OPERATIONAL GUIDELINES FOR NEW BORN AND CHILD ...

O p e r a t i o n a l G u i d e l i n e s 2 0 2 0 - 2 1 , C h i l d H e a l t h , N H M , A s s a m .

| P a g e

1

OPERATIONAL GUIDELINES FOR

NEW BORN AND CHILD HEALTH ACTIVITES AS PER APPROVAL OF ROP 2020-21

DISTRICT


| P a g e

2

Preface

There has been a continuous decline in the Neonatal Mortality Rate of Assam as per the SRS report 2017.The Neonatal mortality in Assam is 22 per thousand lives birth which is a point less than national NMR of 24. But the Infant Mortality Rate (IMR) of Assam is 44 per thousand live births against the National IMR of 33 per thousand live births. The IMR remains static compared to SRS 2016. So we need more focus on new-borns and child health related issues to reduce the NMR and IMR further. Birth asphyxia is the leading cause of neonatal mortality in Assam. Quality antenatal check-up to detect high risk pregnancy and their timely referral, use of partograph during intrapartum period and timely referral of High Risk Pregnant Women, judicious use of oxytocin during intrapartum period are important in the prevention of birth asphyxia. Provision of a pair of hand exclusively for new-born in labour room and OT is important to take care of new born at the time of delivery including new-born resuscitation. The services of already engaged Neonatal Nurses in labour room and CS OT is very crucial for managing these neonates and districts should ensure their services in district hospital and medical colleges. Preterm deliveries contribute to neonatal mortality and major cause among them is the Respiratory Distress Syndrome (RDS)due to surfactant deficiency. Initiative should be started at the district level to reorient the medical staff on use of single course of Antenatal Corticosteroid (ANC) in preterm labour (Less than 34 weeks of gestation) as near universal coverage of this intervention can reduce 40% of mortality amongst preterm neonates. The use of ANC in preterm labour should be the priority of each district. The successful implementation of program like Home Based New born Care (HBNC) and follow up of SNCU discharged new born and LBW will help to reduce mortality and morbidity in the state. As SNCU admitted new born are fragile, they need long term follow up to help the parents for proper care as well as early identification and early referral of new born with danger signs will reduce the mortality by timely interventions. 10% of HBNC visits by ASHAs should be accompanied by members of BPMU/DPMU for hand holding. Both over and under referral under HBNC should be a concern for all of us. Child Death Review (CDR) will help us to understand the gaps at all level, proper implementation of CDR is important. To initiate new interventions accurate data from the facilities and communities are important. Child Death Review (CDR and eCDR) should be strengthen this time in all districts. Use of SNCU ONLINE PORTAL is essential for each SNCU. It will help to understand the trend and issues related to each SNCU, so that corrective measures can be taken. The analysis of inborn and out born admission data will help the districts to identify the areas where there is requirement of specific and active interventions. To continue the follow up till 15 months of age, GOI has recently launched Home Based Young Child (HBYC). This program will cover early childhood development, immunization, feeding in different age group, early detection of diarrhoea and pneumonia, deworming, IFA and vitamin supplementation. At present from 8 districts in last FY 2019-20, we are going to cover 5 additional districts in FY 2020-21.continous follow up after completion of HBNC is important. To reduce mortality because of pneumonia, GOI has newly launched SAANS CAMPAIGN (Social Awareness & Action To Neutralize Pneumonia Successfully). This campaign is to ensure adequate protection, prevention and treatment of children against Pneumonia. In the 1st phase State is going to start this new initiative in nine need based districts in the FY 2020-21. It will be expanded to other districts in the next FY. To ensure quality services at all the facilities capacity building of manpower is essential. Training is an integral part of District ROP. It is important for all of us to ensure the quality training at district level. Early initiation and timely completion of all district level training should be ensured in this financial year maintaining the quality of each training. To improve the quality of services in all PICUs/ HDUs in the state, supply of equipment, manpower engagement and training of manpower on critical care management has been initiated under child health division of NHM. We earnestly hope the district ROP guideline would be fruitfully used at district and block level to strengthen the facility and services to provide better care to new born and children of our state. As a service provider we must understand each and every program is important not only to reduce mortality but to improve overall development and cognition of the children.

Child Health Division National Health Mission, Assam


| P a g e

3

VARIOUS CHILD HEALTH GUIDELINES

NAVJAAT SHISHU SURAKSHA KARYAKRAM

BASIC NEWBORN CARE AND

RESUSCITATION PROGRAM MANUAL

Ministry of Health and Family Welfare, Government of India

Child Health DivisionMinistry of Health and Family WelfareGovernment of IndiaNirman Bhawan, New Delhi 110011

Child Health DivisionMinistry of Health and Family WelfareGovernment of India

OPERATIONALGUIDELINESInjection Vitamin K Prophylaxis at Birth (in facilities)


| P a g e

4

HOME BASED NEWBORN CAREOperational Guidelines

(Revised 2014)

Ministry of Health and Family Welfare Government of India

lR;eso t;rs

Operational GuidelinesUse of Gentamicin by ANMs for management of sepsisin young infants under specific situations

Ministry of Health and Family WelfareGovernment of India

February 2014

)PNF�#BTFE�$BSF�GPS�:PVOH�$IJME�)#:$�4USFOHUIFOJOH�PG�)FBMUI��/VUSJUJPO�UISPVHI�)PNF�7JTJUT

01&3"5*0/"-�(6*%&-*/&4"QSJM��

"�+PJOU�*OJUJBUJWF�PG�.JOJTUSZ�PG�)FBMUI�BOE�'BNJMZ�8FMGBSF��.JOJTUSZ�PG�8PNFO�BOE�$IJME�%FWFMPQNFOU�


| P a g e

5

Kindly visit the website : NATIONAL HEALTH MISSION. Ministry of Health and Family Welfare, Government of India website (Go to NHM Components - RMNCH+A - Child Health- Guidelines CH)

Ministry of Health & Family Welfare,

Government of India New Delhi

2009

World Health Organization

Unicef

INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS

(IMNCI)

Modules 1 to 9

Ministry of Health & Family Welfare,

Government of India New Delhi

2009

World Health Organization

Unicef

Facility Based Integrated Management of Neonatal and Childhood Illness (F-IMNCI)

Facilitators Guide (Facility Based Care)

i

Students’ Handbook for

IMNCI Integrated Management of Neonatal and Childhood Illness

WORLD HEALTH ORGANIZATION Country office for India

Ministry of Health & Family Welfare Government of India

2003


| P a g e

6

Summary of Approvals (Rs. In Lakhs)

FMR Budget Head Total Amount Approved for FY 2020-21

State HQ Allocation

District Allocation

1 U.1 Service Delivery-Facility Based 621.650 94.40 527.250 2 U.2 Service Delivery-Community

Based 0.000 0.00 0.000

3 U.3 Community Interventions 1647.810 0.00 1647.810 4 U.4 Untied Fund 0.00 0.00 5 U.5 Infrastructure 116.260 116.26 0.000 6 U.6 Procurement 761.150 706.82 54.330 7 U.7 Referral Transport 281.760 281.76 0.000 8 U.8 Human Resource 0.000 0.00 0.000 9 U.9 Training 346.290 12.45 333.844 10 U.10 Review, Research, Survey and

Surveillance 45.290 0.00 45.290

11 U.11 IEC/BCC 0.000 0.00 0.000 12 U.12 Printing 105.070 105.07 0.000 13 U.13 Quality / Assurance 0.000 0.00 0.000 14 U.14 Drug Warehousing and

Logistics 0.000 0.00 0.000

15 U.15 PPP 0.000 0.00 0.000 16 U.16 Programme Management 34.632 6.95 27.682 17 U.17 IT Initiatives for Strengthening

Service Delivery 0.000 0.00 0.000

18 U.18 Innovations 11.620 11.62 0.000 Grand Total 3971.532 1335.326 2636.206


| P a g e

7

SUMMARY SHEET OF FMR CODE WISE APPROVALS (EXCLUDING HR AND IEC) FOR

FY 2020-21 CHILD HEALTH DIVISION,NHM,ASSAM

SL No

FMR code Activity Approved

Budget State HQ

Allocation District

Allocation 1 1.3.1.1 SNCU 369.00 55.00 314.00 2 1.3.1.2 NBSU 28.00 2.29 25.71 3 1.3.1.3 NBCC 52.15 3.11 49.04 4 1.3.1.5 Family Participatory Care (KMC) 21.00 0.00 21.00 5 1.3.1.14 State new-born resource center 1.50 0.00 1.50 6 1.3.1.15 Pediatric HDU /Emergency 150.00 34.00 116.00

7 3.1.1.1.3 Incentive for Home Based New-born Care

programme 1190.39 0.00 1190.39

8 3.1.1.1.4

Incentive to ASHA for follow up of SNCU discharge babies and for follow up of LBW babies

125.87 0.00 125.87

9 3.1.1.1.12 Incentive to ASHA for quarterly visits under

HBYC 331.55 0.00 331.55

10 5.1.1.1.7 Facility based new-born care centers

(SNCU/NBSU/NBCC/KMC unit) 88.88 88.88 0.00

11 5.1.1.3.7

Facility based new-born care centers (SNCU/NBSU/NBCC/KMC unit)/MNCU & State resource centre/CLMC units/Pediatric HDUs

27.38 27.38 0.00

12 6.1.1.2.1 Equipment for Pediatric HDU, Emergency, OPD

and Ward 102.50 102.50 0.00

13 6.1.1.2.3 Handheld Pulse Oximeter and nebulizer under

SAANS 124.50 124.50 0.00

14 6.1.1.2.4 Any other equipment (for SRC/MNCU/SNCU/

NBSU/NBCC/NRC/ etc 376.19 376.19 0.00

15 6.2.2.1 JSSK drugs and consumables 109.78 71.98 37.80 16 6.4.4 Free Diagnostics for Sick infants under JSSK 37.20 24.90 12.30 17 6.4.5 Any other (please specify) 10.98 6.75 4.23 18 7.2 Free Referral Transport - JSSK for Sick Infants 281.76 281.76 0.00

19 9.1.6.1

Development/ translation and duplication of training materials (including SAANS training modules)

2.30 2.30 0.00


| P a g e

8

SL No

FMR code Activity Approved

Budget State HQ

Allocation District

Allocation

20

9.5.2.1 IMNCI (including F-IMNCI; primarily budget for planning for pre-service IMNCI activities in medical colleges, nursing colleges, and ANMTCs other training)

12.77 0.00 12.77

21 9.5.2.2

Orientation/Planning Meeting/Launch on SAANS initiative at State or District (Pneumonia)/IDCF orientation

10.30 4.00 6.30

22 9.5.2.4 Child Death Review Trainings 19.05 0.00 19.05 23 9.5.2.7 IMNCI Training for ANMs / LHVs 64.05 0.00 64.05

24 9.5.2.9 F-IMNCI Trainings for Medical officers and Staff

Nurses 19.52 0.00 19.52

25 9.5.2.10 F-IMNCI Training for Staff Nurses 69.60 0.00 69.60 26 9.5.2.13 NSSK Training for Medical Officers 18.12 0.00 18.12 27 9.5.2.14 NSSK Training for SNs 31.08 0.00 31.08 28 9.5.2.16 4 days Training for facility based new-born care 19.02 2.036 16.984

29 9.5.2.17 2 weeks observer ship for facility based new-

born care 50.59 2.11 48.48

30 9.5.2.21 Trainings for Family participatory care (KMC) 7.89 0.00 7.89

31 9.5.2.24 State/District ToT of SAANS, Skill Stations under

SAANS 22.00 2.00 20.00

32 10.1.2 Child Death Review 45.29 0.00 45.29

33 12.2.1 Printing for IMNCI, FIMNCI, FBNC, NBSU

training packages and the translation 5.00 5.00 0.00

34 12.2.2 Printing for National Childhood Pneumonia

Management Guidelines under SAANS 0.07 0.07 0.00

35 12.2.4 Printing of Child Death Review formats 7.48 7.48 0.00 36 12.2.10 Printing (SNCU data management) 21.00 21.00 0.00

37 12.2.11 Printing of HBNC referral cards and other

formats 60.31 60.31 0.00

38 12.2.12 Printing cost for HBYC 11.21 11.21 0.00

39 16.1.2.1.3 Review/orientation meetings for child health

programmes 26.162 5.680 20.482

40 16.1.4.3.1

(16.1) SNCU Follow-up Data Management 8.47 1.27 7.20

41 18.5

Strengthening of FBNC services (SNCU & NBSU mentoring), HBNC and SNCU Graduate follow up services in Dhemaji and Tinsukia districts.

11.62 11.62 0.00

Total 3971.532 1335.326 2636.206 Note: It doesn’t include cost of Human Resource and IEC/BCC activities


| P a g e

9

OPERATIONAL COST

SL No FMR code Activity Approved

Budget (Lakh)

State HQ

Allocation

District

Allocation

1 1.3.1.1 SNCU 369.00 55.00 314.00

2 1.3.1.2 NBSU 28.00 2.29 25.71

3 1.3.1.3 NBCC 52.15 3.11 49.04

4 1.3.1.5 Family participatory care 21.00 0.00 21.00

5 1.3.1.14 State new-born resource

center

1.50 0.00 1.50

6 1.3.1.15 Pediatric HDU /Emergency 150.00 34.00 116.00

Total 621.650 94.40 527.250


| P a g e

10

Activity: Operating Expenses for Facilities (E.g. operating cost , stationary, Internet, office expenses etc.) FMR Code: 1.3.1.1 Total Amount Approved: 369.00 Lakh Relevance of the Activity: Operational cost for SNCUs in All Districts (Medical College SNCU/District Hospital SNCU) FNR Owner/Resource Person for the Activity: State: -Consultant Child Health, PE (Child Health) District: Nodal Officer SNCUs and DPMs Medical College: Nodal Officer SNCUs and DPMs

SL No Name of SNCU District No of

SNCU Fund Allocation

Total amount to the district as SNCU fund pool (in Lakh)

1 Barpeta Medical College Barpeta 2 16.00 22.00

2 SNCU Barpeta Civil Hospital 6.00

3 Tezpur Medical College Hospital Sonitpur 2 15.00 23.00 4 Sonitpur CH 8.00 5 Cachar SMCH Cachar 1 20.00 6 AMCH, Dibrugarh Dibrugarh 1 25.00 7 GMCH

Kamrup Metro

3 25.00 43.00 8 Kamrup M, MMCH 12.00 9 Sonapur Civil Hospital 6.00 10 Jorhat Medical College SCNU Jorhat 1 25.00 11 Karbianglong CH/ Diphu Medical

College KarbiAnglong 1 10.00

12 Bongaigaon Civil Hospital Bongaigaon 1 8.00 13 Dima Hasao Civil Hospital Dima Hasao 1 6.00 14 Darrangi Civil Hospital Darrang 1 8.00 15 Dhemaji Civil Hospital Dhemaji 1 8.00 16 Dhubri Civil Hospital Dhubri 1 10.00 17 Goalpara Civil Hospital Goalpara 1 8.00 18 Golaghat K.K. Civil Hospital Golaghat 1 10.00 19 Hailakandi, S K Roy Civil Hospital Hailakndi 1 8.00 20 Karimganj Civil Hospital Karimganj 1 8.00 21 Kokrajhar,Civil Hospital Kokrajhar 1 8.00 22 Lakhimpur Civil Hospital Lakhimpur 1 8.00 23 Morigaon Civil Hospital Morigaon 1 8.00 24 Nagaon, SCNU, BPCH Nagaon 1 8.00 25 Nalbari, SMK Civil Hospital Nalbari 1 8.00 26 Sivasagar Civil Hospital Sivsagar 1 10.00 27 Tinsukia Civil Hospital Tinsukia 1 8.00 28 Udalguri Civil Hospital Udalguri 1 6.00 29 Baksa Civil Hospital Baksa 1 6.00 30 Chirang Civil Hospital Chirang 1 2.00

District Allocation 314.00 State HQ Allocation 55.00

Total Budget Approved 369.00


| P a g e

11

Guideline for Utilization of SNCU Operational Cost Important Notes:

• District Health Society will transfer the fund to the concerned Medical College/ DH as early as possible on receiving the district ROP.

• The operational committee of SNCUs must approve and maintain minutes of all decisions for expenditure related to SNCUs.

• Expenditure of SNCU operational cost should be aimed at zero out of pocket expenditure in the treatment of new-born.

• The operational cost for 7 medical colleges (AMCH, GMCH, SMCH, JMCH, FAAMCH, TMCH and Karbi- Anglong CH/Diphu Medical Colleges) have been sanctioned for the whole FY 2020-21fully as per the GOI ROP 2020-21 approval. No additional amount will be sanctioned from state HQ for medical colleges. Any additional expenditure beyond the sanctioned amount will be born from the parent hospital resource envelope only.

• Barpeta, Sonitpur and Kamrup Metro districts where there are SNCUs in medical college and district hospital, they may rationalize the money to be sanctioned to SNCUs from the district wise SNCU fund pool as mentioned in the table above. They may not release the sanctioned amount as a whole at a time but they have to adjust the fund for these SNCU for the whole FY 2020-21 from the SNCU pool fund.

• Respective district, where there is medical college should clearly communicate to the medical college authority regarding this matter.

• For district hospital SNCUs, additional funds may be sanctioned to the SNCUs as per the norms and subject to utilisation, submission of SoE and UC and subject to availability of budget provision under the respective FMR code as per GOI approval.

• For purchase of stationary, disposables, medicines &surgical items, procedure of one-year rate contract should be followed when the purchase of goods costing up to Rs.2,50,000/-. This rate contract should be renewed every year.

• The Nodal officer of the SNCU will put up requirement in advance and will get approval from the SNCU Operational Cost utilization committee.

