Gumla NHRM District Plan 2011-12

Gumla,DHAP 2011-12

District Health Action Plan

Year 2011 -12 District: - GUMLA

District Rural Health Society, Department of Health & FW Government of Jharkhand

Gumla,DHAP 2011-12

Acknowledgment

This District Health Action Plan (DHAP) is one of the key instruments to achieve NRHM goals. This plan is based on health needs of the district.

The goals of the Mission are to improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women and children.

I appreciate the effort of ACMO, DIO, DTO, DLO, DMO and specially DPM, DDM & DPC regarding preparation the DHAP. I also appreciate the effort of Development Partners in preparation of DHAP

I am sure that this detailed report will galvanize the leaders and administrators of the primary health care system in the district, enabling them to go into details of implementation based on lessons drawn from this study.

(Dr. T. Hemrom)

CS cum CMO

Gumla

Gumla,DHAP 2011-12

Abbreviations

ABER Annual Blood Examination Rate IPHS Indian Public Health Standard ACMO Assistant Chief Medical Officer IUCD Intra Uterine Contraceptive Device ANC Ante-Natal Care IYCF Infant and Young Child Feeding ANM Auxiliary Nurse Midwife JSY Janani Suraksha Yojana ANMTC ANM Training Centre LHV Lady Health Visitor APHC Additional PHC MMR Maternal Mortality Ratio API Annual Parasite Index MO Medical Officer Adolescent Reproductive and Sexual Mo Ministry of Health and Family ARSH Health HFW Welfare ASHA Accredited Social Health Activist MOIC Medical Officer Incahrge Ayurveda, Yoga and Naturopathy, Unani, AYUSH Siddha and Homoeopathy MTC Malnutrition Treatment Centre National Buildings Construction BCC Behaviour Change Communication NBCC Corporation Ltd. BPL Below Poverty Line NFHS National Family Health Survey CHC Community Health Centre NGO Non Governmental Organisation National Iodine Deficiency CMO Chief Medical Officer NIDD Disorder Control Programme National Leprosy Eradication DDM District Data Manager NLEP Programme National Programme on Control on DDT Dichloro Diphenyl Trichloro-ethane NPCB Blindness DGHS Directorate General Of Health Service NRHM National Rural Health Mission DH District Hospital NSV Non-scalpel Vasectomy National Vector Borne Disease DHAP District Health Action Plan NVDCP Control Programme DHS District Health Society OCP Oral Contraceptive Pill DIO District Immunisation Officer PHC Primary Health Centre District Level Household and Facility DLHS Survey PIP Programme Implementation Plan DLO District Leprosy Officer PMU Programme Management Unit DPM District Programme Manager PPP Public Private Partnership

Gumla,DHAP 2011-12

DTC District Training Centre RCH Reproductive and Child Health DTO District TB Officer RDK Rapid Diagnostic kit FRU First Referral Unit RKS Rogi Kalyan Samiti Revised National Tuberculosis HMIS Mealth Management Information System RNTCP Programme HSC Health Sub Centre SC Scheduled Caste Inetegrated Child Development ICDS Programme SDH Sub Divisional Hospital Integrated Counselling and Treatment ICTC Centre SNCU Sick Neonatal Care Unit IDSP Integrated Disease Surveillance SPM State Programme Manager Information Education and IEC Communication SRS Sample Registration System Integrated Management of Neonatal and IMNCI Childhood Illnesses ST Scheduled Tribe IMR Infant Mortality Rate TFR Total fertility Rate IPC Intra Personal Communication UF Untied Fund VHC Village Health Committee Reference Material:

1. NRHM – Framework for Implementation 2. Broad framework for preparation of district health action plans 3. Indian Public Health Standards (IPHS), DGHS, MoHFW 4. Gram Swasthya & Poshan Diwas 5. DLHS – 3 6. NFHS – 3 7. SRS Bulletin 2009 8. Gram Swathya Samiti (VHC) & Sahiyya guidelines, Govt. of Jharkhand 9. RNTCP Performance report 10. Census 11. District HMIS Reports 12. Facility Survey Output Data

Gumla,DHAP 2011-12

Summary of Budget

Amount S. N. Sections Rs. In Lakhs

A. Reproductive & Child Health

MMJSSA (JSY) 26598000

STERILIZATION Compensation 5050000

B NRHM Additinalities 95976800

C Routine Immunisation 17986600

D Other National Disease Control Programmes

D.1 National Leprosy Eradication Programme 101013500

D.2 National Vector Borne Disease Control Programme 17551060

D.3 Revised National TB Control Programme 2031000

D.4 National Blindness Control Programme 2812000

D.5 Integrated Disease Surveillance Project 500000

D.6 NIDDCP 50000

E Budget for Additional District Issues 6900000

F Budget for Shaiyya program 32635640

308804600 TOTAL

Gumla,DHAP 2011-12

RCH Section

Sl. Budget Head Amount (Rs. In Lakh)

1 Maternal Health 30063000

A JSY 26598000

B Others 3465000

2 Child Health 845000

3 Family Planning 6898000

Sterilisation Compensation (Male & A 5050000 Female)

B Others 1848000

4 Adolescent Reproductive and Sexual Health 55000

5 Urban RCH 0

6 Tribal RCH / Vulnerable groups 660000

7 Innovations / PPP/ NGO / PCPNDT 905000

8 Infrastructure and Human Resources 0

9 Institutional strengthening 0

10 Training 7653670

11 BCC/ IEC 504000

12 Procurement 0

13 Programme management 2880000

TOTAL 50463670

Gumla,DHAP 2011-12

Budget for Additional District Issues

Sl Particulars Budget Remarks No

1 Equipments & Others of DH & 1900000 Annexure – II Raidih CHC

2 Other District Issues 5000000 Annexure – I

3 Shaiyya program 32635640 Annexure – III

Total 39535640

(Rs Three Crore Ninety Five Lakhs Thirty Five Thousand Six Hundred Forty only)

Gumla,DHAP 2011-12

Process of Plan Preparation

Activity I: Initiation of plan preparation

The Plan has been prepared as a joint effort under the chairmanship of Deputy Commissioner

of the district, Civil Surgeon, ACMO, all programme officers and the State level team . To start with a state level one day orientation on DHAP preparation was organized on 9th November, 2010 at state RCH office. This was followed by district level consultation on 16th

November involving all the programme officers followed by block level consultations on 18th, 19th & 20th November. Further interviews with ANMs and Sahiyyas were conducted at block level.

The inputs taken from the stakeholders were recorded noted and then planning exercises were conducted at all levels as mentioned above. A drafting team consisting of DPM, DDM, DPC and the programme officers was formed to document and write up the entire processes and to put them together in the form of a plan. After several consultations at the district and with the State PMU, the first draft was prepared and shared in the district with all the stakeholders who were involved from the very beginning of the process on 23rd November, 2009. The information and plans were validated and triangulated with the district team and the concerned officers and members of the team before finalizing it.

The composition of District Planning Team Name Designation 1. Dr. Tunul Hembrom CMO cum Civil Surgeon 2. Dr ADN Prasad DIO 3. Dr. Ashok Kumar DTO 4. Dr. Sugender Sai DLO 5. Dr.J. P. Sanga DS 6. Jaya Reshma Xaxa DPM 7. Pankaj Kumar DPC Gumla. 8. Subhasini Chandrika Hospital Manager 9. Rajiv kumar DDM 10. Rahul Kumar CA RCH Gumla.

Gumla,DHAP 2011-12

District Health Society

Composition: Designation Name Designation holding in society

1 Sri Rrahul Sharma Deputy Commissioner Chairman

2 Sri Punai Oraon DDC Vice chairman

3 Dr. T. Hemrom Civil Surgeon Member secretary

4 Smt. Nayantra kerketta DSWO Member

5 Sri N.Mandal DWO Member

6 Sri Sonaram Manjhi District Ayush Officer Member

7 Smt. Jaya R Xaxa DPM Convener

8 Dr. AND Prasad DRCHO Member

9 Dr. Ashok kumar DTO Member

10 Dr. Sugender sai DLO Member

Gumla,DHAP 2011-12

Contents

Topics Page No. I. Background Information of the district II. Planning Process III. Situation Analysis IV. NRHM – Goals & Objectives V. Technical Components A. Reproductive & Child Health B. NRHM Additionalities C. Routine Immunization & PPI D. Disease Control Programmes 1. RNTCP 2. NVBDCP 3. Blindness Control Programme (NPCB) 4. NLEP 5. IDSP 6. NIDD Control Programme

(National Iodine Deficiency Disorder) 7. National Programme for Prevention and Control of

Deafness 8. National Tobacco Control Programme 9. Mental Health Programme E. Convergence VI. Comprehensive Training Plan of District VII. HMIS VII. IEC/ BCC VIII. Procurement & Logistics IX. Work plan & Budget X. Annexure I Annexure II

Gumla,DHAP 2011-12

Organizational Chart

Gumla,DHAP 2011-12

Chapter 1 Background

Brief profile of Gumla District

Blessed with nature’s beauty, the district of Gumla is covered by dense forests, hills and rivers. It is situated in the southwest portion of the Jharkhand State. The District was carved out of Ranchi District on 18th May 1983. Previously it was a sub-division of old Ranchi district. The district lies between 22° 35” to 23° 33” north latitude and 84° 40” to 85° 1” east longitude.

The various legends are in currency regarding its name. The most popular one ascribes to its word 'Gumla' in Mundari language, which relates to the occupation of the local Tribes in rice processing work (dhan-kutna). The second legend 'Gau-mela' relates to cattle fair. Cattle fair was weekly held in Gumla town every Tuesday. In rural areas, Nagpuri and Sadri people still call it 'gomila'.

Till 30th April 2001, Gumla district consisted on 2 sub-divisions viz. Gumla and Simdega. But after the creation of Jharkhand State, a new district of Simdega was carved out of Gumla district on 30th April, 2001. Now, Gumla district consists of only one sub-division namely Gumla. Total area of the district is about 5327 sq. km. The total population of district as per 2001 census is 832447, out of which 355505 is male population and 350984 is female population. There is predominance of tribal people in Gumla district.

The primitive tribe’s population is 1283, SC population is 25659, ST population is 487148, and BC population is 132610. Since obvious that the district has a total of 68% of tribal population, therefore, it comes within scheduled area.

Sisai, Bharno and Kamdara blocks have plain lands while other areas are mostly undulating in nature. There is a hill range named as 'Ghera-pahar', which starts from Palkot block area and continues to Bishunpur block area. These elevated plateau areas of Bishunpur and Ghaghra blocks are locally known as 'PAT' area. These PAT areas are made-up of volcanic rock. The average height of these PAT areas is about 2500 ft. to 3000 ft. above the mean sea level.

Gumla,DHAP 2011-12

District Map

Source :- nic gumla website

Gumla,DHAP 2011-12

District Demographic Profile

Variable Data Total area (In Hq. ) (Source;- Census 2001) 90256953 Total no. of Gram Panchayat (Source;- Census 2001) 153 Total no. of Revenue Villages (Source;- Census 2001) 943 No. of Subdivisional Hospital 0 Total Population (Source:- Projected as per census 2001) 983723 Male population (Source:- Projected as per census 2001) 546513 Female population (Source:- Projected as per census 437210 2001) Sex Ratio (Calculated as per projected population ) 993

Adolescent population (10-19yrs) (Source…22% of Total 216419 population.) Women 15 -49 years 120233 (Source………………….…) Above 49 years 96186 Child population: (Source:- Projected 0-12 months 24450 as per census 2001) 13 months - 60 127884 months (5 yr.) SC population : Total 32463 (Source:- Projected as per Male 18035 census 2001) Female 14428 ST Population (Source:- Total 661062 Projected as per census Male 367257 2001) Female 293805 PTG Population (Source:- Total 22753 Block Data) Male 10835 Female 11918 BPL Population (Block 213285 Data) No. of Eligible Couples (Source:- 17% of projected 167233 population 2001)

Name of the block Total Population Male Female SC ST

Bharno 72767 40426 32341 2401 49118

Sesai 114145 57175 56970 1128 57291

Raidih 71206 36308 34898 2780 41733

Chainpur 57319 31844 25475 1892 38518

Gumla,DHAP 2011-12

Dumri 79299 38517 38317 3749 63231

Palkot 82461 42461 42400 6332 48981

Basia 78933 39275 39658 3721 49997

Kamdara 64842 32506 32337 3246 38905

Ghaghra 104852 52891 51968 8388 62911

Bishunpur 33315 31388 2135 43480 64703 Sadar 73600 72563 4827 98289 146263

Human Resourse

Variable Units No. of Doctors (Govt. + Pvt.) 41 Government Total 38 MBBS 34 BHMS (Homeopathy) 2 BAMS (Ayurvedic, Unani) 2 Specialist ( Gynaecologist) 2 Specialist ( Anesthatist) 1 Specialist ( Surgeon) 3 Specialist ( Paediatritian) 1 MBBS Multiskilled in EmOC 3 MBBS Multiskilled in Anesthasia 3 Private (Attach list with Total 4 Name, specialization if MBBS 3 any, address, contact BHMS (Homeopathy) 1 number) BAMS (Ayurvedic, Unani) 0 No. of ANMs Total 401 Regular 179 Contractual 222 No. of Male Health Total 88 Worker Regular 88 Contractual 0 Total 7 Regular 3

Gumla,DHAP 2011-12

Contractual 4 No. of Paramedicals 43 Total (LT+Pharmacist+Dresser+ Regular 23 Contractual 22 No. of MPW 99

District Infrastructural Status

Variable Units No. of CHC 10 No. of Referral Hospital 2 No. of PHCs 13 No. of HSCs 242 No. of Anganwadi Centers (Source:-ICDS) 1670 No. of Anganwadi Workers(Source:- ICDS) 2133 No. of Village Health Committees( Source:- Internal 943 record) No. of Sahiyya (Internal record) 1666 Total No. of SHG/ Mahila Mandals (Block data) 1707 No. of Primary Schools (Get data from Block Education 1234 office) No. of Seconday Schools (including Middle and High 332 schools) No. of villages having source of drinking water: (Block 72 PHED offfice) Well 21452 Tube Well 7336 Pond River 1099 Piped Water 27 No. of Inaccessible villages (Hard to reach /which are 154 devoid of health services) - Attach list of such villages with approximate distance from CHC) No. of PTG villages (Attach list of such villages with approximate distance from CHC, population)( Source:- Tribal Research Institute Morhabadi) No. of villages having motorable roads 776 No. of village having Community Hall (Block data) 214 No. of village have Telephone Facility NA

Health Services / Facilities in the District

Gumla,DHAP 2011-12

Variable Total No. Remarks No. of CHC 24 x7 functional 10 No. of PHC 24 x7 functional 0 No. PHC running in HSC 12 building No. CHC running in PHC 0 building No. SDH / Referral running in 0 PHC/CHC building Facility Services Available Functional Not Functional Ambulance for assured referral 13 13 0

Genset 11 11 0

X-ray 3 1 2 Laboratory (Functional if, Urine and HB test are happening along with malaria and sputum test) 12 12 0 Blood Storage/ Blood bank 1 1 0 Malnutrition Treatment Centre (MTC) 2 2 0 New born corner 11 11 0 Sick New borne Care Unit (SNCU) 0 0 0

Cold Chain 12 12 0

ARSH clinic 11 11 0 Toilets 11 11 0 Toilets for female 11 11 0 Computer 11 11 0 Internet facility 12 11 1 Telephone facility 12 12 0 Residential facility for staff 4 3 0 Sahiyya Desk 11 11 0 Waiting hall for 5 patients/attendants Number of Beds available in the 100 facility (DH) Number of rooms in the facility 53 (District Hospital) Average number of OPD per day 150 (As per data of April to Sept 2010)

Gumla,DHAP 2011-12

Average number of IPD per 40 month (As per data of April to Sept 2010) Average number of Delivery per 110 month (As per data of April to Sept 2010) No. of BPM inposition 7 No. of BAM inposition 11 No. of DPM inposition 1 No. of DAM inposition 0 No. of Lady doctor in position 10 Number of NGOs in the district 3

Name & Address Contact No. 9534227455

06523278306 Vikas Bharti 9304240188 Ekjute 9430146121 Arouse Name / address of the NGOs Number of Central 8 Govt./Missionaries/ Pvt hospitals in the block/CHC area Name & Address Contact No. St. Joshep Hoapital 9431116509 Name and address of Ursulla Hospital, konbir 9199002790 Missionaries/ Pvt hospitals in the St.Levance Health Centre 9430118548 block/CHC area St. Charls Health Centre 9470336346 Number of hospitals (any) in the 0 block/CHC area with facility of caesarean op./blood storage/blood bank Name & Address Contact No. Name and address of hospitals with facility of caesarean 0 op./blood storage/blood bank

Gumla,DHAP 2011-12

Chapter 2 Situation Analysis

In the present situational analysis of the blocks of district gumla the vital statistics or the indicators that measure aspects of health/life such as number of births, deaths, fertility etc. have been referred from census 2001, report of chief Medical Officer & Health office, Gumla and various websites as well as other sources. These indicators help in pointing to the health scenario in Gumla from a quantitative point of view, while they cannot by themselves provide a complete picture of the status of health in the district. However, it is useful to have outcome data to map effectiveness of public investment in health. Further, when data pertaining to vital rates are analyzed in conjunction with demographic measures, such as sex ratio and mean age of marriage, they throw valuable light on gender dimension

District Health Profile

Name of District Jharkhand Data Source

Infant Mortality rate 46 SRS 2008

Key Population Maternal mortality rate 302 NFHS3 indicators Crude birth rate 25.8 SRS 2008

Death rate 7.1 SRS 2008

Total Fertility Rate 2.3 NFHS 3

District Level Household & Facility Survey DLHS 3 DLHS 2 Jharkhand (07-08) (02-04) Trend DLHS 3

Key RCH Girls marrying below 18 years 29.5 19.1 - 36.3 Indicators (in percentages) Birth order 3+ 52.9 60.6 + 53.9 Current use of any FP method 32 18.1 + 34.9

Total unmet need 38.1 52.8 + 21.3

Pregnant women who registered in the first 36.4 0 30.1 trimester

Pregnant women receive at least 1 TT 62.6 45.4 + 54.4 injections

Pregnant women receive 3 ANC 30 26.2 + 31.6

Pregnant women receive 100 IFA Tablets 30 26.2 + 31.6

Gumla,DHAP 2011-12

Delivery assisted by a skilled attendant at 6.6 10.7 + 8.9 home

Institutional births 10.3 6.2 + 17.8

Children with full immunization 68.6 20.7 + 54.1

Children with Diarrhoea treated within last 28 52.3 two weeks who received treatment

Children with Acute Respiratory infections in the last two weeks who were given 42.1 56 treatment

Gumla,DHAP 2011-12

Financial Progress

Name 2008-09 2009-10 2010-11 Routine immunization 67.51 36.36 63.05 JSY 74.70 57.25 102.77 Family planning 48 43.09 59.98 Untied fund for VHC 0 18.39 40.53 Untied fund for CHC & PHC 81.85 57.35 64.51 untied fund of HSC 57.74 70.53 63.44 AMG CHC 55.50 30.43 28.0 AMG HSC 0 0 28.01 HMS 44.07 51.37 60.15 ANM Salary 71.39 108 105 Family planning Camp 3.19 40.62 0 RCH Camp (Maternal Health) 59.94 34.07 54

Gumla,DHAP 2011-12

Chapter 3. NRHM - Goals & Objectives

Recognizing the importance of Health in the process of economic and social development and improving the quality of life of our citizens, the Government of India has resolved to launch the National Rural Health Mission to carry out necessary architectural correction in the basic health care delivery system. The Mission adopts a synergistic approach by relating health to determinants of good health viz. segments of nutrition, sanitation, hygiene and safe drinking water. It also aims at mainstreaming the Indian systems of medicine to facilitate health care. The Plan of Action includes increasing public expenditure on health, reducing regional imbalance in health infrastructure, pooling resources, integration of organizational structures, optimization of health manpower, decentralization and district management of health programmes, community participation and ownership of assets, induction of management and financial personnel into district health system, and operationalize community health centers into functional hospitals meeting Indian Public Health Standards in each Block of the Country. The Goal of the Mission is to improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women and children. To achieve these goals NRHM will:

o Facilitate increased access and utilization of quality health services by all.

o Forge a partnership between the Central, state and the local governments.

o Set up a platform for involving the Panchayati Raj institutions and community in the arrangement of primary health programmes and infrastructure.

o Provide an opportunity for promoting equity and social justice.

o Establish a mechanism to provide flexibility to the states and the community to promote local initiatives.

o Develop a framework for promoting inter-sectoral convergence for promotive and preventive health care.

The Objectives of the Mission:

o Reduction in child and maternal mortality

o Universal access to public services for food and nutrition, sanitation and hygiene and universal access to public health care services with emphasis on services addressing women’s and children’s health and universal immunization

o Prevention and control of communicable and non-communicable diseases, including locally endemic diseases.

o Access to integrated comprehensive primary health care.

o Population stabilization, gender and demographic balance.

o Revitalize local health traditions & mainstream AYUSH. 23

Gumla,DHAP 2011-12

The expected outcomes from the Mission as reflected in statistical data are:

 IMR reduced to 30/1000 live births by 2012.

 Maternal Mortality reduced to 100/100,000 live births by 2012.

 TFR reduced to 2.1 by 2012.

 Malaria Mortality Reduction Rate - 50% up to 2010, additional 10% by 2012.

