District Health Action Plan 2011 – 2012

DISTRICT HEALTH ACTION PLAN 2011 – 2012

District Patna District Patna

District Patna

Kako Jehanabad Modanganj

Ratni Faridpur District Nalanda

Ghosi

Makhdumpur District Arwal Hulasganj

District Gaya

Name of District: - Jehanabad

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This District Health Action plan prepared Under a Short & Hard Process of about survey of one month and this was a good Opportunity to revisit the situation of health services status and national programmes in district as well as to have a positive dialogue with departments like Public Health Engineering, Women and Child Development, Maternal and Child Health care etc.

This document is an outcome of a collective effort by a number of individuals, related to our institutions and programmes:-

Smt. Palka Shahni ,Chairperson of District Health Society, Jehanabad was a source of inspiration towards this effort vide her inputs to this process during D.H.S review meetings. Dr.Arvind kumar (A.C.M.O) Nodal officer for this action plan who always supported this endeavor through his guiding words and language. Mr. Nimish Manan , District Programme Manager was in incharge for the development of the DHAP(2011-12) . Mr Ravi Shankar Kumar , Distirct Planning Coordinator has given full time effort in developing DHAP(2011-12). Mr. Kaushal Kumar Jha, District Account Manager has put huge effort in financial Planning. Mr. Arvind Kumar, M&E Officer is the technical advisor for the data introduced inside this DISTRICT HEALTH ACTION PLAN. Mr. Manish Mani & Sefali from PHRN have given huge support. All district level Programme officer for various Health Programmes, B.H.Ms, M.O.I .Cs, PHCs, Field Office Staff have supported with their full participations, cooperation and learning spirit through out this process.

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

Dr. Smt. Shashi Rani Smt. Palka Shahni

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

District Health Society, Jehanabad . District health society, Jehanabad

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District Patna District Patna

District Patna

Kako Jehanabad Modanganj

Ratni Faridpur District Nalanda

Ghosi

Makhdumpur District Arwal Hulasganj

District Gaya

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N N E W

S District Patna District Patna

Dist rict Patna

District Patna

Modanganj Kakooo Jehan abad S adar PHC

Ratni Faridpur District Nalanda PHC Bharthu Dedhsaiy Ghosi

PHC

HSC Ikkil Dehuni Makhdumpur Hulasganj District Arwal pur

HSC Badheta PHC PHC

Daraurt Keur

District Gaya

Level 2

Level1

Level 3

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Chapter I: Introduction, profile of the district and process. PAGE NO Introduction …………………………………………………………………………….. 9 History of District………………………………………………………………………. 10 District Profile…………………………………………………………………………… 13 District Planning objective and priorities and planning Process… 18

Chapter II: *SWOT analysis of Part A,B,C,D …………………………………… . 22 * HMIS DATA ANALYSIS …………………………………………………. 26

Chapter III: Part A

MATERNAL HEALTH 34 CHILD HEALTH 65 FAMILY PLANNING 74

Chapter IV: PART B

NRHM PART “ B” DECENTRALIZATION 79 INFRASTRUCTURE 81 CONTRACTUAL MANPOWER 82 MAINSTREAMING OF AYUSH UNDER NRHM 84 DE-CENTRALIZED PLANNING 85

Chapter V:

Part C – Immunization Routine Immunization/Polio

Chapter VI:

Part D – National Disease Control Programmes KALAZAR 88 BLINDNESS 91 LEPROSY 93 FILERIA 94 TB 96

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BUDGET NRHM Part A – RCH II NRHM Part B – Additionalities NRHM Part C – Immunization NRHM Part D – NDCP Summary of Budget

Chapter VIII

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

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

Annexure: C

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CHAPTER 1:

INTRODUCTION, PROFILE OF THE DISTRICT & PROCESS

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Introduction : Jehanabad district was carved out of the old GAYA district on 1 st August 1986. Earlier it was a subdivision of Gaya since 1872. It is situated 56 km to the south of the State Head Quarters, Patna and 47 km to the north of Gaya by road and is well connected to both the stations via an electrified rail- route as well. Again, in the year 2001, the district of Arwal was created out of the district of Jehanabad. Geography : The district covers 941.4 sq. km. of geographical area in South Bihar. The town of Jehanabad, which is the HQ of the district, is situated at the confluence of rivers Dardha and Jamuna. Lying between 25-0’ to 25-15’ degree north latitude and 84-13’ to 85-15’ degree eastern longitude, the district is bounded by districts of Patna in the north, Gaya in the south, Nalanda in the east and Arwal in the West. Topography and Terrain : Fertile alluvial soil locally called "Kewal" supports the district's predominantly agricultural economy and is currently being tilled for production of paddy, wheat, cane, potato, pulses, vegetables etc. The south-east area of the district is hilly terrain bounding the district from this site and it offers feverable terrain for the nexalites to operate and build their bases. Because of geographical constraints and lack of metalled road communication carrying out of anti naxal operations becomes a tedious task. Naxalites take shelter in theses areas and they take advantage of the porous inter district boarders. Naxals run trainings in these areas and commit crime after which they easily sleep into the border of the neighboring district. The geographical features become obstacles in the smooth movement of troops besides being vulnerable to planting of land mines and becoming easy targets of ambush laid by naxalites. Since, there several commoflause and concealment places the naxals take shelter in these areas and convene secret meetings and out spread the extremist ideology.

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History : Description of Jehanabad in the history is found in the famous book "AINA-E-AKBARY" wrote by Abul Fazal. The book states that in the 17 th century this place was badly affected by famine and people were dying of hunger. Moghul emperor Aurangzeb, in whose times the book was re-written established a "Mandi" for relief of the people and named it 'JEHANARABAD'. The Mandi was under the direct control of Jehanara and she spent a great deal of time here. In due course of time, the place became 'JEHANARABAD' and later 'JEHANABAD'

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

Socio-Economic : The relatively small sized district is a cauldron of conflict as far as the socio-economic situation is concerned. There were extreme caste tensions (with an economic bearing) prevailing in the whole Magadh area (old Gaya district - now broken into 5 districts of Gaya, Aurangabad, Nawada, Jehanabad and Arwal) and they were manifested in their worst forms in this district. Thus this place has been badly affected by Naxalism (PWG, MCC, ML(Lib) etc.) and has seen the emergence of rival outfits such as Ranvir Sena. In the result this district has witnessed horrifying spate of large scale carnages in the past which has resulted in the killing of hundreds of innocents. Nonhi-Nagwan, Parasbigha, Khagari-Damuha, Laxmanpur-Baathe, Rampur-Chauram, Senari, Shankarbigha and Narainpur - there is a long list of villages where big massacres have occurred.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Natural Resources The rivers- Falgu, Dardha, Jamuna and Morhar flow by crossing the district's plan topography. The river Falgu has got religious importance where 'PIND DAN' is offered to their forefather's by the Hindus. All these rivers are mainly rainfed, have a meagre discharge in the other parts of the year and go dry in the summers. As far as minerals are concerned, the district has only minor ones. The sand available with the river beds in the major part of the year is collected and transported to other parts of the district besides to the adjoining districts and is useful in construction work. The soil is alluvial- textured brown gray which cracks open in the dry season and gets very sticky in the rains and the mud tracks become unmotorable during that period. The fertility is reasonably good. The forest cover of the district is small- 1030 hectares, which is mainly concentrated near the Barabar Hills. They belong to the category of reserve forests. Human Resources There are about 1.11 lakh cultivators including 92138 small and marginal farmers, 1.78 lacs agricultural labourers, 7969 skilled labours, 5075 house hold entrepreneurs and 95755 are engaged in allied agro business. The total population in the working age group is 358723 out of which there are 236199 males and 122534 females. Statistical Profile (based on 2001 census)

Sl. Population Male Female Total No. 1. Bihar 43153964 39724832 82878796 2. Jehanabad 480518 443959 924477 3. Rural Population 420777 391807 812584 4. Urban Population 59741 52152 111893 5. Literacy rate 70.29% 40.43% 55.91% 6. Rural 69.03% 37.94% 53.99%

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District Profile :-

1. Area (in Sq. KM) 941.4 sq.km 2. Decadal growth rate 28.64% (91 to 2001) 3. Population density 963 PPSK (Person per sq.km) 4. Sex ratio 928 (per 1000 male) 5. Villages Populated - 562 Uninhabited - 43 Total - 605 6. Town 02 7. Municipality 02 8. Rural Families 144199 9. SC Population 124856 10. Cultivator 1.40 Lacs 11. Small and margioner farmers 92138 12. Agriculture labours 1.78 Lacs 13 Skilled labours/ artisan 7967 14. House hold courtage workers 12661 15. Other workers 59716 16. Net area under cultivation 78000 Hec. 17. Gross cropped area 260735.46 acr. 18. Net irrigated area 66450 Hec. 19. Area under forest 1030 Hec. (0.41%) 20. Water area fishery 1176..46 Hec. 21. Total cattle 2.04 Lacs (1982) 22. Black top/Hard surface - 541.65 km Road length Kacha or mud - 450.90 km 23. Electrified villages 241 24. Urban- 764 Hand tube well Rural -7997 Total - 8761 25. Drilled tube well Urban - 0, Rural - 31 26. Rural Water supply 11 Schemes 27. Urban water supply 6 Schemes

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Infrastructure: The district is linked to the bigger cities of Patna & Gaya both by road and rail route. The recently electrified Patna-Gaya branch railway line (P.G. line) traverses through the district and links the Grand Chord with Patna. There are four railway stations- Jehanabad, Court, Tehta and Makhdumpur in the 31 km long stretch of the railways. National Highway No. 83 comes from Patna via Masaurhi, goes directly to Gaya through Makhdumpur and runs almost parallel to the railway line. There is a network of PWD roads and REO roads across the district, albeit in a bad shape. The total length of surfaced roads is 541.65 kms and mud tracks are 450.90 kms. The condition of the roads in the rural parts is good. The district has wide network of markets dealing mainly with grains and vegetables. Major centers of trade and commerce are located in Jehanabad, Ghosi, Kako and Makhdumpur. Besides in rural areas hats function usually once in the week. The trade consists mainly of export of oil seeds, rice, gur, stone chips and vegetables. The principal imports are coal, cement and other construction materials, clothes, K. oil, tea, tobacco, fresh fruits and other perishable/ non perishable consumer goods. The telecommunication network in the district is good. The whole of the district is either covered by basic or mobile phones.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. The educational infrastructure available in the district can be summarized as following- Primary schools - 561 Middle schools - 118 High schools - 43 Sanskrit Schools - 05 Colleges - 02 Besides, the Sarva Shiksha Abhiyaan (SSA) has been started in the district in a big way and there is a lot of improvement underway in the quality of the buildings through additional classrooms, toilets, hand pumps, annual repair and maintenance grants etc. Distribution of Teaching and learning materials, text books etc. is being simultaneously carried out in a big way. Credit facilities Banks - 34 PACS - 62 Hospitals District Hospital - 1 Sub-Divisional Hospital - 1 Referral Hospital - 2 Block P.H.C. - 7 Addl. PHCs - 32 Sub-centre - 81 T.B. Sanitarium - 1 Leprosy control unit - 1

The district has no big industrial unit but there is a network of village and cottage industries comprising hand looms, local spinning units, shoe making, carpenters, brick kiln, stone crushers etc. We have an operational Milk Chilling Plant with a capacity of 5000 Litres per day which is being run by COMFED, Bihar. As far as infrastructure for tourism is concerned, we have a few places to mention. There are three historical places in the district. The foremost one of Barabar or "Vanavar", situated 11 kms to the east of the NH - 31 from Makhdumpur, has the temple of Lord Shiva in the name of Baba Sidheshwar 14

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Nath, at the top of the hill, about 1100' above M.S.L. There are a few rock cut caves namely Karna Chaupar and Sudama, relating to the times of Emperor Ashoka. There is a Lomash Cave, named after a saint. A spring known as Patal Ganga is said to be built by Ashoka. There is Nagarjuni caves located nearby. The great Chinese traveler, Huen-Tsang, had visited this place and had described it in his book. It has been described in E.M. Forster's "A Passage to India". In recent times the district administration has renovated this place and constructed two tourist bungalows, a restaurant, a cemented stair case to the top of the hill, a children's park, boating facilities etc to promote tourism. Another Yatri Niwas is coming up at the base camp under MPLADS. This place witnesses a huge fair in the month of "Shravani" and it is estimated that about two to three lakhs of devotees come to offer their prayers. Situated 11 km south-east of Jehanabad railway station in Kako block, Bhelawar is famous for an old temple of Lord Shiva. A big fair is organised every year on the occasion of Maha Shivaratri. Specimens of art of the Hindu and Muslim period have also been found here. Also in Kako itself, which is equally important both for the Hindus and the Muslims, there is a temple having old statue of Lord Sun in the North- east of Kako village. It is said that Rani Kekai, wife of King Dasharatha and step-mother of Lord Rama had domiciled here for sometime. On her name this village got the name as 'Kako'. There is also a graveyard of a great Muslim Sufi Lady-Hazrat Kamalo Bibi, aunt of Hazarat Makhdum Sahab of Bihar Sharif, who is said to have been blessed with divine powers.

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Total area 33378 142500 102463 100.63 23091

Total 145920 215000 70116 126392 77248 population

Male 74000 71250 115219 36038 66010 40013 population

Female 71920 68148 99781 34078 60382 37235 population

Adolescent 38340 15285 population (10- 19yrs)

Sex Ratio 912 912 1000-866 918

Child 4380 2137 2103 population: 0-6 8760 6413 4207 months

13140 12825 6310

:6mn-2yrs

:2-5yrs

SC population : 14165 9700 32250 12540 15271 Male 13354 8500

: Female

ST population : 103 00 00 Male 128 00 00

: Female

BPL 17222 13000 8847 population

No of Eligible 24820 19950 23138 couples

Total no. of 16 14 10 22 08 14 09

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No of APHCs 04 07 06 05 03 05 02

No of HSCs 16 10 11 22 10 13 10

No. of 143 123 89 215 80 214 77 Anganwadi centers

No of Doctors

No of ANMs

No of Grade A Nurse

No of Paramedicals

No. of 136 120 88 204 80 211 77 Anganwadi workers

No of ASHA 151 135 100 182 80 138 85

Total No. of 136 80 76 SHG/ Mahila mandals

No. of primary 95 59 15 schools

No. of 85 13 52 electrified villages

No. of villages 48 having source

of drinking

water: 275

Well

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

1. Strengthening safe institutional Delivery by JBSY 2. Reducing Maternal and infant mortality rate by adopting tools of maternal autopsy and increasing focus on neo natal child care by starting SNCU in the district headquarter. 3. Special focus on ARSH Programme by starting separate clinics for adolescents, and training frontline workers to create awareness regarding RTI/STI and UTI. 4. Vulnerable sections to be given priority in all health care facilities. 5. Increasing Immunization Coverage. 6. Family planning and unmet needs of contraceptives to be met with. 7. Increasing community participation in the health system by formation and strengthening of VHSC, effective functioning of Rogi Kalyan Samiti at PHC and Registration of RKS at APHC level. Proper utilization of untied fund at PHC and HSC level. 8. Training to all frontline facility providers to be given. 9. Awareness and BCC regarding all communicable and vector borne diseases.

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

1. Initiating SNCU in the District hospital , Jehanabad 2. Radiology, Pathology and Ultrasound facilities in all PHCs and Referral hospitals. 3. Up gradation of Blood Bank of Jehanabad. 4. ISO certification for District Hospital, Makdumpur Referral and Kako PHC. 5. Generic Drug Storage at all seven PHC. Presently storage is only in District Hospital. 6. To provide special health facility in Naxal affected areas of Jehanabad district. 7. Establishment of NRC at district level.

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Planning Process → Planning in the district began in September 2010 with the Fast Track Capacity building Programme in State health Society, Patna. The District Level planning team was formed and training was given. The Jehanabad training team consisted of:

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

→ The team after taking State level training organized a workshop in the District in which MOICs, BHMs and accountant of each block were trained for preparing Block level planning.

→ All the Programme officers of the district participated in the workshop along with District accounts Manager. Civil Surgeon had energized the workshop by giving his presence and participation throughout the day. ACMO, who is the nodal person facilitated the workshop and announced the district Programme officers as the nodal officers for different blocks. Mr. Manish Mani from NHSRC and Ms. Shefali from PHRN facilitated the process and components of planning. Further formats were discussed by DPM,DPC and queries were solved. → Further at each block a workshop was done and all the members of Block PHC and ANMs were sensitized and given orientation regarding the planning. The District Programme officers in charge for the block facilitated the workshop in their blocks. → All the blocks filled up the situation analysis format and took out the gaps present in their facilities. → Thereby district compiled the data and added the information, goals, issues, strategies, activities and budget of the district and submitted it to the State by 15 th December 2010.

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

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DISTRICT WORKSHOP: ------

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CHAPTER 2

SWOT ANALYSIS OF PART A,B,C,D

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SWOT ANALYSIS

SWOT ANALYSIS OF PART “A”

STRENGTH *Skilled clinical staff.

* Doctors availibity.

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

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

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

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

WEAKNESS • lack of specialist Doctors. • Lack of all PHC Blood storage unit. • Lack of proper training to all clinical staff. • Lack of SNCU at district level. • Lack of NRC for under nutrition child.

OPPORTUNITY • Opportunity to Start NRC. • Strengthen All clinical staff after giving training. • Opportunity to start SNCU.

THREAT • Threat of demotivation of clinical staff due to lack of HR Policies and NAXAL AFFECTED AREA which will initiate adverse affect. • Threat of Drought.