• The Nodal officer of the SNCU will prepare the list of items which are required for the SNCU and send the list to the Superintendent office of that hospital (In medical college SNCUs, the list prepared by the SNCU Nodal officer will be countersigned by the HOD, Dept of Paediatrics). The Superintendent office will supply the items to the SNCU as early as possible for smooth running of the SNCU.

• Inventory will be maintained by the institution for the item purchased. • Bills will be paid after physical verification and stock book entry through the DAM/ BAM/BPM/BAM

of the hospital/MCs as per existing rules of the hospital. • Utilization certificate of the fund will be submitted to the Director Finance, NHM Assam through

District Health Society as per existing rules. • Proper stock register to be maintained against each of the items purchased . Consumption register

to be maintained by the SNCU sister in charge in each SNCU. The SNCU Nodal officer will check this register periodically.

• Nodal Officer of SNCU, Accounts Person of the respective Medical College/ District Hospital shall strictly follow guidelines during implementation of the activity as well as procurement of any item and utilisation of funds.

• The committee for utilization of SNCU Operational Cost in Medical College/ DH along with Jt DHS, DPM and DAM of the respective district will review the utilization of SNCU operational fund quarterly and minuted meeting copy along with break-up of utilization (i.e. for medicines,


| P a g e

12

consumables, fuel, minor repairing, any investigation, petty cash, printing. etc)should be shared with State Health Society, NHM through Jt DHS of respective district. • Each year each SNCU has been provided with separate fund for SNCU Data Management

(Excluding HR) under FMR code. 16.1.4.3.1. The committee for utilization of SNCU Operational Cost should utilize this fund as per the guideline under FMR. 16.1.4.3.1.

• In case of referral to higher facility 102/108 services shall be utilized.

Expenditure can be incurred for following activities: A. Purchase of Medicines and Consumables and Diagnostics/Investigations:

• Emergency medicines and surgical items not available in SNCU/ District Hospital Drug Store/ District medical store may be purchased from this fund.

• Every effort must be given for constant supply and use of medicines and consumables which are available under EDL. If some drugs and consumables under EDL are not available in the district hospital/Medical college store, this must be highlighted urgently to the State HQ through DDSM before purchasing EDL enlisted medicines and consumables from SNCU fund. This will help to restore the supply of EDL enlisted medicines and consumables as early as possible.

• Consumables and Disposables required for sick new-borns which are not available in the SNCU/District Hospital Drug Store /District medical store.

• Fund provided under JSSK drugs and consumables (FMR 6.2.2.1) may be used by the districts to procure drugs and consumables for SNCU on emergency situation.

• Most essential investigation which are advised by the treating doctor and not available in the hospital laboratory. The committee for Utilization of SNCU operational cost will decide which outside laboratory facility will be used for this purpose, using standard one-year rate contract process to find out the lowest bidder for different tests, which are not available in the Govt. hospital.

• Disinfectants, cleaning agents, essential stationary items. • Consumables and disposables for CPAP and ventilators may be purchased from this fund

maintaining standard financial procedure. Proper stock register to be maintained. B. Repair and Maintenance: Maintenance of Electrical, Furniture, Central Gas Pipeline and water

supply fittings. It includes replacement of batteries of online UPS for SNCU after proper verification .

C. Printing of clinical protocols/guidelines/poster for SNCU (Note: Not more than 4000/- per annum)

D. Petty Cash: • Petty Cash of ₹3000 for SNCU may be maintained with SNCU Nodal Officer/Staff Nurse In-charge

at any given point of time. • This cash is for the purpose of fulfilling any kind of emergency expenditure, so as to keep the

SNCU functioning and provide timely care to the sick new-born. • After the expenditure is done, this cash may be refilled after duly submitting the receipts. • In any given month expenditure through this mode cannot exceed Rs.4000/-. • All the necessary records should be maintained as per accounting norms of NHM, Assam.

E. Fuel Expenditure: • Fuel expenses for running DG Sets. But effort should be made to provide round the clock power

supply to SNCU with discussion with the ASEB authorities. • Logbook of power cuts and utilisation of DG set is to be maintained by the facility. • Average requirement of fuel per hour for running the DG Set is to be certified by SNCU

committee every year. If the cost of fuel expenditure is very high information should be given to NHM, HQ urgently.

F. Any other emergency expenditure required for smooth functioning of SNCU with due approval from SNCU Committee (Note: not more than 25,000/- annum).


| P a g e

13

The committee for utilization of SNCU Operational Cost will be as follows For Medical College SNCUs;

• Principal/ Superintendent of the Medical College Hospital : Chairman • HOD, Department of Paediatrics : Member Secretary • Nodal Officer, SNCUs/Senior Most Paediatrician : Member • DPM : Member • BPM/BAM : Member

For District Hospital SNCUs

§ Superintendent of the District Hospital : Chairman § Nodal Officer, SNCU : Member Secretary § DPM : Member § DAM : Member § Hospital Administrator : Member

The goal of this activity is “To Ensure Zero out of pocket expenditure” for the treatment of New-born admitted and being treated in the SNCUs.

Activity: New born Stabilization Unit (NBSU) operational cost FMR code: 1.3.1.2 Total Budget Approved 28.00 Lakhs Relevance of the Activity: Total Budget Approved 28.00 Lakhs The Operational Cost for functioning of New-Born Stabilization Units (NBSU) in the districts FMR Owner/Resource person for the Activity: State: -Consultant-CH/PE (Child Health) District: DPMs Block: BPMs and BAMs

Guidelines for utilization of the Operational Cost:

• All local purchases should be done as per existing financial norms. • Purchase of consumable like disposable nasal prongs/ Oxygen Hood for oxygen delivery,

feeding tube, Distilled water for oxygen concentrator etc. • Small equipment like Neonatal Resuscitation Bag, Laryngoscope, Foot Operated Suction

machine may be purchased after approval of the NBSU operational cost committee on emergency basis. The amount for this kind of purchase should not be more than Rs. 5000/- in the FY 2020-21.

• Keeping standby oxygen Unit with Oxygen cylinder, trolley, disposable tubes, wrench and refilling of empty oxygen cylinder to be used at the time of non-functioning of oxygen concentrator.

• Ensure availability of Functional new-born resuscitation bag for Bag & Musk Ventilation, Baby caps, radiant warmer bed spread, blanket etc.

• Few essential drugs like Inj. Vitamin K (1mg/ml or 1mg/0.5 ml) till it is available in the EDL. Discourage the use of Inj. Vitamin K 10mg/ml in neonate.

• Repairing/ Replacement of mattress cover and day to day maintenance of material within NBSU.

• Antiseptic solution & disinfectant - bleaching powder, Lysol (5%), Detergent, liquid hand wash, utility gloves etc.

• Keeping functional water taps, electrical switches, FL bulb, furniture etc. • Surgical attire for service provider, like gown, face mask, head cap, sleeper, shoe cover,

gloves etc. • Printing of new-born Bed Head ticket, Nurses record sheet, Discharge sheet, Referral sheet

and NBSU admission register. (Must be in GOI format which are already supplied) • Monthly utilization certificate with detail of expenditure to be submitted for further release

of fund. • In case of referral to higher facility 102/108 services shall be utilized


| P a g e

14

Instruction: Admission criterion for NBSU is as per table given below,

Care at Birth Care of Normal New-born

Care of Sick New-born

Prevention of Infection Breastfeeding/ Feeding Support.

Management of LBW infants ≥1800 gms. With no other complications.

Provision of Warmth Immunisation Services.

Phototherapy for new-borns with hyper-bilirubinaemia.

Resuscitation Management of new-born sepsis. Early Initiation of Breastfeeding

Stabilisation and referral of sick new-borns and those with very low birth weight.

Weighing of New-born Referral Services. Committee for NBSU Operational Cost:

• Superintendent/Deputy Superintendent/SDM&HO of the Hospital : Chairman • Nodal Officer, NBSU : Member Secretary • BAM : Member • BPM : Member

The goal of this activity is “To Ensure Zero out of pocket expenditure” for the treatment of New born admitted and being treated in the NBSUs. To strengthen the NBSUs in the state high emphasis has been be given on selected NBSUs (46 in number in 1st phase)in the districts. Any modification if requires must be highlighted by the districts as early as possible.

NBSU operational cost district wise

Sl No District Name & Address of the facility

Type of facility

Amount No of NBSU

District Total

(In lakh) 1 Baksa Barama CHC Barama BPHC CHC 13000 3 0.390 2 Baksa Jalah CHC Jalah BPHC CHC 13000 3 Baksa Salbari Model Hospital Jalah

BPHC CHC 13000

4 Barpeta Barpeta Civil Hospital DH 13000 8 1.33 5 Barpeta Barpeta Road FRU CHC 30000 6 Barpeta Chenga BPHC Chenga BPHC 13000 7 Barpeta Howly CHC Bhawanipur CHC 13000 8 Barpeta Mandia BPHC Mandia BPHC 13000 9 Barpeta Nagaon BPHC Nagaon BPHC 13000

10 Barpeta Pathsala FRU Nityananda SDCH 25000 11 Barpeta Sarukhetri CHC Chenga CHC 13000 12 Bongaigaon ABHAYAPURI CHC CHC 25000 4 0.64 13 Bongaigaon BIDYAPUR CHC CHC 13000 14 Bongaigaon MG MODEL HOSPITAL

BOITAMARI MH 13000

15 Bongaigaon MG MODEL HOSPITAL MANIKPUR BOITAMARI

CHC 13000

16 Cachar BikrampurBikrampur PHC 13000 13 1.81 17 Cachar Borkhola PHC Borkhola PHC 13000 18 Cachar Dholai PHC 13000 19 Cachar FulbariBikrampur MPHC 13000 20 Cachar Harinagar BPHC Harinagar BPHC 13000 21 Cachar Joypur SHC Harinagar SHC 13000


| P a g e

15

22 Cachar Kalain FRU Jalalpur CHC 13000 23 Cachar Katigorah Model Hospital

Jalalpur MH 25000

24 Cachar NarsingpurDholai PHC 13000 25 Cachar S.M. Dev Civil Hospital DQ DH 13000 26 Cachar Sonabarighat SHC Sonai SHC 13000 27 Cachar Sonai PHC Sonai PHC 13000 28 Cachar UdharbondUdharbond PHC 13000 29 Chirang Bhetagoan CHC Ballamguri CHC 13000 1 0.13 30 Darrang Deomornoi CHC Patharighat CHC 13000 3 0.88 31 Darrang Kharupetia CHC Kharupetia CHC 50000 32 Darrang Sipajhar CHC Sipajhar CHC 25000 33 Dhemaji Bengenagarah CHC CHC 13000 5 0.89 34 Dhemaji GogamukhGogamukh BPHC CHC 25000 35 Dhemaji Jonai CHC Jonai BPHC CHC 13000 36 Dhemaji Silapathar Model Hospital

Sissiborgaon BPHC CHC 25000

37 Dhemaji Sissiborgaon BPHC Sissiborgaon BPHC

BPHC 13000

38 Dhubri Bilashipara SHC SHC 13000 7 1.03 39 Dhubri CHAPAR CHC Chapar BPHC 24x7

CHC 25000

40 Dhubri Dharmasala PHC Dharmasala BPHC

PHC 13000

41 Dhubri Dhubri Health & Maternity Centre Dhubri Urban

24x7 PHC

13000

42 Dhubri Gauripur CHC CHC 13000 43 Dhubri Golakganj BPHC BPHC 13000 44 Dhubri Halakura CHC CHC 13000 45 Dibrugarh Dibrugarh SD Barbaruah PHC 13000 9 1.41 46 Dibrugarh Lahowal PHC Lahowal PHC 13000 47 Dibrugarh Moran SD Khowang PHC 13000 48 Dibrugarh Moran tiloi CHC Khowang CHC/FR

U 25000

49 Dibrugarh Naharani CHC Naharani CHC/FRU

25000

50 Dibrugarh Naharkatia CHC Naharani CHC 13000 51 Dibrugarh Namrup MPHC Naharani PHC 13000 52 Dibrugarh Panitola PHC Panitola PHC 13000 53 Dibrugarh Tengakhat M.G Model

Hospital MH 13000

54 D. Hasao Umrangso CHC CHC 13000 1 0.13 55 Goalpara Bikali Model Hospital PHC 13000 7 1.04 56 Goalpara Dudhnoi CHC/FRU Rangjuli FRU 25000 57 Goalpara Lakhipur PHC Lakhipur CHC 13000 58 Goalpara Matia PHC Matia PHC 13000 59 Goalpara MCHC Goalpara Urban PHC 13000 60 Goalpara Mornai PHC Mornai PHC 13000 61 Goalpara Simlitola MPHC Rangjuli PHC 13000 62 Golaghat Dergaon CHC Misamara CHC 13000 4 0.64 63 Golaghat MERAPANI CHC CHC 13000


| P a g e

16

64 Golaghat Sarupathar CHC Sarupathar CHC 13000 65 Golaghat SKMCH Bokakhat SDCH SDCH 25000 66 Hailakandi Algapur PHC PHC 13000 2 0.26 67 Hailakandi Lala CHC CHC 13000 68 Jorhat Garamur SDCH/ FRU SDCH 25000 3 0.75 69 Jorhat Teok FRU Kakajan FRU 25000 70 Jorhat Titabar SDCH Titabar SDCH 25000 71 Kamrup M GACH West MC 13000 4 0.76 72 Kamrup M MCH Dhirenpara FRU 25000 73 Kamrup M Pandu FRU FRU 25000 74 Kamrup M KHETRI CHC Sonapur CHC 13000 75 Kamrup R Azara PHC/FR

U 25000 9 2.13

76 Kamrup R Bezera CHC-FRU CHC-FRU

25000

77 Kamrup R Bihdia 24*7 13000 78 Kamrup R BOKO CHC/FRU Boko CHC/FR

U 25000

79 Kamrup R Hajo BPHC/FRU Hajo CHC 25000 80 Kamrup R Kamalpur Model Hospital CHC 25000 81 Kamrup R Rangia CHC/FRU Rangia FRU 25000 82 Kamrup R Sualkuchi FRU Sualkuchi FRU 25000 83 Kamrup R Sontoli PHC PHC 25000 84 K. Anglong Manja BPHC Manja BPHC 13000 1 0.13 85 Karimganj BaraigramMPHCPatherkandi PHC 13000 9 1.17 86 Karimganj BazaricherraPatherkandi SHC 13000 87 Karimganj Kaliganj MPHC Nilambazar PHC 13000 88 Karimganj MCL&GH Patherkandi PHC 13000 89 Karimganj MG Girishganj Model Hospital CHC 13000 90 Karimganj Nilambazar PHC Nilambazar PHC 13000 91 Karimganj Patherkandi CHC CHC 13000 92 Karimganj R K Nagar PHC R K Nagar BPHC 13000 93 Karimganj SRIGOURI CHC Kachuadam CHC 13000 94 Kokrajhar Balajan BPHC BPHC 13000 6 0.90 95 Kokrajhar Dotma CHC Dotma Block BPHC 13000 96 Kokrajhar Gossaigaon BPHC PHC 13000 97 Kokrajhar Gossaigaon SDCH SDCH 25000 98 Kokrajhar Kachugaon BPHC BPHC 13000 99 Kokrajhar Tulsibil SHC Gossaigaon Block SHC 13000

100 Lakhimpur Boginodi Model Hospital PHC 13000 6 0.90 101 Lakhimpur Bongalmora CHC CHC 13000 102 Lakhimpur Dhakuakhana SDCH SDCH 25000 103 Lakhimpur Dhalpur BCHC Dhalpur BCHC CHC 13000 104 Lakhimpur Laluk Model Hospital CHC 13000 105 Lakhimpur Nawboicha CHC CHC 13000 106 Morigaon Bhuragaon SHC Laharighat SHC 13000 9 1.17 107 Morigaon Chabukdhara CHC

Bhurbandha CHC 13000

108 Morigaon Dharamtul SHC Jhargaon SHC 13000 109 Morigaon Jagibhakatgaon SD Jhargaon SD 13000


| P a g e

17

110 Morigaon Jhargaon PHC Jhargaon PHC 13000 111 Morigaon Laharighat Model Hospital CHC 13000 112 Morigaon MG Model Hospital,

NakholaJhargaon CHC 13000

113 Morigaon Moirabari CHC /FRU Laharighat

CHC 13000

114 Morigaon Nellie SD Jhargaon SD 13000 115 Nagaon BATADRAVAMPHC Dhing PHC 13000 15 2.67 116 Nagaon Dagaon PHC Dagaon PHC 13000 117 Nagaon DHING FRU Dhing CHC 25000 118 Nagaon Garajan SD Singimari PHC 13000 119 Nagaon Hojai FRU Jugijan CHC 25000 120 Nagaon Jakhalabandha CHC 25000 121 Nagaon Jugijan Model Hospital J CHC 13000 122 Nagaon Juria MPHC Dagaon PHC 13000 123 Nagaon KACHUA SD Kathaitoli PHC 13000 124 Nagaon KAMPUR FRU Kathaitoli CHC 25000 125 Nagaon KATHIATOLI PHC Kathaitoli PHC 13000 126 Nagaon KAWAIMARI FRU Samaguri CHC 25000 127 Nagaon LUMDING FRU Lanka CHC 25000 128 Nagaon RUPOHI MH Samaguri CHC 13000 129 Nagaon SAMAGURI PHC Samaguri PHC 13000 130 Nalbari Mukalmua FRU FRU 25000 3 0.75 131 Nalbari Tihu FRU FRU 25000 132 Nalbari BelsoreAmg Model MH 25000 133 Sivasagar Amguri CHC Morabazar CHC 13000 4 0.88

