etc.

Pamphlets] IEC Material

ator, STS, IEC Officer, NGO Partners

ities/ Photographs

Challenge 2: High Default Rate (example 2)

Advocacy Activities

High Default Rate

Sensitizing district authorities about the importance of reducing default cases & for their support for necessary instructions to the Programme staff

1.Health care providers

Public & Private

2. STS

1.Interaction Meetings

2.One to One Interaction Meetings

3. Use of Information Booklet

Audio Visual Adds

-Posters-booklets/brochure

-poster in local language

-Factsheets

-success stories

District Program Managers

MOTC

Review of default case TU wise

Record of meetings

Reduction in default rate by 2% - Data analysis

Study to docu

- 149 -

ment default within one yr

Communication Activities

Patients, Their Family Members, DOTs Providers

Sharing of experience of cured patients / Patients during Treatment.

√

√

√

√

MO,

STS & Communication facilitators

High Default Rate

To motivate patients & their families for completion of treatment

Community TB Groups / NGOs

Patient interaction meetings & involvement of cured persons

Flip Chart Development

Development of material for Community DOT Provi

√

√

√

√

MO-TC, STS, ANMs

Records of meeting

Evidence of material development – pre testing

Increase in no. community base

Reduction in default rate by 2%- Analysis of programme data

Reducti

- 150 -

ders d NGOs involvement

on in time for retrieval of defaults

One to one meeting with the patient

Interpersonal communication with patients

Patient information booklet

√

√

√

√

MO, STS, DOT Provider

Evidence of such meeting

Patient information booklet

Reduction in defaults

Cost of patient informat

ion booklet (if not

budgeted above)

(no cost for one-to one IPC)

Social Mobilization

High Default Rate

To link poor patients to the welfare schemes

Sensitization of Departments Social welfare schemes

Posters, programme fact sheet,

Presentation

Annual

√

√

DTO, MO TC

Documentation, Records , Photographs

Data of

Reduction in defaults

Do

Cost of one

meeting no of

meetings

- 151 -

reports

referral of TB patients t symptomatic will increase

cumentation of effectiveness of such linkages through a study after one year

For mobilizing support from Community groups

Community support groups

Cured patients

Interaction meetings

Information material,

√

√

MO-TC, STS, Communication Facilitators

Formation of TB support groups in X no. of villages

Decrease in the no. of defaults

Cost of such

meetings

- 152 -

in such villages

Challenge 3:-

Advocacy activities

Communication activities

1.

Social Mobilization Activities

TOTAL

BUDGET PART D-I

- 153 -

FMR Code

Budget Head Financial Requirement (in RS)


D IDD 11,000

E IDSP 1,630,040

F.1.1 Malaria 21,000

F.1.4 Filaria 438,220

F.2 Kalazar 19,96,000

G Leprosy 6,12,900

H Blindness 16,44,508

I RNTCP 31,58,900

Total 95,12,568

Total Budget

- 154 -

TOTAL BUDGET NRHM

PART NAME TOTAL

NRHM PART 'A' 14,07,93,971

NRHM PART 'B' 10,07,59,709

NRHM PART 'C' 33,64,153

NRHM PART 'D'-'I' 95,12,568

TOTAL 25,44,30,401

- 155 -

CHAPTER 7

ANNEXURE

ANNEXTURE

DISTRIC HOSPITAL GAPS:

- 156 -

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

2. 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.

HR Requirement in Disrict Hospital and some common Department for District.

Department Required Personal and Expected output.

- 157 -

name

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 307 290 17

MO

144 70 74

SPECIALIST 51 14 37

Training required for MO.

Facility Name Lsas Emoc Mtp Nssk f-imnci

Imnci Mini-lap

Laproscopy Nsv Iucd Others

- 158 -

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

RH Makhdumpur

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

- 159 -

VILLAGE HEALTH ACTION PLAN 2012 – 2013

MAKHPA, PHC MAKHDUMPUR

District Patna

District Patna

Jehanabad

Kako Modanganj

Ratni Faridpur

Ghosi

Makhdumpur

Hulasganj

District Nalanda

District Arwal

District Gaya


- 160 -

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

about survey of concerned village and this was a good Opportunity to revisit the situation of health services status and national programmes in Village as well as to have a positive dialogue with departments like Public Health Engineering, Women and Child Development, Maternal and Child Health care etc.


v Mr Balamurgan D ,Chairperson of District Health Society, Jehanabad was a source of inspiration towards this effort vide her inputs to this process.

v Dr.Shobha Sinha (C.S) always supported throw her guiding words and language.

v Mr. Nimish Manan, District Programme Manager was in incharge for the development of the VHAP(2012-13) .

v Mr Ravi Shankar Kumar , Distirct Planning Coordinator has given full time effort in developing VHAP(2012-13).

v Dr B.N.Sharma (MOIC) Block level Nodal Officer PHC cum Referral Hospital, Makhdumpur has put huge effort in this Planning.

v Mr. Md. Shamshad Alam (Block Health Manager) PHC cum Referral Hospital, Makhdumpur has given full time efforts.

v Mr. Kunal Bharti (Hospital Manager) Referral Hospital, Makhdumpur has given huge support.

v All Village Level Staffs, ASHA, AWW, PRI member have supported with their full participations, cooperation and learning spirit through out this process. I on behalf of the Health Sub Centre, Dakara, PHC Makhdumpur

acknowledge the grateful contribution of all those mentioned above.