 Kala-azar Mortality Reduction Rate - 100% by 2010 and sustaining elimination until 2012.

 Filaria/Microfilaria Reduction Rate - 70% by 2010, 80% by 2012 and elimination by 2015.

 Dengue Mortality Reduction Rate - 50% by 2010 and sustaining at that level until 2012.

 Cataract operations-increasing to 46 lakhs until 2012.

 Leprosy Prevalence Rate –reduce from 1.8 per 10,000 in 2005 to less that 1 per 10,000 thereafter.

 Tuberculosis DOTS series - maintain 85% cure rate through entire Mission Period and also sustain planned case detection rate.

 Upgrading all Community Health Centers to Indian Public Health Standards.

 Increase utilization of First Referral units from bed occupancy by referred cases of less than 20% to over 75%.

 Engaging 4,00,000 female Accredited Social Health Activists (ASHAs).

The expected outcomes at Community level

 Availability of trained community level worker at village level, with a drug kit for generic ailments.

 Health Day at Aaganwari level on a fixed day/month for provision of immunization, ante/post natal checkups and services related to mother and child health care, including nutrition.

 Availability of generic drugs for common ailments at sub Centre and Hospital level.

 Access to good hospital care through assured availability of doctors, drugs and quality services at PHC/CHC level and assured referral-transport-communication systems to reach these facilities in time.

 Improved access to universal immunization through induction of Auto Disabled Syringes, alternate vaccine delivery and improved mobilization services under the programme.

Gumla,DHAP 2011-12

 Improved facilities for institutional deliveries through provision of referral transport, escort and improved hospital care subsidized under the Janani Surakshya Yojana (JSY) for the below poverty line families.

 Availability of assured health care at reduced financial risk through pilots of Community Health Insurance under the Mission.

 Availability of safe drinking water.

 Provision of household toilets.

 Improved outreach services to medically under-served remote areas through mobile medical units.

 Increase awareness about preventive health including nutrition.

Gumla,DHAP 2011-12 Chapter 4 Infrastructure

CHC Infrastructure (Building) Progress : Status of ongoing construction works of CHCs, PHCs and HSCs in the district (up to Nov. 2010) Sl. Nature of Work DDO Agency Work status as per agency No report

1. CHC Raidih Under Secretary(HQ) NBCC Completed , Quarters not Completed

2. CHC Bharno Under Secretary(HQ) NBCC up to ground floor work stopped due to non payment of Bills

3. CHC Bishunpur Under Secretary(HQ) NBCC 2nd floor slab is in progress

(work is slow due to non payment of Bills

4 Sadar Hospital Gumla- D.C Gumla Special Div. Work completed 100 beded

5 Mental Hospital Ward D.C Gumla Special Div. Work completed

6 Postmortem House D.C Gumla Special Div. Work completed

7 CS Office building D.C Gumla Special Div. Work in progress

8 HSC Puto Ghaghra D.C Gumla Special Div. Work in progress

9 HSC, Rerwa Sisai D.C Gumla Special Div. Work in progress

10 HSC,Raikera Bharno D.C Gumla Special Div. Work in progress

11 HSC,Kurkura Kamdara D.C Gumla Special Div. Work in progress

12 HSC, Kumhari Basia D.C Gumla Special Div. Work stopped due to land dispute

13 HSC Keragani Chainpur D.C Gumla Special Div. Work stopped due to anti social elements

14 HSC Parsa Raidih D.C Gumla Special Div. Work completed

15 HSC Ratasilly Dumri D.C Gumla Special Div. Work stopped due to anti social elements

16 HSC Baghima Palkot D.C Gumla Special Div. Work Complete

17 HSC Beti Bishunpur D.C Gumla Special Div. Work in progress

18 HSC Asni Gumla D.C Gumla Special Div. Work in progress

19 HSC Chapatoli DRHS BDO Work in Progress Bishunpur

20 HSC Akasi Dumri DRHS Spl Div Tender not Received

Gumla,DHAP 2011-12

New Sadar Hospital Building, Gumla

New CHC, Raidih Building

Gumla,DHAP 2011-12

Condition of Infrastructure Condition of CHCs &DH Condition Assu Con Toil Functio Condi No Functional Conditi Condi of CHCs red tinu ets nal tion of . of Operation on of tion of runni ous with Labour labou be Theatre Operati ward ng pow run room r ds (minor) on water er ning room Theatre suppl supp wate y in ly r the supp facilit ly y Basia Yes Good Yes Yes Good 30 Yes Good good Chainpur Yes Good Yes Yes Bad 6 Yes Good good Dumri Yes Good Yes Yes Good 6 Yes Good good Bishunpur Yes Good Yes Yes Good 6 Yes Good good Raidih Yes Good Yes Yes Good 6 Yes Good good Ghaghra Yes Good Yes Yes Good 6 Yes Good good Sesai Yes Good Yes Yes Good 30 Yes Good good Bharno Yes Good Yes Yes Good 6 Yes Good good Palkot Yes Good Yes Yes Good 6 Yes Good good Kamdara Yes Good Yes Yes Good 6 Yes Good good DH Yes Good Yes Yes Good 100 Yes Good good

District hospital is newly constructed. Labour Room and OTs(minor) of all CHCs of Gumla District is good except the Chainpur CHC.

Gumla,DHAP 2011-12

Condition of PHCs Assu red Toile runn ts Condit ing with Functi Condi Contin ion of wate runn onal tion of Functi Condi N Total No Of uous OT r ing Labou labou onal tion of o PHC power (Good supp wate r r OT ward supply Condit ly in r room room ion) the supp facili ly ty 1 13 Total Available 1 2 1 12 0 Total Not Available 12 10 12 3 12 Total Irregular Supply 0 1 Total Good Condition 1 1 1 Total Needs Major Repair 2 0 2 Total Needs Minor Repair 4 0 0 Total Needs New Building 6 12 10

Total 13 PHCs are in Gumla District. Out of 13 only 1 PHC have its own building. Only Karenj PHC is newly constructed. Rest of PHCs are running in HSC buildings.

Gumla,DHAP 2011-12

Condition of HSC

Total No Of Assu Contin Toil Functi Condi No. Resid Condi Stat HSC red uous ets onal tion of of ential tion of us runn power Labou labour beds Facili ANM of ing supply r room room ty for reside HS wate ANM nce C r suppl y 242 Total Available 0 5 86 172 90 83 Total Not Available 242 231 136 70 152 159 Total Irregular Supply 0 6 Total Good Condition 61 11 164 Total Needs Major Repair 32 25 10 Total Needs Minor Repair 81 64 Total Needs New Building 68 141 68

Total 242 HSCs are in Gumla, 68 HSCs Running in rented building and 8 HSC’s are running in rent free buildings. Out of 242 76 HSC’s needs new building and 10 HSCs buildings needs major repair.

Gumla,DHAP 2011-12

Chapter 5 Human Resource

Remarks In position Sl.No Post Sanctioned Vacant (on deputations/ available) Regular Contractual CS Office 1 Civil Surgeon 1 1 0 0 Medical 2 1 1 0 0 Officers 3 Head Clerk 1 1 0 0 4 Clerks 3 3 0 0 5 Steno 1 1 0 0 6 Peon 2 2 0 0

DPMU 1 DPM 1 0 1 0 2 DAM 1 0 0 1 3 DDM 1 0 1 0 4 DPC 1 0 1 0

ACMO

Office Add. Chief 1 1 0 0 1 Medical Officer Statistical 2 1 0 0 1 Assistant 3 Head Clerk 1 0 0 1 4 Typist 1 1 0 0 5 Cashier 1 1 0 0 6 Store Keeper 1 1 0 0 Clerk cum 7 1 1 0 0 Typist 8 Computer 0 0 0 0 9 FPW 0 0 0 0

Gumla,DHAP 2011-12

10 Driver 1 1 0 0 Night Guard/ 11 3 3 0 0 cum peon

Distt. RCH Office Dist. RCH 1 1 1 0 0 Medical Officer 2 Clerk 1 1 0 0 Statistical 3 1 0 0 1 Assistant Refrigerator 4 1 0 0 1 Assistant 5 Driver 1 1 0 0 6 ANM 0 0 0 0

Distt. Leprosy office 1 DLO 1 0 1 0 Medical 2 1 1 0 0 Officers Non Medical 3 1 1 0 0 Assistant 4 MSW 0 0 0 0 Non Medical 5 26 10 0 16 Assistant (field) 6 A grade Nurse 0 0 0 0

Distt. Malaria office 1 DMO 1 0 0 1 2 MO 0 0 0 0 3 MTS 5 0 5 0 4 MPW 242 0 106 136 5 LT 11 4 0 7

Distt. TB

Office 1 Dist. TB 1 1 0 0

Gumla,DHAP 2011-12

Officer 2 Medical Officer 1 1 0 0 X-ray 3 1 1 0 0 Technician 4 LT 2 0 2 0 5 Health Visitor 4 1 0 3 6 A/c Clerk 1 1 0 0 7 Statistical Clerk 0 0 0 0 8 Pharmacist 0 0 0 0 9 Driver 1 1 0 0 B.C.G. 10 6 2 0 4 Technician BCG Team 11 1 0 0 1 Leader 12 4th Grade Staff 4 4 0 0 13 Lab. Assistant 1 0 0 1 14 B.C.G. Orderly 0 0 0 0 13 Data Operator 0 0 1 -1

Distt. Mass

Media Office Distt. Mass 1 1 0 0 1 Media Officer Distt. Sub Mass 2 1 0 0 1 Officer (M) Distt. Sub Mass 3 1 0 0 1 Officer (F) Projector 4 1 0 0 1 Operator Cleaner cum 5 1 0 0 1 Assistant 6 Photographer 1 0 0 1

Gumla,DHAP 2011-12

Analysis of Human Resource in the District

Total 54 Doctors need to be recruited in DH and CHCs of Gumla & 13 more Doctors need to be recruited in different PHCs of Gumla District..

Doctors at CHCs

Sl no. Doctors Contractu On Total CHC Regular al Deputation Total Gap Requirem Name Sanction In Vaca ent as per ed position nt IPHS (1) 7(3+5+ 2 3 4 5 6 6) 8 (1-7) 1 Basia 6 4 3 1 1 0 4 2 Chainpu 2 r 6 4 2 2 0 1 3 3 3 Dumri 6 4 1 2 1 1 3 3 4 Palkot 6 4 2 2 0 1 3 3 5 Raidih 6 4 2 2 1 0 3 3 6 Sadar 6 4 1 1 0 0 2 4 7 Sesai 6 4 4 0 0 0 4 2 8 Bharno 6 4 3 1 0 0 3 3 Bishunp 9 ur 6 4 2 3 1 0 3 3 10 Ghaghra 6 4 3 3 0 0 3 3 Kamdar 11 a 6 4 1 3 2 0 3 3 12 DH 31 15 10 5 0 0 10 21 Total 97 59 34 25 6 3 43 54

Gumla,DHAP 2011-12

Doctors at PHCs

Tot Doctors al Contract On Total Regular ual Deputation Total Gap CHC No. Requirem Sanction In Vaca Name of ent as per ed position nt IPHS (1) PH 7(3+5+ C 2 3 4 5 6 6) 8 (1-7) Chainpu r 1 2 2 1 1 0 0 1 1 Dumri 1 2 2 2 0 1 1 2 0 Palkot 1 2 2 1 1 0 0 1 1 Raidih 2 4 4 1 1 0 0 1 3 sadar 2 4 4 2 1 0 0 0 0 Bharno 3 6 6 2 4 0 0 2 4 Bishunp ur 1 2 2 0 2 0 0 0 2 Ghaghr a 1 2 2 0 2 0 0 0 2 Total 13 26 26 9 12 1 1 6 13

Staff Nurse

Staff Nurse at CHCs& DHThere is a huge shortfall of staff Nurse. Total 96 nos of Staff Nurse need to recruit in DH & CHCs. Appointment of 30 nos of Staff Nurses are in pipeline.

Staff nurse SL. Name of On Total No CHC Requirement Regular Contractual Deputation Total Gap as per IPHS In (1) Sanctioned position Vacant 2 3 4 5 6 7(3+5+6) 8 (1-7) 1 Chainpur 7 0 0 0 1 0 1 6 2 Dumri 7 0 0 0 0 0 0 7 3 Palkot 7 0 0 0 0 0 0 7 4 Raidih 7 0 0 0 1 0 1 6 5 Sadar 0 0 0 0 0 0 0 0 6 Basia 7 4 2 2 1 0 3 4 7 Bharno 7 0 0 0 0 0 0 7 8 Bishunpur 7 0 0 0 0 0 0 7

Gumla,DHAP 2011-12

9 Ghaghra 7 0 0 0 0 0 0 7 10 Kamdara 7 0 0 0 0 0 0 7 11 Sesai 7 4 1 3 2 0 3 4 12 DH 50 6 6 0 12 0 18 32 Total 127 14 9 5 17 0 31 96

ANM s in HSC There is a shortage of 114 ANMs in HSCs of Gumla District. Recruitment of ANMs urgently needed at District. Appointment of 60 ANMs are in pipeline.

Tot al ANM CHC No. Contract On Total Name of Regular ual Deputation Total Gap Requirem HS Sanction In Vaca ent as per ed position nt C IPHS (1) 7(3+5+ 2 3 4 5 6 6) 8 (1-7) Basia 21 42 21 18 3 20 0 38 4 Chainpu r 19 38 19 10 24 19 0 29 9 Dumri 23 46 23 9 14 17 1 27 19 Palkot 22 44 22 17 5 25 0 42 2 Raidih 21 42 21 14 7 21 0 35 7 Sadar 30 60 30 27 3 24 0 51 9 Sesai 25 50 25 16 9 14 3 33 16 Bharno 16 32 16 13 3 16 0 29 3 Bishunp ur 18 36 18 7 16 11 1 19 17 Ghaghra 27 54 27 14 13 18 3 35 19 Kamdar a 19 38 19 9 10 18 2 29 9 Total 241 482 241 154 107 203 10 367 114

Gumla,DHAP 2011-12

A-1. Maternal Health

1. Situational Analysis

Women are the foundation of the Country’s families and communities. Over the years, complications of pregnancy and childbirth are the leading cause of death and disability for childbearing women in many parts of the country. Comprehensive, high-quality maternity care can help prevent infant and maternal death and disability. No matter where they live, women should have access to the information and care that keeps them healthy and safe.

The immediate causes of maternal mortality are well known. They are sepsis, hemorrhage, obstruction, anemia, toxemia and unsafe abortions. The larger social determinants of these are also equally well known – they include educational status of women, poverty levels, social inequities and access to quality care.

It is evident that all the health / health service indicators o f Gumla district are as better as compared to that of Jharkhand CDR, MMR IMR but in Immunization, Institutional Delivery and Safe delivery is not better . However efforts in terms of quality and service need to be taken for the betterment of the present indicators. Service utilization is not good in Gumla district. In urban areas, there is no Urban Health Centre in the Gumla district. The population residing in the slums is also neglected in terms of proper immunization, Institutional Delivery and Safe delivery.

Two blocks are covered by coal mines due to which the level of pollution is high in these areas , besides covered by the mines these areas and the periphery is not easily accessible.

Table Representing some Maternal Health Indicators of Gumla District

Gumla,DHAP 2011-12

DLHS DLHS HMIS HMIS(April 2010- Maternal Health Indicators (2002- (2007- (2009-2010) Sept, 2010) 2004) 2008)

% of pregnant women 45.4 62.6 67 74 registered for ANC

% of pregnant women with 3 26.2 30 54 ANC check up 40 Mothers who got at least one TT injection 45.4 62.6 71 86

Institutional Delivery (%) 6.2 10.3 28 29

Delivery at home & other places assisted by a 10.7 6.6 12 10 doctor/nurse /LHV/ANM(%)

Gumla,DHAP 2011-12

ANC & Institutional Delivery

FY : 2009-10

Registration Delivery Sl. Name of PHC Target for No. Reg. % Inst. ANC Total Home Inst. Total Under Del. Reg.till Reg. Del. Del. Del. MMJSSA % Mar'10

1 BISHUNPUR 1954 1553 76 1018 296 1314 15

2 GHAGHRA 3166 2227 63 961 709 1670 22

3 SADAR 4417 3041 68 1821 375 2196 8

4 RAIDIH 2099 1487 70 669 455 1124 22

5 CHAINPUR 1732 1065 59 683 358 1041 21

6 DUMRI 2399 1640 59 1035 309 1344 13

7 PALKOT 2472 1978 75 1126 663 1789 27

8 KAMDARA 1962 1340 67 634 581 1215 30

9 BHARNO 2202 1841 84 432 904 1336 41

10 SISAI 3447 2225 63 1341 476 1817 14

11 BASIA 2388 1874 77 640 869 1509 36

12 S.Hosp 1492 752 50 0 1637 1637 110

ST. JOSEPH 13 0 340 340 HOSPITAL Ursuline 14 0 163 163 Hospital, Gumla St. URSULA, 15 0 107 107 Konbir, Basia

Gumla 29729 21023 74 10360 8242 18602 28

Gumla,DHAP 2011-12

FY 2010-11( Up to Nov 10)

Registration Delivery Sl. Yearly Name of CHC Target Total Reg. Home Total Inst. No. Inst. Del. for ANC Reg. % Del. Del. Del. % Reg 1 BISHUNPUR 1941 1281 66 548 473 1021 24

2 GHAGHRA 3046 1802 59 522 692 1214 23

3 SADAR 3686 2277 62 1186 434 1620 12

4 RAIDIH 2085 1080 52 387 442 829 21

5 CHAINPUR 1645 988 60 395 435 830 26

6 DUMRI 2280 1239 54 641 316 957 14

7 PALKOT 2368 1310 55 511 687 1198 29

8 KAMDARA 1945 1036 53 274 691 965 36

9 BHARNO 2183 1510 69 348 842 1190 39

10 SISAI 3424 1811 53 1023 630 1653 18

11 BASIA 2368 1318 56 345 675 1020 29

12 S.Hosp 1279 506 40 0 1135 1135 89

13 ST. JOSEPH HOSPITAL 1804 0 404 404

14 Ursuline Hospital, Gumla 419 0 130 130

St. URSULA, Konbir, 15 557 0 142 142 Basia

Gumla 28251 18938 67 6180 8128 14308 29

Gumla,DHAP 2011-12

Institutional Delivery (in %) of last 3 Years 29 28 30 25 19

0 2008-09 2009-10 2010-11 (upto Nov'10)

Maternal Health Current Target for Objective Level 2011-2012 (HMIS Data)

1 Increase in coverage of pregnant woman with ANC 67% 85% services

2 Increase in institutional deliveries 29% 45%

3 FRU made functional ( Sisai, Basia and Raidih CHCs) 1 3

3 Increase in Pregnant women receive at least 1 TT 86% 95% injection

4 Increase in Pregnant women receive IFA 86% 95%

Gumla,DHAP 2011-12

Strategies and Activities:

Strategies / Indicators Remarks Timeline Budget Responsibility Activities

Q1 Q2 Q3 Q4

Strategy : Quality ante-natal care.

Procurement of Untied equipment to √ ANM, MOIC Fund HSC

Streamlining logistics from State / Dist. HQ √ State

Effective coordination with ICDS CDPO, MOIC, CS workers √ √ √ √ DPO (Monthly meeting /BLMC/DLMC)

Prepare Micro √ BPM,MOIC plan of VHND

No and % Implementation of Planned of monthly VHN √ √ √ √ MOIC, CDPO Monthly D at AWC VHNDs

See in Increase IEC IEC /BCC activity part

Monitoring and √ √ √ √ supportive supervision of BPM,MOIC,CDPO ANM’s at VHND session

2 Strategies ; Referral Transport System

Gumla,DHAP 2011-12

Referral No of Transport with CHCs the help of ,where Ambulances referral BAM,BPM,MOIC √ √ √ √ provided to the transport ACMO,CS NGOs & GOs by services Govt. of are Jharkhand functional

Prepare a directory of private vehicles √ MOIC,DPMU at PHC Level with local resources

Strategy; Institutional Delivery

No of HSC √ ,BPM, MOIC Delivery facilities equipped √ at HSC and PHCs delivery facilities Untied 24 hour % PHCs √ BPM,MOIC Fund,AMG, delivery conducting RKS services at 10 PHCs (6) deliveries √ Karenj,Duria,J per month ura Kotam, Fori,Kondra.

Involving / No of Pvt √ DPMU, ACMO, CS private and nursing nursing homes homes √ in deliveries involved. (3)

No of Nodel officer SBA Training ANM Reflect in Training, DPMU, √ √ √ √ of ANMs Trained in Trg Budget ACMO, CS SBA

Gumla,DHAP 2011-12

Involvement of MOIC, ANMs, Sahiya CDPO,DPC,,ACMO,CS AWWs, VHC in √ √ √ √ identification of pregnant women at high risk.

Strategy : Opresraanlisation of FRU -3 Block PHC Sisai, Basia & Raidih.

Preparation of DPMU, ACMO, CS √ FRU Action Plan

Procurement of √ CS Equipment for CHCs to provide basic and/ or comprehensive emergency obstetric health care.

Ensuring 4FRU √ ACMO, CS adequate and made safe blood functional supplies by strengthening existing blood banks or opening 600000 new blood Storage unit at Sisai, Basia, Raidih in the district.