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SWOT ANALYSIS OF PART “B”

STRENGTH • Well qualified Management and Administrative wing. • To manage Asha now we have Block community Mobilizer. • For Better Planning DPC at district level. • AYUSH Doctor at APHC to initiate AYUSH Treatment. • Better cold Chain Status. • Functioning of RKS at all PHC.

WEAKNESS • Lack of Infrastructure. • Lack of Functioning of RKS at APHC level. • Lack of Some selected facility to delivery. • Lack of proper procurement of Drug.

OPERTUNITY

• We have sufficient land to infrastructure strengthening. • Opportunity to develop skill of ASHA to deliver Health Facility to villagers. • Opportunity to select some facilities for Deliveries.

THREATE

• Threat of Naxalism.

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SWOT ANALYSIS OF PART “C”

STRENGTH • Better Cold Chain status. • To monitor RI Program better Team as DIO, CS, ACMO, DPM,DCHM, BHM,JCHM, DPC. • Special focus to out reach site.

WEAKNESS • Lack of Proper Documentation. • Lack of vehicle to monitor RI Programme. • Lack of training to ANM on RI.

OPERTUNITY • Opportunity to insure 100% RI By Providing Vehicle to all Officers. • By giving training Documentation can be done better,which will insure improvement in RI coverage.

THREATE

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SWOT ANALYSIS OF PART “D”

STRENGTH • Each separate Unit for each vector born and other disease. • Additional support of outside agencies in Different programme as like in TB Damien Foundation India Trust.

WEAKNESS • lack of proper coordination with other internal department. • Lack of combined approach for improvement of health system. • Lack of proper Documentation.

OPERTUNITY • NRHM part D component include all other diseases so opportunity to bring under one umbrella. • Opportunity to focus on each disease.

THREATE

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Bihar- Jehanabad

HMIS DATA ANALYSIS 2009-10

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

TT1 given to Pregnant ANC Registration against Expected 318% women against ANC 21% Pregnancies Registraion 100 IFA Tablets given to 3 ANC Check ups against ANC 9% Pregnant women against 2% Reigtrations ANC Registraion Deliveries HOME Deliveries( SBA& Unreported Deliveries against 34.4% Non SBA) against 0.3% Estimated Deliveries Estimated Deliveries HOME Deliveries( SBA& Institutional Deliveries against 65.3% Non SBA) against 0.5% Estimated Deliveries Reported Deliveries C Section Deliveries Institutional Deliveries against 99.5% against Institutional 0% Reported Deliveries Deliveries( Pvt & Pub) Births & Neonates Care New borns weighed Live Births Reported against 37% against Reported Live 58% Estimated Live Births Births New borns weighed less Still Births (Reported) 233 than 2.5 kgs against 9% newborns weighed New borns breastfed within one hr of Birth Sex Ratio at Birh 1,033 26% against Reported live Births Child Immunisation( 0 to 11 mnths) BCG given against Expected Live Measles given against 92% 79% Births Expected Live Births Fully Immunised Children OPV3 given against Expected Live 87% against Expected Live 35% Births Births

DPT3 given against Expected Live 87% Births

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Family Planning Family Planning Methods Users ( IUD Insertions against Sterilisations(Male &Female)+IUD+ 8,495 36% reported FP Methods Condom pieces/72 + OCP Cycles/13) Sterilisation against reported FP Condom Users against 52% 8% Methods reported FP Methods OCP Users against 4% reported FP Methods Other Services OPD 4,84,225 Major Operations 50 IPD 110 Minor Operations 11,876

Bihar-Jehanabad- Deliveries Apr'09 to Mar'10 Total Population 10,37,295 Expected Deliveries 31,437 Total Deliveries Unreported Home SBA Home Non SBA Institutional Reported Deliveries 59 34 20,520 20,613 10,824 Total Deliveries Unreported Home SBA % Home Non SBA% Institutional % Reported % Deliveries % 0% 0% 65% 66% 34%

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

Institutional Deliveries (Public) Institutional Deliveries (Pvt)

20,520 -

C Section 59 -

C Section% 0% 0

Complicated Pregnancies attended 61 -

Complicated Pregnancies attended % 0% 0

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

Live Birth - Live Birth - Live Birth - Sex Ratio Abortion( Still Birth Males females Total at birth Induced/Spontaneous

13 5,607 5,792 11,399 1,033 233

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Bihar-Jehanabad- Apr'09 to Mar'10

Total Abortions Abortion Rate

101 0.3%

Bihar-Jehanabad-Sterilisations - Apr'09 to Mar'10 Reported %age of Reported Sterilisation

Total Sterilisation 4,405 -

NSV 54% 2,394

Laproscopic 0% -

MiniLap 46% 2,011

Post Partum 0% -

Male 54% Sterilisation 2,394

Female 46% Sterilisation 2,011

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

Reported %age of All Reported FP Methods

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Total Reported FP Methodd (All - types) Users 8,495

Sterilisations 52% 4,405

IUD 36% 3,074

Condom Users 8% 684

OCP Users 4% 332

Limiting 52% Methods 4,405

Spacing 48% Methods 4,090

Bihar-Jehanabad- Service Delivery - Apr'09 to Mar'10

Operation major Operation minor Adolescent (General and Dental Total (No or local AYUSH counselling spinal Procedures Total OPD anaesthesia) services IPD anaesthesia)

50 11,876 24 24 - 4,84,225 110 Operation major (General and Operation minor Adolescent IPD as spinal (No or local AYUSH Dental counselling percentage of anaesthesia) as anaesthesia)as %ge as %ge of Procedures as services as %ge of OPD of OPD OPD %ge of OPD %ge of OPD OPD

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

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CHAPTER 3

NRHM PART “A”

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Part A- RCH Maternal Health:

MATERNAL HEALTH

Logical Framework

Sl. Goal Sl. Impact indicators

1 To 1.1 Reduction in MMR improve maternal health

Sl. Objective Sl. Outcome Sl. Strategy Sl. ACTIVITES s indicators

1 To 1.1 % of 1.1.1 To make 1.1.1.1 TO make increase institutional functional PHC all PHC 100% delivery (24hr x7days) for functional institutio reported institutional OT and nal safe deliveries Labour delivery room with by 42.5% equipment ( DLHS3) 1.1.1.2 All PHC to 100% having by year Obestetric 2012 First Aid medicine 24hrx 7 days

1.1.1.3 Grade A nurse available 24hrx7days

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 1.1.1.4 functioning all PHC Neo-natal care units

1.1.2 To make 1.1.2.1 One FRUs functional FRUfor having institutional functional deliveries blood storage units linkage with blood banks and 24hr ready referral transport

1.1.2.2 No of FRUs having EmOc and CEmOc facilities

1.1.2.3 No of FRUs having specialist doctors/ multiskilled Medical Officers

1.1.2.4 No of FRU having functional Neo-natal care units

1.1.3 To provide 1.1.3.1 No of Referral transport pregnant services at FRU women /PHC availed the referral facilities (pick up and

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1.1.4 To strengthen 1.1.4.1 Nos Janani Suraksha pregnant Yojana / JSY women reecieved JSY payments immediatel y after delivery

2 To 2.1 Proportion of 2.1.1 To ensure 2.1.1.1 home increase birth support of SBA at deliveries safe attendent by home deliveries attended by delivery skilled health SBA trained by personnel ANM. trained SBA 10.6%( DLHS3) to 100% by year 2012

3 To 3.1 ANC reported 3.1.1 To strengthen 3.1.1.1 Almost all increase through HMIS HSC for providing HSCs having ANC formats / Form outreach ANMs coverage -7 maternal care with quality 30.6% (DLHS3) 3.1.2 To organise 3.1.2.1 f RCH to 75% by integrated RCH camps year 2012 camps specially planned for hard to reach and held areas, isolated population and Maha Dalit Tolas

3.1.3 To improve 3.1.3.1 No of adolescent pregnant reproductive and adolescent sexual health counselled by ANM/

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. AWW/ASHA so activity at HSC, AWW center.

3.1.4 To accelerate 3.1.4.1 Insure of APHC for OPD OPD clinics and Fixed AN organized clinics at APHC level.

4 To 4.1 % MTP cases 4.1.1 To provide MTP 4.1.1.1 No of provide reported services at health facilities safe through HMIS facilities having MTP abortion formats / Form services services -7 (public and at all private facilities involvemen t)

5 To 5.1 % of Mahila 5.1.1 To strengthen 5.1.1.1 monthly increase mandal Monthly Village Village communi meetings Health and Health & ty conducted. Nutrition Days Nutrition participat Days ion in planned maternal and held care

MATERNAL HEALTH

Sl Strategy Sl Gaps Sl Activities .

To make Infrastructure functional A PHC (24hr 1.1 All PHCs are 1.1.1 Need based ( Service 1 x7days) for running with only delivery)Estimation of institution six bedded cost for up gradation al facility. All of of PHCs deliveries facilities are not Selection of any two adequate as per PHCs for ISO IPHS norms.(List certification in first attached, phase

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1.2 At present 7 PHC are 1.2.1 2. Preparation of priority working with average list of interventions to 10 delivery per day, deliver services and insure 10 FP use of patograph by ANM. operation/emergency operation and 125 OPD per day in each PHC. This huge workload is not being addressed with only six beds inadequate facility.

1.4 The comparative 1.4.1 2. Sending the analysis of facility recommendation for the survey(08-09) and certification with existing DLHS3 facility services and facility detail. survey(06-07) , the service availability tremendously increased but the quality of services is still area of improvement.

1.5 Lack of equipments as 1.5.1 3 Prioritizing the per IPHS norms and equipment list according also under utilized to service delivery and equipments. IPHS norms.

1.5.2 Purchase of equipments

1.6 Lack of appropriate 1.6.1 Purchase of Furniture furniture

1.11 Lack of facilities/ basic 1.11.1 Rennovation of all 7 PHCs amenities in the PHC buildings

1.12 As per IPHS norms each PHC requires the following clinical staffs:(List attached)

Salary of Contractual Doctors

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 1.12.1 But the actual Selection and recruitment position is not of Doctors on contractual sufficient as per IPHS basis and give priority in norms List of Human selection those who are resource is attached living in same PHC. in Annexure “A” 1.12.10.1 Salary of Contractual Grade A + 1.12.10 Selection and recruitment of grade A for conducting delivery

Selection and recruitment of dresser

Selection and recruitment of Pharmacist.

Three month indication training of Grade A nurse under supervision of District level resource team.

1.13 1.13.1 Training need Assessment of PHC level staffs

Honorarium of Block Accountants

Rent of Data Center

Honorarium of BHM

Mobility support to BHMs / Accountant

1.14 1.14.1 Appointment of Block Health Managers, Accountants in all institutions.(7 PHCs, 2 Referrals and Sadar hospital.) and 2 extra Accountant in Sadar Hospital and Referral Hospital, Ghosi)

Process of all recruitments

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Training on Program, Finance management and HMIS

Drug Supply

1.16 Irregular supply of 1.16.1 Ensuring the availability of drugs because of lack FIFO list of drugs with of fund disbursement store keeper. And ABC on time. Analaysis.

1.17 Only 38 essential 1.17.1 Implementing drugs are rate computerized invoice contracted at state system in all PHCs level .

Purchase of Drug invoice software and one pc.

Lack of fund for the 1.17.2 3.Fixing the responsibility transportation of on proper and timely drugs from district to indenting of medicines( blocks. keeping three months buffer stock)

1.18 1.18 .Payment from Rogi Kalyan samiti account.

1.19 There is no clarity on 1.19.1 5. Orientation meetings/ the guideline for need training on guidelines of based drug RKS for operation. procurement and transportation.

1.2 Drugs are not 1.20.1 6. Enlisting of equipments properly stored for safe storage of drugs.

1.20.2 7. Purchase of enlisted equipments.

1.20.3 8.training of store keepers on invoicing of drugs

Performance

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 1.21.1 Excessive load on PHC 1.21.1 Recruitment of Doctors on in delivering all contractual basis services i.e. 10 deliveries per day, 4 inpatient Kala-azar, 10 FP operation/emergency operations and 120 OPD per day in each PHC.

1.21.2 Doctor vacancies list are enlisted in annexure A

1.22 All posted doctors are 1.22.1 Hiring of rented houses not regularly present from RKS fund for the during the OPD time residence of doctors and so the no of OPDs key staffs. done is very less( only average16 patients 1.22.2 Incentivizing doctors on per Doctor per OPD their performances days, however the especially on OPD, IPD, FP IPHS norms says that operations, Kala-azar the OPD should be 40 patients treatment. per Doctor.) 1.22.3 Revising Duty rosters in such a way that all posted doctors are having at least 8 hrs assignments per day

1.24 07 PHCs are lacking 1.24.1 Ensure 24 hrs new born 24 hrs new born care care services in all 7 PHC. services.

1.27 Lack of 24 hrs BEmoC 1.27.1 Ensure 24 hrs BEmoC services. services at 07 PHC

Training of Doctor from each PHC on BEmoC.

Equipments for BEmoC

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 1.29 All Phc have T.B lab 1.29.1 Deputation of regular Lab Technician. In tech at PHC level for addition to this the providing free of cost lab regular lab technician services to all pregnant has been deputed for women and BPL families. this purpose.

1.3 1.30.1

Training of TB lab technician on other pathological tests.

Purchase reagent (recurring) for strengthening lab.

Purchase of equipments/ instruments if needed. Fund could be rooted through RKS and if it is not utilized it could be diverted to other women and child friendly activates.

1.32 Health facility with Establishing one AYUSH services is not Panchkarm center in Kako. being provided

Establising two homeopathy centers in Kako and Makhdumpur.

1.33 Referral Services

1.33.1 No pick up facility for 1.33.1.1 Provision for pick up & PW or BPL patients. drop out for pregnant mothers and BPL families free of cost using existing Ambulance services at PHC level.

Provide EDD list of pregnant women to Ambulance driver and Number of ambulance deriver and 102 /PHC tell

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1.33.3 Lack of maintenance 1.33.3.1 Repairing of 2 defunct of ambulances Ambulances

1.33.4 Shortage of 1.33.4.1 Hiring of ambulances as ambulances per need.

Prepare list of Vehicle those are utilised in Monitoring work in PHC that can be use in pick up and drooping facility for PW.

1.34 Quality of food, 1.34.1 Assigning mothers cleanliness (toilets, committees of local BRC Labour room, OT, for food supply to the wards etc) electricity patients in govt’s facilities are not approved rate. satisfactory in any of the PHC. Rewiev of Cleanliness activity in all PHC by Quality assurance committee and payment of agency should be link with it.

1.34.2 Hiring of workers for cleanliness of OT and Labour room in PHC

Perchage equipments and uniform for clinginess in all PHC

Training of Workers on using machine/equipments and importance of clinginess .

Develop mechanism for monitoring of clinginess 43

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1.35 All PHCs have their 1.35.1 Repairing of PHCs genets own generator sets and initiating their use. but are not in use.

1.7 Non availability of 1.7 Printing of formats and HMIS purchase of stationeries formats/registers and stationeries 1.7.2 Biannual facility survey of PHCs through BHM as per IPHS format

1.7.3 Regular monitoring of PHC facilities through PHC level supervisors in IPHS format.

1.8 Operation of RKS: 1.8.1 Ensuring regular monthly meeting of RKS.

1.8.2 Appointment of Block Health Managers, Accountants in institutions.( 01 Referral Hospital Ghosi.)

1.9 Lack in uniform 1.9.1 Training to the RKS process of RKS signatories for account operation. operation.

1.9.2 Trainings of BHM and accountants on their responsibilities.

1.1 Lack of community 1.10.1 Meeting with community participation in the (School children or functioning of RKS. other)representatives on erecting boundary, beautification etc,

1.10.2 Meeting with local public representatives/ Social workers and mobilizing them for donations to RKS.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 1.36 In serving emergency 1.36.1 Meeting in RKS with Local cases, there are Police Station in charge to maximum chances of handle emergency misbehave from the situation . part of attendants, so staffs reluctant to handle emergency cases.

Training local NCC/NYK/Scout & Guide/NSS etc. volunteers on identification of emergency situation. And deployment of volunteers at PHC.

1.37 Several cases of theft 1.37.1 Insurance of all properties of instruments, and staffs of PHC computers, and submersible pumps etc at PHCs.

1.38 No guidance to the 1.38.1 Pictorial wall painting on patients on the every section of the services available at building denoting the PHCs. facilities and attached trained volunteers to guide patients.

1.39 Non friendly attitude 1.39.1 Name plates of Doctors of staffs towards the poor patients in Displaying Name general and women Photograph and DOB of all are disadvantaged staff of PHC and put group in particular. clinginess staff name on top of the list.

1.41 Lack of counseling 1.41.1 LHV experience can be services utilize in counseling work of women and adolescent girls after training.

1.42 there is no hot water 1.42.1 Installation of solar heater facility for PW and system and light with the there is no adequate help of BDO/Panchayat at liting facility at PHC or purchase adjoining area of PHC equipments from market.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 1.43 Lack of convergence 1.43.1 Convergence meeting by RKS & DHS

1.44 Lack of timely 1.44.1 Orientation of the staffs reporting and delay in on indicators of reporting data collection formats

1.44.2 Purchase of Laptops for DPC with internet facility.

1.45 Lack of space for 1.45.1 Gardening waiting, environmental 1.45.2 Sitting arrangement for cleanliness around patients PHC, provision for hospitality etc

Construction of patients waiting shade

1.45.3 Installation of LCD projector for manages Waite over time of OPD patients.

1.45.4 Installation of safe drinking water equipments/water cooler,

1.45.5 Apron with name plates with every doctors

1.45.6 Presence of staffs with uniform and name plates.

1.45.7 Payment of 63 MAMTA @100 Rs.

2.1 C-Section deliveries 2.1.1 Devlop PHC Makhdum,pur are not conducted in and Sadar Hospital for C- institution. section facility

2.1.2 Training of MOs of 5 PHCs in mullti skilling.

2.1.5 Specialist should be posted at Sadar Hospital/and above

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2.1.6 C-section in a month the incentive money should be distributed among all staff of the PHC after the decision of RKS.