134 Sivasagar Demow CHC Demow BPHC CHC 25000

135 Sivasagar Nazira SDCH Ligiripukhuri SDCH 25000

136 Sivasagar Sonari SDCH Sapekhati BPHC SDCH 25000

137 Sonitpur BaliparaBalipara PHC 13000 7 1.27 138 Sonitpur Behali PHC Behali BPHC 13000 139 Sonitpur BiswanathChariali SDCH SDCH 25000 140 Sonitpur Dhekiajuli CHC Dhekiajuli CHC 25000 141 Sonitpur Gohpur SDCH Gohpur BPHC SDCH 25000 142 Sonitpur North jamuguri CHC CHC 13000 143 Sonitpur Ranagapara PHC Rangapara PHC 13000 144 Tinsukia Dangari CHC Kakopathar CHC 13000 7 1.39 145 Tinsukia Digboi CHC Ketetong CHC 25000 146 Tinsukia Doomdooma FRU FRU 25000 147 Tinsukia Chapakhowa FRU FRU 25000 148 Tinsukia Jagun MPHC Ketetong MPHC 13000 149 Tinsukia Kakopather BPHC BPHC 13000 150 Tinsukia Margherita FRU Ketetong CHC 25000 151 Udalguri Orang CHC Orang CHC 13000 2 0.26 152 Udalguri Tangla CHC Udalguri CHC 13000

District Allocation 25.71 152 25.71 State HQ Allocation 02.29

Total 28.00


| P a g e

18

NBCC operational cost

S.No. Name of the district No of NBCC Approval/NBCC operational cost

1 Barpeta 45 5000 225000

2 Baksa 56 4500 252000

3 Cachar 40 5000 200000

4 CHIRANG 38 4500 171000

5 Darrang 28 5000 140000

6 Dhubri 41 5000 205000

7 Goalpara 41 5000 205000

8 Hailakandi 26 5000 130000

9 Karimganj 27 5000 135000

10 Karbianglong 72 4500 324000

11 Nagaon 79 5000 395000

12 Udalguri 30 4500 135000

13 Bongaigaon 33 5000 165000

14 Dhemaji 23 5000 115000

15 Dibrugarh 32 5000 160000

16 Dima Hasao 9 4500 40500

17 Golaghat 33 5000 165000

18 Jorhat 36 5000 180000

19 Kamrup M 21 5000 105000

20 Kamrup (R) 52 5000 260000

21 Kokrajhar 39 4500 175500

22 Lakhimpur 45 4500 202500

23 Morigaon 38 4500 171000

24 Nalbari 22 4500 99000

25 Sivasagar 22 4500 99000

26 Sonitpur 46 4500 207000

27 Tinsukia 54 4500 243000

District Allocation 1028 49.04

State HQ Allocation 03.11

Total Fund Allocation 52.15

Activity: Operational cost of New-born Care Corner (NBCCs)

FMR Code: -1.3.1.3

Total Budget Approved : 52.15 Lakhs

Relevance of the Activity: All Districts and All Facilities having NBCCs,

FMR Owner/Resource Person for the Activity:

State: -Consultant (Child Health)/ PE (Child Health)

District: DPMs Block: BPMs


| P a g e

19

Expected services at NBCC

Care at Birth Care of Normal New-born Care of Sick New-born Prevention of Infection Breastfeeding/ Feeding

Support. Identification and prompt referral of “at risk” and “sick” new born.

Provision of Warmth Resuscitation Early Initiation of Breastfeeding Weighing of New-born

New Born Care Corners are for essential care of new-born at birth and screening and referral from the delivery point and are expected to remain ready 24x7. To meet the routine and emergency expenditure an amount of ₹5,000/- (Rupees Five Thousand) per NBCC is provided.

Guidelines for utilization of the Operational Cost: • All local purchases should be done as per existing financial norms. • Disposables like nasal prongs/ oxygen hood for oxygen delivery, refilling of oxygen

cylinder. • Baby receiving towels (Two towels of size 75cm X 75cm are required for each delivery.

Total no. required = Daily expected delivery X 2 plus 20% extra) duly sterilized, baby caps, radiant warmer bed spread, blanket, identification tags.

• Replacement of cracked Mattress cover and day to day maintenance of other-wear and tear-able materials.

• Antiseptic solution & disinfectant - bleaching powder, Lysol (5%), detergent, soap, hand wash, Utility gloves.

• Surgical attire for Service Provider, e.g. gown, face mask, head cap, sleeper, shoe cover, gloves if not procured from RKS.

• Emergency Drugs like Inj Vitamin K (1mg/ml or 1mg/0.5 ml), Inj. Adrenaline, if not available at store with clear mentioning of the period.

• To keep the Water taps, electrical switches, electrical bulbs functional. • NBCC reporting format, and register development (must be in GOI format, soft copy of

which is already supplied) • All New-born Care Corners (NBCCs) should have the Neonatal Resuscitation Protocols fixed

at appropriate height for reading of the service providers. Printing cost for such Flex Print can be used from this operational cost.

• In case of referral to higher facility 102/108 services shall be utilized The goal of this activity is “To Ensure Zero out of pocket expenditure.

Activity: Operational cost for Kangaroo Mother Care Units

FMR Code 1.3.1.5-Family participatory care (KMC)

Total Budget Approved : 21.00 Lakhs

Relevance of Activity: Operational Guidelines for 28 KMC units. The Operational Cost for functioning Kangaroo Mother Care (KMC) units in the districts. FMR Owner/Resource Person for the Activity: State:- Consultant Child Health/P E (Child Health) District: DPMs

Expenditure can be incurred for following activities. Purchase of Medicines and Consumables:

• Consumables and Disposables required for the new-borns. • Disinfectants, cleaning agents, essential stationary items.


| P a g e

20

Guidelines for utilization of the Operational Cost:

• Feeding equipment (Tubes, Katoris and spoons, and like other items etc), Clothes for Newborn (Diapers, Caps, Socks and like other items), Gowns for Mothers, Soap or other cleansing agents, Emergency Medicine /Cotton/Gauge and other like materials(from regular supply), record registers/case sheets (from regular supply), and other maintenance cost.

• Maintenance of Electrical, Furniture and water supply fittings. • Any other emergency expenditure required for smooth functioning of KMC Unit with due

approval from Committee established for SNCU. • Overall functioning of KMC unit to be assigned to SNCU Nodal officers already identified at

hospital and the funds related activities should be under existing SNCU committee. Procedure for Expenditure: The committee (FMR:1.3.1.1) for utilising SNCU operational cost will also be responsible for KMCU operational cost utilisation. The operational committee of SNCUs/KMCUs must approve and maintain minutes of all decisions for expenditure related to KMCUs.

SI KMC unit Unit Operational cost

1 AMCH 1 1.0 2 SMCH 1 1.0 3 JMCH 1 1.0 4 GMCH 1 1.6 5 FAAMCH 1 1.0 6 TMCH 1 1.0 7 Chirang 1 0.6 8 Barpeta Civil Hospital (Kalgachia) 1 0.6 9 Kokrajhar 1 0.6

10 Golaghat 1 0.6 11 Karimganj 1 0.6 12 Darrang 1 0.6 13 Goalpara 1 0.6 14 Morigaon 1 0.6 15 Nagaon 1 0.6 16 Sonitpur DH 1 0.6 17 Tinsukia 1 0.6 18 Lakhimpur 1 0.6 19 Nalbari 1 0.6 20 Baksa 1 0.6 21 Bongaigaon 1 0.6 22 Dhemaji 1 0.6 23 Dhubri 1 0.6 24 Dima Hasao 1 0.6 25 Hailakandi 1 0.6 26 Kamrup_M (Sonapur) 1 0.6 27 Kamrup_MMCH 1 0.6 28 KarbiAnglong 1 0.6 29 Sivasagar 1 0.6 30 Udalguri 1 0.6 Total (in lacs) 21.00


| P a g e

21

Activity: Operational cost for State new-born resource centre

FMR code: 1.3.1.14 Total Budget Approval = Rs.1.5 lakhs. FMR Owner: State HQ: Consultant- Child Health, Consultant (Training) District : DPM (Kamrup M) Medical College: BPM

In order to improve the skills of service providers at the facilities providing specialized new-born care services at SNCUs, NBSUs there needs quality skilled training. The FBNC training is provided to SNCU MOs and SNs for improving such skills to ensure quality of services and care. There are four medical colleges in Assam which are providing FBNC trainings. In order to train the increasing manpower at such facilities and covering the load there is a need of a training hub for capacity building.

Activities for establishing SRC: • GMCH is selected to establish a training hub as a State Resource centre. • Head of the department of Paediatrics or Another person designated by HOD, Paediatrics will be the

Nodal person for SRCNC. • SRC nodal person will be designated for coordinating the functioning of SRCNC. He/she will be

responsible for the execution of designated activities under SRCNC. • The faculty will be engaged to provide the 4 days FBNC training at the centre • 14 days FBNC observer ship training will also be conducted at the centre. • State level pool of experts will be developed.

Roles and responsibilities: o Act as a technical guiding force for FBNC trainings o Undertake the activities of 4 days FBNC trainings under FMR. 9.5.2.16 o Undertake the 14 days observer ship trainings under FMR 9.5.2.17

The committee for utilization of SRCNC Operational Cost is as follows: o Principal, GMCH/ Superintendent, GMCH : Chairman o HOD, Department of Paediatrics : Member Secretary o Nodal Officer, SRCNC : Member o BPM/BAM, GMCH : Member

Activity Unit cost (Rs) Remarks Operational Cost 150000.00 Annual

Activity: Operational Cost for Paediatrics HDU/Emergency FMR: 1.3.1.15

Approved Budget : 150.00 Lakhs

Relevance of Activity: Operational cost for PICUs at medical college and HDU at district hospital FMR Owner/Resource Person for the Activity: State: Consultant (Child Health) Districts: Nodal Officer (PICU/HDU) and DPM Medical College: Nodal Officer (PICU/HDU) and DPM

Operational cost for PICUs at Medical college and HDU in District Hospitals

Sl No Operational cost (in Lakhs) No of PICU/HDU in the District

1 GMCH 16.00 1 2 SMCH 10.00 1 3 JMCH 14.00 1


| P a g e

22

4 AMCH 15.00 1 5 FAAMCH 8.00 1 6 TMCH 8.00 1 7 Lakhimpur 4.00 1 8 Sivasagar 6.00 2 9 Golaghat 8.00 2 10 Nagaon 6.00 2 11 Goalpara 4.00 1 12 Dhemaji 4.00 1 13 Dhubri 6.00 1 14 Darrang 4.00 1 15 Nalbari 3.00 1


Total 150.00 lakh

# Operational cost for HDU/ PICU of MMCH (Kamrup Metro), Barpeta Civil Hospital, Kokrajhar, Udalguri, Baksa, Dima Haso, Karbi-Anglong, Tinsukia and Karimganj will be provided once the equipment are supplied and they start functioning.

Guideline for Utilization of PICU/HDU Operational Cost

Important Notes: • District Health Society will transfer the funds to the concerned Medical College/ DH as early

as possible on receiving the district ROP. • The operational committee of PICU/HDUs must approve and maintain minutes of all

decisions for expenditure related to PICU/HDUs. • Expenditure of PICU/HDUs operational cost should be aimed at zero out of pocket

expenditure in the treatment of children. • Additional funds may be sanctioned to the PICU/HDUs as per the norms and subject to

utilisation, submission of SoE and UC and subject to availability of budget provision under the respective FMR code as per the GOI approval.

• For purchase of stationary, disposables, medicines &surgical items, procedure of one-year rate contract should be followed when the purchase of goods costing up to Rs.2,50,000/-. This rate contract should be renewed every year.

• The Nodal officer of the PICU/HDUs will put up requirement in advance and will get approval from the PICU/HDUs Operational Cost utilization committee.

• The Nodal officer of the PICU/HDUs will prepare the list of items which are required for the PICU/HDUs and send the list to the Superintendent office of that hospital (In medical college PICU/HDUs the list prepared by the PICU/HDUs Nodal officer will be countersigned by the HOD, Dept of Paediatrics). The Superintendent office will supply the items to the PICU/HDUs as early as possible for smooth running of the PICU/HDUs.

• Inventory will be maintained by the institution for the item purchased. • Bills will be paid after physical verification and stock book entry through the DAM/

BAM/BPM/BAM of the hospital/MCs as per existing rules of the hospital. • Utilization certificate of the fund will be submitted to the Director Finance, NHM Assam

through District Health Society as per existing rules. • Proper stock register to be maintained against each of the items purchased. Consumption

register to be maintained by the PICU/HDUs sister in charge in each PICU/HDUs.


| P a g e

23

• Nodal Officer of PICU/HDUs, Accounts Person of the respective Medical College/ District Hospital shall strictly follow guidelines during implementation of the activity as well as procurement of any item and utilisation of funds.

• The committee for utilization of PICU/HDUs Operational Cost in Medical College/ DH along with Jt DHS, DPM and DAM of the respective district will review the utilization of PICU/HDUs operational fund quarterly and minuted meeting copy along with break-up of utilization (i.e. for medicines, consumables, fuel, minor repairing, any investigation, petty cash, printing. etc)should be shared with State Health Society, NHM through Jt DHS of respective district.

Expenditure can be incurred for following activities:

1. Purchase of Medicines and Consumables and Diagnostics/Investigations: • Emergency medicines and surgical items not available in PICU/HDUs/ District Hospital Drug

Store/ District medical store. • Every effort must be given for constant supply and use of medicines and consumables

which are available under EDL. If some drugs and consumables under EDL are not available in the district hospital/Medical college store, this must be highlighted urgently to the State HQ through DDSM before purchasing EDL enlisted medicines and consumables from PICU/HDUs fund. This will help to restore the supply of EDL enlisted medicines and consumables as early as possible.

• Consumables and Disposables required for sick new-borns which are not available in the PICU/HDUs/District Hospital Drug Store /District medical store.

• Most essential investigation which are advised by the treating doctor and not available in the hospital laboratory. The committee for Utilization of PICU/HDUs operational cost will decide which outside laboratory facility will be used for this purpose, using standard of one-year rate contract process to find out the lowest bidder for different tests, which are not available in the Govt. hospital.

• Disinfectants, cleaning agents, essential stationary items. • Consumables and disposables for CPAP and ventilators can be purchased from this fund

maintaining standard financial procedure. 2. Repair and Maintenance: Maintenance of Electrical, Furniture, Central Gas Pipeline and

water supply fittings. It includes replacement of batteries of online UPS for PICU/HDUs. 3. Printing of clinical protocols/guidelines/poster for PICU/HDUs (Note: Not more than

4000/- per annum) 4. Petty Cash: o Petty Cash of ₹3000 for PICU/HDUs may be maintained with PICU/HDUs Nodal Officer/Staff

Nurse In-charge at any given point of time. o This cash is for the purpose of fulfilling any kind of emergency expenditure, so as to keep

the PICU/HDUs functioning and provide timely care for sick children. o After the expenditure is done, this cash may be refilled after duly submitting the receipts. o In any given month expenditure through this mode cannot exceed Rs.4000/-. o All the necessary records should be maintained as per accounting norms of NHM, Assam. 5. Fuel Expenditure: o Fuel expenses for running DG Sets. But effort should be made to provide round the clock

power supply to SNCU with discussion with the ASEB authorities. o Logbook of power cuts and utilisation of DG set is to be maintained by the facility. o Average requirement of fuel per hour for running the DG Set is to be certified by PICU/HDUs

committee every year. If the cost of fuel expenditure is very high information should be given to NHM, HQ urgently.


| P a g e

24

o Any other emergency expenditure required for smooth functioning of PICU/HDUs with due approval from PICU/HDUs Committee (Note: not more than 25,000/- annum).

The committee for utilization of PICU/HDUs Operational Cost will be as follows For Medical College PICUs;

• Principal/ Superintendent of the Medical College Hospital : Chairman • HOD, Department of Paediatrics : Member Secretary • Nodal Officer, PICU : Member • DPM : Member • BPM/BAM : Member For District Hospital PICU/HDUs 1. Superintendent of the District Hospital : Chairman 2. Nodal Officer, PICU/HDU : Member Secretary 3. DPM : Member 4. DAM : Member 5. Hospital Administrator : Member The goal of this activity is “To Ensure Zero out of pocket expenditure” for the treatment of children admitted and being treated in the PICU/HDUs.


| P a g e

25

ASHA INCENTIVES (COMMUNITY PROCESS)

SL No FMR code Activity Approved

Budget (Lakh) State HQ Allocation

District Allocation

7 3.1.1.1.3 Incentive for Home Based New-born Care programme

1190.39 0.00 1190.39

8 3.1.1.1.4 Incentive to ASHA for follow up of SNCU discharge babies and for follow up of LBW babies

125.87 0.00 125.87

9 3.1.1.1.12 Incentive to ASHA for quarterly visits under HBYC

331.55 0.00 331.55

TOTAL 331.55 0.00 331.55


| P a g e

26

Activity: ASHA Incentives for Home Based Newborn Care Programme (HBNC)

FMR Code: 3.1.1.1.3 Total Budget Approved: 1190.39/-lakhs Relevance of the Activity: All Districts and Blocks FMR Owner/Resource Persons for the Activity: State: SCM, PE (Child Health) District: DCMs Block: BCMs

To reduce the Neonatal Mortality, effective implementation of HBNC is very important. In

this regard a revised guideline has been issued by the Government of India. HBNC Visit Schedule:

• Home Delivery: 1, 3, 7, 14, 21, 28, 42 days. (Total 7 visits) • Institutional Delivery: 3, 7, 14, 21, 28, 42 days. (Total 6 visits)

Payment to ASHA:

ü ASHA will receive ₹250/- for conducting home visits for the care of new-born and post-partum mother provided she had made all the required 6/7 home visits and the child is alive on 42nd days of birth.