ANM (Nodal)

HSC Dakara,

- 161 -

PHC cum Referral Hospital, Makhdumpur

NAME OF BLOCK- Makhdumpur

Name of HSC - Dakra

Village Name- Makhapa

Introduction , Profile of the Block & Village:------

Introduction (Objective):------------

· To Analyze the Health Facility at the level of end User.

· Decentralization of Planning Process.

· To Full fill the Gaps of Health Services for Villagers.

Block & HSC Profile:---------

Introduction:-------

Makhdumpur PRIMARY HEALTH CENTER (P.H.C) cum Referral Hospital

Makhdumpur is situated at 18 km from the district head quarters. It is on the NH-83, which

connects Patna to Gaya..

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. graphical constraints and lack of metalled road communication carrying out of anti

naxal operations becomes a tedious task. Since, there several commoflause and concealment places the

naxals take shelter in these areas and convene secret meetings and out spread the extremist ideology.

Dialect :

The dialect spoken here is Magadhi (Magahi).

Administration:

There are 22 Gram Panchyats.

HSC Dakra is far away around 6 km from PHC Cum Referral Hospital Makhumpur.

ANM Name ----- Chinta Kumari ®, MO- 9234665515

Surekha Kumari © MO- NA

Village Profile:---------

Makhpa village is around 1400 populated Village. There are 1 Urdu Primary School, 1 AWC. This

Village Connectivity with Road (Gramin Sadak). Purley Muslim family Based Village. There incomes

- 162 -

Sources based on Agriculture and service. Educated peoples are living here. One of Famous leader of

JD (U) Md. Shakil Ahamad khan belongs to this village.

Team and Respondent Details:---------

Team Member-

A) BHM

B) ANM

C) ASHA

D) AWC

Respondent- Villagers

- 163 -

Process:------

District Level Meetingà Block Level meeting -à Selection of village--àSelection Of Team Member à Gram Shabha along With Villagers -à Collection of Feed back of Villagers -à Sharing with Block and District Officials-à Preparation of Village Health Action Planà Final approval through ANM.

General Information

Name of ANM ® Chinta Kumari SBA trinned

Name of ANM © Surekha Kumari

Name of HSC Dakara

Name of Panchayat Makhpa

Name of APHC tagged Dharaut

Distance of village from HSC 1 km

Distance of Village from PHC 6 km

Population of Village ( 2011 census) 1400

Number of AWC in Village 1

Total Population Covered SC

Male

Female

Total No of SHG in Village

Name of Asha Sita Devi

Total Population Adolescent the age

group of 10-19 Female population in the age of

Child population

M F Total M F Total 15-49 Above 49 years

0-6 months

6mn –

2yrs

2-6 years

Total

765 635 1400 88 82 170 366 187 25 73 63 161

CHILD HEALTH

- 164 -

Nutritional Status (weight for age) Name of AWC

No of Children in AWC

Grade I Grade II

Grade III

Grade IV

Total

0-3 years 20 28 15 5 68 Makhpa

3-6 years 28 40 10 0 78

Name of Village

Name of hamlet Source for Drinking water

Distance from the hamlets

Is it available round the year

Alternate source of

water

HAND PUMP Yes well

Makhpa

Village Health and Sanitation Committee:

VHSC

formed

Name of the

members

Designation Number of

meetings of the VHSC

Name of the VHSC member of monitoring committee

Designation Funds with the VHSC

No. of meetings

of the monitoring committee

Yes Shushma kumari

Chairman Shushma Kumari

Mukhiya 147460

Chinta Kumari

Secretary Sita Devi ASHA

Kiran Kumari

AWW

Village Details:

- 165 -

Distance from health centres in km

HSC APHC PHC

Motorable road

AWC

School

Electricity

A meeting

hall

1 km 7 km 6 km Yes Yes Yes Yes Yes

Diseases in summer season

Sun Stroke

Diarrea

Diseases in rainy season

Diarrea

Diseases in Winter season

Ashthma

Epidemiology pattern (Season wise major

illnesses)

Village Health & Nutrition Day (Till 0-4-2011 to 30-9-2011)

Name of the Village

VHND Day Participants in VHND Day

Major activities carried out on the day

Any suggestions for improvement

Makhpa 5 Villagers, ANM, ASHA,AWC

RI, Condom Distribution, FP

Counselling,ANC,PNC

Within 30 minutes Availability of Referral Transport:

SNO Name of Village

Name of ASHA

Vehicle Type

Vehicle No Name & Mobile No

Remarks

1 Makhpa Sita Devi

- 166 -

What are health services have Positive impact (villager’s findings)

· ASHA working at Grass root level that is Good. · Availability of Drug through ASHA Kit at emergency time has Good Impact on Villagers. · People are Satisfied with RI Facility. · Villagers are satisfied with counseling session during there visit about sanitation, Family

Planning.