2.1.8 Need based Equipments and drugs in O.T and Labour room.

None other of the Up gradation of district PHC provides 24 hour blood bank. blood transfusion services, however PHC Makhdumpur has been established blood storage unit.

Training of lab technician on management of blood storage

Infection control 2.2.2 Licensing blood storage / protocols is not at all blood bank maintain at all facilities

2.2.3 Meeting infrastructure requirements as per norms Blood BANK.

2.2.4 Training of MO and lab tech/ staff nurse blood storage on grouping /cross matching and management of transfusion reactions stabilized linkages with mother blood bank.

2.2.5 Provide free of cost Blood for pregnant women who need blood transfusion for severe anemia/ PPH on prescribed through RKS

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2.2.11 Organize Blood donation camps at all institution and mobilize community for voluntary blood donation

2.3 Welcome PW at 2.3.1 Provision of food for the Institution and PHC delivered mothers and and FRU mothers under gone in tubectomy in all the health facilities.

2.3.2 Mobilize community Resources for providing Free food for PW at Institution.

2.3.3 Quality indicators (clean environment, wards with clean linen, clean toilets , clean labour rooms, running waters supply, hot water and protected water for inpatients, new born corners, treatment protocols, aseptic precautions, immediate disbursement of

2.4 Reporting of maternal 2.4.1 Training of ASHA & ANM death Maternal death on reporting of Maternal reporting is usually deaths and conduct not reported by Verbal Autopsy worker 2.4.2 Incentives for maternal death reporting by ASHA @ Rs 50/-per maternal death

2.4.3 Reporting line should be in five columns – name of mother, place of death, date of death, cause of death and no. of birth.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 2.4.4 Institution and urban center also to report Maternal death to the district CS/CMO.

2.4.5 Maternal Death should be reported by ASHA AWW, ANM Staff Nurse & Doctors to the district data center .

2.4.6 Investigation of maternal death by district team. and third party review(District magistrate)

2.4.7 Training of ASHA and investigation team objective and process of investigation and review of maternal death

2.5 Biomedical waste 2.5.1 Procurement of management is not equipment and staff properly taken care recruitment. off at all institution 2.5.2 As per example Introduce color coded buckets for facilities as per IMEP

4.1 Tracking of pregnant 4.1.1 Review of early women from first registration with 3 AN Trimester is not done checkup ,two TT.100/200 form the register. IFA Tab. in ASHA Diwas.

4.2 Too much 4.2.1 Ensure 100 %Pregnancy documentation Test Kit is to ASHA and process. Photo regular supply. required for mother and baby. It cost 4.2.2 Direct transfer of funds Rs.30/- to Rs.60/- . from district to PHC through core banking / directly from DHS

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 4.2.3 Finger print technology for JSY beneficiaries at facility level where computer with internet facility is available. This will help in financial monitoring.

4.2.4 The photo system should be replaced by some other alternatives like- bank account opening of pregnant women in first trimester and directly transfer the money to their account after delivery.

Incentive for institutional delivery.

5 To ensure 5.1 Home Delivery is 5.1.1 Home Delivery should support of still prevailing be conducted by SBA SBA at through untrained trained Staff Nurse or home traditional Dai’s ANM. deliveries 5.1.2 Provision of Dai Delivery kit(DDK) to TBA where institution access is poor. And it should be supervised by ANM for home deliveries.

5.1.3 Delivery kit (equipment, medicine)for ANM should be supplied

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 5.1.4 Supply of delivery Kits as per number of deliveries conducted in home.

5.2 Reporting of 5.2.1 Incentive based home delivery is system for reporting not done so the of home delivery by PNC is not ASHA and it should provided linked with ANM

5.3 Non payment of 5.3.1 The JSY money to the Home delivery mother who has through JSY delivered baby at Home paid by ANM.

6 To Infrastructure strengthen HSC for 6.1 Out of 81HSCs 6.1.1 Strengthening of HSCs providing only 34 are having having own buildings outreach own building maternal care 6.2 In existing 34 6.2.1 White washing of HSC buildings 10 are in buildings. running comparatively in 6.2.2 Organize adolescent good condition, girls for wall painting 18 are being and plantation./hire renovated, one is local painter for very poor colorful painting of condition. HSC walls. 6.2.3 List out all services which is provided at HSC level. On the wall.

6.2.4 Gardening in HSC premises by school children.

6.3 No one building is 6.3.1 Mobilize running having running water facility from water and electric near by house if they supply. have bore well and water storage facility and it could be on monthly

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Arrangement of water supply up to HSC ( Wiring ) from water source

To 6.4 Lack of 6.4.1 Purchase of strengthen appropriate Furniture Prioritizing HSC for equipments and the equipment list providing ANM are according to service outreach reluctant to keep delivery(for ANC maternal all equipments in /Family planning care HSC . /Immunization/)

6.4.2 Purchase of equipments according to services

6.4.3 Purchase one almarah for keep all equipment safely and it could be keep in AWW / ASHA house.

6.5 Non payment of 6.5.1 Strengthening of HSCs rent of 20 HSCs running in rented for more than buildings. three years 6.5.2 Estimation of backlog rent and facilitate the backlog payment within two months

6.5.4 Purchase of Furniture as per need where building is on rent

6.5.5 Prioritizing the equipment list according to service delivery

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6.6 The district still needs 83 more HSCs to be 6.6.1 Preparation of PHC formed. wise priority list of HScs according to IPHS population and location norms of HScs

6.6.2 Community mobilization for promoting land donations at accessible locations.

6.6.3 Meeting with local PRI /CO/BDO/Police Inspector in smooth transfer of constructed HSC buildings.

To 6.7 Non participation 6.7.1 Biannual facility strengthen of Community in survey of HSCs HSC for monitoring through local NGOs as providing construction work per IPHS format outreach maternal 6.7.2 Regular monitoring of care HSCs facilities through PHC level supervisors in IPHS format.

6.7.3 Monitoring of renovation/constructi on works through VHSC members/ Mothers committees/VECs/oth ers as implemented in Bihar Education Project.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 6.7.4 Training of VHSC/Mothers committees/VECs/Ot hers on technical monitoring aspects of construction work.

6.7.5 Quarterly Meeting of one representative of VHSC/Mothers committees on construction work and other issues

6.8 Lack of 6.8.1 Formation and community strengthening of ownership in the VHSCs, Mothers committees,

6.8.2 “Swasthya Kendra chalo abhiyan” to strengthen community ownership

One week Training of Nukkad Natak team on IPHS

6.8.3 Nukkad Nataks on Citizen’s charter of HSCs as per IPHS

6.8.4 Monthly meetings of VHSCs, Mothers committees

7 Human Resource

7.1 1.Out of 13 7.1.1 Selection and sanctioned post recruitment of 67 of LHVs only 05 ANMs are placed, 2.All 240 posted ANM are not trained enough to 7.1.2 Selection and deliver services. recruitment of 28 3. 67 seats of male workers

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. contractual are 7.1.3 Training need Vacant. Assessment of HSC level staffs by BHM in weekly meeting

7.1.4 Training of staffs on various services in the PHC,

To Open 7.2 7.2.1 To Start an ANM ANM Training School in the Training District. School for providing 7.2.2 Deployment of regular required training to staffs/trainers ANMs. 7.2.3 Hiring of trainers as per need

7.2.4 Preparation of annual training calendar issue wise as per guideline of Govt of India.

7.2.5 Allocation of fund and operationalization of allocated fund

8 To Drug Kit Availability strengthen HSC for 8.1 No drug kit as 8.1.1 Weekly meeting of providing such for the HSCs HSC staffs at PHC for outreach as per IPHS promoting HSC staffs maternal norms.(KitA, Kit B, for regular and timely care drugs for delivery, submission of indents drug for national of drugs/ vaccines disease control according to services program (DDT, and reports MDT, DOTs, DECs)and contraceptives,

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. No Drug kit for 8.1.2 Ensuring supply of Kit AWCs(@one kit A and Kit B biannually per annum,) . No through Developing ASHA kit, only PHC wise logistics need based route map emergency but that too being 8.1.3 Hiring vehicles for irregular in supply supply of drug kits through untied fund.

8.1.4 Developing three colored indenting format for the HSC to PHC(First reminder- Green, Second reminder-Yellow, Third reminder-Red)

8.1.5 Hiring of couriers as per need

8.1.6 Payment of courier through ANMs account

9 To Performance strengthen HSC for 9.1 Unutilized untied 9.1.1 Training of signatories providing fund at HSC level on operating Untied outreach fund account, book maternal keeping etc care 9.1.2 Timely disbursement of untied fund for HSCs

9.1.3 Assigning a person at PHC level for managing accounts

9.2 No ANC at HSC 9.2.1 Identification of the level Only 26.7% best HSC on service PW registered in delivery first trimester with three ANCs is 9.2.2 Listing of required 30.6%, TT1 equipments and coverage is 54.5% medicines as per IPHS norms in facility survey

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 9.2.4 Honoring the ANM those who develop women friendly HSC in given criteria (list is attached)

9.3 Family Planning 9.3.1 Gap identification of Status:-Any 39 HSCs through method- facility survey 28.2%,Any modern method- 9.3.2 Eligible Couple Survey 24.01%,No 9.3.3 Ensuring supply of sterilization at contraceptives with HSC level,IUD three month’s buffer insertion - stock at HSCs. 1%,Pills- 0.9%,Condom- 9.3.4 One day training of 1.6%,Total unmet AWW/ASHA on family need is 39.8%, for planning methods spacing-15.3% and RTI/STI/HIV/AIDS ,Lack of counseling Skill. 9.3.5 Training of ANMs on IUD insertion

9.4 HSC unable to 9.4.1 Review of all disease implement control programs HSC disease control wise in existing programs Tuesday weekly meetings at PHC with form 6.( four to five HSC per week)

To 9.4.2 Strengthening ANMs strengthen for community based HSC for planning of all providing national disease outreach control program maternal care 9.4.3 Reporting of disease control activities through ANMs

9.4.4 Submission of reports of national programs by the supervisors duly signed by the respective ANMs.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 9.5 80% of the HSC 9.5.1 Submission of staffs do not absentees through reside at place of PRI. NO proper posting arrangement for stay over there

9.6 Lack of 9.6.1 Fixed Saturday for convergence at meeting day of ANM, HSC level AWW, ASHA,LRG with VHSCs rotation wise at all villages of the respective HSC.

9.6.1 Monthly Video shows in all schools of the concerned HSC area schools on health, nutrition and sanitation issues.

9.7 Lack of 9.7.1 Training to the field Knowledge and staffs in filling up skill of filled level form 6, Form 2, staff of data Immunization report compilation in format, MCH HMIS formats and registers, Muskan format. achievement reports etc

9.7.2 Printing of adequate number of reporting formats and registers

1 To 10.1 Out reach camps 10.1.1 Identifying Socially 0 organize are not organized Backward, Slums & integrated in planed manner. Maha Dalit Tolas. RCH camps It is totally base specially on demand of 10.1.2 Hiring trained for hard to organization and alternate vaccinator/ reach it eventually it is retired ANMs and areas, not reported to Medical officer .hiring isolated respective HSCs vehicle for fixed day population and PHC. out reach camps with and Maha drugs.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Dalit Tolas 10.1.3 Fixed day OPD clinics at APHC level and adjoining HSC of respective APHCs. with dedicated MO and support staff.

10.1.4 To make calendar for camps with date and identified areas. And link NGOs those who are willing to organized Camps.

10.1.5 Community based reporting system through SMS. involve PRI members and training on reporting and Camp approach

1 To 11.1 No training 11.1.1 Multipurpose 1 improve Programme for counselor can be adolescent adolescent used for adolescent reproducti particularly health care. For this services ve and and sex. of LHV can be used. sexual and calendar of health activity could be develop.

11.2 Preventions of 11.2.1 Linkage with anemia in adolescent anemia adolescence girls control Programme in Schools with Unicef. And training to the one teacher from the school

11.3 Marriage before 11.3.1 Sensitization of PRI legal age. members particularly women

11.4 Preventions of 11.4.1 Adolescent teen age pregnancy should be pregnancy and addressed with abortion. priority care( eclampsia, 3 ANC, anemia, 100 IFA, 100% institution

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. delivery, low birth Wight baby, Brest feeding. PNC with in 48 hours.

11.6 Limited 11.6.1 Family counseling for interventions for adolescent pregnancy empowering tracking on above adolescent girls mention through ASHA and AWW.

11.6.2 State to develop and issue guidelines for implementation of Kishori Mandals Formation of Kishori Mandals by registration of all girls(11-18 yrs)

To 11.6.3 Prepare a monthly improve plan of activities for adolescent one day per week reproducti ve and 11.6.4 Counseling nutrition, sexual health and social health issues every week at AWCs by AWW

11.6.5 Weekly distribution of IFA Tablets to out-of- school girls at AWCs

11.6.6 Deworming adolescent every 6 months

11.6.8 Initiate family schools for learning child care , safe mother hood life skills and Family life education

1 To provide 12.1 MTP services are 12.1.1 Selection of facilities 2 MTP not available in for provision of safe services at Public sectors abortion services

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. health 12.1.2 Location of facility facilities availability of trained service provider, space, equipments.

12.1.3 To Provide appropriate equipments at all facilities and MVA syringes.

12.1.4 Putting the trained doctors at appropriate facilities to commence the services

12.1.5 Training of Medical officers and Para medical staffs on Safe abortion services training including awareness about legal aspects of MVA/ EVA and Medical abortion by IPAS .

12.1.6 Formation of district level committee (DLC) to accredit private sites as per GOI guide line .

12.1.7 Develop reporting system of MTP services in private and public sector.

12.1.8 Through training program make the govt. doctors skilled to perform MTP in the approved sites.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. To provide 12.1.9 To Involve community MTP to aware about services at location of services , health process and legal facilities aspects of MTP services through - AWW, ASHA & ANM, LRG and mass media.(IEC)

12.1.10 The services of Pregnancy testing should be strengthen and it should be linked with MTP services.

12.1.11 NGO’s and local Practitioner should be involved for counseling and information of facility

12.1.12 Assurance of privacy and link with family welfare services counseling at all facility.

12.1.13 Linkage with MTP services with NGOs (PPP) those who are working in Safe abortion services. and create one modal center at district and PHC level.

12.1.14 Training of ASHA on medical abortion.

1 To 13.1 Nutrition and 13.1.1 AWC should be 3 strengthen Counseling develop Hub of Monthly Component is not activities (VHND) Village visible in VHND Health and and there is no 13.1.2 Develop an activity Nutrition monitoring of plan calendar for VHND activity by VHND as seasonality.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Days Community. 13.1.3 Counseling of mothers on ANC, preparation for Child care ,STI/RTI, and AYUSH, adolescent Health

13.1.4 Organize VHND in Four Table concept regularly where One place is for registration, one is for weighing, one is for immunization and fourth is for counseling

13.1.4 Meeting of VHSC and preparation for area specific epidemiological planning and community based monitoring.

13.1.5 Skill development training is required to ANM , ASHA & AWW and Dular (LRG)

13.1.6 Develop monitoring plan map of each village and displaced at AWC with identification of priority houses with PW, lactating women ,Malnourish children , New born, DOTs and other services

13.1.7 SMS reporting system of conducting VHND and ANM collect Data from field level and compile it in weekly/Monthly

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. B APHC Infrastructure

To form 1.3 Out of 32 APHCs 1.3.1 Registration of RKS /strenghte only 11 are having n APHC in own building Phase manner

1.4 Existing 11 1.4.1 Rennovation of buildings are not APHCs buildings from properly RKS Fund maintained

1.5 Non payment of 1.5.1 Payment Of Rent of rent of 16 APHCs APHC building for more than one year.

1.6 Lack of 1.6.1 Purchase of equipments, equipment as per service need from RKS fund

1.7 Lack of 1.7.1 Purchase of Furniture appropriate from RKS fund furniture

2 Human Resource

2.1 in the district no 2.1.1 Operational sing one any APHC APHC in each PHC by functioning as per conducting daily OPD IPHS norms by Doctor. And support staff.

2.2 2.2.1 Notification from district for operational sing APHC

3 Drug Supply

3.1 No drug kit as 3.1.1 Purchasing 23 listed such for the OPD Drugs of PHC for APHCs as per IPHS APHC norms.

5 RTI/STI 5.1 No regular clinic 5.1.1 Trained service services at at all PHCs & provider on syndrome health APHCs. management of RTI/STI (As per GOI

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5.1.2 Logistics of setting of clinics and free drugs availability

5.1.3 Integrated Counseling services in four public sector facilities by trained personnel.

5.1.4 IEC/BCC for awareness available RTI/STI services at all health facilities.

Child Health

Logical Framework

Sl. Goal Sl. Impact indicators

1 1.1 Reduction in IMR

To improve 1.2 Child performance in the school - enrolment, attendance and dropout Child health & achieve child survival

Sl. Objectives Sl. Outcome Sl. Strategy Sl. Output indicators indicators

1 To increase 1.1 % increase of 1.1.1 % of PHC ORS ORS initiated distribution distribution . IMNCI and from IMNCI,Home HBNC 13.6%(DLH Based Newborn training. S3) to 80% Care/HBNC

2 To increase % increase of treatment of treatment of diarrohoea diarrhea within from 74.7% two weeks to 90%

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3 To increase % increase of treatment of treatment of ARI/Fever in ARI/Fever in the last two the last two weeks from weeks 72.6%(DLH S3) to 95%

4 To increase % increase of All PHC of infant infant care with initiated care with in in 24hr of HBNC 24hr of delivery . with delivery trained from MAMTA, 29.8%(DLH Straitening of Facility ASHA on S3) to 50% Based Newborn facility Care/FBNC and based trained workers on new born using equipments. care..