ü In case delivery outcome is more than one (like twin delivery or triplets) incentive provided to ASHA will be ₹250 × total numbers of new-borns. This incentive will be paid for each alive new-born at the end of 42 days.

ü In case of Caesarean Section delivery or in case of other complications like PPH, Placenta retention, etc. where the mother has to stay in facility for prolonged duration; ASHA will be entitled to full incentive of ₹250/- if she completes all the remaining visits after the mother and new-born are discharged from hospital.

ü In case when a new-born is admitted in SNCU, ASHAs are eligible to full incentive amount of ₹250/- for completing the visits considering day of discharge as Day 1.

ü In case the woman delivers at her maternal house and returns to her husband’s house, two ASHAs undertake the HBNC visits then each ASHA will get ₹125/- as an incentive for providing HBNC to the new-born. Thus total incentive will be ₹250/- per new-born.

ü ASHA will submit the Home Based New-born form (Along with BPHC copy of HBNC vouchers signed by ASHA Supervisor) and ANM to PHC/Block Accounts Manager after taking approval from MO/PHC who will review the implementation of HBNC during monthly meeting of ASHA &ASHA Supervisor.

ü ANM should certify the caesarean section delivery or SNCU admission with photocopy of SNCU discharge sheet as supporting document.

ü District/Block wise HBNC ranking will be done as per the criteria specified at district and State Head Quarter respectively for assessing the quality of the HBNC programmes.

Conditionality for making payment to ASHAs:

ASHA will be entitled to receive above mentioned incentive (₹250/-) only, if she fulfils the following conditionality:

• Complete all visit as per guideline. • Recorded weight & temperature in HBNC form properly. • Ensures BCG, OPV 0 dose and Hepatitis B birth dose, 1st dose of OPV and Pentavalent

vaccination. • Ensures registration of birth of the baby. • The baby is alive up to 42 days.


| P a g e

27

Each HBNC form should have the following additional things mentioned on it:

1. Mode of delivery – Normal/ Caesarean. 2. In case of SNCU admission – SNCU case ID mentioned on discharge card. 3. Duration of stay in SNCU. (From _____ to _____ date) 4. Birth registration number. 5. Immunization status. 6. Gender 7. Date of Birth.

Incentive for Home based New born Care (HBNC)

SI Districts Estimated live births

Expected Target

Total amount @ Rs 250

80 % of the Total Amount

(In Lakh) 1 Baksa 18,898 15,118 3779556 30.24

2 Barpeta 39,733 31,786 7946544 63.57

3 Bongaigaon 16,230 12,984 3245905 25.97 4 Cachar 50,146 40,117 10029189 80.23 5 Chirang 9,992 7,994 1998474 15.99 6 Darrang 21,884 17,507 4376714 35.01 7 Dhemaji 17,674 14,139 3534855 28.28 8 Dhubri 49,764 39,811 9952734 79.62 9 Dibrugarh 27,590 22,072 5518097 44.14

10 D. Hasao 4,298 3,438 859530 6.88 11 Goalpara 25,228 20,182 5045587 40.36 12 Golaghat 24,985 19,988 4997063 39.98 13 Hailakandi 23,204 18,563 4640730 37.13 14 Jorhat 22,454 17,963 4490872 35.93 15 Kamrup M 25,186 20,148 5037110 40.30 16 Kamrup R 29,979 23,983 5995801 47.97 17 K. Anglong 22,339 17,871 4467827 35.74

18 Karimganj 36,276 29,021 7255263 58.04 19 Kokrajhar 20,689 16,551 4137732 33.10 20 Lakhimpur 27,209 21,767 5441744 43.53 21 Marigaon 25,618 20,495 5123695 40.99 22 Nagaon 77,229 61,784 15445898 123.57 23 Nalbari 15,473 12,379 3094690 24.76 24 Sibsagar 23,315 18,652 4663023 37.30 25 Sonitpur 40,324 32,259 8064817 64.52 26 Tinsukia 30,170 24,136 6034095 48.27 27 Udalguri 18,107 14,486 3621466 28.97

Total 7,43,995 5,95,196 148799009 1190.39


| P a g e

28

Activity: Incentives to ASHA for follow up of SNCU discharge babies and for follow up of LBW babies FMR code: 3.1.1.1.4 Total Budget Approved: 125.87 Lakhs Relevance of the Activity: All Districts and Blocks FMR Owner/Resource Person for the Activity: State: - SCM and PE (Child Health) District: DCMs Block: BCMs

Guidelines for incentive to ASHA for follow up of SNCU discharge babies and follow up of LBW babies

Low Birth Weight (LBW) and SNCU discharged new-borns are at the greatest risk of dying and /or developing the related complications or developmental delays which increases the chances of severe morbidities. Percentage of LBW new-borns dying within one year of age is very high. Also those LBW new-borns who survive their initial period of life, are very prone to developmental delays related to Social/Emotional, Language/Communication, Cognitive, Physical Development, etc. This causes high morbidity among these children. The percentage of LBW new-borns as per National Family Health Survey (NFHS) 2015-16 is 15.8%.

The follow-up of SNCU discharged babies as per the SNCU Online reporting system indicates that most of the mortality following SNCU discharge is within one month of discharge, risk being highest during first week (GoI). SNCU discharged new born are at additional risk of developmental delays and non-communicable diseases (NCDs) at later age. Therefore, it is imperative that these babies are followed up closely after being discharged from SNCU.

New born discharged after treatment of sickness from Special New-born Care Units (SCNU) and those who are born as preterm or low birth weight babies form the two major risk groups for new born/child mortality. The cohort of Low Birth Weight (LBW) babies contributes significantly to the prevalence of underweight and stunted children and has higher mortality during infancy when compared to children born with normal weight. They are also likely to have compromised growth, delayed cognitive development and neurological deficits unless proactive monitoring is under taken throughout infancy to improve eventual outcomes.

• In case of SNCU discharged new-borns, the day of discharge is to be taken as day one. ASHAs would make the first home visit within 24 hours of discharge (Day 1) and complete the remaining home visits as per HBNC visit schedule i.e. 3, 7, 14, 21, 28 and 42ndday from the day of discharge.

• On completion of these visits ASHA will conduct follow up visit once every quarter starting from 3rdmonth onwards till one year of life i.e., four visits at the completion of 3rd, 6th, 9th and 12thmonth of life

• In case of LBW or preterm new born who did not require SNCU admission, after completion of HBNC visits(till42days of birth),ASHA will visit once every quarter starting from 3rd month onwards till one year of life i.e., four visits at the completion of 3rd, 6th, 9th and 12thmonth of life.

Thus it is very important to follow-up these new-borns for extended period of time. To address this issue GoI has released revised HBNC Guidelines to include the follow-up of LBW New-borns up to 1 year of age. Each LBW new-borns will receive the full package of care under existing HBNC program up to 42 days of life as per HBNC schedule of visits. Beyond this period (i.e. from 3rd month to 12th month) each LBW new-born will be followed up on quarterly basis up to 1 years of life i.e. 12 months. This schedule comes to 4 additional visits per LBW new-born.


| P a g e

29

Objective of these visits:

1. Ensuring compliance with follow up visits and treatment as advised on the discharge- ticket by SNCU / NBSU (New born Stabilization Unit)

2. Timely identification of danger signs with prompt referral using JSSK referral mechanism 3. Enabling access to health care services for treatment as and when required 4. Integrating Anganwadi Center (AWC) services including growth monitoring and supplementary

food 5. Early identification of danger signs and early referral. 6. Identification of developmental delays. 7. Adherence to the discharge instructions. 8. Ensuring Kangaroo Mother Care (Skin to skin contact and exclusive breastfeeding). 9. Early and prompt referral. 10. Regular assessment of nutritional status through weight monitoring and assessment using

MUAC. ASHA Incentives:

ASHA will be incentivised @ ₹50 per visit for these 4 visits. Total ASHA incentive for completing follow-up of one LBW new-born will be ₹200 for 4 visits. ASHA incentive is payable as per schedule mentioned below.

Payment to ASHA will be as follows:

Scheduled Visits ASHA Incentive per

new-born Payable at time

0-42 days of life ₹ 250. Immediately after HBNC schedule is completed and adherence to HBNC guidelines.

3rd, 6th, 9th, 12th month # ₹ 50 per visit i.e. 50×4= ₹200.

At the end of one year age of child.

# In 7 aspirational districts plus Karimganj the ASHA will not get the money for follow up of LBW and SNCU discharge babies, instead they will get the incentive for HBYC visit only. The same will be implied in 5 new districts (Nagaon, Cachar, Jorhat, Sonitpur, Morigaon) where the HBYC program will be started in FY 20-21.

Reporting Mechanism:

LBW follow-up cards are already included in the HBNC form book supplied from the state. • The HBNC voucher contains SNCU discharge/Low Birth Weight baby follow-up, HBNC

voucher will be submitted by the ASHA along with form in similar line of HBNC voucher. • ASHA will submit the monthly report to ASHA Supervisor by 1stof every month. • ASHA Supervisor (Sub-Centre wise) will submit compiled report to BPHC by 3rd of every

month. • Block PHC will compile the information and send it to district by 7th of every month. • Districts will compile the block reports and send it to State by 10th of every month.


| P a g e

30

Targets and amount sanctioned as per the table given below:

Incentive for ASHA for follow up LBW babies and SNCU discharged babies SI Districts Estimated

live births Expected LBW

Target (50%

of LBW)

To be follow

ed Under HBYC

Actual Target

for LBW follow

Up

SNCU Follo

w up

Amount for LBW Follow

Up (In Lakh)

Amount for SNCU Discharge Follow up (In Lakh)

Total Incentiv

e for ASHA#

(In Lakh

1 Baksa 19,486 2,728 1364 512 853 380 1.71 0.76 2.47

2 Barpeta 38,210 5,349 2675 1003 1672 616 3.34 1.232 4.58

3 Bongaigaon 15,711 2,200 1100 0 1100 238 2.20 0.476 2.68

4 Cachar 48,366 6,771 3386 635 2751 2220 5.50 4.44 9.94

5 Chirang 10,254 1,436 718 0 718 0 1.44 0 1.44

6 Darrang 20,948 2,933 1466 550 916 848 1.83 1.696 3.53

7 Dhemaji 17,110 2,395 1198 0 1198 600 2.40 1.2 3.60

8 Dhubri 46,924 6,569 3285 1232 2053 652 4.11 1.304 5.41

9 Dibrugarh 28,206 3,949 1974 0 1974 2050 3.95 4.1 8.05

10 Dima Hasao 4,345 608 304 0 304 208 0.61 0.416 1.02

11 Goalpara 24,052 3,367 1684 631 1052 578 2.10 1.156 3.26

12 Golaghat 25,337 3,547 1774 0 1774 584 3.55 1.168 4.72

13 Hailakandi 22,134 3,099 1549 581 968 370 1.94 0.74 2.68

14 Jorhat 23,346 3,268 1634 306 1328 1440 2.66 2.88 5.54

15 Kamrup M 24,771 3,468 1734 0 1734 3465 3.47 6.93 10.39

16 Kamrup R 29,978 4,197 2098 0 2098 0 4.20 0 4.20

17 K. Anglong 21,989 3,078 1539 0 1539 247 3.08 0.494 3.57

18 Karimganj 34,618 4,846 2423 909 1515 396 3.03 0.792 3.82

19 Kokrajhar 22,026 3,084 1542 0 1542 580 3.08 1.16 4.24

20 Lakhimpur 26,774 3,748 1874 0 1874 700 3.75 1.4 5.15

21 Marigaon 24,288 3,400 1700 319 1381 280 2.76 0.56 3.32

22 Nagaon 73,767 10,327 5164 968 4195 962 8.39 1.924 10.31

23 Nalbari 15,827 2,216 1108 0 1108 708 2.22 1.416 3.63

24 Sibsagar 24,230 3,392 1696 0 1696 430 3.39 0.86 4.25

25 Sonitpur 40,295 5,641 2821 529 2292 1230 4.58 2.46 7.04

26 Tinsukia 30,103 4,214 2107 0 2107 424 4.21 0.848 5.06

27 Udalguri 18,763 2,627 1313 493 821 166 1.64 0.332 1.97

Total 7,31,857 1,02,460 51230 8667 42563 20372 85.13 40.74 125.87

# Total Incentive for Follow up of SNCU discharge and LBW babies.


| P a g e

31

Activity: Incentive to ASHA for quarterly visits under HBYC FMR: 3.1.1.1.12 Total funds Approved : 331. 55lakhs FMR Owner/Resource Person for the Activity: State: - SCM and PE (Child Health) District: DCMs Block: BCMs

The objective of the Home Based Care for Young Child is to reduce child mortality and morbidity and improve nutrition status, growth and early childhood development of young child through focused and effective home visits by ASHAs. The purposes of the additional home visits by ASHAs are promotion of evidence based interventions delivered in four key domains namely nutrition, health, child development and WASH (Water, Sanitation and Hygiene).

Salient features of Home Based Care of Young Child Programme are:

• Convergent action by MWCD &MoHFW • Evidence Based Intervention • Convergence and Integration across interdependent domains of Health, Nutrition, WASH &

early childhood development • Five additional home visits by ASHA in coordination with AWWs starting from 3rd month and

extending into 2nd year of life (in 3rd, 6th, 9th, 12th and 15th months) • Additional incentives of INR 250/- for five visits to be provisioned for ASHA under NHM and

disbursed using existing ASHA payment mechanism. • SBCC (Social Behaviour Change Communication) plan to focus on addressing adverse social

norms in health care seeking especially for girl child. • ASHAs and AWWs will make home visits at 3rd, 6th, 9th, 12th and 15th month for the same ASHAs

would be paid an incentive of Rs.50/visit with total incentives of Rs.250/-per child for making five visits. Overall these visits will ensure counselling for continuation of exclusive breastfeeding, complimentary feeding, growth monitoring, vaccination and sickness related counselling.

• HBYC visits will also ensure the continuum of care from the time of birth and help the State to meet target for exclusive breastfeeding for 6 months and adequate complimentary feeding with continued breastfeeding thereafter.

• Additional home visits by ASHAs will promote evidence based intervention delivered in four key domains namely nutrition, health, child development and WASH (water sanitation and hygiene).

In addition, following activities will be ensured: • Counselling for optimal IYCF practices, Growth monitoring, Health and nutrition education • Education on improved caring practices including early childhood care and development. • Regular health check-up for all children, Primary immunization • Deworming as per guidelines, counselling to ensure proper nutrition during sickness and

Referral for sick children.


| P a g e

32

District wise fund allocated for the incentives and supervision of activity is as under:

Sl District Total ASHA Supervisors

Total ASHAs

Estimated Live Births

Proposed Target

for HBYC(75% of

LB)

ASHA Incentive for

HBYC Visit @250/ per child for 5

visits

Incentive For ASHA

Supervisors@500 PM

(Rs)

Incentive For ASHA

Supervisors@500 PM (In Lakhs)

Total Incenti

ve under HBYC

(Lakhs) 1 Baksa 97 950 19486 7307 18.27 181875 1.82 20.09

2 Barpeta 149 1610 38210 14329 35.82 279375 2.79 38.62

3 Darrang 82 978 20948 7856 19.64 153750 1.54 21.18

4 Dhubri 176 1996 46924 17596 43.99 330000 3.30 47.29

5 Goalpara 97 1067 24052 9019 22.55 181875 1.82 24.37

6 Hailakandi 67 715 22134 8300 20.75 125625 1.26 22.01

7 Karimganj 114 1235 34618 12982 32.45 213750 2.14 34.59

8 Udalguri 95 1065 18763 7036 17.59 178125 1.78 19.37

9 Nagaon 204 2443 73767 13831 34.58 153000 1.53 36.09

10 Cachar 162 1826 48366 9069 22.67 121500 1.22 23.89

11 Jorhat 113 1265 23346 4377 10.94 84750 0.85 11.79

12 Sonitpur 181 1946 40295 7555 18.89 135750 1.36 20.25

13 Morigaon 83 948 24288 4554 11.39 62250 0.62 12.01

Total 1620 18044 435197 123811 309.53 2201625 22.02 331.55

Justification: In 7 Aspiration district &Karimganj, the ASHAs(50% of ASHAs) trained in 2019-20 expected to do HBYC visits for 50% of LB in their areas.For new ASHAs who will be trained in 2020-21 will have the target of 25% of LB. In 2020-21, Cachar, Jorhat , Sonitpur, Nagaon, Morigaon will be new districts for HBYC roll out considering high infant deaths. a) Proposed HBYC ASHA Incentive for 123812 no. of child @Rs-250/ per child. b) ASHA Supervisor Incentive for 439 ASHA Supervisor trained in 2019-20 @Rs-500/ PM for 6 Months c) ASHA Supervisor Incentive for 590 ASHA Supervisor( 219 AS will be active out of 439 AS to be trained in 2020-21 in 8 districts and 371 AS out of 741 AS to be trained in 2020-21 in new 5 districts) @Rs-500/ PM for 3 Months

HBYC incentives • Incentives for five visits @ Rs. 250/child (Considering 75% coverage in the 1st year of implementation. • Payment will be done in 3 parts: Rs.100/- after completion of 3rd and 6th months visit, Rs.100/- after

completion of 9th and 12th months visit and Rs. 50/- after completion of 15 months visit. • # If the ASHA visits a home where there is SNCU discharge or LBW baby then the ASHA will get Rs.250/-

after completion of 5 visits as per HBYC guideline and will not be eligible for claiming incentive under the FMR code.3.1.1.1.4 for follow up of SNCU discharge and LBW babies.

• Monitoring for entering HBYC data @ 5 entries/child*Rs.5/entry + 0.5 lakhs per district for 6month assessment

• Annual Incentives for supervisors @ 500/month/Sup. For 6 months. Note: Activity to be initiated after the training is done. The training of the ASHA/ASHA Supervisors to be done by ASHA division and SPM.