Training of MOs No. of √ STATE & LT on BSU MOs √ Trained

Procurement of √ CS Blood Storage Unit equipment for Sisai, Basia, 1200000 Raidih

Gumla,DHAP 2011-12

Strategy; Safe MTP Services

No of √ √ √ √ MOIC, CS Strengthen MTP CHCs services at CHCs providing (4) MTP Services

No. of Nodal officer Training of Lady √ Reflect in LMOs √ Training MOs 0n MTP Trg Budget Trained

Meeting of √ √ √ DPM ACMO CS District level √ 4000 Committee & Its Meeting

Strategy ; JSY Scheme

Implementation √ √ √ MOIC ,DPMU, CS of JSY √

MOU with Pvt DPM,CS Hospitals √

Awareness √ √ √ MOIC,CS generation about JSY among women/ √ community through Sahiya.

Gumla,DHAP 2011-12

Target for MMJSSA (FY 2011-12) Quarter 1 Quarter 2 Quarter 3 Quarter 4 TOTAL

ry ry gistration Sl. No. women women women women Delive Delivery Delivery Delivery Delivery compensation Est. no. of PW Fund Required Fund Required Fund Required Fund Required Total Population Est. no. Pregnant Est. no. Pregnant Est. no. Pregnant Est. no. Pregnant Name ofName the CHC Fund Required for Est. Est. no. Institutional Est. no. Institutional Est. no. Institutional Est. no. Institutional Est. no. Institutional Est. no. Registration Est. no. Registration Est. no. Re Est. no. Registration Est. no. for Registration

1 BISHUNPUR 64703 489 489 147 293100 489 489 195 390800 489 489 244 488500 489 489 269 537350 1954 1954 855 1709750

2 GHAGHRA 104852 792 792 237 474900 792 792 317 633200 792 792 396 791500 792 792 435 870650 3166 3166 1385 2770250

3 GUMLA 146263 1104 1104 331 662550 1104 1104 442 883400 1104 1104 552 1104250 1104 1104 607 1214675 4417 4417 1932 3864875

4 RAIDIH 69513 525 525 157 314850 525 525 210 419800 525 525 262 524750 525 525 289 577225 2099 2099 918 1836625

5 CHAINPUR 57231 433 433 130 259800 433 433 173 346400 433 433 217 433000 433 433 238 476300 1732 1732 758 1515500

6 DUMRI 79299 600 600 180 359850 600 600 240 479800 600 600 300 599750 600 600 330 659725 2399 2399 1050 2099125

7 PALKOT 81866 618 618 185 370800 618 618 247 494400 618 618 309 618000 618 618 340 679800 2472 2472 1082 2163000

8 KAMDARA 64842 491 491 147 294300 491 491 196 392400 491 491 245 490500 491 491 270 539550 1962 1962 858 1716750

9 BHARNO 72767 551 551 165 330300 551 551 220 440400 551 551 275 550500 551 551 303 605550 2202 2202 963 1926750

10 SISAI 114145 862 862 259 517050 862 862 345 689400 862 862 431 861750 862 862 474 947925 3447 3447 1508 3016125

11 BASIA 78933 597 597 179 358200 597 597 239 477600 597 597 299 597000 597 597 328 656700 2388 2388 1045 2089500

12 S.Hosp 49310 373 373 112 223800 373 373 149 298400 373 373 187 373000 373 373 205 410300 1492 1492 653 1305500

TOTAL 983723 7433 7433 2230 4459500 7433 7433 2973 5946000 7433 7433 3716 7432500 7433 7433 4088 8175750 29730 29730 13007 26013750

Gumla,DHAP 2011-12

Blood Storage Facilities & FRU operationalization

Gumla District does not have health institutions with emergency health services. 3 blocks are surrounded by NH 33 which leads to a no. of accidental cases. Moreover these facilities are inaccessible for the rural community during the emergency situations particularly in case of pregnancy due to poor communication facilities. It is therefore urgently needed to establish and operationalize FRUs. Presently 1 FRU is functional in District Hospital.

Plan for FY 11-12 for blood storage unit

Facility No. of Blood storage

Unit to be equipped in 11-12 Blood Storage Unit in 3 Sesai, Basia & Raidih

As most of deaths in the hospitals occurring due to haemorrhage, blood banks have a crucial role in saving the human life.

Budgetary provision: Facility Unit Cost Unit Total Cost (In Lacs) Establishment of blood storage 400000 3 1200000 facility (Equipment & Others) Operational cost of FRU 200000 3 600000

Total 3 1800000

Reducing Maternal Mortality through Safe abortion services Achieving the Millennium Development Goal of improved maternal health and reducing maternal mortality requires actions on all these fronts. One Medical officer in each facility are trained on comprehensive Abortion Care (CAC). Strategy MTP needs purely technical skill.  Community needs to be sensitized on safe and early abortion, practices and the availability of services through wall writings, banner, posters and Nukkad Natak. The NGOs and Community Based Organizations may play important role in this issue.  Sahiyya also plays an important role. Already the training module of Sahiyyas has this issue, only refresher course is required.  RCH Camps shall have a provision of counseling where cases of abortion shall be identified and referred to the concerned PHCs.

Gumla,DHAP 2011-12

 As per MTP Act each District must have a District Level Committee (DLC) under the Chairmanship of the Civil Surgeon. This committee will have the sole authority to give permission to the private health facilities.

SBA Training: According to DLHS 3 data, 19.3% deliveries are conducted at home. It is essential that the home deliveries are ensured through provision of trained health personnel. Hence Skilled Birth Attendant training is needed for both the medical officers as well as nursing personnel. Based on the GOI guidelines and the patient load in hospitals a three week SBA training curriculum with certification has been designed.

Status of SBA Training :

Facility Total No. of ANMs in Total No. trained the Facility SDH 4 4 Referral Hospital 6 4 CHC 22 11 PHC 26 6 HSC 343 6 Total 401 31

7 Batches SBA Training has been conducted in the district. 320 ANMs are yet to be trained in SBA skills.

Village Health and Nutrition Days at Aaganwadi Centres For a holistic implementation of the health services, convergence with various departments especially health and ICDS is very vital. Convergence is the corner stone of NRHM. The Village Health & Nutrition Day (VHND) is a very important strategy. Under this strategy each sub centre shall conduct monthly Village Health and Nutrition Day in each village on monthly basis. The detailed activity guideline has already provided to the districts and blocks.

Planned April – Held April to Block Planned 2011-2012 Sept,2010 Sept,2010 Basia 900 900 1896 Chainpur 718 718 1236 Dumri 912 912 1824 Bishunpur 552 542 1044 Palkot 672 672 1344

Gumla,DHAP 2011-12

Kamdara 648 648 1298 Ghaghra 1049 1047 2110 Sesai 930 906 1860 Bharno 406 406 702 Raidih 980 974 1680 Sadar 714 708 1224 TOTAL 8481 8433 16218

Package of services during the Village Health and Nutrition Day.  Counseling on:  Age of Marriage  Early Registration of pregnancy  Focused ANC  Care during pregnancy  Danger sign during pregnancy  Birth preparedness  Importance of nutrition  Institutional delivery  Identifying of referral transportation mechanisms  Referral for women with sign of complications during pregnancy and those needing emergency care

Maternal Death 33 Maternal Deaths were reported in Gumla. Verbal Autopsy conducted for two death at Ghaghra & Basia. Root cause of these two deaths was severe anemia.

Gumla,DHAP 2011-12

A 2. Child Health

Immunization is the most effective service to the community to reduce IMR. The recent DLHS3 data shows that total 68.9 % children are receiving BCG vaccine, three doses of DPT vaccine, three doses of OPV vaccine and measles before their first birthday. The trend of Immunization in the district is as follows;

FY 2009-10

District Full Drop Drop Leftou Leftout Target Cumulative % of Achievement Im Out % Out % t% % Infan TT(P OPV DPT DPT m DPT1- BCG- PWs ts W) 3 1 3 BCG Measles DPT3 Mes. DPT1 BCG

BISHUNPUR 1954 1741 79 99 96 99 92 95 95 -4 -2 4 8

GHAGHRA 3166 2821 70 94 88 95 86 89 89 -8 -4 12 14

SADAR 4417 3935 72 92 90 92 94 89 89 -3 5 10 6

RAIDIH 2099 1870 66 87 82 87 82 85 85 -6 -4 18 18

CHAINPUR 1732 1543 61 81 75 82 72 75 75 -9 -5 25 28

DUMRI 2399 2137 64 90 86 90 82 89 89 -5 -8 14 18

PALKOT 2472 2202 80 96 89 96 91 90 90 -9 1 11 9

KAMDARA 1962 1748 63 81 73 82 75 85 85 -12 -13 27 25

BHARNO 2202 1961 85 91 97 93 92 86 86 4 6 3 8

SISAI 3447 3071 64 96 87 96 83 91 91 -10 -9 13 17

BASIA 2388 2128 83 86 83 87 88 87 87 -4 1 17 12

NAC 1492 1329 55 75 78 75 86 62 62 4 28 22 14

2972 2648 Gumla 71 90 86 91 86 86 86 -5 0 14 14 9 6

Gumla,DHAP 2011-12

FY-2010-11 (Up to Nov10)

District Full Drop Drop Leftout Target Cumulative % of Achievement Imm Leftout% Out Out %

PW Infan TT(P OPV DPT DPT BC Measle DPT1- BCG- s ts W) 3 1 3 G s DPT3 Mes. DPT1 BCG

BISHUNP 1294 1167 100 84 85 84 95 88 88 1 7 15 5 UR

GHAGHR 2031 1719 89 97 98 97 95 94 94 1 0 2 5 A

SADAR 2457 2177 100 106 108 105 112 105 105 3 6 -8 -12

RAIDIH 1390 1229 73 76 81 77 83 72 72 5 13 19 17

CHAINPU 1097 957 91 97 93 97 91 83 83 -4 9 7 9 R

DUMRI 1520 1385 78 75 75 75 79 77 77 1 2 25 21

PALKOT 1579 1459 83 80 81 80 81 77 77 1 5 19 19

KAMDAR 1297 1105 69 87 89 87 90 76 76 3 15 11 10 A

BHARNO 1455 1252 94 87 106 94 98 92 92 11 6 -6 2

SISAI 2283 1889 79 87 96 87 101 91 91 9 9 4 -1

BASIA 1579 1319 87 80 84 81 86 78 78 4 9 16 14

NAC 853 643 84 90 102 93 118 89 89 9 25 -2 -18

188 Gumla 16300 86 88 92 89 94 87 87 4 8 8 6 34

Gumla,DHAP 2011-12

The graphical representation of performance of district

Full Immunization (in %) of last 3 Years 87 86 87 86 85 84 83 81 82 81 80 79 78 2008-09 2009-10 2010-11 (upto Nov'10)

The above table depicts that

 Approx 30% of Children are not receiving BCG vaccine which shows the poor mobilization activity, poor availability and accessibility. This also indicates that there is some problem in geographical coverage and certain areas are still untouched from immunization services.  Average dropped out rate is approx 10 which indicate that there is need to improve mobilization and quality of services.

Action point

To ensure the availability of vaccines in the district, PHCs and Immunization Sites following actions can be taken:

 Cold Chain maintenance,  Arrangement of vaccine movement from state to district, district to PHCs and and PHCs to R I session sites.  Strengthening existing Alternate Vaccine Delivery System  Continuation of Cold Chain mechanics at District.

Gumla,DHAP 2011-12

To accessibility we need to focus on the following activities;

 Revising R I Microplan on regular interval  Identification of Hard to Reach areas and incorporating them in R I microplan and organizing R I sessions in these areas. At present there are 93 villages/ Hamlets in the district which are hard to Reach.  To increase accessibility of Routine Immunization services Village Health and Nutrition Day can be operationalzed . The VHND micro plan will be based on the Routine Immunization plans with addition of other services once in a month at the villages. This will provide an opportunity to receive multiple services at one point of contact every month.  Monitoring and evaluation  Review of RI activities at Health Sub center, PHC level and district level  Proper functioning of RI monitoring cell at district level.

The above mentioned activities also ensure the utilization and adequate coverage status of the district.

To ensure effective coverage of the district we need to focus on capacity building activities for the service providers like

 Cold Chain training for Cold Chain handlers  RI handbook training for front line workers  Training on Injection safety and Waste management

Strengthening of the existing Malnutrition Treatment Centres (MTCs)

Operationalization of new MTCs, improving the quality of implementation, equipping the MTCs, training the staff was the main focus in 2011-12.

Child Health Current Target for Objective Level 2011-2012

2 Increase coverage of full Immunization 87% 95%

3 To established Opretionalization of MTC 2 1

4 To established & Operetionalize SNCU O 1

5 Increase in New born given colostrums 18.3% 40%

6 Increase in prevalence of exclusive breastfeeding 3.2% 20%

Gumla,DHAP 2011-12

Strategies and Activities

Strategies / Indicators Remarks Timeline Responsibility Activities

Q1 Q2 Q3 Q4

Introduction of a package of √ home based new born care

Referral of sick √ √ √ √ MOIC child

Strengthen √ new born care through CS,DS, DPM establishment & Opretionalization of SNCU at DH.

Regular meeting √ √ √ of IMNCI Cell at √ CS, DPM District.

IMNCI Training √ √ √ √ DRCHO of ANM,AWW

. Educating . %Increase √ √ √ √ mothers on in benefits of prevalence immediate of breast exclusive feeding, breastfeedi exclusive ng breast . Increase in feeding, type Percentage CS,DSWO,MOIC,CDPO of of New supplements born given and also the colostrums need to start supplements from sixth month onwards.

Gumla,DHAP 2011-12

 IYCF √ √ √ √ DRCHO, DPM Training of ANM,AWW & Sahiya

Identification of No of MTCs DPM, MOIC ,BPM place for MTC at Started √ Bishunpur

Deputation of √ CS Paramedics for MTC

Training of Staffs √ DRCHO, DPM

Procurement of CS ,MOIC √ equipment

√ √ √ √

 Increase in Percenta ge of Admission of severely Children malnouri shed children referred to MTCs

Orientation of √ MOIC LS, MOIC & CDPOs

Training of AWW √ √ DPM, MOIC for identification of Malnourished children

Gumla,DHAP 2011-12

Plan for percentage of √ √ √ √ DIO,DPM, MOIC BPM Outreach fully session. protected children in 12-23 months as per national immunization schedule by 90% to 95%

Organize RCH √ √ √ √ MOIC ,BPM Camps

Regular supply of √ √ √ √ DIO Vaccine

Training of MO & √ √ DRCHO, DPM ANM on Immunization Handbook.

Training of Cold chain handler.

IEC through √ √ √ √ MOIC, DPC Sahiya.

Percentage √ Directed DRCHO, DPM coverage by the Implementation with Vitamin State of Biannual A prophylaxis √ Round in 5-36 months children by 93% to 95%

District & Block √ DRCHO, MOIC level Training. √

Micro Planning √ DRCHO, MOIC

Gumla,DHAP 2011-12

A3. FAMILY PLANNING

In all the blocks of district Gumla the achievement with respect to target in case of Family Welfare is not satisfactory. The availability of family planning does more than enable women and men to limit family size. It safeguards individual health and rights, preserves our planet's resources, and improves the quality of life for individual women, their partners, and their children. This section provides basic information on a range of contraceptive methods, including factors to consider when choosing a method. In all the blocks of district Gumla the achievement with respect to target in case of Family Welfare is not satisfactory.

FY-2009-2010

Sterilization IUD Oral Pills Nirodh Sl. Name of Ach.( N % % % % Ach.(i PHCs Tar Tub Targ Ac in % o. Target NSV Ach Ac Ac Target Ac Target n get ec et hi. Cycl Ach. . h. h. h. Pcs.) e) 1 Bishunpur 50 19 38 274 84 31 539 104 19 9058 1744 19 81120 23186 29

2 Ghaghra 50 24 48 474 145 31 874 271 31 14679 3594 24 53880 25666 48

3 Gumla 50 46 92 681 191 28 1219 452 37 20477 6420 31 147360 60281 41

4 Raidih 50 67 134 298 35 12 579 156 27 9732 3020 31 72000 26880 37

5 Chainpur 50 18 36 237 44 19 478 152 32 8028 2578 32 64560 20502 32 6 Dumri 50 24 48 347 83 24 662 107 16 11124 2781 25 70800 25200 36 7 Palkot 50 51 102 359 165 46 682 307 45 11461 4962 43 79800 53083 67

8 Kamdara 50 62 124 275 101 37 541 222 41 9096 3165 35 74400 41310 56

9 Bharno 50 40 80 315 227 72 608 319 53 10207 3959 39 81600 32587 40

10 Sisai 50 84 168 521 136 26 951 452 48 15980 5628 35 118080 51170 43

11 Basia 50 131 262 345 167 48 659 287 44 11072 4099 37 72600 58480 81

Sadar 12 50 126 252 197 152 77 412 146 35 6919 2090 30 56520 26900 48 H.Gumla

13 Joyti Clinic 40 40 689 432 366 13783 4404 97272 TOTAL 600 732 122 1570 36 8204 45 32 445245 46 3 4 4 0 0

Target Achi. % Total Str. 4923 2302 47

Gumla,DHAP 2011-12

FY-2010-11 Month : upto Nov'10 Sterilization IUD Oral Pills Nirodh Sl. Name of Ach. No % % % % Ach. % PHCs Tar NS Tar Tu Tar Ac Tar (in Tar . Ac Ac Ac Ac (in Ac get V get bec get hi. get Cycl get h. h. h. h. Pcs.) h. e) Bishunpu 44 905 811 1546 1 35 21 60 220 85 39 674 66 1698 19 19 r 2 8 20 0 108 58 146 538 4365 2 Ghaghra 75 28 37 356 121 34 54 3052 21 81 9 8 79 80 4 10 132 32 204 147 4216 3 Gumla 80 85 497 131 26 25 4064 20 29 6 4 8 77 360 0 28 973 720 2228 4 Raidih 60 50 83 243 60 25 645 44 2448 25 31 3 2 00 0 40 802 645 2051 5 Chainpur 30 21 70 195 75 39 602 67 3123 39 32 4 8 60 0 22 111 708 2072 6 Dumri 35 12 34 270 76 28 707 32 2231 20 29 7 24 00 5 39 114 798 3891 7 Palkot 67 38 57 278 77 28 756 53 4224 37 49 9 61 00 2 11 14 30 909 744 4653 8 Kamdara 80 220 57 26 690 44 4074 45 63 6 5 1 6 00 0 10 42 102 816 2387 9 Bharno 115 87 247 131 53 754 56 2012 20 29 0 2 07 00 5 112 39 159 118 3248 10 Sisai 104 47 45 435 36 8 35 4339 27 28 3 8 80 080 0 11 36 110 726 4834 11 Basia 125 94 268 72 27 867 42 3724 34 67 7 5 72 00 0 Sadar 691 565 2000 12 30 10 33 270 14 5 769 81 11 3599 52 35 H.Gumla 9 20 0 Joyti 29 13 18 2 1740 Clinic 1 66 350 100 45 137 3858 972 3766 TOTAL 836 79 937 27 45 28 39 3 0 00 29 834 8 720 66 Tar Ac % get hi. Total Str. 433 16 37 6 00

Gumla,DHAP 2011-12

Total S terilization (in %) of last 3 Years

50 39 45 37 40 35

30 25 20 15 10 5 0 2008-09 2009-10 2010-11 (upto Nov'10)

Gumla,DHAP 2011-12

Family Planning

Current Target for Objective Level 2011-2012 (DLHS Data)

1 To reduce total unmet need 38% 25%

2 Increase in contraceptive Use Rate 34.9% 55%

Strategies and Activities:

Strategies / Activities Indicators Timeline Budget Remarks Responsibility

Q1 Q2 Q3 Q4

Strategy : Compensation Package

Providing Compensation √ √ √ √ MOIC, for NSV& Tubectomy

Strategies ;Family planning Camps

Organizing NSV Camps √ √ √ √ MOIC ACMO,CS

. Organizing Tubectomy √ √ √ √ Camps

Strategy :Capacity Building

Mini lap training for MO √ DPMU,ACMO,CS

NSV Training for MO. √ Reflect CS in trg IUCD Training for √ budget ACMO,CS ANMSs, LHVs, A grade& √ MOs

Strategy; Community Mobilization

Gumla,DHAP 2011-12

Counseling eligible MOIC, CS couples for the acceptance of spacing & √ √ √ √ terminal methods through Sahiya

A4. ARSH (Adolescent Reproductive & Sexual Health)

Sexual development is a normal part of adolescence. Fortunately, most adolescents go through these changes without significant problems. Nonetheless, all adolescents need support and care during this transition to adulthood, and some need special help.

The lives of millions of adolescents worldwide are at risk because they do not have the information, skills, health services and support they need to go through sexual development during adolescence and postpone sex until they are physically and socially mature, and able to make well-informed, responsible decisions.

The main issues in adolescent sexual and reproductive health are:

. Sexual development and sexuality (including puberty) . Sexually transmitted diseases/ HIV/AIDS . Unwanted and unsafe pregnancies

Objectives and Targets

Current Target for Objective Level 2011-2012

Increase in number of Health facilities CHCs offering 1 11 11 ARSH service

ARSH CLINICS

ARSH Clinic is established in all the block’s CHCs. They are functional. In the year 2010-11 a KISHORI SAPTAH had been organized to reduce the anemia of school going KiSHORIs. It requires more focus on this type of programme in the district to improve the health services and reduce the anemia.