To increase % increase of 1.1.2 No of % of breastfeeding training breastfeedin within 1 hr of orgnised g from birth . in PHC on 18.6% to IYCF 70% within 1 hr of birth

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

To increase % increase of exclusive exclusive breastfeedin breastfeeding g among 0- among 0-6 6 month of month of children children. from 10.9% to 80% Infant and Young To increase % increase of Child Feeding/IYCF immunizatio full 66

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To increase To increase Vit 1.1.3 Two round vit A A reported of Child coverage of adequate survival received at coverage Month least one among (9m to organized dose 5ys ) in one (9month to finical 35 months ) year. from Management of 66.00% to diarrhea , ARI and 80% and Micronutrient include up Malnutrition through to 5 years. Child survival months

To decrees % of decrease 1.1.4 Care of Sick Children No of Malnutrition Malnutrition and Severe VHND form age group of (0 Malnutrition and organized 58%(NFHS to 5 yrs) strengthen VHND at vs. III state ) to all AWCs Planed. 30% of the 2 age group 2.1 School Health No Of of (0 to 5 Programme school

yrs) health 2.1.1 Programm e organized in the PHC

Sl. Strategy Gaps Activities

IMNCI,Hom Assessment of Training e Based Training load and prepare Newborn Gaps(AWW- calendar of training Care/HBNC 905/925,ASHA- 0,ANM- Incorporate ASHA in 150/249,MPW- IMNCI training team 0,MO-

100/140,CDPO- 05/7,ICDS Super- 05,Health supervisors- 15,NGOs-06)

No ASHA is ASHA kit regular supply 67 and incorporate use of ASHA Kit in training Please purchase 'PDFcamp Printer' on http://www.verypdf.com/curriculum. to remove this message. trained on IMNCI

Inadequate Division of area among monitoring of all trained supervisiore this activity at for revision of IMNCI field level activity in their area.

BHM will be responsible for review of health supervisor and LS(ICDS)on given format. Unicef staff will support in developing review mechanism in PHC.

Incorpate IMNCI reports in HIMS format

Encouraging mother regarding child care. in VHND

Frequent checkups of babies by Pediatrician.Distribute telephone number to AWW and ANM of respective doctors those who are supervising them in the field.

Wednesday could be fixed a day for IMNCI related work at HSC level

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Community based Monitoring support system develop with SHG in seven PHC Training of Group members seed money to SHG for referral services and other need based services.

only one institutions has baby warmer machines but maintenance of machine is not All PHCs should be up to the mark equipped with baby and. warmer machines.

ANMs and Doctors are not trained to Training of Doctors and operate these ANM to operate baby machines warmer machine.

There is no Facility provision of stay Organize training Based of mothers of programme for newborn Newborn neonates at care for the nurses in Care/FBNC PHC. the district hospitals

District level Supporting supervisory team should be developing with the responsibility of nonfunctioning of Neonatal Care neonatal care Unit not up to unit.Training of team on mark. monitoring of NCU

Training of Mamta and staff nurse on logistics of Untrained of New born Care units. by “MAMTA” at district level supervisory PHC level. Team.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Colostrums feeding and Infant and breast feeding Young Child inclusively for six Feeding/IYC months. Through IMNCI F Training.

Baby friendly hospital Training of one doctor Non awareness form each Nursing of breast hospital at District Level feeding and proper diet of Two days training of one young children. staff nurse from each private hospital on counseling skill.

Accreditation of nursing home and facility according to norms of baby friendly hospital

Development and Printing of BCC materials

Poor knowledge regarding new born care and Preparing adolescent child feeding and pregnant mother practices on IYCF by IPC through AWW, LRP and ASHA

Linking JBSY with

colostrums feeding

Myths and Counseling and orientation of local misconception s about early priests, opinion

initiation of leaders, fathers, breast feeding, mother in laws by exclusive ICDS/ Health

breast feeding functionaries in and mothers meetings and complementar VHSCs meetings

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Uniform message on radio from state head quarter

Organize social events

through VHSCs

Strengthening of Mahila Mandal meetings- fortnightly with involvement of adolescent girl

Organize Mela on healthy baby shows, healthy mother / Lack of pregnant woman. awareness on importance of Appreciation and appropriate reorganization of and timely IYCF positive practices in community. For this purpose hiring a documentation

specialist.

Celebration of “Annaprashan( Muhjutthi) Day ” at

AWC

Demonstration of recipes.

Exposure visits to existing NRCs to

observe different models in the country

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Procurement of ,ORS , Vitamin A supplementation(9m to 5 years children) with De-worming pediatric IFA syrup. There is high Include coverage of prevalence of Vitamin A and IFA, Managemen PEM and children in New HIMS t of diarrhea , anemia among format. ARI and children Micronutrien because of Insure two round of t Child nutrition Vitamin A and Malnutrition is least priporty deworming for the age among service group of (9m to 5 yrs) providers. & (2 yrs to 5 yers) respectively in the month of April And Oct as per GOI guide line.

Involvement of ICDS, school teachers and PRI for monitoring and evolution

No Pre School Half yearly health School Health checkup checkup camp for Health & complete children in schools Programme Immunization should be organized. card.

No training of Training of school school teacher teacher by the medical for basic health personnel with support care and administrative person. personnel hygiene.

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No Training & Linking existing Screening of ophthalmic paramedics school’s teacher with this program and for eye sight developing school wise test. calendar.

No other School health anemia specific program control programme

has been should be strengthen formulated in with bi annually de the district. worming.

Organizing competitions/Debates/P ainting competitions/Essay/de monstration and model preparation of nutritional food and health.

Half yearly Health checkups and health card of all school going children.

Films shows on health, sanitation and nutrition issues

Social Since Lab activities.

Rally and Prabhat Phery in epidemic areas. (Kala- azar & Malaria)

Referral system for the school children for higher medical care.

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Family Planning

Sl. Goal Sl. Impact indicators

1 Population 1.1 To decrease TFR upto replacement leve l stablisation To increase sex ratio

Sl. Objectives Sl. Outcome Sl. Strategy Sl. Output indicators indicators

2 To increase 2.1 % increase in 2.1.1 2.1.1.1 % of female female Terminal/Limiting terminal/limiting sterilisation from sterilisation Methods methods use present 20.01% (DLHS3) to 50% 2.1.2 Dissemination of 2.1.2.2 No of facilities manuals on providing sterilization quality manuals standards & on sterilization quality standard of assurance of sterilization sterilization services. services

2.1.3 2.1.3.3 No of camps Female organize for Sterilization female camps sterilization.

2.1.4 Compensation 2.1.4.4 % of Female for female received sterilization compensation

2.1.5 2.1.5.5 No of IUD used IUD camps in Camps

2.1.6 2.1.6.6 No of Private Accreditation of providers private providers accrediation for for IUD insertion IUD Insertion services services.

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3.1.3 3.1.3.3 No of Private Accreditation of providers private providers accrediate for for sterilization Sterilization services services.

4 To increase use 4.1 % increase in 4.1.1 4.1.1.1 Insure of condoms from the use of distribution of 1.6% (DLHS3) to condoms Promotion to Condom 5% Social Marketing through Social of condoms Marketing.

4.1.2 4.1.1.2 No of Seminars Organized on Contraceptive Contraceptive Update seminars Update.

5 To increase use 5.1 % increase in 5.1.1 5.1.1.1 Pills of pills from the use of pills distribution present through Social 0.9%(DLHS3) Marketing. among current married women Promotion to age 15-49 yrs to Social Marketing 5% of pills

Sl. Strategy Gaps Activities

Ensure one MO trained on on minilap and NSV up to PHC

Lack of Training of nurses Terminal/Limiting knowledge of and ANMs on IUD Methods small family and other spacing norms. methods at PHC level.

Ensure availability of contra septives (indenting ,

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Trained doctors on laparoscopy.

Procure Female Laparoscopy Laparoscopy Sterilization surgery not equipments for camps done. trained doctors

Training of doctors needed.

Trained doctors NSV camps are not available. Procurement of equipment.

Fund for Immediate Compensation Compensation disbursement of for female for sterilization incentive after sterilization is not sterilization available on camps. time at facility. Compensation Logistic planning is for male needed before sterilization organizing camps.

Block Health manager could be hire one support staff for disbursement for logistic support.

Immediate disbursement of incentive after sterilization camps.

Logistic planning is needed before organizing camps.

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Accreditation of private nursing home. As per GOB

Training of ANM & IUD camps Camps not held staff nurse for IUD insertion.

Procurement of IUD. No Equipments for Accreditation of accreditation of IUD insertion private providers private for IUD insertion providers for Accreditation of services IUD insertion private providers services for IUD insertion services. As per GOI guide lines.

Social marketing of need based OC & IUD. Monitoring of Social Increasing access Social Marketing Marketing is to contraceptive of contraceptives not monitored through by PHC. communities based distribution system free of cost.

seminars for MO and other through Contraceptive Professional Not being held. Update seminars bodies (FOGSI. BMA, Nursing association etc. on

Copper -t 380 -A 77 should be

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Awareness for emergency contraceptive.

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CHAPTER 4 NRHM PART”B”

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Issues Objective Gaps Strategy Activities

Asha To Strength 1. Training needed 2. Training support Asha and to Asha on needed to system deliver various model. Capacitate all Asha quality 2. unavailable of Asha to on various services at asha drug kit. better model. village level 3. lack of approach 3. motivatio motivation to at village nal Asha. level. package 4. lack of dress for those code. Asha who working best to motivate every month Asha.

4. Purchase s of Asha

drug kit. 5. Distributi on of Proper sharee to utilization of Asha Untied untied fund 1. problem Fund of at all level of Empowring under all level by HSC , utilizati giving APHC, PHC on of knowledge untied of use of

fund. untied Village fund. 1.workshop on utilization Sentisization 1.lack of knowledge of ANM of untied fund to ANM, MOIC. health and On VHSC. and PRI member about sanitation meaning of VHSC. committee 1. 2. Gap of utilization of fund of 1. Combined VHSC. meeting of ANM and PRI member at block level with

intervention of District.

2. work shop at Block level on VHSC.

3. Meeting

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Rogi Kalyan 1. lack of proper interest of 1.change of those member who Samiti. member in RKS meeting. are more than 2 year.

2. Gap of non functional of RKS 2.quarterly meeting of RKS at APHC level. member with DH in the presence of DM.

3.Regestration of RKS at APHC level.

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ISSUES OBJECTIVE GAPS STRATEG ACTIVITIES Y

Infrastructure To insure 1.out of 92 HSC Special 1. For 3 HSC stretching better only 34 are attention need new infrastructure having own toward building. for all level Building. those (HSC,APHC, facility 2. for 3 APHC 2.in existing 34 needed 3 PHC, RH,DH) where new building 10 are needed running in good building construction condition. to satart of Building. 3.lack of water 24*7 3. One RH facility Makhdumpur And electricity at for needed HSC. Delivery. Building. 4.lack of 4. one multiplex equipment building 5.There are 32 needed for APHC out of this DH. 11 having own 5. Renovation of building that those building needed whise needed renovation at any level( Lack of HSC,APHC,PH furniture and C,RH,DH) equipment at APHC level

6. 7 PHC needed land and new building for upgradation.

7. DH Hospital Needed new building for increase capacity

8.lack of Building for RH Makhdumpur to expand but availability of land over there.

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Contractual Manpower HR status.

Issues Objective Gaps Strategy Activities.

Block To 1. less salary Workshop and 1.BHM salary 18000/-,BAM salary programme strengthen structure training for both 12000/-,DPM salary3300/-,DPC Management HR and of all managerial and salary 30000/-,DAM salary 27000/-, staffs like Unit. capacitate to clinical personal. M&E Officer Salary 22500/- BHM, more quality BAM, And 10% increment every year. work and DPM, District maintain DPC,DAM, Programme Motivation M&E Officer, 2.clinical staffs salary should increase Management level ANM and 50%. unit. other clinical Other clinical staff. staffs and 2. lack of 3. selection of 67 ANM. doctors. manpowe r

4.selection and recruitment of 7 Training male workers. status of different 3.lack of staffs. training to all clinical staffs. 5.Selection of 45 MO.

4.ANM in 6. Selection of 41 Specialist. sanctioned 7. training to clinical and managerial 307 out of staffs. that 240 in position.

8.training calendar.

5.Doctors Sanctioned 144 out of that 99 in position.

Specialists sanctioned 51 out of that 10 in position.

6.training

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7.One accountant for DH, one Data Operator for DH.

8.10 system and 10 personal to establish centralize server.

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Indicators Objective Gaps Strategy Activities

AYUSH Doctors Bringing 1. Unavailable A separate Unit 1. procurement of Drug. Ayush of drug for should be therapy for Ayush. understand. 2. Need each people separate 2.Occupy building at all building for APHC for Ayush or Ayush. during construction of 3. No IEC building of APHC design display. for separate building for 4. Training for AYYUSH. Ayush Doctor.

3.Training for all AYUSH Doctor at District level with the help of state.

4. IEC display at all main place of villages, wall painting what the benefit of Ayush therapy.

5.A special meeting at village level with old peoples also involving villagers in the presence of PRI member in that Ayush doctor of that APHC will Involve.

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Indicators Objective Gaps Strategy Activities

Strengthen 1. Less Interest A separate 1.Need orientation Planning of all DPO important work to all officer about Decentralized Process. and all could be planning so that it officer in planning understand. could be Planning. understand 2. Unavailable of data for important part of planning. system. 3. No system DPC of communicat ion so that 2.There should be all made mandatory information of all Health of District related District could reach information could to DPC. also flow to DPC so 4. No assisting that Better Hand for data planning could be compilation done. and in collecting of data. 5. No vehicle 3.one data for data operator and one collection clerical staff and for needed for coordination planning process. . 6. less Salary of DPC. 4.one laptop For DPC with internet Data card with printer should be available.

5.one full time vehicle should be available for DPC so that in Coordination with all DPO, PHC and with other department could be done for convergence and 86

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6.One mobile phone needed to DPC for data collection and Communication.

7.Joint signatory Power to DPC with CS of Planning Budget so that according to need fund could used.

8. Salary of DPC should be 30000/- pm.

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CHAPTER 6 NRHM PART “D”

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Kala azar

Gaps Objective Strategy Activities

Poor Vector To coverage of control increase the DDT spray through coverage of insecticide DDT spray in spray in the endemic the attack zone , there area should be proper 1. Ensure planning for timely spray monitoring 1 of DDT in Feb-March and May-June for by the 40 days in each block supervisors, capacity building of the sprayer, supervisors and other healthcare professionals

Monitoring 2. Identification of Houses with Kala- of the azar patients by ANM & ASHA @ 50/ spraying per village. squad by MOIC 3. Two round of spraying scheduled in Feb-March and May-June should be strictly observed

4. DDT spray should be at the rate of 1gm/sq. meter upto the height of 6 feet.

Less time Training and Regular capacity building training on spent on capacity prescribed module for the sprayer to spraying building for ensure that very corner of the house is DDT proper properly spray up to height of six feet spraying from ground level.

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Poor Regular Fund allocation and timely release for : condition checking of maintanceof old sprayer pumps, of Sprayer, the spraying Purchase of new pumps and other pump and pumps for articles needed- buckets, mugs etc. nozzles etc better No of functioning Pumps and timely available- replacement 0, No of of the faulty pumps pieces. required- 30, No of bucket savailable- 70, No of buckets required- 70, No of gallon available- 21, No of gallon required- 49, No of pond measure available- 21, No of pond measure required- 49, .

Inadequate Making Ensure adequate Stock of DDT through stock of available proper & timely indenting to improve DDT, DDT DDT during the quality of spray available- spraying 9.5mt. round (Not required)

Faulty Appropriate Fund would be allocated for regular payment fund payment of wages (147 SFW to be plan allocation for used and 735 FW to be used for the payment monitoring and spraying work) of the

spraying of

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Poor rate of Early Case Increase efficiency of case detection case diagnosis detection through training of Community detection of and rate should workers on signs and symptoms of Kalazar treatment be increased Kala-azar: 1) three weeks persisten through with fever not responding to antibitics, PHC appropriate malaria being excluded, with palpable system diagnostic spleen. 2) Ensure availability of test aldehyde test at PHC level 3) Purchase of RK 39 kit for detection of Kalazar

Reduction Early 1. Ensuring availability of 2 of kala- diagnosis Amphotoricin at all level azar and

mortality treatment and through PHC Loss of wages for KZ patients(case morbidity system detection in year 2007-3275)

2. Replacing of medicines on priority based

3. Training of ANMs and ASHA for IM injection

Lack of Monitoring Preparation of Monthly visit plan for monitoring and supervision : and supervision - Checking spraying schedule supervision mechanism - For supervision & treatment follow mechanism, up

Office expenses

4 Lack of Increasing Community 1. Fund allocation for training activities appropriate awareness participation BCC & for in reducing 2. Identification of NGO/Private Community prevention mortality and partner as trainer

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Mobilization. of Kala- morbidity 3. Knowledge sharing with the azar due to Kala- community on signs and symptoms of azar Kala-azar through VHSC

4. Training of VHSC/PRI and community health worker on sign & symptom of Kala-azar

5. Regular monitoring of IEC activities

6. IEC activities through nukkad natak, kalajatha mass media like radio

7.Activity for survilence like polio survilence

8.Wall painting of Tretment protocole and provisions for pateints in PHC in Hindi.