Data entry to be ensured by Block Data Manager (BPM) once the programme is implemented The IEC/BCC activity to be ensured by District Media Expert (DME) strictly as per guidelines of HBYC programme once the programme is in implementation stage.


| P a g e

33

INFRASTRUCTURE

S. No FMR

code Activity Approved

Budget State HQ

Allocation District

Allocation

10 5.1.1.1.7 Facility based new-born care centers (SNCU/NBSU/NBCC/KMC unit)

88.88 88.88 0.00

11 5.1.1.3.7 Facility based new-born care centers(SNCU/NBSU/NBCC/KMC unit)/MNCU & State resource centre/CLMC units/Pediatric HDUs

27.38 27.38 0.00

TOTAL 116.260 116.260 0.00


| P a g e

34

Activity: Facility based new-born care centres (SNCU/NBSU/NBCC/KMC unit) (Central Oxygen Pipeline at SNCUs) FMR: 5.1.1.1.7 Total funds Approved = 88.88 lakhs @12.69,721.00/Unit FMR Owner/Resource Person for the Activity: State: - Consultant (Civil), Consultant-CH

SNCUs where Central Oxygen Line is Needed Sl No District

1 Bongaigaon 2 Goalpara 3 Hailakandi 4 MMCH( Kamrup M) 5 Sivasagar 6 Dhubri 7 Sonitpur CH

Activity: Facility based new-born care centers (SNCU/NBSU/NBCC/KMC unit)/MNCU & State resource center/CLMC units/Pediatric HDUs FMR: 5.1.1.3.7 Total funds Approved = 27.38 lakhs. Provision of Central Oxygen Pipeline in HDU FMR Owner/Resource Person for the Activity: State: - Consultant Civil and Consultant-CH

Sl.No. District Renovation/Repair work Unit cost

1 Baksa Central Oxygen pipe line with 10 Jumbo cylinders

547521 2 Barpeta Civil Hospital 547521 3 Dima Hasao 547521 4 Kokrajhar 547521 5 Udalguri 547521

Total 2737605.0 27.38 Lakh


| P a g e

35

EQUIPMENT

SL No FMR code

Activity Approved Budget

State HQ Allocation

District Allocation

13 6.1.1.2.1 Equipment for Pediatric HDU, Emergency, OPD and Ward

102.50 102.50 0.00

14 6.1.1.2.3 Handheld Pulse Oximeter and nebulizer under SAANS

124.50 124.50 0.00

15 6.1.1.2.4 Any other equipment (for SRC/MNCU/SNCU/ NBSU/NBCC/NRC/ etc

376.19 376.19 0.00

TOTAL 603.19 603.19 0.00


| P a g e

36

Activity: Equipment for Pediatric PICU, Emergency, OPD, Ward FMR Code 6.1.1.2.1 Total funds Approved = 102.50 lakhs @ 12.81 Lakh/ Unit FMR Owner/Resource Person for the Activity: State: - BME (HQ) and Consultant-CH For purchase of equipment for setting up of HDU, Emergency Triage area, Pediatrics OPD and Isolation and Diarrhea Ward in eight district :

MMCH (Kamrup M), Udalguri, Baksa, Dima Hasao, Barpeta Civil Hospital (Barpeta), Goalpara, karbi Ananglong, Kokarajhar.

Activity: Handheld Pulse Oximeter and nebulizer under SAANS FMR Code 6.1.1.2.3 Fund Allocation 124.50 Lakhs FMR Owner/Resource Person for the Activity: State: - BME (HQ), Consultant Child Health and Consultant (Training) Procurement of equipment and Mannequins for setting up of Skill station at state and 9 districts for conducting SAANS trainings :

Kamrup R, Hailakandi, Barpeta, Nalbari, Dibrugarh, Nagaon, Morigaon, Dhubri,

Karimganj

Activity: Any other equipment (for SRC/MNCU/SNCU/ NBSU/NBCC/NRC/ etc FMR Code 6.1.1.2.4 Fund Allocation 376.19Lakhs FMR Owner/Resource Person for the Activity: State: - BME (HQ) and Consultant-CH A .SNCUs Equipment 277.57 B. Power Backup Equipment for NBSU 77.19 C. Equipment for NBSU 21.43 Total 376.19 (In Lakhs)

A. LIST OF SNCU EQUIPMENT:

Sl No SNCU R. Warmer

O2 Con

Inf Pump

P Oximeter

LED Photo

therapy

VITAL SIGN

MONITOR

Suction pump

Bubble CPAP

1 Baksa 1 4 4 4 2 1

2 Bongaigaon 5 2 5 4 1 2 2

3 Chirang 2 4 4 3 1 2

4 Darrang 4 3 4 5 4 4

5 Dhemaji 3 3 4 1 2 2

6 Dhubri 7 2 5 3 1 2 4 7 Dima Hasao 2 2 3 3 3 1 2 2 8 Goalpara 5 0 5 5 0 1 1 4

9 Golaghat 2 4 4 2 2 3

10 Hailakandi 4 2 4 2 3 1 3 2


| P a g e

37

11 MMCH 6 2 5 4 6 1 3 3

12 Sonapur 3 2 4 4 4 1 2 2

13 K. Anglong 2 2

14 Karimganj 2 5 4 4 1 3 3

15 Kokrajhar 6 2 5 4 4 3

16 Lakhimpur 2 4 2 2 2

17 Morigaon 6 3 3 3 4 1 2 3

18 Nagaon 5 4 1 2 2

19 Nalbari 6 2 4 4 4 3 3

20 Sivasagar 4 2 3 3 5 1 2

21 Sonitpur CH 5 2 4 5 4 1 1 3

22 Tinsukia 2 4 4 2 2

23 Udalguri 5 2 4 4 4 1 2 2

24 Barpeta CH 1 2

Total 71 39 82 82 69 15 40 58

B. Power Backup Equipment for NBSU

Sl No District Name & Address of the facility 1 Barpeta Barpeta Road FRU Barpeta road

2 Barpeta Pathsala FRU Nityananda 3 Bongaigaon ABHAYAPURI CHC SRIJANGRAM 4 Cachar Katigorah Model Hospital Jalalpur 5 Darrang Kharupetia CHC Kharupetia 6 Darrang Sipajhar CHC Sipajhar 7 Dhemaji Gogamukh Gogamukh BPHC 8 Dhemaji Silapathar Model Hospital Sissiborgaon BPHC 9 Dhubri CHAPAR CHC Chapar BPHC

10 Dibrugarh Moran tiloi CHC Khowang 11 Dibrugarh Naharani CHC Naharani

12 Goalpara Dudhnoi CHC/FRU Rangjuli 13 Golaghat SKMCH Bokakhat SDCH Bokakhat 14 Jorhat Garamur SDCH/ FRU Kamalabari 15 Jorhat Teok FRU Kakajan 16 Jorhat Titabar SDCH Titabar 17 Kamrup Rural Azara Azara 18 Kamrup Rural Bezera CHC-FRU North Guwahati 19 Kamrup Rural BOKO CHC/FRU Boko

20 Kamrup Rural Hajo BPHC/FRU Hajo

21 Kamrup Rural Kamalpur Model Hospital Kamalpur 22 Kamrup Rural Rangia CHC/FRU Rangia

23 Kamrup Rural Sualkuchi FRU Sualkuchi 24 Kamrup Rural Sontoli PHC 25 Kokrajhar Gossaigaon SDCH Gossaigaon Block 26 Lakhimpur Dhakuakhana SDCH 27 Nagaon DHING FRU Dhing 28 Nagaon Hojai FRU Jugijan 29 Nagaon Jakhalabandha Jakhalabandha 30 Nagaon KAMPUR FRU Kathaitoli


| P a g e

38

31 Nagaon KAWAIMARI FRU Samaguri 32 Nagaon LUMDING FRU Lanka

33 Nalbari Mukalmua FRU Mukalmua BPHC 34 Nalbari Tihu FRU Tihu Reporting Unit 35 Sivasagar Demow CHC Demow BPHC 36 Sivasagar KSHS Nazira SDCH Ligiripukhuri Gelekey BPHC 37 Sivasagar Sonari SDCH Sapekhati BPHC 38 Sonitpur Biswanath Chariali SDCH Biswanath Chariali 39 Sonitpur Dhekiajuli CHC Dhekiajuli 40 Sonitpur Gohpur SDCH Gohpur BPHC 41 Tinsukia Digboi CHC Ketetong

42 Tinsukia Doomdooma FRU

43 Tinsukia Chapakhowa SDCH

44 Tinsukia Margherita FRU Ketetong

C. Equipment for strengthening NBSUs (First Phase ) Sl No District Name of the NBSU Radiant

Warmer L.E.D Phototherapy

1 Barpeta Barpeta Road FRU (Extended NBSU) 2 1 2 Barpeta Pathsala FRU 0 0 3 Bongaigaon Abhayapuri CHC 1 1 4 Cachar Katigorah Model Hospital 1 1 5 Darrang Kharupetia CHC (Extended NBSU) 2 2 6 Darrang Sipajhar CHC 1 1 9 Goalpara Dudhnoi CHC/FRU 0 1

10 Golaghat SKMCH Bokakhat SDCH 1 1 11 Jorhat Garamur SDCH/ FRU 1 1 13 Jorhat Titabar SDCH 1 1 14 Kamrup M Dhirenpara 1 1 15 Kamrup M Pandu FRU 1 1 23 Kokrajhar RNB SDCH Gossaigaon 1 1 24 Lakhimpur Dhakuakhana SDCH 0 1 25 Nagaon DHING FRU 1 1 26 Nagaon Hojai FRU 1 1 27 Nagaon Jakhalabandha 1 1 29 Nagaon KAWAIMARI FRU 1 1 34 Sivasagar Demow Model 1 1 35 Sivasagar KSHS Nazira SDCH Ligiripukhuri 1 1 36 Sivasagar Sonari SDCH 0 1 38 Sonitpur Dhekiajuli CHC 1 1 39 Sonitpur Gohpur SDCH 0 1 40 Tinsukia Chapakhowa FRU 0 1 41 Tinsukia Digboi CHC 1 1 42 Tinsukia Doomdooma CHC 0 1 43 Tinsukia Margherita FRU 0 1 44 Udalguri Rowta Model Hospital 2 1


| P a g e

39

Janani Shishu Suraksha Karyakaram (JSSK)

SL No FMR code


State HQ Allocation

District Allocation

15 6.2.2.1 JSSK drugs and consumables 109.78 71.98 37.80 16 6.4.4 Free Diagnostics for Sick

infants under JSSK 37.20 24.90 12.30

17 6.4.5 Any other (please specify) Free Blood Transfusion under JSSK

10.98 6.75 4.23

18 7.2 Free Referral Transport - JSSK for Sick Infants

281.76 281.76 0.00

TOTAL 439.72 96.88 42.03


| P a g e

40

Activity: JSSK Drugs and Consumables FMR code: 6.2.2.1 Total Approval: 109.78 (lakhs) Relevance of Activity: All districts including all level of facility (PHCs, CHCs, SDHs DHs/MCs or equivalent institutions. FMR Owner/Resource Person of the Activity: State- DSM HQ and Consultant-CH District- DPMs and DDSMs

Guideline for JSSK drugs and consumables

• The goal of this activity is “To Ensure Zero out of pocket expenditure” for the treatment of infants (up to one year) under JSSK, regardless of the level of facility

• As per the Govt. of India all sick new-born and infants (up to one year) should avail free treatment, drugs and diagnostics in the health facilities under Janani Shishu Suraksha Karyakram (JSSK).

• For smooth management of sick new-born and Infants, fund is approved to District Health Societies to reimburse the expenditure incurred by all health facilities (such as DH, CHC/FRU, PHC or any other hospitals like Medical Colleges) for specified essential drugs & consumables not available at the Health Facilities.

• The breakup of fund is considered with the number of probable sick new-born and infants. District Health Society may also disburse the funds to the facilities having high load OPDs & IPDs of Infants up to 1 year. Approval is accorded for the sick infant @ Rs.100/- per infant as per the budget sheet/annexure .

SI Districts Total amount (In Lakhs) 1 Baksa 1.00 2 Barpeta 2.00 3 Bongaigaon 1.00 4 Cachar 2.00 5 Chirang 1.00 6 Darrang 1.50 7 Dhemaji 1.50 8 Dhubri 2.00 9 Dibrugarh 2.00

10 Dima Hasao 0.80 11 Goalpara 1.50 12 Golaghat 1.50 13 Hailakandi 1.50 14 Jorhat 2.00 15 Kamrup M 2.00 16 Kamrup R 1.00 17 KarbiAnglong 1.00 18 Karimganj 1.00 19 Kokrajhar 1.00 20 Lakhimpur 1.00 21 Marigaon 1.00 22 Nagaon 2.00 23 Nalbari 1.00 24 Sibsagar 1.50 25 Sonitpur 2.00 26 Tinsukia 1.00 27 Udalguri 1.00



| P a g e

41

The Fund has been provided for procurement of essential drugs and consumable as and when required. It is also to be noted that this amount will have to utilized within the limit of sanctioned amount mentioned as per financial norms/procedures. Drugs, consumables included in the essential drugs list notified by Govt. should only procured when the drugs and consumables are not available.

A Committee is to be constituted with following members for this purpose – Chairman --------- ADC (Health) Co- Chairman --------- Jt. DHS Convenor --------- DPM Co- Convenor --------- District Drugs Store Manager Member :

1. Superintendent, DH/Medical College 2. HOD, Paediatrics/SNCU Nodal Officer 3. Hospital Administrator 4. DAM

Activity: Free Diagnostic for Sick Infants under JSSK FMR Code: 6.4.4 Total Approval: 37.20 lakhs Relevance of Activity: All districts including all level of facility (PHCs, CHCs, SDHs DHs/MCs or equivalent institutions. FMR Owner/Resource Person of the Activity: State-Consultant-CH and PE (Child Health) District-DPMs Block - BPMs

The goal of this activity is “To Ensure Zero out of pocket expenditure” for the treatment of infants (up to one year) under JSSK, regardless of the level of facility.

• As per the Govt. of India all sick new born and infants (up to one year) should avail free treatment, drugs and diagnostics in the health facilities under JSSK.

• For smooth management of sick new-born and Infants, fund is approved to District Health Societies to reimburse the expenditure incurred by all health facilities (such as DH, CHC/FRU, PHC or any other hospitals like Medical Colleges) for specified essential diagnostics which are not available at the Health Facilities.

• The breakup of fund is considered with the number of probable sick new-born and infants and also with the available special facilities to manage those sick children.

Approved Investigations for New-born and Infants:

• Both for Medical College and District Hospital and other Govt Health Institutes. • Other tests beyond these tests will not be approved for payment. • The Medical College, District Hospital and other Health Facility Authorities should be clearly

informed about the approved tests by District Health Society) 1. Sr. Bilirubin (Total and Fraction) 2. G6PD Deficiency 3. Blood Glucose, 4. Sr. Albumin 5. Complete Blood Count, Platelet Count 6. Blood Grouping 7. ESR (Micro), 8. Urine Culture 9. Sr. Ionised Calcium 10. CSF Culture 11. Electrolytes (Sr. Sodium, Sr. Potassium, Sr. Magnesium), 12. TLC, DLC 13. Sepsis Screening,


| P a g e

42

14. C-Reactive Protein, 15. Blood Culture & Sensitivity 16. Haemoglobin, 17. X-Ray 18. USG, etc 19. CT scan 20. Thyroid Function Test

Important Point: All tests must be as per the treatment guidelines given in FBNC training module and based on clinical condition of the newborn. Also all investigations are not required in NBSU due to limitations on service provision. Process of utilisation of JSSK fund for diagnostics:

• Except few, most of the approved tests are freely available under Free Diagnostic Scheme including CT scan, districts must identify the other required diagnostic investigations for various units providing Paediatric Services like SNCU, NBSU, PICU, Paediatric Ward, Paediatric OPD, NRC, etc.

• Further after assessing the requirement, districts must list down the investigations which are not available in the health facilities under the free diagnostic scheme. This list should be facility wise as different facilities will have different requirements.

• Further these investigations must be outsourced to the outside facilities maintaining all financial norms under NHM. Preference to be given to any other nearby Govt. Institution like Medical College, Regional Diagnostic Laboratory, Hospitals already under PPP, etc.

• For outsourcing to private laboratories preference must be given to those accredited by NABL. In case no NABL accredited lab is available in the districts/block, the district level committee can accredited and empanel the laboratory which are of proper standing under the clinical establishment act for the tests which are not available in the hospital/HLL labs.

• Once the required investigations are outsourced, the investigations must be done through that facility only and in no case patient should incur out of pocket expenditure.

• All payments to the outsourcing facility must be done directly from facility. • Cash benefit to patient/care givers should not be offered under any circumstances using

JSSK funds. • This fund is for diagnostics only. It is not for reimbursement of hospital bed charges (Both

ward , PICU and drug etc). Guidelines for utilization of the fund:

• Amount calculated is on average. Actual expenditure for treatment of each individual may vary.

• Under JSSK scheme infants up to 1 year of age are entitled to receive free treatment, free diagnostics and free referral transport.

• Under JSSK scheme there is no provision to provide cash incentive to caregiver of the patient and to service provider.

• This fund is not meant to reimburse the charges levied by Health Facility for investigation at the laboratory/radiology in-house.

• The present fund under JSSK for Infants is meant to use for reimbursement to Health facilities treating infants with required diagnostic services under facility-based management of New-born and infants. It is to be certified by the Facility in-charge that the bill submitted for reimbursement contains only approved tests and not available from other sources at the time of use.