What are the suggestions of community/ASHA/ANM/AWW

· Delivery Facility at HSC level. · Insure the Availability of Drug. · Use the Fund of VHSC. · Demand of Doctor on HSC level. · OPD Daily Facility on HSC Level. · Drinking Water Facility should be made available in Summer Season. · Need DDT spray in Village.

- 167 -

Conclusion

Makhpa Villagers are Satisfied with Govt. Facility but they have demand to open HSC daily, so that they find easy to avail services of health facility in easy way. They demanded more drugs available to ASHA / ANM so that they could find Drugs at emergency time. Demand of Doctor at HSC level was most Prerotisable. At HSC level demand of 24*7 Facility. Drinking Water Facility should be Available in Drought condition because of Drought Prone Area. Sanitation Problem should be Strengthen.

- 168 -

VILLAGE HEALTH ACTION PLAN 2012 – 2013

LODIPUR , PHC JEHANABAD

District Patna

District Patna

Jehanabad

Kako Modanganj

Ratni Faridpur

Ghosi

Makhdumpur

Hulasganj

District Nalanda

District Arwal

District Gaya


- 169 -

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

about survey of concerned village and this was a good Opportunity to revisit the situation of health services status and national programmes in Village as well as to have a positive dialogue with departments like Public Health Engineering, Women and Child Development, Maternal and Child Health care etc.


v Mr Balamurgan D ,Chairperson of District Health Society, Jehanabad was a source of inspiration towards this effort vide her inputs to this process.

v Dr.Shobha Sinha (C.S) always supported throw her guiding words and language.

v Mr. Nimish Manan, District Programme Manager was in incharge for the development of the VHAP(2012-13) .

v Mr Ravi Shankar Kumar , Distirct Planning Coordinator has given full time effort in developing VHAP(2012-13).

v Dr Dilip Kumar Sinha (MOIC) Block level Nodal Officer PHC Jehanabad has put huge effort in this Planning.

v Mr. Anup Sinha Block Health Manager PHC Jehanabad has given full time efforts.

v Mr. Rajeev Ranjan has given huge support. v All Village Level Staffs, ASHA, AWW, PRI member have

supported with their full participations, cooperation and learning spirit through out this process.

I on behalf of the Health Sub Centre, Karuna, PHC Jehanabad acknowledge the grateful contribution of all those mentioned above.

ANM (Nodal)

HSC KARUNA,

PHC, JEHANABAD

- 170 -

NAME OF BLOCK- Jehanabad

Name of HSC - Karuna

Village Name- karuna

Introduction , Profile of the Block & Village:------

Introduction (Objective):------------

· To Analyze the Health Facility at the level of end User. · Decentralization of Planning Process. · To Full fill the Gaps of Health Services for Villagers.

Block & HSC Profile:-----------

Jehanabad PRIMARY HEALTH CENTER is situated at 1 km from the district

head quarters. It is on the NH-83, which connects Patna to Gaya.

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. graphical constraints and lack of metalled road communication

carrying out of anti naxal operations becomes a tedious task. Since, there several

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

secret meetings and out spread the extremist ideology.

Dialect : The dialect spoken here is Magadhi (Magahi).

Administration: There are 14 Gram Panchayats.

HSC Karuan is far away around 4km from Sadar Hospital.

ANM Name ----- Nitu Kumari,© MO- 8804243041

Maya Kumari © MO-

Village Profile:---------

Lodipur village is around 975 populated Village. There are 1 Middle School, 1 AWC. This

Village Connectivity with Train root and Road (Gramin Sadak). Peoples are well educated,

well cultered, Purley Hindu family Based Village. There incomes Sources based on

Agriculture.

- 171 -

Team and Respondent Details:---------

Team Member-

E) BHM

F) ANM

G) ASHA

H) AWC

Respondent- Villagers

Process:------

District Level Meetingà Block Level meeting -à Selection of village--àSelection Of Team Member à Gram Shabha along With Villagers -à Collection of Feed back of Villagers -à Sharing with Block and District Officials-à Preparation of Village Health Action Planà Final approval through ANM.