IEC van for each PHC

Blindness issues Strategy Activities

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

Recruitment of Opthalmic Assistants on contractual basis.

Untrained staffs Capacity building Training of Doctors on IOL technique

Training of Opthalmic Assistant

Low achievement Increasing noof camps Organising Operations at District level

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Establishing another Cataract Operation Center at PHC Kako.

Purchase of equipments and medicines

Lackof awareness Awareness building Assigning LHV/Supervisor counseling work

Organising eye screening camps in villages/ schools

IEC on cataract and its facilities

Meeting with Local InvolvingNGOs NGOs onthis issue

Arrangement of carrying patients to the Operation Centers and then Lackof adequate referal Strengthening referal taking them back services system homes

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

Developing records of cataract cases from OPD registers at PHC level

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Gaps issues Strateg Activities y

· Existing PR of the district is 1.1 and the target is only 1, so the existing program performance is good.

Lack of Awarenes IEC on Leprosy • Lack of awareness is still a problem with Awarene s the Leprosy Program as most of the cases ss generatio are detected accidentally. n

• Inadequate staff, Only 6 supervisors and Lack of Staff Recruitment of 11 11 Non Medical Assistants are working while Human Recruitm supervisors the requirement of Supervisor is 17 and that Resourc ent in e of NMA is 33( One NMAeach in each APHC) contract basis

• There is no active involvement of the Strength Orientation of Mos Medical officers at sector and Block levels. en and staffs on Health Leprosy Care • Lack of PHC staff involvement. No Case validation, to Services manpower support, have check on wrong diagnosis and re registration

Prompt and early detection of the cases to avoid deformity and disability,

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

No lab testing facility in the district Infrastru Establish Establishing Lab at cture ing Lab district level

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Lack of monitoring at all level Monitori Increasin Updation of master ng Gap g register mobility Mobility support for DLO

Office expenses

Fileria

Gaps issue Strategy Activities s

It affects mainly the 1. Single dose DEC Line listing economically weaker sections of mass therapy once a of the communities year in identified blocks cases and selected DEC Purchse of treatment in filariasis equipments endemic areas. for the manageme nt of Filaria cases like towel, Bucket, soap, mug etc

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

Purchse of DEC

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Result in low priority being Meeting with VHSC accorded by governments for 2. Continuous use members the control of lymphatic of vector control filariasis. measures.

Detection and treatment of micro- Filaria carriers, treatment of acute Low effectiveness of the tools and chronic used by the control programme filariasis.

Wall paintings

4. IEC for ensuring community awareness and participation in vector control as well as personal protection The chronic nature of the disease measures.

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

District:- JEHANABAD. State :- BIHAR.

Name_ Dr. Vijay Kumar Singh, Designation_DTO ______

Section-A – General Information about the District

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

2 Urban population 102061

3 Tribal population -

4 Hilly population -

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

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

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

Does the district have a DTC Yes

ORGANIZATION OF SERVICES IN THE DISTRICT:

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

Govt NGO Govt NGO Private

1 DTC, Jehanabad. 681323 1 0 4 0 0

2 Ghosi 473222 1 0 4 0 0

DISTRICT 1154545 02 0 08 0 0

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RNTCP performance indicators:

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

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 Annualized tested for put on detection corresponding rate lakh pop) on HIV treatment rate (per quarters NSP CDR treatment (85%) lakh p op)

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

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

District 1191 501

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

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

1 Training Training of MO's

Training of ASHA, ANM worked in all PHC by STS

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

3 Supervision Vehicle Hiring for DTO & MO-TC

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

Civil Works

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

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

DTC 1 1 0

TUs 2 2 0

DMC 8 8 0

Total 15100.00 Laboratory Materials

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

(Rs.)

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

Purchase 150000.00 of Lab 67798.00 150000.00 Materials

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

(Rs.)

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

Honorarium 200000.00 20000.00 180000.00 We have for DOT 200000.00 planed to providers distribute the (both tribal recommended and non insentive to tribal DOT districts) Providers for cured / completed TB Patients.

Honorarium for DOT providers of Cat IV patients

Equipment Maintenance:

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

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

100

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

Binocular Microscopes ( 8 0.00 13500.00 RNTCP)

43500.00

Training:

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

(Rs.)

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

Training of

MOs

Training of 15000.00 LTs of DMCs-

Govt + Non Govt

Training of MPWs

Training of MPHS, pharmacists,

nursing

101

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Training of Comm Volunteers

Training of Pvt Practitioners

Other trainings #

Re- training 84 66 20 20 20 20 32000 of MOs

Re- Training 10 10 10 10 5000 20000.00 of LTs of DMCs

Re- Training 20000.00 of MPWs

Re- Training 10000.00 of MPHS

Re- Training of Pharmacists

Re- Training of nursing staff, BEO

Re- Training of CVs

Re-training 700 700 200 200 150 150 38000.00 of Pvt Practitioners

TB/HIV 10000.00 Training of MOs

102

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TB/HIV Training of STLS, LTs , MPWs, MPHS, Nursing Staff, Community Volunteers etc

TB/HIV Training of STS

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

Provision for 10000.00 Update Training at Various Levels(key staff & MO- PHIs)

Any Other 75000.00 75000.00 Training Activity( Key staff & MO- PHIs) # Please specify

103

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

(Rs.)

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

Four - - - - Wheelers

Two 02 02 19618.18 50000.00 50000.00 Wheelers

Vehicle Hiring:

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

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

For DTO 01 01 66184.00 143816 268800

For MO- 02 02 0.00 58800.00 TC

202616 268800

104

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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 remarks involved planned the planned for for the next in for this previous current financial RNTCP year 4 financial year for in the quarters year which plan district is being submitted

(Rs.)

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

ACSM Scheme: TB advocacy, communication, 0.00 and social mobilization

SC Scheme: Sputum

Collection Centre/s

Transport Scheme: Sputum Pick-

Up and Transport Service

DMC Scheme: Designated Microscopy Cum Treatment Centre (A & B)

LT Scheme: Strengthening RNTCP diagnostic services

105

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Adherence scheme: Promoting treatment adherence

Slum Scheme: Improving TB control in Urban Slums

Tuberculosis

Unit Model

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

TOTAL 0.00

106

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Activity* Amount Amou Expendit Estimated Justification/ permissi nt ure (in Expenditure for the remarks ble as spent Rs) next financial year per the in the planned for which plan is norms previ for being submitted in the ous 4 current district quart financial (Rs.) ers year

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

165000 8768 77319 165000 0

165000 * Please mention the main activities proposed to be met out through this h

Contractual Services:

Activity No. No. No. Amoun Expendi Estimated Justifi required actuall planned t spent ture (in Expenditure for catio as per the y to be in the Rs) the next n/ norms in prese additional previou planned financial year remar the district nt in ly hired s 4 for for which plan ks the during quarter current is being distric this year s financia submitted t l year (Rs.)

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

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

STS 02 02 00 172226 144000. 288000.00 .00 00

STLS 02 02 00 304284 120000. 288000.00 .00 00

TBHV 00 00 01 0.00 0.00 0.00

107

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Accountant 00 00 01 0.00 0.00 36000.00 – part time

Contractual 04 00 362801 187000. 480000.00 LT .00 00

96535 49562 1548000.00 9.00 5.00

Printing:

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

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

Printing* 100000.00 26936.0 73064.00 100000.00 0

* Please specify items to be printed

108

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Any Operational Research project planned (Yes)

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

Estimated Budget (to be approved by STCS).______

Medical Colleges

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

(a) (b) (c)

Contractual Staff: MO (In place: Yes/No) STLS (In place: Yes/No) LT (In place: Yes/No) TBHV (In place: Yes/No)

Research and Studies: Thesis of PG Student Operations Research*

Travel Expenses for attending STF/ZTF meetings

IEC: Meetings and CME planned

109

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

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

4-wheeler **

2-wheeler

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

Procurement of Equipment:

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

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

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

Any Other

110

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Section D: Summary of proposed budget for the district – Budget estimate for the coming FY 2011- 12

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

1 Civil works 15100.00

2 Laboratory materials 150000.00

3 Honorarium 200000.00

4 IEC/ Publicity 75000.00

5 Equipment maintenance 43500.00

6 Training 75000.00

7 Vehicle maintenance 50000.00

8 Vehicle hiring 268800.00

9 NGO/PP support 150000.00

10 Miscellaneous 165000.00

11 Contractual services 1548000.00

12 Printing 100000.00

13 Research and studies 0.00

14 Medical Colleges 0.00

15 Procurement –vehicles 0.00

16 Procurement – equipment 0.00

TOTAL 2840400.00

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

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

111

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 1) Information on previous year’s Annual Action Plan 2011-12 a) Budget proposed in last Annual Action Plan: 100000.00 b) Amount released by the state: 20000.00 c) Amount Spent by the district- 0.00 2) Permissible budget as per norm : 75000.00 3) Budget for next financial year for the district as per action plan detailed below: 75000.00

Program Challenge s to be WHY For WHAT When Monitori Budget WHO ng and tackled By by ACSM M Evaluati WHO on during ACSM ACSM Time M the Year Objective Activities Frame 2009 - 10 Targe t Audie nce

Q Q Q Q Key Total 1 2 3 4 imple expendit Based on Desired Activiti Media ment Outp Ou ure for er existing TB behavior es / uts; tc the and indicators or action o activity and (make Mater RNTC m P during analysis of SMART: ial es office Evid the communic specific, Requi : red r ence financial ation measurabl respo that year challenges e, nsible the for achievable activ Evi , realistic super vision ities de (Maximu & time have nc m 3 bound been e Challenge objectives done th s ) ) at it ha s be en eff ect ive

112

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Advocacy Activities

1.One Public 1.Me 1. No cost to one ation etin In involved Low Case Gaining District meetin s √ 1. g cr Detection Administr Magist Distri g Minu ea ative rate/ district PPT ct tes se support DHS Progr author - ref from ities am 2.Ph err Audio District Mana otog al authorities Visual gers raph of for Adds s ch increase - est referral 3. Poste 2. Rep sy from OPD Health rs- MOTC m Cost of 2.Sens orts and bookl ( with pt sensitiza itizatio √ other ets/br suppo o tion n depart ochur rt m meeting meetin 4. ment e from ati g Revi admini WHO c2 - ew strator Cons Pr 3. poste mee s ultant og Briefin r in ting ) ra Private g local by Cost of m Health meetin langu the commun √ m care gs age auth ication e provid oriti material 4. Da ers - es Progra Facts ta mme heets inform ation, -

succe 5. Cost of ss World Factsh storie √ TB Day eets s activities

6. World TB Day

113

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Communication Activities

To inform 1Gene Use of Bookl 1.De Cost of communiti ral region et, velo develop Low Case es and Public al / Flip ped 1.I ment of Distri Detection care cable Book, IPC nc material √ √ √ √ ct providers chann Poste Mate re including Progr about the els rs, rial as 2. am DOT Stick and e School Mana services ers, evid sel s gers for early Bann ence f Partici re detection 3. ers, MOTC of pate in po Develop Religio the Pamp pre us hlet, testi rti biannu ng bodies al Patie ng nt of / 4. health infor mat ref Care mela matio erial err provid n al er bookl 2.

et Flip book 2. s for An STS aly and sis CFs of 3. da Wall ta writi ngs 3. 4. KA Stoc P k st Regi ud ster y aft Awarenes Wall DTO, 1.Vis Cost of er s paintin ible wall on Generatio Genera g on √ MO- wall writings e n in l TB TC, pain yr general Public, MO, tings kn public school IEC at ow s, Office Sub th r cent e er 114

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. level aw ar en es Puppet Script DTO, Doc Cost of s shows, and Com ume hiring of lev street profe √ √ muni ntati professi el play ssion catio on/ onal of al n repo agency( ge group Facilit rt cost per ne s ator, play X ral STS, 2. no. of pu IEC Scri activities bli Office pt ) c. r, for stre NGO Partn et ers play s 3. Phot ogra phs

4. Scho ol quiz form at

News Adver DTO, Paper tisem Com Advert ent √ √ muni NEW Cost of S newspap iseme for catio nt news n pape ers paper Facilit r writings , ator, Clipp Letter STS, ings to IEC NEWs Office Paper r, Editor NGO . Partn ers

Social Mobilization

MO- Minu In Cost of TC, tes cr material Low Case 1.Generat Comm Comm Flip 115

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Detection e unity unity Chart √ √ √ √ IEC of ea + cost Awarenes Meetin and Office Meet se of s in Genera g Poste r, ings Se commun general l rs, Com lf ity public Public, Talks muni Displ re meeting Patient catio ay of po s total s, n Post rti number DOTs ers 2. Facilit ng of Provid ator, in meeting Encourage ers Flip early self STS Char ch s reporting t est planned sy 3. m Communit pt y Groups. o PRI m ati c

Celebr Displ DTO, Doc Pr Budgete ation ay MO- ume e- d above of Mater TC, ntati po World ial for MO, on st TB day World Com of l ev TB muni worl alu Day catio d TB ati n Day on Facilit activ of ator, ities W STS TB Da y act ivi tie s wit h sp eci fic ob jec tiv es

Exhibit displa DTO, Doc In Cost of ions y - ume cr Hiring of 116

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. /Mela’ Mater √ ntati ea place s / ial ( MO, on se and Popula Poste √Com of Se display r rs, munic activ lf material Events Stick ation ity re & cost in ers, Facilit po interacti Distric Bann ator, Writ rti ve t. ers, e ng games, Pamp ups of prizes hlet) / TB etc. brief pa used tie in Inter nt play s ( active s game KA s P st ud y aft er on e yr)

School Drawi Game DTO, Doc Pr Cost of Childre ng & s – Com ume e- one n Quiz Snak muni ntati po school Compe e and √ √ √ catio on st activity titions ladde n of int X no. of r, Facilit Activ er activities Chakr ator, ities/ ve planned aview STS, Phot nti in the Game IEC ogra on distict= etc. Office phs ev r, alu Pamp NGO ati hlets] Partn on IEC ers Mater ial

Colleg TB Game DTO, Doc Da 4000 e & Sessio s – Com ume ta School ns Snak muni ntati An NSS during e and catio on aly Studen NSS ladde n of sis caps r, Facilit Activ

117

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Challenge 2: High Default Rate (example 2)

Advocacy Activities

Sensitizin Audio g district Visual High authorities 1.Healt 1.Inter Adds Distri Revi Re Default about the h care action ct ew du Rate importanc provid Meetin - Progr of cti ers gs Poste am defa on e of reducing rs- Mana ult in Public 2.One bookl gers case de default & to One cases & ets/br TU fa Private Intera ochur wise ult for their MOTC ction e rat support Meetin for e gs - by necessary poste Reco instruction 3. Use rd of 2 r in % s to the of local mee Programm Inform tings - langu Da e staff ation age Bookle ta t - an Facts aly heets sis

- succe St ss ud storie y s to do cu

118

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Communication Activities

Patient Patie MO, Reco Re s, Sharin nt rds du High To Their g of intera √ √ √ √ STS of cti Default motivate & Family experi ction mee on Rate patients & Membe ence meeti Com ting in their muni rs, of ngs de families DOTs cured & catio fa for n Provid patient involv Evid ult completio ers s / emen facilit rat ence n of Patient t of ators e treatment of s cured mat by during perso erial 2

Treat ns deve % ment. - lopm ent An

Flip – aly sis Comm Chart √ √ √ √ MO- pre of unity Devel TC, testi pr TB opme STS, ng og Groups nt ANMs ra / NGOs Devel m

opme m nt of Incr e mater ease da ial for in ta Com no.

munit com y muni Re DOT ty du Provi base cti 119

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One Interp Patie MO, Evid Re Cost of to one ersona nt STS, ence du patient meetin l infor √ √ √ √ DOT of cti informat g with comm matio Provi such on ion the unicati n der mee in booklet patient on bookl ting de (if not with et fa budgete patient Patie ult d above) s nt s infor mati on (no cost book for one- let to one IPC)

Social Mobilization

High To link Sensiti DTO, Doc Re Cost of Default poor zation Poste MO ume du one Rate patient of rs, √ √ TC ntati cti meeting s to Depart progr on, on no of the ments amm Reco in meeting welfar Social e fact rds de s e welfar sheet , fa schem e , Phot ult es schem ogra s

es Prese phs ntatio

Annu Data al of Do 120

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. repor refer cu ts ral m of en TB tat patie ion nts t of sym eff pto ect mati ive c will ne incre ss ase of su ch lin ka ge s thr ou gh a st ud y aft er on e ye ar

For Comm Intera Infor For Cost of mobilizing unity ction matio mati such support suppor meetin n √ √ MO- on De meeting TC, cr from t gs mater of s Communit groups ial, STS, TB ea y groups Com supp se muni ort in catio th Cured grou n ps in e patient Facilit no s X ators no. . of of villa de ges fa ult s 121

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Challenge 3:-

Advocacy activities

Communication activities

Social Mobilization Activities

TOTAL

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CHAPTER 8 ANNEXURE

123

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DISTRIC HOSPITAL GAPS:

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

• Walls and floor needed tiles. • Through out repairing of blood bank building. • Water problem Plumbing. • Need lab renovation. • Need of some equipments as heamoglobinometer , foam some stationary item • There is gap of fund transfer to blood bank in charge for proper management of blood bank.

Gaps of District Hospitals:---

# Safety and security and Dignity ----1. there is need of patient privacy and during general OPD. 2. Free movement of patient attended in labor room and Gyne OT as needed guard for that to not inter in that area.