• Districts should reimburse on monthly basis observing all financial norms. • Monthly submission of SoE and UC is mandatory along with statement of Physical and

Financial achievement.


| P a g e

43




The Fund has been provided for investigation as and when required. It is also to be noted that this amount will have to utilized within the limit of sanctioned amount mentioned as per financial norms/procedures.

Investigation which are not done under free diagnostic schemes will be paid after approval of a committee.

A Committee is to be constituted with following members for this purpose – Chairman --------- ADC (Health) Co- Chairman --------- Jt. DHS Convenor --------- DPM Co- Convenor --------- District Drugs Store Manager Member :

1. Superintendent, DH/Medical College 2. HOD, Paediatrics/SNCU Nodal Officer 3. Hospital Administrator 4. DAM


| P a g e

44

Activity: Others ( Free Blood Transmission for Infants under JSSK) FMR code: 6.4.5 Total Fund Allocation: 10.98 Lakhs Free Blood transmission to all JSSK Beneficiaries FMR Owner of the Activity: State HQ: Consultant-CH, PE (Child Health) District: DPM




Activity: Free referral for infants under JSSK FMR code: 7.2 Fund Allocation: 281.76 Lakhs FMR Owner of the Activity: PE-Referral Transport

The goal of this activity is “To Ensure Zero out of pocket expenditure” for the transport and referral of infants (up to one year) for treatment under JSSK, regardless of the level of facility and from facility to facility. The referral transport for sick infant is approved by GOI. This fund is to be used for referral transport of the sick infant from home to facility and from one facility to others transport. No infant should incur the OOPE for referral transport for treatment.


| P a g e

45

TRAINING

SL No FMR


Budget (Lakh) State HQ

Allocation District

Allocation

19 9.1.6.1 Development/ translation and duplication of training materials (including SAANS training modules)

2.30 2.30 0.00

20 9.5.2.1 IMNCI (including F-IMNCI; primarily budget for planning for pre-service IMNCI activities in medical colleges, nursing colleges)

12.77 0.00 12.77

21 9.5.2.2 Orientation/Planning Meeting/Launch on SAANS initiative at State or District (Pneumonia)/IDCF orientation

10.30 4.00 6.30

22 9.5.2.4 Child Death Review Trainings 19.05 0.00 19.05 23 9.5.2.7 IMNCI Training for ANMs / LHVs 64.05 0.00 64.05 24 9.5.2.9 F-IMNCI Trainings for Medical

officers and Staff Nurses 19.52 0.00 19.52

25 9.5.2.10 F-IMNCI Training for Staff Nurses 69.60 0.00 69.60 26 9.5.2.13 NSSK Training for Medical Officers 18.12 0.00 18.12 27 9.5.2.14 NSSK Training for SNs 31.08 0.00 31.08 28 9.5.2.16 4 days Training for facility based

new-born care 19.020 2.036 16.984

29 9.5.2.17 2 weeks observer ship for facility based new-born care

50.59 2.11 48.48

30 9.5.2.21 Trainings for Family participatory care (KMC)

7.89 0.00 7.89

31 9.5.2.24 State/District ToT of SAANS, Skill Stations under SAANS

22.00 2.00 20.00

TOTAL 346.290 12.450 333.844


| P a g e

46

State Translation & Printing of training module (200 nos) and Treatment Protocols (200 colored A3 size per district)

50000 1 50000

District Printing of training module (1500 Nos)Treatment Protocols (50 colored A3 size) (One time cost)

20,000

9 180000

Total 2,30,000.00

Note: Fund at State HQ

Activity: IMNCI (including F-IMNCI; primarily budget for planning for pre-service IMNCI activities in medical colleges, nursing colleges, and ANMTCs other training)

FMR: 9.5.2.1

Total Fund Allocation :12.77 Lakhs

Relevance of Activity: F-IMNCI pre service training in medical colleges. Total = 12.77lakhs @0.85 per batch for 15 batches of 50 students per batch Owner of the Activity: State Level: Consultant Training-CH, PE (Child Health) District & Medical College: DPMs and BPMs (Medical College)

Guideline for F-IMNCI pre service training in medical colleges Total = 12.77 lakhs @0.85 per batch for 15 batches of 50 students per batch This facility-based-care IMNCI (Integrated Management of Neonatal and Childhood Illness) training focuses on providing appropriate inpatient management of major causes of neonatal and childhood mortality such as asphyxia, sepsis, and low birth weight in neonates; and pneumonia, diarrhoea, malaria, meningitis, and severe acute malnutrition in children.

F-IMNCI training for medical students of all the six medical college (15batches ~ 50-60 per batch) is sanctioned. The purpose of the F-IMNCI training is to ensure the pass out students joining government health system can treat the neonatal and childhood illnesses more effectively. The fund should be released to respective Medical Colleges (training venue) for this training.

Existing trainers of F-IMNCI for Medical Colleges will be the resource persons for this training and capacity building of the students. This training is for to be pass out students of Medical Colleges. To be done as per the Government of India Pre Service package of f-IMNCI.

The tentative budget for the training is provided in the table below which is suggestive; however, norms for RCH trainings must be followed.

Activity: Development/ translation and duplication of training materials (including SAANS training modules) FMR code: 9.1.6.1 Fund Allocation: 2.30 Lakhs Relevance of Activity: All districts including all level of facility (PHCs, CHCs, SDHs DHs/MCs or equivalent institutions. FMR Owner of the Activity: State HQ: SPM , Consultant (Training)


| P a g e

47

F-IMNCI orientation pre service for Medical Students in Medical colleges

50 participants+ 4 Trainers

S. N. Activity Cost per batch

Unit Cost Unit No of Days Total Cost

4 Honorarium to the Resource Person

4000 4 2 32,000

6 Food to the participants (Breakfast/ Lunch/ Tea

(Participants + RP)

250 54 2 27,000

8 Training Kit 100 50 1 5,000

(Pen, Pad, folder, pencil, Eraser)

9 Printing of modules and Chart Booklet for Participants

200 50 1 10,000

74,000

11 Contingency per batch (15%) 11,100

Cost of One batch 85,100

FIMNCI orientation Plan District Name of the Institute Batches Total (In Lakhs) Kamrup Metro GMCH 3 2.558 Dibrugarh AMCH 4 3.404 Jorhat JMCH 2 1.702 Cachar SMCH 2 1.702 Barpeta FAAMCH 2 1.702 Sonitpur TMCH 2 1.702 Total 15 12.77

Name of the Activity: Orientation/Planning Meeting/Launch on SAANS initiative at State or District (Pneumonia) FMR: 9.5.2.2 Total Budget 10.30 Lakhs Relevance: Roll out of SAANS initiative in 9 districts(Kamrup R, Hailakandi, Barpeta, Nalbari, Dibrugarh, Nagaon, Morigaon, Dhubri, Karimganj) of the State. State, District and Block level Orientation on SAANS FMR Owner of the Activity: State : Consultant CH, Consultant (Training), PE (Child Health) District: DPM and DME

Activity Rate

State Launch Event on World Pneumonia Day 200000

State Planning & Review Meeting 200000

Total 400000

Activity Rate Quantity Cost District Launch Event (Annually) 50000 9 450000 District Planning & Review Meeting (One time) 20000 9 180000

For Each District 630000


| P a g e

48

Total ( for 9 districts) 1030000

SL. No District Fund allocation in Lakh 1 Kamrup Rural 0.70 2 Hailakandi 0.70 3 Barpeta 0.70 4 Nalbari 0.70 5 Dibrugarh 0.70 6 Nagaon 0.70 7 Morigaon 0.70 8 Dhubri 0.70 9 Karimganj 0.70 District Allocation 6.30 State Allocation 4.00 Total 10.30

Name of the Activity: Child Death Review Trainings FMR: 9.5.2.4 Total Budget 19.05 Lakhs Relevance: All districts and blocks. District level CDR 2 days training @0.7055 Lakhs per batch FMR Owner of the Activity: State : PE (Child Health) and SCM District: DPM Block: DCM The Master level trainers trained in state TOT will be conducting the district Level training for strengthening the implementation of CDR guidelines & Processes. All the SMO, Medical officer , Paediatricians , ANM ,etc to be trained. ASHA/ANM workers to be sensitized

District level orientation on CDR (Two day) Cost per Batch SL No Particulars No Days Rate Amount

1 Honorium for Trainer ( state , National , District)

2 2 1000 4000

2 Travel charges for trainers 2 2 1000 4000 3 Accommodation for trainer 2 3 1000 6000 4 Honorium for Participants 30 2 500 30000 5 Working lunch 35 2 150 10500 6 Training material 30 1 250 7500 7 Overhead Incidental charges ( 15 %

total expenses training venue ( on actual basis ,local transport etc.)

8550

8 Total 70555 For 27 District 1905550

In Lakhs 19.05


| P a g e

49

Name of the Activity: IMNCI Training for ANMs / LHV FMR: 9.5.2.7 Total Budget: 64.05 lakh Relevance of Activity: IMNCI training for ANMs/ LHVs FMR Owner/Resource Person of the Activity: State Level: Consultant Training-CH, PE (Child Health) District: DPMs and DCMs

The IMNCI strategy includes both preventive and curative interventions that aim to improve practices in health facilities, the health system and at home. At the core of the strategy is integrated case management of the most common childhood problems with a focus on the most common causes of death by using structured format and algorithm. To be strictly done as per GOI, IMNCI guidelines including the field visits.

IMNCI Training of Health workers (ANM/ LHV) 24 participants + 3 RP

S. N. Activity Cost per batch Unit Cost

Unit No of Days

Total Cost

1 DA to the participants 400 24 8 76,800 2 Accommodation to participants where

residential facility is not available. 1000 24 8 192,000

3 Honorarium to the Resource Person 600 3 8 14,400 4 Accommodation to resource persons

where residential facility is not available.

3000 3 8 72,000

5 Food to the participants (Breakfast/ Lunch/ Dinner/ Tea (Participants + RP)

250 28 8 56,000

6 Hiring of vehicle for field visit @2 vehicles per day

2000 2 4 16,000

7 Hiring of Venue 3000 1 8 24,000 8 Honorarium to the Resource Person at

District Hospital for 1 SN @300/) for 3 days

300 1 3 900

9 Contingency (Including Printing of modules and Chart Booklet for Participants, Pen, Pad, folder, pencil, Eraser)

300 24 1 7,200

10 TA to the participants as per actual 200 24 1 4,800

11 Institutional Overhead (15%) 69,615 Cost of One batch 5,33,715.00

S.N. District No of Batches Sanctioned Total Amount (in

Lakhs) 1 Barpeta 1 5.343 2 Darrang 1 5.337 3 Dhubri 1 5.337


| P a g e

50

4 Goalpara 1 5.337 5 Hailakandi 1 5.337 6 Lakhimpur 1 5.337 7 Morigaon 1 5.337 8 Nagaon 1 5.337 9 Sonitpur 1 5.337

10 Karimganj 1 5.337 11 Cachar 1 5.337 12 Kamrup R 1 5.337 Total 12 64.05

General Instructions:

ü Participants for the training will be ANM, LHV. Facilitators will be the master trainers from districts.

ü Training venue should have accommodation facility for the trainees as well as facilitators. ü Training is strictly residential and the arrangements must be made directly by district. ü Training must be combination of class room sessions and field visits. ü At least 3 morning sessions must be dedicated for field visits at Anganwadi centres for practice

of case assessment (0-2m, 2m-5 yrs.),2 morning sessions at SNCU to have practical sessions for identification of sick children (0-2 months) and 1 morning session at Paediatric OPD for identification of sick children (2 months – 5 yrs.) Every morning session at field must be followed by class room session and group presentation during afternoon session.

ü District needs to ensure travel arrangements for field visits & incentives to 1 Paediatrician and 1 SN.

ü Districts should print the training materials which include modules, assessment formats beforehand.

ü Districts must maintain all the name based data base of the training.

Note: The tentative budget for the training is provided in the table below which is suggestive; however, norms for RCH trainings must be followed.

Name of the Activity: F-IMNCI Trainings for Medical officers and Staff Nurses FMR: 9.5.2.9 Total Budget=19.52 Lakh Relevance of Activity: 8 Batches of F-IMNCI trainings FMR owner/Resource Person of the Activity: State: Consultant Training-CH, PE (Child Health) Districts-DPMs and BPMs in Medical Colleges

This facility-based-care F-IMNCI (F-Integrated Management of Neonatal and Childhood Illness) training focuses on providing appropriate inpatient management of major causes of neonatal and childhood mortality such as birth asphyxia, neonatal sepsis, and pre-term & low birth weight in neonates; and management of pneumonia, diarrhoea, malaria, meningitis, and severe acute malnutrition in children.

Child Health division NHM Assam is planning to conduct F-IMNCI training (5 days) for MO & Staff Nurses at Medical Colleges to ensure better quality and improved hands on Training for case management of newborn and infants at Facility Level. The training will help to create capacity building of service providers. Four Medical Colleges namely GMCH, AMCH, JMCH and SMCH will conduct the training for Financial Year 2020-21.

This training will be done at Medical Colleges involving participants from various districts in the State including staff nurses posted in PICU and Paediatrics wards. Priority for this training will be given to Medical Officers & Staff Nurse posted in PICU, Paediatrics ward and NBSU.


| P a g e

51

F-IMNCI 5 days training

District Name of the Institute Batches Unit Cost in Lakhs Total (In Lakhs)

Kamrup Metro GMCH 2 2.44 4.88

Dibrugarh AMCH 2 2.44 4.88

Jorhat JMCH 2 2.44 4.88

Cachar SMCH 2 2.44 4.88

Total 8 2.44 19.52

F-IMNCI 5 days Training for Medical Officer & Staff Nurse

S. N. Activity Cost per batch

Unit Cost Unit Days Total Cost


4000 4 5 80,000

2 DA to the Medical Officer 700 4 5 14,000

3 DA to Staff Nurse 500 12 5 30,000

4 TA for participants 1000 16 1 16,000

5 Accommodation for Participants 1000 16 1 16,000 6 Food to the participants

(Breakfast/ Lunch/ Tea (Participants + RP)

350 25 5 43,750

7 Training Kit 150 20 1 3,000

(Pen, Pad, folder, pencil, Eraser)

8 Printing of modules and Chart Booklet for Participants

350 20 1 7,000

9 Banner & Poster 2000 1 1 2,000

211,750

11 Contingency per batch (15%) 31,763


Total 2.44 (in Lakhs)

Name of the Activity: F-IMNCI training of Staff Nurses FMR: 9.5.2.10 Total Budget=69.60 (@5.80 per batch for 12 batches in 4 MCs) Relevance of Activity: 12 Batches of F-IMNCI trainings FMR owner/Resource Person of the Activity: State: Consultant Training-CH, PE (Child Health) Districts-DPMs BPMs in Medical Colleges

Guidelines for F-IMNCI training of Staff Nurse This facility-based-care IMNCI (Integrated Management of Neonatal and Childhood Illness) training focuses on providing appropriate inpatient management of major causes of neonatal and childhood mortality such as asphyxia, sepsis, and low birth weight in neonates; and pneumonia, diarrhoea, malaria, meningitis, and severe acute malnutrition in children. Child Health Division, NHM, Assam is planning to conduct F-IMNCI training for MOs and SNs at medical colleges to ensure better quality and improved hands on training for case management at facility level.


| P a g e

52

Four medical colleges, namely GMCH, AMCH, JMCH and SMCH will be conducting the trainings for 2020-21. Department of Community Medicine of these four medical colleges will conduct these trainings. The training materials must be printed at district level and provided to medical colleges. Strict compliance to Govt. of India f-IMNCI modules is to be ensured.

This training will be done in the Medical Colleges involving participants from various districts in the State. The fund should be released to respective Medical Colleges (training venue) on priority. Priority for this training to be given to Medical Officers and staff nurses posted in the New-born Stabilization Units (NBSUs)@ 5.80 lakh/- per batch. Numbers of batches are as under:

District Name of the Institute

Batches Cost of single Batch

Total (In rupees)

Total cost In Lac

Kamrup Metro GMCH 3 580000 1740000.0 17.40 Dibrugarh AMCH 3 580000 1740000.0 17.40 Jorhat JMCH 3 580000 1740000.0 17.40 Cachar SMCH 3 580000 1740000.0 17.40 Total 12 580000 6960000.0 69.60 Note: The tentative budget for the training is provided in the table below which is suggestive; however, norms for RCH trainings must be followed.

F IMNCI Training of MO/SNs in Medical Colleges 16 participants+ 4 Trainers

S. N. Activity Cost per batch Unit

Cost Unit No of

Days Total Cost

1 DA to the participants (MO) 700 8 11 61,600 2 DA to the participants (SN) 400 8 11 35,200 3 Accommodation to participants

where residential facility is not available.

1000 16 11 176,000


1000 4 11 44,000

5 Accommodation to resource persons where residential

facility is not available.

3000 4 11 132,000

6 Food to the participants (Breakfast/ Lunch/ Tea

(Participants + RP)

250 20 11 55,000

7 Hiring of Venue 2000 1 11 22,000 8 Training Kit 200 16 1 3,200 9 Printing of modules and Chart

Booklet for Participants 500 16 1 8,000

10 Travel cost to the participants as per actual

1000 16 1 16,000

553,000 11 Contingency per batch 27,000



| P a g e

53

Activity Name :Navjaat Shishu Suraksha Karyakram (NSSK) for Medical Officer

FMR: 9.5.2.13

Total Approved = 18.12 lakhs

(1.47 per batch for 15 batches)

Relevance of Activity: Navjaat Shishu Suraksha Karyakram (NSSK) for Medical Officer

FMR Owner of the Activity: State : Consultant Training-CH, PE (Child Health) District: DPMs/DCMs

Navjaat Shishu Suraksha Karyakram (NSSK) for Medical Officer

• 12 batches of training as per the list below are sanctioned for the districts. • This training is to be done to all Specialists and Medical Officers working in the delivery

points. • All high delivery points should be saturated with the availability of NSSK trained Medical

Officers. • Funds allocated for this training is 1.51lakh per batch, however State RCH norms must be

followed. • To be strictly done as per NSSK training package. Availability of Neonatalies/Mannikins

must be ensured for hands on training.