- 172 -

General Information

Name of ANM © Nitu Kumari

Name of ANM © Maya Kumari

Name of HSC Karuna

Name of Panchayat Karuna

Name of APHC tagged Sikariya

Distance of village from HSC 2 km

Distance of Village ffrom PHC 5 km

Population of Village ( 2011 census) 975

Number of AWC in Village 1

Total Population Covered SC

Male 25

Female 12

Total No of SHG in Village 0

Name of Asha Bindiya Devi

Total Population Adolescent the

age group of 10-19

Female population in the age of

Child population

M F Total M F Total 15-49 Above 49

years

0-6 months

6mn –

2yrs

2-6 years

Total

502 473 975 50 57 107 302 87 24 26 30 80

- 173 -

CHILD HEALTH

Nutritional Status (weight for age) Name of AWC

No of Children in AWC

Grade I Grade II

Grade III

Grade IV

Total

0-3 years 30 20 8 1 59 Lodipur

3-6 years 22 10 2 0 34

Name of Village

Name of hamlet Source for Drinking

water

Distance from the hamlets

Is it available round the year

Alternate source of

water

Hand pump Yes Well

Lodipur

Village Health and Sanitation Committee:

VHSC

formed

Name of the

members

Designation Number of

meetings of the VHSC

Name of the VHSC member

of monitoring committee

Designation Funds with the

VHSC

No. of meetings

of the monitoring committee

Yes Sanjay Kumar

Chairman 1 Manju Sinha

Mukhiya 10000

Sushila kumara

Secretary Bindiya Devi

ASHA

Village Details:

- 174 -

Distance from health centres in km

HSC APHC PHC

Motorable road

AWC

School

Electricity

A meeting

hall

2 km 6km 4 km Yes Yes Yes Yes Yes

Diseases in summer season

Sun Stroke

Diarrea

Diseases in rainy season

Diarrea

Diseases in Winter season

Ashthma Pneumonia

Epidemiology pattern (Season wise major

illnesses)

Village Health & Nutrition Day (Till 0-4-2011 to 30-9-2011)

Name of the Village

VHND Day Participants in VHND Day

Major activities carried out on the day

Any suggestions for improvement

Lodipur 5 Villagers, ANM, ASHA,AWC

RI, Condom Distribution, FP

Counselling,ANC,PNC

Done in Broad Manner

- 175 -

Within 30 minutes Availability of Referral Transport:

SNO Name of Village

Name of ASHA

Vehicle Type

Vehicle No Name & Mobile No

Remarks

1 Lodipur Bindiya Devi

Referral system is vey poor.

What are health services have Positive impact (villager’s findings)

· ASHA working at Grass root level that is Good. · Availability of Drug through ASHA Kit at emergency time has Good Impact on

Villagers. · People are Satisfied with RI Facility.

What are the suggestions of community/ASHA/ANM/AWW

- 176 -

· Delivery Facility at HSC level. · Insure the Availability of Drug. · Use the Fund of VHSC. · Demand of Doctor on HSC level. · OPD Daily Facility on HSC Level. · Regular Visit of ANM not only in RI Day.

Conclusion

Lodipur Villagers are Satisfied with Govt. Facility but they have demand to open new HSC in there village. Reffral system is very Poor. They Want Ambulance Facility over there. There attention toward AWC to more strengthen. They demanded more drugs available to ASHA so that they could find Drugs at emergency time.

- 177 -

NAME OF HEALTH SUB-CENTER

S.NO NAME OF PHC

Functional/ Sanc.

NAME OF HSC

Running in

Building

Land Availability

Remarks 1 Remarks 2

1 Jehanabad 12/13 1. kasai Own Govt. Building

2. Amain Own Govt. Building

3. Pinjaura Own Govt. Building

4. Gonma Rent Yes

khata no- 274, plot no- 2442

Iap, water lodging

5.Sewanan Own Govt. Building

6. Mustichak Panchayat Bhawan Yes

khata no- 32, plot no-

360

Iap, Started foundation

work

7. Paras Bhigha Rent Yes

khata no-

50,khasra- 94

Iap, Till linter work.

8. Kinari Own Govt. Building

9. Ramdev Chak Rent Yes

khata no-133, khasra no- 441

Iap, Foundation

work

- 178 -

10. Bhewad Own Govt. Building

11. Bhawani Chak Rent Yes

khata no-

76,khasra-2452

Iap, Plinth level

12. Karuna Hault

Own Govt. Building

13. Kamdev Bhigha ( Non Functional)

Yes

Building underconstruction floor not completed, window glasses not fixed, not

hand over

2 Modanganj 12/12 1. Dewara Own Govt Building Need minor

repair

2. Jalapur Rent Yes Iap,

Foundation work

3. Naima Rent No

4. Aarhit Own Govt Building Need minor

repair

5. Pitambarpur

In pustkalaya Yes Iap, Plinth

level

6. Saistabad Own Govt Building Need minor

repair

7. Masad Rent Yes Iap,

Foundation work

8. Muriya Bigha

Own Govt Building Need minor

repair 9. Modanganj Rent No

10. Baina Own Govt Building Need minor

repair

11.Sakrautha Own Govt Building Need minor

repair

12. Charui Own Govt Building

3 Makhdumpur 21/22 1. Newari Rent No

2. Ikkil Own Govt. Building Need

baundary

3. Supi Panchayat Bhawan No

- 179 -

4. Mahamat pur 1

Own Govt. Building

5. Shekhpura Rent No 6.Tilkai Rent No 7. Makarpura Rent No

8. Serthua Own Govt. Building

9. Sumera Own Govt. Building

Need Major

Repairing

10. Sugao Panchayat Bhawan No

11. Nawabganj Rent No

12. Bhimpura Own Govt. Building

13.