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

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

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

3. No fire safety.

# Administrative problem------

1. lack of written communication 2. Negligence to medical services. 3. Lack of ABC inventory system so needed one operator and one desktop with all accessories. 4. Lack of Drug . 5. Lack of HR department at District level. 6. Lack of Feed back system so need of one feedback department. 7. Lack of intercom phone connectivity so that one department and other staff could communicate with them so medical services should be insure properly. 8. Lack of central sterilization services department. 9. Lack of Regular Audit According to IPHS norms. Need quarterly audit after formation of Audit team. 10. Lack of tries area. 11. Lack of cafeteria. 12. Need of insect cacher . 13. Lack of management in Dietary services Delivery. 14. Lack of Laundry department. 15. Lack of hot water arrangement.

124

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Department Required Personal and Expected output . name

Filling and Record Need 10 personal ( in that 4 should be diploma in medical record + 4 maintains clerks and 2 fourth grade staff with 24*7). Department at district Hospital.

HR department for Need 2 Data operator 4 Clerks 2 Managers. Total of 8 personal team district which will work for entire district and proper use of human resource could be used as DPC could work as HR Head of Department as it is immense part of Planning.

Data Operator and TB, NLEP need one Data operator and one Accountant. Accountant to Department

Central Sterilization 4 personal for this department, they all will be master in sertization service Department for District Hospital.

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

Sanctioned Current working Vacant position

ANM 307 240 67

144 99 45

SPECIALIST 51 10 41

125

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ANNEXURE “B ” Training required for MO.

Facility Name Lsas Emoc Mtp Nssk f- Imnci Mini- Laproscopy Nsv Iucd Ot imnci lap he rs

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

RH 4 4 4 4 4 4 4 4 4 4 Makhdumpu r

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

PHC 2 2 2 2 2 2 2 2 2 2 Hulasganj

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

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

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

Total 21 21 21 21 21 21 19 19 21 21

Training Required to ANM.

Facility Name NSSK SBA IMCI IUCD OTHERS

PHC okari 9 6 9 9

PHC Sadar 9 6 9 9

PHC Kako 4 4 4 5

PHC Hulasganj 4 4 4 4

PHC Ratni 3 1 3 3

RH Makhdumpur 8 8 8 8

District Hospital 9 9 9 9

HSC OF all District 100 39 100 100

Total 146 77 146 147

126

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127

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

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

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

Apr-2010 Makhdumpur 5601 259 152 11 181 20 348 425 3003 1.60% 372 Ratni Apr-2010 5103 101 91 21 151 2 37 321 1558 1.60% 210 Faridpur

Apr-2010 Hulashganj 3074 183 80 7 346 18 17 179 1171 0.83% 117 Okari / Apr-2010 2170 67 46 11 134 15 84 189 1138 0.48% 134 Modanganj Jehanabad Apr-2010 6028 7 0 11 0 7 12 441 2329 0.77% 240 Block

Apr-2010 District 40420 2861 1312 154 2166 108 926 2338 13399 1.00% 1926 May- Jehanabad 8569 1564 637 93 903 7 174 224 946 1.83% 321 2010 Sadar May- Kako 5087 79 71 14 119 7 44 453 1808 1.48% 246 2010 May- Ghosi 4741 157 79 29 258 10 111 247 1150 0.70% 147 2010 May- Ghosi Refral 2914 101 33 3 203 4 91 2010 May- Makhdumpur 6765 314 186 4 282 17 409 523 2857 1.11% 328 2010 May- Ratni 4899 99 62 28 173 4 66 357 1342 1.25% 167 2010 Faridpur May- Hulashganj 3487 245 80 7 409 9 16 224 902 0.48% 121 2010 May- Okari / 2475 97 63 16 178 0 132 235 1087 1.36% 114 2010 Modanganj May- Jehanabad 8353 17 0 15 0 17 17 486 2150 1.54% 193 2010 Block May- District 47290 2673 1211 209 2525 75 1060 2749 12242 1.17% 1637 2010

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

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

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

Jul-2010 Makhdumpur 8879 410 247 2 259 29 537 610 2703 2.29% 707 Ratni Jul-2010 4873 124 103 38 233 10 85 292 1395 0.39% 367 Faridpur

Jul-2010 Hulashganj 3645 232 115 6 518 36 17 244 1156 0.91% 223 Okari / Jul-2010 5934 99 59 28 176 15 44 213 1122 0.87% 226 Modanganj Jehanabad Jul-2010 9084 26 0 12 0 27 17 526 2252 1.15% 403 Block

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

129

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. New Name of Referred Family General New Born Month OPD Indoor Delivery Emergency Mother Child Polio Born Polio PHC/Hospital Case Planning Operation Childs Childs Aug- Jehanabad 11359 2186 1090 106 957 3 176 263 964 2010 Sadar Aug- Kako 4307 134 129 14 193 5 51 421 1559 2010 Aug- Ghosi 6647 225 159 28 318 8 323 262 1181 2010 Aug- Ghosi Refral 3703 116 64 3 206 3 161 2010 Aug- Makhdumpur 8642 511 355 18 211 15 523 507 2529 2010 Aug- Ratni 7362 153 147 25 306 4 88 363 1428 2010 Faridpur Aug- Hulashganj 4263 257 173 4 466 15 17 228 1090 2010 Aug- Okari / 6631 140 120 25 198 6 82 195 1153 2010 Modanganj Aug- Jehanabad 7279 11 0 8 0 13 17 475 2102 2010 Block Aug- District 60193 3733 2237 231 2855 72 1438 2714 12006 2010 Sep- Jehanabad 5974 1345 876 78 808 0 0 149 1150 1.30% 811 2010 Sadar Sep- Kako 5252 170 164 17 202 6 52 268 2126 0.91% 919 2010 Sep- Ghosi 6432 213 162 22 299 20 253 224 1507 0.49% 617 2010 Sep- Ghosi Refral 939 103 60 3 245 8 58 2010 Sep- Makhdumpur 8187 511 352 2 203 50 478 451 2918 0.43% 1346 2010 Sep- Ratni 6148 160 133 32 260 9 66 353 1525 0.91% 783 2010 Faridpur Sep- Hulashganj 3615 319 225 0 483 20 21 234 911 0.91% 524 2010 Sep- Okari / 4174 119 108 26 186 8 97 200 1243 0.91% 475 2010 Modanganj Sep- Jehanabad 7085 0 0 0 0 0 0 82 513 1.36% 871 2010 Block

130

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

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

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

Oct-2010 Makhdumpur 7529 526 369 5 246 54 486 367 2936 Ratni Oct-2010 8955 164 146 46 266 6 69 246 1723 Faridpur

Oct-2010 Hulashganj 3101 259 206 4 520 29 20 149 1258 Okari / Oct-2010 2935 148 122 43 194 14 47 151 1317 Modanganj Jehanabad Oct-2010 3895 24 0 0 0 25 6 424 2782 Block

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

2010 Sadar Nov- Kako 2010 Nov- Ghosi 2010 Nov- Ghosi Refral 2010 Nov- Makhdumpur 2010 Nov- Ratni

2010 Faridpur Nov- Hulashganj 2010 Nov- Okari /

2010 Modanganj Nov- Jehanabad

2010 Block

131

2010 Sadar Dec- Kako 2010 Dec- Ghosi 2010 Dec- Ghosi Refral 2010 Dec- Makhdumpur 2010 Dec- Ratni

2010 Faridpur Dec- Hulashganj 2010 Dec- Okari /

2010 Modanganj Dec- Jehanabad

2010 Block Dec- District 2010 Jehanabad Jan-2011 Sadar

Jan-2011 Kako

Jan-2011 Ghosi

Jan-2011 Ghosi Refral

Jan-2011 Makhdumpur Ratni Jan-2011 Faridpur

Jan-2011 Hulashganj Okari / Jan-2011 Modanganj Jehanabad Jan-2011 Block

132

Jan-2011 District Feb- Jehanabad

2011 Sadar Feb- Kako 2011 Feb- Ghosi 2011 Feb- Ghosi Refral 2011 Feb- Makhdumpur 2011 Feb- Ratni

2011 Faridpur Feb- Hulashganj 2011 Feb- Okari /

2011 Modanganj Feb- Jehanabad

2011 Block Feb- District 2011 Mar- Jehanabad

2011 Sadar Mar- Kako 2011 Mar- Ghosi 2011 Mar- Ghosi Refral 2011 Mar- Makhdumpur 2011 Mar- Ratni

2011 Faridpur Mar- Hulashganj 2011 Mar- Okari /

2011 Modanganj

133

2011 Block Mar- District 2011 Jehanabad MONTHS 60130 12385 5736 600 6411 44 1063 1380 7945 2105 Sadar

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

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

MONTHS Ghosi Refral 17702 695 313 17 1529 29 758

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

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

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

Okari / MONTHS 27519 754 581 197 1209 58 660 1392 8300 949 Modanganj Jehanabad MONTHS 48057 99 0 54 0 103 79 3003 14585 1707 Block

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

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New New Sl. Name of Referred Family General Month OPD Indoor Delivery Emergency Mother Child Polio Born Polio Born No. PHC/Hospital Case Planning Operation Childs Childs

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

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

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

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

4 Apr-2009 Makhdumpur 4937 260 172 10 302 27 405 392 3094 1.56% 433 Ratni 5 Apr-2009 2198 118 110 29 201 1 54 219 2527 0.38% 226 Faridpur

6 Apr-2009 Hulashganj 2596 94 66 1 375 18 50 121 1255 1.11% 142 Okari / 7 Apr-2009 1111 206 186 12 173 8 47 149 939 1.07% 151 Modanganj Jehanabad 8 Apr-2009 3825 0 12 0 13 7 301 2663 1.62% 274 Block

9 Apr-2009 District 29538 2555 1139 137 2113 131 976 1636 15630 1.12% 2016 May- Jehanabad 1 9220 1585 478 64 884 20 305 158 1176 2.58% 326 1.33% 217 2009 Sadar May- 2 Kako 2919 106 73 22 203 33 78 272 1758 0.38% 434 0.71% 165 2009 May- 3 Ghosi 3148 58 41 26 183 7 107 229 2111 0.38% 303 1.03% 147 2009 May- 3 Ghosi Refral 2227 80 25 5 160 17 101 2009 May- 4 Makhdumpur 5970 312 140 4 304 93 420 415 3214 1.25% 603 1.07% 241 2009 May- Ratni 5 1966 123 112 25 225 0 64 204 2451 0.67% 289 1.54% 147 2009 Faridpur May- 6 Hulashganj 3128 163 67 11 495 54 87 139 1420 1.11% 248 0.40% 89 2009 May- Okari / 7 1682 78 56 9 81 0 47 138 1269 0.74% 213 1.72% 92 2009 Modanganj 8 May- Jehanabad 4397 0 15 0 27 9 324 2603 0.37% 338 0.77% 174

135

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2009 Block

May- 9 District 34657 2505 992 181 2535 251 1218 1879 16002 0.97% 2754 1.09% 1272 2009 Jun- Jehanabad 1 11123 1628 519 60 1012 10 245 205 1000 1.33% 258 2009 Sadar Jun- 2 Kako 3488 98 94 29 181 4 76 329 1463 1.03% 232 2009 Jun- 3 Ghosi 5688 89 57 10 205 9 111 227 2183 0.38% 189 2009 Jun- 3 Ghosi Refral 2991 55 28 5 130 3 95 2009 Jun- 4 Makhdumpur 7266 315 144 18 379 47 354 402 2728 1.00% 300 2009 Jun- Ratni 5 2491 113 100 45 269 5 64 266 2110 0.74% 207 2009 Faridpur Jun- 6 Hulashganj 4149 228 64 12 596 49 77 192 1089 0.74% 124 2009 Jun- Okari / 7 2591 157 129 5 136 3 13 108 1081 1.07% 136 2009 Modanganj Jun- Jehanabad 8 7087 0 12 3 9 8 385 2588 0.74% 201 2009 Block Jun- 9 District 46874 2683 1135 196 2911 139 1043 2114 14242 0.89% 1647 2009 Jehanabad 1 Jul-2009 12086 1771 717 67 886 33 235 254 1070 1.33% 258 Sadar

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

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

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

4 Jul-2009 Makhdumpur 7789 345 220 9 391 16 418 629 3392 1.00% 300 Ratni 5 Jul-2009 2825 148 129 49 280 0 73 367 2509 0.74% 207 Faridpur

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

136

Okari / 7 Jul-2009 2666 163 126 9 113 7 40 221 1641 1.07% 136 Modanganj Jehanabad 8 Jul-2009 7776 0 17 0 34 0 496 2929 0.74% 201 Block

9 Jul-2009 District 51629 2959 1505 217 2801 140 1073 2869 17502 0.89% 1647 Aug- Jehanabad 1 12349 2098 917 37 867 15 237 228 1056 1.25% 399 2009 Sadar Aug- 2 Kako 4081 154 129 13 214 54 65 246 1456 1.11% 367 2009 Aug- 3 Ghosi 4888 176 110 19 275 9 77 215 2139 0.00% 311 2009 Aug- 3 Ghosi Refral 3531 100 57 5 186 7 101 2009 Aug- 4 Makhdumpur 7400 449 295 17 480 51 448 401 3080 1.38% 525 2009 Aug- Ratni 5 2978 204 181 34 294 25 60 234 2034 0.38% 301 2009 Faridpur Aug- 6 Hulashganj 4532 199 117 10 501 22 54 198 1468 1.07% 193 2009 Aug- Okari / 7 2708 142 88 20 184 7 29 201 1218 0.43% 242 2009 Modanganj Aug- Jehanabad 8 7148 0 4 0 56 3 407 2970 1.33% 367 2009 Block Aug- 9 District 49615 3522 1894 159 3001 246 1074 2130 15421 0.92% 2705 2009 Sep- Jehanabad 1 9350 2059 991 56 902 46 190 226 1366 2.12% 608 2009 Sadar Sep- 2 Kako 3262 198 160 12 285 66 52 241 1569 0.74% 461 2009 Sep- 3 Ghosi 3748 138 106 23 222 11 49 215 2412 0.42% 331 2009 Sep- 3 Ghosi Refral 2580 102 62 7 157 13 105 2009 Sep- 4 Makhdumpur 5098 559 373 22 561 51 420 527 3426 1.13% 669 2009 Sep- Ratni 5 1753 290 265 31 325 20 47 239 2133 1.48% 339 2009 Faridpur

137

Sep- 6 Hulashganj 2930 220 160 6 437 15 57 188 1783 0.80% 233 2009 Sep- Okari / 7 1739 135 99 26 181 13 23 165 1396 0.80% 239 2009 Modanganj Sep- Jehanabad 8 5398 0 13 0 71 7 395 2852 0.40% 410 2009 Block Sep- 9 District 35858 3701 2216 196 3070 306 950 2196 16937 1.05% 3290 2009 Jehanabad 1 Oct-2009 8014 2255 1202 66 757 71 247 177 1805 Sadar

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

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

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

4 Oct-2009 Makhdumpur 6578 693 440 19 607 98 487 353 3021 Ratni 5 Oct-2009 1862 326 286 17 362 32 34 207 1817 Faridpur

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

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

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

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

Nov- Jehanabad 1 7705 2513 1146 57 636 95 239 205 1558 1.61% 692 2009 Sadar

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

138

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

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

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

Nov- Ratni 5 2036 330 262 24 360 89 47 182 1711 1.86% 775 2009 Faridpur

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

Nov- Okari / 7 1833 173 108 14 146 75 21 106 1296 1.82% 433 2009 Modanganj

Nov- Jehanabad 8 5862 0 0 0 153 7 228 2742 3.55% 770 2009 Block

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

Dec- Jehanabad 1 7786 2287 989 57 599 104 196 176 1717 1.54% 473 2009 Sadar

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

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

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

139

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

Dec- Ratni 5 2216 269 240 23 288 50 38 162 1795 1.27% 314 2009 Faridpur

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

Dec- Okari / 7 2164 162 78 1 136 23 20 99 1586 1.11% 226 2009 Modanganj

Dec- Jehanabad 8 6304 0 0 0 133 20 269 3023 1.47% 378 2009 Block

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

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

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

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

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

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

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

140

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

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

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

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

Feb- Jehanabad 1 7442 2456 824 27 313 72 224 176 1124 1.20% 382 2010 Sadar

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

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

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

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

Feb- Ratni 5 2420 207 176 12 204 30 38 188 1752 1.00% 209 2010 Faridpur

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

Feb- Okari / 7 1903 126 82 11 110 41 53 90 1432 0.95% 143 2010 Modanganj

141

Feb- Jehanabad 8 5517 92 0 0 0 92 13 264 2673 0.91% 273 2010 Block

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

Mar- Jehanabad 1 7653 2711 857 69 921 60 212 181 1339 2.86% 394 2010 Sadar

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

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

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

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

Mar- Ratni 5 2005 166 140 14 226 41 45 306 1678 0.77% 282 2010 Faridpur

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

Mar- Okari / 7 2337 110 86 20 146 21 42 153 1164 2.41% 183 2010 Modanganj

Mar- Jehanabad 8 6244 68 0 12 1 69 18 408 2590 0.83% 351 2010 Block

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

142

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

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

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

3 MONTHS Ghosi Refral 29353 934 480 49 1706 162 1009

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

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

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

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

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

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

143

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Gener New Sl. Name of Referred Family al Indoor Delivery Emergency Mother Child Polio Born No. Month OPD Case Planning Operat PHC/Hospital Childs ion 1 Apr-2008 Jehanabad Sadar 8167 2262 455 47 753 29 332 54 995 1.78% 250 2 Apr-2008 Kako 2172 97 74 7 213 28 35 17 2069 1.03% 216 3 Apr-2008 Ghosi 4656 99 84 23 353 8 65 210 1688 0.38% 169 4 Apr-2008 Makhdumpur 4516 209 140 16 280 14 270 296 3202 1.48% 314 5 Apr-2008 Ratni Faridpur 1479 31 54 39 148 20 64 152 2966 1.60% 176 6 Apr-2008 Hulashganj 2018 46 46 6 330 19 34 198 1625 0.80% 108 Okari / 7 Apr-2008 1809 74 47 15 129 15 66 347 1110 0.40% 119 Modanganj 8 Apr-2008 Jehanabad Block 1850 0 20 24 178 2643 1.54% 179 9 Apr-2008 District 26667 2818 900 153 2206 153 890 1452 16298 1.07% 1531 May- 1 Jehanabad Sadar 10509 2346 404 43 836 6 385 85 1036 1.78% 2008 May- 2 Kako 3420 127 81 22 217 12 70 297 2072 1.03% 2008 May- 3 Ghosi 6432 101 63 33 353 7 126 273 2362 0.38% 2008 May- 4 Makhdumpur 5681 221 143 18 304 16 319 744 3643 1.48% 2008 May- 5 Ratni Faridpur 2052 91 74 20 161 13 85 232 2654 1.60% 2008 May- 6 Hulashganj 2637 60 60 7 416 34 47 342 1969 0.80% 2008 May- Okari / 7 2813 68 39 21 104 8 100 187 1317 0.40% 2008 Modanganj May- 8 Jehanabad Block 1869 0 9 27 310 2847 1.54% 2008