Note:

• Priority to be given to saturate all high delivery load facilities with NSSK trained MOs/specialists.

• Districts have to find out the high delivery points of the district and preference will be given to these delivery points.

• Newly appointed Medical Officers should be the priority. • If staffs are already trained and it is more than 3 years since last training , reorientation should

be done in those delivery points where the load is very high.

SI Districts Batches Approved Budget in Lakhs 1 Barpeta 1 1.51 2 Cachar 1 1.51 3 Darrang 1 1.51 4 Dhubri 1 1.51 5 Goalpara 1 1.51 6 Golaghat 1 1.51 7 Karimganj 1 1.51 8 Kokrajhar 1 1.51 9 Baksa 1 1.51

10 Morigaon 1 1.51 11 Udalguri 1 1.51 12 Sonitpur 1 1.51

Total 12 18.12 Note: The tentative budget for the training is provided in the table below which is suggestive; however, norms for RCH trainings must be followed.


| P a g e

54

NSSK Training for Medical Officers S.N. Head Category Unit

Cost No of Days

No Total Cost

1 DA MO/Ayush MO ₹ 700 2 32 ₹ 44,800 2 Honorarium Resource

Person ₹ 1,000 2 4 ₹ 8,000

4 Breakfast, Tea, Lunch

₹ 250 2 37 ₹ 18,500

5 Accommodation for trainers where residential facility is not available.

₹ 3,000 1 4 ₹ 12,000

6 Accommodation for participants

₹ 1,000 1 32 ₹ 32,000

7 Training materials, Misc.

₹ 300 1 32 ₹ 9,600

8 TA (As per actual) ₹ 200 1 32 ₹ 6,400 Total ₹ 131,300

9 Institutional Overhead (15% of training expenses)

₹ 19,695

Grand Total ₹ 150,995 Total in Lakhs 1.50995

Name of the Activity: NSSK training for Staff Nurses FMR: 9.5.2.14 Total Approved =31.08 lakhs (Budget Allotted = 1.15/batch for 27 batches) Relevance of activity: Navjaat Shishu Suraksha Karyakram (NSSK) for Staff Nurses FMR Owner of the Activity: State : Consultant Training-CH, PE (Child Health) District: DPMs, DCMs

• 30 batches of training as per the list below are sanctioned for the districts. • This training is to be done to all Staff Nurses working in the delivery points. • All high delivery points labour room staff nurses must be trained in NSSK on priority. • District to ensure saturation of high delivery points with the availability of NSSK

trained Staff Nurses on priority. • Funds allocated for this training is 1.15 per batch, however State RCH norms must be

followed. To be strictly done as per NSSK training package. Availability of Neonatalies/Mannikins must be ensured for hands on training.

District wise batches allocation: SI. No Districts Batches Approved Budget in Lakhs 1 Baksa 1 1.15 2 Barpeta 1 1.15 3 Bongaigaon 1 1.15 4 Cachar 1 1.15 5 Chirang 1 1.15 6 Darrang 1 1.15 7 Dhemaji 1 1.15


| P a g e

55

8 Dhubri 1 1.15 9 Dibrugarh 1 1.15 10 Dima Hasao 1 1.15 11 Goalpara 1 1.15 12 Golaghat 1 1.15 13 Hailakandi 1 1.15 14 Jorhat 1 1.15 15 Kamrup M 1 1.15 16 Kamrup R 1 1.15 17 KarbiAnglong 1 1.15 18 Karimganj 1 1.15 19 Kokrajhar 1 1.15 20 Lakhimpur 1 1.15 21 Marigaon 1 1.15 22 Nagaon 1 1.15 23 Nalbari 1 1.15 24 Sibsagar 1 1.15 25 Sonitpur 1 1.15 26 Tinsukia 1 1.15 27 Udalguri 1 1.15

Total 27 31.08 Note: The tentative budget for the training is provided in the table below which is suggestive; however, norms for RCH trainings must be followed.

S.N. Head Category Unit Cost No of Days No Total Cost 1 DA CHO/SN/ANM ₹ 400 2 32 ₹ 25,600 2 Honorarium, Resource Person ₹ 1,000 2 4 ₹ 8,000 4 Breakfast, Tea, Lunch ₹ 250 2 37 ₹ 18,500 6 Accommodation for participants ₹ 1,000 1 32 ₹ 32,000 7 Training materials, Misc. ₹ 300 1 32 ₹ 9,600 8 TA (As per actual) ₹ 200 1 32 ₹ 6,400

Total ₹ 100,100 9 Institutional Overhead (15% of training expenses) ₹ 15,015

Grand Total ₹ 115,115

• Priority to be given to saturate all high delivery load facilities with NSSK trained staff nurses. • 2 staff nurses from NRC to be included in the training group. • Districts have to find out the high delivery points of the district and preference will be given to

these delivery points. • If staffs are already trained, and it is more than 3 years since last training reorientation should be

done in those delivery points where the load is very high.

Name of the Activity:4 days Training for facility based new-born care FMR: 9.5.2.16 Approved Budget =19.02 Lakhs Relevance of Activity: 4 Batches of 4 days training for Facility Based New-born Care (FBNC) and 2 weeks (14 days) observer ship for Facility Based New-born Care (FBNC) Owner of the Activity: State: Consultant Training, PE (Child Health) District: DPM


| P a g e

56

4 days training for FBNC (4 batches)

To conduct the training of doctors & Nurses under FBNC (4 days) at the state level (GMCH/State Resource Center). The fund should be released to respective training venue for FBNC (4 Days) under FMR: 9.5.2.16 of District RoP 2020-21 from. GOI, package of FBNC and observer ship training must be adhered to including hands on training using manikins.

The priority for 4 days FBNC training to be given to the Staff Nurses and Medical Officers/Paediatricians posted in the Special New-born Care Units.

District Name of the Institute Batches Per batch Total Amount

Kamrup Metro

GMCH 2 4.246 8.492

Cachar SMCH 1 4.246 4.246 Dibrugarh AMCH 1 4.246 4.246

Total District Allocation (In Lakhs) 16.984 State HQ Allocation 2.036

Total 19.02 L

Travel of Resource Persons from Duty Station to training venue and back (For State resource persons) As per Actual

28,000

Honorarium of 4 resource persons (4000*4days*4RP) 64,000 Accommodation for 2 Resource Persons (2*4000*4Days) (Out Side district) 32,000 Travel of participants from duty station to training venue and back (1000*24) 24000 DA & Accommodation for 24 participants (24*2000*4days) Lump sum 192000 Lunch, Tea, Coffee, Dinner for 30 Persons @500 per day (30*500*4days) 60,000 Audio-visual & Venue Charges 5,000 Training Materials Printing @400 per set for 24 sets. 9,600 Postage, Xerox, Stationary, etc. 5,000 Miscellaneous (Banner, Photography, Contingency, etc.) 5,000 Total 424,600.00

Observer ship for 14 days on Facility Based New-born Care (FBNC) training to be imparted to the Staff already trained in 4 days FBNC and they must complete both the 4 days and 14 days training. If after 4 days of training, the 14 days observer ship training is not done then the training will be considered as incomplete. Note: The tentative budget for the training is provided in the table below which is suggestive; however, norms for RCH trainings must be followed.

Activity Name: 2 weeks Observer ship Training of FBNC FMR:9.5.2.17 Total Approved : 50.59 Lakhs Relevance of Activity: 16 Batches of 2 weeks observer ship training for FBNC Owner of the Activity: State : Consultant(Training), PE (Child Health) District: DPMs

To conduct the compulsory observer ship duty of doctors & Nurses as part of FBNC training.

The staff trained in 4 days FBNC at state level will be deputed in any of the SNCU (depending upon the availability) to complete the 14 days observer ship. Only after completion of this observation


| P a g e

57

training the candidate will be certified for FBNC. The observer ship duty roster of participants to be prepared at State HQ.

The fund should be released to respective (OBSERVERSHIP venue) under FMR: 9.5.2.17of District RoP 2020-21.

GoI, package of FBNC and observer ship training must be adhered to including hands on training using manikins. The priority for 4 days FBNC training to be given to the Staff Nurses and Medical Officers/Paediatricians posted in the Special New-born Care Units

Note: The tentative budget for the training is provided in the table below which is suggestive; however, norms for RCH trainings must be followed.

District Name of the Institute Batches Cost per batch

Total Amount in Lakh

Kamrup M State Resource Center 6 3.03 18.18 Dibrugarh AMCH 4 3.03 12.12 Cachar SMCH 2 3.03 6.06 Jorhat JMCH 2 3.03 6.06 Sonitpur TMCH 2 3.03 6.06 Total District Allocation 16 3.03 48.48 State HQ Allocation 02.11 Total 50.59

FBNC Observer ship Training. (14 Days) (Batch Size - 6)

(2 Doctors and 4 Staff Nurses) Travel of Participants from duty station and back @2500 for 6 persons (As per Actuals)

15,000

DA & Accommodation of Participants @2000 for 6 persons for 14 days (Lump sum)

168000

Breakfast, Lunch, Dinner, Tea, Coffee for Participants @500 (8*500*14) 56,000

Local travel for Participants @500 per day per batch 3,000 Honorarium for Faculty @2000 per day for 2 Faculties 56,000 Contingency for Stationary, training materials. Clerical and Logistics 5,000 Total 303,000 3.03

Name of the Activity: Training for Family Participatory Care (KMC)

FMR: 9.5.2.21 Total Budget=7.89 Lakh Relevance of Activity: TOT for Mo and Training for Family Participatory Care (KMC) FMR Owner of the Activity: State : Consultant Training-CH, PE (Child Health) District : DPMs/ BPM Block : BPMs at MCs

Level-I State Level Training of Trainers (TOT) at State/District Hospital Level-II Training of all Service Providers in SNCUs 1-2 days (At SNCUs) Level-III Structured session with parents-attendants on daily basis Family Participatory Care (FPC) essentially means involving the families of sick and pre term new born as partners in care giving and decision making in the new born care facilities. However, the primary responsibility of care continues with the conventional health care providers namely the nurse and Doctors.


| P a g e

58

Family Participatory Care (FPC) provides a setting in which family is empowered, encouraged, and supported as the constant care providers, in addition to available nursing staff, to compliment care of sick new born in nursery, from admission till discharge. As per the guidelines four suggestive sessions are: Session-1: Protocols for Entry into Nursery Session 2: Developmentally supportive care and feeding Session 3: Kangaroo Mother Care Session 4: Preparation for Discharge Kangaroo Mother Care is a low resource, evidence based, high impact intervention and standardized care for low birth weight infants which, like breastfeeding should be part of routine care. It can prevent half of all deaths in infants weighing less than 2000 gm.. The districts have to nominate the MOs and SNs specifically from NBSUs and SNCUs for KMC trainings. The practical session or orientation will be done by visiting nearest SNCU/KMC unit.

Kangaroo Mother Care Training-District Level ( One Batch Per Distt.)

20 participants+ 3 Trainers S. N. Activity Cost per batch

Unit Cost Unit No of Days

Total Cost

1 DA to the participants (MO) 700 4 1 2,800 2 DA to the participants (SN) 400 16 1 6,400 3 Honorarium to the Resource Person(

Trained at State TOT) 1000 3 1 3,000

6 Food to the participants (Breakfast/ Lunch/ Tea (Participants + RP)

250 24 1 6,000

8 Training Kit(FPC Module, DVDs & Stationaries)

300 24 1 7,200

25,400 12 Contingency per batch (15%) 3,810

Cost of One batch 29,210 27 District 7.89 Lakh

Activity Name: State/District ToT of SAANS, Skill Stations under SAANS

FMR CODE : 9.5.2.24

Budget Approved: 22.00 Lakhs

Relevance of Activity: State Launch Event on World Pneumonia Day and State Planning & Review Meeting. State Training of Trainers for one batches of 30 participants each(MO and Staff Nurses), District level training of CHO/ANM/ASHA total 50 Batches @40000/- for 9 district

FMR Owner of the Activity:

State : Consultant Training-CH, PE (Child Health), SCM District: DPMs, DCM and DME

Sl District Batches Cost per batch Total

1 Kamrup Rural 6 40,000/- 2,40000/-

2 Hailakandi 5 40,000/- 2,00000/-

3 Barpeta 5 40,000/- 2,00000/-


| P a g e

59

4 Nalbari 4 40,000/- 1,60000/-

5 Dibrugarh 6 40,000/- 2,40000/-

6 Nagaon 6 40,000/- 2,40000/-

7 Morigaon 5 40,000/- 2,00000/-

8 Dhubri 7 40,000/- 2,80000/-

9 Karimganj 6 40,000/- 2,40000/-

Total 50 20,00000/-

Activity Cost in Rs State Training of Trainers for one batches of 30 participants each

200000

District Training 50 Batches @ 40,000Rs 2000000 Total 2200000

State ToT for SAANS(2 Days ) Cost per Batch

Particulars No Days Rate Amount

Honorarium for trainer selected by NHM

2 2 2000 8000

Honorarium to Participants (MO) 30 2 700 42000

Travel on actual basis for trainer) 2 1 2000 4000

Travel to Participants(As per Actual) 30 1 1000 30000 Accommodation for trainer 2 3 2000 12000

Accommodation for participants where residential facility Not available

30 2 1000 60000

Food (Breakfast, Lunch, Tea) 40 2 350 28000

Training Material 30 1 350 10500

Certificates & Other IEC material 30 1 50 1500

Total 200000

District level Training on SAANS(one days ) Cost per Batch Particulars No Days Rate Amount Honorium for Trainer ( state , District) 2 1 1000 2000 Travel charges for trainers 2 1 1000 2000 Accommodation for trainer 2 1 1000 2000 Honorium for Participants 30 1 500 15000 Working lunch 35 1 150 5250 Training material 30 1 250 7500

Overhead Incidental charges ( 15 % total expenses training venue ( on actual basis ,local transport etc.)

6250

Total 40000


| P a g e

60


| P a g e

61

CHILD DEATH REVIEW

SL No FMR code


State HQ Allocation

District Allocation

32 10.1.2 Child Death Review 45.29 0.00 45.29


| P a g e

62

Name of the Activity: Child Death Review FMR: 10.1.2 Total Budget approved: 45.29 Lakhs Relevance: All districts and blocks. Incentive to ANM 100Rs per FBIR form, to Verbal autopsy team 500Rs per verbal autopsy, Reimbursement to relative 300Rs for travel for CDR meeting.(excluding ASHA incentive) FMR Owner of the Activity: State : PE (Child Health), SCM District : DPM and DCM Block : BCM

Following is the broad guidelines for utilization of the fund:

1. Child Death Review is to identify the leading causes of child deaths (0-59 months) and the contributory factors. Analysis of sequence of events of every child death will identify the gap areas for service delivery and will help in strengthening child health care service delivery and in reduction of Neonatal, Infant and under five mortalities.

2. Child Death review process is to identify the cause specific mortality data and to take a corrective action to improve the service delivery. The major objective of CDR is as follows,

• To provide cause specific mortality data. • Gap filling of birth and death reporting and registration. • To evaluate effectiveness of health interventions in reducing mortality. • To identify issues relating to health seeking behaviour and • To identify issues relating to service delivery to prevent avoidable deaths. • To take policy level decision on allocation of resources and strategic interventions. 3. All deaths in age group of 0-59 months to be covered under CDR. 4. CDR will be implemented with TWO processes. i.e. Community Based CDR and Facility

Based CDR. Process:

S.N. Activity No of Deaths to be reported

Responsible Person

Timeline Incentive

1 First Brief Investigation All ANM 15 Days ₹ 100 2 Verbal Autopsy All VA Team of 2-3

persons 2

Months ₹ 500

3 District CDR Review Meeting (Both CBCDR & FBCDR)

3/month DNO Monthly -

• Reimbursement of travel expenses for relatives of deceased attending District CDR Meeting @ ₹100 per case and maximum 3 cases per month per District.

• Contingency of ₹9000 Per District per year. District wise Allocation of Funds is as under:

District Amount in Lakhs Baksa 1.6

Barpeta 2.1 Bongaigaon 1.1 Cachar 2.5 Chirang 0.64


| P a g e

63

Darrang 1.32 Dhemaji 1.23 Dhubri 2.33 Dibrugarh 1.77 Dima Hassao 0.81 Goalpara 1.53 Golaghat 1.56 Hailakandi 1.34 Jorhat 1.97 Kamrup M 1.55 Kamrup R 2.56 KarbiAnglong 1.94 Karimganj 1.76 Kokrajhar 1.19 Lakhimpur 1.74 Morigaon 1.09 Nagaon 3.51 Nalbari 1.36 Sivasagar 1.99 Sonitpur 2.33 Tinsukia 1.51 Udalguri 0.97 Total 45.29 Lakh


| P a g e

64


| P a g e

65

PRINTING

SL No FMR


Budget State HQ

Allocation District

Allocation 34 12.2.1 Printing for IMNCI, FIMNCI,

FBNC, NBSU training packages and the translation

5.00 5.00 0.00

35 12.2.2 Printing for National Childhood Pneumonia Management Guidelines under SAANS

0.07 0.07 0.00

36 12.2.4 Printing of Child Death Review formats

7.48 7.48 0.00

37 12.2.10 Printing (SNCU data management)

21.00 21.00 0.00

38 12.2.11 Printing of HBNC referral cards and other formats

60.31 60.31 0.00

39 12.2.12 Printing cost for HBYC 11.21 11.21 0.00 Total 105.070 105.070 0.00


| P a g e

66

Name of the Activity: Printing of IMNCI FMR: 12.2.1 Total Approval: 5.00 Lakhs Relevance of Activity: Printing of IMNCI training material Owner of the Activity: State : SPM, Consultant (Training)

The IMNCI training requires Chart Booklet, Photo Booklet & Training Module. The photo

booklet and chart booklet is given to ANM and LHVs which needs to be carried on field during visits to support proper identification of illness and necessary treatment or follow up to be done.