Gumla,DHAP 2011-12

The Adolescent Clinics that are operationalised ensure the following (as per the GoI guideline)

1. Health facilities provide the specified package of health services that adolescents need 2. Health facilities deliver effective health services to adolescents 3. Adolescents find the environment at health facilities conducive to seek services 4. Service providers are sensitive to the needs of adolescents and are motivated to work with them 5. An enabling environment exists in the community for adolescents to seek the health services they need 6. Adolescents are well informed about the availability of good quality health services from the service delivery points 7. Management systems to be in place to improve/sustain the quality of health services THE SERVICE PACKAGE FOR 2011 -12

Level of care Service Service Target Routine Package of services center provider Group service delivery Village Level Anganwari -Sahiyya Married/ Day to day -Friendly talk to adolescents of their centre -AWW unmarried service problems and its solution -ANM Male and II half of RI - Enrolment of Newly Married female couples

- Provision of Spacing methods - Routine ANC care and institutional delivery

Panchayat Health sub ANM Married/ During routine - Enrolment of Newly Married Level centre unmarried sub centre clinic couples Male female hours - Provision of Spacing methods - Routine ANC care and institutional delivery - Periodic Hemoglobine testing - Referrals for early and safe abortion - RTI/STI and HIV/AIDS preventive education

Block/District PHC/CHC/ -LHV Married/ Once a week : Contraceptive condom programming Level DH -MO (F) unmarried teen clinic will Management of Menstrual disorders , -MO (M) Male and be organised at menstrual hygiene guidance female PHC for 2 hrs. RTI/STI testing, sceering and HIV/AIDS Saturday prevention and management. 1:00pm to 3:00 pm

Gumla,DHAP 2011-12

A 5. TRIBAL HEALTH

RCH & OUT Reach(PTG) Camp

RC&Out Reach/ PTG Camps Out reach/ PTG RCH Camps Camps Name of Held ( Apr Held ( Apr to TARGET TARGET the to Sep Sep 2010) (2011-12) (2011-12) Blocks 2010) Basia 8 24 12 24 12 Chainpur 7 4 24 12 Dumri 7 5 24 12 Bishunpur 7 5 24 12 Palkot 8 3 24 12 Kamdara 10 2 24 12 Ghaghra 7 3 24 12 Sesai 7 0 24 12 Bharno 8 0 24 12 Raidih 7 4 24 12 Sadar 7 3 Total 83 264 29 132

Monthly RCH camps will be organized in all blocks in hard to reach and underserved areas. These underserved areas will be covered through the Camp mode. RCH Camp will be organized twise a month & Outreach Camps will be organize in a month in remote villages of every CHCs. The Sahiyyas and the AWW are trained for the reporting of the deaths. The facility level deaths will also be given top priority and recorded for dissemination.

Gumla,DHAP 2011-12

A-6. PC&PNDT

In Gumla districts still have a healthy sex ratio as compared to the National average. But it is matter of serious concern that following table shows the decline in the ratio which is alarming & necessary and timely steps need to be undertaken before the situation starts damaging the basic social fabric of the District.

Sex Ratio of Gumla District

1999 Censes 2001Censes Difference

Sex 988 976 -12 Ratio

PC & PNDT

Target for Objective Current level 2010-2011

1 To maintain the Sex Ratio 976 976

Strategies and Activities:

Strategies / Activities Indicators Timeline Budget Responsibility

Q1 Q2 Q3 Q4

Regular meeting of District PC& PNDT √ √ √ √ CS, DPM Committee

Gumla,DHAP 2011-12

Monitoring of Clinics √ √ √ √ CS , DPM

Orientation of MO and Service Provider √ DPMU,CS on PC& PNDT Act

Gumla,DHAP 2011-12

A-7. Innovations

In the meeting of Governing body of DHS the resolution has passed for some new innovations for the district. Although these innovations are seems to be very small but in long term it may results good.

1. Cloth for New born – Under the New Born Care we are giving a new cloth to the new born babies who delivered at health institution. Pink color cloth is for girl child and blue cloth is for boy child.

2. Award to the best worker and best Medical officer for their good performance at CHC level & District level. This activity will increase the motivational level of front line worker and the programme will be great successful. District had experience of this in the last pulse polio round and became the highest booth coverage district of Jharkhand.

3. Referral system- Deptt. Of Health and Family welfare Govt. of Jharkhand provided Ambulances to the Govermental &Non Governmental Organizations. A meeting of these organizations will plan to organized at District Hq under the chairmanship of DC Gumla. A mobile will made available to the ambulance drivers and these mobile number will be displayed at CHCs & HSCs. On call these ambulances will carry the patient from their house to the next higher health institution.

4. ISO Certification of District Hospital, Gumla.

Gumla,DHAP 2011-12

Innovation

% Target for Objective 2011-2012

1 Increase in Institutional delivery 29 45%

Strategies and Activities:

Strategies / Activities Indicators Timeline Budget Responsibility

Q1 Q2 Q3 Q4

Cloth for New Born Babies Budget reflect in MOIC, √ √ √ √ delivered at CHC & DH mission flexi pool DPM,DIO,CS

Mobile to Drivers of √ √ √ √ Ambulances (Recharge MOIC,CS Coupon)

ISO Certification of DH √

Awards for the Best √ Performing Worker, MO, CHC

Gumla,DHAP 2011-12

A-8. Infrastructure & Human Resource

% Target for Objective 2011-2012

1 To establish new ANMTC at district 0 1 nos

Strategies and Activities:

Strategies / Activities Indicators Timeline Remarks Responsibility

Q1 Q2 Q3 Q4

Construction at of New ANMTC State Dept of Health √ √ at District fund &FW,GOJ

Appointment of Health Personel at FRUs (Basia, Sisai, Raidih)

Pediatrician- 3nos √ Regular Dept of Health Gynecologist – 3nos √ &FW,GOJ.

Surgeon -3nos √

Recruiment of Contractual

District Media & Training √ Consultant-1 JRHMS District statistical officer-1 √

Driver for DPMU Vehicle -1 √ DPM,CS

Appointment of Health

Personnel at Eye Department

Eye Surgeon-1 nos √ Dept of H&FW

Ophthalmic Assistant -7nos √ Directorate Health

Gumla,DHAP 2011-12

A-9. Institutional Strengthening

Strategies and Activities:

Strategies / Activities Indicators Timeline Budget Remarks Responsibility

Q1 Q2 Q3 Q4

Strategy : Strengthening of Pvt ANM Training School, RKS,&VHCs

Quota system for DHS (20seat) at St Joshep √ √ √ √ MOIC, Hospital.

Regular monthly meeting of RKS followed √ √ √ √ MOIC by proceedings

Training of VHCs Reflect in members on accounting √ √ MOIC,DPC, Trg budget procedure

Gumla,DHAP 2011-12

A-11. Training

Sl Traini . ng Funds N load require o. Name proje Trai Dura No. of ment of the Tota cted ned tion Partici for Trainin l for Time Rem Category Till Venue of pant training g Trai cover Line ark Dat Train per during Progra ning age e ing batch 2010- mme Load durin 11 Per g batch 2011- 12

1 2 3 4 5 6 7 8 9 10 12 13

1 SBA LHV,ANM. 400 24 Sadar 21da 4 48 248360 Qt Training A grade Hospital ys 1,2,3, 4

2 AWW,,AN 212 10 11600 IMNCI M 0 120 CHCs days 30 24 0

AWW,SAH 393 2day 3 IYCF IYA ANM 1 600 CHCs s 50 576 11650

Sadar 6 4 MTP MO 24 12 Hospital days 2 12 16000

State 5 Minilap MO 12 0 HQ 4

Sadar 6day 7 IUCD ANM 450 40 Hospital s 10 40 34690

Gumla,DHAP 2011-12

Sl Traini . ng Funds N load require o. proje ment Trai Dura No. of Budg Tota cted for Name of the ned tion Partici et Tim Categor l Ven for trainin Training Till of pant Estim e y Trai ue cover g Programme Dat Train per ated Line ning age during e ing batch (Rs.) Load durin 2010- g 11 Per 2010- batch 11

1 2 3 4 5 6 7 8 9 10 11 12

9 VHCs accounting VHC 1296 0 CH 1day 1296 2000 22000 Qt Procedure Member C 2&3 s

1 Stat 0 e Emoc MO 11 3 HQ 4

Stat 1 e 1 Anesthesia MO 11 3 HQ 4

Qt 1 Sahiya Moduler CH 8day 67500 1,2, 2 Training VI to VIII Sahiya 1793 0 C s 40 1793 15000 0 3,4

Stat 1 e 3 Training on BSU LT &MO 12 0 HQ 12

Gumla,DHAP 2011-12

A-11. BCC/IEC

The Importance of IEC/BCC activities has always been a fostering process for increase in awareness generation and availing the health services. Providing health services in the hard to reach and illiterate masses is quite a challenging task. Once the people are aware and sensitized for the existing services available in our District hospital, Referal Units, CHC/PHCs and HSC, they come in action and avail the existing services. IEC and BCC increased the awareness level and increase in users in health facilities.

9.1 Objective

 To enhance Awareness, Generate Demand and Facilitate Behaviour Change in specific target populations for health services related to FP, MH, CH, HIV/AIDS and ARSH, to improve indicators of IMR, MMR and TFR.

 To build trust in and improve the image of the health system, by increasing the IPC skills of providers through training and capacity building and by creating linkages between the private and public sectors to ensure quality of services.

 To create an enabling and supporting environment through community based dialogue, advocacy, and social mobilization

Gumla,DHAP 2011-12

Strategies and Activities:

Strategies / Activities Indicators Timeline Budget Remarks Responsibility

Q1 Q2 Q3 Q4

Strategy : Awareness creation & Demand Generation

Print Media √ √ √ √ MOIC,

Printing of Handbills of JSY Scheme and its √ CS distribution(1lakh)

Printing of handbills on Sahiya incentives of all √ CS health programme & its distribution 2000 nos

Newspaper advertisements 0n observation of Different √ √ √ √ CS,DC health days

Printing of handbills (Family √ CS Planning)(1 lakh)

Outdoor Publicity

Making & Display of JSY Scheme at Blocks (Flakes √ Board)12nos

Display of JSY Beneficiary list MOIC at HSC,CHC,DH √ CS

NSV Rath for publicity √ √ √ √ CS

Folk Media

Nukad Natak √ √ √ √ MOIC

Drum Beating √ √ √ √ MOIC

Gumla,DHAP 2011-12

A-12. Health Management Information System(HMIS)

Strong MIS system has a role to play in improving the effectiveness of the health sector as a whole by maximising the use of scarce knowledge and limited resources and facilities. New and emerging communication tools could bring life- enhancing knowledge to people in ways they can use, when and where they need it. District has completed the District level HMIS training of district level officers ,MOICs & Sanganaks. The block levels HMIS trainings going on. Out off 11 trainings, district has completed 4 trainings, rest of the trainings will be completed very shortly. The main objective of the HMIS is to strengthen the use of Information Technology in health sector in monitoring & supervision.

Strategies and Activities:

Strategies / Activities Indicators Timeline Budget Remarks Responsibility

Q1 Q2 Q3 Q4

Strategy : Implementation of HMIS at facility level

Internet & Telephone connectivity to BPMU for √ √ √ √ MOIC, uploading data

Printing of HMIS √ Formats(3000nos)

Refresher Training of BPMU √

Gumla,DHAP 2011-12

A-13. Programme Management

Under NRHM, Programme Management Units has been established at Districts & Block levels to coordinate & implement different activities

District Programme management Unit Presently the post of DAM is vacant in the district

Block Programme management Units Presently 4 post of BPMs are still vacant in the District. These posts are vacant in Raidih, Bharno, Chainpur & Bishunpur.

Proposed plan for strengthening PMU:

 Contractual services of DPMU and BPMUs will be renewed annually based on performance. The annual enhancement in honorarium after completion of one year service will be done based on the performance in the preceding year. The enhancements in honorarium will be as mention in the budget sheet.

Gumla,DHAP 2011-12

B. NRHM ADDITIONALITIES

B 1. HOSPITAL MANAGEMENT SOCIETY

Rogi Kalyan Samiti / Hospital Management Society is a simple yet effective management structure. This committee, which would be a registered society, acts as a group of trustees for the hospitals to manage the affairs of the hospital. It consists of officials from Government sector and members from NGOs, local elected representatives and who are responsible for proper functioning and management of the hospital / PHC. Each HMS has one Governing Board for policy decisions and one Executive Committee for execution of the functioning of HMS. HMS can accept funds from NRHM and other sources including the donations from private parties. Each district hospital would get a grant of Rs 5 lakhs, each CHC (existing PHC), PHC (existing APHC), Sub Divisional Hospital (SDH), Refferal Hospital, and Urban Family Welfare Centre would get a grant of Rs 1 lakhs each from NRHM flexi-pool. The RKS/ HMS is free to prescribe, generate and use the funds placed with it, as per its best judgment for smooth functioning and maintaining the quality of services.

Objectives the RKS (Hospital Management Society)  Upgrade and modernize the health services provided by the hospital and any associated outreach services.  Organize outreach services/ health camps at facilities under the jurisdiction of the hospital  Display a Citizens’ Charter in the Health facility.  Generate resources locally through donations, user fees and other means  Undertake construction and expansion in the hospital building  Ensure optimal use of hospital land as per govt. guidelines  Ensure subsidized food, medicines and drinking water and cleanliness to the patients and their attendants.  Ensure proper use, timely maintenance and repair of hospital building equipment and machinery.  Acquiring equipment, furniture, ambulance (through purchase, donation, rental, or any other means, including loans, from banks) for the hospital  Making arrangements for the maintenance of hospital building (including residential buildings), vehicles and equipment available with the hospital.  Improving boarding/ lodging arrangements for the patients and their attendants

Progress and target for FY 11 -12

Gumla,DHAP 2011-12

In Gumla District there are 24 HMS/RKS among them 1 for district, 13 for PHCs and 10 for CHCs. All the 24 RKS/HMS are registered.

Utilization pattern of Hospital Management society.

Sl HMS no. CHC Name Number No. of Fund Fund Balance fund Fund required of Meetings Received Utilized till Sep 2010 For 2011-12 Members held (including till Sep opening 2010 in Rs balance) '000(SOE till Sep in submitted) Rs '000 1 Chainpur 12 1 224000 150791 73209 100000 2 Dumri 13 4 100000 17200 82800 100000 3 Palkot 8 6 184100 93381 90719 100000 4 Raidih 7 8 199922 69715 130207 100000 5 SADAR GUMLA 0 18 0 0 0 500000 6 Bharno 9 2 103259 179654 23605 400000 7 Bishunpur 7 4 238000 160000 78000 200000 8 Ghaghra 8 15 114375 30531 83844 100000 9 Kamdara 16 4 232318 202520 29798 100000 RH 10 2 RH 11 305046 211366 93680 200000

PHCs 11 13 PHC 74 2585367 1144245 1443384 1300000

Gumla,DHAP 2011-12

B 2. Untied Funds and Annual Maintenance Grant

Objective  To increase functional, administrative and financial resources and autonomy to the field units.  To develop the physical infrastructure and centre specific activities for PHCs.

Strategy  Provide Untied Funds to Village Health Committees @ Rs. 10,000 each  Provide Untied Funds to Health Sub centres @ Rs. 10,000 each  Provide Untied Funds to Primary Health Centers @ Rs. 25,000 each  Provide Untied Funds to Community Health Centers @ Rs. 50,000 each  Provide Annual Maintenance Grant to Health Sub centres @ Rs. 10,000 each  Provide Annual Maintenance Grant to Primary Health Centers @ Rs. 50,000 each  Provide Annual Maintenance Grant to Community Health Centers @ Rs. 1,00,000

Progress So far

Untied fund

Facilities Fund Fund Utilized till Sep SoE Fund required For 2011- Received 2010 Submitted 12

CHC Basia 68860 23840 23840 50000

Chainpur 81431 50863 50863 50000

Dumri 90587 48932 48932 50000

Palkot 74965 44791 44791 50000

Raidih 50000 24556 24556 50000

SADAR GUMLA 50153 26903 26903 50000

Sesai 76332 47932 47932 50000

Bharno 50945 37742 37742 50000

Gumla,DHAP 2011-12

Bishunpur 50000 19227 19227 50000

Ghaghra 86540 36515 36515 50000

Kamdara 3219 23421 23421 50000

PHC 13 PHC 476163 135104 135104 325000 HSC 242 4600223 1500509 1500509 2420000

Village Health Committee  Any village level public health activity like cleanliness drive, sanitation drive, school health activities, ICDS, Anganwadi level activities, household surveys etc.  Health care need of the poor household.  Community activities that involve and benefit more than one household. Nutrition, Education & Sanitation, Environmental Protection, Public Health Measures shall be key areas. 

Total No. VHC Fund given Status Total no. Total Total Sl. Name of of A/C of No. of no. of No. PHC Revenue Phase Phase Phase Phase Open Panchayat Sahiyya VHC Total Village I II III IV

1 Bishunpur 10 68 199 68 56 0 40 0 96 68

2 Ghaghra 18 120 225 120 87 0 51 0 138 114

3 Sadar 25 108 148 108 25 80 3 0 108 108

4 Raidih 13 61 186 61 63 0 30 0 93 57

5 Chainpur 10 82 86 82 0 70 14 0 84 76

6 Dumri 14 114 170 114 0 100 14 0 114 112

7 Palkot 14 73 174 73 23 0 49 59 131 73

8 Kamdara 10 73 86 73 46 0 27 73 146 73

9 Bharno 12 69 87 69 7 44 23 0 74 69

10 Sisai 18 87 200 87 23 0 63 0 86 78

11 Basia 15 88 104 88 45 0 47 88 180 88

Total 159 943 1665 943 375 294 361 220 1250 916

Gumla,DHAP 2011-12

Annual Maintenance Grant

Annual maintenance Grant

Fund Fund Utilized till Sep SoE Fund required For 2011- Facilities Received 2010 Submitted 12 CHC Basia 219927 132753 132753 100000

Chainpur 200000 163593 163593 100000

Dumri 263445 155650 155650 100000

Palkot 193550 123625 123625 100000

Raidih 200000 0 0 100000

SADAR GUMLA 241143 224210 224210 100000

Sesai 193004 122938 122938 100000

Bharno 100000 53641 53641 100000

Bishunpur 125000 47283 47283 100000

Ghaghra 200435 40170 40170 100000

Kamdara 150000 135000 135000 100000

PHC- 13 PHC 411000 161326 161326 50000 HSC 242 1449000 242002 242002 174000

Gumla,DHAP 2011-12

B 3. COMMUNITY MOBILIZATION

Strategy : Community Participation

 Trainings for Sahiyas- % of ANC registration module VI - VIII in first trimester of √ √ √ √ BAM,BPM,MOIC,DPC pregnancy

 Monitoring of working √ √ √ √ ANM, MOIC capacity of Sahiyas  Incentives for √ √ √ State Sahiyas working in √ difficult areas  Trainings VHCs BAM ,BPM, MOIC √ √ members on accounting ,DPC CS procedure 

SAHIYYA DETAILS

Total Total Trained Sahiyya Total Sl. Name of No. of no. No. of No. PHC Revenue of Module Sahiyya Module I Module II Malaria TB Module V Village VHC III & IV

1 Bishunpur 68 199 68 209 205 210 70 134 166

2 Ghaghra 120 225 120 228 225 228 190 209 201

3 Sadar 108 148 108 142 143 138 94 93 143

4 Raidih 61 186 61 229 231 230 229 136 168

5 Chainpur 83 86 82 86 84 83 86 78 80

6 Dumri 114 170 114 131 137 138 128 104 148

7 Palkot 73 174 73 173 169 170 134 98 167

8 Kamdara 73 86 73 88 87 88 91 90 80

Gumla,DHAP 2011-12

9 Bharno 69 87 69 86 81 85 73 85 80

10 Sisai 87 200 87 291 298 243 285 192 175

11 Basia 88 104 88 90 88 85 64 75 80

Total 944 1665 943 1753 1748 1698 1444 1294 1488

As per the data collected total no of Sahiya in the district is 1665, out of them 1488 Sahiyas has completed their 5th Module training. The meetings are organized at the HSC level but it has to be required more focus on the programmes at village level and strengthen the Community Mobilization.

Plan for FY 11-12

1. Introduction of an integrated incentive package for Sahiyyas, based on consolidated payment system based on her performance every month. 2. Dissemination of the quarterly Sahiyya Sandesh Newsletter 3. Dissemination of other print media campaign material 4. Formation as well as 4 quarterly meetings of the District Sahiyya Mentoring Group in all blocks. 5. Selection and deployment of Sahiyya-Sathis in all blocks 6. Conducting 12-day training of Sahiyya-Sathis in all the Sahiyya Modules at the district level. 7. Imparting 12-Day training package for Sahiyyas, based on the proposed training plan and modules 8. Imparting 2-day orientation for all VHC Office Bearers, Sahiyyas, ANMs and AWWs on VHC functioning, VHND and Village Health Plans- at block level 9. Organising monthly VHC meetings (12) and VHNDs (12) in all revenue/scheduled villages, 10. Organising Two monthly meetings of the Sahiyya Sathis (12) in all the blocks 11. Preparation and publication of Annual Report of Community Health Action 12. Holding an internal assessment of community action outcomes at the end of the year, and wider sharing of the same in a workshop.