144

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Gener New Sl. Name of Referred Family al Indoor Delivery Emergency Mother Child Polio Born No. Month OPD Case Planning Operat PHC/Hospital Childs ion May- 9 District 35413 3014 864 164 2391 105 1159 2470 17900 1.07% 2008 1 Jun-2008 Jehanabad Sadar 10719 1953 400 43 732 10 337 238 648 0.97% 289 2 Jun-2008 Kako 3900 117 93 11 248 21 53 394 1575 1.07% 273 3 Jun-2008 Ghosi 6402 106 64 28 340 26 109 532 1134 1.03% 168 4 Jun-2008 Makhdumpur 6044 241 149 15 280 17 309 1267 3108 1.07% 391 5 Jun-2008 Ratni Faridpur 2434 78 59 24 140 16 63 310 2579 0.37% 229 6 Jun-2008 Hulashganj 2770 60 60 9 436 13 51 367 1651 0.74% 147 Okari / 7 Jun-2008 2861 71 37 19 108 12 84 379 1438 0.71% 146 Modanganj 8 Jun-2008 Jehanabad Block 2300 2 26 19 686 2768 1.67% 251 9 Jun-2008 District 37430 2626 864 149 2284 141 1025 4173 14901 0.95% 1894 1 Jul-2008 Jehanabad Sadar 12254 2504 573 40 952 8 304 273 1020 2.40% 306 2 Jul-2008 Kako 3804 114 108 10 191 7 76 551 1329 1.07% 219 3 Jul-2008 Ghosi 3659 113 75 21 169 0 47 736 1455 0.74% 136 3 Jul-2008 Ghosi Refral 3454 75 33 8 151 11 94 4 Jul-2008 Makhdumpur 7855 316 197 14 350 14 386 1198 2591 0.83% 337 5 Jul-2008 Ratni Faridpur 3013 99 78 32 177 4 71 473 1851 0.83% 191 6 Jul-2008 Hulashganj 3958 123 84 9 490 14 72 359 1242 1.38% 117 Okari / 7 Jul-2008 3105 73 52 23 114 11 72 51 944 0.00% 137 Modanganj 8 Jul-2008 Jehanabad Block 2552 0 9 31 568 2623 1.07% 243

145

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Gener New Sl. Name of Referred Family al Indoor Delivery Emergency Mother Child Polio Born No. Month OPD Case Planning Operat PHC/Hospital Childs ion 9 Jul-2008 District 43654 3417 1200 157 2594 78 1153 4209 13055 1.04% 1686 Aug- 1 Jehanabad Sadar 12225 2771 799 62 1059 27 306 195 896 2.40% 2008 Aug- 2 Kako 4427 148 135 40 234 48 101 539 890 1.07% 2008 Aug- 3 Ghosi 4013 78 80 12 164 19 712 1766 0.74% 2008 Aug- 3 Ghosi Refral 3581 99 37 16 137 41 53 2008 Aug- 4 Makhdumpur 10360 472 308 32 485 56 457 1113 2590 0.83% 2008 Aug- 5 Ratni Faridpur 3203 164 131 40 240 16 60 672 1498 0.83% 2008 Aug- 6 Hulashganj 3425 216 123 12 521 51 67 409 949 1.38% 2008 Aug- Okari / 7 2882 620 78 26 161 27 79 271 717 0.00% 2008 Modanganj Aug- 8 Jehanabad Block 4542 0 46 19 1044 2495 1.07% 2008 Aug- 9 District 48658 4568 1691 240 3001 312 1161 4955 11801 1.04% 2008 1 Sep-2008 Jehanabad Sadar 14777 3441 909 44 975 21 195 208 1092 1.15% 647 2 Sep-2008 Kako 5219 244 218 43 257 70 73 303 1184 0.80% 896 3 Sep-2008 Ghosi 4949 119 112 13 209 70 344 1540 0.40% 610 3 Sep-2008 Ghosi Refral 3888 127 54 13 130 46 50 4 Sep-2008 Makhdumpur 11393 552 404 15 558 72 721 893 2930 0.38% 1210 5 Sep-2008 Ratni Faridpur 3465 200 159 26 253 33 60 622 1718 1.07% 677

146

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Gener New Sl. Name of Referred Family al Indoor Delivery Emergency Mother Child Polio Born No. Month OPD Case Planning Operat PHC/Hospital Childs ion 6 Sep-2008 Hulashganj 3862 253 166 9 596 73 74 295 926 1.11% 387 Okari / 7 Sep-2008 3385 178 109 30 193 42 81 307 584 0.42% 474 Modanganj 8 Sep-2008 Jehanabad Block 3824 0 96 15 917 2384 1.11% 721 9 Sep-2008 District 54762 5114 2131 193 3171 453 1339 3889 12358 0.82% 5622 1 Oct-2008 Jehanabad Sadar 11490 3972 1078 67 957 29 163 200 1495 1.15% 2 Oct-2008 Kako 4203 254 193 25 276 68 98 372 1859 0.80% 3 Oct-2008 Ghosi 3753 145 143 17 235 48 224 2064 0.40% 3 Oct-2008 Ghosi Refral 3145 139 64 4 195 51 112 4 Oct-2008 Makhdumpur 7676 669 561 8 640 57 525 532 3182 0.38% 5 Oct-2008 Ratni Faridpur 3411 239 218 19 312 32 76 541 2549 1.07% 6 Oct-2008 Hulashganj 3814 187 155 8 485 46 60 211 1404 1.11% Okari / 7 Oct-2008 2560 252 151 7 215 34 58 298 1340 0.42% Modanganj 8 Oct-2008 Jehanabad Block 3617 0 30 100 29 686 3272 1.11% 9 Oct-2008 District 43669 5857 2563 185 3315 417 1169 3064 17165 0.82% 1 Nov-2008 Jehanabad Sadar 11482 3390 914 47 760 73 252 176 1590 1.38% 642 2 Nov-2008 Kako 3570 284 231 13 316 54 142 421 1604 0.38% 811 3 Nov-2008 Ghosi 3268 121 129 10 191 59 226 1933 0.77% 606 3 Nov-2008 Ghosi Refral 2571 93 29 16 120 35 34 4 Nov-2008 Makhdumpur 6956 548 456 9 524 98 427 496 3414 0.97% 1200 5 Nov-2008 Ratni Faridpur 2280 308 313 25 383 45 73 489 2200 1.07% 642

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Gener New Sl. Name of Referred Family al Indoor Delivery Emergency Mother Child Polio Born No. Month OPD Case Planning Operat PHC/Hospital Childs ion 6 Nov-2008 Hulashganj 3356 176 135 1 318 38 60 174 1295 0.74% 407 Okari / 7 Nov-2008 2215 188 136 18 187 44 109 210 1042 0.74% 451 Modanganj 8 Nov-2008 Jehanabad Block 5597 0 30 88 12 540 2844 0.71% 856 9 Nov-2008 District 41295 5108 2343 169 2799 475 1168 2732 15922 0.86% 5615 1 Dec-2008 Jehanabad Sadar 11716 3496 949 51 637 90 280 189 1754 1.72% 454 2 Dec-2008 Kako 3294 300 213 13 262 114 121 481 1933 1.49% 588 3 Dec-2008 Ghosi 3032 90 83 18 180 18 42 260 1988 0.36% 387 3 Dec-2008 Ghosi Refral 2856 144 54 5 154 71 70 4 Dec-2008 Makhdumpur 7135 633 422 9 502 141 435 558 3897 1.33% 743 5 Dec-2008 Ratni Faridpur 2156 304 211 24 317 142 53 432 2247 1.29% 466 6 Dec-2008 Hulashganj 3308 230 139 1 429 93 86 214 1430 1.33% 317 Okari / 7 Dec-2008 1782 204 161 12 189 96 112 195 1340 1.07% 291 Modanganj 8 Dec-2008 Jehanabad Block 6248 0 23 1 143 16 519 3123 0.38% 534 9 Dec-2008 District 41527 5401 2232 156 2671 908 1215 2848 17712 1.14% 3780 1 Jan-2009 Jehanabad Sadar 5804 2790 663 29 450 20 51 39 559 2 Jan-2009 Kako 2755 230 130 8 186 109 75 415 765 3 Jan-2009 Ghosi 1182 111 79 3 128 51 11 120 1826 3 Jan-2009 Ghosi Refral 653 52 32 3 118 39 26 4 Jan-2009 Makhdumpur 2314 527 326 7 389 129 304 387 1703 5 Jan-2009 Ratni Faridpur 1839 293 187 20 228 88 49 352 1510

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Gener New Sl. Name of Referred Family al Indoor Delivery Emergency Mother Child Polio Born No. Month OPD Case Planning Operat PHC/Hospital Childs ion 6 Jan-2009 Hulashganj 2268 179 96 1 280 171 54 157 1171 Okari / 7 Jan-2009 1329 163 87 12 93 82 38 139 846 Modanganj 8 Jan-2009 Jehanabad Block 2290 0 1 0 52 0 122 1049 9 Jan-2009 District 20434 4345 1600 84 1872 741 608 1731 9429 1 Feb-2009 Jehanabad Sadar 10383 2929 641 41 457 65 100 143 1390 5.28% 388 2 Feb-2009 Kako 2820 217 126 8 177 94 70 345 2383 0.69% 446 3 Feb-2009 Ghosi 1998 87 66 9 133 33 19 368 2270 0.38% 324 3 Feb-2009 Ghosi Refral 1428 44 32 3 96 18 25 4 Feb-2009 Makhdumpur 4074 570 363 11 421 162 367 606 3516 1.03% 647 5 Feb-2009 Ratni Faridpur 1786 260 159 26 239 89 50 340 2437 0.71% 381 6 Feb-2009 Hulashganj 2119 124 83 1 290 89 25 166 1552 0.38% 213 Okari / 7 Feb-2009 1559 185 122 10 121 61 34 224 1367 1.61% 251 Modanganj 8 Feb-2009 Jehanabad Block 4043 0 3 0 172 2 393 2995 0.94% 421 9 Feb-2009 District 30210 4416 1592 112 1934 783 692 2585 17910 1.52% 3071 1 Mar-2009 Jehanabad Sadar 10529 2774 621 56 709 54 152 206 1351 1.82% 328 2 Mar-2009 Kako 2263 143 120 13 171 38 78 344 1540 0.75% 276 3 Mar-2009 Ghosi 3420 99 66 16 145 14 46 366 1907 0.36% 186 3 Mar-2009 Ghosi Refral 2040 45 27 5 104 18 78 4 Mar-2009 Makhdumpur 5594 380 254 6 341 62 405 767 3326 1.56% 433 5 Mar-2009 Ratni Faridpur 2030 165 119 33 208 31 58 405 1789 0.38% 226

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Gener New Sl. Name of Referred Family al Indoor Delivery Emergency Mother Child Polio Born No. Month OPD Case Planning Operat PHC/Hospital Childs ion 6 Mar-2009 Hulashganj 2907 109 77 4 376 70 86 226 1382 1.11% 142 Okari / 7 Mar-2009 1548 189 133 17 149 36 52 287 1395 1.07% 151 Modanganj 8 Mar-2009 Jehanabad Block 4946 0 3 0 104 7 510 2394 1.62% 274 9 Mar-2009 District 35277 3904 1417 153 2203 427 962 3111 15084 1.12% 2016 1 MONTHS Jehanabad Sadar 130055 34628 8406 570 9277 432 2857 2006 13826 3304 2 MONTHS Kako 41847 2275 1722 213 2748 663 992 4479 19203 3725 3 MONTHS Ghosi 70380 2087 1406 276 3805 487 1203 4371 21933 2586 4 MONTHS Makhdumpur 79598 5338 3723 160 5074 838 4925 8857 37102 5275 5 MONTHS Ratni Faridpur 29148 2232 1762 328 2806 529 762 5020 25998 2988 6 MONTHS Hulashganj 36442 1763 1224 68 4967 711 716 3118 16596 1838 Okari / 7 MONTHS 27848 2265 1152 210 1763 468 885 2895 13440 2020 Modanganj 8 MONTHS Jehanabad Block 43678 0 2 90 1 865 201 6473 31437 3479 9 MONTHS District 458996 50588 19397 1915 30441 4993 12541 37219 179535 25215

150

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National Rural Health Mission

Strategy & Activity Plan with budget

Name of the State/ UT:_JEHANABAD______S Activity Plan Budget Plan r. STRATEGIES 2010- 2011-2012 FY 2010-2011 FY 2011-2012 FY 2012 N Code Output Output

(only at 2011FY

151

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E} = BP BP = E} ± ± ± ± Rem arks (other than NRHM source) than (otherNRHM advance vity Executed (Y) Executed vity than than planned) {Z+(X~Y)} =AP to to be adopted) Variance(X~Y) NOVEMBER 2010)NOVEMBER budget for 2011-12budget {(AP {(AP x A) Activity planned (X) Activity planned time line of activities activities time of line Acti Reasons forReasons Variance Tentative Cost (A) Unit Budget Planned {X xPlanned Budget = (A)} B Budget utilised {Y x (A)} = D (UPTO (UPTO x utilised = (A)} {Y D Budget Activity planned including previous yrsprevious gap including Activity planned Budget Planned (including spill amount) (including Planned over Budget Budgetary Source under or over-utilised Budget {(B~D} or over-utilisedunder Budget Budget received B or C or B C received Budget Special efforts to overcome constraints (Process (Process overcome constraints Special efforts to 1 2 3 5 6 8 9 11 12 13 15

Q Q Q Q 1 2 3 4

152

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. A.1 .1 1.1Operation alise facilities (disseminati on, monitoring & quality) (details of infrastructur e & human resources, training, IEC / BCC, equipment, drug and supplies in relevant sections) A.1 1.1.1 RS. .1. Operationali 4725 N 1 se Block 34 68 78 6840 2114 4725 3256 3256 R PHCs/ 2 2 0 20 40 (PR 00 22 78 578 578 H CHCs/ 00 00 EV.Y M SDHs/ EAR DHs as )

153

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A.1 1.1.1 .1. Operationali 1.1 se FRUs (Diesel, Service Maintenance Charge, 0 Misc. & Other costs) 1.1.1.1 Operationali se Blood Storage units in FRU

154

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. A.1 1.1.2 NO .1. Operationali ANY 2 se 24x7 WO PHCs RKS (Organise HOP workshops FOR on various THE aspects of FINA operationali NCI sation of AL 24x7 YEA services at N R 25 the facilities 200, 200, R 2010 0 8 8 ,0 0 0 0 @ Rs. 000 000 H -11 , 00 25,000 / year M DIST / district) RIC T & BLO CK LEV EL WO RKS HOP (24X 7)

155

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A.1 MTP .1. services at 0

156

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 3 health facilities A.1 RTI/STI .1. srvices at 0 4 health facilities A.1 Operationali 3 .1. se Sub- A 5 centres P H N NE 20 C 1200 1200 R W 6 6 00 0 0 0 0 & 000 000 H PLA 00 3 M N H S C A.1 1.2 Referral .2 Transport 0

157

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. A.1 1.2.1. To .2. develop 1 guidelines regarding referral transport of the pregnant women and 0 sick new born / children and disseminatio n of the same @ Rs. 50,000 for the state A.1 1.2.2. .2. Payment to 2 Ambulances for all PHCs @ Rs. 200 / 0 case of pregnancy for Jehanabad district

158

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A.1 1.3. .3. Integrated outreach 0 RCH services A.1 1.3.1. RCH .3. Outreach N 1 Camps in # 83 1400 1370 1370 1370 R 3000 un-served/ # 3 00 00 00 00 H under- M served areas

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. A.1 1.3.2. N .3. Monthly O 2. Village 1 T Health and I FI N Nutrition N N 1123 1123 1123 1123 R Days at Y 0 1 Y A 0 60 60 60 60 H AWW E L M Centres A D R A T E A.1 1.4. Janani .4 Evam Bal Suraksha 0 Yojana/JBS Y