The F-IMNCI training modules needs for conducting the F-IMNCI trainings. The IMNCI service booklet contains assessment forms which need to be filled during assessment of the child in field visit. The IMNCI supervisory forms needs to be used and filled by all supervisors of IMNCI program which includes all sector MOs, SDM & HOs etc.

Name of the Activity: Printing for National Childhood Pneumonia Management Guidelines under SAANS FMR: 12.2.2 Total Approval: 0.07 Lakhs Relevance of activity: Printing of Guideline for SAANS training for State Level Training Owner of the Activity: State : SPM & Consultant CH

Name of the Activity: Printing of Child Death Review Formats FMR: 12.2.4 Total Approval: 7.48Laks Relevance of activity: Owner of the Activity: State : SPM & PE (Child Health)

1. The printing of required nos. of format following all financial norms under NHM. 2. It is to be ensured that the notification cards are printed in local language, so as to make

the reporting convenient for ASHAs. 3. Printing of formats must have done considering the existing stock at all levels in the district.

Head Unit Unit Cost Total (b*c) In Lakh

Notification Card 200000 1 200000 2.0 FBI 200000 2 400000 4.0 3A 8000 5 40,000 0.4 3B 4000 5 20,000 0.2 3C 12000 4 48,000 0.5 4A 6000 5 30,000 0.3 4B 2000 5 10,000 0.1

Total 748000 7.48


| P a g e

67

Name of the Activity: Printing (SNCU data management) FMR: 12.2.10 Total Approved Budget : 21.00 Lakhs Owner of the Activity: SPM and Consultant CH

For recording the newborns details in the SNCU various case sheets, discharge cards, follow up cards and different registers as well as case recording formats needs to be printed. Printing cost for various requirements of SNCUs is proposed.

Name of the Activity: Printing of HBNC referral cards and other formats FMR: 12.2.11 Approved Budget : 60.31 Lakhs Owner of the Activity: SPM and SCM at State HQ

Name of the Activity: Printing cost for HBYC FMR: 12.2.12 Total Approval: 11.21 Lakhs Relevance of activity: 1. Printing of 6605 Nos Job aids @Rs-15/- 2. Printing of 371 AS Registers @Rs-64/- 3. Printing of 10475 Nos ASHA Handbook@Rs-65/- 4. Printing of 123812 Nos HBYC cars @Rs-1.5/- 5. Printing of 26418 Nos ASHA Poster @Rs-5/- Owner of the Activity: State : SPM, SCM and PE (Child Health)


| P a g e

68


| P a g e

69

OTHERS: Review/SNCU Follow Up

Sl No FMR code Activity Approved Budget (Lakh)

State HQ Allocation

District Allocation

39 16.1.2.1.3 Review/orientation meetings for child health programmes

26.162 5.680 20.482

40 16.1.4.3.1 (16.1)

SNCU Follow up and Data Management

8.47 1.27 7.20

41 18.5 Strengthening of FBNC services (SNCU & NBSU mentoring), HBNC and SNCU Graduate follow up services in Dhemaji and Tinsukia districts.

11.62 11.62 0.00


| P a g e

70

Name of the Activity: Mobility Support for DPMU/District (including SAANS supportive supervision) FMR: PM Annexure (FMR 16.1.3.3.3) Approved Budget: The Cost for Mobility will be utilized from usual DPMU mobility fund Relevance of activity: Monitoring , evaluation and supportive supervision of the SAANS training and rollout activities at 9 districts. Owner of the Activity: State: SCM and Consultant CH District: DPM

Under this FMR the District and Block level monitors will do filed visits for supportive supervision. A detailed monitoring checklist is given as Annexure 4 in the GOI main guideline on Childhood Pneumonia Management. The guideline may be downloaded from the website of MH&FW.

Name of the Activity: Review/orientation meetings for child health programme FMR: PM Annexure (FMR 16.1.2.1.3) Approved Budget:26.162 Lakh Relevance of activity: Review/orientation meetings for child health programme Owner of the Activity: State: Consultant CH, Consultant (Training), PE (Child Health) District: DPM

A) Data collection and district level review of HBYC data: 13.606 Lakh B) Bi-annual 4 Regional level Review Meeting on Child Health (District level, region wise ):6.864 Lakh C) Dedicated 2 SNCU Review Workshop(State HQ):5.86 Lakh

Sl No District Total

ASHA Supervisor

Total ASHAs

Estimated Live Births

Proposed Target for

HBYC

Data

Collection

Review/Assessment @Rs-0.4 Lakh per meeting

Total Monitoring

& Assessment

Cost 1 Baksa 97 950 19486 7307 0.37 0.8 1.17

2 Barpeta 149 1610 38210 14329 0.72 0.8 1.52

3 Darrang 82 978 20948 7856 0.39 0.8 1.19

4 Dhubri 176 1996 46924 17596 0.88 0.8 1.68

5 Goalpara 97 1067 24052 9019 0.45 0.8 1.25

6 Hailakandi 67 715 22134 8300 0.42 0.8 1.22

7 Karimganj 114 1235 34618 12982 0.65 0.8 1.45

8 Udalguri 95 1065 18763 7036 0.35 0.8 1.15

9 Nagaon 203 2443 73767 13831 0.35 0.4 0.75

10 Cachar 162 1826 48366 9069 0.23 0.4 0.63

11 Jorhat 113 1265 23346 4377 0.11 0.4 0.51

12 Sonitpur 180 1946 40295 7555 0.19 0.4 0.59

13 Morigaon 83 948 24288 4554 0.11 0.4 0.51

Total 1618 18044 435197 123812 5.21 8.40 13.620 L

Remarks:

• Data Collection for 20% of the target is proposed for 7 Aspirational districts and Karimganj. For new 5 districts (Cachar, Jorhat, Nagaon, Morigaon & Sonitpur 10% proposed against target.

• Review/Assessment meeting has been proposed for 2 meetings every six month for old 8 districts and one meeting in Feb-March 2021 for 5 new district.


| P a g e

71

Activity-B One Day Bi-annual Regional Child Health Workshop

Darrang & Nagaon( 7 Districts)

Budget Break Up Per Workshop

SN Heads Unit Cost Unit No of

Days Total Cost Participants from each districts


JDS/Adl.CM & HO, DPM, DDM, DME, DCM, DFPC, SNCU NO,PICU

NO, Dietician, BPMs

2 Working lunch, tea, coffee, snacks and

water 150 120 1 18,000

3 Workshop Kit 50 120 1 6,000

4 Contingency

(Venue Charge, Banner & other Misl)

15000 1 1 15,000

Total 99,000

Dibrugarh & Sonitpur ( 8 Districts)





JDS/Adl.CM & HO, DPM, DDM, DME, DCM, DFPC, SNCU NO,PICU

NO, Dietician, BPMs

2 Working lunch, tea, coffee, snacks and

water 150 126 1 18,900

3 Workshop Kit 50 126 1 6,300

4 Contingency


15000 1 1 15,000

Total 103,200

Baksa & Goalpara ( 8 Districts)





JDS/Adl.CM & HO, DPM, DDM, DME, DCM, DFPC, SNCU

NO,PICU NO, Dietician, BPMs

2 Working lunch, tea, coffee, snacks and water 150 113 1 16,950

3 Workshop Kit 50 113 1 5,650

4 Contingency


15000 1 1 15,000

Total 94,100


| P a g e

72

Cachar & Hailakandi ( 4 Districts) Budget Break Up Per Workshop




JDS/Adl.CM & HO, DPM, DDM, DME, DCM, DFPC, SNCU

NO,PICU NO, Dietician, BPMs

2 Working lunch, tea, coffee, snacks and water 150 57 1 8,550

3 Workshop Kit 50 57 1 2,850

4 Contingency


7000 1 1 7,000

Total 46,900

Total Budget for 4 Bi-annual Regional Workshops(In Lakhs) 6.864

SL No Region Organizing District

Regional Workshop

Month of workshop

Participatory Districts Fund for the workshop

1 Region 1 Darrang First July Barpeta, Darrang, Kamrup Metro, Kamrup Rural, KarbiAnglong, Morigaon, Nagaon

99,000/-

2 Nagaon Second January 99,000/-

3 Region 2 Sonitpur First July Tinsukia, Dibrugarh, Lakhimpur, Dhemaji, Sonitpur, Jorhat, Sivsagar, Golaghat

103,200/-

4 Dibrugarh Second January 103,200/-

5 Region 3 Baksa First July Baksa, Bongaigaon, Chirang, Dhubri, Goalpara, Kokrajhar, Nalbari, Udalguri

94,100/-

6 Goalpara Second January 94,100/-

7 Region 4 Cachar First July Cachar, Karimganj, Hailakandi, Dima Hasao

46,900/-

8 Hailakandi Second January 46,900/-

Total: 686400/- = 6.864 Lakh

C ) State SNCU Performance Review Workshop Activity Proposed: State SNCU Performance review workshop twice a year Whether New/ being continued:

New

Justification: This dedicated SNCU review workshop for all districts to be conducted at state HQ, twice a year to review the progress of the NHM activities under CH at Facility Based New-born Care & Community /Facility Follow-up of SNCU Graduates. Periodic monitoring & result dissemination helps achieving results before the end of F.Y year in order to achieve results in reducing neonatal mortality.

Deliverables: Improvement in CH program progress Owner of the Activity: State: Consultant CH, Consultant (Training), PE (CH)


| P a g e

73

Name of the Activity: SNCU Follow-up Data Management FMR: 16.1.4.3.1 (16.1) Approved Budget: 8.47 lakh Relevance of activity: SNCU Follow-up Data Management Contingency Owner of the Activity: State: Consultant CH, Data Analyst of Child Health District: DPM and DDM

S. N. District SNCU data management (Internet, Cartridge, Phone bills) and Printing Cost of Online reporting form)

Amount Proposed (In lakhs)

1 Baksa 1 0.24 2 Barpeta 2 0.48 3 Bongaigaon 1 0.24 4 Cachar 1 0.24 5 Chirang 1 0.24 6 Darrang 1 0.24 7 Dhemaji 1 0.24 8 Dhubri 1 0.24 9 Dibrugarh 1 0.24

10 Dima Hasao 1 0.24 11 Goalpara 1 0.24 12 Golaghat 1 0.24 13 Hailakandi 1 0.24 14 Jorhat 1 0.24 15 Kamrup_M 3 0.72 16 Kamrup R 0 0 17 KarbiAnglong 1 0.24 18 Karimganj 1 0.24 19 Kokrajhar 1 0.24 20 Lakhimpur 1 0.24 21 Morigaon 1 0.24 22 Nagaon 1 0.24 23 Nalbari 1 0.24 24 Sivasagar 1 0.24 25 Sonitpur 2 0.48 26 Tinsukia 1 0.24 27 Udalguri 1 0.24

Total 30 7.20 For SMS service for SNCU graduate follow up( State HQ) 1.270

Name of the Activity: Strengthening of FBNC services (SNCU & NBSU mentoring), HBNC and SNCU Graduate follow up services in Dhemaji and Tinsukia districts. FMR: PM Annexure (FMR 18.5) Approved Budget:11.62 Lakh Relevance of activity: Owner of the Activity: State: Consultant CH/Consultant (Nutrition), PE (Child Health),SCM District: DPM and DCM Block: BCM

The full community follow up of SNCU discharged newborn in Dhemaji district is 6.79% and in Tinsukia is 21.26%. the facility follow up of SNCU discharged newborn is 15.66% in Tinsukia and 5.91% for Tinsukia district. The % of referral of sick newborn under HBNC is 3% in Dhemaji (April to Sept) and in Tinsukia it is 2%. The mortality, LAMA and referral % in SNCU, Dhemaji are 5%, 7% and 9% respectively. In Tinsukia the mortality rate, LAMA and referral % are 6%, 1% and 32%. So, there is need to improve the quality of FBNC services by monitoring and hand holding of the community service providers and the FBNC facilities.

Mentoring: • The process of ASHA home visit (both for HBNC and SNCU graduate follow up) and quality

of service delivery will be mentored by the department of Community Medicine, AMCH, Assam Health Specialist from UNICEF, WHO and JAPAIGO. The basic intent for this mentoring is the capacity building and handholding support to ASHAs and other for gap filling in quality home visits.

• This mentoring visit will be monthly block level mentoring. The mentors will receive an amount as honorarium per visit per block. Each team will spend two days per visit in that block. This mentoring will not be confined to only HBNC and SNCU discharge follow up, rather will focus on other child and adolescent health programmes and services.

• Apart from these, mentoring visits to SNCU & NBSU by a team of neonatologist to assess the gaps and also to provide the mentoring support as well as supportive supervision and discuss the ongoing issues related to SNCU. The team shall carry the manikin and conduct onsite training if the skills need to be upgraded.

• This mentoring will not be confined to only SNCU and NBSU , but also to the other facility based new born care such as KMC, ENBC, including birth doses of immunization in that facilities etc.

• There is 1 SNCU each in Dhemaji and Tinsukia district and 5 NBSUs in Dhemaji district and 7 NBSU in Tinsukia district. The mentoring visits by a team of neonatologist can improve the quality of newborn care services and capacity building of health care personnel in FBNC. Also to reduce the burden and unnecessary referral and admission to the SNCU and it will help to strengthened the NBSUs.

• If this new activity is successful in reducing the unnecessary referral to SNCU, improves the quality of services in NBSU and SNCU, improves the quality of HBNC and early referral and ultimately reduction in IMR, this will be used in all the districts of the state.

Training Load of Different Districts in FY 2020-21

Sl.No

Na

me o

f Di

stric

t FM

R -5

.9.2

.1

Pr

e se

rvice

IM

NCI

FMR-

9.5.

2.4

CD

R

FMR-

9.

5.2.

7

IMNC

I

FMR

9.5.

2.9

F-IM

NCI (

5day

s)

FMR

-9.5

.2.1

0

F-IM

NCI

FMR

-9.5

.2.1

3 NS

SK(M

O)

FMR-

9.

5.2.

14

NSSK

(SN)

FMR-

9.5

.2.1

6 4d

aysF

BNC

FMR-

9.5

.2.1

7

2wks

Obs

erve

r sh

ip T

rain

ing

FMR-

9.

5.2.

21

FP,K

MC

FMR-

9.5.

2.24

SA

ANS

(Bat

ches

) (B

atch

es)

(Bat

ches

) (B

atch

es)

(Bat

ches

) (B

atch

es)

(Bat

ches

) (B

atch

es)

(Bat

ches

) (B

atch

es)

(Bat

ches

) 1

Bak

sa

1

1

1

1

2

Bar

peta

2

1 1

1 1

1 5

3 B

onga

igaon

1

1

1

4 C

acha

r 2

1 1

2 3

1 1

1 2

1

5 C

hira

ng

1

1

1

6

Dar

rang

1 1

1 1

1

7 D

hem

aji

1

1

1

8

Dhu

bri

1

1

1

1

1

7 9

Dib

ruga

rh

4 1

2

3

1 1

4 1

6 10

D

ima H

asao

1

1

1

12

Goa

lpar

a

1 1

1 1

1

13

Gola

ghat

1

1 1

1

H

ailak

andi

1 1

1

1 5

14

Jorh

at

2 1

2

3

1

2 1

15

K

amru

p (M

) 3

1

2 3

1

2 6

1

16

Kam

rup (

R)

1

1

1

1

6 17

K.

Ang

long

1

1

1

18

K

arim

ganj

1 1

1 1

1 6

19

Kok

rajha

r

1

1 1

1

20

Lakh

impu

r

1 1

1

1

21

Mor

igaon

1 1

1 1

1 5

22

Naga

on

1

1

1

1

6 23

Na

lbari

1

1

1

4 24

Siv

saga

r

1

1

1

25

Soni

tpur

2

1 1

1 1

2

1

26

Tinsu

kia

1

1

1

27

Ud

algur

i

1

1 1

1

To

tal

15

27

12

8

12

12

27

4 16

27

50

Contact Details: Division of Child Health, NHM, Assam

Name Designation Mobile Email Dr. Dipangkar Hazarika

Consultant Child Health

9854753267 [email protected]

Dr. Snigdha Baruah Phukan

Consultant Training 9864023190 [email protected]

Dr. Priyakshi Borkotoky

Consultant Nutrition 9864026177 nutritionconsultant.nhmassam @gmail.com

Pranpurnima Borah Consultant RBSK & RKSK

7002297814 consultant.ppurnima.rksk.nhm @gmail.com

Dr. K.M.Jahirul Islam

State Nutrition Consultant (UNICEF Supported)


Sujata Bezbaroa

Programme Executive (Child Health)

8638088529

[email protected]

Gyanendra Saikia Data Analyst

8638488074

[email protected]

Sajin Rahman

Administrative Assistant


O F F I C E O F T H E M I S S I O N D I R E C T O R NATIONALHEALTHMISSION,ASSAM

Saikia Commercial Complex, Sri Nagar Path, Near Post office Bus Stand, G. S. Road, Christianbasti, Guwahati – 781005

Website: https://nhm.assam.gov.in :: Phone No: 0361-2340236/39 :: Email Id: [email protected]

OPERATIONAL GUIDELINES FOR NEW BORN AND CHILD ...

Documents

Transcript of OPERATIONAL GUIDELINES FOR NEW BORN AND CHILD ...