Mahamatpura 2

Rent No

14. Machil Rent No

15. Dhoda Own Govt. Building

Need Minor

Repairing

16. Umata Own Govt. Building Need minor

repairing

17. Dakara Own Govt. Building

18. Bishunganj

Own Govt. Building Need minor

repairing

19. Saidpur Own Govt. Building

20. Kohara Own Govt. Building Complete handed over

on 2-9-11

21. Indarpur

(Non Functional)

Yes Under consturction

22. kohra Own Govt. Building

4 Kako 21/21 1. Uttar Serthu

Own Govt. Building

- 180 -

2. Barwa Rent No

3. Sfepur Own Govt. Building

4. Chandaura Rent Yes Iap

5.Dewghara Rent Yes Iap, water logging

6.Ainwa Own Govt. Building

7. Saidabad Rent Yes Iap,fondation work

8. Firoji Running in AWC Yes

Govt. Building is ready, not hand over

yet

9. Hatee Own Govt. Building

10. Pinjaura Rent No

11. Nawada Own Govt. Building

12.

Paigamwar Pur

Own Govt. Building

13. Asiyawa Rent No

14. Emaliya Own Govt. Building

15. Bemabhai Own Govt. Building

16. Nonahi Own Govt. Building

17. Purbi

Kako ( Functional)

No

18. Pashchami

Kako ( Functional)

No

19. Maniyawa Running in AWC Yes

Building Undercons

truction

Building complete but not

functional

- 181 -

20. Bibipur Running in AWC No

Govt. Building is ready, not hand over

yet

21. Choti Murhari

Own Govt. Building

5 Ratni- Faridpur 12/12 1. Badetha Own Govt

Building

2. Jhunathi Panchayat Bhawan Yes

Building unconstructi

on during long time

3. Dhanadihari Rent No

4. Sarta Rent No

5. Sariya Bazar

Own Govt Building

6. Pokhawa Rent No

7. Ratni Bazar Rent No

8. Kundila Rent No 9. Sohraiya Rent No

10. Murhara

Own Govt old

Building ( working on rent)

Fully Damaged

that cannot be

repaired

11. Kansua Panchayat Bhawan No

12. Seshambha

Own Govt Building

New Building complete & hand

over

6 Hulasganj 9/11 1. Murgao Own Govt Building

2. Davathu Own Govt Building

3. Khudauri Rent Yes controversail Land

4. Adrakhi Bigha

In Indra Awas No

5. Ginji Own Govt Building

6. Kokarsa Own Govt Building

- 182 -

7. Keur Own Govt Building

8. Tira Own Govt Building

9. Narma Own Govt Building

10. Kandaul (

Non Functional)

Own Govt Building

11. Bhagwan

pur (Non functional)

Yes

New Building Under

construction

7 Ghosi 9/12 1. Dhuriyari Rent No

2. Bajitpur Own Govt Building

3. Lakhawar Rent No 4. Ahiyasa Rent No

5. Bharthu Own Govt Building

6. Dehuni Rent Yes

Building complete

but Plaster of Floor, windows,

work septic tank

and bathroom work not

complete.

7. Sahobigha Rent No

8. Uber Panchayat Bhawan No

9. Kure Own Govt Building

10. Birpur (

Non Functional)

Yes Building

Underconstruction

11. Daharpur

( Non Functional)

Yes Building

Underconstruction

12 Parawan

(Non functional)

Yes Building

Underconstruction

Total 96/103

- 183 -

Sl. No.

YEAR OPD Indoor Delive

ry Referred Case

Emergency

Family Plannin

g

General Operatio

n

Mother Child

New Born

Childs

1 2008-09 458996 50588 19397 1915 30441 4993 12541 37219 179535 25215

2 2009-10 455069 41741 20520 1921 29634 4473 11876 22227 188334 29547

3 2010-11 685704 39852 18563 2414 30356 2917 13485 26778 158023 28803

4 2011-

12 Till Nov

737427 28611 11719 1819 23422 2076 11641 19457 119593 18699

of 221

Annexure 2 Budgetary Proposal:

Physical Target (where applicable) Baseline/Current

Status (as on

December 2011)

Q1 Q2 Q3 Q4 Total no of Units

Unit Cost (in Rs.)

Q1 Q2 Q3 Q4 Total Annual

proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

Committed Fund requirem

ent (if any in Rs.)