Sahiyya Training Budget

Gumla,DHAP 2011-12

Asha 1665P*4d*700*3 13986000 Vhc 2080*943*2*3 11768640 25754640 EVENTS Sahiyya Sathi 90P*250**2 45000 Sahiyya sammelan at Dist level 200000*1 200000 Sahiyya sandesh yatra at PHc level 15000*11 165000 Cluster level meeting With sahiyya,AWW,ANM and VHC member 90*600*3 162000 Honorarium for BTT for 15 days 44*300*180days 2376000 Honorarium for STT for 15 days 3*500*180days 270000 Strengthening of sahiyya help Desk 11*15000 165000 Operational cost(Hon and Travel for shd 11*300*30*12 1188000 Sahiyya sathee remuneration 2000*90*12 2160000 6731000 Community Based monitoring at Dist level 1*30000 30000 AT PHC LEVEL 11*25000 275000 iNNOVATION convergence with ICDS 36*250*3QTR 27000 Sahiyya Day 5000 Crosslearning Exchange Programme for Sahiyya at District level 80000 Sahiyya Help Fund 150000 150000 Total 32635640

Gumla,DHAP 2011-12

B 4. MOBILE MEDICAL UNIT (MMU)

Objective To provide mobile health care services of curative, preventive and rehabilitative nature, to be provided by the service provider along with all primary health care services for the hard-to- reach areas of Gumla Mechanism for coverage:  Route planning for the placement of mobile health units will be done after the mapping and demarcation of the outreach areas.  Cluster of 5-6 surrounding villages will be formed and camps will be organized at cluster level to cover maximum number of patients.  Frequency of the visit will be finalized based on area mapping. It would also prioritize the need of the community.  In order to mobilize patients and to deliver health services to the last household, the active involvement of key stakeholders like ANM, AWW, Sahhiya, Village Health Committees and Gram Pradhan will be ensured.  To ensure the regular service and for supportive supervision a copy of detailed plan and schedule of placement will be shared with these stakeholders. Range of services: The fully equipped mobile medical van will provide a wide range of quality health care services.  Preventive services will be provided for diarrhea, malaria and other communicable diseases.  Clinical services will be ensured on maternal health, ANC, child health, family planning and reproductive health, first aid .  Behavior Change Communication (BCC) activities will be conducted to inculcate health seeking practices among the community.  Need based Information Education and Communication (IEC) materials will be shared among the communities.  Referral transportation facilities will be ensured to District Hospitals and Medical colleges in emergency and critical cases.  Diagnostic and pharmacy services are the integral part of the whole range of services.

The following NGOs are serving with MMU in hard to reach , unsaved , under served area in Gumla . 1. Vikas Bharti 2. St. Levance Hospital 3. St. Michale Health Centre

Gumla,DHAP 2011-12

Routine Immunization & PPI

Dedicated Immunization Staff.

Proposed Trained in last 3 years Position Sanctioned In position Addition on Immunization

D.I.O. 1 1 0 Yes

Cold Chain Mechanic 0 0 2 0

Driver (Dedicated to UIP 2 2 1 N vehicles)

Computer assistant 1 1 0 Yes

Cold Chain handlers 1 0 0 Yes

1. District store 1 0 1

2 .PHC store 11 0

Public Health Infrastructure

Proposed Expansion With Functional Cold Building Sanctioned (No. of Facilities)in the Functional Chain Equipment year 11-12

Sub Centre 242 242

PHC 13 13 0

CHC 11 11 10

District Hospital 1 1 1

Gumla,DHAP 2011-12

Cold Chain Storage Points

Proposed Cold Storage Point Total number expansion

Regional Store 0 0

District Store 1 0

ILR Storage Point 1 0

Cold Chain equipments

DFZ

Non-Working

Installed Working Repairable Non-Repairable

CFC- CF CFC- CFC- CFC- CFC free C free CFC free CFC free

Large 15 9 6 1

Small 9 6 3

ILR

Non-Working

Installed Working Repairable Non-Repairable

CFC- CF CFC- CFC- CFC- CFC free C free CFC free CFC free

Large 4 3 1

Small 15 10 5

Gumla,DHAP 2011-12

Solar DFZ Solar ILR

Site Not where Workin Not Site where not Installe Workin not Installed g Working working d Working g working

10 3 7 12 4 8

Solar Panels

Available Site(Name Installe Workin but Not Stole ) where d g Working n Stolen

11 5

Generators Vaccine van

Not Working Not Working

Not Installe Workin Repairabl Availabl Workin Repairabl Repairabl d g e Not Repairable e g e e

9 6 3 1 1

Gumla,DHAP 2011-12

D. Disease Control Programmes

D-1. RNTCP

Section-A – General Information about the District

1 Population (in lakh) please give projected population 2009 944160

2 Urban population 190405

3 Tribal population 630320

4 Hilly population 123435

5 Any other known groups of special population for specific interventions -

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

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

Does the district have a DTC Yes

ORGANIZATION OF SERVICES IN THE DISTRICT:

S. Name of the TU Population (in Please indicate if the TU is- No. of MCs No. Lakhs) Govt NGO Govt NGO Private

1 Gumla TU 548175 1 - 6 - -

2 Basia TU 395985 1 1 5 1 -

DISTRICT 944160 2 1 11 1 -

Gumla,DHAP 2011-12

RNTCP performance indicators:

Important: Please give the performance for the last 4 quarters i.e. July 08 to June09.

Annualized No of Plan for the next Total New Cure rate for Annualized new year Proportion number smear cases total case smear of TB of positive detected in TB Unit detection positive patients patients case the last 4 Cure rate (per cases put tested for put on detection corresponding Annualized rate lakh pop) on HIV treatment rate (per quarters NSP CDR treatment lakh p op) (85%)

Gumla 125 93% 71 70 86 TU

118 87% 61 60 81

112 98% 77 75 85

110 80% 61 59 83

Gumla 66 84 TU 465 87% 270 75% 90% Total

Basia TU 114 116% 64 87 86

112 114% 63 86 89

86 87% 50 67 88

98 99% 63 85 87

Basia 81 88 TU 410 104% 240 80% 90% Total

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

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

1 Improve Total Case Detection  Implementation of tribal action plan  To open more Microscopy center  To open sputum collection center in difficult areas  More involvement of Sahiya and community volunteers for Suspect referral  Identify and involve NGOs as per their capacity 2. Improve Suspect examination / Lac -Do-

Gumla,DHAP 2011-12

3. Maintain Case Holding  More involvement of Sahiya for DOT delivery  Timely payment of honorarium  Intensify Supervision  Monitoring using checklist

4. Improve Quality of DOTS -do-

5 Intensify ACSM  Implementation of NGO Scheme  More no. of Patient Provider meeting with documentation

Gumla,DHAP 2011-12

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

Activity No. No. No. Pl provide justification if an Estimated Quarter in required actually planned increase is planned (use Expenditure which the as per present for this separate sheet if required) on the planned the in the year activity activity norms district expected to in the be district completed

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

DTC 1 1 - - 4500 -

TUs 3 2 1 Due to propose Tribal 35600 - Action Plan

DMC 11 11 - 11000

Total 51100

Laboratory Materials

Activity Amount Amount Procurement Estimated Justification/ Remarks for permissible actually planned Expenditure for the (d) as per the spent in during the next financial year norms in the last current for which plan is the district 4 financial being submitted quarters year (in Rupees) (Rs.)

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

141634 Purchase of Lab 66883 100000 100000 - Materials

Honorarium

Expenditure Estimated Expenditure for Amount Amount (in Rs) the next financial year for permissible actually planned for which plan is being Justification/ Activity as per the spent in current submitted Remarks for (d) norms in the last 4 financial the district quarters year (Rs.)

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

Honorarium for DOT providers 27000 33750 100000 50000 - (both tribal and

Gumla,DHAP 2011-12

non tribal districts) - Honorarium for - - - - DOT providers of Cat IV patients

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

1) Information on previous year’s Annual Action Plan a) Budget proposed in last Annual Action Plan: 70000 b) Amount released by the state: 37928 c) Amount Spent by the district- 27300 d) Permissible budget as per norm : 75000 2) Budget for next financial year for the district as per action plan detailed below: ……………………….

Progr am Chall WHY For WHOM WHAT When Monitoring Bud enge and get s to By WHOM Evaluation be tackl ACS Target ACSM Time ed by M Audience Activities Frame ACSM Obje durin ctive g the Year 2009 - 10

Q Q Q Q Key Total 1 2 3 4 implementer expe Based Desir Activit Media/ and RNTCP Outpu Outco ndit on ed ies officer ts; mes: ure existi behav Materia responsible for for ng TB ior or l supervision the indica action Require activ tors (mak d Eviden Evide ity and e ce nce duri analys SMA that that ng is of RT: the it has the comm specif activiti been finan unicat ic, es effecti cial ion meas have ve year challe urabl been nges e, done achie vable, realis (Max tic & imu time m 3 boun d

Gumla,DHAP 2011-12

Chall objec enge tives) s )

Challenge 1. Low Case Detection and Suspect Examination

Advocacy Activities

1.One Publica 1.Meet 1. No to one tions ing Increa cost Low Gaini Dy meeti X 1. District Minute se invol Case ng Commissioner ng PPT Program s referr ved Detec Admi / DHS distric Managers al of tion nistra t -Audio 2.Phot chest and tive autho Visual ograp sympt suspe suppo rities Adds hs omati ct rt 2. MOTC ( with c2 exami from - support from 3. Progr nation Distri Posters WHO Report amme ct - Consultant) s Data

autho booklet rities s/broch Health and 4000 for ure other increa 2.Sen 4. department X se sitizat -poster Revie administrators referr ion in local w al meeti langua meeti Private Health 1000 from ng ge ng by care providers the 0 OPD 3. - X author Briefin Factshe ities

g ets

meeti ngs - success 1000 4. stories 0 Progr X amme infor matio n,

5. Facts heets

6. World TB Day

Gumla,DHAP 2011-12

Communication Activities

To 1General Use of Booklet 1.Dev 2500 infor Public region , Flip eloped 0 Low m al / Book, IPC 1.Incr District Case comm cable Posters Materi ease Program Detec unitie chann , X X X X al and self Managers tion s and 2. Schools els Sticker eviden report and care s, ce of ing/ MOTC suspe provi 3. Religious Banner pre referr ct ders bodies s, testin al exami about Partici Pamphl g of 4. Care nation the pate et, materi provider DOT in the Patient al servic biann informa 2.Anal es for ual tion 2. Flip ysis of early health booklet books data detec mela for

tion STS Devel and 3. op CFs KAP 3. study Wall after writin one yr gs know the 4. aware Stock ness Regist level er of gener Awar Wall DTO, 1.Visib al 1000 eness painti le wall public 0 Gener General ng on X MO-TC, MO, painti . ation Public, TB IEC Officer ngs at in schools, Sub gener center

al level public

Puppe Script DTO, Docu 2500 t and Communicatio menta 0 shows profess X X n Facilitator, tion/ , ional STS, IEC report street groups Officer, NGO play Partners 2. Script for street plays 3. Photo graphs

4. School quiz format

Gumla,DHAP 2011-12

Social Mobilization

MO-TC, IEC Minute Increa 2500 Officer, s of se 0 Low 1.Gen Community Com Flip X X X X Communicatio Meetin Self Case erate munit Chart n Facilitator, gs report Detec Awar General y and STS ing in tion eness Public, Meeti Posters Displa chest and in Patients, DOTs ng , Talks y of sympt suspe gener Providers Poster omati ct al s c exami public nation Flip Chart

2. Celebr Display DTO, MO-TC, Docu Pre- Bud Encou ation Materia MO, menta post gete rage of l for Communicatio tion of evalu d early World World n Facilitator, l world ation abov self TB TB Day STS TB of e report day Day WTB ing activiti Day es activit 3. ies Com with munit specifi y c Group object s. PRI ives

Exhibi display DTO, MO-TC, Docu Increa 2000 tions Materia MO, STS menta se /Mela’ l ( X tion of Self s / Posters activit report Popul , X y ing of ar Sticker TB Event s, Write patien s in Banner ups / ts ( Distric s, brief KAP t. Pamphl used study et) in after plays one yr)

Interac tive game s

School Drawi Games DTO, STS, IEC Docu Pre- 5000 Children ng & – Officer, NGO menta post Quiz Snake Partners tion of interv Comp and Activiti ention etition ladder, X X X es/ evalu s Chakra Photo ation view graphs Game etc.

Pamphl ets]

Gumla,DHAP 2011-12

IEC Materia l

College & TB Games DTO, STS, IEC Docu Data 4000 School NSS Sessio – Officer, NGO menta Analy Students ns Snake Partners tion of sis during and Activiti NSS ladder, es/ caps Help Photo in Mohan graphs school etc. and colleg Pamphl e, ets] Drawi IEC ng & Materia Quiz l Comp etition s

Challenge 2: Maintain and Improve Case Holding

Advocacy Activities

Sensi Audio tizing Visual Maint distric 1.Health care 1.Inte Adds District Revie Reduc BUD ain t providers ractio Program w of tion in GET and autho n - Managers defaul defaul ED Impro rities Public & Meeti Posters t case t rate abov ve about Private ngs - TU by e case the booklet wise 2% - holdin impor 2.One s/broch MOTC Data g tance to ure analys

of One is reduci Intera -poster Recor

ng ction in local d of defaul Meeti langua meeti t ngs ge ngs Study

cases to & for 3. Use - docu

their of Factshe ment suppo Infor ets defaul rt for matio t - neces n within success sary Bookl one yr stories instru et ctions to the progr amm e staff

Gumla,DHAP 2011-12

Communication Activities

Patients, Their Patient MO, Recor Reduc Family Shari interact ds of tion in Maint To Members, ng of ion X X X X STS & meeti defaul ain motiv DOTs experi meetin Communicatio ng t rate and ate Providers ence gs & n facilitators by Impro patie of involve 2%- ve nts & cured ment Analy case their patien of Eviden sis of holdin famili ts / cured ce of progr g es for Patien person materi amme compl ts s al data etion during develo of Treat pment treat ment. – pre ment Flip testin Reduc

Chart g tion in Develo time

Community TB pment X X X X MO-TC, STS, for Groups / ANMs retrie

NGOs Develo val of pment defaul

of Increa ts materia se in

l for no. Comm comm unity unity DOT based Provide NGOs rs involv ement

One to one Interp Patient MO, STS, DOT Eviden Reduc patie meeting with erson informa Provider ce of tion in nt the patient al tion X X X X such defaul infor comm booklet meeti ts mati unicat ng on ion book with Patien let patien t ts inform (no ation cost bookle for t one- to one IPC)

Social Mobilization

Maint To link poor Sensit DTO, MO TC Docu Reduc 5000 ain patients to the izatio Posters menta tion in and welfare n of , X X tion, defaul Impro schemes Depar progra Recor ts ve tment mme ds , case s fact Photo holdin Social sheet, graphs g welfar e Present

Gumla,DHAP 2011-12

schem ation Docu es menta Annual Data tion of reports of effecti referra venes l of TB s of patien such ts t linkag

sympt es omatic throu

will gh a increa study se after one year

For Community Intera Inform Forma 2000 mobili support ction ation tion of zing groups meeti materia X X MO-TC, STS, TB Decre suppo ngs l, Communicatio suppo ase in rt n Facilitators rt the from group no. of Com Cured patients s in X defaul munit no. of ts in y village such group s village s s

Equipment Maintenance:

Estimated Amount Expenditure for No. Amount Proposed the next financial actually actually for year for which Justification/ Item present spent in Maintenance plan is being Remarks for (d) in the the last 4 during submitted district quarters current financial yr. (Rs.)

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

Office Equipment 1 7475 30000 30000 -

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

Binocular Microscopes ( RNTCP) 19 - - - -

30000 -

Training:

Gumla,DHAP 2011-12

Activity No. in No. No. planned to be Expenditure Estimated Justification/ the already trained in RNTCP (in Rs) Expenditure remarks district trained during each planned for for the next in quarter of next FY current financial RNTCP financial year for (c) year which plan is being submitted Q1 Q2 Q3 Q4 (Rs.)

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

Training of MOs (Contract)

Training of MOs (Regular New appointed)

Training of LTs of DMCs- Govt + Non Govt

Training of MPWs

Training of MPHS, pharmacists, nursing staff, BEO etc

Training of Comm Volunteers

Training of Pvt Practitioners

Other trainings # (ANM Contract)

Re- training of MOs

Re- Training of LTs of DMCs

Re- Training of MPWs 60 60 29068

Re- Training of MPHS

Re- Training of Pharmacists

Re- Training of nursing staff, BEO

Re- Training of CVs

Re-training of Pvt Practitioners

TB/HIV Training of MOs 1204 304 32528 TB/HIV Training of STLS, LTs , MPWs, 900 MPHS, Nursing Staff, Community Volunteers AWW etc.

100

Gumla,DHAP 2011-12

TB/HIV Training of STS

Training of MOs and Para medicals in DOTS Plus for management of MDR TB

Provision for Update Training at Various Levels(key staff & MO-PHIs)

Any Other Training Activity( Key staff & MO-PHIs)

Training of Sahiya 1793 1193 600 6000

Total 67596 # Please specify

Vehicle Maintenance:

Type of Vehicle Number Number Amount spent Expenditure (in Estimated Justification/ permissible actually on POL and Rs) planned for Expenditure for the remarks as per the present Maintenance in current next financial year norms in the previous 4 financial year for which plan is the district quarters being submitted

(Rs.)

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

Four Wheelers 1 1 56252 125000 125000 -

Two Wheelers 3 2 27242 50000 50000 -

175000

Vehicle Hiring:

Number Number Amount Expenditure (in Estimated Justification/ permissible as actually spent in the Rs) planned for Expenditure for remarks Hiring of Four per the norms present previous 4 current financial the next financial Wheeler in the district quarters year year for which plan is being submitted (Rs.)

101

Gumla,DHAP 2011-12

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

For DTO - -

For MO-TC 50000 -

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

Activity No. of Additional Amount Expenditure Estimated Justification/ currently enrolment spent in (in Rs) Expenditure for remarks involved planned the planned for the next financial in for this previous 4 current year for which RNTCP year quarters financial plan is being in the year submitted district (Rs.)

(a) (b) (c) (d) (e) (f) - ACSM Scheme: TB advocacy, communication, - - - - - and social mobilization - SC Scheme: Sputum 1 - 60000 60000 - Collection Centre/s - Transport Scheme: Sputum Pick-Up and Transport - - - - - Service - DMC Scheme: Designated Microscopy Cum Treatment - - - - - Centre (A & B) - LT Scheme: Strengthening - - - - - RNTCP diagnostic services

Culture and DST Scheme: Providing Quality Assured Culture and Drug ------Susceptibility Testing Services

Adherence scheme: Promoting treatment ------adherence

Slum Scheme: Improving ------TB control in Urban Slums

Tuberculosis Unit Model ------

102

Gumla,DHAP 2011-12

TB-HIV Scheme: Delivering TB-HIV interventions to ------high HIV Risk groups (HRGs)

TOTAL 60000

Miscellaneous:

Activity* Amount Amount Expenditure Estimated Expenditure for Justification/ remarks permissible spent in (in Rs) the next financial year for as per the the planned for which plan is being norms in previou current submitted the district s 4 financial quarter year (Rs.) s

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

141624 25430 50000 50000 -

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

Contractual Services:

Activity No. required No. No. planned Amount Expenditur Estimated Justificati as per the actually to be spent in e (in Rs) Expenditure on/ norms in the present additionally the planned for for the next remarks district in the hired during previous 4 current financial year

103

Gumla,DHAP 2011-12

district this year quarters financial for which year plan is being submitted

(Rs.)

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

Medical Officer- Not to be filled - - - - DTC

STS - 2 1 269950 346500 345000

STLS - 2 1 275581 346500 350000

TBHV - - - 0 0 0

DEO - 1 - 96362 82800 120000

Accountant – part - - - 0 0 0 time

Driver - 1 - 80297 62100 100000

Contractual LT 2 - 193424 180000 260000

1175000

Printing:

Activity Amount Amount Expenditure (in Estimated Expenditure for Justification/ permissible as spent in the Rs) planned for the next financial year for remarks per the norms previous 4 current financial which plan is being in the district quarters year submitted

(Rs.)

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

Printing*

141624 - 50000 50000

* Please specify items to be printed

Research and Studies:

Any Operational Research project planned (Yes)

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

104

Gumla,DHAP 2011-12

Estimated Budget (to be approved by STCS).______

Medical Colleges

Activity Amount permissible Estimated Expenditure for Justification/ as per norms the next financial year(Rs.) remarks

(a) (b) (c) - - Contractual Staff: - . MO (In place: Yes/No) . STLS (In place: Yes/No) . LT (In place: Yes/No) . TBHV (In place: Yes/No)

- - Research and Studies: -- . Thesis of PG Student . Operations Research*

Travel Expenses for attending - - - STF/ZTF meetings

IEC: Meetings and CME planned - - -

- - -

Procurement of Vehicles:

Equipment No. actually No. planned Estimated Expenditure for the next Justification/ present in the for this year financial year for which plan is remarks district being submitted (Rs.)

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

4-wheeler ** - - - -

50000 Due to propose TAP

2-wheeler 2 3 100000 Due to Replacement of 6 years old 2wheeler. As per Norms & Basis of Costing for RNTCP II

105

Gumla,DHAP 2011-12

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

Procurement of Equipment:

Equipment No. actually No. planned Estimated Expenditure for Justification/ remarks present in the for this year the next financial year for district which plan is being submitted (Rs.)