A.1 1.4.1 .4. Home 1020 1020 2100 2100 1 deliveries 0 (500/-) 00 00 00 00

A.1 1.4.2 # # # # .4. Institutional 0 # # # # 2 Deliveries

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. A.1 1.4.2.1 Rura .4. l (A) 2.1 Institutional deliveries N 41,0 24,0 (Rural) @ 20 1699 6790 6790 R 00,0 02,2 Rs.2000/- 00 7797 0000 0000 H 00 03 per delivery M for 10.00 lakh deliveries A.1 1.4.2.2 Urba .4. n (B) 2.2 Institutional deliveries 12 2500 2000 5000 5500 5500 (Urban) @ Rs.1200/- 00 00 00 0 00 00 per delivery for 2.00 lakh deliveries

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. A.1 1.4.2.3 .4. Caesarean 2.3 Deliveries (Facility Gynec, Anesth & paramedic) 15 1500 100, 5000 1750 1750 10.3.1 00 00 000 0 00 00 Incentive for C- section(@15 00/-(facility Gynec. Anesth. & paramedic) A.1 1.4.3 Other .4. Activities(JS 3 Y) 1.4.3. Monito r quality and 54 5400 5400 5400 5400 utilisation of 0 0 00 00 00 00 services and Mobile Data Centre at HSC and APHC Level

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Total (JSY) 0

A.1 1.5 Other .5 strategies/ac 0 tivities A.1 1.5.1 .5. Maternal 1 Death Audit 1.1.3 Survey on maternal and perinatal 250, 250, 0 0 0 0 0 deaths by 000 000 verbal autopsy method (in two districts) @ 850 per

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A 2. Child . Health 0 2

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. A.2 2.1. .1 Integrated Management of Neonatal & Childhood Illness/IMNC I (Monitor progress against plan; follow up with training, 13 procurement 50 0 , review 00 meetings etc) 2.1. IMNCI (details of training, drugs and supplies, under relevant sections) 2.1.1. Monito r progress

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166

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. A.2 2.2 Facility .2 Based Newborm Care/FBNC in districts (Monitor progress against plan; follow up with training, procurement # , view 38,0 3800 38,0 38,0 38 0 # meeting 00 0 00 00 # etc.) 2.2.1. Imple mentation of FBNC activities in districts. (Monitor progress against plan; follow up with training,

167

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A.2 2.3 Home .3. Based New born 0 care/HBNC A.2 2.4 School .4 Health 30 2212 2910 1921 3097 3097 Programme 00 413 00 413 379 379 (Details annexed) A.2 2.5 Infant .5. and Young Child 0 Feeding/IYC F

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in camp # # # # 00 000 771 229 229 229 mode 3.1.2.1. Provi de female sterilisation services on fixed days at health facilities in districts (Mini Lap) A.3 3.1.5 .1. Compensati # 2 # # 15 3375 1700 3205 3205 3205

5 on for male # 0 # # 00 00 0 00 00 00 3.1 slerilisation

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. .2. 3.1.2.4. 4 Compensati on for NSV Acceptance @50000 cases x1500 A.3 3.1.6 .1. Accreditatio 6 n of private 3.1 providers .3. for 1 sterilisation services 3.1.3.1 4170 4170 4170 4170 0 Compensati 000 000 000 000 on for sterilization done in Pvt.Accredit ed Hospitals (1.50 lakh cases) A.3 3.2. Spacing .2 Methods 0

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A.3 Accreditatio .2. n of private 3 providers 0 for IUD insertion services A.3 Social .2. Marketing of 5000 5000 0 4 contraceptiv 0 0 es A.3 3.2.5 .2. 3.2.2. Contr 5 aceptive 71 4991 4991 4991 4991 3.2 Update 0 35 0 0 0 0 .2. Seminars (Organise Contraceptiv

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. e Update seminars for health providers (one at state level & 38 at district level) (Anticipated Participants- 50-70) A.3 3.3 POL for .3 Family Planning for 1296 1225 1255 1255 7100 500 below 00 00 00 00 sub-district facilities A.3 3.4 Repair of .4 Laproscope 0 s (Rs. 5000 x 40 nos.)

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. (Details of training, IEC/BCC in 0 relevant sections) A.4 Adolescent .1 services at health facilites. 4.1.1. Disseminate ARSH guidelines.4. 1.2. Establishing ARSH Cells 0 in Facilities 4.1.2.1. Developing a Model ARSH Cell for the facilities 4.1.2.2. Establishing ARSH Cell at

176

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177

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178

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. titutions/org anisations- 50lakhs & Operationali sing 20 UHCs through private clinics @540000/- pm A 6 Tribal . 0 Health 6

A.6 Tribal RCH 0 .1 services Other A.6 strategies/ac 0 .2 tivities A 7. . Vulnerable 0 7 Groups

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A.8 NGO 0 .3 Programme

Other A.8 innovations 0 .4 (if any)

A . INFRASTRU 9 CTURE & 0 HR

Contracutal A.9 Staff & 0 .1 Services

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A.9 9.1.2 23 3510 3510 3510 3510 .1. Laboratory 40 0 00 00 00 00 2 Technicians 00 A.9 12 7200 5400 1800 9000 9000 .1. Staff Nurses 00 000 000 000 000 000 3 0

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. OPD in under or un served areas @ Rs. 1000/- week x 52 weeks ; 10.1.2.3. Empanelling Gyaneocolo gists for PHCstoprovi de OPD services @ Rs. 300/- weekx 52 weeks; 10.1.2.4 Hiring Anaesthetist positions @ Rs.1000 per case x 120000; 10.1.2.5. Hiring Paediatricia

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. n for facilities where there are vacant Paediatricia ns positions @ Rs. 35,000/- month (2 per district); 10.1.2.6 Hiring Gynaecologi sts for facilities that have vacant positions @ Rs. 650 per case x 75000 cases

186

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SIHFW/Hirin 7 0 7 7 7 g Consultant at SIHFW 10.1.1 Honorarium of Voluntary Workers @ of 1200/- PA x 3106 No. A.9 Incentive/Aw .1. ards etc. 6 8.2.1 Incentive for 6918 3202 3715 6918 6918

ASHA per 000 931 069 000 000 AWW center (80000x200 per month)

187

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190

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A.1 10.2 0.2 Logistics 3000 3000 managemen 0 00 00 t/improveme nt A.1 10.3 0.3 Monitoring Evaluation/H MIS 11.3 Monitoring 2921 1130 2808 7729 7729

& evaluation 13 0 13 26 26 through monitoring cell at SIHFW

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es @ 1770 0 0 0 00 00 no. x Rs.500/- x 60 months A.1 10.5. Other 0.5 strategies/ac . tivities TA & 3000 3000 DA for the 0 30 days 00 00 contact programme A . 11 Training 0 1 1 11.1 Strengtheni A.1 ng of 0 1.1 Training Institutions

193

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194

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195

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. EmOC Training 12.1.3 EmOc A.1 Training of 5000 5000 1.3 (Medical 0 0 0 .2 Officers in EmOC (batchsize is 8 ) 11.3.3 Life Saving Anaesthesia Skills training A.1 12.1.5 1.3 Training of 0 .3 Medical Officers in Life Saving Anaesthesia Skills (LSAS)

196

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197

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198

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11.5.2 Facility Based A.1 Newborn 1000 1000 1.5 Care 12.2.2.1 0 00 00 .2 SNCU Training 12.2.2.2.NSU (TOT)

11.5.3 Home A.1 Based 1.5 0 Newborn .3 Care

11.5.4 Care A.1 of Sick 1.5 Children and 0 .4 severe malnutrition

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A.1 11.5.5 Other 1.5 CH Training 0 .5 (Pl. Specify)

11.6 Family A.1 Planning 0 1.6 Training

12.6.1 A.1 Laproscopic 1.6 0 Sterilisation .1 Training 11.6.2 Minilap Training 12.3 .2.1. Minilap A.1 training for 7024 7024 7024 7024 1.6 0 medical 0 0 0 0 .2 officers/staff nurses (batch size of 4)

200

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201

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A.1 Contraceptiv 1.6 e Update 0 .5 Training A.1 Other FP 1.6 0 Training .6 11.7 ARSH Training 12.4.1 ARSH training for medical officers 12.4.3 One A.1 Day ARSH 0 1.7 Orientation by the MOs of 25% ANMs 12.4.4 One Day ARSH Orientation

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11.8 A.1 Programme 0 1.8 Management Training

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204

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205

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A.1 Other 0 1.9 Training

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A 12. BCC/IEC . (for NRHM 0 1 Part A, B & 2 C) A.1 12.1 2.1 Strengtheni ng of BCC/IEC 2445 4200 2025 4200 4200

Bureaus 00 0 00 00 00 (State and District Levels)

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209

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A.1 BCC/IEC 2.3 activities for .2 CH 0

A.1 12.3.3 2.3 BCC/IEC .3 activities for 0 FP

A.1 12.3.4 2.3 BCC/IEC .4 activities for 0 ARSH

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211

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. intervention s (Radio, kalajattha and for IEC strategy disseminatio n) 13.11 Media Advertiseme nts on various health related days 13.12 Various advertiseme nts/tender advertiseme nts/EOIs in print media at State level 13.13 Developing Mobile Hoarding Vans and A

212

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213

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. specific intervention s including innovations of BCC strategy/pla ns District level (Rs. 5000 x 38 x 12) 13.18 Implementin g need based IEC Activities in Urban Areas (Support for Organization of need based IEC Activities in Urban Areas) (Rs.50000 x 9 x 2) 13.19 Capacity building of

214

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Sub-total IEC/BCC 0

215

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216

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217

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218

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219

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220

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A.1 13.2.3 Drugs 3.2 Supplies for .3 FP 0

A.1 13.2.4 3.2 Supplies for .4 IMEP 0

A.1 General 3.2 drugs & 1249 1249 1249 1249 .5 supplies for 0 6000 6000 6000 6000 health facilities A 14. Prog. . Manag- 0 1 ement 4

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222

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4.2 16.2.1. Contra 120 00 120 240 240 ctual Staff for DPMSU recruited and in position

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224

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225

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. Total Prog. Mgt. 0 A Others/Untied . Funds 0 1 5 Total RCH II Base Flexi Pool 0

Total JSY, Sterilisation and IUD 0 Compensatio n, and NSV Camps Grand Total RCH II 0 TOTAL 92,0 36,2 55,8 134, 134, 85,9 34,0 51,9 409, 409, 72.0 27.0 45.0 898. 898. 0 0 0 00 00

226

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Sr. Budget Plan NO

2010-2011FY 2011-2012FY

Activities =E (A)} = B (onlyat statelevel) E} = BP E} ± ± ± ± (other than NRHM source) advance Remarks budgetfor 2011-12 {(AP x {(AP A) TentativeUnit Cost (A) ComponentCode Budgetutilised {Y (A)} x =D Budgetreceived or B ( or than planned) Budget(including Planned over spill amount) Budgetary Source Budget Planned {X x underover-utilised or Budget {(B~D}

B NHRM ADDITIONALITIES

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Please Note: plan all possible activities you think necessary for your area to realistically operationalise each strategy. Consider during planning : Infrastructure, Human Resources- all specialist, Para medics etc, Infection control & Environmental Plan, Logistics Management, HMIS, Monitoring & evaluation, Training- PMU, Dai, others, BCC/ IEC, Procurement of equipments/ Drugs, Strengthening Societies, PMU, RKS, VHSC, AYUSH inputs, initiatives for quality management

B.1 Decentrlisation 1.11

ASHA Support system B.1.11 at State level ASHA Support System B.1.12 695907 695907 347953 347954 1043807 1043807 at District Level ASHA Support System B.1.13 672000 672000 107200 564800 1572800 1572800 at Block Level ASHA Support System B.1.14 0 0 0 at Village Level

ASHA Drug Kit & B.1.15 1650806 1650806 0 1650806 1650806 1650806 Replenishment

B.1.16 Motivation of ASHA 645475 645475 79020 566455 566455 566455

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B.1.18 ASHA Divas 898872 898872 334564 564308 1165200 1165200

Untied Fund for Health Sub Center,Additional B.1.20 Primary Health Center 1637000 1637000 876000 761000 2847000 2847000 and Primary Health Center Village Health and B.1.21 6207500 6207500 3912500 2295000 6615000 6615000 Sanitation Committee

B.1.22 Rogi Kalyan Samiti 2100000 2100000 1120980 979020 1400000 1400000

B.2 Infrastrure 0 Strengthening

Rs. 342 000 0 as per last Construction of HSCs ( B.2.1 0 0 0 8091000 8091000 yea 315 No.) r bu dg et 200 bihar 9- 15.57 govt. 10 Rs. 637 Construction of PHCS & 800 B.2.2A 0 0 29175000 29175000 APHCS 0 bihar as 75.99 govt. per

229

Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. last yea r bu dg et 200 9- 10 Construction of Doctor,Staff,and Nurses(Residential B.2.2B 12000000 12000000 Quarter) PHC,APHC AND DISTRICT bihar HOSPITAL govt. Rs 400 000 0 as per last Up gradation of CHCs B.2.4 0 0 0 4000000 4000000 yea as per IPHS standards r bu dg et 200 9- 10 Annual Maintenance B.2.5 Grant 1839000 1839000 367,122 1471878 2871878 2871878

B.2.7 Anm Training Schools 0 0 0 0 12000000 12000000 bihar govt. B.3 TOTAL 0

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Block Programme B.3.2 3481380 3481380 1838163 1643217 7512084 7512084 Mannagement Unit

Additional Manpower B.3.4 for NRHM : Hospital 450000 450000 45833 404167 1004167 1004167 Managers in FRUs

Advanced Life Saving B.4.3 0 2340000 2340000 Ambulance(call 108)

Referal Transport in B.4.4 2574000 2574000 403698 2170302 4744302 4744302 District

Services of Hospital Waste Treatment and Disposal in all B.6 0 1016300 1016300 Government Health facilities up to PHC in Bihar (IMEP) Dialysis unit in various B.7 Government Hospitals 0 of Bihar Setting Up of Ultra- Modern Diagnostic Centers in Regional Diagnostic Centers B.8 0 (RDCs) and all Government Medical College Hospitals of Bihar Outsourcing of Pathology and B.9 808333 808333 110625 697708 2217708 2217708 Radiology Services from PHCs to DHs

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B.10 Operationalising MMU 0 0 0 8424000 8424000

Monitoring and Evaluation (State , B.11 900000 900000 240525 659475 1559475 1559475 District & Block Data Centre) Strenthening of Cold B.14 Chain (infrastrcure 800000 800000 111180 688820 1488820 1488820 strengthening)

Mainstreaming Ayush B.15 6025200 6025200 0 6025200 12050400 12050400 under NRHM

Procurement of SCNU equipment for DH & B.18.2 418476 418476 0 418476 418476 418476 Newborn corner equipments for PHCs De-Centralised B.19 455000 455000 135000 320000 835000 835000 Planning B.21 Anm { R } 7392000 7392000 6409857 982143 10800000 10800000

Incentive for AWW B.22 1676000 1676000 375400 1300600 1318600 1318600 under Muskan Project

TOTAL 41,326,949.00 16,815,620. 24,511,329. 41,326,949.00 140,728,278.00 140,728,278.00 00 00

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Activity Plan Budget Plan

2010-2011 FY 20011-2012 FY 2010-2011FY 2011-2012FY E} = E} ± ± ± ± be )} =AP)}

=E x A) x (A)} = B (< > or than planned) Output 2012 BP BP (other than NRHM source) advance Remarks adopted) Variance(X~Y) budgetfor 2011-12 Activity plannedActivity (X) time line oftime line activities Activity Executed(Y) Reasonsfor Variance TentativeUnit Cost (A) Budgetutilised {Y (A)} x =D Budgetary Source Budget Planned {X x underover-utilised or Budget {(B~D} Specialefforts to overcome constraints (Process to Activity plannedActivity including previous yrs gap {Z+(X~Y Budget(including Planned over spill amount) {(AP Budgetreceived or B C Q1 Q2 Q3 Q4

2427103 2427103 713165 1713938 4141041 4141041

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8549927 8549927 7 4589450 13139377 13139377

1097703 1097703 467364 0 17280418 17280418 0 0 2 6303388

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2010-2011 FY 20011-2012 FY 2010-2011FY 2011-2012FY E} = E} ± ± ± ± be )} =AP)}

=E x A) x (A)} = B (< > or than planned) BP BP (other than NRHM source) advance Remarks adopted) Variance(X~Y) budgetfor 2011-12 Activity plannedActivity (X) time line oftime line activities Activity Executed(Y) Reasonsfor Variance TentativeUnit Cost (A) Budgetutilised {Y (A)} x =novtillD 10 Budgetary Source Budget Planned {X x underover-utilised or Budget {(B~D} Specialefforts to overcome constraints (Process to Activity plannedActivity including previous yrs gap {Z+(X~Y Budget(including Planned over spill amount) {(AP Budgetreceived or B C

3160948 3160948 46000 3114948 3114948 3114948

23640 23640 23640 0 47280 47280 673000 673000 358000 1843640 315000 1843640 432285 432285 749570 115000 317285 749570

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54100 54100 0 54100 54100 54100

432750 432750 398000 467500 34750 467500

2075000 2075000 505000 2840400 1570000 2840400

1445640 0 9862288 9862288 7,596,573.00 7,596,573.00 6150933

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BUDGET AT A GLANCE 2011-12

Sl. No, Budget Head Budget Amount % age 1 NRHM PART - A, RCH 134409898 44.47%

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Please purchase 'PDFcamp Printer' on http://www.verypdf.com/ to remove this message. 2 NRHM PART - B, NRHM Additionalities 140728278 46.56% 3 NRHM PART - C, RI, PP 17280418 5.72% 4 NRHM PART - D, Diseases Control Programme 9862288 3.26% TOTAL 302,280,882.00 100%

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