Responsible

Agency (State/SHSB/Na

me of Develop

ment Partner)

A.1.1.1.2 Monitor Progress

and Quality of Service Delivery

1 1 1 1 4 12500 12500 12500 12500 12500 50000

A.1.1.2

Operationalise 24*7 PHCs

(MCH Centre- APHC)

1 2 3 1 7 25000 25000 50000 75000 25000 175000

- 185 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.1.1.5

Operationalise Sub Centres

(MCH Centre- HSC)

2 2 50000 100000 100000

A.1.3.1 RCH Outreach Camps/ Others 7 7 7 21 7000 49000 49000 49000 147000

A.1.3.2 Monthly VHSND 904 150000 150000 100000 93400 493400

A.1.4.1 Home Deliveries 300 500 75000 75000 150000

- 186 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.1.4.2.a Rural

(Institutional Delivery)

8000 6000 5000 4755 23755 2000 16000000 12000000 10000000 9510000 47510000

A.1.4.2.b Urban

(Institutional Delivery)

1000 800 800 624 3224 1200 1200000 960000 960000 748800 3868800

A.1.4.2.C Institutional Deliveries C-

section 70 70 60 60 260 1500 105000 105000 90000 90000 390000

A.1.4.3 Administrative Expenses 81223 81223 81223 81223 324892

A.1.5 Maternal Death Review 50 50 50 50 200 750 37500 37500 37500 37500 150000

innovation 0

- 187 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

(A)

Monitoring by MO

Transportaion Expences to visit

HSC on Fixed day in month

three times at one HSC.

864 864 864 864

96 HSC* 3 times*1

2 month

300 259200 259200 259200 259200 1036800

A.2.1.1

Implementation of IMNCI

activities in districts

50000 50000

- 188 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.2.2 New Born

Stabilization UNIt

1 1 775,000 0 775,000

A.2.6

Management of Diarrhoea, ARI

and micronutrient malnutrition

(NRC)

1 1118133 1118133 1118133 1118136 4472535

A.2.7 Vitaming A round

2 Round

193926

193926 193926 387852

Innovation 0

A.2.6 a Zinc ORS programme 1417631

1417631

- 189 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

Promotion/ senitization

programme on world breast

feeding week and National

Nutrition week at District

1* 2 event 50000 100000 100000

Block 7*2 event 10000 140000 140000

b.

HSC level 96* 2 event 1000 192000 192000

- 190 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.3.1.1

Dissemination of Manuals on Sterilization

Standers & QA of sterilization

services

20000 20000

A.3.1.2 Female

Sterilization Camps

54 54 54 54 216 5000 270000 270000 270000 270000 1080000

A.3.1.3 NSV Camps 1 1 1 1 4 5000 5000 5000 5000 5000 20000

A.3.1.4 Compensation

for Female Sterilization

1800 1000 2000 1200 6000 1000 1800000 1000000 2000000 1200000 6000000

- 191 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.3.1.5 Compensation

for Male Sterilization

186 186 186 186 744 1500 279000 279000 279000 279000 1116000

A.3.1.6

Accreditation of Private Providers for sterilization

services

200 300 200 300 1000 1500 300000 450000 300000 450000 1500000

A.3.3 POL for Family Planning 29750 29750 29750 29750 119000

A.3.5.4

Provide IUD services at Health

Facility (IUD camps)

7 7 7 7

28 camps

for Block.

1500 10500 10500 10500 10500 42000

- 192 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

1

1 mega camp

for District

2000 2000 2000

Innovation 0

Prize for Debate competition 22 24 23 24

93 pancha

yat 500 11000 12000 11500 12000 46500

A.4.2 School Health Programme 1500000 1500000

Weekly IFA

Supplementation Programme

90111

52 tabs/year per girls* RS 0.105

123000 123000 123000 123006 492006

- 193 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

Training of

ANM,ASHA,AWW

2029 2029 70 142030 142030

Budget for Social Mobilization and

IEC, BCC material

964 50 12050 12050 12050 12050 48200

A.7.2 PNDT Sex Ratio 1 100,000 25000 25000 25000 25000 100000

- 194 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.8.1.1

ANMs, Staff Nurses,

Supervisory Nurses (salary Contractual

ANM/Contractual SN)

0

A Grade 39 22000*12 2574000 2574000 2574000 2574000 10296000 858000

ANM 139 12650*12 5275050 5275050 5275050 5275050 21100200 1758350

A.8.1.2 Laboratory

Technicains in Blood Banks

3 11000*12 99000 99000 99000 99000 396000

- 195 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.8.1.5

Medical Officers at CHCs/ PHC

(Salary of Mo in Blood Banks)

1 35000*12 105000 105000 105000 105000 420000 35000

A.8.1.7

Others- Computer

Assistants/ BCC Co-ordination etc (FP Counsellors)

1 15000*12 45000 45000 45000 45000 180000

- 196 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.8.1.8

Incentive / Awards etc. to

SN,ANMs etc.(Muskaan Programme- incentive to

ASHA and ANM

871 200*3 time 130650 130650 130650 130650 522600

Innovation 0

HR Requiremet

for 7 APHC Functioning

4179000 4179000 4179000 4179000 16716000

- 197 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.9.3.1 Skilled

Attendance at Birth

3 3 2 2 10 batch 88110 264330 264330 176220 176220 881100

A.9.3.7

Other MH training (any

Integrated training,etc)