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

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

Any Other - - - -

106

Gumla,DHAP 2011-12

2. D-2 National vector Born Disease Control Programme (NVBDCP) 3. Specific constraints for implementation of the programme:

a) Implementation of the programme activities includes diagnosis with microscopy and rapid Diagnostic Kits- Pv & Pf Kit required. b) Implementation with revised drug policy (2010) – Frequently Training given & Evolution. c) Management of severe and complicated malaria – Facilitate with RKS & Awareness among people, Villages stream lined with Ambulance. d) Spray activities including its planning and execution – Awareness among people about benefit of Spray activity, motivate & trained Sahiya about benefit of Spray. e) Distribution and use of bed nets – yet to be supplied by NVBDCP. Lack of awareness among people about the use of Bed-Nets, need awareness. f) Inter-sectoral collaboration involving NRHM institutions like Village Health & Sanitation Committee etc – Need motivation & Training among VHSC about Malaria Programme.

3. Prioritization of the areas including the criteria of prioritization

a) To implement the NVBDCP activities, the area need to be prioritized for diagnosis & treatment as well as for undertaking interruption measures –Map below showing API > 10 in Panchayats & HSCs.We have to increase Surveillance work(fever cases screening) timely.

107

Gumla,DHAP 2011-12

b) The area should be prioritized based on Pf proportion, API and deaths for use of Rapid Diagnostic Kits and the drugs recommended as per the guidelines – List attached *Epidemiological Report (2003-2009).Monitoring & Evaluation by MTS & Fortnightly by District Officer.

108

Gumla,DHAP 2011-12

c) Similarly the area should be prioritized for distribution of bed nets giving priority to the BPL families –List attached more than 2 API, for distribution of LLINs. No of LLINs required- 94658 to cover the villages more than 5 API.

d. I.R.S -- According to high A.P.I, Village & H.S.C has been identified, and this activity will be done through VHSC & Monitoring by Department. Identified H.S.C, Village & Population, for Spray activity 2011 showing below:-

Squad Insecticide Sl.No. P.H.C H.S.C Village Population in M.T

1. Gumla 16 41 40695 3 6

2. Raidih 19 39 38456 3 6

3. Chainpur 21 67 43212 3 6.5

4. Dumri 18 54 38606 3 6

5. Bishunpur 20 83 62348 5 9.5

6. Bharno 16 37 39000 3 6

7. Sisai 18 51 49515 4 7.5

8. Kamdara 16 41 39772 3 6

9. Basia 21 63 56460 4 8.5

10. Palkot 15 40 36449 3 5.5

11. Ghaghra 21 62 49723 4 7.5

TOTAL 201 578 494236 38 75

109

Gumla,DHAP 2011-12

Detail Action Plan to be prepared date –wise but name villages & HSC attached Appendix –I.

e. Biological Control – 12 mother hatcheries and 60 Sub-hatchery required for the development & distribution of Gambustia Fish to the logging water bodies, through V.H.C.

Mother S.No Sub-Hatchery(Water Bodies) Hatchery

1 Gumla H.Q Kotam, Basua, Kulabira, Kaliga, Armai, Nawadih

2 Raidih Upper Khatanga, Kemte, Silam, Sursang, Kondra

3 Bharno Supa, Karanj, Domba, Turiamba, Karaundajor

4 Sisai Ghaghra, Charda, Nagar, Rerwa, Shivnathpur, Olmunda

5 Dumri Jairagi, Akasi, Majhgaon, Jarda, Sikri, Bhikhampur,Khetli

6 Palkot Baghima, Billingbera, Bangru, Kullukera, Tengaria

7 Bishunpur Banari, Amtipani, Sakhuapani, Helta, Nirasi,

8 Basia Sakiya, Kaliga, Mamarla, Pokta, Konbir

9 Ghaghra Bimarla, Belagarha, Badri, Sarango, Dewaki, Nawdiha,

10 Chainpur Bardih, Kating, Bamda, Chichchwani, Keragani

11 Kamdara Kulburu, Ramtolya, Sarita, Hanfu, Saleguttu

110

Gumla,DHAP 2011-12

f. Status of Spray equipments:-

S.No Name of Equipment No. of Equipment

1 Stirrup Pumps 350

2 Buckets (15 Liter) 610

3 Buckets (05 Liter) 1000

4 Measuring Founds (1 Liter) 1000

5 Nozzle Tips 1000

4. Strategy & innovation proposed : (a) Need Pv/Pf Kit (b) Falcigo inj. in place of E.Mal inj. (c) Frequent motivation to Sahiya about Malaria by Training & Meeting and award them. (d) Motivation to M.P.W for the best performance. (e) Priority based micro-plan i.e like LLIN distribution among Hard to Reach Areas, Socio-Economic Backward Areas etc. 5. Requirement for commodity as per technical norms and considering balance of stores, consumption capacity and justification- Drug Requirement for Year 2011.

(a) Chloroquine – 600000 tab. (b) Primaquine (7.5) – 75000 tab.

(e) Quinine tab. – 500 tabs. (f) Quinine inj. – 1000 amp.

(g) E.Mal/Falcigo inj. – 5000 amp. (h) R.D.T – 125000 Kit.

(i) S.P- 15000 tab. (j) A.S – 45000 tab.

111

Gumla,DHAP 2011-12

(k) Slide – 150000 pieces. (l) Pricking Needle – 150000 pieces.

(m) Spirit – 242 x 500ml.

6. Cash assistance requirement-

Activity Total Proposed Budget in Rs.

Blood Slide Collection & examination, fever cases screening. 300,000 (M-2,J.S.B Stain,etc Purchasing)

RDT & B.S.C By Sahiya (Honararium ) 2,000,00

Management of Severe Malaria By Hospital Management Society & H.S.C

L.L.I.N By N.V.B.D.C.P

I.R.S (Wages) 2370060

Insecticide Transportation (Dist to 3,00,000 Villages )

R.R.T 25,000

Re impregnation of Bed nets 2,00,000

Gambutia Fish 11,75,000

Training (MO, Paramedical, Sahiya) 6,00,000

Cluster meetings, Gram gosthi, 50,000

Surveillance Meetings 50,000

Salary of VBD Consultant 360,000

Salary of M.P.W, Rs.97,20,000

Activity Total Proposed Budget in Rs.

112

Gumla,DHAP 2011-12

Salary of L.T, Rs. 4,32,000

Salary of M.T.S, Rs. 7,20,000

Salary of D.E.O, Rs.78000

Salary of F.L.A Rs.96000

POL for Monitoring & evaluation 75,000

IEC 700000

NAMMIS Data Entry by Internet 10,000

Inverter facility 25,000

Office Maintenance 75,000

Furniture 50,000

Godown required As per Estimate Budget

Total Rs.17551060

7. Assistance for Capacity Building and IEC/BCC activities incorporated

- By Posters, Banners, Hording, Micking, Dug-Dugi, By Sahiya /VHC, Mata Samuh.

B.C.C :-- B.C.C will be done through V.H.C, Sahiya, Paramedical Staff at V.H.N.D, Gram gosthi, Posters, Banners, Hording, Micking, Dug-Dugi, , Mata Samuh.

113

Gumla,DHAP 2011-12

Trainings:--

 M.O - 52 (R) 9 (C), M.O to be trained for severe and complicated Malaria.

 Paramedical – 50 trained & 152 (R) 279 (C) Paramedical Staff to be trained for new drug policy of Malaria.

 V.H.C:-- 1296 V.H.C to be trained for awareness of Malaria & Surveillance activity.

 Sahiya: -- 1665 trained but Refresher Training is needed for drug schedule, R.D.K Test & Blood Slide collection.

4th Sl.N Post/Designa No. of 1st 2nd 3rd No. Quarte o tion Batch Quarter Quarter Quarter r

1 M.O 61 2 30 - 31 -

2 Para. Staff 481 19 150 150 100 81

3 V.H.C 1296 26 300 350 300 346

4 Sahiya 1665 42 417 416 416 416

Monitoring & Evolution:--

Dist. Level: - C.S & A.C.M.O -05 visits/month.

D.M.O -10 visits/month.

A.M.O -15 visits/month.

Consultant -15 visits/month.

114

Gumla,DHAP 2011-12

M.I & M.T.S -20 visits/month.

P.H.C Level: - M.O.I/C - 07 visits/month.

M.O -10 visits/month.

Supervisor -20 visits/month

Filaria :

1. Situation analysis of the disease: Line –listing attached.

2. Specific Constraints for implementation of the programme.

Special IEC/BCC needed, Absence of beneficiaries during working hour, Difficulty in implementing night blood survey, late reporting.

3. Prioritization of the areas including the criteria of prioritization: List attached.

Name of No.of Sl.No PHC Name HSC/Village Cases

1. Basia Solengbera 65

Karaundi 211

Basua 144

2. Gumla Pugu 88

Fori 67

Kumharia 64

3. Bharno Attakora 78

115

Gumla,DHAP 2011-12

Jura 51

Puto 90

Arangi 46 4. Ghaghra Duko 40

Gamharia 196

Kemte 45 5. Raidih Patratoli 33

Chegri 33 6. Sisai Chharda 33

Ward No. 10 185 Karamtoli 7. NAC Gumla Ward No. 4 Ajaad 95 Basti

4. Strategy & innovations proposed :

a) District/PHC/HSC level Training b) Identification of volunteers/drug distributors- MPW, ANM, Sahiya, AWW, NGO volunteers c) Preparation at village and sub-centre level - Meeting of VHSC- RKS for IEC & Drug compliance, Management of adverse effect. d) Media sensitization at district and block level. e) IEC activities at local level- Wall writing, Village level meeting, Miking, Drum Beating 5. Requirement for commodity as per technical norms and considering balance of stores, consumption capacity and justification- DEC – 18,00,000 & Albendazole – 9,00,000

6. Cash assistance required –

116

Gumla,DHAP 2011-12

* Night Blood Survey-Rs. 50,000.

* Training:

(a) M.O – 50,000 (b) A.N.M/H.W – 1, 00,000

* Honrarium to Drug Distributor – 1, 60,000

* Honorarium to Supervisors – 50,000

*Monitoring – 1, 00,000

* Hydrocele Operations – 1000xRs.750=7, 50,000

* I.E.C/B.C.C –

(a) Posters – 20,000 (b) Wall-Writings – 50,000

(e) Dug-dugi – 50,000

Grand Total - 1605000

7. Assistance for Capacity Building and IEC/BCC activities may be incorporated – By Posters, Banners, Hording, Micking, Dug-Dugi, By Sahiya /VHC, CBO.

Kala- Azar :

1. Situation analysis of the disease – Cases not found.

2. Specific Constraints for implementation of the programme.

3. Prioritization of the areas including the criteria of prioritization :

4. Strategy & innovations proposed:

117

Gumla,DHAP 2011-12

5. Requirement for commodity as per technical norms and considering balance of stores, consumption capacity and justification.

6. Cash assistance required from Centre and unspent balance available with State.

7. Assistance for Capacity Building and IEC/BCC activities may be incorporated.

Acute Encephalitis Syndrome including Japanese Encephalitis

1. Situation analysis of the disease – Cases not found.

2. Specific Constraints for implementation of the programme.

3. Prioritization of the areas including the criteria of prioritization :

4. Strategy & innovations proposed:

5. Requirement for commodity as per technical norms and considering balance of stores, consumption capacity and justification.

6. Cash assistance required from Centre and unspent balance available with State.

7. Assistance for Capacity Building and IEC/BCC activities may be incorporated.

Dengue/Chikungunya:

1. Situation analysis of the disease – Currently Cases not found.

2. Specific Constraints for implementation of the programme-

118

Gumla,DHAP 2011-12

A) Vector Control- Anti larval measures should be done with help of Ngarpalika for reduction of mosquito means and to prevent the occurrence of Disease.

B) Rapid Diagnostic Test Kit required, Diagnostic Facilities like Elisa Reader, Plate late separator should be provide in SSH.

C) Training required to Medical & Paramedical staff.

D) Clinical guidelines should be provided for case management.

E) Training Status for Dengue:-.

S. Category of Total Total No. Total No. N Staff No. In Trained Untrained Position

1 MO 61 0 61

2 Paramedical staff 481 0 481

3. Prioritization of the areas including the criteria of prioritization – Nagarpalika area should be focused, rural area to be checked for migrate cases.

4. Strategy & innovations proposed- Entomological teams needed to conduct Anti larval measures in domestic area of Nagarpalika.

5. Requirement for commodity as per technical norms: Rapid Diagnostic Test Kit required, Diagnostic Facilities like Elisa Reader, Plate late separator should be provide in SSH.

119

Gumla,DHAP 2011-12

6. Cash assistance required from Centre and unspent balance available with State-

Dengue/ 2010-11 2011- Chikungunya 2012(Proposed)

Strengthening - 1,00,000 surveillance at 2 SSH

IEC/BCC/Social - 1,00,000 Mobilization

Training/work shop - 1,50,000

7. Assistance for Capacity Building and IEC/BCC activities

IEC / BCC activities should be done through out the year by wall paintings, ads, advertorials, posters and other print media. D-3 NLEP (National Leprosy Eradication Programme)

1. Situation analysis -

Identify Strength, weakness, opportunities and threats

New initiatives suggested to improve physical & financial performance (if any)

SWOT ANALYSIS

120

Gumla,DHAP 2011-12

Strength - MO, G.H Sare trained

- Sahiya (Trained) involved in Leprosy work - Vehicle & Driver - Adequate P.O.L - Co-operative Civil Surgeon

Weakness - Few MO and H.S. are not trained.

- Not available permanent D.L.O. - Some Sahiyas are not trained

Opportunity - N.G.O. (Vikas Bharti)

- RCH Mela & other mela

Threat - Multiplicity of Language

- Hard to reach areas - Regular migration - Frequent Band call - Naxalite prone District.

Objectives- -Referral services to be improved.

-DPMR services to be improved

-Supervision System to be improved.

-Drug Management system to be improved.

-To improve awareness about Leprosy in community.

2. Performance under NLEP -

121

Gumla,DHAP 2011-12

Indicators 2006-7 2007-08 2008-09 2009-10 2011-12

(till Date)

No. of new cases 19.3 19.4 15.5 17.5 17.5 detected (ANCDR)

No. of cases on 1.08 1.15 0.89 0.98 1.0 record at year edn (PR)

No. of Grade II 1.1 2.7 2.0 5.7 0.0 disability among new cases (%)

Treatment 96.8 92.0 95.5 92.1 - Completion Rate

Re-constructive - - 01 - 0 Surgery conducted

(Cumulative number to be mentioned and rate/percentage to be given in brackets)

3. Training Plan –

122

Gumla,DHAP 2011-12

4 days training of newly appointed MO (rural & urban) –

3 days training of newly appointed health worker & health

supervisor – 397 (Sep. 11)

2 days refresher training of MO & GHS – 396 (Oct.11)

5 days training of newly appointed Lab. Technician – 11+3 = 13

(July 11)

4. IEC plan –

IPC & folk media – 100 (April 11 to Feb. 12)

Rally – 2 (2nd Oct. 11 & 30thJan. 12)

School Quiz – 2 (2nd Oct. 11 & 30thJan. 12)

Wall writing – 300

Hording – (11+4)=15

5. DPMR plan –

MCR Footwear – 150x2=300 pair (April 11 to March 12)

Eye kit (Goggles) - 9 (April 11 to March 12)

Self care kit – 150 (April 11 to March 12)

123

Gumla,DHAP 2011-12

Ulcer care kit – 80 (April 11 to March 12)

RCS – 10 Case

6. Procurement plan – Indicate plan for procurement of supportive

drugs, lab reagents/equipments, printing registers/forms etc also

taking number of leprosy colonies in consideration

Prednisolone : 50 pts.

For One Pts. 50 pts.

40 mg – 14 tabx50 = 700 tab

20 mg – 28 tabx50 = 1400 tab

10 mg – 42 tabx50 = 2100 tab

05 mg – 28 tabx50 = 1400 tab

Clofazimine(100mg) – 5 pts.

For One Pts. - 180 caps

For 5 Pts. – 180x5 = 900 caps

Soframycin – 240 tube

Bandage – 240

Cotton – 240

Lab Reagent

124

Gumla,DHAP 2011-12

7. Incentive for ASHA (SAHIYA) – . Incentive for ASHA – Number of

ASHA trained & involved in NLEP in 2010-11, Number of new PB &

MB cases likely to be detected during 2011-12 by ASHA based on the

trend of new case detection.

Total No. of Sahiya – 1622

No. of Sahiya Trained – 294

Expected no. of Leprosy Case – (PB+MB)= 50 pts.

8. Vehicle POL & Maintenance –

POL – Rs. 75000/-

9. NGO services – Name of NGOs providing leprosy services under

SET scheme.

10. NLEP monitoring and Review plan –

State level

District level

11. Vehicle operation and hiring –

State level

District level

125

Gumla,DHAP 2011-12

12. Office expenditure and Consumable –

State level

District level

13. Cash Assistance –

TA/DA to vertical staff for mobility

IEC activities carried other than regular IEC

126

Gumla,DHAP 2011-12

DETAILED BUDGET (National Leprosy Control Programme) :2011- 2012

P Rate Q1 Q2 Q3 Q4 Total Bu hy si dge Bas S ca t e- l. l (Rs./u hea Physical Target in Numbers & Amount in Lakhs Ta line nit) d G. Re rg T m et ot ar U al ks Targ Tar Targ Tar nit Targ (cur et get et get of Am Am et rent for Amo for for Amo for Amo NLEP m oun oun for stat the unt the the unt the unt ea t t the us) qua qua qua qua su Year rter rter rter rter re

Dist rict 1 Lev el

Sala ry of Con 1 trac . 1 tual Staf f Driv er

Serv ices Thro ugh 2 ASH A/S AHI YA

127

Gumla,DHAP 2011-12

Sen sitis

2 atio . n 1 of Sahi yya

Ince

2 ntiv . e to 2 SAH IYA

Aver age Nu mbe r of 2 22 PB . 180 270 180 120 750 50 2 Case 25 300 6 9 6 4 25 0 0 0 0 0 . dete 0 1 ctio n in the Distr ict.

Aver age Nu mbe r of 2 MB . 300 500 400 300 150 2 Case 30 500 6 10 8 6 30 0 0 0 0 00 . dete 2 ctio n in the Distr ict.

3 Offi ce Exp enc ess 128 & Gumla,DHAP 2011-12

Con sum abl es

Offi 200/ 3 240 ce mon mo 600 600 600 600 0 Exp th nth ens es (An nua l

3 cha . rge 1 for 500/ 3 150 150 150 150 600 Ele mon mo 0 0 0 0 0 ctri th nth city, 40 Tel 40 eph 0 one etc. )

Con sum able (Sta 3 320 . tion 00 2 ary & Oth ers)

Cap acit y Buil 4 din g (Tra inin g)

Day 25 624 624 s 129

Gumla,DHAP 2011-12

trai 60 60 nin g of Ne w ent ran ts - 2 day MO

2 day s reo rien tati on trai 327 327 683 nin 200 200 g of PH C MO, HW and HS

Trai nin g 2 day 790 790 13 s of 0 0 Pha rma sist

5 day s trai 207 207 207 13 ning 25 25 25 of Lab Tec h.

130

Gumla,DHAP 2011-12

for Sme ar Ema min atio n Dist . Lev el - 2 and CHC – 1

Trai ning of Sahi 162 105 105

ya 2 570 570 for 1/2 day

Ope rati onal guid elin e on DP 52 MR 0 0 38 (Pri 55 mar y & Sec ond ary leve l)

5 IEC

131

Gumla,DHAP 2011-12

Ne ws Pap 2 er, 5 10 10 0 . TV 2 1000 1 0 0 1 0 0 2 7 00 00 0 1 Cab 9 0 le 2 Adv 5 . 0

5 Pos 55 . By SLS 0 0 0 0 0 0 0 0 0 0 2 ters 0

6 5 Ban 10 12 22 17 2 . ner 25 250 4 5 9 7 25 00 50 50 50 5 3 s 0

5 Lea 55 . flet By SLS 0 0 0 0 0 0 0 0 0 0 0 4 s

1 5 0 Rall 50 50 . 2 5000 0 0 0 0 1 1 2 0 ies 00 00 5 0 0

6 5 Qui 30 30 0 . 2 3000 0 0 0 0 1 01 2 z 00 00 0 6 0

IPC Thr oug h 5 5 Co 10 10 15 15 0 10 10 . mm 500 20 00 20 00 30 00 30 00 0 0 0 7 unit 0 0 0 0 0 y 0 List ein g

5 Hoa . rdi 15 By SLS 0 0 0 0 0 0 0 0 0 0 8 ngs

132

Gumla,DHAP 2011-12

Wal 5 l 30 . By SLS 0 0 0 0 0 0 0 0 0 0 wri 0 9 ting

Ne 5 ws 5 . Pap 0

1 er 0 0 Add 0 .

DP 6 MR

MC 3 1 6 R 10 12 7 1 75 75 15 . Foo 150 250 40 00 50 50 30 5 2 00 00 0 1 twa 0 0 0 7 re 30 0 8 0 AID 6 S & By . App SLS 2 lian ces

Wel fare allo wan ces for RCS Ope 6 rati By . 6 on SLS 3 for Pati ents fro m BPL Fam ilies

6 RCS 10 350 2 70 2 70 4 14 2 70 10 3 . for 0 00 00 00 00 5 4 Me 0 0 dica 0 133

Gumla,DHAP 2011-12

l 0 Coll ege

G-I & II 4 Pts 40 0 36 PO 361 28 2 1 D 0 8 Cap 0 s.

Urb an 7 Lep ros y

Sup port ive Med icin e Incl ude s Pre 7 dini . solo 1 ne, Dre ssin g Mat erial s and Med icin es.

7 MD . T 2 Deli very Serv

ices 134 and

Foll ow Gumla,DHAP 2011-12

up of und er trea tme nt pati ent

Mo nito ring , Sup ervi sio n and coo rdi nati on 7 whi . ch 3 incl ude s peri odi c me etin gs and mo bilit y.

Materia l & 8 Supplie s

135

Gumla,DHAP 2011-12

Supporti ve Medicine including Predniso lone, 8. 150 Antibioti 1 00 cs, Clofazimi ne, Dressing Materials etc.

180 Ulcer Care Kit 00 ,POD Kit 8. 120 Eye Care 2 00 Kit and Lab 135 regents 0

Patient Welfare (Blanket 8. By s etc.) to 3 SLS be procured by SLS

Material & 8. Supplies 4 Printing 4635 Cost 0

POL / Vechicl 9 e Maintai nance

9. Mobility 1 and 1000 Vehicle 00 Operati

on (State 136 Leprosy Gumla,DHAP 2011-12

Cell)

Vehicle Operati 9. on and 2500 250 250 250 100

2 hiring 0 00 00 00 000 (District )

Review 1 Meetin 0 g

Supervi sion , monito ring 12 3 1 (TA/DA @10 300 300 300 120 mo mon 3000 1 ) & 00/ 0 0 0 00 nth th MDT Deliver y to 1200 district 0

Cash 1 Assista 2 nce

Comput er Set, with 1 UPS,

3 Laser Printer, Steblise 7300 r 0

1010 G.TOTAL 135

137

Gumla,DHAP 2011-12

Budget breakdown & summary – Jharkhand

Activity Plan-Budget 2011-2012

Total costs( Rs.) A Fund Respon (Budg ct. Duration & ing Activities sible Items required et N Date sour Staff detail o. ce in Annex )

Result 1: Training & suprevisory system established

Result 2: DPMR (POD) sevices established

April 11 to 37500. MCR chappals 300 DLO March 12 150@250 00

April 11 to 18000. Self care kit – 150 kit March 12 @120/ 150 kit 00

April 11 to 12000. Ulcer cate kit – 80 kit March 12 @150/ 80 kit 00

April 11 to 1350.0 Goggles – 9 March 12 @150/ 09 kit 0

Oct. 11 to @3500/ 10 35000. RCS – 10 Jan. 12 kit 00

May 00 to 40280. PoD camp March 12 12 00

Pts. Welfare Oct. 11 & (Blankets etc) Jan. 12 - 0.00

PoD training, April 11 to programme ANM/ ILEP March 12 - 0.00

GHS/Sahiya

Total 144130

138

Gumla,DHAP 2011-12

.00

Result 3: Sustained case management

TA, DA, Lunch, T. 62460. MO Training 2 days DLO Sep. 11 materials 00

Trainer - 2, miscellaneous

ANM & HS Training Oct, 11 to 32720 - 2 days Dec. 11 Venue, do 0.00

Sahiya Training - 1/2 July 11 to 10557 day Jan. 12 Dari, do 0.00

Lab. Technician 20725. Training - 5 day Jul-11 do 00

51595 Total 5.00

66008 Grand Total 5.00

139

Gumla,DHAP 2011-12

Total costs(Rs.) Act. Responsible Funding Activities Duration & Date Items required (Budget No. Staff source detail in Annex)

Result 4: Increased community awareness on signs, curability+availability

TV Cable - advertisement-2 DLO June 11 & Oct. 11 Consults Cable operator 2000.00

Banner- 25 Cloth, Painter charges 6250.00

Rallies – 2 2 Oct. & 30 Jan. Participates, Sound system 10000.00

Quiz – 2 2 Oct.11 & 30 Jan.12 Participators, Prize etc. 6000.00

IPC – 100 Apr.11 to Feb.12 - 50000.00

Hoarding – 15 By SLS - 0.00

Wall wiriting -300 By SLS - 0.00

New paper aid – 5 Aug.,Oct.Nov. Jan - 5000.00

Sahiya incentive - PB - 25 Apr.11 to March 12 - 7500.00

Sahiya incentive - MB - 30 Apr.11 to March 12 - 15000.00

Total 101750.00

Result 5: Drug management system inproved

Pharmasist Training - 2 day- 13 DLO April 2011 TA, DA, Lunch, T. materials 7900.00

Training materials

Trainers - 2

Miscellaneous

Grand Total 769735.00

Result 6: System cooperation with other system organization established

140

Gumla,DHAP 2011-12

141

Gumla,DHAP 2011-12

Act. Apr. Aug. Activities May 11 June 11 July 11 No. 11 11

Result 7: Programme management ensured

Monitoring, Supervision DLO April 11 to March 12 Evaluation 12000.00

Office expenditure April 11 to March 12 Electricity & Telephone 8400.00

POL Vehicle April 11 to March 12 Fuel 100000.00

Consumables April 11 to June 11 Stationary & other 32000.00

Prednisolone, etc April 11 to March 12 Prednisolone, clofazimine etc 15000.00

Computer Desktop (Full set) TFT monitor/Broadband/ 65000.00

Stablizer/HP Printer with

Softwares 8000.00

Total 240400.00

Grand Total 1010135.00

Result 8: Improved Urban Leprosy services

142

Gumla,DHAP 2011-12

D-4. National Blindness Control Programme

o"kZ 2011&2012 dk dk;Z;kstuk

o"kZ 2009&10 dh o"kZ 2011&2012 dk;ZØe dk uke miyfC/k gsrq y{; fu/kkZj.k vko';drk,¡

1- lnj vLirky xqeyk esa us= ltZu dk in fjDr gSA vr% ;Fkk'kh?kz ltZu dk inLFkkiu fd;k tk,A

eksfr;kfcUn vkijs'ku 1219 3000

Ldwy LØhfuax 55339 70000

us=nku 550

143

Gumla,DHAP 2011-12

D-6. NIDD Control Programme

National Iodine Deficiency Disorder Control Programme is centrally sponsored national programme being implemented with the objective of reducing & preventing iodine disorder control programme.

Strategy

1) To promote awareness of Iodine deficiency disorder( IDD) and benefits of iodized salt intake I.D.D. day observation on October 21st every year.

Health education & publicity: wide publicity through out the district about the importance of Iodized salt to prevent Iodine Deficiency Disorders among the community through Health education programmes in schools, Radio jingles, Television, Wall Paintings, distribution of pamphlets, Booklets etc.

144

Gumla,DHAP 2011-12

Convergence

Objective

To converge with different department to address and deliver the package of Health and Nutrition services, ICDS services, water and sanitation and education at one platform.

In the district, to addressing the convergence issue following activities going on and will continue these in year 2011-12.

 BLMC  DLMC  VHND  Celebration of New Born Care Week  Celebration of Breast feeding Week  Celebration of Nutrition Week  School Health Programme  Malnutrition treatment Centre

145

Gumla,DHAP 2011-12

SUMMARY OF MISSION FLEXIBLE POOL (MFP) PIP 2011-12 Phsyical Propose Budget Achievemen d Unit required S. No Item t as on 30th Physical Remarks Cost for 2011- October Target FY 12 2010 2011-12 1.1 Human Resource Remuneration & 3381600 1.1.1 Allowance 0 Remuneration of contractual ANM ( 2457600 1.1.1.1 196 256 96000 ANMs recruited 0 under NRHM) Hardship & Applicable Mobility for LWE Allowance for 1.1.1.2 0 0 0 0 districts- already recruited Kindly ANMs (ANMs for check LWE) Remuneration of contractual Staff 1.1.1.3 22 52 144000 7488000 Nurse/ A Grade Nurse Remuneration of 1.1.1.4 12 12 102000 1224000 contractual LT Remuneration of 1.1.1.5 contractual 1 1 120000 120000 Radiologist Remuneration of 1.1.1.6 contractual 4 4 102000 408000 Pharmacist 1.1.2 Recruitment 0 Applicable for LWE Recruitment of 1.1.2.1 0 0 0 0 districts- ANM for LWE Kindly check Applicable Recruitment of for LWE 1.1.2.2 Staff Nurse for 0 0 0 0 districts- LWE Kindly check Applicable Recruitment Male for LWE 1.1.2.3 Health Workers 0 0 0 0 districts- for LWE Kindly check Recruitment of 1.1.2.4 contractual 0 0 0 0 Medical Officer

146

Gumla,DHAP 2011-12

Rrecruitment of 0 0 0 0 Specialist (Gynae., 1.1.2.5 Padiat., Ansth., 0 0 Surgery, Medicine) Total for Health Human 3381600

Resources 0 Provision for Applicable Mobile to HSCs & for LWE PHCs in Hard to 1.1.12 districts- reach area/ Naxal Kindly effected Ares & check DRCHOs 1.1.12.1 ANM 370 370 1800 666000 1.1.12.2 MO 11 11 3600 39600 1.1.12.3 DRCHO 1 1 3600 3600 Total for mobiles to service 382 382 9000 709200 providers 1.1.15 Hospital Manager Consultant 1.1.15.1 1 1 288000 288000 Hospital Manager Support for 1.1.15.2 establishment of 0 12 2000 24000 Hospital Manager Total Hospital Managers 1 13 290000 312000 1.1.16 COLD CHAIN Refrigerator 1.1.16.6 0 1 96000 96000 Mechanic proMIS Operator/ 1.1.16.7. Store Keeper for 0 1 96000 96000 3 District Warehouse Cold Chain 0 1 120000 120000 Handler 1.1.16.8 POL for Cold Chain 0 132 5000 660000 Total Cold Chain 0 135 317000 972000 augmentation Block Programme 1.1.17 Management Unit Block Programme 1.1.17.1 7 11 180000 1980000 Manager Block Account 1.1.17.2 11 11 180000 1980000 Manager Mobility support for Monitoring & 1.1.17.4 0 12 3000 36000 Monthly Meeting at Dist level 1.1.17.5 Block Data 11 11 96000 1056000

147

Gumla,DHAP 2011-12

Manager Total Block level PMU 29 45 459000 5052000 Infrastructure 1.2 Upgradation New HSC 150000 1.2.1 2 2 3000000 construction 0 Malnutrition 1.2.4 treatment Corners 2 1 300000 300000 (MTC) Block level Strengthening of 150000 1.2.5 18 Pahariya/PTG 0 1 1500000 0 Health Subcentre Total Infrastructure 330000 3180000 4 4 Upgradation 0 0 Community 1.4 Mobilization Budget for for Cluster meetings, 1.4.1.1 ASHA 0 132 500 66000 convention, trainings etc. Orientation 1.4.1.2 VHC 0 44 500 22000 , training etc. 1.4.1.3 Salary of DPC 0 1 300000 300000 Beneficiary 1.4.1.4 0 0 16800 2520000 enlisting for RI Total Community 0 176 17800 2908000 Mobilization Rogi Kalyan 1.7 Samiti 1.7.1 District Hospital 1 1 500000 500000 CHC (Presently 1.7.3 Primary Health 8 8 100000 800000 Centres) PHC (Presently 1.7.4 Addl. Primary 13 13 100000 1300000 Health Centres) 1.7.5 Referral Hospital 2 2 100000 200000 Total Rogi Kalyan Samiti 24 24 800000 2800000 1.8 Untied Fund CHC (Presently 1.8.1 Primary Health 11 11 50000 550000 Centres) PHC (Presently 1.8.2 Addl. Primary 13 13 25000 325000 Health Centres)

148

Gumla,DHAP 2011-12

Health Sub 1.8.3 242 242 10000 2420000 Centres Village Health 1.8.4 943 943 10000 9430000 Committee 1272500 Total Untied Fund 1209 1209 95000 0 Annual 1.9 Maintenance Grant Sub Divisional 1.9.1 0 0 0 Hospital CHC (Presently 1.9.2 Primary Health 11 11 100000 1100000 Centres) PHC (Presently Addl. Primary 1.9.3 13 13 50000 650000 Health Centres) - Govt. Building Health Sub 1.9.4 Centres - Govt. 132 174 10000 1740000 Building Total Annual Maintenance 156 198 160000 3490000 Grant 1.1 CONVERGENCE Convergence 1.10.1.3 meeting at block 0 132 500 66000 level Mapping of different 1.10.2 stakeholder 0 0 0 0 working on health and nutrition Operational Studies on 1.10.3.1 0 0 0 0 convergence issues Resource book on 1.10.3.2 convergence 0 0 0 0 (printing) Drop-in centre 1.10.4 under HIV 0 0 0 0 programme Total Convergence 0 0 0 0 1.11 Conflict area plan Lab Strengthening 1.11.1 132 132 500 66000 with consumables Additional POL 1.11.2 132 132 2000 264000 for Genset 1.11.3 Additional POL 132 132 2000 264000

149

Gumla,DHAP 2011-12

and maintenance for Ambulance Establishment cost 1.11.4 of Sahiyya help 11 0 0 0 desk Sahiyya help desk 1.11.5 11 11 100 1100 at all CHCs Food for in 1.11.6 279 2500 30 75000 patients in CHC Upgrading 5 HSCs (Swasth guarantee 1.11.7 0 55 10000 550000 upkendra) per block as per IPHS 1.11.8 TA for ANMs 110 110 6000 660000 Holding health camps twice a year in each HSC 1.11.9 68 110 500 55000 with compulsory drugs and supplies. Provisioning of incentive for Sahiyya for 1.11.10 referral of 0 1200 100 120000 malnourished children with follow up Issuing referral 1.11.11 0 11 20000 220000 cards to Sahiyyas Training on life 1.11.12 saving skills to 0 0 0 0 ANMS Social Audit and Public hearing for 1.11.13 0 11 2500 27500 measure entitlements Development of Social Audit and Public hearing 1.11.14 0 0 0 0 tools and dissemination of the same Outsourcing of services like Diating etc. (RS. 1.13 11 10000 110000 10000 per CHC/FRU per month) Total Conflict Area Plan 875 4415 53730 2412600

150

Gumla,DHAP 2011-12

Management Cost 1.15 & Contingencies Stationary & 1.15.1 Printing & Office 0 144 7500 390000 expenses 1.15.1.2 District 0 12 5000 60000 1.15.1.3 Block 0 132 2500 330000 Postage & Telegraph/TeleFa 1.15.2 0 300 9000 474000 x / Mobile / Internet /datacard 1.15.2.2 District 0 12 5000 60000 1.15.2.3 Block 0 132 2500 330000 News Paper & 1.15.3 0 144 500 72000 Periodicals DPMU Management Cost 1.15.4 (Security, 0 12 1000 12000 Cleaning, Gardining etc.) Total Management Costs 0 444 16500 864000 Monitoring & 1.16 Evaluation / HMIS Strengthening of 1.16.1 0 24 35000 190000 M&E Cell Establishment of Internet & Telephone 1.16.1.1. Connectivity to 0 1 20000 20000 4 District Programme Managemnt Unit for HMIS (Yearly) Internet & Telephone 1.16.1.1. Connectivity to 0 11 10000 110000 5 Block Programme Management Unit for HMIS (Yearly) AMC for Block & District level 1.16.1.1. Computer and 0 12 5000 60000 6 allied infrastructure Operationalising 1.16.2 the new MIES 0 11 25000 275000 format 1.16.2.1 Printing of new 11 25000 275000

151

Gumla,DHAP 2011-12

forms Total Monitoring & 0 35 60000 465000 Evaluation Preparation of 1.17 Annual Plan Preparation of Annual District 1.17.2.2 1 1 20000 20000 Health Action Plan Preparation of Annual Block 1.17.2.3 11 11 5000 55000 Health Action Plan Total preparation of Annual 12 12 25000 75000 Plan Routine 1.22 Immunisation Additionalities 1.22.1 POL for Genset 120 144 5000 720000 Mobility Support 1.22.4.4 0 6 2000 12000 for PTG Group 1.22.4.5 JMSSPM 0 12 25000 300000 Cold Chain Additionality - 1.22.4.6 0 144 1000 144000 Maintainance of ILR and DF etc. Total Routine Immunisation 120 306 33000 1176000 Additionalities 563603 9957680 G.TOTAL 2812 7416 0 0

152

Gumla,DHAP 2011-12

RCH FLEXIBLE POOL PIP 2011-12 Propos Phsyical Financial ed Budget Achieveme Expenditu Physical for FMR nt as on re on Unit ACTIVITY Target require Remarks Code 30th 30th Cost FY d 2011- October October 2011- 12 2010 2010 12 MATERNAL A.1 HEALTH Operationalise 60000 180000 A.1.1 0 0 3 facilities 0 0 Kindly check if your Operationalise 60000 180000 A.1.1.1 3 instituti FRUs 0 0 on is listed as FRU MTP services at A.1.1.3 0 0 0 health facilities A.1.2 Referral Transport 1150 300 345000 Integrated A.1.3 outreach RCH 0 services RCH Outreach 132000 A.1.3.1 264 5000 Camps 0 Janani Suraksha A.1.4 Yojana / JSY A.1.4.1 Home Deliveries 1000 500 500000 Institutional 260140 A.1.4.2 0 0 13007 2000 Deliveries 00 A.1.4.2 260140 Rural 13007 2000 .1 00 A.1.4.2 Urban 0 0 0 .2 A.1.4.2 Caesarean 60 1400 84000 .3 Deliveries Other activities A.1.4.3 0 0 0 (JSY) Sub-total Maternal 60030 214500 Health (excluding 0 0 1153 0 0 JSY) 265980 Sub-total JSY 0 0 14067 3900 00 A.2 CHILD HEALTH

153

Gumla,DHAP 2011-12

Integrated Management of A.2.1 Neonatal & 650 300 195000 Childhood Illness/ IMNCI Facility Based A.2.2 Newborn Care/ 0 0 0 FBNC School Health A.2.4 26 25000 650000 Programme Other A.2.8 0 0 0 strategies/activities Sub-total Child 0 0 676 25300 845000 Health FAMILY A.3 0 PLANNING Terminal/Limiting 661000 A.3.1 0 0 4488 42500 Methods 0 Female Sterilisation A.3.1.2 44 20000 880000 camps A.3.1.3 NSV camps 44 20000 880000 Compensation for 350000 A.3.1.4 3500 1000 female sterilisation 0 Compensation for 135000 A.3.1.5 900 1500 male sterilisation 0 A.3.2 Spacing Methods 0 0 10044 2020 288000 A.3.2.1 IUD camps 44 2000 88000 IUD services at A.3.2.2 health facilities / 10000 20 200000 compensation Other A.3.5. 0 0 strategies/activities Sub-total Family Planning 184800 0 0 132 42000 (excluding 0 compensation) Sub-total compensation of 505000 0 0 14400 2520 Sterilisation , IUD 0 & NSV camps A.4 ARSH ARSH clinics at A.4.1 6 11 5000 55000 health facilities A.4.2 0 Sub-total ARSH 6 0 11 5000 55000 Check if A.5 URBAN RCH applicab le A.5.1 Urban RCH 0 0 0

154

Gumla,DHAP 2011-12

Services Other A.5.2 0 0 0 strategies/activities Sub-total Urban 0 0 0 0 0 RCH A.6 TRIBAL RCH Tribal RCH services A.6.1. - PTG Out reach 132 5000 660000 camps etc. Other A.6.2 0 0 0 strategies/activities Sub-total Tribal 0 0 132 5000 660000 RCH VULNERABLE A.7 0 0 GROUPS Sub-total 0 0 0 0 0 Vulnerable Groups INNOVATIONS/ A.8 PPP/ NGO PNDT and Sex A.8.1 1 5000 5000 Ratio Public Private A.8.2 0 0 Partnerships Other innovations A.8.4 (if any) Cloth for 50000 18 900000 New Born babies Sub-total Innovations/PPP/N 0 0 50001 5018 905000 GO INFRASTRUCTU A.9 RE & HR Contractual Staff A.9.1 0 0 0 0 0 & Services Other contractual A.9.1.5 0 0 staff - ANM Other contractual A.9.1.6 0 0 staff - MPW A.9.3 Minor civil works 0 Sub-total Infrastructure & 0 0 0 0 0 HR INSTITUTIONAL A.10 STRENGTHENIN G Logistics A.10.2 management/ 0 improvement Monitoring & A.10.3 5000 0 Evaluation / HMIS

155

Gumla,DHAP 2011-12

Sub-total Institutional 0 0 0 5000 0 Strengthening A.11 TRAINING Strengthening of A.11.1 Training 0 0 Institutions Maternal Health 27036 315632 A.11.3 0 0 20 Training 0 0 A.11.3. Skilled Birth 24836 298032 12 1 Attendance / SBA 0 0 A.11.3. Other MH Training 8 22000 176000 7 Core skill trg Child Health 18490 377260 A.11.5 0 0 37 Training 0 0 A.11.5. 14490 347760 IMNCI 24 1 0 0 A.11.5. Facility Based 10 25000 250000 2 Newborn Care Care of Sick A.11.5. Children and 3 15000 45000 4 severe malnutrition A.11.5. 0 0 Other CH Training 5 0 Family Planning A.11.6 2 0 15 49250 317750 Training A.11.6. IUD Insertion 2 4 32000 128000 4 Training A.11.6. Contraceptive 0 11 17250 189750 5 Update Training A.11.7 ARSH Training 0 0 11 37000 407000 A.11.9 ARSH training 11 37000 407000 54151 765367 Sub-total Training 2 0 83 0 0 A.12 BCC / IEC Strengthening of A.12.1 12 2000 24000 BCC/IEC Bureaus Implementation of A.12.3 0 0 1 40000 480000 BCC/IEC strategy A.12.3. BCC/IEC activities 0 12 10000 120000 1 for MH A.12.3. BCC/IEC activities 0 12 10000 120000 2 for CH A.12.3. BCC/IEC activities 0 12 10000 120000 3 for FP A.12.3. BCC/IEC activities 0 12 10000 120000 4 for ARSH A.12.4 Other activities 0 0 0 Sub-total BCC/ IEC 0 0 13 42000 504000