1 1 2 115000 115000 115000 230000

A.9.5.1 IMNCI 8 9 8 8 33 batches 134760 1078080 1212840 1078080 1078080 4447080

2 TOT, 159600 159600 159600 319200

2 Follow

up supervi

sion

54860 54860 54860 109720

- 198 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.9.5.5.3 NSSK Training 1 1 1 1 4 52900 52900 52900 52900 52900 211600

A.9.6.2 Minilap Training 1 1 70237 70237 70237

A.9.6.4.1 Training of

Medical Officers in IUD insertion

1 1 55300 55300 55300

A.9.6.4.2 Training of

ANMs/LHVs/SN in IUD Insertion

1 1 1 3 29425 29425 29425 29425 88275

A.9.8.2 DPMU Training 1 50000 50000 50000

- 199 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

Mamta Training 59

participants

48785 48785

A.10.1.5 Mobility Support (District Malaria

Office) 45000 45000 45000 45000 180000

A.10.2.1

Contractual Staff for DPMU

Recruited and in Position

0

- 200 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

District

Programme Manager

1 42000*12 126000 126000 126000 126000 504000

District

Accoutants Manager

1 35937*12 107811 107811 107811 107811 431244

District M&E Officer 1 29947*12 89841 89841 89841 89841 359364

District Planning Coordinator 1 22,000*12 66000 66000 66000 66000 264000

Recurring Expenses 1,05,000*

12 315000 315000 315000 315000 1260000

- 201 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.10.2.2

Provision of Equipment

/furniture and mobility support for DPMU Staff

305000 305000 305000 305000 1220000

A.10.3 Strengthening of Block BPMU 1416030 1416030 1416030 1416030 5664120

A.10.4.2 Renewal (upgradation)

1 district,

7 blocks

8100 2700 27000 27000

- 202 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A10.4.3 AMC (state, Regional &DHS)

1 district,

7 blocks

22,500 10,000 92500 92500

A.10.4.9

Management unit at FRU (Hospital Manager & FRU

Accountant)

2 495000 247500 247500 247500 247500 990000

A.10.5.1 Annual Audit of the programme (Satutory Audit)

4 36000 36000

- 203 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

A.10.6 Concurrent

Audit (state & District)

1 60000 60000 60000 60000 240000

B. 1.1.1 Asha Training 871 5100 2221050 2221050 4442100

B.1.1.2 Asha Drug kit & Replenishment 871 250 217750 217750

B.1.1.3 Asha Divas 871 100 261300 261300 261300 261300 1045200

B.1.1.4.A Awards to Asha/ link 7 2000 14000 14000

2nd prize 7 1000 7000 7000

Worker 7 500 3500 3500

certificate Printing 21 250 5250 5250

- 204 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.1.1.4.C Asha Identity Card 871 30 26130 26130

B.1.1.5 Asha Rsource centre 0

DCM salry 1 22,000 66000 66000 66000 66000 264000

DDA salary 1 18,150 54450 54450 54450 54450 217800

BCM salary 7 13,200 277200 277200 277200 277200 1108800

office Expence 0

T.A 7 1000 21000 21000 21000 21000 84000

mobile Recharge 2 300 1800 1800 1800 1800 7200

Internet Recharge 1 750 2250 2250 2250 2250 9000

- 205 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

BCM meeting Snacks 12

month 300 900 900 900 900 3600

B.2.1 Untied Fund for SDH/CHC 2 50000 1,000,000 1000000

B.2.2.a Untied Fund for PHCs 9 25000 225000 225000

B.2.2 b Untied fund for APHCs 32 25000 800000 800000

B.2.3 Untied fund for sub centre 96 10000 960000 960000

B.2.4 Untied fund for VHSC 552 10000 5520000 5520000

- 206 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.3.1 CHC (Referral Hospital) 2 300,000 600000 600000

B.3.2 Annual

Maintenance Grant for PHCs

7 200,000 700000 700000 1400000

B.3.2.a

Annual Maintenance

Grant for APHCs

32 100,000 3200000 3200000

B.3.3

Annual Maintenance Grant for Sub

Centre

96 25,000 1200000 1200000 2400000

- 207 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

Annual

Maintance Grants For DH

1 500,000 250000 250000 500000

B.4.3 Sub Centre Rent

and Contingencies

36 500 54000 54000 54000 54000 216000

B.5.2 b

Construction of Residential quarters for

Doctors and Staff nurses

15 2250000 2250000 4500000

- 208 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.5.2 c Strengthening of Cold Chain 800000 800000

Construction, Renovation of

PHC,APHC,HSC,SD (fund Demanded

through District PIP- through DM

Office)

0

632254000

Demanded

through Bihar Govt

- 209 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.5.2.a Construction of APHC 2 75.99lakh 0 8,820,000

Construction of HSC 6 9.50 lakh 0 2,280,000

B.6.1 District Hospitals 1 500000 500000 500000

B.6.2 CHCs (RH) 2 100000 200000 200000

B.6.3 PHCs 7 100000 700000 700000

B.6.4 Others (APHCs) 8 8 8 8 32 100000 800000 800000 800000 800000 3200000

B.7 District Action

Plans (including Block, Village)

96 HSC 1500 144000 144000

- 210 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

25 village 1000 25000 25000

7 PHC 5000 35000 35000

1 DHAP 50,000 50000 50000

1 Data Operat

or 6000 18000 18000 18000 18000 72000

B8.1

Constitution and orientation of Community leader & of

VHSC, CHC,PHC,SHC

etc.

93 1500 69750 69750 139500

- 211 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.8.2

Orientation workshops,

trainings and capacity Building of PRI at State/ District Health

Societies,CHC,PHC

102 606 61812 61812

B.9.1 a AYUSH Specialists 27 20,000 1620000 1620000 1620000 1620000 6480000

- 212 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B10.1

Development and operationalize of State BCC/IEC

Strategy

500000 400000 300000 200000 1400000

B 10.3 Health Mela (Leprosy) 1 1 2 5000 5000 5000 10000

B.11 MMU 1 1053000 1053000 1053000 1053000 4212000

Micro plan Preparation at District and at

Block Level with Monitoring

Chart

7 1500 10500 10500

- 213 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.12.2.d 102 Ambulance Service

7 (APHC

) 15000*12 315000 315000 315000 315000 1260000

B.12.2.c 108 ambulance 1 429000 429000 429000 429000 1716000

B.12.2.c BLS Ambulance

8 1,16,700*12 2,800,800 2,800,800 2,800,800 2,800,800 11203200

B.13.3.b

Outsourcing of Pathology and

Radiology Services from PHCs to DH

14 1125000 1125000 1125000 1125000 4500000

- 214 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.13.3.d IMEP (Bio Waste Management) 13 276000 276000 276000 276000 1104000

Pathological Services for

APHC 7 75000 75000 75000 75000 300000

Outsourcing of

Silent Gensate of 5 KV at aphc

7

RS 150 *24 hrs

*30 days*12 month

2268000 2268000 2268000 2268000 9072000

- 215 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

Outsourcing of dietry Provision

at APHC 7

RS 50*5 patient* 30 days

*12 month

157500 157500 157500 157500 630000

B.14.b

Yukti Yojana Accreditation of

Public and Private Sector For Providing Safe Abortion

Services

304 25791 25791 25791 25793 103166

- 216 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.15.3.1.a

State, District , Divisional, Block

Data Centre 9 10,000 270000 270000 270000 270000 1080000

B.15.3.2.a MCTS and HRIS 6 46608 46608 46608 46609 186433

B.15.3.2.b RI Monitoring 7 32500 32500 32500 32500 130000

B.15.3.3.b

Plan for HMIS supportive

Supervision and Data Validation

45500 45500 45500 45500 182000

- 217 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.16.1.1

Procurement of Equipment : (MH Labour

Room)

11 167,464 1842104 1842104

B.16.1.2

Procurement of equipment : CH (SCNU &NBCC, ICU equipment)

4,900,000

4900000

B.16.1.3.a

Procurement of Minilap Set :FP 35 3000 52500 52500 105000

- 218 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.16.1.3.b

Procurement of NSV Kit (FP) 5 1100 5500 5500

B.16.1.3.c Procurement of IUD Kit (FP) 1 15,000 15000 15000

B.16.2.1.A

Parental Iron sucrose (IV/IM) as therapeutic

measure to pregnant women

with severe Anemia

1 700,000 350000 350000 700000

- 219 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.16.2.1.B

IFA Tablets for Pregnant & Lactating Mothers

200000 200000 200000 200000 800000

B.16.2.2.a

IFA small Tablets and

syrup for children 6-59

months

250000 250000 250000 250000 1000000

B.16.2.2.b IMNCI Drug kit 2400 250 300000 300000 600000

- 220 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

B.16.2.5 General Drugs &

Supplies for Health Facilities

3100000 3100000 3100000 3100000 12400000

B.22.4 Support

Strengthening RNTCP

19800 19800 19800 19800 79200

B.23.A Payment of

Monthly Bill to be BSNL

7491 7491 7491 7491 29964

C. pulse Polio 0 945914

C. RI 841038 841038 841038 841039 3364153

D.3 IDD 11000 11000

E IDSP 407510 407510 407510 407510 1630040

F.1.1 Malaria 21000 21000

- 221 -


Status (as on

December 2011)


Unit Cost (in Rs.)


proposed budget (in

Rs.)

FMR Code

Budget Head/Name of

activity

District Total

Unit of measure

(in words)

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total

District Total


ent (if any in Rs.)

Responsible


me of Develop

ment Partner)

F.1.4. Filaria 109555 109555 109555 109555 438220

F.1.5 Kalazar 499000 499000 499000 499000 1996000

G Leprosy 153225 153225 153225 153225 612900

H Blindness 600000 600000 444508 1644508

I RNTCP 789725 789725 789725 789725 3158900

Total 84383579 64538866 55415069 50092887 254430401 15472264

DISTRICT HEALTH ACTION PLAN 2012 – 2013

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Transcript of DISTRICT HEALTH ACTION PLAN 2012 – 2013