156

Gumla,DHAP 2011-12

PROGRAM A.13 0 MANAGEMENT Strengthening of 96000 288000 A.13.1 State society/ 3 3 0 0 DPMU Strengthening of A.13.2 District society/ 0 0 BPMU Strengthening of Financial A.13.3 0 0 Management systems Other activities (Program mgmt. A.13.4 0 0 expenses, mobility support) Sub-total Program 96000 288000 3 0 3 Management 0 0 0 Total RCH II Base

Flexi Pool Total RCH II

Demand Side GRAND TOTAL

RCH II

157

Gumla,DHAP 2011-12

YEAR 2011-2012

District : - Gumla

Budgutary Provision(in Name Of District Gumla Rs.) In Lakhs

Population 965221

Target of Cataract Surgery 3000 2250000.00 22.5

Target of School Screening 70000 330000.00 3.3

Target of Eye Donation 550 15000.00 0.15

Other IEC Activity like 0

Add in Newspaper / Pumplet / Banner / Miking etc. 50000.00 0.5

Organization Expenses 0

Honororium of ACMO 2000/- per month 24000.00 0.24

Honororium of office Assistance 1500/- per month 18000.00 0.18

Contingencies 10000.00 0.1

Stationary 5000.00 0.05

TA/DA ( For Gust Surgeon and Ophthalmic Asst.) including POL 50000.00 0.5

Air Conditionar 60000.00 0.6

Total 2812000.00 28.12

( Twenty Eight lakh Fifty Two Thousand only )

158

Gumla,DHAP 2011-12

Action Plan of School Screening

District:- Gumla

Year 2011-12

No. of Target spectacl of Name of Populati es to be Sl.N. school Fund Required Total PHC on provide screeni d ng Spectacles (Target) POL @ 200/per

3000.0 31000. 1 Gumla 143305 7000 140 0 28000.00 00

2500.0 22500. 2 Raidih 68150 5000 100 0 20000.00 00

2500.0 22500. 3 Chainpur 56219 5000 100 0 20000.00 00

2500.0 22500. 4 Dumri 77897 5000 100 0 20000.00 00

2500.0 26500. 5 Palkot 80261 6000 120 0 24000.00 00

2500.0 26500. 6 Basia 77537 6000 120 0 24000.00 00

2500.0 22500. 7 Kamdara 63695 5000 100 0 20000.00 00

2500.0 26500. 8 Sisai 111907 6000 120 0 24000.00 00

2500.0 22500. 9 Bharno 71480 5000 100 0 20000.00 00

3000.0 31000. 10 Ghaghra 102796 7000 140 0 28000.00 00

2500.0 22500. 11 Bishunpur 63706 5000 100 0 20000.00 00

1500.0 33500. 12 NAC Gumla 48268 8000 160 0 32000.00 00

159

Gumla,DHAP 2011-12

Monitoring & Supervision of C.S/ACMO/ 20000. 20000. DPM 00 00

50000. 330000 Total 965221 70000 1400 00 280000.00 .00

Action Plan of Eye Donation

District :- Gumla

Year 2011-12

Target of eye Sl.N. Name of PHC Population Donation IEC Activity

1 Gumla 143305 70 1000

2 Raidih 68150 30 1000

3 Chainpur 56219 30 1000

4 Dumri 77897 40 1000

5 Palkot 80261 40 1000

6 Basia 77537 40 1000

7 Kamdara 63695 30 1000

8 Sisai 111907 55 1000

9 Bharno 71480 35 1000

10 Ghaghra 102796 50 1000

11 Bishunpur 63706 30 1000

12 NAC Gumla 48268 100 4000

160

Gumla,DHAP 2011-12

Total 965221 550 15000

NATIONAL LEPROSY ERADICATION PROGRAMME

Format for inclusion in the Action Plan for 2011-12

Format for submitting budget proposal under NLEP for 2011-12

(Rs. in lakhs)

Activity proposed S.No Amount proposed .

1) Contractual Services

State- District -

2) Services through ASHA/

Sensitization of ASHA, 22500 .00 Incentive to ASHA

Office expenses & 40400.00 Consumables 3)

Capacity building 4) (Training)

4 days training of newly appointed MO (rural & urban)

3 days training of newly 523855.00 appointed health worker & health supervisor

2 days refresher training of MO

5 days training of newly

161

Gumla,DHAP 2011-12

appointed Lab.

Technician

Behavioral Change 5) Communication (IEC)

Mass media, Outdoor 79250.00 media, Rural media and Advocacy

POL/Vehicle operation & 6) hiring

2 vehicles at state level & 1 100000.00

vehicle at district level

7) DPMR

MCR footwear, Aids and appliances, Welfare allowance to BPL patients 144130.00 for RCS, Support to govt. institutions for RCS

8) Material & Supplies

Supportive drugs, lab. reagents & equipments, 15000.00 printing forms

9) Urban Leprosy Control

Township, Medium cities-I,

Medium cities-II & Mega cities

NGO - SET Scheme 10)

Supervision, Monitoring & Review 11) 12000.00

162

Gumla,DHAP 2011-12

Review meetings and travel

expenses

Equipment- Computer Set

with HP laser Printer, 73000.00 UPS etc. 12)

TOTAL Budget 1010135.00

Budget should be proposed separately for various activities under each component along with detail calculations indicating how the budget was arrived at.

Action Plan of Cataract Surgery

District:- Gumla

Year 2011 – 12

Budgutary Provision Target of @750/ Sl.N. Name of PHC Population Cataract Surgery case

1 Gumla 143305 430 322500

2 Raidih 68150 200 150000

3 Chainpur 56219 200 150000

4 Dumri 77897 240 180000

5 Palkot 80261 240 180000

6 Basia 77537 230 172500

7 Kamdara 63695 190 142500

163

Gumla,DHAP 2011-12

8 Sisai 111907 350 262500

9 Bharno 71480 220 165000

10 Ghaghra 102796 300 225000

11 Bishunpur 63706 200 150000

12 NAC Gumla 48268 200 150000

Total 965221 3000 2250000

NVBDCP Budget 2011- 12

Activity Total Proposed Budget in Rs.

Blood Slide Collection & examination, fever cases screening. 300,000 (M-2,J.S.B Stain,etc Purchasing)

RDT & B.S.C By Sahiya (Honararium ) 2,000,00

Management of Severe Malaria By Hospital Management Society & H.S.C

L.L.I.N By N.V.B.D.C.P

I.R.S (Wages) 2370060

Insecticide Transportation (Dist to 3,00,000 Villages )

R.R.T 25,000

Re impregnation of Bed nets 2,00,000

Gambutia Fish 11,75,000

164

Gumla,DHAP 2011-12

Training (MO, Paramedical, Sahiya) 6,00,000

Cluster meetings, Gram gosthi, 50,000

Surveillance Meetings 50,000

Salary of VBD Consultant 360,000

Salary of M.P.W, Rs.97,20,000

Activity Total Proposed Budget in Rs.

Salary of L.T, Rs. 4,32,000

Salary of M.T.S, Rs. 7,20,000

Salary of D.E.O, Rs.78000

Salary of F.L.A Rs.96000

POL for Monitoring & evaluation 75,000

IEC 700000

NAMMIS Data Entry by Internet 10,000

Inverter facility 25,000

Office Maintenance 75,000

Furniture 50,000

Godown required As per Estimate Budget

Total Rs.17551060

165

Gumla,DHAP 2011-12

Budget 2011-12 RNTCP

Section D: Summary of proposed budget for the district – Budget estimate for the coming FY 2010- 11

S.No. Category of Expenditure (To be based on the planned activities and expenditure in Section C)

1 Civil works 51000

2 Laboratory materials 100000

3 Honorarium 50000

4 IEC/ Publicity 70000

5 Equipment maintenance 30000

6 Training 70000

7 Vehicle maintenance 175000

8 Vehicle hiring 0

9 NGO/PP support 60000

10 Miscellaneous 50000

11 Contractual services 1175000

12 Printing 50000

13 Research and studies 0

14 Medical Colleges 0

15 Procurement –vehicles 150000

16 Procurement – equipment 0

TOTAL 2031000

166

Gumla,DHAP 2011-12

Budget for Routine Immunisation

A. HARDWARES

ACTIVITY PARTICULARS 2011-12 SL.NO. Unit Total Total Cost Cost Units

1. Waste disposal

1 AT DH,SDH, CHC, PHC@5500/pit 5,500 1 5,500

2 Bleaching powder-25kg bag / DH,SDH, CHC, 3000 12 36,000 PHC

Total 41,500

B. SERVICE DELIVERY

ACTIVITY PARTICULARS 2011-12 SL.NO. Unit Total Total Cost Cost Units

1.POL for Transportation of Vaccine and Vehicle Maintenance Support

3 From District to State@6000/pm*12*2=144000per 1,44,000 1 1,44,000 annum

4 From PHC/CHC to District @1000 24,000 10 2,40,000 *12*2=24000per annum

Total 3,84,000

2. Alternate delivery of Vaccine

5 Alternate Vaccine Delivery to HARD TO REACH 4800 92 4,41,600 area@200per session*2*12*HSC=4800per annum(session site in each HSCwhich is HTR)

6 Alternate Vaccine Delivery@50per 3,600 1,670 60,12,000 session*6*12*HSC=2400per annum

Total 64,53,600

167

Gumla,DHAP 2011-12

3.Mobilization of children by Sahiyaa/AWW

7 Mobilization of Children through AWW/other 1,800 1,670 30,06,000 s@150*12=1800per annum

Total 30,06,000

4. Support to slum and underserved area

4.1 Support to slum & underserved (Rural) 4,200 6 25,200 Area(ANM@300/session+50)*12=4200 per annum

Total 63,00,000

5. Mobility Support

9 DIO-100000/pa 50,000 1 50,000

Total 50,000

6.Support to State RI cell.

10 Computer Assistant@12000/pm*12 1,44,000 0 0

Total 0

7.Support to District RI cell.

11 Computer Assistant@8000/pm*12 96,000 1 96,000

Total 96,000

8.POL and Maintenance for Gensets

12 Regional@100000pa 1,00,000 0 0

13 District@10000/pm*12 1,20,000 1 1,20,000

14 CHC @10000/month*12 1,20,000 11 13,20,000

Total 14,40,000

9.Maintenance of cold chain

15 District@10000/annum 1 10,000 10,000

16 CHC@500/annum 500 11 5,500

Total 15,500

10. Training

168

Gumla,DHAP 2011-12

17 District level -3days residential training for 2,00,000 1 2,00,000 IMMUNIZATION HAND BOOK FOR DOCTORS

18 District level TOT-on MAMTA(Child tracking 30,000 0 0 Software)

19 CHC level Training-on data/ data entry on 24,000 0 0 MAMTA(Child tracking Software)

Total 2,00,000

Grand Total 1,79,86,600

169

Gumla,DHAP 2011-12

ANNEXTURE –I

District Issues 2011-2012

Sl Issues Discussion Action Budget

RCH

1 Labour room Labour room of CHC Dumri &CHC To upgrade & 100000 Chainpur needs upgradation, furnish LR

2 Operation There is a plan for made FRU at RH To Upgrade & 750000 Theatre Sesai, RH Basia & CHC raidih plan furnished OTs

3 Cold chain Gen set of Bharno, Procurment of Ghaghra,Bishunpur,sesai, Raidih new gen set ,Kamdara &palkot become very old for these 1750000 and needs replacement. blocks.

4 MTC Large number of malnaouised Establistment 3000000 children are in Bishunpur block . of new MTC at

Therefor there a urgent need of to Bishunpur. open MTC at CHC Bishunpur.

5 New Borne Baby warmer needed for 10 CHCs & Corner DH Supply of Baby warmer from state.

6 Blood Bank/ Blood storage Unit is the essential Establishment Blood Storage part of FRU . There is need to of 3 blood

170

Gumla,DHAP 2011-12

establish 3 blood storage Unit. storage units

7 ANY OTHER Procurment of 75000 (Pls. Specify): mobile set. 24 nos. Mobile for

DPC ,Hospital Manager ,BPM &BAM. Appointment of Driver for Recruitment DPMU . of Driver for DPMU . Appointment of Block Data Assistant.

INFRASTRUCURE

4 Computer One additional computer for Block Procurementof 550000 PMU. Desktop -

11n0s

171

Gumla,DHAP 2011-12

7 Ambulance Ambulance of palko tDumri & Supply of three 0 Chainpur is in very poor condition. ambulences

One more ambulance for DH is from state.. urgently needed.

8 ANY OTHER Construction o fPTG HSC at 2000000 (Pls. Specify): Mirchaipart Dumri.

9 ANY OTHER Construction of New HSC Building - 112000000 (Pls. Specify): 56 Nos

Improvement of Services

1 Equiepment Sadar Hospital is newey upgraded Procurement 1200000 and needs equipment . of equipment & others

2 Equipment Raidih CHC is newely upgraded. Procurement 700000 Recently upgraded 6 bed to 30 beds of equipment

& in this situation equipments and & others. others is urgently needed.

3 Medicine & ARV is urgently needed Procurement 1500000 Logistic of ARV

4 ANY OTHER Procurement 500000 (Pls. Specify): of cloths Cloth for New Born babies those delivered in Health facilities.

172

Gumla,DHAP 2011-12

5 ANY OTHER 800000 (Pls. Specify): ISO Certification of DH,Gumla.

OTHER PROGRAMMES

1 Malaria & Kala Supply of azar medicated bed

nets from state,.

Some of the Blocks identified as Malaria Prone.

2 Payment of Budget for JSY & Family Family There should be budgetary provision Planning Planning of transportation for Family planning Operation. Operation.

ANY OTHER ISSUES / Recommendation

3 12

.Mobile for DPC ,Hospital Manager,BPM,BAM.

173

Gumla,DHAP 2011-12

4 13 200000

.Provission of Computer for DH.

5 Annual Maintenance Grant for DH. 200000

6 . 2. Untied Fund for DH. 100000

7 . Rs 10 lakh for 100beded DH as HMS 1000000 fund.

8 Vehicle for MOIC Palkot 700000

9 Appointment of Block Program Co- ordinator.

Appointment of Block Data Manager.

174

Gumla,DHAP 2011-12

Annexure - II List of Equipment & HR for Sadar Hospital Gumla. year 2011-2012

EQUIPMENT

LABOUR ROOM & Neonatal

S.No Name of the equipment Current Quan Required

1. Labour Table 3 (old & worn 3 out)

2. Instrument Trolley Nil 5

3. Baby Warmer 1 1

4. Patient Bed 3 5

5. Sterilizer (instrument) big (2 Nil 1 bin)

6. Sitting Chairs for Attendants Nil 3 (3 seater)

7. Dressing Drum 1 5

8. Instrument Tray 2 3

9. Baby Tray 1 4

10. Oxygen Stand 1 2

11 Steel Cupboard 1 worn out 2

12. Suction machine 1 Pedal 1 automatic

13. Bed side stool (Revolving) Nil 10

14. Cardiac Monitor Baby Nil 1

15. Nebulizer adult 1 2

16. Steel Foot Stool 1 2

175

Gumla,DHAP 2011-12

Operation Theater

S.No Name of the equipment Current Quan Required

1. Operation Table Hydraulic 1 1 Minor

2. Instrument Trolley 1 3

3. Instrument Tray 2 5

4. Oxygen Stand 1 2

5. Suction machine electric 1 pedal 1 automatic

6. AC Nil 4

7. Hot Air Blower Nil 1

8. Sitting Chairs for Attendants Nil 3 (3 seater)

9. Foot Stool 1 3

10. Table & Chair Nil 1 set

11. Shadow less Lamp Ceiling - Nil 1 Major

12 Shadow less Lamp Ceiling - Nil 1 Minor

13. Sterilizer (instrument) big (2 1 1 bin)

CSSD

14. Auto Clave HP Horizontal Nil 1- big, 1- medium

15. Linen Steel Lockers Nil 8

16. Table & Chair Nil 1 set

176

Gumla,DHAP 2011-12

HOSPITAL ACCESSORIES

S.No Name of the equipment Current Quan Required

1. Hospital Bed 80 (40) 60

2. Cardiac Bed 1 3

3. Oxygen Stand 3 12

4. Bed Side Cupboard 40 60

5. Bed Side Stool 6 120

6. BP Apparatus 3 ( 2 damage) 6

7. Chairs (for nurses) Nil 8

8. Bed Pan 1 20

9. Urinal – Male, Female Nil 20

10. Back Rest Nil 4

11. Instrument Trolley Nil 15

12. Medicine Trolley Nil 6

13. Stretcher/Patient Trolley Nil 12

14. Case Sheet Holder with clip Nil 70

15. Foot Stools Nil 12

16. Wheel Chair Nil 4

17. Incinerator Nil 1

18. ICCU cots Nil 4

19. Patient Waiting Chairs Nil 6 (3 seater)

20. Basin Assorted (ss) Nil 30

21. Basin Assorted (ss) stand Nil 30

22. Saline Stand 10 10

23. Hospital Beds (Peads) Nil 10

177

Gumla,DHAP 2011-12

24. Office Table 6 4

25. Office Chairs 9 5

26. Executive Chairs 5 3

27 Examination Table 4 5

28. Kitchen Utensils

29. Waste Disposal Trolley Nil 2

30. Arm Board Adult, child Nil 10

31. Stomach Washing Set Nil 2

32. Emergency Resuscitation kit Nil 2 Adult

33. Postmortem Set Nil 3 (Instruments)

34. Spot Lights Nil 2

35. Weighing Machine (Organs) Nil 4

36. Ambulance 1 Not in 1 condition

37. Mattress Adult all damaged 150

38 Mattress Peads Nil 10

39. Mackintosh Sheet Nil 150

40. Abdominal Sheet OT Nil 50

41. Generator – 5KVA Nil 1

OT & LR

42. AC Nil 2

43. Intercom Nil 20

44. Fax Machine Nil 1

45. Computer 2 4

46. Washing Machine (big) Nil 1

47. Hot Water Gasser Nil 1

178

Gumla,DHAP 2011-12

48. LCD Projector Nil 1

49. Lead Apron Nil 1

50. Dental Chair 1 un reparable 1

51. Dental X-ray machine Nil 1

52. Dental Unit Nil 1

53. Dental Kit Nil 1

54. ECG Machine Nil 1

55. Ventilator Adult Nil 1

56. Ventilator Paed Nil 1

57. Suction machine electric 1 pedal 2 automatic

1 Ped.

58. Air Rotor for dental Nil 1

OFFICE OF THE CIVIL SURGEON, SADAR HOSPITAL, GUMLA

BUDGET FOR FAMILY FRIENDLY HOSPITAL INITIATIVE

SL HEAD Unit Cost YEARLY

1 Fuel for generator (25 kv) 10000/month 120000

2 Outsoursing Guard( 6 Guard) 3955/month/worker 284760

3 Outsoursing clean workers (20 workers) 3000/month/worker 720000

4 Cleaning Matarials (Herpik, Brush, Jharu, Surf etc.) 6000/month 72000

5 Hospital Maintainance 0 100000

6 Cleaning of blocked toilets included tank 5000/month 60000

7 Hospital bedsheets (400) piece in 6 colours 150/pec. 60000

8 Lights facility ( CFL,Murcury etc.) 0 10000

9 Miscellanceous 0 10000

10 Fuel for Ambulance 5000/month 60000

Total 1496760

179

Gumla,DHAP 2011-12

HUMAN RSOURCE

S.NO. Department Required In position

1. General Physician 2 1

2. General Surgeon 2 Nil

3. Orhopedician 2 1

4. Pediatrician 2 1

5. Anesthetic 2 1

6. Gynecologist 2 nil

7. General Medical Officer (Male) 5 2

8. General Medical Officer (lady) 4 1

9. Radiologist 2 nil

10. Dermatologist 1 nil

11. OT Assistant 4 nil

12. ' A' Grade Nurses( Cont- 12, Regular – 6) 52 18

13. Fourth Grade Workers, Regu-17 50 17

14. Driver 3 1

15. ECG Technician 1 nil

16. Pharmacist 4 nil

17. Security Contract- 3 12 3

18. Electrician 1 nil

19. Plumber 1 nil

20. Ultrasound Technician 1 nil

180

Gumla,DHAP 2011-12

Annexure - III

Sahiyya Training Asha 1665P*4d*700*3 13986000 Vhc 2080*943*2*3 11768640 25754640 EVENTS Sahiyya Sathi 90P*250**2 45000 Sahiyya sammelan at Dist level 200000*1 200000 Sahiyya sandesh yatra at PHc level 15000*11 165000 Cluster level meeting With sahiyya,AWW,ANM and VHC member 90*600*3 162000 Honorarium for BTT for 15 days 44*300*180days 2376000 Honorarium for STT for 15 days 3*500*180days 270000 Strengthening of sahiyya help Desk 11*15000 165000 Operational cost(Hon and Travel for shd 11*300*30*12 1188000 Sahiyya sathee remuneration 2000*90*12 2160000 6731000 Community Based monitoring at Dist level 1*30000 30000 AT PHC LEVEL 11*25000 275000 iNNOVATION convergence with ICDS 36*250*3QTR 27000 Sahiyya Day 5000 Crosslearning Exchange Programme for Sahiyya at District level 80000 Sahiyya Help Fund 150000 150000 Total 32635640

181